Body mass, plasma leptin, glucose, insulin and C-peptide in offspring of diabetic and non-diabetic mothers.

OBJECTIVE: The aim was to investigate the relationship between body mass index (BMI), plasma leptin, glucose, insulin and C-peptide levels in the offspring of diabetic mothers (DM) and non-diabetic healthy mothers (HM). DESIGN: Seventy-two offspring (37 girls and 35 boys, age 4-20 years) of DM were investigated in a prospective study. Those 14-16 years old (Tanner stage II-IV) were compared with age-matched offspring of HM (33 girls and 33 boys). RESULTS: BMI strongly correlated with plasma leptin concentration in the offspring of both DM and HM children. There were higher BMI and plasma leptin and glucose levels in DM than in HM children. There was no difference in plasma insulin or C-peptide levels between HM and age-matched DM children. There was a highly significant positive correlation between plasma leptin and C-peptide in boys of DM. CONCLUSIONS: The higher plasma leptin found in the offspring of DM reflects their higher BMI. A moderately high but still normal glycemia might be a preclinical sign of insulin resistance or other disturbance of glucoregulation.

[Primary ciliary dyskinesia--importance of early diagnosis]. / Primárna dyskinéza riasiniek--význam vcasnej diagnózy.

BACKGROUND: Primary ciliary dyskinesia (PCD) is an inherited disease characterized by specific ultrastructural defects of cilia and sperms. The impairment of mucociliary clearance (MCC) results in chronic respiratory infections and subsequently in bronchiectasis. MAIN PURPOSE: The evaluate rational decisions in early diagnosis of PCD. METHODS: Samples of nasal mucosa or tissue of tonsilla pharyngea after adenotomy were studied by transmission electron microscopy (TEM) in 47 patients aged 1-15 years, suffering from recurrent or chronic respiratory infections. RESULTS: Congenital ultrastructural ciliary defects specific for PCD--the lack of dynein arms, radial spokes defects and microtubular transposition--were observed in 13 patients. TEM investigation is an expansive, time consuming method not available in routine practice. Therefore we have evaluated a diagnostic procedure which uses available examination methods focused on the diagnoses of PCD. TEM of respiratory cilia is indicated in patients with situs viscerum solitus if chronic respiratory disease develops and after more frequent causes--asthma, cystic fibrosis, congenital anomalies of respiratory system and immunodeficiency had been excluded. CONCLUSIONS: The correct and early diagnosis is important for effective therapy in order to improve MCC. This approach can prevent the development of bronchiectasis during childhood.

Susceptibility of Streptococcus pneumoniae isolated from the respiratory tract of hospitalized children with respiratory tract infections.

The most frequent nasopharyngeal carriers of Streptococcus pneumoniae are young children. Frequent use of antimicrobial therapy in children facilitates the selection of penicillin-resistant strains in this population. These strains, especially if highly resistant, may cause serious therapeutic problems. Aim of the study was to monitor penicillin- and multidrug-resistant S. pneumoniae strains in hospitalized children with respiratory tract infections. Hospitalized children up to five years were examined for S. pneumoniae presence in their upper respiratory tract. Susceptibility to penicillin, erythromycin, trimethoprim/sulfamethoxazole, tetracycline, and chloramphenicol was determined by the disk-diffusion method. The minimal inhibitory concentrations (MIC) of penicillin, erythromycin and trimethoprim/sulfamethoxazole were measured by the E-test. S. pneumoniae strain was isolated from 60 (34.7%) out of 173 microbiologically examined children; 2 different strains were isolated in 9 cases. Nine strains (13.0%) were penicillin resistant with MICs ranging from 1.5 to 8 mg/L, and 17 strains (24.6%) had intermediate susceptibility. Seventeen (24.6%) strains were erythromycin resistant (MIC > or = 1 mg/L). Eighteen strains (26.1%) were resistant and 7 strains (10.1%) were intermediately susceptible to trimethoprim/sulfamethoxazole. Ten strains (14.5%) were not susceptible to tetracycline, and 11 (15.9%) to chloramphenicol. Non-susceptibility (resistance or intermediate susceptibility) to the tested antimicrobials was more prevalent in penicillin-nonsusceptible strains. The current level of S. pneumoniae resistant to antimicrobial drugs in children with respiratory tract infections in the hospital department monitored in our study do not cause problems in the choice of antibacterial therapy. Penicillins still can remain the drug of choice in cases when typical bacterial causing agents of respiratory tract infections are suspected. (Tab. 3, Fig. 2, Ref. 31.)

