bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Renal Anomalies in Children Prenatally Exposed to Ethanol
Authors: Taylor Carolyn L. , Jones Kenneth L. , Jones Marilyn C. , Kaplan George W. 
Published: December 2021

Objective. Based on a number of studies involving animals as well as human case reports indicating an association between prenatal ethanol exposure and renal malformations, it has been suggested that children with fetal alcohol syndrome (FAS) should be screened for renal anomalies. The purpose of this study was to evaluate a group of children prenatally exposed to alcohol to determine the incidence of renal anomalies and to evaluate the need for such a screening procedure.
Methods. Renal ultrasounds were performed on a total of 84 patients (68 children, 13 adolescents, and three adults). In addition to screening for malformations, renal size was studied. Data were analyzed using both chronologic and height-age as determinants of kidney size.
Patients. Of these 84 patients, 51 (61%) had FAS, and 33 (39%) had a history of prenatal ethanol exposure but did not have FAS.
Results. Three (3.6%) patients (one with FAS, two with prenatal ethanol exposure who did not have FAS) had significant renal abnormalities. This incidence was not significantly different from that found in ultrasound screening of newborns. The kidneys of children with both FAS and prenatal ethanol exposure who did not have FAS were significantly smaller than normal for both chronologic and height-age. When children were compared across chronologic ages, those with FAS had significantly smaller kidneys than those who had no evidence of FAS. After adjusting for height, the difference between these two groups was no longer significant.
Conclusions. Based on these data, children prenatally exposed to ethanol do not need to be screened for renal anomalies.
Influenza B Virus Infection in Pediatric Solid Organ Transplant Recipients
Authors: Mauch Teri Jo , Myers Tim , Kashtan Clifford E. , Bratton Susan , Krane Elliot , Gentry Sharron R. 
Published: December 2021

Objective. Influenza B virus causes epidemic infection in normal children, but only one case of infection in an immunocompromised solid organ transplant (SOT) recipient has been reported. Characterization of the clinical course of influenza B virus infection in pediatric SOT recipients may increase the utilization of preventive and therapeutic interventions by pediatricians caring for these immunocompromised children.
Design. Retrospective chart review of patients whose respiratory viral cultures yielded influenza B from January 1989 through March 1992.
Patients. Twelve pediatric SOT recipients with influenza B virus infection were identified. These included five renal, four hepatic, and three cardiac allograft recipients, ranging from 19 months to 17 years 9 months of age (median 6 years 2 months). The post-transplant interval ranged from 6 weeks to 4 years 6 months (average 26.7 months). No patient had been immunized against influenza. Exposure histories were documented for eight children; five of these occurred in the hospital.
Results. Clinical symptoms included fever (12/12), respiratory (11/12), or gastrointestinal complaints (8/12). Five patients had neurologic involvement; one died of uncal herniation. Ten children were hospitalized (median duration, 3 days; range, 2 to 79 days). Two patients (post-transplant interval, 3 to 8 months) required mechanical ventilation, and one of these received aerosolized ribavirin. Three children had concurrent allograft rejection.
Conclusions. Influenza B infection is potentially life-threatening in pediatric SOT recipients. We recommend annual immunization of pediatric SOT recipients, their household contacts, and health care workers. Prospective studies are needed to evaluate the efficacy of influenza vaccination in pediatric SOT recipients.
ANAPHYLACTIC SHOCK AFFER INSECT-STING CHALLENGE IN 138 PERSONS WITH A PREVIOUS INSECT-STING REACTION
Authors: Cvietusa Peter , Spahn Joseph , ADinoff Allen 
Published: December 2021

Purpose of the Study. The goal of the study was to establish the frequency with which anaphylactic reactions reoccur after sting challenge in persons with previous insect-sting anaphylactic reactions, as well as the relation between the severity of anaphylaxis and levels of catecholamines and angiotensins.
Methods. One hundred thirty-eight patients with a history of an anaphylactic reaction and eight normals (including five patients who had been previously stung) were subjected to provocation test with the relevant insect. Blood samples were collected and assayed for epinephrine, norepinephrine, dopamine, and angiotensin I and II levels.
Findings. "Only" 39 of 138 (28%) patients with a previous insect sting anaphylactic reaction developed anaphylactic symptoms after sting challenge. Only those with a history of a severe reaction developed anaphylactic shock. No change in cardiovascular mediators or blood pressure was seen in patients with no or mild reactions, while those patients with anaphylactic shock had a mean arterial blood pressure drop of 33%. Significant increases in epinephrine, norepinephrine, and angiotensin II were observed within 5 minutes after the onset of symptoms and were strongly correlated with a drop in blood pressure. Dopamine and angiotensin I levels did not change significantly in any participants.
Reviewers' Comments. The repeat rate of systemic reactions of 28% is substantially lower than the previously reported rate of 60% (Hung KJ, et al. NEJM. 1978;299:157). Unfortunately, the present study does not provide significant information regarding the study population, particularly the time lapsed between the original and rechallenge stings. We are all aware of the associated problems of beta-blockers and anaphylaxis.
NATIONAL ASTHMA ATTACK AUDIT, 1991 TO 1992
Authors: Bell Thomas 
Published: December 2021

Purpose of the Study. This study takes the newly developed guidelines for asthma management and compares them to ongoing asthma management in general practice.
Methods. A correspondence survey covering 218 general practices in the United Kingdom covered 1775 patients of all ages who had a total of 1805 attacks. Patient characteristics, place of management of attacks, and actual management were compared to recommended guidelines. The physicians from participating practices had attended a special one-half day course on the guidelines, largely derived from the British Thoracic Society and then took part in the survey for three consecutive months.
Findings. There is extensive demographic data of interest, including level of care, incidence of hospitalization, age distribution, and other parameters—too lengthy for inclusion in this review. Hospital admissions peaked (16%) in the 0-to 9-and &gt;69-year age ranges. Twenty-nine percent had their own peak flow meters (PPM), and 34% had been issued their own asthma self-management plan. Two deaths were reported—both were moribund upon arrival for treatment. On presentation PFM readings were obtained in 82% and asthma ratings in 97%. After this great start, things began to deteriorate when we examined therapy. Nebulization was given to only 35% of patients, and steroids to 55%. A sizable proportion of patients graded as "breathless and distressed" did not receive the recommended lifesaving antiasthma treatment with nebulization (46%) and steroids (48%). The authors stress that the standards or guidelines derived from hospital care may not necessarily be applicable to general practice. Thirty-five percent of the patients were given antibiotics.
LONG TERM EFFECTS OF A LONG-ACTING B2-ADRENORECEPTOR AGONIST, SALMETEROL, ON AIRWAY HYPERRESPONSWENESS IN PATIENTS WITH MILD ASTHMA
Authors: Chipps Bradley E. 
Published: December 2021

Purpose of the Study. To investigate long term effects of long-acting β2 agonist (salmeterol) on bronchodilation and bronchoconstriction caused by methacholine (MCH).
Study Population. Twenty-four adult asthmatics (average age 25, range 19-36 yrs) who had not required any regular medication for 6 months.
Methods. Parallel double blind study where either salmeterol 50 µg twice daily or placebo was administered during an 8-week trial. A complete dose response curve for MCH was recorded on days 0, 28, 56, and 2 and 4 days after the study ended. The PC20 (concentration required for 20% drop in FEV1) was recorded. Albuterol in an aggregate dose of 400 µg/day was allowed as rescue medication.
Findings. Salmeterol caused a significant increase in FEV1 which did not change throughout the study. On the first treatment day salmeterol afforded protection against bronchoconstriction with 10-fold increase in PC20. After 4 and 8 weeks of therapy the change in PC20 returned to baseline after 4 days of washout.
Reviewer's Comments. The regular use of long-acting beta agonist leads to tolerance to its protective effect against a bronchoconstrictor stimulus, although bronchodilator properties remain unchanged. Although the mechanism is unknown, this data suggests that long-term monotherapy with beta agonist may not be optimal.
RISK OF FATAL AND NEAR-FATAL ASTHMA IN RELATION TO INHALED CORTICOSTEROID USE
Authors: Goldsobel Alan B. 
Published: December 2021

Purpose of the Study. To examine the relationship between patterns of use of inhaled beclomethasone dipropionate (50 µg/puff) and the risk of fatal and near-fatal asthma.
Study Population. A cohort of 12 301 individuals aged 5 to 54 years was identified from the residents of Saskatchewan, Canada. These were asthma patients dispensed ten or more prescriptions for drugs in common use for asthma treatment from 1978 to 1987.
Methods. A case control analysis was performed. Cases were defined as persons within the cohort who met predetermined criteria for having fatal or near-fatal asthma. These were matched with 655 controls within the cohort who had asthma, but no fatality or near-fatality. The subjects were then stratified as to their use of inhaled beclomethasone dipropionate for the 12 months prior to the fatal or near-fatal event, or index date for controls. Each person's use of inhaled beclomethasone was divided into three groups: no medication in the prior 12 months, less than 12 units in the previous 12 months, or greater than 12 units over the previous 12 months.
Findings. Of the 784 cases and controls, 269 had been dispensed inhaled beclomethasone in the prior 12 months. Of these, 232 had been dispensed less than 12 units, and only 37 had been dispensed 12 or more units. Matched odds ratio adjusted for use of other medications and number of hospitalizations for asthma showed a 1.6 times increased risk of fatal and near-fatal asthma in the group using less than 12 units of beclomethasone per year as compared to the group using none, but this did not meet statistical significance.
CD40 LIGAND GENE DEFECTS RESPONSIBLE FOR X-LINKED HYPER-IgM SYNDROME
Authors: Levy Arden , Liu Andrew 
Published: December 2021

Purpose of the Studies. Hyper-IgM immunodeficiency is characterized by recurrent bacterial infections, normal or elevated IgM, and markedly decreased IgG, IgA, and IgE. Previous research suggested that the T cells of these patients are defective in their ability to help B cells make functional antibody. CD40 ligand (CD4OL) is a membrane glycoprotein on activated T helper cells and binds the CD40 molecule expressed on B cells, and induces proliferation and immunoglobulin class switching (in conjunction with IL-4). The gene for the CD4OL has been mapped to position q26.3-q27.1 on chromosome X (same as the Hyper-IgM gene and the area of isotype switching). Several research groups sought to determine if the immunodeficiency in Hyper-IgM patients is due to defective CD4OL.
Findings. The five papers listed above document the work of different research groups that simultaneously found abnormalities in the CD4OL gene in a total of 16 patients with X-linked Hyper-IgM syndrome. Different mutations of the CD4OL gene have been discovered, including point mutations, deletions, and nonsense sequences. Mutant version of CD4OL taken from Hyper IgM patients were unable to "help" B cells in vitro. Thus, deficient CD40/CD40L interactions between B and T cells results in severely impaired immunity. Restricted CD40L gene expression to T cells may ultimately allow gene therapy as treatment.
Reviewers' Comments. A concise editorial by Jean Marx entitled "Cell Communication Failure Leads to Immune Disorder" describes this landmark research and accompanies the Spriggs article in the February 12th issue of Science (pp. 896-897). This discovery may not only lead to treatment of this disorder, but also modification of other less favorable immune responses.
CD40 LIGAND MUTATIONS IN X-LINKED IMMUNODEFICIENCY WITH HYPER-IgM
Authors: Levy Arden , Liu Andrew 
Published: December 2021

Purpose of the Studies. Hyper-IgM immunodeficiency is characterized by recurrent bacterial infections, normal or elevated IgM, and markedly decreased IgG, IgA, and IgE. Previous research suggested that the T cells of these patients are defective in their ability to help B cells make functional antibody. CD40 ligand (CD4OL) is a membrane glycoprotein on activated T helper cells and binds the CD40 molecule expressed on B cells, and induces proliferation and immunoglobulin class switching (in conjunction with IL-4). The gene for the CD4OL has been mapped to position q26.3-q27.1 on chromosome X (same as the Hyper-IgM gene and the area of isotype switching). Several research groups sought to determine if the immunodeficiency in Hyper-IgM patients is due to defective CD4OL.
Findings. The five papers listed above document the work of different research groups that simultaneously found abnormalities in the CD4OL gene in a total of 16 patients with X-linked Hyper-IgM syndrome. Different mutations of the CD4OL gene have been discovered, including point mutations, deletions, and nonsense sequences. Mutant version of CD4OL taken from Hyper IgM patients were unable to "help" B cells in vitro. Thus, deficient CD40/CD40L interactions between B and T cells results in severely impaired immunity. Restricted CD40L gene expression to T cells may ultimately allow gene therapy as treatment.
Reviewers' Comments. A concise editorial by Jean Marx entitled "Cell Communication Failure Leads to Immune Disorder" describes this landmark research and accompanies the Spriggs article in the February 12th issue of Science (pp. 896-897). This discovery may not only lead to treatment of this disorder, but also modification of other less favorable immune responses.
DEFECTIVE EXPRESSION OF CD40 LIGAND IN X-CHROMOSOME LINKED IMMUNOGLOBULIN DEFICIENCY WITH NORMAL OR ELEVATED 1gM
Authors: Levy Arden , Liu Andrew 
Published: December 2021

