bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Parents Understand Growth Charts? A National, Internet-Based Survey
Authors: Ben-Joseph Elana Pearl , Dowshen Steven A. , Izenberg Neil 
Published: September 2009

OBJECTIVE: The objective of this study was to assess parental knowledge and understanding of growth charts.
METHODS: An online survey was conducted with 1000 parents selected to be demographically representative of the US population. Questions explored awareness of, knowledge of, and attitudes toward growth monitoring, as well as the ability to interpret growth chart data.
RESULTS: Seventy-nine percent of parents surveyed claimed to have seen a growth chart before, with the majority thinking that they understood it well. Sixty-four percent of parents thought it was important to be shown growth charts to see how their child was growing, and 40% expressed the need to see their child's growth chart as confirmation of their health care provider's verbal interpretation. However, when provided with multiple-choice questions and answers, only 64% could identify a child's weight when shown a plotted point on a growth chart. Ninety-six percent had heard of the term “percentile,” but only 68% identified the percentile of the plotted point, and only 56% could identify the definition of percentile. Up to 77% interpreted incorrectly charts containing height/weight measurements in tandem.
CONCLUSIONS: Although growth charts are used frequently as visual aids to educate parents about their children's growth, many parents cannot comprehend the data. This finding is significant because many parents prefer to be shown growth charts by their health care provider, and many parents report recording their children's measurements on growth charts at home.
Relationship of Serum S100B Levels and Intracranial Injury in Children With Closed Head Trauma
Authors: Bechtel Kirsten , Frasure Sarah , Marshall Clement , Dziura James , Simpson Christine 
Published: September 2009

OBJECTIVE: To determine if serum levels of S100B are higher in children with CHT and ICI as detected by cranial CT and if long bone fractures affect the level of S100B in children with CHT and skeletal injury.
METHODS: Children &lt;18 years of age who presented to an urban pediatric emergency department or were transferred from a referral hospital within 6 hours after accidental closed head trauma and who underwent cranial computed tomography were enrolled prospectively. Mean serum S100B levels for children with or without intracranial injury (ICI) and long-bone fractures were evaluated through analysis of covariance.
RESULTS: One hundred fifty-two children, 24 with ICI and 128 without ICI, were enrolled prospectively. Twenty-five children had long-bone fractures. Children with ICI were significantly younger than those without ICI (6.9 vs 9.8 years; P = .01). The time of venipuncture after injury was significantly later in children with ICI (P = .03). Mean S100B levels were significantly greater for children with ICI (212.9 vs 84.4 ng/L; P = .001), children with long-bone fractures (P = .008), and nonwhite children (P = .03). After controlling for time of venipuncture, long-bone fractures, and race, mean S100B levels were still greater for children with ICI (409 vs 118 ng/L; P = .001). The ability of serum S100B measurements to detect ICI, determined as the area under the curve, was 0.67.
CONCLUSIONS: After controlling for time of venipuncture, long-bone fractures, and race, S100B levels were still higher in children with ICI than in those without ICI. However, the ability of serum S100B measurements to detect ICI was poor.
Systematic Review of Screening for Bilirubin Encephalopathy in Neonates
Authors: Trikalinos Thomas A. , Chung Mei , Lau Joseph , Ip Stanley 
Published: September 2009

