bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast feeding in neonatal alloimmune thrombocytopenia
Authors: REESE J. , RAGHUVEER T. S. , DENNINGTON P. M. , BARFIELD C. P. 
Published: March 2008

AbstractInfants with neonatal alloimmune thrombocytopenia are at risk of severe intracranial haemorrhage. Placental transfer of maternal immunoglobulin G (IgG) directed against fetal platelet antigens is known to be the underlying mechanism. Since breast milk contains IgG it is theoretically possible that breast feeding of these infants could cause thrombocytopenia. The following case report shows that an infant with neonatal alloimmune thrombocytopenia may be safely breast fed, even when the breast milk contains the platelet specific antibody (HPA‐1a).
Rare disease surveillance
Authors: ELLIOTT E. J. , CHANT K. G. 
Published: March 2008

AbstractRare diseases in children account for disproportionate morbidity and mortality and are particularly demanding of both families and health resources. Surveillance may provide data on their epidemiology, aetiology, management and outcome and on the support requirements of affected children. Existing methods for rare disease surveillance include mandatory and voluntary notification schemes, which may be active or passive, hospital discharge databases and death certification data. The recent establishment of the Australian Paediatric Surveillance Unit has facilitated active, prospective, national case ascertainment by voluntary notification of selected rare conditions. Information obtained should enable estimation of incidence rates, evaluation of prevention and management strategies, extend data collected by existing methods and help estimate future health needs.
Hospitalization of infants for infections in Western Australia, 1980–91
Authors: GRACEY M. , GEE V. 
Published: March 2008

AbstractRates of hospitalization of Aboriginal infants in Western Australia from 1980 through 1991 for infections were much higher than for other infants and were consistently higher in rural areas than in metropolitan areas. There were substantial declines in rates of hospital admissions and bed occupancy of rural Aboriginal infants for respiratory and gastrointestinal infections during the study period; changes in rates for other infections were less marked and less consistent. Despite recent improvements, Aboriginal infants are hospitalized much more frequently and for longer than other infants because of these diseases. Hospitalization rates reflect many factors including disease incidence and severity but also are affected by isolation, climatic and physical conditions, and access to medical and nursing care. Preventive health programmes need to be maintained and intensified in order to improve health standards of young Aborigines and to lessen their need for hospital care.
Clothing and bedding and its relevance to sudden infant death syndrome: Further results from the New Zealand Cot Death Study
Authors: WILSON C. A. , TAYLOR B. J. , LAING R. M. , WILLIAMS S. M. , MITCHELL E. A. ,   the NEW ZEALAND COT DEATH STUDY GROUP
Published: March 2008

AbstractAs part of a large nationwide case‐control study covering a region with 78% of all births in New Zealand during 1987–90, the clothing and bedding of infants dying of sudden infant death syndrome (SIDS) and that of an appropriate control group were recorded. Cases consisted of 81% (n= 393) of all cases of SIDS in the study area and 88.4% (n= 1592) of 1800 control infants randomly selected from the hospital births and who completed a home interview.Use of a wool ‘waterproof’ underblanket was associated with a significantly reduced risk of SIDS (adjusted OR 0.44; 95% CI: 0.26‐0.73) while sheepskin use was not. Firm tucking was identified as contributing to a reduced risk of SIDS even after adjusting for potentially confounding variables (adjusted OR 0.63, 95% CI: 0.46–0.86).Sixty case infants (15.6% of cases) were found dead with the head covered but there were no equivalent data for controls. Having been found previously completely covered by bedding was equally common in cases and controls (28.8% cases and 30.6% of control infants). Other differences of bedding and clothing between cases and controls were small; mattress characteristics were not studied.The exact methods in which babies are cared for are important and this study suggests that infants are at lower risk of SIDS when firmly tucked in and when sleeping on a ‘waterproof wool underblanket.
Application of capture—recapture methodology to estimate the completeness of child injury surveillance
Authors: ROBERTS I. , SCRAGG R. 
Published: March 2008

AbstractThis paper describes the use of the two sample capture‐recapture method to estimate the completeness of ascertainment of injury events in both routine public hospital discharge statistics and in an active injury surveillance system. For all child pedestrian injuries public hospital discharge statistics were 90% complete and the active surveillance system 77% complete. For non‐traffic child pedestrian injuries public hospital discharge statistics were 66% complete, the active surveillance system being 79% complete. Capture‐recapture methods have the potential to improve the accuracy of traditional childhood injury surveillance systems.
Sole parenthood and the risk of child pedestrian injury
Authors: ROBERTS I. 
Published: March 2008

