Summary The aim of the present investigation, concerned with 279 girls with their first‐time, or in a few cases second‐time urinary tract infection, was to explore the possibility to improve the “1‐year cure rate” by means of long‐term sulfonamide therapy (2 months) instead of short‐term sulfonamide therapy (10 days). A “1‐year cure” was then defined as an eradication of the index infection and freedom from infection during the following year. The “1‐year cure rate” was found to be equal in the two therapy groups i. e. 64 per cent. The material showed some characteristics which might permit some general statements about uncomplicated first or second‐time urinary tract infections in girls. The material showed a marked predominance of the younger age groups. This finding is discussed with regard to the pathogenesis of urinary tract infection. The bacteria isolated at the initial infections were in 90 percent E. coli and also in 90 per cent sensitive to sulfonamide. Thus for the present there is no reason to abandon sulfonamide as the drug of choice in uncomplicated first‐time infections in girls. The first recurrence had a tendency to appear shortly after the original infection rather than late. Observations suggest that recurrences, even those occurring immediately after cessation of therapy, were usually a reinfection and not a recrudescence. These findings are discussed in relation to the pathogenesis of recurrent urinary tract infections. The first recurrence was in 1/3 of the cases asymptomatic, in the other 2/3 symptomatic. During long term prophylaxis asymptomatic infections even outnumbered the symptomatic ones. Therapy thus may mask an infection. The bacteria isolated at the first recurrences after the index infection were in 30–90 per cent resistant to sulfonamide, the rate being related to the time interval between the cessation of therapy and the recurrence. The therapeutic consequences of the difference in sulfonamide sensitivity of the initial infection and the recurrences are discussed.
Summary A description is given of a census investigation of imbecility and idiocy within a group of children comprising 10 one‐year classes in a population of altogether 265,000 individuals in Sweden. The incidence of mental subnormality of these degrees was 7.1 per 1,000 boys and 5.8 per 1,000 girls in the ages 2–11 years. The distribution of different clinical types in this material was studied and the educability in the different clinical groups is discussed. The occurrence of complications concerning pregnancy, delivery and birth weight, as well as of signs of cerebral injury during the first week of life, was investigated in certain groups of the material. Half of the cases in the sporadic idiopathic oligophrenic group had early potential injury or signs of cerebral injury of the type described above. In a control material of unselected newborns, the corresponding figure was only 20 per cent. A comparison with a special, unselected series of children with cerebral palsy seemed to show that abnormal conditions concerning pregnancy, child birth and birth weight can be traced in sporadic idiopathic imbecility and idiocy almost as often as in cerebral palsy. Etude de groupe du retard intellectuel chez l'enfant. Investigation statistique de l'imbecillité et de l'idiotie dans un groupe d'enfants, comprenant 10 classes d'un an, et issus de 265000 parents suédois. La fréquence de tels retards intellectuels entre 2 et 11 ans, peut être fixée à 7,1 pour mille chez les garcons, et 5,8 pour mille chez les filles. La répartition des divers types cliniques, ainsi que les possibilités éducatives de chaque groupe ont étéétudiées. L'existence de facteurs étiologiques a été recherchée, notamment au cours de la grossesse ou de l'accouchement, le poids de naissance, et les signes de traumatisme cérébral observés dans la première semaine. Dans 50 % des cas d'oligophrénie essentielle, on retrouvait des signes de maladie cérébrale précoces. Ce pourcentage dans un groupe de nouveauxnés témoins n'était que de 20 %. La comparaison avec un groupe d'enfants atteints de «paralysies cérébrales» semble montrer que de sfacteurs anormales en connection avec la grossesse et l'accouchement pathologique ou la prématurité peuvent étre trouvés presque aussi frequents dans l'imbécillité et l'idiotie sporadiqvie que dans la paralysie cérébrale. Eine Übersichtsstudie über die geistige Unterentwicklung bei Kindern. Beschrieben wird eine statistische Untersuchung über das Vorkommen von Imbezilität und Idiotie unter einer Gruppe von Kindern, welche 10 Ein‐Jahr Klassen einer Bevölkerung von insgesamt 265000 Menschen in Schweden umfasst. Die Häufigkeit geistiger Unterentwicklung dieser Schweregrade betrug 7,1 auf 1000 Jungen und 5,8 auf 1000 Mädchen in den Altersstufen zwischen 2. bis 11. Lebensjahr. Die Verteilung der verschiedenen klinischen Gruppen in dieser Serie wurde studiert vind die Erziehungsmöglichkeiten der verschiedenen klinischen Gruppen diskutiert. Bei gewissen Gruppen dieser Untersuchungsreihe wurde das Vorliegen von Komplikationen in der...
Summary The methods of estimating and indicating the prevalence of cerebral palsy in a population are critically discussed. A survey is given of the occurrence of cerebral palsy in a 10‐year group of a population of 265,000 individuals in Sweden. The incidence of cerebral palsy was here 2.1 per 1000 children in the ages 2–11 years. In two thirds of the cases prematurity, illness of the mother during pregnancy or an abnormal obstetrical history was shown to have been present. Mental defects, corresponding to I.Q.<70, occurred in 57 per cent and low grade mentality (I.Q. <50) in 38 per cent of the cases. La fréquence des encéphalopathies chroniques de l'enfance. L'auteur discute les méthodes employées pour estimer et déterminer la fréquence de la paralysie par encéphalopathie dans une population. On a étudié la fréquence de la paralysie par encéphalopathie dans un groupe d'enfants âgés de dix ans parmi une population de 265.000 habitants en Suède. Elle était de 2,1 pour mille enfants âgés de 2 à 11 ans. Dans deux tiers des cas on a retrouvé dans l'anamnèse la prématuration, une maladie de la mère pendant la grossesse ou des difficultés obstétriquales à la naissance. Dans 57 % des cas il y avait une déficience mentale correspondant à un quotient d'intelligence inférieur à 70, dans 38 % des cas il y avait débilité mentale marquée (quot. d'intell. inférieur à 50). Die Verbreitung der cerebralen Kinderlähmung (Morbus Little). Die Methoden zur Schätzung der Verbreitung der cerebralen Kinderlähmung in einer Bevölkerungsgruppe werden kritisch beurteilt. Es wird ein Uberblick über die Häufigkeit der cerebralen Kinderlähmung in einer 10 Jahre umfassenden Bevölkerungsgruppe von 265000 Einwohnern in Schweden gegeben. Die Häufigkeit der cerebralen Kinderlähmung betrug hier 2,1 pro 1000 Kinder im Alter von 2–11 Jah‐ren. In zwei Drittel der Fälle fand man Prämaturität, Krankheit der Mutter während der Schwangerschaft oder einen anormalen Geburtsverlauf. Geistige Defekte, einem I.Q. <70 entsprechend, traten in 57 % der Fälle auf, und Geistesschwäche (I.Q. <50) in 38 % der Fälle. La incidencia de parálisis cerebral. Se discuten los métodos de estimación de la incidencia de parálisis cerebral en una población. Se relata un estudio de la ocurrencia de parálisis cerebral en un grupo de personas cuyas edades abarcaban un periodo de 10 años, en una población de 265.000 individuos, en Suecia. La incidencia de parálisis cerebral fué de 2,1 por 1000 niños en las edades de 2 a 11 años. En dos tercios de los casos se encontraron prematurez, enfermedad de la madre durante la gravidez o una historia obstétrica anormal. De‐fectos mentales correspondiendo a I.Q. 70 se encontraron en 57 % y una mentalidad de bajo grado I.Q. 50 se encontre en 38 % de los casos.
SUMMARY A clinical and pathologico‐anatomic syndrome resembling that occurring in offspring of diabetic and prediabetic mothers has been described in two overweight newborn sisters. Both patients had convulsions and died during the neonatal period. In one of them where blood glucose determinations were performed a marked hypoglycemia was diagnosed. Since the mother has given birth to quite normal infants between and after the diseased children and because of the fact that there is no evidence of a prediabetic state it is suggested that the syndrome has developed as a consequence of some other metabolic error. The fact that the parents are first cousins supports the supposition that the disease may be genetically determined.
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