bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between intrauterine and postnatal growth on the subsequent psychomotor development of very low birthweight (VLBW) infants
Authors: TUDEHOPE DAVID I. , BURNS YVONNE , O'CALLAGHAN MICHAEL , MOHAY HEATHER , SILCOCK ANNE
Published: March 2008

ABSTRACT. The aim of this study was to demonstrate the relationship between intrauterine and postnatal growth and subsequent neurological and intellectual development of very low birth weight (VLBW) infants.

The effect of intrauterine growth was assessed by comparing the developmental outcomes of the 131 appropriate weight for gestational age (AGA) infants with the 33 small for gestational age (SGA) infants. No significant differences were found between the two groups with respect to head circumference, neurological, intellectual or sensory handicap rates. The mean General Quotient (GQ) at the last clinic assessment for the AGA infants was 101.2 and 97.2 for the SGA infants.

The effect of extra‐uterine growth on subsequent development was assessed in the AGA and SGA infants separately, at the time of discharge and again at 12 months. The 31 AGA infants who failed to grow adequately in the nursery had more neonatal risk factors than the 100 AGA infants who continued to grow adequately after birth. This early postnatal growth failure was not predictive of developmental outcome. At 12 months of age, 26 infants (20%) who were initially appropriately grown at birth were failing to thrive. These infants had sustained more chronic diseases and caretaking disorders in the first year of life than their appropriately grown counterparts. They also had lower GQ and head circumference measurements (p<.05).

The SGA infants who exhibited “catch up'’growth between birth and term had larger head circumference measurements at 1 year than those with persistent growth failure. Growth assessment at 12 months of age was not predictive of developmental outcome in SGA infants.

We failed to show a relationship between intrauterine growth of VLBW infants and their subsequent development. AGA infants whose weights had dropped to the 3rd percentile by 12 months of age had a poorer outcome than their appropriately grown counterparts. Furthermore, early postnatal growth failure before term had no additional effects if catch up growth occurred thereafter. In the SGA group neither failure to reach the 3rd percentile by term or 12 months affected outcome.
Clumsy children: a prognostic study
Authors: KNUCKEY NEVILLE W. , GUBBAY SASSON S.
Published: March 2008

ABSTRACT. Twenty‐four clumsy children of whom 13 had matched controls were reappraised eight years after their original assessment. The findings indicate that developmental clumsiness generally has a favourable prognosis. Mild and moderate degrees of clumsiness improved to normality, but severe degrees of clumsiness had a less favourable outcome only in regard to motor proficiencies. Clumsiness seemed not to have bearing, either on social class or on the subsequent pursuit of sporting activities. Although there was a lower level of academic achievement in the clumsy children, who also chose careers which were less manually exacting, these observations did not reach statistical significance.

Maturational lag might be the aetiology in mild developmental clumsiness, whereas structural lesions involving the cerebral cortex may be present in more severely afflicted children. These findings should be considered when counselling clumsy children, both academically and vocationally.
Changes in body size and fatness of Australian schoolchildren 1911–1976
Authors: DUGDALE A. E. , O'HARA V. , MAY G.
Published: March 2008

ABSTRACT. Data have been analysed from surveys of Queensland schoolchildren done in 1911, 1950 and 1976. Over this period there has been a marked increase in both height‐for‐age and weight‐for‐age in boys and girls. However, in boys, this increases growth has been associated with minimal increase in fatness. In girls there has probably been a real increase in body fatness, particularly since 1950. Raw data from past growth studies would make the analysis for secular changes in stature more meaningful and accurate. We suggest that a central data bank for Australian growth studies be set up.
Serum opsonins of control children of different ages
Authors: PEREIRA H. ANNE , HOSKING C. S.
Published: March 2008

ABSTRACT. Sera from a group of randomly selected control children between the ages of one and fourteen years were assessed for opsonic activity utilising the Neutrophil lodination Micro‐Method (NIMM). The opsonic capacity of fresh and heat inactivated serum from these children was compared with that of adult controls utilising the following micro‐organisms: C. albicans, S. cerevisiae, zymosan, S. aureus (Oxford and Cowan I strains), S. epidermidis, E. coli meningitidis, and a nonpathogenic strain of E. coli. The overall opsonic capacity of children under the age of four was similar to that of the adults and the older children (four to fourteen years) for all the micro‐organisms tested except C. albicans. With five of the eight micro‐organisms tested the heat stable opsonic activity of children in the younger age group was significantly lower than the other two groups tested. It is suggested that opsonic function in children approaches that of adults around the fourth year of life.
Milk antibodies in pulmonary inhalation
Authors: KEMP A. S. , McVEAGH P. , LO E. , HOWMAN‐GILES R.
Published: March 2008

