bluuebunny/crossref_metadata_2025_split huggingface dataset:
Twelve-hour Spontaneous Nocturnal Growth Hormone Secretion in Growth Retarded Patients
Authors: Spadoni G.L. , Cianfarani S. , Bernardini S. , Vaccaro F. , Galasso C. , Manca Bitti M.L. , Costa F. , Boscherini B. 
Published: November 2007

Twelve-hour nocturnal GH secretion was studied in 30 children with familial short stature (FSS), constitutional growth delay (CGD), total growth hormone deficiency (TGHD), partial growth hormone deficiency (PGHD), or idiopathic short stature (ISS). No difference was observed between subjects with FSS and children wtih CGD. The mean 12-hour serum GH concentration was significantly lower in patients with TGHD (p < 0.001), children with PGHD (p < 0.01), and subjects with ISS (p < 0.01) than in subjects with FSS and CGD. No overlap was observed between the range of mean concentration values of children with TGHD and that of subjects with FSS. A significant correlation was found between growth velocity expressed as SD from the mean for bone age and GH concentration (p < 0.001). All patients with a growth velocity <3rd percentile for bone age showed a mean nocturnal concentration <4 ng/ml. These data suggest that evaluation of 12-hour spontaneous nocturnal GH secretion with GH sampling every 30 minutes can be usefully employed in the diagnosis of GH deficiency.
Transient Blindness Following Mild Head Trauma
Authors: Yamamoto Loren G. , Bart Robert D. 
Published: November 2007

A series of seven children in Hawaii experienced transient cortical blindness following mild head trauma. All children, ages 3 through 8, recovered fully. The most prominent clinical feature was initial restlessness and agitation following relatively mild head trauma without significant loss of consciousness (LOC). One child may have experienced this several times. The clinical features associated with a benign outcome in this syndrome include: pediatric age group, mild head trauma, brief or no LOC, onset of blindness occurring within hours of the head injury, absent optokinetic nystagmus, duration of blindness less than 24 hours, agitation and restlessness, absence of skull fracture or visible cerebral injury on CT scan, absence of other neurological deficits, and EEG findings that initially show posterior slowing with subsequent normalization. Transiently fixed and dilated pupils have been described in these patients but should be viewed cautiously by clinicians in making this diagnosis, since cortical blindness is defined by sparing of the pupils. This syndrome may be underdiagnosed, since it may not be obvious that the child is blind unless the diagnosis is considered.
In an Infant with Previously Undiagnosed Hemophilia A
Authors: Faillace Walter J. , Warrier Indira , Canady Alexa I. 
Published: November 2007

We report a 3-month-old infant who became paraplegic from an epidural hematoma caused by a diagnostic lumbar puncture for work-up of sepsis. The differential diagnosis of the cause of paraplegia was epidural hematoma formation versus spinal abscess. Hemophilia A was diagnosed when coagulation studies were discovered to be abnormal, and non-contrast CT scan revealed an epidural mass with spinal cord displacement. The coagulopathy was rapidly corrected preoperatively with an infusion of cryoprecipitate. A medially limited bilateral T8-L4 laminectomy allowed complete evacuation of the hematoma with maximum preservation of normal bone tissue, but no clinical improvement resulted. Coagulopathy should be highly suspect in an infant who becomes paraplegic after lumbar puncture. The coagulopathy may be rapidly corrected with deficient factor replacement, allowing major spinal surgery to be performed safely.
Giftedness
Authors: Shapiro Bruce K. , Palmer Frederick B. , Antell Sue E. , Bilker Stacey , Ross Alan , Capute Arnold J. 
Published: November 2007

A cohort of 200 children, who were followed from birth and periodically evaluated as part of a longitudinal study of child development, was used to determine the ability of the Bayley Scales of Infant Development (BSID) to predict children who would be considered intellectually gifted at 7.5 years. The cohort was predominantly white (91%), upper middle class (70% in Hollingshead class 1 or 2), and had preschool educational experiences (94% ). At outcome, 36 children had WISC-R verbal, performance, or full scale IQs greater than 135 and were called gifted. On average, gifted children walked 0.7 months earlier and spoke two-word sentences 2.2 months earlier than the non-gifted group. As a group, gifted children showed statistically significant, but clinically small, advantages for age of walking, age of speaking two-word sentences, BSID, and Stanford Binet IQ. Of the 36 children who later proved to be gifted, only two had BSID IQs > 134. Of the four children who had BSID IQs > 134, two maintained their superior function but 2 did not. A discriminant function analysis was used to predict giftedness for individual children based on BSID performance. The resulting classification achieved sensitivity = 0.69 and specificity = 0.39. Although groups of infants who will be gifted have higher BSID scores, the BSID cannot be endorsed as a method of identifying individual infants who will later demonstrate superior cognitive function.
Measures of Attention Deficit
Authors: Blondis Thomas A. , Accardo Pasquale J. , Snow Jeffrey H. 
Published: November 2007

Despite much progress in the diagnosis and management of children with attentional problems, hyperactivity, and learning difficulties, current diagnostic techniques remain inadequate to readily distinguish a primary attentional disorder from a more complex secondary problem. Developmental and behavioral questionnaires to supplement office evaluation of hyperactivity, neuromaturation, and selected cognitive processes continue to be improved. These measures suffer from different biases, focus on different childhood characteristics and associated problems, and approach childhood interaction with the environment differently. Several are psychometrically more sound, and several provide the physician with developmental and social information that may help improve the habilitative prescription. The general pediatrician can use these questionnaires to complement his or her evaluation and follow-up of children who present with learning and behavioral problems. Prior to choosing an instrument, the clinician should review the advantages of each and choose the one most suited to his or her practice.
Very-low-birth-weight, Preterm Infants With or Without Intracranial Hemorrhage
Authors: Ford Lisa M. , Kim Han B. , Steichen Jean , Babcock Diane , Fogelson Harold 
Published: November 2007

Fourteen very-low-birth-weight (VLBW) preterm infants with and without intracranial hemorrhage (ICH) were prospectively followed from birth to 4 to 8 years for the purpose of determining neurologic and cognitive sequelae associated with ICH severity and to correlate outcomes with brain morphology as determined by Magnetic Resonance Imaging (MRI). Intracranial hemorrhage was documented by cranial ultrasonography performed in early life. Follow-up assessments included neurologic and psychometric examinations and cranial MRI scans. Of six children with no ICH, five had normal results on all three follow-up measures. Three children with Grade I-II ICH had mild to moderate neurologic and cognitive sequelae with focal white matter MRI abnormalities. Five children with Grade III-IV ICH had severe neurologic, cognitive, and MRI deficits, including MRI regional and diffuse white matter abnormalities and/or cortical atrophy. Focal and diffuse neurologic deficits correlated with the extent of MRI morphologic abnormalities. Results of this study indicate that ICH severity correlated with outcomes in children at follow-up ; the more severe the ICH, the more adverse the neurologic, cognitive, and MRI results. MRI white matter abnormalities were present in all children with any degree ICH, while ventriculomegaly was seen only in severe ICH (Grade III-IV ICH). Neurologic deficits correlated with MRI structural abnormalities.
Auditory Dysfunction
Authors: Oberklaid Frank , Harris Claire , Keir Eddie 
Published: November 2007

One hundred thirty-three children with school problems referred to a hospital-based multidisciplinary clinic were screened audiologically to determine the frequency of auditory problems, and to determine whether one could predict auditory problems from clinical data. Ninety-three (69.9%) failed one or more parts of the screening procedure. Twenty-two children (7.9% of the total group) had abnormal hearing acuity, 33 (30.6%) abnormal speech discrimination in noise, and 73 (62.4%) abnormal short term auditory memory. These figures are significantly higher than those found in a representative sample of school children. Not one of 16 items from parent and teacher questionnaires and neurodevelopmental findings predicted auditory acuity or speech in noise problems; there were correlations between short term auditory memory items and parental and teacher rating of a language problem, teacher rating of reading and sequencing problem, and neurodevelopmental finding of auditory sequencing problem. In view of this inability to clinically predict auditory processing deficits, the authors suggest that a full audiological assessment, including short term memory and speech in noise testing, is warranted as part of the evaluation of children with learning difficulties.
Capillary Blood Glucose Monitor
Authors: Presti Blair , Kircher Tobias , Reed Chuck 
Published: November 2007

