bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotics 1971
Authors: Review Topical , Plotkin Stanley A. 
Published: November 2007

The Tenth Interscience Conference on Antimicrobial Agents and Chemotherapy, which convened in Chicago from October 18 to 21, 1970, dealt with a wide range of topics on infectious diseases. Penicillins, cephalosporins and gentamicin dominated the discussions, with as much emphasis given to their pharmacology as to their antibacterial activity. New Penicillins
The Pediatric Emergency Department
Authors: Solky Charles G. , Hoekelman Robert A. 
Published: November 2007

The prevalence of known psychiatric dis turbance in one or both parents of a 15 per cent sample of children seen over a three month period in the emergency de partment of the University of Rochester Medical Center was 12 per cent. Compari son of this group with a control group of children utilizing the emergency depart ment whose parents did not have a known psychiatric disturbance showed no signifi cant differences for race, age, or sex of the children, in frequency of use of the emer gency department, inappropriate use of the emergency department, or frequency of ap pointment breaking. Parents with charac ter disorders and anxiety reactions were most apt to use the pediatric emergency department inappropriately. Since the demographic and utilization characteristics reported upon are of no help in identifying emotional illness in par ents of children brought to the emergency department for care, more subtle indicators of psychosocial difficulties in parents are presented and methods of helping the phy sician in training to recognize and respond to them are outlined.
Deaths Due to Childhood Asthma
Authors: Wood David W. , Lecks Harold J. 
Published: November 2007

Seven cases of death in patients with severe asthma are presented. The cause of death in asthmatic children is discussed under the following headings: mucus plugs, insufficient treatment, infection, aspiration, concomitant disease, oversedation, theophylline toxicity, overuse of metered dose pressurized aerosols, inadequate steroid therapy, and sudden cardiopulmonary arrest. The authors conclude that asthmatic deaths are preventable.
Diarrhea, Red Diapers, and Child Abuse
Authors: Fleisher David , Ament Marvin E. 
Published: November 2007

Three children were chronically given phenolphthalein in the form of laxatives by emotionally disturbed mothers. All children had repeated hos pitalizations and extensive diagnostic testing because of recurrent intractable unexplained diarrhea. One child died. Pink-red urine and stool were passed at some time during their illnesses. The presence of phenolphthalein was tested for by application of dilute acid or dilute alkali to the diapers causing respec tively disappearance or deepening of the pink-red color. Cases went un- diagnosed for prolonged intervals because mothers seemed exemplary. Evidence of their psychiatric illnesses was found once the possibility was considered. Phenolphtalein poisoning should be tested for in any case of intractable diarrhea when objective evidence of intestinal mucosal damage cannot be found. The condition represents a heretofore unrecognized variant of child abuse or battering.
Changes in Aerobic Pharyngeal Flora Related to Antibiotic Use and the Emergence of Gram-negative Bacilli
Authors: Yoshioka Hajime , Fujita Kozo , Maruyama Shizuo , Oka Ryuji 
Published: November 2007

Pharyngeal flora were evaluated semi-quantitatively by counting and differentiating the colonies growing on blood agar plates into four major bacterial groups. In children they consisted mainly of α-streptococci, followed by smaller portions of Neisseria, and of gram-positive organisms other than α-streptococci. Gram-negative bacilli did not occur under normal conditions. Oral ampicillin in a daily dose of 50 mg/kg caused suppression of the α-streptococci, and promoted emergence of gram-negative bacilli. Oral cephalexin in the same dose caused changes in the same direction, but less extensively than ampicillin. Parenteral aminoglycoside antibiotics in usual dosage did not change the pharyngeal flora. Differential counting of the growth is a simple and useful tool to evaluate the ecology of pharyngeal flora. It serves to monitor overgrowth of resistant organisms in the respiratory tract.
Tags and Bands of the Female External Genitalia in the Newborn Infant
Authors: Mor Naomi , Merlob Paul , Reisner Salomon H. 
Published: November 2007

