Summary Out of 448 cases of febrile convulsions admitted to the Children's Hospital, Gothenburg, during 1945–1954, at least 7.6% (34 cases) occurred in connection with exanthema subitum. Among the children with febrile convulsions who were 12 months old or younger, exanthema subitum was the cause of fever in 16.2%. The 34 cases of exanthema subitum had a median age of 12.5 months, the remaining 414 children with convulsions had a median of 20.8 months. Exanthema subitum is supposed to cause convulsions not only because of fever, but because of a specific cerebral effect. Persisting cerebral lesions may occur, resulting in new attacks of convulsion later on. Sur 448 cas de convulsions fébriles admis à l'hopital de Gothembourg au cours des années 1945 à 1954, 7,6% d'entr'eux au moins présentaient une association avec un exanthème subit. Cet exanthème était la cause de l'hyperpyrexie dans 16,2% des cas, chez les enfants d'un âge égal ou supérieur à 12 mois. L'âge moyen des enfants présentant de l'exanthème subit était de 12,5 mois, et celui des autres de 20,8 mois. L'exanthème subit semble être la cause des convulsions; non, par la fièvre qui s'y associe, mais en raison d'une atteinte cérébrale spécifique. Des lésions cérébrales peuvent d'ailleurs persister, provoquant de nouveaux accés convulsifs, ultérieurement.
A physician with a clientele of children does not seldom come across infants with symptoms which resemble or are identical with those of asthma or asthmatic bronchitis seen in later years. The infant coughs, has obvious expiratory dyspnoea and, if it does not cry a t examination, ample sibilant rhonchi are heard diffusely over the lungs during expiration. Sometimes the patient has fever and signs of upper respiratory infection, sometimes not, An acute, diffuse bronchitis involves the secretion of viscous mucus and pronounced swelling of the mucous membrane to such an extent that a relative stenosis in the fine bronchi is present. Moreover, the bronchi are narrower on expiration than on inspiration, which explains the expiratory dyspnoea and other physical findings. The physician mentions spasm in the bronchi, speaks of allergy, and perhaps makes the diagnosis of asthma or asthmatic bronchitis which may "grow away" or possibly have a worse prognosis. The parents, perhaps having had experience with asthma, look towards a dismal future and might be more pessimistic than is necessary. What is the prognosis for infants with this clinical picture? Is there a great risk that an invalidizing asthma will develop? To try to elucidate these questions, this investigation has been performed. Earlier InvestigationsDiagnosis.-Certain authors are of the opinion that bronchial asthma is a very rare illness during the age of infancy, if it occurs a t all (FINKELSTEIN). Others, probably the majority, believe that asthma may very well develop during the first year of life (cf. BROCK, BUFFUM). BRAY mentions that of 1,390 cases of asthma during childhood 22.25 per cent startcd before the age of one year. It is impossible distinctly to define the diagnoses bronchial asthma and asthmatic bronchitis (spasmodic bronchitis) of different types in the infant (BAAGOE). RATNER, among others, points out that many illnesses in the infant may cause an asthma picture. He also believes that a definite diagnosis of asthma should not be made on the basis of an isolated 27-553605A4cln Fadiatrica Val. X L I V
Summary The positive facial phenomenon or Chvostek's symptom is not infrequently demonstrable in infants and children under 2 years of age without any co‐existent symptoms suggestive of infantile tetany. The phenomenon may be elicited in unchanged form for many years. It thus seems as if its presence in the spasmophilic age may be of the same innocent nature as it is in older children. Neither does it seem to be pathognomonic of neuropathy. Résumé II n'est pas rare que ľon puisse constater le signe facial, ou symptôme Chvostek, chez des nourrissons ou des enfants au‐dessous de 2 ans, sans la coexistence de symptômes causés par la tétanie infantile. Le signe peut subsister de nombreuses années sous sa forme primitive, inchingée. II semble done que sa présence àľàge de la spasmophilic puisse être de la même nature anodine que chez les enfants plus àgés. II ne semble pas non plus ètre pathognomonique de la neuropathic Zusammenfassung Das positive Facialisphänomen oder Ohvosteks Symptom kann relativ oft bei Säuglingen und Kindern unter 2 Jahren nachgewiesen werden ohne dass gleiehzeitig Symptome infantiler Tetanie vorhanden sind. Das Phänomen kann in unveränderter Form jahrelang bestehen bleiben. Es sclieint also das Vorhan‐densein desselben im Spasmophilic—Alter derselben harmlosen Natur zu sein wie bei älteren Kindern. Auch scheint es nicht pathognomonisch zu sein für eine Neuropathic. Resumen El fenómeno positivo, facial, del síntoma de Chvostek se puede muchas veces observar en criaturas y niños de menos de 2 años de edad, sin ningún otro síntoma coexistente, sugestivo de tetania infantil. El fenómeno so puede edueir en forma inalte‐rada durante muchos años. Parece, por consiguiente, que su presencia durante la edad espasmofílica es de la misma naturaleza inofensiva que en niños de mayor edad. Tampoco parece ser patognomónico de neuropatia.
