bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rollerblading injuries in young people
Authors: HELLER DR , ROUTLEY V , CHAMBERS S 
Published: March 2008

Objective: To study injuries In young people associated with the use of rollerblades, draw comparisons with skateboarding and rollerskating injuries, and suggest strategies for injury prevention. Methodology: Injuries associated with the use of rollerblades, skateboards and rollerskates in young people aged 14 years recorded on the Victorian Injury Surveillance System database since its inception in 1989 were examined to identify secular trends. All injuries associated with these pastimes recorded on the database by three sentinel hospitals during a 1 year period were examined in detail. Medical notes were perused to verify features of the event and obtain further information. A semi‐structured telephone interview of a sample of 10‐14 year old rollerbladers, the most commonly injured age‐group, was carried out to obtain more specific information. Results: There has been a marked increase in the absolute numbers of injuries associated with the use of rollerblades since 1989. In 1992, they were most common in the 10‐14 year age group, which sustained 59% of all injuries; 47% of injuries were fractures of the forearm and wrist. Of a sample of 33 of those injured in the 10‐14 year age group, 10 (30%) had been using rollerblades for the first time. There is some evidence to suggest a concomitant fall in skateboarding injuries. Conclusions: Injury surveillance data collected in Melbourne suggest an increasingly important contribution by rollerblading to the pattern of injury seen in young people. Preventive strategies require further evaluation but could include learning basic techniques in a controlled setting, separation from road traffic and the wearing of helmets and wrist, elbow and knee guards.
Does the amniotic fluid protein absorption contribute significantly to the fetal weight?
Authors: CHENG W , MYA GH , SAING H 
Published: March 2008

Objective: This study was carried out to evaluate the significance of amniotic fluid protein ingestion and absorption on fetal growth. Methodology: Neonates with small bowel atresia during a 30 year period were studied retrospectively. Results: There were 56 patients enlisted, 17 with duodenal atresia, 18 with jejunal atresia and 21 with ileal atresia. The percentage of mothers with polyhydramnios and the percentage of premature babies decreases as the intestinal atresia becomes more distal. The mean gestational age and the mean birthweight increase as the intestinal atresia becomes more distal. On the other hand, the percentage of the neonates with birthweight below the 50th and the 10th percentiles do not differ significantly as the intestinal atresia becomes more distal. Conclusions: It appears that the variation of birthweights in babies with different levels of small bowel atresia may be due to the difference in gestation caused by polyhydramnios. The effect of amniotic fluid protein absorption on fetal bodyweight could not be demonstrated clinically in this study.
Stress and work relationships in the neonatal intensive care unit: Are they worse than in the wards?
Authors: OATES PR , OATES RK 
Published: March 2008

Objective: To compare working conditions, sources of stress and professional relationships between a group of nurses working in neonatal intensive care units (ICU) and those working in general paediatric teaching hospital wards. Methodology: Surveys were sent to 96 nurses working in general paediatric wards in three Sydney paediatric teaching hospital centres and to 291 nurses working in six major neonatal ICU in Sydney. The survey asked about work environment, patient care, decision‐making, sources of stress and professional relationships. Thirty‐one questions were identical in each survey. The survey also included the General Health Questionnaire (GHQ) as a measure of emotional health. Results: The response rate was ward nurses 86% and neonatal intensive care nurses 66%. Of the 31 identical statements, nine were significantly different between the two groups. Neonatal nurses were more likely to feel that their ward work areas were overcrowded and poorly laid out with little patient‐free space. They had more concerns about inadequate staffing and conflict between nurses and doctors. The general ward nurses were more likely to feel that adequate priority was given to patient pain relief and that they had more influence in such decisions but experienced more stress in keeping up to date and were more likely to feel that communication problems between doctors and nurses were a major source of conflict. Forty per cent of general ward nurses and 32% of neonatal nurses had GHQ scores indicating possible psychological impairment, a significantly higher proportion than would be expected in the population. Conclusions: Paediatric nurses perceive a variety of stresses in their work, with problems in communication between doctors and nurses being a prominent perception. The high GHQ scores may be a reflection of some of those problems. Attention to problems of under‐staffing, better work environment and improved communication may help resolve some of these issues and may have implications for improving patient care.
National trends in the use of stimulant medication for attention deficit hyperactivity disorder
Authors: VALENTINE J , ZUBRICK S , SLY P 
Published: March 2008

