A new method of surfactant application was associated with a lower prevalence of mechanical ventilation and better pulmonary outcome. A prospective controlled trial is required to determine whether this approach is superior to standard care.

No abstract

Several PVC medical devices contain the plasticizer Di-(2-ethylhexyl)-phthalate (DEHP) in high concentration. Taken systematically DEHP only has minor toxic effects in the human organism. In three preterm infants artificially ventilated with PVC respiratory tubes unusual lung disorders resembling those observed in hyaline membrane disease, verified both clinically and radiologically, were observed during the fourth week of life. It was assumed that these lung disorders were causally related to the exposure to high doses of DEHP, which was released from the walls of the respiratory tubes. DEHP was found in the lung tissue of one patient who died of pneumothorax soon after birth after being artificially ventilated. It is strongly recommended that for disposable PVC respiratory devices the plasticizer DEHP should be used with more restrictions.

Milia-like idiopathic calcinosis cutis is a rare entity. Only 17 cases have been reported so far. Two-thirds of these have been associated with Down syndrome. We report the fifth case occurring in a child without Down syndrome. Milia-like idiopathic calcinosis cutis has long been regarded as a peculiar subtype of idiopathic calcinosis cutis. The pathogenesis of the disorder remains unclear.

Questionnaires designed to test attitudes toward old people were given to both the freshman class and the senior class of students in the University of California School of Medicine. Results of the study showed that these two groups shared most of the general societal conceptions and misconceptions about the aged. In addition, these students adhered to a set of medical stereotypes about aging to a degree surprisingly unmodified by the much-vaunted medical socialization process; freshmen and seniors agreed on many aspects of the subject. The results of this attitudinal status were manifested in a medical prejudice against old patients, as expressed in the replies given to the questionnaire. How much of the difference observed between the attitudes of the freshmen and the seniors was due to non-medical acculturative influences (such as the demographic characteristics unique to each group) and how much to the medical socialization procedure, was difficult to ascertain. More significant, however, was the lack of difference between the two student classes and the failure of three years of medical education to mitigate factors injurious to a major and growing segment of the population-aged patients.An extensive review of the current literature supports the contention that the medical care of aged patients in the United States (though not uniquely here) is characterized by negativism, defeatism, and professional antipathy. This state of affairs, opposed to ethic, and patently unacceptable in any other medical situation, is somehow complacently received and even considered somewhat justified in dealings with the old. The result is that therapy for the aged sick is often little better than palliative procrastination (1,2).The attitudes of the doctor and of the doctor-in-training toward the old

We investigated the association between the interleukin 6 (IL-6)-174-genotype and unfavorable outcomes in preterm infants since it has been reported that the IL-6-174GG-genotype is associated with increased susceptibility to sepsis, and the IL-6-174CC-genotype is more common in preterm infants with severe intraventricular hemorrhage (IVH). We studied 1206 preterm infants with a birth weight below 1500 g. In contrast to previously published data, the frequency of IVH grade IV, periventricular leukomalacia, ventricular-peritoneal-shunting or death was not different between infants with different IL-6-genotypes: IL-6-174GG (n ¼ 430) 8%, IL-6-174GC (n ¼ 605) 9% and IL-6-174CC (n ¼ 167) 12% (P ¼ 0.2 for IL-6-174CC vs GG þ GC). Furthermore, we were not able to confirm previously reported association between sepsis and the IL-6-174GG-genotype. Blood-culture-proven sepsis occurred in 19% of IL-6-174GG-carriers (n ¼ 157), 26% of IL-6-174GC-carriers (n ¼ 193) and 27% of infants carrying the IL-6-174CC-genotype (n ¼ 67). We were not able to confirm previously reported associations between sepsis, cerebral injury and the IL-6-174-genotype in VLBW-infants.

No abstract

Few data for normal urinary oxalate (Ox) and calcium (Ca) excretion related both to gestational age and nutritional factors have been reported in preterm or term infants. We therefore determined the molar Ox and Ca to creatinine (Cr) ratios in spot urines from 64 preterm and 37 term infants aged 1-60 days, either fed formula or human milk (HM). Only vitamin D was supplemented; renal or metabolic diseases were excluded. Urinary Ox/Cr ratio was higher in preterm than in term infants, both when formula fed (1st month 253 vs. 180 mmol/mol and 2nd month 306 vs. 212 mmol/mol; P<0.05) or HM fed (206 vs. 169 mmol/ mol and 283* vs. 232 mmol/mol; *P<0.05). Ox/Cr was also higher in formula- than HM-fed preterm infants. The ratio increased during the first 2 months of life irrespective of nutrition. Urinary Ca/Cr ratio was comparable in all groups during the 1st month of life, except for a lower (P < 0.05) value in term infants fed HM (0.10 mol/mol). It increased in all groups during the 2nd month of life, being highest in HM-fed preterm infants (1.86 mol/mol). In conclusion, urinary Ox and Ca excretion is influenced by both gestational age and nutrient intake in preterm and term infants.