The performance of a rapid capillary blood glucose monitor, the Glucoscan 2000, was evaluated in a neonatal patient population by comparison with a reference method on 283 paired patient samples. The median glucose was 56 mg/dL (3.1 mmol/L). The slope of the regression line was .93 with a correlation coefficient r of .82. The average error in Glucoscan values at low, intermediate and high glucose ranges was 43%, 20% and 12% respectively. Precision analysis by replicate determinations also showed an increased coefficient of variation, 7.4%, at low glucose values. The Glucoscan 2000 lacks sufficient accuracy and precision at low glucose values to serve as the exclusive analytic test for the diagnosis of neonatal hypoglycemia.
Potential Substance Abuse
Authors: Schwartz Richard H. , Wirtz Philip W. 
Published: November 2007

The authors administered an abbreviated revision of a previously field-tested, self-administered, brief screening test (the 30-item Drug and Alcohol Problem Quick Screen) to 355 consecutive middle-class adolescent patients seen at a five-pediatrician group practice setting. Ninety-six percent (341) of the subjects completed the 30-item screening questionnaire. Eighty-nine percent of the 341 responders wrote in their names in the space provided for that purpose. Fifty-two patients (approximately 15%) of the 341 responded "yes" to six or more items in the current study. Based on a previous study comparing scores from 200 adolescents from the same pediatric practice with answers from 100 identified adolescent drug abusers at a drug abuse treatment facility, those patients with a score of 6 or more were considered high risk for "red flag" behaviors, particularly drug or alcohol abuse. Forty (77%) of those patients who scored six or greater identified themselves by name. Four key items on the questionnaire accounted for 70 percent of the variation between those at high and those at low risk for drug or alcohol abuse. These four most important items encompassed 1) use of tobacco products; 2) accusation by others of having a drinking or drug problem; 3) school suspension; and 4) riding in a motor vehicle with a driver who drank too much. The DAP Quick Screen appears to be practical as a screening tool in physician's offices for detection of serious problems during adolescence.
Munchausen Syndrome by Proxy and Apnea (MBPA)
Authors: Light Michael J. , Sheridan Mary S. 
Published: November 2007

The authors sent questionnaires to 127 apnea monitoring programs asking whether they had treated patients whose apnea appeared to have been induced by a parent (Munchausen syndrome by proxy-apnea, or MBPA). Fifty-one programs (40%) reported 54 cases of this kind from among their 20,090 monitored patients (0.27%). The authors obtained further information on 32 of these patients, 83% of whom presented with infantile apnea before the third month of life. Although medical problems were documented, including apnea, the clinical condition of these infants was inconsistent with the multiple life-threatening episodes typically reported by parents. Twenty-one of the infants reportedly received cardiopulmonary resuscitation at home, 15 had ambulance calls to the home, and 24 were rehospitalized. Child Protective Service agencies were consulted for 12 patients, 5 of whom were placed in foster homes. Three index infants and five siblings are known to be dead, and one additional infant is severely brain damaged from abuse. The typical presentation of MBPA is multiple, reported, serious episodes of apnea occurring in the presence of only one person. When neither episodes nor cause can be documented satisfactorily, the diagnosis of MBPA should be considered and steps taken to confirm or refute it.
Diseases That Mimic Meningitis
Authors: Levy Maurice , Wong E. , Fried D. 
Published: November 2007