AbstractChildren of sole parents have the worst mortality record of all social groups. Road vehicle related injuries account for a large part of their excess mortality. In this case‐control study the association between sole parent status and the risk of child pedestrian injury was examined. Cases (n= 258) were children killed or hospitalized as a result of a pedestrian injury in the Auckland region over a period of 2 years and 2 months. Controls were a random sample of the child population. The children of sole parents were at a significantly increased risk of injury (odds ratio = 1.57; 95% confidence interval (CI) 1.09, 2.27). However, there was a striking difference in the effect of sole parent status according to ethnic group. Among European families, sole parenthood was associated with a greatly increased risk of injury (OR = 3.13; 95%CI 1.84, 5.31), whereas in Pacific Island families sole parenthood was associated with a significant protective effect (OR = 0.40; 95%CI 0.18, 0.89). The protective effect of sole parent stalus in Pacific Island families may reflect the beneficial effects of the social support provided by extended family networks. Children of sole parents in the context of the nuclear family may be particularly vulnerable.
Genetic predisposition to hypertension (as detected by Na+/Li+ countertransport) and risk of diabetic nephropathy in childhood diabetes
Authors: CHIARELLI F. , VERROTTI A. , KALTER‐LEIBOVICI O. , LARON Z. , MORGESE G. 
Published: March 2008

AbstractIn order to evaluate whether insulin‐dependent diabetes mellitus patients with incipient nephropathy have an overactivity of erythrocyte sodium‐lithium countertransport (Na+/Li+ CT), 82 diabetic children and 38 healthy age‐matched control subjects and their parents and grandparents were studied. The children were divided into two groups according to the presence of persistent microalbuminuria (MA). Diabetic children with MA had Na+/Li+ CT activity higher than normoalbuminuric diabetics and healthy controls. The parents and grandparents of microalbuminuric patients showed higher Na+/Li+ CT than parents and grandparents of normoalbuminuric diabetics and of the controls. This study demonstrates that predisposition to hypertension, as indicated by increased Na+/Li+ CT activity in erythrocytes, is more frequently detectable in patients with persistent microalbuminuria than in diabetics without persistent microalbuminuria or in healthy controls. Overactivity of Na+/Li+ CT is present also in parents and grandparents of diabetic children with MA. This study suggests that genetic predisposition to hypertension is more frequent in patients at risk of developing diabetic nephropathy, as well as in their parents and grandparents.
A cross‐sectional study of growth, puberty and endocrine function in patients with thalassaemia major in Hong Kong
Authors: KWAN E. Y. W. , LEE A. C. W. , LI A. M. C. , TAM S. C. F. , CHAN C. F. , LAU Y. L. , LOW L. C. K. 
Published: March 2008

Methodology: A cross‐sectional study of growth, puberty and endocrine function was performed on 35 girls and 33 boys with thalassaemia major.Results Despite regular transfusion and chelation therapy, 75% of the girls and 62% of the boys over the age of 12 years were below the third percentile for height. Hypogonadotropic hypogonadism was found in a similar percentage of patients. Moderate to marked zinc deficiency secondary to chelation therapy was considered unlikely because normal serum zinc levels were found in all but three of our patients, but we could not exclude the possibility of a marginal status of zinc nutrition causing growth failure. Growth hormone deficiency and diabetes mellitus were sometimes encountered but hypothyroidism, hypoparathyroidism and adrenal insufficiency were rare among our patients. Most of the patients with growth failure had normal growth hormone (GH) response to insulin induced hypoglycaemia. The serum insulin‐like growth factor‐1 (IGF‐1) levels were low in our patients and no significant difference in the serum IGF‐1 levels was found between prepubertal children with or without growth failure (0.4±0.1 mU/mL vs 0.37±0.11 mU/mL, P = 0.39). Similarly, no difference in the serum IGF‐1 levels was found between pubertal children with or without growth failure (0.48 ± 0.2 U/mL vs 0.56 ±0.14 U/mL, P= 0.26).Conclusions Delayed sexual maturation and a possible defect in growth unrelated to the GH‐IGF‐1 axis may be responsible for the growth failure in adolescent children with thalassaemia major.
Efficacy of phototherapy for hyperbilirubinaemia in infants with the respiratory distress syndrome
Authors: TAN K. L. , LIM G. C. , BOEY K. W. 
Published: March 2008

