[Hypertension in children].
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Antihypertensive Agents↗
Biomedical subjects
M Uhari
Publications and source records attributed to M Uhari.
Occurrence of childhood encephalitis: a population-based study.
The occurrence of childhood encephalitis was evaluated in a population-based study in an area with no arboviral infections. Ninety-five children were treated for encephalitis during 1973 to 1987, giving an annual incidence of 8.8/100,000 children younger than 16 years of age (95% confidence interval, 6.7 to 10.1). Based on virologic and serologic studies the most common etiologic agents were varicella (24 cases), mumps (8), herpes simplex (7) and measles (4). The etiology remained unknown in 37 children. No cases of encephalitis caused by mumps, measles or rubella were found in the population after 1982, when vaccination against these viruses was introduced.
Adolescent↗
Epidemiology of symptomatic infections of the urinary tract in children.
The epidemiology of symptomatic infections of the urinary tract in children and the factors that may alter the risk of infection are not well known. Numbers of children aged under 15 discharged from hospitals because of symptomatic infections of the urinary tract during 1978-84 were obtained from the database kept by the Finnish National Board of Health. Information on continuous treatment for recurrent urinary tract infections was obtained from records kept by the Social Insurance Institution on patients receiving free medicines. The yearly rate of attacks of symptomatic infections/1000 girls decreased significantly from 2.67 (95% confidence interval 2.52 to 2.82) in 1978 to 1.88 (1.76 to 2.01) in 1984. In boys the rate also decreased significantly, from 0.85 (0.77 to 0.93) in 1978 to 0.59 (0.52 to 0.66) in 1984. The period prevalence of free treatment/1000 girls decreased significantly from 7.80 (7.55 to 8.05) in 1978 to 5.30 (5.10 to 5.51) in 1984 but did not change significantly in boys. Although the findings may partly have been caused by changes in policies of admission to hospital, they suggest a decreasing trend in symptomatic urinary tract infections in childhood, which may be associated with changes in the care of infants.
Adolescent↗
Effect of prophylactic acetaminophen administration on reaction to DTP vaccination.
The effectiveness of acetaminophen in preventing post-vaccination fever was studied in a double-blind randomized manner. Healthy five-month-old infants vaccinated with diphtheria-tetanus-pertussis (DTP) or DTP-inactivated polio vaccine were randomly allocated to receive either placebo (n = 130) or 75 mg of acetaminophen (n = 133) four hours after the vaccination. Rectal temperatures of the infants were measured in the post-vaccination evening and next morning by the parents. The mean values of rectal temperatures were equal in both groups, i.e. 37.6 degrees C, both in the evening and in the morning. No significant difference was found in the occurrence of other minor adverse reactions. Antibody titres to diphtheria and tetanus toxoids and pertussis bacteria of the placebo (n = 25) and acetaminophen (n = 34) groups did not differ significantly from each other. It is concluded that acetaminophen in a single dose schedule is ineffective in decreasing post-vaccination fever and other symptoms.
Acetaminophen↗
Antigen detection in the diagnosis of viral infections.
The value of viral antigen detection from nasopharyngeal secretion (NPS) by enzyme immunoassay (EIA) in everyday clinical practice was evaluated in 570 children hospitalized because of infections. NPS-EIA gave a positive result in 32% of all cases. Virus isolation was positive in the NPS in 25%, virus isolation in stool samples in 14%, and virus serology in 28% of the cases. NPS-EIA was superior for detecting adenovirus, respiratory syncytial (RS) and parainfluenza viruses. In a series of 124 patients in whom 3 methods were compared, NPS-EIA was the only positive method in 48% of all findings positive for adenoviruses, in 73% for RSV, and in 58% for parainfluenza viruses. Antigen detection by NPS-EIA markedly increased the diagnostic potential in everyday clinical practice, especially for viral respiratory diseases.
Adenovirus Infections, Human↗
[Application of the t-test to between-group comparisons].
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Analysis of Variance↗
[Do most readers understand the biostatistics of medical articles?].
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Humans↗
Three-year tracking of serum fatty acids in Finnish boys and girls.
The composition of fatty acids in serum lipids has been shown to reflect the quality of dietary fat. In order to examine the long-term stability (tracking) of the serum (and hence dietary) fatty acid composition serum cholesteryl ester fatty acids were analysed by gas chromatography in a randomly selected population sample of 1029 Finnish boys and girls aged 3, 6, 9, 12, 15 and 18 years, and again from the same individuals 3 years later. The tracking was evaluated by calculating linear correlation coefficients for the percentages of individual fatty acids between the 2 time points. For all fatty acids the correlations were highly significant, e.g. for linoleate and arachidonate they were 0.58 and 0.61, respectively. In 1980 the means of the percentages of some fatty acids showed certain differences between the various age and sex groups; in 1983 these differences had become smaller and had largely shifted towards three years older age groups, implying that the differences were due to dietary differences between the cohorts rather than to age and sex per se. The present results indicate that serum fatty acid composition has a fairly good biological reproducibility (tracking) and suggest that age and sex as such are only minor determinants of the serum fatty acid composition.
