摘要:

Adequate nutrition is essential for normal growth during childhood. This is so important that the United Nations has included ‘provision of adequate nutrition’ in their International Declaration of the Rights of the Child. For paediatricians, satisfactory growth is the most important, practical indicator of adequate nutrition but growth is affected by other genetic and environmental factors, particularly repeated or chronic infect

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02536.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Recent decades have ushered in the most substantial shifts in the composition and structure of Australian families seen in this country's history. Fertility rates have declined dramatically, from an average of 3.4 children per woman in 1960, to 1.8 children per woman in 1990. Twelve per cent of children are now raised in single parent homes, and the labour force participation of women with children has increased significantly. Thirty‐two per cent of mothers with children under 5 years of age now work outside the home, and this has resulted in a growing demand for supplemental child car

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02537.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract It is generally agreed that low osmolar contrast media are better tolerated than conventional media. This study examined both tolerance and image quality of ioxaglate in a group of paediatric patients undergoing angiocardiography for congenital heart disease. A consecutive series of 50 patients (mean age 5.47 years; range 4 days‐14 years) were examined. The mean dose of ioxaglate administered per patient was 2.93 mL/kg. In general, ioxoglate was well tolerated. Three patients became febrile and another developed eosinophilia. Serum creatinine rose by a mean of 10 μmol/L. Significant renal dysfunction occurred in 12 patients with an increase in creatinine of 20–30 μmol/L. In no patient, however, were these effects a significant clinical problem. Diagnostic image quality was generally considered to be good with both cine‐angiography and digital subtraction angiographic t

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02538.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract Twenty‐five children (age range 1.2–14.5 years) who sustained accidental head injury requiring admission to hospital were prospectively examined for evidence of retinal haemorrhage. In no case were retinal haemorrhages detected. It is suggested that accidental head injury seldom results in retinal haemorrhage and that the finding of retinal haemorrhage in a child with a head injury should prompt suspicion of

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02539.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract This study examined the relationship between parents' and physicians' reports of treatment‐related behaviour and adjustment problems of children with cystic fibrosis (CF), and children's clinical status as assessed by measures of pulmonary functioning and global ratings of clinical status. Parents completed a Cystic Fibrosis Problem Checklist which measures the extent to which children experience behaviour and adjustment difficulties with different aspects of treatment, including chest physiotherapy, medication taking and diet. A high proportion of parents in each age group reported at least some treatment‐related behaviour difficulties, with significantly more problems being reported with younger children. There was no significant relationship, however, between the child's age, sex and clinicians' ratings of compliance. A stepwise multiple regression showed that the only variables which significantly predicted clinicians' ratings of the severity of the child's disease were forced expired volume and height. Clinicians' ratings of compliance explained a small amount of extra variance (2.4%). It was found that parental reports of treatment‐related behaviour problems were not related to clinical status. The implications of the findings for clinical practice are di

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02540.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract The nutritional profiles of 37 children (aged 0.5–14.0 years) with chronic liver disease at the time of acceptance for orthotopic liver transplantation (OLTP) have been evaluated using clinical, biochemical and body composition methods. Nutritional progress while waiting for a donor has been related to outcome, whether transplanted or not. At the time of acceptance, most children were underweight (mean standard deviation (s.d.) weight = 1.4±0.2) and stunted (mean s.d. height = ‐ 2.2±0.4), had low serum albumin (27/35) and had reduced body fat and depleted body cell mass (measured by total body potassium ‐ mean % expected for age = 58±5%,n= 15). Meanad libitumnutrient intake was 63±5% of recommended daily intake (RDI). Those who died while waiting (n= 8) had significantly lower mean initial s.d. weight compared with those transplanted. The overall actuarial 1 year survival of those who were transplanted (mean waiting time = 75 days) was 81% but those who were initially well nourished (s.d. weight>‐ 1.0) had an actuarial 1 year survival of 100%. There were no significant differences in actuarial survival in relationship to age, type of transplant (whole liver or segmental), liver biochemistry or the presence or absence of ascites. Of the total group accepted for OLTP, whether transplanted or not, the overall 1 year survival for those who were relatively well nourished was 88% and for those undernourished (initial s.d. weight>‐ 1.0) was 38% (P<0.003). Declining nutritional status during the waiting period also adversely affected outcome. We conclude that malnutrition and/or declining nutritional status is a major factor adversely affecting survival in children awaiting OLTP. In transplant units where waiting time is greater than 40 days, earlier referral, prioritization of cases and the use of adult donor livers may reduce this risk and efforts to maintain or improve nutritional status deserv

