bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essential fatty acid deficiency in parenterally fed preterm infants
Authors: LEE E. J. , SIMMER K. , GIBSON R. A. 
Published: March 2008

AbstractTo determine the incidence of essential fatty acid (EFA) deficiency during short term fat‐free parenteral nutrition, the authors investigated prospectively the EFA status of nine low birthweight (1145 ± 343 g) preterm (28.2 ± 1.9 weeks) infants, in whom delivery of dietary fat was delayed postnatally for 2–9 days. Serial determinations of plasma fatty acids showed that during fat‐free alimentation, the major EFA, linoleic acid (LA), decreased rapidly (‐0.75% total fatty acids per day), accompanied by a rise in endogenously produced non‐essential fatty acid, eicosatrienoic acid (Mead acid). Essential fatty acid deficiency was confirmed biochemically by an elevation in the triene‐tetraene ratio in six of the infants, only one of whom developed clinical symptoms. Abnormal fatty acid profiles were corrected within a few days of fat delivery by either intravenous or enteral routes.Essential fatty acids and their metabolites are involved in a wide range of physiological functions vital to postnatal growth and development. Depletion of these nutrients can be corrected by providing a minimum of 0.25 g LA/kg per day (equivalent to 0.50 g/kg per day of 20% Intralipid or 30–50 mL/kg per day of breast milk).
The cost of improving the outcome for infants of birthweight 500‐999 g in Victoria: THE VICTORIAN INFANT COLLABORATIVE STUDY GROUP
Authors: KITCHEN W. H. , BOWMAN E. , CALLANAN C. , CAMPBELL N. T. , CARSE E. A. , CHARLTON M. , DOYLE L. W. , DREW J. , FORD G. W. , GORE J. , KELLY E. A. , LUMLEY J. , McDOUGALL P. , RICKARDS A. L. , WATKINS A. , WOODS H. , YU V. Y. H. 
Published: March 2008

AbstractThe aim of this study was to conduct an economic evaluation of neonatal intensive care for extremely low birthweight (ELBW) infants born in the state of Victoria. Two distinct eras (1979–80 and 1985–87) were compared. Follow‐up data at 2 years of age were available for all 89 survivors from the 351 live births in 1979–80, and for 211 of 212 survivors from the 560 live births in 1985–87. The overall cost‐effectiveness for ELBW infants during 1985–87 compared with 1979–80 was$104 990 ($A 1987) per additional survivor, or$5390 ($A 1987) per additional life year gained. Cost‐effectiveness improved with increasing birthweight. If the quality of life of the survivors was considered, the economic outlook was more favourable. The cost per quality‐adjusted life year gained was$5090 ($A 1987), approximately one‐tenth of that obtained from the only previous full economic evaluation of neonatal intensive care. Although neonatal intensive care is expensive, it compares favourably with some other health care programmes, particularly as the outcome for ELBW infants continues to improve.
A fatal case of necrotizing enterocolitis in a neonate with polyagglutination of red blood cells
Authors: MARSHALL L. R. , BARR A. L. , FRENCH N. P. , LOWN J. A. , KNOWLES S. 
Published: March 2008

AbstractAn infant of 30 weeks gestation developed necrotizing enterocolitis (NEC) 8 days after birth and died 2 days later after a fulminating course. During her illness she received two blood transfusions, both of which produced sub‐optimal rises in her haemoglobin and were associated with evidence of haemolysis. Retrospective analysis demonstrated T antigen (Tk) polyagglutination of the infant's red blood cells and donor plasma. Although bacterial cultures were negative throughout the course of the illness in this case, T antigen exposure is associated with certain anaerobic infections and with severity of NEC. Infants with NEC should be regularly screened for T antigen exposure and if this test is positive, plasma (immunoglobulin) containing infusions should be avoided.
Flunitrazepam in terminal care
Authors: SMALES O. R. C. , SMALES E. A. , SANDERS H. G. 
Published: March 2008

AbstractFlunitrazepam is a benzodiazepine of long half‐life with sedative, anxiolytic, muscle relaxant and anticonvulsant properties. It has proved effective in controlling terminal agitation, confusion, restlessness, dystonia and fitting in adults and can be given by subcutaneous infusion in combination with other drugs. Its use in children during their terminal illness is described. Good symptom control without excessive sedation was achieved over the 24 h prior to death.
Side effects of stimulant use
Authors: LEVY F. 
Published: March 2008