Adolescent↗
Renovascular hypertension in a child with Rett's syndrome.
A girl with Rett's syndrome and renovascular hypertension because of a stenosis in the right renal artery is described. The girl was operated on twice because of the stenosis. Her blood pressure normalized after the second operation in which the artery was reconstructed. High blood pressure causes neurological symptoms which may be difficult to distinguish from the basic disease. The importance of the measurement of blood pressure in every child with neurological symptoms is emphasized. The possibility of an association between renovascular hypertension and Rett's syndrome should be studied in large series.
Ammonia↗
Perioperative dissemination of Salmonella.
A hypophyseal adenoma was operated on in a patient who was a carrier of Salmonella typhimurium. A chronic salmonella osteitis developed in her calvarium at the site of operation. Our case and reported experience emphasise that asymptomatic carriers of salmonella should be given perioperative antibiotic prophylaxis, especially if they are immunosuppressed.
Adenoma↗
Decreased renal perfusion after correction of experimental coarctation.
Hemodynamical changes in coarctation were studied with an experimental model. Coarctation of the thoracic aorta was induced in seven puppies at the age of 8 wk. After a 7-month follow-up period a corrective operation with a venous patch was performed. Two dogs were lost a few hours after the correction operation. The remaining five dogs were followed for 12 months postoperatively. Renal perfusion was measured with a 133Xenon washout method just prior to the operation, 1 h, 6 and 12 months postoperatively. The glomerular filtration rate was measured using the 51Cr-EDTA method 1 wk before the operation, 3 wk, 2, 6, and 12 months after it. Six healthy adult dogs were used as controls for glomerular filtration rate measurements. Peripheral renin activity was measured at operation, just before the correction of aortic coarctation, 1/2, 1 h, 1, 3, 7 days, 2 and 6 months after the correction operation. Renal perfusion decreased significantly (p less than 0.05) immediately after the correction operation and rose again during the follow-up. Peripheral renin activity rose significantly (p less than 0.01) from the preoperative values and was at its greatest 1 day after the operation. Later on, peripheral renin activity values returned to normal. Coarctated dogs had significantly (p less than 0.01) lower glomerular filtration rate values than controls in each measurement except at the 2 months postoperative measurement. These results support decreased renal perfusion with resultant increased peripheral renin activity as part of the pathomechanism of the paradoxical hypertension observed after correction of coarctation.
Animals↗
Acceptance of antibiotic mixtures by infants and children.
The acceptance by children of two pharmacologically identical phenoxymethyl-penicillin potassium and erythromycin ethylsuccinate mixtures, differing only in their flavouring agents, was compared in a randomised blind manner. The time a nurse required to give the drug to a child was recorded and a score of the acceptance was given by the nurse. The mean time to give erythromycin Brand 1 was 29 s (SD +/- 21, number of children = 20) and mean time to give Brand 2 it was 16 s (SD +/- 13, n = 18); the difference was significant (p less than 0.05). The mean scores were 2.9 (SD +/- 0.6) and 3.4 (SD +/- 0.5), difference -0.5 (p less than 0.025). The difference between the two penicillin products was not significant. The time required to give a medicine was a useful way to compare the effect of different flavouring mixtures on the acceptance of drugs by infants and children.
Child↗
Renal perfusion in experimental coarctation of the aorta during antihypertensive therapy.
Renal perfusion and the effectiveness of antihypertensive therapy were evaluated in experimental coarctation. A sham operation was performed at the age of two months on one group of dogs (n = 5); coarctation of the thoracic aorta was produced at the same age in a second group (n = 7) which was not treated with antihypertensive drugs; and coarctation was similarly produced in a third group (n = 6) which was treated with antihypertensive drugs; the drug treatment was begun one month after the coarctation operation. After operation, all dogs were observed for seven months under similar circumstances. With high doses of antihypertensive agents (hydrochlorothiazide 25 mg/day, propranolol 80 mg/day, and prazosin 20 mg/day), the blood pressure decreased significantly in the coarctation with treatment group compared with the coarctation without treatment group. Renal perfusion, when measured by xenon-133 washout at the age of five months, was similar in the coarctation without drug treatment and control groups but significantly lower (23% decrease, p less than 0.01) in the coarctation with drug treatment group; renal perfusion was similar in all three groups when measured at the ages of eight and nine months. The observed temporary decrease suggests a need to evaluate renal perfusion during antihypertensive treatment in coarctation in man.
