bluuebunny/crossref_metadata_2025_split huggingface dataset:
Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas
Authors: CHOO K. E. , RAZIF A. R. , OPPENHEIMER S. J. , ARIFFIN W. A. , LAU J. , ABRAHAM T. 
Published: March 2008

AbstractData are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP‐CP) for Salmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP‐CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positive S. typhi culture in a febrile child (culture positive vs the rest) showed the best model to be an O‐ and/or H‐titre of ≥ 1 in 40 (sensitivity 89%; specificity 89%). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of O and H (> 1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP‐CN patients really were typhoid but were missed by culture. The TYP‐CN patients showed a very similar clinical and age profile to TYP‐CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific ‘fever screen’ for typhoid although it will not identify all cases. In children, lower cut‐off points for O‐ and H‐titres should be used than are generally recommended.
Do diagnosis related groups separate the case‐mix of a specialist children's hospital and a paediatric unit in a general hospital?
Authors: PHELAN P. D. , BAXTER K. , BISHOP J. , HUDSON I. , HINDLE D. 
Published: March 2008

AbstractThe ability of diagnosis related groups (DRG) and refinement diagnosis related groups (RDRG) to measure differences in case‐mix was investigated using discharge data for patients <18 years of age from three specialist children's hospitals and four district hospitals. While the three children's hospitals each had a greater percentage of RDRG for more complex patients, only one children's hospital had more complex patients based on DRG and RDRG cost weights and on the percentage of diagnoses per discharge. Cost weights based on USA practices may be inappropriate in Australia, and Australian weights will be necessary for firm conclusions. Refinement diagnosis related groups with appropriate cost weights may be acceptable measures of case‐mix in specialist children's hospitals, but they have inherent limitations for paediatric patients in that many complex paediatric patients are ill very seriously with one disorder, whereas complex adult patients usually have secondary diagnoses and secondary procedures. Moreover, no DRG version developed in the US will be suitable for use in Australia unless it takes account of medical costs and transfer practice.
The prevalence of anencephalus and spina bifida in New Zealand
Authors: BORMAN B. , CRYER C. 
Published: March 2008

AbstractDespite the plethora of epidemiological research conducted on anencephalus and spina bifida, few of the studies have used multiple source case ascertainment and controlled for the effect of possible confounding factors. This paper reports the results from a study of the relationships between various risk factors and the prevalence of anencephalus and spina bifida in New Zealand during 1978‐82, using case data obtained from multiple sources and a national cohort of births as the denominator. The rates of anencephalus and spina bifida in New Zealand were 0.78/1000 and 0.94/1000 total births, respectively. The rate of a neural tube defect (NTD) birth for Maori parents was less than for their non‐Maori counterparts. Paternal ethnic origin and maternal ethnic origin made similar contributions to the model of anencephalus rates, but the results suggest that paternal ethnic origin is a less important risk factor in the prevalence of spina bifida. The rate of both NTD was high among female infants and low among births to women born in countries other than the British Isles and New Zealand. The rate of anencephalus showed a distinct north‐south gradient, but there was no evidence of effects for maternal or paternal age, parity, urban‐rural place of residence, nuptiality, social class or season of birth in the prevalence of either NTD in New Zealand.
C‐Reactive protein as a diagnostic tool of sepsis in very immature babies
Authors: WAGLE S. , GRAUAUG A. , KOHAN R. , EVANS S. F. 
Published: March 2008

Abstract Three hundred and nine septic screens were performed on 123 consecutively admitted infants of <30 weeks gestation. As part of the septic screen, serial quantitative measurements of C‐reactive protein (CRP) were performed daily until discontinuation of antibiotic therapy. Complete blood counts were performed daily for the first 2 days of each septic episode.The babies had a mean birth weight of 1035.8 g s.d. 273.2 and a mean gestational age of 27 weeks s.d. 1.8. A CRP level of 10 mg/L or above was considered abnormal. Subsequently the receiver operator characteristic curve for CRP was constructed to demonstrate the ideal cut off value.Of the 309 septic screens, there were 51 instances of proven sepsis and 39 instances of deep culture negative sepsis. In the remaining 219, a diagnosis of proven or deep culture negative sepsis could not be made.On the first day of the septic episode CRP showed a sensitivity of 62.7%, specificity of 87.2% and negative predictive value of 92.2% for proven sepsis. There was a significant increase in the sensitivity (90.2%) and negative predictive value (97.7%) of CRP with a specificity of 80.6 when both day 1 and 2 estimations were combined.We conclude that when the CRP is elevated on day 1 and/or day 2, the diagnosis of sepsis is extremely likely and when the CRP is within normal limits on days 1 and 2 of the septic episode, neonatal sepsis can be confidently excluded and antibiotic therapy ceased.
Survival of low birthweight infants in central Queensland
Authors: MERCER H. P. , ROPER P. C. , O'DUFFY J. F. , NESS G. J. 
Published: March 2008

AbstractThe survival of low birthweight infants £2000g born in the central Queensland area during the years 1979 to 1991 was examined. Five hundred and sixty such infants were either delivered at one of the two Rockhampton obstetric units (Rockhampton Base Hospital and the Mater Misericordiae Hospital) or retrieved from outlying central Queensland areas. Both hospitals had intensive care nurseries capable of ventilation and infants were transferred to tertiary centres only for cardiac or surgical treatment. The study involved all liveborn infants', including those with lethal malformations and all deaths up to the time of discharge. Survival rates were as follows: £500 g 0%, 501 £750 g 30%, 751 £1000 g 51%, 1001 ± 1500 g 79%, 1501 £2000g 93%. The survival of Aboriginal infants and outborn infants were found to be essentially the same as the overall group.
Well health care and the sudden infant death syndrome
Authors: FORD R. P. K. , MITCHELL E. A. , TAYLOR B. J. 
Published: March 2008

AbstractThe aim of this study was to examine whether poor attendance at routine antenatal and postnatal ‘well child’ health services was associated with a higher risk of sudden infant death syndrome (SIDS, or cot death). A nationwide case‐control study of SIDS in New Zealand enrolled 485 postneonatal deaths due to SIDS and 1800 control infants who were selected randomly. The risk for SIDS was found to be higher for infants whose mothers attended their first antenatal check later than 3 months into the pregnancy, made fewer antenatal visits, and did not go to antenatal education classes. However, this increased risk was largely explained by high parity, maternal smoking, the mother not being married, mother being <20 years old at the birth of her first child, and delivery during the winter months. Infants not attending a 6 week postnatal check had an almost three‐fold increased risk of SIDS compared with those who did attend (odds ratio [OR] 2.86; 95% confidence interval [Cl] 1.93, 4.24). Similarly, infants not attending well child clinics were at increased risk of SIDS (OR 2.75; 95% Cl 2.09, 3.62). These differences persisted when adjusted for likely confounders. This study demonstrates that infants who miss child health nurse clinics are those most at risk for SIDS and are those who warrant increased surveillance.
Early intervention: The professional views and referral practices of paediatricians in Victoria
Authors: REDDIHOUGH D. S. , TINWORTH S. , MOORE T. G. , IHSEN E. , DENNEHY S. 
Published: March 2008

AbstractEarly intervention services for young children with developmental disabilities have developed considerably in the past decade, yet little information is available about the referral practices and views of Australian paediatricians. During 1991, 100 paediatricians in Victoria completed a postal questionnaire designed to gain information regarding their attitudes to early intervention and referral practices. The results indicated that paediatricians had a positive view of early intervention, and perceived the standard and quality of the services in their region as comprehensive (16%) or adequate (54%). They were likely to make prompt referrals in the presence of an established disability (75%), but with suspected developmental delay, many (45%) were likely to wait until the delay was confirmed. Referrals were more often made for intervention for the child rather than for family support. However, paediatricians felt that early intervention had a beneficial effect on family functioning (81%). In general, the results indicate that there seem to be few barriers between paediatricians and the early intervention field.
Sudden infant death syndrome and infant mortality in Aboriginal and non‐Aboriginal infants
Authors: ALESSANDRI L. M. , READ A. W. , STANLEY F. J. , BURTON P. R. , DAWES V. P. 
Published: March 2008

