bluuebunny/crossref_metadata_2025_split huggingface dataset:
Status epilepticus in 37 Chinese children: Aetiology and outcome
Authors: KWONG KL , LEE SL , YUNG A , WONG VCN 
Published: March 2008

Objective:The aetiology and clinical features of status epilepticus (SE) are described, with the aim of defining any relationship between risk factors and clinical outcome.Methodology:A retrospective review was performed of 37 Chinese children admitted to Queen Mary Hospital, Hong Kong, from 1989 to 1993 with the diagnosis of SE.Results:Eighty‐six per cent had onset before 5 years of age; 60% were due to an acute central nervous system (CNS) insult, 11% were idiopathic, 13% had a pre‐existing CNS insult, 5% were febrile and 11% were due to progressive encephalopathy. An abnormal neurological status was present in 24% before the episode of SE, and a history of seizures before the onset of SE was present in 35% of patients. Fifty‐four per cent of the episodes of SE were generalized. The mortality rate was 11% during the period of follow up but no deaths were attributed to SE. Neurological sequelae were observed in 27% of patients and recurrent SE occurred in 12%.Conclusions:In those patients with normal neurological status before an episode of SE and without acute CNS insult or progressive encephalopathy, the outcome was favourable.
Growth, development and behaviour in adolescents born small‐for‐gestational‐age
Authors: PRYOR J , SILVA PA , BROOKE M 
Published: March 2008

Objective:To examine the effects on adolescents of being born small‐for‐gestational‐age (SGA).Methodology:The sample are members of a cohort longitudinal study in which growth, cognitive development and behaviour are being studied into adulthood, Ninety‐one SGA subjects were available for comparison with the rest of the sample (n= 1037) on measures of height, weight, head circumference, cognitive performance and behavioural variables to the age of 18 years old.Results:SGA subjects were shorter and lighter at 18 years of age than their appropriate‐for‐gestational‐age (AGA) counterparts despite age of onset of menarche being the same in both groups. At age 13, SGA subjects scored significantly lower than the AGA group on the WISC‐R scales. They were rated by parents as having more behaviour problems at age of 15.Conclusions:SGA birth appears to be a potential problem which extends beyond childhood in its effects on growth, behaviour and cognitive performance.
Higher rates of SIDS persist in low income groups
Authors: FORD RPK , NELSON KP 
Published: March 2008

Objective:To examine how changes in the rates of sudden infant death syndrome (SIDS) have varied in different income groups during a 25 year period.Methodology:Census data were obtained for five census periods (1971, 1976, 1981, 1986 and 1991) on the number of SIDS cases and inevitable deaths. Census area units (CAU) were ranked according to the average income earned by adults over the age of 15 years for each census year. The CAU were then divided into three equal income groups: low, middle and high.Results:The rates of SIDS differed significantly between the three income groups for the 1991 census period with the low income SIDS rate being 4.6/1000 births compared to 1.2/1000 live births for the higher income groups (Chi‐squared = 18.3, P>0.0001). There was no association between rates of inevitable deaths and income groups.Conclusion:Currently, low income groups have three times the rate of SIDS compared to those in higher income groups. The reason for this is probably because the disadvantaged groups carry an overall higher burden of risk factors for SIDS. This must be kept in mind as further SIDS educational programmes are developed and implemented.
Evaluation of an early childhood programme based on principles of conductive education: The Yooralla Project
Authors: CATANESE AA , COLEMAN GJ , KING JA , REDDIHOUGH DS 
Published: March 2008

Objective:To perform an objective evaluation of a programme based on conductive education (CE) for preschool and early school‐aged children with cerebral palsy.Methodology:The progress of 17 children participating in a CE‐based programme (the Yooralla programme) was compared with 17 children enrolled in traditional early childhood services. Videotapes of the children performing items from the Vulpe Assessment Battery (VAB) were scored by assessors blind to the treatment group; three standardized tests of cognitive ability were administered; and the questionnaire on resources and stress (QRS‐F) was given to the primary caregiver at the beginning and conclusion of 6 months.Results:The Yooralia group improved in motor performance and parental coping variables. Both groups showed improvement on the cognitive measures, with the control group demonstrating slightly greater gains.Conclusions:Conductive education may benefit the motor development of children with cerebral palsy and provide greater parental support. A randomized control study with adequate subject numbers is necessary to confirm this tentative conclusion.
Psychological outcome of ECMO‐eligible neonates with severe respiratory failure treated using conventional medical therapy
Authors: MATHIAS JL , CLARK SM , NETTELBECK T , JAMES SL , WHITE DA 
Published: March 2008

Objective:The present study addressed a National Health and Medical Research Council (NHMRC) recommendation that the outcome of neonates who are treated conventionally for respiratory problems be further investigated before setting up additional extracorporeal membrane oxygenation (ECMO) centres in Australia.Methodology:The cognitive and behavioural outcome of ECMO eligible infants who received conventional treatment for respiratory problems at birth was assessed in 18 infants aged 1.5–3 years (index group). ECMO was not available at either of the treating hospitals. Index children were compared to a matched control group of children who did not experience any major complications at birth. Children were assessed using either the Bayley or McCarthy scales of infant development and the Child Behavior Checklist.Results:Overall, a mortality rate of 19% and a psychological morbidity rate of 18% suggest that children born with severe respiratory failure, who meet existing ECMO eligibility criteria, have a good prognosis when treated using conventional medical therapy.Conclusions:Improvements to conventional treatments indicate that ECMO eligibility criteria may need to be revised to identify accurately those infants who are at extreme risk of mortality if treated conventionally.
Factors associated with the age of introduction of solids into the diet of New Zealand infants
Authors: FORD RPK , SCHLUTER PJ , MITCHELL EA ,   NEW ZEALAND COT DEATH STUDY GROUP
Published: March 2008

Objective: To describe the current timing of the introduction of solids in infancy and the factors influencing the decision to introduce solids.Methodology: Eighteen hundred infants were selected randomly as part of the New Zealand Cot Death Study. Of these, 88% of the parent/caregivers were interviewed when their infant was aged between 1 and 12 months. They were asked when solids were first introduced into the diet.Results: By 12 weeks of age more than 20% of infants had been given solids; by 16 weeks and by 6 months 50 and 90% of babies, respectively, had been given solids. Maternal smoking, low educational achievement and not being breast‐fed exclusively to 4 weeks of age were factors which were strongly associated with the early introduction of solids.Conclusion: Half of New Zealand infants are being started on solids earlier than is presently recommended. More education is needed to promote the later introduction of solid foods into the diet.
Bedwetting and psychopathology in adolescents
Authors: REY JM , BIRD KD , HENSLEY VR 
Published: March 2008

Objective: To ascertain whether nocturnal enuresis in adolescents is associated with depression, hyperactivity, oppositionality, conduct and peer problems.Methodology: This was investigated cross‐sectionally in adolescents aged 12‐16 years from a community sample (n= 528) and a clinically referred cohort (n= 2325) using parents' reports.Results: Referred adolescents were 7 times more likely to wet the bed than their community counterparts. There was a small but significant association between nocturnal enuresis and hyperactivity. Depressed adolescents were half as likely to wet the bed as those without depression. Bedwetters had more problems relating to peers but were not disliked more often. There was no association between bedwetting, oppositionality, conduct problems and gender. Gender differences disappeared when the effect of hyperactivity was controlled.Conclusions: Clinicians need to inquire about symptoms of attention deficit hyperactivity disorder in adolescents who present with enuresis and vice versa.
Health promotion using television in hospital waiting rooms: The Adelaide Children's Parent Education Project
Authors: COCKINGTON RA 
Published: March 2008

Objectives:The Adelaide Children's Hospital Parent Education Project was designed to determine the effect of the screening of health promotion programmes via closed circuit television facilities in hospital waiting rooms on parents' knowledge of child health issues.Methodology:A knowledge test was constructed with an internal consistency co‐efficient of 0.95 and used to identify target groups of parents with low knowledge. The education programmes screened were aimed at the knowledge deficits. To assess the effects of the programmes an experiment was conducted using a post‐test only/control group design, including a time delay. Days of the week were assigned randomly to programme days when health education programmes were screened and non‐programme days when normal television programmes were screened. The experimental group was selected randomly from the attendance registers on programme days and the control group from non‐programme days.Results:The experimental group of parents gained substantial increases in knowledge with some knowledge scores increasing by nearly 70%. Overall there was a statistically significant difference between the knowledge scores of experimental and control groups. The recall of programme content by parents was notable in view of the fact that because of waiting times most only viewed part of the education programmes. Health‐promoting behaviour changes were also reported.Conclusions:The screening of health programmes via hospital waiting room television significantly increases the health knowledge of viewers, although there is a decline over time.
Analgesia for venepuncture in a paediatric surgery centre
Authors: BRISLIN RP , STAYER SA , SCHWARTZ RE , PASQUARIELLO CA 
Published: March 2008

Objective:To establish an effective and efficient method of painless venepuncture in children 8 years and older in an ambulatory paediatric surgery centre.Methodology:Sixty patients aged 8‐21 years were randomized to one of three groups: (i) nitrous oxide with EMLA cream; (ii) nitrous oxide with intradermal lidocaine; and (iii) nitrous oxide alone (n= 20 in each group). Patients in all three groups received oral midazolam for pre‐operative anxiolysis. The degree of patient sedation and anxiolysis was noted by two observers before and 2 min after the administration of 50% nitrous oxide. The patient's response to venepuncture or intradermal lidocaine was rated by the two observers using an Observer Response Score. After successful venepuncture, the nitrous oxide was discontinued and the patient was asked to rate the pain of venepuncture using a Patient Response Score.Results:There were no differences in the degree of sedation and anxiolysis between the three groups before or after the administration of nitrous oxide. Patients in the control group (nitrous oxide alone) had a higher incidence of withdrawal or vocalization with venepuncture. When the patients rated the pain of venepuncture, there were no differences between the three groups.Conclusions:Oral midazolam in combination with 50% nitrous oxide provides adequate analgesia and anxiolysis for venepuncture in patients 8 years and older. The addition of EMLA cream or intradermal lidocaine will decrease the likelihood of patient movement.
Autonomic neuropathy in diabetic children
Authors: VERROTTI A , CHIARELLI F , BLASETTI A , MORGESE G 
Published: March 2008

Objective:Evaluate the presence of cardiovascular autonomic nerve dysfunction in children and adolescents with insulin‐dependent diabetes mellitus.Methodology:We studied 110 patients (54 male, 56 female) and 100 healthy sex and age‐matched children. Autonomic nerve function was assessed by standard cardiovascular reflex tests: (1) Fall in systolic blood pressure in response to standing. (2) Heart rate in response to standing. (3) Beat‐to‐beat rate variation during deep breathing. (4) Quotient of heart rate during and after Valsalva manoeuvre. (5) Change in blood pressure response to sustained handgrip. The coefficient of variation of heart rate was determined from 150 systoles using a microcomputer‐based technique. The lower limits of normal were defined according to statistical analysis taking into account the relationship between heart rate variability and age.Results:Forty‐seven of the 110 diabetic children and adolescents studied showed one or more abnormal tests for cardiovascular autonomic dysfunction; many patients had an abnormality in more than one test. Twenty‐two patients showed early involvement, 18 patients had definite and 7 severe involvement. No correlation was found between sex, glycaemic control, duration of diabetes or presence of retinopathy and persistent microalbuminuria and the autonomic nerve function.Conclusions:In the paediatric age group also, autonomic nerve dysfunction can be present in asymptomatic diabetic patients. Heart rate variation during Valsalva manoeuvre and maximum/minimum 30:15 ratio are the most sensitive indices to detect autonomic abnormalities in children.
Gastroschisis: 13 years' experience at RCH Melbourne
Authors: TAWIL K AL , GILLAM GL 
Published: March 2008

Objective:To review recent experience of gastroschisis at the Royal Children's Hospital, Melbourne.Methodology:Retrospective review of admissions over a 13 year period, June 1980‐June 1993 inclusive, including an analysis of those factors influencing mortality, morbidity and complications.Results:There were 49 infants, of whom two died (4%), both having an associated bowel atresia. Mode of delivery, age at operative repair, birthweight centile and silo repair had no significant effect on the duration of total parenteral nutrition (TPN) or hospital stay. The presence of short gut and/or gut resection and localized bowel narrowing or bowel atresia resulted in a significant increase in the duration of TPN and hospital stay. The presence of a central venous line was a highly significant risk factor for the development of systemic sepsis.Conclusion:Currently gastroschisis has a good outlook with a low mortality. Infants with short gut/resection and bowel atresia have a long duration of TPN and hospitalization, with significant morbidity and complications.
A simple hospital triaging system for infants with acute illness
Authors: HEWSON P. H. , GOLLAN R. A. 
Published: March 2008

Objective: To determine the simplest combination of symptoms and signs for use as a triaging procedure in young infants presenting to hospital, and to compare this with the ‘Baby Check’ system. Methodology: Six hundred and eighty‐two babies were assessed when presenting with acute illness to a children's hospital emergency department. Results of analysis were compared to the results of the Baby Check system, which was derived from the data on the same babies. Results: The presence of at least one of the following markers: drowsiness on examination, significant chest wall recession, generalized pallor, a history of feeding less than 50% or decreased activity, had a sensitivity of 91%, a specificity of 72%, a positive predictive value of 29% and a negative predictive value of 98% when predicting the need for intervention in hospital. The ‘Baby Check’ system with a score of 13 or more had a sensitivity of 95%, a specificity of 70%, a positive predictive value of 28% and a negative predictive value of 99%. Less common but predictive markers such as bile‐stained vomiting, respiratory grunt, apnoea and convulsions add further to the sensitivity. Based on this data set, if historical variables alone (the presence of either drowsiness, difficult breathing, being more pale than usual, feeding less than 50% or decreased activity) were used (as in telephone screening) 92% of babies needing treatment in hospital would be identified. Conclusion: A simple five‐marker system is almost as powerful as the 19‐marker Baby Check system and provides a useful basis for a triaging system and educational guidelines when assessing sick babies.
A neonatal early discharge and home support programme: Shifting care into the community
Authors: RIEGER I. D. , HENDERSON‐SMART D. J. 
Published: March 2008

Objective: The Neonatal Early Discharge and Family Support Programme (NEDP) was an initiative aimed at providing extended care for families whose infants had required neonatal special care, thereby allowing earlier discharge. Methodology: Two groups of families were examined; one before and one after the instigation of the NEDP. Hospital and community service usage and psychosocial effects were examined. Results: Families who received support were able to be discharged earlier and rooming‐in was unnecessary as support was provided at home. Visits to family doctors for mothercraft issues were less frequent. Transport of babies from the Level 3 nursery to other nurseries in order to be closer to home was also provided by the nursing team, saving on ambulance costs and freeing their time for emergencies. There was no increase in maternal anxiety and infants were less difficult in the patient group. Conclusions: NEDP and family support programme is a worthwhile extension of neonatal intensive care.
The danger of freely rocking cradles
Authors: BEAL S. M. , MOORE L. , COLLETT M. , MONTGOMERY B. , SPROD C. , BEAL A. 
Published: March 2008

Objective: To assist the Adelaide State Coroner with his inquest into the death of two infants in South Australia, and to assist the Department of Public and Consumer Affairs develop Australian Standards for rocking cradles. Methodology: A sample of each brand of new cradle commercially available in South Australia was examined. Videotapes were made of 11 healthy infants in rocking cradles to examine how they moved and how they reacted in different positions. Results: Many cradles had insecure locking pins. Infants in a cradle tilted at 10d̀ or greater, face down with the side of the face against the bars, and an arm trapped between the body and bars or through the bars, were unable to obtain a clear airway unless a dummy was in the mouth. Conclusions: Infants should never be left unattended in freely rocking cradles. Australian Standards should recommend locking pins be bolted into place and that cradles cannot tilt to greater than 5d̀.
Do adolescents know where to find help for mental health problems? A brief report
Authors: FOTHERINGHAM M. J. , SAWYER M. G. 
Published: March 2008

Objective: Few previous studies have investigated adolescents' knowledge of the services available to provide help with mental health problems. This is an important omission as knowledge about the availability of mental health services may significantly influence the extent to which adolescents with mental health problems receive appropriate help for their difficulties. The purpose of this study was to investigate knowledge of mental health services among socio‐economically disadvantaged adolescents. Methodology: Students attending the participating high school completed a questionnaire describing mental health services in South Australia. Results: The results suggest that the adolescents had little knowledge of mental health services and they primarily discussed their problems with other family members or friends. The results also suggest that the adolescents prefer to obtain information about mental health problems from education programmes in schools or on television. Conclusions: There is a need to make adolescents and their families more aware of the services available to provide help for mental health problems.
Urinary 17α‐hydroxyprogesterone in management of 21 ‐hydroxylase deficiency
Authors: LIM Y. J. , YONG A. B. W. , WARNE G. L. , MONTALTO J. 
Published: March 2008

Objectives: The study was designed to assess the reliability of measurement of 24‐hour urinary 17α‐hydroxyprogesterone (17‐OHP) by radio‐immunoassay (RIA) as an alternative biochemical assessment for monitoring the treatment of congenital adrenal hyperplasia (CAH) due to 21 ‐hydroxylase deficiency (21 ‐OHD) and to assess the need for sample purification by column chromatography to improve assay specificity. Methodology: Morning serum 17‐OHP was measured using RIA and 24‐hour urinary pregnanetriol using gas chromatography. Twenty‐four‐hour urinary 17‐OHP was measured in samples from 17 prepubertal patients with CAH due to 21 ‐OHD, and 20 normal prepubertal children as controls. In 24 urine samples, RIA of 17‐OHP was performed with and without column chromatography. Results: There was a good correlation between 24‐hour urinary 17‐OHP and 24‐hour urinary pregnanetriol (r = 0.962, P<0.01) and between 24‐hour urinary 17‐OHP and morning serum 17‐OHP (r= 0.955, P<0.01). There was no significant difference in the RIA of the urine samples with and without purification by column chromatography. Conclusions: The measurement of 24‐hour urinary 17‐OHP is a reliable alternative for the biochemical monitoring of 21‐OHD, and RIA specificity is unaffected by omission of column chromatography.
Cholestatic jaundice and congenital hypopituitarism
Authors: ELLAWAY C. J. , SILINK M. , COWELL C. T. , GASKIN K. J. , KAMATH K. R. , DORNEY S. , DONAGHUE K. C. 
Published: March 2008

Objective: The prevalence of cholestatic jaundice as a presenting feature of congenital hypopituitarism is assessed. Methodology: A retrospective case record analysis of the presenting features in all patients diagnosed as having congenital hypopituitarism between 1973–93. Results: Seven of the 20 patients with congenital hypopituitarism presented with cholestatic jaundice as the major initial manifestation of the disorder. Liver biopsy findings in three revealed intracellular bile pigment accumulation and variable giant cell formation. Conclusion: Cholestatic jaundice was the major manifestation of congenital hypopituitarism in 35% of patients presenting in the neonatal or early infancy period.
Pathophysiology of overheating in a piglet model: Findings compared with sudden infant death syndrome
Authors: ELDER DE , BOLTON DPG , DEMPSTER AG , TAYLOR BJ , BROADBENT RS 
Published: March 2008

Abstract Objective: To examine the nature of hyperthermia‐induced pathophysiological changes in an animal model including effects on lung compliance. Methodology: Piglets were randomly assigned to heated or non‐heated groups. Heated animals were warmed to 4°C above normal body temperature while sedated and breathing spontaneously. Cardiorespiratory variables were recorded serially and haematological assessments and blood cultures taken at 0 and 6 h. After 6 h the animals were killed and a limited postmortem was performed. Control animals had all procedures without heating. Results: Heated piglets developed tachycardia, hypotension and a metabolic acidosis in addition to tachypnoea, hypocapnic alkalosis and a neutrophil leucocytosis. Rectal temperature after death fell at the same rate in both groups. Lung histology revealed an excess of lung haemorrhage and alveolar oedema in the heated group. No significant group differences in dynamic lung compliance were demonstrated. Conclusions: The pathological changes that occur during hyperthermia are non‐specific but not incompatible with those found in sudden infant death syndrome. There was no confirmation of the thesis that hyperthermia causes death by altering lung compliance.