Archives of Disease in Childhood articles from July 2003

Archives of Disease in Childhood archives from July 2003

Protecting children, supporting professionals: how can clinicians, managers, and national bodies maintain a high standard of child protection work as part of mainstream practice? (Child Protection).
July 1, 2003... Child protection is for many clinicians an important part of child health practice. Multidisciplinary teamwork in early recognition of child abuse and support for the family may be very rewarding, (1) although paediatric assessment and clinical...

Paediatricians and child protection: the need for effective education and training. (Child Protection Training).
July 1, 2003... "Child protection training is essential for all health professionals engaged in services for children. It is not an optional extra" (Bary Capon, Chair of Independent Inquiry into Death of Lauren Wright) (1). Child maltreatment has become...

From Cosette to Climbie: "progress is the aim, the ideal is the model". (Images in Paediatrics).(Brief Article)
July 1, 2003... In Hugo's Les Miserables (1862), Cosette, a neglected and abused orphan is rescued from her exploitative carers by Jean Valjean who devotes his life to raising and caring for her. This picture taken from the late nineteenth century is a...

Improving the quality of paediatric care in peripheral hospitals in developing countries: a coordinated and collaborative approach is required. (Quality of Care).
July 1, 2003... Recent observational evidence suggests there is considerable scope for improving the quality of hospital care for severely ill children in many developing countries. (1) In a study of 21 hospitals in Asia and Africa that evaluated the...

Airway infections in infancy and the presence of allergy and asthma in school age children. (Original Article).
July 1, 2003... Aim: To investigate the association between a history of otitis media and respiratory tract infections in infancy and allergic sensitisation and asthma in school age children of atopic and non-atopic parents. Methods: Based on a survey of...

Parent reported longstanding health problems in early childhood: a cohort study. (Original Article).
July 1, 2003... Aim: To study changing prevalence and correlates of longstanding health problems across early childhood. Methods: Of 2576 infants enrolled in the Coventry Cohort Study at birth, parents of 2157 at 8 weeks, 1752 at 8 months, 1521 at 18...

Timing of growth faltering in rural Malawi. (Original Article).
July 1, 2003... See end of article for authors' affiliations Aim: To determine the timing of growth faltering among under 3 year old children. Methods: Prospective population based cohort study in Lungwena, rural Malawi, southeast Africa. A total of...

Postcard from the road.
July 1, 2003... Safety first We arrived in Ayutthaya, about 60 km north of Bangkok in Thailand at the start of the festival Loi Krathong. Celebrated on the full moon day of the twelfth lunar month the event involves, at its simplest and most benign, the...

Funhaler spacer: improving adherence without compromising delivery. (Original Article).
July 1, 2003... A novel asthma spacer device, the "Funhaler", incorporates incentive toys which are isolated from the main inspiratory circuit by a valve. Here we show that its use does not compromise drug delivery. Improved adherence combined with...

Long term effects of long chain polyunsaturated fats in hyperphenylalaninemic children. (Short Report).
July 1, 2003... Blood fatty acid status and visual function of 20 treated hyperphenylalaninemic (HPA) children, randomly allocated into two groups to receive supplementation of either long chain polyunsaturated fatty acids (LCPUFA), including docosahexaenoic...

Awareness of swimming pool suction injury among tour operators. (Short Report).
July 1, 2003... A 6 year old girl suffered rectal prolapse after being sucked onto a swimming pool drain from which the cover had been removed. After six days in hospital she made a full recovery. The severe form of this injury may result in evisceration of...

Therapeutic implications of sex differences in asthma and atopy. (Review).
July 1, 2003... Clear sex differences exist in asthma and atopy with a preponderance of boys before puberty. There is a reversal of this sex ratio during puberty with girls having more asthma and atopy throughout the reproductive years. Elucidating the reasons...

Islet transplant: an option for childhood diabetes? (Review).
July 1, 2003... Careful assessment of the safety and efficacy of islet transplantation should guide the selection process of a small number of children with type 1 diabetes who may be eligible for the procedure--some of whom are already receiving...

Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders. (Review).
July 1, 2003... A proposal is made to recognise pathological demand avoidance syndrome (PDA) as a separate entity within the pervasive developmental disorders, instead of being classed under "pervasive developmental disorder not otherwise specified" (PDDnos,...

Pathophysiology of meningococcal meningitis and septicaemia. (Current Topic).
July 1, 2003... Neisseria meningitidis is remarkable for the diversity of interactions that the bacterium has with the human host, ranging from asymptomatic nasophayngeal colonisation affecting virtually all members of the population; through focal infections...

