bluuebunny/crossref_metadata_2025_split huggingface dataset:
Child Behaviour Checklist classification of behaviour disorder
Authors: NOLAN TM , BOND L , ADLER R , LITTLEFIELD L , BIRLESON P , MARRIAGE K , MAWDSLEY A , SALO R , TONGE BJ 
Published: March 2008

Objective: The aim of this study was to determine the applicability of the published clinical cut‐off scores of the Child Behaviour Checklist (CBCL) for the classification of behaviour disorders. Methodology: Child Behaviour Checklists were obtained for 1342 subjects newly referred to the six major mental health centres in Melbourne. The normative community sample of 1002 7‐, 12‐ and 15‐year‐olds was drawn from a school‐based asthma prevalence study. Results: The mean total problem T‐score for the children referred to mental health centres was 67 and was above the clinical range for all age groups. Using referral to psychiatric services as the gold standard, the sensitivity and specificity of the CBCL using a cut‐off of ≥ 60, was 77.4 and 83.2%, respectively. This compares favourably with the sensitivity of 68% and specificity of 82% for the American sample. Using a cut‐off score of ≥ 63, the sensitivity was 70.5% and the specificity was 88.6%. The referred and community samples differed with respect to socio‐economic status, family structure and mothers' level of education. Fifty‐two per cent of the clinically referred children lived with both parents, compared with 89% of the community sample. Conclusions: While there are some limitations to this study in terms of both the clinic and community sample, support is provided for the usefulness and applicability of the recommended CBCL cut‐off scores in an Australian population.
CYP11β1 (11‐beta‐hydroxylase) deficiency in congenital adrenal hyperplasia
Authors: BURREN CP , MONTALTO J , YONG ABW , BATCH JA 
Published: March 2008

Objective: To review experience of CYP11β1 deficiency (previously known as 11β‐hydroxylase) at the Royal Children's Hospital, Melbourne, Victoria. Methodology: A retrospective case review was conducted from 1974 to 1995 with five cases identified. Results: Age of presentation ranged from 1 day to 7 years. Presentation was with ambiguous genitatia at birth (two females), simple virilization (two males) and suspected early puberty in mid childhood (one female). Associated clinical features were hypertension (three cases) and tall stature with markedly advanced bone age (four cases). Biochemical abnormalities consistent with CYP11β1‐deficiency were elevated urinary tetrahydro‐11‐deoxycortisol (n= 5) and elevated serum 11‐deoxycortisol (n= 3). Additional abnormalities were elevated 17‐hydroxyprogesterone (n= 3), elevated androstenedione (n= 4) and elevated dehydroepiandrosterone sulphate (n= 4). The clinical features and investigations suggested CYP11β1‐classical deficiency in four patients and CYP11β1‐non‐classical deficiency in one patient. Conclusions: The five cases of CYP11β1‐deficiency demonstrate a spectrum of clinical abnormalities, with diagnostic difficulties in two cases and delayed presentation in three cases. Prompt diagnosis of CYP11β1‐deficiency is facilitated greatly by the availability of a gas chromatography‐mass spectrometry instrument and is essential to avoid the long‐term effects of hypertension and hyperandrogenism.
Comparison of morbidities in very low birthweight and normal birthweight infants during the first year of life in a developing country
Authors: BOO NY , ONG LC , LYE MS , CHANDRAN V , TEOH SL , ZAMRATOL S , NYEIN MK , ALLISON L 
Published: March 2008

