bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of developmental screening and assessment instruments by paediatricians in Australia
Authors: ROSSITER E. J. R. 
Published: March 2008

AbstractTwo hundred and seven Australian paediatricians were sent a questionnaire to determine whether they undertook developmental screening and/or assessment. Replies were received from 140(68%) paediatricians of whom 115 (82%) stated they did developmental screening and 58 (41%) said they did developmental assessment The Denver Developmental Screening Test was the most widely used (74%), but several other tests were used, not all correctly. There was greater confusion in the area of developmental assessment and appropriate tests, although 37 (26%) used the Griffiths.The results are described in detail and some of the current concerns about developmental screening and assessment are discussed.
Infantile hypertrophic pyloric stenosis: A clinical review from a general hospital
Authors: ZHANG A‐L. , CASS D. T. , DUBOIS R. S. , CARTMILL T. 
Published: March 2008

AbstractA review of 212 cases of infantile hypertrophic pyloric stenosis (IHPS) in a general hospital during an 8.5 year period documents clinical features and suggests refinement of treatment. Features such as sex, age at onset and presentation were similar to other studies. There was a preponderance of infants born in the summer. Premature infants represented 10% of the series, and the most premature (<33 weeks gestation) presented later after birth (40 vs 25 days). Diagnosis was clinical in 65% of cases, but 4% presented before physical examination and diagnostic tests were positive. At the time of admission only 15% had significant abnormalities of serum electrolytes (chloride <85 mmol/L). The periumbilical incision resulted in a hidden scar. Duodenal perforation (3.3%) and wound dehiscence (1.4%) are related to technical factors and can be avoided. The timing of commencement of postoperative feeds did not influence the rate of vomiting. The average length of stay was 3.5 days. These results are discussed with suggestions about how to minimize diagnostic tests and length of hospital stay.
Aminophylline therapy and cerebral blood flow velocity in preterm infants
Authors: CHANG J. , GRAY P. H. 
Published: March 2008

AbstractPulsed Doppler ultrasound was used to evaluate the cerebral blood flow velocity (CBFV), in the middle and anterior cerebral arteries in 10 infants before and after the administration of aminophylline (7.5 mg/kg). Mean CBFV, heart rate, blood pressure, oxygen and carbon dioxide tensions were recorded before the loading dose, and then at 1, 2, 6 and 24 h after completion of the infusion. Mean CBFV in the middle and anterior cerebral arteries were 16.8 cm/s and 10.8 cm/s respectively prior to the infusion. There was a significant decrease (P<0.05) in velocities in both arteries at 1 and 2 h post drug therapy, which returned to base values by 6h, and remained as such at 24h. The heart rate increased (P<0.05) after the infusion, while no consistent changes were observed in blood pressure or oxygen tension. Carbon dioxide levels were significantly reduced (P<0.05) at 2h. The reduction in CBFV, however, was more than would be expected on the basis of the change in carbon dioxide levels alone, suggesting that other factors may be exerting an influence. While no adverse effects were noted in the infants studied, it is suggested that aminophyiline should be used judiciously in sick preterm infants at highest risk from ischaemic brain injury.
Communicable disease outbreaks in long day care centres in western Sydney: Occurrence and risk factors
Authors: JORM L. R. , CAPON A. G. 
Published: March 2008

AbstractWe surveyed the directors of all 92 long day care centres in western Sydney to document the occurrence of communicable disease outbreaks during 1992 and to identify risk factors for the occurrence of these outbreaks. A total of 6092 children were enrolled at the centres, of whom 530 (8.7%) were less than 3 years old. Most centres (80.4%) reported at least one outbreak of communicable disease. Diarrhoea was the most commonly reported outbreak type (60 outbreaks), followed by conjunctivitis, head louse infestation and chicken pox (46, 44 and 24 outbreaks, respectively). Chicken pox outbreaks had the largest mean number of cases per outbreak (9.6) and the longest mean outbreak duration (4.4 weeks). Centres with a large total enrolment (50 or more children), those that were open for 12 or more hours each day and those which had commenced operating in 1990 or more recently were generally more likely to report outbreaks, particularly of diarrhoea. The vast majority of communicable disease outbreaks (92.1%) were handled by day‐care staff without seeking outside assistance. Day‐care centre directors may be unaware of the health services that could help them. We need to work more closely with long day care centres, and to focus preventative efforts on large centres, those open for long hours, and newly opened centres.
Lumbar punctures in suspected bacterial meningitis: Too many or too few?
Authors: SELBY A. , ISAACS D. , GILLIS J. , HANSON R. , O'CONNELL A. , SCHELL D. , MAI T. VAN 
Published: March 2008

