bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemodynamic instability during resection of pheochromocytoma in MEN versus non-MEN patients
Authors: Scholten Anouk , Vriens Menno R , Cromheecke Geert Jan E , Borel Rinkes Inne H M , Valk Gerlof D 
Published: April 2011

ObjectiveHemodynamic (HD) instability still underlies difficulties during pheochromocytoma resection. Little is known about HD instability in patients with multiple endocrine neoplasia (MEN) type 2-related pheochromocytoma. Our aim was to assess differences in HD during pheochromocytoma resection between MEN2 and non-MEN patients. In addition, we sought to identify risk factors for intraoperative HD instability.DesignRetrospective cohort study.MethodsA total of 22 MEN2 and 34 non-MEN patients underwent 61 pheochromocytoma resections at the University Medical Center Utrecht between 2000 and 2010. All MEN2-related pheochromocytomas were diagnosed by annual screening. HD instability was assessed by measuring the frequency of hypotensive (mean arterial blood pressure (MABP) <60 mmHg) and/or hypertensive (systolic arterial blood pressure (SABP) >200 mmHg) episodes.ResultsCompared with non-MEN patients, MEN2 patients were younger at diagnosis, had less symptoms, lower hormone levels, and smaller tumors. Intraoperatively, MEN2 patients had a similar frequency of hypertensive episodes (1.3 vs 1.9, P=0.162, 95% confidence interval (CI): −6.7 to 35.4) and a similar maximum SABP (200 vs 220 mmHg, P=0.180, 95% CI: −9.7 to 50.5). However, MEN2 patients experienced less frequent (1.04 vs 2.6, P=0.003, 95% CI: 0.57 to 2.6) and less severe hypotensive episodes after tumor resection (lowest MABP: 52.5 vs 45.6 mmHg, P=0.015, 95% CI: −12.6 to 1.16). Tumor size was an independent risk factor for HD instability for the total group after multivariate analysis.ConclusionMEN2 patients with pheochromocytoma, despite their smaller tumors, do not distinguish themselves from non-MEN patients in terms of hypertensive episodes during pheochromocytoma resection. Therefore, pretreatment with α- and β-blockade remains the standard of care in MEN2-related as well as in non-MEN-related pheochromocytomas.
Adolescent Chronic Fatigue Syndrome: Prevalence, Incidence, and Morbidity
Authors: Nijhof Sanne L. , Maijer Kimberley , Bleijenberg Gijs , Uiterwaal Cuno S. P. M. , Kimpen Jan L. L. , van de Putte Elise M. 
Published: April 2011

OBJECTIVE:
To determine nationwide general practitioner (GP)-diagnosed prevalence and pediatrician–diagnosed incidence rates of adolescent chronic fatigue syndrome (CFS), and to assess CFS morbidity.

DESIGN AND SETTING:
We collected data from a cross-sectional national sample among GPs and prospective registration of new patients with CFS in all pediatric hospital departments in the Netherlands.

PATIENTS AND METHODS:
Study participants were adolescents aged 10 to 18 years. A representative sample of GPs completed questionnaires on the prevalence of CFS in their adolescent patients. Pediatric hospital departments prospectively reported new cases of CFS in adolescent patients. For every new reported case, a questionnaire was sent to the reporting pediatrician and the reported patient to assess CFS morbidity. Prevalence was estimated through the data from GP questionnaires and incidence was estimated on the basis of cases newly reported by pediatricians from January to December 2008.

RESULTS:
Prevalence was calculated as 111 per 100 000 adolescents and incidence as 12 per 100 000 adolescents per year. Of newly reported patients with CFS, 91% scored at or above cutoff points for severe fatigue and 93% at or above the cutoff points for physical impairment. Forty-five percent of patients with CFS reported &gt;50% school absence during the previous 6 months.

