Goldwater PN, Kernick CG, Martin AJ
… +2 more, Delbridge RG, Matthews NT
Aust Paediatr J
· 1988 Jun · PMID 3421880
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A 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...A 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.
Aust Paediatr J
· 1988 Jun · PMID 3421879
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A 6 year old boy presented with cardiogenic shock following a mild gastroenteritis-like illness. He was subsequently found to have adrenal failure secondary to adrenoleucodystrophy. Despite adequate corticosteroid replac...A 6 year old boy presented with cardiogenic shock following a mild gastroenteritis-like illness. He was subsequently found to have adrenal failure secondary to adrenoleucodystrophy. Despite adequate corticosteroid replacement and intensive cardiorespiratory support, progressive cardiac failure occurred and the patient died. High levels of endogenous catecholamines may be toxic to the myocardium in the absence of sufficient corticosteroid.
Aust Paediatr J
· 1988 Jun · PMID 3421878
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The clinical management of three patients (two children, one adult) with carbon monoxide poisoning is presented. Treatment included hyperbaric oxygen therapy with a good outcome in two of the three patients. The pathophy...The clinical management of three patients (two children, one adult) with carbon monoxide poisoning is presented. Treatment included hyperbaric oxygen therapy with a good outcome in two of the three patients. The pathophysiology of carbon monoxide poisoning and the benefits of treatment with hyperbaric oxygen therapy are reviewed.
Aust Paediatr J
· 1988 Jun · PMID 3421877
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A new method of collecting and analysing sweat (Wescor Macroduct) has advantages of simplicity of collection and direct reading of results by osmometry. Forty-seven children with cystic fibrosis and 47 normal children ha...A new method of collecting and analysing sweat (Wescor Macroduct) has advantages of simplicity of collection and direct reading of results by osmometry. Forty-seven children with cystic fibrosis and 47 normal children had sweat tests performed simultaneously by the Gibson and Cooke method and by the Wescor Macroduct method. The new method had a higher rate of inadequate collection (19% vs 6%) which was more marked in children under 5 years of age. This was due partly to the difficulty of fitting a 2.5 cm pilocarpine gel disc to small arms. When an adequate collection was obtained, results were reliable with no false negatives occurring during this study. The Wescor Macroduct sweat test is a reliable method for use in peripheral centres to screen patients suspected of having cystic fibrosis. All children with an inadequate collection or a positive result should be referred to a reference centre for confirmation of the diagnosis. However, the majority will be saved the expense and disruption of travel.
Aust Paediatr J
· 1988 Jun · PMID 3421876
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The volume of infant formula required for babies below the age of 6 months continues to pose problems both for parents and child health care workers. To investigate this, about 150 bottle-fed babies were studied every 2...The volume of infant formula required for babies below the age of 6 months continues to pose problems both for parents and child health care workers. To investigate this, about 150 bottle-fed babies were studied every 2 months from birth for their milk intake and weight gain. They were fed on demand with full strength infant formula and weaning was started at about 4 months. Weight gain was normal, with growth patterns comparable to Cambridge babies. The mean (s.d.) daily milk volumes in millilitres consumed were: 582 (144), 847 (163), 851 (176), 812 (219) at 7 days, 2, 4 and 6 months, respectively. With such a wide range of milk intake at each age, it would be inappropriate and misleading to provide a single mean recommended volume. Thus, percentile values are suggested as a better guideline for recommended intake. Estimation was made for the volume of milk required if milk was the sole source of energy for the first 6 months.
Aust Paediatr J
· 1988 Jun · PMID 3421875
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Partial 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...Partial 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.
Aust Paediatr J
· 1988 Jun · PMID 3421874
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Retrospective study of infants who survived the neonatal period after delivery at 24-26 weeks gestation revealed patency of the ductus arteriosus (PDA) in 44%. The mean birthweight of infants who developed PDA was lower....Retrospective study of infants who survived the neonatal period after delivery at 24-26 weeks gestation revealed patency of the ductus arteriosus (PDA) in 44%. The mean birthweight of infants who developed PDA was lower. Retinopathy of prematurity (ROP) was seen in 79% of survivors with 24% having grade III or IV involvement. All but one of the more severe grades of ROP occurred among infants with PDA. Infants with PDA required more prolonged ventilatory support. Perinatal factors did not have a significant role in the development of these complications.
Aust Paediatr J
· 1988 Jun · PMID 3048236
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One 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...One 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.
Aust Paediatr J
· 1988 Jun · PMID 3048235
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Ten 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 intrave...Ten 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 less than 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 less than 0.05).
