bluuebunny/crossref_metadata_2025 huggingface dataset:
Contributions of Red Cells and Plasma to Blood Viscosity in Preterm and Full-Term Infants and Adults
Authors: Linderkamp Otwin , Versmold Hans T. , Riegel Klaus P. , Betke Klaus
Published: December 2021

In preterm infants, plasma and red blood cells display several specific properties (eg, RBC size, plasma composition) that could influence blood flow behavior. Hemorheologic properties of blood from 20 preterm infants (24 to 36 weeks of gestation), ten full-term neonates, and ten adults were studied by means of a coneplate viscometer adpated with a Couette-type chamber allowing viscometry at a wide range of shear rates (1.15 to 230/s). Blood viscosity (at given hematocrit of 60%), plasma viscosity, and RBC aggregation were very low in the smallest preterm infants, increased with gestational age, and reached the highest values in the adults. Whole blood viscosity increased directly with increasing plasma viscosity, plasma fibrinogen, and total plasma protein concentration, with the strongest correlations at the lowest shear rate of 1.15/s. The viscosity of RBCs suspended in a nonaggregating buffer solution was similar in all groups, thereby indicating that RBC deformability is similar in preterm infants, full-term neonates, and adults. Because mixing of neonatal and adult blood components occurs in most small preterm infants as a result of the transfusion of adult blood products, viscosities of cross suspensions (neonatal RBCs in adult plasma and adult RBCs in neonatal plasma) were measured. The exchange of neonatal plasma for adult plasma increased blood viscosity values in the neonates to adult values. On the other hand, the exchange of neonatal RBCs for adult RBCs did not affect blood viscosity. These results indicate that viscosity of blood with given hematocrit is lower in preterm infants than in term neonates and adults as a result of low plasma viscosity and low RBC aggregation, and that neonatal RBCs do not possess specific properties that influence blood viscosity.
Twenty-Five Years of Residents: What and Where Are They Now
Authors: DeAngelis Catherine , Duggan Ann , Oski Frank
Published: December 2021

To evaluate the effectiveness of our program in meeting the subsequent career needs of our graduates and to describe their professional experiences as a microcosm of pediatrics, a survey was completed of the 419 pediatricians who had completed the Harriet Lane Residency Program at The Johns Hopkins Hospital between 1960 and 1984. Overall, the 326 respondents found the program to have been effective in the areas they deemed appropriate to be taught in residency years. In decreasing order, the chief resident, fellow house officers, and fulltime faculty were rated to have had the greatest teaching effectiveness. The women respondents were less likely to be married (76% vs 89%), had fewer children on average (1.2 vs 2.31), missed more work, and were more likely to enter postresidency training (89% vs 78%) than the men. Of all respondents, 73% reported being certain of their career goals during residency and 77% of those reported a reasonable similarity with current positions. More than 93% reported being satisfied with their current careers, and 87% would still choose pediatrics. They are generally well reimbursed financially, with academician salaries matching those of private practitioners 10 years after completing residency and surpassing them, slightly, thereafter. This information provides much food for thought in preparing tomorrow's pediatricians.
Structured Encounter Form: The Impact on Provider Performance and Recording of Well-Child Care
Authors: Duggan Anne Kaszuba , Starfield Barbara , DeAngelis Catherine
Published: December 2021

The impact of record format on provider performance and recording of the process of care and their concordance were examined in this study. The process of care was defined by existing sets of explicit criteria developed for quality assessment. The study was conducted in an urban teaching hospital pediatric primary care clinic. Housestaff were encouraged, but not required, to use the clinic's structured, age-specific forms for recording well-child care. Performance and recording were compared during required well-child visits using the structured form and those using the basic clinic form. Study data from 1031 visits to 68 housestaff during a 14-month period were collected using medical record abstracting of all visits and direct observation of 243 of them. Twenty-three of the providers were assigned randomly to an unobserved control group to assess the effect of observation on recording. Use of the structured form was associated with significantly higher levels of both recorded and observed performance. When performance could be merely checked off to document performance, overdocumentation was found. Record-based estimates of performance were more accurate during visits when the structured form was used. Record format can improve provider performance and recording of the process of care.
Parvovirus, Erythema Infectiosum, and Pregnancy
Authors:   Committee on Infectious Diseases
Published: December 2021

Recent outbreaks of erythema infectiosum (fifth disease) have caused consternation among pregnant women and their physicians, because of the risk of spontaneous abortion caused by this viral infection. This statement contains information concerning the infection and recommendations regarding control of exposure.

The agent of erythema infectiosum is a single-stranded DNA virus called parvovirus B19, which infects humans only.1,2 Parvovirus B19 is principally transmitted by respiratory secretions,3 and a primary site of replication is the red blood cell precursors found in the bone marrow.4 After an incubation period of approximately 1 week's duration, the virus produces a febrile illness accompanied by reticulocytopenia, which lasts approximately 7 days.5 The normal person recovers without evident anemia and, in some cases, within another week, a distinctive rash, consisting of a slapped cheek appearance and an erythematous, lacy rash on the trunk and extremities, will develop. Atypical maculopapular rashes also occur.6 In adult patients, particularly women, arthralgia or arthritis may develop at this stage7,8; children infrequently experience joint involvement. Asymptomatic infection without rash may occur more frequently than illness with typical rash.

