Search PubMed⌕ Search

Biomedical subjects

F Oberklaid

Publications and source records attributed to F Oberklaid.

At least 37 records · Page 2Linked to original sources
PubMed1996

Helicobacter pylori and recurrent abdominal pain in children.

Recurrent abdominal pain is one of the most common presentations to pediatricians; yet an organic etiology can be found in only 10% of cases. Because infection with Helicobacter pylori in adults and children results in gastritis, a causative role for the organism has been postulated. To investigate this theory, we conducted a prospective case-control study in children with recurrent abdominal pain using serum H. pylori IgG antibodies measured by an enzyme immunoabsorbent assay. Age, sex, ethnicity, and socioeconomic status were adjusted in the statistical model. Five subjects (5.1%) and 14 controls (14.3%) had raised serum IgG antibodies to H. pylori (adjusted OR, 0.21; 95% confidence interval, 0.05, 0.85). The negative association between H. pylori and recurrent abdominal pain indicates that this organism is unlikely to have an important etiologic role in this disorder.

Abdominal Pain↗
PubMed1996

Pay attention to ADHD.

Explore the source record for details and available documents.

Attention Deficit Disorder with Hyperactivity↗
PubMed1995

Late diagnosis of congenital sensorineural hearing impairment: why are detection methods failing?

This study was designed to look in detail at the paths to diagnosis for a group of 197 children with congenital sensorineural hearing impairment (SNHI), who were diagnosed between 1989 and 1991 in the state of Victoria, Australia. Despite the existence of universal infant screening at 7-9 months by distraction test or questionnaire, the median age at diagnosis for the study group was 18.0 months, with median age at aid fitting of 20.8 months, and median age at commencement of specialised intervention programmes of 22.3 months. Parent questionnaires completed for 143 (73%) of these children showed that 49% had known risk factors for hearing loss yet only 20% of them had been referred for audiological assessment before the 7-9 month screen. Only 63% of those eligible for the 7-9 month screen had received it. Of those children who were screened by distraction test 46% passed as did 57% of those screened by questionnaire. Twenty four parents (17%) described how they had initially 'denied' their own observations of their infants' abnormal hearing behaviour. When concerns were raised with professionals, 10% of parents were falsely reassured without audiological assessment. Detection methods are failing through a combination of poor screen test efficacy, incomplete population coverage, and parental and professional denial.

Age Factors↗
PubMed1995

Is community screening for amblyopia possible, or appropriate?

Photoscreeners are becoming increasingly available and are being widely used to screen for visual abnormalities in young children. However, consideration of accepted criteria for screening programs indicates there is still much further research that needs to be carried out before amblyopia screening could be recommended as a routine component of a community health surveillance program--an adequate description of the potential consequences of an individual developing amblyopia has yet to be provided and the natural history of the condition and factors that determine the effectiveness of treatment have yet to be fully described. While there is the promise of technology that satisfies specific test requirements, this still needs to be trialed in community settings and community trials are required before it will be possible to determine whether the costs that will be incurred in carrying out routine screening and in providing the resources for treatment are warranted. In conclusion, the development of new and possibly more effective technology for screening is only part of the answer to the amblyopia question. While superficially this technology makes screening for amblyopia a possibility, we do not know at this stage whether or not it is appropriate.

Amblyopia↗
PubMed1993

A comparison of a bodyweight dose versus a fixed dose of nebulised salbutamol in acute asthma in children.

OBJECTIVE: To compare the efficacy of salbutamol as a fixed dose Ventolin Nebule (2.5 mg) and as variable dose respirator solution (0.1 mg/kg bodyweight). DESIGN: Multicentre, randomised, double-blind, parallel group comparison. SETTING: The Emergency Departments of the Royal Children's Hospital, Melbourne, Victoria; Princess Margaret Hospital for Children, Perth, Western Australia; and The Children's Hospital, Sydney, New South Wales. PATIENTS: Ninety-nine children between four and 12 years of age who presented to the Emergency Departments with mild to moderate acute asthma from May to December 1990. INTERVENTIONS: Children enrolled in the study were randomly allocated to one of two groups. Group 1 received one Nebule (2.5 mg salbutamol in 2.5 mL aqueous solution) delivered by wet nebulisation. Group 2 received salbutamol (approximately 0.1 mg/kg bodyweight) diluted with saline to 2.5 mL, delivered by identical wet nebulisation. MAIN OUTCOME MEASURES: (i) Clinical score; (ii) pulse oximetry; and (iii) peak expiratory flow rate (PEFR) where possible--measured before, and at 15 and 30 minutes after treatment with salbutamol. RESULTS: The clinical score significantly improved in both treatment groups after 15 minutes (P < 0.001), but the difference between the two treatments (adjusted for covariates) was not significant (P = 0.97). Both preparations of salbutamol produced a significant increase in oxygen saturation after 15 minutes (P < 0.05), while the difference between the two treatments (adjusted means) was not significant (P = 0.46). Peak flow measurements were available for 65 of the 99 patients. Both preparations of salbutamol produced highly significant (P < 0.001) improvements in PEFR at 15 minutes after treatment. The difference in peak flow rates between the two treatment groups (adjusted means) was not significant (P = 0.89). The study had a power of 0.8 to detect differences between treatments of 9% PEFR (percentage predicted), 0.8% oxygen saturation and 0.77 units of clinical score. CONCLUSIONS: A fixed dose of nebulised salbutamol is as efficacious as a salbutamol dose calculated for bodyweight in children with mild to moderate acute asthma.

Administration, Inhalation↗
PubMed1993

Sex differences in psychological adjustment from infancy to 8 years.

The objective of this study was to explore sex differences in development from infancy to 8 years of age in a community sample. Measures of biological, social, interactive, and parental functioning as well as teacher reports were obtained. There were minimal differences in infancy, but major psychosocial differences emerged with increasing age. In the biological sphere boys were disadvantaged only in ratings of language and motor skills at 3 to 4 years old. They showed greater temperamental "difficulty" and low persistence factor scores from 5 years onward. Boys were significantly more likely to have problems with adaptive behavior and social competence and to show behavior problems of the hyperactive and aggressive type, as rated by mothers. Parent and family functioning measures did not differentiate between the sexes. Teachers rated boys as having more problems in academic and behavioral domains the first 3 years of school. Path analyses combining data sets gathered when the children were 3 to 8 years old demonstrated the differential courses of development for boys and girls although temperamental flexibility was the best predictor of behavioral adjustment for both sexes. A social learning explanation of the increased incidence of problems among males is supported, although biological influences are not ruled out.

Adaptation, Psychological↗
PubMed1993

Precursors of hyperactivity and aggression.

OBJECTIVE: This study investigated the early characteristics of children who at 8 years old were hyperactive, aggressive, or both, to clarify the etiology of these disorders. METHOD: Prospective data from infancy to 8 years on children who were hyperactive (N = 65), aggressive (N = 57), or both (N = 60) at 8 years were compared with those on a normal comparison group (N = 70). Variables included ratings of temperament, behavior, school performance, and socioeconomic and life stress indices. RESULTS: The two aggressive groups, particularly the hyperactive-aggressive group, were more difficult in temperament and behavior from infancy and had less optimal environments. In contrast, the "pure" hyperactive group showed more problems than did the comparison group only from 3 to 4 years on. All three clinical groups had poorer academic performance than did the controls. CONCLUSIONS: The findings are consistent with a transactional model of development in which aggression (with or without hyperactivity) emerges when difficultness in infancy interacts with a stressed environment. Hyperactivity, when unassociated with aggression, may emerge later from poor self-regulation when faced with societal, especially school, demands. The pattern of group differences found suggest that risk indicators for specific patterns of later maladjustment may be identifiable for early intervention.

Adolescent↗
PubMed1993

New concepts in the management of encopresis.

Persistent fecal incontinence without anatomic abnormality, otherwise known as soiling or encopresis, frequently brings ridicule and shame to the affected child. The disability that it imposes is accentuated by the parental anger, guilt, and helplessness it engenders; by the peer hostility and rejection it promotes; and by the disgust with which it may be greeted by teachers. Home-based pediatric therapy is safe, generally very effective, and rewarding to patient, family, and physician. However, it requires a comprehensive understanding of both the underlying pathophysiology and the integrated therapeutic program of counseling, pharmacotherapy, and behavior modification.

Biofeedback, Psychology↗
PubMed1993

Predicting preschool behavior problems from temperament and other variables in infancy.

There is uncertainty about the relationship between difficult temperament in infancy and reported problem behaviors later in childhood. In this study data from a large, representative community cohort (total N studied = 1583) were used to determine whether preschool behavior problems (at age 4 to 5 years) could be predicted from difficult temperament and other variables in infancy. Maternal ratings of difficult temperament on the Revised Infant Temperament Questionnaire predicted only 17.5% of those with preschool behavior problems, a percentage not significantly greater than the 14% of the total sample rated as having problems. There was some improvement in prediction when difficult temperament was added to other variables such as male sex (28%). However, mothers' overall rating of temperament was a more powerful predictor of preschool behavior problems, both alone (26.0%) and in combination with other variables such as perinatal stress (36.8%), male sex (29.5%), and non-Australian parent (29.4%). Similarly, maternal reports of infant behavior problems was a more powerful predictor of preschool behavior problems both alone (21.8%) and in combination with male sex (24.6%), low socioeconomic status (26.1%), non-Australian parent (21.8%), and nurse's overall rating of temperament (21.8%). The best consistent predictor of later problems was the combination of mothers' overall rating of temperament and maternal reports of infant behavior problems (27.0%), especially when combined with other infant variables such as perinatal stress (35.3%), male sex (31.5%), and non-Australian parent (30.0%).(ABSTRACT TRUNCATED AT 250 WORDS)

Australia↗
PubMed1992

Health screening of international adoptees. Evaluation of a hospital based clinic.

OBJECTIVE: To report the findings of health screening of 100 international adoptees. DESIGN: Retrospective case review. SETTING AND PATIENTS: The first 100 children to attend the Outpatient Inter-Country Adoption Clinic at the Royal Children's Hospital, Melbourne. INTERVENTIONS: A medical history was taken and a thorough physical examination and series of screening investigations were performed on all children. RESULTS: The children ranged in age from two months to 16 years (median, five months; mean, 2.8 years). The countries most represented were Korea, with 36 children, and India, with 21. Thirty children fell below the third Australian centile for both height and weight. Abnormalities on physical examination included hepatosplenomegaly (13 children), scabies (six) and severe dental caries (six). Parasitic infestation of the stools was found in 23 children, a positive Mantoux test result in nine (three had active tuberculosis), anaemia in 12, elevated hepatic transaminase levels in nine and positive hepatitis B surface antigen and e antigen in two. One child had acquired syphilis. Screening for human immunodeficiency virus antibody gave negative results in all children. CONCLUSION: International adoptees constitute a special paediatric subgroup requiring assessment and screening investigations as soon as possible after arrival in their adoptive country.

Adolescent↗
PubMed1992

Charting infant distress: an aid to defining colic.

The value of a 24-hour distress diary, previously validated against a voice-activated audiotape record, was investigated in 30 infants with colic and 30 control infants. The infants with colic had significantly more distress behavior (300.0 minutes vs 102.5 minutes; p < 0.001), although overlap of duration of distress was noted. On the basis of a clinical definition of colic--total distress lasting 180 minutes in a 24-hour period--the diary had a sensitivity of 77% and a specificity of 87%. The sensitivity of the chart was confirmed in a separate study of another 90 infants with colic.

Child Behavior↗
PubMed1992

Transient versus stable behavior problems in a normative sample: infancy to school age.

Identified 3 subgroups of children from a prospective longitudinal study of temperament and development: (a) those with stable, (b) transient, or (c) no-behavior problems, as rated by mothers across the toddler, preschool, and preparatory school grade periods. Children with stable behavior problems were particularly characterized by more difficult temperament, mothers' overall perception of the child as difficult, and aggressive behavior in the 2- to 4-year age period. Group differences were linear rather than categorical with transient behavior problem children showing a lesser degree of difficulty. In a second study where more comprehensive child and family measures were available, temperament was again an important discriminator, with Vineland Adaptive Behavior Composite Score, mothers' overall perception of the child's temperament, and maternal psychological health and stress factors also more adverse for the stable group. However, correct classification of the members of these groups using a combination of the above variables was not impressive.

Child↗
PubMed1992

The detection of developmental problems in children.

General practitioners are ideally placed to assist in the identification of children whose development is slower than expected for age. In this article various methods of detecting developmental delay are discussed, and an algorithm is proposed for application in a busy office.

Age Factors↗
PubMed1991

Can short hospital admissions be avoided? A review of admissions of less than 24 hours' duration in a paediatric teaching hospital.

OBJECTIVE: To review the records of children admitted to hospital for less than 24 hours to assess the appropriateness of the admission and subsequent discharge, and the suitability of these patients for admission to a short stay area rather than the hospital wards. DESIGN: Retrospective study consisting of a one in three sample of all children admitted to the hospital's general medical units over one year. All admissions were listed sequentially, and every third patient was included in the study. SETTING: Royal Children's Hospital, Melbourne; a tertiary paediatric hospital with a major primary care role. PARTICIPANTS: There were a total of 660 patients eligible for inclusion in the study; 220 were selected, and all records were reviewed. RESULTS: It was found that although 87.7% of admissions could be justified on medical grounds alone, the children quickly recovered with at least 65% being fit for discharge within 12 hours of admission. In spite of this the mean duration of admission was 17.0 hours. The majority of patients were suffering from easily diagnosed and treated disorders, with 78.9% falling into four diagnostic groups (asthma, ingestions, infections, and convulsions). Criteria for admission to a short stay observation area were satisfied in 65% of patients (at the time of the study no such area existed in the hospital). No patients were discharged inappropriately early. CONCLUSIONS: A significant number of children require brief hospitalisation for relatively minor illness, but unnecessary delays caused by administrative aspects of hospital admission and relatively infrequent inpatient review by medical staff often lengthen the period of admission. Significant cost savings are possible with the use of a short stay facility, and a large number of patients are suitable for this form of care.

Australia↗
PubMed1991

Randomised trial of laxatives in treatment of childhood encopresis.

Primary faecal incontinence (encopresis) in children is usually treated with laxative medication and a behaviour modification programme aimed at promoting regular toileting, but the effectiveness of laxatives has never been adequately investigated. 169 children with encopresis and evidence of stool on plain abdominal radiograph were randomly allocated to receive multimodal (MM) therapy (laxatives plus behaviour modification; n = 83) or behaviour modification alone (BM; n = 86). Mean (SD) follow-up was 55.1 (27.0) weeks and 56.7 (32.0) weeks, respectively. By 12 months' follow-up 42 (51%) of the MM group and 31 (36%) of the BM group (p = 0.079) had achieved remission (at least one 4 week period with no soiling episodes) and 52 (63%) vs 37 (43%) (p = 0.016) had achieved at least partial remission (soiling no more than once a week). MM subjects achieved remission significantly sooner than BM subjects, and the difference in the Kaplan-Meier remission curves was most striking in the first 30 weeks of follow-up (p = 0.012). The patterns of compliance with toileting in the treatment groups were almost identical, although about 1 in 8 children overall did not comply with the sitting programme. After exclusion of the 24 poor compliers, there was no significant difference between BM and MM groups. This study shows a clear advantage overall for the use of laxative medication, although the benefit may not be as great for children who are able to maintain regular toileting.

Adolescent↗