bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal bacterial sepsis in a neonatal intensive care unit: A 5 year analysis
Authors: SANGHVI KP , TUDEHOPE DI 
Published: March 2008

Objective: To study the pattern of neonatal sepsis in a neonatal intensive care unit (NICU) during a 5 year period and assess the relationship between maternal risk factors and early onset sepsis (EOS). Methodology: The study reported here was a retrospective analysis of 209 episodes of septicaemia and 5 episodes of bacterial meningitis in 198 newborn infants, 22 of whom died. Eighty‐one infants had EOS (≤72h) and 117 infants had late onset sepsis (LOS >72 h). All infants had clinical evidence of sepsis, a computerized haematological score for sepsis of 4 or greater, and either treatment with antibiotics for 7 days or more or had earlier death due to sepsis. The organisms causing neonatal sepsis were analyzed according to the day of onset, gestational age, birthweight and year of infection. Results: Sepsis occurred in 5.6 per 1000 live births and 3.8% of NICU admissions. There were 81 episodes of EOS and 128 of LOS. Coagulase negative staphylococci (CONS) 38.8%, group B Streptococcus (GBS) 20.1% and Gram‐negative bacilli (GNB) 20.1% were the common causes of sepsis; and GBS (50.6%) and CONS (60.9%) were the most common organisms in EOS and LOS, respectively. The mean gestational age and birthweight were heigher in babies with EOS than compared with LOS. The higher likelihood of probable rather than definite infection in infants with EOS was related to more mothers in the EOS group receiving intrapartum antibiotics. GNB infection was more common in their babies. Conclusions: GBS and CONS were the most common causes of EOS and LOS, respectively. The use of maternal intrapartum antibiotics interferes with neonatal blood culture results. Because blood cultures are not always positive in neonatal septicaemia, a combination of clinical, haematological and other microbiological evidence should be used when diagnosing neonatal septicaemia.
Partnership in chronic health care: Care management as an integral part of the paediatric hospital system
Authors: O'NEILL C , CONTOLE J , BRYAN D , SCHWARZ R , MINOGUE C 
Published: March 2008

Abstract:Care management for children with complex care needs in the hospital setting is not just about care managers developing and maintaining partnerships between hospital and community professionals, children and their families. It also requires organizational commitment to a system which is patient centred, recognizes parental expertise and offers clinical skills which are co‐ordinated across specialty areas.
Prevalence of maternal depression and its relationship to ADL skills in children with developmental delay
Authors: HARVEY JM , O'CALLAGHAN MJ , VINES B 
Published: March 2008

Objective:To determine the prevalence of maternal affective symptoms in children with developmental problems compared to a control group, and to examine their relationship to the child's Activities of Daily Living (ADL), socialization skills and behaviour.Methodology:This study examined prospectively the prevalence of symptoms of maternal depression, maternal anxiety, stress and adverse life events in 65 mothers whose children were attending a Child Development Clinic. ADL and socialization skills were measured using the Vinelands Adaptive Behaviour Scales, and behaviour using a checklist.Results:Symptoms of maternal depression (P=0.04), maternal anxiety (P=0.01) and number of adverse life events (P=0.03) were increased in the study compared to control mothers. Presence of maternal symptoms was unrelated to ADL or socialization skills though was associated with increased behavioural symptoms in the child.Conclusion:Affective disturbance in mothers of children with developmental problems are common and should be addressed as part of a comprehensive assessment of such children.
Cutis marmorata telangiectatica congenita: An unusual presentation with monoatrophy in two Chinese children
Authors: WONG V 
Published: March 2008

Abstract:Cutis marmorata telangiectatica congenita (CMCT) is a rare cutaneous vascular anomaly. Two children with monoatrophy of one limb referred for neurological assessment were found to have a segmental form of CMTC. The paediatrician and paediatric neurologist should be alerted to this rare disease in children referred for cutaneous lesion with associated limb asymmetries as distinguished from other neurocutaneous syndromes.
Chronic illness in adolescents: Transfer or transition to adult services?
Authors: SAWYER SM , BLAIR S , BOWES G 
Published: March 2008

Abstract:It is widely believed that the improved survival of young people with chronic diseases will be associated with the development of appropriate services within the adult healthcare domain. There is, however, little evidence to suggest that this is happening at a rate commensurate with clinical requirements. This paper highlights the multiplicity of barriers that impede the development of transition services to facilitate the transfer of medical care from the paediatric to the adult domain. Different models of transition care are described, and the terms ‘transfer’ and ‘transition’ are differentiated. The clinical demand for service development is highlighted, as well as the need for specific research in this area of healthcare delivery.
Progressive myoclonic epilepsies: Recent genetic advances
Authors: ELLAWAY CJ , ELLIOTT EJ , CHRISTODOULOU J 
Published: March 2008

Abstract:The progressive myoclonic epilepsies are a rare group of debilitating epileptic encephalopathies characterized by myoclonic seizures, progressive neurological dysfunction and dementia. In the past year advances in gene mapping have isolated gene loci for the majority of progressive myoclonic disorders, paving the way for specific diagnosis, more accurate prognosis and risk calculation, as well as opening the potential for prenatal and pre‐symptomatic diagnosis in at risk families.
Emergency management skills of South Australian paediatric trainees
Authors: BRADY RM , RAFTOS J 
Published: March 2008

Objective:This article describes a theoretical and practical assessment of the emergency management skills of South Australian paediatric trainees. The aim was to identify strengths and weaknesses so as to optimally orientate future training in this area, and to provide a baseline that could be used to assess effectiveness of future interventions.Methodology:Thirty‐four paediatric trainee medical officers responsible for after hours emergency care in Adelaide were asked to anonymously complete a 24 question theory assessment based on recognized emergency management training programmes, and to perform a mock clinical resuscitation. Response rate was 90% for the theoretical section and 69% for the practical.Results:The average trainee was found to be deficient in one quarter to one third of the theoretical precepts, and required an average of 2 min to establish effective bag‐valve‐mask ventilation with an infant manikin.Conclusions:There is a range of theoretical and practical resuscitation deficits that may currently hinder effective emergency management by paediatric trainees.
The overlap of attention deficit hyperactivity disorder with other common mental disorders
Authors: HAZELL P 
Published: March 2008

Objective:The literature on the overlap (co‐morbidity) of attention deficit hyperactivity disorder (ADHD) with conduct disorder, specific learning disability, and anxiety disorders was reviewed to examine: (i) the evidence for ADHD being a syndrome distinct from the other conditions; and (ii) the evidence for co‐morbid patterns representing meaningful subtypes of ADHD.Methodology:Narrative review of the literature.Conclusions:Conduct disorder is distinguished from ADHD by prognosis, patterns of association and familial aggregation. ‘Pure’ disorders are uncommon, however, and there is little evidence to support a distinct co‐morbid subtype. There are few data that reliably distinguish ADHD from specific learning disabilities, but there are weaknesses in research to date. A specific ADHD + learning disabled subtype may exist, but as yet the implications for treatment are not known. Attention deficit hyperactivity disorder is distinguished from anxiety by symptom discrimination, factor analysis, patterns of association, familial aggregation and treatment response. There is evidence for a distinct ADHD + anxiety subtype.
The immunogenicity of Haemophilus influenzae: Meningococcal protein conjugate vaccine in Polynesian and non‐Polynesian New Zealand infants
Authors: AMERATUNGA SN , LENNON DR , ENTWISTLE B , ROBINSON E , AMERATUNGA RV 
Published: March 2008

Objective:To examine the comparative immunogenicity of the Haemophilus influenzae type b‐meningococcal protein (PRP‐OMP) conjugate vaccine in Polynesian and non‐Polynesian New Zealand infants.Methodology:Fifty‐six Polynesian and 53 non‐Polynesian infants aged 2–7 months recruited from primary health care settings in Auckland received a two‐dose primary series of PRP‐OMP. A sub‐sample of 83 participants received a booster dose of PRP‐OMP at 12–16 months of age. Anti‐PRP antibody concentrations were measured in pre‐ and post‐vaccination blood samples.Results:Antibody responses consistent with long‐term protection (≥1.00 μg/mL) were observed in 72, 85 and 95% of children following the first, second and booster doses.Conclusions:Despite differences in disease epidemiology, PRP‐OMP was highly immunogenic in Polynesian and non‐Polynesian infants.
Sunburn and sun protection among young children
Authors: McGee R , Williams S , Glasgow H 
Published: March 2008