Infection with parvovirus B19 can also cause aplastic crisis in patients with red blood cell abnormalities leading to shortened red blood cell halflives (such as sickle cell disease and autoimmune hemolytic anemia). The aplastic crises develop approximately 1 week after onset of the acute illness due to parvovirus B19.9 Patients with aplastic crisis appear to be contagious from the onset or before the onset of acute illness and through the subsequent week or so.
Cough as a Risk Factor for Neonatal Intraventricular Hemorrhage
Authors: ARGENT A. C. , KLEIN M. , ROTHBERG A. D.
Published: December 2021

To the Editor.—

The recent study by Drs Perlman and Thach1 casts important light on an earlier work by Drs Perlman et al.2,3 Initially, Perlman et al2 showed that the risk of intraventricular hemorrhage in infants with the respiratory distress syndrome correlated with fluctuations in arterial blood pressure and cerebral blood flow. In their second study,3 they found the corollary: muscle paralysis eliminated the pressure and flow fluctuations and markedly reduced the risk of intraventricular hemorrhage.
Private Health Insurance of Chronically III Children
Authors: Fox Harriette B. , Newacheck Paul W.
Published: December 2021

Accurate information regarding the adequacy of private health insurance coverage available to the families of chronically ill children is scarce. A national survey was conducted of firms offering health insurance to employees and their dependents. Data were collected concerning private health insurance coverage of services needed by chronically ill children, including basic medical care services, ancillary therapies, mental health services, and long-term care. Nearly all surveyed firms offered health insurance. Coverage of inpatient hospital care, outpatient physician services, medical supplies and equipment, x-ra y stuies, laboratory services, and prescription medications was widespread, but coverage of services such as physical therapy, speech therapy, occupational therapy, and nutrition services was much less prevalent. More than two thirds of the firms covered comprehensive home health services but often with limits and only in lieu of more expensive inpatient care. Longterm care, such as skilled nursing home care, was covered by only one third of firms. Overall, the survey results, combined with information concerning recent trends in private health insurance, reveal increasing coverage of lower cost alternatives to hospital or institutional care and improved maximum lifetime benefits and stop-loss coverage but also increased cost-sharing requirements. These results suggest that, although families with chronically ill children may have access to a widening range of services such as home health care or individual benefits management, they may be forced to bear an increasing proportion of the cost.
Swimming Pool Owners' Opinions of Strategies for Prevention of Drowning
Authors: Wintemute Garen J. , Wright Mona A.
Published: December 2021

Training in cardiopulmonary resuscitation for pool owners and mandatory placement of a barrier around pools, two commonly suggested strategies for prevention of drowning, will depend, in part, on the support of pool owners to be successfully implemented. To measure this support, an equal probability sample of 795 Sacramento County households with pools was surveyed. An 80% response rate was achieved. A large majority (86%) favored voluntary cardiopulmonary resiscitation training, and a plurality (40%) favored required cardiopulmonary resuscitation certification for poo1 owners. However, 61% opposed a universal barrier requirement, and 49% objected to a barrier requirement for new pools only. Respondents with small children at home were more likely (P = .0001) to support a required barrier. The previous occurrence of a significant immersion event had surprisingly little effect. The results suggest some specific directions for programs to prevent swimming pool drownings.
Cell Therapy in Children With Down Syndrome: A Retrospective Study
Authors: Van Dyke Don C. , Lang David J. , van Duyne Susan , Heide Frances , Chang Hyejung
Published: December 2021

Cell therapy, the administration of freezedried or lyophilized cells derived from fetal tissue of animals, has been suggested and accepted by some parents as a treatment for Down syndrome. Such therapy regimens have been purported to ameliorate dysmorphic features and to result in improvement in IQ, motor skills, social behavior, height, language, and memory. Interest in this therapy continues despite a lack of empirical support for its use and its illegality in the United States. In this study, 190 subjects of whom 21 had received cell therapy (from sources external to this study) were studied for 18 variables in the areas of growth, motor development, cognitive development, and adaptive/social status. Comparing the cell-treated group with a control group matched for sex, age, socioeconomic status, and cardiac history showed no statistically significant differences for any of the developmental or growth variables measured. These findings fail to support continued claims of improved functioning following cell therapy in persons with Down syndrome.
Lead Poisoning Risk Determination in an Urban Population Through the Use of a Standardized Questionnaire
Authors: Schaffer Stanley J. , Szilagyi Peter G. , Weitzman Michael
Published: December 2021

Background. The Centers for Disease Control and Prevention (CDC) has recommended using a five-item questionnaire at every regular office visit for all children 6 to 72 months of age to identify those at risk of high-dose exposure to lead.

Objective. To determine how well the questionnaire identifies children with elevated lead levels.

Research design. Comparison of results of the questionnaire, which is intended to identify children as being low-risk or high-risk for lead poisoning, with children's blood lead levels.