A high incidence of hymenal tags (5.75%) and hymenal bands (2.7%) was found during the routine physical examination of 974 female infants within the first 24 hours of life. Hymenal tags usually disappear spontaneously as the estrogen effect diminishes. If they do not, biopsy should be considered. A simple test is proposed to demonstrate the superficial position of the hymenal band and its lack of connection with an internal structure.
Inflammatory Constriction Following Complete Pericardiectomy in Tuberculous Constrictive Pericarditis
Authors: Kashani Iraj A. , Higgins Charles B. , Utley Joe R. 
Published: November 2007

A 13-year-old boy with active tuberculous constrictive pericarditis underwent complete pericardiectomy together with antituberculous therapy and a short course of steroids. Six weeks following the surgery, he was seen with clinical and hemodynamic findings of recurrent pericardial constriction, presumably due to an inflammatory collection around the heart. Symptoms gradually resolved within six months with resumption of steroid therapy. Repeat hemodynamic study showed normal hemodynamics. The case demonstrates the production of cardiac constriction by nonpericar dial inflammatory tissue and the possible benefits of steroid therapy in the treat ment of tuberculous constrictive pericarditis.
Pediatric Cardiopulmonary Resuscitation
Authors: Ludwig Stephen , Kettrick Robert G. , Parker Margot 
Published: November 2007

Cardiopulmonary resuscitation (CPR) records of 130 pediatric patients with cardiac arrest were reviewed. Ninety-six resuscitations were performed on patients hospitalized on the Medical and Surgical units of the Children's Hospital of Philadelphia (HP) and 34 on Emergency Department patients (EDPs). In HP, initial survival was 90%. In 27% of HPs, airway and breathing techniques alone were life saving. A mean of 2.45 drugs per patient were used for HP. In EDP, initial survival was 56%. There had been advanced CPR during the prehospital transport phase for the EDPs. All but two EDPs required drug management. The mean was 4.25 drugs per patient. Lidocaine and direct current defibrillation were used only rarely. Glucose was used frequently (33%) and should be considered in the list of essential resuscitation drugs. The necessity for resuscitation was most commonly associated with pulmonary diseases. These findings reflect differences between pediatric CPR and adult CPR, and suggest limitations in applying adult standards to infants and children. It is suggested that the medical community develop separate pediatric CPR courses as independent modules for those who assume responsibility for resuscitating children.
Management of Children with Failure to Thrive in a Rural Ambulatory Setting
Authors: Casey Patrick H. , Wortham Betty , Nelson Joann Y. 
Published: November 2007

To evaluate the growth course of children with failure to thrive (FTT) who receive aggressive management, we reviewed the 2-year experience of a secondary level ambulatory diagnostic and management clinic for children with FTT in a mostly rural state. We examined the children managed in this setting for cause of FTT, for growth outcomes after 1 year according to FTT clinical type, and for differentiating predisposing sociodemographic information. Of 154 children referred to this clinic, 131 were diagnosed as suffering from FTT. Eighteen were admitted to the hospital after initial outpatient evaluation, and 93 were followed for at least 1 year. Twenty-two (17%) suffered from organic, 59 (45%) non-organic, and 46 (35%) mixed etiology FTT. After 1 year, 48 (52%) of the FTT children were improved, 37 (40%) were stable, and 8 (9%) were worse. Children placed in foster care were more likely to be improved (78%). FTT children considered improved after 1 year demonstrated the following at the time of initial diagnosis: lower maternal income, lower maternal education, and lower family socioeconomic status; higher birth order; more often black; and less likely for the father to be present in the home (all p ≤ .05). This experience offers several insights into the growth course and team management of FTT children.
Quantitative Reviewing of Medical Literature
Authors: Ottenbacher Kenneth J. , Petersen Paul 
Published: November 2007