Objective: To examine the extent of sun exposure, sun protection and experience of sunburn among young New Zealand children on summer weekends. Methods: In a telephone survey of 1243 respondents, those with children in the household were asked about sun exposure and protection for the youngest child in the family. Information was obtained for 285 children aged from infancy to 10 years. Results: Over 90% of the children were reported to be outside on the preceding Saturday and/or Sunday; 7% of those outside experienced some degree of sunburn. The worst burning was on the face, head, neck or ears. On either day about half the children were wearing sunscreen and 60% were wearing a hat. Parental use of sun protection was the strongest predictor of sun protection among the children. Conclusions: While reports of sun protection among young children were encouraging, many children in the community are still at high risk of sunburn. Efforts to promote sun protection as a family responsibility may reduce the experience of burning among the young.
Meningitis in Hong Kong children, with special reference to the infrequency of haemophilus and meningococcal infection
Authors: SUNG RYT , SENOK AC , HO A , OPPENHEIMER SJ , DAVIES DP 
Published: March 2008

Objective: To study the epidemiologic and aetiologic features of meningitis in children in Hong Kong. Methodology: A retrospective study of 85 children resident in the New Territory East region of Hong Kong admitted to a teaching Hospital because of meningitis during a 9 year period. Results:
Mycobacterium tuberculosis was the most common aetiological agent accounting for 13 cases (15.3%). Other bacteria accounted for 41 cases (48%); among these one fifth were caused by Haemophilus influenzae type b. The overall admission rates for tuberculous meningitis in Chinese children were 0.76/100 000 (95% CI 0.25‐1.78) and 0.42/100 000 (CI 0.19‐0.8) per year, respectively, for under 5 year olds and under 15 year olds. The overall annual incidence rates of bacterial meningitis other than tuberculous were 5.2/100 000 (CI 3.72‐7.43) and 1.6/100 000 (CI 1.14‐2.29) for Chinese children under 5 years and under 15 years, respectively. The annual incidence of H. influenzae meningitis in Chinese children under 5 years old was low at 1.1/100 000 (0.43‐2.2). All five cases of meningococcal meningitis were in Vietnamese children (under 5 years of age incidence: 13.0/100 000 per year, CI 4.2‐30.3). There were no cases of meningococcal meningitis in Chinese children during the 9 year period. Conclusion:
M. tuberculosis was the most common aetiological agent of meningitis in Hong Kong children. The incidence of haemophilus or meningococcal meningitis was very low.
Usefulness of stable microbubble test of tracheal aspirate for the diagnosis of neonatal respiratory distress syndrome
Authors: BOO N‐Y , CHEONG K‐B , CHEONG S‐K , LYE M‐S , ZULFIQAR MA 
Published: March 2008

Objectives: To compare the overall accuracy of the stable microbubble test (SM test) with measurement of level of surfactant protein A (SP‐A) of tracheal aspirate for the diagnosis of respiratory distress syndrome (RDS). Methodology: Tracheal aspirates were obtained from neonates on ventilatory support. The SM test was carried out on specimens of tracheal aspirate immediately after collection. Levels of SP‐A in tracheal aspirates were determined by enzyme‐linked immunosorbent assay (ELISA) method. The results of the SM test and SP‐A level of the tracheal aspirates were compared against the clinical diagnosis of RDS based on clinical, radiological and bacteriological findings. Results: Both the median microbubble counts (6 microbubbles/mm,2 range = 0–90) and median SP‐A levels (100μg/L, range = 0–67 447) of infants with RDS were significantly lower than those of infants with no obvious lung pathology (P<0.0001), and pneumonia (P<0.0001). The SM test of tracheal aspirates had higher overall accuracy for the diagnosis of RDS than measurement of SP‐A levels (94.6%vs 82.4%). When the receiver operating characteristic (ROC) curves of both tests for RDS were compared, the area under the ROC curve of the SM test was larger (0.9689) than that of the SP‐A method (0.8965). Conclusions: This study showed that the SM test of tracheal aspirate was a useful bedside diagnostic test for RDS. It could be carried out at any time after birth on infants requiring ventilatory support.
Ocular sequelae in extremely premature infants at 5 years of age
Authors: HEBBANDI SB , BOWEN JR , HIPWELL GC , MA PJ , LESLIE GI , ARNOLD JD 
Published: March 2008

Objective To report long‐term ophthalmological sequelae in extremely premature infants at 5 years and to determine the relationship between neonatal variables (including retinopathy of prematurity; ROP) and the 5 year ophthalmological outcome of these infants. Methodology The study cohort comprised 84 surviving infants born with a birthweight <1000 g or gestational age <28 weeks from June 1985 to December 1989. All infants had an ophthalmological assessment between 34 and 40 weeks post conceptional age to document grade of ROP and were assessed at 5 years of age for fundoscopy, visual acuity, refractive error and ocular mobility. Results Of the 84 long‐term survivors 69 (82%) were formally assessed at 5 years. Overall, 30 (43%) had some form of ocular disorder. Nineteen (27%) had reduced visual acuity of <6/6 and three of these were blind. Myopia > −0.5 dioptre was noted in eight (12%), hypermetropia ≥2.0 dioptre in five (8%), astigmatism in seven (11%) and strabismus was present in nine (14%) of the cohort. There was a significant relationship (P<0.0001) between the incidence of ocular disorders and ROP. However, even those premature children without ROP had a 31% incidence of ocular disorder at 5 years. Conclusion Long‐term ophthalmological follow‐up is recommended in all extremely premature infants regardless of the presence of ROP in the neonatal period.
Biological predictors and co‐morbidity of attention deficit and hyperactivity disorder in extremely low birthweight infants at school
Authors: O'CALLAGHAN M J , HARVEY J M 
Published: March 2008

Objective: To examine biological predictors and co‐morbidity of Attention Deficit Hyperactivity Disorder (ADHD) and associated academic and social impairment in a cohort of extremely low birthweight of (ELBW) children attending school. Methodology: Eight seven (70%) of 125 ELBW children born between 1977 and 1986 were followed prospectively. Neonatal and biological data including cranial ultrasound for 62% of children, formal developmental assessment at 4 or 6 years of age, teacher and parent ADHD questionnaire, parental rating of health status and social impairment and school teacher rating of academic performance was recorded. Results: Apart from grades 3 or 4 intraventricular haemorrhage in a minority of children, there was no evidence to suggest an association between ADHD and perinatal adversity in ELBW children. Social impairment, academic difficulty and atopic symptoms were significantly related to ADHD. Conclusions: Extremely low birthweight children presenting with symptoms of ADHD are likely to suffer social and learning impairment and these, rather than perinatal risk factors, should be the focus of clinical attention.
Cushing's syndrome in childhood and adolescence
Authors: ROBYN JA , KOCH CA , MONTALTO J , YONG A , WARNE GL , BATCH JA 
Published: March 2008