Animals↗
Dietary fatty acids and platelet thromboxane production in puerperal women and their offspring.
The effects of the ratio of polyunsaturated to saturated fatty acids in the diet of puerperal women on maternal and neonatal fatty acids and thromboxane A2 synthesis were studied in 91 mother-infant pairs on the fourth to fifth day after delivery. The mothers received a diet with either a low (0.1) or a high (1.5) polyunsaturated to saturated fatty acid ratio for 4 to 5 days. The fatty acid composition in maternal and neonatal serum and in breast milk was determined in 34 mother-infant pairs from both dietary groups. The capacity of the platelets to produce thromboxane B2, a stable metabolite of thromboxane A2, was determined in another 57 mother-infant pairs. The percentage of linoleic acid was increased in maternal and neonatal sera as well as in the breast milk in the group with a high dietary polyunsaturated to saturated fatty acid ratio, whereas the content of arachidonic acid was increased only in maternal serum. This was accompanied by increased platelet thromboxane B2 production in the mothers, and maternal and neonatal thromboxane B2 synthesis correlated significantly with each other (r = 0.43, p less than 0.05). This finding may provide therapeutic possibilities in the future.
Arachidonic Acid↗
Fatty acid composition of serum cholesteryl esters in relation to serum lipids and apolipoproteins in 3-18-year-old Finnish children and adolescents.
Serum cholesteryl ester (CE) fatty acids, serum lipids and apolipoproteins were analysed from 1348 Finnish children aged from 3 to 18 years. The study was part of a comprehensive survey of coronary heart disease risk factors and their determinants in Finnish children and adolescents. The percentage of CE linoleate (18:2) had significant negative correlations with the serum concentrations of total and LDL cholesterol, triglycerides as well as apo B. The associations of HDL to CE fatty acids were weak, although there was a significant positive correlation of CE-18:2 to HDL cholesterol and apo A-I. The ratio of HDL to total cholesterol and the ratio of apo A-I to apo B increased strongly in quintiles of increasing percentage of CE-18:2. In conclusion, the present results show significant associations between serum CE fatty acid composition and the different components of serum lipoproteins among free-living Finnish children and imply a relation between the quality of dietary fats and serum lipoproteins within this population.
Adolescent↗
Fatty acid composition of serum cholesteryl esters in 3- to 18-year-old Finnish children and its relation to diet.
The composition of fatty acids in serum cholesteryl esters (CE) was analyzed gas chromatographically in 1348 boys and girls aged from 3 to 18 yr. A dietary survey was carried out simultaneously using the 48-h recall method. The dietary P/S ratio had highly significant correlations with CE fatty acids: positive with linoleate (0.567) and total omega 6 fatty acids and negative with saturated, monounsaturated, and omega 3 polyunsaturated fatty acids. The highest mean percentage of CE-linoleate was found in 15-yr-old girls (52.7, SD 4.68%) and lowest in 3-yr-old girls (48.1, SD 5.00%). Age, sex, and the degree of puberty had no independent effect on CE-linoleate after it had been adjusted for the effect of dietary P/S ratio by analysis of covariance. These results indicate that the fatty acid composition of serum CE depends on the quality of dietary fat and that CE-linoleate is a useful reflector of the dietary P/S ratio. The negative correlation between CE omega 3 fatty acids and dietary P/S ratio may be due to displacement of the omega 3 acids in serum CE by the much higher proportion of dietary linoleate.
Adolescent↗
Neonatal jaundice and fatty acid composition of the maternal diet.
The role of serum fatty acid composition in neonatal jaundice was studied by comparing the incidence of jaundice among 332 newborn infants receiving breast milk from mothers on a diet with either a low (0.1, n = 145) or a high (1.5, n = 187) polyunsaturated to saturated fatty acid (P/S) ratio. The diet was started immediately after delivery. The composition of fatty acids in the breast milk and sera of the mothers and in the sera of the newborns was evaluated from a random sample of 15 mother-newborn pairs on the control diet (low P/S ratio) and 19 pairs on the experimental diet. Five days after delivery the relative amounts of fatty acids, especially that of linoleate, in the sera of the mothers differed significantly depending on the diet. Differences were also observed in breast milk samples taken three, four or five days after delivery and in the sera of the newborns sampled at the age of four or five days. Nine of the 145 newborn infants (6.2%) in the control group had to be treated with light therapy compared with 12 out of 187 (6.4%) of the newborn infants in the experimental group (high P/S ratio). Serum bilirubin concentrations were 142.5 mumol/l (SD 65.8) and 140.7 mumol/l (SD 73.5) in the experimental and control groups, respectively, at the age of five days. It appears that the changes in the composition of serum fatty acids reached in this study had no effect on the neonatal jaundice.
Bilirubin↗