bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Connection to Primary Care Matter for Children With Attention-Deficit/Hyperactivity Disorder?
Authors: Toomey Sara L. , Finkelstein Jonathan , Kuhlthau Karen 
Published: August 2008

OBJECTIVE. Whether high-quality primary care in the form of a medical home effectively meets the health care needs of children with attention-deficit/hyperactivity disorder is unknown. The objectives of this study were to (1) describe the percentage who report unmet health care need, (2) evaluate whether having a medical home is associated with lower risk for having unmet needs, and (3) compare the impact of having a medical home on unmet need for children with attention-deficit/hyperactivity disorder with those with asthma.
METHODS. Cross-sectional analysis was conducted of the National Survey of Children's Health, 2003, a nationally representative sample. The primary outcome variable was parent-reported unmet health care need. Multivariate logistic regression tested the impact of having a medical home on unmet needs for children with attention-deficit/hyperactivity disorder and asthma.
RESULTS. The National Survey of Children's Health interviewed parents of 6030 children who had attention-deficit/hyperactivity disorder and 6133 children who had asthma and were between the ages of 6 and 17 years. A total of 16.8% of children with attention-deficit/hyperactivity disorder had at least 1 unmet need compared with 6.7% of children with asthma. Although the proportion of children with a medical home was comparable, children with attention-deficit/hyperactivity disorder were 3.5 times more likely to have an unmet need than were children with asthma. Children with asthma who have a medical home have less than half the likelihood of reporting an unmet need in comparison with those without a medical home; however, among children with attention-deficit/hyperactivity disorder, having a medical home was not associated with decreased likelihood of reporting an unmet need.
CONCLUSIONS. Having a medical home is not associated with fewer unmet needs for children with attention-deficit/hyperactivity disorder. Our results suggest that high-quality primary care may not be as successful at meeting the needs of children with behavioral health conditions compared with those with physical conditions.
Perceptions of Oral Health Training and Attitudes Toward Performing Oral Health Screenings Among Graduating Pediatric Residents
Authors: Caspary Gretchen , Krol David M. , Boulter Suzanne , Keels Martha Ann , Romano-Clarke Giusy 
Published: August 2008

BACKGROUND. There is a lack of access to oral health services for American children. Some propose that pediatricians be trained to deliver preventive screening and education to families until they access a dental home. However, little is known about the current oral health training provided during pediatric residency.OBJECTIVE. The purpose of this work was to evaluate the oral health training that pediatricians receive during residency and their attitudes toward performing basic oral health screenings.METHODS. The American Academy of Pediatrics Survey of Graduating Residents is an annual, randomly sampled national survey of graduating pediatric residents. The 2006 Survey of Graduating Residents surveyed 611 residents and examined their perception of their oral health training and their attitudes about performing oral health screenings.RESULTS. Thirty-five percent of residents received no oral health training during residency. Of those who did, 73% had &lt;3 hours of training, and only 14% had clinical observation time with a dentist. Seventy-one percent felt that they had too little oral health training, and only 21% felt that their residency was very good or excellent in preparing them to perform oral health-risk assessments. Residents felt confident in their ability to offer anticipatory guidance but not to do the more technical oral health screenings. The majority of residents believed that pediatricians should conduct basic oral health screenings. Multiple regression analysis indicated that residents who received ≥3 hours of oral health training, who applied for jobs in the inner city, and whose career goal was to work in primary practice are those most likely to support this idea.CONCLUSIONS. Pediatric residents currently receive little training in oral health, and the majority wish for more. This study shows that oral health training during residency can increase pediatrician confidence in participating in important oral health promotion tasks, including anticipatory guidance, oral screenings, and oral health-risk assessment.
Seasonal Invasive Pneumococcal Disease in Children: Role of Preceding Respiratory Viral Infection
Authors: Ampofo Krow , Bender Jeffrey , Sheng Xiaoming , Korgenski Kent , Daly Judy , Pavia Andrew T. , Byington Carrie L. 
Published: August 2008

