[Immunoglobulin A in saliva of children: age dependence and effect of respiratory tract diseases]. / Immunglobulin A im Speichel von Kindern: Altersabhängigkeit und Einfluss von Atemwegserkrankungen.

Immunoglobulin A (IgA) plays an essential role in the local defence mechanism and is part of the immunologic system. It is transported to the endothelial surface either as a monomer or as a dimer of two molecules of IgA connected by a j-chain and attached to a secretory component. The aim of the present study was to assess the relation of salivary IgA to the age of children and to assess a possible influence by acute and chronic respiratory diseases. IgA was measured in the saliva of altogether 230 children by means of radial immunodiffusion (LC-IgA Partigen, Behring) following a standardised protocol. Relation to age was measured in 159 healthy children aged one month to 15 years. The median of IgA was 36 mg/l with a range of 3.5-291 mg/l. There was no statistically significant relationship between salivary IgA and the age of the children. Median IgA in the saliva of children without any respiratory disorders (n = 169) was 36 mg/l (3.5-291 mg/l), of children with acute respiratory diseases (n = 33) 51 mg/l (3.5-257 mg/l) and of children with chronic respiratory diseases (n = 28) 47 mg/l (3.5-165 mg/l). There was no statistically significant difference between these three groups. In conclusion, the results of this study show that IgA in the saliva of children may not be related to age or influenced by acute or chronic respiratory diseases.

[The current status of vaccinations]. / Der aktuelle Stand des Impfwesens.

The vaccines which are now at our disposal have been largely perfected, are constantly examined and have proved most successful. It is owing to their use that epidemics have been eradicated and tremendous suffering has been relieved. It is a matter of course that all vaccination recommendations are to be constantly monitored and also revised in case new situations come about; however, it would be foolish not to make use of this excellent possibility offered by prophylactic medicine.

Clinical experience with intravenous Augmentin in the treatment of paediatric infections.

The clinical efficacy of intravenous Augmentin (a formulation containing amoxycillin plus clavulanic acid) was investigated in an open study in fifty-eight children with a mean age of 6 years (range 1-15 years). The normal dosage was in the range 100-200 mg/kg/day Augmentin, administered parenterally by short i.v. infusion in 3 or 4 divided doses. Most patients were hospitalised for lower respiratory tract infections. Complete clinical cure or distinct clinical improvement was achieved in all assessable cases. Bacteriological success was obtained in 92% of the assessable cases. In two patients, mild, transient exanthema was noted after i.v. Augmentin was replaced by oral Augmentin. No additional therapeutic measures were required.

Development and clinical use of an oral heat-inactivated whole cell pertussis vaccine.

An orally administered, killed whole cell pertussis vaccine was developed which proved to be safe and potent in animal experiments. This vaccine was studied in limited field trials in Austria. In these field trials 1 X 10(12) bacterial cells were given orally on days 2, 3, 4, and 5 after birth with an oral booster of 1 X 10(12) cells given at six weeks. This vaccine was tolerated without side effects in more than 20,000 newborns, did induce a specific immune response including anti-pertussis IgG in serum, anti-pertussis IgA in saliva and specific pertussis mitogen stimulation. This immune response occurred significantly earlier in the orally but not in the parenterally vaccinated group. In addition, anti-pertussis antibodies in saliva were not induced in the parenterally vaccinated group. Pertussis morbidity in 11,192 orally vaccinated infants was compared to 3496 infants who did not receive oral vaccination and was found to be significantly lower for up to one year. There was no overall difference between orally and non-orally vaccinated infants as far as pertussis hospitalization and verified pertussis infection after one year was concerned.

[Inflammatory diseases of the nose and nasal sinuses in children]. / Die entzündlichen Erkrankungen der Nase und der Nasennebenhöhlen im Kindesalter.

Inflammatory diseases in childhood are quite different from those occurring in adults. The reasons are the special physiological, anatomical and immunological factors at the different stages of development. The different diagnostic possibilities (nasal swabs for virological and bacteriological examinations, X-ray, sonography, CT, endoscopy of the nose and paranasal sinuses) are discussed and the principles of the conservative and surgical therapy were demonstrated.

[Preliminary findings with oral whooping cough vaccination in young infants (author's transl)]. / Erste Ergebnisse mit oraler Keuchhustenimpfung bei jungen Säuglingen.

A preliminary report is presented on oral vaccination against whooping cough. 23 babies younger than, and 2 older than nine weeks and 12 newborn infants were vaccinated orally. No side effects were observed. Serum antibody titres did not increase markedly, but no child was seronegative after vaccination. An evident antibody titre rise to a higher level than in serum was found in the saliva. These results point toward an adequate local immunity. At present a definite statement about the efficacy of this oral vaccination is difficult to make. Further investigations are necessary.

[First results of sportmedical examinations in children norm-values and influence of overweight on physical efficiency (author's transl)]. / Erste Ergebnisse kindersportärztlicher Untersuchungen. Normwerte und Einfluss des Ubergewichtes auf die körperliche Leistungsfähigkeit

The individual physical efficiency was ascertained according to a method developed by RUTENFRANZ, where the criterion was taken as being the particular performance which resulted in a pulse rate of 170 beats per minute. This was termed the p.w.c. 170 (physical working capacity), and was measured on a bicycle ergometer, with increasing loading of 1, 2, and 3 watt per kilogram of body weight. During this loading the E.C.G. was watched telemetrically on an oscilloscope, and recorded each minute. The p.w.c. 170 was ascertained both graphically and arithmetically from the respective pulse rate in the 6th minute of each load level. Initially, twenty healthy children were tested, so as to arrive at normal values. The average reading for these children was about 5% below the normal values given by RUTENFRANZ. Subsequently, fifty five obese children were examined, so as to clarify the question as to whether there was a linear correlation between overweight and physical efficiency. Indeed, it was possible to establish a regression equation according to which each 10% of overweight lead to a decrease of physical efficiency of 5.8%. The results of further examinations will be reported in the next paper.

[Cardiac manifestations in prenatal coxsackie virus myocarditis (author's transl)]. / Herzerkrankungen bei praenataler Coxsackievirusinfektion

This is a report of 6 single cases of prenatal virus myocarditis originated from an endemic region around Salzburg. The cardiac involvement showed different grades dependent too on time of infection and on transfer of maternal antibodies to the child. Infections immediately before delivery cause severe illness, but infections some weeks before birth less severe damage. Symptoms of meningitis were not noticed. The diagnosis of myocarditis by Coxsackie virus was certain in two deceased newborns (Patient 1 and 2), very probable in one decreased baby (Patient 3) and probable in the surviving children (Patient 4, 5 and 6).

[Methods and technique of investigations in the course of sport activities of children (author's transl)]. / Methodik und Technik kindersportärztlicher Untersuchungen

In order to carry out investigations in the course of sport activities of children an efficient telemetering device is essential, which can also be used on children. The Kinderspital Salzburg has developed a telemetry system in cooperation with the Technische Versuchs- und Forschungsanstalt der Technischen Hochschule Wien and the Messerschmitt-Bölkow-Blohm-Werke München. For the first time in this field a Pulse Code Modulation (P.C.M.) System was utilized, implying high accuracy on data transmission and recovery as required for scientific examinations. The children's physical capacity is determined on a bicycle ergometer, and the performance measured in this fashion is then compared with the performance achieved in sport.

[Psychological and social aspects of overweight children (author's transl)]. / Psychische und soziale Merkmale übergewichtiger Kinder

If children who were originally fully capable and active according to their respective age groups, remain more than 50% overweight for a period of more than 3 years, develop a significantly lower motor, intellectual and social activity. They tend to develop an anxious auto-aggressive behavior, because it is difficult for them to transmit to others the social pressures to which they are subject. The probability of a permanent therapeutic success diminishes as the duration of the period of overweight increases. Only physically and emotionally orientated therapy is rational as 78% of our overweight children come from neurotically disturbed families. Overweight can often be due to lack of love where intensity of affection is wrongly applied.

[Long-term-follow-up-study after measles-vaccination (author's transl)]. / Langzeitstudie nach Masernimpfung

Following a first field trial in the year 1966 a second field trial was carried out in the Pediatric Clinic of the University of Vienna in the years 1967 und 1968, in which 420 children were vaccinated against measles by various methods. Apart from the observations of the clinical reactions the chief purpose of the examination was to establish the height of the antibodies achieved, how long they persisted and whether the primary vaccination with split-vaccine had any influence on the level and persistance of antibodies. The results following the combined vaccination were compared with those following with Schwarz-strain alone, whereby no significant differences appeared. The serological follow-up examinations were made after a month, a year, after 3 and finally after 7 years. Whilst in the first year the combined vaccinated children showed an average higher titre, the average antibody titre following single live vaccination were somewhat higher after 7 years and showed a lesser degree of scatter. The values of antibody titres are impart so high that one has to assume a silent booster effect since none of the examined children were taken ill with measles. The single live vaccination by means of Schwarz-vaccine has thus been proved outstanding, is to be regarded as the general method of choice and should be applied as widely as possible since the morbidity risk of measles is considerably high and vaccination is not dangereous. The use of split-vaccine is indicated only with chronically ill children for instance with leukaemia, mucoviscidosis etc. and in infants in the first year of life, if one wants to protect them against measles. If we reach our aim of through-vaccination of the population against measles, infants will no longer be in danger and a prevaccination in the first year of life will not be indicated.

[Tasks and significance of investigations in paediatric sport medicine (author's transl)]. / Aufgaben und Bedeutung kindersportärztlicher Untersuchungen

Hitherto there have been hardly any paediatric investigation into the effect of sport on children,--apart from physiological ones, (Rutenfranz). Yet these days children take part in sporting activities as a matter of course, and frequently very heavy demands are made on them. It therefore appeared appropriate to initiate these investigations. The basic requirements for the evaluation of the physical capacity of each individual child are successive examinations of the effects of each type of sport on the cardiovascular system, pulmonary function, locomotor system, metabolism, and the psychology of healthy children. The following investigations are therefore deemed desirable: electrocardiogram, respiration rate, respiratory volume, respiratory gas analysis, blood pressure, body temperature, electro-encephalogram, electro-myogram, gravity and pressure (acceleration) effects, and psychological assessment. It is necessary to examine both the immediate stress and strain, on the child, which can at times assume dangerous proportions, as well as the more long-term effects which can be of a positive nature (effect of training), or of a negative nature (detriments). A further basic of paediatric sport investigations is the evaluation of consequences of climate and altitude in relation to sport. But one must also examine the effects of individual types of sport on children with diseases of the heart, lungs, metabolism, locomotor system, and central nervous system, from the point of view as to which type of sport can be expected of such children which might be beneficial or might be detrimental. Paediatric sport examination should also demonstrate ways and means how disadvantageous effects of sport can be avoided and as a consequence, the results of the serial investigations must be of benefit in the assessment and counselling of the individual child.