Setting. A pediatric continuity clinic located in a major teaching hospital in Rochester, NY.

Patients. A consecutive sample of 476 children aged 6 to 72 months without a prior history of lead poisoning who were seen in the clinic in July and August 1992, and who had not had a lead screen in the previous 6 months (for those aged <36 months) or 12 months (for those aged 36 to 72 months).

Measurements and main results. Fingerstick lead samples were obtained from all children, and those ≥15 µg/dL (0.72 µmol/L) were confirmed by subsequent venous lead determinations. Twenty-eight percent had blood lead levels ≥10 µg/dL (0.48 µmol/L), 8% had levels ≥15 µg/dL (0.72 µmol/L), and 5% had lead levels ≥20 µg/dL (0.96 µmol/L). According to responses on the questionnaire, 44% were initially classified as low-risk, and 43% were high-risk. In 13% risk could not be determined because one or more items on the questionnaire had not been answered or were answered equivocally, whereas all other items were answered "No." Children for whom risk could not be determined were presumed to be at high risk and were added to that category, resulting in 56% of the study population so designated. The questionnaire was moderately effective in identifying children with elevated lead levels. Seventy percent of children having lead levels ≥10 µg/dL (0.48 µmol/L) and 82% of children having lead levels ≥15 µg/dL (0.72 ≥mol/L) had been classified as high-risk by the questionnaire. Children classified as low-risk were very unlikely to have elevated lead levels. Eighty-one percent of low-risk children had lead levels <10 µg/dL, and 97% had lead levels <15 µl/dL. An abbreviated questionnaire using only the first three items from the CDC questionnaire had almost identical effectiveness.

Conclusions. In this clinical setting, in which children are largely urban, poor, and have a moderate to high risk of developing elevated lead levels, the CDC risk assessment questionnaire is effective in identifying children with elevated lead burdens. However, an abbreviated version of the questionnaire may be as effective as the complete questionnaire. Additional questions should be added to the questionnaire to improve its overall sensitivity, and the questionnaire should be tested in other settings to see if it is effective with children having different environmental exposures to lead.
AGGRESSION IN PRESCHOOLERS: ITS RELATION TO SOCIALIZATION
Authors: Minde Klaus
Published: December 2021

The present article discusses developmental changes of aggression seen in preschool children and reports on an 18-month short-term prospective study of three preschool populations: a group referred for aggressive behavior problems, a normal control group, and a group of youngsters who had lived in violent homes, but showed no aggressive behaviors. Results indicate that the aggressive children, in comparison with the other two groups at age 4, showed a significant delay in their interpersonal awareness and perspective taking ability. However, although the aggressive children caught up with their peers in the course of the study period, there was no accompanying decrease in their aggressive behavior. The theoretical and clinical implications of these findings are discussed.
Do Questions About Lead Exposure Predict Elevated Lead Levels?
Authors: Tejeda David M. , Wyatt Deborah D. , Rostek Barry R. , Solomon William B.
Published: December 2021

Objective. To assess the usefulness of the lead poisoning questionnaire developed by the Centers for Disease Control and Prevention as a screening tool for elevated lead levels.

Methods. This descriptive study used a five-question questionnaire at our hospital-based general pediatric clinic and in two local private practices. We obtained venous lead levels from 485 children aged 9 months to 6 years who were brought for health supervision visits. The questionnaire was completed by a primary caretaker of 330 patients (68%). Contingency tables were used to compare lead levels with the responses on the questionnaire.

Results. Lead levels of ≥10 µg/dL were found in 23 (7%) of 330 who completed the questionnaire. Caretakers of children with elevated lead levels were more likely to answer yes to questions about chipping paint and home remodeling than those whose children had levels <10 (P = .0001). These questions had sensitivities for detecting elevated lead levels of 70% and 74% with negative predictive values of 97% and 98%, respectively. Questions about known contacts with lead poisoning and job or industrial exposure to lead each had sensitivities of <10%. The Centers for Disease Control and Prevention's definition of high risk for lead poisoning (one or more positive responses) was nearly 90% sensitive for detecting elevated lead levels with a negative predictive value of 99%.

Conclusion. This risk assessment questionnaire is an effective screening method for elevated lead levels in our population. Questions about the home environment were more sensitive indicators of elevated lead levels than other standard high-risk questions.
Aminophylline Therapy Does Not Improve Outcome and Increases Adverse Effects in Children Hospitalized With Acute Asthmatic Exacerbations
Authors: Strauss Raphael E. , Wertheim David L. , Bonagura Vincent R. , Valacer David J.
Published: December 2021

Objective. To evaluate the effects of aminophylline (Am) in children hospitalized with asthma.

Methods. Prospective, randomized, double-blind, placebo-controlled trial. Subjects were children between the ages of 5 and 18 years admitted for asthma exacerbation to either a tertiary care children's hospital or an innercity general hospital in New York. Exclusion criteria were admission to the intensive care unit, initial theophylline level > 5 µg/dL, or the presence of other systemic disorders. All patients received nebulized albuterol therapy and intravenous glucocorticosteroids in standardized doses. Thirty-one patients were randomized to receive either an Am bolus followed by continuous Am infusion or placebo (P) bolus and infusion. The outcome variables were: duration of hospitalization, percent of predicted peak expiratory flow rates recorded at 12-hour intervals, number of albuterol treatments required, and adverse effects.

Results. There were no significant differences at study entry in age, sex, race, number of previous hospital admissions, prior medications used, clinical symptom scores, or initial peak flow rates for the two groups. For 26 patients who completed this study, 15 patients in the P group were hospitalized for a mean duration of 2.33 ± 1.3 days, whereas 11 patients in the Am group required 2.58 ± 1.5 days. There were no significant differences between the two groups for hospital days, peak flow rates at any time interval, or amount of albuterol therapy required (P > .2). In the Am group, 6 of the 14 patients who entered the study experienced significant adverse effects consisting of nausea, emesis, headache, abdominal pain, and palpitations. Only 1 of 17 patients in the P group had an adverse effect (P <. 05).

Conclusions. There is no benefit and considerable risk of adverse effects associated with the use of Am in hospitalized asthmatic children.
Toluene Embryopathy: Delineation of the Phenotype and Comparison With Fetal Alcohol Syndrome
Authors: Pearson Margaret A. , Rimsza Mary E. , Hoyme H. Eugene , Seaver Laurie H.
Published: December 2021

Objective. To determine if maternal toluene abuse produces any structural or developmental disabilities in the developing fetus, a cohort of toluene-exposed infants was ascertained and examined.

Methodology. Eighteen infants with a history of in utero toluene exposure were examined at birth. Nine of these infants were reexamined 3 to 36 months after their initial evaluations. The clinical findings in these patients were compared with those of similarly exposed children from the literature and with patients who had the fetal alcohol syndrome.

Results. Thirty-nine percent of all toluene-exposed infants described in this and other studies were born prematurely, and 9% died during the perinatal period. Fifty-four percent were small for gestational age, and 52% exhibited continued postnatal growth deficiency. A 33% incidence of prenatal microcephaly, a 67% incidence of postnatal microcephaly, and an 80% incidence of developmental delay were observed. Eighty-three percent of the patients had craniofacial features similar to the fetal alcohol syndrome, and 89% of these children had other minor anomalies.

Conclusions. Data from the patients herein described and the available scientific literature suggest that the mechanism of alcohol craniofacial teratogenesis may be nonspecific, with a variety of teratogens, including toluene, giving rise to phenotypic facial abnormalities similar to those of the fetal alcohol syndrome. We propose a common mechanism of craniofacial teratogenesis for toluene and alcohol, namely a deficiency of craniofacial neuroepithelium and mesodermal components due to increased embryonic cell death.
Prevention of Intellectual Impairment in Children of Women Who Smoke Cigarettes During Pregnancy
Authors: Olds David L. , Henderson Charles R. , Tatelbaum Robert
Published: December 2021

Objective. To analyze the influence of a comprehensive program of nurse home visitation on the intellectual functioning of children born to women who smoked cigarettes during pregnancy.

Design. Randomized clinical trial. Treatment 1: sensory and developmental screening at ages 1 and 2 years; treatment 2: screening plus free transportation for prenatal and well-child care; treatment 3: screening, transportation, plus prenatal home visitation; treatment 4: screening, transportation, prenatal home visitation, plus postnatal home visitation through the children's second birthdays.

Setting. Semirural community in Upstate New York.

Participants. 400 families in which the mothers registered before the 30th week of pregnancy and had no previous live births. Eighty-five percent of the mothers were either teenagers, unmarried, or poor. Analysis was limited to whites, who constituted 89% of sample.

Intervention. Nurse home visitation during pregnancy (treatments 3 and 4) or during pregnancy and the first 2 years of the child's life (treatment 4). During pregnancy, the nurses helped women improve their health-related behaviors, informal social support, and linkage with needed community services.

Main findings. Children born to women who smoked 10 or more cigarettes per day at registration during pregnancy and who were assigned to treatments 3 and 4 had IQs (averaging across the 3rd and 4th years of life) that were 4.86 (95% CI: 0.47, 9.26) points higher after adjustment for covariates than did children born to women who smoked 10+ cigarettes per day and who were assigned to treatments 1 and 2. The positive influence of the home-visiting program on reducing the harmful effect of smoking appears to be due to prenatal visitation.

Conclusion. Comprehensive prenatal home-visitation services can offset the impairment in intellectual functioning associated with substantial maternal smoking during pregnancy.
Family-Based Intervention Improves Maternal Psychological Well-being and Feeding Interaction of Preterm Infants
Authors: Meyer Elaine C. , Coll Cynthia T. Garcia , Lester Barry M. , Boukydis C. F. Zachariah , McDonough Susan M. , Oh William
Published: December 2021

Objective. To determine the efficacy of an individualized, family-based intervention with preterm infants and their families.

Design. Randomized, repeated measures intervention outcome study.

Setting. Level III neonatal intensive care nursery.

Patients. Random sample of 34 preterm infants ≤1500 g and their families.

Interventions. Individualized, family-based intervention during the hospitalization and transition to home addressed problems identified by parents in four domains including: infant behavior and characteristics, family organization and functioning, caregiving environment, and home discharge and community resources.

Measurements and Main Results. Standardized questionnaires were administered at baseline and discharge to mothers, and predischarge bottle-feeding interactions were videotaped and coded by two blinded observers. Results were in favor of intervention (Int) versus control (Con) mothers (baseline; discharge) (P < .05) on the Parental Stressor Scale Sights and Sounds subscale (Int 2.4 ± 1.0; 2.0 ± 0.8 vs Con 2.4 ± 0.9; 2.6 ± 0.8); Child's Appearance and Behavior subscale (Int 2.8 ± 1.0; 2.5 ± 1.1 vs Con 2.8 ± 0.8; 3.1 ± 0.6); and Total Stressor Score (Int 93.9 ± 36.6; 72.3 ± 41.8 vs Con 87.5 ± 26.7; 87.8 ± 26.2). On the Beck Depression Inventory, intervention mothers had significant decreases in depressive symptoms (39%; 11%) vs control mothers (31%; 44%). Maternal self-esteem in both groups improved over time. There were no significant group differences in family environment. During feeding interactions, intervention infants grimaced (P < .001) and gagged (P < .05) less than controls. Intervention mothers less frequently interrupted feedings (P < .001); less frequently stimulated infant sucking (P < .01); smiled more (P < .001); vocalized more (P < .01); demonstrated greater sensitivity to infant behavior (P < .001), better quality of physical contact (P < .001), and more positive affect (P < .01).

Conclusions. Individualized, family-based intervention appears to reduce maternal stress and depression, and to enhance early mother-infant feeding interactions. Further research is needed to determine whether these short-term beneficial effects persist beyond the newborn period.
Tilt-Table Testing and Oral Metoprolol Therapy in Young Patients With Unexplained Syncope
Authors: O'Marcaigh Aengus S. , MacLellan-Tobert Susan C. , Porter Co-burn J.
Published: December 2021

Objective. Tilt-table testing is useful for investigating unexplained syncope in pediatric patients. No data are available on the use of intravenous metoprolol during testing to identify children who might respond to subsequent oral β-adrenergic blockade or on the efficacy and safety of such oral therapy.

Design. To provide these data, we obtained follow-up information on 27 consecutive pediatric patients who had tilt-table testing for unexplained syncope.

Results. Nineteen patients (70%) had positive test results with or without isoproterenol infusion. All these patients had negative test results after intravenous infusion of metoprolol and subsequently were treated with oral metoprolol. Taking oral metoprolol therapy alone, 9 (47%) of the 19 patients were asymptomatic, 8 (42%) reported a decreased frequency of syncopal episodes, and 2 (11%) had unchanged or more frequent episodes. The mean dosage of metoprolol required to prevent symptoms was 1.5 mg/kg per day. Mild side effects were reported by 6 (32%) of the 19 patients. Six patients (32%) required additional medications.

Conclusions. We conclude that metoprolol is safe and effective for the treatment of most cases of neurocardiogenic syncope in children and that this response cannot be predicted accurately by the use of intravenous metoprolol during testing.
Geographic Mobility and Children's Emotional/Behavioral Adjustment and School Functioning
Authors: Simpson Gloria A. , Fowler Mary Glenn
Published: December 2021

Objective. To evaluate the relationship of geographic mobility to children's emotional/behavioral adjustment and school functioning.

Design. Analysis of data from the 1988 National Health Interview Survey of Child Health in which multistage probability sampling was used to obtain data for nationally representative estimates of health and demographic characteristics of US children.

Participants. 10 362 US school-age children and their families.

Measurements. The 1988 National Health Interview Survey of Child Health includes data on health and demographic characteristics, emotional/behavioral variables, school functioning, and geographic mobility for 10 362 US school-age children. This study examined the relationship of children's geographic mobility to children's reported emotional problems, use of psychological help, scores on a Behavior Problem Index, repeating a grade in school, and being suspended or expelled from school.

Results. Twenty-four percent of children have never moved, 35% of children have moved once or twice, and 39% of children aged 6 to 17 years have moved three or more times in their lifetime. Using multiple logistic regression to control for important demographic variables, children who moved three or more times were 2.3 times more likely to have had emotional/behavioral problems, 2.2 times more likely to have received psychological help, 1.7 times more likely to have repeated a grade, and 1.9 times more likely to have been suspended or expelled from school compared with children who had never moved. Multiple regression was also used to analyze the impact of mobility in relation to scores on the Behavior Problem Index. Children who moved three or more times were 1.6 times more likely to be in the top tenth percentile of scores on the Behavior Problem Index compared with children who had never moved.

Conclusions. Children who move three or more times are at increased risk for emotional/behavioral and school problems. Thus, pediatricians, other health professionals, and educators should be alert to the potential educational and psychological problems among children from highly mobile families.
Geography of Pediatric Publication
Authors: Eldor Joseph
Published: December 2021

The number of all medical publications in 1990 from online database EMBASE was related to physician population in 20 countries. United Kingdom ranked first, with Israel in second place.1

It was interesting to compare the country of the first author under the title of "Pediatrics" to the physician population of that country. For that the Excerpta Medica Abstract Journals on Silver-Platter CD-ROM of 1990 was searched. Excerpta Medica Abstract Journals encompasses 45 abstract journals published every year, covering a wide range of medical and biomedical subjects.
Usefulness of Specific IgM in the Diagnosis of Helicobacter pylori Infection
Authors: Blecker Uwe , Vandenplas Yvan
Published: December 2021

Serologic enzyme-linked immunosorbent assay (ELISA) tests for the detection of Helicobacter pylon-specific IgG have been demonstrated to be comparable to invasive techniques.1 Therefore they have been proposed as a inexpensive and reliable screening method for the diagnosis of H pylori infection.2 To study further the value of last-generation serologic tests as a screening technique for H pylori infection, we evaluated a last-generation ELISA kit for the detection of H pylori-specific IgM.

During presurgical blood analysis venous blood was taken for last-generation ELISA tests for the detection of anti-H pylori IgG and IgM (Malakit Helicobacter pylori series, Biolab, Belgium) in 452 asymptomatic children (age 1 to 12 years, mean age 6.65 years) admitted for minor elective surgery.
Letter to the Editor
Authors: Lehmann Harold P. , Andrews John
Published: December 2021

We commend Pediatrics for publishing articles that use Bayesian statistical methods.1,2 The power of Bayesian methods is that they enable researchers to model formally issues of real concern to clinicians, and they allow clinicians to examine critically the influence of their own prior beliefs on the conclusions they should reach from a set of studies.3,4 In both cases, the methods employed may be audited by the critical reader, because the beliefs of the researchers (and of the analysts) and the models used are explicit.
Letter to the Editor
Authors: Hupert Jordan
Published: December 2021

I wish to comment on the recent review/meta-analysis/guidelines article that discussed the management of young febrile children (0 to 36 months of age) in whom no source for the fever is discovered.1 Although I applaud the authors' attempt to bring order to a topic afloat in chaos, the article suffered from a number of significant deficiencies and methodological problems. Some of my concerns follow.

1. How was Medline searched? Specification of key words used in the search and number of articles obtained from the search were not provided.
Letter to the Editor
Authors: Falik Holly Lee
Published: December 2021

I read the article by Baraff et al1 hoping to gain some clarification of the management of fever. However, I did not understand the parameters of the meta-analysis. In Table 21,p6 the authors cite nine studies; in these the incidence of bacteremia varied widely (2.7% to 12.4%; mean 4.3%) and the age of the patients varied from starting ages of 1 to 6 months and ending ages of 24 to 36 months. Yet in setting guidelines, the authors took the outer limits: a temperature of only 39°C and an age range from 3 to 36 months.
Letter to the Editor
Authors: Baraff Larry J. , Bass James W. , Fleisher Gary R. , Klein Jerome O. , McCracken George H. , Powell Keith R. , Schriger David L.
Published: December 2021

We are pleased at the interest the publication of the Practice Guideline created among the readers of Pediatrics and to have an opportunity to respond to the reader's comments.

Meta-analysis. We appreciate the thoughtful comments of Drs Lehmann and Andrews, Hupert, and Kokx regarding the methods of meta-analysis. The Medline search strategies were: (1) febrile (tw) or bacteremia (tw) and child (tw) or infant (tw) and not foreign language with subheadings of therapy, diagnosis, or epidemiology; (2) children (MESH) and explode fever (MESH) and not foreign language.
Closing the Global Immunization Gap: Delivery of Lifesaving Vaccines Through Innovation and Technology
Authors: Desai Sachin N. , Kamat Deepak
Published: December 2021

One of every 5 children does not receive basic vaccines because of concerns related to storage and delivery in resource limited countries. Transporting vaccines over long distances in extreme temperatures is a common challenge. Issues that involve production and formulation, delivery technologies, cold chain logistics, and safety factors need to be addressed to properly adapt vaccines to resource constrained settings. Current successful field interventions include United Nation Children’s Fund cold boxes, which are used to store and distribute vaccine in disaster struck areas, and vaccine vial monitors, which allow health workers to gauge whether vaccine is still usable in areas with unreliable electricity and refrigeration. This review aims to provide a general overview of innovative approaches and technologies that positively affect vaccine coverage and save more lives.
Twinkle artifact in renal ultrasound, is it a solid point for the diagnosis of
renal stone in children?
Authors: AlSaiady Moath , Alqatie Ahmad , Almushayqih Musab
Published: December 2021

Background: Twinkle artifact, also known as color Doppler comet-tail artifact,
occurs behind very strong, granular, and irregular reflecting interfaces such as
crystals, stones, or calcification. This is visualized as a random mixture of red and
blue pixels in the high-frequency shift spectrum located deep to the interface. Study
results have suggested that the sonographic twinkling artifact may aid in the detection
of renal stones with a variety of reference standard imaging modalities, including
abdominal radiography, excretory urography, gray-scale sonography, and CT. Material and
methods: Our retrospective observational study included children who had undergone
abdomen/renal ultrasound for kidneys stones in our radiology department between 2013 and
2019. Presence of the twinkle artifact, and stone numbers and sizes were documented. CT
examinations done <3 months prior to or after US were retrospectively assessed to
confirm the presence of kidney stones as a reference standard. Results: Thirty-three
abdominal renal US scans of 33 patients (21 males, 12 females) fulfilled the entry
criteria. The interval between the US and CT was <3 months for all patients. The
median overall age of the patients was 4 years (IQR: 3.125, range: 1– 165 months), The
median number of days between the US and CT was 13 (IQR: 26, range: 0–81 days). US
detected 33 hyperechoic foci suspected to be stones; 26 were confirmed as true positive
(i.e. showed the twinkle artifact and were seen in CT), 4 were false positive (showed
the twinkle artifact but were not seen in CT), and 3 were false negative (did not show
the twinkle artifact but were seen in CT). The overall median stone size was 2 mm in the
right kidney, and 5 mm in the left kidney (IQR: 6,11 mm), respectively. Twinkle artifact
sensitivity was found to be 89.7% (95% CI 39.574%–90%). The twinkle artifact was
assessed in all true-positive stones, determining a relatively high PPV of 26/29 (86.7%)
for the twinkle artifact. The twinkle artifact was not dependent on stone size.
Specificity for the twinkle artifact could not be calculated due to a lack of true
negatives. Conclusion: The twinkle artifact is a sensitive US tool for detecting
pediatric kidney and ureter stones, but with a small risk of false positive
findings.
Comparative study of the reliability of ultrasound to confirm the position of
endotracheal tube with cuff inflated with saline versus air
Authors:   Université de Lorraine,
            Département d’Anesthésie-Réanimation, Chru de Nancy, Nancy, France, Santinelli Sarah , Audibert Gérard ,   Service
            d’Anesthésiologie-Réanimation et médecine péri-operatoire, Chru de Nancy, Nancy,
            France, Thi-Lambert Phi Linh ,   Service de méthodologie,
            Chru Nancy, Nancy, France, Van Der Woude Henk-Jan ,   Service
            d’Anesthésiologie-réanimation et médecine péri-operatoire, Chru de Nancy, Nancy,
            France
Published: December 2021

Aim: To compare the reliability of transtracheal ultrasound to confirm the
endotracheal tube position with saline versus air inflated cuff. Methods: This was a
prospective randomized cadaveric study. Four techniques were randomized: endotracheal
tube in the trachea with air or saline inflated cuff, and endotracheal tube in the
esophagus with air or saline inflated cuff. The investigator used the Mcgrath to
randomly place the endotracheal tube in the trachea or in the esophagus with saline or
air inflated cuff. During the first series of measurements, nine residents performed
transtracheal ultrasound with linear transducer placed transversely at the suprasternal
notch. They were recorded with a cut off fixed to 30 seconds, and a questionnaire was
completed by the residents after each transtracheal ultrasound in order to report where
the endotracheal tube is positioned according to them. The second series followed the
same protocol and included three residents who had participated in the first series. The
primary outcome was the success rate in determining the position of the endotracheal
tube. Results: In the first series, the success rate was 46.5%. In the second series,
the success rate was 72.9%. There was no significant difference between cuff inflated
with saline and air (p = 1.00). The overall mean time required was 20.6 s (95% CI
13.0–28.2 s). Based on an empirical data set, transtracheal ultrasound had a sensitivity
of 62.2%, specificity of 100%, positive predictive value of 100%, and negative
predictive value of 26.08%. Conclusion: This investigation shows that regardless of the
contents of the endotracheal tube cuff, the use of transtracheal ultrasound to confirm
the position of endotracheal tube reports disappointing results.
Konsistensi Putusan Hakim Terhadap Perkara Kerugian Lingkungan Hidup di Indonesia
Authors: Wahyuni Sri , Rahmawati Arum Nur , Kumala Dewi Cheryl Permata , Manika Widya Chrisna , Hermawan Sapto
Published: December 2021

