摘要:

On 21 November 1989 the United Nations Secretary General, Mr Javier Perez de Cuellar, addressed the general assembly with these words: We have taken the first seminal step: to furnish the world's children with the means of assuring their fundamental rights.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02368.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractA multi‐centre open trial of Buserelin, a luteinizing hormone‐releasing hormone (LHRH) analogue, was conducted in 13 children with central precocious puberty. Eleven children (eight girls and three boys), aged 3.4–10.2 years at commencement, completed the required 12 month period of treatment. Initially all patients received the drug by intranasal spray in a dose of 1200 μg/day, but by the end of the 12 month period two were having daily subcutaneous injections and three were receiving an increased dose intranasally. The first month of treatment was associated in one boy with increased aggression and masturbation, and in the girls with an increase in the prevalence of vaginal bleeding. Thereafter, however, both behavioural abnormalities and menstruation were suppressed. Median bone age increased significantly during the study, but without any significant change in the ratio of height age to bone age. The median predicted adult height for the group therefore did not alter significantly over the twelve months of the study. Buserelin treatment caused a reduction in the peak luteinizing hormone and follicle‐stimulating hormone (FSH) responses to LHRH, mostly to prepubertal levels, and also suppressed basal FSH. In the first weeks of treatment, the girls' serum oestradiol levels rose significantly and then fell to prepubertal or early pubertal levels. A similar pattern was seen for serum testosterone levels. Serum somatomedin‐C levels, however, showed little fluctuation over the course of the study. Buserelin treatment was safe and well accepted, and offers the promise of improved linear growth potential in precocio

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02369.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe aluminium concentrations in breast milk and in 25 commercially available infant formulae were measured. The mean concentration in breast milk was 49 μg/L while concentrations in most of the humanized formulae were less than 500 μ/L. Higher concentrations were found in Nan, Prem Enfamil and the three soya formulae.We suggest that all formulae have the potential to be contaminated with aluminium, and to varying degrees in different batches. Until it is known whether aluminium toxicity occurs in normal infants fed these formulae, it seems reasonable to expect manufacturers to routinely measure aluminium and keep aluminium contamination to a minimum. This may be especially important for formula fed to infants with compromised gastrointestinal and renal system

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02370.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractCongenital teratomas of the neck and nasopharynx are unusual tumours that seldom metastasize. Due to their rarity, reviews often have relied upon compilations of isolated case reports. We report our experience of the early outcome of 18 cases (14 cervical, four nasopharyngeal) to demonstrate the high morbidity and mortality that these benign but critically placed lesions have because of local mass effects. Six patients (33%) either were stillborn or died of disease within 2 days of birth; of the survivors, four (22%) had significant respiratory obstruction requiring surgery. Tumour location and size rather than histologic grading were the most significant features affecting the immediate clinical course. All but one of the patients who underwent early surgical resection had a favourable outcome.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02371.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractChildren with hyperactivity and self‐destructive behaviour present a difficult problem for parents and paediatricians. The syndrome described by Smith and Magenis is due to a deletion on the short arm of chromosome 17: del(17)(p 11.2 p 11.2). Clinical manifestations include brachycephaly and a flat mid‐face; brachydactyly; short, broad hands; mental retardation; and aberrant behaviour, including hyperactivity. We report on five children, and review the literature on a newly recognised syndrome in which the behaviour manifestations may precede and often overshadow the learning disabilities and unusual appearance. In addition, we have found sleep disturbance to be a major feature in our patie

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02372.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractCase records were retrospectively reviewed for 40 adolescents presenting to a paediatric sexual abuse service with a history of acute (23 cases) or chronic (17 cases) abuse. The chronic cases disclosed the abuse to a family member, the abuse was intrafamilial, and they had similarities to the chronically abused younger child. The acute cases disclosed the abuse outside the family, and were abused by strangers or acquaintances. Some acutely abused adolescents had similarities to child victims of stranger assault; however a larger sub‐group was identified (14 of 23; 35% of total) whose indescriminate behaviour may have placed them at increased risk of abuse. They were characterized by previous contact with police and welfare agencies, alcohol/drug abuse, voluntary sexual activity, contraceptive use, genital infections and apparent indifference to the abuse. Half the total group felt emotionally unsupported, and four subsequently attempted suicide. This study identifies unique problems of sexually abused adolescents, and recognizes potential multiple problems in those acutely abuse

