bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience of Families with Very Low Birthweight Children with Neurologic Sequelae
Authors: Rivers Ann , Caron Blanche , Hack Maureen 
Published: November 2007

To describe the quality of life for surviving very low birthweight (VLBW, <1.5 kg) children and their families, the authors interviewed the parents of 22 neurologically abnormal VLBW children, 3 to 7 years after their birth and compared them to the parents of 15 neurologically normal VLBW children. The infants were born between 1976 and 1979, (mean birthweight, 1.2 kg; mean gestational age, 30 weeks). They included three with spastic quadriplegia, 14 with spastic diplegia, and five with hydrocephalus. Eight children were not walking. Seven families rated their child's neurologic problem as severe, while 15 rated the problem as mild. Neurologically abnormal children tended to display more screaming and crying than the normal children. Cost of ongoing medical care was a problem for families of nine neurologically abnormal as compared with two families of normal children. The abnormal children required a total of 61 postneonatal rehospitalizations versus 11 in the normal group. Families of neurologically abnormal children reported on significant major changes in their personal lives for the care of their child. Both groups of parents reported heightened appreciation of their child. Plans for future children were affected in both. Parents identified an urgent need for better medical information, education of pediatricians regarding preterm development and neurologic sequelae, and better contact and support among parents themselves.
Long-term Prognosis for Children With Nephrotic Syndrome
Authors: Wynn Susan R. , Stickler Gunnar B. , Burke Edmund C. 
Published: November 2007

Follow-up survival and health information were obtained, after a median of 27.5 years, from 132 patients who had been seen originally as children with nephrotic syndrome between 1951 and 1967. Ninety seven patients were alive. Recurring edema or proteinuria, or both, persisted in 15 percent of those still alive. Eight of 11 parous women reported relapses during pregnancy. There was no apparent increase in malignancies, atopic diseases, clinical defects in cell-mediated immunity, or cardiovascular diseases. Twenty two patients (17%) died of renal causes between 3 months and 8 years after the onset of nephrotic syndrome. Steroid resistance was the presenting feature universally predictive of a poor outcome; nine of the 11 such patients died and the other two are now receiving hemodialysis. Hematuria was present initially in 41 percent of the patients who died of renal causes, compared with 14 percent of those still alive. Hypertension was noted on the first examination in 22 percent of those who died of renal causes, compared with 10 percent of those alive.
Bone Status in Nonambulant, Epileptic, Institutionalized Youth
Authors: Fischer Milton H. , Adkins William N. , Liebl Birgit H. , VanCalcar Sandra C. , Marlett Judith A. 
Published: November 2007

This study was conducted to determine if the adverse effects of anticonvulsant drug therapy and nonambulancy on bone status could be overcome with vitamin D therapy in severely handicapped individuals. Six male and five female gastrostomy fed, nonambulant, epileptic, profoundly mentally retarded individuals ranging in age from 7 to 17 years were given vitamin D therapy at a dosage of 4,000 IU/m2 body surface area/day for 6 months. Photon absorptiometry and biochemical indices of bone status were measured to follow the effects of therapy. Bone mineral content expressed as a percentage of normal improved by 11 percent (p < 0.01), from 59.6 to 66.1 percent. Tartrate-resistant acid phosphatase, total alkaline phosphatase, and the bone isoenzyme activities declined 11 percent, 18 percent, and 11 percent respectively. These reductions were not statistically significant but they were consistent with the improvements observed by photon absorptiometry. The results of our study suggest that a conservative supplement of vitamin D will improve the bone status of severely disabled youths.
Intussusception Reduced by Barium Enema
Authors: Bonadio William A. 
Published: November 2007

A retrospective study was performed of 88 consecutive cases of intussusception that occurred during a 3-year period. Forty-eight patients experienced hydrostatic reduction of intussusception with barium enema and 40 patients required surgical correction of intussusception when barium enema reduction was unsuccessful. Patients with fever or duration of symptoms greater than 24 hours, or ileo-ileocolic type of intussusception had a significantly greater rate of unsuccessful hydrostatic reduction (p < 0.001). Of 48 cases of intussusception hydrostatically reduced by barium enema, 47 patients received repeat physical examination after reduction, 45 having normal findings. Oral feeding was tolerated in these 47 patients within 12 hours after reduction. All 41 hospitalized patients were discharged within 24 hours of reduction without developing complication; of seven non-hospitalized patients, six reported no complications during the initial 24 hour post-reduction period. The single complication that occurred was recurrence of intussusception (ileo-ileocolic type) in a patient 6 hours after initial reduction; this was the only case in which neither post-reduction physical examination nor trial of feeding had been performed. Children with intussusception hydrostatically reduced by barium enema are at low risk for complication during the subsequent 24 hour post-reduction period. When the pre-reduction course has been relatively uncomplicated, the post-reduction physical examination does not reveal abnormalities, and the patient is able to tolerate oral feeding, close outpatient monitoring appears to be safe.
Massive Levothyroxine Ingestion
Authors: Mandel Scott H. , Magnusson A. Roy , Burton Brent T. , Swanson J. Robert , LaFranchi Stephen H. 
Published: November 2007

The clinical course of a 29-month-old girl who was referred for evaluation after ingesting ninety 0.2-mg tablets of levothyroxine is reported. Despite an initial thyroxine (T4) level of 282 μg/dl and a triiodothyronine (T3) level of 1,837 ng/dl at 48 hours postingestion, her symptoms were mild and included irritability, vomiting, tremor, and tachycardia. Treatment was limited to activated charcoal and propranolol. Thyroid hormone levels fell to normal by 13 days postingestion. The child's clinical course was benign. Even after massive acute ingestions of levothyroxine, children's symptoms are usually mild and may be controlled with propranolol. This conservative approach should be considered before expensive and potentially dangerous therapies are undertaken.
Ticarcillin/Clavulanic Acid Combination
Authors: Kristjansson Kristleifur , Cox Frederick , Taylor Luann 
Published: November 2007

Eighteen patients 2 months to 11 years of age with culture proven bacterial infections were treated with parenteral ticarcillin/clavulanic acid in a noncomparative study. Seven patients had pneumonia, two had tracheobronchitis, three had soft tissue abscess, two had periorbital cellulitis, three had urinary tract infection and one had purulent bursitis. Four of the 18 were bacteremic. Organisms treated included Staphylococcus aureus (6), Pseudomonas aeruginosa (5), Haemophilus influenzae (2), Branhamella catarrhalis (2), Escherichia coli (1), Streptococcus pneumoniae (1), Klebsiella pneumoniae (1), Streptococcus pyogenes (1) and Serratia marcescens (1). Thirteen of 15 (87%) organisms tested were beta-lactamase positive. Therapy was given intravenously in six doses per day at 310 mg/kg. Duration of treatment ranged from 5 to 28 (mean 11) days, with an average time of 4 days to clinical improvement. Seventeen patients (94%) were clinically cured. One patient with recurrent aspiration pneumonia due to mixed infection with multiple gram-negative enteric bacilli failed therapy. Adverse effects were minimal and transient. Notably, mild to moderate thrombocytosis occurred in four (22%) patients that resolved uneventfully. We conclude that ticarcillin/clavulanic acid is safe and effective therapy for serious infections in hospitalized children.
"Abandoned" Parents
Authors: Porter Basil 
Published: November 2007

Maternal incompetence in childrearing is described in three widely different cultural settings in the southern Negev area of Israel. It is suggested that this incompetence stems from "abandonment" of the parents by traditional family support systems and is reinforced by the inability or lack of readiness of the health system to supply the missing support mechanisms. This picture of parental "abandonment" in widely different cultural settings in Israel may represent an end result of cultural and social upheaval common to other communities in the world. Techniques for prevention include improving awareness of health workers to this problem, teaching appropriate strategies for improving parental confidence and competence, and ensuring that maternal and infant care focuses appropriately on issues of infant behavior and parental concerns.
Neurologic Complications in Chronic Renal Failure: A Restrospective Study
Authors: Uysal Serap , Renda Yavuz , Saatci Umit , Yalaz Kalbiye 
Published: November 2007

We have retrospectively examined 324 patients with chronic renal failure and evaluated the probable underlying causes of neurologic complications, laboratory data and therapeutic interventions. The common neurologic problems in our patients were alterations in consciousness (40.7%) and convulsions (35.1%). When BUN concentration was above 135 mg/dl and creatinine clearance was below 8 m/min/1.73 m2, alteration of consciousness was observed and when BUN concentration was 200 mg/ dl and creatinine clearance was below 7 m/min/1.73 m2, abnormal convulsives appeared. Changes in deep tendon reflexes and pathologic reflexes were associated with hypertension. All of the patients with cortical atrophy using computerized cranial tomography aluminum hydroxide at least for 18 months, and six of them had hemodialysis. Fourteen patients who underwent dialysis developed convulsions and were thought to have disequilibrium syndrome. These findings are consistent with the suggestion that the metabolic and biochemical derangements associated with CRF may be particularly detrimental to the still developing CNS of the child.
Screening for Biotinidase Deficiency in Children with Unexplained Neurologic or Developmental Abnormalities
Authors: Sutherland Steven J. , Olsen Richard D. , Michels Virginia , Schmidt Michael A. , O'Brien John F. 
Published: November 2007

To test the hypothesis that the frequency of biotinidase deficiency is greater in children with unexplained developmental delay or neurologic abnormalities than in the general population, we studied children seen at a large outpatient clinic over a four-year period who had one or more of these neurologic abnormalities and for whom no specific cause for their abnormalities could be found. The group totaled 274 children (163 boys; 111 girls) whose ages ranged from 2 weeks to 17 years. Characteristics were IQ/DQ, 30 to 70 in the 115 for whom scores were available; 41% had seizures; 15% had sensorineural hearing loss; 54% showed gross motor delay or ataxia; and 27% had decreased muscle tone. One patient with a classical clinical picture of biotinidase deficiency was diagnosed during the study period and was not included in the study. None of the patients with nonclassic findings had a deficiency of biotinidase activity. Our results suggest that biotinidase deficiency does not account for a large proportion of children with unexplained neurologic abnormalities or developmental delay. This does not negate the importance of biotinidase testing in children with clinical patterns specifically suggestive of the deficiency.
Underdiagnosis and Undertreatment of Chronic Sinusitis in Children
Authors: Richards Warren , Roth Richard M. , Church Joseph A. 
Published: November 2007

A review of outpatients diagnosed with sinusitis during the previous year by the allergy services of Childrens Hospital of Los Angeles and Kaiser Permanente, Orange County, revealed 34 patients who had protracted discomforting and debilitating symptoms. The mean duration of symptoms was approximately six months (range 1-14 months). None had been previously diagnosed as having sinusitis or received appropriate treatment. Although all were referred for evaluation of allergic rhinitis and/or asthma, approximately 1/3 were found to have neither of these conditions. Among patients who had asthma, their asthmatic symptoms were aggravated by the sinusitis. All patients eventually responded favorably to appropriate antibiotic therapy. Earlier diagnosis and appropriate therapy would have foreshortened the course of this very discomforting condition. In recent years, we have observed a marked increase in the number of patients referred with the chief complaint of "worsening allergy" and who were subsequently found to have sinusitis. Most of the patients experienced significant incapacitation for protracted periods before a correct diagnosis was made and treatment instituted. In all but a few cases, prompt and sustained improvement followed appropriate therapy. The purpose of this report is to present a retrospective review of 34 illustrative cases.
Diaper Choice
Authors: Rockney Randy M. , Culpepper Larry , Figueira Gracinda Cristina , Mize William L. 
Published: November 2007

"In the coming year, it is expected that the Fresh Kills Landfill on Staten Island, NY will become the largest man-made object on earth, nosing in front of the Great Wall of China, which has held that honor for the last 5000 years."1 Diaper choice (cloth vs. disposable) has become a controversial issue with increased public concern for the environment. One hundred and twenty-four consecutive mothers were surveyed during the postpartum period about diaper choice. Six percent reported physician/nurse discussion of diaper choice during prenatal care. Seventy-seven percent planned to use disposable diapers only. Twenty-two percent planned to use cloth diapers or a combination of cloth and disposable diapers. Major reasons for choice of disposables included convenience, avoidance of safety pins and cleanliness. Mothers selecting cloth or a combination cited environmental concerns, low cost and cleanliness as reasons for their choice. Factors found to be significantly associated with choice of cloth or combination were older maternal age, use of cloth with other children, and perception that disposables are more expensive. No significant association could be demonstrated between diaper choice and several demographic variables, breastfeeding, or knowledge of the environmental impact of disposables. An educational intervention promoting the use of cloth diapers did not influence diaper choice at two months. Most mothers have made a diaper choice by the time an infant is born. Providers of prenatal care seldom discuss diaper choice with pregnant women. An educational intervention to promote choice of cloth diapers had no effect on the diaper choices made by our population.
Infrared stimulated luminescence (IRSL) dating of late-Holocene aeolian sands in the Mojave Desert, California, USA
Authors: Wintle Ann G. , Lancastert Nicholas , Edwards Stephen R. 
Published: November 2007

A new method of dating potassium feldspar grains from aeolian sands is demonstrated. A luminescence signal is measured whilst the grains are stimulated in the near infrared at 880 nm. A surface sand sample gave an age of 40 ± 15 years, showing that this method is able to provide ages for very young samples. Since the measurement of an infrared stimulated luminescence (IRSL) signal can take place with a short infrared exposure, the IRSL signal of the grains is not depleted; thus growth curves can be obtained for 5 mg sample aliquots. This procedure was exploited in this paper. Dates were obtained for 10 samples from the Kelso dune field as a demonstration of the applicability of the method in a desert environment where there is no material suitable for radiocarbon dating. Although the number of dates are limited, sand from an area at the eastern end of the dune field with crescentic dunes showing a different wind direction from that of today had an age of 4115 ± 335 years, similar to the 3960 ± 385 years for another sand unit nearby. At the western end of the dune field differently oriented crescentic dunes gave ages of 1540 ± 135 and 1470 ± 145 years, indicating a different phase of aeolian activity. Reworking in the late Holocene is proposed for areas with dates ranging from 845 to 105 years.
Hydrochlorothiazide Increases Efferent Glomerular Arteriolar Resistance in Spontaneously Hypertensive Rats
Authors: Komatsu Kazutoshi , Numabe Atsushi , Ono Yuko , Frohlich Edward D. 
Published: November 2007

Background: Micropuncture studies were performed to determine the intrarenal hemody namic effects of two conventional antihypertensive agents, hydrochlorothiazide (HCTZ) and hydralazine (HYDR) alone and in combination. Methods and Results: Male spontaneously hypertensive and normotensive Wistar Kyoto rats (19 weeks old) were treated for 3 weeks with vehicle (control), HCTZ (80 mg/kg/d), HYDR (5 mg/kg/d), or combined therapy (HCTZ 30 mg/kg/d and HYDR 2 mg/kg/d). Each treatment significantly reduced arterial pressure while effective renal plasma flow, glomerular filtration rate and single nephron glomerular filtration rate were unaffected by any treatment in either strain. In spontaneously hypertensive rats HCTZ decreased single nephron plasma flow (11 ± 8 to 84 ± 4 nL/min; P < .05) but, despite this reduction, glomerular pressure remained unchanged (51.4 ± 0.7 to 52.1 ± 0.8 mmHg) attributable to increased efferent glomerular resistance (1.58 ± 0.14 to 2.11 ± 0.12 10 U; P < .05). By contrast, HYDR increased single nephron plasma flow (to 147 ± 8 nL/min; P < .01) and decreased efferent glomerular resis tance (to 1.09 ± 0.09 U; P < .05). Combined treatment produced responses similar to HCTZ when used alone, thereby nullifying the beneficial efferent glomerular resistance effects: sin gle nephron plasma flow ± fell (to 89 ± 7 nL/min; P < .05) and efferent glomerular resistance increased (to 2:05 ± 0.17 U; P < .05). In Wistar Kyoto rats, HCTZ and combined treatment had no-effect. HCTZ alone induced glomerular ischemia that was associated with efferent glomerular arteriolar constriction in these spontaneously hypertensive rats. Conclusions: These findings provide a possible explanation for the lack of improved renal target-organ damage in controlled multicenter trials employing thiazide diuretics.
Efficacy and Safety of Nifedipine Coat-Core versus Amlodipine in Patients With Mild to Moderate Essential Hypertension: Comparison of 24-Hour Mean Ambulatory Diastolic Blood Pressure
Authors: Byyny Richard L. , Shannon Timothy , Schwartz Lawrence A. , Rotolo Christa , Jungerwirth Steven 
Published: November 2007

Background: Calcium channel blockers have been successfully used for the treatment of hypertension. In this study, the antihypertensive efficacy and safety of the dihydropyridine calcium channel blockers nifedipine coat-core 30 mg and amlodipine 5 mg were evaluated. Methods: This multicenter, double-blind, prospective, randomized, parallel-arm study com pared once daily administration of nifedipine coat-core 30 mg with once daily amlodipine 5 mg in subjects with mild-to-moderate essential hypertension. A 4-week placebo run-in period was followed by an 8-week active treatment period. Blood pressure reduction was measured by ambulatory blood pressure monitoring and casual office blood pressure measured by mer cury sphygmomanometer. Results: Nifedipine coat-core and amlodipine produced equivalent reductions in mean dias tolic blood pressure, as determined by 24-hour ambulatory blood pressure monitoring. Mean reduction in diastolic blood pressure was 5.4 mmHg and 5.8 mmHg for nifedipine coat-core and amlodipine, respectively. Both drugs were well tolerated and neither treatment resulted in a significant change in heart rate. Conclusions: Nifedipine coat-core 30 mg once-daily is comparable to amlodipine 5 mg once-daily for blood pressure reduction.
Differential Effects of Protein Kinase C Activators and Inhibitors on α- and β-Adrenoceptor-mediated Positive Inotropic Effect in Isolated Rabbit Papillary Muscle
Authors: Hassan Talukder M.A. , Endoh Masao 
Published: November 2007

Background: A number of novel agents that activate or inhibit protein kinase C (PKC) in vitro have been developed to evaluate the physiologic role of PKC in regulation of cellular function. However, most of the PKC inhibitors also affect the protein kinase A, and the effects of these agents in intact myocardium remain still controversial. The present study was carried out to examine the effects of these agents on the positive inotropic effect (PIE) medi ated by α- and β-adrenoceptors in isolated rabbit papillary muscle. Methods and Results: A potent PKC activator, phorbol 12, 13-dibutyrate (PDBu) at 10 and 30 nM, induced a significant PIE. PDBu at 3 nM and higher inhibited the α-mediated PIE and abolished it at 100 nM without affecting the β-mediated PIE. Phorbol 12-myristate 13- acetate (PMA) and 1-oleyl-2-acetyl-sn-glycerol (OAG) elicited a similar selective inhibitory action on the α-mediated PIE. The PIE of PDBu was abolished by chelerythrine and partially inhibited by staurosporine, but H-7 or calphostin-C did not affect the PIE. These PKC inhibitors consistently inhibited the α-mediated PIE by 20-30% at concentrations that they did not affect the β-mediated PIE. None of the PKC inhibitors influence the PDBu-induced inhibitory action on the α-mediated PIE, an indication that they failed to reach the site of the inhibitory action of PDBu. Conclusion: Selective modulation by the PKC activators and inhibitors of the α-mediated PIE with little effect on the β-mediated PIE implies that the activation of PKC has a physiological relevance to the α-mediated PIE. However, the externally administered PKC activators do not mimic the effect of diacylglycerol that is generated endogenously by α-stimulation. By con trast, externally applied PKC inhibitors selectively antagonize the α-adrenoceptor-mediated PIE in rabbit ventricular myocardium.