To ensure environmental sustainability, environmental management must be supported by the enforcement of environmental law through litigation process, whether on criminal, civil, or administrative aspects.  (In Indonesia, there are numerous cases of environmental losses, as well as examples of environmental damage that have been attempted on the court of mandalawangi, natural kallista and sungailiat cases.) The purpose of this research is to find out the extent of court decisions’s consistencies  on environmental cases Using normative legal research method, this research examined three court decisions form two different types of court, which are criminal court (Sungai Liat case) and civil court (Mandalawangi case and Kalistas case). It was found that these judicial decisions show inconsistencies. This condition may weaken the enforcement of environmental law in Indonesia. On the other hand, this difference in judgments may be apprehended as a new standpoint of environmental law in Indonesia. Keberlangsungan pengelolaan lingkungan hidup harus ditunjang dengan penegakan hukum lingkungan, baik melalui jalur peradilan maupun luar peradilan, baik yang bersifat perdata, pidana, maupun administrasi. Penelitian ini mengkaji tiga kasus lingkungan hidup yang diselesaikan melalui peradilan pidana dan perdata, yaitu Kasus Mandalawangi, Kasus Kallista Alam dan Kasus Sungailiat. Tujuan penelitian ini adalah untuk mengetahui problematika penegakan hukum lingkungan hidup di Indonesia, dan untuk mengetahui dampak dari konsistensi putusan hakim dalam perkara lingkungan di Indonesia yang berbeda-beda. Untuk mencapai tujuan tersebut, ketiga putusan hakim tersebut di atas dikaji dengan menggunakan metode penelitian hukum normatif. Hasil penelitin menunjukkan bahwa ketiga kasus tersebut diputuskan secara berbeda. Inkonsistensi tersebut dapat menjadi faktor pelemahan penegakan hukum lingkungan di Indonesia. Namun di samping itu dapat dimaknai sebagai suatu pandangan baru terhadap ketentuan lingkungan hidup di Indonesia.
SELECTION OF THE TECHNOLOGICAL PARAMETERS OF FERMENTATION OF HIGH-CONCENTRATION WORT WITH OSMOPHILIC YEAST RACES FOR OBTAINING BIOETHANOL
Authors: Kovalchuk S. , Mudrak T.
Published: December 2021

Bioethanol production is a key issue that helps meet the growing demand for energy resources and ensure a sustainable economy. A promising direction is producing bioethanol by using the technology of fermentation of high-concentration wort obtained from the dry matter of grain raw materials. The purpose of this work is researching osmophilic races of distiller’s yeast under the conditions of fermentation of high-concentration wort at increased acidity. Selective breeding of a new strain of the yeast Saccharomyces cerevisiae DO-16 has allowed obtaining ethanol producers able to ferment grain wort with the dry matter concentration 24–34% at pH 6.0–3.0, with alcohol accumulation in the fermented wash up to 17% vol.  It has been studied how the pH of wort affects the dynamics of yeast cell synthesis by the distiller’s yeast races Saccharomyces cerevisiae DO-11 and Saccharomyces cerevisiae DO-16. It has been established that at the pH values 2.5, 3.0, 3.5, and 4.0, the concentration of yeast cells in the race Saccharomyces cerevisiae DO-16 was higher by 2.6, 1.7, 1.5, and 1.4 times respectively, as compared with Saccharomyces cerevisiae DO-11. It has been found that culturing industrial yeast of these races at low pH values ​​will provide not only the required sterility of the substrate, but also a high content of yeast cells, which is 250–320 million/cm³. The chemical and technological parameters of the fermented wash obtained by using the yeast races Saccharomyces cerevisiae DO-11 and DO-16 at the wort concentration 20–34% DM have been studied. It has been found that under all research conditions, the yeast of the race Saccharomyces cerevisiae DO-16 synthesised more ethanol than the strain Saccharomyces cerevisiae DO-11 did. The use of a new high-productive strain of Saccharomyces cerevisiae DO-16 will allow fermenting wort with a high ethanol concentration in the wash. It will also reduce the consumption of heat expended on isolating alcohol from the wash and of water expended on cooling, and lessen the amount of post-alcohol stillage.
ANALYSIS OF THE EXISTING METHODS AND SPECIFIC FEATURES OF DRYING SHIITAKE MUSHROOMS
Authors: Avdieieva L. , Zhukotskyi E , Dekusha H. , Ivanov S.
Published: December 2021

The paper reviews and analyses the advantages and disadvantages of the existing technologies of drying shiitake mushrooms, which are a valuable source of bioactive polysaccharides, vitamins, antioxidants, etc. The findings presented in the paper show how various drying methods and their thermotechnological operating parameters affect the mechanostructural properties, chemical composition, content of aromatic substances and other compounds of mushrooms. It has been demonstrated that the traditional convection drying of shiitake in the temperature range 50–60°C allows maximum preservation of phenolic compounds, organic acids, nucleotides, sulphuric aromatic substances, and enhances the unique aroma of the mushroom. Radiation drying has such advantages as lower shrinkage of dried shiitake mushrooms, a higher coefficient of rehydration and higher hardness, and the drying time reduced by 66% compared with freeze-drying. Vacuum drying makes it possible to obtain high quality products, but significantly increases the duration of the process and reduces the content of aromatics. Radiation drying combined with hot air allows obtaining a dry form of shiitake rich in protein and bioactive polysaccharides and having high physicochemical properties, and reduces the duration of the process by 37.5% compared with convection drying. Spray drying of shiitake mushrooms is highly practical economically and allows organising industrial manufacture of high-quality dry mushroom powder in large volumes. It is characteristic of this drying method that its temperature effect on the product is slight, which makes it possible to preserve thermolabile bioactive substances. When using spray drying, it is advisable to add dextrin additives. This improves the structuring and moisture-conducting properties of the suspensions and their thermal stability, and helps preserve the unique aroma of shiitake mushrooms due to encapsulation of aromatic compounds. Studying the effect of various drying methods on the physicochemical properties of shiitake will lead to improving the existing technological processes and will make it possible to obtain products with desired properties.