bluuebunny/crossref_metadata_2025 huggingface dataset:
Humidification in viral croup: a controlled trial
Authors: BOURCHIER D. , DAWSON K. P. , FERGUSSON D. M.
Published: March 2008

Abstract Sixteen children (mean age 1.9 years) admitted to hospital with viral croup were assigned randomly to either a high humidity atmosphere or room air. No other treatment was given. During the initial 12 h both groups of patients showed a simitar rate of recovery as measured by pulse rate, respiration rate, transcutaneous oxygen (TcO2), transcutaneous carbon dioxide (TcCO2) and a clinical rating. No therapeutic benefit was demonstrated from the provision of a high humidity atmosphere. The widespread use of humidification in the management of croup requires reappraisal.
Outcome of very low birthweight infants who required prolonged hospitalization
Authors: YU V. Y. H. , KINLAY S. , ORGILL A. A. , BAJUK B. , ASTBURY J.
Published: March 2008

Abstract Over a 4 year study period, 294 infants with a birthweight ≤ 1500 g survived their initial hospitalization; 103 (35%) were discharged after a gestational age of 40 weeks. The postdischarge infant mortality was significantly higher in those with prolonged initial hospitalization compared with the remaining survivors (6% vs 1%). During the first 2 years, significant infections were found in 66% and rehospitalization in 54% of the children who had prolonged initial hospitalization. At 2 years, 34% were below the 10th centile for weight as were 39% for height; head circumferences were normal. Major disability (27% vs 15%) and developmental delay (13% vs 4%) were significantly more common in survivors with prolonged initial hospitalization compared with the remaining survivors. The study demonstrated the continuing toll of perinatal morbidity among very low birthweight infants who required prolonged hospitalization and emphasized the need for comprehensive medical and social support, not only during their initial hospitalization, but also after discharge.
Fluorometric microassay of trypsin and enteropeptidase in children — comparison with a titrimetic assay
Authors: MITCHELL JOHN D. , MESSINA ISABELLA M.
Published: March 2008

Abstract Two trypsin assay methods for the estimation of this enzyme in duodenal fluid from children have been compared. Assay results for a fluorometric method based on the use of N‐carbobenzoxy‐diglycyl‐L‐arginyl‐2‐naphthylamide hydrochloride (GANA) as the trypsin substrate were found to correlate well (r=0.91, P<0.001) with those obtained with a much less sensitive titrimetric assay which used benzoylarginine ethylester hydrochloride (BAEE) as substrate. The higher sensitivity of the fluorometric assay has allowed accurate determination of trypsin activity in 10 μl aliquots of duodenal fluid. This low volume requirement makes the assay suitable for studies on infants of all ages and conserves duodenal fluid for use in other investigations often warranted during the assessment of childhood malabsorption.

The fluorometric assay has also been used to monitor the separation of enteropeptidase from trypsin(ogen) by chromatography on Sephacryl S‐200 in samples of duodenal fluid from two children. Different proteolytic pathway deficiencies were confirmed in these children.
Failure of Mullerian duct development. The Mayer‐Rokitansky‐Kuster‐Hauser Syndrome
Authors: WRIGHT JAMES E.
Published: March 2008

Abstract A 3 year old girl with this syndrome is described. She presented with bilateral inguinal hernias containing palpable gonads. She was found to have total absence of vagina, absence of uterus, Fallopian tubes and right kidney. She had an ectopic left kidney and spinal abnormality. Chromosome analysis revealed normal 46 XX karyotype and the gonads were histologically normal ovaries. The Mayer‐Rokitansky‐Kuster‐Hauser Syndrome is a failure of development in part or whole of the paramesonephric (Mullerian) duct, and sometimes of part of the mesbnephric (Wolfflan) system. This results in absence of uterus, tubes, cervix uteri and usually the whole vagina. The syndrome is contrasted with testicular feminization in which the patient has an XY karyotype, has no uterus or tubes but usually a shallow vagina.
Oesophageal atresia in father and daughter
Authors: LIPSON ANTHONY H. , BERRY ANDREW B.
Published: March 2008

Abstract We report oesophageal atresia without tracheo‐oesophageal fistula in a father and daughter, the first case of recurrence of oesophageal atresia without fistula to be reported in a parent and offspring.
Drug overdose in children
Authors: TIBBALLS J. , McARDLE EDWARD J. , BROWN T. C. K.
Published: March 2008

This paper reviews epidemiological factors, drugs taken, management and outcome of 478 children admitted to the Royal Children's Hospital with drug poisoning during the 5 years 1978‐82. Accidental ingestion in young children is still common whilst self poisoning is increasing in the age group 8‐17 years. Suicide attempts and self destructive ingestion accounted for 11.5% of all cases with two deaths. A significant number in this group were less than 10 years of age. latrogenic poisoning accounted for 11% of all cases with metoclopramide or prochlorperazine frequently involved. Benzodiazepines, major tranquillizers and antihistamines were the most commonly taken groups of drugs whilst the greatest number of admissions to Intensive Care Unit were due to tricyclic poisoning. Principles of management are discussed.
Intestinal parasites and bacteria in Aboriginal children in South West Australia
Authors: GILL J. S. , JONES H. I.
Published: March 2008

