Archives of Disease in Childhood articles from May 2003

Archives of Disease in Childhood archives from May 2003

Making medicines that children can take: the role of the pharmacist. (Licensing of Medicines).
May 1, 2003... The Medicines Act of 1968 and subsequent UK and European legislation established the process of licensing (now authorisation) to assure the safety, efficacy, and quality of medicines. While the majority of medicines for adults are licensed,...

Recent developments in lasers and the treatment of birthmarks: despite rapid advances during the past two decades there are still unanswered questions. (Laser Treatment).
May 1, 2003... There have been numerous advances during the past two decades in the treatment of birthmarks, concerning both efficacy and safety. Although initial results of laser treatment for portwine stains are encouraging, there remain unanswered...

Postcard from the road: a leap into the unknown-working overseas.
May 1, 2003... Like most of these things, the opportunity to work for a year in Brisbane came about by chance, one in a series, in a lifetime filled with lucky circumstances. I had already decided, with my wife, to take six months of unpaid leave in...

Group B streptococcal conjugate vaccines. (Review).
May 1, 2003... Linkage of bacterial capsular polysaccharides to proteins to create conjugate vaccines has had a dramatic impact on the health of children. Although unconjugated polysaccharides are poorly immunogenic in infants and some older children and...

Images in paediatrics: trichobezoar.
May 1, 2003... A 13 year old adolescent girl presented with vague abdominal pain of a week's duration. The pain was not associated with vomiting, fever, or weight loss. She was thin built and had mild pallor. Examination of the abdomen revealed a large...

Immunologic memory in Haemophilus influenzae type b conjugate vaccine failure. (Original Article).
May 1, 2003... Aims: To compare the convalescent antibody response to invasive Haemophilus influenzae type b (Hib) disease between conjugate vaccine immunised and unimmunised children, to look for evidence of priming for immunologic memory. Methods:...

Emergency asthma inhalers in school. (Review).
May 1, 2003... Despite there being a lack of direct evidence of the effectiveness of providing emergency inhalers to schools, the balance of evidence at present suggests the benefits outweigh any possible harm. However, unless UK prescribing law or its...

Complementary use of radiological skeletal survey and bone scintigraphy in detection of bony injuries in suspected child abuse. (Original Article).
May 1, 2003... Aim: To compare the effectiveness of radiological skeletal survey and bone scintigraphy for the detection of bony injuries in cases of suspected child abuse. Methods: All cases with a discharge diagnosis of child abuse that presented to...

Survival of children born with congenital anomalies. (Original Article).
May 1, 2003... Aim: To describe the survival to age 5 years of children born with congenital anomalies. Methods: Between 1980 and 1997, 6153 live born cases of congenital anomaly were diagnosed and registered by the population based Glasgow Register of...

Looking for subgroups in the autistic spectrum. (Archivist).(Brief Article)
May 1, 2003... Subgroups within the autistic spectrum disorders may be definable on clinical, physiological, genetic, and pharmacological grounds. One possible subgroup has been suggested by a study in North Carolina (G Robert Delong and colleagues....

Long term follow up after meningitis in infancy: behaviour of teenagers. (Original Article).
May 1, 2003... Aims: To determine the effects of meningitis in infancy on subsequent teenage behaviour. Methods: A national postal survey of parents and teachers using an established standard behavioural questionnaire. Subjects were 739 of the surviving...

Restrained rehabilitation: an approach to children and adolescents with unexplained signs and symptoms. (Personal Practice).
May 1, 2003... The validation of treatment approaches for children and adolescents diagnosed with unexplained signs and symptoms is made difficult by the variety of clinical presentations and the different developmental levels of different patients. There is...

Fryns syndrome. (Archivist).
May 1, 2003... Here's a syndrome to bear in mind when you see a newborn baby with congenital diaphragmatic hernia. In 1979 JP Fryns and colleagues described two siblings who were stillborn and had craniofacial anomalies (coarse fades, large nose with flat...

The investigation of hypocalcaemia and rickets. (Review).
May 1, 2003... Our understanding of disorders that present with hypocalcaemia has advanced rapidly in the past decade. The molecular basis of many of these disorders and conditions associated with phosphate wasting has now been established. While many...

ISABEL: a web-based differential diagnostic aid for paediatrics; results from an initial performance evaluation. (Original Article).
May 1, 2003... Aims: To test the clinical accuracy of a web based differential diagnostic tool (ISABEL) for a set of case histories collected during a two stage evaluation. Methods: Setting: acute paediatric units in two teaching and two district general...

Cranial MRI scans are indicated in all girls with central precocious puberty. (Original Article).
May 1, 2003... Aims: (1) To assess the value of cranial magnetic resonance imaging (MRI) scans in the investigation of girls with central precocious puberty (CPP); and (2) to determine the clinical predictors of abnormal cranial MRI scans in these patients....

Hypoalbuminaemia in critically ill children: incidence, prognosis, and influence on the anion gap. (Original Article).
May 1, 2003... Aims: Hypoalbuminaemia has significance in adult critical illness as an independent predictor of mortality. In addition, the anion gap is predominantly due to the negative charge of albumin, thus hypoalbuminaemia may lead to its...

Disease severity and associated family impact in childhood atopic dermatitis. (Original Article).
May 1, 2003... Aim: To examine the association between childhood atopic dermatitis (AD) severity and family impact at baseline and after an intervention by a physician specialist, using validated measures of both severiiy and family impact. Methods:...

Management of necrotising enterocolitis. (Archivist).
May 1, 2003... Necrotising enterocolitis (NEC) and focal intestinal perforation (FIP) in preterm babies are both associated with hypoxia, indomethicin treatment, and hypertonic feeds and may be different manifestations of the same disease. Laparotomy has been...

Restoration of ovarian function after chemotherapy for osteosarcoma. (Original Article).
May 1, 2003... Aim: To evaluate ovarian function after modern intensive multi-agent chemotherapy for osteosarcoma given during childhood or adolescence. Methods: After discontinuation of treatment, 10 female osteosarcoma survivors were followed up for...

Fever in returned travellers: a prospective review of hospital admissions for a 2 1/2 year period. (Original Article).
May 1, 2003... Aim: To identify causes of fever, treatable diseases, and the mast helpful investigations in febrile children, who had travelled to the tropics or subtropics in the preceding year. Methods: Prospective observational study of all admissions...

Jejunal haemorrhage in Henoch-Schonlein syndrome. (Images in Paediatrics).
May 1, 2003... A 14 year old boy presented to the paediatric department with a two week history of severe recurrent colicky abdominal pain, anorexia, and weight loss. On examination he had localised tenderness in his epigastrium, no guarding, normal bowel...

Unexpected medical coincidences require systematic and careful strategies: an example. (Short Report).
May 1, 2003... In a cohort of 14 children with identical cardiac xenografts, two boys developed acute myeloid leukaemia 11 and 16 months respectively after the operation. A dedicated working group designed a scheme intending to take care of all aspects of the...

Causes and outcome of young infant admissions to a Kenyan district hospital. (Original Article).
May 1, 2003... Aims: To provide a comprehensive description of young infant admissions to a first referral level health facility in Kenya. These data, currently lacking, are important given present efforts to standardise their care through the integrated...

Increasing antibiotic resistance among urinary tract isolates. (Short Report).
May 1, 2003... A five year retrospective study was performed to identify organisms isolated from the urinary tract of 2815 children in the community and 1314 children with underlying renal problems and their antimicrobial susceptibilities. Isolates from...

HBV associated nephrotic syndrome: resolution with oral lamivudine. (Case Report).(hepatitis B virus treatment)
May 1, 2003... A 6 year old boy presenting with a five month history of fever, lethargy, and anorexia, was found to have hepatitis B associated membranous glomerulonephropathy and nephrotic syndrome. After two months treatment with oral lamivudine, his...

Education and training in the paediatric senior house officer grade: analysis of RCPCH hospital/child health visits reports, 1997-2001. (Medical Education).
May 1, 2003... Aims: To review the process and outcome of education and training visits to paediatric departments by the RCPCH. Methods: Retrospective audit of visits reports (1997-2001) against the RCPCH criteria for general professional training....

Towards evidence based medicine for paediatricians. (Archimedes).
May 1, 2003... In order to give the best care to patients and families, paediatricians need to integrate the highest quality scientific evidence with clinical expertise and the opinions of the family. (1) Archimedes seeks to assist practising clinicians by...

Is gradual introduction of feeding better than immediate normal feeding in children with gastroenteritis? (Archimedes).
May 1, 2003... A mother with her 11 month old daughter attends the surgery. The child has gastroenteritis and is mildly dehydrated. Mum has been starving the child the past 24 hours as "everything comes back up". She has read this and also that milk feeds...

Are follow up chest x ray examinations helpful in the management of children recovering from pneumonia? (Archimedes).
May 1, 2003... A 4 year old boy with a cough and a fever is referred by his general practitioner. On auscultation of his chest there are focal signs suggestive of a lower respiratory tract infection; a chest x ray examination confirms right lower lobe...

Should preterm neonates with a central venous catheter and coagulase negative staphylococcal bacteraemia be treated without removal of the catheter?
May 1, 2003... A 10 day old neonate (corrected gestation 29 weeks, birth weight 960 g) has been slow to establish feeds. Intravenous access is difficult and he is receiving parenteral nutrition through a central venous catheter (CVC). He develops temperature...

Letters.
May 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...

Nitazoxanide is a broad-spectrum anti-parasitic drug active against Cryptosporidium parvum. (Lucina).(Brief Article)
May 1, 2003... Nitazoxanide is a broad-spectrum anti-parasitic drug active against Cryptosporidium parvum. A study in Zambia (Lancet 2002;360:1375-80) has shown it to be effective treatment for cryptosporidial diarrhoea in children. The trial included 47...

Sinoatrial re-entry tachycardia is a form of supraventricular tachycardia in which the P-wave morphology is normal. (Lucina).(Brief Article)
May 1, 2003... Sinoatrial re-entry tachycardia is a form of supraventricular tachycardia in which the P-wave morphology is normal. Radiofrequency ablation has been used but until now the youngest patient so treated has been 15 years old. Now cardiologists in...

Women who take 5-aminosalicylic acid for ulcerative colitis during pregnancy may be at increased risk of stillbirth or preterm birth. (Lucina).(Brief Article)
May 1, 2003... Women who take 5-aminosalicylic acid for ulcerative colitis during pregnancy may be at increased risk of stillbirth or preterm birth. In Denmark (Gut 2003;52:243-7) a cohort study showed a doubling of the risk of preterm birth and a six-fold...

Twenty children had a second stroke 1.5 to 36 (median 5) months after the first. (Lucina).(Brief Article)
May 1, 2003... Researchers in Germany (Lancet 2002;360:1540-5; see also commentary, Ibid: 1526-7) followed up 301 children who had had a first stroke aged between 6 months and 18 years. Twenty children had a second stroke 1.5 to 36 (median 5) months after the...

With bi-directional case-crossover analysis the level of environmental hazard at the time of an event is compared with the levels before and after the event. (Lucina).(Brief Article)
May 1, 2003... With bi-directional case-crossover analysis the level of environmental hazard at the time of an event is compared with the levels before and after the event. Researchers in Canada (Journal of Epidemiology and Community Health 2003:57:50-5)...

Pollutant levels were, however, significantly associated with large (>20%) decrements in peak flow. (Lucina).(Brief Article)
May 1, 2003... On the other hand a study at three schools in Kent (Occupational and Environmental Medicine 2003;60:82-9) has shown no clear effect of air pollutants on mean peak expiratory flow rates in the winter months. Pollutant levels were, however,...

A post-mortem study of 204 children in Melbourne. (Lucina).(Brief Article)
May 1, 2003... To what extent injuries found at autopsy can be attributed to resuscitation attempts remains controversial. A post-mortem study of 204 children in Melbourne (Emergency Medicine Journal 2003;20:10-12) included 153 for whom resuscitation had been...

Drinking water contains disinfection by-products (DBPs) the most important of which are trihalomethanes (THMs) including chloroform, bromodichloromethane, dibromochloromethane, and bromoform. (Lucina).
May 1, 2003... Drinking water contains disinfection by-products (DBPs) the most important of which are trihalomethanes (THMs) including chloroform, bromodichloromethane, dibromochloromethane, and bromoform. Many DBPs are suspected of being carcinogens and of...

The anti-tumour necrosis factor drugs etanercept and infliximab are effective treatment for adults with rheumatoid arthritis and etanercept is effective in juvenile idiopathic arthritis (JIA). (Lucina).(Brief Article)
May 1, 2003... The anti-tumour necrosis factor drugs etanercept and infliximab are effective treatment for adults with rheumatoid arthritis and etanercept is effective in juvenile idiopathic arthritis (JIA). In a non-randomised, open label trial in Finland...

A landless nation of people, the Arab Saharan Democratic Republic. (Lucina).
May 1, 2003... A landless nation of people, the Arab Saharan Democratic Republic, has been living in refugee camps in the middle of the Algerian Sahara desert for over 25 years. A Spanish team (British Journal of Ophthalmology 2003;87:142-6) has examined 527...