AbstractChildren aged 1 month to 14 years admitted to the Royal Alexandra Hospital for Children during a 10 month period with suspected meningitis were studied prospectively. The aims were to determine how often lumbar puncture (LP) was delayed or never done, in relation to the outcome of all children, in order to determine the risks of LP and the risks of not doing LP. Of 218 children with suspected meningitis, LP was performed immediately in 195 (89.4%). Meningitis was diagnosed in 49 of these (bacterial 18, viral 31). No child developed cerebral herniation due to immediate LP. There were 11 traumatic taps and two children required repeated attempts. Lumbar puncture was delayed, but performed at a later time in 17 children, of whom three had proven bacterial meningitis, 1 had presumed bacterial meningitis but no organism was detected and 13 had alternative diagnoses. Six children never had an LP, although ventricular cerebrospinal fluid was obtained from two Four of these six children had presumptive bacterial meningitis, one had tuberculous meningitis presenting with acute hydrocephaius and diagnosed post‐mortem, and one had a very poor neurological outcome and no final diagnosis was reached. Of the 27 children with bacterial meningitis, LP was performed immediately in 18, or two‐thirds. There were only minor adverse effects of immediate LP. Delayed LP probably resulted in failure to identify the organism in one child with bacterial meningitis, but did not adversely affect outcome in any child. Of the six children in whom LP was never performed, in only one was no final diagnosis reached. There was no evidence of excessive morbidity attributable to performing too many or too few lumbar punctures.
Impaired increase of prostaglandin E2 in gastric juice during steroid therapy in children
Authors: SHIMIZU T. , YAMASHIRO Y. , YABUTA K. 
Published: March 2008

AbstractTo investigate the aetiology of steroid‐induced peptic ulcers in children, prostaglandin E2 (PGE2) release and acid secretion into gastric juice was evaluated in 10 children receiving a corticosteroid before and after injection of pentagastrin. The concentration of luminal PGE2 was measured by radio‐immunoassay. The basal levels of PGE2 concentration and acid secretion in gastric juice did not differ significantly between the steroid therapy group and control group. After stimulation with pentagastrin, acid secretion increased significantly (P>0.01) in both groups and PGE2 concentration increased significantly (P>0.01) only in the control group. Prostaglandin E2 concentration was significantly lower in the steroid therapy group than in the control group 20‐40 and 40‐60 min after pentagastrin stimulation (P>0.01 and P>0.05, respectively). Since PGE2 has a cytoprotective effect on the gastric mucosa, the results of impaired increase of PGE2 in response to increased acid secretion during steroid therapy may indicate causality with the development of steroid‐induced peptic ulcers.
An outbreak of Pneumocystis carinii pneumonia in children with malignancy
Authors: CHEUNG Y. F. , CHAN C. F. , LEE C. W. , LAU Y. L. 
Published: March 2008

AbstractAn outbreak of Pneumocystis carinii pneumonia (PCP) in three patients within a 6 week period was reported. Two patients had acute lymphoblastic leukaemia and one had brain‐stem glioma. They shared common features of immuno‐suppression and absence of cotrimoxazole prophylaxis and had been nursed in the same room. The severity of PCP and its response to treatment may be related to the degree of immunosuppression. Because of the morbidity and mortality of PCP, chemoprophylaxis should be given to all at‐risk cases. Furthermore, isolation of patients with PCP should be considered in view of increasing evidence of nosocomial transmission.
Dumping syndrome after Nissen fundoplication
Authors: VEIT F. , HEINE R. G. , CATTO‐SMITH A. G. 
Published: March 2008

AbstractDumping syndrome is infrequently reported in children, but has significant morbidity. It may be difficult both to diagnose and manage. Two children are reported who developed dumping syndrome after Nissen fundoplication. Symptoms occurred soon after the operation and included post‐prandial pallor, sweating, lethargy and diarrhoea. Failure to thrive was a prominent feature. Typical biochemical changes included hyperglycaemia shortly after meals, followed by hyperinsulinaemia and reactive hypoglycaemia. Effective treatment was only achieved with continuous enteral feeding. Children undergoing fundoplication should be closely monitored for episodes of hypoglycaemia and unresponsiveness. The incidence of dumping syndrome after fundoplication may be underestimated, particularly in children.
The effect of growth hormone on growth and blood urea levels in children with chronic renal failure
Authors: McMAHON K. A. , POWELL H. R. , WALKER R. G. , JONES C. L. 
Published: March 2008

AbstractIt has been claimed that low protein diets slow deterioration of chronic renal failure (CRF) by reducing renal solute load. The anabolic effect of recombinant human growth hormone (rhGH) also has potential to reduce renal solute load and thereby slow progression of renal failure. The aim of this study was to determine the effect of rhGH on growth, renal solute load and renal function in children with CRF.Seven prepubertal children, aged 2‐14 years, with moderately severe CRF (creatinine clearance 7.7‐23.4 mL/min per 1.73 m2) were treated with daily subcutaneous rhGH, 1 U/kg per week for 10‐12 months. As expected, mean height velocity standard deviation scores (SDS) increased, from ‐ 2.87 before treatment to + 3.39 on rhGH, and mean height increased from ‐ 3.1 to ‐ 2.4 SDS. Serum urea concentrations decreased in most patients during the first month of growth hormone treatment from a mean of 20.0pm7.7 mmol/L to 14.8pm5.8 mmol/L (P= 0.006). The serum urea then returned to pretreatment levels over the next few months.In the 12 months before treatment with growth hormone, mean creatinine clearance decreased from 19.3 mL/min per 1.73 m2 to 16.7 mL/min per 1.73 m2. In the next 12 months on rhGH mean creatinine clearance decreased further to 13.5 mL/min per 1.73 m2. Therefore the rate of deterioration of renal function was unaffected during treatment with growth hormone. Initial treatment with rhGH is associated with decrease in serum urea concentrations in children with CRF, probably mediated by stimulation of anabolic incorporation of dietary nitrogen into body protein. Despite this reduction in renal solute load, renal function deterioration continued unchanged in most children.
Retention and use of personal health records: A population‐based study
Authors: JEFFS D. , NOSSAR V. , BAILEY F. , SMITH W. , CHEY T. 
Published: March 2008

AbstractA parent‐held record has been issued to all children born in New South Wales (NSW), Australia since 1988. Five years after its introduction, an evaluation was undertaken to determine its retention rate over time, rate of documentation of immunization status and other important child health information, and its perceived usefulness to parents. The cross‐sectional study comprised an interviewer administered questionnaire to 622 households derived from a stratified random sample of 25 local government areas, representative of 73% of all households containing children under 5 years of age in NSW. A concurrent postal survey assessed the attitudes and use of the Personal Health Record (PHR) among a stratified random sample of 911 health care providers.Results showed that the PHR was well retained, with 89% claimed retention at 4 years, and over 78% of parents able to produce the record for inspection at interview. Of the records examined, 91% had at least one immunization recorded while 68% had a complete regimen documented by age 4 years. Overall, 93% of parents expressed satisfaction with the PHR, while 64% of all health care providers also felt that the PHR was ‘beneficial to the health care children received’, although only 53% of these used it regularly to record their findings. It is concluded that the PHR currently issued in NSW is well retained and valued by parents, and used by and useful to a range of health professionals.
Day care and asthma morbidity
Authors: CONNETT G. J. , CONNETT C. J. , QUEK S. C. , LEE B. W. 
Published: March 2008

AbstractAn association between attendance at day care centres and lower respiratory symptoms among pre‐school asthmatic children who were attending follow‐up appointments at a specialist respiratory outpatient clinic was studied. Parents of 69 children completed a questionnaire. Because of the variation in the age distribution of the two groups, analysis was restricted to children aged 2‐4 years old; results from 49 children were analysed. Cough, wheeze at night and wheeze on waking occurred significantly more frequently in the two weeks prior to clinic visits among asthmatics attending day care. Among asthmatic children requiring specialist outpatient follow up, those attending day care are more likely to be troubled by lower respiratory symptoms than those looked after at home.
Smoking in pregnancy and child development to age 9 years
Authors: McGEE R. , STANTON W. R. 
Published: March 2008