In a study of intestinal parasites in 697 Aboriginal children under the age of 6 years in South‐west Australia, Giardia lamblia was recorded in 26% and Hymenolepis nana in 13.9%. G. lamblia infections occurred above 4 months of age, and H. nana infections above 18 months of age. There was a close correlation between infection with these two species (X2, P<0.001). Campylobacter jejuni, the predominant bacterial species recorded, was isolated in 2.3%, and was related to bowel symptoms in one child. G. lamblia was more prevalent in the country areas than in the Perth metropolitan area (X2, P<0.05. H. nana was more prevalent in children whose weight was below the third percentile (X2, P<0.02), and in those with diarrhoea (X2, P<0.01). There were strong correlations between low weight (below third percentile), a history of recent diarrhoea, and discharging ears.
Mumps as a cause of admission to hospital: An estimate for Western Australia 1981
Authors: MASTERS PETER L. , O'CONNOR GAVAN P. , BUCENS MARION , BROOKS BERESS
Published: March 2008

Close to 40% of children admitted to Princess Margaret Hospital with mumps over the period 1979 to 1982 were diagnosed retrospectively as a result of virological tests and their illness was not coded as being due to mumps. This clinical underestimate of the incidence of mumps is due to the frequent absence of salivary gland enlargement, especially in preschool children. In such cases there is usually evidence of inflammation of the upper respiratory tract. The main clinical features leading to admission were neck stiffness, fits and high fever. An appropriate adjustment was made to the figures obtained from the computerised data on discharges with the diagnosis of mumps from Western Australian hospitals in 1981. This led to the estimate that 104 patients suffering from mumps were discharged from hospital during that year. It was also estimated that mumps was responsible for 379 in‐patient days. Our findings show that the benefit cost ratios for mumps immunization of others are underestimates.
Acute chromium poisoning in a 2 year old child
Authors: WALPOLE IAN R. , JOHNSTON KAY , CLARKSON ROGER , WILSON GARTH , BOWER GEOFF
Published: March 2008

Sodium dichromate ingestion in children is uncommon and potentially lethal. The most appropriate management is uncertain because of the lack of sound data contained in the few reports of successfully treated patients. Immediate treatment should include urgent induction of emesis, administration of ascorbic acid as an antidote, followed by supportive treatment.
Infant feeding in colonial Australia 1788–1900
Authors: THEARLE MICHAEL J.
Published: March 2008

Abstract In nineteenth century Australia, concern to reduce a high infant mortality rate prompted discussion of various alternatives in infant feeding practices. Breast feeding was encouraged, although problems inherent in the practice of wet nursing were highlighted. Warnings against adulterated milk and poorly prepared cereal food were frequent. At the end of the nineteenth century a consensus had been reached which paved the way for the development of the educative initiatives of the infant welfare movement of the twentieth century.
The incidence and type of reactions to plain and adsorbed DTP vaccines
Authors: FEERY BRIAN J. , FINGER WILLIAM K. , KORTUS ZYGMUNT , JONES GILLIAN A.
Published: March 2008

Abstract The incidence and type of reactions after administration of plain and adsorbed diphtheria‐tetanus‐pertussis vaccine were recorded in a blind controlled prospective study of 2041 vaccinations in 1075 infants receiving routine childhood immunization. There was no significant difference in the total incidence or type of general reactions after plain and adsorbed vaccine, but local reactions were significantly less frequent after plain vaccine. General reactions were recorded after 41.5% of vaccinations with plain vaccine and after 40.8% of vaccinations with adsorbed vaccine. Local reactions were reported in 66.7% and 76.5% of recipients respectively. The most commonly reported systemic reactions were irritability and fever. Three recipients of plain vaccine and one of adsorbed vaccine suffered hyporesponsiveness or collapse. One recipient of each vaccine suffered a convulsion. No persisting sequelae were recorded.
The assessment of children with school problems: Evaluation of a hospital‐based multidisciplinary clinic
Authors: OBERKLAID FRANK , WHITE MARGARET
Published: March 2008

Abstract A hospital based multidisciplinary clinic for the assessment of children with school problems was evaluated. Questionnaires were sent to parents and teachers of 44 children seen during the first year of operation of the clinic. The majority of parents found the assessment and report valuable in answering their questions about the child; felt the report was clear and helpful, and the recommendations appropriate and practical. Ninety per cent of recommendations made were implemented. These results indicate that such clinics would seem to be an appropriate way to address the needs of children with school problems, an important segment of the new paediatric morbidity.
The harmful effects of noise in a children's ward
Authors: KEIPERT JAMES A.
Published: March 2008

Abstract Because of concerns frequently expressed by members of staff about the annoyance caused by noise in a children's ward, noise levels were measured. These confirmed that ambient and peak levels were well in excess of levels recommended for hospital wards and were often above those recommended for average outdoor situations.

The harmful effects of noise in general are discussed with regard to annoyance and the effects on hearing, performance, accident rates, social relationships and sleep. Interviews with members of ward staff confirmed a high degree of worry about noise levels and revealed that machines for ward cleaning were the most annoying noise source, followed by the crying of infants. Patients and parents probably suffer similar annoyance and distress from noise. Possible harmful effects on patients are discussed and measures to reduce noise levels in wards are suggested.
Congenital rubella syndrome in Western Australia
Authors: STANLEY FIONA J. , BURGAR PAMELA J. , FONG NEALE W. , MILROY HELEN M.
Published: March 2008

Abstract The birth prevalence of congenital rubella syndrome (CRS) in Western Australia has been around 20 per 10 000 live births with peaks up to 100 per 10 000 in rubella epidemic years. The rate appears to be falling but it is still too soon to know whether the rubella vaccination programme in Western Australia has made a significant impact. The cohorts of young women who would have received the schoolgirl vaccination programme are only now entering the child bearing age groups. Observed falls may be due also to delayed diagnosis particularly of cases of deafness only. The proportion of nonimmune young women who would have been eligible for the programme in one maternity hospital has fallen.

This study needs to be repeated to ascertain whether further epidemics of rubella have resulted in peaks of CRS or whether the vaccination programme has started to have an effect.
Renal abnormalities and spondylometaphyseal dysplasia
Authors: CARTER P. , BURKE J. R. , SEARLE J.
Published: March 2008

Abstract A renal lesion has not been previously described in association with spondylometaphyseal dysplasia. A case of nephrotic syndrome with progression to renal failure from focal segmental glomerulosclerosis is described.
A comparison of inhaled powders of fenoterol and salbutamol in asthma
Authors: ASHER M. I. , DUNN C.
Published: March 2008

Abstract The present study compares fenoterol and salbutamol powders (0.2 mg). Twenty‐five children with frequent episodic asthma, aged 4–9 years, entered a double‐blind, randomized, crossover, placebo controlled study. On each of three days fenoterol, salbutamol or placebo were given in random order. Lung function testing and other observations were made before and at set intervals up to 4 h after the treatments. Both inhaled powders increased the forced expired volume in 1 s and the maximum mid‐expiratory flow rate significantly above placebo effect. No side effects were observed and there were no significant differences in bronchodilator efficacy between fenoterol and salbutamol.
Pulmonary actinomyces in a child
Authors: MASTERS BRENT , PHELAN PETER D. , AULDIST ALEX W.
Published: March 2008

Abstract Pulmonary actinomycosis is rare in Australian children. A patient with the condition is described in whom a diagnosis was made by open lung biopsy. She was treated successfully with penicillin and tetracycline.
Herbicides and congenital malformations: A review for the paediatrician
Authors: PEARN JOHN H.
Published: March 2008

The herbicides 2,4,5‐T and 2,4‐D are relatively non‐toxic to primates, in acute exposure. Dioxins, which have occurred as impurities in these two herbicides, manifest universal biological toxicity. The best understood dioxin TCDD, has, in susceptible strains of mice, a very low teratogenic minimal effective dose of 1–10 μg/kg. This fact has engendered an era of uncertainty about the potential teratogenic effects of herbicides, in the context of potential human exposure. This paper reviews current knowledge concerning herbicide teratogenesis following maternal exposure. Because of species specificity of teratogenic agents, it is not possible to extrapolate from effects in lower animals to potential effects in humans. It remains a fact however that all proven human teratogens have parallel animal models. Following maternal exposure to herbicides and to dioxins, it has not been possible to produce teratogenic effects in primates, although fertility may be affected. Epidemiological reports from Hungary, Italy (the ICMESA accident), New Zealand, the United States, Europe and Australia have not revealed any positive evidence to indicate that a human herbicide teratogenic syndrome exists.
Usefulness of oesophageal pH monitoring
Authors: DAVIDSON G. P.
Published: March 2008

Gastro‐oesophageal reflux (GOR) is a common paediatric problem which usually in the past has been diagnosed clinically, perhaps backed up by the barium oesophagogram. In the past 10 years, there has been a proliferation of further diagnostic techniques for GOR, possibly reflecting the inability of any single test to make a definitive diagnosis. The justification for this explosion of tests and the need to make a definitive diagnosis is two fold. Firstly, we know that GOR can cause significant disabilities which are often difficult to diagnose or determine the cause of (e.g. recurrent respiratory disease and sudden infant death syndrome),1 and secondly, an effective model of surgical therapy is now available.2
Headache
Authors: COLLINS KEVIN J.
Published: March 2008

Headache is said to be the most common human ailment and has been described from ancient times. While recurrent or chronic headaches are less common in children than in adults, they remain a source of great concern to parents and frequently result in paediatric or neurologic referral. This review will address some issues in the initial evaluation of the child with headaches.
The growth and development of twins compared with singletons at ages 9 and 11
Authors: SILVA PHIL A. , CROSADO BRYN
Published: March 2008

The growth and development of 9 and 11‐year old twins who have been studied at birth, and at ages 3, 5, and 7 years was compared with that of a large group of singletons. The twins were not signficantly different to the singletons in language development, reading, spelling or Performance IQ. They remained significantly shorter, lighter and had smaller head circumferences. This difference was shown to have been fairly consistent from age 3. The twins had significantly lower Verbal and Full Scale IQ, but in view of a lack of disadvantage in educational progress this was not considered to be of any practical importance.
Kernicterus in term infants
Authors: YEUNG C. Y.
Published: March 2008

Kernicterus is a frequent occurrence in Chinese term infants. In a previous study, the mean level of serum bilirubin of 152 kernicteric infants was 35.4 mg/dl (605.3 μmol/l) and the range was 22.3‐50 mg/dl. More recently, three further term infants developed kernicterus and one exhibited bilirubin level of only 23.3 mg/dl. Features of haemolysis were lacking in 56.8% of these infants. Evidence of brain damage occurred in 26.5% in a former series and in 5.5% of the more recent study of those infants who developed bilirubinaemia exceeding 20 mg/dl. Such a high risk favours the present practice of exchange transfusion for rising bilirubin beyond 20 mg/dl (342 μmol/l) in Chinese term infants.
A comparative study of the inhaled dry powders of salbutamol and fenoterol and their delivery systems
Authors: DAWSON K. P. , ALLAN J. , FERGUSSON D. M.
Published: March 2008

Abstract A study was designed to establish whether there was a difference in response to inhaled salbutamol powder (400 μg) and fenoterol powder (200 μg) and whether the specific inhaler devices were a contributing factor. In the study of 40 children no significant difference could be attributed to the devices, but the salbutamol treated group had a marginally better response in two parameters of lung function.
Comparison of hydrometry, refractometry, osmometry and Ames N‐Multistix SG in estimation of urinary concentration
Authors: McCROSSIN T. , ROY L. P.
Published: March 2008

Abstract The four currently available methods used for estimating urinary concentration were assessed. One hundred and fifty urine specimens were collected and 130 were measured. Twenty were excluded as they contained protein and/or glucose. The volume of 41 samples was inadequate for hydrometry.

In urines not containing dissolved macromolecules, hydrometry, refractometry and osmolality reliably reflect the degree of concentration. Except at the extremes, the reagent strip on N‐Multistix SG is not a reliable indicator of specific gravity.

In a Children's Hospital, one‐third of urine specimens will be of insufficient volume for standard hydrometry.
Endocardial fibroelastosis and infantile polycystic disease
Authors: EBELING PETER , BURKE JOHN R. , RADFORD DOROTHY J.
Published: March 2008

Abstract A child with infantile polycystic disease who developed cardiac failure from endocardial fibroelastosis is described. Endocardial fibroelastosis has been reported in adult type polycystic disease in childhood. Endocardial fibroelastosis should be suspected in a child with polycystic disease who develops unexplained cardiac failure.
Hereditary pancreatitis presenting in childhood: Case report with family studies
Authors: HILMER RALPH S. , NAYANAR VIMALA V. , BOHANE TIMOTHY D.
Published: March 2008

Abstract A 12‐year‐old boy presented with recurrent abdominal pain and failure to thrive and was shown to have chronic calcific pancreatitis. Investigations failed to show any of the demonstratble causes of pancreatitis, but on family study four close paternal relatives were found to have had chronic pancreatitis, three with radiological calcification. No definable cause for pancreatitis had been determined in any of these relatives.
The medicalization of Aboriginal children: A comparison of the lengths of hospital‐stay of Aboriginal and non‐Aboriginal children in Western Australia and the Northern Territory
Authors: WADDELL CHARLES , DIBLEY MICHAEL
Published: March 2008

This paper compares the lengths of hospital‐stay of Aboriginal and non‐Aboriginal children in Western Australia and the Northern Territory over the past few years. The comparison yields two trends: (1) Aboriginal children stay longer in hospital than do non‐Aboriginal children; (2) within each racial group, children stay longer in hospital in the Northern Terrritory than in Western Australia. By‐and‐large, these trends continue irrespective of age, sex, diagnostic category. hospital and usual piece of residence. It appears that factors In addition to high rates of infectious disease, severity of illness and remoteness of home address affect length of hospital stay. Two organizational factors are suggested: (1) the latent, working logic of service institutions such as public hospitals and (2) the tendency of government to institutionalize impoverished people. It is concluded however, that as health care becomes holistic and more the responsibility of Aboriginal people, there is every reason to predict a decrease in the lengths of hospital stay of Aboriginal children.
Sleep in middle childhood — A longitudinal study of sleep problems in a large sample of Dunedin children aged 5‐9 years
Authors: CLARKSON SARAH , WILLIAMS SHEILA , SILVA PHIL A.
Published: March 2008

Complaints of sleeping difficulties in a large group of New Zealand children were studied prospectively over four years from 5 to 9 years of age. No association was found between sleeping difficulties and the sex, intelligence, or educational attainments of the child. Mothers who described their child as anxious or who were poor sleepers themselves, tended to report sleeping problems in their child more frequently. There was no association between sleeping problems and teacher ratings of behaviour problems. Children who reported sleep problems also tended to report other problems. There was low agreement between parents and children. Only 0.3% of the total sample had a problem which persisted over the whole period.
The perception of asthma
Authors: COURIEL J. M. , DEMIS T. , OLINSKY A.
Published: March 2008

Subjective scores of ‘wheeze’ or ‘tightness in the chest’ were compared with the forced expiratory volume in 1 s (FEV1) in 40 asthmatic children before and after administration of nebulized salbutamol. Symptom scores were poor predictors of the degree of airways obstruction. Many children underestimated their improvement after salbutamol.

The results suggest that reliance on the child's perception of his symptoms and his response to a bronchodilator may result in incorrect assessment and inappropriate treatment.
Vitamin A status in children who are prone to respiratory tract infections
Authors: PINNOCK CAROLE B. , DOUGLAS ROBERT M. , BADCOCK NEIL R.
Published: March 2008

The effect of Vitamin A supplementation on susceptibility to acute respiratory infections was investigated in a randomized controlled trial. One hundred and forty‐seven preschool‐age children with a history of frequent respiratory illness were randomized into Vitamin A supplemented (450 g/day) and placebo groups. Respiratory symptoms were recorded on a daily basis over a period of 11 months. The children who received the supplement experienced 19% fewer episodes of respiratory symptomatology (P<0.05) than their placebo counterparts, despite the fact that their plasma retinol levels did not change. Children with a prior history of lower respiratory illness or of allergy benefited most from supplementation. The plausibility of a role for Vitamin A in the aetiology of respiratory proneness is reviewed.
Responses to partial nasal obstruction in sleeping infants
Authors: NEWMAN NEVILLE M. , FROST JAMES K. , BURY LOIS , JORDAN KERRY , PHILLIPS KATHLEEN
Published: March 2008

Partial nasal obstruction was performed during a morning of quiet sleep (QS: non‐REM) and active sleep (AS: REM) at ages 1 week, 2 weeks, 1, 2, 3, 4 and 6 months on 12 normal infants, 15 subsequent siblings of victims of the Sudden Infant Death Syndrome (SIDS) and 12 infants admitted for investigation of infant apnoea (‘near‐miss’ SIDS). In all three groups the numbers failing to arouse after 240 s (FTA‐240) in QS were significantly greater than those in AS. After 2 months of age all groups showed a decrease in the number FTA‐240 in AS, whereas in QS the number did not change significantly. Subsequent siblings of SIDS had a significantly higher number FTA‐240 in QS than controls. There was no significant difference in FTA‐240 in QS between controls and infant apnoeas, although there was a trend for this to be higher in subsequent siblings of SIDS than infant apnoeas.

It was concluded that arousal from AS is more marked than from QS, that after 2 months of age the ability to arouse from AS increases, and that in relation to SIDS, QS is the sleep state in which the infant is less able to arouse. Furthermore, subsequent siblings of SIDS differ from normal infants in their ability to arouse from QS.
Influence of age, sex, duration of symptoms and dehydration of serum electrolytes in hypertrophic pyloric stenosis
Authors: BEASLEY S. W. , HUDSON I. , HOK PAN Y. , JONES P. G.
Published: March 2008

A review was conducted of 234 consecutive patients with hypertrophic pyloric stenosis (HPS) proven at operation. The relationship of age, sex, the duration of symptoms and the clinical degree of dehydration to the severity of metabolic derangement as reflected by alterations in serum electrolytes and acid‐base status, was analysed statistically. The length of history and the degree of dehydration was found to have predictive value in identifying those likely to have major metabolic disturbances. Where severe vomiting has persisted for more than 1 week, major derangements of the biochemical parameters should be anticipated; and where clinical assessment of dehydration is estimated as being greater than 5%, there is almost always some major biochemical abnormality present. Nevertheless, variation in individual cases necessitates that all patients with suspected HPS should have serum electrolytes and acid‐base estimations performed.
Periventricular haemorrhage and leukomalacia in extremely low birthweight infants
Authors: SZYMONOWICZ W. , YU V. Y. H.
Published: March 2008

Forty (49%) of 82 extremely low birthweight (ELBW, <1000 g) infants had periventricular haemorrhage (PVH). Ten (12%) had germinal layer haemorrhage (GLH) alone, 16 (20%) had intraventricular haemorrhage (IVH) and 14 (17%) had intracerebral haemorrhage (ICH). Almost all the cases of PVH had developed by 4 days of age. Small‐for‐gestational age infants (12% of study population) had a significantly lower incidence and severity of PVH than appropriate‐for‐gestational age infants. Of 94 infants born between 23 and 28 weeks gestation, 45 (48%) had PVH. The PVH incidence was 60% in those of 23‐26 weeks and 38% in those of 27‐28 weeks. The hospital survival rate of ELBW infants was 69% in those without PVH and 43% in those with PVH; 70% in GLH alone; 50% in IVH and 14% in ICH. Three survivors developed post‐haemorrhage hydrocephalus of whom two required ventriculoperitoneal shunting. Five survivors developed periventricular leukomalacia (PVL) evidenced by cysts identified between 3 and 7 weeks of age. A significant decrease in the incidence of PVH occurred over the study period (67% in 1982, 38% in 1983 and 33% in 1984). This decrease was seen for ail grades of PVH. The reasons for this decreased incidence are still to be ascertained but this trend suggests that improvements in neonatal intensive care have the potential to improve the neurological outcome of more recent ELBW survivors.
Duodenal ulceration: A complication of Tolazoline therapy
Authors: BUTT W. , AULDIST A. , McDOUGALL P. , DUNCAN A.
Published: March 2008

Tolazoline Hydrochloride is a pulmonary vasodilator that is used for the treatment of pulmonary hypertension of the newborn. Two patients who were receiving Tolazoline by infusion developed duodenal ulceration and subsequent intestinal perforation. This undesirable side effect of Tolazoline may be prevented by the concomitant use of antacids to maintain gastric pH greater than 5.
Should a lateral chest radiograph be routine in suspected pneumonia?
Authors: KENNEDY J. , DAWSON K. P. , ABBOTT G. D.
Published: March 2008

Abstract A study was undertaken on the chest X‐rays of 414 children suspected clinically of having pneumonia, to ascertain whether the lateral film provided additional diagnostic information. In only nine cases the lateral film confirmed the diagnostic value of the frontal film and it is suggested that a routine lateral chest film should not be taken for children suspected of having pneumonia.
Cardiac surgery in the first year of life: The effect on weight gains of infants with congenital heart disease
Authors: SHOLLER G. F. , CELERMAJER J. M.
Published: March 2008

Abstract Forty‐seven infants with ventricular septal defect (n= 17), tetralogy of Fallot (n= 7) and transposition of the great arteries (n= 23) who had ‘corrective’ surgery in the first year of life were reviewed with respect to birthweight and pre‐ and postoperative growth. The mean birthweight for each group was below that of the standard population. There was an overall decrease in growth velocity pre‐operatively which was reversed after surgery. At follow up, 12‐18 months later (means), most infants had regained at least their birthweight percentile, while the group with ventricular septal defect exceeded it. Consideration is given to the pathophysiological mechanisms contributing to these observations.
Blood glucose monitoring by children at home: A comparison of methods
Authors: ANDERSON D. G. , GLEESON M. , BOULTON T. J. C.
Published: March 2008

Abstract The accuracy of measurements of blood glucose performed at home by the index children and/or parents was compared using the Boehringer Mannheim reagent strips, Ames Visidex‐2 strips, an Ames Glucometer and a Boehringer Mannheim Reflolux reflectance meter.

