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Biomedical subjects

L Lubitz

Publications and source records attributed to L Lubitz.

13 recordsLinked to original sources
PubMed2002

Chronic fatigue syndrome: successful outcome of an intensive inpatient programme.

OBJECTIVE: To study the outcome of adolescents with chronic fatigue syndrome (CFS) following an intensive multi-disciplinary inpatient programme. METHODS: A follow-up questionnaire was distributed to all 57 adolescents who had completed the CFS inpatient programme at the Austin and Repatriation Medical Centre. RESULTS: Forty-two adolescents (74%) returned follow-up questionnaires. Immediately following the programme and up to five years after the programme, the majority of participants had returned to school and were functioning better in terms of physical activity and social interactions as compared with before the programme. Before the programme, 94% of adolescents were attending school half-time or less. Up to 5 years after the programme, 78% of adolescents were attending school full-time or with occasional absences only. CONCLUSIONS: A multidisciplinary inpatient programme for CFS was successful in helping to rehabilitate this group of adolescents who were significantly incapacitated prior to entering the inpatient programme.

Adolescent↗
PubMed2001

Near-total absence of the cerebellum.

We report five cases of near-total absence of the cerebellum with accompanying pontine hypoplasia. The cerebellar remnant in each case comprised only antero-superior masses, the posterior fossa being otherwise fluid filled. Three of these patients, two teenagers and an infant, presented a fairly consistent clinical and neuroradiological phenotype, and a few similar cases are recorded in the literature. The cerebellar remnant was irregular and asymmetrical, and no ventral pontine prominence was discernible. In at least the older two, cerebellar motor functions were not greatly compromised, and intellectual handicap was of a mild degree. We propose that these cases represent a distinct entity of "near-total absence of the cerebellum with flat ventral pons, and relatively mild clinical affection". All cases have been sporadic, implying that the risk of recurrence within a family may be low. Quite different clinical pictures, of considerably greater severity, are demonstrated in the remaining two cases. One had pontocerebellar hypoplasia type 2, while the other had a complex cerebellar and cerebral malformation.

Adolescent↗
PubMed1998

Symptomatic zinc deficiency in breast-fed term and premature infants.

Two 3-month-old exclusively breast-fed infants, one born at full-term and the other born prematurely, developed symptomatic zinc deficiency manifested by an acrodermatitis enteropathica-like eruption. Inadequate breast milk zinc was demonstrated in both cases. A rapid clinical response followed oral zinc supplementation after which their serum zinc levels returned to normal. The infants remained asymptomatic following cessation of zinc therapy. Reports of similar cases suggest that in a group of infants breast milk does not meet their nutritional zinc requirements. Inadequate breast milk zinc is thought to result from a defect in transfer of zinc from maternal serum to breast milk.

Acrodermatitis↗
PubMed1995

Role of gastro-oesophageal reflux in infant irritability.

Gastro-oesophageal reflux (GOR) disease may cause excessive crying in infants. The role of GOR was evaluated in infant irritability and an attempt was made to define clinical predictors of pathological reflux. Seventy consecutively admitted infants with irritability and presumptive GOR were retrospectively reviewed. All had undergone prolonged oesophageal pH monitoring. Pathological GOR was defined as a fractional reflux time of > or = 10% and was significantly less common in infants under 3 months (one of 24; 4.2%) than in older infants (10 of 46; 21.7%). All infants with pathological GOR presented with frequent vomiting, and 'silent' pathological reflux did not occur. Poor weight gain, feeding refusal, backarching, and sleep disturbance were not significantly associated with pathological GOR. The results suggest that pathological GOR is an unlikely cause of infant irritability under the age of 3 months.

Age Distribution↗
PubMed1995

A continuing quality improvement (CQI) approach to improving the results of treatment in intussusception.

There is little incentive to change existing protocols or clinical practices of medical conditions in which the results of treatment are considered already to be satisfactory. Our approach to continuing quality improvement (CQI) demands that, even in these conditions, attempts should be made to improve performance further. This report shows how the management of childhood intussusception has been refined at our institution, producing a measurable reduction in the operation rate and thus reducing the overall morbidity to the child. At each step, audit was followed by an intervention, the effect of which was documented. It is our belief that this approach can be applied to any number of medical conditions, and it is a responsibility of CQI personnel to encourage such processes.

Barium↗
PubMed1993

Delayed umbilical cord separation in alloimmune neutropenia.

Delayed umbilical cord separation in association with neonatal alloimmune neutropenia is reported. Delayed umbilical cord separation has been described in association with defects in neutrophil function. The present case indicates that deficiency in neutrophil number should also be considered as a cause of delayed cord separation.

Female↗
PubMed1992

Nail biting, thumb sucking, and other irritating behaviours in childhood.

Parents are frequently concerned about their children's behaviour patterns, especially if they are repetitive or stereotyped. These patterns are important: they are common in children with normal psychological status, but they may also occur in children with developmental problems or emotional difficulties, or may be secondary to physical disorders.

Adolescent↗
PubMed1989

Single dose trimethoprim for urinary tract infection.

A randomised clinical trial of single dose trimethoprim against a seven day course of co-trimoxazole (trimethoprim/sulphamethoxazole) for the treatment of uncomplicated urinary tract infection was carried out in 106 children aged between 2 and 16 years. Of the 50 children with confirmed urinary tract infections who were followed up 48 hours after treatment with a single dose of trimethoprim all were free of infection, whereas two of the 56 who received the course of co-trimoxazole (4%) had persisting infections. At follow up after 10 days, however, significantly more of the group treated with trimethoprim had evidence of recurrent urinary tract infection compared with those who had received co-trimoxazole (10 of 44, 23%, compared with one of 46, 2%). Of the recurrences in the trimethoprim group, six were asymptomatic. We conclude that single dose trimethoprim is effective in clearing the urine of bacteria, but the risk of asymptomatic bacteriuria soon after treatment is high.

Adolescent↗
PubMed1985

Enteric colonization in sporadic neonatal necrotizing enterocolitis.

Microflora of the gut was studied close to the onset of sporadic necrotizing enterocolitis (NEC) in neonates. Enteric flora in 25 babies with NEC differed from that in 23 matched controls. Bacteroides spp and lactobacilli were less common in babies with NEC compared with controls: 32 versus 61% (p = 0.03) and 12 versus 48% (p = 0.006), respectively. Clostridium perfringens was isolated from 40% of babies with NEC compared with 13% of controls (p = 0.03). It was present in 33% of babies with NEC aged less than 14 days but was not detected in control babies of the same age. The incidences of C. butyricum and C. difficile were similar in patients and controls. Colonization with C. perfringens in the absence of a protective barrier flora may be crucial in the pathogenesis of severe sudden onset NEC. Two potentially valuable marker factors to predict onset of this form of sporadic NEC are the use of fecal smears and estimation of fecal tryptic activity.

Bacteroides↗
PubMed1985

A multidisciplinary approach to the management of psychosocial admissions to a general paediatric ward.

This study investigated the characteristics of all new in-patients with major psychological and/or social problems admitted to a medical ward over a 4-week period. Fifteen successive patients were studied prospectively. The professional time spent by the medical and paramedical personnel involved in the initial assessment and management was reviewed, and the children followed-up 6 months later. The study found that the patients readily fell into two major groups. Group I were infants and children who had been maltreated or were at risk for child abuse. Group II were older children who presented with psychosomatic symptoms arising from disturbed family or environmental backgrounds. The medical, psychiatric and social work input was considerable for both groups (19 vs 27 h per patient respectively). Their hospital stay was prolonged (15 vs 21 days respectively; the hospital average was 4.4 days). The outcome differed in the two groups. Patients in Group I failed to attend follow-up appointments in most cases unless such attendance was legally mandatory. In contrast, Group II patients usually kept their follow-up appointments, the intervention generally being successful.

Adolescent↗
PubMed1982

Development of gut colonisation in pre-term neonates.

Twenty-eight pre-term babies of low birth weight were monitored for developing microflora in throat, stomach and faeces during the first 3 weeks of life. The flora at all levels of the gastrointestinal tract differed from that of healthy breast-fed and artificially fed full-term babies. Colonisation of throat and stomach was delayed beyond 4 days of life in 87% and 60% of babies respectively. Only 10% of babies had "normal" oral flora throughout the period of study. Flora of the stomach was sparse, and resembled faecal flora. Faecal flora was established more rapidly than throat or stomach flora, and 70% of babies were colonised during the first 4 days of life. Initially Bacteroides spp. were predominant (57% babies), but Escherichia coli and other aerobic gram-negative bacilli gradually increased in frequency. Colonisation by gram-positive bacteria was slow. Clostridium spp. were present in only 10% of babies during the first 4 days of life. Most strains were transient. Colonisation with C. butyricum (30%), C. perfringens (35%) and C. difficile (25%) was maximum after the first 2 weeks of life. Lactic-acid-producing bacteria usually appeared late in the third week of life. Parenteral feeding immediately after birth was associated with delayed colonisation by a restricted number of species. Parenteral antibiotics (penicillin or gentamicin or both) restricted colonisation with normal oral flora, the lactic-acid-producing bacteria and penicillin-sensitive clostridia, but had little effect on E. coli even when the colonising strain was sensitive to the aminoglycoside in the regimen. Systemic spread of bacteria via the blood stream was not detected in any babies. The pattern of colonisation of the enteric tract in pre-term infants in the special-care nursery studied, differs from that of healthy full-term babies; this merits consideration when the results of bacteriological tests of this vulnerable group of infants are being interpreted.

Anti-Bacterial Agents↗