摘要:

Abstract:The optimal diet for the low birthweight infant is one that supports a growth rate approximating that of the third trimester of intra‐uterine life without imposing stress on the developing metabolic or excretory systems. Although preterm human milk does not meet the energy and nutrient needs of developing preterm infants, the benefits such as contributions to host defence and gastrointestinal trophic aspects, and the psychological benefits of maternal‐infant bonding, make it the preferred d

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02551.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Evidence exists for a potential role for inhaled corticosteroids, particularly when used in high dose to cause growth impairment, delayed maturation and adrenal suppression in children and adolescents with asthma. The functional significance of biochemical adrenal suppression remains uncertain. Similarly, there is as yet insufficient evidence to determine whether inhaled corticosteroids may adversely affect bone mineral density in children and adolescents with asthma.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02552.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Neonatal hypoglycaemia remains a controversial issue. Uncertainty surrounds what constitutes the optimal safe blood glucose for newborn babies. There are good reasons and evidence for maintaining blood glucose greater than 2.5mmol/L in newborn babies. Since 1986 neonatal paediatricians have changed in their definition of neonatal hypoglycaemia. Ideally, screening of blood glucose in neonatal intensive care units should be done with an on‐site glucose analyze

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02553.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Circumcision has been the traditional treatment for phimosis, but now is not the only management option, the best of which appears to be topical steroid application. Importantly, the literature suggests that phimosis probably is over‐diagnosed, indicating that a prospective, randomized controlled study is needed to compare the non‐circumcision options. Such a study would require consensus on the diagnostic criteria for phimosis; therefore, a more exacting definition would be needed and is suggested. Despite the non‐controlled data on medical treatment of true phimosis, there seems little doubt that surgical intervention is not needed for all male infants with adherence of the foreskin to the glans, a non‐retractable foreskin or, indeed, true p

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02554.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Children are particularly vulnerable to injury and death in two types of 20th century conflicts: terrorist attack and civil war. This account describes some first‐hand experiences of the aftermath of the Rwandan Civil War of 1994. Events leading to the conflict are described, eye witness accounts of child trauma during the war are recorded and the medical problems (currently ongoing) affecting children are described. Over a period of 3 months from April to June 1994, between half and one million Rwandese, a significant proportion of them women and children, were murdered in brutal hand‐to‐hand killing, dying from close‐quarter gunshot and machete slaughter. Nearly half of the population became refugees in neighbouring countries or displaced persons in their own land. UNAMIR II, the United Nations Emergency Humanitarian Response, grew to some 7000 persons by May 1995. Medical aid was provided by emergency medical contingents from the United Kingdom, Canada and Australia, the latter through its Australian Medical Support Force, providing the definitive emergency medical infrastructure from August 1994. In the consequent post‐war civil and social disruption, children suffered from burns, cholera and from motor vehicle trauma. Ongoing landmine blasts continue to affect children and adolescents especially. A new international humanitarian code to build a time‐expiry device into landmines and other similar ordinance is urgently required as the post‐conflict ongoing disasters in Rwanda, Afghanistan and Cambodia illustrate. Current problems affecting children include an increasing risk of HIV infection, trauma and the special humanitarian needs of thousan

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02555.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To determine the incidence of breast‐feeding in very preterm babies while in neonatal intensive care.Methodology: A retrospective records analysis of all 151 babies with gestational age less than 35 weeks admitted to the neonatal intensive care unit (NICU) of a major teaching hospital in 1993.Results: On discharge 64% of babies were having some breast milk (45% having breast milk alone, 19% both breast milk and formula), and 38% some breast‐feeding (17% being solely breast‐fed, the other 21% combining breast‐feeding with either bottle‐feeding or an intragastric tube [IGT]). Breast milk was the first milk for 41% of babies, with 83% having breast milk at some stage.Increasing gestational age was associated with a decreased likelihood of first milk being breast milk (73% of those less than 29 weeks compared to 21% of those aged 33–34 weeks,P<0.001), but with increased rates of breast‐feeding (23 compared to 59%,P= 0.01) and breast milk consumption (42 compared to 73%,P= 0.04).Conclusions: Breast‐feeding rates in NICU are well below those found on discharge for full term babies. Both maternal and staff‐related factors contribute to this. More and better education of mothers, doctors and nurses as well as changes to some unit practices could inc

