bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baby Powder Use in Infant Skin Care
Authors: Hayden Gregory F. , Sproul George T. 
Published: November 2007

One hundred parents of infants aged 2 weeks to 6 months were surveyed at the time of routine well-child visits to assess parental knowledge about baby powder and to determine whether hospital policy of providing a free powder sample to newly delivered mothers was unwittingly promoting powder usage. Most parents (69%) reported regular baby powder use as part of routine infant skin care. Powder-users were significantly more likely than nonusers to attribute to baby powder the ability to kill bacteria and yeast and to prevent diaper rash (p < 0.01). Even among nonusers, fewer than half were aware that aspiration/ingestion of baby powder was a potential health hazard. Almost all parents reported receiving a free sample of baby powder while in the hospital as part of a complimentary gift pack provided by the manufacturers. Most powder-users were currently using a brand they had received as a sample, and eight parents cited the receipt of a sample as the major determinant for selecting a particular brand of powder. The short- and long-term effects of distributing sample packs to newly delivered parents deserve further study.
Generalized Convulsions as the Presenting Sign of Amoxapine Intoxication
Authors: Rogol Alan D. , Schoumacher Robert , Spyker Daniel A. 
Published: November 2007

Two infants presented for medical evaluation with sudden onset of seizures or coma, without obvious cause. Suspicious circumstances led to toxicological screening analysis. Amoxapine, a recently released antidepressant, was found in the gastric contents of both children an undetermined time after the putative ingestion, but elevated serum concentrations were noted only in one. The pharmacokinetics are described. There were no obvious cardiotoxic or anticholinergic effects in these infants. Thus, they, like older children and adults, manifest mainly central nervous system toxicity rather than the cardiotoxicity and anticholinergic effects of overdose seen with tricyclic antidepressants.
Systemic Haemophilus influenzae Infection in Finland
Authors: Peltola Heikki , Virtanen Marita 
Published: November 2007

A total of 813 patients from the years 1976 to 1980 who had a bacteremic Haemophilus influenzae infection were analyzed. Special attention was paid to disease entities (16.5% of the total) other than meningitis (60.5%) or epiglottitis (23.0%). Ninety-six cases in the nonmeningitis, nonepiglottitis (NMNE) group showed the following distribution: 25 patients with septicemia without specific focus, 21 arthritis, 19 cellulitis, 17 pneumonia, six otitis, four local abscess, two laryngotracheo bronchitis, and two with an eye infection. Eighty-eight percent of the cases were children who were less than 5 years old; in the septicemia and pneumonia groups, however, 33 percent were 15 years of age and older, and 10 percent were over 60 years of age. All diseases in the NMNE group were acute; 51 percent of the patients sought medical advice within two days. C-reactive protein (CRP) was elevated constantly at presentation, erythrocyte sedimentation rate (ESR) was increased (>20 mm/hr) in 87 percent, high fever greater than 38.5°C (101.3°F) was measured in 85 percent, and leukocytosis (>15 × 109/1) was present in 71 percent. Various antimicrobial agents were given for an average of 17 days. The mean period of hospi talization was 13 days. Case fatality rate was 4 percent; all deaths occurred among patients with an underlying disease. No permanent damage was observed.
Cardiopulmonary Responses of Asthmatic Children to Strenuous Exercise
Authors: Chryssanthopoulos C. , Maksud M.G. , Gallen W.G. , Hause L.L. 
Published: November 2007

The purposes of the study were to investigate the cardiopulmonary adaptations of asthmatic children to physical exercise and to evaluate the effects of theophylline. Two groups of children were evaluated. Eight asthmatic children participated in two exercise sessions. Half of the patients received theophylline in predetermined doses during the first session and half prior to the second session. Seventeen normal children matched for age, height, and weight served as controls. Various car diorespiratory parameters were measured every 2 minutes during exercise and prior to termination of maximal physical effort. The results indicate that children with chronic asthma reach the range of predicted maximal aerobic capacity for their age. Theophylline increases the endurance of asthmatic children to maximal physical efforts without improving the cardiorespiratory parameters that were measured. The use of theophylline in therapeutic doses appears safe under conditions of vigorous exercise.
Factors Affecting Visitation of Sick Newborns
Authors: Giacoia George P. , Rutledge Darnelle , West Kerstin 
Published: November 2007

