bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antenatal Phenobarbital Therapy and Neonatal Outcome I: Effect on Intracranial Hemorrhage
Authors: Shankaran Seetha , Cepeda Eugene , Muran Geraldine , Mariona Federico , Johnson Samuel , Kazzi S. Nadya , Poland Ronald , Bedard Mary P. 
Published: December 2021

Objective. To evaluate the effect of antenatal phenobarbital (PB) therapy on neonatal intracranial hemorrhage (ICH) in preterm infants.
Design. Prospective, randomized, controlled trial.
Setting. Single institution study.
Subjects and Interventions. Women in preterm labor (&lt;35 weeks' gestation) were assigned to control and treatment groups. The treatment group received 10 mg/kg (maximum, 1000 mg) PB intravenously, followed by 100 mg orally daily, until delivery. Neonates did not receive PB after birth. Head sonograms were performed on days 3, 7, and 14 and at discharge. Hemorrhage was classified as mild, moderate, or severe by a single reader.
Outcome Measures. Incidence of neonatal ICH in all infants, infants weighing less than 1250 g, and infants of multiple gestations.
Results. The study population comprised 110 women, 60 in the control group and 50 in the PB group. Neonates in the control group (n = 74, including 10 pairs of twins and 2 sets of triplets) were comparable to those in the treatment group (n = 62, including 7 pairs of twins, 1 set of triplets, and 1 set of quadruplets) regarding birth weight, gestational age, and other clinical risk factors for ICH. There was a trend for the incidence of any grade of hemorrhage to be lower in the PB group (22% [14 of 62]) compared with the control group (35% [26 of 74]). Moderate and severe hemorrhages were significantly lower in the PB group (1.6% [1 of 62]) compared with the control group (9.4% [7 of 74]). Among infants weighing less than 1250 g, overall ICH was lower in the PB group (23% [6 of 261) compared with the control group (51% [18 of 35]). Among multiple-gestation infants, overall ICH was 4.7% (1 of 21) in the PB group, compared with 31% (8 of 26) in the control group.
Conclusions. Antenatal PB therapy results in a significant decrease in moderate and severe ICH in infants born at less than 35 weeks' gestation. Antenatal PB therapy also resulted in a decrease in the incidence of all grades of ICH in infants weighing less than 1250 g and infants born of multiple gestations.
Percutaneous Endoscopic Gastrostomy in Children: Influence on Gastroesophageal Reflux
Authors: Launay V. , Gottrand F. , Turck D. , Michaud L. , Ategbo S. , Farriaux J. P. 
Published: December 2021

Objective. Few data exist in the literature about the relationship between percutaneous endoscopic gastrostomy (PEG) and gastroesophageal reflux (GER) in children, and the data that do exist are contradictory. The aim of the present study was to evaluate the effect of PEG on GER.
Methods. Twenty children underwent PEG for enteral nutrition. They were 55 ± 55 months old and weighed 13 ± 10 kg. A pH study was performed before and after PEG without treatment when GER status was unknown (n = 10) or under treatment (n = 10) if previous GER was demonstrated. In these cases, the pH study was performed under the same treatment before and after PEG.
Results. Six pH studies had abnormal results before PEG. After PEG, the GER of these 6 children significantly improved after the treatment was intensified (n = 5) or spontaneously normalized (n = 1). Results of 13 pH studies that were previously normal remained normal. Only one child with a normal reflux index before PEG had GER after it. For the 20 children, the mean reflux index did not change significantly after PEG (5.5% vs 5.6%).
Conclusion. Contrary to surgical gastrostomy, PEG does not worsen GER. Therefore, GER is not a contraindication to PEG.
The New Edition of the Guide to Clinical Preventive Services
Authors: Wilson Modena , Berwick Donald M. , DiGuiseppi Carolyn 
Published: December 2021

Preventive services compose a large portion of primary care pediatrics, and pediatricians by their nature and training seem extraordinarily disposed toward clinical prevention. Therefore, when the first edition of the Guide to Clinical Preventive Services appeared in 1989 from the US Preventive Services Task Force (USPSTF), the negative reaction of the organized pediatric community was disappointing.
The second edition of that guide has just been released, and we three pediatricians, who have worked hard during the past 5 years as members and staff of the second task force, hope for a far more positive reaction from our colleagues this time around.
Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma
Authors: Carrel Aaron L. , Somers Stephanie , Lemanske Robert F. , Allen David B. 
Published: December 2021

Glucocorticoids are a cornerstone of the anti-inflammatory treatment of asthma. To minimize adverse effects of oral glucocorticoids (OGC), clinicians have used alternate-day oral or inhaled corticosteroids (IC), both generally considered safe for chronic asthma therapy in children. Although reversible growth suppression occasionally occurs, the general consensus is that, despite detectable biochemical alterations, these modes of therapy are not associated with clinically significant adrenal insufficiency.1 We report the occurrence of hypoglycemia due to cortisol deficiency during combination alternate-day oral and inhaled corticosteroids.
CASE HISTORY
A 3½-year-old boy with asthma was found one morning to be unarousable, limp, and blue around the lips.
HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 REPLICATION CAN BE INCREASED IN PERIPHERAL BLOOD OF SEROPOSITIVE PATIENTS AFTER INFLUENZA VACCINATION
Authors: Church Joseph A. 
Published: December 2021

Purpose of the Study. Immune activation in vitro and in vivo appear to upregulate human immunodeficiency virus (HIV) replication. The purpose of this study was to determine the effect of influenza vaccination on HIV replication in clinically stable adults with HIV.
Study Population. Thirty-four HIV-seropositive adult patients with intermediate stage disease were entered into the study. Twenty patients received influenza vaccination and 14 did not.
Methods. Blood was collected on three occasions during the month before influenza vaccination, during the first week, the second week, and 4 to 6 weeks after vaccination. Samples from each patient were batched and quantitative polymerase chain reaction (PCR) analysis was used to measure HIV DNA and RNA in peripheral blood mononuclear cells.
Results. Influenza vaccination did not increase HIV DNA in the peripheral blood of these patients. However, vaccination was associated with a greater than fourfold increase in HIV RNA in 50% of vaccinated patients. Peak increases in HIV RNA occurred one to two weeks postvaccination and returned to baseline at later points. At more than 3 years mean follow-up, the pattern of virologic response to influenza vaccination (increased HIV RNA vs no increase) did not predict clinical outcome.
Reviewer's Comments. The transient increase in HIV replication after influenza vaccination in adults has also been seen on other adult studies with pneumococcal vaccination. Although in these studies increased viremia was transient, the situation for perinatally-infected children receiving repeated multiple vaccinations over the first 2 years of life is yet to be determined.
Parents' Attitudes Toward School-based Hepatitis B Vaccination of Their Children
Authors: Woodruff Bradley A. , Unti Lisa , Coyle Karin , Boyer-Chuanroong Lynda 
Published: December 2021

Objective. As part of a larger hepatitis B vaccination program in San Francisco, hepatitis B vaccine is offered to seventh-grade students in selected middle schools. We investigated attitudes and beliefs about hepatitis B, hepatitis B vaccine, and school-based vaccination among parents of eligible students.
Methods. A survey was conducted of random samples of parents who consented, refused, or did not respond to a request for vaccination consent.
Results. A larger proportion of persons who signed a vaccination consent or refusal form were biological parents and were Asian or white than parents who did not return a signed form. The most common reason for refusing vaccination, given by 84% of refusing parents, was that their children had already been vaccinated against hepatitis B. These parents recognized the severity and duration of hepatitis B virus infection as much as parents consenting to vaccination. About one third of parents who refused vaccination did not agree that schools were good places to vaccinate children. Overall, 116 parents (40%) consulted someone before deciding to consent or refuse; 95 (33%) spoke with a health professional. Most parents not returning signed consent or refusal forms reported that they never received forms from their children or that they returned signed forms to their children, who never delivered them to school.
Conclusions. Most parents accepted school-based vaccination, and obtaining parental consent for schoolbased vaccination was possible. Nonetheless, new approaches may be needed for those students and parents who do not comply with the consent process.
Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: A Working Group Report from the National High Blood Pressure Education Program
Authors:   National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents
Published: December 2021

Background. The "Report of the Second Task Force on Blood Pressure Control in Children—1987" developed normative blood pressure (BP) data for children and adolescents. These normative data are used to classify BP levels. Since 1987, additional BP data in children and adolescents, the use of newer classes of drugs, and the role of primary prevention of hypertension have expanded the body of knowledge regarding the classification and treatment of hypertension in the young.
Objective. To report new normative BP data in children and adolescents and to provide additional information regarding the diagnosis, treatment, and prevention of hypertension in children.
Methods. A working group was appointed by the director of the National Heart, Lung, and Blood Institute as chair of the National High Blood Pressure Education Program (NHBPEP) Coordinating Committee. Data on children from the 1988 through 1991 National Health and Nutrition Examination Survey III and nine additional national data sets were combined to develop normative BP tables. The working group members produced initial draft documents that were reviewed by NHBPEP Coordinating Committee representatives as well as experts in pediatrics, cardiology, and hypertension. This reiterative process occurred for 12 draft documents. The NHBPEP Coordinating Committee discussed the report, and additional comments were received. Differences of opinion were adjudicated by the chair of the working group. The final report was sent to representatives of the 44 organizations on the NHBPEP Coordinating Committee for vote. It was approved unanimously by the NHBPEP Coordinating Committee on October 2, 1995.
Conclusions. This report provides new normative BP tables for children and adolescents, which now include height percentiles, age, and gender. The fifth Korotkoff sound is now used to define diastolic BP in children and adolescents. New charts have been developed to guide practicing clinicians in antihypertensive drug therapy selection. The primary prevention of hypertension in these age groups is discussed. A statement on public health considerations in the treatment of children and adolescents is provided.
Research and Public Policy
Authors: Eron Leonard D. 
Published: December 2021

