bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to recommended medical regimens in childhood and adolescence
Authors: FOTHERINGHAM M. J. , SAWYER M. G. 
Published: March 2008

Objectives:Factors that appear to influence treatment adherence among adults have been the focus of considerable research in recent years. However, less research has focused on children's treatment adherence. This paper reviews current knowledge about factors that appear to influence adherence among children and adolescents.Methodology:Factors associated with adherence to medical regimens reviewed here include: (i) the psychosocial characteristics of children and their parents; (ii) the nature of the treatment regimen; and (iii) the relationship between health practitioners, parents and paediatric patients.Conclusions:Issues for future research include: (i) the adherence of both children and their parents to children's treatment, and the allocation of responsibility for treatment adherence; (ii) the wide range of behaviours involved in regimen adherence should be acknowledged; patients' adherence to one aspect of their regimen should not be considered indicative of their overall adherence; and (iii) longitudinal studies are required to examine the causal relations between patient adherence and its antecedents.
The prevalence of respiratory symptoms in South Australian preschool children. I. Geographic location
Authors: VOLKMER R. E. , RUFFIN R. E. , WIGG N. R. , DAVIES N. 
Published: March 2008

Objectives: This study was designed to ascertain the prevalence of respiratory symptoms in South Australian preschool children and to investigate the relationship between prevalence rates and geographic location.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 State preschool population of that age. At the time of a routine preschool health check, parents completed a questionnaire regarding their child's respiratory health and place of residence (postcode).Results: Results showed that the prevalence rates were as follows: (i) ever having chest wheezing 38.6%; (ii) chest wheezing within the preceding 12 months 25.2%; (iii) ever having asthma 22.5%; (iv) ever having a dry cough at night 33.7%; (v) ever having bronchitis or cough with sputum 55.3%; (vi) ever having hay fever 29.7%; (vii) prone to excessive head colds 32.6%; and (viii) ever having eczema 18.8%. Over 38% of parents claimed that winter was the season for the most frequent or severe attacks of wheezing and 31.7% claimed no seasonal difference. Winter was the season most associated with episodes of bronchitis (50.9%), with no seasonal difference in episodes for 29.8% of children. Prevalence rates differed by geographic location within South Australia and within the Adelaide metropolitan region.Conclusion: This population‐based survey shows that over 22% of South Australian 4 to 5 year old preschool children have had (or continue to have) asthma. The study also documented the geographic distribution of respiratory symptom prevalence within South Australia.
Another outcome of neonatal intensive care: First year mortality and hospital morbidity
Authors: NIVEN G. R. , HARDING J. E. 
Published: March 2008

Objectives: To determine first year mortality and hospital morbidity after neonatal intensive care.Methodology: Cohort study of 6077 surviving infants inborn in one regional hospital in 1988. Nine hundred and eighty‐eight received neonatal intensive care and 103 were very low birthweight (VLBW).Results For infants who required care in the neonatal intensive care unit (NICU), the relative risk of dying before their first birthday was 3.6 (95% confidence intervals [Cl] 1.5‐8.8). This increased risk was associated with low birthweight (LBW) rather than requirement for NICU care. Of all inborn survivors, 10.4% were readmitted to hospital in the first year and 2.4% more than once. The readmission rate was 20% for NICU survivors and 30% for VLBW infants. The risk of hospitalization was independently associated both with NICU admission (odds ratio 2.3, Cl 1.9‐2.9) and with VLBW (OR 1.8, Cl 1.1‐3.0). The NICU survivors also had multiple admissions and prolonged hospital stays.Conclusions Both low birthweight and neonatal illness requiring intensive care are important indicators of continuing medical vulnerability over the first year of life.
Home oxygen management of neonatal chronic lung disease in Western Australia
Authors: SILVA D. T. , HAGAN R. , SLY P. D. 
Published: March 2008