CONTEXT: Severe neonatal hyperbilirubinemia is associated with chronic bilirubin encephalopathy (kernicterus).
OBJECTIVE: To systematically review the effectiveness of specific screening modalities to prevent neonatal bilirubin encephalopathy.
METHODS: We identified studies through Medline searches, perusing reference lists and by consulting with US Preventive Services Task Force lead experts. We included English-language publications evaluating the effects of screening for bilirubin encephalopathy using early total serum bilirubin (TSB), transcutaneous bilirubin (TcB) measurements, or risk scores. Severe hyperbilirubinemia was used as a surrogate for possible chronic bilirubin encephalopathy, because no studies directly evaluated the latter as an outcome. We calculated the sensitivity and specificity of early TSB, TcB measurements, or risk scores in detecting hyperbilirubinemia.
RESULTS: Ten publications (11 studies) were eligible. Seven (2 prospective) studies evaluated the ability of risk factors (n = 3), early TSB (n = 3), TcB (n = 2), or combinations of risk factors and early TSB (n = 1) to predict hyperbilirubinemia (typically TSB &gt; 95th hour-specific percentile 24 hours to 30 days postpartum). Screening had good ability to detect hyperbilirubinemia: reported area-under-the-curve values ranged between 0.69 and 0.84, and reported sensitivities and specificities suggested similar diagnostic ability. Indirect evidence from 3 descriptive uncontrolled studies suggests favorable associations between initiation of screening and decrease in hyperbilirubinemia rates, and rates of treatment or readmissions for hyperbilirubinemia compared with the baseline of no screening. No study assessed harms of screening.
CONCLUSIONS: Effects of screening on the rates of bilirubin encephalopathy are unknown. Although screening can predict hyperbilirubinemia, there is no robust evidence to suggest that screening is associated with favorable clinical outcomes.
Research During Pediatric Residency Training: Outcome of a Senior Resident Block Rotation
Authors: Vinci Robert J. , Bauchner Howard , Finkelstein Jonathan , Newby P. K. , Muret-Wagstaff Sharon , Lovejoy Frederick H. 
Published: September 2009

BACKGROUND: The Pediatric Residency Review Committee requires programs to provide a curriculum that advances residents' knowledge of the basic principles of research. In July 2002, the Boston Combined Residency Program instituted a 3-month career-development block (CDB) rotation. During the rotation residents pursue an academic or clinical project under mentorship by a faculty member.OBJECTIVE: Our objective for this study was to evaluate the outcome of the CDB rotation since it was implemented.METHODS: A survey was administered to 165 residents who completed the CDB rotation.RESULTS: Of 165 residents, 136 (82%) responded to the survey. Of 122 residents who reported the type of project they conducted, 59 (48%) completed a clinical/health services project, 24 (20%) completed a project in education or curriculum development, and 7 (6%) worked in basic science. Thirty-five residents (27%) received funding to support their work. Thirty-five residents (26%) presented at national meetings such as the Pediatric Academic Societies Meeting. Fifteen (11%) residents have had manuscripts accepted for publication, and 22 (16%) additional residents have submitted manuscripts for publication. Factors associated with successful publication included having received funding (odds ratio: 3.37 [95% confidence interval: 1.34–8.42]) and the nature of the research project (odds ratio: 3.55 [95% confidence interval: 1.40–9.04]). The majority of residents (84%) stated that the CDB rotation enhanced residency training.CONCLUSIONS: A dedicated academic rotation that includes protected time, senior faculty mentorship, and program funding, can lead to productive research accomplishments by pediatric residents. Support of academic work during residency training may encourage engagement in a variety of academically oriented activities.
Family-Based Treatment of Severe Pediatric Obesity: Randomized, Controlled Trial
Authors: Kalarchian Melissa A. , Levine Michele D. , Arslanian Silva A. , Ewing Linda J. , Houck Patricia R. , Cheng Yu , Ringham Rebecca M. , Sheets Carrie A. , Marcus Marsha D. 
Published: September 2009

OBJECTIVE: We evaluated the efficacy of family-based, behavioral weight control in the management of severe pediatric obesity.
METHODS: Participants were 192 children 8.0 to 12.0 years of age (mean ± SD: 10.2 ± 1.2 years). The average BMI percentile for age and gender was 99.18 (SD: 0.72). Families were assigned randomly to the intervention or usual care. Assessments were conducted at baseline, 6 months, 12 months, and 18 months. The primary outcome was percent overweight (percent over the median BMI for age and gender). Changes in blood pressure, body composition, waist circumference, and health-related quality of life also were evaluated. Finally, we examined factors associated with changes in child percent overweight, particularly session attendance.
RESULTS: Intervention was associated with significant decreases in child percent overweight, relative to usual care, at 6 months. Intent-to-treat analyses documented that intervention was associated with a 7.58% decrease in child percent overweight at 6 months, compared with a 0.66% decrease with usual care, but differences were not significant at 12 or 18 months. Small significant improvements in medical outcomes were observed at 6 and 12 months. Children who attended ≥75% of intervention sessions maintained decreases in percent overweight through 18 months. Lower baseline percent overweight, better attendance, higher income, and greater parent BMI reduction were associated with significantly greater reductions in child percent overweight at 6 months among intervention participants.
CONCLUSIONS: Intervention was associated with significant short-term reductions in obesity and improvements in medical parameters and conferred longer-term weight change benefits for children who attended ≥75% of sessions.
Prediction of Birth Weight By Cotinine Levels During Pregnancy in a Population of Black Smokers
Authors: El-Mohandes Ayman A.E. , Kiely Michele , Gantz Marie G. , Blake Susan M. , El-Khorazaty M. Nabil 
Published: September 2009

OBJECTIVE: The goal was to investigate the association between maternal salivary cotinine levels (SCLs) and pregnancy outcomes among black smokers.METHODS: In a randomized, controlled trial conducted in 2001–2004 in Washington, DC, 714 women (126 active smokers [18%]) were tested for SCLs at the time of recruitment and later in pregnancy. Sociodemographic health risks and pregnancy outcomes were recorded.RESULTS: Birth weights were significantly lower for infants born to mothers with baseline SCLs of ≥20 ng/mL in comparison with &lt;20 ng/mL (P = .024), ≥50 ng/mL in comparison with &lt;50 ng/mL (P = .002), and ≥100 ng/mL in comparison with &lt;100 ng/mL (P = .002), in bivariate analyses. In linear regression analyses adjusting for sociodemographic and medical factors, SCLs of ≥20 ng/mL were associated with a reduction in birth weight of 88 g when SCLs were measured at baseline (P = .042) and 205 g when SCLs were measured immediately before delivery (P &lt; .001). Corresponding results were 129 g (P = .006) and 202 g (P &lt; .001) for ≥50 ng/mL and 139 g (P = .007) and 205 g (P &lt; .001) for ≥100 ng/mL. Gestational age was not affected significantly at any SCL, regardless of when SCLs were measured.CONCLUSIONS: Elevated SCLs early in pregnancy or before delivery were associated with reductions in birth weight. At any cutoff level, birth weight reduction was more significant for the same SCL measured in late pregnancy. Maintaining lower levels of smoking for women who are unable to quit may be beneficial.
Risk Factors for Lower Respiratory Tract Infection Death Among Infants in the United States, 1999–2004
Authors: Singleton Rosalyn J. , Wirsing Elisabeth A. , Haberling Dana L. , Christensen Krista Y. , Paddock Christopher D. , Hilinski Joseph A. , Stoll Barbara J. , Holman Robert C. 
Published: September 2009

OBJECTIVE: To describe maternal and birth-related risk factors associated with lower respiratory tract infection (LRTI) deaths among infants.METHODS: Records for infants with LRTI as a cause of death were examined by using the linked birth/infant death database for 1999–2004. Singleton infants dying with LRTI and a random sample of surviving singleton infants were compared for selected characteristics.RESULTS: A total of 5420 LRTI-associated infant deaths were documented in the United States during 1999–2004, for an LRTI-associated infant mortality rate of 22.3 per 100000 live births. Rates varied according to race; the rate for American Indian/Alaska Native (AI/AN) infants was highest (53.2), followed by black (44.1), white (18.7), and Asian/Pacific Islander infants (12.3). Singleton infants with low birth weight (&lt;2500 g) were at increased risk of dying with LRTI after controlling for other characteristics, especially black infants. Both AI/AN and black infants born with a birth weight of ≥2500 g were more likely to have died with LRTI than other infants of the same birth weight. Other risk factors associated with LRTI infant death included male gender, the third or more live birth, an Apgar score of &lt;8, unmarried mother, mother with &lt;12 years of education, mother &lt;25 years of age, and mother using tobacco during pregnancy.CONCLUSIONS: Low birth weight was associated with markedly increased risk for LRTI-associated death among all of the racial groups. Among infants with a birth weight of ≥2500 g, AI/AN and black infants were at higher risk of LRTI-associated death, even after controlling for maternal and birth-related factors. Additional studies and strategies should focus on the prevention of maternal and birth-related risk factors for postneonatal LRTI and on identifying additional risk factors that contribute to elevated mortality among AI/AN and black infants.
Screening of Infants for Hyperbilirubinemia to Prevent Chronic Bilirubin Encephalopathy: US Preventive Services Task Force Recommendation Statement
Authors:   US Preventive Services Task Force
Published: September 2009

