Archives of Disease in Childhood articles from September 2002

Archives of Disease in Childhood archives from September 2002

Are paediatricians failing at school? Paediatricians need to understand the morbidity of children with special educational needs. (Education).
September 1, 2002... The notion that paediatricians act in the interests of the child to facilitate optimal outcomes is well entrenched within the medical culture. From this perspective paediatricians act to provide curative interventions in reversible...

Health services: who are the best advocates for children? (Health Care).
September 1, 2002... "Advocacy is not about sayinq what's best for a child or young person but about enabling in that child or young person to come to in Formed decisions about matters which are affecting their lives" This quotation comes from the evidence...

Advances in the prevention and treatment of paediatric HIV infection in the United Kingdom: a summary of recent developments. (Infection).
September 1, 2002... In the five years since our last review there have been considerable advances, both in the prevention of mother to child transmission (MTCT) of HIV, and in the treatment of HIV infected children with highly active antiretroviral therapy...

The role of lumbar puncture in suspected CNS infection--a disappearing skill? (Lumbar Puncture).(central nervous system)
September 1, 2002... Introduced by Quincke in 1891 to diagnose and treat tuberculous meningitis, lumbar puncture (LP), has since been used extensively in the investigation of many neurological conditions. (1) Cerebrospinal fluid (CSF) analysis and culture is the...

The treatment of parental height as a biological factor in studies of birth weight and childhood growth. (Original Article).
September 1, 2002... Parental height is frequently treated as a biological variable in studies of birth weight and childhood growth. Elimination of social variables from multivariate models including parental height as a biological variable leads researchers to...

A visual motor psychological test as a predictor to treatment in nocturnal enuresis. (Original Article).
September 1, 2002... Background and Aims: The neurological control of bladder function and the ability to be dry at night involves not only the acquisition of normal daytime control, but also the establishment of a circadian rhythm in vasopressin release and the...

Leptin, malnutrition, and immune response in rural Gambian children. (Original Article).
September 1, 2002... Background: The adipocyte derived hormone, leptin, has cytokine like function and may mediate the effects of starvation on immunity. Mice with congenital leptin deficiency (ob/ob) have small hypocellular thymuses and impaired cellular...

Ventriculoperitoneal shunt block: what are the best predictive clinical indicators? (Original Article).
September 1, 2002... Aims: To evaluate the predictive value of symptoms, signs, and radiographic findings accompanying presumed ventriculoperitoneal (VP) shunt malfunction, by comparing presentation with operative findings and subsequent clinical course. ...

Causes of morbilliform rash in a highly immunised English population. (Original Article).
September 1, 2002... Aims: To determine the causes of morbilliform rash and fever in a population with high vaccination coverage for measles and rubella. Methods: Comprehensive laboratory investigation additional to routine oral fluid testing of children...

The emergence of resistant pneumococcal meningitis -- implications for empiric therapy. (Original Article).
September 1, 2002... Background: Following the emergence of penicillin and cephalosporin resistant pneumococcal meningitis in the United States, inclusion of vancomycin in empiric therapy for all suspected bacterial meningitis was recommended by the American...

Late post traumatic epilepsy. (Archivist).(Brief Article)
September 1, 2002... Estimates of the incidence of late epilepsy after head injury in children have varied considerably, probably because of differences in the populations studied. Rates of below 5% and above 20% have been reported. In Liverpool (RE Appleton and...

The impact of human immunodeficency virus 1 on largyngeal airway obstruction in children. (Short Report).
September 1, 2002... Children with laryngeal airway obstruction (LAO) require admission to the intensive care unit (ICU). The unresolved ethical dilemma of CU access for HIV infected children in resource poor settings requires further scientific data to help...

High dose growth hormone treatment induces acceleration of skeletal maturation and an earlier onset of puberty in children with idiopathic short stature. (Original Article).
September 1, 2002... Background: Long term growth hormone (GH) treatment in children with idiopothic short stature (ISS) results in a relatively small mean gain in final height of 3-9 cm, which may not justify the cost of treatment. As it is unknown whether GH...

Controlled study of respiratory viruses and wheezing. (Short Report).
September 1, 2002... Wheezing in early childhood is common, occurring in approximately 50% of children before the age of 6 years. (1) Understanding the role of respiratory viruses in triggering acute wheezing in children has been compromised by the lack of...

