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For health economic evaluations of rotavirus vaccination, estimates of the health and cost burden of rotavirus are required. Due to differences in health care systems and surveillance organisations, this is difficult to achieve by imputing estimates from one country to others. This study aimed to estimate the burden of rotavirus disease in Belgium. In children younger than 7 years of age, rotavirus is predicted to account annually for about 5,600 hospitalisations (676:100,000 children); 26,800 outpatient, general practitioner and paediatrician visits; and about 44,600 episodes for which no medical care is sought. This burden is estimated to represent direct costs of 7.7 million Euro and indirect costs of 12.8 million Euro. Rotavirus disease causes a substantial health and economic burden in Belgium. [ABSTRACT FROM AUTHOR]

Detailed knowledge of body composition in preterm neonates during their later postnatal period may be important for the treatment process. However, little consideration has been given to test whether bioelectrical impedance analysis (BIA) is a useful bedside method to predict fat-free mass (FFM). The aim of the study is to assess whether BIA is a bedside method to measure FFM in preterm neonates. FFM of 118 white subjects (51 males, 67 females), mean gestational age of 30.1±3.1 weeks and birth weight of 1.26±0.47 kg, was measured at a gestational age of 38.6±3.8 weeks and actual body weight of 2.6±0.54 kg using dual energy X-ray absorptiometry (FFMDXA). Weight (W), height (Ht), and bioelectric impedance (I) measurements were collected. Multiple regression analysis was performed to develop prediction equations to estimate FFM with impedance index (Ht2/I, cm2/Ω) and W (kg) as predictor variables. Bootstrap analysis was performed for validating the derived prediction equations. Correlations between FFMDXA and weight were 0.96, 0.98, and 0.97 in boys, girls, and both sexes, respectively. Those between FFMDXA and Ht2/I were: 0.73, 0.81, and 0.79. Equations used to predict FFM (kg) were for boys: $$ FFM = {0.05Ht^{2} } \mathord{\left/ {\vphantom {{0.05Ht^{2} } I}} \right. \kern-\nulldelimiterspace} I + 0.68W + 0.40{\left( {R^{2} = 0.919} \right)} $$ and for girls: $$ FFM = {0.04Ht^{2} } \mathord{\left/ {\vphantom {{0.04Ht^{2} } I}} \right. \kern-\nulldelimiterspace} I + 0.71W + 0.29{\left( {R^{2} = 0.957} \right)} $$ . Conclusions. In preterm neonates, weight is a more effective predictor of FFM than impedance index. The study provides a bedside procedure for estimating FFM, mainly based on anthropometric parameters rather than BIA. [ABSTRACT FROM AUTHOR]

This study was performed to prove the applicability of the small-for-gestational age (SGA), appropriate-for-gestational age (AGA), and large-for-gestational age (LGA) classification depending on birth weight to predict percentage body fat (%BF) measured by dual-energy X-ray absorptiometry (DXA) in term and preterm infants. The data of 159 healthy term and preterm neonates (87 boys and 72 girls) with a gestational age at delivery of 38.4 weeks from two longitudinal studies were analyzed. Anthropometry and body composition data were assessed within the first 10 days after birth. Correlations between anthropometric parameters and fat mass measured by DXA were calculated. Prevalences of observations with low, middle, and high %BF measured by DXA were compared between SGA, AGA, and LGA groups, according to sex and gestational age. In term infants, 42.9% of the newborns with less than 10% body fat were classified to be AGA; 9.9% of all AGA newborns had less than 10% body fat. For the whole group, among the ratios investigated, the weight-length ratio (r=0.82) showed the best correlation to fat mass measured by DXA. The %BF at the time of study was higher in girls (14.75%) than in boys (11.95%). In conclusion, traditional classification based on birth weight centiles does not reflect %BF in term and preterm newborns. [ABSTRACT FROM AUTHOR]

Mortality was studied in 504 infants weighing less than 1501 g at birth and treated in four neonatal intensive care units of South-Belgium between 1976 and 1980. Two hundred and twenty-one babies died during their stay at the hospital, a mortality rate of 438 per 1000 live births. The neonatal mortality rate (mortality during the first 28 days of life) was 373 per 1000 live-births. Thirty-three infants died after the neonatal period, which is 15% of the total number of deaths. Two-thirds of these post-neonatal deaths were related to complications of diseases associated with pre-term delivery. Mortality rates were higher in infants of less than 1001 g than in those of 1001-1250 g or 1251-1500 birth weight. In each birth weight category, patients born in their own obstetrical departments and referred infants has similar mortality rates. Longitudinal analysis showed improving mortality rates between 1976 and 1977 in the total population of VLBW infants, between 1977 and 1978 in infants of less than 1001 g and in 1980 compared to 1976 in the 1251-1500 g group. There were higher incidences of need for ventilatory assistance, patent ductus arteriosus, necrotising enterocolitis and septicaemia in referred patients of less than 1001 g than in patients born in their own obstetrical departments with comparable birth weight. Artificial ventilation was more often required in referred infants of 1251-1500 g. This study confirms the importance of considering at least the complete hospital stay when analysing mortality in VLBW infants. Infants of less than 1001 g had high mortality, particularly after the neonatal period.(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

Unlabelled: We wish to report two cases of congenital abnormality after antenatal car accidents resulting in ruptured spleen and severe hypotension in the mothers at 8 and 14 weeks gestation. The first case had the classical Moebius syndrome with 6th and 7th cranial nerve palsy with abnormal brain stem evoked responses, presumably due to hypoxic/ischaemic brain stem damage and the second case had severe retardation and hypertonic cerebral palsy which at post mortem was found to be due to old hypoxic/ischaemic lesions to the caudate nucleus putamen and striatum.Conclusion: The cases described provide evidence that severe maternal hypotension during pregnancy can be associated with lesions to the midbrain and brain stem of offspring. The mechanism is probably utero-placental insufficiency, and extrapolation from these two unusual cases would support utero-placental insufficiency as a cause of Moebius syndrome and limb deficiency after chorionic villus sampling. [ABSTRACT FROM AUTHOR]

Technological advances in the intensive care of low birth weight (LBW) infants have resulted in major increases in their survival. New challenges in meeting their nutritional needs have emerged. Very low birth (VLBW) weight infants have very little body fat or glycogen reserves at birth, making them susceptible to starvation. If fed enterally, they require at least 120 calories/kg per day for growth. Numerous immaturities in the gastrointestinal tract and liver limit protein digestion, absorption, and metabolism. Several amino acids not considered essential to the older child or adult are essential to the VLBW infant. Supplying a high protein load with an inappropriate amino acid composition may lead to metabolic imbalances. The digestion and absorption of fats differs from the older child or adult. Lingual and gastric lipases are important, and the lack of bile acids limits fat absorption. Lipoprotein lipase deficiency causes problems when too much fat or fat of incorrect composition is provided. There are controversies regarding the most appropriate carbohydrate source, but research shows that lactose remains an important carbohydrate source for most of these infants. Calcium, magnesium, and phosphorus requirements pose questions in both enterally and parenterally nourished infants. Studies of iron usage suggest that VLBW infants fed either human milk or formula should receive iron supplements. Vitamin E may be helpful in preventing oxygen toxicity. Vitamin D deficiency contributes to bone demineralization and rickets. Controversy exists regarding the correlation between vitamin A nutrition and development of chronic lung disease. Guidelines have been developed for recommended intakes, but much needs to be learned to provide a sound scientific basis upon which to provide optimal nourishment for the high risk, LBW infant. [ABSTRACT FROM AUTHOR]

Dry blood spot immunoreactive trypsin was measured by radioimmunoassay in 84 preterm babies and in 65 full-term newborns studied daily from the first to the fifth day of life. In a control group of 3858 full-term newborns, trypsin concentrations at days 4-6 of life exhibited a log-normal pattern distribution, the geometric mean being 18 ng/ml serum. Immunoreactive trypsin concentrations did not change significantly between days 1, 2, 3, 4 and 5 after birth. Immunoreactive trypsin was found to be significantly lower (geometric mean 9 ng/ml, P less than 0.01) in preterm newborns before 32 weeks of gestation. In hypotrophic newborns of 34 weeks gestational age, immunoreactive trypsin values were higher than those observed at 31 weeks of gestation in eutrophic newborns, the mean birth weight not being different between both groups. These data suggest that trypsin production by the pancreas is dependent on maturity but does not seem related to intrauterine nutritional status. Immunoreactive trypsin concentrations do not change after 32 weeks gestational age and during the first postnatal week. [ABSTRACT FROM AUTHOR]

We describe a child with multiple congenital anomalies born to a women treated with valproic acid (1000 mg/day) for post traumatic epilepsy. Defects included the typical dysmorphism of the 'fetal valproic syndrome', bilateral radial ray aplasia, unilateral proximal phocomelia of the upper limb, kidney hypoplasia and brain atrophy. A direct teratogenic effect of valproic acid is suspected on an experimental basis, and validated by two previous reports of radial defects after valproic acid exposure. [ABSTRACT FROM AUTHOR]