Ole Wasz‐Höckert

Twenty-Five Years of Scandinavian Cry Research

The study of crying can be dealt with from many different perspectives: anatomical, physiological, psychological, phonetic, and pediatric. During the last two decades, the cry has also been an important factor in studies of mother-child interaction.

Sound Spectrographic Cry Analysis of Infants with Bacterial Meningitis

A total of 110 pain‐induced cries from 14 infants with bacterial meningitis were analysed by sound spectrographic methods. The infants were between four days and six months old, and the cries were analysed between one and 14 days after the diagnosis. The cry analysis was compared with the crying of 75 full‐term healthy infants. 15 cry attributes were studied.

Pain cry in full-term asphyxiated newborn infants correlated with late findings.

Abstract. 115 pain‐induced cries from 45 full‐term newborn infants with pre‐ and perinatal asphyxia were analyzed by sound spectrographic methods. All the infants had signs of intrauterine asphyxia and Apgar score of 6 or less at 5 min. The mean birth weight was 3170 g. The pain cries were recorded before the age of 8 days, 83 % of the cries before 3 days of age. The cry analysis was compared with the pain cries of 75 full‐term, healthy newborn infants of corresponding birth weight and gestational age. The results showed significant differences between the cries of the asphyxiated newborn and the healthy infants. The duration of the phonation was shorter, the maximum and minimum pitch of the fundamental frequency was significantly higher. Bi‐phonation and vibrato occurred more often, double harmonic break and glottal roll less often. An increase in rising, falling‐rising and flat types of melody was observed. Retrospectively, the cries were more abnormal if the infant was found to be neurologically damaged at the check‐up at 2–8 years.

Tonspektrographische Untersuchungen des Säuglingsgeschreis

A preliminary report is given on the use of sound spectrographic techniques for the study of the non-verbal means at the disposal of the newborn child or the small infant to express itself to the environment. Certain types of signals were found to be common in the non-verbal cry of different infants. A typical sonogram is described in detail.

11. CRY STUDIES IN NEONATAL HYPERBILIRUBINEMIA

We have analyzed the pain cry of 45 newborns with hyperbilirubinemia. This material consisted of 15 cases with Rhimmunisation, 15 cases with ABO-immunisation and 15 cases with hyperbilirubinemia, where no blood group incompatibility could be demonstrated. Our normal material, used as controls, is reported in detail elsewhere (1). The pain cry recordings were performed during the first 15 days of life. A standardized method of recording and analyzing the pain cry was used (1). For evaluating the normality or abnormality of the individual cases, a new screening method, cry score is used (2). Signs of developing encephalopathy were found in 21 cases during the first week of life, and one case had evident manifestations of kernicterus.

Persistence of Tuberculin Sensitivity in BCG Vaccinated Persons Isolated in Institutions

Summary

A Follow‐up of 103 Children Recovered from Tuberculous Meningitis

A general review of the results of follow‐up examinations of 103 children who have recovered from tuberculous meningitis is presented.

Modern Treatment and Late Prognosis of Tuberculous Meningitis

Certain controversial subjects in the treatment of tuberculous meningitis are analyzed, amongst them intrathecal administration of streptomycin, the toxicity of isoniazid, long‐term treatment with INH, and the etiological role of the primarily resistant strains of tubercle bacilli. The corticoid problem is given special consideration and the possibility of iatrogenic late sequelae due to corticoids is discussed at length. The importance of proper neurosurgical management in cases with increased intracranial pressure and signs of block formation and the value of preventive measures, like BCG vaccination, chemoprophylaxis and isolation are also stressed.

Late Neurological Sequelae of Tuberculous Meningitis

The neurological findings in a follow‐up study of 103 children treated for and cured of tuberculous meningitis in 1949—54, are presented. Fifty children were found to be free of late neurological sequelae, 29 had minor neurological sequelae including 2 with cranial nerve palsies, nystagmus, and ataxia, 13 with mild disturbances of coordination and 10 with symptoms of upper motor neuron lesion without subjective complaints. Gross neurological sequelae were found in 22 cases, including 8 with spastic palsies, 9 with spastic palsies and convulsions, and 5 with convulsions without spastic palsies. Two children were found to have sequelae of spinal lesions; one had paraplegia and the other disturbance of sensation on the dorsum of the left foot. Fourteen children had convulsions.

The duration of immunity after vaccination with BCG.

It has been demonstrated, principally by Scandinavian workers ( WALLGREN, HEIMBECK, SCHEEL, TORNELL, ANDERSON and BELFRAGE, NORDWALL, WINGE, HYGE, etc.), that vaccination with BCG according to the principles initiated by Wallgrcn, gives definite protection against primary tuberculosis. It also, indirectly, gives protection against early post-primary forms of tuberculosis to a certain degree. I n aiming, by means of this prophylactic immunization, a t decreasing the morbidity and mortality rate particularly in childhood and adolescence the indications for BCG vaccination have, during recent years, been increasingly extended. I n Sweden, for example, it is estimated that more than 200 000 such vaccinations are carried out each year, and in Norway, obligatory vaccination of tuberculin-negative persons has even been planned. Since vaccination with BCG has assumed such proportions, and includes persons who may possibly only be exposed to virulent tuberculous infection several years after vaccination, the importance of knowing how long the organism retains the artificial immunity brought about by BCG vaccinat,ion as against that due to virulent, exogenous tuberculous infection has become greater in practice. The basic principle for assuming that a tuberculin-negative individual can be considered as BCG vaccinated is that he is not exposed to tuberculous infection before the tuberculin reaction has become positive. It is, however, equally important that the person is tuberculin-positive after the vaccination even when virulent tuberculous infection occurs. Prophylactic tuberculosis measures should, thus, also be