A study of visiting patterns to an intensive care nursery over a 6-month period was undertaken. Data on visits were obtained from 167 admissions, 99 of which were from infants transferred from other towns. In addition, the parents were interviewed to determine factors precluding visiting. Inborn (Group A) and out-of-town (Group B) data were analyzed. For Group A, the mean number of weekly visits was 6.59 (range, 1.7-16.5) and the total cost of visiting during hospitalization was $135.00 (range, 5.76-649.36); for Group B, the figures were 3.6 (range, 0.1- 12.4) and $328.00 (range, 12.96-1523.36), respectively. Parents in Group B visited less often, made fewer telephone inquiries, and earned a lower salary than parents in Group A. Frequency of visits was correlated to social class. The most commonly identified factors limiting visiting were care of siblings, demands of work, cost of the trip, and distance.
Persistent Hypertransaminasemia as the Presenting Finding of Childhood Muscle Disease
Authors: Rutledge Joe , Andersen John , Fink Chester W. , Cook Jay , Strickland Alan 
Published: November 2007

Four children with isolated, persistent elevations of serum transaminases were investigated for hepatic disease and followed for 4 to 24 months before serum creatine kinase determinations were obtained and found to be markedly elevated. Evidence of muscle disease was obtained by close questioning, retrospectively, and mild abnormalities were found on physical examination. Review of laboratory tests in our center for 6 months revealed 30 additional cases of anicteric hypertransaminasemia (20% of those with elevated enzymes), only two of which were unexplained by the admitting diagnosis. Serum transaminase values are elevated in a variety of diseases of different organ systems. Creatine kinase determinations may provide the clue to the diagnosis of occult muscle disease in some children with unexplained anicteric hypertransaminasemia.
Home Phototherapy
Authors: Grabert Brian E. , Wardwell Charlotte , Harburg Susan K. 
Published: November 2007

Hyperbilirubinemia in the healthy, term neonate is the most common reason for prolonged hospitalization. Expense, separation from a nursing mother, imparting a sense of illness to the infant, and disrupting such processes as "bonding" are all drawbacks to in-hospital phototherapy. Home Phototherapy Associates in Colorado Springs, Colorado has treated 260 newborns from April 1982 to February 1985. The infants treated by home phototherapy averaged 0.81 days of hospital phototherapy before being discharged to home phototherapy for an average of 2.44 days. Average bilirubin on entry into home phototherapy was 14.19 mg/dl and 10.97 mg/dl when discontinued. The average age upon entering home phototherapy was 3.97 days. Home phototherapy was ordered at the discretion of the private physician. Parents were given verbal and written instructions on care of the jaundiced newborn, kept a record of their baby's progress and signed a consent form. There have been no complications in 260 newborns treated at home. There were 17 rehospitalizations. Home phototherapy is an effective and safe alternative to prolonged hospitalization for the healthy, full-term newborn with jaundice. Parental satisfaction has been nearly 100 percent. The average daily decrement in bilirubin is comparable with that reported by others for in-hospital phototherapy. The cost savings, uninterrupted "bonding" process, and the ability to keep mother and child united are some of the observable benefits.
A Study of Brucellosis in Childhood
Authors: Sharda Dinesh C. , Lubani Mahmoud 
Published: November 2007

Two hundred children with brucellosis are described. The clinical characteristics on presentation included prolonged fever, arthralgia, weight loss, and malaise in the majority of the patients. Biochemical characteristics included a relative lymphocytosis in 92.9 percent of the patients and elevated liver enzymes in 83.5 percent. The Brucella agglutination titer was 1:320 or more in all the cases studied, but repeated blood cultures yielded growth of Brucella organisms in only 42 percent of the patients. Brucellosis is an important cause of fever in children living in areas where Brucella-infected animals are raised. Consumption of raw milk or dairy products made from raw milk are the main sources of infection. Education of the public and governmental control are necessary to eradicate the disease.
Erythromycin Prophylaxis for Recurrent Otitis Media
Authors: Lampe Richard M. , Weir Michael R. 
Published: November 2007

Patients with recurrent otitis media without persistent middle ear effusion were studied for antibiotic prophylaxis efficacy. In the first phase, erythromycin ethylsuccinate was used as prophylaxis for otitis media in 45 patients in a dose of 10 mg/kg twice daily. Acute otitis media occurred in eight of 45 (18%) while receiving erythromycin, and in 22 of 41 (54%) following prophylaxis termination. The attack rate (episodes of otitis media per 2-month period) was 0.86 before prophylaxis, 0.20 during prophylaxis, and 0.79 following prophylaxis. In a second phase of the study, erythromycin was compared with sulfisoxazole for otitis media prophylaxis in a group of 42 children. Sulfisoxazole (500 mg per dose) was administered twice daily. Acute otitis media occurred in five of 28 (18%) children while receiving erythromycin and in nine of 21 (43%) children while receiving no prophylaxis. The attack rate (episodes of otitis media per 2-month period) was 0.81 before erythromycin prophylaxis, 0.18 while receiving erythromycin, and 0.50 after erythromycin prophylaxis. Acute otitis media occurred in eight of 14 (51 %) children while receiving sulfisoxazole, and in two of five (40%) children while receiving no prophylaxis. The attack rate (episodes of otitis media per 2-month period) was 0.78 before sulfisoxazole, 0.72 while receiving sulfisoxazole, and 0.56 after sulfisoxazole prophylaxis. Erythromycin antimicrobial prophylaxis for children with recurrent otitis media was superior to no prophylaxis and to sulfisoxazole prophylaxis in this study of patients with recurrent otitis media without persistent middle ear effusion.
Pediatric Management of Nonpervasively "Hyperactive" Children
Authors: Landman Gary B. , McCrindle Brian 
Published: November 2007

Sixty-five children viewed by their teachers as hyperactive were evaluated as to whether they would benefit from stimulant medication. All underwent extensive neurodevelopmental and educational testing. Additional information was obtained from school and parent questionnaires and interviews. Children were not placed on medication unless they demonstrated characteristic impulsive, inattentive, and/or overactive behavior in two of three environments (home, school, clinic). Fifty-two children (80%) were not placed on medication. Follow-up was completed in 80 percent, and 93 percent of these children were doing well with nonpharmacologic interventions. Initial comparison of children not placed and placed on medication revealed that age, race, SES, amount of resource help and retention could not distinguish groups. Children placed on medication had difficulties earlier in school (X2 = 4.88, p < 0.05), weren't as delayed academically (X2 = 6.30, p < 0.05) and had less neurodevelopmental disorders (X2 = 9.01, p < 0.01). If a careful psychosocial history does not reveal impulsive, inattentive, and/or hyperactive behavior outside of school, a child should be evaluated to rule out neurodevelopmental and educational problems.
Milk-Thickening Agents as a Treatment for Gastroesophageal Reflux
Authors: Vandenplas Yvan , Sacré Liliane 
Published: November 2007

Milk thickening agents are believed to reduce episodes of gastroesophageal reflux, but their use has not been evaluated thoroughly. We studied the effect of these agents in 30 bottle-fed babies, 6-8 weeks old, with clinical gastroesophageal reflux pathology. Continuous 24-hour esophageal pH monitoring revealed gastroesophageal reflux pathology for all parameters studied: reflux index (18.4%), duration of the longest reflux episode (23.3 min), number of reflux episodes in 24 h (34.5), number of reflux episodes > 5 min (6.8). All investigations were performed in prone-anti-Trendelenburg position. The infants were treated with milk thickening agents (1 g to 115 ml, as recommended by Carre). Most (n = 25) showed clinical improvement of their symptoms. A second pH monitoring was performed under treatment conditions after 7-14 days, and showed in 24 infants a decrease of the number of reflux episodes (15.1 in 24 h) (p < 0.001), but a comparable reflux index (17.8%) (NS) and number of long lasting (>5 min) reflux episodes (7.8) (NS). The duration of the longest reflux episode, however, increased significantly (56.6 min) (p < 0.001). In six infants all parameters were within normal ranges at follow-up. Milk thickening agents seem clinically effective as a treatment for gastroesophageal reflux in individual cases, but can lead to occult gastroesophageal reflux episodes of long duration, possibly increasing the risk for esophagitis or respiratory dysfunction.
Erythromycin-induced Drug Interactions
Authors: Zitelli Basil J. , Howrie Denise L. , Altman Harold , Maroon Thomas J. 
Published: November 2007