Summary The author analyses and discusses a 10 year series of 952 premature live‐births from a Swedish district hospital where the percentage of prematures was 5.4%. The author shows that multiple births are partly responsible for prematurity and that the mothers of prematures are more frequently unmarried. The total mortality at the hospital was 21.6%, the death rate being 12.3% for the first day and 17.9% for the first week. The death rate of boy infants was significantly higher than that of girls. Obstetric intervention did not increase mortality, probably because in intervention cases the infants' birth weights were higher. The mortality rate of the infants of mothers with nephropathia gravidarum seemed lower, presumably because of longer intra‐uterine life. The author also reports 176 premature still‐births from the same period, but with a weight distribution different from that of the live‐births and a lower percentage of multiple births. The mothers of still‐births were relatively older and more frequently married. Nephropathia gravidarum was present in the mothers of 22.7% of the still‐births. Finally, the results are compared with the figures of earlier authors. The author recommends standardization of relevant definitions and registration methods so that the true prognosis of the premature may be established and the efficacy of modern therapeutic measures judged. YLPPÖ's nomenclature is recommended. Résumé L'auteur analyse et discute une série de dix ans comprenant 952 cas de naissance avant‐terme d'enfants vivants dans un hôpital de district suédois où le pourcentage des accouchements avant‐terme était de 5,4. L'auteur démontre que les naissances multiples sont en partie la cause d'accouchements prématurés et que les mères d'enfants nés avant‐terme le plus souvent ne sont pas mariées. La mortalité totale à l'hôpital était de 21,5%, le pourcentage étant de 12.3% pour le premier jour et de 17,9% pour la première semaine. Le pourcentage de décès des enfants mâles était sensiblement plus élevé que celui des filles. Les interventions obstétricales n'ont pas augmenté la mortalité, probablement parce que dans les cas d'intervention le poids des enfants à la naissance était plus élevé. Le pourcentage de mortalité chez les enfants de mères atteintes de néphropathia gravidarum semblait plus bas, probablement à cause de la période plus longue de vie intrautérine. L'auteur rapporte aussi 176 cas de naissance avant‐terme d'enfants mort‐nés pendant la même période, mais présentant une répartition de poids différente de celle des naissances d'enfants vivants et un pourcentage plus bas de naissances multiples. Les mères d'enfants mort‐nés étaient relativement plus âgées et plus fréquemment mariées. On a constaté de la nephropathia gravidarum chez les mères de 22,7% des enfants mort‐nés. Finalement on établit une comparaison avec les résultats et les chiffres obtenus par des auteurs antérieurs. L'auteur recommande la standardisation des définitions pertinentes et des méthodes d'enregistrement afin de permettre une prog...
According to RITSCH (4) the initial loss in weight of newborns during the first few days of life is on an average 7.31 per cent of the birth weight. GYLLENSWARD (2), who studied newborns with a birth weight exceeding 2 200 g, estimates the initial loss in weight t o be 6.21 per cent 0.07. The smaller the birt8h weight was, the smaller was the loss per cent.Opinions differ concerning the initial loss in weight of prematurely born infants. Some authors consider the loss t o be proportionally larger than in full-term infants, possibly proportional t o a relatively larger body surface, whilst others (RUSCH (4) et al.) contend that premature children lose less weight, the loss decreasing with diminishing birth weight.
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