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Biomedical subjects

A Ruben

Publications and source records attributed to A Ruben.

7 recordsLinked to original sources
PubMed2002

Controlled trial of cumulative behavioural effects of a common bread preservative.

OBJECTIVE: Many anecdotes and one scientific report describe cumulative behavioural effects of bread preservative on children. METHODOLOGY: Twenty-seven children, whose behaviour improved significantly on the Royal Prince Alfred Hospital diet, which excludes food additives, natural salicylates, amines and glutamates, were challenged with calcium propionate (preservative code 282) or placebo through daily bread in a double-blind placebo-controlled crossover trial. RESULTS: Due to four placebo responders, there was no significant difference by ANOVA of weighted placebo and challenge Rowe Behaviour Rating Inventory means, but a statistically significant difference existed in the proportion of children whose behaviours 'worsened' with challenge (52%), compared to the proportion whose behaviour 'improved' with challenge (19%), relative to placebo (95% confidence intervals 14-60%). CONCLUSIONS: Irritability, restlessness, inattention and sleep disturbance in some children may be caused by a preservative in healthy foods consumed daily. Minimizing the concentrations added to processed foods would reduce adverse reactions. Testing for behavioural toxicity should be included in food additive safety evaluation.

Analysis of Variance↗
PubMed1999

Low rates of hospitalization for asthma among Aboriginal children compared to non-Aboriginal children of the top end of the northern territory.

OBJECTIVE: To determine the hospitalization rates from asthma for Aboriginal and Torres Strait Islander (ATSI) and non-Aboriginal (non-ATSI) children in the 'top end' of the Northern Territory and to determine the proportion of hospitalizations due to asthma. METHODOLOGY: A retrospective review was undertaken of separation data from the Royal Darwin Hospital for the period July 1991 to June 1997. All children aged 1-9 years residing in the Darwin urban or rural district were included, with asthma identified by the International Classification of Diseases Version 9 codes 493.0-493.9. RESULTS: The overall average annual hospitalization rate per 1000 population with a principal diagnosis of asthma for ATSI children from rural areas (ATSI-rural) was 2.6, 4.7 for ATSI children from urban areas (ATSI-urban) and 5.5 for non-ATSI children. These hospitalization rates were significantly different between ATSI and non-ATSI children (rate ratio 0.72, 95% CI 0.59-0.86). On stratification for residence, the rates were significantly different between ATSI-rural and non-ATSI children (rate ratio 0.61, 95% CI 0. 47-0.80) but not different between rural and urban dwelling ATSI children (rate ratio 0.76, 95% CI 0.54-1.07) or between ATSI-urban children and non-ATSI children (rate ratio 0.81, 95% CI 0.63-1.03). Asthma was diagnosed in 6.5% of ATSI admissions (4.0% for ATSI-rural and 13.8% for ATSI-urban) and 12.7% of non-ATSI admissions. CONCLUSION: The hospitalization rate for ATSI children with asthma was significantly lower than for non-ATSI children. Asthma plays a far less significant role in the spectrum of disease affecting hospitalized ATSI children compared to non-ATSI children. There are significant differences in disease frequency between urban and rural resident ATSI children but less marked differences between urban resident ATSI children and non-ATSI children. Further study is required if the underlying causes behind these differences are to be determined.

Asthma↗
PubMed1999

Evaluation of a national surveillance unit.

AIM: The Australian Paediatric Surveillance Unit (APSU) facilitates national active surveillance of uncommon childhood conditions. This study assessed whether it fulfilled its objectives and satisfied criteria established by the Centers for Disease Control and Prevention (CDC) for evaluating surveillance systems. METHODS: Anonymous questionnaires were sent to users of the system, individual studies were reviewed, and data were collected from independent sources. RESULTS: Seven hundred and sixty six clinicians, 48 investigators, and 15 public health professionals responded to the questionnaires. Clinicians reported that the APSU was useful, 33% saying information provided by the APSU informed or changed their clinical practice. Most (88%) reported that completing monthly report cards was not a burden. Impact on policy development was limited by suboptimal dissemination of information to public health professionals. Flexibility and timeliness were limited by design. Estimated sensitivity of APSU studies ranged from 92% (congenital rubella) to 31% (drowning/near drowning). Positive predictive value of notified cases was over 70% for most studies. CONCLUSION: The APSU fulfils most of its objectives and meets CDC criteria salient to these. Ways in which the APSU could be improved have been identified, as have methodological challenges and limitations in applying CDC guidelines to this type of unit.

Australia↗
PubMed1998

School screening in remote aboriginal communities--results of an evaluation.

As part of ongoing quality assurance, the effectiveness of the school screening program in meeting the health needs of Aboriginal children in a rural district in the Northern Territory Top End was evaluated. The major health problems of Aboriginal children were analysed for their suitability for screening programs. A prospective cross-sectional study used routinely collected field data from the school screening program in 1993. To ascertain follow-up, children who had failed screening tests had their clinic notes reviewed. A total of 774 children from 11 remote communities were screened. The results confirmed high level of disease, with rates for anaemia, malnutrition and trachoma reaching 39%, 22% and 26% respectively. Nearly one-third failed the hearing screening, urinalysis was abnormal in 19%, 3% failed visual acuity and 6% were considered to have abnormal heart auscultation. Many of the major health problems did not meet the recommended criteria for screening programs and others would be better dealt with by ongoing surveillance rather than a single screening. Some abnormalities found on screening were inadequately investigated and/or treated. This evaluation has demonstrated a limited role for school screening in identifying and meeting the health needs of Aboriginal children living in remote areas. In collaboration with the NT Department of Education, a school-age child health policy, including a new school-age child health surveillance program, is being developed. This promotes greater participation by communities, families and schools with the aim of improving the health and learning outcomes for all school-age children in the NT.

Adolescent↗
PubMed1981

Biliary lipid and bile acid composition in insulin-dependent diabetes mellitus. Arguments for increased intestinal bacterial bile acid degradation.

Bile cholesterol saturation and bile acid composition was studied in 12 nonobese male insulin-dependent diabetics and 28 controls. The total bile lipid concentration in the bile rich duodenal aspirate was lower in the diabetics. The bile cholesterol saturation index was lower in the diabetics if calculated according to Thomas and Hofmann, but not if calculated according to Carey's critical tables. A negative correlation was observed between the cholesterol saturation index of the bile of the diabetics and their long-term metabolic control, as measured by the percentage HbA1c. No correlation existed between the saturation index and the metabolic control at the time of bile sampling as measured by serum glucose, beta-hydroxybutyrate, free fatty acids, and triglycerides. There was also a negative correlation between the cholesterol saturation index and the serum cholesterol concentrations. The glycine-taurine ratio of the conjugated bile acids was increased in the diabetics, as was the percentage concentration of secondary bile acids (deoxycholic acid and lithocholic acid). No correlation was found between the metabolic control of the diabetic state and either the glycine-taurine ratio or the percent concentration of secondary bile acids. These results do not favor a higher incidence of cholesterol gallstones in male juvenile-onset insulin-dependent diabetics. The increased glycine-taurine ratio of the conjugated bile acids and the elevated concentration of secondary bile acids may be due to increased bacterial invasion of the small intestine or decreased absorption of bile acids in the terminal ileum in these insulin-dependent diabetics.

Adolescent↗