bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different Guidelines for Imaging After First UTI in Febrile Infants: Yield, Cost, and Radiation
Authors: La Scola Claudio , De Mutiis Chiara , Hewitt Ian K. , Puccio Giuseppe , Toffolo Antonella , Zucchetta Pietro , Mencarelli Francesca , Marsciani Martino , Dall’Amico Roberto , Montini Giovanni 
Published: February 2013

OBJECTIVE:
To evaluate the yield, economic, and radiation costs of 5 diagnostic algorithms compared with a protocol where all tests are performed (ultrasonography scan, cystography, and late technetium99dimercaptosuccinic acid scan) in children after the first febrile urinary tract infections.

METHODS:
A total of 304 children, 2 to 36 months of age, who completed the diagnostic follow-up (ultrasonography, cystourethrography, and acute and late technetium99dimercaptosuccinic acid scans) of a randomized controlled trial (Italian Renal Infection Study 1) were eligible. The guidelines applied to this cohort in a retrospective simulation were: Melbourne Royal Children’s Hospital, National Institute of Clinical Excellence (NICE), top down approach, American Academy of Pediatrics (AAP), and Italian Society of Pediatric Nephrology. Primary outcomes were the yield of abnormal tests for each diagnostic protocol; secondary outcomes were the economic and radiation costs.

RESULTS:
Vesicoureteral reflux (VUR) was identified in 66 (22%) children and a parenchymal scarring was identified in 45 (15%). For detection of VUR (47/66) and scarring (45/45), the top down approach showed the highest sensitivity (76% and 100%, respectively) but also the highest economic and radiation costs (€52 268. 624 mSv). NICE (19/66) and AAP (18/66) had the highest specificities for VUR (90%) and the Italian Society of Pediatric Nephrology had the highest specificity (20/45) for scars (86%). NICE would have been the least costly (€26 838) and AAP would have resulted in the least radiation exposure (42 mSv).

CONCLUSIONS:
There is no ideal diagnostic protocol following a first febrile urinary tract infection. An aggressive protocol has a high sensitivity for detecting VUR and scarring but carries high financial and radiation costs with questionable benefit.
Interns' Success With Clinical Procedures in Infants After Simulation Training
Authors: Kessler David O. , Arteaga Grace , Ching Kevin , Haubner Laura , Kamdar Gunjan , Krantz Amanda , Lindower Julie , Miller Michael , Petrescu Matei , Pusic Martin V. , Rocker Joshua , Shah Nikhil , Strother Christopher , Tilt Lindsey , Weinberg Eric R. , Chang Todd P. , Fein Daniel M. , Auerbach Marc 
Published: February 2013

BACKGROUND AND OBJECTIVE:
Simulation-based medical education (SBME) is used to teach residents. However, few studies have evaluated its clinical impact. The goal of this study was to evaluate the impact of an SBME session on pediatric interns’ clinical procedural success.

METHODS:
This randomized trial was conducted at 10 academic medical centers. Interns were surveyed on infant lumbar puncture (ILP) and child intravenous line placement (CIV) knowledge and watched audiovisual expert modeling of both procedures. Participants were randomized to SBME mastery learning for ILP or CIV and for 6 succeeding months reported clinical performance for both procedures. ILP success was defined as obtaining a sample on the first attempt with &lt;1000 red blood cells per high-power field or fluid described as clear. CIV success was defined as placement of a functioning catheter on the first try. Each group served as the control group for the procedure for which they did not receive the intervention.

RESULTS:
Two-hundred interns participated (104 in the ILP group and 96 in the CIV group). Together, they reported 409 procedures. ILP success rates were 34% (31 of 91) for interns who received ILP mastery learning and 34% (25 of 73) for controls (difference: 0.2% [95% confidence interval: –0.1 to 0.1]). The CIV success rate was 54% (62 of 115) for interns who received CIV mastery learning compared with 50% (58 of 115) for controls (difference: 3% [95% confidence interval: –10 to 17]).

