Child health

Where do cystic fibrosis and chlamydia intersect with autism and alcohol misuse? In adolescent medicine, which is the focus of one of the first texts on this topic to be published in Australia. While adolescent health was addressed in this Journal in 1959, considerable time elapsed before clinical units became formally established. These are now centres of excellence in an expanding field in Sydney, Melbourne ...

Murray G Williams

Children at clandestine drug laboratories are at risk of physical injury as well as exposure to methamphetamine and toxic chemicals

Sharon L Hawkrigg · Peter M Winterton

A fragile life opens a new dimension to family love

John S Whitehall FRACP

A newborn child’s critical illness changes his mother’s perspective on her own medical careerOn a cold Monday night in late winter, I pulled on my scrubs, packed my lunch and crept quietly into the small, cosy room my children share. My daughter was lying rumpled and skewiff in her big bed, covers thrown back, her little nappy-clad bottom in the air. I moved to the ...

Kristin J Boyle MB BS

Halloween is becoming increasingly popular in Australia, but what are the public health implications?The use of fictional characters and festivals to sell unhealthy commodities is well established. Both Santa Claus and the Easter bunny have been employed to influence people, especially children, towards unhealthy behaviour.1,2 Each year, on 31 October, an increasing number of witches and wizards darken the doors of Australian households, demanding free junk ...

Gillian P Porter MB BS, DCH · Nathan J Grills MB BS, DPhil, MPH

To the Editor: The two contributions by Gray and colleagues1 and Loblay and colleagues2 on the topic of salicylate intolerance illustrate that absence of evidence does not equate to evidence of absence.3 Neither paper quotes the admittedly sparse European peer-reviewed literature on the topic, including an understanding of the basic biochemistry,4,5 a diagnostic test, and clinical prevalence studies of intolerance to dietary salicylate.5-7 A wealth ...

Richard F Heller · C Ann Heller · Jane Heller

To the Editor: I am concerned that the recent articles on salicylate diets in the Journal1,2 may be seen as a current position statement on the usefulness of a low-chemical elimination diet. An elderly psychiatrist colleague said in 1976, “In 20 years time many parents will not be giving their children red cordial but scientists will still be discussing the issue!” The discussion continues, not because ...

Joan C Breakey

In reply: We are pleased that our publication has generated discussion regarding the benefits of low salicylate diets. However, the correspondence and references from Heller and colleagues and Breakey do not provide any further evidence for the use of such diets and simply reaffirm the lack of good-quality data in this area. Until such data are available, the use of salicylate elimination diets remains an ...

Paul E A Gray*

The tragic death of a child from complications of severe atopic dermatitis represents an extreme outcome of parental neglect due to alternative health beliefs and fear of using topical corticosteroids.

Saxon D Smith MB ChB, MHL, FACD · Amanda M Stephens BA, MB BS, PhD · Julia C Werren BA, LLB, MHlthMedLaw · Gayle O Fischer MB BS, MD, FACD

With consumer demand for storage of cord blood increasing, regulatory bodies need to develop policies to enable research that may lead to novel uses of cord blood.

Michael X Han · Maria E Craig MB BS, PhD, FRACP

Even in the hands of experts, listening through a stethoscope is not the best way to screen for rheumatic heart disease in Indigenous children, according to this cross-sectional screening survey of more than 1000 children

Kathryn V Roberts MPHTM, FRACP, MB BS · Alex D H Brown BMed, MPH, PhD · Graeme P Maguire PhD, FRACP, MB BS · David N Atkinson MPH, MB BS · Jonathan R Carapetis PhD, MB BS, BMedSci

Data from a tertiary paediatric refugee health clinic show that instances of post-traumatic stress disorder are on the rise in this population, particularly in children who have been held in detention.

Joshua R Francis · Sarah Cherian · David Forbes

Closing the gap among First Nations children requires community involvement in service implementation, consistent monitoring of child health indicators, and a good understanding of how public policies affect children.

Sandra J Eades BMed, PhD · Fiona J Stanley MB BS, MSc, MD

To the Editor: Conflicting information about treatments is known to undermine compliance with the use of medications.1 The education of patients and caregivers that accompanies prescribing should therefore be as consistent as possible. Clients may conduct research on the internet into particular medicines and try to corroborate “what the doctor said”. In the case of the use of clonidine in children, publicly available information is ...

Klaus Martin Beckmann

Children in two remote Northern Territory Aboriginal communities were studied to measure the impact of four weeks of daily swimming on rates of ear discharge with a tympanic membrane penetration and on the microbiology of the nasopharynx and middle ear.

Anna T N Stephen MPH · Amanda J Leach BAgSc(Hons), MAgSc, PhD · Peter S Morris MB BS, PhD, FRACP

When children with rare chronic diseases grow up, it’s often a rocky pathway to adult care.

Yvonne A Zurynski BAppSc, MAppSc, PhD · Elizabeth J Elliott MD, MPhil, FRACP

A review of case notes from our Sydney-based paediatric allergy services, between 1 January 2003 and 31 December 2011, identified 74 children who had been prescribed diets that eliminated foods containing natural salicylates before attending our clinics. The most common indications for starting the diets were eczema (34/74) and behavioural disturbances (17/74) including attention deficit hyperactivity disorder (ADHD). We could find no peer-reviewed evidence to support the efficacy of salicylate elimination diets in managing these diseases. We do not prescribe these diets, and in a survey of European and North American food allergy experts, only 1/23 respondents used a similar diet for eczema, with none of the respondents using salicylate elimination to treat ADHD. A high proportion (31/66) of children suffered adverse outcomes, including nutritional deficiencies and food aversion, with four children developing eating disorders. We could find no published evidence to support the safety of these diets in children. While this uncontrolled study does not prove a causal relationship between salicylate elimination diets and harm, the frequency of adverse events appears high, and in the absence of evidence of safety or efficacy, we cannot recommend the use of these diets in children.

Paul E A Gray Mb Chb, FRACP, FRCPA · Sam Mehr MB BS, FRACP, FRCPA · Constance H Katelaris MB BS, PhD, FRACP · Brynn K Wainstein MB ChB, FRACP, PhD · Anita Star BHlthSc, PhD, APD · Dianne Campbell MB BS, FRACP, PhD · Preeti Joshi MB BS, FRACP, PhD · Melanie Wong PhD, FRACP, FRCPA · Brad Frankum BMed(Hons), FRACP · Karuna Keat MB BS, FRACP, FRCPA · Geraldine Dunne BSc(Hons), RN · Barbara Dennison DipCommNut, ANAPD · Alyson Kakakios MB BS, FRACP · John B Ziegler FRACP, MD, FAAAAI

An audit of cases treated at a major children’s hospital reveals that significant burns from motorcycle exhausts still occur much too frequently

Ela J Hyland · Rachel A D’Cruz · John G Harvey