In order to explain processes underlying the transfer of fatty acids from the maternal compartment into human milk, the lipid content and the fatty acid composition of maternal plasma and milk have been analyzed in breastfeeding mothers at 1 day and 3 months of lactation. The rise in milk lipids occurring during the study period was concomitant with a fall in plasma total fat content, mainly due to the decrease of triglycerides. Significant correlations between plasma and milk fatty acids at the two time points were observed only for linoleic (LA, 18:2 n-6) and (alpha;-linolenic acid (alpha LNA, 18:3 n-3), while for arachidonic (AA, 20:4 n-6) and docosahexaenoic acid (DHA, 22:6 n-3) correlations were found only at one day and 3 months, respectively. These data suggest that levels of the n-6 and n-3 18C polyunsaturated fatty acids in milk are closely dependent on their concentrations in maternal plasma, in turn related with the dietary intake, while the accumulation of AA and DHA in milk is the result of a sequence of transfer and metabolic processes.

Adult↗

PubMedDate not supplied

Time course of plasma levels and electrophysiologic effects of propranolol in man.

We studied the time course of three electrophysiologic effects of propranolol after intravenous and oral administration and their relationship with plasma levels within the same subjects. Ten patients who had undergone cardiac catheterization for diagnostic purposes received 0.1 mg/kg of propranolol intravenously. Blood was drawn at intervals for 12 hr and heart rate and the effective refractory periods of the atrium (ERPA) and the atrioventricular node (ERPAVN) were determined at the same time. Eight patients continued treatment with propranolol by the oral route for up to 4 days (40 mg every 12 hr). Blood was sampled after each morning dose. Plasma concentrations of propranolol were measured by gas chromatography. Maximal lengthening of ERPA after propranolol (15.1% i.v. and 9.4% oral) was much less marked than that of ERPAVN (23.2% i.v. and 19.4% oral). Heart rate decreased 23.5% (i.v.) and 13.1% (oral). Effects were seen much sooner after intravenous (5-8 min) than after oral administration (86-146 min), but they lasted about twice as long after oral as after intravenous treatment.

Administration, Oral↗

PubMedDate not supplied

Pharmacokinetics of amiodarone in man.

We studied the kinetics of amiodarone in three healthy volunteers after single oral (400 mg) and intravenous (150 mg) doses and in six patients with supraventricular tachycardia. Three patients were studied after the first oral dose (400 mg) and during subsequent therapy (200 mg/day); the other three after 5 mg/kg of amiodarone intravenous. Blood was drawn at intervals for 24 h in patients and up to 32 h (i.v.) and 50 h (p.o.) from healthy volunteers. The drug was measured by high pressure liquid chromatography (HPLC). No difference in kinetic parameters was found between healthy subjects an patients. The pharmacokinetic parameters, calculated on the intravenous data using a two-compartment open model, indicate a very large volume of distribution (9.26-17.17 L/kg in healthy volunteers and 6.88-21.05 L/kg in patients). The elimination half-life ranged from 12.09 to 20.70 h in volunteers and from 11.60 to 19.60 h in patients. Oral absorption was slow an erratic, with fourfold individual variations in systemic bioavailability (22-86%). A slight accumulation of amiodarone was observed in patients under chronic treatment.

Administration, Oral↗

PubMedDate not supplied

Pharmacokinetics of amiodarone in rats.

We studied the kinetics of amiodarone in the rat. After an intravenous dose of 50 mg/kg, the time-course of the drug concentrations was assessed by high-pressure liquid chromatography in blood and tissues up to 16 h. The drug disappeared from the blood with an elimination half-life (t1/2beta) of 514 min and distributed extensively into tissues [apparent volume of distribution (Vd)= 29.51 L/kg]. Concentrations were highest in liver, kidney, and heart, and lowest at all times in the brain. The highest concentrations were found within 5-30 min of administration. Amiodarone accumulated extensively in adipose tissue and reached a fat/blood concentration ratio of about 1,000 at 16 h. Single-pass rat liver perfusion experiments gave an hepatic extraction ratio of 0.49 and an intrinsic clearance of 5.48 ml/min. Amiodarone disappearance in rat liver recirculation experiments was biexponential, with a half-life of 58 min.

Amiodarone↗

PubMedDate not supplied

Domiodol treatment for bronchopulmonary diseases in the paediatric age group: a double-blind controlled clinical trial versus placebo.