A retrospective review of charts for 650 children who had lumbar puncture for suspected meningitis was undertaken to determine the characteristics of patients with and without meningitis, identify other conditions suggesting meningitis, and evaluate the predictive value of signs and symptoms of meningitis. The incidence of positive lumbar punctures increased with patient age. Younger infants did not present with classical features of meningitis. Bulging fontanel, lethargy, and irritability were nonspecific symptoms. Vomiting and headache, although not specific, proved to be more sensitive indicators of meningeal infection. Most patients with meningitis (75%) had at least one sign of meningeal irritation, but so did 25% of patients without meningitis. Brudzinski's sign was not specific. In contrast, nuchal rigidity and Kernig's sign had high predictive value. Up to age five, the diseases most often suggesting meningitis were right-sided pneumonia, gastroenteritis, otitis, tonsillitis, exanthema subitum, and urinary tract infections. Of 171 patients with febrile convulsion, one (0.5% ) had bacterial meningitis and four had aseptic meningitis.
Ultrasound Guidance
Authors: Rosenberg Henrietta Kotlus , Sherman Nancy H. 
Published: November 2007

Since the advent of improved realtime ultrasound (US) imaging and the availability of the needle biopsy attachment, US-guided percutaneous biopsy and the drainage procedure can be performed safely in the pediatric patient. The authors review their experience over 3 years using US-guided interventional techniques in 96 children aged 5 days to 21 years. A wide variety of procedures were performed and included renal biopsy, nephrostomy tube placement, renal mass biopsy, puncture of bladder sinus tract and pancreatic pseudocyst, ventriculoperitoneal shunt placement and intraoperative localization of brain or renal tumor and renal calculi. No complication occurred. US can be safely and accurately used as guide for interventional procedures in children as long as the area of interest can be clearly demonstrated and the depth and necessary angle of needle insertion can be predetermined as feasible.
Gastroesophageal Reflux in the Older Child: Presentation, Response to Treatment and Long-Term Follow-Up
Authors: Treem William R. , Davis Patricia M. , Hyams Jeffrey S. 
Published: November 2007

Much attention has been focused on the natural history of gastroesophageal reflux (GER) in neurologically normal infants which generally resolves by two years of age. In contrast, little is known of the outcome of GER diagnosed in normal older children. The charts of 32 children (21 males) without neurologic or esophageal anatomic abnormalities, age 3.5 to 16 years (mean = 9.8) at the time of diagnosis, were reviewed. Diagnosis was based on suggestive presenting symptoms and evaluation of prolonged intraesophageal pH monitoring. Esophagitis was diagnosed by histologic criteria in 16 of the 32 patients. Medical treatment consisted of prokinetic agents (metoclopramide, bethanechol) and H2-receptor antagonists. After a one to eight year follow-up period (mean ± SD - 3.4 ± 2.1), the symptoms in 13 children had resolved or were sufficiently improved to discontinue medication. In 13 patients, symptoms were improved but medication was required for adequate control. Four children were symptomatic without improvement in spite of medical therapy and two others required fundoplication for continued severe symptoms and refractory esophagitis. In summary, less than 50% of otherwise normal older children with GER undergo spontaneous resolution of marked improvement in symptoms and the remainder require continued long-term medical and/or surgical management.
General circulation (GCM) modelling of palaeoclimates: a critique
Authors: Street-Perrott F. Alayne 
Published: November 2007

The best method so far devised for testing the ability of a general circulation model (GCM) to simulate climates very different from today is to conduct 'snapshot' experiments for specific times in the past at which the climatic forcing can be prescribed in detail. This paper focuses on the period from the last glacial maximum through the Holocene. During this interval, changes in atmospheric circulation were driven primarily by variations in the seasonality of insolation and secondarily by variations in surface-boundary conditions accompanying deglaciation. Changes in atmospheric transparency are usually neglected, apart from lower CO2 at 18 ka BP. Palaeoclimatic simulations have yielded important insights into the dynamics of glacial/interglacial climate change. The results have been tested in three main ways: 1) qualitative comparison of the spatial patterns of climate anomalies; 2) comparison of the simulated climate at individual grid points or groups of grid points with quantitative estimates derived from geological data; and 3) further processing of the model output to yield simulated values of palaeoclimatic indicators such as pollen spectra. The first approach makes effective use of qualitative data, for example, aeolian evidence. The second is largely confined to data-rich areas such as Europe and North America. The third technique, which capitalises on the relative strengths of both approaches, deserves much greater attention.
The Holocene climatic record of the salt caves of Mount Sedom Israel
Authors: Frumkin A. , Magaritz M. , Carmi I. , Zak I. 
Published: November 2007