ABSTRACT. To determine the association between inhalation and increased circulating milk antibodies, the presence of milk precipitins and haemagglutinating titres of antibody to casein and lactalbumin were determined in a series of 100 children studied by radionuclide ‘milk scan’and/or barium swallow for possible milk inhalation. Sixty‐five were investigated because of reflux and/or inhalation (REFLUX), while 35 were evaluated after near‐miss sudden infant death (SID). Inhalation was demonstrated in 23/65 Reflux and 9/35 Sid patients. The incidence of milk precipitins was 22% (5/23) of the REFLUX with demonstrable inhalation, 12% (5/42) of the REFLUX without demonstrable inhalation, 0% (0/23) SID and 2% (21/1005) of an unselected series of hospital patient sera. The incidence of milk precipitins was increased in cases with demonstrated inhalation and lower respiratory tract symptoms. Determination of antibody titres to casein and lactalbumin did not provide additional benefit in the diagnosis of milk inhalation. Detection of milk precipitins can provide additional support to the diagnosis of milk inhalation.
VM‐26 and dimethyl triazeno imidazole carboxamide in Ewing's sarcoma
Authors: CAMPBELL A. M. , EKERT H. , WATERS K. D.
Published: March 2008

ABSTRACT. Twenty‐seven patients with biopsy proven Ewing's sarcoma were randomised to receive one of two adjuvant chemotherapy regimens for two years. Group A were given monthly courses of vincristine, adriamycin and dimethyl triazeno imidazole carboxamide (DIC); Group B received monthly courses of VM‐26, adriamcyin and DIC. Chemotherapy was commenced after biopsy confirmation of disease. The primary tumour was treatedd with irradiation to 3,000–5,000 rad and by resection in three patients. With a median follow‐up of 26 months, 52% of patients are disease free. Ten patients died, seven from recurrent disease and three from complications of treatment. There was a significant difference in disease free survival rate of patients with long bone lesions (11/12) compared with patients with flat bone lesions (6/15). The disease free survival rate of Groups A and B was similar. Our results suggest that in combination chemotherapy for Ewing's sarcoma, vincristine and VM‐26 have similar anti‐tumour activity.
Primary hypomagnesaemia: Case report
Authors: ARNOLD J. D. , OLDFIELD R. K. , POLLARD A. C. , SILINK M.
Published: March 2008

ABSTRACT.A patient with primary hypomagnesaemia is presented. The condition is associated with abnormal magnesium absorption from the small bowel.

The duodenal mucosal magnesium content in this patient was estimated and was normal. This has implications about the pathophysiological basis of the defect which are discussed.
Development of the pre‐school child: the validation of a psychomotor screen, and the influence of the home environment on psychomotor development
Authors: EU BERNICE , O'NEILL MARIE J.
Published: March 2008

ABSTRACT.The present study was designed to validate and standardize a short psychomotor screening test on Australian four‐year‐old‐preschool children and to assess their home environment using Caldwell's HOME Inventory. The Adelaide Psychomotor Screen (APS) is a short, 10‐‐15 minute screening test which uses 13 separate items to assess “General” development, “Gross Motor” development, “Social/Emotional Behaviour” and “Speech”.

In the area of “General” development, 12 children screened as “abnormal” and 54 children screened as “normal” were further assessed by a psychologist on the McCarthy Scales of Children's Abilities. There was a high correlation between the APS “General” scores and the McCarthy (General Cognitive Index) scores (r = 0.75, p<0.001 for the younger children, and r = 0,90, p <0.001 for the older children).

Caldwell's HOME Inventory takes an hour to complete, and involves a visit by the assessor to each home. The correlation between the HOME total scores and the McCarthy (General Cognitive Index) scores was r =0.06, p < 0.001. It is suggested that the HOME Inventory may be more valuable as a predictor of a child's future development than an index of his present developmental status.

It is suggested that nurses and teachers used the APS as a screening test of the individual child, and use the HOME inventory as an assessment of the home environment.
Neurogenic faecal incontinence in children with spina bifida: rectosphincteric responses and evaluation of a physiological rationale for management, including biofeedback conditioning
Authors: SHEPHERD KARIN , HICKSTEIN ROSEMARY , SHEPHERD ROSS
Published: March 2008

ABSTRACT. The rectosphincteric responses of 22 spina bifida (SB) children, aged 3.0 to 11.0 years, with frequent neurogenic faecal incontinence were investigated by clinical and anomanometric techniques and a bowel habilitation programme based on the physiological rationale of timed regular and complete evacuations, regulation of bowel habit and faecal consistency by diet and biofeedback conditioning of rectosphincteric responses. Eighteen patients had perianal anaesthesia, flail anus and absent anorectal reflex, but some degree of (reduced) rectal sensation. Four had reduced perianal sensation and normal to high pressure external sphincter and a megarectum apparently causing an absence of rectal sensation. Twenty were unable to expel the rectal balloon voluntarily. After biofeedback exercises (2‐‐5 sessions) and a home programme of evacuation and diet, 21 of the 22 achieved satisfactory continence over 2‐‐6 months with improved rectal sensation and ability to evacuate voluntarily. This experience suggests that early anorectal evaluation and a comprehensive bowel habilitation programme may be an effective approach to the prevention of disability due to faecal incontinence in SB children.
Ventricular tachycardia in a neonate secondary to hyperkalaemia
Authors: EMDER PHILLIP , CRAWFORD GEOFFREY
Published: March 2008

ABSTRACT. We report a preterm infant with ventricular arrhythmias secondary to hyperkalaemia in the first 48 hours of life. The arrhythmias were life threatening and required pharmacological and electrical cardioversion. Aspects of neonatal hyperkalaemia and related arrhythmias are discussed.
Cost of neonatal intensive care
Authors: JOHN ELIZABETH , LEE KUI , LI GLORIA M.
Published: March 2008

ABSTRACT. An analysis was made of the costs of provision for the intensive care of inborn babies in an inner city hospital equipped to deal with high risk obstetrics. Costs showed the expected inverse proportion to birthweight. The larger number of more mature babies nevertheless contributed almost 2/3 of the total cost. The adjusted cost/survivor (“adjusted'’to reflect the fact that only the survivors benefit) was $39,845 for babies less than 801 g; $26,100 for those between 801 g and 1,000 g; $14,137 between 1,001 g and 1,500 g and $4,782 over 1,500 g. The largest single expense was in nursing salaries which constituted 60–80% of the total outlay.