Thirty children (25 males, five females), mean age 9.33 +/- 2.57 years, with acute infectious pulmonary diseases or acute flare-ups of chronic bronchitis, were randomly treated with either domiodol or placebo. The study was conducted between November 1986 and February 1987. Domiodol was administered orally for 14 days in doses of 0.5 mg/kg three times daily. Subjective symptoms (cough, sputum viscosity, difficulty in raising sputum and sputum characteristics) were assessed semi-quantitatively. They were all reduced significantly in the group treated with domiodol compared to those given placebo. Spirometric measures of vital capacity and peak expiratory flow rate were also improved in patients given domiodol compared with placebo. Conversely, no differences were noted in forced expiratory volume in 1 s, Tiffenau index, or mid-expiratory flow. There were no clinical side-effects and no changes in any other parameters measured; in particular, levels of thyroid hormone and thyroid stimulating hormone were unchanged. Thus, domiodol proved effective in reducing the symptoms of infection of the lower respiratory tract and in improving the consistency of mucus in children.

Adolescent↗

PubMedDate not supplied

Comparison of miocamycin versus amoxycillin in lower respiratory tract infections in children. Clinical response and effect on natural killer activity.

The clinical efficacies of 50 mg/kg.day miocamycin and 60 mg/kg.day amoxycillin were studied in 23 patients aged 3-11.5 years with presumed bacterial infection of the lower respiratory tract (bronchopneumonia and acute bronchitis). During the therapy, which continued for 10 days, non-specific immune function, represented by natural killer cell activity, was monitored by measurement of the rate of lysis induced on target K-562 51Cr-labelled tumour cells. The results confirmed the therapeutical efficacy of miocamycin and amoxycillin in the oral therapy of bronchopneumonia and acute bronchitis in paediatric patients. The natural killer cell activity of patients treated with miocamycin was increased on days 7 and 10 of therapy compared with baseline. This finding did not occur in patients treated with amoxycillin.

Acute Disease↗

PubMedDate not supplied

Recurrent respiratory infections in childhood: experience with a bacterial extract plus bacterial ribosomes (Immucytal).

A total of 60 children (mean age +/- SD 7.6 +/- 3.5 years, range 2 - 14.2 years) with recurrent respiratory infections were treated with bacterial wall extract plus bacterial ribosomes (Immucytal) or placebo sprayed into the nostrils and oropharynx three times a day for 1 or 2-week periods over 3.5 months. The treatment was completed by 58 subjects; two patients in the placebo-treated group were withdrawn, one for poor compliance and the other because of headaches. Respiratory symptoms improved from the first month in the Immucytal treated children, but not in the placebo group, with a reduction in the incidence of infections in the upper and lower airways. No changes were noted in respiratory function parameters. Treatment with Immucytal significantly increased serum immunoglobulin A (P less than 0.02) and immunoglobulin M (P less than 0.01) and enhanced skin response to the in vivo lymphocyte blastization test, but there was no significant change in the circulating lymphocyte subpopulations. Both physicians and the patients' parents judged the bacterial extract to be clinically better than the placebo. Immucytal, therefore, may provide a useful alternative therapy for recurrent respiratory infections in infancy.

Adjuvants, Immunologic↗

PubMedDate not supplied

Treatment of respiratory tract infections in children: a study of a combination of amoxycillin and clavulanic acid.

In an open study, 70 in-patients and 23 out-patients aged between 1 and 14 years with sinusitis (n = 1), perforated otitis media (n = 4), pharyngotonsillitis (n = 25), tracheobronchitis (n = 30) or broncho-pneumonia (n = 33) were treated daily with a combination of 40 mg/kg amoxycillin and 10 mg/kg clavulanic acid in three equal doses for between 6 and 15 days. Purulent specimens were cultured when obtainable and pathogenic organisms identified were Staphylococcus aureus, beta-haemolytic streptococcal group A, Pseudomonas aeruginosa, Pseudococcus species and Klebsiella pneumoniae infections, of which 45.7% were beta-lactamase-producing and 54.3% were ampicillin-susceptible. After treatment, only one beta-lactamase-producing Streptococcus and one Staphylococcus infection persisted. Side-effects (vomiting, nausea, diarrhoea, maculopapular exanthema, rash) occurred in 16 patients and treatment was withdrawn in eight. It is concluded that the amoxycillin--clavulanic acid combination is a suitable first choice for the treatment of respiratory tract infections in children in whom the pathogenic organism may not have been established.

Adolescent↗

PubMedDate not supplied

Effect of granulocyte-colony stimulating factor in glycogen storage disease type Ib.

Five children with glycogen storage disease type Ib (glycogenosis Ib), a metabolic defect associated with neutropenia and impairment of neutrophil function, were treated with granulocyte colony stimulating factor, a haemopoietic growth factor that induces a significant increase in polymorphonuclear leucocyte count in vivo. Recurrent bacterial or fungal infections were recorded in the three patients who had very low polymorphonuclear leucocyte counts. Experience at this centre indicates that the absolute number of polymorphonuclear leucocytes is more important than the alteration of their metabolic function in determining the susceptibility of the patients to infection. Granulocyte colony stimulating factor was effective at increasing polymorphonuclear leucocyte numbers (and restored function to some extent) in patients with glycogenosis Ib. This drug might be beneficial in cases of severe infection, in glycogenesis Ib patients with neutropenia.

