bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motavizumab for Prophylaxis of Respiratory Syncytial Virus in High-Risk Children: A Noninferiority Trial
Authors: Carbonell-Estrany Xavier , Simões Eric A.F. , Dagan Ron , Hall Caroline B. , Harris Brian , Hultquist Micki , Connor Edward M. , Losonsky Genevieve A. ,   for the Motavizumab Study Group
Published: December 2009

OBJECTIVE: Palivizumab reduces respiratory syncytial virus (RSV) hospitalization in children at high risk by ∼50% compared with placebo. We compared the efficacy and safety of motavizumab, an investigational monoclonal antibody with enhanced anti-RSV activity in preclinical studies, with palivizumab.
METHODS: This randomized, double-blind, multinational, phase 3, noninferiority trial assessed safety and RSV hospitalization in 6635 preterm infants aged ≤6 months at enrollment or children aged ≤24 months with chronic lung disease of prematurity who received 15 mg/kg palivizumab or motavizumab monthly. Secondary end points included outpatient medically attended lower respiratory tract infections (MALRIs), RSV-specific LRIs, otitis media, antibiotic use, development of antimotavizumab antibodies, and motavizumab serum concentrations.
RESULTS: Motavizumab recipients had a 26% relative reduction in RSV hospitalization compared with palivizumab recipients, achieving noninferiority. Motavizumab was superior to palivizumab for reduction of RSV-specific outpatient MALRIs (50% relative reduction). Overall, adverse events (AEs) were not significantly different between groups. Cutaneous events were reported in 2 percentage points more motavizumab recipients (7.2% vs 5.1%); most were mild, but 0.3% resulted in dosing discontinuation. Antidrug antibodies (ADA) were detected in 1.8% of motavizumab recipients. Patients with anti-drug antibody reported 6 RSV events and 17 cutaneous events.
CONCLUSIONS: Children receiving prophylaxis with motavizumab or palivizumab had low rates of RSV hospitalization; motavizumab recipients experienced 50% fewer RSV MALRIs than palivizumab recipients. AEs were similar in both groups, although cutaneous AEs were higher for motavizumab recipients. Motavizumab may offer an improved alternative in prophylaxis for serious RSV disease in infants and children at high risk.
Effect of Domperidone on the Composition of Preterm Human Breast Milk
Authors: Campbell-Yeo Marsha L. , Allen Alexander C. , Joseph K. S. , Ledwidge Joyce M. , Caddell Kim , Allen Victoria M. , Dooley Kent C. 
Published: December 2009

OBJECTIVE: Domperidone is increasingly prescribed to improve breast milk volume despite a lack of evidence regarding its effects on breast milk composition. We examined the effect of domperidone on the nutrient composition of breast milk.
PATIENTS AND METHODS: Forty-six mothers who had delivered infants at &lt;31 weeks' gestation, who experienced lactation failure, were randomly assigned to receive domperidone or placebo for 14 days. Protein, energy, fat, carbohydrate, sodium, calcium, and phosphate levels in breast milk were measured on days 0, 4, 7, and 14, serum prolactin levels were measured on days 0, 4, and 14, and total milk volume was recorded daily. Mean within-subject changes in nutrients and milk volumes were examined.
RESULTS: Maternal and infant characteristics, serum prolactin level, and breast milk volume and composition were not significantly different between domperidone and placebo groups on day 0. By day 14, breast milk volumes increased by 267% in the domperidone-treated group and by 18.5% in the placebo group (P = .005). Serum prolactin increased by 97% in the domperidone group and by 17% in the placebo group (P = .07). Mean breast milk protein declined by 9.6% in the domperidone group and increased by 3.6% in the placebo group (P = .16). Changes in energy, fat, carbohydrate, sodium, and phosphate content were also not significantly different between groups. Significant increases were observed in breast milk carbohydrate (2.7% vs −2.7%; P = .05) and calcium (61.8% vs −4.4%; P = .001) in the domperidone versus placebo groups. No significant adverse events were observed among mothers or infants.
CONCLUSION: Domperidone increases the volume of breast milk of preterm mothers experiencing lactation failure, without substantially altering the nutrient composition.
Pediatric Specialists' Beliefs About Gastroesophageal Reflux Disease in Premature Infants
Authors: Golski Catherine A. , Rome Ellen S. , Martin Richard J. , Frank Scott H. , Worley Sarah , Sun Zhiyuan , Hibbs Anna Maria 
Published: December 2009

