The Journal of the Singapore Paediatric Society最新文献

Complications of chemotherapy for a synovial sarcoma in an eight-year old boy included cisplatinum nephrotoxicity and adriamycin cardiotoxicity. The resultant renal failure and fluid overload necessitated peritoneal dialysis. Intractable hypomagnesemia was also a prominent feature.

A premature female infant was noted to have an unusual combination of abnormalities, consistent with the CHARGE ASSOCIATION. 1. Left (L) choanal stenosis 2. Fallot's Tetralogy 3. Esophageal atresia with distal TOF (Tracheo-Oesophageal Fistula) 4. Duodenal stenosis 5. Annular pancreas with ectopic pancreatic tissue in the proximal jejunum. Baby had surgery for the gastrointestinal tract abnormalities. She lived for only 19 days.

A case of eosinophilic meningitis in a young boy from Indonesia is reported. Clinically, he had a subacute meningitis with eosinophilic pleocytosis in the cerebrospinal fluid. The clinical and laboratory findings strongly suggest Angiostrongylus cantonensis as the aetiologic agent although the parasite was not found. The other most likely causes in the region are also considered and the life-cycle of Angiostrongylus cantonensis and the epidemiology of its infection are briefly reviewed.

The greatest challenge in neonatal infection is to correctly identify an infected neonate and not to overtreat those who are not. We studied 80 Asian neonates suspected of sepsis. C-Reactive Protein (CRP), Total White Cell Count (TW) and Immature to Total Neutrophil Ratio (I/T ratio) were evaluated in terms of their specificity, sensitivity, positive and negative predictive values. CRP was measured quantitatively by Fluorescence Polarisation Immunoassay Technology (FPIT). There were 36 positive cases (positive blood culture or Chest Radiography [CXR] showed pulmonary infiltrates). Using the FPIT, CRP in 98% of clinically healthy individuals is (less than or equal to) 1.0mg%. When CRP is less than or equal to 1.0mg% is taken as norm, its specificity range from 0.84-0.91 and its sensitivity from 0.22-0.50. However, CRP may be marginally raised in conditions of stress like birth asphyxia and fetal distress. Thus when CRP less than or equal to 1.5mg% is considered as norm, its specificity range from 0.93-1.00 and its sensitivity from 0.14-0.33. The positive predictive value range from 71%-100% and the negative predictive value from 57%-63%. The normal I/T ratio is less than 0.2. The specificity of I/T range from 0.75-0.91 and the sensitivity range from 0.22-0.47. The positive and negative predictive values range from 60%-76% and 58%-66% respectively. Hence CRP is very specific especially when it is less than 1.5mg% but not as sensitive. I/T although less specific is also more specific than sensitive. Combining CRP and I/T as a marker of sepsis only increases its specificity (range 93%-100%) but not its sensitivity (range 16%-45%).(ABSTRACT TRUNCATED AT 250 WORDS)

In this paper, we describe a child with Henoch-Schonlein nephritis presenting with nephrotic syndrome and selective proteinuria. Renal biopsy showed ISKDC Class IIIA nephritis. He responded to steroid treatment and is currently well. The significance of renal involvement in Henoch-Schonlein Purpura is discussed.

We present 4 neonates with enteroviral meningitis. The cerebrospinal fluid findings were variable and posed a diagnostic problem. Immediate outcome was excellent and 3 of the 4 infants were normal at follow-up at 6 months of age. However long-term follow-up will be necessary to to determine any long-term sequelae.

Between 1976 and 1979, hand radiographs of 112 Malay children, 55 males and 57 females aged from 12 to 28 months, from higher socio-economic class families were obtained and studied by two radiologists. These children were part of a longitudinal study on growth and development. A total of 268 hand and wrist radiographs were taken, which the radiologists read independently of each other using the Greulich and Pyle Atlas. The bone age was then compared with the chronological age and the difference, if any, was noted and 'scored'. It was found that 83.4% of cases for males and 94.8% of cases for females matched within the +/- 6 months discrepancy range. For practical purposes therefore, our population may use the Greulich-Pyle Atlas with a good degree of confidence. Typical hand radiographs of male and female Malay children at 12, 18 and 24 months of age are also presented and these may be used as standards for Malaysian children at the respective age groups.