[Risk factors for sudden infant death in the practice of Hungarian neonatal departments]. / A csecsemókori hirtelen halál rizikófaktorainak felmérése hazai újszülöttosztályok gyakorlatában.

Sudden infant Death Syndrome (SIDS) is recognized to be one of the main causes of postneonatal mortality. The WHO Regional Office for Europe was carrying out in 1999 a study at maternity level in SIDS. The study instrument for conducting this survey was a simple questionnaire, and the basis was the fact, that the SIDS has been strongly associated with prone infant sleeping position. The sleep practices are often established as a result of initial advice given to mothers by a nurse or doctors in the maternity hospital. 84 Hungarian maternity unit and hospital participated in this study. The Hungarian results are presented in this paper.

Influence of apolipoprotein E genotypes on serum lipid parameters in a biracial sample of children.

UNLABELLED: The goals of this study were to compare the allelic distribution of the apolipoprotein E(apoE) gene in Hungarian and Hungarian Gypsy children and to examine the impact of apoE polymorphism on quantitative levels of lipids in the two racial groups. Our data yielded calculated allele frequencies of 6.4% and 8.9% for apoE2; 83.8% and 73.8% for apoE3; and 9.8% and 17.3% for apoE4 in Hungarian and in Gypsy children, respectively. The frequency of the apoE4 allele was significantly higher (P<0.05) in Gypsy children than in Hungarians. The effect of apoE genotypes on serum lipid parameters differed considerably in the two racial groups. In the Gypsy group the lowest total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and triglyceride levels were in the E3/E3 group and these values differed significantly (P<0.0001 for TC and LDL-C and P<0.01 for triglyceride) from the values in the E2/E3 and E3/E4 groups. There were no significant differences in TC, LDL-C and triglyceride levels between E2/E3 and E3/E4 groups. The high-density lipoprotein-cholesterol (HDL-C) levels did not differ significantly among the genotype groups. In Hungarian children, the apoE2/3 group displayed lower, the E3/4 group higher, values of TC and LDL-C than in the E3/3 group, but the differences were not significant (P>0.05). HDL-C and triglyceride values did not differ among the genotype groups. CONCLUSION: Our results demonstrate that the apolipoprotein E allele frequencies differ between Hungarian and Gypsy children and suggest that these alleles influence the serum lipid levels, but other genetic and environmental factors can considerably change this effect.

[Preliminary results of the study of the relationship between cricopharyngeal incoordination and gastroesophageal reflux in infants]. / A csecsemókori cricopharyngealis incoordinatio és a fokozott gastrooesophagealis refluxkészség közötti kapcsolat vizsgálatának elózetes eredményei.

The authors summarise the results of barium swallow examinations and polysomnographic studies performed on 66 infants (41 male, 25 female), average age 63 days (26-130 days). Oesophageal pH monitoring was also performed as part of the polysomnographic examination. The results showed the highest incidence of cricopharyngeal incoordination (CPI) in the 6-10 weeks age group. Although they failed to demonstrate statistical significance between CPI and increased gastro-oesophageal reflux, they consider the two entities to be most probably related. No relation was found between CPI and abnormal polysomnographic results. They give an overview of the literature on the pathology of the cricopharyngeal muscle and with regard to the lack of uniformity in the terminology of previous publications, they present their use of terminology.

Chemokine receptor CCR2 and CCR5 polymorphisms in children with insulin-dependent diabetes mellitus.

Studies have shown the important roles of several regulatory and proinflammatory cytokines in insulin-dependent diabetes mellitus (IDDM). CC-chemokine receptors CCR2 and CCR5 bind chemokines that are involved in the trafficking of leukocytes in both basal and inflammatory states. A common 32-bp deletion mutation in the CCR5 gene (CCR5delta32) and a G-to-A nucleotide substitution in the CCR2 at position 190 (CCR2-64I) have recently been described. In the present study, we have determined the frequency of the CCR5delta32 and CCR2-64I alleles in children with IDDM [n = 115; age 1-14 (9.3+/-4.3) y] and in nondiabetic subjects [n = 280; age 1-14 (8.5+/-4.5) y]. The CCR5delta32 allele frequencies were 0.117 in children with IDDM and 0.111 in nondiabetic subjects, indicating that the deletion allele has no association with IDDM. The CCR2-64I allele frequency in children with IDDM was 0.226, which differed significantly from the allele frequency in controls (0.114, p = 0.001). The role of this mutation in IDDM cannot be explained yet, but, because CCR2 mediates the chemotaxis of CD4+ and CD8+ T cells to areas of inflammation and because these cells play important roles in insulitis, a mutation in the CCR2 gene may contribute to the susceptibility to the disease. Alternatively, the 64I allele could be a marker of a linked mutation through linkage disequilibrium. According to these results, the CCR2 gene may be a new candidate for the susceptibility locus of IDDM. However, because no IDDM locus has been identified near 3p21 until now, further investigations are needed to confirm this statement.

[Objective audiologic assessment of children treated with amikacin]. / Amikacinnal kezelt gyermekek objektív audiológiai vizsgálata.

Hearing assessment of 14 children suffered from urinary tract infection and treated by amikacin is reported. The dosage of amikacin was 7.5 mg/kg/daily for 10 days and the serum level of amikacin not exceeded the 35 mcg/ml. The aim of the study was on the one hand to determine the hearing damaging side effect of amikacin and on the other to assess the usefulness of objective methods for detection of hearing loss in this population. Authors used for screening a transient otoacoustic emission (TEOAE) during and after (2-4 weeks) therapy. If subjective and objective (TEOAE) methods gave a good result, no further checkup has considered as necessary, but if there were no evoked emission, acoustic brainstem response audiometry has been carried out for verification. It result no hearing loss could be detected in the measured specimen. In conclusion it has been stated that by proper dosage and serum level screening amikacin may no lead to hearing loss in children, and objective methods are valuable for hearing screening and monitoring of such population of children.

[Polysomnographic screening of infants at risk for SIDS]. / A csecsemökori hirtelen halál szempontjából veszélyeztetett csecsemök szürése poliszomnográfiával.

The authors present a Sudden Infant Death Syndrome prevention program. The study analyses the data of 92 children having participated in the complex prevention program, including polysomnography, between May 1997 and February 1998. The role of polysomnography and its use as a clinical method is described through the statistical analysis of the results of the study.

High prevalence of silent celiac disease in preschool children screened with IgA/IgG antiendomysium antibodies.

BACKGROUND: Because of the different sensitivity and specificity of serologic tests, the search for silent celiac disease is usually performed with the combined or sequential use of several tests. Among these, the IgA-class endomysium antibody test has the highest specificity and positive predictive value, but it may overlook IgA-deficient patients. METHODS: To test a new one-step screening approach, serum samples from 427 apparently healthy, 3- to 6-year-old Hungarian children were investigated for IgA-class and IgG-class endomysium antibodies using monkey esophagus and human jejunum as substrates. RESULTS: Five new cases with flat mucosa were identified by strong endomysium antibody positivity and subsequent jejunal biopsy, yielding a celiac disease prevalence of 1:85. An additional child may have latent celiac disease (slight histologic changes at present). Two of the screening-detected celiac patients exhibited only IgG-class endomysium antibodies due to associated IgA-deficiency. Despite the young age of the screened population, antigliadin antibodies were positive in only three of the five celiac patients. CONCLUSIONS: Prevalence of celiac disease in the study population was much higher than expected on the basis of antigliadin antibody-based studies. The screening system used detected celiac cases in which there was IgA-deficiency and those in which there was not and also those negative for antigliadin antibodies. The findings suggest the importance of the primary testing of autoantibodies in future celiac disease screening policies.