The quantitative literature review is presented as a unique type of research endeavor complete with formal stages that parallel those associated with primary or experimental research. This article provides a tutorial overview of the quantitative literature review procedure and, in con junction with the companion article published in this issue, serves to illustrate the application of this technique in the review process. The stages in quantitative review include: (1) problem formation; (2) data collection; (3) data evaluation; (4) analysis and interpretation; and (5) reporting results. It is argued that inferences made in the research review process are as central to the establishment of valid biomedical and clinical knowledge as inferences made in primary research. Despite some limitations, quantitative reviewing procedures constitute a significant advance over the traditional narrative methods of integrating empirical research in an area of interest. The use of quantitative reviewing procedures represents a paradigm shift in which the literature review is conceptualized as a unique form of scientific inquiry complete with formal stages and methods. The adoption of these methods should assist researchers in the behavioral and biomedical sciences in establishing scientifically valid data bases to guide theory development and direct future clinical investigation.
Breast- vs. Bottle-Feeding
Authors: Eiger Marvin S. , Rausen Aaron R. , Silverio John 
Published: November 2007

This study compares the morbidity of two groups of healthy, full-term infants (25 in each group) who were exclusively either bottle-fed or breast-fed for 5 months. There were no statistically significant differences in morbidity between the two groups except for a borderline greater frequency of upper respiratory infections in the bottle-fed group. Although the study groups are limited in size, the results suggest that, when appropriate hygienic measures are taken and statistical biases eliminated, differences in morbidity between bottle-fed and breast-fed babies are relatively minor. The data also show that modern infant formulas seem to be nutritionally complete in that there was no difference in the rate of growth or in hematological parameters measured in the bottle- fed and breast-fed group.
Incidence of Hyperbilirubinemia in Breast- vs. Formula-fed Infants
Authors: Adams Joyce A. , Hey Dennis J. , Hall Robert T. 
Published: November 2007

A retrospective study of 233 consecutively born full-term infants was performed to determine the effect of several variables on the development of hyperbilirubinemia. Thirty-five (15%) of the infants developed peak bilirubin levels greater than 12 mg/dl in the first week of life. Step wise multiple regression analysis revealed that breast-feeding was the most predictive of a group of eight variables for the development of hyperbilirubinemia greater than 12 mg/dl. The correlation between type of feeding and hyperbilirubinemia was significant (p < 0.02). None of the other factors evaluated was significantly associated with hyperbilirubinemia. Breast-fed infants also were found to have a significantly higher incidence of hyperbilirubinemia greater than 15 mg/dl; 12 of 101 (12%) infants compared with 2 of 117 (2%) formula-fed infants (p < 0.002). This group of infants accounted for the increased incidence of hyperbilirubinemia greater than 12 mg/dl in breast-fed infants. There was no significant correlation between weight loss and development of hyperbilirubinemia in the breast-fed infants.
A Comparative Analysis of Newborn Outcome in a Hospital-based Birthing Center
Authors: Waskerwitz Steven , Fournier Linda , Jones Phyllis , Meier Werner 
Published: November 2007

Medical records of babies born in a hospital-based birthing center were reviewed to determine whether a birthing center alternative to traditional hospital care of the newborn is safe and cost- effective. A cohort of 123 hospital-based birthing center low-risk deliveries was compared to 100 control low-risk deliveries born in the traditional setting at the medical center during the same time period. Morbidity was assessed using the Hollister Classification as reference and was based on treatment need. The analysis of the babies' status at birth, 24 hours, and 72 hours revealed no difference in immediate morbidity. Cost of hospitalization was reduced by $340.00 per cohort baby. These data suggest that this alternative can be safe and cost-effective. This study applies only to hospital-based birthing centers, because the safety of free-standing birthing centers has not been established and because screening for low risk can not eliminate morbidity.
Cystinosis Presenting with Features Suggesting Bartter Syndrome
Authors: Whyte Michael P. , Shaheb Sudah , Schnaper H. William 
Published: November 2007

Features suggestive of Bartter syndrome (hypokalemia, hypochloremic metabolic alkalosis, and normal blood pressure despite hyperreninemia and hyperaldoster onism) were found in a 5-year-old black child with cystinosis and Fanconi syndrome. Review of his medical records revealed that these abnormalities had probably been present when he first became clinically ill at 2 years of age. Sodium and potassium chloride supplementation lead to improved growth and strength, partial correction of his electrolyte abnormalities, and a decrease in markedly elevated plasma renin activity. Literature review disclosed a similar presentation in four Caucasian children with cystinosis. Biochemical findings compatible with Bartter syndrome can occur together with evidence of generalized proximal renal tubular dysfunction (Fanconi syn drome) in nephropathic cystinosis.
Respiratory Complications of Metatropic Dwarfism
Authors: Belik Jaques , Anday Endla K. , Kaplan Frederick , Zackai Elaine 
Published: November 2007

Two infants with clinical and radiologic features of metatropic dwarfism presented in the neonatal period with episodes of cyanosis. Diagnostic studies to determine the etiology of these spells, including electrocardiogram, electroencephalogram, arterial blood gases, and metabolic and sepsis studies, were unremarkable. Chest roentgenograms revealed the characteristic long, narrow thoracic cage with no evidence of parenchymal disease. Cervical spine stability evaluation, pulmonary function studies, and chest impedance monitoring with qualitative air flow thermistor studies and transcutaneous oxygen monitoring were carried out. Both patients demonstrated a significant increase in resistance of the respiratory system following passive maneuvering of the head from a neutral position, suggestive of hypopharyngeal air flow obstruction. Obstructive sleep apnea resulting in cyanosis was documented in both patients. All other studies failed to yield a cause for the episodes of cyanosis. Our investigation failed to alter the clinical course which resulted in respiratory arrest and death by 7 months of age. A table is presented for the differentiation of skeletal dysplasias presenting in the perinatal period.
Age-specific Patterns of Diagnosis of Acute Otitis Media
Authors: McFadden D.M. , Berwick D.M. , Feldstein M.L. , Marter S.S. 
Published: November 2007

A retrospective review of clinical experience with the diagnosis of acute otitis media (AOM) in a large pediatric population (age, 0-12 years old) reveals two age-specific patterns of diagnosis: one in preschool children and one in schoolage children. In the population as a whole, AOM is diagnosed most frequently in the first 5 years of life; rates of diagnosis vary with gender (male: female ratio = 1.10) and season (fall/winter peak). In a linear regression model, age, gender, season, and interactions among these account for 52 percent of the variability in diagnostic rates. In children less than 5 years of age, rates of diagnosis vary strikingly with gender and season; the regression model accounts for 55 percent of observed variability in diagnostic rates. In schoolage children (5-11 years old), however, males and females are equally likely to be diagnosed to have AOM, and seasonal variability is blunted; among these children, the regression model predicts only 22 percent of diagnostic rate variability. These findings buttress existing knowledge of the epidemiology of AOM and have important implications for clinical practice, health planning, and pediatric research.
Group C and Group G Streptococci
Authors: Schwartz Richard H. , Shulman Stanford T. 
Published: November 2007

The importance of non-group A streptococci as etiologic agents of acute pharyngitis in endemic circumstances is unclear. The authors attempted to clarify this issue in patients undergoing throat culture for acute pharyngitis in a suburban pediatric practice. Of 6,694 throat cultures, 2,243 (34%) yielded B-hemolytic streptococci, 83 percent (1,783) of which were bacitracin-sensitive and presumptive group A organisms. A random selection of 279 of the 460 bacitracin-resistant streptococci yielded 56 group C, 42 group G, 35 group F, 2 group A, and 3 mixed groups of streptococci. Paired serologic specimens were obtained from 12 children with group C or G streptococci. Four of six group C subjects from whom paired serum specimens were obtained had a significant increase in anti-streptolysin O titer. However, no change in anti-C/G hyaluronidase or anti-C carbohydrate titer was observed. Similarly, two of six subjects with group G streptococci on throat culture in whom paired serum specimens were obtained showed an increase in ASO titer. No seroconversion to anti-C/G hyaluronidase, anti-C, or anti-G carbohydrates was demonstrated. Despite substantial clinical and circumstantial evidence, it could not be confirmed serologically that group C and G streptococci produced acute pharyngitis in this endemic setting.
Relationship of Body Fat Distribution to Metabolic Complications in Obese Prepubertal Girls
Authors: Legido Agustín , Sarría Antonio , Bueno Manuel , Garagorri Jesús , Fleta Jesús , Abós Dolores , Pérez González José 
Published: November 2007

