bluuebunny/crossref_metadata_2025 huggingface dataset:
Math computation, error patterns and stimulant effects in children with Attention Deficit Hyperactivity Disorder
Authors: Benedetto-Nasho E. , Tannock R.
Published: March 2007

This study compared the math performance, error patterns, and concurrent overt behavior of 14 children with Attention Deficit Hyperactivity Disorder (ADHD) and 15 typically developing peers, matched in age, IQ and arithmetic achievement. Subsequently, the group with ADHD participated in a double-blind placebo-controlled trial of methylphenidate (MPH) to determine the effects of stimulant medication on academic efficiency, error pattern, and overt behavior. In comparison with their non-affected peers, children with ADHD had lower levels of academic efficiency, used more immature computation strategies, made substantially more trading errors in subtraction and exhibited increased levels of inattention and disruptive behavior. MPH exerted a significant positive effect on all measures. The possible interplay between a faulty memory system and poor academic achievement is discussed.
Levels of self-reported depression among mothers of children with Attention-Deficit! Hyperactivity Disorder
Authors: West J. , Houghton S. , Douglas G. , Wall M. , Whiting K.
Published: March 2007

Objective: The aims of the present research were to identify levels of depression in mothers of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) and to determine whether maternal depressive severity varied according to the child's ADHD subtype.

Method: Data were obtained using the self-administered Beck Depression Inventory (BDI) which was completed and returned by 80 mothers from a randomly selected clinical sample.

Conclusions: Mothers of ADHD Combined Type children self-report significantly higher levels of depressive severity than mothers of ADHD Predominantly Inattentive Type children. Furthermore, mothers of more than one ADHD child report significantly higher levels of depression than mothers of a single ADHD child. The results suggest that there may be serious maternal health consequences associated with parenting a child (or children) with ADHD, particularly for mothers of ADHD Combined Type children or mothers of more than one ADHD child. Furthermore, the differences between mothers' BDI scores according to their child's ADHD subtype suggests that depression in mothers of ADHD children is not a homogeneous entity and that future intervention strategies may need to be adapted accordingly.
Importance of Family History in Lifestyle Management
Authors: Crouch Michael A.
Published: March 2007

Families affect the health of their members by transmitting genetic predisposition to wellness and illness. Families also model and teach health beliefs, attitudes, and behaviors. Eliciting an individual's family history can identify potential genetic vulnerabilities to disease and lifestyle influences. This review explores the implications of family history for patient education about lifestyle. Family history is particularly useful for helping health care providers be effective with individuals who have strong family patterns of atherosclerotic cardiovascular disease, major risk factors (dyslipidemia, hypertension, diabetes, and tobacco use), and related factors (obesity, poor nutrition, physical inactivity, and alcohol excess). Gathering and recording family history information can be problematic, even with an electronic medical record (EMR). The genogram (expanded genetic pedigree) is an efficient way to record and display family history data. Family history data in genogram format can be used as a versatile patient education tool. Despite its clinical utility, the genogram has been used more for teaching than for patient care. Thus far, the genogram has not been integrated into the EMR. Adding relevant cultural information to the conventional genogram might increase its utility for helping health care providers encourage lifestyle changes that promote wellness and prevent disease, disability, and premature death in ethnically diverse populations.
Naturally occurring C-terminally truncated STAT5 is a negative regulator of HIV-1 expression
Authors: Crotti Andrea , Lusic Marina , Lupo Rossella , Lievens Patricia M. J. , Liboi Elio , Chiara Giulia Della , Tinelli Marco , Lazzarin Adriano , Patterson Bruce K. , Giacca Mauro , Bovolenta Chiara , Poli Guido
Published: March 2007

CD4+ cells of most individuals infected with HIV-1 harbor a C-terminally truncated and constitutively activated form of signal transducer and activator of transcription-5 (STAT5Δ). We report that the chronically HIV-infected U1 cell line expresses STAT5Δ but not full-length STAT5. Granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulation of U1 cells promoted early activation of STAT5Δ and of extracellular signal regulated kinases (ERKs), followed by later activation of activator protein 1 (AP-1) and HIV expression. Inhibition of ERK/AP-1 by PD98,059 abolished, whereas either tyrphostin AG490 or a STAT5 small interfering RNA (siRNA) enhanced, virion production in GM-CSF–stimulated U1 cells. Chromatin immunoprecipitation demonstrated the induction of STAT5Δ binding to STAT consensus sequences in the HIV-1 promoter together with a decreased recruitment of RNA polymerase II after 1 hour of GM-CSF stimulation of U1 cells. Down-regulation of STAT5Δ by siRNA resulted in the up-regulation of both HIV-1 gag-pol RNA and p24 Gag antigen expression in CD8-depleted leukocytes of several HIV-positive individuals cultivated ex vivo in the presence of interleukin-2 but not of interleukin-7. Thus, the constitutively activated STAT5Δ present in the leukocytes of most HIV-positive individuals acts as a negative regulator of HIV expression.
Hematopoietic stem cell–targeted neonatal gene therapy reverses lethally progressive osteopetrosis in oc/oc mice
Authors: Johansson Maria K. , de Vries Teun J. , Schoenmaker Ton , Ehinger Mats , Brun Ann C. M. , Fasth Anders , Karlsson Stefan , Everts Vincent , Richter Johan
Published: March 2007

Infantile malignant osteopetrosis (IMO) is a fatal disease caused by lack of functional osteoclasts, and the only available treatment is hematopoietic stem cell (HSC) transplantation. In the majority of patients, the TCIRG1 gene, coding for a subunit of a proton pump essential for bone resorption, is mutated. Oc/oc mice have a deletion in the homologue gene (tcirg1) and die at 3 to 4 weeks, but can be rescued by neonatal transplantation of HSCs. Here, HSC-targeted gene therapy of osteopetrosis in the oc/oc mouse model was developed. Oc/oc fetal liver cells depleted of Ter119-expressing erythroid cells were transduced with a retroviral vector expressing tcirg1 and GFP, and subsequently transplanted intraperitoneally to irradiated neonatal oc/oc mice. Eight of 15 mice survived past the normal life span of oc/oc mice. In vitro osteoclastogenesis revealed formation of GFP-positive osteoclasts and bone resorption, albeit at a lower level than from wild-type cells. The skeletal phenotype was analyzed by X-ray and histopathology and showed partial correction at 8 weeks and almost normalization after 18 weeks. In summary, osteopetrosis in oc/oc mice can be reversed by neonatal transplantation of gene-modified HSCs leading to long-term survival. This represents a significant step toward the development of gene therapy for osteopetrosis.
Densitometry for assessment of effect of lung volume reduction surgery for emphysema
Authors: Stolk J. , Versteegh M. I. M. , Montenij L. J. , Bakker M. E. , Grebski E. , Tutic M. , Wildermuth S. , Weder W. , el Bardiji M. , Reiber J. H. C. , Rabe K. F. , Russi E. W. , Stoel B. C.
Published: March 2007

To explore if change in the extent of emphysema correlated with change in lung function, the effect of resection of emphysematous tissue was studied by computed tomography (CT) densitometry. In addition, the current authors studied how surgery-induced change in emphysema related to lung density in control subjects.

In total, 30 patients (14 females; mean±sdage 59±10 yrs) with severe emphysema before and 3 months after lung volume reduction surgery (LVRS), 48 patients with moderate emphysema and 76 control subjects were investigated. Lung density (15th percentile point) of both lungs and heterogeneity of lung density between 12 isovolumetric partitions in each lung were calculated from chest CT images.

The 15th percentile point and its heterogeneity could distinguish controls from subjects with moderate emphysema with a sensitivity and specificity of >95%. LVRS significantly increased lung density by 5.0±10.9 g·L−1(n = 30). Improvement in the diffusing capacity of the lung for carbon monoxide and in residual volume significantly correlated with an increase in lung density (n = 20 and 28, respectively). Change in forced expiratory volume in one second did not correlate with change in lung density.

In conclusion, lung density 15th percentile point is a valuable surrogate marker for detection of both the extent of and reduction in emphysema.
Nonatopic asthma is associated with helminth infections and bronchiolitis in poor children
Authors: Pereira M. U. , Sly P. D. , Pitrez P. M. , Jones M. H. , Escouto D. , Dias A. C. O. , Weiland S. K. , Stein R. T.
Published: March 2007

Asthma is common in urban centres in Latin America, but atopic asthma may not be the main phenotype among children. Helminth infections are highly prevalent in poor populations, and it was hypothesised that they attenuate allergic asthma, whereas other factors are related to the expression of a nonatopic wheeze/asthma phenotype.

A total of 1,982 children from Southern Brazil with a mean±sdage of 10.1±0.76 yrs completed asthma questionnaires, and 1,011 were evaluated for intestinal parasites and atopy using skin-prick tests (SPTs).

Wheeze in the previous 12 months was reported by 25.6%, and 9.3% showed current asthma; 13% were SPT-positive and 19.1% were positive for any helminths. Most children with either wheeze or asthma were SPT-negative; however, severe wheeze was more prevalent among the atopic minority. Helminth infections were inversely associated with positive SPT results. Bronchiolitis before the age of 2 yrs was the major independent risk factor for asthma at age 10 yrs; high-load Ascaris infection, a family history of asthma and positive SPT results were also asthma risk factors.

Most asthma and wheeze are of the nonatopic phenotype, suggesting that some helminths may exert an attenuating effect on the expression of the atopic portion of the disease, whereas viral bronchiolitis predisposes more specifically to recurrent airway symptoms.
Inference of miRNA targets using evolutionary conservation and pathway analysis
Authors: Gaidatzis Dimos , van Nimwegen Erik , Hausser Jean , Zavolan Mihaela
Published: March 2007

Background

MicroRNAs have emerged as important regulatory genes in a variety of cellular processes and, in recent years, hundreds of such genes have been discovered in animals. In contrast, functional annotations are available only for a very small fraction of these miRNAs, and even in these cases only partially.

Results

We developed a general Bayesian method for the inference of miRNA target sites, in which, for each miRNA, we explicitly model the evolution of orthologous target sites in a set of related species. Using this method we predict target sites for all known miRNAs in flies, worms, fish, and mammals. By comparing our predictions in fly with a reference set of experimentally tested miRNA-mRNA interactions we show that our general method performs at least as well as the most accurate methods available to date, including ones specifically tailored for target prediction in fly. An important novel feature of our model is that it explicitly infers the phylogenetic distribution of functional target sites, independently for each miRNA. This allows us to infer species-specific and clade-specific miRNA targeting. We also show that, in long human 3' UTRs, miRNA target sites occur preferentially near the start and near the end of the 3' UTR.

To characterize miRNA function beyond the predicted lists of targets we further present a method to infer significant associations between the sets of targets predicted for individual miRNAs and specific biochemical pathways, in particular those of the KEGG pathway database. We show that this approach retrieves several known functional miRNA-mRNA associations, and predicts novel functions for known miRNAs in cell growth and in development.

Conclusion

We have presented a Bayesian target prediction algorithm without any tunable parameters, that can be applied to sequences from any clade of species. The algorithm automatically infers the phylogenetic distribution of functional sites for each miRNA, and assigns a posterior probability to each putative target site. The results presented here indicate that our general method achieves very good performance in predicting miRNA target sites, providing at the same time insights into the evolution of target sites for individual miRNAs. Moreover, by combining our predictions with pathway analysis, we propose functions of specific miRNAs in nervous system development, inter-cellular communication and cell growth. The complete target site predictions as well as the miRNA/pathway associations are accessible on the ElMMo web server.
Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia
Authors: Müller Beat , Harbarth Stephan , Stolz Daiana , Bingisser Roland , Mueller Christian , Leuppi Jörg , Nusbaumer Charly , Tamm Michael , Christ-Crain Mirjam
Published: March 2007

Background

Community-acquired pneumonia (CAP) is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP.

Methods

545 patients with suspected lower respiratory tract infection, admitted to the emergency department of a university hospital were included in a pre-planned post-hoc analysis of two controlled intervention trials. Baseline assessment included history, clinical examination, radiography and measurements of procalcitonin (PCT), highly sensitive C-reactive protein (hsCRP) and leukocyte count.

Results

Of the 545 patients, 373 had CAP, 132 other respiratory tract infections, and 40 other final diagnoses. The AUC of a clinical model including standard clinical signs and symptoms (i.e. fever, cough, sputum production, abnormal chest auscultation and dyspnea) to diagnose CAP was 0.79 [95% CI, 0.75–0.83]. This AUC was significantly improved by including PCT and hsCRP (0.92 [0.89–0.94]; p < 0.001). PCT had a higher diagnostic accuracy (AUC, 0.88 [0.84–0.93]) in differentiating CAP from other diagnoses, as compared to hsCRP (AUC, 0.76 [0.69–0.83]; p < 0.001) and total leukocyte count (AUC, 0.69 [0.62–0.77]; p < 0.001). To predict bacteremia, PCT had a higher AUC (0.85 [0.80–0.91]) as compared to hsCRP (p = 0.01), leukocyte count (p = 0.002) and elevated body temperature (p < 0.001). PCT, in contrast to hsCRP and leukocyte count, increased with increasing severity of CAP, as assessed by the pneumonia severity index (p < 0.001).

Conclusion

PCT, and to a lesser degree hsCRP, improve the accuracy of currently recommended approaches for the diagnosis of CAP, thereby complementing clinical signs and symptoms. PCT is useful in the severity assessment of CAP.
Inhaled tobramycin solution-associated recurrent eosinophilia and severe persistent bronchospasm in a patient with cystic fibrosis: a case report
Authors: Santos Roberto P , Awa Emad , Anbar Ran D
Published: March 2007

Background

Delivery of tobramycin by inhalation to the lungs of patients with cystic fibrosis (CF) who are infected with Pseudomonas aeruginosa has been proven to be effective and safe. The aerosol administration allows high concentrations of tobramycin to be delivered to the site of infection with limited systemic absorption. In rare patients, systemic absorption of inhaled tobramycin may be significant enough to produce toxic effects, such as renal and vestibular toxicities.

Case presentation

We report a patient with CF who developed recurrent eosinophilia and severe persistent bronchospasm following repeated administration of preservative-free tobramycin by inhalation, beginning at 16 months of age. Also, he developed similar signs and symptoms when he was administered tobramycin intravenously on one occasion at 5 1/2 years. The patient had a history of environmental allergies. Temporal sequence of his signs and symptoms after each administration of tobramycin (similar to re-challenge testing), and his improvement after discontinuation of the drug strongly suggest an adverse drug reaction.