AbstractThis study examined the association between women's retrospective reports of smoking during pregnancy and subsequent language, cognitive, behavioural and physical development in their children up to age 9 years. While there was a strong association between maternal smoking and an index of disadvantageous child rearing, maternal smoking was not associated with more general family disadvantage. After controlling for levels of background disadvantage, no relationship was found between reports of smoking and language, cognitive or physical development. However, smoking was related to maternal reports of behaviour problems at age of school entry. Possible explanations for this relationship are discussed.
Is cow's milk protein intolerance a cause of gastro‐oesophageal reflux in infancy?
Authors: McLAIN B. I. , CAMERON D. J. S. , BARNES G. L 
Published: March 2008

AbstractTo test the hypothesis that cow's milk protein intolerance (CMPI) might cause or contribute to gastro‐oesophageal reflux (GOR), 10 of 14 infants with abnormal GOR on prolonged oesophageal pH monitoring who had failed to respond to conventional antireflux therapy were placed on a hypo‐allergenic diet for 1 month. In no child was there significant improvement in pH monitoring indices, and only two showed any symptomatic improvement. Therefore, in these children, CMPI did not appear to contribute to GOR. It is probable that CMPI is rare as a cause of passive GOR, although our results do not exclude CMPI as a cause of active vomiting.
Risk factors and outcomes associated with low birthweight delivery in the Australian Capital Territory 1989‐90
Authors: HERCEG A. , SIMPSON J. M. , THOMPSON J. F. 
Published: March 2008

Abstract: The objectives of this study were to describe outcomes of low birthweight (LBW; >2500g) babies born in the Australian Capital Territory (ACT) and to identify risk factors associated with LBW in the ACT. A cohort study was conducted involving all births recorded in the ACT Maternal and Perinatal Data Collection sets for 1989‐90.Status at discharge is presented for 9373 births each weighing more than 499 g born in the ACT in 1989 and 1990, classified by birthweight. Other outcomes are given for live births (n = 9309) only. Adjusted odds ratios for significant risk factors for LBW are given for 9084 singleton births whose computer records contained all relevant information.Perinatal mortality rates for LBW babies are consistent with other States, apart from 500‐999 and 1500‐1999g babies which have higher rates. Eighteen per cent of LBW babies are transferred to other hospitals. Low birthweight babies are more likely than normal birthweight babies to have 1 and 5 min Apgar scores less than 7, to need resuscitation and to take more than 5 min to establish respiration. Risk of LBW is associated with maternal primiparity, age 35 years or more in primiparous women, history of one or more spontaneous abortions, induced abortions or perinatal deaths, chronic illness, public health insurance and single marital status, and with fetal female sex and congenital anomalies.Babies born weighing less than 2500 g in the ACT have more adverse outcomes and are much more likely to be transferred than normal birthweight babies. Modifiable risk factors for LBW relate to lower maternal socio‐economic status. Measures to decrease the incidence of LBW and its subsequent costs will have greatest gains in this group of women.
Sequelae of Haemophilus influenzae type b meningitis in Aboriginal and non‐Aboriginal children under 5 years of age
Authors: BOWER C. , PAYNE J. , CONDON R. , HENDRIE D. , HARRIS A. , HENDERSON R. 
Published: March 2008

AbstractBetween 1984 and 1990, 257 cases of Haemophilus influenzae type b (Hib) meningitis occurred in children under five years of age in Western Australia. We obtained information on possible sequelae in 131 cases (all non‐Aboriginal) by medical record review and parental interview, and in a further 116 cases (60 non‐Aboriginal, 56 Aboriginal) by medical record review only; no follow‐up information was available for ten children (nine non‐Aboriginal, 1 Aboriginal). The incidence of Hib meningitis in children under five years of age was 26.3 per 100000 for non‐Aboriginal and 152.2 per 100000 for Aboriginal children. The case fatality rate was 3.5% for non‐Aboriginal children and 14.0% for Aboriginal children. Sequelae were recorded for 17.1% of non‐Aboriginal and 22.4% of Aboriginal children who survived Hib meningitis. Surviving Aboriginal children experienced severe sequelae following Hib meningitis almost three times more frequently than surviving non‐Aboriginal children (10.5%vs 3.6%), although mild and moderate sequelae were not more common in Aboriginal children. The information on incidence and severity of sequelae in this study was obtained by chart review and parental interview, and hence may be subject to error or bias, particularly for mild and moderate disabilities. Outcomes like death and severe sequelae, such as cerebral palsy and profound intellectual and physical disability, are less subject to bias. Of Aboriginal children who contracted Hib meningitis in Western Australia over the study period, 22.8% either died or had severe sequelae, while only 7.0% of non‐Aboriginal children experienced these severe outcomes.
Two hour seminar improves knowledge about childhood asthma in school staff
Authors: HENRY R. L. , HAZELL J. , HALLIDAY J. A. 
Published: March 2008

AbstractTeachers and support staff are often called upon to manage asthma at school but may have little knowledge and understanding of the condition. The aim of this study was to determine whether a short seminar would improve knowledge in non‐health professionals. Seventy school staff attended one of five 2 h seminars presented by an asthma educator. Participants completed the Newcastle Asthma Knowledge Questionnaire (AKQ) before, and 2 months after, the seminar. The mean initial score (maximum possible 31) was 16.4 (range 4–26), increasing to 23 (range 13–29, P= 0.0001). There was a large increase in knowledge about symptoms, pathophysiology, preventive medications and side effects of medications. Initially almost all of the participants had deficiencies in knowledge about reliever medications and the management of exercise‐induced asthma. After the seminar, knowledge in these areas was still poor, with only one‐third of the participants answering them correctly. The results have been used to modify the content of the 2 h seminar with increased emphasis on those areas in which deficiencies in knowledge were demonstrated. No data are available yet as to whether this improved knowledge has improved management.
Congenital heart disease: A 10 year cohort
Authors: BOWER C. , RAMSAY J. M. 
Published: March 2008

AbstractIn order to describe the epidemiology of congenital heart disease in Western Australia, a retrospective, population‐based cohort study was conducted using data collected from multiple sources of ascertainment by the Western Australian Birth Defects Registry. The prevalence of congenital heart disease was 7.65 per 1000 total births. Nine per cent of all cases had a chromosomal disorder, another 17% had extracardiac defects in addition to congenital heart disease, and 75% had isolated congenital heart disease. Congenital heart disease was more common in Aboriginal compared with non‐Aboriginal infants, and in multiple births compared with singletons. Compared with infants weighing 3000 to 3499 g, infants of lower birthweight were more likely to have congenital heart disease, and infants in the heaviest category (£3500 g) were less likely to have congenital heart disease. Three per cent of all stillbirths were known to have a cardiac defect, as were 15.2% of neonatal deaths and 10.8% of post‐neonatal deaths.
Death in neonatal intensive care
Authors: KELLY N. P. , ROWLEY S. R. , HARDING J. E. 
Published: March 2008

AbstractThe aim of this study was to review the frequency of decisions to withdraw treatment from neonates who had died in a large neonatal intensive care unit the reasons for these decisions, and the procedures followed. A 12 month retrospective review of medical and nursing records was undertaken. There were 67 deaths; treatment was withdrawn from 52 infants who were dead or dying, from 9 infants on the basis of a severe congenital abnormality, and from 6 infants with severe acquired brain damage. The decision‐making process and the management of treatment withdrawal are reviewed. It is concluded that withdrawal of treatment resulting in death occurs frequently in the neonatal intensive care service of National Women's Hospital, Auckland, New Zealand, but is usually a recognition of the inevitable. Truly elective withdrawal of treatment is uncommon in the immature infant, but does occur in the context of multiple abnormalities or severe birth asphyxia, where it follows a formal procedure.
A comparative study of the growth of South‐East Asian children in south‐west Sydney born in Australia and overseas
Authors: LOKA P. , NOSSAR V. , BAUMAN A. E. 
Published: March 2008

AbstractThe height and weight of two groups of South‐East Asian children between the ages of 1 and 10 years living in south‐west Sydney were compared to determine the effects of environment on growth and development. One group of these children was born overseas and the other in Australia. The children who were born in Australia were found to be significantly taller (1–2%) and heavier (10%) than those born overseas. This would suggest that ecological factors including health and nutrition contribute to these differences.