Objective: To describe the course and management of infants with neonatal chronic lung disease who were discharged home on low‐flow supplemental oxygen.Methodology Retrospective case series in Western Australia.Results Fifty‐six neonates born in the 6 year period 1987‐92 inclusive were discharged home on supplemental oxygen. The median gestational age was 27 weeks (range 22‐40), median birthweight 865 g (range 450‐3350), median oxygen flow rates 125 mL/min (range 30‐850). The median corrected age at discharge was 1 month (range term‐9.5) and this had decreased throughout the study period. Acute hospital readmissions were common (36 of 56, 64%). The majority of these admissions were for wheezing illnesses. Three infants died. The median corrected age at weaning from day oxygen was 4 months (range term‐33) and from night oxygen was 6 months (range 2‐38). Monitoring of oxygen saturation in air, in low‐flow oxygen and in the overnight sleep study were important non‐invasive guides in deciding when patients were ready for discharge, reducing the oxygen flow rate and when oxygen could be ceased, respectively.Conclusions The home oxygen programme enables infants with neonatal chronic lung disease to be discharged home earlier, is safe, and well accepted by parents and community health care workers.
Has changing diagnostic preference been responsible for the recent fall in incidence of sudden infant death syndrome in South Australia?
Authors: BYARD R. W. , BEAL S. M. 
Published: March 2008

Objective: An apparent decrease in deaths attributed to sudden infant death syndrome (SIDS) has been noted in a number of diverse geographical areas during the past several years. At the same time the definition of SIDS has been in a state of flux and some observers have raised the possibility that the fall in SIDS deaths is due to diagnostic transfer rather than to a genuine decrease in numbers. The present study was undertaken to investigate this possibility.Methodology: All sudden and unexpected deaths in infants under 1 year of age in South Australia during a 10 year period from 1984 to 1993 were reviewed.Results: The number of deaths due to SIDS fell from 40 in 1984 to 17 in 1993, with a maximum of 52 cases per year in 1987. In contrast, the number of cases of sudden death not due to SIDS remained under 10 per year. The overall infant death rate also fell, while the total number of births per year remained relatively unchanged.Conclusions: The lack of major change in sudden infant death rates from other causes, combined with the fall in SIDS deaths, is not supportive of diagnostic transfer being a major determinant of the declining SIDS death rate. Therefore, other factors are likely to be responsible for the falling SIDS rate in this population.
The changing prevalence of asthma‐like respiratory symptoms in South Australian rural schoolchildren
Authors: CROCKETT A. J. , CRANSTON J. M. , ALPERS J. H. 
Published: March 2008

Objectives: To describe the changing prevalence of wheezy breathing and doctor‐diagnosed asthma, as obtained by questionnaire data, from the years 1984‐92 in a sample of South Australian rural schoolchildren.Methodology A cross‐sectional study of three populations of schoolchildren from the South Australian rural towns of Burra (mid‐north), Gladstone (mid‐north) and Kingston (southern, coastal). The cumulative or lifetime prevalences and the 12‐month period prevalence (current) of respiratory symptoms were estimated from questionnaire data obtained from parental responses for 1032 schoolchildren aged from 5 to 18 years, and compared with prevalences obtained from a previous study.Results The overall cumulative prevalence of wheezy breathing in 1992 was 36.2%, an increase from 24.1% in 1984 with a 12‐month period prevalence of 25.0%. The 1992 cumulative prevalence of doctor‐diagnosed asthma was 23.3%. There was no difference in the prevalence of wheeze between the three rural regions studied. A trend to a higher prevalence of doctor‐diagnosed asthma in one of the three regions was thought to be due to medical specialist input.Conclusions The cumulative prevalence for wheeze among school‐age children in South Australian rural communities has increased in the period 1984‐92. There were no regional differences in the cumulative prevalence rates. The results confirm previous studies in Victoria and New South Wales.
Adrenal 21‐hydroxylase deficiency in childhood: 25 years' experience
Authors: LIM Y. J. , BATCH J. A. , WARNE G. L. 
Published: March 2008

Objective: To review past and present management of congenital adrenal hyperplasia at a single centre, as a guide to best practice.Methodology The records of 89 patients with congenital adrenal hyperplasia due to 21‐hydroxylase deficiency managed in a children's hospital in Australia over a period of 25 years were reviewed.Results The diagnosis was made in infancy in 66 patients (37 males and 29 females) and later in 23 (11 males and 12 females). The mean age for genitoplasty in females with ambiguous genitalia was 18 months before 1984 and 3 months thereafter. Significant differences were found between males and females presenting after infancy with regard to virilization, bone age advancement, risk of true precocious puberty and final height. The mean final height standard deviation scores for seven males and seven females treated from infancy were — 1.32 and — 1.26, respectively.Conclusions The results emphasize the importance of early diagnosis and good control in ensuring a good outcome for patients with 21‐hydroxylase deficiency.
Minicores and congenital fibre type disproportion observed in a family
Authors: JONGPIPUTVANICH S. , WALSH P. J. , KAKULAS B. A. 
Published: March 2008

Objective: To report a family in which congenital fibre type disproportion (CFTD) and minicore disease have been observed in members of the same family, and raise the question of the relationship between CFTD and minicores.Methodology: A follow‐up clinical and biopsy study of a girl who presented to hospital because of marked hypotonia and non‐progressive weakness. She had muscle biopsies at the age of 18 months and again at 4 1/2 years. Her asymptomatic parents were also biopsied. The muscle specimens were processed for histopathological and morphometric studies.Results: The histopathological findings of the muscle of the daughter were consistent with CFTD. The muscle biopsy of her father was normal whereas her mother's revealed minicore formation.Conclusions: The findings of CFTD and minicore disease in members of the same family suggest that CFTD and minicore formation may both be the result of a common pathological mechanism rather than each being a distinct clinicopathological entity.
Review Article Towards a better understanding of childhood asthma
Authors: van ASPEREN PP 
Published: March 2008

Objective: To explore the ways asthma may be defined in childhood and consider the current evidence to support these possible definitions.Methodology The relationship of symptoms, atopy, bronchial hyperresponsiveness (BHR) and airway inflammation in defining childhood asthma is reviewed.Results While none of the four proposed methods of defining asthma can stand alone as the ‘gold standard], in childhood asthma, all four, namely clinical symptoms, atopy, BHR and airway inflammation, are intimately related. The degree of atopy and BHR, and the presence of airway inflammation, should be viewed as significant risk factors for persistent wheezing in childhood.Conclusion At present the clinical diagnosis of asthma in childhood remains largely based on symptoms but it is likely that, with further research, the group of children who are now labelled as having asthma will be subdivided into different subgroups with implications for both treatment and outcome.
The Fremantle Lead Study
Authors: WILLIS FR , ROSSI E , BULSARA M , SLATTERY MJ 
Published: March 2008

Objective: To ascertain blood lead levels in a sample of preschool children from Fremantle, Western Australia, and to correlate these with possible risk factors.Methodology The study was a cross‐sectional prevalence survey of 120 children from day‐care centres and 44 hospital inpatients. Blood lead and ferritin levels were determined and a risk factor questionnaire was completed by parents.Results Of the 164 children 25.6% had lead levels above the NH&MRC goal (<10μg/dL). Nine of 133 (6.7%) had ferritin levels below 10 μg/L suggesting iron deficiency. Excessive blood lead concentrations as defined by the NH&MRC (>9μg/dL) related to: child's presence during house renovation (OR 3.35, P = 0.007, 95% Cl 1.39‐8.81); Aboriginality (OR 6.4, P = 0.008, 95% Cl 1.6‐24.9), and, in the 9‐24 month age group, inversely to distance between home and a road carrying >7000 vehicles/day (r‐0.56, P = 0.009, n = 24).Conclusions A group of Fremantle children with unacceptably high blood lead levels has been identified. Renovation of older housing and Aboriginality are important risk factors.
Aminophylline and Doppler time‐averaged mean velocity in the middle cerebral artery in preterm neonates
Authors: GOVAN JJ , OHLSSON A , RYAN ML. , MYHR T , FONG K 
Published: March 2008

Objective: The purpose of this study was to assess the effect of an intravenous loading dose of aminophylline (6 mg/kg) on Doppler time‐averaged mean velocity in the middle cerebral artery in ventilated preterm neonates.Methodology: Twenty infants were studied by colour/duplex Doppler technique prior to and at 5, 10, 30 and 60 min after the administration of aminophylline.Results:Aminophylline treatment was associated with a statistically significant reduction in time‐averaged mean velocity from baseline (P>0.001) and an increase in heart rate (P>0.001) at all timepoints. The largest reduction in time‐averaged mean velocity of 19% (95% confidence interval ‐ 10 to ‐ 28%) occurred at 10 min post‐dose. There were no statistically significant changes in transcutaneous Pco2 or mean arterial blood pressure.Conclusions:The observed reduction of 19% from baseline in time‐averaged mean velocity following treatment with aminophylline alone is unlikely to be of clinical importance. Whether aminophylline in combination with other drugs that decrease central blood flow velocity such as indomethacin and/or dexamethasone could result in a clinically significant reduction deserves further study.
Teacher initiated improvement of asthma policy in schools
Authors: HAZELL J , HENRY RL , FRANCIS JL , HALLIDAY JA 
Published: March 2008

Objective:To assess whether information about asthma acquired by individual teachers, following attendance at an inservice seminar, would be communicated to other school staff, and whether policies about asthma management would be subsequently developed in schools.Methodology:A telephone interview was conducted of 50 primary school teachers in the Hunter Region who were selected randomly from those who had represented their school at an inservice seminar about asthma.Results:All 48 respondents had provided feedback to their colleagues, mostly at a staff meeting. After the seminar the number of schools with a written policy about the management of asthma had increased from 1 to 20. Initially the school's first aid kits contained a bronchodilator inhaler in 25 schools (increasing to 43 after the seminar), a spacer device in six schools (increasing to 47) and written guidelines for management of an asthma attack in seven schools (increasing to 32). Teachers from four schools indicated that all school staff knew how to recognize an acute attack prior to the seminar compared with 22 schools afterwards. Before the seminar 18 schools asked parents to supply written instructions for the management of their children at school but this increased to 44 after the seminar.Conclusions:A programme of one‐off seminars attended by one teacher from each primary school resulted in large increases in the proportion of schools with appropriate policies for the management of asthma in the school environment.
Respiratory mechanics before and after late artificial surfactant rescue
Authors: TODD DA , CHOUKROUN M‐L , FAYON M , KAYS C , GUÉNARD H , GALPÉRINE I , DEMARQUEZ J‐L 
Published: March 2008

Objective:To assess the effect of late administration of synthetic surfactant (Exosurf) on the ventilatory function of premature infants with hyaline membrane disease (HMD).Methodology:Prospective non‐randomized study in the Neonatal Intensive Care Unit (NICU) of a major referral hospital. The patients included two groups of premature infants with a birthweight between 750 and 2000 g who developed HMD. In group 1 with moderate to severe HMD, 2x5mL/kg doses of Exosurf were given 12h apart (first dose given at a mean age of 18.7±3.4h [mean ± s.e.m.]). In group 2 with milder HMD, no surfactant was given.Results:Significant reductions (P>0.05) in the fraction of inspired oxygen (Flo2) occurred 6 h after surfactant administration (24 h of life) and by 48 h (64 h of life) in group 2. These improvements in gas exchange preceded improvements in passive respiratory compliance which occurred 24 h after surfactant (42 h of life) and by 72 h (88 h of life) in group 2 (P>0.01). In both groups pulmonary resistance increased and was significant (P>0.05) by 48 h (66 h of life) in group 1.Conclusions:Synthetic surfactant given as late as a mean age 18.7±3.4 h still improves gas exchange but these early improvements cannot be completely explained by modifications of respiratory compliance.
BiliBlanket phototherapy system versus conventional phototherapy: A randomized controlled trial in preterm infants
Authors: COSTELLO S. A. , NYIKAL J. , YU V. Y. H. , McCLOUD P. 
Published: March 2008

Objective: This study compares the use of standard overhead fluorescent phototherapy units with the BiliBlanket a woven fibreoptic pad which delivers high intensity light with no ultraviolet or infrared irradiation in the treatment of jaundice in preterm infants. Methodology: We chose to study infants between 800 and 2500 g, with strict criteria for commencing and ceasing phototherapy. Serum bilirubin levels were followed at 12–24 h intervals until 24 h after cessation of phototherapy. Infants were allocated at random to receive either conventional phototherapy or the BiliBlanket. Results: There were 24 infants in the conventional group and 20 in the BiliBlanket group. Mean duration of phototherapy was compared and was 44 h for the conventional group versus 42 h for the BiliBlanket group. Conclusions: We have shown that the BiliBlanket is as effective as conventional phototherapy and was well accepted by nursing staff and parents.
Enzyme activity of glucose‐6‐phosphate dehydrogenase‐deficient Malaysian neonates during the first 10 days of life
Authors: BOO N. Y. , AINOON O. , ARIF Z. A. ZAINAL , CHEONG S. K. , HALIZA M. S. 
Published: March 2008