Mount Sedom is a salt diapir, on the southwestern shore of the Dead Sea, which has been rising above the local base level throughout the Holocene. Karst development within the salt body has kept pace with the rise forming subhorizontal cave passages with vertical shafts. Wood fragments found embedded in flood sediments that were deposited in the cave passages yielded 14C ages ranging from c. 7100 to 200 BP. A palaeoclimatic sequence was constructed, based on parameters that include: relative abundance of plant types or floral communities, the elevations of the corresponding cave passages and the ratio of their width to present passage width. The results were correlated to the Holocene sedimentary sequence of the Dead Sea Basin, and other features associated with shifting lake levels. Moister climatic stages are indicated by relatively abundant wood remains, by wide cave passages and by elevated outlets indicating high Dead Sea level. Arid periods are marked by a scarcity of wood remains, by narrow cave passages and by low-level outlets. The Holocene sequence of Mount Sedom is subdivided into 10 climatic stages: A moist stage in the early Holocene, older than 7000 BP, and nine subsequent stages of drier climate, fluctuating between conditions that are somewhat drier, up to somewhat moister than those of today. The Dead Sea level dropped from c. -300 MSL during the early moist period to -400 MSL or lower during the subsequent arid periods.
The late Holocene record of aeolian and fire activity in northern Québec, Canada
Authors: Filion Louise , Saint-Laurent Diane , Desponts Mireille , Payette Serge 
Published: November 2007

A set of 196 14C dates was used to reconstruct Late Holocene aeolian activity in the Hudson Bay area along a south-north transect crossing the northern boreal forest, the forest tundra and the shrub tundra zones. The record indicates a minor period of aeolian activity between 4650 and 4050 BP, and three major periods at 3650-2750 BP and after 700 BP. In the northern boreal forest, there was little temporal variation in dune activity, except around 1300-950 BP where a major peak of activity is recorded. In the forest tundra, two major peaks of activity are recorded between 1650-950 BP and after 700 BP. Only minor activity occurred in the shrub tundra during the last 4000 14C-yr and some aeolian events appear to have been slightly out-of-phase compared to the two other zones. Most dates were obtained from non-charred material in the shrub tundra where, unlike in the Subarctic, the aeolian activity responded to a triggering process unconnected with fire. The dune record is compared with that of gelifluction activity in snowpatch environments and with a detailed fire chronology derived from radiocarbon-dated conifer charcoal sampled in present-day treeless sites of the forest tundra. Post-fire gelifluction reached a maximum around 1500-1100 BP and 750 BP. Fire activity was also at a maximum after 2000 BP in the forest tundra. The similarity of the chronologies suggests that fires occurring during cold periods of the late Holocene were catastrophic, having a significant impact on soil erosion and deforestation.
Acute Renal Failure After Cardiopulmonary Bypass: A Possible Association With Drugs of the Fibrate Group
Authors: Sharobeem Kamel M. , Madden Brendan P. , Millner Russell , Rolfe Lindsey M. , Seymour Carol A. , Parker John 
Published: November 2007

Background: Renal failure is a recognized, but infrequent, complication following cardiac surgery. The causes for this condition are multifactorial, and a major concern is that the occurrence of postoperative acute renal failure is still associated with a high mortality rate. Methods and Materials: We report unexpected acute renal failure occurring in 4 patients after uncomplicated cardiac surgery. Each patient was taking a fibric acid derivative at the time of surgery. Renal failure occurred rapidly within 3 days of surgery and was associated with increased concentrations of skeletal muscle-derived creatine kinase (CK). One patient devel oped myoglobinuria, and another developed a malignant hyperthermia-like syndrome. Conclusions: These cases show that patients receiving lipid lowering medications could be at higher risk of developing acute renal failure after cardiac surgery. This association merits careful evaluation in large prospective studies and, if proved, would suggest that patients taking either statins or fibrates should discontinue doing so before cardiac surgery.