Relationship between the duration of the breast-feeding period and the lipoprotein profile of children at the age of 13 years.

Selected parameters of lipid metabolism were studied in a group of 76 children aged 12-13 years. The children were divided into 4 subgroups according to the duration of neonatal nutrition (no breast feeding, breast feeding for 3, 6 or more than 6 months). We studied the concentration of total serum cholesterol, its distribution into lipoprotein fractions, the concentration of serum triacylglycerols and apolipoproteins A1 (Apo A1) and B (Apo B). Atherogenic indexes were calculated from the data obtained. The highest cholesterol levels (5.20+/-0.15 mmol x l(-1)) were found in children who had been breast-fed for more than 6 months, while the highest concentrations of Apo B (0.80+/-0.07 g x l(-1)) and Apo A1 (1.76+/-0.06 g x l(-1)) and the highest Apo B/Apo A1 ratio (0.45+/-0.04) were found in children with the shortest period of breast-feeding. No significant sex-related differences in total, VLDL, LDL, HDL cholesterol, triacylglycerols and apolipoproteins were observed.

[Modern views on pneumococcal infections in infants and toddlers]. / Súcasné názory na pneumokokové infekcie u dojciat a batoliat.

Pneumococci colonize the upper respiratory tract predominantly in sucklings and toddlers. By means of their factors of virulence (capsule, ahesines, peptidoglycan, and polysaccharides of the capsule, cytoplasmic membrane enzymes) they can either avoid or impair the immunity mechanisms causing thus severe infections especially in children younger than three years of age and in patients with immunity defects. Regarding the possibility of occurrence of pneumococci with altered susceptibility to penicillin and some other drugs (erythromycin, cotrimaxazol, ceftriaxon, chloramphenicol, tetracycline) it is necessary to treat severe pneumococcal infections on the basis of in vitro detected susceptibility.

[IgG subclasses in children with recurrent respiratory diseases]. / Podtriedy IgG u detí s recidivujúcimi respiracnými chorobami.

The authors examined IgG sub-classes, using the ELISA method, in 35 patients with relapsing respiratory diseases and 27 children of a control group aged 3-15 years. In children with relapsing respiratory diseases without deficiency of the main immunoglobulin classes they found a statistically significantly reduced value in sub-class IgG2 (P < or = 0.01). The changes found in other sub-classes were not statistically significant. The authors draw attention to the fact that deficiency in IgG sub-classes should be considered in case of repeated respiratory infections caused by encapsulated microorganisms--H. influenzae, Str. pneumoniae--and also when reduced levels of IgG and IgA are found. However, even normal levels do not rule out deficiency.

Search for optimal age for weaning. Ten-year prospective study.

The effect of infant nutrition on some clinical and biochemical parameters was studied from birth in a longitudinal prospective study. The data covering the period up to 7 years were reported previously. At the age 10 years 80 children were examined. Two children have been regularly followed up because of high blood pressure. Both had been breast-fed for less than one week and are obese at present. Surprisingly serum total cholesterol was the highest in the group breast-fed for more than 6 months. There were no pronounced differences in the levels of lipoprotein cholesterol carriers. The incidence of a high (over 6.0) atherogenic index (total chol - HDL chol) x APOB/APOA1 x HDL chol) and cholesterolemia over 4.8 mmol/l was significantly (chi 2 test) higher in the group breast-fed for over 6 months. Thyroid function parameters were not affected by the duration of breast-feeding. We conclude that besides undoubtedly favorable effects of breast-feeding, some functions might be also adversely affected if it lasts for more than 6 months. For justified recommendation of optimal duration of breast-feeding all aspects should be considered and more data collected.

[Biostim in the treatment of recurrent respiratory diseases in children]. / Biostim v liecbe recidivujúcich respiracných chorôb u detí.

The authors treated with Biostim (Roussel Uclaf Co., France) 20 children aged 3 to 15 years with relapsing and chronic diseases of the respiratory system. A favourable clinical effect was observed in 45% and improvement in 40% of the patients. In the investigated immunological indicators the response to treatment Biostim was manifested in the antibody immunity by a reduction of IgE values (P < 0.01) and of IgM (P < 0.05). As to cellular immunity, there was a significant increase of the phagocytic activity (P < 0.05). The tolerance of the preparation was very good.

[The activities of Professor Alojz Chura at the Comenius University Medical School in Bratislava]. / Pôsobenie profesora MuDr. Alojza Churu na Lekárskej fakulte Univerzity Komenského v Bratislave.

One of the most outstanding personalities of Slovak nationality acting at the Medical Faculty of Comenius University in the first two decades of its existence was Prof. MUDr. Alojz Chura. He was among the first students of the Faculty and was then its active member until 1945. The aim of the present study was to contribute to a better understanding and unbiased evaluation of the importance and impact of the activities of this remarkable personality of Slovak pediatrics. In 1925 MUDr. Chura started to work at the Teaching Hospital of Pediatrics and in 1945 he was forced to leave both his position of Director of the Hospital and that of Full Professor of Pediatrics. As Director he had succeeded Prof. Brdlík who on leaving for Prague had suggested Prof. Chura for this responsible position. The contribution of Prof. Chura to the development of pediatrics in Slovakia was exceptional. His extensive sociological study "Slovakia without the Young Generation" laid the basis of social pediatrics in Slovakia. The Teaching Hospital of Pediatrics experienced considerable development under his guidance and that in all its areas of activity, i.e. teaching, prevention, therapy, and research. Besides his manifold activities at the Hospital and Medical Faculty, Prof. Chura was involved in many pursuits, particularly those which were related to the car of the youngest generation. He was Chairman of the Association of Pediatricians in Slovakia for many years. The study analyzes also the Memorandum issued in 1935 which is an important document of the actual social and health conditions in the Slovak country.(ABSTRACT TRUNCATED AT 250 WORDS)

[Immunologic indicators in the treatment of recurrent respiratory diseases using peroral bacterial vaccines]. / Niektoré imunologické ukazovatele pri liecbe recidivujúcich respiracných chorôb perorálnymi bakteriálnymi vakcínami.

The authors treated on account of relapsing respiratory diseases 95 children with Broncho-vaxom (Lab. ltd. Meyrin, Geneva) and 75 children with bacterial vaccine prepared with regard to the microbiological examination. Restoration or improvement of the clinical condition was achieved in 80% of the patients. No side-effects were observed during treatment. As to investigated immunological indicators they recorded after treatment a significant reduction of IgM (P less than 0.001), IgA (P less than 0.01), SIgA in saliva (P less than 0.01), values of the nitroblue tetrazolium test (P less than 0.01) and (P less than 0.05). The assembled data revealed that bacterial vaccines are useful as immunomodulating preparations.

[Activation of damaged nasal mucociliary function in children]. / Aktivácia poskodenej nosovej mukociliárnej funkcie u detí.

In 25 children with damaged mucociliary function of the nasal mucosa the authors used local ATP treatment. It was found that ATP solution applied to the nasal mucosa improves mucociliary function and reduces the transport time to normal; in acute, relapsing and allergic rhinosinusitis, in Kartagener's syndrome it improves partially the function of cilia, while transport remains prolonged. It seems that local application of ATP in drops may have a favourable effect on rhinosinusitis and prevent relapses.