Objectives: To evaluate the efficacy of phototherapy for hyperbilirubinaemia in preterm infants with and without the respiratory distress syndrome (RDS).Methodology: Prospective cohort study of preterm infants cared for at Kandang Kerbau Hospital, Singapore: 170 with RDS and 477 without RDS, sepsis or other complications (control group) presenting with non‐haemolytic hyperbilirubinaemia at about the same time were exposed to daylight phototherapy when bilirubin concentrations exceeded 255 μmol/L or 222 μmol/L if <48h of age. Bilirubin values were monitored 6‐hourly during exposure, and daily for at least 2 days postphototherapy.Results The infants were comparable in birthweight, gestational age, postnatal age, haemoglobin, haematocrit and bilirubin values, at start. The response to phototherapy of the infants with RDS was comparable to that of the well preterm infants; the duration of exposure was 50.1 ± 1.6 (mean ± s.e.m.) versus 50.1 ± 1.4 h, 24‐hour decline rate 25.71 ± 1.29% versus 26.32 ± 0.65, and overall decline rate 0.96± 0.03%/h versus 0.95±0.02%/h.Conclusion The presence of RDS did not affect the efficacy of phototherapy for neonatal hyperbilirubinaemia in preterm infants.
Retinopathy of prematurity in infants weighing 1000‐1499 g at birth
Authors: KEITH C. G. , DOYLE L. W. 
Published: March 2008

Objectives: To review the incidence and severity of retinopathy of prematurity (ROP) in infants with birthweights 1000‐1249 g and 1250‐1499 g, to establish whether the upper weight limit for routine ophthalmological examination might safely be lowered.Methodology Prospective cohort study of infants born between 1 January 1977 and 31 December 1992 cared for in the neonatal nurseries at the Royal Women's Hospital, Melbourne. Data were retrieved on 1373 infants who survived their initial hospitalization. They comprised 657 with birthweights 1000‐1249g (group 1) and 716 with birthweights 1250‐1499g (group 2). There were 76 outborn infants in group 1 and 97 in group 2; the remaining infants were all born at the Royal Women's Hospital. Ocular examinations commenced at 2 weeks of age, when possible, and at 2‐weekly intervals after that.Results In group 1, ROP was detected in 14.6% (96/657) and severe ROP (bilateral stage 3‐5) in 5.0% (33/657). Five (0.8%) children required surgical intervention (reaching threshold disease); following surgery, one was legally blind, one had severely impaired vision, and the other three had near‐normal vision. Another child was blind; he was born at 28 weeks gestational age with a birthweight of 1170g, and was transferred to a Level II hospital at 9 weeks chronological age with no detectable retinopathy. He returned 1 year later totally blind with detached retinae (grade 5 ROP). The prevalence of bilateral blindness in this group was 0.3% (2/657). In group 2, ROP was detected in 6.4% (46/716) and severe ROP in 0.8% (6/716). No children required surgery; three were found to be myopic at follow up but the corrected visual acuity was normal. No children in group 2 were blind. No significant difference was found between the rates of ROP in inborn and outborn infants.Conclusion In neonatal units with similar rates of ROP and visual outcome, routine ophthalmological examination in the neonatal nursery of infants weighing more than 1249g at birth is probably unnecessary.
Delayed diagnosis of cystic fibrosis in children with a rare genotype (ΔF508/R117H)
Authors: FITZGERALD D. , van ASPEREN P. , HENRY R. , WATERS D. , FREELANDER M. , WILSON M. , WILCKEN B. , GASKIN K. 
Published: March 2008

Objectives: In neonatal screening for cystic fibrosis (CF), infants recognised as ΔF508 heterozygotes require a sweat test to confirm the diagnosis. However, compound heterozygotes with ΔF508 and the R117H mutation are known to have non‐diagnostic sweat chlorides (<60 mmol/L) at an early age. As genotyping for rare mutations is not readily available in Australia, there is a need to determine whether quantitative pancreatic stimulation tests could facilitate the diagnosis of CF in three infants with the ΔF508/R117H mutation.Methodology Formal sweat testing, genotyping and pancreatic stimulation tests were performed in three subjects heterozygous for ΔF508 who initially had non‐diagnostic sweat chloride results (40‐60 mmol/L) but presented later with persisting chest symptoms and/or signs consistent with CF.Results All three patients were shown to have the ΔF508/R117H genotype with initial sweat chloride results ranging from 40 to 58 mmol/L. Pancreatic stimulation tests demonstrated reduced enzyme secretion in two and decreased fluid, bicarbonate and chloride secretion in all three patients.Conclusions In infants recognized as ΔF508 heterozygotes by the newborn screening programme, the presence of an equivocal sweat chloride does not exclude the diagnosis of CF. If such patients with an initially equivocal sweat chloride subsequently develop symptoms suggestive of CF and have a persisting non‐diagnostic sweat chloride then the diagnosis of CF can be confirmed by more extensive genotyping if available or by pancreatic stimulation testing.
Obstructive sleep apnoea presenting as failure to thrive in infancy
Authors: FREEZER N. J. , BUCENS I. K. , ROBERTSON C. F. 
Published: March 2008