Objective: To document the use of stimulant medication in the diffent states and territories of Australia in 1993 and trends in use of stimulant medication in Western Australia and New South Wales from 1988 to 1993. Methodology: Health authorities in the states and territories of Australia were contacted and requested to provided data on total numbers, patient gender, date of birth, postcode and type of stimulant medication prescribed to estimate the prevalence of use of stimulant medication in Australia Results: Despite variation in the data obtained from each health authority there is a significant difference in the rates of use of stimulant medication between states and territories in Australia, and a significant increase in use between 1988 and 1993 in Western Australia and New South Wales. Conclusions: These trends should continue to be closely monitored and the possibilty of establishing national prescription guidelines considered.
Neonatal subgaleal haematoma: Associated risk factors, complications and outcome
Authors: CHADWICK LM , PEMBERTON PJ , KURINCZUK JJ 
Published: March 2008

Objective: To describe the obstetric and perinatal factors, in particular the method of delivery, associated with development of a subgaleal haematoma (SGH) and to determine the outcome of survivors with this type of birth trauma. Methodology: Perinatal and obstetric data were retrospectively reviewed for 37 infants admitted to the neonatal unit of the sole tertiary paediatric referral hospital in Western Australia with an SGH, over a 24 year period from 1970 to 1993. These data were compared to data for all Western Australian births. The long‐term outcome was obtained through medical and private paediatric records for 26 of these infants. Results: All except one of the neonates had instrumental deliveries; 89% had a vacuum extractor applied to the head at some stage of delivery compared to 10% of the general population of births in Western Australia. There was also a significantly increased risk of failure of attempted vacuum extraction. Of the cases where a vacuum extraction was attempted, 45% also had forceps applied to the head. Coagulopathy was associated with the severity of the SGH. There was also a high frequency of occurrence (40%) of associated head trauma such as intracranial haemorrhage, skull fracture and cerebral oedema, as well as neonatal encephalopathy (73%). The occurrence of these associated features did not correlate significantly with the severity of SGH. Minor complications of SGH included jaundice and facial bruising.There was an excess mortality associated with SGH; however, the long‐term outcome for neonatal survivors with this disorder was good. None of the cases studied subsequently developed cerebral palsy or intellectual disability, and minor neurological sequelae only were documented in four infants. Conclusions: SGH is an uncommon type of birth trauma, and is associated with delivery or attempted delivery by vacuum extraction. The most commonly associated clinical problems were hypovolaemia and coagulopathy. The long‐term outcome for neonates with this condition is good.
A new breast milk supplement for preterm infants
Authors: SIMMER K 
Published: March 2008

Objective: To assess the effect of a new formula (Prenan), which contains n‐3 and n‐6 long‐chain polyunsaturated fatty acids (LC PUFA) on the fatty acid profile of preterm infants. Methodology: Plasma fatty acids were measured in 61 preterm infants at term by gas liquid chromatography. In 20 of these infants, paired samples were collected and changes in fatty acids with time analysed. Results: Plasma docosahexaenoic acid (DHA) levels were higher in those who had been fed expressed breast milk (EBM) ±/or Prenan compared with those fed standard formula ± EBM, P<0.05. The plasma arachidonic acid (AA) levels of infants fed Prenan were not different to those fed EBM, both groups achieving higher levels than infants fed standard formula, P<0.05. Further, paired analysis demonstrated that DHA levels increased in infants changed from standard formula to Prenan to levels equal or higher than those of fully breast‐fed infants (P<0.01), whereas DHA levels remained unchanged with time in all other groups. Conclusions: The fatty acid composition of Prenan enables preterm infants fed formula to have plasma DHA and AA levels similar to those of infants fed breast milk and consequently different to those of infants fed standard formula. Prenan is an appropriate supplement to breast milk for preterm infants in that it provides LC PUFA as well as additional phosphorus and protein without exposing the infant to intact cows milk protein.
Factors affecting the neonatal response to artificial surfactant
Authors: SKELTON R , JEFFERY HE 
Published: March 2008

Objective: To define the individual neonatal response to the artificial surfactant, Exosurf, and factors that may influence the response. Methodology: Eighty‐two consecutive, preterm neonates with respiratory distress syndrome, who received Exosurf at <12h of age were studied. Their response was categorized from the graphical change in the oxygenation index with postnatal age, for 12h after each of two doses of surfactant and assessed independently by two observers. Clinical factors were analysed for their effect on the four pre‐defined categories of response, namely: none; mild; good; relapsed; and good: sustained. Results: Within the first 12h, 11% of the neonates showed no response, 5% a mild response and 84% a good response, but 34% relapsed. By 24h, 6% still showed no response (all died), 11% showed a mild response and 83% a good response, of whom half relapsed. At 24h, no response was significantly associated with low gestational age and asphyxia mild response with less severe lung disease. According to the response there was a gradation in the risk of death during the first week. Conclusions: The response to Exosurf can be individually and reproducibly categorized and demonstrated that 83% of neonates had a good response but half relapsed. No response was associated with extreme prematurity and asphyxia
Symptoms, sweating and reactivity of infants who die of SIDS compared with community controls
Authors: TAYLOR BJ , WILLIAMS SM , MITCHELL EA , FORD RPK ,   THE NEW ZEALAND NATIONAL COT DEATH STUDY GROUP
Published: March 2008

Objective: To describe the symptoms of illness reported by the parents of infants who have died of sudden infant death syndrome (SIDS) compared with those reported by community controls. Methodology: A nationwide case—control study involving regions of New Zealand with 78% of all births between 1987 and 1990. Home interviews were completed with parents of 393 (81% of total) infants who died from SIDS in the post neonatal age group, and 1592 (88.4% of total) controls who were a representative sample of all hospital births in the study region. Results: Symptoms of infection were common in both cases and controls, but were not significantly different. Infants dying of SIDS, however, were likely to have symptoms suggestive of more severe illness in the 2 days before death (odds ratio [OR] = 3.02, 95% confidence interval [CI] 1.69‐5.38). After adjusting for potential confounding this was still statistically significant (adjusted OR 2.36, 95% Cl 1.14‐4.90). Also, babies dying of SIDS were more likely to have been less reactive to their environment in the 2 weeks before death compared with the controls (univariate OR 0.88, 95% Cl 0.55‐1.39, adjusted OR 0.55, 95% Cl 0.59‐0.88).‘Drenching’ sweats at least weekly were reported for 15.6% of case infants compared with 5.9% of control infants (adjusted OR 2.12, 95% Cl 1.53‐3.39). Forty per cent of these infants had this symptom in the first 4 weeks of life when it was also associated with a significantly raised risk of SIDS. Apnoea lasting more than 20 s was reported for 13.2% of case infants compared with 5.3% of control infants (adjusted OR 1.93, 95% Cl 1.17‐3.17). Similarly, 71.8% of case infants' faces were reported to never turn red while awake compared to 49.8% of control infants (adjusted OR 2.98, 95% Cl 2.19‐4.07). Conclusions: Only a small number (6.4%) of babies who die of SIDS have symptoms of serious illness in the 2 days before death. There is support for the hypothesis that there is a group of babies dying of SIDS who have subtle abnormalities in autonomic control or arousal ability.
Bronchopulmonary dysplasia and very low birthweight: Lung function at 11 years of age
Authors: DOYLE LW , FORD GW , OLINSKY A. , KNOCHES AML , CALLANAN C. 
Published: March 2008