Capillary plasma samples, collected simultaneously, were later analysed by a Beckman glucose oxidase analyser. The coefficent of correlation between the self‐monitored results (SMR) and the laboratory‐analysed results (LAR) ranged from 0.59 to 0.92, the composite being 0.74. The mean difference between the SMR and the LAR was 1.0 mmol/l.

The occurrence of potential errors of management due to incorrect SMR results was determined. On four occasions, the SMR was greater than 6 mmol/l when the LAR was less than 3 mmol/l, and on 36 occasions a discrepancy greater than 50% occurred between the two values, without resulting hypoglycaemia.
The value of catecholamine metabolite determination on untimed urine collections in the diagnosis of neural creast tumours in children
Authors: KELLIE S. J. , CLAGUE A. E. , McGEARY H. M. , SMITH P. J.
Published: March 2008

Abstract There is still controversy regarding the relative merits of catecholamine metabolite estimations on 24 h versus untimed urine collections. The former has the advantage of taking into account diurnal variation in the rate of metabolite excretion but has the disadvantages of delaying results and of being affected by errors in collection. In this study percentile values were established for a reference population of 181 children for urinary 4‐hydroxy‐3‐methoxyphenylacetic acid (HVA) creatinine and 163 children for 4‐hydroxy‐3‐methoxymandelic acid (VMA)/creatinine, using untimed urine collections. Results of similar determinations performed as part of the diagnostic work up of 23 consecutive children subsequently proven to have neural crest tumours showed that all patients had the value of at least one metabolite concentration at or above the highest reference value. In neuroblastoma all patients' VMA/creatinine exceeded the highest reference value and in neural crest tumors overall, this ratio was greater than the highest reference value in 96% of patients. These results are as good as, or better than, previously published results and demonstrate the practical value of using catecholamine metabolite determinations expressed as ‘creatinine equivalents’ on untimed urine specimens in the diagnosis of neuroblastoma and related tumours in children.
Poor co‐ordination in 5 year olds: A screening test for use in schools
Authors: JOHNSTON O. , CRAWFORD J. , SHORT H. , SMYTH T. RAYMOND , MOLLER J.
Published: March 2008

A simple standardized screening test (South Australian Motor Co‐ordination Screening Test, SAM Test) was developed to screen for poor co‐ordination in 5 year olds; This SAM Test, which can be used by teachers, nurses and doctors, has explicit pass/fail criteria and has classified correctly 90% of children. The McCarthy Motor Scales, which are time consuming and limited to use by psychologists, were used to categorize 60 poorly co‐ordinated and 60 normal children. The 120 children thus selected were tested on 19 items covering gross and fine motor skills. Statistical analysis to determine which items best discriminated between the two groups found the following five gross motor items to be most effective: one leg balancing, hopping, heel‐toe walking on line, jumping Over ribbon and dropping ball and catching.
The severity of acute asthma attacks in children admitted to hospital
Authors: DAWSON K. P.
Published: March 2008

One hundred and twenty‐six children admitted to hospital with an acute asthmatic episode were assessed as to the severity of their attack by the use of a clinical score. Fifty‐one per cent had a score which equated with severe or very severe asthma. Frequent independent scoring indicated that observer bias was minimal. The proportion of children with severe asthma admitted to hospital in Christchurch was significantly greater than a similar study in England using the same scoring system. The rise in hospital admission rates for asthma in Christchurch is not due to an increase in the admission of children with milder forms of asthma.
Food intake at age 8 1. Energy, macro‐ and micronutrients
Authors: MAGAREY A. , NICHOLS J. , BOULTON J.
Published: March 2008

The food energy, macro‐, and micronutrient intake of 78 boys and 63 girls aged 8 years who have been studied since birth is reported. Nutrient intake was calculated from 4 day weighed records using the CSIRONET data bank based on British tables of food composition.

The mean values for daily intake for girls and boys, respectively, for energy (MJ), protein, fat, carbohydrate and fibre (g) were 7.4 and 6.5; 64 and 57; 71 and 62; 232 and 206; and 15 and 12 g.