Purpose of the Studies. Hyper-IgM immunodeficiency is characterized by recurrent bacterial infections, normal or elevated IgM, and markedly decreased IgG, IgA, and IgE. Previous research suggested that the T cells of these patients are defective in their ability to help B cells make functional antibody. CD40 ligand (CD4OL) is a membrane glycoprotein on activated T helper cells and binds the CD40 molecule expressed on B cells, and induces proliferation and immunoglobulin class switching (in conjunction with IL-4). The gene for the CD4OL has been mapped to position q26.3-q27.1 on chromosome X (same as the Hyper-IgM gene and the area of isotype switching). Several research groups sought to determine if the immunodeficiency in Hyper-IgM patients is due to defective CD4OL.
Findings. The five papers listed above document the work of different research groups that simultaneously found abnormalities in the CD4OL gene in a total of 16 patients with X-linked Hyper-IgM syndrome. Different mutations of the CD4OL gene have been discovered, including point mutations, deletions, and nonsense sequences. Mutant version of CD4OL taken from Hyper IgM patients were unable to "help" B cells in vitro. Thus, deficient CD40/CD40L interactions between B and T cells results in severely impaired immunity. Restricted CD40L gene expression to T cells may ultimately allow gene therapy as treatment.
Reviewers' Comments. A concise editorial by Jean Marx entitled "Cell Communication Failure Leads to Immune Disorder" describes this landmark research and accompanies the Spriggs article in the February 12th issue of Science (pp. 896-897). This discovery may not only lead to treatment of this disorder, but also modification of other less favorable immune responses.
DEFECTIVE EXPRESSION OF T-CELL CD40 LIGAND CAUSES X-LINKED IMMUNODEFICIENCY WITH HYPER IgM
Authors: Levy Arden , Liu Andrew 
Published: December 2021

Purpose of the Studies. Hyper-IgM immunodeficiency is characterized by recurrent bacterial infections, normal or elevated IgM, and markedly decreased IgG, IgA, and IgE. Previous research suggested that the T cells of these patients are defective in their ability to help B cells make functional antibody. CD40 ligand (CD4OL) is a membrane glycoprotein on activated T helper cells and binds the CD40 molecule expressed on B cells, and induces proliferation and immunoglobulin class switching (in conjunction with IL-4). The gene for the CD4OL has been mapped to position q26.3-q27.1 on chromosome X (same as the Hyper-IgM gene and the area of isotype switching). Several research groups sought to determine if the immunodeficiency in Hyper-IgM patients is due to defective CD4OL.
Findings. The five papers listed above document the work of different research groups that simultaneously found abnormalities in the CD4OL gene in a total of 16 patients with X-linked Hyper-IgM syndrome. Different mutations of the CD4OL gene have been discovered, including point mutations, deletions, and nonsense sequences. Mutant version of CD4OL taken from Hyper IgM patients were unable to "help" B cells in vitro. Thus, deficient CD40/CD40L interactions between B and T cells results in severely impaired immunity. Restricted CD40L gene expression to T cells may ultimately allow gene therapy as treatment.
Reviewers' Comments. A concise editorial by Jean Marx entitled "Cell Communication Failure Leads to Immune Disorder" describes this landmark research and accompanies the Spriggs article in the February 12th issue of Science (pp. 896-897). This discovery may not only lead to treatment of this disorder, but also modification of other less favorable immune responses.
Early Discharge of the Term Newborn: A Continued Dilemma
Authors: Britton John R. , Britton Helen L. , Beebe Susan A. 
Published: December 2021

Objective. To provide the pediatric practitioner with a summary of available data regarding the appropriate time of hospital discharge of the term newborn.
Methodology. Published series on early discharge were critically reviewed.
Results. Heterogeneity and limitations of methodology and study design substantially limit conclusions that may be drawn from published studies.
Conclusion. Early discharge recommendations of the American Academy of Pediatrics remain appropriate, and decisions regarding the timing of discharge of the well term newborn should be individualized and made by the practitioner based upon the medical, social, and economic aspects of each case.
Functional Outcome After Pediatric Head Injury
Authors: Greenspan Arlene I. , MacKenzie Ellen J. 
Published: December 2021

Objectives. To examine the consequences of head injury and the medical, economic, and sociodemographic factors affecting functional status 1 year after injury.
Methods. A follow-up was conducted on 95 children (aged 5 to 15) 1 year after they were hospitalized for head injury. Parents were interviewed by phone concerning their child's preinjury and current health status, and the family's economic and social resources during the 1 year postinjury. Inpatient medical records were reviewed to obtain information regarding the characteristics of the injury.
Results. We found that study children were more likely than children from the general population to have limitations in physical health, behavioral problems, and to be enrolled in a special education program. These findings were true for all levels of head injury severity, although children with severe head injuries (Abbreviated Injury Scale 5) were more likely to demonstrate these functional limitations than were children with less severe injuries (Abbreviated Injury Scale 2, 3, 4). After controlling for head injury severity, we found that the poorer outcomes were associated with poverty, preinjury chronic health problems, and lower extremity injuries.
Conclusions. The large proportion of children who demonstrated functional limitations underscores the importance of evaluating all children hospitalized with head injuries for functional limitations and providing rehabilitation and social services when needed.
The Relationship Among Television Watching, Physical Activity, and Body Composition of Young Children
Authors: DuRant Robert H. , Baranowski Tom , Johnson Maribeth , Thompson William O. 
Published: December 2021

Purpose. Television watching has been reported to be associated with obesity, resting energy expenditure, and lower daily physical activity among both children and adolescents. However, most of these studies were based on self report or data collected in laboratory settings. This study examined the relationship among observed time of television watching, observed physical activity level and body composition among 3- or 4-year-old children.
Methods. African-American (41.4%), Mexican-American (23%), and Anglo-American (35.6%) children (N = 191, males = 90) from the Texas site of the Studies of Child Activity and Nutrition program were observed from 6 to 12 hours per day up to 4 days over 1 year. Activity level each minute of the day was measured with the Children's Activity Rating Scale (interobserver reliability = .84 ± .001). The interobserver reliability of time of television watching was .96 ± .08.
Results. The median of the longest number of consecutive minutes of television watching was 15 (range = 1 to 79). The median percent of minutes of television watching of total observed minutes was 14.8% (0% to 58%) and the median percent of minutes of inside minutes was 17.9% (0% to 80.9%). There were no gender or ethnic differences in time watching television or physical activity during television watching. Physical activity during television watching was lowest during the longest bout of television watching (\l=x_\ = 1.48 ± .28) compared to outside minutes (\l=x_\ = 2.38 ± .21), inside non-television minutes (\l=x_\ = 1.96 ± .13) and inside television minutes (\l=x_\ = 1.65 ± .18). The level of physical activity during television-watching times was highest (P &lt;.0031) during October and November and lowest during March, April, June, and July. Longest bout of television watching and percent of minutes watching television to total observed minutes were inversely associated with mean physical activity, percent of minutes of physical activity levels 3, 4, or 5, and percent of physical activity levels 4 or 5. Percent of television watching to inside minutes was negatively correlated with physical activity levels 4 or 5. Television-watching behavior was not associated with body composition.
Conclusions. Television watching was weakly negatively correlated with physical activity levels, and physical activity was lower during television-watching than non-television-watching time in this sample of children. Television viewing behavior was not associated with body composition.