Fractional urinary sodium excretion (FENa) and urinary sodium excretion (UNaE) were determined 88 times in 42 healthy, appropriate weight-for-gestational age infants. Gestational ages (GA) were 28-41 weeks; birthweights...Fractional urinary sodium excretion (FENa) and urinary sodium excretion (UNaE) were determined 88 times in 42 healthy, appropriate weight-for-gestational age infants. Gestational ages (GA) were 28-41 weeks; birthweights were 930-4135 g. Nineteen preterm infants were studied serially a total of 59 times between 1 and 55 days after birth. During the first 4 days after birth, multiple hierarchical regression analyses showed that FENa and UNaE were inversely related to GA (P less than 0.001). Postnatal age (PN) was not significantly related to FENa or UNaE. However the effect of GA on FENa and UNaE was not significantly greater than the effect due to postnatal age (PA) (P = 0.31 and P = 0.80, respectively). UNaE (1.6 +/- 0.2 mmol/kg per day) was significantly greater than sodium intake (1.1 +/- 0.2 mmol/kg per day) at 2.6 +/- 0.2 days (P less than 0.05). Longitudinal studies extending beyond 4 days indicated that GA and PA had interactive effects on FENa and UNaE; hence the contribution for a given GA was dependent on PA (and vice versa). Sodium intake remained stable (average 1.8 mmol/kg per day) beyond 7 days after birth and was consistently greater than UNAE (P less than 0.01). It is suggested that in healthy preterm infants beyond 2 weeks PA, a sodium intake of 2-3 mol/kg per day may be adequate to meet the renal sodium losses.
Of 220 children referred for suspected 'hyperactivity', 55 were subjected to a 6 week trial of the Feingold diet. Forty (72.7%) demonstrated improved behaviour and 26 (47.3%) remained improved following liberalization of...Of 220 children referred for suspected 'hyperactivity', 55 were subjected to a 6 week trial of the Feingold diet. Forty (72.7%) demonstrated improved behaviour and 26 (47.3%) remained improved following liberalization of the diet over a period of 3-6 months. The parents of 14 children claimed that a particular cluster of behaviours was associated with the ingestion of foods containing synthetic colourings. A double-blind crossover study, employing a single-subject repeated measures design was conducted, using eight of these children. Subjects were maintained on a diet free from synthetic additives and were challenged daily for 18 weeks with either placebo (during lead-in and washout periods) or 50 mg of either tartrazine or carmoisine, each for 2 separate weeks. Two significant reactors were identified whose behavioural pattern featured extreme irritability, restlessness and sleep disturbance. One of the reactors did not have inattention as a feature. The findings raise the issue of whether the strict criteria for inclusion in studies concerned with 'hyperactivity' based on 'attention deficit disorder' may miss children who indicate behavioural changes associated with the ingestion of food colourings. Moreover, for further studies, the need to construct a behavioural rating instrument specifically validated for dye challenge is suggested.
An interview study investigating attitudinal and other factors influencing the selection of primary medical care (PMC) is described. It focuses on parents of sick children, excluding those with trauma or medical/surgical...An interview study investigating attitudinal and other factors influencing the selection of primary medical care (PMC) is described. It focuses on parents of sick children, excluding those with trauma or medical/surgical emergencies, and was conducted in part of the Western Region (WR) of Melbourne in late 1983, the period immediately prior to the introduction of Medicare. It is based on a cross-sectional survey of in-hours attenders of eight general practices (GP), the Western Region Community Health Centre (WRCHC), the general clinic of the casualty departments at the Western General Hospital (WGH), and the Royal Children's Hospital (RCH), a teaching hospital outside the region. The most commonly stated reasons for attendance at services generally were 'closeness to home/work', 'recommendation' and 'good service'. 'Cheap/economic reasons' were given less frequently overall than the above reasons. There were however some differences in reasons given by attenders at different places of care. 'Cheap/economic reasons' was offered significantly more often and 'recommendation' significantly less often by WGH attenders compared with other attenders. 'Specialists available' and 'dissatisfaction with other doctors' was offered significantly more frequently and 'close to home' and 'no other doctor' significantly less frequently by RCH attenders than other attenders. Health insurance status did not differ significantly at the different places of care. Attenders of the RCH were significantly more knowledgeable about community health centres than GP or WGH attenders. Non-GP attenders had more often used other than their current place of care for treatment in the recent past than GP attenders had.(ABSTRACT TRUNCATED AT 250 WORDS)
The selenium status of children with phenylketonuria on a synthetic low phenylalanine diet was assessed. Correlation between blood selenium and red cell glutathione peroxidase was unsatisfactory (r = 0.65) due to the poo...The selenium status of children with phenylketonuria on a synthetic low phenylalanine diet was assessed. Correlation between blood selenium and red cell glutathione peroxidase was unsatisfactory (r = 0.65) due to the poor discrimination of red cell glutathione peroxidase with a low selenium diet. No symptoms of deficiency were observed. Supplementation with 50 micrograms per week of selenium as brewers yeast tablets over a period of 6 months significantly increased the blood selenium of the phenylketonuric children. Plasma Vitamin E levels were within normal limits. The supplementation effectively doubled their selenium intake to 15-17 micrograms per day, which is probably sufficient for this group with an adequate Vitamin E status, though considerably lower than the recommended minimum intake of 50 micrograms per day.