Objectives: To study the postoperative outcome of infants under the age of 18 months in whom an adenotonsillectomy had been performed, with particular emphasis on the pre‐ and postoperative weight gain and linear growth velocities, and the resolution of symptoms of obstructive sleep apnoea (OSA).Methodology A retrospective study of all infants in whom an adenotonsillectomy had been performed during the 5 year period to January 1990. Details of pre‐ and postoperative outcome variables were obtained by review of hospital and office records and by telephone calls to the parents.Results Complete data were available for 29 (76%) of the 38 infants in whom an adenotonsillectomy had been performed. The data from these infants are reported. Pre‐operatively, all infants had clinical symptoms of OSA, and 52% of infants also presented with failure to thrive (FIT). Seven infants were dysmorphic: three had Down syndrome, three had a craniofacial anomaly and one infant had Mobius syndrome. Following adenotonsillectomy, 23 infants (79%) had complete resolution of their OSA symptoms. Two infants with Down syndrome required a tracheostomy to relieve persistent upper airway obstruction. Eighty‐seven per cent of the infants with pre‐operative FTT had a significant increase in weight gain velocity postoperatively (mean 195.1 ± 80.8 s.d. vs 509.8± 249.1 g/month; P<0.001), including the infants with mild persistent symptoms of OSA. The weight gain velocity of infants who were not failing to thrive pre‐operatively did not change significantly following adenotonsillectomy (328.1 ± 106.9 vs 333.2±146.4 g/month; P= 0.82). The linear growth velocity of all infants did not change significantly postoperatively.Conclusions: SA should be considered in infants with FTT, as adenotonsillectomy is an effective treatment for OSA in infancy, and the weight gain velocity of these infants may increase significantly postoperatively. Overnight oximetry or other physiological studies may be required if the clinical signs and symptoms of OSA are equivocal.
Morphine increases synchronous ventilation in preterm infants
Authors: DYKE M. P. , KOHAN R. , EVANS S. 
Published: March 2008

Objectives: To examine the short‐term cardiorespiratory effects of intravenous morphine infusion in ventilated preterm infants.Methodology A randomized double‐blind placebo‐controlled trial in a neonatal intensive care unit. Twenty‐six preterm infants (29‐36 weeks gestation) with hyaline membrane disease requiring ventilatory assistance on the first day after birth were included in the study. A loading dose of morphine 100 μg/kg over 30 min followed by a continuous intravenous infusion at 10 μg/kg per hour was given. Primary measures were heart rate, blood pressure, respiratory rate and interaction of spontaneous respiration with mechanical ventilation. Secondary measures were durations of oxygen therapy, ventilator therapy and hospitalization as well as incidence of bronchopuimonary dysplasia, periventricular haemorrhage and pneumothorax.Results Morphine‐treated infants spent a significantly greater percentage of total ventilated time breathing in synchrony with their ventilators (median [IQ]= 72[58‐87]vs 31 [17‐51]%; P= 0.0008). Heart rate and respiratory rate, but not blood pressure, were reduced in morphine‐treated infants. Duration of oxygen therapy was reduced (median [IQ]= 4.5[3‐7]vs 8[4.75‐12.5] days; P= 0.046).Conclusions Intravenous morphine infusion increases synchronicity of spontaneous and ventilator‐delivered breaths in preterm infants. Morphine reduces heart rate and respiratory rate without reducing blood pressure, and may help to reduce duration of oxygen therapy in preterm infants with hyaline membrane disease.
Clinical signs associated with Triple Antigen (DTP) vaccination in infants
Authors: HARRIS G. , NOLAN T. , HARTMAN L. 
Published: March 2008

