bluuebunny/crossref_metadata_2025_split huggingface dataset:
False negative HIV serology in a case of congenital/perinatal AIDS
Authors: GOLDWATER P. N. , KERNICK C. G. , MARTIN A. J. , DELBRIDGE R. G. , MATTHEWS N. T. 
Published: March 2008

AbstractA case of congenital or perinatal Acquired Immunodeficiency Syndrome (AIDS), the first recognized case of mother to child human immunodeficiency virus (HIV) infection resulting in the full‐blown syndrome in Australia, is reported. The baby who died in November 1985 was diagnosed retrospectively after the child's father had presented with Category A disease (Pneumocystis carinii pneumonia) in May 1987. This case illustrates some of the difficulties that may be experienced in the serological diagnosis of HIV in young children and foreshadows the effects of spread of HIV in the heterosexual community.
Variability of Doppler flow velocity and cerebral perfusion pressure is reduced in the neonate by sedation and neuromuscular blockade
Authors: COLDITZ P. B. , WILLIAMS G. L. , BERRY A. B. , SYMONDS P. J. 
Published: March 2008

Abstract Doppler flow velocity (DFV) in the anterior cerebral artery was recorded every 12 h and cerebral perfusion pressure (CPP) continuously in 21 sick, ventilated preterm neonates for 48 h from shortly after birth. Ten received a neuromuscular blocker, seven were sedated with morphine infusions and five received neither of these treatments. Variability of DFV and CPP was assessed by the coefficient of variation (CV) and the autocorrelation function (ACF).Variability of both signals was lowest in the group treated by neuromuscular blockade (DFV CV 3, s.d. = 0.8; CPP CV 9, s.d. = 2.2; CPP ACF 37, s.d. = 19.2), intermediate in the group receiving sedation by morphine infusion (DFV CV 3.4, s.d = 0.7; CPP CV 11, s.d. = 2.2; CPP ACF 31, s.d. = 21.6) and highest in the group receiving neither treatment (DFV CV 5, s.d. = 1.8; CPP CV 14, s.d. = 2.3; CPP ACF 27, s.d. = 16.7).Variability also increased with decreasing gestational age, suggesting that immature cerebrovascular regulatory mechanisms were present in the least mature neonates.
Treatment of precocious puberty using an intranasal luteinizing hormone‐releasing hormone analogue: Buserelin
Authors: LOW L. C. K. , WANG C. , CHEUNG P. T. , CHAN F. L. 
Published: March 2008

Abstract Fourteen patients with precocious puberty were treated for 1‐3 years with 900‐1800 μg/day of intranasal (i.n.) Buserelin. The peak luteinizing hormone and follicle‐stimulating hormone responses to intravenous luteinizing hormone‐releasing hormone were reduced significantly 4 weeks after starting treatment and remained suppressed while the patients were on treatment. Two patients were withdrawn because of drug non‐compliance. Three patients showed regression of pubertal changes, four patients showed no progression and five patients showed progression of breast size or pubic hair staging after 1.5‐2 years of treatment.Treatment was changed to the subcutaneous route in two patients because of hormonal escape and accelerated skeletal maturation. The mean growth velocity decreased from 10.78 cm/year (s.e.m. = 0.64) to 7.06 cm/year (s.e.m. = 0.85) after 1 year of treatment (P< 0.005). After an increase in dosage (from 900 μg/day to 1800 μg/day) in most patients, further significant falls in growth velocity to 5.29 cm/year (s.e.m. = 0.45), 4.63 cm/year (s.e.m. = 0.8) and 5.06 cm/year (s.e.m. = 0.5) were observed at 18, 24 and 30 months, respectively, compared with the pretreatment value (P< 0.001). With treatment, the increased rate of skeletal maturation normalized. In 10 patients who had completed 2 years of treatment, the height standard deviation score for bone age improved from a pretreatment value of ‐2.42 ± 0.42 to ‐1.6 ± 0.42 after 2 years of treatment (P< 0.01), indicating an improvement in height prognosis. It is concluded that i.n. Buserelin at a dose of 1800 μg/day is effective in the treatment of most but not all patients with precocious puberty.
Fifth day fits in the newborn
Authors: NORTH K. N. , STOREY G. N. B. , HENDERSON‐SMART D. J. 
Published: March 2008

Abstract During the 1970s, there was an epidemic of neonatal convulsions occurring in apparently normal babies during the fourth and fifth days of life. This syndrome was noted in France as well as in Australia. A study was undertaken to review the King George V Hospital (KGV) experience with these ‘fifth day fitters'. All cases of neonatal convulsions at KGV during the years 1972‐85 were reviewed. A total of 94 cases of fifth day fits occurred during this period, accounting for 57% of all neonatal convulsions occurring during 1972‐79.The fits occurred in healthy term infants after an uncomplicated pregnancy. They appeared on the fourth and fifth days of life. The seizures lasted an average of 24 h, were refractory to drug therapy and, despite extensive investigation, no cause was found. The infants were assessed as normal at the time of discharge from hospital. Follow‐up of these infants was incomplete. However, from the data available, it cannot be assumed to be a benign entity.The ‘fifth day fit’ syndrome reached epidemic proportions at a number of maternity units during the 1970s. At KGV, no case has been observed since 1982.
Extracorporeal membrane oxygenation (ECMO) for non‐ECMO intensive care nurseries
Authors: THAMBAPILLAI E. , DOYLE L. W. , MURTON L. J. 
Published: March 2008

AbstractAn extracorporeal membrane oxygenation (ECMO) centre has been established in the sole outborn‐only level 3 nursery in Melbourne. In the absence of other guidelines, an infant may qualify for ECMO if the expected mortality, based on assessment of the severity of hypoxia, exceeds 80%. However, for a non‐ECMO centre, this involves the additional hazard of transport for an already critically‐ill infant. The aim of this study was to determine the predictors of at least 80% mortality in babies who might have qualified for ECMO but who were cared for in a non‐ECMO level 3 nursery. Regardless of the severity or duration of hypoxia, we were unable to identify a group of infants whose mortality exceeded 80%. Since outborn infants were disproportionately over‐represented amongst those who might qualify for ECMO, it would be advisable to admit preferentially those born outside the level 3 perinatal centres who might qualify for ECMO directly to the ECMO centre. For infants born within our level 3 perinatal centre, it is recommended not to transfer those who might qualify based on data from other centres until the exact role of ECMO is determined. Alternatively, a randomized controlled trial of transfer versus non‐transfer to the ECMO centre for severely hypoxic infants cared for in non‐ECMO level 3 nurseries could be considered.
Regional cerebral blood flow velocity patterns in newborn infants
Authors: LUI K. , HELLMANN J. , SOTO G. , DONOGHUE V. , DANEMAN A. 
Published: March 2008

Abstract Using range‐gated pulsed Doppler sonography, cerebral blood flow velocity (CBFV) waveforms from the anterior cerebral artery (ACA), middle cerebral artery (MCA) and circle of Willis artery (CW) were examined in a total of 34 newborn infants. We compared the pulsatility index (PI) from the three cerebral arteries sampled in 10 term and 10 preterm (29 ± 2 weeks) newborn infants without a history of perinatal asphyxia or intracranial pathology. The PI in the ACA ranged from 0.60 to 1.03. There were no significant differences in PI between the three vessels by paired comparisons. The PI of the MCA differed from that of the ACA by 0.00 ± 0.05. The variation coefficient (CV) was 7%. For CW wih ACA, the difference was 0.00 ± 0.04 and CV was 6%. Both intra‐ and interexaminer variation in PI measurements were studied in another 14 infants. The variation coefficients were 5–8% for all three cerebral arteries.We showed that CBFV waveform patterns were similar in regional cerebral arteries, with PI being a consistent CBFV index. In normal cerebral circulation, the intervessel PI differences were within observer variations. Deviation from this may suggest abnormal regional cerebral haemodynamics.
Sensorineural hearing loss
Authors: JARMAN F. C. 
Published: March 2008

ABSTRACTHearing losses in children are disabling and frequently unrecognized. Children with persistent uncorrected hearing impairment are at high risk for speech and language delays, behavioural problems, and socialization and learning difficulties. Although most hearing impairment in childhood is conductive in type. about 1 in 1000 Australian children have significant sensorineural hearing losses (SNHL) of mild to profound degree.
Outcome to 8 years of infants <1000 g birthweight: Relationship with neonatal ventilator and oxygen therapy
Authors: DOYLE L. W. , KITCHEN W. H. , FORD G. W. , RICKARDS A. L. , KELLY E. A. , CALLANAN C. , RAVEN J. , OLINSKY A. 
Published: March 2008

AbstractThe study involved a cohort of 59 consecutive survivors with birthweights < 1000 g, born between 1977 and 1980, to 8 years of age. The aim of the report was to determine if those survivors who had received more oxygen and ventilator therapy differed in their outcome compared with those who had received less oxygen and ventilation. Children were graded into four groups, characterized by decreasing durations of oxygen and ventilation. Children who had received less oxygen and ventilation were more likely to be below the third percentile for weight at 2, 5 and 8 years but the trends were significant only at 2 and 5 years (P= 0.006, P= 0.013 and P= 0.19 respectively). The rate of cerebral palsy was 8% at 8 years; the only children with severe or moderate disabilities from their cerebral palsy were in the lowest oxygen and ventilation group (n= 4, P <0.02). The frequency of hospital re‐admission and the duration of re‐hospitalization did not vary significantly between the four groups at any age. The rates of recurrent wheezing episodes or asthma did not vary significantly between the groups. Although the cohort as a whole had some impairment of lung function compared with healthy full‐term controls, there was no significant difference between the four groups. Contrary to expectations, our findings suggest lower rates of poor growth and adverse neurological outcomes with increasing durations of oxygen and ventilation in the newborn period.
What do health care professionals know about childhood asthma?
Authors: HENRY R. L. , FITZCLARENCE C. A. B. , HENRY D. A. , CRUICKSHANK D. 
Published: March 2008

AbstractThe aim of this study was to examine the level of knowledge about childhood asthma in paediatric nurses, pharmacists and general practitioners to assess their potential value as sources of accurate information for patients with asthma. The main outcome measure was the score obtained on an asthma knowledge questionnaire which had been validated previously. The maximum possible score was 31. Eighty‐three general practitioners had a mean score of 28.1 (range 14–31); 82 pharmacists scored a mean of 24.2 (range 15–30) and 30 paediatric nurses had a mean score of 25.5 (range 16–30). General practitioners scored well in most questions but had some worrying deficiencies, particularly in distinguishing preventive therapy from symptom relieving medication. Pharmacists and paediatric nurses had a number of problems in certain important areas. In particular pharmacists as a group were unaware of many of the clinical features of asthma, had misconceptions, such as the need to avoid cow's milk, and recorded incorrect responses to clinical scenarios of acute treatment. Paediatric nurses tended to overestimate the side effects of inhaled medications, and also the value of auscultation. They had poor knowledge of exercise‐induced asthma.The data overall suggest that specific educational strategies should be devised for different groups of health professionals who manage children with asthma and suggest that poor knowledge on the part of health care providers may contribute to morbidity.
Ureaplasma urealyticum in a neonatal intensive care population
Authors: DYKE M. P. , GRAUAUG A. , KOHAN R. , OTT K. , ANDREWS R. 
Published: March 2008

AbstractThe incidence of Ureaplasma colonization at birth and its effect on the development of chronic lung disease (CLD) and on mortality was studied in a neonatal intensive care population. Ureaplasma colonization was associated with a birthweight < 1000 g (odds ratio [OR] 3.45 confidence intervals [CI] 2.13‐5.60) and a gestational age < 30 weeks (OR 2.54 CI 1.71–3.79). In a case‐controlled study of 112 infants, significant associations with Ureaplasma colonization were maternal pyrexia in labour (n= 38 vs 21; P= 0.015), the requirement for antibiotics in labour (n= 39 vs 16; P= 0.0005) and vaginal delivery (n= 78 vs 58; P= 0.009). Risk factors associated with the development of CLD were birthweight < 1000 g (OR 3.77 CI 2.53–5.62) and delivery by Caesarean section (OR 1.65 CI 1.11–2.43). Within the group delivered by Caesarean section. Ureaplasma colonization was also associated with an increased risk of CLD (OR 1.97 CI 1.08–3.62). Ureaplasma colonization of infants at birth is associated with factors suggestive of maternal chorioamnionitis as well as preterm birth and low birthweight. In infants delivered by Caesarean section, Ureaplasma colonization is associated with an increased risk of chronic lung disease.
Cardiac arrhythmias as a manifestation of acquired heart disease in association with paediatric respiratory syncitial virus infection
Authors: ARMSTRONG D. S. , MENAHEM S. 
Published: March 2008

AbstractRespiratory syncitial virus (RSV) is a common cause of upper and lower respiratory tract infection in infants. An association between RSV bronchiolitis and cardiac arrhythmias has been described but is rare. A further case of an infant with supraventricular tachycardia in association with culture‐positive respiratory syncitial virus bronchiolitis is reported. This case prompted a review of the two other cases of arrhythmia associated with RSV infection seen at this institution and a review of all other published cases.
Oesophageal duplication cyst: Another cause of neonatal respiratory distress
Authors: STEWART R. J. , BRUCE J. , BEASLEY S. W. 
Published: March 2008

AbstractOesophageal duplication cysts in infants (usually males) should be recognized as a cause of respiratory distress which worsens during the neonatal period, and which is associated with feeding difficulties. Their radiological appearance is that of a right‐sided posterior mediastinal mass, which is shown to be cystic on ultrasound. Excision is curative.
Plasma fibronectin levels in extremely preterm infants in the first 8 weeks of life
Authors: DYKE M. P. , FORSYTH K. D. 
Published: March 2008

Abstract Fibronectin has in the past been considered to function simply as a non‐specific plasma opsonin. However, recent studies have demonstrated that this molecule plays an important role in fundamental components of the immune response, for example, neutrophil adhesion, T cell activation and endothelial function. Additionally, fibronectin is important in lung homeostasis where it contributes to alveolar epithelial integrity. In this study plasma fibronectin levels were measured longitudinally in a group of extremely preterm infants, mean gestational age 27 weeks.Plasma fibronectin levels at birth were significantly lower in the preterm study group than in term controls (mean 91±33 μg/mL compared with 214±62 μg/mL in the term controls, P<0.0001). The preterm cohort demonstrated a more than two‐fold rise in plasma fibronectin on days one and two; levels fell almost to baseline values by day three with a subsequent slow rise to a plateau by day 28. No further increase was seen by day 56. This sequence of early changes in fibronectin levels mirrored closely the time course of respiratory distress syndrome. Infants of mothers with pre‐eclampsia had significantly lower peak fibronectin levels than in those without (P= 0.016), and those infants with bronchopulmonary dysplasia showed a trend towards lower basal fibronectin levels (P= 0.07) and a greater difference between peak and basal levels (P= 0.05).Neonates, particularly those born preterm, have blunted immunological responses to infection. Fibronectin plays a key role in immunological responsiveness. The significant changes in fibronectin levels after birth in the preterm neonate are likely to have important pathophysiological consequences. The relationship between alterations in fibronectin after birth, endothelial and epithelial cell function, and respiratory distress syndrome (RDS) remain to be explored.
Infectious diarrhoea in children: Controlling transmission in the child care setting
Authors: THOMPSON S. C. 
Published: March 2008

AbstractAn increase in the number of preschool children cared for within groups in child care centres has been associated with increasing numbers of women in the workforce. Children at this age are at high risk for gastrointestinal diseases caused by a large number of enteric pathogens, and the risk is increased by the greater potential for person‐to‐person transmission within group care. This report considers the pathogens that may cause diarrhoeal illness in children, with particular reference to those that have been reported in formal day care settings. The major risk factors for transmission of these agents and a high rate of diarrhoeal illness in the child care setting include attendance of non‐toilet‐trained children, staff combining nappy changing and food preparation duties, large enrolment, low staff‐to‐child ratio, and poor hygiene and child handling practices. Investigations undertaken during an outbreak of diarrhoea have frequently used limited diagnostic testing, often suitable for identifying only bacterial and protozoal agents. Such limited investigations have tended to incriminate agents that have prolonged carriage and are easily identifiable in standard microbiology laboratories. Finding a pathogen in these circumstances needs to be interpreted with caution. Prevention and control measures include training and education in good personal hygiene, emphasis on the need for frequent handwashing, separation of change areas from food handling and eating areas, routine cleaning and disinfection of environmental surfaces and personal items, and exclusion of any child or child care worker with diarrhoea.
Study of hemiplegic cerebral palsy with a review of the literature
Authors: KHAW C. W. H. , TIDEMANN A. J. , STERN L. M. 
Published: March 2008

AbstractDetails of 66 children with hemiplegic cerebral palsy seen over a 20 year period are presented, with comparisons between right and left hemiplegia. There were slightly more right hemiplegics than left hemiplegics. There were minor differences in the frequency of associated problems, but overall there were no major differences between right and left hemiplegics. It is likely that this is due to the greater plasticity of the immature brain. The results of this study are compared with earlier studies of hemiplegic cerebral palsy.
How appropriate are commercially available human milk fortifiers?
Authors: METCALF R. , DILENA B. , GIBSON R. , MARSHALL P. , SIMMER K. 
Published: March 2008

