Biomedical subjects

N Mogridge

Publications and source records attributed to N Mogridge.

17 recordsLinked to original sources

PubMed1992

Selenium and glutathione peroxidase levels in premature infants in a low selenium community (Christchurch, New Zealand).

By world standards, the selenium status of the adult population of Christchurch, New Zealand is low. To determine the status of infants undergoing neonatal intensive care, plasma and red cell selenium and glutathione peroxidase levels were measured in infants admitted to the regional neonatal unit. Plasma levels in all newborn infants were one third to one half those in adults. Premature infants had levels significantly lower than those in cord blood from term infants, but their levels were not different from those of term infants admitted to the unit. There were no differences between adult and infant red cell levels. The premature infants remaining in the neonatal unit showed dramatic decreases in plasma selenium and glutathione peroxidase with age, with many infants having selenium levels of less than 0.13 mumol/L (10 micrograms/L). Low levels were seen in infants fed orally as well as those on parenteral nutrition. Thus, the low selenium status of New Zealanders is associated with particularly low selenium levels in premature infants. Because these infants have a high risk for oxidative diseases such as bronchopulmonary dysplasia (chronic lung disease) and retinopathy of prematurity, the possibility that these conditions are more serious in the New Zealand population needs to be assessed and consideration given to dietary supplementation.

Adult↗

PubMed1991

Severe acute laryngotracheitis in Christchurch 1980-90.

A review of children admitted to Christchurch Hospital with acute laryngotracheitis over a 10 year and nine month period revealed that 894 admissions occurred for this condition. Forty-four (4.9%) were admitted to the intensive care unit of the hospital, of whom 12 (1.3% of all laryngotracheitis admissions) required endotracheal intubation. The mean time of intubation was 170 hours (range 24-432). There were no deaths, although seven children who were intubated had serious complications, of which perforation of a gastric ulcer was the most important. In our group of patients intubation is a rare event, and the need for aggressive treatment with dexamethasone at the time of admission to the general ward is questioned.

Airway Obstruction↗

PubMed1991

Admission patterns for childhood acute asthma: Christchurch 1974-89.

OBJECT: to examine trends in hospital admission for acute childhood asthma in Christchurch over the period 1974-89. METHODS: trends in the estimated annual rates of admission and readmission for asthma were compared between boys and girls in each of three age groups: 0-4 years, 5-9 years, 10-13 years. RESULTS: for both sexes there was a 4.5-5 fold increase in overall rates of admission during the survey period. Boys on average had higher admission rates than girls with this effect being most marked in the preschool age group. Since the mid 1980s there has been a changing pattern of admissions with a downward trend in admission rates for school aged children and a continuing upward trend in the preschool age group. An alarming new trend is a rise in the numbers of preschool girls admitted with acute asthma: admission rates for this group have shown a three-fold increase since 1983. CONCLUSIONS: possible reasons for the changing pattern of admissions are discussed, with emphasis on the possible role of the increased use of cromoglycate and inhaled steroid in older children. Further research is needed to determine whether the trends in these data are reflected throughout the country.

Acute Disease↗

PubMed1991

A paediatric day unit: the first year's experience.

In June 1989 a day unit was introduced into the paediatric department of Christchurch Hospital. Over the subsequent year, 1308 admissions occurred to the unit. Five hundred and thirty (40.6%) of the children were discharged home on the day of referral, only 22 (4%), were readmitted to the inpatient facility within a week of their first assessment. The common conditions dealt with were asthma and acute respiratory tract infection and the pattern generally reflected that normally seen in the inpatient wards. The average stay in the day unit was four hours thirty minutes. The day unit has proved to be effective in reducing overnight inpatient admissions but it requires a higher staff ratio than allocated to ensure rapid and efficient turnover. Utilisation on the weekends and wider use by other specialities dealing with children would increase the units effectiveness further.

Adolescent↗

PubMed1991

Parental perceptions of paediatric inpatient care.