No data are available for precise comparison. The figures are presented as a basis on which to begin forming judgements of the cost effectiveness of newborn intensive care.
Ketoconazole treatment of nail infection in chronic mucocutaneous candidiasis
Authors: ROBERTON D. M. , HOSKING C. S.
Published: March 2008

ABSTRACT. Chronic mucocutaneous candidiasis is an immunodeficiency disorder which has significant morbidity due to mucous membrane, skin and nail infection. Attempts at reconstitution of immunological abnormalities have had only limited success. Ketoconazole is a newly available oral antifungal agent with activity against candida species. Prolonged administration of ketoconazole to four children with chronic mucocutaneous candidiasis caused marked improvement at infected sites. Resolution of nail infections took up to 12 months.
Use of health care services for an infant population in a poor socio‐economic status, multi‐ethnic municipality in Melbourne
Authors: CARMICHAEL ALLAN , WILLIAMS HOWARD E.
Published: March 2008

ABSTRACT.Use of preventive and curative health services for a birth cohort of infants is described and related to morbidity patterns and family characteristics.

The maternal and child health service provided continuing contact and effective preventive care for the majority of families. However, a small group of families, predominantly recent immigrants with poorer education and inability to speak English, did not use these services effectively.

By contrast, medical care for most families was carried out by a number of different doctors in general practices or hospitals. Continuity of care was lacking, with only 30% of families having continued contact with either one practitioner or group practice, and 15% not using any medical services for their infants.
Accidental death in Australian children
Authors: O'CONNOR PETER J.
Published: March 2008

ABSTRACT. In 1980 the Child Accident Prevention Foundation of Australia commissioned a national study of children's accidents.

The results indicate that accidents are becoming relatively more important as a cause of death in childhood. Variations in accident death rates between the age groups, the sexes and the States indicate broad target groups for preventive activity and further research. In particular attention should be focused on deaths from transport accidents and drowning.
Bronchopulmonary dysplasia in very low birthweight infants
Authors: YU V. Y. H. , ORGILL A. A. , LIM S. B. , BAJUK B. , ASTBURY J.
Published: March 2008

ABSTRACT. Twenty‐four (6%) of 375 infants with birthweights ≦1500g developed bronchopulmonary dysplasia (BPD); 16 (15%) of 107 in those ≦100g and 8 (3%) of 268 in those >1000g. The incidence was 10% in those who required assisted ventilation. Perinatal asphyxia, significant respiratory distress, pulmonary interstitial emphysema and patent ductus arteriosus were statistically more common in BPD infants compared with the remaining 351 very low birthweight infants. Hyaline membrane disease was the primary respiratory disease in 54% of BPD infants. The mean durations of oxygen and ventilatory therapy were 68 days and 37 days respectively. Twenty‐nine percent did not require more than 60% oxygen for over 24 hours. Only 38% required a peak airway pressure of over 30 cmH2O. Early postnatal growth was satisfactory on parenteral nutrition support. No perinatal factor was found to be predictive of death from BPD. The prolonged duration of hospital treatment has obvious implications to the psychosocial and economic costs of BPD.
Comparison of salbutamol powder with terbutaline aerosol administered with a tube spacer in asthmatic children
Authors: FRANCIS PAUL W. J. , KELLY CATHERINE A. , ZIMMERMAN PAUL V.
Published: March 2008

ABSTRACT. The bronchodilator effect of 400 μ of salbutamol powder (2 capsules) administered by a rota‐haler was compared with that of 500 μg of terbutaline (2 mete red doses) administered as an aerosol via a tube‐spacer in a group of ten stable asthmatic children (mean age 12 years). The salbutamol powder produced significantly greater bronchodilatation compared with the terbutaline. Forty‐five minutes after the administration of each preparation, nebulised salbutamol was given to determine if further bronchodilatation was possible. Additional bronchodilatation was seen in both groups, the greater additional change being after terbutaline. It is concluded that 400 μg of salbutamol powder was more effective than 500 μg of terbutaline via tube‐spacer but following both preparations, nebulised salbutamol produced significant additional bronchodilatation.
The obesity hypoventilation syndrome and the Prader‐Willi syndrome
Authors: BYE ANN M. E. , VINES ROBERT , FRONZEK KAREN
Published: March 2008

ABSTRACT. Fourteen children with the Prader‐Wllli syndrome have been managed at the Royal Alexandra Hospital for Children between the years 1964–1980 — twelve male, two female. Six male children developed features of the obesity hypoventilation syndrome. The age of onset of this complication ranged from 4.0 to 12.6 years.

With one exception those children with the obesity hypoventilation syndrome were more obese than those without it. At the time of onset of the syndrome, five of six patients had weights greater than or equal to 6.5 standard deviations above ideal body weight. Those children without the obesity hypoventilation syndrome had a range of standard deviations 1.0 to 4.2 above the ideal body weight. In four of six cases weight reduction and a cardiac failure regimen resulted in reversal of the obesity hypoventilation syndrome. With two of the six children there had been cardiomegaly and increased pulmonary venous vascularity on x‐ray at a chronological age of three months. Two of the six children died.
Toxic adenoma in childhood — case report
Authors: LEPRE F. , CAMERON D. P. , HARTLEY L.
Published: March 2008

ABSTRACT. A 12‐year‐old girl was noted to have a left sided thyroid nodule on routine examination. Although clinically euthyrold she was found to have an elevated T3 value, and the TSH failed to rise following TRH injection. Thyroid scan showed a hyperfunctioning nodule in the left lobe of the thyroid gland. Following surgical removal of the nodule the patient became biochemically euthyroid and a repeat thyroid scan demonstrated the previously suppressed normal right lobe.
A seven year follow‐up study of the cognitive development of children who experienced common perinatal problems
Authors: SILVA PHIL A. , McGEE ROB , WILLIAMS SHEILA
Published: March 2008

The prevalence of perinatal problems in a sample of 1037 children was described. There was no significant association between perinatal problems and socio‐economic status. The association between perinatal problems and cognitive development was examined by stepwise regression analyses of the more common perinatal problems on cognitive factor scores, using measures of language and, intelligence taken when the children were aged 3, 5, and 7 years. Of 14 perinatal problems analysed in this manner, only two, being a twin or being small for gestational age, were found to be consistently associated with a significantly lower cognitive factor score.
Necrotizing enterocolitis in very low birthweight infants: a four‐year experience
Authors: YU V. Y. H. , JOSEPH R. , BAJUK B. , ORGILL A. , ASTBURY J.
Published: March 2008

Fifty (13%) of 375 infants who weighed 1500 g or less at birth had necrotizing enterocolitis (NEC). Haematological changes suggestive of sepsis occurred in 83% and positive bacteriological cultures were found in 38%, the most common organism isolated being Clostridium perfringens. Complications included intestinal perforation in six patients and recurrence of NEC in five, of whom one subsequently developed an intestinal stricture. Five of the eight nursery deaths were secondary to peritonitis and overwhelming sepsis from NEC. In spite of the discontinuation of milk feeds for prolonged periods, satisfactory caloric intake and weight gain were achieved with parenteral nutrition in the survivors. Of the 41 long‐term survivors, six (15%) were found to have a disability at 2 years of ago, corrected for prematurity, compared with 48 (20%) of 241 very low birthweight survivors from the same study period who did not have NEC. None had evidence of gastrointestinal dysfunction. Six (15%) children remained below the 10th percentile for both weight and height. This study showed that early diagnosis and therapy for NEC in very tow birthweight infants were associated with a favourable short‐ and long‐term outcome.
Weight, height and weight for height in 6–7‐year‐old children I. Relationship with demographic variables
Authors: RUTISHAUSER INGRID H. E.
Published: March 2008

Relationships between weight, height and weight for height at 6–7 years of age and a number of demographic variables have been studied in data from Infant Welfare Centre and school medical records. In both boys and girls height and weight were significantly related to birthweight. After allowing for birthweight and age no significant relationships were found in either boys or girls between height and any of the demographic variables. However, body mass index differed significantly according to birth order, the number of children in the family and the parents country of birth. No associations were observed between anthropometric measures at 6–7 years and paternal occupational status, maternal age and the number of younger siblings. Comparison of the study group with reference values from America and Australia provided no support for the view that one of these reference standards is more appropriate than the other for assessment of growth in Australian children.
Nebulized gentamicin in children and adolescents with cystic fibrosis
Authors: KUN P. , LANDAU L. I. , PHELAN P. D.
Published: March 2008

A study of 29 children and adolescents with cystic fibrosis over 2 years showed some evidence of benefit from the twice daily inhalation of 20 mg nebulized gentamicin when compared to the inhalation of a nebulized saline mixture. Clinical symptoms, deterioration in pulmonary function, antibiotic usage, days in hospital and development of Pseudomonas aeruginosa in the sputum were recorded. There was no significant difference in antibiotic usage, days in hospital or clinical symptoms between the two regimes. Those subjects with P. aeruginosa in sputum showed significantly less deterioration in lung function over 2 years while using gentamicin aerosol. There was no difference in progress between the two treatment regimes for those subjects with P.aeruginosa in sputum at the beginning of the study, nor was there any difference in the number developing P. aeruginosa in sputum.
Medication compliance in children with asthma
Authors: SMITH NERIDA A. , SEALE J. PAUL , SHAW JOHN
Published: March 2008