AbstractThe aim of this study was to investigate sudden infant death syndrome (SIDS) in the context of total infant mortality for Aboriginal and non‐Aboriginal infants. Deaths for infants born in Western Australia from 1980 to 1988 inclusive were ascertained from a total population data base. Infant mortality rates and rates by period and cause of death were calculated for both populations. Aboriginal infants had a mortality rate three times that for non‐Aboriginal infants (23.6 cf. 7.9 per 1000 live births) and both populations showed a similar rate of decline in mortality over the study period. There were differences in the proportion of deaths occurring neonatally and postneonatally in the two populations. In terms of SIDS, 21% of the deaths in Aboriginal infants occurred neonatally compared with 7% for non‐Aboriginal infants. The overall cause of infant death distribution differed significantly between the two populations (P < 0.001). During the study period, Aboriginal infants showed a significant increase in deaths due to SIDS and a significant decrease in those due to birth defects and low birthweight. These results suggest it would be useful to review the pathology and diagnosis of sudden unexplained death in infancy.
Headache and asthma
Authors: WILKINSON I. A. , HALLIDAY J. A. , HENRY R. L , HANKIN R. G. , HENSLEY M. J. 
Published: March 2008

AbstractThe aim of this study was to investigate the association between headache and asthma, bronchodilators and atopy in school children. A cross‐sectional survey of all primary school children was conducted in two towns near Newcastle, New South Wales, Australia; one in the vicinity of two coal‐fired power stations, the other free of outdoor industrial air pollution. The main outcome measures were frequent headache, wheezing, bronchial reactivity, use of bronchodilators and atopy. Eight hundred and fifty‐one primary school children aged 5‐12 years participated (92% response rate). Twenty‐three per cent of the children were reported to have had a history of frequent headache. Crude odds ratios indicated that the odds of frequent headache was significantly higher in children with asthma and atopy and where there was a smoker in the home, but that there was no association between frequent headache and use of bronchodilators or the sex of the child or socio‐economic status measured as father's occupation. Stepwise logistic regression with frequent headache as the outcome of interest showed that, after adjusting for age and smoking in the home, the odds ratio for asthma (defined as current wheeze) was 3.24 (95% confidence interval [CI] 2.19‐4.77). The similarly adjusted odds ratio for asthma defined as bronchial hyperreactivity (BHR).was 1.60 (95% Cl 1.09‐2.37). Atopy was not statistically significantly associated with headache for either model. Asthma (defined as wheeze or BHR) is an independent risk factor for frequent headache. The relationship between headache and asthma is an association with bronchial hyperresponsiveness rather than atopy.
Coagulopathy with piperacillin administration in cystic fibrosis: Two case reports
Authors: RYE P. J. , ROBERTS G. , STAUGAS R. E. M. , MARTIN A. J. 
Published: March 2008

AbstractTwo cases are reported of coagulopathy in association with the administration of piperacillin to patients with cystic fibrosis. In both cases the coagulopathy was associated with the development of a serum sickness‐like illness with fever, rash and abnormal liver function tests occurring on day 12 and day 16 of treatment, respectively. On withdrawal of the piperacillin, both the serum sickness and the coagulopathy resolved rapidly, without sequelae.
Screening test for growth hormone deficiency: Usefulness of L‐dopa‐propranolol provocative test
Authors: LIM Y. J. , KWAN E. , LOW L. C. K. 
Published: March 2008

AbstractThis is a retrospective review of 185 short children who were tested for growth hormone (GH) secretion using the L‐dopa‐propranolol provocative test. One hundred and thirty‐three children were deemed to have passed the screening test when a GH concentration of greater than 15 miu/L was elicited after stimulation. Fifty‐two failed the screening test, of which 33 were diagnosed as having growth hormone deficiency (GHD) when they had inadequate growth hormone response to insulin‐induced hypoglycaemia. The other 19 were low‐responders since they showed adequate GH response to insulin tolerance test (ITT). The low‐responder rate to L‐dopa‐propranolol provocative test among short children who are not GH deficient was 12.5%. The low cost of L‐dopa and propranolol, the simplicity and safety of the test, and the acceptable rate of low‐responders make the test an effective screening test for GHD.
Avoidance of red blood cell transfusion in an extremely preterm infant given recombinant human erythropoietin therapy
Authors: YU V. Y. H. , BACSAIN M. B. 
Published: March 2008

AbstractTo avoid red blood cell (RBC) transfusions, recombinant human erythropoietin (rHuEPO) was given to an infant born at a gestation of 26 weeks and a birthweight of 830 g to parents who were Jehovah's Witnesses. The infant had hyaline membrane disease and required 52 days of assisted ventilation and 19 days of oxygen therapy. He received theophylline therapy for 61 days for recurrent apnoea and bradycardia. He developed bilateral intraventricular haemorrhage (IVH) and left‐sided periventricular leucomalacia (PVL). Intravenous rHuEPO was started on day 1 at 200 U/kg per day for 1 month followed by subcutaneous rHuEPO 400 U/kg three times a week for 6 more weeks, supplemented with Vitamin E, folic acid and iron. Blood sampling was kept to a minimum and non‐invasive blood‐gas monitoring was used consistently. Consequently, the estimated cumulative volume of blood loss from sampling was only 21 mL during his hospital stay. His haemoglobin (Hb) was 150 g / L at birth and this fell to below 100 g / L from day 25 onwards. His lowest leucocyte count was 3.6x109/L. He was discharged on day 83 with a Hb of 95 g/L, Hct of 29%, reticulocyte count of 2.8% and weight of 2400 g. At a postnatal age of 3 months, he had a Hb of 113 g/L. At 6 months, investigations showed: Hb 121 g/L, haematocrit 33%, reticulocyte 1% and a weight of 4.4 kg. He was readmitted to hospital once for an episode of vomiting and follow up to date showed developmental delay. Concerns remained whether the withholding of RBC transfusion in the infant was related to his IVH, PVL, prolonged recurrent apnoea and bradycardia and poor weight gain. Although rHuEPO therapy shows promise in reducing the need for RBC transfusions, its overall efficacy and safety remain to be proven and its routine use in preterm infants has to be weighed up against the potential benefits and risks of RBC transfusions.
Inguinal hernia in extremely preterm infants
Authors: YEO C. L. , GRAY P. H. 
Published: March 2008

AbstractThe prevalence of inguinal hernia during primary hospitalization was determined in 250 infants with gestational age 24–29 weeks. Fourteen per cent developed hernia, with prevalence significantly higher in boys than girls. Infants with respiratory distress syndrome and those requiring prolonged mechanical ventilation were significantly predisposed to the development of hernia. Male infants, especially those who required prolonged ventilatory assistance, were at greatest risk. This information may be used when counselling parents regarding complications of very preterm infants.
Factors adversely associated with breast feeding in New Zealand
Authors: FORD R. P. K. , MITCHELL E. A. , SCRAGG R. , STEWART A. W. , TAYLOR B. J. , ALLEN E. M. 
Published: March 2008

AbstractControl data from 1529 infants studied in a multicentre case‐control study of sudden infant death in New Zealand were analysed to identify factors that might hinder the establishment and duration of breast feeding. Although 1300 infants (85%) were exclusively breast‐fed at discharge from the obstetric hospital, this fell to 940 (61%) by 4 weeks. Logistic regression was used to identify factors that might adversely influence breast feeding ‘at discharge’,‘at 4 weeks’ and the overall ‘duration’ of breast feeding.When adjusted for confounding factors, not exclusive breast feeding ‘at discharge’ was significantly associated with: twin pregnancy, being a Pacific Islander, mother not bedsharing, subsequent dummy use, birthweight less than 2500g, heavy maternal smoking, not attending antenatal classes and mother less than 20 years old at first pregnancy. Mothers smoking more than 20 cigarettes a day were nearly twice as likeiy to not exclusively breast feed on discharge compared to those who did not smoke. A ‘dose response’ was apparent with the heaviest smokers having the least likelihood of establishing exclusive breast feeding.Being exclusively breast‐fed at discharge but not ‘at 4 weeks’ was associated with: twin pregnancy, admission to a neonatal intensive care unit, subsequent dummy use and not being married. A shorter overall ‘duration’ of breast feeding was associated with maternal smoking, subsequent dummy use, mother not bedsharing, twin pregnancy, mother less than 20 years old at first pregnancy, low occupational status and not attending antenatal classes. These effects persisted when social and demographic factors, including birthweight, were taken into account.This study showed that 31% of New Zealand women had smoked during their pregnancy. A concerted effort to achieve smokefree pregnancies would not only directly improve the health of mother and child but may enhance both the initiation and duration of breast feeding. The influence on the duration of breast feeding of both dummy usage and the mother sharing the bed with her infant needs to be explored further, as a causal relationship cannot be established from these data.
Insulin‐dependent diabetes mellitus in southern Chinese children: An overview
Authors: WONG G. W. K. 
Published: March 2008

AbstractThirty‐three southern Chinese children with insulin‐dependent diabetes mellitus (IDDM) were studied. The patients had a mean follow‐up of 5.2 years (range 1.2–8.2). The mean age of onset was 8.3 years (range 1.7–13.5). The mean duration of symptoms before diagnosis was 22 days. Ten patients (30%) presented with diabetic ketoacidosis at diagnosis. Only one patient (3%) was found to have thyroid microsomal antibodies and none was found to have hypothyroidism or hyperthyroidism. Incidence and prevalence were calculated from data recorded retrospectively and prospectively in a population‐based registry of IDDM. The prevalence in 1991 and 1992 was 8.3 per 100000 children under 15 years of age. The age‐standardized incidence of IDDM was 1.7/100 000 per year with the 95% confidence interval of 1.2–2.4/100 000 per year for children under 15 years of age during the years 1986–93. The incidence for males was 1.1/100 000 per year and for females, 2.4/100 000 per year.
integrated health and education input in the development of educational resources about asthma for schools
Authors: HENRY R. L. , GIBSON P. G. , VIMPANI G. V. , HAZELL J. , LEGGATT R. , MOWBRAY C. , THOMPSON S. , PINE J. , VALENTINE M. , JOYCE J. 
Published: March 2008

AbstractThe development of educational packages on health‐related topics has become common in school curricula. This paper describes an integrated health and education input in the development of an educational package about asthma for Year 8 high school students. Ownership and educational relevance of the package (ensuring its appropriateness for inclusion within the Personal Development/Health/Physical Education curriculum) was achieved by collaboration between teachers with an understanding of the principles of curriculum design and health professionals with content knowledge about asthma. The model used for the production of the package about asthma could be extended to other health topics.
Incidence of apnoea and bradycardia in preterm infants following triple antigen immunization
Authors: BOTHAM S. J. , ISAACS D. 
Published: March 2008

AbstractNinety‐seven preterm infants were immunized with diphtheria‐tetanus‐pertussis (DTP) prior to discharge from hospital. The mean gestational age at birth was 28.1 weeks (range 24‐34) and the mean age at immunization was 80.6 days (range 44–257). Nineteen (20%) infants developed apnoea or bradycardia within 24 h of immunization. The infants who developed apnoea and/or bradycardia had a younger gestational age at birth than those who did not (P= 0.03), were artificially ventilated for longer (P= 0.01) and were more likely to have a diagnosis of chronic lung disease (P= 0.006). In the majority of infants these events were not clinically significant. Two infants who developed concurrent upper respiratory tract infections required additional oxygen and one of them was treated with oral theophylline. In general, it is safe practice to immunize preterm infants with DTP unless otherwise contraindicated. However, it is recommended that cardiorespiratory function is monitored after immunization in very preterm infants who had prolonged ventilatory support and/or chronic lung disease.
Congenital Candida pneumonia in a preterm infant
Authors: NG P. C. , SIU Y. K. , LEWINDON P. J. , WONG W. , CHEUNG K. L. , DAWKINS R. 
Published: March 2008

AbstractA 24 week gestation survivor of congenital Candida pneumonia who received prompt antifungal treatment and modern neonatal intensive care is reported. It was an unusual case in that fungal chorioamnionitis occurred without a foreign body in the maternal genital tract. Early diagnosis and treatment of congenital fungal pneumonia was possible because of prior knowledge of the obstetric history. Amphotericin B was successfully used for the treatment of this condition but combination with fluconazole (a fungistatic agent) was unsatisfactory and may be undesirable. Dexamethasone therapy to assist extubation was instituted once the fungal infection had been successfully controlled.