CONCLUSIONS:
Participation in a single SBME mastery learning session was insufficient to affect pediatric interns’ subsequent procedural success.
Trends in Resource Utilization for Hospitalized Children With Skin and Soft Tissue Infections
Authors: Lopez Michelle A. , Cruz Andrea T. , Kowalkowski Marc A. , Raphael Jean L. 
Published: February 2013

OBJECTIVE:To describe trends in national resource utilization for pediatric skin and soft tissue infection (SSTI) hospitalizations.METHODS:This was a cross-sectional analysis of hospital discharges from 1997 to 2009 within the Healthcare Cost and Utilization Project Kids’ Inpatient Database for children with isolated SSTIs. Outcomes examined included patient and hospital characteristics, number of hospitalizations, and resource utilization including length of stay (LOS), hospital charges, and performance of incision and drainage (I&D). Trends in resource utilization were assessed by using linear regression in a merged data set with survey year as the primary independent variable. Multivariate logistic regression was conducted for 2009 data to assess factors associated with increased I&D.RESULTS:The weighted proportion of SSTI hospitalizations among all hospitalizations doubled (0.46% vs 1.01%) from 1997 to 2009. During the same period, patient demographic trends included a shift to increased hospitalizations in infant and preschool-age groups as well as publicly insured children. Mean LOS decreased from 3.11 to 2.71 days. Increased resource utilization included changes in mean charges from $6722 to $11 534 per hospitalization and a twofold increase in I&D (21% to 44%). Factors associated with I&D include young age, African American race, female gender, publicly or uninsured children, and southern region of the United States.CONCLUSIONS:SSTI is responsible for an emerging increase in health services utilization. Additional study is warranted to identify interventions that may effectively address this public health burden.
Growth Outcomes of Weight Faltering in Infancy in ALSPAC
Authors: ud Din Zia , Emmett Pauline , Steer Colin , Emond Alan 
Published: February 2013

OBJECTIVE:The goal of this study was to investigate growth outcomes in term infants with weight faltering.METHODS:Conditional weight gain was calculated on term infants from the Avon Longitudinal Study of Parents and Children. Cases of weight faltering were infants with a conditional weight gain below the fifth centile. Outcome growth measurements included weight and length/height (from 9 months to 13 years), BMI, mid-arm circumference, and waist circumference (at 7, 10, and 13 years).RESULTS:Weight data were available on 11 499 infants; 507 had “early” weight faltering (before 8 weeks), and 480 had “late” weight faltering (between 8 weeks and 9 months). The early group showed enhanced weight gain from 8 weeks until 2 years, then gained weight at the same rate as the controls. Gain in height was proportionally slower than gain in weight through childhood. By 13 years, they had BMI, mid-arm circumference, and waist circumference similar to the controls. The late group showed steady weight gain throughout childhood; enhanced weight gain compared with the controls only occurred between 7 and 10 years. Gain in height was proportional to gain in weight. This group remained considerably lighter and shorter than the controls up to the age of 13 years.CONCLUSIONS:Children with weight faltering before 8 weeks showed a different pattern of “catch-up” to those with weight faltering later in infancy. By 13 years, the anthropometric profile of the 2 groups was within population norms.
Practices of Unregulated Tanning Facilities in Missouri: Implications for Statewide Legislation
Authors: Balaraman Brundha , Biesbroeck Lauren K. , Lickerman Stephanie H. , Cornelius Lynn A. , Jeffe Donna B. 
Published: February 2013