Objective: To determine the relationship between lung function at 11 years of age and bronchopulmonary dysplasia (BPD) in very low birthweight (VLBW) children. Methodology: This study comprised 154 consecutive surviving VLBW children, divided into three groups with respect to their neonatal respiratory morbidity: group I developed BPD; group II required assisted ventilation but did not develop BPD; and group III required no assisted ventilation. Lung function tests were measured on 120/154 (77.9%) children at 11 years of age. The relationship between various lung function variables and neonatal lung disease was analysed by multiple linear regression. Results: Several lung function variables reflecting airflow were significantly diminished in the BPD group (n= 15), and residual volume was significantly higher. Despite poorer lung function overall, few children in the BPD group had lung function abnormalities in the clinically significant range (n= 2 [13.3%] with a forced expired volume in 1 s <75% predicted; n= 2 [13.3%] with a forced vital capacity <75% predicted; n= 1 [6.7%] with a residual volume/total lung capacity >35%). There were no significant differences in lung function variables between group II (n= 41) and group III (n= 64). Changes in lung function tests between 8 and 11 years did not vary significantly between the three groups. Conclusions: VLBW children with BPD in the newborn period have poorer lung function at 11 years of age than other surviving VLBW children without BPD, although few have lung function abnormalities in the clinically significant range.
Paediatric urolithiasis in a remote Australian Aboriginal community
Authors: WILLIAMS WM , NICHOLAS JJ , NUNGURRAYI PB , NAPURRULA CR 
Published: March 2008

Abstract: A retrospective study of Community Health Service patient records revealed 10 cases of urolithiasis in Aboriginal children under 5 years of age in a remote central Australian Aboriginal community over a 4 year period, out of a total under‐5 population estimate of 62. The highest attack rate was in the 0–2 age group, where nearly one in 10 children presented per year. All children had significant associated morbidity. Two children underwent pyelolithotomy.Aboriginal children in the remote arid zone study community suffer exceptionally high rates of urolithiasis. Inadequate diet, dehydration and recurrent infectious disease are factors in pathogenesis. Further study may elucidate aetiology, but the implications of these data for improving environmental conditions and health service delivery in Aboriginal communities are urgent.
De novo terminal deletion of chromosome 7 [46, XX, del(7)(q35)]
Authors: LO BH , MURCH A. , CHABROS V. , WITHNELL R. 
Published: March 2008

Objective: To report a new case of de novo 7q deletion distal to q35. Methodology: Developmental, cytogenetic and audiological investigations were carried out in the assessment of this rare chromosomal condition. Results: Moderate developmental delay, mild congenital microcephaly, growth retardation and conductive hearing impairment were found for this case of 46, XX, del(7)(q35). Conclusions: The phenotype of 7q terminal deletion is highly variable.
Lead exposure and children's intelligence: Do low levels of lead in blood cause mental deficit?
Authors: DE SILVA PE , CHRISTOPHERS AJ 
Published: March 2008

Objective:It has come to be generally accepted that low levels of lead exposure may result in mental deficit. This causal inference is based on claimed time precedence of the lead exposure and on biological plausibility. The objective of this study is to argue that mental deficit causes pica which causes lead exposure (i.e. to support the theory of reverse causation).Methodology:The literature since the 1930s has been interpreted in the light of our own long experience in the investigation of lead exposure in children and adults to support the arguments in favour of reverse causation.Results:The arguments for reverse causation are based on: (i) analogy with mental retardation which causes increased lead exposure; (ii) the results of published prospective studies that show a special relationship between blood lead levels at 24 months and intelligence tested later, exactly what would be predicted by the reverse causation theory; and (iii) on an alternative explanation for mental retardation following lead encephalopathy (i.e. that mental retardation following encephalopathy is due to anoxia and not due to a direct destructive effect on the brain neurones). The arguments, which have been proposed for the conventional view, are rejected for the following reasons: (i) none of the prospective studies have found a relationship between cord blood lead levels and intelligence tested later, undermining the argument based on time precedence of lead exposure; and (ii) there is no convincing evidence that lead poisoning, short of encephalopathy, causes mental retardation.Conclusion:We believe that the reverse causation hypothesis is a more plausible explanation of the facts.
Preliminary study of glycopyrrolate in the management of drooling
Authors: STERN LM 
Published: March 2008

Objective:A study was undertaken to assess the efficacy of an oral anticholinergic drug, glycopyrrolate, in the management of drooling in children and young adults with disabilities.Methodology:Glycopyrrolate was used by 24 children and young adults for up to 28 months. Parents/carers were asked to complete a questionnaire on the effects of the drug on severity and frequency of drooling and to report any side‐effects.Results:Twenty‐two questionnaires were returned. There was a statistically significant decrease in both severity and frequency of drooling with minimal side‐effects reported.Conclusion:In this preliminary study, glycopyrrolate was found to be an effective and well‐tolerated addition to the management of drooling in children with disabilities.
High frequency ventilation
Authors: RAMSDEN CA , PILLOW JJ 
Published: March 2008