AbstractThe current literature on side effects of central nervous system (CNS) stimulant medications used in the treatment of attention deficit hyperactivity disorder (ADHD) is reviewed, with particular emphasis on dose‐response effects on differing behavioural systems. The reasons for variation in findings may lie in individual differences in children, or in differing responses of target behavioural systems. These may be understood in terms of underlying pharmacological mechanisms. Social, educational and philosophical issues relating to medication use are discussed, and the need for ongoing critical clinical and research approaches, rather than polarization of professional attitudes, is emphasized.
Extremely low birthweight infants at 3 years: A developmental profile
Authors: BOWEN J. R. , STARTE D. R. , ARNOLD J. D. , SIMMONS J. L. , MA P. J. , LESLIE G. I 
Published: March 2008

AbstractThis study documents the neurodevelopmental outcome at 3 years of 52 of 55 extremely low birthweight (ELBW) survivors (survival rate 49%) born in a tertiary maternity centre from July 1985 through December 1988, and examines more closely the developmental profile of the neurologically normal survivors. At 3 years, 6 (12%) children had severe neurodevelopmental impairment (severe cerebral palsy, blindness, deafness or a General Quotient (GQ)<70 on the Griffiths Scales), 11 (21 %) had mild to moderate impairment and 35 (67%) had no neurosensory impairment and normal development (GQ≥ 85). Significant risk factors for severe impairment were stage 3 or 4 retinopathy of prematurity (odds ratio [OR] 21.5), treatment with postnatal steroids (OR 21), grade III or IV intraventricular haemorrhage (OR 11) and supplemental oxygen at ‘term’(OR 6.4). The developmental profile of the 35 neurologically normal children revealed a significant weakness in eye and hand coordination skills and a relative strength in hearing and speech skills. Early recognition of this developmental profile may allow implementation of more appropriate preschool programmes for ELBW children.
Severe thrombocytopenia in extremely low birthweight infants with systemic candidiasis
Authors: DYKE M. P. , OTT K. 
Published: March 2008

AbstractThe clinical, haematological and microbiological features of 12 extremely low birthweight (ELBW) infants with Candida infection were compared with 36 gestational‐age and birthweight matched controls who experienced 42 episodes of bacterial septicaemia. Thrombocytopenia was the feature observed most commonly, occurring in 12 of 12 study infants and 23 of 42 controls (P= 0.004). Minimum platelet counts were below 50 x 109/L in 11 of 12 study patients compared with seven of 42 controls (P < 0.0001). Severe thrombocytopenia may be a useful indicator of systemic Candida infection in ELBW infants.
Pneumomediastinum complicating childhood acute lymphoblastic leukaemia
Authors: COPEMAN M. C. , MOORE P. , SHAW P. J. 
Published: March 2008

AbstractA case of pneumomediastinum that developed in a 10 year old girl receiving induction chemotherapy for acute lymphoblastic leukaemia is reported. Three factors were identified that may have been associated with this complication: the patient suffered recurrent vomiting during her induction chemotherapy; she had travelled by air the day before the pneumo mediastinum was diagnosed; and was septic with Enferobacter at time of diagnosis. The pneumomediastinum resolved over 2 weeks without specific treatment and without further complications.
Chromosome testing in children with developmental delay in whom the aetiology is not evident clinically
Authors: GRAHAM S. M. , SELIKOWITZ M. 
Published: March 2008

AbstractA review was carried out to establish the value of chromosome testing in children with significant developmental delay, where the aetiology was not evident clinically. During 1990, 315 children had been assessed at a child development clinic and found to be significantly delayed in one or more areas of development; in 256, the aetiology was not evident clinically. Chromosome testing of these children revealed an abnormality in 10 (3.9%). Thirty children had dysmorphic features; six (20%) of these had an abnormal karyotype. Four (2%) of the 226 who had no dysmorphic features had a chromosome abnormality. One hundred and fifty‐five children had intellectual disability; eight (5%) of these had an abnormal karyotype. Two (2%) of 101 who had a specific delay in their development had a chromosome abnormality. The advantages of chromosome testing in children with developmental delay in whom the aetiology is not evident clinically are discussed.
Immunization status and demographic characteristics of New Zealand infants in the first 6 months of life
Authors: ESSEX C. , COUNSELL A. M. , GEDDIS D. C. 
Published: March 2008

AbstractIn the Royal New Zealand Plunket Society's 1990‐91 cohort study, of 3902 children, 985 (25.2%) had fallen behind the immunization schedule by 6 months of age. These children were more likely to be from lower socio‐economic groups or to have mothers who were older, with high or low education, or of higher parity. The infants were also more likely to be from non‐European families, or to have unemployed fathers. Eight hundred and ten (82.2%) of the incompletely immunized children at that age could be brought up‐to‐date with their immunizations by a single visit to the doctor. The most common reason for delaying immunization was that the baby was sick. This was a false contraindication in 69.2, 79.0 and 78.4% of these children at the 6 week, 3 month and 5 month immunization, respectively.
In utero repair of diaphragmatic hernia
Authors: MACMAHON R. A. , YARDLEY R. W. , SHEKLETON P. A. , RENOU P. M. 
Published: March 2008

AbstractThis report describes the first in utero repair of diaphragmatic hernia in Australia. The patient was a 32 year old woman with major infertility problems who was diagnosed at 15 weeks gestation as having an infant with diaphragmatic hernia. After extensive consideration and counselling the parents requested in utero repair. This was performed at 28 weeks gestation and was technically successful, but the infant was found to be dead after uterine closure. The mother has subsequently been delivered of normal twins at term by Caesarean section. in utero repair of diaphragmatic hernia requires a high degree of team work, is technically demanding and has major ethical implications. It should be restricted to nationally designated units.
A medium term follow‐up study of patients with hypertrophic pyloric stenosis
Authors: ZHANG A‐L , CASS D. T. , DAWSON K. P. , CARTMILL T. 
Published: March 2008

AbstractA structured questionnaire was sent to the parents of 120 children from a cohort 192, who had undergone a pyloromyotomy for pyloric stenosis at Westmead Hospital during the years 1984‐91. Information was gained from 85 children in 82 families regarding gastrointestinal complaints and family history of pyloric stenosis. There were few gastrointestinal problems, no reports of recurrent abdominal pain, but two reports of clinically significant vomiting (2.3%) and one of infantile colic. Of the 85 individuals studied, 21 (24.7%) had a positive family history of pyloric stenosis, a higher frequency than previously reported.
The micro‐environment of the sleeping newborn piglet covered by bedclothes: Gas exchange and temperature
Authors: GALLAND B. C. , PEEBLES C. M. , BOLTON D. P. G. , TAYLOR B. J. 
Published: March 2008

AbstractThis study followed the thermal and gaseous micro‐environment of the newborn piglet sleeping under two levels of bedding insulation. After 1 h in the piglet's thermal comfort zone, the head of each piglet was covered for 2h with bedding either 12 mm or 21 mm thick. Body temperature rose rapidly, but the arterial gases showed no change in the direction of asphyxia; with the thicker covering Pao2 was unchanged and Pao2 fell and pH rose. These changes were despite a small rise in environmental Pao2 and fall in Pao2 but were also minimized by the piglet's ability to avoid profound hypocapnia by panting at a very low tidal volume. No significant changes in blood gases occurred with the thinner bedding; the temperature rose markedly but more slowly. It is suggested that human babies submerged under bedclothes for any length of time would be more likely to succumb to the effects of hyperthermia than of asphyxia.
A practical intervention to address ear and lung disease in Aboriginal primary school children of central Australia
Authors: BARKER R. N. , THOMAS D. P. 
Published: March 2008

AbstractAustralian Aboriginal populations have an extremely high prevalence of lung disease and ear disease. In addition to an improvement in socio‐economic conditions, implementation of strategies to address the problem, within the limitations of present conditions, is needed. A 5 month trial was conducted to investigate the effectiveness of a school‐based intervention programme involving nose blowing, deep breathing and coughing combined with exercise performed daily. This was a community‐based trial, designed to give priority to cultural and ethical considerations, to be non‐intrusive and to utilize local skills and resources. Results of the trial showed that signs of upper and lower respiratory tract disease and pulmonary function measurements were statistically significantly improved. Hearing levels showed no statistically significant change. The programme met with a good response from children and teachers. This study does suggest that this strategy may help address the existing problems of lung and ear disease in Aboriginal primary school children, providing some immediate benefits within the limitations of the present socio‐economic conditions.
Neonatal renal candidiasis
Authors: MORRIS S. A. , BAILEY C. J. , CARTLEDGE J. McP. 
Published: March 2008

