bluuebunny/crossref_metadata_2025_split huggingface dataset:
Invasive pneumococcal infection in children, 1981‐92: A hospital‐based study
Authors: DAVIS CWC , McINTYRE PB 
Published: March 2008

Objective: To document the pattern and sequelae of invasive pneumococcal infection in hospitalized children.Methodology Retrospective review of Streptococcus pneumoniae (Sp) isolates from normally sterile sites from 1981 to 1992 at three paediatric centres in Sydney for demographic data, spectrum of disease, predisposing conditions, mortality, and sequelae from meningitis.Results: Four hundred and thirty‐one episodes in 417 patients were identified. Foci of infection were: meningitis, 34%; pneumonia, 29%; bacteraemia without apparent focus, 30%; and other foci, 7%. Sixty‐one per cent of all cases and 64% of cases with meningitis were less than 2 years old. Predisposing conditions were present in 37%, were significantly more common in patients over age 2 years and were more common with foci other than meningitis. Overall mortality was 6.6% whereas the mortality for those with meningitis was 8%. Neurological sequelae were identified in 34% of previously normal children, and severe hearing loss occurred in 11.5%.Conclusions The high morbidity and mortality from invasive pneumococcal infection in children justifies further evaluation of preventive strategies.
Follow‐up validation study of the Victorian Congenital Malformations Register
Authors: KILKENNY M , RILEY M , LUMLEY J 
Published: March 2008

Objective: To determine whether there has been an improvement in ascertainment of malformations in the Victorian Congenital Malformations Register (VCMR).Methodology The medical records of 500 children under 4 years of age admitted consecutively to two paediatric teaching hospitals in Victoria in 1992 were viewed to determine whether these cases had been notified to the Register.Results Over three‐quarters of the defects recorded had been notified to VCMR. There was 100% ascertainment of chromosomal anomalies and a high proportion of major structural malformations were notified.Conclusion This study repeats the validation study completed in 1986 and shows marked improvement in ascertainment of malformations in the VCMR by 1992.
Herpes simplex virus infections in the neonate
Authors: MALOUF DJ , OATES RK 
Published: March 2008

Objectives: To review the experience of the Camperdown Children's Hospital with neonatal herpes simplex viral (HSV) infections between 1960 and 1992.Design: A retrospective record review of all cases of HSV infection.Results: Fifteen proven HSV infections were found. Only three cases had a definite history of HSV infection during pregnancy. Six were delivered at 36 weeks gestation or earlier. Seven weighed 2500 g or less. Forty‐three per cent developed physical signs within 7 days of birth. Three cases were confined to skin, eyes and mouth, five were generalized, six had encephalitis with or without skin lesions, and one had pneumonitis. The mortality rate comprising the five with generalized infection was 47%, one with encephalitis and the one with pneumonitis. Four of the eight survivors have persisting neurological impairment. Those with disseminated infection and encephalitis did poorly regardless of antiviral treatment.Conclusion A high index of suspicion of HSV infection is important so that antiviral treatment can be commenced early, particularly for those infections localized to skin, eye and mouth where there may be a good prognosis.
Anti‐neutrophil cytoplasmic antibodies in Japanese children with ulcerative colitis
Authors: KANEKO K , SUZUKI Y , SHIMIZU T , YAMASHIRO Y , YABUTA K , LIFSCHITZ CH 
Published: March 2008

Objective: To investigate the diagnostic value of anti‐neutrophil cytoplasmic antibodies (ANCA) in the diagnosis of ulcerative colitis (UC) in Japanese children.Methodology Serum samples from 23 children with UC (17 Japanese, 6 non‐Japanese), 27 children with Crohn's disease (CD) (10 Japanese, 17 non‐Japanese), 10 children with other diarrhoeal diseases, and 33 normal, healthy adult volunteers were assayed for ANCA using an indirect immunofluorescence technique.Results ANCA were detected in 6/17 (35%) UC patients and 0/10 (0%) CD patients in Japanese children, and in 3/6 (50%) UC patients and 3/17 (18%) CD patients in non‐Japanese children. The difference in prevalence between Japanese and non‐Japanese children with UC was not statistically significant (P>0.05). ANCA were not found in other diarrhoeal patients and volunteers.Conclusions Although ANCA have been reported to be useful in the diagnosis of UC in adults, they may be of limited use in Japanese children. This might reflect the heterogeneity of UC.
Selenium status of New Zealand infants fed either a selenium supplemented or a standard formula
Authors: DARLOW BA , INDER TE , SLUIS KB , NUTHALL G , MOGRIDGE N , WINTERBOURN CC 
Published: March 2008

