[On the treatment of whooping cough].
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Biomedical subjects
Publications and source records attributed to W Burmeister.
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Vitamin D-deficiency has been observed among immigrant children with rickets and osteomalacia in Western Europe. So vitamin D-status in 34 children and juveniles (17 girls, 17 boys) of African and Asian diplomats staying in West Germany only for a certain time is examined. During summer 1989 plasma levels of alkaline phosphatase, calcium, phosphate, 25-hydroxy-cholecalciferol and 1,25-dihydroxycholecalciferol is measured. According to their native country the subjects are divided into three groups: I North Africa (n = 7), II Central Africa (n = 18), III Asia (n = 9). No clinical signs of rickets or osteomalacia are detected. All plasma levels of calcium and phosphate are in the normal range so as most of the values of the alkaline phosphatase. In Group I 85.7% (n = 6), group II 77.8% (n = 14) and group III 44.4% (n = 4) have decreased values of 25-OHD whereas most strikingly elevated amounts of 1,25-OH2D are measured in 57.1% (n = 4) of the subjects in group I, 66.7% (n = 12) in group II and 11.1% (n = 1) in group III. Normal values for both 25-OHD and 1,25-OH2D are rare: one case (11.1%) in group I, no case in group II, four cases (44.4%) in group III. The influence of the time staying in West Germany on vitamin D-status, a possible dietary lack due to inadequate nutrition, the role of skin pigmentation and a potential genetic abnormality of vitamin D-metabolism is discussed to explain the results.
In 73 healthy (group I) and 32 children and juveniles with insulin dependent diabetes mellitus (IDDM, group II) urinary albumin excretion is determined by radioimmunoassay (RIA). In both groups albumin excretion is observed in every urine sample when measured by RIA (mean +/- SD: group I: 7-19 h: 5.17 +/- 5.28 mg, 19-7 h: 3.86 +/- 4.00 mg, 24 h: 9.03 +/- 8.60 mg; group II: 7-19 h: 6.68 +/- 6.86 mg, 19-7 h: 3.46 +/- 2.82 mg, 24 h: 10.13 +/- 9.25 mg). No significant difference is detected between the values of the two groups. However in diabetic patients a significant difference is observed between diurnal and nocturnal urinary albumin excretion. Microalbuminuria is defined as an albumin excretion above 30 mg/d and is present in 6.9% of the values in group I and in 3.1% in group II. The physiological limits of microalbuminuria in children and juveniles compared to adults and several methods of urine sampling are discussed.
In 73 healthy (group I) and 32 children and juveniles with insulin dependent diabetes mellitus (IDDM, group II) urinary albumin excretion is determined by radioimmunoassay (RIA) and kinetic nephelometry. Intention of the study is to examine, if the kinetic nephelometry is--as observed in adults--a suitable method also in children and juveniles to detect microalbuminuria (greater than 30 mg/d). In both groups albumin excretion is observed in every urine sample when measured by RIA. Because of it's higher threshold kinetic nephelometry detects albumin excretion only in a part of the urine samples. The correlation between the two methods is very high (r = 0.905, p less than 0.001, n = 174). So kinetic nephelometry is not suitable to determine reference values. But as a faster and possibly more specific method than RIA nephelometry is a very effective way for a screening of microalbuminuria also in children and juveniles.
Idiopathic juvenile osteoporosis appears in temporal coherence with puberty leading to a reversible generalized osteoporosis of the skeletal system, spontaneous fractures and skeletal deformities. First symptoms in a 14 years old boy occurred as muscle pareses. A lymphocytic pleocytosis could be detected in cerebrospinal fluid. The next two years more than 20 spontaneous fractures occurred. Height was reduced by 15 cm. We first saw the boy at 17 years and could find decreased serum concentrations of calcitriol. Substitution with calcitriol resulted in regression of the pareses within days. Spontaneous fractures did not develop during the next two years of therapy. Subsequently serum calcitriol level was normalized. In a 10 years old boy first symptom occurred as fractures resulting from minimal traumas. In this case also during previous calcitriol therapy no new fractures occurred.
Report of an 3 1/2 year old girl who because of resistant anemia and thrombocytopenia received blood transfusions since her third month of life. 15 months later she developed diabetes mellitus. Sensorineural deafness was noticed since her third year of life. Daily 25 mg thiamine prevented anemia and thrombocytopenia. The syndrome is compared with the 5 published cases of world literature.
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