AbstractA preliminary investigation was made into the effectiveness of two breastmilk fortifiers on the Australian market (FM‐85 [Nestle, Vevey, Switzerland] and Enfamil Human Milk Fortifier [EHMF; Mead Johnson, Evansville, IN, USA]). Infants < 1800 g and < 34 weeks gestation at birth, who were receiving breast milk, were randomized to receive either of the fortifiers (n= 14 for FM‐85, n= 10 for EHMF), until a weight of 2 kg was reached. Infants not receiving breast milk (n= 9) were fed a preterm formula (Prenan, Nestlé). The two fortifier groups were similar in most parameters examined: (i) weight gain (17.9 ± 3.0 vs 17.4 ± 3.5g/kg per day); (ii) head circumference growth (1.02 ± 0.28 vs 1.03 ± 0.25 cm/week); (iii) arm muscle area growth (32.6 ± 20.0 vs 33.5 ± 13.7 mm2/week); (iv) arm fat area growth (14.3 ± 6.1 vs 14.0 ± 8.7 mm2/week); (v) plasma calcium (2.52 ± 0.08 vs 2.58 ± 0.15 mmol/L); (vi) plasma phosphate (2.02 ± 0.21 vs 2.13 ± 0.32 mmol/L); (vii) plasma copper (5.28 ± 2.83 vs 5.66 ± 3.07 pmol/L); and (vii) plasma zinc (13.3 ± 5.5 vs 15.8 ± 9.2 μmol/L). The FM‐85 group had a higher alkaline phosphatase level (355 ± 110 vs 231 ± 70 iu/L) than the EHMF group; however, no values were outside the normal range. The Prenan group had a higher rate of weight gain (23.6 ± 3.3 g/kg per day) and higher arm fat area growth rate (25.2 ± 7.6 mm2/week) than the fortifier groups, while all other parameters were similar. The incidence of feed intolerance was considered high in both fortifier groups. The addition of many of the components of breastmilk fortifiers has not been well validated and it is proposed that a simplified fortifier composed of protein and phosphate may be better tolerated and equally effective at optimizing growth and bone mineralization. The specific needs of extremely low birthweight infants (>1000 g) have not been addressed.
Age‐related changes in oxygen saturation over the first year of life: A longitudinal study
Authors: MASTERS I. B. , GOES A. M. , HEALY L. , O'NEIL M. , STEPHENS D. , HARRIS M. A. 
Published: March 2008

AbstractStability of oxygen saturation depends on maturation and function of individual components of the respiratory system. The aim of this study was to record and analyse comprehensive oxygen saturation data in a longitudinal study over the first year of life. Detailed sleep studies were performed on 15 normal infants eight times in the first year of life. The accrued oxygen saturation data were analysed on a computerized oximetry data analysis system. Results show the mean sleep saturation levels trending upwards and stabilizing by 185 days. There was an inverse curvilinear relationship between mean age and median desaturation time and the median number of desaturations at ≥95, ≥92 and ≥90% saturation. The mean cumulative desaturation time ≥90% in the first 4 months was 11.08 min (range 2.5–36.57 min). This study demonstrates monotonic patterns of increasing saturation and decreasing number and time of desaturations ≥95% and ≥90% but a random pattern of desaturations ≥85% occurs across the first 6 months of life. Cumulative desaturation times over the first 4 months of life were high and could be important to the development of maturity of the respiratory system. After 6 months, all indices of saturation and desaturation point to a stable and mature respiratory system.
The effect of halothane on neonatal ciliary beat frequency
Authors: O'CALLAGHAN C. , ATHERTON M. , KARIM K. , GYI A. , LANGTON J. A. , ZAMUDIO I. , BARRY P. 
Published: March 2008

AbstractThe effect of a commonly used anaesthetic agent, halothane, on neonatal cilial function was determined. A nasal cilial sample was taken from 13 healthy, term, newborn infants. For 1 h, half of each sample was exposed to halothane and half to air. Cilial function was assessed by measuring beat frequency with a modified light transmission method. Cilial beat frequency was significantly slower in the cilia exposed to halothane, 9(s.d. 2.5)Hz, than to air, 12.9(s.d. 1.5)Hz. Decreased mucociliary clearance following halothane anaesthesia is due, at least in part, to a directly depressant effect of halothane on ciliated cells.