Objective: New Zealand soils are deficient in the essential micronutrient, selenium. New Zealand infants have low selenium levels at birth and experience a further decline if fed cows milk based formula. This study examined the selenium status of infants fed with a new commercially available selenium supplemented formula.Methodology Forty‐four newborn infants, whose mothers wished to formula feed, were randomized in an open controlled trial to be fed a commercially available selenium supplemented cows milk formula (containing 17 μg Se/L) or an unsupplemented formula (containing 4.6 μg Se/L). Cord, 1 and 3 month blood samples were obtained for selenium status (plasma and red cell selenium and glutathione peroxidase) and thyroid function.Results Mean plasma selenium and glutathione peroxidase values were significantly higher in supplemented than unsupplemented infants at 1 month (unpaired t‐tests; P<0.0001 and P= 0.001 respectively) and 3 months (P<0.0001 and P= 0.0005). Analysis within treatment groups between time points (paired t‐tests) showed that selenium supplementation prevented the fall in plasma selenium from birth to 1 month seen in unsupplemented infants and was associated with a rise in levels between 1 and 3 months (P= 0.002).Conclusions Supplementing cows milk formula with selenium to replicate the levels found in breast milk is nutritionally sound. Feeding from a few days of age with a formula containing 17 μg Se/L in infants with low selenium status at birth is sufficient to cause a rise to 80% of adult levels at 3 months of age.
Immunity to hepatitis B, poliomyelitis and measles in fully vaccinated Aboriginal and Torres Strait Island children
Authors: HANNA JN , SEXTON WL , FAOAGALI JL , BUDA PJ , KENNETT ML , BRUSSEN KA 
Published: March 2008

Objective: To determine the immunity to hepatitis B, poliomyelitis and measles in fully vaccinated Aboriginal and Torres Strait Island children in north Queensland.Methodology: A cross‐sectional survey of immunity in a sample of children; 101 fully vaccinated Aboriginal and Torres Strait Island children, with a median age of 24.5 months, from 10 communities in North Queensland participated in this study. The main outcome measures were the prevalence of adequate antibody levels against hepatitis B, poliomyelitis and measles.Results: Only 54% (95% Cl 44–63%) of the children had adequate immunity (10 m iu/mL) to hepatitis B, and one child had been infected despite vaccination. Although all the children (95% Cl 96–100%) had adequate immunity (i.e. neutralizing antibodies at a dilution of 1:8) to poliovirus 2, only 93% (95% Cl 86–96%) and 60% (95% Cl 50–69%) had adequate immunity to polioviruses 1 and 3, respectively. Nearly all (96%; 95% Cl 90–98%) of the children had adequate immunity (i.e. detectable IgG antibody) to measles.Conclusions: Although a relatively low proportion of the children had adequate antibody levels against hepatitis B the clinical significance of this observation is uncertain. Further studies are needed to determine whether fully vaccinated Torres Strait Island children have been adequately protected and whether they require a booster dose of hepatitis B vaccine. A substantial proportion of fully vaccinated Aboriginal and Torres Strait Island children are inadequately protected against poliomyelitis, and therefore any such child with acute flaccid paralysis should be investigated fully for poliomyelitis. Vaccinated Aboriginal and Torres Strait Island children are well protected against measles, as are other Australian children.
Inferior vena cava pressure as an estimate of central venous pressure
Authors: YUNG M , BUTT W 
Published: March 2008

Objective:To determine whether pressure in the inferior vena cava (IVC) is similar to central venous pressure.Methodology:Prospective measurement of both central venous pressure (CVP) and inferior vena cava pressure (IVCP) in the same child; each child had to have both catheters in situ. Two measurements of each pressure in reverse order (IVCP then CVP, and CVP then IVCP) were done and the mean of each was recorded. Comparison of the pressures was performed using the method of Bland and Altman.Results:Thirty‐nine children had pressures recorded. The CVP ranged from 3 to 17 mmHg. In 22 of 39 measurements IVCP was equal to CVP; in 33 of 39 measurements IVCP was different from CVP by 1 mm or less and in 37 of 39 measurements IVCP was different from CVP by 2 mm or less. The mean difference between IVCP and CVP was + 0.33 mmHg, the 95% confidence interval was 2.26 to + 2.93 mmHg.Conclusion:Measurement of IVCP is a good approximation to CVP and can be routinely used in clinical care of children who do not have raised intra‐abdominal pressure.
Neonatal systemic candidiasis
Authors: McDONNELL M , ISAACS D 
Published: March 2008

Abstract: Systemic candidiasis is notoriously difficult to diagnose in neonates; however, it is frequently described and has a high mortality and morbidity. It is particularly likely to occur in extremely low birthweight babies, especially those receiving long‐term parenteral nutrition and antibiotics. The clinical features are non‐specific. Thrombocytopenia occurs in almost all cases of systemic candidiasis, but also in about half the cases of bacterial sepsis. Empirical antifungal therapy should be considered more readily for high‐risk, clinically septic, thrombocytopenic babies.
A case‐control study examining risk factors for invasive Haemophilus influenzae type b disease in Victoria, Australia 1988‐90
Authors: CLEMENTS DA , WEIGLE† KA , GILBERT‡ GL 
Published: March 2008

Objective: To determine whether day‐care attendance was a risk factor for Haemophilus influenzae type b (Hib) disease, particularly for epiglottitis.Methodology: A case‐control analysis of risk factors for invasive Hib disease was performed in Victoria, Australia between February 1988 and February 1990 prior to the introduction of immunization for Hib. A total of 210 cases and 367 day surgery hospital controls were enrolled prospectively. Data were collected by questionnaire at the time of admission.Results: Logistic regression analysis showed that risk factors for meningitis were day‐care attendance, household crowding and recent illness in a sibling. Risk factors for epiglottitis were day‐care attendance and mother's birthplace in Australia or New Zealand.Conclusions: This study confirms that day‐care attendance is a risk factor for Hib epiglottitis as well as meningitis. In addition, the mother's birthplace in Australia or New Zealand is a risk factor for epiglottitis in these data. The reason for this latter observation is unclear.
Obsessive‐compulsive behaviour in children and adolescents: A cross‐sectional Australian study
Authors: KING NJ , MYERSON NN , INGLIS S , JENKINS M , OLLENDICK TH 
Published: March 2008

Objective:To examine the reliability of the survey form of the Leyton Obsessional Inventory‐Child Version (LOI‐CV), ascertain the prevalence of self‐reported obsessive‐compulsive behaviour together with age and sex differences and identify the most common obsessive‐compulsive behaviours and their associated level of interference.Methodology:The survey form of the LOI‐CV was administered to a large sample of children and adolescents attending regular schools. Participants were aged between 8 and 16 years (n= 1602).Results:We found the survey instrument to have adequate internal consistency and test‐retest reliability. There was an age‐related decline in self‐reported obsessive‐compulsive behaviour and girls reported a higher level of obsessive‐compulsive behaviour than boys. The most common obsessive‐compulsive behaviours included: repeated thoughts or words, having trouble making decisions, having to do certain things and doing things in the exact manner and having a bad conscience. For the most part, these behaviours were associated with low levels of interference. However, for a significant minority of youth (5 to 14%), these behaviours did cause problems and significantly interfered with their lives.Conclusions:Although many obsessive‐compulsive behaviours are part of normal development, they may still be problematic for some children and adolescents.
Neonatal outcome in a randomized, controlled trial of low‐dose aspirin in high‐risk pregnancies
Authors: LESLIE GI , GALLERY EDM , ARNOLD JD , ROSS MR , GYORY AZ 
Published: March 2008

Objective:To determine the value of low‐dose aspirin in high‐risk pregnancies, and assess its impact on fetal growth, as well as on perinatal mortality and morbidity.Methodology:One hundred and eight women with singleton pregnancies were enrolled in a randomized, double‐blind, placebo‐controlled trial of 100 mg/day aspirin from 17 to 19 week gestation. Enrolment criteria included pre‐existing chronic essential hypertension or renal disease, or a history of previous early, severe pre‐eclampsia.Results:There were four stillbirths (all aspirin) and two neonatal deaths (both placebo), to yield respective perinatal mortality rates of 69/1000 and 40/1000 (P=0.499). Liveborn infants in the aspirin group were significantly more mature (P= 0.017) and of heavier birthweight (P= 0.034) but had similar length (P= 0.091) and head circumference (P= 0.257). Fewer infants in the aspirin group were liveborn prematurely (5/54 vs 14/50; P= 0.016) or were of low birthweight (3/54 vs9/50; P= 0.052). There were no significant between‐group differences for standard deviation (Z) scores for weight, length or head circumference, or for skinfold thickness measurements. There was no significant difference in occurrence of low Apgar scores or in neonatal intensive care unit use between the groups.Conclusions:Low‐dose aspirin does not appear to have a significant effect on perinatal morbidity. The increase in weight at birth associated with low‐dose aspirin therapy is due to prolongation of pregnancy rather than prevention of intra‐uterine growth retardation.
Health status of Victorian special school children
Authors: ACKLAND MJ , WADE RW 
Published: March 2008

Objective: This study sought to determine the health status and health needs of a sample of students attending special schools for the intellectually disabled in Victoria, Australia.Methodology: Two hundred and forty‐nine students not previously seen by a Community Child Health Medical Officer (CCHMO) were assessed at school. Data on student, parent and staff needs were obtained through personal interviews and documented on a standard questionnaire. Health status was documented using data obtained from parents and teachers as well as the clinical assessment.Results: Comparison of the number of problems reported by parents with the number confirmed at examination showed significant underreporting of vision, hearing and general medical problems. However, behaviour problems were nearly all reported. Many students had multiple problems with 63% having 2‐4 problems and 11% having 5‐8 problems. Ninety‐nine (40%) of the 249 children seen had newly detected problems; vision (24), hearing (24) and obesity (9) were the most common. Two hundred and forty‐four (98%) had known problems and 27% of these had insufficient information available from parents or staff to completely ascertain their health status. In 115 cases the primary problem was intellectual impairment of unknown cause. Down syndrome was the next most common underlying diagnosis (30) followed by autism (24), epilepsy (21) and cerebral palsy (15). The most common secondary diagnoses were asthma (16), congenital heart defects (12), seizures (8) and skin problems (8). Many students required referral for further management both for newly detected problems (64%) and known problems (18%). Parents required counselling and/or discussion on a number of issues for both newly detected problems (66%) and known problems (39%); when counselling had taken place parent and staff concerns had reduced significantly by the time of the follow‐up assessment.Conclusions: This study demonstrated that in those students with known intellectual impairment there were many with other unrecognized health problems and unmet needs. These findings have implications for health services provided to children attending special schools.
Lumbar puncture in suspected neonatal sepsis
Authors: McINTYRE P. , ISAACS D. 
Published: March 2008

Objective: The importance of lumbar puncture (LP) as part of the evaluation of suspected neonatal sepsis is assessed, as it may be the only positive diagnostic test in about 10% of septic babies with meningitis but negative blood cultures. However, LP may compromise respiratory function, and the interpretation of cerebrospinal fluid (CSF) may not be straightforward. Conclusion: The clinical setting and the probability of meningitis are important determinants of the likely value of LP. For asymptomatic neonates with obstetric risk factors for sepsis, and for babies with early‐onset respiratory distress alone, LP may be delayed and only performed later if blood cultures are positive. This is because hundreds of LP will be needed to diagnose a single case. However, infants with suspected late‐onset sepsis should have an immediate LP because finding Gram‐negative bacilli or fungi in the CSF will affect treatment choices.
Sudden infant death syndrome: Effect of breast and formula feeding on frontal cortex and brainstem lipid composition
Authors: BYARD R. W. , MAKRIDES M. , NEED M. , NEUMANN M. A. , GIBSON R. A. 
Published: March 2008

Methodology: Docosahexaenoic acid levels were measured by gas chromatography in samples of frontal lobe and brain‐stem taken from 28 and 26 infants, respectively, who had died of sudden infant death syndrome (SIDS). Results: Significantly higher levels of docosahexaenoic acid were present in the frontal lobe tissues derived from the 13 breast fed infants (age range = 3.3–36.3 weeks; mean 15.9 ± 11.3 weeks) compared to the 15 formula fed infants (age range = 6.9–47.7 weeks; mean 19.3 ± 10.6 weeks); mean (± s.d.) levels were 8.5 ± 1.1% and 7.6 ± 0.8% of total fatty acids (P= 0.019). There was, however, no significant difference in brainstem docosahexaenoic acid levels between breast and formula fed infants. Conclusions: Given these variable findings, further investigation of the relationship between dietary fatty acid intake and cerebral lipid levels may help to clarify whether different modes of feeding have a role in the pathogenesis of SIDS.
An evaluation of the action plans of children with asthma
Authors: DAWSON K. P. , VAN ASPEREN P. , HIGGINS C. , SHARPE C. , DAVIS A. 
Published: March 2008

Objective: To assess the provision and use of action plans in children attending hospital because of asthma. Methodology: An interviewer administered a structured questionnaire to the parents of 279 children attending the Casualty Department, Outpatient clinics or admitted to hospital because of asthma, at two Level 3 teaching hospitals. Results: Only 82 (29%) of the children attending hospital had a written action plan. The majority (57%) were devised by paediatricians and covered the salient aspects of care. However, indications for steroid use were included in only 28% of plans and only 37% of the action plans in children over 5 years incorporated the use of peak flow meters. Conclusion: Action plans are still under‐utilized in children with asthma. General practitioners should be encouraged to consider the use of action plans for the group of children not already covered.
Therapy methods for cerebral palsy
Authors: GRAVES P. 
Published: March 2008

Objective:Current approaches to therapy for cerebral palsy tend to be child‐focussed and claim functional improvements. Such approaches lead to demands for more therapy and more services as the solution for problems associated with cerebral palsy. This report suggests an alternative approach.Methodology:The literature on therapy methods for cerebral palsy is reviewed and compared with the literature on early intervention for children with intellectual disabilities.Results:The claims for functional improvements resulting from therapy methods cannot be substantiated. The literature on early intervention for children with cognitive impairments indicates a shift in emphasis from the child's impairments to the whole child, the family and the wider community.Conclusions:Demands for more and better therapy are, at best, simplistic and tend to detract from the real needs of the child and family. An ongoing ecological approach is more likely to produce positive outcomes.
Annotation New rapid microbiological diagnostic techniques
Authors: BURGNER D , ISAACS D , GIVNEY R 
Published: March 2008

Abstract Objective: To briefly and critically review the role of new, rapid techniques, especially PCR, in the diagnosis of infectious diseases. Methodology: Review of the literature. Results: New diagnostic techniques show great promise but many techniques are still in their infancy and the relative roles of the various methods remain uncertain. Conclusions: It seems likely that different techniques will continue to be useful in a number of different contexts. No one technique is likely to become ‘diagnostically dominant’ in the foreseeable future.
The social and educational outcome of a cohort of rural children in relation to the racial and socio‐economic groupings of their parents
Authors: COX JW 
Published: March 2008

Abstract Objective: To evaluate the outcome after a generation of extra health and educational intervention among children whose antenatal and perinatal characteristics appeared influenced by racial origin and socio‐economic status. Methodology: Sixty‐five of an original cohort of 103 children born in Cunnamulla, Queensland, 1974‐75, remained in the area allowing educational and social outcomes to be assessed: 40 were Aboriginal, 25 were children of unemployed Caucasians and 38 were children of employed Caucasians. The criteria for a successful outcome on leaving school were progression to further education or finding paid employment. Results: Fifty‐three of the children who had left school were assessed (the remaining 12 were still at school). Only four of the 30 assessed Aborigines had successful outcomes compared with 10 of the 13 employed Caucasians and three of the 10 unemployed Caucasians. Gender influenced success, with females under‐represented such that among the 23 Aboriginal and unemployed Caucasian girls only one had a successful outcome; 13 of these 23 girls were pregnant before finishing secondary education. Conclusions: The educational and social success of Aborigines is poor compared with the children of employed Caucasians. Outcomes for children of unemployed Caucasians are similar to those of Aborigines, suggesting failure of a range of government and community intervention programmes.