The purpose of this study is to assess the relative effects of body fat distribution and obesity "per se" on serum glucose, insulin, and insulin resistance. Seventeen obese and nine nonobese control prepubertal girls were studied. Biceps, triceps, subscapular, and suprailiac skinfold thickness were measured. Percentage of body fat (% BF) and total body fat (TBF) were calculated. Body fat distribution was assessed by analyzing the central (suprailiac, subscapular)/peripheral (biceps, triceps) ratios. Oral glucose tolerance test was performed. Serum glucose and insulin were measured and insulinogenic index (insulin/glucose) was calculated. Body fat anthropometric data and body fat distribution indexes were significantly higher (p < 0.001) in the obese group. The obese population presented significantly elevated values of glucose, insulin, and insulinogenic indexes (p < 0.01-p < 0.001). In the obese group, insulin showed significant positive correlations (p < 0.05-p < 0.001) with biceps, subscapular, and suprailiac skinfolds, % BF and TBF, whereas the insulinogenic index had positive correlations with suprailiac skinfold and TBF (p < 0.05). Obese girls showed positive correlations between the body fat distribution indexes and insulin or insulinogenic indexes (p < 0.05-p < 0.001). In prepubertal girls obesity is of the centripetal (central) type. This pattern has an important role in determining the alterations in the glucose-insulin homeostasis that characterize the childhood nutritional obesity.
Renal Function in Full-Term Newborns Following Neonatal Asphyxia
Authors: Olavarría Fernando , Krause Sergio , Barranco Luis , Herrmann Fernando , Paez Viviana , Mezzano Sergio , Leal Nora , López María 
Published: November 2007

A prospective study of full-term infants with neonatal asphyxia was performed to evaluate possible alterations in renal function. Twenty-one newborns with an Apgar score ≤ 3 at 1 minute after birth and a control group of 20 normal infants were included. Oliguria of 12 hours or more (less than 1 ml/Kg/h) during the first 24 hours after birth was considered indication for a volume challenge test and use of diuretic. The study of renal function was effected between 24 and 48 hours after birth for asphyxiated and control infants (Period I), and was repeated between 48 and 72 hours (Period II) for the asphyxiated group only. Intrinsic acute renal failure was diagnosed in two patients, one of whom died. In 10 cases, prerenal oliguria responded promptly to volume expansion with improvement of biochemical indices in Period II. In nine cases, urine volume was not altered, and all functional parameters were comparable with those of control.
The Accuracy of Blood Glucose Testing by Children
Authors: Strumph Paul S. , Odoroff Charles L. , Amatruda John M. 
Published: November 2007

While studies have evaluated the accuracy of adult patients and health personnel in reading various glucose oxidase impregnated strips to estimate blood glucose, there are no studies exclusively evaluating the accuracy of children with diabetes reading their own strips as compared to a staff member, and meter to meter variability in reading these strips. We evaluated the accuracy of reading chemstrip bG by children at a summer camp. The children's visual readings of their own strips were compared to the visual reading of a single staff member. A total of 356 Chemstrip bG's were visually read by diabetic children and a single trained staff member at a summer camp for diabetics. The strips were then analyzed by two Accu-Chek bG meters. Intermachine variability was found to be negligible over the entire bG range. For the purposes of this study, we define accurate visual readings as those within ±15 percent of the meter reading of a given strip. At low bG values (40-79 mg/dl), accuracy by children and staff is low, with underestimating occurring in 39 percent of staff readings and 57 percent of children's readings. At intermediate bG values (120-239 mg/dl) readings are more accurate, especially when read by the staff, with misreadings occurring in only 16-19 percent of the strips. At high bG values (240-399 mg/dl), accuracy by children is decreased, with underestimation 500 percent more often than staff. We conclude that children are less accurate at reading Chemstrip bG than a trained staff member (51% versus 33% misreading), especially at the upper and lower ranges of bG values when visual readings are least accurate, and the need for therapeutic intervention is the greatest.