bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of methylprednisolone as prophylaxis for immediate adverse infusion reactions in hypogammaglobulinaemic patients receiving intravenous immunoglobulin: A controlled trial
Authors: ROBERTON D. M. , HOSKING C. S. 
Published: March 2008

AbstractTen children and young adults with humoral immunodeficiency disorders were enrolled in a blind crossover study of the effect of intravenous methylprednisolone in preventing immediate adverse infusion reactions to intravenous immunoglobulin. The patients selected had all experienced frequent adverse reactions previously. Each patient received two infusions of intravenous immunoglobulin at least 4 weeks apart. Infusions were of constant volume and rate for each patient. Intravenous methylprednisolone in a dose of 1 mg/kg bodyweight was given 20 min prior to one of the infusions only. A significant decrease in the severity of infusion‐associated immediate adverse reactions was seen following the administration of methylprednisolone (P < 0.01). Interruption of the infusion was necessary for only one patient when methylprednisolone prophylaxis was given, but temporary cessation of the infusion was required for eight of the 10 patients when methylprednisolone was not given (P < 0.05).
Urological anomalies detected on antenatal ultrasound: A 9 year review
Authors: AHMED S. , LeQUESNE G. W. 
Published: March 2008

AbstractOne hundred and forty‐eight patients (107 male, 41 female), in whom a urological anomaly was detected on antenatal ultrasound examination, are reviewed. Postnatal imaging was done primarily by ultrasonography (US) which was often repeated. Depending upon the ultrasound findings, the patients had a renal nuclide scan (RNS) and/or micturating cysto‐urethrogram (MCU), but intravenous urogram (IVU) was not usually considered necessary. A range of urological anomalies was encountered, but renal anomalies were most common. Over half the cases had anomalies which did not require surgery, with non‐obstructive pelvicalyceal dilatation being frequent. Almost half the operated cases had features which should have allowed a clinical diagnosis without the knowledge of the antenatal findings. A fifth of the cases were occult in that they would not have been diagnosed early in life but for the antenatal detection. The majority had congenital pelviureteric junction obstruction and results of early reconstructive surgery were satisfactory.
Maternal determinants of birthweight in normal pregnancy
Authors: FUNG K. P. , Ngan H. Y. S. , WOO J. S. K. , WONG T. W. 
Published: March 2008

AbstractPartial and multiple regression analysis was performed to find out the correlation between birthweight and maternal anthropometric variables. Pearson regression analysis revealed significant dependence of birthweight on gestation of pregnancy, maternal weight, symphysis‐sternal distance and height, but not on armspan and skin thickness. However, the only maternal variable bearing significant influence on birthweight in partial regression analysis was bodyweight. The effects of maternal determinants on birthweight, though some of them were statistically significant, were clinically unimportant.
Stage‐related behavioural problems in the 1‐4 year old child: Parental expectations in a child development unit referral group compared with a control group
Authors: TICEHURST R. L. , HENRY R. L. 
Published: March 2008

Abstract Behavioural problems in preschool (1‐4 years) children are a common cause of referral to health services. Parents of children presenting to the child development unit with behavioural problems (n= 18) were compared with a control group (n= 45). A questionnaire was utilized to examine the parents’expectations of the children's behaviours.As might be expected, the parents of children presenting to the Unit rated their children as having more difficult behaviours. These parents had unrealistic expectations, particularly for the ‘negative’behaviours (disobedience, temper tantrums, defiance and whinging). However, they were able to anticipate normal age‐related difficulties in some problem areas (dawdling during mealtimes, masturbating, not sharing toys and being jealous of one's siblings).Counselling should address the issue of matching the expectations of parents with the individual rates of development of their children.
Correction of developmental and intelligence test scores for premature birth
Authors: RICKARDS A. L. , KITCHEN W. H. , DOYLE L. W. , KELLY E. A. 
Published: March 2008

Abstract When using tests of infant development and intelligence in children born prematurely, the subject's age is commonly corrected for the degree of prematurity. However, there is disagreement: first, on whether this correction should ever be applied, and second, at what age to discontinue the adjustment.In a theoretical model, the difference between corrected and uncorrected scores in early infancy was massive and the difference remained clinically important until the age of 8.5 years in children who were born extremely prematurely. The clinical implications of using corrected or uncorrected scores were then evaluated in 174 very low birthweight children without severe sensorineural disabilities and with paired Bayley Mental Development Index (MDI) and Wechsler Preschool and Primary Scales of Intelligence (WPPSI) full scale scores. Failure to correct for prematurity reduced the mean MDI by 12.1 points but reduced the mean WPPSI by only 4.1 points. The disparity between individual MDI and WPPSI scores increased significantly with decreasing gestational age if uncorrected scores were used (P= 0.015) but not if scores were corrected. Using corrected scores, the MDI correctly predicted the WPPSI category in 86.1% of children (P < 0.001) but in only 54.6% using uncorrected scores (the difference was not significant).It is suggested that a practical solution to the dilemma is to correct test scores for prematurity in the age range 2–8.5 years recognizing that only in extremely immature infants will uncorrected scores be substantially lower than corrected ones at a later age.
Current issues in the nutritional management of children with cystic fibrosis
Authors: DANIELS L. A. , DAVIDSON G. P. 
Published: March 2008

Abstract Recent evidence suggests that malnutrition has a negative impact on pulmonary function in children with cystic fibrosis. In the past, dietary management has aimed at high energy low fat intake, but this has recently been shown to fall far short of the 120‐150% of the recommended daily allowance for energy cystic fibrosis patients require.This paper outlines the current principles of nutritional management for children with cystic fibrosis. These include a high energy, high fat containing diet (within limits of individual tolerance); high carbohydrate intake; high salt intake; replacement of fat‐soluble vitamins; appropriate use of pancreatic enzyme preparations; and supplemental feeding when indicated.It is vital that a nutrition education programme be established for each child and his or her family so that the emphasis shifts from treatment of malnutrition to prevention. The long‐term aim must be to promote an independent, healthy lifestyle which incorporates good nutrition and other healthy pursuits such as exercise.
Selective improvement in cognitive test scores of extremely low birthweight infants aged between 2 and 5 years
Authors: KITCHEN W. H. , RICKARDS A. L. , FORD G. W. , DOYLE L. W. , KELLY E. A. , RYAN M. M. 
Published: March 2008

Abstract The cognitive development at 2 and 5 years of a cohort of extremely low birthweight (ELBW) children (birthweight 500‐999 g) was compared with that of cohorts of larger very low birthweight (VLBW) children (birthweight 1000‐1500 g) and normal birthweight (NBW) children (birthweight > 2500 g) to determine whether the improvements in cognitive function of ELBW infants between 2 and 5 years are apparent or real.At 2 years of age, ELBW children had a mean Mental Developmental Index (MDI) on the Bayley Scales of 90.4, significantly lower than the means of 100.3 for the larger VLBW children (P= 0.006), and 107.8 for the NBW children (P= 0.0002). However by 5 years the mean scores on the Wechsler Preschool and Primary Scales of Intelligence (WPPSI) full‐scale for the ELBW and larger VLBW children were virtually identical (105.9 and 106.0 respectively)—but still lower than the mean WPPSI full‐scale of 114.6 for the NBW children. After standardizing the MDI and WPPSI scores relative to the NBW children, the ELBW children improved between 2 and 5 years (paired t‐test, t= 3.2, P= 0.004) whereas the larger VLBW infants did not.We postulate that ELBW children require more time than larger VLBW children after birth to compensate for perinatal and other stresses, and that developmental delay at 2 years may not always persist to 5 years.
Neonatal sepsis and infection control policies in Australia
Authors: YU V. Y. H. 
Published: March 2008

AbstractThe pattern of neonatal bacterial infection, its management and the types of infection control policy were ascertained in 20 neonatal intensive care units (NICU) in Australia by questionnaire survey. Group B Streptococcus and Escherichia coli were the predominant organisms responsible for perinatally acquired infection for which the most common antibiotic combination used was Penicillin and Gentamicin. Staphylococcus epidermidis and aureus (majority Methicillin resistant) were the predominant organisms responsible for nosocomial infection for which the most common antibiotic combination used was Vancomycin and Cefotaxime. A Serratia epidemic was experienced in four NICU. Lumbar and suprapubic punctures were frequently done as part of the diagnostic workup in nosocomial infections but not with perinatally acquired infections. Haematological indices considered useful as a diagnostic aid varied between NICU and acute phase reactants were rarely relied upon for diagnosis or for monitoring treatment response. Granulocyte transfusion and intravenous immunoglobulins were infrequently used in therapy. No consensus was found on infection control policies. Eight NICU required routine gowning on entry, two restricted sibling visiting and four restricted visiting by relatives and friends. Although routine bacteriological surveillance on staff or equipment was uncommon, serial cultures were carried out in infants from the body surface in six NICU and from the endotracheal aspirate in 17 NICU. Antiseptics used with technical procedures included iodine, chlorhexidine and alcohol used singly or in combination. Skin and umbilical cord care also varied between NICU. The literature was reviewed to determine the effectiveness or otherwise of some of the existing policies in the prevention or management of neonatal infection to encourage consensus towards a more rational approach to neonatal infection in Australia.
Zidovudine (AZT) therapy in children with HIV infection: the Australian experience
Authors: PALASANTHIRAN P. , ZIEGLER J. B. , KEMP A. S. , EKERT H. , JUPE D. M. , GATENBY P. A. , KELLER A. J. , SMALES O. 
Published: March 2008

AbstractFifteen children (11 males and four females), on oral Zidovudine (AZT) for symptomatic HIV infection were studied retrospectively. Twelve acquired HIV via blood products, two from vertical transmission (maternal intravenous needle sharing) and one through breast feeding. Their mean age at the start of therapy was 8.6 years (s.d. 4.4 years, range 1.8‐15.3 years). The main indications for therapy were failure to thrive (FTT) in 10, recurrent respiratory tract infections (RRTI) in eight, and developmental delay (DD) in one, with overlapping indications being Pneumocystis carinii pneumonia (PCP) in one and pulmonary lymphoid hyperplasia (PLH) in two. The mean commencement dose was 24 mg/kg per day orally in 3‐6 divided doses (range 16‐35 mg/kg per day). The duration of therapy was 2 weeks‐21/2 years. Significant improvement in growth was observed by 2 months; at 6 months, growth was sustained in these otherwise ill children, with only two falling below pretreatment weight. Decrease in the frequency of RRTI based on subjective reports of the attending clinicians was observed in seven of the eight evaluable children still on therapy.Improvement in PCP and PLH occurred in two children and modest improvement was subjectively reported in PLH in one while still early in the course of therapy. Overall, AZT was well tolerated. Dose modifications were for neutropenia in three (of which only two were drug related), rapidly falling neutrophil count in one, anaemia in two (with concurrent history of chronic gastrointestinal tract blood loss in one), severe GIT irritation in one and transient sedation in one. Seven opportunistic infections were reported (three in the same patient) of which two occurred following cessation of therapy, one after only 2 weeks of therapy, and one had not been on primary prophylactic therapy. Three deaths occurred, one associated with opportunistic infections and two while off therapy (one respiratory failure, one PCP).
Dialysis and renal transplantation in children: Long term and recent experience
Authors: LEWIS D. J. , McIVER M. , SCOTT D. F. , THOMSON N. M. 
Published: March 2008

AbstractThe outcome of 38 children with endstage renal failure who entered a dialysis and renal transplant programme over a period of 16 years is reported. The initial care was given in an adult programme but in 1985 this was changed to a comprehensive and specifically paediatric programme. Patient survival was 97, 86 and 80% at 1, 5 and 10 years respectively. Thirty‐four of the patients spent a mean period of 19 months (range 1‐160 months) on dialysis with the preferred form of dialytic therapy being continuous ambulatory peritoneal dialysis. Primary cadaveric graft survival was 72 and 42% at 1 and 3 years respectively; although since 1985 1 year graft survival has risen to 90%. The major long term problems have been growth failure and poor social development. Eighty‐seven per cent of children have been able to continue normal schooling, and of the 18 who have left school 14 (78%) are employed or undertaking tertiary education. Thus dialysis and transplantation has allowed not only excellent patient survival but also the achievement of satisfactory educational standards and subsequent employment for the majority of patients.
Two unusual tumours of the gastrointestinal tract in a patient with tuberous sclerosis
Authors: BYARD R. W. , PHILLIPS G. E. , DARDICK I. , ROBERTSON E. , CARTER R. F. , BOURNE A. J. 
Published: March 2008

ABSTRACTA 16 year old girl with an established diagnosis of tuberous sclerosis presented with a 1 year history of swelling of the left cheek. A 2 cm diameter tumour was excised which showed histological features of a solid variant of a minor salivary gland basal cell adenoma. One year later during laparotomy and excision of multiple renal angiomyolipomas, a 5 cm diameter subserosal tumour was found at the hepatic flexure of the colon. Examination of biopsy material revealed a leiomyoma. This case is presented to demonstrate two tumours that have not to the authors' knowledge been previously described in a young patient with tuberous sclerosis. Although the association may be coincidental, these tumours could represent two rare associations of tuberous sclerosis.
Childhood obsessive‐compulsive disorder
Authors: KING N. J. , TONGE B. J. 
Published: March 2008

ABSTRACTOf fascination for many decades, obsessive‐compulsive disorder in adults (OCD) has been subjected to extensive investigation. However, it is also clear that OCD can be experienced by children and adolescents (for convenience we refer to ‘childhood’ OCD). Childhood OCD is a complex clinical syndrome characterized by obsessive ideation, typically accompanied by overt behavioural acts carried out in a ritualistic fashion.1 As obsessive‐compulsive children are notoriously secretive about their aberrant behaviour, it can be sometime before parents and teachers become aware of the actual extent of the child's obsessive‐compulsive behaviour.
An epidemiological survey of dog bites presenting to the Emergency Department of a children's hospital
Authors: GREENHALGH C. , COCKINGTON R. A. , RAFTOS J. 
Published: March 2008

AbstractGerman shepherds are the most popular registered breed of dog in South Australia, but are also the most hazardous to children, biting more often and more severely. A study of the victims of dog bites presenting to the Emergency Department of the Adelaide Children's Hospital over an 18 month period revealed that, although many breeds were involved, only German shepherds were implicated more frequently than their prevalence in the community. Attacks occurred most often in a domestic setting involving a friendly dog that was known to the victim. Boys were more often bitten than girls and children aged 1‐6 years most commonly involved. Injuries to the face and scalp were frequent and the usual ones to require admission for suture under general anaesthetic. Some scarring was a common sequel and resulting fear of dogs remained with some children. Most attacks were reported to be unprovoked and a previous biting history on the part of the dog was uncommon. Parents who are contemplating obtaining a dog for a family pet should be made aware of these facts and advised regarding the biting hazards and possible prevention. The German shepherd situation especially should be brought to their attention.
Failure of intravenous infusions in neonates
Authors: HECKER J. F. , DUFFY B. J. , FONG T. , WYER M. 
Published: March 2008

AbstractThe median life expectancy (survival) of 286 peripheral intravenous infusion sites in 105 babies in a children's intensive care unit was 36 h. Unadjusted univariate survival analysis revealed that dextrose infusions and the initial infusions received by a baby had longer survival than total parenteral nutrition (TPN) infusions and later infusions respectively. Also infusions with cloxacillin and penicillin survived for longer than average while infusions with phenytoin had reduced survival. Gestational age, weight, infusion site, other drugs, co‐infusion of Intralipid with TPN solutions and neutralization of TPN did not influence survival of infusions. Multivariate survival analysis confirmed the findings for TPN and penicillin but not for cloxacillin, phenytoin or later Infusions. Multivariate analysis also suggested that survival was improved with ampicillin and aminophylline and worse for leg sites, for older babies and for infusions in which the fluids were given at greater rater. It also indicated that neutralization of TPN improved survival.
Breast feeding practices and severe hyperbilirubinaemia
Authors: TUDEHOPE D. , BAYLEY G. , MUNRO D. , TOWNSEND S. 
Published: March 2008

ABSTRACTThis study establishes the association between early onset severe hyperbilirubinaemia (serum bilirubin (SBR) level ≥ 272 μmol/L) with no assigned cause and breast feeding. The rates of breast feeding at hospital discharge increased from 46.4 to 75.4% in non‐insured (public) women and 58.6 to 89.2% in insured (private) women between 1975 and 1987, and were accompanied by an increase in severe hyperbilirubinamia from 1.6 to 3.1% in public and 0.9 to 3.6% in private babies. The case control study involved 125 term breast feeding infants born between 1 July 1985 and 1 July 1986 with severe hyperbilirubinaemia (SBR level 272 μmol/L) with no assigned cause who were compared with 125 matched controls who had peak SBR levels ≥ 272 μmol/L Severe hyperbilirubinamia was associated with primiparous and non‐Caucasian mothers, non‐smoking and oxytocin usage. Univariate analysis of feeding practice variables revealed that less frequent breast feeds, greater weight loss and less frequent stools over the first 3 days related to severe hyperbilirubinaemia (P <0.05). Multivariate analysis of the eight significant univariate factors revealed that maternal non‐smoking, less frequent breast feeding, less frequent stooling and excessive infant weight loss were the best predictors of severe hyperbilirubinaemia. With the wide promotion of breast feeding, the contribution of individual feeding practices to severe hyperbilirubinaemia demands ongoing analysis and review.
Cord whole blood hyperviscosity: Measurement, definition, incidence and clinical features
Authors: DREW J. H. , GUARAN R. L. , GRAUER S. , HOBBS J. B. 
Published: March 2008

ABSTRACTCord whole blood viscosity and haematocrit values (PCV) were determined in 2461 live birth infants. Viscosity measurements were performed on an Australian‐designed coaxial narrow‐gap viscometer. Normal viscosity values were determined for each week of gestation above 34 weeks. Hyperviscosity was defined as a viscosity value above 2 s.d. from the mean for each week of gestation and it occurred in 164 (6.7%) newborn infants. Although a close relationship existed between cord whole blood viscosity and PCV (r= 0.6597, P <0.0001), only 47.4% of polycythaemic infants (PCV>65) were also hyperviscous and only 23.9% of hyperviscous infants were also polycythaemic. Hence, using the haematocrit to select which infants require viscosity studies fails to detect many hyperviscous newborn infants. Hyperviscosity was less common (3.6%, P <0.001) in infants who were born by Caesarean section and more common (16.5%, P <0.001) in those who were growth retarded. Of the hyperviscous infants, 84.5% were not growth retarded, most (87.8%) were term and most (86.6%) were delivered vaginally. Most hyperviscous newborn infants may thus remain undetected unless routine whole blood viscosity studies are performed.
The use of Dexamethasone in full‐term infants with severe respiratory failure and pulmonary barotrauma
Authors: BARR P. 
Published: March 2008

ABSTRACTEight full‐term infants (mean gestation 39.9 weeks [range 37‐42] and mean birthweight 3642 g [range 3060‐4200]) with severe respiratory failure (median oxygenation index 28 [range 16‐65] and median arterial/alveolar Po2 ratio (a/APo2) 0.094 [range 0.038‐0.165]) and pulmonary barotrauma were treated with Dexamethasone, 0.5 mg/kg per day, from the median age of 5 days (range 3‐22). Six of the eight (75%) infants survived. They were weaned from mechanical ventilation and extubated a median of 2.5 days after commencing treatment with Dexamethasone. Two infants died and one of them suffered recurrent pneumothoraces. There was a significant improvement in oxygenation in the seven infants who survived the 72 h period of observation. Their median oxygenation index was 24 when Dexamethasone was commenced compared with 8 after 12 h (P <0.05) and 10 after 36 h (P <0.025). Their a/APo2, ratio was 0.095 when Dexamethasone was commenced compared with 0.289 after 12 h (P <0.05) and 0.207 after 36 h (P <0.025). There was a significant increase in the infants' arterial mean blood pressure associated with Dexamethasone therapy and one infant developed Staphylococcus aureus septicaemia. In this uncontrolled study of eight full‐term infants with severe respiratory failure and pulmonary barotrauma, the use of Dexamethasone was associated with significant improvement in oxygenation and rapid weaning from mechanical ventilation.
Infant botulism: A review in South Australia (1980–89)
Authors: THOMAS D. G. 
Published: March 2008

AbstractBetween March 1980 and March 1989 there were six identified cases of infant botulism. The presenting symptoms were predominantly poor feeding, lethargy and constipation, and the presenting signs were predominantly hypotonia, weak gag reflex and respiratory difficulty. All required intensive care and prolonged hospital stays. Recovery was eventually complete in all cases. Infant botulism is an uncommon condition but early recognition with adequate intensive care usually results in complete recovery.