bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a Homeopathic Preparation for “Infantile Colic” and an Apparent Life-Threatening Event
Authors: Aviner Shraga , Berkovitch Matitiahu , Dalkian Hedva , Braunstein Rony , Lomnicky Yossef , Schlesinger Menachem 
Published: January 2010

OBJECTIVE:An apparent life-threatening event (ALTE) caused by ingestion of drugs or toxins has been reported rarely among infants. None of these agents was homeopathic medication. We report 11 infants who presented with an ALTE after ingestion of Gali-col Baby, a homeopathic agent indicated for “infantile colic.”METHODS:A retrospective case-control study was conducted. Charts of all infants who were younger than 1 year and were admitted with an ALTE from January 2005 through August 2008 to the pediatric division at the Barzilai Medical Center were reviewed. Age-matched infants who were admitted on the same dates for a reason other than ALTE served as a control group. Information on medications administered before admission was recorded.RESULTS:During the study period, 36 635 children visited the pediatric emergency department of the Barzilai Medical Center. There were 11 057 admissions to the pediatric division during this period, 115 of which were because of an ALTE. Eleven of these infants received Gali-col Baby before the event as opposed to none in the control group (P &lt; .005). Three infants received a significant overdose, compared with the manufacturer's recommended dosage. After a thorough investigation, no other presumptive causes for ALTE were found among the 11 infants.CONCLUSIONS:Gali-col Baby is associated with an ALTE in some infants. There are no published controlled trials on the efficacy or safety of its use; therefore, better control and supervision of Gali-col Baby and probably other homeopathic medications are needed to prevent possible serious adverse effects.
LDH Concentration in Nasal-Wash Fluid as a Biochemical Predictor of Bronchiolitis Severity
Authors: Laham Federico R. , Trott Amanda A. , Bennett Berkeley L. , Kozinetz Claudia A. , Jewell Alan M. , Garofalo Roberto P. , Piedra Pedro A. 
Published: January 2010

OBJECTIVE:
Because the decision to hospitalize an infant with bronchiolitis is often supported by subjective criteria and objective indicators of bronchiolitis severity are lacking, we tested the hypothesis that lactate dehydrogenase (LDH), which is released from injured cells, is a useful biochemical indicator of bronchiolitis severity.

PATIENTS AND METHODS:
We retrospectively analyzed a study of children &lt;24 months old presenting to the emergency department with bronchiolitis. Demographic, clinical information, nasal wash (NW), and serum specimens were obtained. NW samples were analyzed for respiratory viruses, caspase 3/7 activity, and a panel of cytokines and chemokines. Total LDH activity was tested in NW samples and sera.

RESULTS:
Of 101 enrolled children (median age: 5.6 months), 98 had NW specimens available. A viral etiology was found for 82 patients (83.6%), with respiratory syncytial virus (RSV) (66%) and rhinovirus (19%) being the most common viruses detected. Concentrations of LDH in NW specimens were independent from those in sera and were higher in children with RSV infection or with dual infection. Significant correlations were found between NW LDH and NW cytokines/chemokines. Similarly, NW LDH correlated with NW-caspase 3/7 activity (r = 0.75; P &lt; .001). In a multivariate analysis, NW LDH concentration in the upper quartile was significantly associated with a reduced risk of hospitalization (odds ratio: 0.19 [95% confidence interval: 0.05–0.68]; P = .011).

CONCLUSIONS:
NW LDH levels in young children with bronchiolitis varied according to viral etiology and disease severity. Values in the upper quartile were associated with ∼80% risk reduction in hospitalization, likely reflecting a robust antiviral response. NW LDH may be a useful biomarker to assist the clinician in the decision to hospitalize a child with bronchiolitis.
Nutrition Menu Labeling May Lead to Lower-Calorie Restaurant Meal Choices for Children
Authors: Tandon Pooja S. , Wright Jeffrey , Zhou Chuan , Rogers Cara Beth , Christakis Dimitri A. 
Published: January 2010

OBJECTIVE:
Our aim was to determine whether nutrition labeling on menus would lead to lower-calorie choices for children.

