Cow's milk-specific cellular and humoral immune responses and atopy skin symptoms in infants from atopic families fed a partially (pHF) or extensively (eHF) hydrolyzed infant formula.

BACKGROUND: Hydrolyzed milk formulas are recommended to feed infants at high risk of atopy if breast-feeding is not possible. We studied the specific cellular and humoral immune response to cow's milk proteins and occurrence of atopic dermatitis under different feeding regimens: two hydrolyzed infant milk formulas (partially [pHF] and extensively hydrolyzed [eHF]) and under exclusive breast-feeding (BF). METHODS: Seventy-two infants from families with atopic symptoms were randomized in the pHF and eHF groups, respectively. At 6 and 12 months of age, peripheral blood mononuclear cell proliferation along with specific IgG and IgE to cow's milk proteins was determined in infants fed pHF or eHF, respectively, and those who had not yet received any formula at 6 months of age (BF). Cases of atopic dermatitis were recorded throughout the first 12 months of life, and their severity was evaluated with SCORAD points. RESULTS: A significantly decreased proliferation to cow's milk caseins was found in the pHF group compared to the exclusively breast-fed group. Medians of stimulation indexes for CAS at 6 months were as follows: pHF 1.18; n=24; BF 1.70; n=24 (P=0.033, Mann-Whitney U-test). Higher levels of plasma IgG antibodies to BCAS were found in infants fed pHF than in those fed eHF at 12 months. Optical density (OD): (25th percentile; median; 75th percentile): pHF: 0.00; 0.14; 0.38; n=30; eHF: 0.00; 0.03; 0.14; n=28; P=0,089, Mann-Whitney U-test. Cow's milk-specific IgE was detected at 6 months as follows: BF: 3 of 24; eHF: 2 of 21; pHF: 0 of 23. The number of cases of atopic dermatitis and their severity did not differ among the groups during the first 12 months. CONCLUSIONS: Feeding pHF appears to suppress cow's milk-specific cellular responses and stimulate specific IgG production. Specific IgE sensitization can occur also with breast-feeding.

[Cryocoagulation in the treatment of retinopathy of prematurity]. / Kryokoagulace v lécbe retinopatie nedonosených.

The authors give an account on cryotherapy of retinopathies in the premature--130 eyes of 93 children treated during 1984-1988. Almost in all children cryocoagulation was made, using a transconjunctival approach, in the avascular periphery of the retina under local instillation anaesthesia. Twenty-eight eyes were coagulated already in stage 2 of the proliferative phase (along with the other more severely affected eye), the results being very satisfactory. In this stage, however, spontaneous regression cannot be ruled out. This is the reason why only 102 eyes were evaluated in detail, i.e. those coagulated in stage 3a and the latter were compared with findings in 90 eyes equally affected where cryocoagulation was not performed. In the group after coagulation 51% of the eyes had findings in stage I and II of the cicatricial phase with good and very good vision, in 17.6% the final finding is stage III with vision in the zone of visual debility and 31.4% of the eyes with findings stage IV and V are blind. In the group without coagulation there were 4.4% eyes in stage I and II, 28.9% eyes in stage III and 66.7% in stages IV and V. In eyes after coagulation the percentage of adverse results (31.4%) is by one half lower than in untreated eyes (66.7%).

[Evaluation of pulmonary function in children of preschool age treated in the neonatal period with distension methods]. / Hodnocení plicních funkcí u detí predskolního veku, lécených v novorozeneckém veku distencními metodami.

Within the framework of a long-term follow up of the development of neonates with low birth-weight the authors investigated pulmonary functions in a group of 20 children aged 5.5 years treated during the neonatal period on account of early asphyctic syndrome, hyaline membrane syndrome and bronchopulmonary dysplasia by the distension method, using a continual positive pressure. The birth-weight of the investigated children varied between 600 and 1500 g. While the authors observed a significant reduction of the forced vital capacity, as compared with the appropriate values for the given age, sex and anthropometric data in almost 40% of the children, the values indicating obstructive changes (one-second vital capacity - FEV1 and mean flow rate - FEV25-75%) were reduced only in 15% of the investigated children. The revealed changes detected during the symptom-free period with a normal clinical picture are the functional background for aimed prevention of chronic bronchopulmonary disease and effective rehabilitation.

Influence of intravenously administered intralipid on free fatty acid concentration and albumin binding capacity to bilirubin in newborn infants.

During a 24-hour interval, examination was carried out of 5 full-term and 4 preterm newborns in whom no disturbance of postnatal adaptation was found. The newborns received parenteral nutrition using infusates containing 20% Intralipid during 7 hours on the average. The mean daily dose of Intralipid was 1.2 g/kg, infusion rate was 0.17 g/kg/h. The concentration of FFA (n = 9) and ABC/Bi was examined three times in the course of 24 hours, and that prior to Intralipid administration, after one-hour infusion, and approximately 17 hours after the end of infusion. Before infusion and 24 hours after the first collection, blood bilirubin and glucose concentrations, and the values of pH, pCO2 and BE (= 9) were examined. One hour after the start of Intralipid infusion the mean FFA concentration was reduced and decreased again during the following 23 hours. The differences were mostly insignificant. One hour after the start of infusion the mean value of the ABC/Bi ratio decreased insignificantly, but returned to the initial value by the end of the follow-up period (24 hours). The mean concentration of bilirubin and blood glucose and the values of pH, pCO2 and BE did not change significantly. It may be reasonably assumed, that in newborns showing normal postnatal adaptation in the first days of life, the administration of 20% Intralipid (as parenteral nutrition) exerts no substantial effect on the plasma FFA concentration and ABC/Bi ratio in the course of 24 hours. General principles for the indication of parenteral Intralipid administration to the newborn are given.

Postnatal development of plasma FFA concentration and its influence of the separation of bilirubin from albumin binding in newborns.

The first part of the study gives data on the FFA concentrations, glycaemia and energy quotient in newborns with uncomplicated postnatal adaptation in the first 2 weeks of life. The study was carried out in a group of 69 full-term and 69 pre-term infants at the age of 24, 48, 72, 96 hours and 7 and 14 days. Although it is not the case of consecutive values of FFA concentrations in plasma, a certain developmental trend can be suggested. This is analogous in both groups with the only difference that in pre-term infants FFA culminate and decrease earlier (pre-term 48-72 hours, full-term infants 72-96 hours). The study shows that, in pre-term and full-term infants with satisfactory postnatal adaptation and above nutrition, stabilization of glucose-lipid metabolism occurs on the 3rd and 4th day after birth, respectively. In pre-term infants supplementary nutrition by the glucose system (glucose and amino acids) had a favourable effect. The second part of the study assesses the potential risk of increasing plasma FFA concentration for the separation of bilirubin from albumin binding. The means plasma FFA concentrations reached 25-48 and 49-72 hours after birth had no significant effect on the BCA/Bi ratio and, therefore, they are not dangerous as regards the possibility of displacing bilirubin from albumin binding.