Half trie food energy came from carbohydrate, divided equally between starch and simple sugars, 15% from protein, and 35% from fat. This comprised 41 % saturated (S), 33% mono‐ and 16% polyunsaturated (P). The mean P: S ratio for girls was 0.46, and 0.41 for boys. Overall sweets and soft drinks contributed 4–5% to energy intake, with large individual differences. Mineral and vitamin intakes were satisfactory in relation to theoretical optimal population needs. Vitamin and/or mineral supplements were taken by 8.5% of the sample. These results are discussed in relation to the Nutritional Guidelines.
Perinatal factors and the development of chronic lung disease in preterm infants: A case control study
Authors: WATSON E. D. , HENDERSON‐SMART D. J. , STOREY G. N. B. , PEAT B. , GRATTAN‐SMITH P.
Published: March 2008

A case control study of neonates was performed to determine those factors contributing to the development of chronic lung disease (CLD). During the 5 years 1981 ‐84 there were 487 neonatal survivors at gestations of 25–32 weeks; 391 of these developed respiratory failure (oxygen therapy required for more than 6 h). Fifty‐six of the latter developed CLD (oxygen therapy required for more than 28 days and a coarse reticular pattern on chest X‐ray). These neonates were predominantly of the shortest gestational ages, regardless of the initial chest X‐ray diagnosis. Forty‐three of these infants with CLD were matched for gestation and initial chest X‐ray appearance (respiratory distress syndrome, n= 20; normal, n= 15; non‐specific, n= 8) with 42 control infants.

The mean duration of oxygen therapy (P< 0.001), maximum FiO2 (P< 0.001), incidence (P< 0.01) and duration of intermittent positive pressure respiration (IPPR; P < 0.05) and peak IPPR (P < 0.05) were significantly greater in the CLD group. Mean birthweight (P < 0.001), arterial cord pH (P < 0.05) and base excess (P < 0.05) were significantly lower in the CLD group. Factors that were not statistically significant in the development of CLD included antenatal fetal heart rate abnormality, hypertensive disease of pregnancy, acute intrauterine infection (chorioamnionitis or umbilical vasculitis). administration of antenatal steroids, sex, patent ductus arteriosus and pneumothorax.
Low colloid osmotic pressure in very low birthweight infants receiving assisted ventilation
Authors: LESLIE G.I. , PHILIPS J.B. , CASSADY G.
Published: March 2008

Plasma colloid osmotic pressure (COP) was measured in three groups of very low birthweight infants. Babies in Group 1 (n= 8) were breathing spontaneously and had no respiratory disease. Those in Group 2 (n= 9) received assisted ventilation for hyaline membrane disease (HMD), and those in Group 3 (n= 7) received assisted ventilation for other reasons (five apnoea, two pneumonia).

Both assisted ventilation groups had lower mean COP values than spontaneously breathing infants. Mean values (s.e.m.) for Groups 1,2 and 3, respectively, were: 15.3 (0.6), 11.3 (0.4) and 11.9 mmHg (0.5)(P < 0.001) on Day 1; and 15.2 (0.4), 12.9 (0.4) and 12.8 mmHg (0.3) (P < 0.001) on Day 2. The Increase from Day 1 to Day 2 was significant for those with HMD (P < 0.05). Colloid osmotic pressure correlated with mean blood pressure (r= 0.51; P< 0.001) but not with birthweight, gestation, crystalloid fluid intake or pH.

The role of low COP in the pathogenesis of acute respiratory failure in infants with uncomplicated HMD is unclear, but such low COP may contribute to development of pulmonary oedema as a complication, particularly if the ductus'arteriosus is still patent and the infants are given high volume intravenous fluids.
Intracranial embryonal carcinoma and precocious puberty
Authors: CHEUNG P. T. , LOW L. C. K.
Published: March 2008

A boy aged 7.5 years presented with precocious onset of secondary sexual characteristics and symptoms and signs of neurological dysfunction. A CT brain scan demonstrated a suprasellar mass lesion. The elevated β‐hCG and α‐fetoprotein concentrations in cerebrospinal fluid and in serum were consistent with a diagnosis of intracranial embryonal carcinoma, although histological diagnosis was not available. The tumour markers β‐hCG and α‐FP should be looked for in all children with precocious puberty presenting with midline brain tumours.
Acute abdominal distension following Cryptosporidium infection
Authors: STUART J. , BURGESS M.
Published: March 2008

Two children, aged 15 months and 3 years, developed abdominal distension following proven Cryptosporidium enteritis. Both required readmission to hospital and both improved rapidly, one spontaneously and one with the help of an enema. The association of abdominal distension and Cryptosporidium infection has not been described previously.
Lung function after pertussis
Authors: HUGHES D. M. , NEWTON‐JOHN H. , CHAY O. M. , LANDAU L. I.
Published: March 2008

The relationship between pertussis infection and subsequent abnormalities of pulmonary function is not clear. Thirty subjects (16 male, 14 female) aged 14.3 years (s.e.m.= 1.9) were studied who had been hospitalized with culture‐proven pertussis when less than 6 months of age. Details of respiratory symptoms in the subjects and their families were obtained. Standard spirometry, lung volumes by body plethysmography, maximum flows at low lung volumes and histamine challenges were performed.

Nine of 30 (30%) subjects were symptomatic with a history of recurrent cough and wheeze while 11 of 30 (37%) had abnormal pulmonary function tests. Seven of nine symptomatic subjects had abnormal pulmonary function including positive histamine challenges. Twenty‐one per cent had a family history of asthma.

