bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normal early infant behaviour patterns
Authors: WALKER A. M. , MENAHEM S. 
Published: March 2008

AbstractAs part of a wider study, infant behaviour was reviewed prospectively, using a 24 h diary completed by the mother. Infants' sleep, awake, fussing, crying and feeding behaviour were recorded at 1,2,4,6 and 8 weeks. Completed records were obtained from 21 infants. As expected most time was spent asleep, with a mean of 16.2 h at 1 week and 15.5 h at 8 weeks. Most sleeping occurred between midnight and 4 a.m. even by week 1 and there was a progressive fall in the average duration of feeding during that time interval over the 8 week period. Fussing and crying were mostly noted between 4 and 8 p.m. with an additional peak between 8 a.m. and noon, the latter disappearing by week 4. There was also a progressive drop in both the average feeding and fussing/crying times by week 8, reflecting increased settled and awake periods. It is against a background of normal early infant behaviour patterns that one can evaluate interventions aimed at altering such behaviour and dealing with the vexed problem of ‘colic’.
Alcohol and drug usage in parents soon after stillbirth, neonatal death or SIDS
Authors: VANCE J. C. , NAJMAN J. M. , BOYLE F. M. , EMBELTON G. , FOSTER W. J. , THEARLE M. J. 
Published: March 2008

AbstractThe behaviour of bereaved parents with respect to their drug and alcohol ingestion was examined 2 months following the loss of an infant from stillbirth (SB) neonatal death (NND) or sudden infant death syndrome (SIDS). Responses from bereaved families (99 SB, 109 NND, 52 SIDS) were compared with 252 control families (who had a liveborn infant). There was no difference in self‐medication using aspirin as the example. The use of sedative drugs was significantly higher in all bereaved mothers (but especially the SIDS group). Use of sedatives by fathers was significantly higher only in the SIDS group. There was also a greater frequency of heavy drinking of mothers in all the bereaved groups and fathers in the SIDS group. These results have implications for the understanding and care of families following infant loss.
Subureteric Polytef injection in the management of vesico‐ureteric reflux in children
Authors: DEWAN P. A. , GOH D. W. 
Published: March 2008

AbstractSubureteric Polytef injection is one of the alternatives now available for the management of vesico‐ureteric reflux in children. The results of the treatment by one surgeon, over a 2 year period, were studied prospectively in 47 children (60 refluxing units). Following a single injection, reflux was abolished in 49 (82%) ureters and of the 11 failures, 10 ureters showed a reduction of the grade of reflux while one remained unchanged. A repeat injection was performed in nine of these ureters with success in five, persistence in two, and two children are awaiting a follow‐up cystogram. The conservative success, with the addition of a second injection, was 90% (54/60). Of the four with unresolved reflux, two have low grade reflux and are free of infection, and two have had a ureteric reimplant, one of which was after a single injection, at the request of the parents. There were no instances of ureteric obstruction. These results show a viable, minimally invasive alternative to open ureteric reimplantation in the management of vesico‐ureteric reflux in children.
Outcome of neonates transported between Level III centres depends upon centre of care
Authors: HARDING J. E. , MORTON S. M. 
Published: March 2008

AbstractThis study aimed to clarify whether the adverse outcomes seen in babies transported between New Zealand Level III intensive care nurseries were due to the transport itself or to possible differences in care in different centres. The outcomes of 34 infants inborn at National Women's Hospital, Auckland but transported to other centres were compared with those of 68 matched controls inborn at the receiving centres and with 68 controls inborn and cared for at National Women's Hospital.Transport was associated with a transient (non‐significant) deterioration in respiratory status but no increase in chronic lung disease. However, infants cared for elsewhere, whether transported or control, had more periventricular haemorrhage than Auckland babies (23% and 29%vs 15%, P= 0.03) and worse neurodevelopmental outcome (70% and 66%vs 88% of those whose outcomes were known were normal at follow up, P= 0.002).We conclude that differences in care between centres may be more important than the transport itself in determining the long‐term outcome of transported neonates.
A blinded comparison of clinical and echocardiographic evaluation of the preterm infant for patent ductus arteriosus
Authors: SKELTON R. , EVANS N. , SMYTHE J. 
Published: March 2008

