bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of Breast-feeding Patterns Established in the Hospital
Authors: Ryan Alan S. , Wysong Jeffrey L. , Martinez Gilbert A. , Simon Stephen D. 
Published: November 2007

Data from a national survey of new mothers were analyzed to determine the effect that demographic characteristics, breast-feeding instructions, and infant formula discharge kits had on breast-feeding patterns established in the hospital. Results indicated that mothers who exclusively breast-fed their infant were more likely to be affluent, college educated, and not working outside the home. Mothers who exclusively breast-fed their infants in the hospital and subsequently practiced partial breast-feeding or formula, or cow's milk feeding were more likely to return to the work force within the first 6 postpartum months. Mothers who partially breast-fed their infants in the hospital were more likely to have a low-birth-weight neonate. Stepwise logistic regression analysis indicated that greater total family income, a better education, and having more than one child had positive significant effects on exclusive breast-feeding by the first and fourth month. Women who received a formula discharge kit compared with those who did not had a slightly higher probability of initiating partial breast-feeding (10 vs. 7% by the first month; 27 vs. 25% by the fourth month). Maternal employment had a large impact on duration of exclusive breast-feeding. By the fourth month, mothers who were employed had a higher probability of initiating partial breast-feeding (43 vs. 19%) compared with mothers who were not in the work force.
Public Law 99-457 and the Clinical Pediatrician
Authors: Downey William S. 
Published: November 2007

Public Law 94-142 is a federal law, enacted in 1975, guaranteeing a free public education and related services for every handicapped child, from 5 to 21 years of age. In 1986, this act was amended by PL 99-457, where the age limit for mandated services was changed to include children 3-5 years of age. Moreover, in a section called Infants and Toddlers, states were given the option to extend these services, here called early intervention services, to children from birth to age 3. This latter section has profound ramifications for the practicing pediatric clinician when the law is implemented. These laws are reviewed with that focus in mind. This article is a two-part presentation of the requirements and implications for the pediatrician of federal act PL 99-457. This first part defines the details of the law. The second part, to be printed in Clinical Pediatrics next month, will explore the implications for the pediatrician.
Parainfluenza Type 3 Meningitis
Authors: Arguedas Adriano , Stutman Harris R. , Blanding Jeanne G. 
Published: November 2007

The authors present two immunocompetent children with parainfluenza type 3 meningitis. In each case, the outcome was favorable without detectable complications. The authors reviewed the literature, showing that central nervous system (CNS) involvement by parainfluenza viruses has rarely been described but may present with a variety of neurologic syndromes. Pediatricians and laboratory personnel should recognize that these viruses, commonly known to produce respiratory syndromes, can also be a cause of CNS infections. If additional studies confirm these observations, clinicians and virology laboratories may consider whether early hemadsorption testing to detect myxoviruses is warranted.
The Schinzel-Giedion Syndrome
Authors: Pul Mehmet , Yilmaz Nuran , Komsuoglu Baki 
Published: November 2007

The authors discuss a 1-day-old boy who had Schinzel-Giedion syndrome. This is the fifth case reported in the literature, and it presents additional abnormalities that have not been reported previously. The Schinzel-Giedion syndrome includes facially dysmorphic, skeletal, cardiac, and genitourinary anomalies, but mainly congenital hydronephrosis. The diagnosis can be made by clinical and radiological examinations.
Reliability of the Dinamap Non-invasive Monitor in the Measurement of Blood Pressure of III Asian Newborns
Authors: Chia F. , Ang A.T. , Wong Tze-Wai , Tan K.W. , Fung Kam-pui , Lee J. , Khin Khin 
Published: November 2007

Four hundred thirty-one paired sets of readings of systolic and diastolic blood pressure and 438 paired sets of readings of mean arterial BP from 49 ill newborns, including 21 very low birth weight infants, were analyzed for the extent and pattern of agreement and the linear relationship between the Dinamap oscillometric monitor and the direct intraarterial blood pressure readings. Agreement between the two methods was measured by the intraclass correlation, whereas the linear relationship was assessed by the product-moment correlation. The intraclass correlations for systolic, diastolic and mean blood pressures were 0.696, 0.766, and 0.781, respectively. The product-moment correlations for systolic, diastolic and mean blood pressures were 0.706, 0.768, and 0.786, respectively. BP measurements by the Dinamap monitor showed reasonably close agreement to those obtained by the intraarterial mean arterial pressure ranges above 40 mmHg. For mean arterial pressure of 40 mmHg and lower, BP readings by the Dinamap monitor tended to be higher than those obtained by the intraarterial method. These findings appeared to be consistent regardless of the birth weight of the newborn.
Prevalence and Etiology
Authors: Bhatia M.S. , Dhar N.K. , Singhal P.K. , Nigam V.R. , Malik S.C. , Mullick D.N. 
Published: November 2007

Of a total of 800 children (aged 3-12 years) attending a pediatric outpatient department, 182 (22.8%) were found to be having temper tantrums (mean age, 4.7 years). Temper tantrums were found to be most common at 3-5 years (75.3%), less common at 6-8 years (20.8%), and least common at 9-12 years (3.9%). Children aged 3-5 years were more likely to be of a lower social class (p < 0.01), whereas in other age groups (6-8 years and 9-12 years) children were more likely to be of an upper social class. Boys dominated the study significantly: the ratio of boys to girls was 3.1:1. Boys having temper tantrums were more likely to be of an upper social class (p < 0.001) compared with girls, who tended to be of a lower social class (p < .01). Children showed a higher incidence of history of postnatal trauma and seizure disorder compared with the control group (p < 0.05). Parental overprotection and marital discord were found to be stress factors in a significantly higher number of boys than girls (p < 0.01); parental negligence was a significant stress factor for girls (p < 0.01). Associated behavioral problems, such as thumb sucking, enuresis, tics, head banging, sleep disturbances, and hyperkinesis were found to be significantly higher among children with tantrums.
Relationship of Head Circumference to Measures of School Performance
Authors: Desch Larry W. , Anderson Sharon K. , Snow Jeffrey H. 
Published: November 2007

To study the possible relationship of head circumference (HC) to learning problems in children, a retrospective study was done, using records from 360 subjects who had been evaluated between the years 1976 and 1981. The data selected from the records included standardized academic test results, e.g., IQ scores and school achievement test results, as well as determinations of visual motor abilities. Statistical analyses demonstrated a positive correlation between full scale IQ (FSIQ) and HC (p < 0.005). The incidence of specific learning disabilities based on significant academic and achievement discrepancies was 54% in those with HC > 2 S.D., 39% for normocephalic, and 23% for those with HC < 2 S.D. Comparison of HC with results from the Wide Range Achievement Test (WRAT) demonstrated a tendency for those children with HC > 2 S.D. to have lower arithmetic scores when compared to results of children with normocephaly. Scores for spelling and reading ability did not demonstrate this tendency. The results of this study were found to be somewhat incongruous to those of previous studies of similar children. Further studies using large unselected populations are needed to better define the risks to learning that may be related to the extremes of head circumference.
Cardiac Hydatid Cyst in a Child
Authors: Ben - Musa A.A. , Singh Harjit , Shembesh A.H. , Chugh J.C. 
Published: November 2007

Presentation of hydatid disease is uncommon in children, and cardiac hydatid cyst is rare at any age. The authors discuss a pediatric patient with cardiac hydatid cyst in the posterior wall of the left ventricle. The cyst was diagnosed by two-dimensional echocardiography and by serology. A 3 month course of mebendazole therapy was only partially effective. The patient remains asymptomatic 2 years after diagnosis. HYDATID DISEASE is endemic in the Middle East.1 In a study from a surgical hospital in eastern Libya,2 the disease accounted for 0.89 percent of all hospital admissions. The echinococcus cyst grows very slowly and unless located in a critical anatomic site, it takes many years to evolve. Consequently, presentation in pediatric patients is distinctly uncommon. In an epidemiologic study from Benghazi,2 only 11.7 percent of patients were under 10 years old. Cardiac hydatid disease is rare at any age, accounting for less than 2 percent of all hydatid disease.3 Since the introduction of two-dimensional echocardiography, more cases are being diagnosed. All the reports in the recent literature are in adult patients. 4-8 We report here, however, a cardiac hydatid cyst in the left ventricular wall in a child.
Febrile Infants Less than Eight Weeks Old
Authors: Broner Cynthia W. , Polk Sara A. , Sherman James M. 
Published: November 2007

Febrile infants less than eight weeks old frequently are admitted and receive parenteral antibiotics for treatment of possible sepsis. The authors assess 52 infants less than eight weeks old with a rectal temperature of 38.1 °C or higher as having either a readily identifiable focus of infection by physical examination, appearing "toxic" without a focus, or appearing well. The authors screened patients by using white blood cell (WBC) counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and chest radiographs in addition to blood, cerebrospinal fluid and urine cultures. The authors found a 9.6% incidence of bacteria in the 52 infants evaluated, with a 4.3% incidence in those febrile infants who appeared well. Five patients had positive blood cultures with Group B B Hemolytic streptococcus (four patients), and Viridans streptococcus (one patient). A clinical assessment of toxicity and a total band count ≥ 0.5 X 103 cells/uL together were sensitive indicators of bacteremia, as were toxicity and a positive CRP. A "toxic" appearance, a WBC count > 15X10 3cells/uL and an ESR >30 were specific indicators of bacteria. Based on these data, identification of bacteremia in febrile infants may be possible with clinical assessment and screening laboratory tests. Because of the relatively small sampling size of this study, the authors feel that evaluation of a larger number of patients is warranted to evaluate these sensitivities in a more diffuse patient population.
Gastrointestinal Bleeding in a 15 Month Old Male A Presentation of Munchausen's Syndrome by Proxy
Authors: Mills R.W. , Burke Susan 
Published: November 2007

Munchausen's syndrome by Proxy is a well-described entity that may not always be immediately considered in a complicated case. We describe this syndrome being portrayed through the guise of gastrointestinal bleeding in a 15 month old male and discuss not only the difficulty involved in solidifying this diagnosis but also the consequences that may occur should this diagnosis not be entertained. Failure to diagnose Munchausen's syndrome by proxy often results from failure to consider the diagnosis. These cases frequently have specific characteristics that allow seasoned clinicians to suspect the diagnosis. Once the diagnosis is considered, it is crucial to take steps to protect not only the index patient but also siblings who not infrequently are also recipients of this life threatening form of child abuse.
Two Siblings with Phenotypes Mimicking Peroxisomal Disorders but with Discordant Biochemical Findings
Authors: Pietrzyk Jacek J. , Turowska-Heydel Dorota , Klimek Malgorzata , Kaczmarski Franciszek , Kaluza Jozef 
Published: November 2007

The authors present a report on two siblings with a nearly identical phenotype mimicking peroxisomal disorder but with totally discordant biochemical findings. In an attempt to confirm the diagnosis of a peroxisomal disorder, plasma levels of very long chain fatty acids (VLCFA) and phytanic acid were determined. In addition, fibroblasts profile of VLCFA and plasmalogen levels were evaluated for Case 2. Pathomorphological examinations represented by lymph node and kidney biopsies as well as postmortem examinations of liver, adrenals and brain were performed in Case 1. The phenotypes of both siblings showed marked resemblance to those observed in children with Zellweger syndrome. The results of biochemical tests performed in Case 1, together with abundant peroxisomes in the liver and the wide spectrum of clinical abnormalities suggest pseudo-Zellweger or Zellweger-like syndromes, but no conclusive data have been found. The plasmalogen level in fibroblasts as well as the fibroblasts profile of VLCFA noted in Case 2 were within the normal range, thus excluding the possibility of a peroxisomal disorder. The striking phenotype resemblance of the siblings mimicking Zellweger, together with discordant biochemical findings, are difficult to explain on the basis of currently available tests.
Clinical Management of Port-Wine Stain in Infants and Young Children Using the Flashlamp-Pulsed Dye Laser
Authors: Stuart Nelson J. , Applebaum Jay 
Published: November 2007

The flashlamp-pulsed dye laser (FLPDL) at 585 nm, a wavelength well absorbed by oxyhemoglobin, causes highly selective vascular injury. In addition, the 450 microsecond pulse duration produced by this laser approximates the thermal relaxation time for dermal blood vessels thereby confining the energy to the target. This new laser effects excellent lightening of port-wine stain (PWS) in infants and young children without the adverse complications of hypertrophic scarring, permanent pigmentation abnormality, or textural changes, complications often seen with conventional laser systems. The FLPDL now permits treatment of this patient population expected to gain the most benefit from early laser therapy in a much safer manner, before the psychological complications of being a "marked" person develop. The purpose of this report is to: (1) describe the theoretical considerations behind achieving selective removal of PWS that can be understood and used by a nonsurgically-oriented practitioner; and (2) describe the practical application of the device used in the clinical management of infants and young children.
The Indian Experience with Hypertrophic Pyloric Stenosis
Authors: Sharma Mahesh , Jain S.K. , Pathania O.P. , Taneja S.B. 
Published: November 2007

A study of 58 consecutive Indian infants operated for congenital hypertrophic pyloric stenosis revealed an accentuated male predominance in the incidence of the disease and far less preoperative hemetemesis as compared to that in their Western counterparts. 'Pyloric tumor' was palpable in 89% of cases. Only 34.5% of these infants were first born. Postoperative vomiting occured in 13.8% of patients and wound sepsis was not encountered. Air contrast radiography confirmed the diagnosis in clinically doubtful cases.
Nailbiting
Authors: Leung Alexander K.C. , Robson Lane M. 
Published: November 2007

Nailbiting is a common oral habit in children and young adults. It is estimated that 28 to 33% of children between the ages of 7 to 10 years and 45% of adolescents are nailbiters. The etiologies suggested for nailbiting include stress, imitation of other family members, heredity, a transference from the thumb sucking habit, and poorly manicured nails. Nailbiting is usually confined to the fingernails and most nailbiters bite all 10 fingers equally rather than selectively. Complications of nailbiting include damage to the cuticles and nails, secondary bacterial infection and dental problems. Treatment should be directed at any precipitating causes of stress. Reminders should only be used with the consent of the child. Care of the nails and cuticles, behavioral modification techniques, positive reinforcement, and regular follow-up are important aspects of treatment. Nailbiting, or onychophagia, is defined as the habit of biting one's nails and is a common oral habit in children and young adults. Nailbiting is embarrassing, unattractive, socially undesirable, and can predispose to the development of paronychia. Physicians are frequently consulted about nailbiting but not withstanding the prevalence of the problem, there is a surprising lack of literature on nailbiting. The purpose of this article is to familiarize the reader with the problem and to suggest appropriate approaches to treatment.
Clostridium Septicum Sepsis and Meningitis as a Complication of the Hemolytic-Uremic Syndrome
Authors: Broughton Robert A. , Lee Eun Y. 
Published: November 2007

Hemolytic-uremic syndrome (HUS) is recognized by the triad of acute microangiopathic hemolytic anemia, thrombocytopenia, and oliguric renal failure. The condition is usually preceded by gastroenteritis associated with bloody diarrhea. Escherichia coli 0157:H7, an enterohemorrhagic verotoxin producing E. coli, is now recognized as the most common pathogen associated with hemorrhagic colitis and HUS in North America.1 Since its description, a variety of gastrointestinal and neurologic complications of HUS have been noted. An association between HUS and meningitis due to Hemophilus influenzae 2 and Streptococcus pneumoniae3 has been previously reported. In addition, the first reported case of Clostridium septicum sepsis and cerebritis complicating gastrointestinal involvement in HUS was reported in 1988.4 We report the second confirmed case of fatal C. septicum sepsis and meningitis as a complication of HUS, suggesting that this entity may be more common than previously recognized. We review the epidemiology and clinical manifestations of C. septicum infections and speculate on the pathogenesis of the colitis and invasive C. septicum infection in our patient.
The Emperor's New Clothes: Why Boards and Managers Find Accountability Relationships Difficult
Authors: Mordaunt Jill 
Published: November 2007

In their book on corporate governance, Lorsch and McIver (1989) document that board members said they felt confident in their ability to question the CEO of their organisation about matters of concern. Yet in their observed performance, board members rarely did this. If board members raised problems, this was generally done covertly and outside the board. Similar accountability issues occur in nonprofit organisations. Board performance rarely reflects the rhetoric implicit in regulatory and legislative requirements. There are competing and at times contradictory expectations and demands. How do boards and managers seek to balance these in ways that allow them to maintain their integrity and yet still satisfy the expectations of different stakeholders? This paper explores some of the issues that make accountability problematic for boards and managers. It then outlines how different stakeholders have differing capacities to enforce accountability demands. This creates complex dilemmas for boards and for managers because there are not options to fulfil one demand and not the other. However, the paper also suggests that there is a game played that raises interesting issues about how accountability is enacted in organisations. Finally, it outlines the issues that need investigation to understand the strategies boards and managers adopt to deal with these problems.
A 1000-year record of winter precipitation from northwestern New Mexico, USA: a reconstruction from tree-rings and its relation to El Niño and the Southern Oscillation
Authors: D'Arrigo Rosanne D. , Jacoby Gordon C. 
Published: November 2007

A 1000-year reconstruction of winter (cool season) November-May precipitation for northern New Mexico is developed for AD 985-1970 based on six millenium-long tree-ring records from moisture-sensitive coniferous sites in New Mexico and southern Colorado. Two of the most prolonged and severe droughts occurred during the last 100 years: in the AD 1890s-1904 and the AD 1950s-early 1960s. These were exceeded in length and severity only once in the 1000-year reconstructed record, in the late 1500s, and almost equaled in the early 1200s. The five decadal-scale intervals of greatest drought were, in descending order, AD 1577-1598, AD 1955-64, AD 1895-1904, AD 1217-1226, and AD 1778- 1787. The wettest periods were AD 1835-49, AD 1905-28, AD 1429-1440, AD 1609-23, and AD 1487- 98. The most abrupt shift from severe sustained drought to extremely high precipitation occurred in the 1890s to early 1900s. The intensity of this shift is unprecedented over the 1000-year period of the reconstruction. Relatively dry conditions are indicated for part of the 1400-1600s period around the onset of the Little Ice Age, and the reconstruction indicates average conditions during the Medieval Warm Period. The southwestern US is an area of known teleconnection with the El Nine-Southern Oscillation (ENSO), coinciding with a tendency for wetter conditions to occur during ENSO years (warmer events) and drier conditions during colder events. The chronologies and reconstruction show correspondence with indices of ENSO, including Wright's Southern Oscillation Index (SOI). The years AD 1720, 1484, 1816 and 1941 (interpreted as ENSO-related events in instrumental or historical data) are the four wettest individual years in the reconstruction. Variance spectral analysis of the chronologies and reconstruction reveals significant peaks at approximately 2-7 year, 22 year and 80-100 year. There is potential for modelling the amplitude and frequency of the ENSO signature in the southwestern US over the past 1000 years or more, particularly by integrating tree-ring data from this region with other sources of high-resolution palaeoclimatic information.
Tephra geochemistry: a discussion of some persistent analytical problems
Authors: Hunt John B. , Hill Peter G. 
Published: November 2007

Distal tephrochronological studies are reliant upon precise and accurate geochemical quantitation. This quantitation can involve difficulties not often encountered in more conventional petrology. Solving these problems is of particular importance in the Holocene (and Late Quaternary) of northwest Europe, where numerous tephra layers of Icelandic origin have been detected in peat bogs and lake and marine sediments. Electron probe microanalysis (EPMA) has proved the most applicable analytical technique when insufficient quantities of tephra are available for bulk analysis. Standard EPMA techniques require fine tuning to the tephra problem as the geochemical instability of glass is a common feature. In many previous studies, geochemical data of avoidably low quality have been produced, and little attention appears to have been directed to modification of EPMA methods. It is suggested that the 'black box' approach to geochemical analysis should be avoided by the consideration of several factors. These include minimization of sodium mobility during analysis, prevention and nonacceptance of low analytical totals, non-normalization of data, and making provision for the acceptable presentation and statistical treatment of data. Amongst tephrochronologists, these suggestions may not receive universal acceptance, but it is hoped that they will serve to promote further discussion on a much neglected topic. Until reliable analytical techniques are universally adopted, there is a real possibility that erroneous tephrochronologies will be established.