The authors report a case of erythromycin-induced carbamazepine toxicity in a 6-year-old child following use of erythromycin ethylsuccinate (50 mg/kg/day). Within 5 days of erythromycin use, vomiting, weakness, lethargy, ataxia, nystagmus, and cogwheeling movements developed. A serum carbamazepine concentration had increased from 11.9 mg/L (measured 1 week prior to antibiotic use) to 25.8 mg/L. Following erythromycin withdrawal, serum concentrations returned toward baseline, and symptoms resolved. Erythromycin has known effects on hepatic enzyme function, with altered cytochrome P-450 function. The dramatic reduction in carbamazepine clearance observed in this patient is similar to that reported when erythromycin is used concurrently with other drugs. A brief review of potentially significant erythromycin drug interactions is presented.
An Evaluation of the Effects of Being Regarded as "Unmotivated"
Authors: Landman Gary B. 
Published: November 2007

To designate someone as unmotivated or lazy has consistently been shown to affect behavior towards that person. A prospective study evaluated the relationship between such a designation and events at school. The subjects included 164 school-aged children who presented to the Johns Hopkins School Problems Clinic and, prior to their evaluation, had extensive forms completed by their teachers and parents. Lack of motivation was seen as the primary cause of school difficulties in 80 children (49%). Testing revealed that 69 percent were more than one year behind academically; 48 percent were more than two years behind. Fifty-one percent had been retained in grade, and 8 percent of those had been retained twice. Only 16 percent were receiving remedial help. A comparison between children seen as unmotivated and those not perceived as such showed that sex, race, and socioeconomic status (SES) were not distinguishing factors. Children seen as unmotivated were further behind academically (Chi2 = 7.02 p < 0.05), had been retained more often (51% versus 25%, Chi2 = 11.6 p < 0.001), and were receiving less intensive remedial help at school (Chi2 = 6.14 p < 0.05). There was a trend for children seen as unmotivated to be older (mean = 129m SD = 38m versus mean = 103m SD = 33m, t = 1.47 p = 0.1).
A Five-Year Chart Review of Children Biopsied to Rule Out Hirschsprung's Disease
Authors: Landman Gary B. 
Published: November 2007

A 5-year chart review of all children biopsied to rule out Hirschsprung's disease was conducted at Johns Hopkins Hospital. A total of 150 (90%) charts of the 160 children who were biopsied were obtained and reviewed. Twenty-four children (16%) had aganglionosis by surgical pathology report. All had the onset of symptoms in the neonatal period. Ninety-seven percent of children without Hirschsprung's disease and who were biopsied after the neonatal period did not have symptoms during the first 4 weeks of life. Despite having severe symptoms from birth, nine (37.5%) of the children with Hirschsprung's disease were not biopsied until an average age of 15 months. Data indicate that using the presence of bowel symptoms from the neonatal period as criteria for referral for biopsy would have missed none of the children with Hirschsprung's disease. Children with symptoms dating from the neonatal period should be considered for biopsy to avoid potential morbidity and mortality from the complication of enterocolitis.
The Natural History of Night Terrors
Authors: DiMario Francis J. , Emery E. Stanley 
Published: November 2007

Night terrors are a sleep disorder, resulting from a partial arousal during slow-wave sleep. They usually occur within 2 hours of sleep onset and are characterized by agitation and unresponsiveness to external stimuli. Nineteen children (ten males, nine females) with onset of night terrors before age 7.5 years were studied by means of a questionnaire. Mean observation time (time from onset age to age at survey) was 8.5 years, but longer than 10 years in nine subjects. Seventy percent of the children had their initial frequency of night terrors as their peak frequency, with a tendency for shorter duration of the parasomnia in this group. Children with onset age less than 3.5 years may be expected to attain a peak frequency of at least one episode per week. Children with onset after 3.5 years, but before 7.5 years, may expect to attain a peak frequency of 1-2 episodes per month. There was a mean duration of 3.9 years, with a tendency for longer duration in children with positive family histories of sleep walking. Fifty percent stopped by age 8 years; 36 percent continued into adolescence. No common abnormal behavioral profile or psychopathology was found. Common precipitants of attacks were not identified.
Non-invasive Diagnosis of Pyomyositis
Authors: Yagupsky Pablo , Shahak Eliezer , Barki Yechiel 
Published: November 2007

