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Ostlund A.,Neonatal Unit | Nordstrom M.,Paediatric Unit | Dykes F.,University of Central Lancashire | Flacking R.,Uppsala University Hospital
Journal of Human Lactation | Year: 2010

To investigate the duration of breastfeeding and the impact of maternal factors for cessation of breastfeeding in twin infants, the authors undertook a population-based cohort study. Breastfeeding data obtained from Child Health Centres were matched with data on infant and maternal demographics from Swedish national registers. A total of 1.657 twins were included, of whom 695 were born preterm. Breastfeeding frequencies in preterm twins were 79% at 2 months, 58% at 4 months, 39% at 6 months, 14% at 9 months, and 6% at 12 months. In term twins, the corresponding frequencies were 84%, 63%, 45%, 18%, and 6%, respectively. In both preterm and term mothers, mothers who had a lower educational level or smoked at first antenatal care visit were subject to earlier cessation of breastfeeding by 6 months of age. In addition, in mothers of term infants, mothers who were < 23 years old or primiparous had a higher risk for cessation of breastfeeding before 6 months. Thus, mothers of twins have a good potential to breastfeed, but additional support is needed for those more susceptible to early cessation of breastfeeding. © Copyright 2010 International Lactation Consultant Association. Source

McDougall P.,Paediatric Unit
Paediatric nursing | Year: 2011

This article summarises the signs and symptoms of bronchiolitis, the advantages of continuous positive airway pressure and outlines the skills nurses need to use it. Early warning signs and deterioration are discussed and the importance of monitoring is looked at. Source

Stevens D.,University of Exeter | Oades P.J.,Paediatric Unit | Armstrong N.,University of Exeter | Williams C.A.,University of Exeter
Journal of Cystic Fibrosis | Year: 2010

Background: Exercise testing is a valuable prognostic tool and exercise training has many health benefits in cystic fibrosis (CF). The objective of this study was to survey the provision of exercise testing and training in UK CF clinics. Methods: A three-page questionnaire was used to determine the extent of, scope and importance assigned to exercise testing and training. Results: Data from returned questionnaires showed that 38.9% of paediatric and 27.8% of adult patients had performed an exercise test in the preceding 12. months, most as part of an annual review process. Pulmonary rehabilitation programmes were accessible in only 31.3% of clinics, and only 26.0% provide exercise training programmes. When assigning importance for exercise testing on a scale from 1 'not important' to 5 'very important', the mean and median respondent scores were 3.5 and 4.0, respectively, and for the importance of training were 4.0 and 4.0, respectively. Conclusions: Despite the level of importance given to exercise testing and training by healthcare providers, exercise is underused as either an assessment tool or therapeutic intervention in the healthcare of patients with CF in the UK. © 2010 European Cystic Fibrosis Society. Source

Mahato P.R.,Paediatric Unit | Pandey S.B.,Radiology Unit
Indian Journal of Human Genetics | Year: 2012

Orofaciodigital syndrome type-VI (Varadi-Papp Syndrome) is a rare autosomal recessive disorder characterized by variable orofacial anomalies, central polydactyly of the hands, and cerebellar dysgenesis (mainly hypoplasia or aplasia of vermis, rarely Dandy-Waker anomaly). Here a case of Varadi-Papp syndrome with recurrent episodic tachypnea-apnea, minimal orofacial features, several Y-shaped metacarpals, and cerebellar vermis hypoplasia, diagnosed in the neonatal age, is reported for the first time in Indian literature. The importance of early accurate diagnosis of this rare disease for proper genetic counseling and prenatal case detection of pregnancy at risk is also emphasized as the prognosis is poor in almost all cases. Copyright © 2012 Indian Journal of Human Genetics. Source

Issack M.I.,Central Health Laboratory | Neetoo Y.,Paediatric Unit
Journal of Infection in Developing Countries | Year: 2011

Introduction: Elizabethkingia meningoseptica is a rare but well-recognised cause of neonatal meningitis. Reported outbreaks have involved very few cases. We describe the management and outcome of a relatively large outbreak of E.meningoseptica neonatal meningitis Methodology: From August 2002 to December 2003, eight cases of meningitis caused by E. meningoseptica occurred among babies admitted to the neonatal ward of Jawarhlal Nehru hospital, Mauritius. In all cases, the organism was isolated from the cerebrospinal fluid. Infection control measures were re-emphasized after each case and environmental swabs were cultured on several occasions. Results: The affected babies were aged 6 to 20 days (mean age of 10 days). Seven of the babies weighed < 2,500 g. All CSF isolates had the same antibiotic susceptibility pattern. Apart from one baby who died shortly after admission, all cases responded to treatment with intravenous piperacillin and oral rifampicin for three weeks. Hydrocephalus developed in two babies and was subsequently fatal in one case. At follow-up of the other cases, one baby had severe neurological sequelae but a full recovery was observed in the other four cases. The source of the outbreak could not be established conclusively. Conclusions: The outcome was better than what has been reported in the medical literature. Prompt identification of the causative organism and initiation of appropriate antimicrobial therapy is essential. The combination of piperacillin and rifampicin should be considered an option for the treatment of E. meningoseptica neonatal meningitis if supported by properly performed antibiotic susceptibility test results. © 2011 Issack and Neeto. Source

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