Bacterial Infections↗

PubMedDate not supplied

Growth factors and HIV-infection in children.

Three children with acquired immunodeficiency syndrome (AIDS) and chronic anaemia and leucopenia were treated with 5 micrograms/kg recombinant granulocyte colony-stimulating factor subcutaneously three times a week and 50 IU/kg erythropoietin subcutaneously twice a week. The therapy was not interrupted during the follow-up period. All children showed an increase of leukocyte count and haemoglobin levels. No transfusion was necessary and the number of admissions into hospital fell. These results suggest that combined therapy with granulocyte colony-stimulating factor and erythropoietin may improve leukopenia and anaemia, which is not zidovudine-related, in children who have AIDS.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

The efficacy and safety of gamma-linolenic acid in the treatment of infantile atopic dermatitis.

The efficacy and safety of gamma-linolenic acid in the treatment of atopic dermatitis was evaluated. The children (mean age, 11.4 months) with atopic dermatitis (mean duration, 8.56 months) were openly treated with 3 g/day gamma-linolenic acid, for 28 days. Clinical evaluations were carried out every 7 days, and parents were asked to keep a diary, recording details of symptoms of eczema every day. Blood chemistry and immunological tests were done before and after treatment. None of the children showed complete recovery of symptoms. A gradual improvement in erythema, excoriations and lichenification was seen; significant differences were shown for itching (P < 0.01), and the use of antihistamines (P < 0.01). A significant rise in the percentage of circulating CD8 was found. No side-effects were recorded. Dietetic and pharmacological approaches are the basis of the treatment of atopic dermatitis and gamma-linolenic acid appears to be a safe and efficient additional therapy for infants and young children.

Administration, Topical↗

PubMedDate not supplied

Dairy products and adolescent nutrition.

Adolescence is an intense anabolic period. The requirement for all nutrients is increased, but particularly that for dietary calcium. A balanced intake of the macronutrients (protein, fats and carbohydrates) is recommended to prevent the chronic degenerative disorders of adulthood. The temporal pattern of the calorie intake also deserves attention since it may affect homeostatic regulation. Adolescents often show disorders of dietary behaviour predisposing them to both obesity and anorexia. Dietary intervention in this age-group should promote the regular consumption of breakfast, a balanced intake of animal and vegetable foods and an increased calcium supply to maximize bone density. Dairy products and vegetables (mainly enriched cereals) constitute the basis of a good diet for adolescents, to supply their needs for growth and for subsequent good health.

Adolescent↗

PubMedDate not supplied

Efficacy and tolerability of levodropropizine and dropropizine in children with non-productive cough.

The antitussive efficacy and tolerability of dropropizine and of its enantiomer levodropropizine were evaluated in children with non-productive cough; 258 were evaluable for tolerability and 254 for efficacy. Patients randomly received either 1 mg/kg dropropizine or 2 mg/kg levodropropizine orally, three times daily for 3 days. There were statistically significant decreases in the frequency of coughing spells and nocturnal awakenings after both levodropropizine and dropropizine treatments (P < 0.001). Gastro-intestinal symptoms were mild in the two groups; somnolence was twice as frequent in the dropropizine group (10.3% vs 5.3%) and the difference is clinically relevant, though not statistically significant. Levodropropizine is as effective as an antitussive as dropropizine, but appears to carry a lower risk of daytime somnolence.

Adolescent↗

PubMedDate not supplied

Calcium intakes in a sample of 35,000 Italian schoolchildren.

The calcium intakes of 35,072 Italian schoolchildren aged 7-10 years were investigated as part of a nation-wide survey of nutritional patterns. The Friuli, Piedmont, Latium and Sicily regions of Italy were selected as representative of the nation's north-south and east-west socio-economic divisions. A food-frequency questionnaire was used to assess the nutritional intakes of the whole sample. The validity of the food-frequency questionnaire method was assessed in a sub-sample of children by traditional methods: 24-h dietary recall and a weighted food diary. The data indicate that the mean calcium intakes of girls were below the recommended daily intake of 800 mg in all of the regions except Sicily, and that the calcium intakes of boys were above the recommended daily intake in all of the regions except Friuli. These results suggest that there may be deficiencies in the calcium intakes of this age-group in the wider population, particularly in girls. Food-frequency questionnaires are potentially valuable as part of a multi-method approach in large-scale nutritional monitoring.

Calcium, Dietary↗