AbstractThe accuracy of the characteristic physical signs of a patent ductus arteriosus (PDA), that is, a systolic murmur, increased volume of pulses and increased praecordial activity, in diagnosing a haemodynamically significant PDA in ventilated premature infants was prospectively evaluated. Fifty‐five ventilated preterm infants (birthweight >1500g) had daily echocardiographic and clinical evaluation for a PDA for the first 7 days of life. The examiners were blinded to each other's findings. Probability analysis was performed for the accuracy of each clinical sign in detecting a haemodynamically significant PDA as defined by echocardiographic criteria. Clinical signs were poor at detecting a significant PDA in the first 4 days of life. On day 1, none of the 10 infants with a significant PDA had a murmur. By day 4, clinical signs were better at detecting a significant PDA, but specificity remained poor with many false positive signs. Six infants had murmurs with a closed duct. The development of echocardiographic haemodynamic significance preceded the development of physical signs by a mean of 1.8 days. Significant ductal shunts often occurred silently, but the development of a murmur often marked an increase in the velocity of the flow through the duct rather than an increase in the size of a shunt. This study confirms that echocardiography is required for the reliable early diagnosis of a PDA in ventilated preterm infants.
Ventricular septal defect and sudden death in early childhood
Authors: BYARD R. W. 
Published: March 2008

AbstractA 21/2 year old boy collapsed at home and was taken immediately to the local hospital in cardiorespiratory arrest where attempted resuscitation was unsuccessful. At autopsy, massive cardiomegaly was found associated with a large membranous ventricular septal defect. There was also an early acute bronchopneumonia. Although growth parameters indicated failure to thrive, no specific health problems had been noted by the family apart from an apparent mild ‘upper respiratory infection’ prior to death. While the occurrence of sudden and unexpected death in cases of undiagnosed isolated ventricular septal defect has not been emphasized in the literature, this case demonstrates that sudden death may be a problem in early childhood. This is particularly so in cases of untreated large defects with cardiomegaly when additional stresses such as acute infection occur.
Hydrocephalus ex vacuo and clasp thumb deformity due to congenital cytomegalovirus infection
Authors: FRASER S. H. , O'KEEFE R. J. , SCURRY J. P. , WATKINS A. M. C. , DREW J. H. , CHOW C. W. 
Published: March 2008

AbstractA case of congenital hydrocephalus in a male infant with flexion deformity of the thumbs and great toes is reported. A maternal uncle had undefined intellectual impairment and X‐linked hydrocephalus was considered among the differential diagnoses. However, this diagnosis was considered unlikely as the pyramids were preserved at autopsy. In addition, postmortem histopathology and viral culture established cytomegalovirus (CMV) infection as the underlying cause of the hydrocephalus. Although CMV infection is a well recognized cause of congenital hydrocephalus, the associated flexion deformities of the thumbs and great toes have not been previously described and may reflect injury to the corticospinal tracts.
Survey on developmental‐behavioural training experiences of Australian paediatric advanced trainees
Authors: CHEE K. Y. , SIMPSON J. M. , HUTCHINS P. 
Published: March 2008

AbstractIn order to monitor whether paediatric education has adapted to meet modern practice 91 paediatric advanced trainees were surveyed to elicit their satisfaction with developmental‐behavioural (DB) training. A response of 69% was obtained to a postal questionnaire. The traditional imbalance persists, with trainees considering themselves significantly better informed in the medical disciplines (P>0.001). Satisfaction with training in the 14 developmental disciplines surveyed is less (P>0.001) and significantly more variable compared with 11 traditional medical disciplines (P>0.01). Formal rotations in DB disciplines had been received by all respondents by the 7th year of training. However, 46–67% consider themselves ill‐informed in learning/school problems, attention‐deficit hyperactivity disorder, adolescent problems, paediatric rehabilitation and language impairment. Thirty‐seven per cent found formal postgraduate instruction unhelpful. Paediatric advanced training gives exposure to, but unsatisfactory formal education, in developmental and behavioural paediatrics. Current initiatives for mandatory DB training have serious implications for achieving adequate resources and standards to meet clinical and training demands.
Myoclonic encephalopathy of infancy: A 10 year review
Authors: NISSEN M. D. , APPLETON D. B. 
Published: March 2008

AbstractMyoclonic encephalopathy of infancy (MEI) is a unique cause of acute ataxia in infants and is a rare presentation of neuroblastoma. Five cases presenting to a tertiary referral children's hospital during a 10 year period are reviewed. Two cases were associated with a neuroblastoma. All children were treated with intramuscular injections of adrenocorticotropic hormone, with symptomatic improvement. One child died from an opportunistic infection following chemotherapy for neuroblastoma. The four survivors have mild to moderate clinical and intellectual deficits. Investigation and continuing observation for occult neural crest tumours is emphasized for all cases of MEI, though no underlying cause was found in 60% of children in this study.
Analysis of paediatric tumour types associated with hemihyperplasia in childhood
Authors: SMITH P. J. , SULLIVAN M. , ALGAR E. , SHAPIRO D. N. 
Published: March 2008

AbstractIn order to further explore the relationship between hemihyperplasia in children and the occurrence of embryonal tumours of childhood, the records at St Jude Children's Research Hospital were examined for patients who presented with a malignant tumour and hemihyperplasia. Of 27 evaluable patients, 19 had Wilms' tumour and one had massive bilateral nephroblastomatosis. The tumours were more likely to occur on the side affected by hemihyperplasia than to be found contralaterally. All but five of these patients developed the tumours before, the age of six. Twenty‐two of the 27 patients developed tumours associated with allelic loss on chromosome band 11p15, suggesting that the locus associated with hemihyperplasia may be also located at chromosome band 11p15.
Urinary N‐acetyl‐beta‐D‐glucosaminidase excretion in term and preterm neonates
Authors: TSUKAHARA H. , HORI C. , TSUCHIDA S. , HIRAOKA M. , SUDO M. , HARUKI S. , SUEHIRO F. 
Published: March 2008

AbstractUrinary N‐acetyl‐beta‐D‐glucosaminidase (NAG) excretion was measured in term and preterm neonates on days 1, 4, 7, 14 and 28 of life. Urinary NAG showed a peak level on day 4 or 7 in these infants. In addition, it tended to be higher with the degree of prematurity. In sick preterms who were depressed at birth and had respiratory failure, the NAG activity was further elevated during the first 2 weeks, suggesting the presence of renal tubular injury in this period. These observations thus suggest that urinary NAG may be a sensitive measure of renal maturation or damage in neonates.
Pulmonary thromboembolism and unexpected death in infancy
Authors: CHAMP C. , BYARD R. W. 
Published: March 2008

AbstractReview of the Department of Histopathology autopsy files over a 30 year period from 1962 to 1991 revealed only three cases in which unexpected death occurred in infants under 1 year of age due to massive pulmonary thromboemboli. Predisposing factors included necrotizing enterocolitis with gut perforation and sepsis, a ventriculoatrial shunt and idiopathic arterial calcification. Diagnosis of the latter autosomal recessive condition was only made at autopsy. These cases demonstrate that pulmonary thromboembolism is a possible, although exceedingly rare, cause of sudden infant death, that some predisposing factors are unique to infancy and that the source of the pulmonary thromboembolus may be difficult to determine at autopsy. Massive pulmonary thromboembolism in infancy may point to the presence of other significant clinically‐unsuspected, disorders.
Effects of nasal continuous positive airway pressure on apnoea index and sleep in infants
Authors: McNAMARA F. , HARRIS M‐A. , SULLIVAN C. E. 
Published: March 2008

Objectives: We examined the effectiveness of nasal continuous positive airway pressure (CPAP) for treatment of sleep apnoea in infants.Methodology: We studied five infants who all had significant central and mixed apnoea and severe sleep fragmentation. Polysomnographic recordings were performed on 2 consecutive nights in these infants. One night was used as a control study and during the second night nasal CPAP was applied throughout the nightResults: Nasal CPAP significantly reduced apnoea in each infant, with the apnoea index (apnoeas/h) decreasing from 65.6± 14.6 during the control study to 10.5± 14.6 during CPAP in non‐rapid eye movement (non‐REM) sleep, and from 106± 13.9 during the control study to 26.6± 13.9 during CPAP in REM sleep. Nasal CPAP also improved the sleep fragmentation markedly; REM sleep increased from 14.2± 1.2% of sleep during the control study to 27.1 ± 1.2% of sleep during CPAP.Conclusions: We conclude that nasal CPAP is an effective treatment for infantile apnoea. Sleep apnoea in these infants is associated with profound sleep fragmentation, which is reversed by nasal CPAP.
Parental asthma knowledge: Its association with readmission of children to hospital
Authors: HENRY R. L , COOPER D. M. , HALLIDAY J. A. 
Published: March 2008

Objectives: To assess whether poor parental knowledge about asthma was a risk factor for readmission of their children to hospital.Methodology: Parents of children who were admitted to the paediatric facility at Newcastle Mater and John Hunter Hospitals were administered a previously validated asthma knowledge questionnaire with a maximum possible score of 31.Results: The mean parental knowledge scores for three groups of children were determined: those with a previous diagnosis of asthma being readmitted to hospital (170 children, mean score 18.3); those with a previous diagnosis of asthma being admitted for the first time (114 children, mean score 17.2); and children being admitted with their first attack of asthma (65 children, mean score 15.6). There was a significant difference in parental asthma knowledge between the first and third group (P<0.001) but not between the first and second group. A linear regression model with knowledge score as an outcome found that increased knowledge was associated with previously diagnosed asthma, higher parental occupation and no smoker in the home.Conclusions: Knowledge was poor in all groups. Readmission rate was related to the severity of the child's asthma.
Clinical manifestations and outcome of Haemophilus influenzae type b disease
Authors: GILBERT G. L. , JOHNSON P. D. R. , CLEMENTS D. A. 
Published: March 2008

Objectives: To document clinical manifestations, laboratory findings and outcome of childhood Haemophilus influenzae type b (Hib) infections.Methodology: Medical records of 235 children with Hib disease admitted to hospital during a 2 year period were reviewed; additional information was obtained by questionnaire and follow up 6 weeks after discharge.Results: Three‐quarters of patients presented with either meningitis or epiglottitis. Children with epiglottitis were older, had shorter illnesses and were less likely to have had antibiotics before admission than those with meningitis; 38% of the latter had been given some antibiotic therapy, with no apparent effect on the outcome. Fever persisted for 7 days or more in 23% of patients with meningitis. Death from meningitis occurred in 3.8% of patients and was due to fulminating disease.Conclusions: These data will assist in recognition and appropriate management of Hib disease as the clinical manifestations become less familiar following the introduction of immunization. Specific laboratory diagnosis is required for accurate surveillance, which should be maintained in order to ensure high immunization rates.
The prevalence of respiratory symptoms in South Australian preschool children. II. Factors associated with indoor air quality
Authors: VOLKMER R. E. , RUFFIN R. E. , WIGG N. R. , DAVIES N. 
Published: March 2008

Objectives: This study investigated the relationship between indoor air quality and the prevalence of respiratory symptoms in South Australian preschool children.Methodology: Data were collected from 14124 families with a child aged 4 years 3 months to 5 years of age. This sample represents 73% of the targeted State preschool population. At the time of a routine preschool health check, parents completed a questionnaire regarding: their child's respiratory health and place of residence (postcode), parental smoking, type of fuel used for cooking and heating and method used for home cooling.Results: For preschool children residing in the greater Adelaide region, logistic regression analyses found that having a natural gas stove compared to an electric stove was significantly associated with increased prevalence rates for: (i) asthma (odds ratio [OR] 1.24); (ii) wheezing in the preceding 12 months (OR 1.16); excessive colds (OR 1.14); and hay fever (OR 1.13). The use of a liquid petroleum gas stove compared to an electric stove was not associated with any respiratory symptoms‐ The use of a flueless gas heater compared to other forms of heating was significantly associated with increased prevalence rates for dry cough (OR 1.26), ever having wheezed (OR 1.15) and wheezing in the preceding 12 months (OR 1.18). The use of a wood fire/heater compared to other forms of heating was significantly associated with a reduced prevalence rate for dry cough (OR 0.84) and ever having wheezed (OR 0.82). Parental smoking was significantly associated with increased prevalence rates for bronchitis (OR 1.21) and ever having wheezed (OR 1.24). The form of home cooling used was not associated with prevalence rates, after accounting for geographic location. Socio‐economic status (postcode level) was not generally associated with prevalence rates.Conclusions: These results suggest that respiratory symptom prevalence is related to the fuel used for cooking and heating and parental smoking. Prospective investigation regarding indoor air quality and respiratory symptoms is required.
Improving asthma documentation in a paediatric emergency department
Authors: TEO S. , HANSON R. , van ASPEREN P. , GILES H. , FASHER B. , DAVIS A. M. , KRISTIDIS P. 
Published: March 2008

Objectives: To improve documentation for children presenting to the Emergency Department (ED) of The Children's Hospital with acute asthma.Methodology: In phase I, the documentation process was analysed using a standard total quality management (TQM) approach to identify specific problems leading to poor documentation. Fifty‐two medical records of children presenting over a 3 week period were reviewed for nursing and medical documentation. A set of minimum criteria, consistent with the Paediatric Asthma Management Plan, were established for documentation by both medical and nursing staff. Following dissemination and education, compliance with documentation was evaluated and compared to an asthma survey performed in the ED in 1991. In phase II, a specific proforma for medical assessment was developed and 80 medical records of children presenting over a 3 week period were reviewed. Fifty‐two (65%) with completed proformas were evaluated. The outcome measure was the documentation rate for minimum criteria established by TQM process.Results In phase I, nursing compliance with documentation ranged from 46% for signs of respiratory distress to 83% for a past history of asthma and 100% for pulse rate. Doctors were similarly poor at documenting essential elements such as severity (31%), palpable pulsus paradoxus (29%), the child's usual doctor (46%) and follow‐up arrangements (21–56%). In phase II, the documentation of the severity of acute asthma (42%) and of the child's usual doctor (42%) remained poor but there were statistically significant improvements in documentation of interval medications, palpable pulsus paradoxus, respiratory rate, pre‐treatment oximetry, education, follow‐up arrangements and communication letters.Conclusion The process of TQM has proved valuable in improving some aspects of documentation of children presenting to ED with acute asthma. It remains to be shown whether improved documentation will result in improved outcome.
Recommended body mass index cutoff values for overweight screening programmes in Australian children and adolescents: Comparisons with North American values
Authors: LAZARUS R. , BAUR L. , WEBB K. , BLYTH F. , GLIKSMAN M. 
Published: March 2008

Objectives: Guidelines for screening children and adolescents for overweight have recently been published by a North American Expert Committee. As Australian clinicians might uncritically adopt these recommendations, we explore the consequences of applying North American body mass index (BMI) cutoff values to an Australian population.Methodology The Australian BMI cutoffs were calculated using the methods recommended from height and weight data for 8492 schoolchildren aged 7‐15 years old.Results Smoothed Australian BMI cutoffs were similar to those derived from the first United States National Health and Nutrition Examination Survey (NHANES‐I) values for whites. However, the NHANES‐I cutoffs would result in systematic misclassification. Among 7 year olds, the NHANES‐I 85th percentile cutoff would wrongly classify 4.6% of normal males and 9.1% of normal females as ‘at risk of overweight’. At age 14 years, the NHANES‐I 95th percentile cutoff would misclassify 3.5% of children as ‘overweight’ instead of ‘at risk of overweight’.Conclusion Australian screening programmes should use BMI cutoffs appropriately derived from local measurements, and these are given for Australian children.