Ethics of antenatal screening for Down's syndrome. (Archivist).
July 1, 2003... Any one who has spent more than a few years in medicine will be able to reflect on how views of what is or is not ethical have changed over time. Some actions are so clearly wrong that they are universally condemned but there are others over...

Treatment of meningococcal infection. (Current Topic).
July 1, 2003... Aggressive early treatment of meningococcal disease can reduce mortality. This relies on prompt recognition and treatment of the complications of septicaemia and meningitis, appropriate ongoing intensive care where necessary, and adequate...

Diagnosis and treatment of bacterial meningitis. (Current Topic).
July 1, 2003... This review focuses on recent advances of topical interest regarding the diagnosis and treatment of common causes of bacterial meningitis occurring in children beyond the neonatal period. Tuberculous meningitis is beyond the scope of this...

Abnormal blood glucose concentrations on admission to a rural Kenyan district hospital: prevalence and outcome. (Original Article).
July 1, 2003... Aims: To determine the prevalence, clinical characteristics, and outcome of hypoglycaemia on admission in children at a rural Kenyan district hospital. Methods: Observational study of 3742 children (including 280 neonates) in Kilifi...

Treatment of plastic bronchitis in acute chest syndrome of sickle cell disease with intratracheal rhDNase. (Case Report).
July 1, 2003... Plastic bronchitis, a condition associated with widespread mucous plugging of the tracheobronchial tree, is an increasingly recognised bronchoscopic finding in acute chest syndrome of sickle cell disease. Removal of casts by bronchoscopy is...

Inflammatory C2-3 subluxation: a Grisel's syndrome variant. (Case Report).
July 1, 2003... The concurrence of non-traumatic atlanto-axial subluxation with inflammation of the adjacent neck tissues is known as Grisel's syndrome. We report a 5 year old boy with recurring episodes of head till and painful and restricted neck movements...

Safe retrieval of impacted central venous line. (Case Report).
July 1, 2003... Embolisation of impacted central venous lines is not uncommon in paediatric practice. We describe a method of preventing this complication and associated risks. Central venous access is increasingly being used for the long term...

Technetium-99m MDP bone scintigraphy shows multiple abnormalities in sickle cell disease. (Images in Paediatrics).(Brief Article)
July 1, 2003... Bone scintigraphy was performed on an 11 year old boy with known sickle cell disease who presented with severe right hip pain. Images showed features of avascular necrosis of the right femoral head. In addition, there was increased accumulation...

Shaking infant trauma induced by misuse of a baby chair. (Case Report).
July 1, 2003... A 2 month old infant presented with bilateral subdural haemorrhages and bilateral subhyaloid haemorrhage. The parent admitted to forceful bouncing of the child in a baby rocker. Experiments showed that violent rocking in the chair could produce...

Tell me a story ... what can paediatricians gain from reading stories? (Review).
July 1, 2003... In our first article (1) we considered literature for and about children, and how writing for the young has changed, reflecting different and evolving perspectives on childhood, in this second article, we will be asking whether literature can...

Towards evidence based medicine for paediatricians. (Archimedes).
July 1, 2003... The duck-yak problem It seems to be every other day that a new wonder test arrives. Yesterday it was CRP, tomorrow serum PCT may loom. How do these tests, which in early studies have such astounding sensitivity and specificity, fall by the...

Journal watch.(Preventing rickets: sunlight exposure may not be sufficient)(The evolving science of peanut allergy)(Natural history of pediatric hepatitis C)(Make no bones about it--midpuberty is when calcium counts)(Author Abstract)
July 1, 2003... Selections from Journal Watch Pediatrics and Adolescent Medicine. Please visit the ADC website (www.archdischild.com) for links to these articles -- many to full text. Preventing rickets: sunlight exposure may not be sufficient ...

Letters.(Category D: unknown whether ill treatment is cause)(Gentamicin usage in newborns: an audit)(Kasabach-Merritt syndrome and interferon alpha: still a controversial issue)(Acute renal failure and cystic fibrosis)(Fatal iatrogenic hyponatraemia)(Thyroid screening in Down's syndrome: current patterns in the UK)(Changes in serum sodium levels during treatment of hyperglycaemia)(Assessing immune responses to pneumococcal vaccines)(Partial splenectomy in CF patients with hypersplenism)(Partial splenectomy--worth the risk)(Letter to the Editor)
July 1, 2003... If you have a burning desire to respond to a paper published in ADC or F&N, why not make use of our "rapid response" option? Log on to our website (www.archdischild.com), find the paper that interests you, click on "full text" and send your...

Lucina.(medical bits and pieces)
July 1, 2003... In the first 3 years after the death of a child, the risk of unnatural death (from motor vehicle accident, suicide, or other accident or violence) is increased almost fourfold in mothers and by 57% in fathers. This was one of the main findings...