[Functional constipation with encopresis. Management of children at an outpatient clinic].
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Biomedical subjects
Publications and source records attributed to A F Bakken.
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A one year prospective study of all children under 15 years of age presenting for acute poisoning in Oslo is reported. There were 181 admissions in 179 children, of which 97 (54%) were boys, giving an annual incidence of 2.3%. All children survived without sequelae. Most poisonings were accidental and only two suicidal attempts were recorded. Of all poisonings 68 per cent occurred between the age of 1 and 2 years. The dominating toxic agents were drugs (44%), tobacco (22%) and petroleum products (9%). Most poisonings were mild and only 7 (4%) classified as severe. Seventy-two per cent of all children were admitted within the second hour after the ingestion of the toxic agent. Therapy should therefore be directed towards emptying the stomach with emetics or gastric lavage, unless corrosives or petroleum products are ingested. Childhood poisonings still call for better preventive measures since the toxic agent was found inappropriately stored in 86% of the accidental poisonings.
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A new use of the histochemical method for intestinal lactase activity is described. Peroral intestinal biopsies from newborn light-treated infants with diarrhoea were investigated for brush-border lactase. The lactase activity found in these infants by the histochemical method correlated well with the infants ability to hydrolyze lactose judged by lactose tolerance test.
The intestinal lactase activity in six newborn jaundiced light-treated infants with diarrhea and in eight normal controls were compared by lactose tolerance test (LTT). The ability to hydrolyze lactose was minimal in the jaundiced infants during light-treatment compared to the controls which could absorb lactose very well. Peroral intestinal biopsies were taken from the newborn jaundiced infants during light-treatment. By histochemical technique no intestinal lactase activity was found in these intestines. When the jaundiced infants with diarrhea were given lactose-free diet, the stools normalized. The effect was reversed when breast milk was given while the baby was still jaundiced and light-treated. These findings indicate that the increased amounts of unconjugated bilirubin in the intestine of jaundiced infants during light-treatment inhibit the intestinal brush-border lactase. When the icterus fades the lactase is again active. The practical consequence is to give light-treated infants lactose-free diet if they get diarrhea, and to reintroduce breast milk or other lactose containing diet when the baby is no longer icteric.
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Fifty samples of human breast milk were analysed by gas chromatography and thin layer chromatography for DDT (dichlordiphenyltrichloraethan), hexachlorobenzol, benezene-hexachlorides, dieldrin, aldrin and heptachlorepoxide. The three first substances were found in all samples in amounts varying from quite small up to eleven times the WHO recommended maximum for cow milk. The other substances were found in fewer milk samples, however, in some of these samples they were found in relatively high amounts. In Norway, only DDT has been investigated earlier (4), and compared to that study, there has been no significant change in the mean concentration of DDT in human breast milk during the last five years. The insecticide content was highest in colostrum and decreased with increasing duration of lactation. Considerable fluctuations in the content of insecticides were recorded in repeated milk samples collected from the same woman a few days apart. The percentage of samples with insecticide content higher than that permitted for cow's milk was greater in May/June (79%) than in early April (54%). The significance of these findings is discussed.
A case of general yersinosis in a male physician is described. Most probably the infection was acquired nosocomially in a paediatric ward. The infection affected several organs including the liver, but osmium tetroxide was nevertheless used to perform chemical synovectomy in a knee joint suffering from active arthritis. The arthritis was cured, and the already existing liver affection did not progress. The only complaint from the patient, months after the osmic acid injection, was a strong metallic taste on the tongue. More than a year after the intra-articular injection, the metallic taste disappeared. The amount of osmium in the patient's blood was then calculated to be less than 100 molecules of osmium per ml blood.
A method is described for an exact and rapid determination of bilirubin in the amniotic fluid. Errors due to turbidity and to contamination of hemoglobin or debris are elliminated because bilirubin is extracted directely into chloroform by a special technique and determined by direct spectrophotometry. The new technique is related to the well known Liley procedure and the results with the new method are plotted into a modified Liley-sceme.
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