Objective: The perceived reactogenicity of pertussis‐containing vaccines is of considerable public health importance. The purpose of this study was to establish prospectively the incidence of systemic and local clinical signs associated with the first three doses of the diphtheria‐tetanus‐pertussis vaccine (DTP) currently used in Australia. In addition, in order to determine whether variability in reporting of such phenomena might be associated with variation in DTP batches, infant behaviour was studied with three batches for the first of the three DTP vaccinations.Methodology : Double blind, randomized controlled trial. There were 591 eligible infants who were recruited sequentially from centres for vaccination in three large Melbourne municipalities, of whom 531 (mean age 10 weeks, 45% female) were randomized and immunized. Of 181 subjects who received DTP from batch 1, 151 were studied at the time of their second DTP dose, and 98 at the third. Infants were assigned randomly to receive one of three batches of DTP vaccine. Parents were provided with a thermometer and a clinical sign diary. Research nurses visited the home 24 h after vaccination, and telephoned 7 days after vaccination to record local and systemic signs.Results There was no significant variation between DTP batches in rates of local or systemic signs. At the time of the first vaccination, the rates of local signs were: redness 16%, induration 29%, swelling 46%, and tenderness 54%. Systemic signs included: irritability 93%, intermittent inconsolable crying 43%, and persistent crying 12%. An axillary temperature of greater than 38°C was recorded in 13% (Cl 9–19%) of babies following the first immunization, 20% (Cl 14–27%) following the second, and 14% (Cl 8–23%) following the third immunization. There were significant reductions in the rates of observed signs over the immunization course for diarrhoea, irritability, intermittent inconsolable crying and persistent crying.Conclusions There is little difference in the rates of clinical signs or presumed minor adverse effects associated with the DTP vaccine used in Australia today compared to that used 10 years ago, despite increases in the diphtheria and tetanus toxoid concentration, and the addition of aluminium phosphate adjuvant. Rates are comparable to those for other DTP vaccines manufactured in North America and Europe.
Neurodevelopmental outcome in very low birthweight infants with necrotizing enterocolitis requiring surgery
Authors: TOBIANSKY R. , LUI K. , ROBERTS S. , VEDDOVI M. 
Published: March 2008

Objective: To assess the effect of necrotizing enterocolitis (NEC) on neurodevelopmental outcome.Methodology: Neurodevelopmental outcome of 20 very low birthweight (VLBW) infants who developed NEC requiring surgery was compared with 40 matched infants controlled for gestation, birthweight, and year of admission. Twenty‐nine VLBW infants who developed NEC and did not require surgery were also compared.Results: Infants with NEC needing surgery were of 26±2 weeks gestation and weighed 892±192 g at birth. Infants with NEC managed medically were of higher gestation (27±2 weeks) but similar birthweights. More infants with NEC requiring surgery required inotropic support. At follow up, NEC surgery infants had a significantly higher incidence of developmental morbidity, 11 of 20 compared with 11 of 40 matched controls (Fisher's exact test P= 0.0493), and six of 29 infants with NEC managed medically (Fisher's exact test P= 0.0174).Conclusions: These findings stress the importance for close follow up for neurodevelopmental sequelae in VLBW infants who have had NEC requiring surgery.
High frequency oscillation in newborn infants with respiratory failure
Authors: McDOUGALL PN , LOUGHNAN PM , CAMPBELL NT , HOCHMANN M , TIMMS BJ , BUTT WW 
Published: March 2008

Objective: To report ventilation strategies, survival and complications in 39 outborn infants treated with high frequency oscillatory ventilation (HFOV).Methodology Data were collected prospectively between 1 May 1992 and 31 December 1993 on all infants treated with HFOV who had severe respiratory failure despite optimal conventional ventilation.Results Twenty‐eight out of 39 (72%) survived. Of the 15 infants with birthweights <1500g, eight survived. Best survival rates were for infants with pulmonary interstitial emphysema with air leak (4/5) and for infants of birthweight >1500g with hyaline membrane disease (8/8), and meconium aspiration syndrome (7/7). Three infants deteriorated while on HFOV and required extracorporeal membrane oxygenation. Complications were: (i) development of pulmonary interstitial emphysema (1); (ii) recurrence of pneumothorax (3); (iii) hypotension (2); and (iv) bronchopulmonary dysplasia (9). One of the eight infants weighing <1500g who received HFOV in the first week of life developed periventricular haemorrhage.Conclusion The initial results of HFOV for severe respiratory failure were encouraging although a learning curve was encountered with its introduction.