Archives of disease in childhood
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The association between patterns of milk intake and anaemia was studied during a surveillance programme for iron deficiency anaemia. Children aged 8-24 months were examined when they attended a routine immunisation clinic. Haemoglobin was measured on finger prick blood samples using a portable haemoglobinometer, and a dietary questionnaire was completed, with special emphasis on the type and volume of milk intake and the age at which whole cows' milk was introduced. ⋯ Continued feeding with breast milk and the early introduction of whole cows' milk were associated with a significantly higher prevalence of anaemia. No child taking formula milk was anaemic. Asian children drank significantly more milk a day than other groups, but there was no correlation between daily milk intake and haemoglobin concentration.
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An infant girl with arachnodactyly, spontaneously resolving contractures, dolichostenomelia, iridodonesis, and mitral and tricuspid incompetence died in cardiac failure. We confirm that congenital contractural arachnodactyly may exhibit serious cardiovascular and ophthalmic complications like Marfan's syndrome. The presence of iridodonesis further obscures the differentiation between classical Marfan's syndrome and congenital contractural arachnodactyly.
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Manipulation of carbohydrate intake was used to treat severe, recurrent D-lactic acidosis in a patient with short bowel syndrome. Dietary carbohydrate composition was determined after assessment of D-lactic acid production from various carbohydrate substrates by faecal flora in vitro. This approach may be preferable to repeated courses of antibiotics.
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Thirty seven healthy infants (18 born at full term and 19 preterm) were studied serially with cross sectional and Doppler echocardiography to compare their postnatal circulatory adaptation. Pulmonary artery pressure was assessed by its inverse relationship with the ratio of pulmonary artery time to peak velocity and right ventricular ejection time measured from Doppler waveform. Patency of the ductus arteriosus and interatrial shunting were assessed by imaging and Doppler ultrasound. ⋯ There was a trend towards later ductal closure in the preterm infants but this was not significant. Atrial shunting level varied, but some left to right shunting was seen in all infants satisfactorily studied. Pulmonary artery pressure seems to fall more slowly after preterm birth even in the absence of respiratory problems, but ductal shunting persisting for more than three days is unusual in healthy preterm infants.