The findings of increasing first admission rate as well as overall admission rate for acute asthma in children under 4 years of age, but decreasing readmissions as well as number of treatment days in hospital, probably reflect changes in the management of the disease, as well as an increasing prevalence of childhood asthma.

No abstract

Respiratory syncytial virus (RSV) infection was diagnosed in 464 children admitted to hospital with acute respiratory disease from autumn 1972 to spring 1978. The virological surveillance was approximately 70%. As a rule, RSV infections occurred in distinct outbreaks in late autumn and winter together with a marked increase in the number of children admitted to hospital with acute lower respiratory tract disease. The incidence in children less than 1 year of age was about 10/1000 children/year. Spread of the infection from one end of the city to the other was discernible in 2 outbreaks. More children than expected with siblings were admitted to hospital because of RSV infection, but no correlation could be observed with some other socioeconomic factors. A negative correlation was observed between RSV disease and mean air temperature and hours of sunshine per month. Rapid immunofluorescence diagnosis of RSV on cells from nasopharyngeal secretions was adopted and became comparable to cell culture technique. The rapid method has become an important adjunct to the clinical management of these patients and the method will form the basis for further epidemiological studies.

Plasma and red cell folate concentrations (lactobacillus casei activity) and other pertinent blood values have been studied during the 1st year of life in 41 premature infants (mean gestational age 31.6, range 26-35 weeks). They were formula-fed, 48.5 nmol (21 micrograms) folate per 1, from 1 month of age. The infants were divided into two groups according to their birth weights (BW): group A, BW less than or equal to 1750 g and group B, BW greater than 1750 g, respectively. One-half of the infants in each group received an extra 113.5 nmol (50 micrograms) folic acid daily. The premature infants were compared with 35 breast-fed term infants considered to have an optimal folate status. The infants not receiving folic acid supplementation had low plasma and red cell folate concentrations during the first months of life, while those receiving supplementation had values comparable to the breast-fed infants. No significant differences in the gain in weight and increase in length were observed when the folic acid supplemented infants in group A were compared with the non-supplemented infants. However, in the case of group B a significant increase in length and a somewhat greater weight gain were observed for infants with folic acid supplementation in comparison with those not given extra folate. No significant differences were observed between the haemoglobin, RBC and VPRC values in the folic acid supplemented and non-supplemented infants. It is estimated that the optimal folate intake during the first months of life in formula-fed premature infants is about 150 nmol (65 micrograms) per day. This amount is higher than previously recommended. The infants from all groups had a folate intake similar to, or above, the minimal daily requirement needed for erythropoiesis.

Fourteen infants with birth weight appropriate for gestational age (AGA) and 16 small for gestational age (SGA) infants were investigated for haemoglobin concentration, haematocrit level and thrombocyte count on the first day of life. Cord serum was tested for erythropoietin (ESF) and thrombopoietin (TSF) activity. The same investigations were performed on venous blood and serum from 18 healthy adult individuals. SGA infants had higher haemoglobin concentration and haematocrit level (p less than 0.05), and lower platelet count (p less than 0.001) than AGA infants. Significant ESF activity was present in cord serum, but was not detectable in serum from adults. Significant TSF activity was present in cord serum as well as in serum from adults, with higher levels in the newborn infants (p less than 0.05). An inverse relationship was found between serum TSF activity and the number of platelets in adults, which was not demonstrable in newborn infants. Long-term intrauterine hypoxia because of placental dysfunction may be the reason for polycythemia and thrombocytopenia in SGA infants. Thrombocytopenia may be caused by competitive mechanisms on common stem cells for erythropoiesis and thrombopoiesis, shunting stem cells in direction of erythropoiesis during hypoxic exposure. Normal serum TSF activity in SGA infants indicates that lack of the humoral factor for platelet production is not the reason for the thrombocytopenia in these infants. A negative feed-back mechanism may exist between platelet number and TSF production.