Objective: To compare the morbidities in the very low birthweight (VLBW; < 1500 g) and normal birthweight (NBW; ± 2500 g) Malaysian infants during the first year of life. Methodology: Prospective observational cohort study of consecutive surviving VLBW infants and randomly sampled NBW infants born in the Kuala Lumpur Maternity Hospital between 1 December 1989 and 31 December 1992. Infants were followed up regularly during the first year of life, after correction for prematurity. Results: Compared with NBW infants (n= 106), VLBW infants (n= 127) had significantly higher risk of failure to thrive (odds ratio [OR] = 8.0, 95% confidence intervals [Cl]: 1.1 to 354.3), wheezing (OR = 3.7, 95% Cl: 1.6 to 9.3), rehospitalization (OR = 2.3, 95% Cl: 1.1 to 5.0), cerebral palsy (OR = 8.6, 95% Cl: 2.0 to 77.6), neurosensory hearing loss (OR = 12.0, 95% Cl: 1.7 to 513.6) and visual loss (7.9 vs 0%, P= 0.002). The mean mental developmental index (MDI) and mean psychomotor developmental index (PDI) at 1 year of age were significantly lower among VLBW infants (MDI 99 [SD = 28], PDI89 [SD = 25]) than NBW infants (MDI 106 [SD = 18], PDI 101 [SD = 18]) (95% Cl for difference between means being MDI: ‐14.1 to ‐1.7; and PDI: ‐17.6 to ‐6.0). Logistic regression analysis showed that among VLBW infants: (i) male sex, Malay ethnicity and bronchopulmonary dysplasia were significant risk factors associated with wheezing; (ii) longer duration of oxygen therapy during the neonatal period, seizures after the post‐neonatal period and wheezing were significant risk factors associated with rehospitalization; and (iii) longer duration of oxygen therapy during the neonatal period was a significant risk factor associated with adverse neurodevelopmental outcome during the first year of life. Conclusions: Compared with NBW infants, VLBW Malaysian infants had significantly higher risks of physical and neurodevelopmental morbidities.
Neurological outcome of severe cystic periventricular leukomalacia
Authors: WILKINSON I , BEAR J , SMITH J , GILL A , CHALLINOR C , JONES W , SHAHIDULLAH M , WOODERSON S 
Published: March 2008

Objective: To determine the neurological outcome of a cohort of premature babies having ultrasound diagnoses of severe cystic periventricular leukomalacia. Methodology: All neonatal intensive care unit admissions born at less than 35 weeks gestation or weighing less than 1500 g underwent serial cranial ultrasounds. Those developing severe bilateral cystic periventricular leukomalacia (12 patients) were then followed clinically to a mean age of 27.3 months. Results: Ten of the 12 patients fulfilling strict ultrasound criteria survived. All had a major neurological handicap, all having spastic quadriparesis and visual impairments, with most suffering global developmental delay and epilepsy. Conclusions: Severe bilateral cystic periventricular leukomalacia results in major permanent handicap. It is currently impossible to identify most patients with this condition while they are being ventilated. Non‐ultrasound techniques are needed to diagnose the condition earlier, and to give guidance to management.
Risk factors for adverse outcomes of bacterial meningitis
Authors: GRIMWOOD K , NOLAN TM , BOND L , ANDERSON VA , CATROPPA C , KEIR EH 
Published: March 2008

Objective: To identify risk factors for adverse outcomes from bacterial meningitis. Methodology: From a cohort of 166 children with bacterial meningitis who were studied prospectively, 130/158 (82%) survivors underwent neurological, neuropsychological, audiological and behaviour assessments 5–9 years following their illness. Results: Major adverse outcomes included 8/166 (4.8%) deaths and severe neurological, intellectual or audiological sequelae in 11/130 (8.5%) children followed. Another 24 (18.5%) had cognitive, auditory or behaviour disorders. Bivariate analysis found age ≤12 months, tertiary referral, symptoms >24 h before diagnosis, seizures, focal neurological signs, deteriorating conscious state in hospital, Streptococcus pneumoniae infection and serum sodium concentration < 130 mmol/L were associated with adverse outcomes. Multivariate analysis showed age ≤12 months, symptoms >24 h, seizures after 72 h in hospital and focal neurological signs as independent risk factors. These were present in 18/19 (95%) children with major sequelae, but absent in 9/24 (37.5%) children with minor disabilities. Conclusions: As minor disabilities following meningitis cannot be predicted, all survivors require assessment during their early school years.
Hypokalaemia following nebulized salbutamol in children with acute attack of bronchial asthma
Authors: SINGHI SC , JAYASHREE K , SARKAR B 
Published: March 2008