A questionnaire to assess compliance with prescribed therapy was completed by 200 children with asthma. The validity of the questionnaire was assessed objectively by measuring plasma theophylline concentrations in 37 subjects and by weighing metered dose aerosol canisters before and after use in 19 subjects. The average compliance was 67.9%. The close agreement between answers to the questionnaire and the objective measurements of compliance indicated that most participants recalled the drug regimens accurately. Good compliance was related to whether Australia was the parents' country of origin, to knowledge of the disorder and to comprehension of medication but was not related to perception of the severity of the illness. This study demonstrates that compliance is relatively poor even in a clinic population which attends regularly and appears well‐motivated.
Value and limitations of bilirubin binding capacity in predicting the development of kernicterus
Authors: TAY JOHN S. H. , LOW P. S. , WONG H. B. , YIP WILLIAM C. L.
Published: March 2008

The serum bilirubin (SBR) and the bilirubin binding capacity (BBC) were determined on hospital admission in 181 consecutive neonates with neonatal Jaundice. Twenty‐three babies were less than 2500 g and two were of birth weight less than 2000 g. Fifteen babies were preterm. There were eight cases of kernicterus. Although the serum bilirubin was generally higher in infants with a BBC < 34 μmol/l, there was no correlation between the bilirubin binding capacity and the presence of kernicterus (r = 0.28, P > 0.05). However, when both the serum bilirubin and the bilirubin binding capacity were used, a tow value of BBC < 34 μmol/l increased the risk of kernicterus. Higher values of BBC, on the other hand, did not mean that there was less risk of kernicterus, other factors being equal. This, while the bilirubin binding capacity may provide an additional source of information, its limitations should always be borne in mind.
Recurrent abdominal pseudocyst after ventriculoperitonoal shunt
Authors: NARASIMHARAO K. L. , PUROHIT A. , YADAV K. , PATHAK I. C.
Published: March 2008

A child with recurrent intra‐abdominal pseudocyst following ventriculoperitoneal shunt is reported. Peritoneal tuberculosis was the most probable aetiology in this case.
High admission rate of infants and young children with whooping cough: clinical aspects and preventive implications
Authors: FORSYTH KEVIN , FARMER KEITHA , LENNON DIANA R.
Published: March 2008

Abstract Eighty‐five children hospitalized with clinical whooping cough over an 8 month period were studied. Of the 53 cultured for Bordetella pertussis, 29 (55%) were culture positive. There was a preponderance of young infants who required a long hospitalization (35% were less than 3 months of age). Many of these children had apnoeic attacks requiring active intervention. Pulmonary atelectasis‐consolidation was found in 46% in spite of negative viral and bacterial studies. Overcrowding and poor socioeconomic status was noted frequently in those hospitalized. This group makes the least use of child health services, and has the lowest rate of immunizations.
Metal content of the liver in sudden infant death syndrome
Authors: STEELE ROBERT J. , FOGERTY ALAN C. , WILLCOX MARY E. , CLANCY SUSAN L.
Published: March 2008

Abstract The metals zinc, iron, copper, manganese, calcium, magnesium, potassium and sodium were analysed in the livers of 67 Australian infants who had died from Sudden Infant Death Syndrome (SIDS) and 29 infants who had died from other causes (non‐SIDS). The results were evaluated in relation to medical data and fatty acid composition of the livers. In infants less than 6 months old the liver potassium levels were significantly lower in SIDS than in non‐SIDS infants. No other significant differences in metals between the SIDS and non‐SIDS livers were found. Zinc, iron and copper levels in infant liver fell with age during the first year.
Control of bleeding in extrahepatic portal hypertension — the reverse splenorenal shunt and portal‐azygos disconnection
Authors: COHEN DOUGLAS , STEPHEN MICHAEL
Published: March 2008

Abstract Variceal bleeding in children with extrahepatic portal hypertension is best controlled by an effective decompressive shunt. Both the standard and central splenorenal shunts require splenectomy which is undesirable in childhood, and alternative shunts such as the mesocaval shunt and the distal splenorenal shunt are also technically difficult with a similar risk of shunt thrombosis.

The reverse splenorenal shunt first described in 1962 by Erlik uses the proximal portion of the left renal vein which was initially anastomosed to the portal vein. It can be anastomosed to any of the major tributaries of the portal system. In the technique described, the proximal end of the renal vein is joined to the side of the splenic vein in continuity. It is preferable for this to be done as an elective planned procedure. Massive continuing haemorrhage which is not responding to conservative management can be controlled by portal‐azygos disconnection with gastric transection. This procedure will control major variceal haemorrhage for several years and allow a decompressive shunt to be performed under optimal conditions and after appropriate preoperative investigations.
Intestinal lymphangiectasia — a report in two Chinese children
Authors: QUAK S. H. , WEE A. , YAP H. K. , TAY J. S. H , QUAH T. C. , YIP W. C. L.
Published: March 2008

Abstract Two Chinese infants with asymmetrical lymphoedema and steatorrhoea were investigated. The laboratory investigations showed that they had hypoproteinaemia without proteinuria. One of them showed peripheral lymphopenia and hypogammaglobulinaemia. Radiologically, they had evidence of extensive lymphangiectasia of the small intestine. This was confirmed histologically. Endoscopy of one of them showed diffuse milky nodular duodenal mucosa. The appearance of the mucosa was rather typical of intestinal lymphangiectasia.
Child abuse and non‐organic failure to thrive: similarities and differences in the parents
Authors: DATES R. KIM
Published: March 2008

A group of 39 mothers who had a physically abused child at an average of 6 years previously and a group of 14 mothers who had a child with non‐organic failure to thrive (NOFTT) 13 years ago were reviewed. Each child was compared with a child matched for age and sex and for ethnic group, residential area and social class of the parents. The mothers from the NOFTT group knew less than their comparison mothers about their child's education and on a personality test were less able at intellectual and abstract concepts. The abuse group mothers were more mobile and more isolated than their comparison group. They were less likely to have been brought up by their own parents and had more negative feelings towards their fathers. They had lower self‐esteem and higher expectations for their children than the comparison mothers On a personality assessment they were more assertive, demanding and suspicious than the comparison mothers, Although child abuse and non‐organic failure to thrive have been described as part of the same spectrum, the characteristics of the parents on follow‐up are different. As some of the adverse characteristics of the parents persist long after the presenting incident, the need for a long term treatment programme aimed at supporting children who remain in these families is recommended.
Nutritional studies during childhood: IV Energy and nutrient intake at age 4
Authors: MAGAREY ANTHEA , BOULTON T. J. C.
Published: March 2008

A study of the usual nutrient intake of a sample of 183 healthy 4 year olds is reported. These children have been the subject of a longitudinal study from birth. Data include daily intakes of food energy, protein, fat, carbohydrate, fibre, minerals, and vitamins. Minor differences in nutrient intake were present between the sexes. Overall nutrient intakes were at a slightly lower level than those described previously. The methodological considerations of such a community nutrition study are discussed, including the intrinsic sources of error which may have contributed to the observed differences Changes in recreational activity level and influences of climate may also be important factors affecting food energy and nutrient intake at this age.
Experience with high dose multiagent chemotherapy and autologous bone marrow rescue in the treatment of twenty‐two children with advanced tumours
Authors: EKERT H. , TIEDEMANN K. , WATERS K. D. , ELLIS W. M.
Published: March 2008

Intensive chemotherapy followed by infusion of cryopreserved autologous bone marrow (ABMR) was used in the treatment of 22 children with advanced tumours. In nine this was their initial therapy; in eight it was used after partial or complete remission had been achieved with standard therapy; and in five, after relapse had occurred. Recovery of marrow function occurred in 20 patients with a mean time of 13.2 and 18.2 days to recovery of neutrophils (>0.5 × 109/t) in newly diagnosed and previously treated patients respectively. Platelet count recovery to >50 × 109/l occurred in a mean time of 13.4 days in newly diagnosed and 20.4 days in previously treated patients.

Control of extensive local tumour was obtained in three of three evaluable patients with abdominal non‐Hodgkin's lymphoma (NHL). Metastatic bony and marrow disease was controlled in two of two patients with retinoblastoma. In Ewing's sarcoma, temporary control of widespread metastatic disease occurred in one patient. In the other, eradication of extensive local mass disease at the primary site had been achieved. Poor response to‐treatment has been seen in seven of eight patients with Stage III or IV rhabdomyosarcoma, three patients with neuroblastoma and four of five patients with recurrent disease

Apart from the anticipated bone marrow toxicity, the major complications were severe mucositis, anaphylaxis following bone marrow infusion and haemorrhagic cystitis. The presence of herpes simplex infection appeared to aggravate mucosal complication. We suggest that intensive chemotherapy and ABMR has a place in the treatment of tumours in which there is evidence of sensitivity to high doses of cyclophosphamide, or where synergy of drugs such as cyclophosphamide and adnamycin may be expected to increase tumour cell kill. The ability to control extensive intra‐abdominal disease in NHL may eliminate the need for total abdominal irradiation in that disease.
Health care needs of the children of single mothers in a Perth suburb
Authors: UNDERWOOD PETER , KAMIEN MAX
Published: March 2008

This paper reports a prevalence study of illness in children in a lower socioeconomic suburb of Perth. The study shows that single mothers reported higher rates of both emotional and physical disorder in their children compared with mothers from nuclear families. The children from single families were also reported as having a poorer immunization status. It is argued that children from single families constitute a vulnerable group and deserve special attention from those in the health system who care for children.
Accuracy of radiological diagnosis in the Casualty Department of a Children's Hospital
Authors: MASEL J. P. , GRANT P. J. F.
Published: March 2008

The radiographs of 1363 patients referred from a hospital Casualty Department were reviewed in order to study possible discrepancies between the interpretations of the films by the casualty medical staff and the radiologist. Interpretations by casualty staff were substantially correct in 96.3% of patients. Discrepancies were noted in 41 patients (3.0%) — pneumonia was overlooked on chest films in 7 cases, while 1,9 fractures were not noted by Casualty staff. These were almost all minor, with no problems resulting from delay in treatment. This study has implications for the training of Casualty medical staff, the cross‐checking of their reports, and the possible need for Casualty department staffing by radiologists.
Salmonella meningitis in infancy
Authors: LOW L. C. K. , LAM B. C. C. , WONG W. T. , CHAN‐LUI W. Y. , YEUNG C. Y.
Published: March 2008

