ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00680.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00681.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00682.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00683.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00684.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis study aimed to clarify whether the adverse outcomes seen in babies transported between New Zealand Level III intensive care nurseries were due to the transport itself or to possible differences in care in different centres. The outcomes of 34 infants inborn at National Women's Hospital, Auckland but transported to other centres were compared with those of 68 matched controls inborn at the receiving centres and with 68 controls inborn and cared for at National Women's Hospital.Transport was associated with a transient (non‐significant) deterioration in respiratory status but no increase in chronic lung disease. However, infants cared for elsewhere, whether transported or control, had more periventricular haemorrhage than Auckland babies (23% and 29%vs15%,P= 0.03) and worse neurodevelopmental outcome (70% and 66%vs88% of those whose outcomes were known were normal at follow up,P= 0.002).We conclude that differences in care between centres may be more important than the transport itself in determining the long‐term outcome of transported neona

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00685.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractBetween 1984 and 1990, 257 cases ofHaemophilus influenzaetype b (Hib) meningitis occurred in children under five years of age in Western Australia. We obtained information on possible sequelae in 131 cases (all non‐Aboriginal) by medical record review and parental interview, and in a further 116 cases (60 non‐Aboriginal, 56 Aboriginal) by medical record review only; no follow‐up information was available for ten children (nine non‐Aboriginal, 1 Aboriginal). The incidence of Hib meningitis in children under five years of age was 26.3 per 100000 for non‐Aboriginal and 152.2 per 100000 for Aboriginal children. The case fatality rate was 3.5% for non‐Aboriginal children and 14.0% for Aboriginal children. Sequelae were recorded for 17.1% of non‐Aboriginal and 22.4% of Aboriginal children who survived Hib meningitis. Surviving Aboriginal children experienced severe sequelae following Hib meningitis almost three times more frequently than surviving non‐Aboriginal children (10.5%vs3.6%), although mild and moderate sequelae were not more common in Aboriginal children. The information on incidence and severity of sequelae in this study was obtained by chart review and parental interview, and hence may be subject to error or bias, particularly for mild and moderate disabilities. Outcomes like death and severe sequelae, such as cerebral palsy and profound intellectual and physical disability, are less subject to bias. Of Aboriginal children who contracted Hib meningitis in Western Australia over the study period, 22.8% either died or had severe sequelae, while only 7.0% of non‐Aboriginal children experienced thes

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00686.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis present study, conducted in 1991, examined trends in the prevalence, severity and medical management of asthma in European school children by repeating the protocol of a study performed in 1985, using the same schools and questionnaire. One thousand, nine hundred and one children in 1991 were compared with 1084 children in 1985. The prevalence of respiratory symptoms increased significantly by approximately one‐third, although the increase in the diagnostic label ‘asthma’ did not increase significantly. Asthma severity indices (<12 asthma attacks in the last 12 months and symptoms in the last month) were not significantly increased, except for night cough in the last month (1985 7.0%, 1991 9.9%,P= 0.008). In 1991, children with wheeze in the last 12 months were more likely to be diagnosed as having asthma and treated with bronchodilators and prophylactic drugs than in 1985. We conclude that the prevalence of asthma symptoms has increased from 1985 to 1991, but the two indices of severity of asthma are mostly unchanged. Diagnosis of asthma in children with symptoms has improved but asthma still appears underrecognized. Drug treatment of asthma has incr

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00687.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractTeachers and support staff are often called upon to manage asthma at school but may have little knowledge and understanding of the condition. The aim of this study was to determine whether a short seminar would improve knowledge in non‐health professionals. Seventy school staff attended one of five 2 h seminars presented by an asthma educator. Participants completed the Newcastle Asthma Knowledge Questionnaire (AKQ) before, and 2 months after, the seminar. The mean initial score (maximum possible 31) was 16.4 (range 4–26), increasing to 23 (range 13–29,P= 0.0001). There was a large increase in knowledge about symptoms, pathophysiology, preventive medications and side effects of medications. Initially almost all of the participants had deficiencies in knowledge about reliever medications and the management of exercise‐induced asthma. After the seminar, knowledge in these areas was still poor, with only one‐third of the participants answering them correctly. The results have been used to modify the content of the 2 h seminar with increased emphasis on those areas in which deficiencies in knowledge were demonstrated. No data are available yet as to whether this improved knowledge has improved m

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00688.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe accuracy of the characteristic physical signs of a patent ductus arteriosus (PDA), that is, a systolic murmur, increased volume of pulses and increased praecordial activity, in diagnosing a haemodynamically significant PDA in ventilated premature infants was prospectively evaluated. Fifty‐five ventilated preterm infants (birthweight>1500g) had daily echocardiographic and clinical evaluation for a PDA for the first 7 days of life. The examiners were blinded to each other's findings. Probability analysis was performed for the accuracy of each clinical sign in detecting a haemodynamically significant PDA as defined by echocardiographic criteria. Clinical signs were poor at detecting a significant PDA in the first 4 days of life. On day 1, none of the 10 infants with a significant PDA had a murmur. By day 4, clinical signs were better at detecting a significant PDA, but specificity remained poor with many false positive signs. Six infants had murmurs with a closed duct. The development of echocardiographic haemodynamic significance preceded the development of physical signs by a mean of 1.8 days. Significant ductal shunts often occurred silently, but the development of a murmur often marked an increase in the velocity of the flow through the duct rather than an increase in the size of a shunt. This study confirms that echocardiography is required for the reliable early diagnosis of a PDA in ventilated preterm infant

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1994.tb00689.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY