bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Active Surveillance to Validate International Classification of Diseases Code Estimates of Rotavirus Hospitalizations in Children
Authors: Hsu Vincent P. , Staat Mary Allen , Roberts Nancy , Thieman Carla , Bernstein David I. , Bresee Joseph , Glass Roger I. , Parashar Umesh D. 
Published: January 2017

Objective. National estimates of hospitalizations for rotavirus, the leading cause of acute gastroenteritis (AGE) in children, have been used to establish the need for rotavirus vaccines. A previous method directly estimated discharges by using the rotavirus-specific International Classification of Diseases (ICD) code, but this method has not been validated. Our study evaluated the sensitivity of the rotavirus ICD code among children hospitalized for AGE by using active surveillance for rotavirus at a tertiary children's hospital.
Design. We compared data for rotavirus-coded hospital discharges in 2000–2001 at Cincinnati Children's Hospital Medical Center with data on laboratory-confirmed cases of rotavirus obtained from active surveillance. We estimated additional rotavirus hospitalizations by extrapolating the proportion of rotavirus-positive results from active-surveillance cases to those with an unknown rotavirus status.
Results. Of 767 cases of AGE-related discharge codes, 103 (13%) were coded as rotavirus, 91% (94 of 103) of which were laboratory-confirmed diagnoses. Among all children discharged with an AGE-related illness, 260 (34%) were enrolled in active surveillance, of whom 155 (60%) tested positive for rotavirus. An additional 47 laboratory-confirmed rotavirus-case patients not enrolled in active surveillance yielded a total of 202 rotavirus cases and a maximum sensitivity of the rotavirus code of 47%. Extrapolation indicated that an additional 170 untested children might be rotavirus-positive, yielding a total of 372 rotavirus hospitalizations and a minimum sensitivity of the rotavirus code of 25%.
Conclusions. Measurement of rotavirus-coded hospital discharges alone seems to greatly underestimate the true burden of rotavirus-associated hospitalizations. The numbers of national rotavirus hospitalization discharges may be substantially greater than previously estimated.
Olfactory Stimulation Prevents Apnea in Premature Newborns
Authors: Marlier Luc , Gaugler Christophe , Messer Jean 
Published: January 2017

Objective. Methylxanthines and doxapram are currently used to treat apnea of prematurity but are not fully effective and often present undesirable side effects. The present study examines whether exposure to an odor known to modulate the infant's respiratory rate could reduce the frequency of apneic spells.
Method. Fourteen preterm newborns born at 24 to 28 gestational weeks presenting recurrent apnea despite caffeine and doxapram therapy were exposed to a pleasant odor diffused during 24 hours in the incubator. Efficiency of the olfactory treatment was judged by comparing frequency and severity of apneas occurring during the day of odorization with that observed the day before (baseline) and the day after (posttreatment control). Apnea was defined as any complete cessation of breathing movements for &gt;20 seconds, or less if associated with hypoxia or bradycardia.
Results. Concerning all types of apneas, a diminution of 36% was observed and seen in 12 of 14 infants. Apneas without bradycardia were reduced (44%) during the day with odorization, and this diminution affected all the infants. The frequency of apnea with moderate bradycardia (heart rate between 70 and 90 beats per minute) was maintained while the frequency of apnea associated with severe bradycardia (heart rate &lt;70 beats per minute) decreased strongly (45%) and affected all the infants. No side effects were observed.
Conclusion. The introduction of a pleasant odor in the incubator is of therapeutic value in the treatment of apneas unresponsive to caffeine and doxapram.
Kikuchi's Disease in Asian Children
Authors: Lin Hsin-Ching , Su Chih-Ying , Huang Shun-Chen 
Published: January 2017

Objective. Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a unique form of self-limiting lymphadenitis and typically affects the head and neck regions. It usually occurs in young adults and has a female predilection. The aim of this study was to review the authors' institutional experience with KD in children over a 16-year period.
Methods. Between January 1986 and May 2002, a total of 23 patients who were younger than 16 years underwent cervical lymph node biopsies and received a diagnosis of KD. Clinical features, laboratory values, pathologic parameters, specific characteristics of our pediatric patients, and long-term follow-up results are discussed. The follow-up period averaged 8 years.
Results. There were 8 girls and 15 boys with a mean age of 12.8. All 23 patients had affected cervical lymph nodes located in the posterior cervical triangle, and 2 cases additionally had affected nodes in the anterior triangle. Cervical lymph nodes were affected unilaterally in 82.6% (19) and bilaterally in 17.4% (4) of these patients. The dimensions of the affected lymph nodes were commonly in the range of 0.5 to 3 cm (52.2%; 12 of 23) and 3 to 6 cm (39.1%; 9 of 23). In 2 (8.7%) patients, the size of the enlarged lymph nodes reached &gt;6 cm. Leukopenia was observed in 5 (21.7%) patients, and fever was observed in 7 (30.4%) patients. One child with KD developed systemic lupus erythematosus 5 years later. The cervical lymphadenopathy usually resolved itself without any medical treatment within 6 months after definite diagnosis was made. Neither recurrence nor persisting KD has since been noted.
Conclusion. KD, although rare, should be part of the differential diagnosis for posterior cervical lymphadenopathy in children, especially in patients of Asian descent. In our pediatric series, KD demonstrated a male predominance, which is in contrast to previously reported adult series demonstrating a female predominance. The children with KD require a systemic survey and regular follow-up for several years to rule out the development of systemic lupus erythematosus.
Mothers of Children With Down Syndrome Reflect on Their Postnatal Support
Authors: Skotko Brian 
Published: January 2017

Objective. Since 1964, researchers have been examining the ways in which physicians deliver a postnatal diagnosis of Down syndrome (DS). Almost all of the studies, however, have been limited to reflections or very small sample sizes. The objective of this study was to document, in the most robust comprehensive way, the reflections of mothers in the United States who received diagnoses of DS for their children.Methods. An 11-page survey was mailed to 2945 persons on the membership lists of 5 DS parent organizations. The survey gathered both quantitative and qualitative data with yes/no questions, open-ended questions, and a series of statements asking the mothers to rate their level of agreement on a Likert scale of 1 to 7.Results. Of the 1250 responses (42.4%), 985 were from mothers who received postnatal diagnoses of DS for their children. The majority of these mothers reported being frightened or anxious after learning the diagnosis, and very few rated the overall experience as a positive one. Mothers reported that their physicians talked little about the positive aspects of DS and rarely provided enough up-to-date printed materials or telephone numbers of other parents with children with DS. Improvement has been made with time, albeit slowly.Conclusion. Mothers have called on physicians to improve the way in which postnatal diagnoses are delivered. Specific recommendations are offered.
The Association Between Presence of Children in the Home and Firearm-Ownership and -Storage Practices
Authors: Connor Susan M. 
Published: January 2017

Objective. American children's ready access to firearms contributes to high rates of firearm-related injuries. Understanding the factors that influence storage decisions is critical for prevention. This study examined the influence of geography and presence of children &lt;16 years old in the home on firearm-ownership and storage decisions of northeast-Ohio residents.Methods. Analysis was based on 522 responses to randomized telephone surveys of urban and rural households in northeast Ohio. Relationships between 4 dependent variables (firearm ownership, type of firearm owned, reasons for owning, and storage) and 2 independent variables (geography and presence of children in the home) were evaluated using odds ratios and multinomial logistic regression.Results. Firearms were significantly more common in rural (31%) than in urban (13%) households. Twenty-two percent of gun owners reported securing all firearms with trigger locks or storing them in locked safes, drawers, or gun cabinets; 12% reported storing guns unlocked and either loaded or together with ammunition. Most gun owners (66%) reported storing all firearms unlocked, unloaded, and separate from ammunition. Rural respondents without children were approximately twice as likely as those with children to have handguns, but children did not influence long-gun ownership. In the urban group, the presence of children was not related to likelihood of firearm ownership. Having children in the home was not significantly associated with higher rates of safe storage for either group.Discussion. These results illustrate the inadequacy of 1-size-fits-all interventions and highlight the need to better understand gun owners' reasoning about children and guns to design and implement successful interventions. Physicians and others interested in reducing pediatric exposure to firearms cannot be credible messengers on gun-safety topics if they cannot demonstrate an understanding of the issues from the perspective of patients and their families.
The Differential Effect of Foreign-Born Status on Low Birth Weight by Race/Ethnicity and Education
Authors: Acevedo-Garcia Dolores , Soobader Mah-J , Berkman Lisa F. 
Published: January 2017

Objectives. This article investigates whether foreign-born status confers a protective effect against low birth weight (LBW) and whether this protective effect varies across racial/ethnic groups and by socioeconomic status (ie, education) within various racial/ethnic groups.
Methods. Logistic regression analyses of the Detail Natality Data, 1998 (n = 2 436 890), were used to examine differentials in LBW by nativity across racial/ethnic groups and by education level.
Results. Although foreign-born status does not protect against LBW among white women (95% confidence interval [CI]: 0.96, 1.03) and it increases the risk among Asian women by 24% (95% CI: 1.13, 1.36), it reduces the risk by ∼25% among black women (95% CI: 0.72, 0.78) and by ∼19% among Hispanic women (95% CI: 0.78, 0.84). By educational attainment, for whites, blacks, and Hispanics the protective effect of foreign-born status is stronger among women with low education (ie, 0–11 years) than among women with more education. The educational gradient in LBW is less pronounced among foreign-born white, black, and Hispanic women than among their US-born counterparts.
Conclusions. Foreign-born status is associated with LBW. The direction and strength of this association varies across racial/ethnic groups, and within those groups it varies by educational level. Future research may test hypotheses regarding the mechanisms underlying these variations in LBW, including health selection of immigrants, cultural factors, social support, and social environment.
Oral Probiotics Reduce the Incidence and Severity of Necrotizing Enterocolitis in Very Low Birth Weight Infants
Authors: Lin Hung-Chih , Su Bai-Horng , Chen An-Chyi , Lin Tsung-Wen , Tsai Chang-Hai , Yeh Tsu-Fuh , Oh William 
Published: January 2017

Objective. We evaluated the efficacy of probiotics in reducing the incidence and severity of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.
Patients and Methods. A prospective, masked, randomized control trial was conducted to evaluate the beneficial effects of probiotics in reducing the incidence and severity of NEC among VLBW (&lt;1500 g) infants. VLBW infants who started to fed enterally and survived beyond the seventh day after birth were eligible for the trial. They were randomized into 2 groups after parental informed consents were obtained. The infants in the study group were fed with Infloran (Lactobacillus acidophilus and Bifidobacterium infantis) with breast milk twice daily until discharged. Infants in the control group were fed with breast milk alone. The clinicians caring for the infants were blinded to the group assignment. The primary outcome was death or NEC (≥ stage 2).
Results. Three hundred sixty-seven infants were enrolled: 180 in the study group and 187 in the control group. The demographic and clinical variables were similar in both groups. The incidence of death or NEC (≥ stage 2) was significantly lower in the study group (9 of 180 vs 24 of 187). The incidence of NEC (≥ stage 2) was also significantly lower in the study when compared with the control group (2 of 180 vs 10 of 187). There were 6 cases of severe NEC (Bell stage 3) in the control group and none in the study group. None of the positive blood culture grew Lactobacillus or Bifidobacterium species.
Conclusion. Infloran as probiotics fed enterally with breast milk reduces the incidence and severity of NEC in VLBW infants.
Children With Congenital Hypothyroidism and Their Siblings: Do They Really Differ?
Authors: Rovet Joanne F. 
Published: January 2017

Objective. Although favorable outcome is typically described in follow-up studies of children with congenital hypothyroidism (CH) identified by newborn screening, IQ reductions and persistent cognitive deficits are still reported. These findings are accounted for by disease and treatment variables as well as methodologic factors including choice of comparison group. Although siblings are ideal because they control for genetic and environmental influences, by definition they have different ages when tested, which can also introduce bias. Because we followed children with CH and their siblings over an extended period of time, there were a number of occasions when both groups were tested at the same age. The purpose of this study was to compare the results of children with CH and their unaffected siblings at the same age and with the same test.Methods. The sample consisted of 42 children with CH detected between 1975 and 1985 and their 42 siblings, all of whom were tested with the McCarthy or Wechsler Intelligence Scale for Children—Revised (WISC-R) intelligence tests. Nineteen pairs of children were evaluated at 6 years with the McCarthy, and 30 pairs of children were evaluated at 7 or 9 years with the WISC-R. Recorded for children with CH were disease etiology, bone age and thyroxine levels at diagnosis, age at onset of treatment, and starting dosage of levothyroxine.Results. Paired t tests revealed that the CH group scored lower than siblings by 8.1 IQ points on the McCarthy and 6.2 points on the WISC-R. Factors contributing to the size of the CH-sibling IQ difference were (1) the etiology of hypothyroidism, reflecting the larger differences by those with athyreosis or an ectopic gland than dyshormonogenesis, and (2) the starting dosage of levothyroxine, with those initially treated with ≥8.2 μg/kg per day having smaller CH-sibling differences than those given lower starting doses. There were no effects of bone age, thyroxine levels at diagnosis, or age at treatment onset.Conclusion. Children with CH treated early in life due to newborn screening may have reduced IQ relative to siblings.
Long Eyelashes in a Case Series of 93 Children With Vernal Keratoconjunctivitis
Authors: Pucci Neri , Novembre Elio , Lombardi Enrico , Massai Cristina , Bernardini Roberto , Caputo Roberto , Campa Luciana , Libero Cinzia de , Vierucci Alberto 
Published: January 2017

Objective. Vernal keratoconjunctivitis (VKC) is a chronic conjunctivitis that affects children mainly in temperate areas, with exacerbations in spring and summer. Eyelashes provide natural protection for the eyes from sunshine, wind, and foreign bodies. These factors induce a worsening of signs and symptoms in VKC, whereas mechanical protection of the eyes produces relief. The aim of this study was to evaluate eyelash length in a large series of VKC patients and in age- and gender-matched healthy subjects.Methods. Upper eyelash length was measured in 93 VKC patients (mean age: 8.7 years; range: 4–18 years) with a digital caliper. History, clinical form, type of presentation, degree of severity, and drug therapy were evaluated. Skin tests and serum-specific immunoglobulin E for common allergens, serum-total immunoglobulin E, peripheral blood eosinophil counts, and serum eosinophil cationic protein were determined. Two age- and gender-matched control subjects for each VKC patient underwent the same eyelash measurement.Results. The upper eyelashes were significantly longer in VKC patients than in control subjects (mean ± SD: 8.9 ± 1.17 mm vs 7.9 ± 1.07 mm). In healthy subjects, a negative correlation was found between eyelash length and age. With multivariate analysis, unlike control subjects, the eyelash length in VKC patients did not correlate with age, was positively correlated with the degree of severity of VKC, and was negatively correlated with the use of topical cyclosporine.Conclusions. Patients with VKC had longer eyelashes than healthy matched subjects. The ocular inflammation, by unknown chemical mediators, was likely responsible for the excessive eyelash growth. The finding may represent a defensive mechanism against physical agents that might have a crucial role in the etiopathogenesis of this disease.
Effect of a Probiotic Infant Formula on Infections in Child Care Centers: Comparison of Two Probiotic Agents
Authors: Weizman Zvi , Asli Ghaleb , Alsheikh Ahmed 
Published: January 2017

Objective. To investigate the effect of 2 different species of probiotics in preventing infections in infants attending child care centers.Methods. A double-blind, placebo-controlled, randomized trial was conducted from December 1, 2000, to September 30, 2002, at 14 child care centers in the Beer-Sheva area of Israel in healthy term infants 4 to 10 months old. Infants were assigned randomly to formula supplemented with Bifidobacterium lactis (BB-12), Lactobacillus reuteri (American Type Culture Collection 55730), or no probiotics. Duration of feeding, including follow-up, for each participant was 12 weeks. All infants were fed only the assigned formula and were not breastfed due to parental decision before recruitment to the study. Probiotic or prebiotic food products or supplements were not allowed. Main outcome measures were number of days and number of episodes with fever (&gt;38°C) and number of days and number of episodes with diarrhea or respiratory illness.Results. Participants (n = 201) were similar regarding gestational age, birth weight, gender, and previous breastfeeding. The controls (n = 60), compared with those fed B lactis (n = 73) or L reuteri (n = 68), had significantly more febrile episodes (mean [95% confidence interval]: 0.41 [0.28–0.54] vs 0.27 [0.17–0.37] vs 0.11 [0.04–0.18], respectively). The controls also had more diarrhea episodes (0.31 [0.22–0.40] vs 0.13 [0.05–0.21] vs 0.02 [0.01–0.05], respectively) and episodes of longer duration (0.59 [0.34–0.84] vs 0.37 [0.08–0.66] vs 0.15 [0.12–0.18] days, respectively). The L reuteri group, compared with BB-12 or controls, had a significant decrease of number of days with fever, clinic visits, child care absences, and antibiotic prescriptions. Rate and duration of respiratory illnesses did not differ significantly between groups.Conclusions. Child care infants fed a formula supplemented with L reuteri or B lactis had fewer and shorter episodes of diarrhea, with no effect on respiratory illnesses. These effects were more prominent with L reuteri, which was also the only supplement to improve additional morbidity parameters.
Delivering Tailored Asthma Family Education in a Pediatric Emergency Department Setting: A Pilot Study
Authors: Sockrider Marianna M. , Abramson Stuart , Brooks Edward , Caviness A. Chantal , Pilney Susan , Koerner Christine , Macias Charles G. 
Published: January 2017

OBJECTIVE. Many children are brought to the pediatric emergency department (ED) with acute asthma symptoms. Emergency asthma care is costly, and many ED visits may be preventable. Families often do not have written asthma action plans and lack asthma self-managment skills. This study tests a tailored self-managment intervention delivered in the ED for families of children with asthma. The primary hypotheses were that the intervention group would have greater confidence to manage asthma 14 days postintervention and more well-asthma visits and fewer urgent care/ED visits at 9 and 12 months.
METHODS. This randomized intervention/usual-care study was part of a larger ED asthma surveillance project in 4 urban pediatric ED sites. Asthma educators used a computer-based resource to tailor the intervention messages and provide a customized asthma action plan and educational summary. Children with acute asthma were enrolled during an ED visit, and follow-up telephone interviews were conducted during the next 9 months. The ED clinician classified the child’s acute and chronic severity.
RESULTS. To date, 464 subjects aged 1 to 18 years have been enrolled. The ED clinicians reported that 46% had intermittent and 54% had persistent chronic severity with 51% having mild acute severity episodes. The confidence level to prevent asthma episodes and keep them from getting worse was significantly higher in the intervention group at 14 days postintervention. More subjects in the intervention group reported well-asthma visits by 9 months. Return ED visits were significantly lower in the intervention group in those with intermittent asthma. Twelve-month follow-up is in process.
CONCLUSIONS. The tailored ED self-management intervention demonstrates significant effects on caregiver self-confidence and well-visit follow-up. Additional evaluation is needed to determine what impact this intervention has long-term.