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02373.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractIn order to begin to evaluate the need for an integrated trauma management service for injured children, a retrospective review of deaths following admission to a suburban teaching hospital was conducted. The medical records and coroners' reports for 64 consecutive cases over 68 months were reviewed, looking for errors in care which may have contributed to fatal outcomes.There was a male predominance (64%). The main causes of death were pedestrian injuries (42%), drownings (20%), injuries to vehicular passengers (17%) and injuries to cyclists (13%).Errors, often multiple, occurred in 29 cases (45%). Errors most frequently involved airway control and ventilatory support (25%), volume replacement (19%) and delays in performing essential investigations (13%). Errors were most frequent at the referring hospitals (49% [17 of/35 referred cases], compared with 14% at the teaching hospital), and principally involved multiply injured victims of blunt trauma (81%, 13 of 16 patients).In only three cases (5%) would better management have salvaged the patient. This can be explained partly by the predominance of what were judged to be irretrievable intracranial injuries (90%) in patients suffering blunt injuries. In contrast, an analysis of the same patient group revealed that in 30–50% the fatality could have been prevented by the full application of well recognised safety strategies. While strategies such as triage and trauma teams should reduce the error rate, it is yet to be proven that optimal post‐injury care will significantly reduce mortal

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02374.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractSeventy‐four children from 21 schools referred because of teacher‐perceived learning difficulties and prescreened for sensory integration (SI) deficits were given tests of SI, reading, vocabulary, perceptuo‐motor furction and motor development, and their teachers rated their classroom behaviour. The results showed that the children suffered primarily from attention deficit disorder without hyperactivity, and from mild deficits of SI. They were then divided into two groups matched approximately for sex, school and degree of SI deficits. One group received no treatment while the other was given about 13 weekly SI sessions, each of 1 h duration. All children were then reassessed on the same set of measures. There were significant improvements with time in both treated and untreated groups on most measures except classroom behaviour. Only one measure showed a treatment effect, though this one was most reflective of SI t

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02375.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe relationship between nutritional status and psychosocial functioning was examined in 35 children with cystic fibrosis, aged 7–16 years. Twelve malnourished children and their families were compared with 23 well nourished children and their families. Established measures of adjustment and coping in the children, parents and families were used. Few statistically significant differences between the two groups emerged, and all comparisons of psychosocial functioning were not significant. The results of the study suggest that there is no relationship between the nutritional status of the child with cystic fibrosis and the current psychosocial adjustment and coping of child, parents and famil

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02376.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractMore than 800 15 year old members of the Dunedin Multidisciplinary Health and Development study cohort completed a questionnaire designed to provide descriptive data concerning the weight control behaviours of this sample of New Zealand adolescents.The results showed that approximately 75% of the adolescents were within acceptable body mass index ranges. However 68% of the girls (but only 19% of the boys) wanted to weigh less than their present weight.Generally, girls were more concerned about their body weight than boys: 26% of girls weighed themselves fortnightly or more often, compared with 12% of boys; 45% of girls reported that they were trying to lose weight at present, compared with 9.5% of boys. The main methods of weight reduction included weight reduction diets (21% of girls, 4% of boys in the previous year); exercise such as jogging, walking, swimming and cycling (60% of girts, 34% of boys); and participation in dieting and fitness clubs (35% of girls, 16% of boys). In addition, 20% of girls reported using techniques such as slimming tablets (3%), cigarette smoking (5%) and self‐induced vomiting (5%) to control weight.The results show that weight control is a major preoccupation of many girls and some boys. Results are discussed in relation to differential social influences on the sexes, and health consequence

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1990.tb02377.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY