358
Letters to the Editor
exchange transfusion, no screening for HBsAg was performed on the blood used for the procedures. ++ Thus, it is uncertain that HB~Ag positive blood was administered to those patients. That the infant reported herein did not develop hepatitis is an important observation to document for prognostic purposes, inasmuch as a vulnerable host received a maximum exposure to HBsAg. Of course, we recommend neither exchange nor direct transfusion of infants with blood containing hepatitis antigen.
Charles L. Paxson, M.D. Frank H. Morriss, Jr., M.D. Eugene W. Adcock, HI, M.D. Department of Pediatrics University of Texas Medical School at Houston Houston, Texas 77025 REFERENCES
1. Walsh JH, Purcell RH, Morrow AG, Chanock RM, and Schmidt PJ: Post transfusion hepatitis after open-heart operations, JAMA 211:261, 1970. 2. Koretz RL, Klahs DR, Ritman S, Damus KH, and Gitnick GL: Posttransfusion hepatitis in recipients of blood screened by newer assays, Lancet 2:694, 1973. 3. Reinicke V, Dybkjaer E, Poulsen H, Banke O, Lylloff K, and Nordenfelt E: A study of Australia-antigen-positive blood donors and their recipients, with special reference to liver histology, N Engl J Med 286:867, 1972. 4. Kaftan D, and Gladtke E: Hepatitis nach Austauschtransfusion, Arch Kinderheilkd 181:119, 1970. 5. King EA, Alter AA, Schwartz O, and Fishman SA: Post exchange transfusion hepatitis in the newborn infant, J PEDIATR 83:341, 1973. 6. Kattamis C, Demetrios D, Davri-Karamouzi Y, and Matsaniotis N: Neonatal hepatitis associated with Australia antigen (Au-1), Arch Dis Child 48:133, 1973.
Intussusception and nutritional status
The Journal of Pediatrics February 1976
Table I.
D i s t r i b u t i o n o f c h i l d r e n a c c o r d i n g to w e i g h t
percentile
Weight percentile 97
CCH 5 3 4 0 2 1 4 2 5 1 2 0 0 0 0 29
I
CMH 6 4 5 3 14 2 13 2 8 2 7 0 3 1 2 72
I Suburban I 2 2 0 0 4 0 4 1 2 1 3 0 0 0 1 20
Total 11 7 9 3 16 3 17 4 13 3 9 0 3 1 2 101
one hundred and one o f them had their weights recorded on admission. Analysis of weight percentiles on date of admission revealed: (1) that two-thirds of the children from each hospital were below the fiftieth percentile (2) that as a group 60% of the suburban children were below the fiftieth percentile (3) that 70% of the children with specific lead point lesions (e.g., Meckel diverticulum or polyp) had weight percentiles below the fiftieth percentile, and (4) that 41.2% of the CCH children and 25% of the CMH children representing 29.5% of the entire group were at or below the tenth percentile (Table I). The assumption that a majority of the children with intussusception will be "well nourished" and have high weight percentiles is not verified by this study. Even more significant is the high incidence of children at or below the tenth percentile. Therefore, though healthy by history and appearance, children with intussusception may be poorly nourished or well nourished.
Joseph S. Janik, M.D. Hugh K Firor, M.D. Division of Pediatric Surgery Cook County Hospital Department of General Surgery Children's Memorial Hospital 1825 W. Harrison St. Chicago, Ill. 60612
To the Editor: Intussusception is a common cause of intestinal obstruction in infancy and childhood. Characteristically male children are afflicted more frequently with the highest incidence occurring in the latter half of the first year of life. From the time of Hirschprung these children have been described as being well nourished or of superior nutrition. 1-~ In fact Hirschprung reportedly said that he never saw a case of intussusception in a malnourished child? To substantiate this state of good nutrition, a review of all children admitted between January, 1964, and December, 1973, to the Cook County Hospital (CCH) and the Children's Memorial Hospital (CMH), Chicago, with documented intussusception, was undertaken. Using the anthropometric scales of the Children's Medical Center, Boston, the state of nutrition was recorded in terms of weight percentile on the date of admission. One-hundred and eight children were studied; the weights of
Number of children from:
REFERENCES
1. Ein SH, and Stephens CA: Intussusception: 354 cases in 10 years, J Pediatr Surg 6:16, 1971. 2. Ravitch MM: Pediatric surgery, Chicago, 1969, Yearbook Medical Publishers, Inc, p 914. 3. Ravitch MM, and McCune RM: Intussusception in infants and children, J PEDIATR 37:153, 1950. 4. Swenson O, and Oeconomopoulos CT: The operatiVe treatment of acute intussusception in infants and young children, Am J Surg 103"599, 1962.
Letters to the Editor
exchange transfusion, no screening for HBsAg was performed on the blood used for the procedures. ++ Thus, it is uncertain that HB~Ag positive blood was administered to those patients. That the infant reported herein did not develop hepatitis is an important observation to document for prognostic purposes, inasmuch as a vulnerable host received a maximum exposure to HBsAg. Of course, we recommend neither exchange nor direct transfusion of infants with blood containing hepatitis antigen.
Charles L. Paxson, M.D. Frank H. Morriss, Jr., M.D. Eugene W. Adcock, HI, M.D. Department of Pediatrics University of Texas Medical School at Houston Houston, Texas 77025 REFERENCES
1. Walsh JH, Purcell RH, Morrow AG, Chanock RM, and Schmidt PJ: Post transfusion hepatitis after open-heart operations, JAMA 211:261, 1970. 2. Koretz RL, Klahs DR, Ritman S, Damus KH, and Gitnick GL: Posttransfusion hepatitis in recipients of blood screened by newer assays, Lancet 2:694, 1973. 3. Reinicke V, Dybkjaer E, Poulsen H, Banke O, Lylloff K, and Nordenfelt E: A study of Australia-antigen-positive blood donors and their recipients, with special reference to liver histology, N Engl J Med 286:867, 1972. 4. Kaftan D, and Gladtke E: Hepatitis nach Austauschtransfusion, Arch Kinderheilkd 181:119, 1970. 5. King EA, Alter AA, Schwartz O, and Fishman SA: Post exchange transfusion hepatitis in the newborn infant, J PEDIATR 83:341, 1973. 6. Kattamis C, Demetrios D, Davri-Karamouzi Y, and Matsaniotis N: Neonatal hepatitis associated with Australia antigen (Au-1), Arch Dis Child 48:133, 1973.
Intussusception and nutritional status
The Journal of Pediatrics February 1976
Table I.
D i s t r i b u t i o n o f c h i l d r e n a c c o r d i n g to w e i g h t
percentile
Weight percentile 97
CCH 5 3 4 0 2 1 4 2 5 1 2 0 0 0 0 29
I
CMH 6 4 5 3 14 2 13 2 8 2 7 0 3 1 2 72
I Suburban I 2 2 0 0 4 0 4 1 2 1 3 0 0 0 1 20
Total 11 7 9 3 16 3 17 4 13 3 9 0 3 1 2 101
one hundred and one o f them had their weights recorded on admission. Analysis of weight percentiles on date of admission revealed: (1) that two-thirds of the children from each hospital were below the fiftieth percentile (2) that as a group 60% of the suburban children were below the fiftieth percentile (3) that 70% of the children with specific lead point lesions (e.g., Meckel diverticulum or polyp) had weight percentiles below the fiftieth percentile, and (4) that 41.2% of the CCH children and 25% of the CMH children representing 29.5% of the entire group were at or below the tenth percentile (Table I). The assumption that a majority of the children with intussusception will be "well nourished" and have high weight percentiles is not verified by this study. Even more significant is the high incidence of children at or below the tenth percentile. Therefore, though healthy by history and appearance, children with intussusception may be poorly nourished or well nourished.
Joseph S. Janik, M.D. Hugh K Firor, M.D. Division of Pediatric Surgery Cook County Hospital Department of General Surgery Children's Memorial Hospital 1825 W. Harrison St. Chicago, Ill. 60612
To the Editor: Intussusception is a common cause of intestinal obstruction in infancy and childhood. Characteristically male children are afflicted more frequently with the highest incidence occurring in the latter half of the first year of life. From the time of Hirschprung these children have been described as being well nourished or of superior nutrition. 1-~ In fact Hirschprung reportedly said that he never saw a case of intussusception in a malnourished child? To substantiate this state of good nutrition, a review of all children admitted between January, 1964, and December, 1973, to the Cook County Hospital (CCH) and the Children's Memorial Hospital (CMH), Chicago, with documented intussusception, was undertaken. Using the anthropometric scales of the Children's Medical Center, Boston, the state of nutrition was recorded in terms of weight percentile on the date of admission. One-hundred and eight children were studied; the weights of
Number of children from:
REFERENCES
1. Ein SH, and Stephens CA: Intussusception: 354 cases in 10 years, J Pediatr Surg 6:16, 1971. 2. Ravitch MM: Pediatric surgery, Chicago, 1969, Yearbook Medical Publishers, Inc, p 914. 3. Ravitch MM, and McCune RM: Intussusception in infants and children, J PEDIATR 37:153, 1950. 4. Swenson O, and Oeconomopoulos CT: The operatiVe treatment of acute intussusception in infants and young children, Am J Surg 103"599, 1962.