METHODS:
We performed a randomized, controlled experiment in a primary care pediatric clinic in Seattle, Washington. Parents of children 3 to 6 years of age presenting for an appointment were eligible. Parents were ineligible if they never ate fast food, if they were not English speaking, if their child was too sick, or if they had already participated. This was a convenience sample, with randomization performed in blocks of 6. Parents were presented with a McDonald's menu and were asked to select meals for themselves and their child. The menus were identical for both groups except for the presence of nutrition information for the intervention group.

RESULTS:
There were 99 participants, for a participation rate of 82%. There were no significant differences in demographic characteristics between the groups. Parents in the intervention arm ordered an average of 102 fewer calories for their children than did control subjects (567.1 cal vs 671.5 cal; P = .04). With adjustment for parent's gender, race, education, and BMI, fast food frequency, and child's BMI z score, the difference remained significant (P = .004). There was no difference in energy between the 2 groups in the parents' choices for themselves.

CONCLUSION:
This study is the first to suggest that labeled menus may lead to significantly lower calorie content in restaurant meals purchased for children.
Mixed-Handedness Is Linked to Mental Health Problems in Children and Adolescents
Authors: Rodriguez Alina , Kaakinen Marika , Moilanen Irma , Taanila Anja , McGough James J. , Loo Sandra , Järvelin Marjo-Riitta 
Published: January 2010

OBJECTIVE:
Problems with language and symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood and adolescence are often strongly linked to low scholastic performance. Early recognition of children who are at increased risk is necessary. Our objective was to determine whether mixed-handedness, which is associated with atypical cerebral laterality, is associated with language, scholastic, and ADHD symptoms in childhood and adolescence.

METHODS:
Prospective data come from the Northern Finland Birth Cohort 1986, a longitudinal, population-based birth cohort with assessments when children were 7 to 8 and 16 years of age (N = 7871). Teacher, parent, and/or adolescent reports were used to assess language difficulties, scholastic performance, and mental health, including ADHD symptoms.

RESULTS:
Mixed-handed children, relative to right-handed, had approximately a twofold increase in odds of having difficulties with language and scholastic performance at the age of 8 years. Eight years later, as 16-year-olds, adolescents had twofold increase in odds concerning difficulties in school with language and with ADHD symptoms. Mixed-handed children were more likely to have scores indicating probable psychiatric disturbance, including ADHD symptoms. As adolescents, mixed-handed children with previous behavioral problems were at considerably higher risk for scoring within the range of probable ADHD-inattention or ADHD-combined case. Mixed-handedness was associated with greater symptom severity in children and adolescents (P = .01) concerning psychiatric disturbance and ADHD inattention but not ADHD hyperactivity.

CONCLUSIONS:
The results indicate that mixed-handed children have a greater likelihood of having language, scholastic, and mental health problems in childhood and that these persist into adolescence. Thus, these results suggest that mixed-handedness, particularly in the presence of difficulties, could aid in the recognition of children who are at risk for stable problems. Additional research is needed to understand the connections between neural substrates related to atypical cerebral asymmetry, mixed-handedness, and mental health problems including ADHD symptoms.
Burden of Influenza-Related Hospitalizations Among Children With Sickle Cell Disease
Authors: Bundy David G. , Strouse John J. , Casella James F. , Miller Marlene R. 
Published: January 2010

OBJECTIVE:
Children with sickle cell disease (SCD) are considered to be at high risk for complications from influenza infection despite minimal published data that characterize the burden of influenza in this population. Our objectives were to (1) estimate the rate of influenza-related hospitalizations (IRHs) among children with SCD, (2) compare this rate with rates of children with cystic fibrosis (CF) and children with neither SCD nor CF, and (3) explore mechanisms that underlie these potentially preventable hospitalizations.

METHODS:
We analyzed hospitalizations from 4 states (California, Florida, Maryland, and New York) across 2 influenza seasons (2003–2004 and 2004–2005) from the Healthcare Cost and Utilization Project State Inpatient Databases. We included hospitalizations with a discharge diagnosis code for influenza in a child &lt;18 years of age. We used census data and disease prevalence estimates to calculate denominators and compare rates of IRH among children with SCD, CF, and neither disease.

RESULTS:
There were 7896 pediatric IRHs during the 2 influenza seasons. Of these, 159 (2.0%) included a co-occurring diagnosis of SCD. Annual rates of IRHs were 112 and 2.0 per 10 000 children with and without SCD, respectively, across both seasons. Children with SCD were hospitalized with influenza at 56 times (95% confidence interval: 48–65) the rate of children without SCD. Children with SCD had approximately double the risk of IRH compared with children with CF (risk ratio: 2.1 [95% confidence interval: 1.5–2.9]). IRHs among children with SCD were not longer, more costly, or more severe than IRHs among children without SCD; they were also rarely nosocomial and co-occurred with a diagnosis of asthma in 14% of cases.

CONCLUSIONS:
IRHs are substantially more common among children with SCD than among those without the disease, which supports the potential importance of vigorous influenza vaccination efforts that target children with SCD.
Children as Hematopoietic Stem Cell Donors
Authors:   COMMITTEE ON BIOETHICS
Published: January 2010

This Policy Statement was retired August 2018.In the past half-century, hematopoietic stem cell transplantation has become standard treatment for a variety of diseases in children and adults, including selected hematologic malignancies, immunodeficiencies, hemoglobinopathies, bone marrow failure syndromes, and congenital metabolic disorders. There are 3 sources of allogeneic hematopoietic stem cells: bone marrow, peripheral blood, and umbilical cord blood; each has its own benefits and risks. Children often serve as hematopoietic stem cell donors, most commonly for their siblings. HLA-matched biological siblings are generally preferred as donors because of reduced risks of transplant-related complications as compared with unrelated donors. This statement includes a discussion of the ethical considerations regarding minors serving as stem cell donors, using the traditional benefit/burden calculation from the perspectives of both the donor and the recipient. The statement also includes an examination of the circumstances under which a minor may ethically participate as a hematopoietic stem cell donor, how the risks can be minimized, what the informed-consent process should entail, the role for a donor advocate (or some similar mechanism), and other ethical concerns. The American Academy of Pediatrics holds that minors can ethically serve as stem cell donors when specific criteria are fulfilled.
COMSEP: An Overview of Its History, Mission, and Relationship to Pediatrics
Authors: Raszka William V. , White Christopher B. 
Published: January 2010

The reader may wonder, “What is COMSEP, and how does an article from COMSEP affect me?” COMSEP, the Council on Medical Student Education in Pediatrics, is a community of pediatric clerkship directors and other educators whose mission is to improve the health of children and their families by advancing the art and science of medical student education in pediatrics.1This is the first in what is envisioned to be a quarterly report from the COMSEP to the readership of Pediatrics. In writing these articles, we hope to accomplish 3 key objectives. First, we want to keep the readership updated on trends that could affect both practice and pediatric education, whether they involve the rise of the pediatric hospitalist service or use of electronic medical records. Second, we hope to share educational techniques or strategies that allow for efficient and effective teaching, particularly in community practice settings. Third, we wish to be a voice for the huge number of pediatric practitioners who are critical not only as role models but also as mentors for the next generation of pediatric care providers. To better understand who and what COMSEP is, this first article is dedicated to the history, structure, and fundamental principles of the organization.
Role of Lactobacillus in the Prevention of Antibiotic‐Associated Diarrhea: A Meta‐analysis
Authors: Kale‐Pradhan Pramodini B. , Jassaly Harjot K. , Wilhelm Sheila M. 
Published: January 2010

