bluuebunny/crossref_metadata_2025_split huggingface dataset:
Used by Physicians During Routine Examinations
Authors: Siegel Lawrence J. , Smith Karen E. 
Published: November 2007

Parents of 316 children seen in the outpatient clinics of a large pediatric teaching hospital completed a questionnaire regarding their attitudes toward the use of infection control procedures by doctors during the routine examination and treatment of their children. Results revealed that the majority of parents held favorable attitudes toward the wearing of gloves and masks during patient care activities. Parents who agreed that gloves and masks should be worn also tended to believe that diseases could be spread through cross-infection, that protective wear would prevent such infection, and that their children generally would benefit from these precautions. Parents of preschool-aged children felt that such procedures might make their children more fearful. These data indicate that many parents are basically supportive of the use of infection control procedures with their children and that such techniques do not appear to be an obstacle to effective relationships between health-care professionals and their patients.
Measures of Attention Deficit
Authors: Blondis Thomas A. , Accardo Pasquale J. , Snow Jeffrey H. 
Published: November 2007

After a detailed behavioral and developmental history has been supplemented by the use of formal questionnaires, the diagnosis of an attentional disorder can be further clarified by the judicious selection of psychoeducational and pediatric physical and neurodevelopmental examinations. The most common difficulty in the interpretation of psychoeducational test subscores and profiles is the significant overlap between the patterns generated by attentional deficits and those associated with memory-based learning disabilities. Certain other medical and behavioral conditions need to receive careful consideration prior to finalizing the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). A thorough but focused general examination coupled with the pediatric neurodevelopmental examination can contribute to this differentiation.
Hepatitis B Virus Vaccine
Authors: Hicks Ralph A. , Cullen John W. , Jackson Mary Anne , Burry V. Fred 
Published: November 2007

A cost-benefit analysis of routine active immunization against hepatitis B virus (HBV) for 500 nursing personnel at The Children's Mercy Hospital in Kansas City, Missouri, is described. Based on outcomes of HBV infection, local charges for medical care and wages lost from illness, the authors calculate the average cost per case of HBV infection to be $1,990. Including the current system of postexposure prophylaxis and an annual attack rate of 1 percent the current annual cost of HBV infection in The Children's Mercy Hospital is $12,630. The HBV immunization program would have to continue for 15 years before its cumulative costs ($189,133) were exceeded by those of the current system ($189,450). Therefore routine immunization of nurses would not be cost effective in the near future. If, however, a subset of high-risk employees with a 2 percent attack rate is identified, or the cost of the HBV vaccine series fell from the current $103 to $27, then routine immunization would become cost beneficial within 6 years.
paranasal Sinus Mucocele in Cystic Fibrosis
Authors: Guttenplan Michael D. , Wetmore Ralph F. 
Published: November 2007

The relationship between cystic fibrosis, nasal polyposis and chronic sinusitis is clearly defined. Mucoceles of the paranasal sinuses, however, are a well-described complication of chronic sinusitis in adults; but they rarely occur in the pediatric age group. We report a three-year-old who presented with epiphora and fullness at the right medial canthus. Computed tomography confirmed a right ethmoid mucocele which was surgically drained, with resolution of symptoms. Approximately 12 other cases of mucoceles have been reported in the pediatric age group. Although many of these patients had recognized cystic fibrosis, some were previously undiagnosed. Only after presentation with a mucocele, did sweat testing reveal their underlying pathology. No pediatric patients in the literature were found with mucoceles and normal sweat tests. Paranasal sinus mucoceles may be diagnostic of cystic fibrosis and may be the presenting sign in some patients.
Triglycerides, Cholesterol, HDL, LDL, and VLDL Cholesterol in Serum of Phenylketonuric Children Under Dietary Control
Authors: Schulpi Kleopatra H. , Scarpalezou Astrinia 
Published: November 2007

Phenylketonuria is currently treated by a special diet to avoid elevated blood concentration of the essential amino acid phenylalanine. The authors examined 20 phenylketonuric children in the Inborn Error of Metabolism Department of Institute of Child Health in Athens. The children had simultaneous clinical and laboratory investigations. Blood cholesterol levels of these children were low in comparison with the levels of healthy children of the same age, but the triglyceride levels were higher as a result of a special diet containing a large amount of carbohydrates. Because of the triglyceride elevation the authors recommend supplementary vegetable fat intake, such as in olive oil, for their patients' dietary control.
Adolescent Cocaine Abuse
Authors: Estroff Todd W. , Schwartz Richard H. , Hoffmann Norman G. 
Published: November 2007

Four hundred seventy-nine drug abusing adolescent patients enrolled in seven Straight, Inc. Adolescent Drug-Abuse Treatment Programs in five geographic regions across the United States were studied to determine the severity and patterns of cocaine abuse. Of these, 341 admitted to cocaine use and became part of this survey. Cocaine use was categorized as heavy, intermediate, or light. Areas examined were the addictive spectrum, psychosocial dysfunction, and psychiatric symptoms. Intermediate and heavy users of cocaine abused significantly less marijuana and inhalants than light cocaine abusers. Heavy and intermediate users were more likely to use cocaine intravenously and to use crack. They developed tachyphylaxis more frequently, progressed to weekly use in less than 3 months more frequently, and became preoccupied with obtaining and using cocaine significantly more frequently. They used more sedative hypnotics to calm themselves and engaged in more criminal behavior, such as stealing from parents and stores and passing bad checks. They had more arrests for possession of drugs, stole more cars, sold more drugs, and were more likely to trade sexual favors to obtain the drug. Heavy and intermediate users were significantly more psychiatrically disturbed than light users, becoming more suspicious, nervous, aggressive, and demonstrating increased symptoms of fatigue, sleeplessness, decreased appetite, and increasing cocaine dysphoria. All of these symptoms could be mistaken for psychiatric disorders. This study suggests that cocaine is as addictive in adolescents as in adults; possibly more so. It also causes psychosocial dysfunction and psychiatric symptoms. Further research into cocaine addiction among adolescents is indicated.
Sickle Cell Disease
Authors: Powars Darleen R. , Brown Mary 
Published: November 2007

A summer camp for children with sickle cell disease (SCD) and other hemoglobinopathies has been in operation for 22 consecutive years (1,556 camper weeks). Two thirds of the campers had sickle cell anemia (SS). With the exception of 1 year, SCD-related medical problems occurred in 10 percent of the children. Episodes of illness were increased during the year when the camp was held at a site 2,200 feet above sea level. Children with SCD can enjoy a remote, physically challenging, and emotionally enriching program. Success requires an experienced and prepared medical staff who leave the organization and "on site" management of camp activities to expert recreational professionals.
Malignant Tumors
Authors: Fischer Philip R. , Ona Ahuka Longombe , Wood Philip B. , Lucas Sebastian 
Published: November 2007

In an effort to better understand the epidemiology of cancer in Zaire, a retrospective review of biopsy-proven malignant tumors was undertaken. Of 188 biopsies taken from children aged 0-15 years over a 4.5 year period, 73 (39%) revealed malignancy. Fifty-six percent of patients with malignant tumors were boys. Lymphoma was the most common tumor (28 patients, 15 with Burkitt's Lymphoma). Sarcoma (15 patients), carcinoma (8 patients), Wilms' Tumor (6 patients), and retinoblastoma (5 patients) were also seen. Lymphomas were most heavily represented in the first 5 years of life, while sarcoma and carcinoma accounted for most of the malignancies in children after 10 years of age. Lymphomas and sarcomas are relatively more common in Zaire than in North America and Europe, while leukemia and central nervous system tumors are notably less common in Zaire. In view of current limitations on health care in rural Zaire, cancer care should be directed toward early diagnosis, quick referral for appropriate surgical care, and use of the limited arsenal of chemotherapy.
Childhood Obesity
Authors: Unger Rebecca , Kreeger Lisa , Christoffel Katherine K. 
Published: November 2007

The prevalence of obesity in U.S. children is rising. Etiologic studies have focused on infants and school age children but little is known about obesity in early childhood. To study the development of childhood obesity and its medical correlates, the authors reviewed 175 charts of obese children seen in a nutrition clinic. The 61 study subjects (37% of charts reviewed) had growth records for ages 7 years and less and were without developmental delay syndromes. Thirty-nine (64%) of 61, were girls; ages at presentation were 1 to 14 years. Data collection included previous and presenting weights, heights, medical problems, and evidence of parental and sibling obesity. Study subjects' mean percent of ideal body weight for height (%IBWH) at presentation was 160 percent. Many study subjects had medical problems considered to be related to obesity: 30 percent had asthma, 25 percent elevated blood pressure, and 28 percent hyperlipidemia. Thirty (63%) of 48, study subjects with data on maternal weight and height, had obese mothers and 14 (31%) of 45 had obese fathers. Fourteen (50%) of 28 had one or more obese siblings. Among all study subjects, the proportion of obese (% IBWH >120%) and severely obese children (% IBWH>140%) increased between ages 1 and 7 years. For example, the proportion >140% IBWH was zero percent at 1 year and 3 years; 0.1 at 2 years; 0.2 at 4 years; 0.5 at 5 to 6 years; and 0.6 at 7 years. Of the 29 study subjects obese beyond 7 years, 0.1 were obese at 1 year; 0.2 at 2 years; 0.4 at 3 years; 0.6 at 4 years; 0.8 at 5 to 6 years; and 0.9 at 7 years. In these 61 study subjects 1.) of those who were obese by age 7, most became obese by age 4 years and severely obese by age 5 years; 2.) most children had obese family members; and 3.) obesity in early childhood was associated with nontrivial medical problems. The data imply that prevention of persistent, severe childhood obesity will require a family-oriented approach aimed at preschool children and suggest specific testable hypotheses related to early childhood obesity.
Sun Protection in Childhood
Authors: Truhan Andrew P. 
Published: November 2007

There is compelling evidence that childhood is a particularly vulnerable time for the photocarcinogenic effects of sun exposure on the skin. Studies indicate that excessive sun exposure during the first 10-20 years of life greatly increases the risk of skin cancer. Nonmelanoma skin cancer (basal cell and squamous cell carcinoma) has been associated with cumulative sun exposure, whereas melanoma has been associated with short, intense sun exposure or blistering sunburn. Under normal circumstances, children receive three times the annual sun exposure of adults; most of one's lifetime sun exposure occurs in childhood. Depletion of the earth's protective ozone layer adds to the photodamage problem. It is clear that sun protection is most vital in the early years. Those with fair skin are at highest risk. Photoprotective measures including sunscreen, clothing, and sun avoidance in childhood may significantly reduce the occurrence of melanoma and other skin cancer in later life. Regular use of sunscreen with a sun protection factor of 15 during the first 18 years of life could reduce the lifetime incidence of nonmelanoma skin cancer by 78%. Pediatricians can play a major role in educating parents and children.
Relationship of Fever Magnitude to Rate of Serious Bacterial infections in Infants Aged 4-8 Weeks
Authors: Bonadio William A. , McElroy Kimberly , Jacoby Patricia L. , Smith Douglas 
Published: November 2007

We correlated the height of fever with underlying infectious etiology in 683 consecutive febrile infants aged four to eight weeks who received outpatient evaluation for sepsis during a five-year period. The relative number of infants with fever was inversely proportional to fever height, as 51 % had a temperature 38.1 - 38.9°C, 45% had a temperature 39 - 39.9°C, and 4% had a temperature >40°C [hyperpyrexia]. There were 34 cases of serious bacterial infections [SBI], including 16 cases of urinary tract infection, 8 cases of bacteremia, 6 cases of bacterial meningitis, and 4 cases of Salmonella enteritis. The rate of SBI increased in direct proportion to fever height, being 3.2% in those with a temperature 38.1-38.9°C, 5.2% in those with a temperature 39-39.9°C, and 26% in those with a temperature >40°C. The 6.8% rate of SBI in those with fever >39°C was significantly greater than the 3.2% rate in those with fever <39°C [p <0.035]; and the 26% rate of SBI in those with hyperpyrexia was significantly greater than the 4.1 % rate in those with fever <40°C [p <0.000004]. In identifying those with SBI, the presence of hyperpyrexia had a sensitivity of 21 %, specificity of 97%, positive-predictive value of 25%, and negative-predictive value of 96%. The rate of SBI in febrile infants aged four to eight weeks is proportional to the height of fever documented at the time of evaluation; yet the predictive-value of hyperpyrexia in identifying individual infants with SBI is low. It is important that all febrile infants aged four to eight weeks receive complete evaluation for sepsis, regardless of height of fever.
Holocene vegetational history and climatic change in west Spitsbergen - plant macrofossils from Skardtjørna, an Arctic lake
Authors: Birks Hilary H. 
Published: November 2007

Macrofossil analyses of a 335 cm-long core from Skardtjørna, a small lake on the west coast of Spitsbergen, Svalbard, are presented. The known processes of deposition of plant remains to arctic lake sediments are summarised, and used in the interpretation of the vegetation history at Skardtjørna. The basal sediment is AMS-dated to 8110 ± 110 BP. The rest of the profile is dated by palaeomagnetic correlation. The lowest sediments have the greatest macrofossil concentration and numbers of taxa per sample. The occurrences of Cassiope hypnoides and Salix cf. glauca before 4000 BP indicate a mean July temperature for the early Holocene about 2°C higher than today, comparable to the Cassiope tetragona vegetation zone of the mid-arctic region of the inner fjords. Increasing climatic severity resulted in the threshold from the Cassiope to the Dryas vegetation zone being passed at about 2500 BP. The inferred climatic history at Skardtjørna is compatible with other evidence from Svalbard and elsewhere in the arctic. The phytogeography of Salix herbacea, Cassiope hypnoides, and Saxifraga flagellaris is discussed in terms of their historical occurrences.
Effects of Sotalol on His-Purkinje Conduction and Refractoriness in Humans
Authors: Nademanee Koonlawee , Noll H. Elizabeth , Feld Gregory K. 
Published: November 2007

Background: The effects of sotalol on refractoriness in human ventricular and atrial muscles have been well established, but the drug's effect on the electrical properties of the His- Purkinje system in humans is not known, especially whether sotalol's effect is due solely to its action on prolonging repolarization or in combination with its beta-blocking properties. We studied the electrophysiologic effects of intravenous sotalol and propranolol in patients undergoing electrophysiologic studies of cardiac arrhythmias. Methods and Results: We studied 22 patients (19 men, 3 women; mean age, 60 ± 6 years) who had coronary artery disease and assessable anterograde, retrograde, or both, His-Purkinje system function. Fifteen patients underwent electrophysiologic studies before and after intra venous sotalol (1.5 mg/kg), and 7 patients underwent electrophysiologic studies before and after intravenous propranolol (0.15 mg/kg). Both sotalol and propranolol had no signilicant effect on the H-V interval, but sotalol significantly increased ventricular refractoriness and His-Purkinje refractoriness, both in anterograde and retrograde conduction, whereas propra nolol did not. Sotalol's effect on His-Purkinje refractoriness also caused alrioventricular block distal to the His bundle during atrial pacing at a moderately fast rate. Sotalol was not effec tive in preventing bundle branch re-entry tachycardia, nevertheless. it increased cycle length of bundle branch re-entry tachycardia by increasing refractoriness. Conclusions: Sotalol increased His-Purkinje refractoriness in humans but had no effect on His-Purkinje conduction. The drug must be used judiciously in patients with a diseased His- Purkinje system because it may cause atrioventricular block distal to His at fast heart rates. Sotalol had no effect on macrore-entry utilising bundle branches.
Angiotensin II Receptor Regulates Ionic Currents in Guinea Pig Ventricular Myocytes
Authors: Yang Xiang-jun , Jiang Wen-ping 
Published: November 2007

Background: Previous studies have shown that angiotensin II (Ang II) receptors are preset in a wide variety of target tissues and that Ang II regulates the target tissue functions through Ang II receptors. However, the action of Ang II receptors on transsarcolemmal currents in ventricular myocytes has not been elucidated. Methods and Results: We performed whole-cell voltage clamp and patch clamp experi ments to determine the effects of Ang II-receptor agonists and antagonists on ionic currents in single isolated guinea pig ventricular myocytes. We found that extracellular perfusion of Ang II (30 nM) increased the L-type Ca2+ current from 581 ± 27 to 837 ± 42 pA (n = 5, P < .01). Ang II also prolonged the Ca2+ current activation and inactivation time constants. These were reversible by losartan (100 nM), a type 1 Ang II receptor (AT,) blockade. On the other hand, perfusion of 30 nM Ang II decreased K+ current (IK) from 1543 ± 28 to 1194 ± 50 pA (n = 5, P < .05) and K+ tail current (IK-tail ) from 275 ± 24 to 206 ± 29 pA (n = 5, P < .05). These effects were also abolished by perfusion of losartan. However, perfusion of Ang II resulted in an increase of inward rectified K+ current (IK1) in whole-cell recordings. Single- channel recordings showed that the increase in IK1 was attributed to a burst opening current with a larger unit of amplitude. These effects were reversed by saralasin but not losartan, indicating possible type 2 Ang II receptor (AT2) involvement. Conclusions : Our results provide evidence that Ang II receptors regulate the transsar colemmal currents in single guinea pig ventricular myocytes. Therefore, Ang II regulation of ionic currents is mediated through the different subtypes of Ang II receptors.
Prolonged Captopril Therapy in Murine Viral Myocarditis
Authors: Reyes Milagros P. , Khatib Riad , Khatib Ghada , Ho K.L. , Smith Frederic , Kloner Robert A. 
Published: November 2007

Background: Acute myocarditis can progress to chronic heart muscle disease and cardiomyop athy. In the coxsackievirus B 3 (CB3) mouse model of myocarditis, early administration of cap topril, an angiotensin-converting enzyme (ACE) inhibitor, ameliorated histopathological changes in inflammation, necrosis, and calcification and reduced heart weight. Late administra tion of captopril reduced heart weight but did not affect the histological findings. In this study, we investigated the effects of prolonged captopril treatment in the chronic phase of this model. Methods and Results: Three-week-old male CD1 mice were infected with CB3 and then randomized to receive placebo or captopril starting on day 7 of infection. Captopril, 2 g/L, was given as the drinking water daily for up to 6 months. Autopsies were performed at 6 and 10 months. Heart-to-body weight ratios were obtained, and deaths were tallied. Myocardial fibrosis was graded according to a score system. In addition, picrosirius red stain (PSR) also was used for assessment of collagen deposition. Mean heart weights were similar in both groups. Mean body weight was significantly lower in captopril-treated mice (40.7 g) than in the untreated group (43.6 g) at 6 months ( P = .0155), and mortality was higher (8.7 vs 0.87%; P = .009). At 6 months, the mean myocardial fibrosis score in treated mice (0.12) was significantly less than in untreated animals (0.35; P = .035). With PSR, the mean myo cardial fibrosis score in the captopril group (1.20) was also significantly less than in the untreated group (1.58; P = .045). At 10 months, fibrosis scores were similar in both groups. Conclusions: Chronic captopril treatment in CB3 myocarditis reduces myocardial fibrosis.
Infarct Size Reduction by Ischemic Preconditioning is a Monophasic, Short-Lived Phenomenon in Anesthetized Pigs
Authors: Schwarz Ernst R. , Fleischhauer Jan , Montino Holger , Chakupurakal Raj , Foresti Mike , Schuetz Thorsten , Sack Stefan , Mohri Masahiro , Arras Margarete , Schaper Wolfgang , Hanrath Peter 
Published: November 2007

Background: Controversy exists concerning the duration of infarct size reduction with ischemic preconditioning in different species. In the present study, we (a) evaluated the time course of protection with preconditioning and (b) sought to determine whether late protec tion (the "second window") after 24 hours is manifest in the open-chest pig model. Methods and Results: Six groups of pentobarbital-anesthetized pigs underwent 1 hour of left anterior descending coronary artery occlusion and 2 hours of reperfusion. Group 1 served as control, and pigs in group 2 received two 10-minute episodes of preconditioning ischemia followed by 30 minutes of reperfusion before the sustained 1-hour occlusion. In groups 3-6, the period of intervening reperfusion between the preconditioning stimulus and the index ischemia was extended to 60, 90, and 300 minutes and 24 hours, respectively. The area at risk was determined by fluorescein dye injection, and infarct size was measured by incubation in p-nitrobluetetrazolium and expressed as percent of the risk area. Infarct size in preconditioned pigs (group 2) was significantly reduced compared with controls (25.6 ± 3.9% v 71.3 ± 5.9%, P < .001). Extension of the intervening reperfusion to 60, 90, and 300 minutes and 24 hours resulted in infarct sizes of 64.5 ± 5.5%, 67.2 ± 8%, 62.6 ± 6.1%, and 75.3 ± 7%, respectively ( P = NS v control). Conclusions: The infarct size-limiting effects of ischemic preconditioning last less than 1 hour in the pig model. Moreover, in contrast to other species, a late protection at 24 hours after the preconditioning stimulus was not detected. These results indicate that precondi tioning-induced reduction of infarct size is monophasic in anesthetized pigs.