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Biomedical subjects

E A Mitchell

Publications and source records attributed to E A Mitchell.

At least 181 records · Page 10Linked to original sources
PubMed1988

Deaths from sudden infant death syndrome on public holidays and weekends.

Deaths from sudden infant death syndrome (SIDS) between 1979 and 1984 were tabulated by month for weekdays, weekends and public holidays. Examination of deaths by day of the week showed the weekend had more deaths than the weekdays (chi 2 = 26.3, df = 6, p = 0.0002) and that this pattern occurred in both the under three months and three-11 months age group. There were 40 deaths on the 78 public holidays in the six years under study. Modelling the data showed that there was no difference between the number of deaths on holidays compared to weekends.

Holidays↗
PubMed1988

International comparison of the prevalence of asthma symptoms and bronchial hyperresponsiveness.

Potential explanations for the higher rates of asthma mortality and hospital admissions in New Zealand (NZ) include greater prevalence of asthma. To evaluate this further, a large community survey has been undertaken. Rates of respiratory symptoms and bronchial hyperresponsiveness (BHR) for children in Auckland, NZ have been compared to those for children in two locations in New South Wales (NSW), Australia: Wagga Wagga (inland) and Belmont (coastal). The methodology used was the same in both studies: parent-completed questionnaire and BHR measured by response to an abbreviated histamine challenge. In Auckland, 1,084 children participated (84% of those selected) and were compared to 769 inland NSW and 718 coastal NSW children. The prevalence of respiratory symptoms, BHR, severity of BHR, and BHR combined with symptoms was similar among Auckland and inland NSW children but lower among coastal NSW children than those from the other two sites. It is concluded that other unidentified factors must be invoked to explain mortality and admission differences between these regions.

Asthma↗
PubMed1987

Comparison of the characteristics of children with multiple admissions to hospital for asthma with those with a single admission.

Hospital admission rates in children for asthma have increased strikingly and part of this increase is due to an increase in the readmission rate. The study compared the characteristics of European children with multiple admission to hospital for asthma with those having their first admission for asthma. The number and magnitude of the differences found were small. Differences found included asthma drug management in the 24 hours prior to the index admission and six months later and days lost from school. Twenty-four percent of study population were readmitted within six months. The number of parents who smoked and the number of pets in the home are of concern and the lack of difference between the multiple and single admission groups suggest our education efforts are ineffectual at altering parental behaviour.

Asthma↗
PubMed1987

Postneonatal mortality review in Auckland: two years experience.

Postneonatal deaths in the Auckland Region in 1984 and 1985 were reviewed. There were 134 deaths and most deaths could be placed into four broad categories, namely sudden infant death syndrome (SIDS, 80 60%), congenital anomalies (24, 18%), infections (9, 7%) and problems arising in the perinatal period (8, 6%). There was good agreement with the cause of death as recorded by the National Health Statistics Centre (98.5%) Potentially preventable causes of death were infrequent (14, 10%), but notable factors were present in 90% of SIDS. For SIDS cases the following notable factors were identifiable: young mothers, Maori, low socioeconomic status, poor accommodation, frequent changes of address, maternal smoking, previous postneonatal death, poor antenatal care, male infant, low birth weight, twin, poor infant weight gain.

Cause of Death↗
PubMed1987

Measles epidemic in Auckland 1984-85.

Epidemics of measles had been seen biennially over the past two decades at Princess Mary Hospital, Auckland, until 1980. After a four year gap, there has been a further epidemic. The medical records of 201 measles cases seen between July 1984 and August 1985 were reviewed. Maori and Pacific Island children were over-represented (86%), as were children aged less than 2 years (53%). Two children died. The most common complications were otitis media (98 cases), pneumonia (70 cases) and croup (28 cases, for which five children were ventilated). The epidemic was chiefly due to low immunisation rates and represents a failure of current immunisation programmes. Recommendations are made for improved immunisation strategies.

Child↗
PubMed1987

The effects of essential fatty acid supplementation by Efamol in hyperactive children.

Thirty-one children, selected for marked inattention and overactivity, were studied in a double-blind, placebo-controlled crossover study of essential fatty acid (EFA) supplementation. Subjects received the active treatment and placebo conditions for 4 weeks each and were assessed on a variety of cognitive, motor, and standardized rating scale measures. EFA supplementation (evening primrose oil; Efamol) resulted in significantly lower levels of palmitoleic acid (a nonessential fatty acid) and higher concentrations of dihomogammalinolenic acid, an EFA previously found to be deficient in some hyperactive children. Supplementation was also associated with significant changes on two performance tasks and with significant improvement to parent ratings on the subscales designated as Attention Problem and Motor Excess of the Revised Behavior Problem Checklist. However, a variety of eight other psychomotor performance tests and two standardized teacher rating scales failed to indicate treatment effects. When the experiment-wise probability level was set at .05, only 2 of 42 variables showed treatment effects. Baseline EFA concentrations appeared to be unrelated to treatment response. It was concluded that EFA supplementation, as employed here, produces minimal or no improvements in hyperactive children selected without regard to baseline EFA concentrations.

8,11,14-Eicosatrienoic Acid↗
PubMed1987

Clinical characteristics and serum essential fatty acid levels in hyperactive children.

This study compared 48 hyperactive children with 49 age-and-sex-matched controls. Significantly more hyperactive children had auditory, visual, language, reading, and learning difficulties, and the birth weight of hyperactive children was significantly lower than that of controls (3,058 and 3,410 g, respectively; p less than 0.01). In addition, significantly more hyperactive children had frequent coughs and colds, polydypsia, polyuria, and a serious illness or accident in the past year than controls, but there was no increase in asthma, eczema, or other allergies. Serum essential fatty acid (EFA) levels were measured in 44 hyperactive subjects and 45 controls. The levels of docasahexaenoic, dihomogammalinolenic, and arachidonic acids were significantly lower in hyperactive children than controls (docosahexaenoic: 41.6 and 49.5 micrograms/ml serum respectively, p = 0.045; dihomogammolinolenic: 34.9 and 41.3 micrograms/ml serum, p = 0.007; arachidonic: 127.1 and 147.0 micrograms/ml serum, p = 0.027). These findings have possible therapeutic and diagnostic implications, but further research is needed to attempt to replicate these differences.

8,11,14-Eicosatrienoic Acid↗
PubMed1986

Demographic characteristics of asthma admissions to hospitals.

The age, sex, race, domicile and geographic distribution of patients admitted to hospital for asthma in New Zealand in 1981 were studied. The 0-14 year age group had a higher admission rate than the older age group. Males were admitted more frequently than females in the youngest and eldest age groups, but the converse was found in the 15-64 year age group. The Polynesian admission rates were more than double those of Europeans in all age groups. The effect of urban or rural domicile on asthma admission rates is age dependent. Urban dwellers under 25 years of age have higher admission rates than those with rural domiciles, however, in those over 45 there is a higher admission rate from rural areas than from urban areas. There was a highly significant difference in the admission rates between hospital boards (p = 0.003). For hospital boards serving populations of 50,000 or more there was a 9 fold difference between the highest (Hawkes Bay) and lowest (Nelson) admission rates. The geographical distribution of asthma admission rates show distinct areas with high (south of the North Island) and low (Auckland and Waikato) rates. The national admission rates almost doubled between 1976 and 1981 and the spatial pattern of admission rates was similar in these two years (r = 0.627 p less than 0.001). This indicates that the increase in admissions occurred uniformly throughout the country.

Adolescent↗
PubMed1986

Asthma education by community child health nurses.

A randomised controlled study of an educational programme for children with asthma and their families was carried out by community child health nurses. Three hundred and sixty eight children aged 2 to 14 years were enrolled in the study after admission to hospital for asthma. The intervention group was visited monthly by a nurse for six months. The subjects were assessed six months later by a postal, self administered questionnaire. European children in the intervention group were taking significantly more drugs for the treatment of asthma six months after the index admission to hospital than those in the control group (mean (SD) intake 2.7 (1.1) v 2.1 (1.0), respectively). In particular, they were using more theophylline (56.6% v 37.0%) and inhaled steroids (34.9% v 21.0%). There was no difference between the groups for parental reports of improvement, of missed schooling, and in severe attacks of asthma of not responding to the usual treatment at home. European children in the intervention group used the hospital services for severe attacks of asthma more than controls (34.2% v 10.5%). There were more re-admissions in the European intervention group in the subsequent six months after the index admission than in the control group (mean (SD) 0.51 (0.97) v 0.29 (0.65). Re-admission continued to be higher in the 12 months after the nurse had stopped visiting (0.81 (1.65) v 0.25 (0.65]. There was no difference in the duration of hospital stay between the intervention and control groups. For Polynesian children there was no difference between the groups for any outcome measures.

Adolescent↗
PubMed1985

Tests for autonomic neuropathy in diabetic children.

Five simple tests of autonomic nerve function were studied in 38 children (12.0 years, s.d. = 3.3) with insulin-dependent diabetes mellitus and a further 38 age and sex matched controls in order to validate the use of these tests in children. The five tests included one test (immediate heart rate response to standing) previously reported. Compared to controls, diabetics showed a significantly faster heart rate at rest (P = 0.022), a reduced heart rate variation during quite respiration (P = 0.003), a smaller change in heart rate following a single deep breath (P = 0.006), a lower Valsalva ratio (P = 0.084) and a lower maximum R-R/minimum R-R ratio in response to standing (P = 0.033). The heart rate response to the Valsalva manoeuvre is less suitable for use in children than adults as it requires considerable co-ordination and co-operation and it did not correlate with the other tests of autonomic nerve function. The other tests significantly correlated with each other and were quick and easy to perform. They required no special co-operation and required no special equipment other than a standard ECG machine. Three diabetics had abnormalities in four of the tests (mean heart rate, heart rate variations during quiet respirations, change in heart rate produced by a single deep breath and the previously reported immediate heart rate response to standing). None of the controls had abnormalities in more than two of the tests.

Autonomic Nervous System Diseases↗
PubMed1985

Cystic fibrosis heterozygotes have normal autonomic innervation of the heart.

Five simple tests of autonomic nerve function based on measurements of cardiovascular responses to various stimuli were used to investigate possible autonomic dysfunction in obligate heterozygotes for cystic fibrosis. There were no significant differences between the heterozygotes and control groups in any of the tests, suggesting that cystic fibrosis heterozygotes have normal autonomic innervation of the heart.

Adult↗
PubMed1985

International trends in hospital admission rates for asthma.

Trends in annual hospital admission rates for asthma in the 0 to 14 year age group were examined in New Zealand, England and Wales, the United States, Canada, and Australia. There has been a striking increase in hospital admissions for asthma in children in all these countries since the mid 1960s.

Adolescent↗