Objective: To determine whether use of nebulized salbutamol therapy for treatment of an acute attack of asthma in children is associated with hypokalaemia and if so what is its frequency, severity and effect on recovery. Methodology: Forty‐six children, aged 10 months to 12 years (mean 7.9±1.5 years) with acute attack of bronchial asthma, treated initially with three doses of nebulized salbutamol 0.15‐0.3mg/kg, every 30 min participated in the study. Blood for serum potassium was obtained at the beginning and after three doses of nebulized salbutamol therapy, before administering other drugs. Results: The mean±SD serum potassium level decreased marginally from 3.9±0.5mEq/L to 3.7±0.5mEq/L (P <0.05). A decrease in serum potassium concentration was noted in 26 (56.5%) and hypokalaemia (serum potassium <3.5 mg/L) in 17 (39%) patients. It was more frequent in patients who had received oral salbutamol for the preceding 7 days. The average time taken for recovery was longer in patients who had hypokalaemia than those who had normal serum potassium concentration (8.6±2.7 h vs 6.5±2.7 h; P <0.005). Conclusions: Hypokalaemia may occur in about one‐third of patients treated with three doses of nebulized salbutamol therapy, especially those on prior oral salbutamol therapy. The monitoring of serum potassium concentration may be warranted in such patients.
Why do Aboriginal newborns weigh less? Determinants of birthweight for gestation
Authors: BLAIR E 
Published: March 2008

Objective: To compare birthweight for gestational age of Aboriginal with Caucasian infants and investigate the origins of their differences. Methodology: Data pertaining to birthweight, gestational age at delivery and pathological factors were abstracted from birth records of 1301 Western Australian singleton Aboriginal pregnancies dated before 24 weeks by ultrasound fetometry and compared with routinely collected data pertaining to Caucasian births of the same period. Results: Median birthweight for gestation was lower in Aboriginal than in Caucasian infants for deliveries after 35 weeks of gestation, and that of pure‐descent lower than that of mixed‐descent Aboriginal infants at all gestations. Pathological factors (e.g. diabetes, urogenital infections, alcoholism and leprosy) occurring more commonly in Aboriginal than in Caucasian pregnancies accounted for most of the differences in birthweight for gestation between mixed‐descent Aboriginal and Caucasian infants but a discrepancy of almost 180 g remained between pure‐descent Aboriginal and Caucasian infants. Conclusions: Identified pathological factors contribute but do not entirely explain the lower birthweights for gestation observed in Aboriginal infants.
Bowel habits of healthy Australian children aged 0‐2 years
Authors: THAM EBA , NATHAN R , DAVIDSON GP , MOORE DJ 
Published: March 2008

Objective: To define the bowel habits of healthy Australian children aged up to 2 years. Methodology: One hundred and forty children were recruited in six age categories with a minimum of 20 children per category. Data on bowel habit was recorded by parents daily for 1 week. Results: Stool frequency decreased with age. Ninety‐five percent of infants 0‐14 days passed more than two stools per day compared with 21% at age 13‐24 months. Breastfed infants passed more frequent and looser stools than children fed infant formula and solids and also showed a wider variation in frequency. Conclusions: Mean stool frequency decreased with age as did the variation. This is a combined effect of age and feed type. These data can be used as a guide to the bowel habit of healthy Australian children.
Primary omental torsion in children
Authors: KIMBER CP , WESTMORE P , HUTSON JM , KELLY JH 
Published: March 2008

Objective: A retrospective review was conducted to establish the prevalence and clinical features of omental torsion or infarction as a cause of acute abdominal pain in childhood. Methodology: The case records were analysed for all patients admitted with primary omental pathology to the Department of General Surgery, Royal Children's Hospital, Melbourne, between January 1975 and July 1994. Results: From 1975 to 1994 (20 years) 13 children were admitted to our General Surgical Department with primary omental disease. There were nine males and four females under 16 years of age. The presenting complaint was abdominal pain with vomiting or diarrhoea. Four children had major medical conditions. Pre‐operative diagnosis in all cases was acute appendicitis. Appendicectomy and omentectomy were performed without complication in all cases. Histology of the omentum demonstrated torsion, infarction or haemorrhage. Conclusions: All children presented with features of acute appendicitis, a majority were male, and two out of the 13 patients were obese. The absence of any children under 4 years was consistent with the relative paucity of omental fat in younger children. We found no clear mechanism for primary omental torsion, although rotation around the right epiploic artery was observed.
Neonatal neutropenia and thrombocytopenia following maternal hypertension
Authors: FRASER SH , TUDEHOPE DI 
Published: March 2008

Objective: To assess the relationship between the subtypes of hypertension in pregnancy and subsequent neonatal haematology. Methodology: Retrospective review of the haematology of newborns of hypertensive mothers at a tertiary neonatal unit Results: Over a 2 year period. 249 infants had full blood examinations. Nineteen (7.6%) were neutropenic and 35 (14.1%) thrombocytopenic, including 11 (4.4%) who were both neutropenic and thrombocytopenic. Neutropenia occurred only in infants whose mothers had severe pre‐eclampsia and eclampsia or pre‐eclampsia with pre‐existing hypertension, whereas thrombocytopenia complicated all maternal hypertension subtypes. Two (10%) of the neutropenic infants developed nosocomial infection while seven (20%) of the thrombocytopenic infants bled. Thirteen (68%) of the neutropenic infants compared with 15 (43%) of the thrombocytopenic infants developed their haematological abnormality within 24 h of birth. All but two infants developed the haematological abnormality by the 5th day of life. Conclusions: Although haematological abnormalities in infants born to hypertensive mothers are uncommon, serious neonatal complications can occur and therefore early haematological screening of these infants is recommended.
Reducing the anxiety of children undergoing surgery: Parental presence during anaesthetic induction
Authors: CAMERON JA , BOND MJ , POINTER SC 
Published: March 2008

Objective: The primary aim was to determine whether child anxiety could be reduced by the presence of a parent during anaesthetic induction. Secondary aims involved clarification of the effect of the timing of parental separation, the use of premedication, the seriousness of the surgical procedure, and the flow‐on effect of parental anxiety on the level of child anxiety. Methodology: Subjects were obtained by approaching all parents of children aged from 1 to 8 years admitted for day surgery to a private hospital in Adelaide, South Australia during a 3 month period. Data pertaining to 74 children, representing a response rate of 80.4%, were obtained. Parents were instructed to rate the anxiety of their child for the period immediately prior to separation, and to then rate their own anxiety for the same period of time. Results: Children accompanied during induction were less anxious than those who were not accompanied. Contrary to the belief that child anxiety might be reduced by allowing separation in the theatre holding bay area, it was demonstrated that child anxiety was higher in this group than when separation occurred in the ward. No relationship between premedication or operation severity and either child or parental anxiety was observed. However, parental anxiety was noted to be a significant predictor of child anxiety. Suggestions for a more detailed examination of the relationship between child and parental anxiety in future research were outlined. Conclusions: It was concluded that there are benefits in allowing parents to be present during anaesthetic induction. However, the potential negative effect of parental anxiety must be acknowledged before parents are allowed to accompany their child as a matter of course.
Early intervention: Professional views and referral practices of Australian paediatricians
Authors: REDDIHOUGH DS , TINWORTH S , MOORE TG , IHSEN E 
Published: March 2008

Objective: To gather information from paediatricians concerning their attitudes to early intervention services for young children with developmental disabilities and to study their referral practices. Methodology: Two hundred and ninety‐five Australian paediatricians completed a postal questionnaire. Results: Paediatricians presented a positive view of early intervention, particularly for its beneficial impact on families, and perceived the quality of services to be comprehensive or adequate. There were few differences between States, or between country or metropolitan areas. Most paediatricians make prompt referrals to early intervention services when a child has an established disability. Referral is much less likely with suspected delay. Conclusions: Paediatricians are aware of the benefits of early intervention but additional information concerning the role of these services and their significant impact on families and children should be provided.
A comparison of endoscopic and capsule small intestinal biopsy techniques in children with upper gastrointestinal disorders
Authors: ELTUMI MA , ONG PS , FRANCIS ND , BRUETON MJ 
Published: March 2008

Objective: To compare the adequacy for histological diagnosis and morphometric analysis of small intestinal biopsies obtained by either endoscopic forceps or a capsule technique. Methodology: Small intestinal biopsies from 176 children were reviewed, 92 obtained by endoscopy and 84 by capsule. Results: The adequacy for making a histological diagnosis was 96 and 81% for endoscopic and capsule biopsies, respectively, and for morphometric analysis it was 86 and 71%. There were more tissue specimens from children who had endoscopic compared with capsule biopsies (2.3 vs 1.8 specimens per patient). Conclusions: Endoscopic biopsies provide better specimens for histological diagnosis and endoscopy has the advantage of allowing macroscopic assessment of the upper gastrointestinal tract which can be of value in recognizing unexpected pathology and in identifying patchy mucosal changes.
Evaluation of an asthma severity score
Authors: YUNG M , SOUTH M , BYRT T 
Published: March 2008

Objective: To evaluate inter‐observer agreement and validity of an asthma severity score derived from wheeze, heart rate and accessory muscle use components. Methodology: Children with acute asthma were examined independently and simultaneously by two observers, followed by pulse oximetry and spirometry in those over 5 years with repeatable measurements. Results: Inter‐observer agreement was very good (weighted kappa 0.82, 95% confidence interval 0.63 to 1.00). the component with the best agreement being the accessory muscle score (0.76, 0.57 to 0.95).The score correlated significantly with oxygen saturation, heart rate, and forced expiratory volume in 1 s (FEV1). In a multivariate model, FEV1 was best related to accessory muscle use. Conclusions: The asthma severity score has very good inter‐observer agreement with a moderate relationship to oxygenation and FEV1.
Breast‐feeding in neonatal intensive care
Authors: YIP E. , LEE J. , SHEEHY Y. 
Published: March 2008

Objective: To determine the incidence of breast‐feeding in very preterm babies while in neonatal intensive care. Methodology: A retrospective records analysis of all 151 babies with gestational age less than 35 weeks admitted to the neonatal intensive care unit (NICU) of a major teaching hospital in 1993. Results: On discharge 64% of babies were having some breast milk (45% having breast milk alone, 19% both breast milk and formula), and 38% some breast‐feeding (17% being solely breast‐fed, the other 21% combining breast‐feeding with either bottle‐feeding or an intragastric tube [IGT]). Breast milk was the first milk for 41% of babies, with 83% having breast milk at some stage.Increasing gestational age was associated with a decreased likelihood of first milk being breast milk (73% of those less than 29 weeks compared to 21% of those aged 33–34 weeks, P<0.001), but with increased rates of breast‐feeding (23 compared to 59%, P= 0.01) and breast milk consumption (42 compared to 73%, P= 0.04). Conclusions: Breast‐feeding rates in NICU are well below those found on discharge for full term babies. Both maternal and staff‐related factors contribute to this. More and better education of mothers, doctors and nurses as well as changes to some unit practices could increase these rates.
Survey of the definition and screening of neonatal hypoglycaemia in Australia
Authors: BONACRUZ GL , ARNOLD JD , LESLIE GI , WYNDHAM L. , KOUMANTAKIS G. 
Published: March 2008

Objective: To determine the approach to identifying neonatal hypoglycaemia and the definition of neonatal hypoglycaemia used by neonatal paediatricians in Australian Level 3 neonatal intensive care units (NICU). Methodology: A questionnaire was sent to the 101 neonatal paediatricians in the 22 Level 3 NICU in Australia asking their method of screening for, and definition of, neonatal hypoglycaemia. Results: Responses were received from 70 neonatal paediatricians, including all 22 directors. A bedside glucose meter is used in 19 of 22 NICU to screen for hypoglycaemia, whilst one NICU uses a glucose analyzer and another NICU uses a visual colour comparison method. One NICU does not screen, but has blood glucose measured in a satellite laboratory. If the screening method suggests hypoglycaemia, 62 of 63 neonatal paediatricians proceed to blood glucose determination in a laboratory, mostly using plasma samples. Based on the laboratory measurement, the definition of neonatal hypoglycaemia ranged from <1.1 to 3.0 mmol/L. Conclusions: The majority of neonatal paediatricians in Australian NICU screen for neonatal hypoglycaemia using a bedside glucose meter. There is a wide range in the definition of neonatal hypoglycaemia from <1.1 to 3.0mmol/L.
Mothers' knowledge of the risk factors and anxiety about SIDS
Authors: COOPER RM , LUMLEY J. 
Published: March 2008

Objective: To assess the impact on mothers' knowledge and anxiety of the 1991‐92 health promotion campaign on Sudden Infant Death Syndrome (SIDS) risk factors. Methodology: A telephone survey of a population based sample of 339 mothers in Victoria, Australia, conducted 1992‐94. Results: Recall by mothers of the risk factors for SIDS was as follows: not breast‐feeding. 15%; smoking, 46%; overheating, 48%; and prone sleeping, 84%. Recall rate increased as the campaign progressed. Receiving the campaign pamphlet was associated with an increased recall of all risk factors. Discussion of the pamphlet with a health professional was rare (9%). One‐third of all mothers reported being very worried about cot death when caring for their babies. Self‐reported worry was significantly more common among mothers whose babies were born at the time of the campaign introduction. Conclusions: The campaign pamphlets were effective in increasing knowledge of the risk factors. The limited discussion with health professionals suggests that future campaigns need increased professional involvement to address problems, including anxiety among new mothers.