DESCRIPTION: Recommendation on screening newborn infants, based on a recent supplemental review of a 2003 Agency for Healthcare Research and Quality evidence report on the effectiveness of various screening strategies for preventing the development of chronic bilirubin encephalopathy, performed at the request of the US Preventive Services Task Force (USPSTF). This topic has not been previously considered by the USPSTF.
METHODS: The USPSTF reviewed experimental and observational studies that included comparison groups. For harms associated with phototherapy, case reports or case series were also included.
CONCLUSION: The evidence is insufficient to assess the balance of benefits and harms of screening for hyperbilirubinemia to prevent chronic bilirubin encephalopathy (I statement).
Familial Factors Do not Confound the Association Between Birth Weight and Childhood Asthma
Authors: Örtqvist Anne Kristina , Lundholm Cecilia , Carlström Eva , Lichtenstein Paul , Cnattingius Sven , Almqvist Catarina 
Published: September 2009

OBJECTIVE: Studies have found associations between low birth weight and asthma. However, this association could be due to familial confounding. Our objective was to investigate whether fetal growth and birth weight affect the risk of asthma in childhood, controlling for gestational age (GA), and shared (familial) environment and genetic factors.
PATIENT AND METHODS: Information on asthma, zygosity, birth characteristics, and potential confounders was collected for all 9- and 12-year-old twins through the Swedish Twin Register and Medical Birth Register. To obtain an overall effect of birth weight on risk of asthma, we performed cohort analyses on all twins (N = 10918). To address genetic and shared environmental confounding, we performed a co-twin control analysis by using the 157 monozygotic and 289 dizygotic same-sex twin pairs who were discordant for asthma.
RESULTS: The overall rate of asthma ever was 13.7%. In the cohort analysis, the adjusted odds ratio (OR) for asthma in relation to a 1000-g decrease in birth weight was 1.57 (95% confidence interval [CI]: 1.38–1.79), and for each reduced gestational week the OR was 1.10 (95% CI: 1.07–1.13). In the co-twin control analyses, a 1000-g decrease in birth weight corresponded to an OR of 1.25 (95% CI: 0.74–2.10) for dizygotic same-sex twins and 2.42 (95% CI: 1.00–5.88) for monozygotic twins.
CONCLUSIONS: There is an association between fetal growth and childhood asthma that is independent of GA and shared (familial) environment and genetic factors, which indicates that fetal growth restriction affects lung development, supporting additional studies on the early metabolic and physiologic mechanisms of childhood asthma.
Neonatal S100B Protein Levels After Prenatal Exposure to Selective Serotonin Reuptake Inhibitors
Authors: Pawluski Jodi L. , Galea Liisa A.M. , Brain Ursula , Papsdorf Michael , Oberlander Tim F. 
Published: September 2009

OBJECTIVE: This study investigated neonatal S100B levels as a biomarker of prenatal selective serotonin reuptake inhibitor (SSRI) exposure.
METHODS: Maternal (delivery; N = 53) and neonatal (cord; N = 52) serum S100B levels were compared between prenatally SSRI-exposed (maternal, N = 36; neonatal, N = 37; duration: 230 ± 71 days) and nonexposed (maternal, N = 17; neonatal, N = 15) groups. Measures of maternal depression and anxiety symptoms were assessed during the third trimester (33–36 weeks), and neonatal outcomes, including Apgar scores, birth weight, gestational age at birth, and symptoms of poor neonatal adaptation, were recorded.
RESULTS: S100B levels were significantly lower in prenatally SSRI-exposed neonates than in nonexposed neonates, controlling for gestational age and third-trimester maternal mood (P = .036). In contrast, SSRI-exposed mothers had significantly higher maternal serum S100B levels, compared with nonexposed mothers (P = .014), even controlling for maternal mood in the third trimester. S100B levels were not associated with maternal or neonatal drug levels, duration of prenatal exposure, demographic variables, or risk for poor neonatal adaptation.
CONCLUSIONS: Prenatal SSRI exposure was associated with decreased neonatal serum S100B levels, controlling for prenatal maternal mood. Neonatal S100B levels did not reflect neonatal behavioral outcomes and were not related to pharmacologic indices. These findings are consistent with prenatal alcohol and cocaine exposures, which also alter central serotonin levels.
Policy Statement—Guidance for the Administration of Medication in School
Authors:   Council on School Health
Published: September 2009