OBJECTIVE. Our objective was to demonstrate correlations between invasive pneumococcal disease in children and circulating respiratory viruses.
METHODS. This retrospective study included 6 winter respiratory viral seasons (2001–2007) in Intermountain Healthcare, an integrated health system in the Intermountain West, including Primary Children's Medical Center in Salt Lake City, Utah. Children &lt;18 years of age who were hospitalized with either invasive pneumococcal disease in any Intermountain Healthcare facility or culture-confirmed invasive pneumococcal disease at Primary Children's Medical Center were included. We analyzed the correlation between invasive pneumococcal disease and circulating respiratory viruses.
RESULTS. A total of 435 children with invasive pneumococcal disease and 203 with culture-confirmed invasive pneumococcal disease were hospitalized in an Intermountain Healthcare facility or Primary Children's Medical Center during the study period. During the same period, 6963 children with respiratory syncytial virus, 1860 with influenza virus, 1459 with parainfluenza virus, and 818 with adenoviruses were evaluated at Primary Children's Medical Center. A total of 253 children with human metapneumovirus were identified during the last 5 months of the study. There were correlations between invasive pneumococcal disease and seasonal respiratory syncytial virus, influenza virus, and human metapneumovirus activity. The correlation with invasive pneumococcal disease was strong up to 4 weeks after respiratory syncytial virus activity. For influenza virus and human metapneumovirus, the correlations were strong at 2 weeks after activity of these viruses. Pneumonia was the most common clinical disease associated with culture-confirmed invasive pneumococcal disease, mostly attributable to serotypes 1, 19A, 3, and 7F.
CONCLUSIONS. In the post–pneumococcal conjugate vaccine era, seasonal increases in respiratory syncytial virus, influenza virus, and human metapneumovirus infections in children were associated with increased pediatric admissions with invasive pneumococcal disease, especially pneumonia caused by nonvaccine serotypes.
Accidental and Nonaccidental Poisonings as a Cause of Apparent Life-Threatening Events in Infants
Authors: Pitetti Raymond D. , Whitman Emily , Zaylor Abigail 
Published: August 2008

BACKGROUND. Apparent life-threatening events are a relatively common event in children for which there may be a number of causes. Previous reports have suggested that poisonings, either accidental or intentional, may be causes of some events. However, this theory has not been systematically studied.METHODS. We conducted a prospective, descriptive study of infants aged &lt;2 years presenting to a pediatric emergency department of a large, urban tertiary care children's hospital with signs and symptoms of an apparent life-threatening event. All of the children presenting with an apparent life-threatening event were to undergo a standardized evaluation, which included obtaining a comprehensive urine toxicology screen. A positive toxicology screen result was defined as follows: a clinically insignificant screen result (identification of a medication that would not cause an apparent life-threatening event) or a clinically significant screen result (identification of a medication that could cause apnea or other event consistent with an apparent life-threatening event, even if it was a medication that the child was known to be taking).RESULTS. During the study period, 596 children presented to the emergency department with an apparent life-threatening event, and 274 (46.0%) had a toxicology screen performed. Of 274 toxicology screen results, 50 were considered truly positive (18.2%), and 23 positive screen results were considered clinically significant (23 of 274 [8.4%]). Thirteen toxicology screen results were positive for an over-the-counter cold preparation (13 of 274 [4.7%]). No parent admitted to having given his or her child an over-the-counter cold preparation.CONCLUSIONS. A substantial number of children presenting to the emergency department with an apparent life-threatening event had a positive toxicology screen result. In particular, a number of children were found to have been given an over-the-counter cold preparation. We would recommend that toxicology screens be included as part of the routine evaluation of children who present with an apparent life-threatening event.
Birth Weight and Cognitive Ability in Childhood Among Siblings and Nonsiblings
Authors: Yang Seungmi , Lynch John , Susser Ezra S. , Lawlor Debbie A. 
Published: August 2008

OBJECTIVES. The purpose of this work was to examine whether the positive association between birth weight and childhood cognitive ability is seen within siblings from the same family, as well as between nonsiblings, and to determine whether these associations vary with age.
METHODS. We compared the association of birth weight with cognitive ability measured at ages 5 to 6, 7 to 9, and 11 to 12 years among a total of 5402 children from different families with that among 2236 to 3083 sibships from the National Longitudinal Study of Youth 1979-Children.
RESULTS. In the whole cohort, there were positive associations between birth weight and cognitive ability at all ages, with the association increasing with age from a 0.81-point increase at ages 5 to 6 years to 1.30 and 1.44 points at ages 7 to 9 and 11 to 12 years, respectively, per 1 SD of gestational age- and gender-adjusted birth weight z score. With adjustment for covariates, there was marked attenuation of these associations. Mean differences were 0.28 points in children aged 5 to 6 years, 0.67 points in those aged 7 to 9 years, and 0.52 points in those aged 11 to 12 years after adjusting for child's gender, race or ethnicity, year of birth, and age at test; maternal age, height, parity, education, smoking during pregnancy, and cognitive ability; and household income. Our family-based analyses that separated within- and between-family effects found that the between-family associations were much stronger than the within-family associations. However, adjustment for potential confounders attenuated the between-family associations, and there was no evidence for a difference in association comparing the between- and within-family associations.
CONCLUSIONS. In these data, the positive association between birth weight and childhood cognitive ability at ages 5 to 12 years is explained largely by family characteristics rather than a specific intrauterine effect.
Long-Term Outcome of the Ketogenic Diet for Intractable Childhood Epilepsy With Focal Malformation of Cortical Development
Authors: Jung Da Eun , Kang Hoon Chul , Kim Heung Dong 
Published: August 2008

OBJECTIVE. We evaluated the efficacy and long-term outcome of the ketogenic diet in patients with intractable childhood epilepsy as a result of focal malformation of cortical development.
METHODS. A retrospective analysis evaluated seizure outcomes of 47 patients who had intractable epilepsy from (and) surgically remediable focal malformation of cortical development and were first treated with the classic ketogenic diet, involving the 4:1 lipid/nonlipid ratio. The long-term prognosis of 21 patients, who became seizure-free 3 months after the ketogenic diet, was followed up with that of 22 patients who eventually underwent epilepsy surgery.
RESULTS. Three months after diet initiation, 29 (61.7%) patients showed a reduction in seizure frequency of &gt;50%, including 21 (44.7%) who became seizure-free. Of the 21 patients with complete seizure control at 3 months, 16 (76.2%) successfully completed the diet for 2 years without relapse, and 10 (47.6%) have remained seizure-free after cessation of the diet (mean follow-up for 3 years and 10 months), including 1 patient who remained seizure-free with additional medication after a relapse. Of the 22 patients who underwent epilepsy surgery, a seizure-free outcome was obtained for 13 (59.1%).
CONCLUSIONS. The ketogenic diet should be considered to be an additional option even in patients with focal malformation of cortical development, and long-term seizure-free outcome can be expected for patients who become seizure-free 3 months after the diet.
Cognitive Function and Brain Structure in Females With a History of Adolescent-Onset Anorexia Nervosa
Authors: Chui Harold T. , Christensen Bruce K. , Zipursky Robert B. , Richards Blake A. , Hanratty M. Katherine , Kabani Noor J. , Mikulis David J. , Katzman Debra K. 
Published: August 2008