AbstractA case is presented of renal candidiasis complicated by obstructive uropathy in a 4 month old infant. Management was successful with surgical decompression combined with peri‐operative amphotericin B, followed by 3 weeks of oral ketoconazole and subsequently 6 weeks of oral fluconazole. Fluconazole was substituted for ketoconazole owing to persistant candiduria, and achieved rapid urinary sterilization. Fluconazole is an effective and less toxic alternative to prolonged courses of amphotericin B in the treatment of neonatal renal candidiasis.
Glucose‐6‐phosphate dehydrogenase enzyme activity of normal term Malaysian neonates of different ethnic origins
Authors: BOO N. Y. , AINOON B. O. , OOI L H. , CHEONG S. K. , HALIZA B. M. S. 
Published: March 2008

AbstractThe cord blood glucose‐6‐phosphate dehydrogenase (G6PD) enzyme activity of 262 normal term Malaysian neonates (92 Malays, 96 Chinese and 74 Indians) was quantitatively determined by the World Health Organisation method. Analysis of variance for the levels of G6PD enzyme activity by ethnic origin and sex showed that there was a significant difference between mean levels of enzyme activity in the three ethnic groups (P= 0.03) but no difference between the sexes (P= 0.36). Multiple range analysis showed that Malays had significantly higher mean levels of G6PD enzyme activity than those of Chinese (P= 0.01). There was no significant difference between the mean levels of G6PD enzyme activity of Chinese and Indians (P= 0.52), nor was there any difference between those of Malays and Indians (P= 0.08). The difference in levels of G6PD enzyme activity among the different ethnic groups could be due to the existence of different G6PD variants.
Acute myeloid leukaemia in patients with trisomy 21 (Down syndrome) treated by bone marrow transplantation
Authors: GOLETA‐DY A. , POZZA L. DALLA , SHAW P. J. , STEVENS M. M. 
Published: March 2008

AbstractPatients with trisomy 21 have an increased incidence of haematological disorders, including neonatal ‘leukaemoid reaction’(transient myeloproliferative disorder [TMD]) and acute leukaemias. In the past it has been felt that patients with trisomy 21 and acute leukaemia do not tolerate, and hence may not warrant, therapy as intensive as those without the syndrome. The present authors' experience and the current literature do not support this view. Two cases are reported of acute myeloid leukaemia in children with trisomy 21, successfully treated with intensive chemotherapy and bone marrow transplantation.
Fludrocortisone induced heart failure in Addison's disease
Authors: WILLIS F. R. , BYRNE G. C. , JONES T. W. 
Published: March 2008

AbstractThe first reported case of congestive cardiac failure in a child with Addison's disease secondary to fludrocortisone therapy is presented. A renal adaptation to compensate for chronic salt and water deprivation is suggested as a possible mechanism for the development of congestive cardiac failure in this patient.
Recognition and crisis management of asthma in schools
Authors: SHAH S. , GIBSON P. G. , WACHINGER S. 
Published: March 2008

AbstractUnder‐reporting of asthma and inappropriate management at school can hamper a child's academic progress. The aim of this study was to assess asthma reporting and crisis management, following implementation of a Primary School Asthma Programme.The intervention covered 12 primary schools with 5093 students in an area of high unemployment with a large proportion of the community from a non‐English background. The programme included School Asthma First Aid Kits, training workshops for school staff and individual Crisis Management Plans for students with asthma. Registration of students with asthma at school increased from 6.2% before the intervention in 1989 to 12.7% in 1992. School Asthma Crisis Plans were completed appropriately by the child's doctor and parents and returned by 68% of the students with asthma. Teachers' asthma knowledge and confidence with the management of acute asthma at school improved following asthma education workshops. It was concluded that asthma reporting and acute crisis management of asthma at school can be achieved by a programme undertaken by school medical services.
Allogeneic and autologous bone marrow transplantation for acute non‐lymphoblastic leukaemia
Authors: VOWELS M. R. , LAM‐PO‐TANG R. , FORD D. , TRICKETT A. , MAMEGHAN H. 
Published: March 2008