BACKGROUND: Wide variation exists in the treatment of suspected gastroesophageal reflux disease (GERD) in premature infants; it is unknown to what degree diagnosis and treatment are affected by the treating physician's medical specialty or interpretation of the medical literature.
METHODS: This study involved an online survey of board-certified neonatologists, pediatric pulmonologists, and pediatric gastroenterologists about their beliefs regarding the symptoms, diagnosis, and treatment of GERD in premature infants in the NICU on the basis of both clinical impression and interpretation of the literature.
RESULTS: A total of 1021 neonatologists, 232 pediatric pulmonologists, and 222 pediatric gastroenterologists participated in the study (47.5% response rate). There was disagreement among specialists in nearly all aspects of the survey. Pulmonologists were most likely to report that respiratory symptoms are caused by GERD (P &lt; .001). Neonatologists were least likely to report that a therapeutic trial of pharmacologic agents would be useful for diagnosing GERD (P &lt; .001) or that lansoprazole, ranitidine, or cimetidine are safe or effective (P &lt; .001). No pharmacologic therapy had &gt;50% of respondents supporting its effectiveness. There was moderate correlation between physician belief based on the medical literature and belief based on clinical impression (Spearman rank correlation: 0.47–0.75). For therapies supported by multiple meta-analyses in infants versus therapies with few infant trials, physicians rated the evidence for effectiveness similarly.
CONCLUSIONS: There is wide variation among pediatric specialists regarding beliefs about GERD in premature infants, as well as about the weight of evidence in the medical literature for this patient population. Physician beliefs do not seem to be driven by the degree of evidence in the neonatal literature. With no agreed-on standard of care in the setting of widespread use of antireflux medications, greater understanding is needed about the ways physicians form clinical impressions, access and process medical evidence, and apply it to patient care.
Clinical Utility of Rome Criteria Managing Functional Gastrointestinal Disorders in Pediatric Primary Care
Authors: Primavera Giuseppe , Amoroso Biagio , Barresi Alba , Belvedere Letizia , D'Andrea Cristina , Ferrara Dante , Cascio Antonina Lo , Rizzari Sara , Sanfilippo Elisa , Spataro Angelo , Zangara Daniela , Magazzù Giuseppe 
Published: December 2009

OBJECTIVE: Our goals were to demonstrate that functional gastrointestinal disorders (FGIDs) can be diagnosed in a positive fashion and managed by family pediatricians (FPs); to assess the compliance of FPs with a predefined diagnostic/therapeutic protocol for managing FGIDs to evaluate efficacy of continuing medical education; and to evaluate the success of reassurance by using a biopsychosocial model in comparison to drug treatment in an open-label, nonrandomized study.
PATIENTS AND METHODS: A total of 9291 patients, aged birth to 14 years, were prospectively enrolled during a 3-month period by 21 FPs. Follow-up was performed at 1-, 3-, and 12-month intervals. To assess compliance, after diagnosis, FPs that participated in the study were asked to comply with the diagnostic/therapeutic protocol and record investigations and treatment prescribed.
RESULTS: Two hundred sixty-one patients (2.8%) met Rome II criteria and were included in the study. In all cases but 4, diagnosis of FGIDs was confirmed at the end of follow-up (98.4%). Average compliance of FPs was &gt;80%. Among 56 patients treated only with the explanation of symptom and reassurance, 52 (92.8%) have reported success, in comparison with 26 of 35 patients (74.3%) treated with drugs (odds ratio: 4.5 [95% confidence interval: 1.3–16]).
CONCLUSIONS: FGIDs can be diagnosed and managed in primary care. Prospective studies in primary care allow assessment of compliance of pediatricians and implementation of what is learned in courses developed in continuing medical education. Informed reassurance and availability of FPs are more useful than over-the-counter drugs, which are often used for FGIDs.
Plasma Phthalate Levels in Pubertal Gynecomastia
Authors: Durmaz Erdem , Özmert Elif N. , Erkekoğlu Pınar , Giray Belma , Derman Orhan , Hıncal Filiz , Yurdakök Kadriye 
Published: December 2009

OBJECTIVE: Several untoward health effects of phthalates, which are a group of industrial chemicals with many commercial uses including personal-care products and plastic materials, have been defined. The most commonly used, di-(2-ethylhexyl)-phthalate (DEHP), is known to have antiandrogenic or estrogenic effects or both. Mono-(2-ethylhexyl)-phthalate (MEHP) is the main metabolite of DEHP. In this study, we aimed to determine the plasma DEHP and MEHP levels in pubertal gynecomastia cases.
PATIENTS AND METHODS: The study group comprised 40 newly diagnosed pubertal gynecomastia cases who were admitted to Hacettepe University Ihsan Doğramacı Children's Hospital. The control group comprised 21 age-matched children without gynecomastia or other endocrinologic disorder. Plasma DEHP and MEHP levels were measured by using high-performance liquid chromatography. Serum hormone levels were determined in some pubertal gynecomastia cases according to the physician's evaluation.
RESULTS: Plasma DEHP and MEHP levels were found to be statistically significantly higher in the pubertal gynecomastia group compared with the control group (P &lt; .001) (DEHP, 4.66 ± 1.58 and 3.09 ± 0.90 μg/mL, respectively [odds ratio: 2.77 (95% confidence interval: 1.48–5.21)]; MEHP, 3.19 ± 1.41 and 1.37 ± 0.36 μg/mL [odds ratio: 24.76 (95% confidence interval: 3.5–172.6)]). There was a statistically significant correlation between plasma DEHP and MEHP levels (r: 0.58; P &lt; .001). In the pubertal gynecomastia group, no correlation could be determined between plasma DEHP and MEHP levels and any of the hormone levels.
CONCLUSIONS: DEHP, which has antiandrogenic or estrogenic effects, may be an etiologic factor in pubertal gynecomastia. These results may pioneer larger-scale studies on the etiologic role of DEHP in pubertal gynecomastia.
Part-time Work Among Pediatricians Expands
Authors: Cull William L. , O'Connor Karen G. , Olson Lynn M. 
Published: December 2009

OBJECTIVE: The objective of this study was to track trends in part-time employment among pediatricians from 2000 to 2006 and to examine differences within subgroups of pediatricians.
METHODS: As part of the Periodic Survey of Fellows, national random samples of American Academy of Pediatrics members were surveyed in 2000, 2003, and 2006. These surveys shared questions concerning working part-time and other practice characteristics. Roughly 1600 pediatricians were included in each random sample. Totals of 812 (51%), 1020 (63%), and 1013 (62%) pediatricians completed the surveys in 2000, 2003, and 2006, respectively. Analyses were limited to nonretired, posttrainee pediatricians.
RESULTS: The number of pediatricians who reported that they work part-time increased from 15% in 2000, to 20% in 2003, to 23% in 2006. The pattern of increased part-time work from 2000 to 2006 held for many subgroups, including men, women, pediatricians who were younger than 40 years, pediatricians who were aged ≥50 years, pediatricians who worked in an urban inner city, pediatricians who worked in suburban areas, general pediatricians, and subspecialist pediatricians. Those who were working part-time were more satisfied within their professional and personal activities. Part-time pediatricians worked on average 14.3 fewer hours per week in direct patient care.
CONCLUSIONS: Increases in part-time work are apparent throughout pediatrics. The possible continued growth of part-time is an important trend within the field of pediatrics that will need to be monitored.
Emergency Department Reliance: A Discriminatory Measure of Frequent Emergency Department Users
Authors: Kroner Eric L. , Hoffmann Raymond G. , Brousseau David C. 
Published: December 2009

OBJECTIVE: High emergency department (ED) use has previously been defined as a person's having a large number of ED visits, implying that all frequent users are the same. ED reliance (EDR), the percentage of all health care visits that occur in the ED, considers ED use in relation to primary care use and, thus, may discriminate among high-ED-user populations. Our objective was to determine whether EDR, as a complementary use measure, could differentiate frequent users secondary to increased need for care from those with access issues.
METHODS: We conducted an analysis of prospectively collected data from the Medical Expenditure Panel Survey from 2000–2001 and 2001–2002. Frequent ED users were defined as having ≥2 ED visits, and EDR was dichotomized as high (&gt;0.33) or low (≤0.33). Odds of being a frequent user or having high EDR were analyzed by using logistic regression.
RESULTS: A total of 8823 children were included. Within frequent-ED-use populations, young children and children with special health care needs were less likely (odds ratio: 0.55 and 0.72, respectively) to have high EDR, whereas those with lower education, low income, and public insurance and those of black race were more likely to have high EDR.
CONCLUSIONS: EDR is a readily available measure in large administrative databases that discriminates among frequent-user populations, differentiating increased need for ED services from lack of access to quality primary care.
Adherence of Streptococcus mutans to Fiber-Reinforced Filling Composite and Conventional Restorative Materials
Authors: Lassila Lippo V.J , Garoushi Sufyan , Tanner Johanna , Vallittu Pekka K , Söderling Eva 
Published: December 2009