OBJECTIVE. Abnormalities in cognitive function and brain structure have been reported in acutely ill adolescents with anorexia nervosa, but whether these abnormalities persist or are reversible in the context of weight restoration remains unclear. Brain structure and cognitive function in female subjects with adolescent-onset anorexia nervosa assessed at long-term follow-up were studied in comparison with healthy female subjects, and associations with clinical outcome were investigated.PATIENTS AND METHODS. Sixty-six female subjects (aged 21.3 ± 2.3 years) who had a diagnosis of adolescent-onset anorexia nervosa and treated 6.5 ± 1.7 years earlier in a tertiary care hospital and 42 healthy female control subjects (aged 20.7 ± 2.5 years) were assessed. All participants underwent a clinical examination, magnetic resonance brain scan, and cognitive evaluation. Clinical data were analyzed first as a function of weight recovery (n = 14, &lt;85% ideal body weight; n = 52, ≥85% ideal body weight) and as a function of menstrual status (n = 18, absent/irregular menses; n = 29, oral contraceptive pill; n = 19, regular menses). Group comparisons were made across structural brain volumes and cognitive scores.RESULTS. Compared with control subjects, participants with anorexia nervosa who remained at low weight had larger lateral ventricles. Twenty-four–hour urinary free-cortisol levels were positively correlated with volumes of the temporal horns of the lateral ventricles and negatively correlated with volumes of the hippocampi in clinical participants. Participants who were amenorrheic or had irregular menses showed significant cognitive deficits across a broad range of many domains.CONCLUSIONS. Female subjects with adolescent-onset anorexia nervosa showed abnormal cognitive function and brain structure compared with healthy individuals despite an extended period since diagnosis. To our knowledge, this is the first study to report a specific relationship between menstrual function and cognitive function in this patient population. Possible mechanisms underlying neural and cognitive deficits with anorexia nervosa are discussed. Additional examination of the effects of estrogen on cognitive function in female subjects with anorexia nervosa is necessary.
Girls Who Disclose Sexual Abuse: Urogenital Symptoms and Signs After Genital Contact
Authors: DeLago Cynthia , Deblinger Esther , Schroeder Christine , Finkel Martin A. 
Published: August 2008

BACKGROUND. Little information is available about idiosyncratic historical details provided by sexually abused girls, yet this information can help medical professionals diagnose sexual abuse.OBJECTIVES. Our goals were to describe types and frequencies of urogenital symptoms/signs reported by girls who disclosed direct genital contact and to explore factors associated with this reporting.METHODS. We reviewed 161 medical charts of 3- to 18-year-old girls who disclosed sexual abuse by direct genital contact for urogenital symptoms/signs, type of genital contact (oral, object, digital, or genital), time interval between last perpetrator contact and physical examination, age and sexual maturity at the time of last perpetrator contact, genital findings, and other medical diagnoses. Regression analyses were performed to determine factors that were most predictive of symptom/sign reporting.RESULTS. Many of the girls reported multiple types of genital contact; 33% reported oral/object-genital contact, 72% reported digital-genital contact, and 55% reported genital-genital contact. Sixty percent of the girls reported experiencing ≥1 symptom/sign; 53% of the total sample had genital pain, 37% had dysuria, and 11% had genital bleeding. Symptoms/signs were highly associated with genital-genital contact: 48% of the girls reporting genital-genital contact had dysuria compared with 25% of girls not reporting genital-genital contact, 72% had genital pain/soreness compared with 32% not reporting genital-genital contact, and 16% had bleeding compared with 4% of those not reporting genital-genital contact. Using regression analysis, the strongest factor predictive of symptom reporting by the girls was genital-genital contact.CONCLUSIONS. Sexually abused girls who experienced direct genital contact frequently reported symptoms related to the abusive episode. These symptoms were reported most frequently with genital-to-genital contact. This information sheds some light on the mechanism of injury leading to symptom reporting and can be used to further study symptoms/signs reported by sexually abused girls compared with the general population.
Keratinocyte Growth Factor Prevents Radiation Damage to Salivary Glands by Expansion of the Stem/Progenitor Pool
Authors: Lombaert Isabelle M.A. , Brunsting Jeanette F. , Wierenga Pieter K. , Kampinga Harm H. , de Haan Gerald , Coppes Robert P. 
Published: August 2008

Abstract
Irradiation of salivary glands during radiotherapy treatment of patients with head and neck cancer evokes persistent hyposalivation. This results from depletion of stem cells, which renders the gland incapable of replenishing saliva to produce acinar cells. The aim of this study was to investigate whether it is possible to expand the salivary gland stem/progenitor cell population, thereby preventing acinar cell depletion and subsequent gland dysfunction after irradiation. To induce cell proliferation, keratinocyte growth factor (ΔN23-KGF, palifermin) was administered to C57BL/6 mice for 4 days before and/or after local irradiation of salivary glands. Salivary gland vitality was quantified by in vivo saliva flow rates, morphological measurements, and a newly developed in vitro salisphere progenitor/stem cell assay. Irradiation of salivary glands led to a pronounced reduction in the stem cells of the tissues, resulting in severe hyposalivation and a reduced number of acinar cells. ΔN23-KGF treatment for 4 days before irradiation indeed induced salivary gland stem/progenitor cell proliferation, increasing the stem and progenitor cell pool. This did not change the relative radiation sensitivity of the stem/progenitor cells, but, as a consequence, an absolute higher number of stem/progenitor cells and acinar cells survived after radiation. Postirradiation treatment with ΔN23-KGF also improved gland function, and this effect was much more pronounced in ΔN23-KGF pretreated animals. Post-treatment with ΔN23-KGF seemed to act through accelerated expansion of the pool of progenitor/stem cells that survived the irradiation treatment. Overall, our data indicate that ΔN23-KGF is a promising drug to enhance the number of salivary gland progenitor/stem cells and consequently prevent radiation-induced hyposalivation.
Disclosure of potential conflicts of interest is found at the end of this article.
CD105-Positive Cells in Pulmonary Arterial Blood of Adult Human Lung Cancer Patients Include Mesenchymal Progenitors
Authors: Chiba Haruki , Ishii Genicihro , Ito Ta-Kashi , Aoyagi Kazuhiro , Sasaki Hiroki , Nagai Kanji , Ochiai Atsushi 
Published: August 2008

Abstract
Mesenchymal progenitor cells (MPCs) exhibit fibroblast-like morphology and are multipotent cells capable of differentiating into various mesenchymal tissues. Although MPCs have been found in adult bone marrow and umbilical cord blood, there is still controversy as to whether the MPCs are present in adult human blood. To determine whether they are, we cultured mononuclear cells (MNCs) from the pulmonary arterial blood of lung cancer patients. In 94% (29 of 31) of the cases, fibroblasts were expanded ex vivo and were differentiated into an osteogenic lineage or an adipogenic lineage, depending on the specific inducing medium used. These results indicated that pulmonary arterial blood (PA) in the vicinity of lung cancers contains MPCs (PA-MPCs). The cDNA profiles of PA-MPCs, MPCs derived from bone marrow (BM-MPCs), and lung tissue-derived fibroblasts were clustered with a hierarchical classification algorithm. The expression profiles of PA-MPCs (three cases) and BM-MPCs were clearly separated from those of the tissue-derived fibroblasts, and the profiles of the PA-MPCs from the two patients were separated from those of the BM-MPCs. To identify the source of the PA-MPCs, the MNCs from pulmonary arterial blood were exposed to anti-CD14, anti-CD105, anti-CD3, and anti-CD20 antibodies. CD105+ MNCs generated MPCs in eight of eight cases (100%), whereas CD14+, CD3+, and CD20+ mononuclear cells generated MPCs in three of five cases (60%), two of five cases (40%), and zero of three cases (0%), respectively. These findings are the first clear proof that the CD105+ MNC fraction in the pulmonary arterial blood of adult lung cancer patients includes MPCs.
Disclosure of potential conflicts of interest is found at the end of this article.