This study indicates that children hospitalized in infancy with pertussis can subsequently be shown to have recurrent lower airways symptomatology and abnormal pulmonary function, but the incidence is not significantly higher than a control group from the same socio‐economic background.
α‐Fetoprotein levels in fullterm and very low birthweight infants
Authors: TAN K. L. , LOGANATH A. , MYLVAGANAM A. , KARIM S. M. M. , KOTTEGODA S. R. , RATNAM S. S.
Published: March 2008

Plasma α‐fetoprotein (α‐FP) levels were determined in fullterm and very low birthweight (VLBW) infants in the first week of life and serially in a cohort of VLBW infants for the first 24 weeks after delivery. A rapid decline in α‐FP levels was observed in both the fullterm and VLBW infants initially. Beyond 2 weeks of age, there was a gradual, linear decline until 6 weeks, followed by a more rapid period of decline from 6 to 16 weeks. The decline in the ensuing weeks demonstrated an asymptotic pattern. The half‐life of α‐FP was 7.5 days in the first week of life in both fullterm and preterm infants, 28.7 days from 2 to 6 weeks of life and 11.9 days from 6 to 16 weeks of life in VLBW Infants.
Objective assessment of limb movement in children with cerebral palsy
Authors: REDDIHOUGH D. S. , COURT J. M. , EVANS O. , HUDSON I. L.
Published: March 2008

Abstact

A preliminary report of a method for assessing the quality of movement in children with cerebral palsy, using an accelerometer, is presented. Able‐bodied and disabled children performed a simple task, and there were marked differences between the two groups. Whilst the technique requires further development, it is hoped that accelerometry may eventually provide an objective tool to enable rigorous testing of various therapeutic procedures in cerebral palsy
Protein, lactose and fat concentration of breast milk of mothers of term and premature neonates
Authors: ARNOLD J. , LESLIE G. , CHEN S.
Published: March 2008

The protein, lactose and fat concentrations in the milk of seven mothers giving birth at term and six mothers giving birth prematurely were determined. Samples were obtained during the first 31 days of lactation. The protein, lactose and fat concentrations of preterm milk were found to be similar to those of fullterm milk over this period. For both term and preterm groups, protein concentration decreased with increasing age, while lactose concentration increased. Fat concentration did not show a consistent pattern of change in the preterm group, but tended to increase with advancing age in the term group.
Intrathoracic pressure fluctuations and periventricular haemorrhage in the newborn
Authors: HILLMAN K.
Published: March 2008

The incidence of periventricular intraventricular haemorrhage (PVH‐IVH) in premature infants with respiratory distress syndrome (RDS) remains at about 40%. Although there are certain inherent anatomical and physiological features of a neonate which predisposes them to PVH‐IVH, there is conflicting evidence about the precipitating cause. The most significant antecedents of PVH‐IVH are mechanical ventilation and barotrauma. This report examines the hypothesis that the final common pathway in PVH‐IVH is fluctuation in intrathoracic pressure, and then attempts to explain previous anomalies and conflicting results which have implicated other causes. Suggestions are offered as to how changes in current management could contribute to a decreased incidence of this serious and widespread complication in premature infants with RDS.
Professional knowledge of infant feeding techniques (or if you want to know how to feed a baby, ask a nurse)
Authors: OATES R. K. , ULBURNE A. M.
Published: March 2008

Three hundred and forty‐two health professionals who deal with children, including general practitioners, paediatric residents and paediatric nurses were asked questions about their knowledge of infant feeding, particularly how they would recommend mothers to reconstitute milk formulae. A proportion of errors was noted in all groups, with errors occurring more frequently in the medical groups. Mothers seeking feeding advice are most likely to obtain the correct answers from paediatrically trained nurses.
The use of epidural Bupivacaine for the relief of childbirth pain
Authors: BENNETT A. , LUMLEY J. , BARTLETT D.
Published: March 2008

Abstract Epidural anaesthesia is now a widely used method for pain relief in childbirth, particularly using the drug Bupivacaine. There are nevertheless differing opinions in the research literature about the advisability of its routine use. While it is clearly very effective in relieving labour pain, there are some consistent, troublesome patterns; for example, a strong association between epidural use and other interventions, such as instrumental delivery. Further, there are no clear answers from the research to date concerning the risks and benefits of epidural anaesthesia for infant and mother. Answers could be provided by randomized clinical trials, but meanwhile a conservative approach to its use is recommended for uncomplicated labours.
Periventricular haemorrhage: Association with patent ductus arteriosus and its treatment with Indomethacin or surgery
Authors: SZYMONOWICZ W. , YU V. Y. H.
Published: March 2008

Abstract A prospective study on 150 infants with a birthweight of 1250 g or less was carried out to investigate the effects of patent ductus arteriosus (PDA), haemorrhagic pulmonary oedema (HPO), Indomethacin therapy and surgical ligation on the development of periventricular haemorrhage (PVH) or the extension of pre‐existing PVH. The incidence of PVH, diagnosed by serial cerebral ultrasonography was 44% and the incidence of PDA, diagnosed by serial M‐mode and contrast echocardiography, was 45%. During the first 8 days after birth when the infants were vulnerable to PVH, the development of PDA did not lead to the development or extension of PVH in 85% of infants. Haemorrhagic pulmonary oedema also had no effect on PVH in 71% of infants. Compared with infants whose PDA or HPO had no effect on PVH, those who had development or extension of haemorrhage had significantly more severe hypercapnia, blood gas instability and hypotension associated with the occurrence of PDA or HPO. Early Indomethacin therapy was not associated with the development or extension of PVH in 93% of infants. Although an elevation of arterial blood pressure was demonstrated after ductal ligation, surgery was performed after 1 week of age in all infants and in no instance was there an effect on PVH. This study suggests that PDA leads to PVH only if it causes significant blood gas and blood pressure disturbances which are known to affect cerebral blood flow adversely.