Child health

Learning from past experience to improve paediatric vaccine safety.

Paul V Effler MD, MPH, FAFPHM · Heath A Kelly MB BS, MPH

CORRECTION Typographical errors in tables of birthweight percentiles: In “Australian national birthweight percentiles by sex and gestational age, 1998–2007”, in the 3 September 2012 issue of the Journal (Med J Aust 2012; 197: 291-294; doi: 10.5694/mja11.11331), there were two errors in Box 3 and one in Box 4 (page 293). In Box 3, the 25th percentile for boys with a gestational age of 34 weeks should be 2100 g, not 200 g, and ...

Timothy A Dobbins BMath, PhD · Elizabeth A Sullivan MD, MPH, FAFPHM · Christine L Roberts MB BS, DrPH, FAFPHM · Judy M Simpson BSc(Hons), PhD

A survey of students and parents shows that bedside teaching is viewed positively in paediatric wards.

Kathryn L Connelly · Michael S Gordon

In a cohort of 65 boys aged 12–16 years at recruitment, treatment for more than 3 years with stimulant medication was associated with a slower rate of physical development during puberty, compared with boys not taking stimulants.

Alison S Poulton MA, MB BChir, MD · Elaine Melzer RN, RM, OAM · Paul R Tait MB BS, FRACP · Sarah P Garnett BSc, MNutrDiet, PhD · Chris T Cowell MB BS, FRACP · Louise A Baur MB BS, PhD, FRACP · Simon Clarke MB BS, FRACP, FCP

You were only 2 months old. I met you in the children’s intensive care unit one night, almost 3 years ago. Intracranial haemorrhage, they said. What happened? We were trying to keep you alive. You were tiny in that large hospital cot, dwarfed by technology and oversized pyjamas, your bedtime lullaby the hissing of the ventilator and suction machines. We calculated fluid requirements, made your blood pressure and electrolytes look ...

Alison M Snodgrass MB BS, MRCPCH(UK) · Hong Liang Tey MB BS, MRCP(UK)

A tale of anxiety, innocence and trust in the anaesthetic roomAs I entered the busy paediatric ward, I scanned the room for my patient — they’re often not easy to find among the other children, the visiting parents and siblings, and the staff, and are rarely anywhere near, let alone in, their assigned beds. I was eventually directed to a small child sitting quietly on his ...

Geoffrey C Mullins MB BS, FANZCA, FRCPC

We read with interest the report by Handelsman describing an increase in Australian testosterone prescriptions, including a particular increase in prescribing of topical testosterone gel. The topically applied formulation of testosterone has a unique adverse-effect profile because of inadvertent exposure to it via direct skin contact. We report progressive virilisation in a 2-year-old girl who presented in 2011 with an 18-month history of body ...

Jacqueline K Hewitt · Margaret R Zacharin

To the Editor: On 5 June 2012, the forum “Eliminating childhood lead toxicity in Australia — a little is still too much” was held at Macquarie University to examine new evidence on the toxicity of lead and its implications for Australian children and communities. Presently, the National Health and Medical Research Council (NHMRC) recommends an increasingly obsolete intervention level that was established in 1993: blood lead levels ...

Mark P Taylor · Chris Winder · Bruce P Lanphear

To the Editor: Alkali drain cleaner has previously been reported to cause oral, oesophageal and cutaneous burns.-4 The risk of these cleaners causing full thickness cutaneous burns in children needs to be emphasised. Two toddlers recently presented to our hospital with severe burns after exposure to alkali drain cleaning products. An 18-month-old boy opened the box and bit open the silver foil packet of a foaming ...

Rachel A D’Cruz · Erik R La Hei · Andrew J A Holland

To the Editor: In describing 8 years of experience in managing adolescent gender identity disorder (GID) at a paediatric hospital clinic, Hewitt and colleagues highlight a small group of patients who require momentous life-long clinical decisions made in a timely manner.1 However, the rarity of this condition means that experience in any centre is limited. The authors state that authorisation from the Family Court of Australia is ...

Ann J Conway · Julie C Hamblin · David J Handelsman

To the Editor: I welcome the article by Hewitt and colleagues,1 but their protocol is problematic. Suppression of puberty improves mental health and general functioning, but not body image and dysphoria.2 For this, cross-sex hormones and/or surgery are the only effective treatments.2 Withholding cross-sex hormones until children are 16 years of age may worsen their mental health,3 cause resentment, and encourage self-medication. Increasingly, young transsexual people are ...

Zoë Hyde

In reply: We thank Hyde and Conway and colleagues for their correspondence following our report on treatment for young people with gender identity disorder (GID).1 We follow current international consensus recommendations for management,2,3 but accept that as more research is performed, there may be future adjustments to endorsed protocols. At present, patients can apply to the Family Court of Australia for authorisation of treatment that ...

Jacqueline K Hewitt · Campbell Paul · Louise K Newman

Cunningham’s perspective provides a timely review of the literature relating to the maternal psychological outcomes of holding stillborn babies, which remains controversial. It is unfortunate that some popular media sources reported it incorrectly as saying that seeing and holding stillborn babies may cause harm. The correct conclusion is that the literature is inconclusive. The Australian and New Zealand Stillbirth Alliance strongly supports Cunningham’s ...

Vicki J Flenady · Christine Carroll · Ros M Richardson

DISTURBANCES OF SLEEP and daytime function are important diagnostic symptoms. Although most of us are well versed in the features and important impacts of sleep apnoea, a search for insomnia should be an indispensable part of most history-taking.Almost a third of our symptomatic patients present with symptoms of stress or mood disorder, where investigations of physical symptoms such as fatigue, dizziness, daily headache, chest pain ...

John M Worthington

The publication of the Australasian Creatinine Consensus Working Group’s position statements in 2005 and 2007 resulted in automatic reporting of estimated glomerular filtration rate (eGFR) with requests for serum creatinine concentration in adults, facilitated the unification of units of measurement for creatinine and eGFR, and promoted the standardisation of assays. New advancements and continuing debate led the Australasian Creatinine Consensus Working Group to reconvene in 2010. ...

Australasian Creatinine Consensus Working Group

John Brown was born on 5 August 1934 in Meadowbank, New South Wales. He lost both parents early in his teenage years and was then raised by his aunt, Doris Johnson. Despite these setbacks, he attended Fort Street Boys’ High and subsequently studied medicine at the University of Sydney. On graduating in 1957, he entered the emerging specialty of paediatrics. While training at the Royal Alexandra Hospital for ...

Lachlan T Brown

Nathan Grills examines unhealthy alliances that highlight corporate social irresponsibilityIndustry sponsorship of charitable causes is increasingly promoted and practised across the corporate sector in Australia and overseas. But should such “corporate social responsibility” be limited in certain circumstances? Apart from tobacco companies, there are currently very few restrictions on which industries are allowed to support which charities. But there is a need to consider whether ...

Nathan J Grills MB BS, DPhil, MPH

IT WAS always going to be a difficult task to summarise all possible paediatric presentations into a single book to help junior medical staff “on call”, so the authors of this effort are to be commended.This is an Australian adaptation of the popular American handbook, and all three Australian authors — Browne, McCaskill and Cheng — are senior staff in the emergency department at the ...

Julian J Kelly

Objective: To determine the nutrient intakes and status of preschool children from a representative population sample in Adelaide.Design, setting and participants: Cross-sectional survey of children aged 1–5 years, using a stratified random sampling method and a doorknocking strategy, between September 2005 and July 2007.Main outcome measures: Dietary intake, assessed using a 3-day weighed-food diary; anthropometrics, biomarkers of iron, zinc and vitamin ...

Shao J Zhou PhD · Robert A Gibson BSc, PhD · Rosalind S Gibson PhD · Maria Makrides BSc, PhD

To describe the experience of hormone treatment of gender identity disorder (GID) in children and adolescents within a specialist clinic. Design, patients and setting: Cohort study by medical record review of children aged 0–17 years referred during 2003–2011 for management at the GID clinic in a tertiary paediatric referral centre — the Royal ...

Jacqueline K Hewitt MB BS, FRACP · Campbell Paul MB BS, FRANZCP · Porpavai Kasiannan DPM, MD, FRANZCP · Sonia R Grover MB BS, MD, FRANZCOG · Louise K Newman MB BS, PhD, FRANZCP · Garry L Warne MB BS, FRACP

To the Editor: The possible extension of the Australian preadolescent female vaccination program against human papillomavirus (HPV) to preadolescent males is not a sensible use of public health resources. In Australia, 71% of 15-year-old girls completed ...

Peter D Massey · David N Durrheim