Journal of paediatrics and child health
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J Paediatr Child Health · Aug 2000
Case ReportsRib fractures in infants: red alert! The clinical features, investigations and child protection outcomes.
To examine clinical features, investigation methods and outcomes of infants with rib fractures. ⋯ Rib fractures in infancy are usually caused by severe physical abuse. Accidental rib fractures are rare in infants and result from massive trauma. Rib fractures, multiple or single, may occur in isolation in abused infants. The implications of such injuries must be recognized to ensure appropriate, safe and consistent child protection outcomes. Bone scintigraphy is more sensitive than radiographs in the detection of acute rib fractures and should be performed in all cases of suspected infant abuse.
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J Paediatr Child Health · Aug 2000
Case ReportsMethaemoglobinaemia secondary to topical lignocaine/ prilocaine in a circumcised neonate.
The use of topical lignocaine/prilocaine (EMLA, Astra Pharmaceuticals, North Ryde, NSW, Australia) for pain relief for neonatal circumcision is becoming more prevalent. Because of immaturity of the methaemoglobin reductase pathway, the neonate is vulnerable to methaemoglobinaemia which is a recognized complication of prilocaine therapy. This is the second report of methaemoglobinaemia due to the use of EMLA in association with circumcision during the newborn period.
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J Paediatr Child Health · Jun 2000
Case ReportsBromocriptine for the management of autonomic dysfunction after severe traumatic brain injury.
This case report describes a child with severe traumatic brain injury with clinical features of autonomic dysfunction in the immediate post-traumatic period. A history of severe asthma in this child contraindicated the use of beta-blockers, the first line approach, and she was managed with bromocriptine (0.05 mg/kg t.d.s) with good effect.
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J Paediatr Child Health · Jun 2000
A 7-year review of deaths on the general paediatric wards at John Hunter Children's Hospital, 1991-97.
To study the palliative management of children dying on the wards of a tertiary referral centre. In particular to identify areas of difficulty and discuss ways in which these can be improved. ⋯ The majority of terminally ill children were managed well with intravenous narcotics and adjuvant medications. There may be scope for such children to be managed successfully at home with appropriate support for the general practitioner by paediatric and palliative care specialists. Some cases in which palliation is difficult do remain in hospital and additional measures need to be employed to ensure a symptom free death for these children.
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J Paediatr Child Health · Apr 2000
General practitioners: their contact with maternal and child health nurses in postnatal care.
To assess the level of contact of general practitioners (GP) with maternal and child health nurses (MCHN) in postnatal care. ⋯ This study provides baseline information on the level of GP contact with MCHN as they provide postnatal care. Although there were GP in Victoria who maintained a level of contact with MCHN, almost half reported no contact in the previous month. Most GP who reported contact with MCHN found it useful. This finding should encourage GP and MCHN coordination to improve continuity and postnatal care outcomes.