Professor Hyman has reviewed for us all the research that has been done on the effects of corporal punishment in the schools.1 It is actually a meager record because of the reasons he has mentioned, many of them ethical, demographic, and religious. Whatever research has been published on the effects of corporal punishment, however, would indicate that although the practice is widespread in the United States, corporal punishment is not an effective means of discipline and has many harmful effects on the recipient of the punishment, both physical and psychological. Certainly there are enough data, which Dr Hyman has assembled over 20 years, to warrant the measures he advocates to get the message out to the public as well as to concerned professionals, and to formulate public policy aimed at eliminating corporal punishment in our schools as well as all other settings, including the home.
And to those cynics who are skeptical about what influence psychological research findings can have on public policy, my own personal experience over 40 years with research on the effects of viewing television violence on aggressive behavior of children indicates that psychological and sociological research findings can have a profound influence. But changing behavior takes persistence and time. There are too many vested interests who favor the status quo and are threatened by change. There are also many professionals who very often have not done any research in the area, but consider themselves authorities, as well as lay persons who are convinced that the old way of doing things is the only right way.
Our Society Is Not More Violent
Authors: BERGMAN ABRAHAM B. 
Published: December 2021

The proposition that our society as a whole has become increasingly violent is now firmly imbedded into the psyche of the American public. As counterpoint to the unremitting tales of crimes in our newspapers and telecasts, waves of "experts" are brought forth to lament how each particular act of mayhem typifies the violent culture in which we live. Multidisciplinary conferences on violence are a growth industry.
There is much wrong with this depiction of the violence "epidemic" (medical metaphors are popular these days), not the least of which is that it is inaccurate. If the term means hurtful actions and behaviors between human beings, I contend that there is considerably less overall violence in the 1990s than occurred 100, 50, or even 25 years ago.
Descriptive Analysis of Eating Behavior in School-age Children With Cystic Fibrosis and Healthy Control Children
Authors: Stark Lori J. , Mulvihill Mary M. , Jelalian Elissa , Bowen Anne M. , Powers Scott W. , Tao Sijia , Creveling Susan , Passero Mary Ann , Harwood Ivan , Light Michael , Lapey Allen , Hovell Melbourne F. 
Published: December 2021

Study Objective. To investigate calorie intake, behavioral eating styles, and parent perception of eating behavior of school-age children with cystic fibrosis (CF) compared with healthy peers.Design. A two-group comparison study.Setting. A clinical sample of 28 school-age children with CF and a community sample of 28 healthy peers matched for age (6 to 12 years) and socioeconomic status.Measurements and Main Results. The children with CF consumed more calories per day (2175 cal/d) than the control children (1875 cal/d) and achieved a significantly higher recommended daily allowance (RDA) of energy (128% of the RDA) than the control children (91.61% of the RDA). Fifty-four percent of the CF sample were achieving the CF dietary recommendations of 120% of the RDA. Despite this energy intake, the CF sample was significantly below the control sample on weight (24.56 vs 31.23 kg), height (125.48 vs 133.06 cm), andz score for weight (−0.811 vs 0.528) and height (−0.797 vs 0.371). On measures of behavioral eating style, the CF sample had significantly longer meals (23.90 min) than the control sample (17.34 min) and had a significantly slower pace of eating (43.27% 10-second intervals with bites) than the control sample (51.29% 10-second intervals with bites) but did not differ significantly on the number of calories consumed during dinner. On a measure of parent report of mealtime behaviors, parents of the children with CF rated mealtime behavior problems of “dawdles” and “refuses food” as more intense (mean, 3.46) than did the parents of control children (mean, 2.67). For the CF sample, a significant correlation was found between the parent intensity ratings of problem behavior in general and meal duration (r = .48), and a significant negative correlation was found between the parent intensity ratings of problem mealtime behaviors and the percentage of intervals with bites (pace of meal) (r = −.533).Conclusions. Although the school-age children with CF were consuming more calories per day than their healthy peers, and more than 50% of the children in the CF sample were at or above the CF dietary recommendations, the children in the CF sample were significantly below the control children on measures of weight and height. The behavioral data suggest that increased caloric intake is not without cost, because the CF sample spent an additional 7 minutes per day at dinner and ate their meals at a slower pace than their healthy peers. These data were associated with higher intensity ratings of mealtime behaviors by parents of children with CF. These findings point to the need for individualized assessment of energy needs for school-age children with CF and comprehensive programs that teach parents behavioral strategies to motivate their children to meet these higher energy requirements in an adaptive manner.
Recurrent Infections
Authors: Hong Richard 
Published: December 2021

Recurrent infections constitute a major challenge to primary care physicians. Primary immunodeficiency or other alterations of the host defense system are extremely rare. In the case of recurrent respiratory infections, particularly of the lungs, a diagnosis will result much more often from ordering a sweat chloride test than a serum immunoglobulin level.
RECURRENT RESPIRATORY INFECTIONS
The major reason for referral to our clinic for investigation of the immune system is a complaint of too many upper respiratory tract infections. Each respiratory infection in a young child means loss of sleep for child and parents, expenditure of time at the physician's office, and possible loss of income in addition to the expense of medication and office visits. The child is often irritable and his or her misery clouds the home atmosphere. With repeated episodes of this sort each year, it is small wonder that parents want relief.
The average number of upper respiratory tract infections experienced by healthy children is approximately 9 to 10 per year. At least 100 viruses can cause the common cold. Accordingly, even when a child has a normal immune system establishing immunity to each virus or virus subtype, it can take many years for a broad enough immunity to develop to diminish the frequency of infection due to newly encountered respiratory viruses.
INDEX OF SUSPICION
Authors: Tejeda David M. , Kaplan Jessica , Andrews John S. , DeAngelis Catherine , Sehgal Neeru 
Published: December 2021

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page.
We invite readers to contribute case presentations and discussions.
Case 1 Presentation
The parents of a 22-month-old boy complain that he has been increasingly clumsy and cranky for the past 7 days. He initially developed a stumbling gait and now prefers to crawl; he no longer can sit on his own. The child has been afebrile but has had a cough for several weeks. He has been on antibiotics for otitis media (with a presumed labyrinthitis) for 5 days. There have been no other recent illnesses, and he has not been ill in the past.
On examination, the child appears irritable and has occasional jerking movements of his extremities. His temperature is 36.3°C, pulse is 128 beats/min, and blood pressure is 84/40 mm Hg. Chaotic, irregular eye movements are present.
Pulmonary Function Testing in Pediatric Practice
Authors: Mueller Gary A. , Eigen Howard 
Published: December 2021

Pulmonary function testing is an important tool in the evaluation of children who have or are suspected of having lung disease. Of particular importance, pulmonary function testing provides objective and reproducible measurements, which then can be used to follow the response to therapy. The measurements of air flow and lung volumes are the mechanical pulmonary function tests used most commonly. However, measurements of the efficiency of gas exchange also are considered a test of pulmonary function and can be assessed by such methods as arterial blood gas and oximetry. This article focuses on those tests readily available to the pediatrician in the office or hospital.
Measuring pulmonary function regularly is analogous to measuring blood pressure in patients who have hypertension, allowing the physician to follow a measurement directly associated with the pulmonary disease process. As with other clinical tests, pulmonary function measurements are most effective when used to answer a specific question about the patient. For example, in a child who presents having a persistent cough and a family history of asthma, the diagnosis may be asthma, and the question "Does the child have airflow obstruction consistent with asthma?" can be answered by spirometry.
Spirometry
The parameters commonly measured in the assessment of respiratory function are lung volumes, air flows and timed volumes, and airway reactivity.
Tonsillopharyngitis 1994
Authors: Denny Floyd W. 
Published: December 2021

Acute infections of the upper respiratory tract, including those of the tonsils and pharynx, are the most common affliction of humans; their tendency to occur with much greater frequency in children makes them especially important to the pediatrician. A host of microbial agents can cause these infections, but only a few are responsive to antimicrobial agents. Because of the paucity of definitive laboratory tools that allow easy recognition of the cause of most acute respiratory infections, it is important for the practicing pediatrician to have other methods to aid in the clinical management of children who have these infections. This review will discuss the etiology and epidemiology of acute respiratory infections that involve primarily the tonsils and pharynx, with emphasis on how this knowledge can guide clinicians in their management. The groundwork for this approach will be laid by suggesting a classification of upper respiratory tract infections that involve the tonsils and pharynx. Causative agents will be enumerated and put into perspective. The major factors associated with the occurrence of acute upper respiratory tract infections will be discussed. Finally, treatment of the patient who has tonsillopharyngitis will be presented.
Uncomplicated acute tonsillopharyngitis will be emphasized primarily and the role of complications only mentioned.