Lancet
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The aminoacid excretion levels of 59 normal and 75 physically and/or mentally handicapped children were measured with ion-exchange chromatography. A computer-assisted statistical analysis of the results from the normal population was used to calculate an approximating frequency distribution. 18 patients were found to be excreting one or more aminoacids above the normal 99.75th or 100th percentiles. They included 1 with dibasic aminoaciduria; 1 six-year-old with phenylketonuria; 1 with hyperphenylalaninuria; 5 with cystathioninuria; 2 with hyperglycinuria; 1 with hyperglycinuria and hypertaurinuria; 5 with hypertaurinuria; 1 excreting high levels of taurine, serine, tyrosine, and histidine, and 1 with asparaginuria.
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During 1971-77 the incidence of bacterial meningitis among Alaskan Eskimos was 84.4 cases per 100 000 population per year, which is more than 10 times that for most other U. S. populations. Haemophilus influenzae (HI) accounted for 68% of meningitis cases. ⋯ S. populations (p less than 0.005). The pharyngeal carriage of HI type b (5%) and the rectal carriage of Escherichia coli K100 (2%), an organism with a capsule antigenically similar to HI type b, did not differ from those in other populations. The high incidence of disease almost exclusively in the very young and the early development of antibody in this population suggest that the high rate of disease is due to early exposure to HI type b rather than to an unusual susceptibility to HI type b.
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A linear-array real-time ultrasound scanner was used to examine the brains of all 95 infants born at less than 33 weeks of gestation who were admitted to the neonatal unit of University College Hospital in 1979. Abnormalities were detected in 41 (43%). 36 infants had haemorrhages into the germinal layer (GLH) and/or ventricles (IVH). 8 infants had cerebral atrophy (together with GLH/IVH in 5 infants). 8 (13%) of 63 infants with normal scans or small (grade-I) GLH/IVHs died, whereas 19 (59%) of 32 infants with larger haemorrhages or other intracranial lesions died (p less than 0.0005). At follow-up, at a median corrected age of 45 weeks, only 2 (4%) of 53 infants with normal scans or grade-I haemorrhages had evidence of major neurodevelopmental handicaps, but 5 (38%) of 13 infants with more extensive haemorrhages or cerebral atrophy had major handicaps (p less than 0.005). Brain scanning with ultrasound in the first days of life identified most infants in the population studied who subsequently died or survived with handicaps severe enough to be detected within the first year.