Objectives.
The aim was to investigate the adhesion of Streptococcus mutans (S. mutans) to a short glass fibers reinforced semi-IPN polymer matrix composite resin. The effect of surface roughness on adhesion was also studied. For comparison, different commercial restorative materials were also evaluated.

Materials and Methods.
Experimental composite FC resin was prepared by mixing 22.5 wt% of short E-glass fibers, 22.5 wt% of IPN-resin and 55 wt% of silane treated silica fillers using high speed mixing machine. Three direct composite resins (Z250, Grandio and Nulite), resin-modified glass ionomers (Fuji II LC), amalgam (ANA 2000), fiber-reinforced composite (FRC) (everStick and Ribbond), and pre-fabricated ceramic filling insert (Cerana class 1) were tested in this study. Enamel and dentin were used as controls. The specimens (n=3/group) with or without saliva were incubated in a suspension of S. mutans allowing initial adhesion to occur. For the enumeration of cells on the disc surfaces as colony forming units (CFU) the vials with the microbe samples were thoroughly Vortex-treated and after serial dilutions grown anaerobically for 2 days at +37°C on Mitis salivarius agars (Difco) containing bacitracin. Bacterial adhesion was also evaluated by using scanning electron microscopy. Surface roughness (Ra) of the materials was also determined using a surface profilometer. All results were statistically analyzed with one-way analysis of variance (ANOVA).

Results.
Composite FC resin and other commercial restorative materials showed similar adhesion of S. mutans, while adhesion to dentin and enamel was significantly higher (p<0.05). Surface roughness had no effect on bacterial adhesion. Saliva coating significantly decreased the adhesion for all materials (p<0.05). Composite FC resin had a significantly higher Ra value than control groups (p<0.05).

Conclusions.
Short fiber-reinforced composite with semi-IPN polymer matrix revealed similar S. mutans adhesion than commercial restorative materials.
Analysis of the Performance of a Standardized Method for the Polishing of Methacrylic Resins
Authors: Corsalini Massimo , Boccaccio Antonio , Lamberti Luciano , Pappalettere Carmine , Catapano Santo , Carossa Stefano 
Published: December 2009

Adhesion of micro-organisms to resin surface may be caused by inadequate polishing. Most of the studies published in literature are relative to manually prepared samples and do not take into account that test repeatability is not guaranteeda priorisince skills may change from one operator to another and the quality of the work done by the same expert operator may depend on “human” factors such as the level of attention, wrist trembling, etc.This paper aims to investigate on the efficiency and reliability of a standardized protocol for polishing methacrylic resins. For that purpose, five different methacrylic resins are considered. For each resin, 20 specimens are realized: 10 are polished by the same expert operator and 10 are polished by means of a mechanical system comprised of a milling tool, a mobile support for samples and a micrometric advance isoparallelometer. Roughness measurements are carried out with a ±0.01 µm resolution profilometer.An extensive statistical analysis is conducted on a population of 100 specimens. Two-way Analysis of Variance (ANOVA) is carried out taking the type of resin (i) and the polishing technique (ii) as predictors in order to evaluate how those variables will finally affect the roughness of the polished surface. The significance of the variable interaction term is assessed. The null hypothesis Ho where response is independent from individual factors as well as from their interaction is assumed to hold true forp-values>0.05 (interval of confidence of the 95%).Experimental data confirm that mechanical polishing leads to obtaining surfaces of much more uniform quality. In fact, statistical dispersion of roughness parameters can decrease significantly. This behavior is observed for all of the tested resins. Therefore, the new approach can eliminate the influence of “human” factors thus making it possible to assess the inherent features of each resin and compare different dental materials submitted to polishing.
Autoimmune myasthenia gravis in a ferret
Authors: Couturier Jérôme , Huynh Minh , Boussarie Didier , Cauzinille Laurent , Shelton G. Diane 
Published: December 2009