Objective: To review the diagnosis, management and outcome of Cushing's syndrome in children and adolescents. Methods: We conducted a retrospective review of nine cases treated between 1976 and 1996 at the Royal Children's Hospital, Melbourne, Australia. Results: Six children with Cushing's disease and three with primary adrenal disease were identified. Mean age at diagnosis in the Cushing's disease patients was 11.3 years and in the children with primary adrenal disease 9.5 years. The most common presenting symptoms were weight gain and delayed growth. Two children had the unusual presenting symptoms of an eating disorder and hemihypertrophy, respectively. Laboratory diagnosis of Cushing's syndrome was established by demonstration of elevated urine free cortisol, loss of normal diurnal variation of serum cortisol, and loss of suppressibility of cortisol secretion by low dose dexamethasone. Investigations used to determine the aetiology of hypercortisolism included serum adrenocorticotropic hormone (ACTH) levels, high dose dexamethasone suppression tests, imaging studies, and inferior petrosal sinus sampling. Four patients with Cushing's disease had successful transphenoidal adenomectomies. Two patients with bilateral primary pigmented nodular adrenocortical dysplasia underwent bilateral adrenalectomies. One child with an adrenal adenoma was treated by left adrenalectomy. Conclusions: Cushing's syndrome in children and adolescents remains a diagnostic challenge. Successful treatment often requires the use of multiple tests to achieve the correct diagnosis, appropriate surgery and a good long‐term outcome.
Increased striatal dopamine release and hyperdopaminergic‐like behaviour in mice lacking both alpha‐synuclein and gamma‐synuclein
Authors: Senior Steven L. , Ninkina Natalia , Deacon Robert , Bannerman David , Buchman Vladimir L. , Cragg Stephanie J. , Wade‐Martins Richard 
Published: March 2008

AbstractAlpha‐synuclein is intimately involved in the pathogenesis of Parkinson's disease, and has been implicated in the regulation of synthesis, release and reuptake of dopamine (DA). However, mice lacking members of the synuclein family have been reported to display no overt behavioural phenotype. This may be a result of compensatory upregulation of other synucleins during development. Here we report on behaviour and DA synapse function of alpha‐synuclein null, gamma‐synuclein null, and alpha‐gamma‐synuclein double‐null knockout mice. Double‐null mice were hyperactive in a novel environment and alternated at a lower rate in a T‐maze spontaneous alternation task, a phenotype reminiscent of mice expressing reduced levels of the DA transporter. To investigate a possible hyperdopaminergic phenotype in alpha‐gamma‐synuclein double‐null mice, we used fast‐scan cyclic voltammetry at carbon‐fibre microelectrodes to assess DA release and reuptake in striatal slices from wild‐type, alpha‐null, gamma‐null and double‐null mice in real time. Double‐null mice were found to have a twofold increase in the extracellular concentration of DA detected after discrete electrical stimuli in the striatum. By measuring the rate of reuptake of DA and tissue DA content in these animals, we showed that the observed increase in size of striatal DA transients was not attributable to a decrease in reuptake of DA via the DA transporter, and can not be attributed to an increase in tissue DA levels in the striatum. Rather, we propose that loss of both alpha‐ and gamma‐synuclein causes an increase in release probability from dopaminergic synapses.
Doublecortin as a marker of adult neuroplasticity in the canary song control nucleus HVC
Authors: Balthazart Jacques , Boseret Géraldine , Konkle Anne T. M. , Hurley Laura L. , Ball Gregory F. 
Published: March 2008

AbstractIt is established that in songbirds the size of several brain song control nuclei varies seasonally, based on changes in cell size, dendritic branching and, in nucleus HVC, the incorporation of newborn neurons. In the developing and adult mammalian brain, the protein doublecortin (DCX) is expressed in postmitotic neurons and, as a part of the microtubule machinery, required for neuronal migration. We recently showed that in adult canaries, DCX‐immunoreactive (ir) cells are present throughout the telencephalon, but the link between DCX and the active neurogenesis observed in songbirds remained uncertain. We demonstrate here that DCX labels recently born cells in the canary telencephalon and that, in parallel with changes in HVC volume, the number of DCX‐ir cells is increased specifically in the HVC of testosterone‐treated males compared with castrates, and in castrated testosterone‐treated males paired with a female as compared with males paired with another male. The numbers of elongated DCX‐ir cells (presumptive migrating neurons) and round multipolar DCX‐ir cells (differentiating neurons) were also affected by the sex of the subjects and their photoperiodic condition (photosensitive vs photostimulated vs photorefractory). Thus, in canaries the endocrine state, as well as the social or photoperiodic condition independently of variation in steroid hormone action, affects the number of cells expressing a protein involved in neuronal migration specifically in brain areas that incorporate new neurons in the telencephalon. The DCX gene may be one of the targets by which testosterone and social stimuli induce seasonal changes in the volume of song nuclei.