: Despite adequate treatment, mortality and morbidity were high among the 13 cases of Salmonella meningitis in this series. Chloramphenicol, being a bacteriostatic agent against Salmonella species, is not a suitable antibiotic for the treatment of Salmonella meningitis. Treatment for 4–6 weeks is recommended with use of an antibiotic capable of achieving an adequate bactericidal concentration in the cerebrospinal fluid such as moxalactam. Intraventricular antibiotic treatment should be considered if there is a delay in the eradication of the Salmonella organisms from the cerebrospinal fluid after starting treatment.
Children with school problems — an expanding role for the paediatrician
Authors: OBERKLAID FRANK
Published: March 2008

Abstract Children with school problems comprise a significant part of the new paediatric morbidity. There is confusion in terminology and it is suggested that instead of attempting to make a diagnosis of doubtful validity and limited clinical utility, paediatricians focus instead on generating an accurate description of the strengths and weaknesses of these children. When placed in the context of a transactional model of aetiology and function, such an individual difference, nondiagnostic, nonlabelling approach facilitates the development of appropriate intervention strategies, as well as creating a suitable framework for interdisciplinary communication. It is suggested that such a broad based approach to the assessment and management of children with school problems allows the paediatrician to play an important role in enabling these children to fulfil their potential.
A comparison of P02 monitoring techniques in newborn infants
Authors: LEWIS I. G. , HASLAM R. R.
Published: March 2008

Abstract This study is an evaluation of different methods of Po2 monitoring in newborn infants. These were an intra‐vascular Pb2 electrode (Searle Life Support Systems); transcutaneous monitoring (Kontron and Hewlett‐Packard); and arteriatized capillary blood samples. Values of each were compared with simultaneous aortic sample values and their correlation compared.

The Searle electrode and TCM were found to be of equivalent accuracy overall, although the Searle was less reliable. Searle catheters were more difficult to insert than normal catheters, with a high wastage. Arterialized capillary Po2 values did not correlate with arterial.

Transcutaneous monitoring is the most reliable and cheapest method.
A case of neonatal bilateral diaphragmatic paralysis requiring surgery
Authors: BOWMAN E. D. , MURTON L. J.
Published: March 2008

Abstract Diaphragmatic paralysis may cause life threatening respiratory distress especially in infancy. A case is reported of a 32 week gestation infant with bilateral phrenic nerve palsies and associated brachial plexus injury who remained severely compromised despite spontaneous recovery of the right hemidiaphragm after 13 weeks. Operative plication of the left hemidiaphragm produced a marked improvement. Surgery should be considered after an adequate trial of expectant management in symptomatic patients.
Haemolytic anaemia associated with acquired toxoplasmosis
Authors: MICHELSON ALAN D. , LAMMI AHTI T.
Published: March 2008

Abstract A 2 year old girl presented with fever, malaise, a maculopapular rash and lymphadenopathy followed by the onset of haemolytic anaemia and massive splenomegaly. Serology was consistent with acquired toxoplasmosis. A 6 week course of pyrimethamine resulted in a rise in the haemoglobin and reduction of the splenomegaly. During the subsequent 10 years, pyrimethamine treatment of three similar acute episodes resulted in similar clinical responses. There was no spontaneous improvement in the haemolytic anaemia or splenomegaly when pyrimethamine was initially withheld for 6,1, and 1.5 months respectively during three of these episodes. Investigations did not reveal an immunodeficiency state. This case suggests the possibility of a previously unreported causal association between acquired toxoplasmosis and haemolytic anaemia in a child.
Handicaps and health problems in 2 year old children of birth weight 500 to 1500 g
Authors: FORD GEOFFREY W. , RICKARDS ANNE L. , KITCHEN WILLIAM H. , LISSENDEN JEAN V. , KEITH C. GREGORY , RYAN MARGARET M.
Published: March 2008

Fifty‐nine infants of birthweight 500 to 999 g born in 1977 to 1980 and 132 infants of birthweight 1000 to 1500 g born in 1977 to 1978 were reviewed at two years corrected age. For the whole cohort, cerebral palsy was found in 12.6%, bilateral deafness in 1%, blindness in 1% and severe developmental delay in 12%. There was no significant difference in these disabilities between the groups of larger and smaller infants; 37.7% of the cohort was readmitted to hospital on at least one occasion, 35.6% of children had wheezing episodes and/or lower respiratory tract infections which together accounted for 51% of hospitalizations. The infants of birthweight 500 to 999 g tended to require more frequent and prolonged hospitalizations.

Dolicocephalic head shape, chest deformities, iatrogenic sequelae from intensive care, poor growth and cicatricial retrolental fibroplasia were significantly more frequent in children of birthweight 500 to 999 g. Parents reported that 39% of their children had ‘colic’, 31.6% had sleep disturbance and 25% had multiple behavioural problems. Low frustration tolerance, inability to wait, hypo‐ or hyperactivity and an inappropriate relationship with the mother as measured by the psychologist all occurred significantly more frequently in children of birthweight of less than 1000 g. This report confirms the belief that a comprehensive follow‐up is required for very low birthweight (VLBW) children because significant health problems continue after primary hospitalization.
Some factors influencing the stature of Dunedin 7 year old children: A report from the Dunedin Multidisciplinary Health and Development Research Unit
Authors: SILVA PHIL A. , BIRKBECK JOHN , WILLIAMS SHEILA
Published: March 2008