Two children, aged 6 and 8 years, were admitted to the hospital because of fever, pain, and tenderness over the muscular masses of the thigh and calf, respectively. The presumptive diagnosis of pyomyositis was confirmed by ultrasound studies. Antibiotic treatment was administered in both cases while one child also required surgical drainage of the muscular suppuration. Complete recovery was achieved in both cases. Performance of ultrasound studies is indicated whenever pyomyositis is suspected.
Sweat Tests in Patients with Diabetes Insipidus
Authors: Doherty-Fuller Eileen , Copeland Kenneth C. 
Published: November 2007

Increased sweat chloride concentrations have been reported in patients with nephrogenic (NDI) but not central diabetes insipidus (CDI).1-5 To determine whether false-positive sweat tests also occur in CDI, six subjects with CDI had plasma electrolytes, osmolalities, and sweat tests performed before and after water deprivation. All subjects were hyperosmolar after dehydration (287 ± 2.0 and 296 ± 3.2 mosm/kg, plasma osmolality before and after dehydration, respectively; p = 0.02). Sweat chloride concentrations before and after dehydration were not different, and no positive sweat tests were observed. Sweat chloride concentrations after dehydration did not correlate with the degree of dehydration as assessed by either plasma sodium or plasma osmolality. We conclude that increased concentrations of chloride in sweat are not typically found in dehydrated subjects with CDI, although they have been reported in subjects with the nephrogenic form.
Post-traumatic Cutaneous Mucormycosis in Diabetes Mellitus
Authors: Ryan-Poirier Kathleen , Eiseman Robert M. , Beaty James H. , Hunt Philip G. , Burghen George A. , Leggiadro Robert J. 
Published: November 2007

Mucormycosis is infrequently encountered in the pediatric population in any of its forms (nasopharyngeal, disseminated, pulmonary, or cutaneous) and generally is associated with the immunocompromised host. We present an adolescent with poorly controlled diabetes mellitus who developed a progressive skin lesion 3 weeks after a motor vehicle accident. Rhizopus species was isolated from the lesion, and the biopsy revealed a fungal vasculopathy. Control of her diabetes, aggressive surgical intervention and a 10-day course of antifungal therapy (amphotericin B) resulted in a favorable outcome. This article illustrates the importance of considering cutaneous fungal infections, especially those in the class zygomycetes, in the diabetic patient with unusual, severe or persistent skin lesions. Early recognition is essential in order to avoid morbidity and mortality from this unusual opportunistic infection.
Group A Streptococcal Rapid Test
Authors: Beach Patricia S. , Balfour Lynda C. , Lucia Helen L. 
Published: November 2007

We studied 29 children, aged 19 months to 16 years, prior to and after 18-24 hours of oral penicillin therapy to confirm the rapid disappearance of detectable pharyngeal antigen and to determine whether the antigen detectable by commercially available kits was excreted into the urine. Patients were recruited based on the presence of pharyngitis, no antibiotic therapy in the preceding 2 weeks, and a positive latex agglutination (LA) for group A beta hemolytic streptococci (GABHS) antigen on pharyngeal swab. Diagnosis was confirmed by positive GABHS culture on blood agar plates. Twenty-five of these children were also tested for GABHS antigen by enzyme-linked immunoassay (EIA). After 18-24 hours of oral antibiotic therapy, only 10 patients had a positive test for GABHS on throat swab. Five of 29 subjects (17%) remained positive by blood agar plate (BAP) culture, eight of 29 (29%) by LA, and four of 23 (17%) by EIA. GABHS antigen was undetectable by LA or EIA in the urines of any of these patients, either prior to or after initiation of treatment, even in specimens concentrated as high as 100 fold. Clinicians should routinely seek a history of prior antibiotic therapy in assessing pharyngitis. Neither of the kits tested are reasonably accurate for GABHS disease by detection of antigen in the pharynx after partial treatment or in the urine at any time.