Abstract:The 1990s have seen a dramatic resurgence of interest in high frequency ventilation (HFV). The role of HFV in the rescue of infants failing conventional mechanical ventilation (CMV) is now relatively well established. However, the wider role of HFV in the routine management of respiratory failure in the newborn is more contentious. Recent trials in small numbers of infants suggest that HFV may be associated with significantly less chronic lung disease than CMV when used under optimal conditions (i.e. with a ‘high‐volume’ strategy, from early in the disease and continued to the point of weaning). Further, clinical trials are now required to define the role of HFV more clearly.
Foramina parietalia permagna: Report of nine cases in one family
Authors: KUTILEK S , BAXOVA A , BAYER M , LEISKA A , KOZLOWSKI K 
Published: March 2008

Abstract:Nine members of a family with foramina parietalia permagna (FPP), inherited as an autosomal dominant trait are reported. Although usually benign, FPP may be associated with other malformations.
The prevalence of hepatitis C in survivors of paediatric malignancy
Authors: Carter TL , Cole CH , Mews CF , Price PJ , Baker DL 
Published: March 2008

Objective: To assess the prevalence of hepatitis C in 200 patients with paediatric malignancies, surviving in remission more than 5 years from diagnosis, who had received blood product transfusions before 1990 when routine screening of blood products for hepatitis C began. Method: The second and third generation Abbott Diagnostics ELISA was used to assess hepatitis C seropositivity. Seropositive patients and those with abnormal liver transaminases were assessed by hepatitis C virus RNA polymerase chain reaction (PCR). Results: A low incidence (4%) of seropositivity for hepatitis C was found in survivors of paediatric malignancy who were transfused prior to routine screening of blood products in this cohort. Conclusions: All patients identified have evidence of hepatitis and may be at high risk of developing cirrhosis.
Persistent hypercholesterolaemia in frequently relapsing steroid‐responsive nephrotic syndrome
Authors: TSUKAHARA H , HARUKI S , HIRAOKA M , HORI C , SUDO M 
Published: March 2008

Objective: To investigate long‐term changes of serum cholesterol levels in children with frequently relapsing steroid‐responsive nephrotic syndrome (NS). Methodology: Serum cholesterol values just before and during or immediately after ‘relapse’ were reviewed and the incidence of hypercholesterolaemia (≥200 mg/dL) was determined in eight patients (M:F, 6:2). Results: The patients with frequently relapsing NS usually showed hypercholesterolaemia (mean incidence, 81%) just before ‘relapse’ during clinical remission, as well as in relapse (mean incidence, 96%). A high incidence of steroid therapy was also found in each case (mean, 89%) just before relapse. Conclusions: Our results demonstrate that children with frequently relapsing NS have prolonged periods of hypercholesterolaemia, even during clinical remission. It is suggested that serum lipid profiles be monitored carefully in such patients.
Phase 1 trial of a candidate rotavirus vaccine (RV3) derived from a human neonate
Authors: BARNES GL , LUND JS , ADAMS L , MORA A , MITCHELL SV , CAPLES A , BISHOP RF 
Published: March 2008

Objective: To conduct a phase 1 safety and tolerability trial of an oral rotavirus vaccine candidate RV3 in healthy volunteers. Methodology: Double blind placebo controlled trial of a single 1 mL oral dose (6.5 × 105 fluorescing focus units [FFU]/mL) in 10 healthy young men, 10 3–4 year old children and 10 3 month old infants with a 4 week surveillance period. The study was undertaken at a children's hospital and nearby community in Melbourne, Australia. Results: All subjects successfully completed the trial. There were no significant side‐effects attributable to the vaccine preparation in any age group. No shedding of vaccine virus was detected by enzyme immunoassay. There was evidence of an. immune response in serum and/or gut secretions in two of five vaccinees in each age group. Conclusion: RV3 rotavirus vaccine appears to be safe and well tolerated. Evidence of immunogenicity in some subjects after a single dose encourages further trials to determine immunogenicity after three doses, after reduction of viral dose, and without prior administration of buffer.