Objective: The objective of this study was to determine the degree of severity of enzyme deficiency in glucose‐6‐phosphate dehydrogenase (G6PD)‐deficient Malaysian neonates as part of an effort to identify risk factors associated with severe hyperbilirubinaemia in G6PD‐deficient infants. Methodology: During this study, enzyme activity was measured in 53/59 (89.8%) hospital‐diagnosed G6PD‐deficient neonates (34 Malays, 12 Chinese, and seven other ethnic groups) born consecutively in the Kuala Lumpur Maternity Hospital. All neonates, except one, were males. Results: The mean level of enzyme activity of the 52 males G6PD‐deficient neonates (0.47 iu/g Hb, 95% confidence intervals: 0.37, 0.57) was less than 10% of that of normal Malaysian male neonates. The enzyme activity of the only female G6PD‐deficient infant, at 1.11 iu/g Hb, was 12.5% of the mean G6PD enzyme activity of normal females. Conclusion: Our results showed that G6PD deficiency in Malaysian neonates predominantly affects males and is usually severe.
Primary infantile hypomagnesaemia: Report of two cases
Authors: PREBBLE J. J. 
Published: March 2008

Objective: To present case reports of two siblings with primary hypomagnesaemia both presenting with seizures, and one also with a cardiac arrhythmia. To briefly review the pathophysiology, clinical features, diagnosis, management and genetics of this disorder. Methodology: Published literature reports of primary hypomagnesaemia and studies of hypomagnesaemia in humans. Reports of the clinical features and inheritance of primary hypomagnesaemia. Results: The information is descriptive of the pathophysiology, clinical features, diagnostic criteria, and management Considered modes of inheritance are presented. Two cases of primary hypomagnesaemia in brothers of consanguineous parents are described. Cardiac arrhythmia at presentation has not previously been reported. Diagnosis and adequate magnesium supplementation controls the biochemical disorder and the neurological development is normal. Conclusions: Primary hypomagnesaemia should be considered in infants with seizures, as failure to identify this metabolic disorder can result in death. Subsequent siblings, particularly male, should be closely monitored.
Nasal inflammation and chronic ear disease in Australian Aboriginal children
Authors: GIBSON PG , STUART JE , WLODARCZYK J , OLSON LG , HENSLEY MJ 
Published: March 2008

Abstract Objective: Chronic middle ear disease is common in Aboriginal children, and may be linked to nasal inflammation and Eustachian tube dysfunction. The pattern of nasal inflammation is unknown. The study reported here was performed to define the role of allergy and infection in causing nasal inflammation in Aboriginal children with chronic middle ear disease. Methodology: Thirty‐one Aboriginal children aged between 3 and 7 years underwent clinical assessment, audiometry and allergy skin tests. Nasal swabs for bacterial culture and cytology were performed during the winter and again in spring to identify any seasonal variation. A randomized trial of nasal beclomethasone for 8 weeks was conducted in children with abnormal tympanometry to identify the effect of therapy upon nasal cytology. Results: Twenty‐six of the 31 children had abnormal tympanograms. Average hearing levels were reduced in nine children. Pathogenic organisms were isolated from most children: Streptococcus pneumoniae (82%), Haemophilus influenzae (79%), Moraxella catarrhalis (39%) and Staphylococcus aureus (29%). Eight of the 31 children (26%) were atopic. Nasal cytology disclosed a marked neutrophil infiltrate (80% of cells) during the winter, which fell significantly in spring to 52% of cells. Only two subjects had nasal eosinophilia of >10%. There was no effect of beclomethasone on nasal cytology. Conclusions: Chronic ear disease in Aboriginal children is associated with nasal inflammation, neutrophil infiltration and the presence of bacteria. These features suggest respiratory infection as the main cause of chronic nasal inflammation in Aboriginal children with middle ear disease. There is a seasonal variation in the severity of the nasal infiltrate, consistent with increased infections during winter. Despite a high prevalence of atopy, allergic nasal disease was uncommon.