AbstractBone marrow transplantation (BMT) has had an increasing role in the treatment of acute nonlymphoblastic leukaemia (ANLL). A review of patients transplanted between May 1975 and August 1991 was undertaken in order to evaluate problems and outcome, and examine the role of both autologous and allogeneic BMT at various stages in the treatment of ANLL. Forty‐seven patients received either an allogeneic (n= 24) if a suitable donor was identified or autologous (n= 23) BMT if there was no allogeneic donor. Conditioning therapy consisted of total body irradiation (TBI) and cyclophosphamide (n= 14) or busulfan and cyclophosphamide (n= 33) with or without melphalan. Graft‐versus‐host disease prevention was with methotrexate (n= 9), methotrexate and cyclosporin (n= 10) or T cell depletion (n= 5). Minimum follow‐up for surviving patients was 24 months (median 65 months). For patients transplanted in first remission there was a 0% and 9±6% transplant‐related mortality, a 37±11% and 33±12% relapse risk and a 63±11% and 63±12% event‐free survival for autologous and allogeneic BMT, respectively. In second remission, there was a 14% mortality, 50±20% relapse risk and 43±19% event‐free survival for allogeneic BMT. No patient transplanted in relapse survived. In patients who survived greater than 24 months, late side effects were noted in all 8 (100%) patients given TBI and in 2 of 19 (10.5%) given busulfan. These data indicate that both allogeneic and autologous BMT are associated with significant event‐free survival when used both as initial therapy after complete remission has been achieved with conventional chemotherapy or in second remission. Allogeneic and autologous BMT would appear to be similarly effective.
A comparison of the growth patterns of Chinese infants in Chengdu and Hong Kong: 0‐2 years
Authors: YANG M. , LEUNG S. S. F. 
Published: March 2008

AbstractFactors affecting geographical differences in the growth of Chinese infants were examined by comparing data obtained from longitudinal growth studies on growth and feeding practices performed in two Chinese populations: Chengdu and Hong Kong infants from birth to 2 years. Their mean growth curves were fitted by the Reed model for the first year and the Count model for the second year. Chengdu mothers were significantly taller than Hong Kong mothers. Chengdu infants grew more rapidly than the Hong Kong infants during the first 6 months; it is likely that this is related to genetic differences in growth potential and earlier introduction of solids in Chengdu infants.
Perhaps vigintiphobia should only apply to infants with Rhesus erythroblastosis
Authors: EBERHARD B. A. , DREW J. H. 
Published: March 2008

AbstractForty‐two children who sustained a serum bilirubin (SBR) level above 339 μmol/L as newborn infants were assessed at our Growth and Development Clinic to determine presence of sequelae. Only one child (2.3%) had mild sensorineural deafness and one child (2.3%) performed below age‐matched standards on psychological testing. As the SBR level rose the psychological scores were lower. Three infants had sepsis associated with the hyperbilirubinaemia. Two (maximum SBR levels of 371 and 366 μmol/L) children were normal (General Cognitive Index (GCI) 117 and 119, respectively) and one child (maximum SBR level 556 μmol/L) was borderline abnormal (GCI 74) on psychological testing; he also suffered from Rhesus erythroblastosis. Premature infants recorded a mean GCI of 109.9 (±33.4) and for term infants mean GCI was 110.3 (±17.3; NS); however, the youngest premature infant was 32 weeks' gestation. When maximum SBR level was correlated with GCI and Motor Index (MI) the only significant correlation (r= ‐0.7445; P= 0.03) occurred in infants with Rhesus erythroblastosis and GCI. Since exchange transfusion has a mortality of between 0.3 and 5.3% and an associated morbidity incidence of 5.2% we suggest that the standard indication for its use (SBR level of 342 μmol/L) should only apply to infants with Rhesus erythroblastosis. The actual SBR level which places a newborn infant at significant risk of bilirubin encephalopathy, where the cause of jaundice is other than Rhesus erythroblastosis, cannot be determined by this study. However, it is above 342 μmol/L and our results suggest that a re‐evaluation should occur of a SBR level of 342 μmol/L in a term infant, being the indicator for exchange transfusion where the cause of jaundice is other than Rhesus erythroblastosis.
Experience with anterior cricoid split for infantile subglottic stenosis
Authors: BERKOWITZ R. G. 
Published: March 2008

AbstractA retrospective study of infants undergoing anterior cricoid split (ACS) from 1989 to 1993 was performed to evaluate our unit's experience with ACS in the management of infantile subglottic stenosis (SGS). Twelve children were identified ranging in age from 10 to 30 weeks and weighing between 1200 and 6500 g. Nine were born at or less than 30 weeks' gestation. Indications for surgery were endotracheal tube dependency, nasopharyngeal continuous positive airway pressure dependency and recurrent croup. All had varying degrees of SGS. Eleven of the 12 patients were extubated successfully following surgery. Two of these required subsequent repeat ACS 6 and 9 months later with one patient eventually requiring tracheostomy. These results suggest that ACS can be safely employed as an alternative to tracheostomy for a variety of clinical presentations of infantile SGS, with a relatively high rate of successful extubation.