Study Objective. To evaluate the efficacy of a Lactobacillus probiotic singleagent regimen in preventing antibiotic‐associated diarrhea (AAD).Design. Meta‐analysis of 10 randomized, blinded, placebo‐controlled trials.Patients. A total of 1862 pediatric and adult patients who received a Lactobacillus single‐agent regimen or placebo for the prevention of AAD.Measurements and Main Results. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched from inception through May 2008 by two investigators independently using the following key words: probiotic, Lactobacillus, antibiotic‐associated diarrhea. Full reports published in English were included if the studies were randomized, blinded, and placebo‐controlled trials that evaluated the efficacy of Lactobacillus single‐agent regimens versus placebo in the prevention of AAD. Bibliographies of recent review articles and systematic reviews were hand searched. Quality of the studies was assessed by using the Jadad scoring system. Number of subjects, age, Lactobacillus regimen, follow‐up period, and occurrence of AAD were extracted into a standardized data collection form. Overall impact of Lactobacillus on AAD was compared with placebo by using a random‐effects model. Ten studies with a total of 1862 patients (50.4% male) met all criteria. Six studies included patients aged 18 years or older, whereas four included patients younger than 18 years (range 2 wks‐14 yrs). Jadad scores ranged from 2–5 (out of 5). The total daily dose of Lactobacillus ranged from 2 times 109 −4 times 1010 colony‐forming units and was administered throughout the entire antibiotic treatment (5–14 days) for all patients. The follow‐up period varied from 2 days‐3 months after the end of the probiotic regimen. The combined risk ratio (RR) of developing AAD was significantly lower with Lactobacillus compared with placebo (RR 0.35, 95% confidence interval [CI] 0.19‐0.67).In a subgroup analysis, this held true for adults but not pediatric patients (RR 0.24, 95% CI 0.08‐0.75 and RR 0.44, 95% CI 0.18‐1.08, respectively).Conclusion. Administration of a Lactobacillus single‐agent regimen as a prophylactic agent during antibiotic treatment reduced the risk of developing AAD compared with placebo in adults but not pediatric patients.
Effects of Oral Ziprasidone and Oral Haloperidol on QTc Interval in Patients with Schizophrenia or Schizoaffective Disorder
Authors: Miceli Jeffrey J. , Tensfeldt Thomas G. , Shiovitz Thomas , Anziano Richard , O'Gorman Cedric , Harrigan Rachel H. 
Published: January 2010

Study Objective. To characterize the effect of oral ziprasidone and haloperidol on the corrected QT (QTc) interval under steady‐state conditions.Design. Prospective, randomized, open‐label, parallel‐group study.Setting. Inpatient clinical research facility.Patients. Fifty‐nine adults (age range 25–59 yrs) with schizophrenia or schizoaffective disorder who had no clinically significant abnormality on electrocardiogram (ECG) at screening.Intervention. During period 1 (days −10 to −4), antipsychotic and anticholinergic drugs were tapered. On the first day (day −3) of period 2, the drugs were discontinued, and placebo was given for the next 3 days (days −2 to 0). On the last day (day 0) of period 2, serial baseline ECGs were collected. During period 3 (days 1–16), patients received escalating oral doses of ziprasidone and haloperidol to reach steady state. Period 4 (days 17–19) allowed for study drug washout and initiation of outpatient antipsychotic therapy; safety assessments were also performed during this period.Measurements and Results. At each steady‐state dose level, three ECGs and a serum or plasma sample were collected at the predicted time of peak exposure to the administered drug. Point estimates and 95% confidence intervals (CIs) were determined for the mean QTc interval at baseline and for the mean change from baseline in QTc at each steady‐state dose level. Mean changes from baseline in the QTc interval (msec) for ziprasidone were 4.5 (95% CI 1.9‐7.1), 19.5 (95% CI 15.5–23.4), and 22.5 (95% CI 15.7‐ 29.4) for steady‐state doses of 40, 160, and 320 mg/day, respectively; for haloperidol, −1.2 (95% CI −4.1‐1.7), 6.6 (95% CI 1.6–11.7), and 7.2 (95% CI 1.4–13.1) for steady‐state doses of 2.5, 15, and 30 mg/day. Although no patient in either treatment group experienced a QTc interval of 450 msec or greater, the QTc interval increased 30 msec or more in 11 and 17 ziprasidone‐treated patients at 160 and 320 mg/day, respectively, and in 3 and 5 haloperidol‐treated patients at 15 and 30 mg/day, respectively. Most treatment‐emergent adverse drug reactions were mild in intensity, and none were severe.Conclusion. The QTc interval in ziprasidone‐and haloperidol‐treated patients increased with dose. Treatment with high doses of ziprasidone or haloperidol did not result in any patient experiencing a QTc interval of 450 msec or greater.
Correlates of Insulin Injection Omission
Authors: Peyrot Mark , Rubin Richard R. , Kruger Davida F. , Travis Luther B. 
Published: January 2010

OBJECTIVE
The purpose of this study was to assess factors associated with patient frequency of intentionally skipping insulin injections.

RESEARCH DESIGN AND METHODS
Data were obtained through an Internet survey of 502 U.S. adults self-identified as taking insulin by injection to treat type 1 or type 2 diabetes. Multiple regression analysis assessed independent associations of various demographic, disease, and injection-specific factors with insulin omission.

RESULTS
Intentional insulin omission was reported by more than half of respondents; regular omission was reported by 20%. Significant independent risk factors for insulin omission were younger age, lower income and higher education, type 2 diabetes, not following a healthy diet, taking more daily injections, interference of injections with daily activities, and injection pain and embarrassment. Risk factors differed between type 1 and type 2 diabetic patients, with diet nonadherence more prominent in type 1 diabetes and age, education, income, pain, and embarrassment more prominent in type 2 diabetes.

CONCLUSIONS
Whereas most patients did not report regular intentional omission of insulin injections, a substantial number did. Our findings suggest that it is important to identify patients who intentionally omit insulin and be aware of the potential risk factors identified here. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to increase adherence to prescribed insulin regimens. This could improve clinical outcomes.
Effect of Periodontal Treatment on Glycemic Control of Diabetic Patients
Authors: Teeuw Wijnand J. , Gerdes Victor E.A. , Loos Bruno G. 
Published: January 2010

OBJECTIVE
There is growing evidence that periodontitis may affect general health. This study was assigned to explore the robustness of observations that periodontal therapy leads to the improvement of glycemic control in diabetic patients.

RESEARCH DESIGN AND METHODS
A literature search (until March 2009) was carried out using two databases (MEDLINE and the Cochrane Library) with language restriction to English. Selection of publications was based on 1) original investigations, 2) controlled periodontal intervention studies where the diabetic control group received no periodontal treatment, and 3) study duration of ≥3 months.

RESULTS
Screening of the initial 639 identified studies and reference checking resulted in five suitable articles. A total of 371 patients were included in this analysis with periodontitis as predictor and the actual absolute change in A1C (ΔA1C) as the outcome. The duration of follow-up was 3–9 months. All studies described a research population of type 2 diabetic patients in whom glycemic control improved after periodontal therapy compared with the control group (range ΔA1C: Δ−1.17 up to Δ−0.05%). The studies in a meta-analysis demonstrated a weighted mean difference of ΔA1C before and after therapy of −0.40% (95% CI −0.77 to −0.04%, P = 0.03) favoring periodontal intervention in type 2 diabetic patients. Nevertheless, this improvement in %A1C must be interpreted with care due to limited robustness as evidenced by heterogeneity among studies (59.5%, P = 0.04).

CONCLUSIONS
The present meta-analysis suggests that periodontal treatment leads to an improvement of glycemic control in type 2 diabetic patients for at least 3 months.
Rethink Organization to iMprove Education and Outcomes (ROMEO)
Authors: Trento Marina , Gamba Silvia , Gentile Luigi , Grassi Giorgio , Miselli Valerio , Morone Gabriel , Passera Pietro , Tonutti Laura , Tomalino Marco , Bondonio Piervincenzo , Cavallo Franco , Porta Massimo ,   for the ROMEO Investigators
Published: January 2010

OBJECTIVE
A trial was performed to establish whether our group care model for lifestyle intervention in type 2 diabetes can be exported to other clinics.

RESEARCH DESIGN AND METHODS
This study was a 4-year, two-armed, multicenter controlled trial in 13 hospital-based diabetes clinics in Italy (current controlled trials no. ISRCTN19509463). A total of 815 non–insulin-treated patients aged &lt;80 years with ≥1 year known diabetes duration were randomized to either group or individual care.

RESULTS
After 4 years, patients in group care had lower A1C, total cholesterol, LDL cholesterol, triglycerides, systolic and diastolic blood pressure, BMI, and serum creatinine and higher HDL cholesterol (P &lt; 0.001, for all) than control subjects receiving individual care, despite similar pharmacological prescriptions. Health behaviors, quality of life, and knowledge of diabetes had become better in group care patients than in control subjects (P &lt; 0.001, for all).

CONCLUSIONS
The favorable clinical, cognitive, and psychological outcomes of group care can be reproduced in different clinical settings.