This Policy Statement was revised. See https://doi.org/10.1542/peds.2024-066839.
Many children who take medications require them during the school day. This policy statement is designed to guide prescribing health care professionals, school physicians, and school health councils on the administration of medications to children at school. All districts and schools need to have policies and plans in place for safe, effective, and efficient administration of medications at school. Having full-time licensed registered nurses administering all routine and emergency medications in schools is the best situation. When a licensed registered nurse is not available, a licensed practical nurse may administer medications. When a nurse cannot administer medication in school, the American Academy of Pediatrics supports appropriate delegation of nursing services in the school setting. Delegation is a tool that may be used by the licensed registered school nurse to allow unlicensed assistive personnel to provide standardized, routine health services under the supervision of the nurse and on the basis of physician guidance and school nursing assessment of the unique needs of the individual child and the suitability of delegation of specific nursing tasks. Any delegation of nursing duties must be consistent with the requirements of state nurse practice acts, state regulations, and guidelines provided by professional nursing organizations. Long-term, emergency, and short-term medications; over-the-counter medications; alternative medications; and experimental drugs that are administered as part of a clinical trial are discussed in this statement. This statement has been endorsed by the American School Health Association.
Combined Endovascular/Surgical Management of a Ruptured Para-Anastomotic Aneurysm of the Left Common Iliac Artery#
Authors: Maras Dimitrios , Papas Theofanis T , Gekas Christos D , Psathas Chrisovalantis , Kotsikoris Ioannis , Nikolaou Achilleas , Pavlidis Polyvios , Andrikopoulos Vassilios 
Published: September 2009

A 75-year old man presented with signs and symptoms of acute abdomen and a clinical picture of hypovolemic shock. An emergency CT scan revealed a ruptured para-anastomotic left common iliac artery aneurysm. The patient had undergone an elective abdominal aortic aneurysm repair operation and placement of an aortoiliac bifurcated graft 10 years before. Para-anastomotic aneurysms had developed in all 3 (aortic and the 2 iliac) anastomosis. As the patient was highrisk, a combined endovascular/surgical approach was undertaken. The patient was discharged 4 days later.
This article discusses the applicability of endovascular procedures in emergency settings to high-risk patients.
The Impact of Combination Antiretroviral Therapy and its Interruption on Anxiety, Stress, Depression and Quality of Life in Thai Patients
Authors: Nüesch Reto , Gayet-Ageron Angèle , Chetchotisakd Ploenchan , Prasithsirikul Wisit , Kiertiburanakul Sasisopin , Munsakul Warangkana , Raksakulkarn Phitsanu , Tansuphasawasdikul Somboon , Chautrakarn Sineenart , Ruxrungtham Kiat , Hirschel Bernard , Anaworanich Jintanat 
Published: September 2009

Objective:Investigation on anxiety, stress, depression, and quality of life (QoL) within STACCATO, a randomised trial of two treatment strategies: CD4 guided scheduled treatment interruption (STI) compared to continuous treatment (CT).Participants:Thai patients with HIV-infection enrolled in the STACCATO trial.Methods:Anxiety, depression assessed by the questionnairesHospital Anxiety and Depression Scale(HADS) and DASS, stress assessed by theDepression Anxiety Stress Scale(DASS), and QoL evaluated by theHIV Medical Outcome Study(MOS-HIV) questionnaires. Answers to questionnaires were evaluated at 4 time-points: baseline, 24 weeks, 48 weeks and at the end of STACCATO.Results:A total of 251 patients answered the HADS/DASS and 241 answered the MOS-HIV of the 379 Thai patients enrolled into STACCATO (66.2 and 63.6% respectively). At baseline 16.3% and 7.2% of patients reported anxiety and depression using HADS scale. Using the DASS scale, 35.1% reported mild to moderate and 9.6% reported severe anxiety; 8.8% reported mild to moderate and 2.0% reported severe depression; 42.6% reported mild to moderate and 4.8% reported severe stress. We showed a significant improvement of the MHS across time (p=0.001), but no difference between arms (p=0.17). The summarized physical health status score (PHS) did not change during the trial (p=0.15) nor between arm (p=0.45). There was no change of MHS or PHS in the STI arm, taking into account the number of STI cycle (p=0.30 and 0.57) but MHS significant increased across time-points (p=0.007).Conclusion:Antiretroviral therapy improved mental health and QOL, irrespective of the treatment strategy.