CONCLUSIONS:
Clinically diagnosed incidence and prevalence rates show that adolescent CFS is uncommon compared with chronic fatigue. The primary adverse impact of CFS is extreme disability associated with considerable school absence.
Outcomes of Laparoscopic Versus Open Fundoplication in Children's Hospitals: 2005–2008
Authors: Fox David , Morrato Elaine , Campagna Elizabeth J. , Rees Daniel I. , Dickinson L. Miriam , Partrick David A. , Kempe Allison 
Published: April 2011

BACKGROUND:Fundoplication is a common pediatric surgery, but little data comparing the laparoscopic approach with the open approach have been published.OBJECTIVE:To compare infection rates, complication rates, length of stay, and cost for laparoscopic fundoplication versus open fundoplication among pediatric patients and to examine trends in utilization of laparoscopic fundoplication.METHODS:We used the Pediatric Health Information System database to conduct a retrospective study of children (aged &lt;19 years) admitted for a fundoplication between 2005 and 2008. Descriptive characteristics for those undergoing a laparoscopic and open fundoplication were compared. Multivariate regression with random effects specified at the hospital level was used to model the association between laparoscopic fundoplication and the outcomes.RESULTS:Fifty-six percent of 7083 fundoplication admissions had laparoscopic fundoplication. Median length of stay was 4 days for laparoscopic and 10 days for open fundoplication. The median cost of laparoscopic fundoplication was $13 003 versus $22 487 for open fundoplication. Laparoscopic fundoplication was associated with a 24% and 51% reduction in the adjusted odds of infection and surgical complications, respectively. The proportion of fundoplications performed laparoscopically increased from 51% in 2005 to 63% in 2008 (P &lt; .001), but there was no increase in the overall fundoplication rate.CONCLUSIONS:In a large study of children's hospitals, laparoscopic fundoplication was associated with improved outcomes compared with the open procedure, even after adjustment for patient severity. Laparoscopic fundoplication has become the most common form of antireflux surgery in children over 1 year of age, but this has not been associated with an increase in the overall utilization of the fundoplication procedure. These data have important implications for clinical practice and surgical training.
Preterm Birth and Attention-Deficit/Hyperactivity Disorder in Schoolchildren
Authors: Lindström Karolina , Lindblad Frank , Hjern Anders 
Published: April 2011

OBJECTIVE:
Previous studies have demonstrated an increased risk for attention-deficit/hyperactivity disorder (ADHD) in follow-up studies of preterm survivors from NICUs. In this study we analyzed the effect of moderate as well as extreme preterm birth on the risk for ADHD in school age, taking into account genetic, perinatal, and socioeconomic confounders.

METHODS:
Register study in a Swedish national cohort of 1 180 616 children born between 1987 and 2000, followed up for ADHD medication in 2006 at the age of 6 to 19 years. Logistic regression was used to test hypotheses. A within-mother-between-pregnancy design was used to estimate the importance of genetic confounding in a subpopulation of offspring (N = 34 334) of mothers who had given birth to preterm (≤34 weeks) as well as term infants.

RESULTS:
There was a stepwise increase in odds ratios for ADHD medication with increasing degree of immaturity at birth; from 2.1 (1.4–2.7) for 23 to 28 weeks' gestation, to 1.6 (1.4–1.7) for 29 to 32 weeks', 1.4 (1.2–1.7) for 33 to 34 weeks', 1.3 (1.1–1.4) for 35 to 36 weeks', and 1.1 (1.1–1.2) for 37 to 38 weeks' gestation compared with infants born at 39 to 41 weeks' gestation in the fully adjusted model. The odds ratios for the within-mother-between-pregnancy analysis were very similar. Low maternal education increased the effect of moderate, but not extreme, preterm birth on the risk for ADHD.

CONCLUSION:
Preterm and early term birth increases the risk of ADHD by degree of immaturity. This main effect is not explained by genetic, perinatal, or socioeconomic confounding, but socioeconomic context modifies the risk of ADHD in moderately preterm births.
Active Surveillance for Adverse Events: The Experience of the Vaccine Safety Datalink Project
Authors: Yih W. Katherine , Kulldorff Martin , Fireman Bruce H. , Shui Irene M. , Lewis Edwin M. , Klein Nicola P. , Baggs James , Weintraub Eric S. , Belongia Edward A. , Naleway Allison , Gee Julianne , Platt Richard , Lieu Tracy A. 
Published: April 2011

OBJECTIVE:
To describe the Vaccine Safety Datalink (VSD) project's experience with population-based, active surveillance for vaccine safety and draw lessons that may be useful for similar efforts.

PATIENTS AND METHODS:
The VSD comprises a population of 9.2 million people annually in 8 geographically diverse US health care organizations. Data on vaccinations and diagnoses are updated and extracted weekly. The safety of 5 vaccines was monitored, each with 5 to 7 prespecified outcomes. With sequential analytic methods, the number of cases of each outcome was compared with the number of cases observed in a comparison group or the number expected on the basis of background rates. If the test statistic exceeded a threshold, it was a signal of a possible vaccine-safety problem. Signals were investigated by using temporal scan statistics and analyses such as logistic regression.

