摘要:

Abstract:Attention deficit hyperactivity disorder (ADHD) is not a disease. The symptoms of its three dimensions (activity, attention and impulsivity) are normally distributed in the population, with an arbitrary level of symptoms being designated pathological. The presence of the ADHD cluster is never grounds for any positive diagnosis; it is an indication for further assessment. Positive response to stimulants is not specific to the ADHD population, and is in no way diagnostic.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01552.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Subgaleal (subaponeurotic) haemorrhage (SGH) is a serious and sometimes life‐threatening condition associated with vacuum extraction. With increasing use of the vacuum extractor as the preferred instrument for assisted vaginal delivery, neonatal paediatricians should be prepared to encounter a greater number of infants with SGH and other effects associated with vacuum extraction. In order to reduce morbidity and to prevent mortality in infants with SGH, neonatal caregivers should be able to recognize the occurrence of this type of bleeding and to institute appropriate forms of management. This annotation describes the effects of vacuum extraction on the newborn infant and suggests some measures for the management of these condition

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01553.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01554.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01555.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Varicella causes a mild, self‐limiting childhood disease that may reactivate years later as shingles. In immuno‐compromised patients with altered cell mediated immunity, and rarely in healthy individuals, varicella results in a life‐threatening infection. The antiviral drug, acyclovir, substantially reduces the mortality and risk of severe disease in these groups of patients. Early commencement of acyclovir is recommended for children with both varicella and altered cell mediated immunity, newborns during the first 2 weeks of life, preterm infants in the neonatal nursery, and severe varicella or shingles (including ocular zoster) in any patient, as well as during pregnancy. Acyclovir may be considered in children with serious cardiopulmonary disease or chronic skin disorders where varicella may exacerbate the underlying disease or increase the risk of secondary bacterial sepsis. Acyclovir, however, is not recommended for healthy individuals without severe disease, as a prophylactic agent against varicella, for asthmatics receiving aerosolized or low‐dose oral steroids and/or as treatment of the post‐varicella syndromes. When acyclovir is prescribed it should be given intravenously to those with severe disease, those at risk of dissemination and in children younger than 2 yea

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01556.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Abstract:Some of the issues related to the doubts and complexities involved in the diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) are reviewed. While some writers claim that it is clear that all children presenting with ADHD should be treated by pharmacological means, there are associated risks and politics. However, in the absence of well established and research‐supported alternative understandings of the aetiology and treatment of the disorder, many practitioners feel unable to offer a useful service. Resulting frustrations have led some parents to form their own support networks, which make strong demands for increased services. More creative and innovative therapeutic interventions focusing on the broader impact of ADHD must be developed to deal with this disorde

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01557.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To document the use of stimulant medication in the diffent states and territories of Australia in 1993 and trends in use of stimulant medication in Western Australia and New South Wales from 1988 to 1993.Methodology: Health authorities in the states and territories of Australia were contacted and requested to provided data on total numbers, patient gender, date of birth, postcode and type of stimulant medication prescribed to estimate the prevalence of use of stimulant medication in AustraliaResults: Despite variation in the data obtained from each health authority there is a significant difference in the rates of use of stimulant medication between states and territories in Australia, and a significant increase in use between 1988 and 1993 in Western Australia and New South Wales.Conclusions: These trends should continue to be closely monitored and the possibilty of establishing national prescription guidelines considered.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01558.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To describe the obstetric and perinatal factors, in particular the method of delivery, associated with development of a subgaleal haematoma (SGH) and to determine the outcome of survivors with this type of birth trauma.Methodology: Perinatal and obstetric data were retrospectively reviewed for 37 infants admitted to the neonatal unit of the sole tertiary paediatric referral hospital in Western Australia with an SGH, over a 24 year period from 1970 to 1993. These data were compared to data for all Western Australian births. The long‐term outcome was obtained through medical and private paediatric records for 26 of these infants.Results: All except one of the neonates had instrumental deliveries; 89% had a vacuum extractor applied to the head at some stage of delivery compared to 10% of the general population of births in Western Australia. There was also a significantly increased risk of failure of attempted vacuum extraction. Of the cases where a vacuum extraction was attempted, 45% also had forceps applied to the head. Coagulopathy was associated with the severity of the SGH. There was also a high frequency of occurrence (40%) of associated head trauma such as intracranial haemorrhage, skull fracture and cerebral oedema, as well as neonatal encephalopathy (73%). The occurrence of these associated features did not correlate significantly with the severity of SGH. Minor complications of SGH included jaundice and facial bruising.There was an excess mortality associated with SGH; however, the long‐term outcome for neonatal survivors with this disorder was good. None of the cases studied subsequently developed cerebral palsy or intellectual disability, and minor neurological sequelae only were documented in four infants.Conclusions: SGH is an uncommon type of birth trauma, and is associated with delivery or attempted delivery by vacuum extraction. The most commonly associated clinical problems were hypovolaemia and coagulopathy. The long‐term outcome for neonates with this condition is

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01559.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To assess the effect of a new formula (Prenan), which contains n‐3 and n‐6 long‐chain polyunsaturated fatty acids (LC PUFA) on the fatty acid profile of preterm infants.Methodology: Plasma fatty acids were measured in 61 preterm infants at term by gas liquid chromatography. In 20 of these infants, paired samples were collected and changes in fatty acids with time analysed.Results: Plasma docosahexaenoic acid (DHA) levels were higher in those who had been fed expressed breast milk (EBM) ±/or Prenan compared with those fed standard formula ± EBM,P<0.05. The plasma arachidonic acid (AA) levels of infants fed Prenan were not different to those fed EBM, both groups achieving higher levels than infants fed standard formula,P<0.05. Further, paired analysis demonstrated that DHA levels increased in infants changed from standard formula to Prenan to levels equal or higher than those of fully breast‐fed infants (P<0.01), whereas DHA levels remained unchanged with time in all other groups.Conclusions: The fatty acid composition of Prenan enables preterm infants fed formula to have plasma DHA and AA levels similar to those of infants fed breast milk and consequently different to those of infants fed standard formula. Prenan is an appropriate supplement to breast milk for preterm infants in that it provides LC PUFA as well as additional phosphorus and protein without exposing the infant to intact cows mil

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01560.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Objective: To define the individual neonatal response to the artificial surfactant, Exosurf, and factors that may influence the response.Methodology: Eighty‐two consecutive, preterm neonates with respiratory distress syndrome, who received Exosurf at<12h of age were studied. Their response was categorized from the graphical change in the oxygenation index with postnatal age, for 12h after each of two doses of surfactant and assessed independently by two observers. Clinical factors were analysed for their effect on the four pre‐defined categories of response, namely: none; mild; good; relapsed; and good: sustained.Results: Within the first 12h, 11% of the neonates showed no response, 5% a mild response and 84% a good response, but 34% relapsed. By 24h, 6% still showed no response (all died), 11% showed a mild response and 83% a good response, of whom half relapsed. At 24h, no response was significantly associated with low gestational age and asphyxia mild response with less severe lung disease. According to the response there was a gradation in the risk of death during the first week.Conclusions: The response to Exosurf can be individually and reproducibly categorized and demonstrated that 83% of neonates had a good response but half relapsed. No response was associated with extreme prematurity and asph

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1996.tb01561.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY