Showing papers by "Princess Margaret Hospital for Children published in 1985"

Bronchodilator Response During Acute Viral Bronchiolitis in Infancy

Abstract: Bronchodilator responsiveness was assessed by measuring specific respiratory conductance before and after inhalation of aerosolized bronchodilator in 50 infants who had acute bronchiolitis due to respiratory syncytial virus infection. Thirty per cent of the infants showed an improvement in specific conductance. Responders could not be differentiated from nonresponders by family histories of atopy, eosinophil counts, or immunoglobulin levels in blood and nasal secretions. Eighty-three per cent of the families and 54% of the mothers of the infants were smokers. Babies of smoking mothers had lower specific conductances than did those of nonsmoking mothers but showed no differences in bronchodilator response. The clinical significance of this bronchodilator-responsive sub-group has yet to be defined.

Isotope bone scans in the assessment of children with hip pain or limp.

Abstract: Bone scans from 43 children referred with hip pain of uncertain cause were reviewed. The bone scan was abnormal in 36 patients: normal in 7. In 12 the findings were diagnostic: osteomyelitis, osteoid osteoma, osteomyelitis with septic arthritis, Perthes' Disease and juvenile chronic arthritis. Twenty-four patients had abnormal scans including diffuse periarticular increase and of these 18 had transient synovitis. Immobilisation and trauma accounted for the remainder. Isotope bone scans have been found to be a valuable investigation in children presenting with hip pain or limp, where the x-rays may appear normal or nondiagnostic.

Acute chromium poisoning in a 2 year old child.

Abstract: Sodium dichromate ingestion in children is uncommon and potentially lethal. The most appropriate management is uncertain because of the lack of sound data contained in the few reports of successfully treated patients. Immediate treatment should include urgent induction of emesis, administration of ascorbic acid as an antidote, followed by supportive treatment.

Periodontal implications of the adolescent cleft palate patient.

Abstract: — The management of the patient with a cleft lip and palate is best accomplished by a multi-disciplinary team approach provided at a paediatric hospital. The role of periodontal treatment is discussed within such a framework. The implications are mainly related to altered soft tissue morphology without true loss of periodontal attachment. The rationale of plaque control and surgical intervention is discussed and the close relationship between periodontal and prosthetic considerations in treatment planning is highlighted.

Refractoriness to bronchoconstriction following hyperventilation with cold dry air.

Abstract: Fifteen subjects undertook repeated periods of hyperventilation of cold dry air and hyperventilation of warm humidified air followed by cold dry air. Hyperventilation of cold dry air induced a biphasic response with initial bronchodilatation followed by bronchoconstriction. However, exercise produced a greater rise in forced expiratory volume in 1 second (FEV1) than hyperventilation alone. Hyperventilation of cold dry air resulted in a period of refractoriness to a second stress of the same type. Refractoriness induced by exercise or hyperventilation of cold dry air may be the result of refractoriness of the trigger site in the large airways.

Prosthodontic implications of the adolescent cleft palate patient

Abstract: — Possibilities in cleft palate prosthodontics have widened in scope in recent years with the advent of improved treatment procedures. With continuing development of specialization in medicine and dentistry, the interdisciplinary team management of the patient presents increased difficulties in management and logistics because of the increasing number of specialties involved. It is important that the prosthodontic implications of the multidisciplinary treatment plan are envisaged early in treatment so that adequate coordination can occur.

Newborn screening for metabolic disorders in Australia and New Zealand: results for 1983: HumanGenetics Society of Australasia Newborn Screening Committee

Abstract: Renal angiography may show a typical \"spoked wheel\" appearance with a dense parenchymal blush and, again, no evidence of renal parenchymal infiltration or renal vein involvement.' However, these angiographic features do not enable positive differentiation to be made from a renal adenocarcinoma.• Macroscopically, the sizes of a large number of reported renal oncocytomas ranged from 1 em to 20 cm in greatest diameter.',9-11 The average size of these reported tumours was about 8 em. Despite their large size, the tumours did not show features of malignancy such as metastases, renal vein invasion or local extension into perinephric fat. Oncocytomas are well circumscribed, and often partially or entirely encapsulated. By contrast, all clear-cell neoplasms of the kidney are potentially malignant, and the likelihood of metastases increaseswith size hence the pathologists' convention of 3 cm diameter to separate the ordinary adenoma from carcinoma. The cut surface of a rental oncocytoma shows that the tumour is well demarcated and has a uniform brown-tan colour. Large tumours usually have a characteristic central stellate scar.\":\" Renal oncocytomas, irrespective of size, are devoid of necrosis. Small areas of haemorrhage may rarely be present. In contrast, clear-cell carcinomas are golden-yellow to orange in colour and often contain large areas of necrosis and haemorrhage. Microscopically, the renal oncocytoma

Congenital diaphragmatic hernia and the management of persistent foetal circulation.

Abstract: Twenty-two cases of diaphragmatic hernia, presenting from 1978 to 1982, were reviewed. Sixteen patients presented before 24 hours of life, of whom nine survived (56%). Six were late presenters who all did well. Seven babies had ten documented episodes of persistent foetal circulation (PFC) occurring as early as three hours postoperatively, although three babies had episodes in their second week. Hyperventilation, with hand bagging, was successful in treating five out of six episodes of PFC (83%), without complication. Tolazoline caused improvement in two out of four episodes of PFC but was associated with significant complications. We recommend early and sometimes persistent use of hyperventilation by hand bagging as a means of managing PFC in diaphragmatic hernia.

Mumps as a cause of admission to hospital: an estimate for Western Australia 1981.

Abstract: Close to 40% of children admitted to Princess Margaret Hospital with mumps over the period 1979 to 1982 were diagnosed retrospectively as a result of virological tests and their illness was not coded as being due to mumps. This clinical underestimate of the incidence of mumps is due to the frequent absence of salivary gland enlargement, especially in preschool children. In such cases there is usually evidence of inflammation of the upper respiratory tract. The main clinical features leading to admission were neck stiffness, fits and high fever. An appropriate adjustment was made to the figures obtained from the computerised data on discharges with the diagnosis of mumps from Western Australian hospitals in 1981. This led to the estimate that 104 patients suffering from mumps were discharged from hospital during that year. It was also estimated that mumps was responsible for 379 in-patient days. Our findings show that the benefit cost ratios for mumps immunization of others are underestimates.