Conclusion

Hypersensitivity reaction should be considered in patients who develop recurrent eosinophilia and deterioration of pulmonary function following the use of tobramycin by inhalation or by intravenous administration.
Homeopathic and conventional treatment for acute respiratory and ear complaints: A comparative study on outcome in the primary care setting
Authors: Haidvogl Max , Riley David S , Heger Marianne , Brien Sara , Jong Miek , Fischer Michael , Lewith George T , Jansen Gerard , Thurneysen André E
Published: March 2007

Background

The aim of this study was to assess the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting.

Methods

The study was designed as an international, multi-centre, comparative cohort study of non-randomised design. Patients, presenting themselves with at least one chief complaint: acute (≤ 7 days) runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8), Germany (8), the Netherlands (7), Russia (6), Spain (6), Ukraine (4), United Kingdom (10) and the USA (8) and given either homeopathic or conventional treatment. Therapy outcome was measured by using the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' in each treatment group. The primary outcome criterion was the response rate after 14 days of therapy.

Results

Data of 1,577 patients were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H: 86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing). In the per-protocol set (H: 576 and C: 540 patients) similar results were obtained (H: 87.7%; C: 86.9%; p = 0.0019). Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of the primary outcome criterion was 1.40 (0.89–2.22) in children and 0.92 (0.63–1.34) in adults. Adjustments for demographic differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was significantly faster upon homeopathic treatment both in children (p = 0.0488) and adults (p = 0.0001). Adverse drug reactions occurred more frequently in adults of the conventional group than in the homeopathic group (C: 7.6%; H: 3.1%, p = 0.0032), whereas in children the occurrence of adverse drug reactions was not significantly different (H: 2.0%; C: 2.4%, p = 0.7838).

Conclusion

In primary care, homeopathic treatment for acute respiratory and ear complaints was not inferior to conventional treatment.
The costs and potential savings of a novel telepaediatric service in Queensland
Authors: Smith Anthony C , Scuffham Paul , Wootton Richard
Published: March 2007

Background

There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person.

Methods

In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry.

Results

During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was A$1,553,264; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider.

Conclusion

Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.
Trans-inhibition of HIV-1 by a long hairpin RNA expressed within the viral genome
Authors: Konstantinova Pavlina , ter Brake Olivier , Haasnoot Joost , de Haan Peter , Berkhout Ben
Published: March 2007

Background

Human immunodeficiency virus type 1 (HIV-1) can be inhibited by means of RNA silencing or interference (RNAi) using synthetic short interfering RNAs (siRNAs) or gene constructs encoding short hairpin RNAs (shRNAs) or long hairpin RNAs (lhRNAs). The use of siRNA and shRNA as antiviral therapeutic is limited because of the emergence of viral escape mutants. This problem is theoretically prevented by intracellular expression of lhRNAs generating multiple siRNAs that target the virus simultaneously, thus reducing the chance of viral escape. However, gene constructs encoding lhRNA molecules face problems with delivery to the right cells in an infected individual. In order to solve this problem, we constructed an HIV-1 variant with a 300 bp long hairpin structure in the 3' part of the genome corresponding to the Nef gene (HIV-lhNef).

Results

Intriguingly, HIV-lhNef potently inhibited wild-type HIV-1 production in trans. However, HIV-lhNef demonstrated a severe production and replication defect, which we were able to solve by selecting spontaneous virus variants with truncated hairpin structures. Although these escape variants lost the ability to trans-inhibit HIV-1, they effectively outgrew the wild-type virus in competition experiments in SupT1 cells.

Conclusion

Expression of the lhNef hairpin within the HIV-1 genome results in potent trans-inhibition of wild-type HIV-1. Although the mechanism of trans-inhibition is currently unknown, it remains of interest to study the molecular details because the observed effect is extremely potent. This may have implications for the development of virus strains to be used as live-attenuated virus vaccines.
Tumor necrosis factor alpha and adalimumab differentially regulate CD36 expression in human monocytes
Authors: Boyer Jean Frédéric , Balard Patricia , Authier Hélène , Faucon Bruno , Bernad José , Mazières Bernard , Davignon Jean-Luc , Cantagrel Alain , Pipy Bernard , Constantin Arnaud
Published: March 2007

In chronic inflammatory diseases, such as rheumatoid arthritis, inflammation acts as an independent cardiovascular risk factor and the use of anti-inflammatory drugs, such as anti-tumor necrosis factor alpha (anti-TNFα), may decrease this risk. The phagocytosis of oxidized low density lipoproteins (LDLs) accumulated in the subendothelium by mononuclear cells influences atherosclerosis and depends on CD36 expression. We investigated the role of TNFα and adalimumab, a human anti-TNFα monoclonal antibody widely used in human pathology, in CD36 expression in human monocytes. Human monocytes were prepared by adherence from whole-blood buffy-coat fractions from healthy donors. CD36 expression was assessed by RT-PCR and flow cytometry, with various TNFα or adalimumab concentrations. Implication of peroxisome proliferator-activated receptor (PPAR)γ in the regulation of CD36 expression was assessed using specific inhibitor or gel shift assays. The impact of redox signaling was investigated using quantification of reactive oxygen species, antioxidant and a NADPH oxidase inhibitor. The F(ab')2 fragment of adalimumab was isolated and its effect was analyzed. TNFα inhibits both CD36 membrane expression and mRNA expression. This inhibition involves a reduction in PPARγ activation. In contrast, adalimumab increases both CD36 membrane expression and mRNA expression. This induction is independent of the Fc portion of adalimumab and involves redox signaling via NADPH oxidase activation. CD36 expression on human monocytes is inhibited by TNFα and independently increased by adalimumab. These data highlight that pro-inflammatory cytokines and their specific neutralization influence the expression of cellular receptors implicated in atherosclerosis. Further studies are needed to investigate the clinical implications of these results in accelerated atherosclerosis observed in rheumatoid arthritis.
The Opportunity Loss of Boarding Admitted Patients in the Emergency Department
Authors: Falvo Thomas , Grove Lance , Stachura Ruth , Vega David , Stike Rose , Schlenker Melissa , Zirkin William
Published: March 2007

Objectives:
Boarding admitted patients in emergency department (ED) treatment beds has been recognized as a major cause of ED crowding and ambulance diversions. When process delays impede the transfer of admitted patients from the ED to inpatient units, the department's capacity to accept new arrivals and to generate revenue from additional patient services is restricted. The objective of this study was to determine the amount of functional ED treatment capacity that was used to board inpatients during 12 months of operations at a community hospital and to estimate the value of that lost treatment capacity.

Methods:
Historical data from 62,588 patient visits to the ED of a 450‐bed nonprofit community teaching hospital in south central Pennsylvania between July 2004 and June 2005 were used to determine the amount of treatment bed occupancy lost to inpatient holding and the revenue potential of utilizing that blocked production capacity for additional patient visits.

Results:
Transferring admitted patients from the ED to an inpatient unit within 120 minutes would have increased the functional treatment capacity of the ED by 10,397 hours during the 12 months of this study. By reducing admission process delays, the hospital could potentially have accommodated another 3,175 patient encounters in its existing treatment spaces. Providing emergency services to new patients in ED beds formerly used to board inpatients could have generated $3,960,264 in additional net revenue for the hospital.

Conclusions:
Significantly higher operational revenues could be generated by reducing output delays that restrict optimal utilization of existing ED treatment capacity.
HIV in pregnancy: evolution of clinical practice in the UK
Authors: Foster C J , Lyall E G H
Published: March 2007

Prior to the introduction of interventions reducing mother-to-child transmission of HIV-1 natural history data reports vertical transmission rates in the order of 25%. The risk of transmission from mother-to-child has been associated with advanced maternal HIV disease, maternal plasma HIV viral load and CD4 lymphocyte count, mode of delivery, length of rupture of membranes, prematurity and breast feeding. During the last 10–15 years the introduction of prelabour cesarean section, formula feeding and antiretroviral therapy has reduced transmission to less than 1% for pregnant women in the UK who are aware of their HIV status. Attention is now turning to the minimization of possible drug side effects for both mother and infant as women are increasingly conceiving on combination antiretroviral therapy. The evolution of current UK guidelines on the prevention of mother-to-child transmission of HIV-1 are discussed.
Fatal attraction: sex, sexually transmitted infections and HIV-1
Authors: Chan D J
Published: March 2007

The predominant mode of HIV-1 transmission globally is from sexual practices. The risk of HIV-1 transmission by sexual means is a function of infectivity, susceptibility and mode of transmission (type of sexual practice). In addition, transmission may be enhanced by the presence of sexually transmissible infections (STIs). An understanding of the interplay between sexual practices, STIs and HIV-1 may facilitate the development of effective treatment and prevention strategies. These topics are the subject of this review.
A review of female-condom effectiveness: patterns of use and impact on protected sex acts and STI incidence
Authors: Vijayakumar Gowri , Mabude Zonke , Smit Jenni , Beksinska Mags , Lurie Mark
Published: March 2007

We conducted a systematic review of 137 articles and abstracts related to various aspects of the female condom, as well as a closer analysis of five randomized controlled trials on effectiveness. These five studies indicated strongly the benefits of female-condom use in increasing protected sex acts, and two studies found promising decreases in sexually transmitted infection (STI) incidence with the introduction of the female condom. Ten studies provided detailed information on patterns of long-term use, many suggesting that the female condom reaches women less likely to use other dual protection methods. There exists limited but convincing evidence that the female condom is effective in increasing protected sex and decreasing STI incidence among women. Future research on the female condom must move away from assessing acceptability and focus on assessing effectiveness and improving impact in diverse settings.
HIV-associated female sexual dysfunction – clinical experience and literature review
Authors: Bell Charlotte , Richardson Daniel , Wall Michelle , Goldmeier David
Published: March 2007

Women form an increasing proportion of HIV-infected individuals in the developed world. Early data suggest that women with HIV are at particular risk of developing sexual problems. The aim of this study was to describe our anecdotal experience of HIV-infected women and to ascertain their sexual dysfunction, and also to conduct a national survey to evaluate what sexual dysfunction services are provided for women in other UK HIV centres. Retrospective analysis of clinic notes of women attending our HIV clinic and letter surveys of HIV centres in the UK were carried out. About half our cohort reported that they had sexual problems or were not satisfied with sex over the preceding 12 months. Contextual issues seemed to be the commonest cause of these problems. Sixty percent of HIV physicians in the UK rarely/never ask their female HIV patients about sexual functioning. Sexual dysfunction is probably common in HIV-infected women. Most physicians seeing women with HIV in the UK do not ask about sexual functioning. 'Physician coaching' could help to redress this situation, so that at the least the sexual problems could be brought up in discussion.
Cost and cost-effectiveness of antiretroviral therapy for HIV infection in Singapore
Authors: Paton Nicholas I , Chapman Chere A T , Sangeetha S , Mandalia Sundhiya , Bellamy Richard , Beck Eduard J
Published: March 2007

The objective of this study was to determine the cost and cost-effectiveness of antiretroviral therapy (ART) in Singapore. The use and cost of HIV services was calculated for patients managed at the national HIV referral centre in Singapore between 1996 and 2001 from a hospital perspective. Three groups of patients were compared by Centers for Disease Control and Prevention (CDC) stage of HIV infection: those who had never received ART; those who had received only dual therapy; and those who had only received highly active antiretroviral therapy (HAART). Hospital charges were used to estimate the average hospital inpatient and outpatient care costs. Life years gained (LYG) were calculated for different stages of HIV infection and the incremental costs per LYG were calculated comparing those on dual ART and HAART with those who did not receive ART. Patients on ART progressed less rapidly across all CDC stages. For CDC stage A, the incremental cost per LYG was $17,007 (Singaporean dollar) (interquartile range [IQR] $7963–25,113) and $22,511 (IQR $11,299–33,724) for those on dual therapy and HAART, respectively. The incremental cost per LYG in stage B was $10,868 (IQR $4506–17,239) and $21,094 (IQR $7774–34,431) for patients on dual therapy and HAART, respectively, while the incremental cost per LYG for stage C patients was $9,848 (IQR $5256–14,419) and $16,513 (IQR $8677–24,337) for dual therapy and HAART, respectively. Dual ART therapy and HAART were cost-effective interventions in Singapore. Cost-effectiveness is likely to improve if drug prices continue to decrease.
Association between HSV-2 and HIV-1 viral load in semen, cervico-vaginal secretions and genital ulcers of Thai men and women
Authors: Chu Kathryn , Jiamton Sukhum , Pepin Jacques , Cowan Frances , Mahakkanukrauh Bussakorn , Suttent Ruengpung , Robinson Noah J , Deslandes Sylvie , Frost Eric , Chaisilwattana Pongsakdi , Suthipinittharm Puan , Grosskurth Heiner , Brown David , Jaffar Shabbar
Published: March 2007

We studied the association between herpes simplex virus type-2 (HSV-2) and HIV-1 viralload in plasma, semen, cervico-vaginal secretions and genital ulcers. Forty-seven (68%) men and 57 (80%) women were HSV-2 antibody positive, of whom 12 (26%, 95% confidence interval [CI] 20, 32) and five (8%, 95% CI 4, 12), respectively, had HSV-2 genital shedding detected by polymerase chain reaction. The mean HIV-1 seminal and cervico-vaginal viral loads did not differ significantly according to the presence of HSV-2 shedding. Eleven men and 15 women presented with genital ulcers; all ulcers were due to HSV-2. Ten men and nine women were followed up over six days: the mean (95% CI) HIV-1 log viral load copies/mL in the genital ulcers at baseline and final visits were 2.5 (2.3, 2.7) and 3.1 (2.0, 4.2) for men and 3.0 (2.6, 3.4) and 2.7 (2.3, 3.1) for women. These findings do not support the hypothesis that HSV-2 increases the HIV-1 viral load in genital secretions.
Wie es vor 25 Jahren war
Authors: Wunderlich Dieter
Published: March 2007

Damals kam die Gründergeneration in das Ruhestandsalter. Man erinnere sich, daß die deutsche Sprachwissenschaft der Nazizeit völkisch, inhaltsbezogen und kulturorientiert war und sich auch danach nur wenige strukturalistische Tupfer erlaubte, als sie, die Gründer, sich 33 Jahre nach Kriegsende (!) endlich eine eigene Organisation schufen, inspiriert von neuen hoffnungsvollen Entwicklungen der generativen Grammatik, der logischen Semantik und der Sprechakttheorie, nämlich die Deutsche Gesellschaft für Sprachwissenschaft – das war fast ein Menschenalter nach der Gründung der Linguistic Society of America im Jahre 1924. So wie zur LSA die Zeitschrift Language gehört, wollte die DGfS ihre eigene Zeitschrift für Sprachwissenschaft haben; es dauerte dann noch drei Jahre, bis der erste Jahrgang 1982 erschien. Diese Gründer nun, aus verschiedensten Gebieten kommend und im Bereich der modernen Linguistik fast allesamt Autodidakten, hatten die Sprachwissenschaft in Deutschland wieder zu einer aktiven Disziplin gemacht – was ihrer Bedeutung ja zukommt –, sie hatten Forschergruppen und Sonderforschungsbereiche betrieben, sich international umgesehen, Bücher und Artikel zunehmend in englischer Sprache geschrieben, Schüler ausgebildet und in die USA vermittelt, neue Zentren gegründet.
Factors Associated With Identification and Management of Maternal Depression by Pediatricians
Authors: Heneghan Amy M. , Chaudron Linda H. , Storfer-Isser Amy , Park Elyse R. , Kelleher Kelly J. , Stein Ruth E. K. , Hoagwood Kimberly Eaton , O'Connor Karen G. , Horwitz Sarah McCue
Published: March 2007

OBJECTIVE. We sought to identify characteristics of pediatricians that were associated with identification or management (referral and/or treatment) of mothers with depression.

METHODS. A cross-sectional survey was mailed to a random sample of 1600 of the 50818 US nonretired members of the American Academy of Pediatrics. Overall, 832 responded, with 745 responses from nontrainee members. The 662 fellow nontrainee members who engaged in direct patient care and completed information on identifying, referring, and treating maternal depression were included in the analyses.

RESULTS. A total of 511 of 662 respondents reported identifying maternal depression; of those who reported identifying maternal depression, 421 indicated they referred and 29 that they treated maternal depression in their practices. Pediatricians who are older, work in practices that provide child mental health services, see primarily (≥75%) white patients, use ≥1 method to address maternal depression, agree that pediatricians should be responsible for identifying maternal depression, think that maternal depression has an extreme effect on children's mental health, and are attitudinally more inclined to identify or manage maternal depression had significantly higher odds of reporting identification of maternal depression. Positive correlates of identification and management of maternal depression included practicing in the Midwest, using ≥1 method to address maternal depression, working in a practice that provides child mental health services, thinking that caregiving problems attributable to maternal health have an extreme effect on children's physical health, having attitudes that are more inclined to identify and to manage maternal depression, and usually inquiring about symptoms routinely to identify maternal depression.

CONCLUSIONS. Pediatricians' practice characteristics and attitudes are associated with their identification and management of mothers with depression.
Inaccuracy in Pediatric Outpatient Blood Pressure Measurement
Authors: Podoll Amber , Grenier Michelle , Croix Beth , Feig Daniel I.
Published: March 2007

OBJECTIVE. Hypertension is common in the pediatric population. There is increasing evidence for early hypertensive target organ damage that may lead to substantial long-term morbidity. Because a critical aspect of any screening program for hypertension is the ability to measure blood pressure accurately, we compared typical blood pressure measurements at a vital sign station with those that were obtained following recommendations set forth in “The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.”

METHODS. We compared the blood pressure measurements that were obtained with standard practice vital sign station screening with those that were obtained by trained personnel in accordance with Fourth Task Force recommendations. A total of 390 children were evaluated at 580 visits to the Pediatric Hypertension Clinic at Texas Children’s Hospital.

RESULTS. Seventy-four percent of the readings were higher at the vital sign station, and only 12% differed by <5 mm Hg for both systolic blood pressure and diastolic blood pressure. The mean difference between vital sign station and examination room was 13.2 ± 8.9 mm Hg for systolic blood pressure and 9.6 ± 7.6 mm Hg for diastolic blood pressure. Multiple regression analyses revealed that age, gender, race, obesity, first versus subsequent visit, essential versus secondary, or white coat hypertension and antihypertensive medications made no statistically significant difference in the lack of correlation of the readings.

CONCLUSION. These results suggest that if pediatricians use vital sign station screening for blood pressure, children with elevated initial measurements must be reevaluated in the examination room.
The Ketogenic Diet: One Decade Later
Authors: Freeman John M. , Kossoff Eric H. , Hartman Adam L.
Published: March 2007

The ketogenic diet, a high fat, adequate protein, low carbohydrate diet, has, during the past decade, had a resurgence of interest for the treatment of difficult-to-control seizures in children. This review traces its history, reviews its uses and side effects, and discusses possible alternatives and the diet’s possible mechanisms of action. Finally, this review looks toward possible future uses of the ketogenic diet for conditions other than epilepsy.
Mortality of Late-Preterm (Near-Term) Newborns in Utah
Authors: Young Paul C. , Glasgow Tiffany S. , Li Xi , Guest-Warnick Ginger , Stoddard Gregory
Published: March 2007

OBJECTIVES. The purpose of this work was to determine the relative risk for mortality and the causes and ages of death for late-preterm newborns (gestational age of 34–36 weeks) compared with those born at term.

METHODS. We reviewed data from birth and death certificates of infants born in Utah between 1999 and 2004. We calculated early neonatal (first week), neonatal (first 28 days), and infant (first year) mortality rates for each weekly estimated gestational age cohort from 34 to 42 weeks and, using 40 weeks as the reference, risk ratios for each cohort. Causes of death were grouped into 8 categories and compared for near term and term newborns. Crude mortality rates and risk ratios for death from all causes and for infants dying of all causes other than birth defects were measured.

RESULTS. Birth defects were the single-most common cause of death for both term and late-preterm newborns. Mortality rates for late-preterm newborns remained significantly higher after excluding those who died of birth defects from the comparisons.

CONCLUSIONS. Compared with those born at term, late-preterm (near-term) newborns have significantly higher mortality rates. Each weekly increase in estimated gestational age is associated with a decreasing risk of death. Birth defects are the leading cause of death among late-preterm newborns but do not entirely account for their higher risk of death.
Special Requirements of Electronic Health Record Systems in Pediatrics
Authors: Spooner S. Andrew ,   and the Council on Clinical Information Technology
Published: March 2007

This Clinical Report was revised. See https://doi.org/10.1542/peds.2024-068509.

Some functions of an electronic health record system are much more important in providing pediatric care than in adult care. Pediatricians commonly complain about the absence of these “pediatric functions” when they are not available in electronic health record systems. To stimulate electronic health record system vendors to recognize and incorporate pediatric functionality into pediatric electronic health record systems, this clinical report reviews the major functions of importance to child health care providers. Also reviewed are important but less critical functions, any of which might be of major importance in a particular clinical context. The major areas described here are immunization management, growth tracking, medication dosing, data norms, and privacy in special pediatric populations. The American Academy of Pediatrics believes that if the functions described in this document are supported in all electronic health record systems, these systems will be more useful for patients of all ages.
Self-injectable Epinephrine for First-Aid Management of Anaphylaxis
Authors: Sicherer Scott H. , Simons F. Estelle R. ,   the Section on Allergy and Immunology
Published: March 2007

Anaphylaxis is a severe, potentially fatal systemic allergic reaction that is rapid in onset and may cause death. Epinephrine is the primary medical therapy, and it must be administered promptly. This clinical report focuses on practical issues concerning the administration of self-injectable epinephrine for first-aid treatment of anaphylaxis in the community. The recommended epinephrine dose for anaphylaxis in children, based primarily on anecdotal evidence, is 0.01 mg/kg, up to 0.30 mg. Intramuscular injection of epinephrine into the lateral thigh (vastus lateralis) is the preferred route for therapy in first-aid treatment. Epinephrine autoinjectors are currently available in only 2 fixed doses: 0.15 and 0.30 mg. On the basis of current, albeit limited, data, it seems reasonable to recommend autoinjectors with 0.15 mg of epinephrine for otherwise healthy young children who weigh 10 to 25 kg (22–55 lb) and autoinjectors with 0.30 mg of epinephrine for those who weigh approximately 25 kg (55 lb) or more; however, specific clinical circumstances must be considered in these decisions. This report also describes several quandaries in regard to management, including the selection of dose, indications for prescribing an autoinjector, and decisions regarding when to inject epinephrine. Effective care for individuals at risk of anaphylaxis requires a comprehensive management approach involving families, allergic children, schools, camps, and other youth organizations. Risk reduction entails confirmation of the trigger, discussion of avoidance of the relevant allergen, a written individualized emergency anaphylaxis action plan, and education of supervising adults with regard to recognition and treatment of anaphylaxis.
Directed Neural Differentiation of Human Embryonic Stem Cells via an Obligated Primitive Anterior Stage
Authors: Pankratz Matthew T. , Li Xue-Jun , LaVaute Timothy M. , Lyons Elizabeth A. , Chen Xin , Zhang Su-Chun
Published: March 2007

Understanding neuroectoderm formation and subsequent diversification to functional neural subtypes remains elusive. We show here that human embryonic stem cells (hESCs) differentiate to primitive neuroectoderm after 8–10 days. At this stage, cells uniformly exhibit columnar morphology and express neural markers, including anterior but not posterior homeodomain proteins. The anterior identity of these cells develops regardless of morphogens present during initial neuroectoderm specification. This anterior phenotype can be maintained or transformed to a caudal fate with specific morphogens over the next week, when cells become definitive neuroepithelia, marked by neural tube-like structures with distinct adhesion molecule expression, Sox1 expression, and a resistance to additional patterning signals. Thus, primitive neuroepithelia represents the earliest neural cells that possess the potential to differentiate to regionally specific neural progenitors. This finding offers insights into early human brain development and lays a foundation for generating neural cells with correct positional and transmitter profiles.

Disclosure of potential conflicts of interest is found at the end of this article.