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Hines E.J.,Gold Coast University Hospital | Hines E.J.,Griffith University | Walsh M.,Lady Cilento Childrens Hospital | Armes J.E.,Materials Health Services | And 4 more authors.
Journal of Paediatrics and Child Health | Year: 2016

Childhood Interstitial lung disease (chILD) is an umbrella term used to define a broad range of rare, diffuse pulmonary disorders with altered interstitial structure that leads to abnormal gas exchange. Presentation of chILD in infancy can be difficult to differentiate from other common causes of diffuse lung disease. This article aimed at paediatricians provides an overview of interstitial lung disease presenting in infancy and includes key clinical features, a suggested approach to investigation and a summary of management. An overview of three clinical cases has been included to demonstrate the diagnostic approach, characteristic investigation findings and varied clinical outcomes. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians). Source


Bennett A.L.,University of Western Australia | Smith D.W.,University of Western Australia | Smith D.W.,PathWest Laboratory Medicine WA | Cummins M.J.,Amarillo Biosciences | And 3 more authors.
Influenza and other Respiratory Viruses | Year: 2013

Background and objective: Interferon alpha (IFNα) is a known antiviral agent. A double-blind, placebo-controlled clinical trial was conducted investigating the use of low-dose oral interferon alpha for preventing acute viral respiratory illnesses. Methods: Two hundred healthy adults aged 18-75 years were enrolled and completed weekly health data questionnaires to monitor for symptoms and impact of respiratory illness. Serum samples were tested for antibodies against influenza and other common respiratory viruses. Results: Low-dose oral IFNα prophylaxis did not reduce the incidence or impact of acute respiratory illness (ARI) or the impact of illness on daily activities. Post hoc analysis of participant subgroups, however, identified significant reductions in the incidence of ARI reported by males, those aged 50 years or more and those who received the 2009 seasonal influenza vaccine. Interferon alpha prophylaxis had a significant impact on the reporting of moderate-to-severe feverishness by the study population. Seropositive participants in the IFN group were more likely to report asymptomatic or mild symptoms compared with those in the placebo group who were more likely to report stronger symptoms. Conclusions: Low-dose oral IFNα prophylaxis was not effective in limiting the overall incidence of ARI in our study population. However, there was evidence that prophylaxis reduced the severity of symptoms and had a beneficial effect in some subpopulations, including those who received the 2009 seasonal trivalent influenza vaccination. © 2013 John Wiley & Sons Ltd. Source


Scott J.A.,Flinders University | Chih T.Y.,Flinders University | Oddy W.H.,Telethon Institute of Child Health Research
Nutrients | Year: 2012

The aim of this study was to investigate the association of breastfeeding duration and food variety at 2 years of age. A secondary data analysis was undertaken of the Western Australian Pregnancy Cohort (Raine) Study, an ongoing longitudinal study. Data collected from a single 24 h dietary recall of 1905, 2 year-old children were used to calculate two food variety scores; a core food variety score (CFVS) and a fruit and vegetable variety score (FVVS). Multivariate linear regression analysis was used to identify those factors independently associated with the CFVS and FVVS. The mean CFVS was 7.52 (range 1-18) of a possible 34 food items or groups and the mean FVVS was 2.84 (range 0-10) of a possible 16 food items or groups. Breastfeeding duration was independently directly associated with the CFVS (p < 0.001) and FVVS (p < 0.001). In addition, maternal age was independently directly associated with the CFVS (p < 0.001) and FVVS (p = 0.001) as was maternal education (CFVS p < 0.001 and FVVS p = 0.043). The presence of older siblings was independently inversely associated with the CFVS (p = 0.003) and FVVS (p = 0.001). This study demonstrated a direct modest association between breastfeeding duration and food variety in 2 year-old children, independent of maternal demographic characteristics known to predict food variety in children. This finding supports the hypothesis that flavours transferred in breast milk provide repeated early exposure to different tastes and positively shape children's food preferences and food variety. © 2012 by the authors; licensee MDPI, Basel, Switzerland. Source


Pillarisetti N.,Royal Melbourne Hospital | Pillarisetti N.,Murdoch Childrens Research Institute | Williamson E.,Murdoch Childrens Research Institute | Williamson E.,Monash University | And 24 more authors.
American Journal of Respiratory and Critical Care Medicine | Year: 2011

Rationale: Better understanding of evolution of lung function in infants with cystic fibrosis (CF) and its association with pulmonary inflammation and infection is crucial in informing both early intervention studies aimed at limiting lung damage and the role of lung function as outcomes in such studies. Objectives: To describe longitudinal change in lung function in infants with CF and its association with pulmonary infection and inflammation. Methods: Infants diagnosed after newborn screening or clinical presentation were recruited prospectively. FVC, forced expiratory volume in 0.5 seconds (FEV0.5), and forced expiratory flows at 75% of exhaled vital capacity (FEF75) were measured using the raised-volume technique, and z-scores were calculated from published reference equations. Pulmonary infection and inflammation were measured in bronchoalveolar lavage within 48 hours of lung function testing. Measurements and Main Results: Thirty-seven infants had at least two successful repeat lung function measurements. Mean (SD) z-scores for FVC were -0.8 (1.0), -0.9 (1.1), and -1.7 (1.2) when measured at the first visit, 1-year visit, or 2-year visit, respectively. Mean (SD) z-scores for FEV0.5 were -1.4 (1.2), -2.4 (1.1), and -4.3 (1.6), respectively. In those infants in whom free neutrophil elastase was detected, FVC z-scores were 0.81 lower (P = 0.003), and FEV0.5z-scores 0.96 lower (P = 0.001), respectively. Significantly greater decline in FEV0.5 z-scores occurred in those infected with Staphylococcus aureus (P = 0.018) or Pseudomonas aeruginosa (P = 0.021). Conclusions: Ininfants with CF, pulmonary inflammation is associated with lower lung function, whereas pulmonary infection is associated with a greater rate of decline in lung function. Strategies targeting pulmonary inflammation and infection are required to prevent early decline in lung function in infants with CF. Source


Astfalck R.G.,Curtin University Australia | O'Sullivan P.B.,Curtin University Australia | O'Sullivan P.B.,Telethon Institute of Child Health Research | Straker L.M.,Curtin University Australia | And 7 more authors.
Spine | Year: 2010

Study Design.: A preliminary cross-sectional comparative study of adolescents with nonspecific chronic low back pain (NSCLBP) and healthy controls. Objective.: To investigate whether differences in spinal kinematic and trunk muscle activity exist in both usual and slump sitting in adolescents with NSCLBP. Summary of Background.: Evidence suggests that low back pain commonly develops in adolescence and increases the risk for low back pain in adulthood. Sitting is an important consideration in adolescents with NSCLBP: currently there are no reports investigating their motor control strategies in sitting. Methods.: Twenty-eight adolescents (14 female) with NSCLBP and 28 matched pain-free controls were recruited from a large cohort study. Pain subjects were subclassified based on O'Sullivan's classification system. Three-dimensional lumbo-pelvic kinematic data and the activation of 3 back and 2 abdominal muscles were recorded during usual and slump sitting. The flexion-relaxation phenomenon in sitting was also investigated. Results.: Spinal posture in usual and slump sitting were similar for adolescents with and without NSCLBP. However, differences were identified in both sitting conditions when those with NSCLPB were subclassified and compared with controls. Muscle activation differences were not consistently identified, with only lower levels of internal oblique activation in usual sitting in NSCLBP compared with pain-free controls showing significance. Flexion relaxation was observed in both iliocostalis and thoracic erector spinae in the NSCLBP group but not controls. Conclusion.: This study provides preliminary results. Differences with sitting posture are only seen when adolescents with NSCLBP are classified. Trunk muscle activation is not a sensitive marker for discriminating subgroups of NSCLBP during adolescence. © 2010, Lippincott Williams & Wilkins. Source

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