摘要:

ABSTRACTThe advent of cross‐sectional echocardiography has revolutionized the practice of cardiology. Technical advances have greatly improved resolution, permitting clear definition of anatomical detail and thereby facilitating a segmental approach to congenital heart disease (defining connections) and the visualization of malformations (e.g. aortic valvar stenosis). In addition to being able to assess ventricular function, wall thickness, vessel and chamber size, the advent of Doppler interrogation enables estimation of flow and gradients across valves, vessels, etc. Echocardiography has become increasingly indispensable in clinical practice and its extension to the prenatal area is not surprising, especially as it is regarded as being safe to the growing fetus, thereby permitting repeated examination.1Winsberg's initial ultrasound recording of a fetal heart,2has led to great advances in fetal echocardiography permitting anatomical diagnoses, an assessment of cardiac function and also aiding in the treatment of fetal arrhythmias and providing information on fetal well‐being.3The information so generated has contributed to the formulation of optimal management plans for the pregnancy, delivery and care of the affected neona

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00354.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Paediatricians, ophthalmologists, plastic and orthopaedic surgeons, pathologists and other dysmorphological fringe‐dwellers should all be familiar with the amniotic band syndrome, even if they call it by another name—amniotic bands, constriction rings, Streeter syndrome, amniotic‐deformity‐adhesions–mutilations (ADAM) complex, amo

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00355.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTHearing losses in children are disabling and frequently unrecognized. Children with persistent uncorrected hearing impairment are at high risk for speech and language delays, behavioural problems, and socialization and learning difficulties. Although most hearing impairment in childhood is conductive in type. about 1 in 1000 Australian children have significant sensorineural hearing losses (SNHL) of mild to profound degree.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00356.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTA follow‐up study of 224 families of a birth cohort of 272 families in a multi‐ethnic poor socio‐economic municipality in Melbourne when the children were 4 years old showed that 27% of the mothers were depressed. There was no difference in the depression rate between Australian‐born and immigrant mothers, a finding in marked contrast to the first year of the study when the depression rate was significantly higher in those immigrant mothers who had been in Australia for less than 3 years, were unable to speak English and who did not have an extended family or close friends. Depression in this group of mothers was attributed to resettlement problems, which over a period of three years had ameliorated.At 4 years the most important factor associated with depression in both Australian‐born and immigrant mothers was the quality of marital relationships. Lack of an intimate support relationship made mothers more vulnerable to the stresses of child care and rearing, home‐making and life events. In Australian‐born mothers only, another significant factor in vulnerability to depression, was their early childhood experiences of being reared in a disruptive home or in an institution and of being unwanted. In immigrant mothers, but not in Australian‐born mothers, life events were significantly correlated with depression.The depressed mothers, both Australian‐born and immigrant, perceived their 4 year old children to have significantly more behavioural problems than mothers who w

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00357.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTAnthropometric data on 110 myelomeningocele (MMC) subjects in relation to age, sex, level of lesion and ambulation were studied to investigate growth and the occurrence of obesity in MMC. In 52 subjects, indices of obesity were validated against body composition analysis of total body fat (%BF) using body potassium and body water techniques. Most subjects were short and light compared to reference data and became relatively shorter and heavier with age. Overall trunk growth was not affected by the level of lesion, but sitting height was affected by kyphoscoliosis. Arm spans were similar to reference data, but were significantly greater in wheelchair users. Leg length was greatest in those who walked. Body composition data showed excess adipose in many MMC subjects, this tendency increasing with age. When correlated with %BF determined from body composition analysis, common clinical indices of obesity had variablervalues (wt/ht20.78; wt/sitting ht20.77; upper arm fat area 0.75; triceps skinfold 0.74; wt/arm span20.68, with the 4 skinfold method correlating best, 0.82). Anthropometric measures, taken with cognizance of level of disability and mobility, can accurately assess body growth and the occurrence of obesity in MMC. The influence of ambulatory activity in promoting normal growth is emphasized.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00358.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe School Entrant Health Assessment (SEHA) programme was established in New Zealand to ensure that every child entering school was assessed by a nurse. This type of service has come under a lot of criticism and so we investigated the scheme in Christchurch, looking at the outcome of the physical examination. We did not explore the health promotion aspect of the nurses' work. We traced the path of 1281 new entrants. The nurses identified problems in 459 (35.8%) children and nearly half were given further appointments or referred on. However, it was judged that only 21 (1.6%) children might have actually received a significant long‐term benefit. We feel that a non‐selective approach to school entry health assessments is inefficient. Nevertheless, the opportunity to fully audit the health of new school entrants is most important and could be a valuable opportunity for health promot

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00359.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe purpose of this study was to observe the effects of methadone exposurein utero, with special reference to maternal and neonatal methadone concentrations and neonatal withdrawal. Two groups of mother‐infant pairs were studied. In the first group, serum methadone concentrations were determined in infants at 1, 6 and 24 h after delivery. In the second group, blood was obtained at 24, 48, 72 and 96 h after birth. There was no correlation between neonatal serum levels and the intensity of withdrawal symptoms. There was no relationship between maternal methadone dose at delivery or maternal serum levels and neonatal methadone levels. The results of this study may be complicated by the prenatal exposure of the neonates to other drugs of abuse apart from methadon

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00360.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe effect of a 21‐day (reducing dose) course of dexamethasone upon platelet numbers, neutrophil numbers and neutrophil morphology in ventilator‐dependent preterm infants with chronic lung disease is reported. Forty‐one infants, who were sespsis‐free throughout the treatment period, received 46 courses of dexamethasone. In these infants the circulating platelet count increased significantly from 235 ± 157 to 476 ± 208 × 109/L Both total neutrophil numbers (7.94 ± 7.16 to 19.56 ± 12.40 × 109/L) and immature neutrophil numbers (1.19 ± 1.22 to 2.68 ± 2.58 × 109/L) also showed a significant increase reaching a peak on day 7 of treatment and decreasing thereafter. The immature: total (I:T) neutrophil ratio remained essentially unchanged. Eight other infants who developed serious sepsis during the treatment period showed a fall in both platelets (293 ± 236 to 140 ± 170 × 109/L) and total neutrophil numbers (18.61 ± 10.83 to 15.76 ± 10.53 × 109/L), together with an increase in immature neutrophils (2.30 ± 2.80 to 8.22 ± 13.91 × 109/L) and consequ

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00361.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTCase studies of five children with congenital cytomegalovirus (CMV) who were referred for audiological evaluation are presented. Significant deterioration of hearing was noted in all cases within the first 4 years of life. It is essential that neonates with congenital CMV be referred for hearing assessment and that the child's hearing be monitored on a long‐term basis. Early intervention is vital for the speech and language development of hearing‐impaired ch

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00362.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThree infants with congenital adrenal hypoplasia are described. The two surviving infants were detected and successfully treated in the neonatal period due to a suggestive family history (Case 1) and antenatal maternal oestriol screening (Case 2). The modes of inheritance, diverse clinical presentation, associated conditions, diagnostic work‐up and pathology of congenital adrenal hypoplasia in these three infants is discusse

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00363.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY