bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐related Quality of Life in Pediatric Patients With Chronic Hepatitis B Living in the United States and Canada
Authors: Schwarzenberg Sarah Jane , Ling Simon C. , Cloonan Yona Keich , Lin Hsing‐Hua S. , Evon Donna M. , Murray Karen F. , Rodriguez‐Baez Norberto , Rosenthal Philip , Teckman Jeffrey , Schwarz Kathleen B. ,   Hepatitis B Research Network
Published: February 2017

ABSTRACTObjectives:The aim of the study was to determine whether selected sociodemographic and hepatitis B virus (HBV)‐specific clinical factors are associated with health‐related quality of life (HRQoL) among pediatric patients chronically infected with HBV.Methods:Children with chronic HBV enrolled in the Hepatitis B Research Network completed the Child Health Questionnaire at study entry. Caregivers of children 5 to <10 years completed the parent‐reported form (CHQ‐Parent Report Form); youth 10 to <18 years completed the child‐reported CHQ‐Child Report Form. We examined univariable associations of the Child Health Questionnaire scores with selected independent variables: sex, adoption status, maternal education, alanine aminotransferase (U/L), aspartate aminotransferase‐to‐platelet ratio index, and HBV‐specific symptom count.Results:A total of 244 participants (83 young children 5–<10 years, 161 youth 10–<18 years) were included, all HBV treatment‐naïve. Among young children, increased alanine aminotransferase level was negatively associated with CHQ‐Parent Report Form psychosocial summary t score (r = −0.28, P = 0.01). No other subscale comparisons for young children were statistically significant. Among youth, adoption was associated with better physical functioning and general health (P < 0.01). Higher maternal education was associated with better role/functioning‐physical and ‐emotional scores (P < 0.05). Maternal education and adoption status were linked with adoption associated with higher maternal education. Increased symptom count in youth was associated with worse HRQoL in subscales measuring bodily pain, behavior, mental health, and self‐esteem (P < 0.01).Conclusions:Although overall HRQoL is preserved in children with chronic HBV, some sociodemographic and HBV‐related clinical factors were associated with impaired HRQoL in our pediatric patients at baseline. Measurement of HRQoL can focus resources on education and psychosocial support in children and families most in need.
Nutritional Assessment and Status of Hospitalized Infants
Authors: Matsuyama Misa , Bell Kristie , White Melinda , Lawson Karen , David Michael , Doolan Annabel , Todd Alwyn 
Published: February 2017

ABSTRACTObjectives:Malnutrition during infancy has long‐term adverse consequences for both physical and psychological development. Early detection of malnutrition among hospitalized infants is essential to provide optimal nutrition support. The primary aim of the present study was to investigate the nutritional status of hospitalized infants using 2 methods: the Subjective Global Nutritional Assessment (SGNA) and anthropometric measurement. We also investigated diagnostic category associated with nutritional status, the mean anthropometric z scores, and explored the association between malnutrition and nutrition focused variables.Methods:Nutritional status of 110 hospitalized infants ages 31 days to 12 months was investigated using the SGNA and anthropometric measurements converted to z scores.Results:Utilizing the SGNA, 78 (70.9%) infants were classified as having normal nutritional status, 30 (27.3%) were moderately malnourished, and 2 (1.8%) were severely malnourished. The proportion of infants with acute malnutrition (weight‐for‐length z score <−2) was 16.4%, and chronic malnutrition (length‐for‐age z score <−2) was 3.6%. The mean anthropometric z scores of infants were significantly lower in infants identified as moderately and severely malnourished using the SGNA. Decrease in serial weight (odds ratio [OR] 44.4; 95% confidence interval [CI]: 4.3–451.5), having prolonged gastrointestinal symptoms (OR 18.8; 95% CI: 1.5–234.7), and reduced nutrition‐related functional capacity (OR 27.6; 95% CI 2.5–301.7) were associated with malnutrition after adjusting for sex, age, and length of hospital stay.Conclusions:Regardless of the method applied, cases of malnutrition amongst hospitalized infants were identified. The SGNA is a comprehensive approach to identifying malnutrition in hospitalized infants.
Frequency of Severe Infusion Reactions Associated With Outpatient Infusion of Infliximab Without Premedications
Authors: Hutsell Stephanie Q. , Wu May , Park K.T. 
Published: February 2017

ABSTRACTIn this report, we describe incremental changes, during a 2‐year period at a single center with the administration of maintenance infliximab infusions. Given practice‐driven changes consisting of 1‐hour infusions and omission of premedications, we aimed to investigate if these changes contributed to severe infusion reactions. We reviewed approximately 900 infliximab infusions in a pediatric ambulatory infusion center from January 1, 2014, to December 31, 2015, for severe adverse reactions requiring either rescue epinephrine or a code blue or “rapid response” activation. In 2015, these practice changes resulted in a 51% decrease in total infusion hours (1281 to 630 infusion hours), despite a 9% increase in total number of infusions. No increase in severe adverse events associated with either rapid 1‐hour infusion or omission of premedications. Our findings highlight a quality‐improvement opportunity to standardize infliximab infusions to streamline care in an ambulatory setting.
Breast‐feeding and Infant Hospitalization for Infections
Authors: Størdal Ketil , Lundeby Karen M. , Brantsæter Anne L. , Haugen Margaretha , Nakstad Britt , Lund‐Blix Nicolai A. , Stene Lars C. 
Published: February 2017

ABSTRACTObjectives:Breast‐feeding may protect against infections, but its optimal duration remains controversial. We aimed to study the association of the duration of full and any breast‐feeding with infections the first 18 months of life.Methods:The Norwegian Mother and Child study (MoBa) is a prospective birth cohort which recruited expecting mothers giving birth from 2000 to 2009. We analyzed data from the full cohort (n = 70,511) and sibling sets (n = 21,220) with parental report of breast‐feeding and infections. The main outcome measures were the relative risks (RRs) for hospitalization for infections from 0 to 18 months by age at introduction of complementary foods and duration of any breast‐feeding.Results:Although we found some evidence for an overall association between longer duration of full breast‐feeding and lower risk of hospitalizations for infections, 7.3% of breast‐fed children who received complementary foods at 4 to 6 months of age compared to 7.7% of those receiving complementary foods after 6 months were hospitalized (adjusted RR 0.95, 95% confidence interval 0.88–1.03). Higher risk of hospitalization was observed in those breast‐fed 6 months or less (10.0%) compared to ≥12 months (7.6%, adjusted RR 1.22, 95% confidence interval 1.14–1.31), but with similar risks for 6 to 11 months versus ≥12 months. Matched sibling analyses, minimizing the confounding from shared maternal factors, showed nonsignificant associations and were generally weaker compared with the cohort analyses.Conclusions:Our results support the recommendation to fully breast‐feed for 4 months and to continue breast‐feeding beyond 6 months, and suggest that protection against infections is limited to the first 12 months.
Feed‐induced Dystonias in Children With Severe Central Nervous System Disorders
Authors: Mordekar Santosh R. , Velayudhan Manjula , Campbell David I. 
Published: February 2017

ABSTRACTDystonias can arise from any painful stimuli in neurologically disabled children. Classically, feed‐induced dystonias from mediastinal pain due to severe gastroesophageal reflux disease are described as Sandifer spasm. We report a case series of 12 severely neurologically impaired children with enteral feed–induced dystonias. Intestinal dysmotility was demonstrated in several. Improvements are seen with jejunal feeds or gut rest with total parenteral nutrition. Use of parenteral nutrition in children with severe neurodisability requires thorough discussion with patient groups and commissioners to give clinicians guidelines to standardize care.
Temporal Trend of Pediatric Inflammatory Bowel Disease
Authors: Ishige Takashi , Tomomasa Takeshi , Hatori Reiko , Tatsuki Maiko , Igarashi Yoshiko , Sekine Kazuhiko , Arakawa Hirokazu 
Published: February 2017