The stature of 987 representative Dunedin 7 year olds was measured and some factors contributing to stature were studied in 666 children for whom complete data were available. Dunedin children were of similar stature to American children but were about 1 cm taller than British children. Socio‐economic stature (SES), birth weight and maternal stature were significantly correlated with stature, while the sex of the child, gestational age, maternal age, ordinal position of the child in the family and number of children in the family were not significantly correlated. The effect of SES in Dunedin was much less than that reported for the United Kingdom. It was concluded that in this population SES and family structural factors are probably less important as determinants of child growth than they are in Britain and are of considerably less importance than the mother's stature and the child's birth weight.
Injuries in the eighth and ninth years of life
Authors: LANGLEY JOHN D. , SILVA PHIL A.
Published: March 2008

From a sample of 818 children, 211 were involved in 256 separate incidents which resulted in 283 injuries requiring medical attention. The most common injuries were lacerations, abrasions and contusions, fractures, concussion, and sprains. The majority of the injuries were minor. The most common incident resulting in injury was a fall, followed by incidents where the child struck against or was struck by an object or persons and incidents involving sharp objects. The nature and circumstances of the serious injuries is presented in detail. Methods of improving the description and the classification of childhood injuries and some incidents worthy of further investigation are discussed.
A retrospective study of juvenile chronic arthritis
Authors: MANNERS PRUDENCE J.
Published: March 2008

During a 20 year period 214 patients had been admitted to a teaching hospital with a diagnosis of definite or possible juvenile chronic (rheumatoid) arthritis (JCA). Eighty‐seven of these patients were reviewed clinically and were classified as having had JCA. Twelve of the 214 patients were later thought to have had rheumatic fever, while 12 had had an illness consistent with viral arthritis.

There was a poor functional outcome in three subgroups of JCA: (i) seropositive polyarticular onset, (ii) systemic onset, and (iii) pauciarticular onset, extending to polyarticular involvement.

The prevalence of inflammatory eye disease was very low with no significant visual handicap detected in patients in this study.
Secular trends in fatal and disabling child trauma
Authors: PEARN JOHN H.
Published: March 2008

Abstract Types and rates of childhood accidents are constantly varying. From the point of view of the potential child victim, the danger‐safety equilibrium is disturbed by changes in lifestyles, availability of new consumer goods, and changes in social order. Balance is achieved by the implementation of preventive measures, particularly safety legislation. ‘Old’ hazards affecting children in pre‐industrial societies can re‐emerge at any time as wealthy sophisticated societies aspire to recapture the delights of open space, the water, and ‘country‐style’ living. Age‐specific fatal accident rates are given for Australian children for the period 1960–1982. Whereas the total child (1–14 y) death rate has fallen from 159 per 100 000 (in 1960) to 86 (in 1982), road traffic deaths have risen from 8.3–11.7 (1–4 year olds) and have remained static (8.3–8.9) for 5–14 year old children. Drowning in older children has been reduced, but drownings among toddlers are still high (9.2 in 1960; 11.7 in 1982). The causes of secular trends, and factors which are known to influence these, are discussed.
Tests for autonomic neuropathy in diabetic children
Authors: MITCHELL E. A. , WEALTHALL S. R. , ELLIOTT R. B.
Published: March 2008

Abstract Five simple tests of autonomic nerve function were studied in 38 children (12.0 years, s.d. = 3.3) with insulin‐dependent diabetes mellitus and a further 38 age and sex matched controls in order to validate the use of these tests in children. The five tests included one test (immediate heart rate response to standing) previously reported. Compared to controls, diabetics showed a significantly faster heart rate at rest (P= 0.022), a reduced heart rate variation during quiet respiration (P=0.003), a smaller change in heart rate following a single deep breath (P=0.033). The heart rate response to the Valsalva manoeuvre is less suitable for use in children than adults as it requires considerable co‐ordination and co‐operation and it did not correlate with the other tests of autonomic nerve function. The other tests significantly correlated with each other and were quick and easy to perform. They required no special co‐operation and required no special equipment other than a standard ECG machine. Three diabetics had abnormalities in four of the tests (mean heart rate, heart rate variations during quiet respirations, change in heart rate produced by a single deep breath and the previously reported immediate heart rate response to standing). None of the controls had abnormalities in more than two of the tests.
Truncus arteriosus and facial dysmorphism
Authors: RADFORD DOROTHY J.
Published: March 2008

Abstract Facial features of infants with truncus arteriosus were photographed and reviewed. Anomalies included hypertelorism, low set ears, micrognathia, down‐slanting palpebral fissures, short philtrum and small mouths. Associated cardiovascular defects were interrupted aortic arch, double aortic arch, right aortic arch and aberrant brachiocephalic vessels. Potential teratogenic factors included maternal diabetes, syphilis, alcohol ingestion, carbimazole therapy and infant chromosomal anomalies.

The facial features, together with the rare cardiac abnormalities of truncus arteriosus and aortic arch defects are similar to those described in Di George syndrome (defect of fourth branchial arch and derivatives of third and fourth pharyngeal pouches). However none of these patients had symptomatic hypocalcaemia or absence of the thymus.

It is concluded that this association of truncus arteriosus, aortic arch abnormalities and facial anomalies involves first and fourth branchial arch maldevelopment, and indicates embryological insult between the fourth and seventh weeks of gestation.