BACKGROUND:The incidence of skin cancer has increased in the United States, concomitant with increased UV radiation (UVR) exposure among young adults. We examined whether tanning facilities in Missouri, a state without indoor-tanning regulations, acted in accordance with the Food and Drug Administration’s recommendations and consistently imparted information to potential clients about the known risks of UVR.METHODS:We conducted a statewide telephone survey of randomly selected tanning facilities in Missouri. Each tanning facility was surveyed twice, in the morning (7 am–3 pm) and evening (3–10 pm), on different days, to determine intrasalon consistency of information provided to potential clients at different times.RESULTS:On average, 65% of 243 tanning-facility operators would allow children as young as 10 or 12 years old to use indoor-tanning devices, 80% claimed that indoor tanning would prevent future sunburns, and 43% claimed that there were no risks associated with indoor tanning. Intrasalon inconsistencies involved allowable age of use, and UVR exposure type and duration. Morning tanning-facility employees were more likely to allow consumers to start with maximum exposure times and UV-A–emitting devices (P &lt; .001), whereas evening employees were more likely to allow 10- or 12-year-old children to use indoor-tanning devices (P = .008).CONCLUSIONS:Despite increasing evidence that UVR exposure in indoor-tanning devices is associated with skin cancer, ocular damage, and premature photoaging, tanning facilities in Missouri often misinformed consumers regarding these risks and lack of health benefits and inconsistently provided information about the Food and Drug Administration’s guidelines for tanning devices.
Chest Compression Quality Over Time in Pediatric Resuscitations
Authors: Badaki-Makun Oluwakemi , Nadel Frances , Donoghue Aaron , McBride Michael , Niles Dana , Seacrist Thomas , Maltese Matthew , Zhang Xuemei , Paridon Stephen , Nadkarni Vinay M. 
Published: February 2013

BACKGROUND:
Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models.

METHODS:
This was a prospective randomized crossover study of 45 in-hospital rescuers performing 10 minutes of single-rescuer continuous compressions on each manikin. An accelerometer recorded compression quality measures over 30-second epochs. Work and power were calculated from recorded force data. A modified visual analogue scale measured fatigue. Data were analyzed by using linear mixed-effects models and Cox regression analysis.

RESULTS:
A total of 88 484 compression cycles were analyzed. Percent adequate CCs/epoch (rate ≥ 100/minute, depth ≥ 38 mm) fell over 10 minutes (child: from 85.1% to 24.6%, adult: from 86.3% to 35.3%; P = .15) and were &lt;70% in both by 2 minutes. Peak work per compression cycle was 13.1 J in the child and 14.3 J in the adult (P = .06; difference, 1.2 J; 95% confidence interval, −0.05 to 2.5). Peak power output was 144.1 W in the child and 166.5 W in the adult (P &lt; .001; difference, 22.4 W, 95% confidence interval, 9.8–35.0).

CONCLUSIONS:
CC quality deteriorates similarly in child and adult manikin models. Peak work per compression cycle is comparable in both. Peak power output is analogous to that generated during intense exercise such as running. CC providers should switch every 2 minutes as recommended by current guidelines.
Maternal Alcohol Use and Sudden Infant Death Syndrome and Infant Mortality Excluding SIDS
Authors: O’Leary Colleen M. , Jacoby Peter J. , Bartu Anne , D’Antoine Heather , Bower Carol 
Published: February 2013

BACKGROUND:
Improvements in the rate of infant mortality (death in first year of life) have not occurred in recent years. This study investigates the association between maternal alcohol-use disorder and sudden infant death syndrome (SIDS) and infant mortality not classified as SIDS using linked, population-based health and mortality data.

METHODS:
Exposed mothers were identified through the presence of an International Classification of Diseases 9/10 alcohol diagnosis, a proxy for alcohol-use disorder, recorded on health, mental health, and/or drug and alcohol datasets (1983–2005). Comparison mothers without an alcohol diagnosis were frequency matched to exposed mothers on maternal age within maternal race and year of birth of their children. All offspring with their birth recorded on the Midwives Notification System compose the exposed (n = 21 841) and comparison (n = 56 054) cohorts. Cases of SIDS (n = 303) and infant mortality excluding SIDS (n = 598) were identified through linkage with the Western Australian Mortality Register. Analyses were conducted by using Cox regression and results presented as adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).

RESULTS:
The highest risk of SIDS occurred when a maternal alcohol diagnosis was recorded during pregnancy (aHR 6.92, 95% CI 4.02–11.90) or within 1 year postpregnancy (aHR 8.61, 95% CI 5.04–14.69). An alcohol diagnosis recorded during pregnancy more than doubled the risk of infant deaths (excluding SIDS) (aHR 2.35, 95% CI 1.45–3.83). Maternal alcohol-use disorder is attributable for at least 16.41% (95% CI 9.73%–23.69%) of SIDS and 3.40% (95% CI 2.28%–4.67%) of infant deaths not classified as SIDS.

CONCLUSIONS:
Maternal alcohol-use disorder is a significant risk factor for SIDS and infant mortality excluding SIDS.
The Diagnosis and Management of Acute Otitis Media
Authors: Lieberthal Allan S. , Carroll Aaron E. , Chonmaitree Tasnee , Ganiats Theodore G. , Hoberman Alejandro , Jackson Mary Anne , Joffe Mark D. , Miller Donald T. , Rosenfeld Richard M. , Sevilla Xavier D. , Schwartz Richard H. , Thomas Pauline A. , Tunkel David E. 
Published: February 2013

This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships.The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem.
Oral Health Care for Children With Developmental Disabilities
Authors: Norwood Kenneth W. , Slayton Rebecca L. ,   COUNCIL ON CHILDREN WITH DISABILITIES,   SECTION ON ORAL HEALTH, Liptak Gregory S. , Murphy Nancy A. , Adams Richard C. , Burke Robert T. , Friedman Sandra L. , Houtrow Amy J. , Kalichman Miriam A. , Kuo Dennis Z. , Levy Susan Ellen , Norwood Kenneth W. , Turchi Renee M. , Wiley Susan E. , Segura Adriana , Boulter Suzanne , Clark Melinda , Gereige Rani , Krol David , Mouradian Wendy , Quinonez Rocio , Ramos-Gomez Francisco , Slayton Rebecca , Keels Martha Ann 
Published: February 2013

This Clinical Report was revised. See https://doi.org/10.1542/peds.2024-067603.
Children with developmental disabilities often have unmet complex health care needs as well as significant physical and cognitive limitations. Children with more severe conditions and from low-income families are particularly at risk with high dental needs and poor access to care. In addition, children with developmental disabilities are living longer, requiring continued oral health care. This clinical report describes the effect that poor oral health has on children with developmental disabilities as well as the importance of partnerships between the pediatric medical and dental homes. Basic knowledge of the oral health risk factors affecting children with developmental disabilities is provided. Pediatricians may use the report to guide their incorporation of oral health assessments and education into their well-child examinations for children with developmental disabilities. This report has medical, legal, educational, and operational implications for practicing pediatricians.
Braile Vena Cava Filter and Greenfield Filter in Terms of Centralization
Authors: Godoy José Maria Pereira de , Menezes da Silva Adinaldo A , Reis Luis Fernando , Miquelin Daniel , Torati José Luis Simon 
Published: February 2013

The aim of this study was to evaluate complications experienced during implantation of the Braile Vena Cava filter (VCF) and the efficacy of the centralization mechanism of the filter.
This retrospective cohort study evaluated all Braile Biomédica VCFs implanted from 2004 to 2009 in Hospital de Base Medicine School in São José do Rio Preto, Brazil. Of particular concern was the filter’s symmetry during implantation and complications experienced during the procedure. All the angiographic examinations performed during the implantation of the filters were analyzed in respect to the following parameters: migration of the filter, non-opening or difficulties in the implantation and centralization of the filter.
A total of 112 Braile CVFs were implanted and there were no reports of filter opening difficulties or in respect to migration. Asymmetry was observed in 1/112 (0.9%) cases. A statistically significant difference was seen on comparing historical data on decentralization of the Greenfield filter with the data of this study.
The Braile Biomédico filter is an evolution of the Greenfield filter providing improved embolus capture and better implantation symmetry.
Periodontal Bone Regeneration and the Er,Cr:YSGG Laser: A Case Report
Authors: Perio Douglas N. Dederich Cert 
Published: February 2013

Background:
Traditional methods of regenerating bone in periodontal bone defects have been partially successful and have involved numerous protocols and materials. More recently, it has been proposed that Er,Cr:YSGG laser energy may also be beneficial in the treatment of periodontal pockets, particularly in the regeneration of bone lost due to periodontal disease.

Case Description:
The purpose of this paper is to present a case report of the Er,Cr:YSGG laser being used to conservatively treat a recalcitrant periodontal pocket in the presence of a periodontal bone defect and that resulted in successful resolution of the pocket and significant radiographic bone fill at the 1 year recall visit.

Clinical Implications:

This protocol using the Er,Cr:YSGG laser for the treatment of periodontal loss of attachment and periodontal bone loss may represent a less invasive alternative than traditional open-flap periodontal surgery or the intrasulcular use of other more penetrating laser wavelengths.
Metabolic Effects of Bariatric Surgery in Patients With Moderate Obesity and Type 2 Diabetes
Authors: Kashyap Sangeeta R. , Bhatt Deepak L. , Wolski Kathy , Watanabe Richard M. , Abdul-Ghani Muhammad , Abood Beth , Pothier Claire E. , Brethauer Stacy , Nissen Steven , Gupta Manjula , Kirwan John P. , Schauer Philip R. 
Published: February 2013

OBJECTIVE
To evaluate the effects of two bariatric procedures versus intensive medical therapy (IMT) on β-cell function and body composition.

RESEARCH DESIGN AND METHODS
This was a prospective, randomized, controlled trial of 60 subjects with uncontrolled type 2 diabetes (HbA1c 9.7 ± 1%) and moderate obesity (BMI 36 ± 2 kg/m2) randomized to IMT alone, IMT plus Roux-en-Y gastric bypass, or IMT plus sleeve gastrectomy. Assessment of β-cell function (mixed-meal tolerance testing) and body composition was performed at baseline and 12 and 24 months.

RESULTS
Glycemic control improved in all three groups at 24 months (N = 54), with a mean HbA1c of 6.7 ± 1.2% for gastric bypass, 7.1 ± 0.8% for sleeve gastrectomy, and 8.4 ± 2.3% for IMT (P &lt; 0.05 for each surgical group versus IMT). Reduction in body fat was similar for both surgery groups, with greater absolute reduction in truncal fat in gastric bypass versus sleeve gastrectomy (−16 vs. −10%; P = 0.04). Insulin sensitivity increased significantly from baseline in gastric bypass (2.7-fold; P = 0.004) and did not change in sleeve gastrectomy or IMT. β-Cell function (oral disposition index) increased 5.8-fold in gastric bypass from baseline, was markedly greater than IMT (P = 0.001), and was not different between sleeve gastrectomy versus IMT (P = 0.30). At 24 months, β-cell function inversely correlated with truncal fat and prandial free fatty acid levels.

CONCLUSIONS
Bariatric surgery provides durable glycemic control compared with intensive medical therapy at 2 years. Despite similar weight loss as sleeve gastrectomy, gastric bypass uniquely restores pancreatic β-cell function and reduces truncal fat, thus reversing the core defects in diabetes.
Effect of hydrothermal treatment on the structure of an aluminosilicate polymer
Authors: Melar Jaroslav , Bednarik Vratislav , Slavik Roman , Pastorek Miroslav 
Published: February 2013

Abstract
The effect of hydrothermal treatment on the structure of an aluminosilicate polymer prepared by a polycondensation reaction between silicate and hydroxoaluminate in alkaline aqueous solution was studied. The structural changes were investigated using X-ray diffraction analysis, Fourier-transform infrared spectroscopy, scanning electron microscopy imaging and thermogravimetric analysis. The results indicated that the amorphous aluminosilicate polymer transformed into a crystalline product during the hydrothermal treatment at 145°C. The crystalline phase was identified as a mineral of the zeolite group, most likely phillipsite. This transformation required an alkaline environment during the hydrothermal treatment.