Idiopathic intracranial hypertension: is papilloedema inevitable? (Short Report).
September 1, 2002... Headaches and papilloedema are key features of idiopathic (benign) intracranial hypertension (IIH). We describe three children in whom IIH was diagnosed in the absence of papilloedema. Recognition of atypical cases of IIH is important because...

Staphylococcal necrotising pneumonia. (Archivist).(Brief Article)
September 1, 2002... In most paediatricians' minds the term staphylococcal pneumonia is associated with a picture of severe bilateral disease in infants and young children, often with pleural effusion, empyema, pneumothorax or pyopneumothorax, lung abscesses, and...

Respiratory depression in the acute management of seizures. (Short Report).
September 1, 2002... The incidence of respiratory depression following treatment of prolonged seizures with benzodiazepines is variable in the literature. We retrospectively reviewed the charts of children treated for prolonged seizure over a one year period. Of...

Atypical bleeding due to idiopathic thrombocytopenia in association with low factor VIII levels. (Short Report).
September 1, 2002... Two children with bleeding from idiopathic thrombocytopenia with low factor VIII levels are described. The presence of a double haemostatic defect in an otherwise healthy individual presenting with bleeding is extremely rare. In both cases...

Erythromelalgia: an endothelial disorder responsive to sodium nitroprusside. (Short Report).
September 1, 2002... Erythromelalgia is an unusual syndrome of painful vasodilatation. Aetiopathology is probably different in children and adults. Presentation can be severe and associated with hypertension. Dramatic benefit from infused nitroprusside suggests...

Breath nitric oxide concentrations. (Archivist).(Brief Article)
September 1, 2002... Exhaled nitric oxide (eNO) concentrations are increased in both children and adults with asthma but whether eNO is a marker of airway inflammation or simply of atopy is debated. Two recent reports suggest the former. In Belfast (TJ Warke...

Treatment with cyclosporin A in a patient with Omenn's syndrome. (Case Report).
September 1, 2002... Unless treated with hoematopoetic stem cell transplantation, Omenn's syndrome, a rare variant of severe combined immunodeficiency, is associated with a fatal outcome. We describe a male infant showing all the typical features of Omenn's...

Postcard from down under: time off.
September 1, 2002... "We'd like to offer you a consultant post. Before you accept, however, please note the terms and conditions of the post, and in particular the following stipulation: After ten years of continuous employment we insist that you take, in...

When to do a lumbar puncture: if you suspect meningitis, unless there is a specific contraindication. (Diagnosis).
September 1, 2002... Lumbar puncture has long been a key investigation. The "classical signs" of meningitis are often absent in infants in the first year of life. Lumbar puncture is thus advocated for any infant who is drowsy or ill, without awaiting the...

Lumbar puncture following febrile convulsion: a painful pointless procedure? (Diagnosis).
September 1, 2002... Much of the medicine we practice is enshrined in dogma. The management of children following febrile seizures is no exception. Every 5-10 years, the value and need for various investigations or treatment has been revisited in the medical...

Controversies and advances in the management of Wilms' tumour. (Review).
September 1, 2002... Wilms tumour is one of the success stories of paediatric oncology with long term survival approaching 90% in localised disease and over 70% for metastatic disease. Although appearing relatively simple compared to other cancer treatment...

Interhospital transport to paediatric intensive care by specialised staff: experience of the South Thames combined transport service, 1998-2000. (Personal Practice).
September 1, 2002... The South London Combined Transport Service retrieved 1536 children aged 1 month to 16 years to paediatric intensive care (PIC) units usually in south London, over a 2.5 year period. Eighty one per cent of cases were for general PIC, the...

Airway resistance measured by the interrupter technique: normative data for 2-10 year olds of three ethnicities. (Original Article).
September 1, 2002... Background and Aims: The measurement of airway resistance using the interrupter technique ([R.sub.int]) is feasible in preschool children and other subjects unable to undertake spirometry. This makes it potentially useful for the measurement...

Phase angle and n-3 polyunsaturated fatty acids in sickle cell disease. (Short Report).
September 1, 2002... Phase angle, an impedance parameter used for nutritional assessment, is reflective of the capacitance properties of cell membranes. We have shown a significant correlation between the proportions of specific n-3 polyunsaturated fatty acids in...

Lactic dehydrogenase isoenzymes in cerebrospinal fluid of children with Guillain--Barre syndrome. (Original Article).
September 1, 2002... Background: Increased levels of lactic dehydrogenase (LDH) in the cerebrospinal fluid (CSF) have been reported in association with several intracranial pathologies. No studies have been performed on patients with Guillain--Barre syndrome...

Respiratory failure due to pulmonary calcification in primary hyperparathyroidism. (Images in Paediatrics).
September 1, 2002... A 5 1/2 year old boy presented with fever, limb pain, polydipsia, and polyuria for 18 months, and respiratory distress for two weeks. His weight and length were below the 5th centile and he had multiple enlarged lymph nodes and...

Towards evidence based medicine for paediatricians. (Archimedes).
September 1, 2002... For a year now, Archimedes has sought to assist practising clinicians 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...

Overgrowth Syndromes.
September 1, 2002... Edited by M Cohen, G Neri, and R Weksberg. USA: Oxford University Press, 2001, $85.00, pp 224. ISBN 0195117468 Paediatricians are often more concerned about failure to grow rather than excessive growth. Bigger is not always better,...

Handbook of Paediatric Intensive Care.
September 1, 2002... G Pearson. London: WB Saunders, 2002, pp 336. ISBN 0 7020 2346 9 George Bernard Shaw said "we have not lost faith, but we have transferred it from God to the medical profession." Paediatric intensive care was born from the increasing...

Practical Endocrinology and Diabetes in Children.
September 1, 2002... JE Raine, MDC Donaldson, JW Gregory, MO Savage. Oxford: Blackwell Science, 2001, pp 201. ISBN 0632051612 This concise textbook has proved extremely useful in general paediatric ward and clinic work. Problem based chapters give an overview...

Human herpesvirus 8 (HHV-8). (Lucina).(Brief Article)
September 1, 2002... Human herpesvirus 8 (HHV-8) is known to be the cause of Kaposi sarcoma and primary effusion B-cell lymphoma in adults with HIV infection or immunosuppression from other causes. Serological studies have shown that HHV-8 infection in children...

Paediatric gastroenterologists. (Lucina).(Brief Article)
September 1, 2002... Paediatric gastroenterologists in Australia (Journal of Pediatrics 2002;140: 14-9) reviewed the records of 125 infants investigated with upper gastrointestinal biopsies and 24-hour oesophageal pH monitoring because of persistent crying and...

Pediatric Sleep Questionnaire. (Lucina).(Brief Article)
September 1, 2002... Lucina is suspicious of studies that purport to show that large numbers of normal children are unhealthy. In Michigan (Journal of Pediatrics 2002;140:97-102) a Pediatric Sleep Questionnaire was filled in by parents of 1038 children aged 2-14...

Kauai schoolchildren. (Lucina).(Brief Article)
September 1, 2002... After disasters, children often suffer long term psychological ill effect and may benefit from treatment. On the Hawaiian island of Kauai schoolchildren were screened 2 years after a major hurricane (Archives of Pediatrics and Adolescent...

Aberdeen. (Lucina).(Brief Article)
September 1, 2002... A study in Aberdeen (Journal of Medical Genetics 2002;39:251-9) has confirmed the high morbidity rate in children exposed to antiepileptic drugs in utero. Rates of neonatal withdrawal symptoms ranged from 13% (phenobarbitone) to 24%...

Infrared spectroscopy study. (Lucina).(Brief Article)
September 1, 2002... A near infrared spectroscopy study of healthy term infants in Italy (British Journal of Obstetrics and Gynaecology 2002;109:2026) has shown that cerebral blood volume falls between 2 and 3 hours after birth but the changes were the same...

Healthcare services. (Lucina).(Brief Article)
September 1, 2002... It is often assumed that chronic pain of uncertain origin (chronic benign pain) is due to somatisation and children with these complaints are disproportionate users of healthcare services. Now a general practice study of children in Rotterdam...

Forest environment. (Lucina).(Brief Article)
September 1, 2002... How do the press and people in industrialised countries cope with information about serious diseases such as Ebola virus infection in far off countries? A study in Britain (Social Science and Medicine 2002;54:955-69) has shown that the...

Trinidad and Tobago. (Lucina).(Brief Article)
September 1, 2002... Plastic bottles are often used as homemade spacer devices by children with asthma in developing countries. Three bottles commonly used in this way in Trinidad and Tobago (West Indian Medical Journal 2002;50:189-93) were compared with a...

Medial metaphysis. (Lucina).(Brief Article)
September 1, 2002... There is still controversy about bow legs in young children. True tibia vara is difficult to define and to distinguish from physiological bowing and most bowed legs will straighten with time but in some children the condition may persist or...