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02556.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To determine the approach to identifying neonatal hypoglycaemia and the definition of neonatal hypoglycaemia used by neonatal paediatricians in Australian Level 3 neonatal intensive care units (NICU).Methodology: A questionnaire was sent to the 101 neonatal paediatricians in the 22 Level 3 NICU in Australia asking their method of screening for, and definition of, neonatal hypoglycaemia.Results: Responses were received from 70 neonatal paediatricians, including all 22 directors. A bedside glucose meter is used in 19 of 22 NICU to screen for hypoglycaemia, whilst one NICU uses a glucose analyzer and another NICU uses a visual colour comparison method. One NICU does not screen, but has blood glucose measured in a satellite laboratory. If the screening method suggests hypoglycaemia, 62 of 63 neonatal paediatricians proceed to blood glucose determination in a laboratory, mostly using plasma samples. Based on the laboratory measurement, the definition of neonatal hypoglycaemia ranged from<1.1 to 3.0 mmol/L.Conclusions: The majority of neonatal paediatricians in Australian NICU screen for neonatal hypoglycaemia using a bedside glucose meter. There is a wide range in the definition of neonatal hypoglycaemia from<1.1 to 3.0mmol/L.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02557.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To compare the definitions of neonatal hypoglycaemia in textbooks and among paediatricians in 1992 with those used in 1986.Methodology: A questionnaire was sent to 420 neonatal paediatricians in the UK and to 88 Australian neonatal paediatricians in 1992 asking for their definition of hypoglycaemia in term babies and preterm/small‐for‐gestational‐age (SGA) babies. Fourteen textbooks on neonatal paediatrics (published since 1990) were also surveyed for the definition of hypoglycaemia used in the text. The UK paediatricians were also asked, ‘Do you believe that a baby who is hypoglycaemic but has no abnormal clinical signs is at less risk of neurological damage than a baby who is hypoglycaemic with abnormal signs?’ The 1992 results were compared with the published results of a similar survey in 1986.Results: There was a 68% response from neonatal paediatricians both in the UK and Australia. Similar to the 1986 results there continued in 1992 to be a wide range in the definition for hypoglycaemia (<1‐4mmol/L) among neonatal paediatricians and in textbooks. The median of the definition of hypoglycaemia for both term and preterm/SGA babies among paediatricians and in textbooks in 1992 was significantly different from the results in 1986. Compared with 1986 there was a significant increase in 1992 in the number of paediatricians and textbooks defining a safe blood glucose concentration as being at least 2mmol/L. Sixty per cent of UK neonatal paediatricians believe that a baby who is hypoglycaemic but has no abnormal clinical signs is at less risk of neurological damage than a baby who is hypoglycaemic with abnormal signs.Conclusions: From 1986 to 1992 there was a significant change in the definition of hypoglycaemia both among paediatricians and in neonatal textbooks compared with the definition in use during 1965‐86. The findings suggest that neonatal paediatricians do change in their practice. The changes in the definition of hypoglycaemia may be due to the data available and discussion on hypoglycaemia since 1988. Neonatal paediatricians still attach significance to clinical signs associated with

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02558.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: Understanding patients' and their parents' perceptions towards asthma medication is important in developing strategies to ensure patient compliance. In this study, parents' perceptions towards their children's use of inhaled medication for asthma treatment were evaluated.Methodology: A questionnaire was administered by interviewing parents of 210 asthmatic children attending the Department of Paediatrics, National University Hospital.Results: Our results showed that 76/210 (36%) of parents either felt opposed to inhaler therapy and/or preferred oral medications. The main reasons for their reluctance to use inhalers were related to fear of dependence, side effects and overdosage, and the child's dislike for inhalers. A third of these parents felt that inhalers were only indicated for very severe asthma.Conclusions: We conclude that a significant proportion of parents have reservations regarding the use of inhalers for the treatment of asthma. These factors should be taken into consideration when planning an effective asthma education programme.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02559.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To assess the impact on mothers' knowledge and anxiety of the 1991‐92 health promotion campaign on Sudden Infant Death Syndrome (SIDS) risk factors.Methodology: A telephone survey of a population based sample of 339 mothers in Victoria, Australia, conducted 1992‐94.Results: Recall by mothers of the risk factors for SIDS was as follows: not breast‐feeding. 15%; smoking, 46%; overheating, 48%; and prone sleeping, 84%. Recall rate increased as the campaign progressed. Receiving the campaign pamphlet was associated with an increased recall of all risk factors. Discussion of the pamphlet with a health professional was rare (9%). One‐third of all mothers reported being very worried about cot death when caring for their babies. Self‐reported worry was significantly more common among mothers whose babies were born at the time of the campaign introduction.Conclusions: The campaign pamphlets were effective in increasing knowledge of the risk factors. The limited discussion with health professionals suggests that future campaigns need increased professional involvement to address problems, including anxiety among ne

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb02560.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY