Shrinking bottle syndrome.
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Bottle Feeding↗
Biomedical subjects
Srinivas Bolisetty
Publications and source records attributed to Srinivas Bolisetty.
Succimer therapy for congenital lead poisoning from maternal petrol sniffing.
An infant, born at 35 weeks' gestation to a woman who sniffed petrol, had a cord blood lead level eight times the accepted limit. Treatment with oral dimercaptosuccinic acid promptly reduced his blood lead levels. To our knowledge, this is the first reported case of congenital lead poisoning secondary to maternal petrol sniffing. We suggest that at-risk pregnancies should be identified, cord blood lead levels tested, and chelation therapy and developmental follow-up offered to affected infants.
Adult↗
Neonatal seizures from in utero venlafaxine exposure.
Venlafaxine (Efexor), a selective noradrenergic reuptake inhibitor, is an important therapeutic option in the treatment of perinatal depression, but its effects on the newborn are uncertain. We present a report of two infants with neonatal seizures attributed to maternal use of venlafaxine. The first infant was hypotonic and required resuscitation at birth. The second was born in a good condition but developed clinically apparent seizures after the second day of life. Both infants responded rapidly to treatment with phenobarbitone that was weaned uneventfully by the first and second week of life. Both remain well at 1 year of age. Other causes of neonatal seizures were excluded and neurological investigations on these two infants were unremarkable. We suggest that all infants exposed to maternal venlafaxine, no matter their condition at birth, be monitored in hospital for at least 3 to 4 days in order to preempt and treat adverse neurological events.
Cyclohexanols↗
Preterm outcome table (POT): a simple tool to aid counselling parents of very preterm infants.
BACKGROUND: Outcome figures published in scientific journals are often cumbersome and difficult to understand by parents during counselling before or immediately after a very premature birth. AIM: To provide simplified up-to-date outcome information in a table for ease of counselling. METHODS: Regional perinatal mortality rates for very premature births (23-31 weeks gestation) and incidence of significant neonatal events for those admitted to neonatal intensive care units (NICU) were obtained from the NSW Midwives Data Collection, ACT Maternal and Perinatal Data Collection and the NSW and ACT NICUS Data Collection for 2000 and 2001. Neurodevelopmental outcome was obtained for the same cohort at 2-3 years of age, corrected for prematurity. The percentage outcomes were rounded off to the closest conservative multiple of 5 for each data point in a table. RESULTS: The preterm outcome table (POT) for each gestational week was constructed from a total of 2315 births. Of these, 401 (17.3%) were reported as stillborn and were predominantly of 23 to 25 weeks gestation. Of those admitted to NICU, hospital survival rates were 30, 50, 65, 75, 80, 90 and > 95% for 23, 24, 25, 26, 27, 28-29 and 30-31 weeks, respectively. Neurodevelopmental outcome was available for 470 (75%) children, of whom 15% had a moderate to severe functional disability at 2-3 years of age, corrected for prematurity. Simplified data on survival to discharge and outcome were tabulated. CONCLUSION: POT appears simple and easy to use but also provides realistic data to assist clinicians in the counselling process.
Australian Capital Territory↗
Respiratory syncytial virus infection and immunoprophylaxis for selected high-risk children in Central Australia.
BACKGROUND: There are limited data on the epidemiology and viral aetiology of bronchiolitis in Central Australia and respiratory syncytial virus (RSV) immunoprophylaxis in an Australian population. OBJECTIVE: To (i) determine the incidence and the viral aetiology of bronchiolitis hospitalisations and (ii) report on the usage of RSV immunoprophylaxis in selected high-risk infants and children in Central Australia. METHODOLOGY: A retrospective review was performed of all hospital separations for bronchiolitis for a three-year period, 1998-2000. Respiratory viruses in the nasopharyngeal aspirates were identified from the cases in the year 2000. A combined retrospective chart review and prospective follow up study was undertaken of all the infants and children who received RSV immunoprophylaxis at the Alice Springs Hospital, Central Australia. RESULTS: Incidence of bronchiolitis hospitalisation in infants for 1998, 1999 and 2000 were 176, 200 and 180 per 1000, respectively. Nine high-risk children had RSV immunoprophylaxis on a total of 46 occasions and there were two mild RSV-related illnesses in them. None had severe lower respiratory tract illness. CONCLUSION: The incidence of bronchiolitis in Central Australia is extremely high. The usage of RSV immunoprophylaxis may be justified in selected high-risk children living in high endemic areas.
Australia↗
Delayed delivery interval between twins: a viable option? A case report.
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Adult↗
Congenital heart defects in Central Australia.
OBJECTIVE: To determine the incidence of congenital heart defects (CHD) in Aboriginal and non-Aboriginal infants in Central Australia and to compare this with the incidence elsewhere in Australia. DESIGN AND SETTING: Data on cases were obtained from patient records of the Alice Springs Hospital, Central Australia, the sole referral centre for paediatric and initial cardiac diagnostic services for the region. PARTICIPANTS: Patients with CHD proven by echocardiography reported between 1 January 1993 and 30 June 2000. MAIN OUTCOME MEASURES: Incidence of CHD using all live births in Central Australia as the denominator. RESULTS: 108 patients with CHD were detected among 6156 live births (incidence, 17.5 per 1000; 95% CI, 14.9-21.7 per 1000); 57 of 2991 were Aboriginal (19.0 per 1000; 95% CI, 14.4-24.6 per 1000) and 51 of 3165 were non-Aboriginal (16.1 per 1000; 95% CI, 12.0-21.1 per 1000). The difference between the two groups was not statistically significant (relative risk, 1.18; 95% CI, 0.81-1.72). CHD incidence in Central Australia was significantly higher than that reported for other parts of Australia (4.3 per 1000 live births in New South Wales and the Australian Capital Territory, 1981-1984; 7.65 and 12 per 1000 total births in Western Australia, 1980-1989, and South Australia, 1993-2000, respectively). CONCLUSIONS: The high rates of CHD in Central Australia may partly reflect the high utilisation of echocardiography for assessing minor lesions. However, the incidence of both major and minor types of CHD was significantly higher than previously reported from other regions of Australia. The role of socioenvironmental factors in this high incidence should be explored.
Australia↗
Red-back spider envenomation in children in Central Australia.
OBJECTIVE: To describe the clinical spectrum of Red-back spider (RBS) envenomation in children up to 12 years of age. METHODS: Retrospective case notes review of children with a discharge diagnosis of RBS bite from January 1992 to June 2001. The setting was Alice Springs Hospital, the main paediatric hospital for the whole region of Central Australia. The patients were 54 children, comprising 39 Aboriginal and 15 non-Aboriginal children. RESULTS: Forty-six (85%) children had systemic envenomation. The three most common systemic features are irritability, hypertension and sweating; 35 (65%) children had all three systemic features. Forty-five (83%) received antivenom therapy. The clinical characteristics and outcomes showed no significant difference between children 4 and > 4 years of age. CONCLUSIONS: There is a high incidence of systemic envenomation due to RBS bite in children in Central Australia. The triad of irritability, hypertension and sweating in a previously well child is highly suggestive of latrodectism.
Age Distribution↗
Antenatal supplementation of antioxidant vitamins to reduce the oxidative stress at delivery--a pilot study.
BACKGROUND: Preterm infants are at increased risk of oxidative stress and free-radical mediated diseases partly related to deficient antioxidant state. The purpose of this study was to investigate if maternal supplementation of antioxidant vitamins prior to delivery would reduce the oxidative stress in the mothers and their infants. STUDY DESIGN: A pilot case-control study. PATIENTS AND METHODS: Five mothers at risk of preterm delivery between 30 and 36 weeks were given a daily oral dose of betacarotene 20 mg, vitamin E 167.8 mg and vitamin C 1000 mg until delivery. Plasma levels of MDA and vitamins A, E and beta-carotene were measured prior to treatment in mothers and at delivery in both mothers and neonates. Seven mother-infant pairs comparable in gestation and birthweight acted as controls. RESULTS: In the supplemented group, median maternal plasma MDA at delivery was significantly lower compared to the pretreatment level (1.9 vs. 3.2 micromol/l, p=0.04) and it was also lower than the control group (1.9 vs. 3.65 micromol/l, p<0.001). In the supplemented group, median maternal plasma vitamin E at delivery was significantly higher than the levels prior to treatment (46 vs. 31 micromol/l, p=0.007) in the same group and those at delivery in the control group (46 vs. 30 micromol/l, p=0.03). There was a trend of lower plasma MDA and higher vitamin E at birth in infants born to supplemented mothers, but it did not reach statistical significance. CONCLUSION: A short supplementation of multiple antioxidant vitamins to a small sample of preterm pregnant women reduced the oxidative stress at delivery in mothers and probably in their neonates. Larger studies probably using larger doses are needed to evaluate the efficacy of this strategy.
Administration, Oral↗
Refining the public health response to primary meningococcal conjunctivitis.
Primary meningococcal conjunctivitis (PMC) is accepted as an uncommon condition. This report describes two recent cases of PMC in newborn infants in a hospital nursery. In both cases the organisms identified were non-groupable strains of N. meningiditis, considered to be of low pathogenic potential. Both infants received systemic therapy and recovered without sequelae. The Guidelines for the early clinical and public health management of meningococcal disease in Australia recommend the notification of PMC to public health authorities and chemoprophylaxis of contacts. However, our 2 cases suggest that the guidelines should allow for an assessment of risk in determining the public health response. This assessment should include the severity of the conjunctivitis and the serogroup of the N. meningitidis isolate.
Anti-Bacterial Agents↗
Reappearance of human cases due to Murray Valley encephalitis virus and Kunjin virus in central Australia after an absence of 26 years.
Murray Valley encephalitis (MVE) and Kunjin virus disease are endemic in the tropical parts of the Northern Territory and Western Australia, but have been absent from Central Australia since 1974. In 2000, 5 laboratory-confirmed cases of encephalitis occurred over a short period in the normally dry inland region of Central Australia. The sudden occurrence of cases in March and April 2000 followed unusually high rainfall in the preceding months and evidence of flavivirus activity in the endemic areas in the Kimberley region of Western Australia. Further cases were reported in the following wet season, without preceding human cases in known endemic areas. These findings indicate the reintroduction of these viruses into Central Australia and establishment of local cycles of infection with an ongoing risk to the local population. This area may also act as a potential source for reintroduction of MVE into south-eastern Australia.
Adult↗