The parents of 206 children admitted to a paediatric department completed a structured questionnaire, 4-6 days after their child's discharge from hospital. The aim of the study was to assess the parents perceptions of the quality of care given over a range of measures. Overall satisfaction was in the order of 86%. Areas of discontent were in the admission process, information about available hospital facilities and information on the future management of the child's illness.

Child↗

PubMed1990

Childhood asthma: what do parents add or avoid in their children's diets?

The parents of 100 children with chronic asthma completed a standard questionnaire designed to determine the extent of deliberate addition and avoidance of items in their children's diets. Forty-seven percent of the parents had added or deleted substances from their child's diet because of the child's asthma or a combination of asthma and another condition. This was predominantly the avoidance of dairy products, additives and eggs. The basis of dietary decisions was said to be self engendered in the main, but the family circle and the media, were stated to be common sources of advance and influence. Professional advice in the form of dietetic and medical influence was minimal. This lack of professional influence may be a reflection upon the controversial status of diet and asthma. While this exists parents may try this dietary option in the hope of therapeutic success.

Adolescent↗

PubMed1990

The chest radiograph in acute bronchiolitis.

The relationship between clinical severity, as judged by a clinical scoring method, and the degree of radiological change on a chest X-ray, was assessed in 153 children with acute bronchiolitis. There was no statistical correlation between clinical severity and the degree of radiological change. The majority of radiographs were requested on the assumption that it was a useful routine investigation. We suggest that the request for a chest X-ray in acute bronchiolitis should be made only when the need for intensive care is being considered, where there has been an unexpected deterioration in the child's condition or the child has an underlying cardiac or pulmonary disorder.

Acute Disease↗

PubMed1989

Acute bronchiolitis: a three year study.

Over the period 1986-88, 261 infants and children, with a mean age of six months, were admitted to Christchurch Hospital with acute bronchiolitis. There was a marked seasonal pattern, with peak admission periods occurring during winter and spring. Two hundred and two children (77%) had a nasopharyngeal aspirate performed for respiratory virus identification. Respiratory syncitial virus was identified in 113 (56%) of those who had viral studies performed. Using a score of severity, 150 (57%) of the children had a mild disease, 47 (18%) moderate, while 64 (25%) had a severe or very severe illness. The median stay in hospital was two days. No deaths occurred during the study period, although six infants required assisted ventilation.

Acute Disease↗

PubMed1989

Children's diets: what do parents add and avoid?

An interview was carried out, using a standard questionnaire, with the parents of 103 children attending as new patients to a medical paediatric outpatient clinic. This interview was designed to determine the extent of deliberate additions and avoidances to their children's diets. Some specific alteration to the diet was seen in 48 children. There were 38 avoidances and 20 additions of some form of food or mineral substance. In 10 children there were both additions and avoidances. Avoidance of a foodstuff, most commonly food additives, was either for a particular illness or health belief. Dairy products and meats were the next most frequently avoided substances. Additions to the diet were predominantly vitamins and minerals. The sources of dietary advice were the media, mainly magazines and books, and family members. Medical influence on dietary alterations was small.

Adolescent↗

PubMed1989

Who comes back to a paediatric outpatient clinic?

Over a four week period, 498 children had appointments to be seen again at a paediatric medical outpatient clinic. 15.8% of the patients did not keep their appointments. The three most common types of disorder accounting for over half the consultations were asthma, neurological/developmental problems and genitourinary conditions. Over half (57%) had been referred within the previous two years, and only 29% had been seen for three or more years. Involvement with other medical and paramedical specialists occurred in 55%. This reflected the multidisciplinary management approach for the longer term patients. Only 14 new such referrals were generated as a result of the consultations over the four week study period. The work of the clinic was concerned with relevant chronic disease.

Adolescent↗

PubMed1989

Children admitted to a general intensive care unit.

A retrospective analysis of the pattern of admission of children to the general intensive care unit of Christchurch Hospital during the period 1980-7 inclusive, is reported. Three hundred and ninety-nine children were admitted during this period and they formed 10.7% of all admissions to the unit. In addition to the intensive care specialist, a paediatrician was involved with the management on 260 occasions and a surgeon on 139 occasions. Acute epiglottitis was the single commonest medical cause for admission and trauma from motor vehicle accidents the commonest surgical reason. Overall mortality was 14.5%, 13% for medical conditions and 16% for those with surgical problems. These results are in keeping with those reported from overseas.

Adolescent↗

PubMed1989

Ketotifen in asthma.

Sixty children aged 5-13 years with moderately severe asthma took part in a double-blind, placebo-controlled trial of ketotifen. The design incorporated a 22 week study period, the addition of ketotifen or placebo to the current medication, and a controlled withdrawal of the regular therapy. Children receiving ketotifen showed significantly lower mean numbers of asthma attacks and less absence from school. The addition of ketotifen to existing treatment was associated with marginally significant changes in rates of day and night wheezing. In the second phase of study, additional therapy was withdrawn from both the ketotifen and placebo groups which resulted in a high (percentage) withdrawal. Children receiving ketotifen did not have a significantly lower failure rate than those given placebo.

Asthma↗

PubMed1989

Parental views on children admitted to hospital with acute asthma.

OBJECTIVE: To gather information on the background to the hospital admission of children with an attack of acute asthma, on the parents' expectations and perceptions of the hospital's role in treatment and the hospital's response to these expectations. METHOD: A structured questionnaire was administered to the parents of 127 children admitted to hospital with an acute attack of asthma of a mild or moderate severity. At 10-15 days after discharge, further information was obtained from 102 of the parents regarding their experiences of the hospital stay. RESULTS: Half of the children were self (parental) referred to hospital. The modal time spent in hospital was one night. Overwhelmingly, the parents felt that the admission had been justified and that discharge time was appropriate. Parental expectations of information and education about the condition differed slightly from the staff as judged by the information given to them. Many parents learned something about asthma and the majority felt that the brief admission was not too disruptive. The reported perceptions and the actions of the parents are in keeping with the hypothesis that the emergency care of childhood asthmatics is moving from the community to the hospital, and that many see a role for the latter in the long-term management of the condition.

Acute Disease↗

PubMed1988

Bacterial meningitis in childhood: a 13 year review.

One hundred and forty-five episodes of acute bacterial meningitis in children seen over a 13 year period are reviewed. The mortality rate was 1.4%. Over the study period H influenzae type b remained as the dominant causative organism, with 11% of the isolates being beta-lactamase positive. The difficulties in diagnosis in children, the sequelae of sensorineural deafness and continued morbidity in this disorder are stressed.

Anti-Bacterial Agents↗

PubMed1988

Assisted ventilation in severe childhood asthma.

Our experience of assisted ventilation in severe childhood asthma over a three year period is reviewed. One per cent of children with an acute attack of asthma required ventilatory support during this time. There were no deaths and no long term sequelae resulting from assisted ventilation. The number of children requiring this type of management however, provides further evidence to support the thesis that asthma is not only common but severe in New Zealand.

Asthma↗

PubMed1987

Inguinal hernia and low birthweight.

Ten point three percent of infants of birthweight less than 2000 g developed an inguinal hernia within one to three years of birth. This figure rose to 18.9% in those who were under 1500 g at birth. The high requirement for surgical repair and the rising survival figures for very low birthweight infants stresses the increasing numbers at risk from postoperative apnoea and bradycardia. The need for respiratory and cardiac monitoring following anaesthesia in low birthweight infants is emphasised.

Female↗

PubMed1986

A case audit of acute severe asthma in children.

Review of one hundred children admitted to a large teaching hospital with asthma. Medicine record audit. Major deficiencies were revealed in the recording of the basic data required for management of the acute attack. Conversely prescribing of drug therapy was consistently accurate. Oxygen therapy and nebulisation regimes were less well recorded, and discharge letters were often lacking in information about follow-up arrangements.

Acute Disease↗