RESULTS:
Ten signals appeared over 3 years of surveillance: 1 signal was reported to external stakeholders and ultimately led to a change in national vaccination policy, and 9 signals were found to be spurious after rigorous internal investigation. Causes of spurious signals included imprecision in estimated background rates, changes in true incidence or coding over time, other confounding, inappropriate comparison groups, miscoding of outcomes in electronic medical records, and chance. In the absence of signals, estimates of adverse-event rates, relative risks, and attributable risks from up-to-date VSD data have provided rapid assessment of vaccine safety to policy-makers when concerns about a specific vaccine have arisen elsewhere.

CONCLUSIONS:
Care with data quality, outcome definitions, comparison groups, and length of surveillance are required to enable detection of true safety problems while minimizing false signals. Some causes of false signals in the VSD system were preventable and have been corrected, whereas others will be unavoidable in any active surveillance system. Temporal scan statistics, analyses to control for confounding, and chart review are indispensable tools in signal investigation. The VSD's experience may inform new systems for active safety surveillance.
Tracking Vaccine-Safety Inquiries to Detect Signals and Monitor Public Concerns
Authors: Miller Elaine , Batten Brigid , Hampton Lee , Campbell Scott R. , Gao Jinrong , Iskander John 
Published: April 2011

BACKGROUND:
The Centers for Disease Control and Prevention frequently receives inquiries from health care providers, public health officials, and the general public seeking data or guidance on vaccine-safety issues. Past inquiries to public health authorities identified potential problems including viscerotropic illness rarely associated with yellow fever vaccination.

OBJECTIVE:
To systematically describe vaccine-safety inquiries received at the Centers for Disease Control and Prevention.

METHODS:
External and internal inquiries were recorded in a database from May 1, 2002 to May 31, 2009. Key variables analyzed included the source of the question, the type of information being sought, and the vaccine type(s) associated with the inquiry.

RESULTS:
A total of 983 vaccine-safety inquiries were answered and analyzed. Health care workers were the source of 43% of the questions, and the general public accounted for 19% of the questions. Nearly half of the requests (49%) concerned information about the Vaccine Adverse Event Reporting System, and nearly one-fourth (21%) were requests from providers for clinical guidance. The most frequent specific topics of inquiry and vaccines involved were neurologic adverse events (AEs) temporally associated with vaccination (17%) and safety of all vaccines or childhood vaccines (20%), respectively.

CONCLUSIONS:
Questions about rare but potentially serious AEs and general concerns about vaccine safety were encountered relatively frequently. The substantial number of clinically focused inquires may indicate a need for more provider support tools and resources. Tracking of inquiries can supplement information received through vaccine AE reporting and contribute to an enhanced scientific and communications response to vaccine-safety concerns.
Vaccine Attitudes, Concerns, and Information Sources Reported by Parents of Young Children: Results From the 2009 HealthStyles Survey
Authors: Kennedy Allison , Basket Michelle , Sheedy Kristine 
Published: April 2011

OBJECTIVE:
To describe the vaccine-related attitudes, concerns, and information sources of US parents of young children.

METHODS:
We calculated weighted proportions and 95% confidence intervals for vaccine-related attitudes, concerns, and information sources of parents with at least 1 child aged 6 years or younger who participated in the 2009 HealthStyles survey.

RESULTS:
The overall response rate for the survey was 65% (4556 of 7004); 475 respondents were parents or guardians (“parents”) of at least 1 child aged 6 years or younger. Among those respondents, nearly all (93.4%) reported that their youngest child had or would receive all recommended vaccines. The majority of parents reported believing that vaccines were important to children's health (79.8%) and that they were either confident or very confident in vaccine safety (79.0%). The vaccine-related concern listed most often by parents was a child's pain from the shots given in 1 visit (44.2%), followed by a child getting too many vaccines at 1 doctor's visit (34.2%). When asked to list their most important sources of information on vaccines, the most common response was a child's doctor or nurse (81.7%).

CONCLUSIONS:
To maintain and improve on the success of childhood vaccines in preventing disease, a holistic approach is needed to address parents' concerns in an ongoing manner. Listening and responding in ways and with resources that address specific questions and concerns could help parents make more informed vaccination decisions.
Racial and Ethnic Differences in Use of Intubation for Periviable Neonates
Authors: Tucker Edmonds Brownsyne , Fager Corinne , Srinivas Sindhu , Lorch Scott 
Published: April 2011

OBJECTIVE:
Racial/ethnic minorities report preferences for resuscitative care at the end of life. The main objective of this study was to determine if there are racial/ethnic differences in use of intubation for periviable neonates. We hypothesized that infants born to black and Hispanic women are more likely to be resuscitated compared with infants born to white women.

METHODS:
We conducted a retrospective cohort study of state-level maternal and infant hospital discharge data of women who delivered between 23.0 and 24.6 weeks' gestation linked to birth and death certificate data for California, Missouri, and Pennsylvania from 1995 to 2005 (N = 9632).

RESULTS:
Overall, 78.9% of the population was aged 18 to 35 years, and almost half were nulliparous; 19.4% of the women were black, 36.6% were Hispanic, and 33.4% were white. Approximately 30% had less than a high school education, and 49.2% were federally insured. Overall, 44.7% of periviable neonates were intubated. In multivariable analyses adjusting for sociodemographic characteristics, black and Hispanic race/ethnicity was significantly associated with neonatal intubation (odds ratios [ORs]: 1.14 [95% confidence interval (CI): 1.01–1.29] and 1.22 [95% CI: 1.10–1.36], respectively). In models controlling for clustering at the level of the delivery hospital, black race remained a predictor of neonatal intubation (OR: 1.25 [95% CI: 1.07–1.46]), but differences among Hispanics dissipated (OR: 1.12 [95% CI: 0.98–1.27]).

CONCLUSIONS:
Racial/ethnic differences exist in patterns of periviable resuscitation, which may reflect underlying differences in patient preference. Alternatively, institutional practices or resources may account for these differences. These findings have important implications for patient care and institutional practice. Our results lay the foundation for additional work to investigate how social, cultural, and institutional factors influence patient–provider decision-making regarding periviable care.
Comparative Salivary Proteomics of Cleft Palate Patients
Authors: Szabo Gyula Tamas , Tihanyi Reka , Csulak Fruzsina , Jambor Eva , Bona Agnes , Szabo Gyula , Mark Laszlo 
Published: April 2011

Objectives To investigate salivary proteins with proteomic technologies to evaluate protein composition differences between samples with cleft lip and palate and healthy controls. Design, Participants Matrix-assisted laser desorption/ionization tandem time-of-flight (MALDI TOF/TOF) mass spectrometry was used as a high-throughput analytical technique for identification of nonsyndromic cleft lip and palate stimulated salivary proteins. The samples consisted of two groups: 31 cleft lip and palate patients and a control group with 20 healthy volunteers. Results The presence of cleft lip and palate stimulated the expression of several proteins, included adaptor-related protein complex 3, dermokine, nidogen 1 precursor, transforming growth factor-β3, and a zinc finger RAN-binding domain containing 2. Conclusions The salivary proteome of cleft lip and palate patients differs from the protein composition of healthy control saliva samples. Several common secreted proteins such as actins, salivary cystatins, and keratins were upregulated by cleft; increased levels of TGF-β3 and dermokine were detected in the pathologic samples. The current proteomic results suggest keratinocyte activation among patients with cleft lip and palate. The score of our preliminary results suggests the hypothesis that identified salivary proteins are of vital clinical importance in tissue regeneration and the molecular repair mechanism seen in patients with cleft lip and palate.
Characterization of Obstructive Sleep Apnea before and after Tongue-Lip Adhesion in Children with Micrognathia
Authors: Sedaghat Ahmad R. , Anderson Iee Ching W. , Mcginley Brian M. , Rossberg Mark I. , Redett Richard J. , Ishman Stacey L. 
Published: April 2011

Objectives To characterize airway obstruction before and after tongue-lip adhesion in children with micrognathia using polysomnography. Design Retrospective pilot case series. Participants and Methods Evaluation of all children with micrognathia who underwent tongue-lip adhesion and polysomnography before and after surgery from 2002 to 2007 (N = 8). Results Eight children met inclusion criteria; six were girls. The mean interval between polysomnography and tongue-lip adhesion was 6 days (range, 2 to 13 days) preoperatively and 17 days (range, 5 to 32 days) postoperatively. Severe obstructive sleep apnea was identified in seven of eight (88%) children, with a mean preoperative obstructive apnea hypopnea index of 52.6 events per hour (range, 7.1 to 85.7 events per hour). None had significant central sleep apneas (>5 per hour). Tongue-lip adhesion resulted in a mean decrease of 34.5 events per hour (range, −65.8 to 71.6 events per hour). After tongue-lip adhesion, seven of eight (87.5%) patients had an improved obstructive apnea hypopnea index, with resolution of obstructive sleep apnea in one child and improvement to mild (two) and moderate (two) obstructive sleep apnea in four others. Only one child had an obstructive apnea hypopnea index that increased after tongue-lip adhesion. Peak end-tidal pCO2 measurements were elevated in all eight children before surgery at a mean of 60 mm Hg (range, 52 to 76 mm Hg) that improved to 51 mm Hg (range, 45 to 59 mm Hg), with normal peak levels in four children. Oxygen saturation nadir improved from 73% (range, 58% to 81%) to 82% (range, 65% to 94%). Conclusions Tongue-lip adhesion may be performed in micrognathic infants to alleviate airway obstruction. Polysomnographic evaluation in this pilot study before and after surgery suggests that tongue-lip adhesion usually improves obstructive sleep apnea, but only 38% had complete resolution. Future studies of tongue-lip adhesion efficacy should include Polysomnographic evaluation.
Family Data and Research in the Health and Retirement Study
Authors: Bianchi Suzanne 
Published: April 2011

Abstract
I discuss the data in the Health and Retirement Study (HRS) that can be used to study family change and intergenerational family relationships and offer suggestions about what might be done to enhance the uses of the HRS family data going forward. A number of family demographic behaviors are altering the family context of more recent cohorts of the HRS. These family changes need to be well-captured in the data collection and and should also inform future design decisions. Changes include the higher rates of childlessness, delayed marriage and childbearing after age 30 among the Baby Boom cohorts just now being enrolled in the HRS. Cohorts coming into the study also have higher rates of (lifetime) labor force participation on the part of women and much higher rates of nonmarital childbearing, marital disruption, and informal cohabitation than the original HRS cohorts. There is also great heterogeneity in family patterns by race and class among Baby Boom cohorts. Many of these changes increase the value of collecting family data in the HRS but also complicate the collection of useful data on transfers between parents and children or among siblings. I offer four suggestions for enhancing data collection in the HRS in light of these family changes. These include the following: 1) Reevaluate decisions about the family members on whom to gather information, particularly the decisions about when to collect data on siblings. 2) Consider collecting more information directly from each spouse (and perhaps expanding the definition of “spouse” to include cohabiting partners as cohabitation is on the rise among cohorts now entering the HRS). 3) Begin to experiment with interviewing adult children of HRS respondents and consider broadening the content to include more on parent-child relationship quality and/or on everyday activities and exchanges. 4) Make the family data in the HRS easier to access and use.
Prevalence of Abnormal Glucose Tolerance and Risk Factors in Urban and Rural Malaysia
Authors: Mustafa Norlaila , Kamarudin Nor Azmi , Ismail Ab Aziz , Khir Amir Sharifuddin , Ismail Ikram Shah , Musa Kamarul Imran , Kadir Khalid Abdul , Yaacob Nor Azwany , Ali Osman , Isa Siti Harnida Md , Wan Bebakar Wan Mohamad , wan Mohamud Wan Nazaimoon 
Published: April 2011

OBJECTIVE
To determine the prevalence of prediabetes and diabetes among rural and urban Malaysians.

RESEARCH DESIGN AND METHODS
This cross-sectional survey was conducted among 3,879 Malaysian adults (1,335 men and 2,544 women). All subjects underwent the 75-g oral glucose tolerance test (OGTT).

RESULTS
The overall prevalence of prediabetes was 22.1% (30.2% in men and 69.8% in women). Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were found in 3.4 and 16.1% of the study population, respectively, whereas 2.6% of the subjects had both IFG and IGT. Based on an OGTT, the prevalence of newly diagnosed type 2 diabetes was 12.6% (31.0% in men and 69.0% in women). The prediabetic subjects also had an increased prevalence of cardiovascular disease risk factors.

CONCLUSIONS
The large proportion of undiagnosed cases of prediabetes and diabetes reflects the lack of public awareness of the disease.