ABSTRACTIncreased incidence and prevalence of pediatric inflammatory bowel disease (IBD) have been reported in Western countries. Changes in the prevalence of pediatric IBD in Asian countries, however, remain unclear. We evaluated the changes in the prevalence of IBD among Japanese adults and children from 2004 to 2013, by using the Japanese national registry data of patients receiving financial aid. Data from children (ages 0–19 years) were compared with those from young adults (ages 20–39 years). In 2004, age‐standardized prevalences of Crohn disease (CD) and ulcerative colitis (UC) among children were 4.2 of 100,000 and 11.0 of 100,000, respectively. The corresponding prevalences among young adults were 41.0 of 100,000 and 89.8 of 100,000, respectively. In 2013, age‐standardized prevalences of pediatric CD and UC were 7.2 of 100,000 and 15.0 of 100,000, respectively. During this period, prevalence of pediatric CD increased by 73.8% among children and by 49.0% in young adults. The prevalence of UC increased by 45.0% among children, and by 73.7% among young adults.
Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian Cancer
Authors: Mirza Mansoor R. , Monk Bradley J. , Herrstedt Jørn , Oza Amit M. , Mahner Sven , Redondo Andrés , Fabbro Michel , Ledermann Jonathan A. , Lorusso Domenica , Vergote Ignace , Ben-Baruch Noa E. , Marth Christian , Mądry Radoslaw , Christensen René D. , Berek Jonathan S. , Dørum Anne , Tinker Anna V. , du Bois Andreas , González-Martín Antonio , Follana Philippe , Benigno Benedict , Rosenberg Per , Gilbert Lucy , Rimel Bobbie J. , Buscema Joseph , Balser John P. , Agarwal Shefali , Matulonis Ursula A. 
Published: February 2017

(Abstracted from N Engl J Med 2016;375(22):2154–2164)
The initial response rate to platinum and taxane treatment in patients with advanced ovarian cancer is high. However, the effectiveness of this regimen diminishes over time, and most patients relapse; with retreatment, relapses occur at shorter intervals until patient death.
Gynecologic Outcomes After Hysteroscopic and Laparoscopic Sterilization Procedures
Authors: Perkins Rebecca B. , Morgan Jake R. , Awosogba Temitope P. , Ramanadhan Shaalini , Paasche-Orlow Michael K. 
Published: February 2017

(Abstracted from Obstet Gynecol 2016;128:843–852)
The contraceptive method chosen by nearly 10 million US women is female tubal sterilization. This procedure can be performed either laparoscopically or hysteroscopically.
Nitrofurantoin vs Other Prophylactic Agents in Reducing Recurrent Urinary Tract Infections in Adult Women: A Systematic Review and Meta-analysis
Authors: Price Jameca Renee , Guran Larissa A. , Gregory W. Thomas , McDonagh Marian S. 
Published: February 2017

(Abstracted from Am J Obstet Gynecol 2016;215(5):548–560)
Infections of the bladder in women are among the most common bacterial infections seen in general practice. Up to 50% of women will have at least 1 episode of uncomplicated urinary tract infection (UTI) during their lifetime, and 20% to 30% will have a recurrent episode.
Prenatal Ultrasound and Childhood Autism: Long-Term Follow-Up After A Randomized Controlled Trial of First- Versus Second-Trimester Ultrasound
Authors: Höglund Carlsson L. , Saltvedt S. , Anderlid B.-M. , Westerlund J. , Gillberg C. , Westgren M. , Fernell E. 
Published: February 2017

(Abstracted from Ultrasound Obstet Gynecol 2016;48:285–288)
Prenatal ultrasound has its pros and cons, the pros being an effective means to assess gestational age and to identify fetal anomalies, whereas the cons are the potential risks associated with exposure to ultrasound, especially with increasing exposure times. Autism spectrum disorder (ASD) is caused by several factors, including infections and toxins.
Glucocorticoid Receptor Polymorphisms and Outcomes in Pediatric Septic Shock*
Authors: Cvijanovich Natalie Z. , Anas Nick , Allen Geoffrey L. , Thomas Neal J. , Bigham Michael T. , Weiss Scott L. , Fitzgerald Julie , Checchia Paul A. , Meyer Keith , Quasney Michael , Gedeit Rainer , Freishtat Robert J. , Nowak Jeffrey , Raj Shekhar S. , Gertz Shira , Grunwell Jocelyn R. , Opoka Amy , Wong Hector R. 
Published: February 2017

Objective:
Polymorphisms of the glucocorticoid receptor gene are associated with outcome and corticosteroid responsiveness among patients with inflammatory disorders. We conducted a candidate gene association study to test the hypothesis that these polymorphisms are associated with outcome and corticosteroid responsiveness among children with septic shock.

Design:
We genotyped 482 children with septic shock for the presence of two glucocorticoid receptor polymorphisms (rs56149945 and rs41423247) associated with increased sensitivity and one glucocorticoid receptor polymorphism (rs6198) associated with decreased sensitivity to corticosteroids. The primary outcome variable was complicated course, defined as 28-day mortality or the persistence of two or more organ failures 7 days after a septic shock diagnosis. We used logistic regression to test for an association between corticosteroid exposure and outcome, within genotype group, and adjusted for illness severity.

Setting:
Multiple PICUs in the United States.

Interventions:
Standard care.

Measurements and Main Results:
There were no differences in outcome when comparing the various genotype groups. Among patients homozygous for the wild-type glucocorticoid receptor allele, corticosteroids were independently associated with increased odds of complicated course (odds ratio, 2.30; 95% CI, 1.01–5.21; p = 0.047).

Conclusions:
Based on these glucocorticoid receptor polymorphisms, we could not detect a beneficial effect of corticosteroids among any genotype group. Among children homozygous for the wild-type allele, corticosteroids were independently associated with increased odds of poor outcome.
Pediatric Acute Respiratory Distress Syndrome in Pediatric Allogeneic Hematopoietic Stem Cell Transplants: A Multicenter Study*
Authors: Rowan Courtney M. , Smith Lincoln S. , Loomis Ashley , McArthur Jennifer , Gertz Shira J. , Fitzgerald Julie C. , Nitu Mara E. , Moser Elizabeth A. S. , Hsing Deyin D. , Duncan Christine N. , Mahadeo Kris M. , Moffet Jerelyn , Hall Mark W. , Pinos Emily L. , Tamburro Robert F. , Cheifetz Ira M. 
Published: February 2017

Objective:
Immunodeficiency is both a preexisting condition and a risk factor for mortality in pediatric acute respiratory distress syndrome. We describe a series of pediatric allogeneic hematopoietic stem cell transplant patients with pediatric acute respiratory distress syndrome based on the recent Pediatric Acute Lung Injury Consensus Conference guidelines with the objective to better define survival of this population.

Design:
Secondary analysis of a retrospective database.

Setting:
Twelve U.S. pediatric centers.

Patients:
Pediatric allogeneic hematopoietic stem cell transplant recipients requiring mechanical ventilation.

Interventions:
None.

Measurements and Main Results:
During the first week of mechanical ventilation, patients were categorized as: no pediatric acute respiratory distress syndrome or mild, moderate, or severe pediatric acute respiratory distress syndrome based on oxygenation index or oxygen saturation index. Univariable logistic regression evaluated the association between pediatric acute respiratory distress syndrome and PICU mortality. A total of 91.5% of the 211 patients met criteria for pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference definition: 61.1% were severe, 27.5% moderate, and 11.4% mild. Overall survival was 39.3%. Survival decreased with worsening pediatric acute respiratory distress syndrome: no pediatric acute respiratory distress syndrome 66.7%, mild 63.6%, odds ratio = 1.1 (95% CI, 0.3–4.2; p = 0.84), moderate 52.8%, odds ratio = 1.8 (95% CI, 0.6–5.5; p = 0.31), and severe 24.6%, odds ratio = 6.1 (95% CI, 2.1–17.8; p < 0.001). Nonsurvivors were more likely to have multiple consecutive days at moderate and severe pediatric acute respiratory distress syndrome (p < 0.001). Moderate and severe patients had longer PICU length of stay (p = 0.01) and longer mechanical ventilation course (p = 0.02) when compared with those with mild or no pediatric acute respiratory distress syndrome. Nonsurvivors had a higher median maximum oxygenation index than survivors at 28.6 (interquartile range, 15.5–49.9) versus 15.0 (interquartile range, 8.4–29.6) (p < 0.0001).

Conclusion:
In this multicenter cohort, the majority of pediatric allogeneic hematopoietic stem cell transplant patients with respiratory failure met oxygenation criteria for pediatric acute respiratory distress syndrome based on the Pediatric Acute Lung Injury Consensus Conference definition within the first week of invasive mechanical ventilation. Length of invasive mechanical ventilation, length of PICU stay, and mortality increased as the severity of pediatric acute respiratory distress syndrome worsened.
Medication Reconciliation Failures in Children and Young Adults With Chronic Disease During Intensive and Intermediate Care
Authors: DeCourcey Danielle D. , Silverman Melanie , Chang Esther , Ozonoff Al , Stickney Carolyn , Pichoff Darla , Oldershaw Alexandra , Finkelstein Jonathan A. 
Published: February 2017

Objectives:
Although medication reconciliation has become standard during hospital admission, rates of unintentional medication discrepancies during intensive care of pediatric patients with chronic disease are unknown. Such discrepancies are an important cause of adverse drug events in adults with chronic illness and are associated with unintentional discontinuation of chronic medications. We sought to determine the rate, type, timing, and predictors of potentially harmful unintentional medication discrepancies in children and young adults with chronic disease.

Design:
Prospective observational cohort study.

Setting:
Patients discharged from the intensive and intermediate care units at a tertiary care children’s hospital from September 2013 to May 2014.

Patients:
Consecutive sample of 308 patients less than 25 years old with chronic disease defined by prescription of at least one predetermined class of chronic medication prior to hospitalization.

Measurements and Main Results:
The number of unintentional medication discrepancies with the potential for harm, as well as patient and medication-related factors predisposing patients to these errors were assessed. Two thousand seven hundred thirty-nine medication discrepancies were identified; 284 (10%) were unintentional and had the potential for harm (0.9/patient). Of these, 128 (45%) were due to errors in taking the preadmission medication history, whereas 156 (55%) were due to errors reconciling the medication history with orders. Most events occurred at admission (66%) and were dosing errors (45%). In multivariable negative binomial regression analyses (adjusted rate ratios [95% CI]), each additional preadmission medication (1.07 [1.04–1.10]), chronic respiratory medications (1.51 [1.01–2.28]), and chronic noninvasive ventilation (1.53 [1.07–2.19]) were associated with increased risk of a discrepancy.

Conclusions:
Unintentional medication discrepancies with the potential for harm are common among children and young adults with chronic disease during critical care admission due to both failure to obtain an accurate medication history and errors in reconciling the history with patient orders. The use of current medication reconciliation processes is insufficient to prevent errors in this high-risk population.
Mechanical Ventilation, Weaning Practices, and Decision Making in European PICUs*
Authors: Tume Lyvonne N. , Kneyber Martin C. J. , Blackwood Bronagh , Rose Louise 
Published: February 2017

Objectives:
This survey had three key objectives: 1) To describe responsibility for key ventilation and weaning decisions in European PICUs and explore variations across Europe; 2) To describe the use of protocols, spontaneous breathing trials, noninvasive ventilation, high-flow nasal cannula use, and automated weaning systems; and 3) To describe nurse-to-patient staffing ratios and perceived nursing autonomy and influence over ventilation decision making.

Design:
Cross-sectional electronic survey.

Setting:
European PICUs.

Participants:
Senior ICU nurse and physician from participating PICUs.

Interventions:
None.

Measurements and Main Results:
Response rate was 64% (65/102) representing 19 European countries. Determination of weaning failure was most commonly based on collaborative decision making (81% PICUs; 95% CI, 70–89%). Compared to this decision, selection of initial ventilator settings and weaning method was least likely to be collaborative (relative risk, 0.30; 95% CI, 0.20–0.47 and relative risk, 0.45; 95% CI, 0.32–0.45). Most PICUs (> 75%) enabled physicians in registrar (fellow) positions to have responsibility for key ventilation decisions. Availability of written guidelines/protocols for ventilation (31%), weaning (22%), and noninvasive ventilation (33%) was uncommon, whereas sedation protocols (66%) and sedation assessment tools (76%) were common. Availability of protocols was similar across European regions (all p > 0.05). High-flow nasal cannula (53%), noninvasive ventilation (52%) to avoid intubation, and spontaneous breathing trials (44%) were used in approximately half the PICUs greater than 50% of the time. A nurse-to-patient ratio of 1:2 was most frequent for invasively (50%) and noninvasively (70%) ventilated patients. Perceived nursing autonomy (median [interquartile range], 4 [2–6]) and influence (median [interquartile range], 7 [5–8]) for ventilation and weaning decisions varied across Europe (p = 0.007 and p = 0.01, respectively) and were highest in Northern European countries.

Conclusions:
We found variability across European PICUs in interprofessional team involvement for ventilation decision making, nurse staffing, and perceived nursing autonomy and influence over decisions. Patterns of adoption of tools/adjuncts for weaning and sedation were similar.