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02541.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract The prevalence of inguinal hernia repair up to 8 years of age was determined in 205 inborn children of birthweight<1500 g who had survived to the age of 8 years; 37 (18.0%) of the children required surgery for inguinal hernia, significantly more frequently for boys than girls (32.0% and 3.9% respectively). The cumulative percentage of inguinal hernia operations in boys was 8.7% during primary hospitalization, 20.4% by 2 years, 30.1% by 5 years and 32.0% by 8 years; and 36.4% (12 of 33) hernias in boys occurred beyond 2 years of age. The risk of hernia in boys was only marginally higher in those who required assisted ventilation and in those of birthweight<1000 g. Very low birthweight infants, particularly boys, are at risk of developing an inguinal hernia not only in infancy but also to at least 8 years of ag

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02542.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract The relationship between the degree of oliguria following severe birth asphyxia and outcome at 12 months was examined in 31 infants. All 31 infants developed encephalopathy following severe birth asphyxia and 25 had oliguria for 24 h or more following delivery. Eighteen had persistent oliguria (i.e.>48 h) and the remaining seven had transient oliguria (between 24 and 48 h). Poor outcome (death or neurological abnormality at 12 months) was significantly associated with the degree of oliguria. Encephalopathy, however, was found to be more closely correlated with poor outcome rather than duration of oliguria and a stepwise regression model confirmed that encephalopathy was the more powerful predictor of poor outcome. In those situations where an infant's degree of encephalopathy can not be assessed accurately (e.g. muscle relaxant use) the duration of oliguria may prove a useful prognostic indicato

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02543.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract Twenty‐three patients with benign intracranial hypertension (BIH) were seen at the Royal Alexandra Hospital for Children, Sydney over an 18 year period to 1988. Age at presentation ranged from 6 months to 13 years and 5 months. The female to male ratio was 2.3: 1. The aetiological factors (sometimes multiple) included: chronic middle ear infection, 30%; dural sinus thrombosis, 22%; head injury, 13% Vitamin A overdosage, 4%; tetracycline exposure, 4%; and no apparent cause, 43%. Headache was the most common presenting symptom occurring in 91% of patients, followed by vomiting in 65% and blurred or double vision in 57%. Papilloedema occurred in 96% of patients, abducens palsy was noted in 48% and visual impairment in 45%. All patients improved clinically after treatment, one with lumbar puncture only. Of 17 patients treated with steroids, 10 patients recovered and seven patients went on to lumboperitoneal shunt. Two patients recovered with steroid and diuretic treatment. Of two patients initially treated with diuretics only, one recovered and one subsequently required a shunt. Only one patient was initially treated with a lumboperitoneal shunt. Three of the shunted patients had shunt block requiring revision. None had permanent visual loss or other significant sequelae.The visual prognosis of BIH in childhood is good. In view of the relatively high complication rate of steroids and shunting, a controlled comparison of steroidvsacetazolamide/diuretic therapy should be underta

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02544.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract Recommendations concerning annual influenza vaccination in children suffering from cystic fibrosis (CF) are not uniform. Previous studies have shown that influenza causes a small proportion of episodes of episodes of acute respiratory deterioration in CF patients. During the 1989 Australian winter, we studied the association between serologically proven influenza infection and acute respiratory morbidity in 20 children with CF. Six children were shown to have influenza infection, four with type A and two with type B. Four of five children requiring hospital admission were shown to have influenza, but only 2 of 15 did not need admission (P≤0.025). As well, influenza was diagnosed in 6 of 12 children who suffered acute respiratory illness leading to school absenteeism (including hospitalization), but diagnosed in no children without this degree of illness (P≤0.25). Influenza significantly increases the incidence of hospitalization and of less serious respiratory illness in children with CF, a finding which suggests that influenza vaccine efficacy studies are necessary in this

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb02545.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY