bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventive Health Care Utilization
Authors: Gemperline Patrick , Brockert John , Osborn Lucy M. 
Published: November 2007

The utilization of preventive health care services prenatally and for children up to 3 years old was determined by mailed questionnaire. The parents surveyed were randomly chosen from birth records provided by the Utah Bureau of Vital Records. "Adequate use of preventive services" was defined as six prenatal visits for a full-term pregnancy and as seven well-child visits during the first 3 years of life. Responses, received from 219 (36.5%) parents, indicated only 1 percent did not utilize adequate prenatal care. Women made an average of 11.3 visits during their pregnancies; 83 percent saw their prenatal health care provider at least 10 times. Well-child visits were less adequately utilized, an average of 6.3 visits per child. Fifty-six percent made fewer than seven visits; only 23 percent made all of the nine visits recommended by the American Academy of Pediatrics. Patients who made seven or more well-child visits were more likely to have received their fourth diptheria, pertussis, tetanus (DTP) immunization and to have health insurance policies that paid for preventive health care services. Results indicate that families use preventive services more consistently before the birth of their children than after. Use of preventive services is associated with adequate insurance coverage and results in more thorough immunization.
Ovarian Cysts in Precocious Puberty
Authors: Arisaka Osamu , Shimura Naoto , Nakayama Yuko , Yabuta Keijiro , Yoshizawa Yasuo , Hirai Yoshinori , Yoshimine Tsugio , Kuwabara Noriyuki 
Published: November 2007

We describe a 7-year-old girl with precocious puberty in whom a single large cyst (5 cm) and several small cysts (8-10 mm) in the single remaining ovary were detected by the ultrasound examination. Endocrinological examinations confirmed the diagnosis of central precocious puberty. Pathologic findings after the removal of the cystic lesions revealed that the large cyst was derived from degenerated follicular cysts and the small cysts were identical to follicular cysts: all were considered to have been formed by gonadotropin stimulation. In general, surgical removal of an ovarian follicular cyst in central precocious puberty is inappropriate. However, in this unusual patient who had a degenerated large cyst, surgery seemed to be appropriate because of a previously removed teratoma in the contralateral ovary.
Recurrent Bacterial Meningitis
Authors: Hayashi Nobana , Kino Minoru , Nobori Urara , Yanagida Masahiro , Ushiro Kohichi , Kumazawa Tadami , Kobayashi Yohnosuke 
Published: November 2007

A 5-year-old girl with congenital sensorial deafness experienced four episodes of bacterial meningitis in a 13-month period. On the fourth episode, an extensive search for the cause of recurrent meningitis was conducted. Complete immunologic studies, humoral, cellular, and phagocytic, yielded negative results. Precise otological examination, i.e., skull roentgenograms, an inner ear target CT scan, and puncture of the eardrum, was attempted, which disclosed the inner ear malformation (Mondini's anomaly) and a cerebrospinal fluid (CSF) fistula. CSF discharge from the oval window was repaired surgically. Extensive otologic evaluation should be conducted in patients with recurrent bacterial meningitis.
Institutionalized Disabled Adolescents
Authors: Furman Lydia M. 
Published: November 2007

Severely handicapped and institutionalized teenage girls have a variety of gynecologic problems that can be readily addressed by a physician with an interest in adolescent medicine who makes "home visits" to the institutions. Disabled teens are a unique group of adolescents whose needs intersect with those of normal teens. Educating and listening to the caretakers, who can then prepare the patients, is essential. Key topics include menses and menstrual calendars, adolescent development, the pelvic examination, and contraception. The clinical problems most frequently encountered are vaginal discharge, menstrual cycle dysfunction, and oligomenorrhea. Basic on-site management is described. In this population, severe chronic illness and subnormal weights for age are not necessarily associated with secondary amenorrhea. Patients, parents, and staff are satisfied when gynecologic needs are met in an empathetic and thorough fashion. A list of educational resources is appended.
Benign Transient Hyperphosphatasia and HIV Infection
Authors: Fennoy Ilene , Laraque Danielle 
Published: November 2007

The disorder, benign transient hyperphosphatasia, has been defined previously as a condition occurring in a normal child with spontaneous, transient elevation of alkaline phosphatase. We report three cases of hyperphosphatasia in patients with congenital HIV infection and underlying liver disease which appear to satisfy the criteria for benign transient hyperphosphatasia despite the presence of chronic disease. These three children, when compared with three normal children with transient hyperphosphatasia exhibited similar patterns of change in serum alkaline phosphatase. Extreme elevation of serum alkaline phosphatase in HIV infected patients does not of itself suggest alterations in clinical status nor indicate the need for extensive evaluation.
Listening Carefully
Authors: Triggs Elizabeth G. , Perrin Ellen C. 
Published: November 2007

A simple checklist was developed for completion by parents prior to their regular meetings with their pediatricians for health supervision. Its efficacy in improving communication between pediatricians and parents about behavioral and developmental concerns was evaluated. Without the checklist, 30 percent of parents' concerns were discussed. More items overall, and more items that were concerns of the parent, were discussed with the use of the checklist than without it (p < 0.05). An intermediate but statistically significant effect was observed even when the pediatrician did not see the completed checklist (43% of concerns were discussed); this effect was increased when he did (53% of concerns discussed). There were marked differences among pediatricians in the number of concerns that were discussed both with and without use of the checklist. Items regarding patterns of family life and child care, death or illness, siblings, and other stresses of modern families were frequently indicated as concerns on the checklist but were less frequently discussed. The data demonstrate the effectiveness of a simple and efficient method to improve communication about childrens' behavior and development between their parents and their pediatricians.
Accuracy of Radiographic Differentiation of Bacterial from Nonbacterial Pneumonia
Authors: Courtoy Isabelle , Lande Arthur E. , Turner Ronald B. 
Published: November 2007

The chest roentgenogram is an accepted tool for the diagnosis of pneumonia. Little information is available, however, addressing the ability of physicians to distinguish bacterial from nonbacterial pneumonias by examination of the chest roentgenogram. Five different observers evaluated 36 chest films from patients with pneumonia who had a laboratory proven etiologic diagnosis. The sensitivity of roentgenogram diagnosis of bacterial pneumonia ranged from 42-58 percent. When clinical and laboratory data were provided to the observers the sensitivity ranged from 42-92 percent. This study indicates that chest film examination is too insensitive to be useful for the selection of patients who have bacterial pneumonia from those whose pneumonia is non-bacterial.
Acute Rheumatic Fever with Advanced Degree AV Block
Authors: Venu Reddy D. , Chun L.T. , Yamamoto Loren G. 
Published: November 2007

Five cases are described of acute rheumatic fever meeting the modified Jones criteria with evidence of second or third degree atrioventricular block (AVB). One patient required a temporary transvenous pacemaker and two patients were treated with corticosteroids. One patient had an associated valvulitis. There was no long-term sequelae due to the AVB in any of the patients. The duration of the advanced degree AVB had a range of about 2 to 12 days. The cause of this advanced degree AVB is uncertain. Advanced degree AVB with acute rheumatic fever appears to be self limited in most instances. Unlike rheumatic valvulitis, it is not associated with significant permanent morbidity.
Self-harm Behaviors (Carving)
Authors: Schwartz Richard H. , Cohen Peter , Hoffmann Norman G. , Meeks John E. 
Published: November 2007

Deliberate self-lacerations by rebellious or delinquent adolescent girls, known by them as "carving," may be erroneously diagnosed as a suicide gesture. Carving is an important physical sign suggesting possible drug and alcohol abuse during adolescence. Eighty-five adolescent female patients in a long-term outpatient, self-payment, therapeutic community-type of adolescent drug treatment program, participated in a descriptive survey of "carving" behaviors. Forty-one girls (48%) admitted to deliberate cutting of their own wrists, arms, or other body parts without suicidal intent. Fifteen of the 85 girls (18%) cut themselves six or more times. Many girls had scarified their bodies with their boyfriends' initials as a visible means of demonstrating their affection and loyalty. They also carved rock group symbols or a Christian cross. Large and disfiguring scars were noted on 14 patients. The girls explained the behavior as a method of dealing with depressed affect, anger, emotional pain, or emptiness. Suicide attempts, usually by purposeful overdose of medication, had been made by 24 (59%) of 41 girls who carved themselves. Multiple suicide attempts were associated with habitual carving. Epidemics of carving, led by one or more angry, depressed, or lonely adolescents, may occur in closed facilities such as correctional institutions and drug abuse treatment facilities.
A Marker for Language Disorders
Authors: Accardo Pasquale , Whitman Barbara 
Published: November 2007

Toe walking unassociated with an autistic disorder or cerebral palsy generally has been considered a normal infant gait. The incidence of toe walking in various diagnostic subgroups of 799 developmentally disabled children presenting to a tertiary-level multidisciplinary assessment clinic was reviewed to investigate the authors' clinical impression that toe walking may be a marker for language dysfunction. Toe walking was found to be more frequent in those diagnostic subgroups with more severe language disorders. Toe walking also correlated with lower IQ scores (p < 0.0001). The sensitivities, specificities, predictive validities and odds ratios all supported the hypothesized association between toe walking and language disorders. Further prospective studies of the neurodevelopmental outcome of children with toe walking are needed to determine whether this behavior can identify children at risk for language disorders.
Development of Positive Feelings in Primiparous Mothers Toward Their Normal Newborns
Authors: Pascoe John M. , French Joyce 
Published: November 2007

Though mothers' development of positive feelings about their newborns is the first step in maternal attachment, little research has described factors which may influence the process. This descriptive study reports normative data for primiparous mothers with normal newborns. The authors interviewed 100 primiparous mothers on the postpartum ward within 72 hours after delivery at a community hospital to ascertain factors associated with the development of positive feelings. Over one third (39%) of mothers studied reported their first positive feeling during the prenatal period, 42 percent during birthing or the first day and 19 percent on the second or third day. A majority of mothers (70%) described their strong positive feelings toward their newborns (i.e., "love") as a sense of caring, commitment and concern. Several demographic, biological and environmental factors were associated with the development of first positive feelings in primiparous mothers. One half of mothers who planned to become pregnant developed positive feelings prenatally, while 57 percent of mothers who did not plan to become pregnant reported their first positive feelings during birth or the first day. Delay in first positive feelings until after the first day was associated with labor longer than 8 hours, disappointment with the "bonding" experience, breast-feeding, and high depressive symptoms.
Young Long Distance Runners
Authors: Nudel Dov B. , Hassett Irene , Gurian Anita , Diamant Shmuel , Weinhouse Elliott , Gootman Norman 
Published: November 2007

This study presents the physiological and psychological characteristics and the running histories of 16 subjects who began long distance running at age 4-12 years. Running duration was 3-15 years (mean 8.4 ± 3.6 yrs). Seven children completed 41 marathons, seven 30-mile races, and eight 60-mile races. The other nine competed at shorter distances. All trained at 30-105 miles/week. Two stress fractures, one back sprain and one knee injury occurred. Athletes who reported injuries from recollection may have underreported some injuries. At age 15.4 ± 4.2 years bone age was 15.3 ± 2.6 years and height was at 51 ± 26.0 percentile. Athletes had larger left ventricular diastolic diameter, higher max O 2 uptake, and delayed onset of anaerobic metabolism compared to controls. Psychological profile: IQ = 121 ± 11, scholastic grade point average (GPA) (n = 13) was ≤3.0 in four, 3.6-3.9 in four, and 4.0 in five. Cattell 16 personality factor (PF): Seven scored above the 85th percentile on boldness, warmth, conformity, sensitivity, dominance, and high drive with tension. Eight scored above the 93rd percentile for self discipline and emotional stability. Human Figure Drawing showed a distorted body image in seven. Two developed anorexia nervosa, and another girl committed suicide. Thus, high physical fitness and no growth retardation were observed. These runners, however, shared distinct positive and negative personality characteristics. The relatively high incidence of severe psychological disorders possibly suggests a need for psychological screening for young children entering a strenuous training program and for close monitoring for development of psychological problems during the program.
Infants with Apparent Life Threatening Events
Authors: Woolf Paul K. , Gewitz Michael H. , Preminger Tamar , Stewart Julian , Vexler David 
Published: November 2007

The role of cardiac dysrhythmias in the pathogenesis of Sudden Infant Death Syndrome (SIDS) is uncertain, 1 but there have been several reports of infants with Apparent Life Threatening Events (ALTE) due to significant dysrhythmias.2-4 To further characterize the cardiac rhythm and conduction of these "at-risk for SIDS" infants, we performed 24-hour continuous (Holter) electrocardiograms on 100 full term, healthy infants with ALTE. Sixty-two patients (62%) had one or more dysrhythmias on Holter monitor. Twenty-five patients (25%) had premature ventricular depolarizations (PVD), including five with couplets. Thirty (30%) had QTc > 2 SD above the mean, and, of these, 40 percent had PVD's. Fifteen (15%) had premature atrial depolarizations and 39 (39%) had evidence of moderate or marked sinus node irregularity. There was no prexcitation, supraventricular tachycardia, ventricular tachycardia, or atrioventricular block. Two patients with marked sinus node dysfunction were treated with propantheline and did well. All patients were monitored at home, with no deaths or clinically significant dysrhythmias on follow-up (1-32 months (mean = 18)). In summary, when Holter monitoring was performed, a high incidence of dysrhythmia was found in infants with ALTE. Most dysrhythmias were clinically insignificant. The incidence of ventricular dysrhythmias and long QTc are consistent with previously advanced theories of cardiac electrical instability in some of these patients, but no patient with ventricular dysrhythmias required therapy. The incidence of sinus node dysfunction requiring therapy was 2 percent. Although Holter monitoring of infants with ALTE only infrequently determines therapy, it may provide data linking theories of cardiac etiology of SIDS with actual clinical events.
Pallid Breath-holding Spells
Authors: DiMario Francis J. , Chee Claire M. , Berman Peter H. 
Published: November 2007

Excessive vagal tone has been implicated as the cause of pallid breath-holding spells (PBHS) in children. The following study was undertaken to test the hypothesis that children with PBHS have underlying autonomic nervous system (ANS) dysfunction. Five patients (age 29-79 months old) who had experienced PBHS were evaluated at a time when they were clear of spells for ANS dysfunction. A battery of clinical bedside tests were given. The results were compared with test results of a control group of children (age 18-104 months) who had not experienced PBHS. Data collected included blood pressure, pulse rate, mean arterial pressure, the 30:15 R-R ratio upon standing, the expiratory:inspiratory (E:I) R-R ratio, pupillary response to conjunctival pilocarpine instillation, and plasma norepinephrine levels upon standing. Breath-holders displayed a statistically significant (p < 0.05) percent decrease in mean arterial pressure (-10.2% PBHS vs. -4.1% controls) and an unsustained increase in pulse rate during the lying to standing maneuver. Two children with PBHS had "positive orthostatic signs," and one child with PBHS had a plasma norepinephrine level of 94 pg/ml (60% below the mean for both groups). There is evidence to suggest a subtle, underlying, generalized autonomic dysfunction in children with PBHS. A strong familial tendency toward syncope, breath-holding spells, and seizures was recognized in nine of ten subjects. Additionally, there was a strong influence from the maternal side of the family in seven of nine subjects.
The Hand as a Target Organ
Authors: Johnson Charles F. , Kaufman Keith L. , Callendar Cynthia 
Published: November 2007

The authors reviewed the abuse reports submitted by the staff of The Children's Hospital, Columbus, Ohio, to determine the incidence and types of injuries inflicted to children's hands. The authors did not study hand injuries in children who were not reported as physically abused. The authors examined two time periods to ascertain changes in injury severity. Of the 631 abuse reports submitted from 1980 to 1982, there were 52 injuries (8.2%) involving the hands. From July 1987 to July 1988 there were 42 hand injuries (13.4%) among 313 reports. In the 94 total cases, 19 (2%) children sustained injury to the hand only, including eight with burns, two with bruises, two with human bites, two with erythema, two with fractures, and one with a laceration. Children with burns to the hand alone were significantly younger than those with other types of injuries. Of the 94 children with hand and other injuries, 18 (20%) required hospital admission. Of the 19 with injuries to the hand only, five required hospital admission. A variety of instruments were used to injure these children. The hand is a delicate organ, and it is frequently the primary or incidental target of child abuse. Familiarity with the patterns and types of hand injury suffered in child abuse is essential for early recognition, reporting, and child protection.
Acute Myocarditis in Infants
Authors: Press Shirley , Lipkind Reina S. 
Published: November 2007

The authors reviewed the initial presentation of seven infants with acute myocarditis. All patients presented with respiratory distress including tachypnea (respiratory rate ≥ 40) and intercostal retractions. Other findings included tachycardia (heart rate ≥ 120) (7/7) and grunting (6/7). Lungs were clear to auscultation in six out of the seven patients. Cardiomegaly was seen in five of the initial chest roentgenograms. Each initial electrocardiogram had abnormal findings. Initial diagnoses were sepsis and shock in three patients, pneumonia and asthma in two, and congestive heart failure in two. Six patients required tracheal intubation. All required admission to the Pediatric Intensive Care Unit (ICU). Two patients died. Myocarditis should be suspected in a child presenting with severe respiratory distress, tachycardia, cardiomegaly, and/or an abnormal electrocardiogram. Prompt stabilization and admission to a pediatric intensive care unit for further evaluation and treatment is essential.
Severe Cow's Milk Induced Colitis
Authors: Wilson Nevin W. , Self Thomas W. , Hamburger Robert N. 
Published: November 2007

Cow's milk induced eosinophilic colitis presenting in the first week of life has been reported, but is very rare. The authors describe a 4-day-old female infant who presented with profuse rectal bleeding resulting in a hematocrit fall from 38% to 30% within 8 hr after hospital admission. Sigmoidoscopy revealed colonic mucosa that was red, edematous, and friable, with punctate hemorrhages. Rectal biopsy showed marked eosinophilic infiltration with multifocal hemorrhage. Further history indicated that while the infant had been exclusively breast-fed since birth, the nursing mother had been drinking 4-5 glasses of cow's milk per day since delivery. Prick puncture skin testing of the infant was positive for cow's milk protein. A serum radioallergosorbent test (RAST) for cow's milk protein was positive. The infant's serum IgE was 1.5 IU/ml. Rectal bleeding resolved when the patient was given a casein hydrolysate formula (Nutramigen, Mead Johnson Nutrition, Evansville, IN), and endoscopy one week later showed improvement, with only scattered areas of erythema, and no friability. We conclude that since the infant was exclusively breast-fed, the milk protein must have passed into the breast milk antigenically intact. Prenatal sensitization probably occurred. Cow's milk induced allergic colitis should be considered in the differential diagnosis of colitis in breast-fed neonates.
Young Children in Recreational Sports
Authors: Stern H. Patrick , Bradley Robert H. , Prince Michael T. , Stroh Suzanne E. 
Published: November 2007

More than 20 million children between ages 6 and 16 years participate in nonschool sports programs, with increasingly more programs being established for younger-age children. A questionnaire based on previous research with adolescent athletes was developed to determine participation motivation of 6- to 10-year-old children. Three hundred fourteen boys participating in a basketball program were interviewed privately with this instrument. Of the 12 participation motivation items, "learn to do my best," "learn and improve skills," "have a coach to look up to," and "get stronger and healthier" were most highly rated, whereas "win games" and "become popular" were rated least important. When responses of 6 and 7 year olds were compared with those of 9 and 10 year olds, older children rated "feel part of a team", "have fun and excitement" and "be with and make new friends" higher at a statistically significant level (p < 0.05). Older children rated "win games" and "become popular" lower at a statistically significant level (p < 0.05). The authors conclude that young children in this recreational sports program make significant distinctions in their participation motivation and that some aspects of participation that motivate them change as they grow older.