Abstract
Case Description—A 7-month-old neutered male ferret was evaluated for episodic pelvic limb weakness of 2 weeks' duration.
Clinical Findings—Neurologic examination revealed flaccid tetraparesis with decreased spinal reflexes suggestive of a neuromuscular disease. Results of hematologic and CSF analyses, thoracic radiography, and abdominal ultrasonography were unremarkable. Electrodiagnostic testing revealed subtle spontaneous activity localized to pelvic limb interosseous muscles, unremarkable motor nerve conduction velocities, and lower than typical compound muscle action potential (CMAP) amplitude for tibial nerve stimulation only. A severe decremental response of the CMAP was detected with repetitive nerve stimulation (45.5% at the third ulnar nerve). An esophagogram revealed mild megaesophagus. Intravenous neostigmine methylsulfate administration resulted in immediate resolution of muscle weakness. Cross-reacting anti-acetylcholine receptor (AChR) antibodies were detected in serum (0.35 nmol/L) by use of a canine- and feline-specific muscle extract. Clinical signs and ancillary test results were diagnostic of acquired myasthenia gravis.
Treatment and Outcome—Pyridostigmine bromide was administered (1 mg/kg [0.45 mg/lb], PO, q 8 h), resulting in complete remission of clinical signs. However, 1 month after the diagnosis, the ferret was euthanized because of recurrence of weakness despite anticholinesterase treatment.
Clinical Relevance—To the authors' knowledge, this is the first report of acquired myasthenia gravis in a ferret and the first identification of anti-AChR antibodies in this species. Autoimmune myasthenia gravis should be considered in ferrets when weakness and flaccid paresis suggest a neuromuscular disease. Electrodiagnostic testing, anticholinesterase challenge, and AChR antibody titer determination were helpful for diagnosis of this condition.
Systemic hypertension in a dog with a functional thyroid gland adenocarcinoma
Authors: Simpson Andrew C. , McCown Jennifer L. 
Published: December 2009

Abstract
Case Description—A 12-year-old 21.9-kg (48.48-lb) spayed female Alaskan Malamute with a long-term history of panting, polydypsia and polyuria, weight loss, hind limb weakness, and a decrease in appetite was evaluated for hypertension.
Clinical Findings—Use of Doppler sphygmomanometry revealed a systolic blood pressure of 250 mm Hg (mean value for 5 consecutive measurements). Palpation of the ventral cervical region revealed a fixed asymmetric mass in the area of the lobes of the thyroid gland. The portion of the mass on the right side was approximately 2 × 2 cm, whereas the portion of the mass on the left side was approximately 1 × 1.5 cm. Hyperthyroidism was diagnosed on the basis of high serum thyroxine concentrations. Thyroidectomy of both lobes of the gland was performed. Histologic examination revealed a bilateral, multilobulated, and encapsulated thyroid gland adenocarcinoma.
Treatment and Outcome—Thyroidectomy of both lobes of the gland was performed with clinical resolution of hypertension. The dog was treated postoperatively with chemotherapeutics, including doxorubicin and carboplatin, and external beam radiation. Calcium and thyroxine homeostasis fluctuated; however, the dog finally achieved concentrations within the respective reference ranges through the administration of calcitriol, calcium carbonate, and levothyroxine.
Clinical Relevance—This report describes concurrent hypertension in a dog with a functional thyroid gland adenocarcinoma with subsequent return of blood pressure values to within reference ranges after thyroidectomy.
Single element and competitive sorption of copper, zinc and lead onto a Luvisol profile
Authors: Sipos Péter 
Published: December 2009

Abstract
The sorption parameters of Cu, Zn and Pb are related to the composition of the different genetic horizons of a Luvisol profile in batch sorption experiments. The affinities of metals towards the soil samples from different horizons followed the same sequence, e.g. Pb≥C>>Zn. By far the highest metal retention was found in the Ck horizon due to the alkaline conditions. It is followed by the A horizon with its high organic matter content, while the lowest sorption capacity was found in the Bt horizon. In the horizons free of carbonate, primarily Pb and Cu were immobilized. The studied soil can be characterized by high amount of organic matter, clay accumulation horizon, as well as calcareous subsoil. This kind of profile development makes soils able to immobilize a significant metal pollution.