bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of near misses in critical care of neonates and children
Authors: Tourgeman‐Bashkin O , Shinar D , Zmora E 
Published: February 2008

AbstractAim: The primary goal of this study was to examine the nature and causes of medical errors known as almost adverse events (AAEs) and potential adverse events (PAEs) in intensive care units.Methods: Observations were conducted in the Neonatal Intensive Care Unit and in the Pediatric Intensive Care Unit in a large hospital in Israel. The AAEs and PAEs were classified into three main categories: environmental, system and human factors. Data encoding and analysis was based on a Bayesian model previously developed to analyse causes of traffic accidents, and the categories were based on systems and ergonomics approaches.Results: ‘Workload’ (a system factor) was the main cause of AAEs and ‘communication failures’ (a human factor) was the second main cause of AAEs. Among the environmental factors, ‘failures in medical devices’ was the most cited cause of AAEs. Environmental factors accounted for most of PAEs and among them ‘form failures’ was the most ‘AAE’‐prone factor.Conclusions: Environmental factors (mainly ‘failures in medical device’) and system factors (mainly ‘workload’) accounted for most of AAEs in the intensive care units studied. The systems and the ergonomics approaches to error analysis can be useful in creating a comprehensive error management programme in order to minimize the gap between work demands and individual capabilities.
Early surfactant in spontaneously breathing with nCPAP in ELBW infants – a single centre four year experience
Authors: Kribs Angela , Vierzig Anne , Hünseler Christoph , Eifinger Frank , Welzing Lars , Stützer Hartmut , Roth Bernhard 
Published: February 2008

AbstractObjective: To evaluate whether the experience with a method to administer surfactant during spontaneous breathing with nasal continuous positive airway pressure (nCPAP) as primary respiratory support in infants with respiratory distress syndrome (RDS) influences the frequency of its use and affects the outcome of patients.Methods: All inborn extremely low birthweight (ELBW) infants treated after introduction of the method were retrospectively studied (n = 196). The entire observational period was divided into four periods (periods 1–4) and compared with a control period (period 0) (n = 51). Primary respiratory support, demographics, prenatal risks and outcomes were compared.Results: There were no changes in demographics or prenatal risks over time. The choice of nCPAP as initial airway management significantly increased from 69% to 91% and for nCPAP with surfactant from 75% to 86%. The rate of nCPAP failure decreased from 46% to 25%. Survival increased significantly between periods 0 and 1 from 76% to 90% and survival without bronchopulmonary dysplasia (BPD) rose from 65% to 80%. No changes in nonpulmonary outcomes were observed.Conclusion: The success of nCPAP increased with increasing use of nCPAP with surfactant. Simultaneously, mortality decreased without deterioration of other outcomes indicating that the use of surfactant in spontaneous breathing with nCPAP could be beneficial.
Cardiorespiratory development in extremely preterm infants: vulnerability to infection and persistence of events beyond term‐equivalent age
Authors: Hofstetter AO , Legnevall L , Herlenius E , Katz‐Salamon M 
Published: February 2008

AbstractObjective: Apnoea, bradycardia and hypoxemia occur frequently in extremely preterm infants, yet there is little longitudinal data describing cardiorespiratory development in these infants. This prospective study characterized early age‐dependent changes in cardiorespiratory function and determined how activity is affected by factors such as underlying disease, postnatal insults and therapeutic interventions.Patients and Methods: Thirty‐three infants born between 23 and 28 weeks gestational age (GA) were monitored weekly from birth to beyond term‐equivalent age (i.e. 25–45 weeks postconceptional age, PCA). Baseline cardiorespiratory activity as well as apnoea/hypopnoea, bradycardia and hypoxemia events were examined using impedance pneumography, electrocardiography (ECG) and pulse oximetry, respectively.Results: Three hundred thirty‐eight cardiorespiratory recordings lasting 3236 h were analysed. While the respiratory rate (RR) did not change during the early postnatal period, heart rate (HR) decreased and O2 saturation improved. There were 5973 total cardiorespiratory events, and their incidence decreased with advancing age. However, they still occurred frequently at term‐equivalent age and after hospital discharge (mean PCA at discharge = 38.3 ± 0.5 weeks). Moreover, infection significantly increased apnoea/hypopnoea and hypoxemia incidence.Conclusion: The persistence of cardiorespiratory events beyond term‐equivalent age as well as the marked impact of infection on cardiorespiratory function indicate that close surveillance after hospitalization is of crucial importance in extremely preterm infants.
Traffic injury mortality in children in transitional Lithuania – a longitudinal analysis from 1971 to 2005
Authors: Strukcinskiene B , Martinkenas A , Towner E , Janson S , Andersson R 
Published: February 2008

AbstractAim: Low‐ and middle‐income countries bear far higher road traffic injury mortality rates than high‐income countries. This paper considers the changing picture of child traffic injury mortality in Lithuania over a 35‐year period.Methods: Road traffic injury mortality data, mortality data from other causes, and population data have been used to compare the trend lines of child road deaths with injury deaths and all deaths and calculate the road traffic mortality rates for children and young people aged 0–19 years.Results: This study revealed an inverted u‐shaped trend, peaking in the 1980s and with a temporary elevated level in the early 1990s, in traffic mortality for the age group 0–19. However, unlike child death by all causes, road traffic injury has not declined significantly between the beginning and the end of the study period. Traffic deaths as a percentage of injury deaths and of all deaths showed a significantly rising trend.Conclusion: Road traffic injury remains a serious public health problem in children and young people in Lithuania, which requires a high priority.
Oestrogen treatment of constitutional tall stature in girls: is there a risk of thrombosis or bleeding?
Authors: Rask Olof , Nilsson Karl Olof , Berntorp Erik 
Published: February 2008

AbstractAim: To evaluate haemostatic effects and clinical outcome of oestrogen treatment of constitutionally tall stature in girls.Methods: We conducted a single‐centre cohort study, 63 girls referred over a period of 15 years were investigated. The girls were given oestrogen treatment for constitutional tall stature at a median initial dose of 300 ug ethinyl estradiol/day and were consecutively examined for changes in coagulation. Medical records were retrospectively reviewed, additional data were collected at follow‐up by blood sampling and interviews.Results: After 1 year of treatment, levels of antithrombin and von Willebrand factor (VWF) were significantly decreased (p < 0.001 and p = 0.015, respectively), whereas there was no significant change in levels of plasminogen inhibitor type 1. No venous thromboembolism (VTE) or major side effects were observed. Genetic risk factors for thrombosis were present, as was expected. The mean height reduction was 5.5 cm. The height‐reducing effect was inversely correlated with chronological age (r =–0.44, p < 0.01) and bone age (r =–0.61, p < 0.01).Conclusions: Changes in coagulation parameters occurred both towards pro‐ and anticoagulation. Treatment with high‐dose ethinyl estradiol can successfully limit final height, and it is most effective when started at a younger bone age.
Outcome of hospital deliveries of women living at high altitude: a study from Lhasa in Tibet
Authors: Yangzom Yeshe , Qian Liling , Shan Mina , La Ya , Meiduo Deji , Hu Xiaoying , Da Qiong , Sun Bo , Zetterström Rolf 
Published: February 2008

AbstractAim: To describe rates of neonatal mortality, low birthweight (LBW), preterm birth and small for gestational age (SGA), and relate outcome to ethnicity and perinatal risk factors of liveborn infants of hospital deliveries in Lhasa. The differences in these variables between ethnic Tibetans and non‐Tibetans were also studied.Methods: Data were prospectively collected on the outcome of all liveborn infants born in four hospitals in the urban area of Lhasa, Tibet, in 2005.Result: A total of 2540 liveborn infants were recorded. The rates of LBW, preterm birth and SGA were 13.6%, 5.7% and 22.2%, respectively. Neonatal mortality rate was 42/1000 for the infants born alive in the hospitals. Lower GA, vaginal delivery, foetal distress and lack of prenatal care, but not ethnicity, were associated with increased risk of death in multivariate logistic regression. Tibetans had higher BW and lower rates of LBW, SGA, need of oxygen supplementation and maternal hypertension, but higher rates of foetal distress, caesarean section, multiple births and low Apgar scores.Conclusion: This study provided a profile of perinatal‐neonatal care of hospital newborn infants in Lhasa, Tibet. The rates of neonatal mortality, LBW and SGA were high. The findings suggest ethnic differences in perinatal‐neonatal adaptation to high altitude.
Late postnatal systemic steroids predispose to retinopathy of prematurity in very‐low‐birth‐weight infants: a comparative study
Authors: Smolkin Tatiana , Steinberg Maya , Sujov Polo , Mezer Eedy , Tamir Ada , Makhoul Imad R. 
Published: February 2008

AbstractBackground and objective: Retinopathy of prematurity (ROP) develops mostly in very‐low‐birth‐weight (VLBW) premature infants. Besides prematurity and hyperoxia, other variables have been brought up as risk factors for ROP. We aimed to search risk factors for ROP by comparing two groups of preemies, one with and the other without ROP.Patients and methods: During 2004–2006, 27 VLBW premature infants developed ROP (ROP group). For each neonate in the ROP group, we chose a neonate born at similar gestational age (GA) (±1week) but without ROP (control group). For each neonate of both groups, we recorded demographic, maternal, gestational, intrapartum, neonatal, interventional, growth and ophthalmologic data from patients' medical records.Results: Eleven of the tested variables were significantly different between the ROP and control groups in univariate analysis. However, only seven of these variables remained significantly different between groups when controlling each variable for GA: bronchopulmonary dysplasia (BPD, p = 0.04), duration of hospitalization (p = 0.017), high‐frequency oscillatory ventilation (HFOV, p = 0.033), duration of oxygen therapy (p = 0.023), surfactant therapy (p = 0.045), inhaled steroids (p = 0.015) and systemic steroids for BPD (p = 0.007). These seven significant variables were related to respiratory morbidity and interventions. Multiple stepwise logistic regression including all significant variables in the univariate analysis showed that only systemic steroids remained significantly different between groups (p = 0.007, OR 5.42, 95% CI 1.60–18.34).Conclusion: Significantly more neonates in the ROP group received late postnatal systemic steroids as compared to controls. We speculate that steroids, by altering insulin growth factor‐1 (IGF‐1) and vascular endothelial growth factor (VEGF) expression, might contribute to the pathogenesis of ROP.
Caregivers attitudes for very premature infants: what if they knew?
Authors: Janvier A , Lantos J , Deschênes M , Couture E , Nadeau S , Barrington K J 
Published: February 2008

AbstractBackground: Decisions about resuscitation of extremely premature babies are controversial. Such decisions may reflect poor understanding of outcomes.Objective: To compare caregivers' attitudes towards the resuscitation of a premature infant if they are only told the infant's gestational age or if they are only given prognostic information for infants at that gestational age.Design/methods: Residents and nurses involved in perinatal care were asked whether they would resuscitate a depressed AGA 24‐week gestation infant at birth. In another question they were asked whether they would resuscitate a depressed preterm infant with a 50% chance of survival, knowing that of those who survived, 50% would have a development ‘within normal limits’, 20–25% a serious handicap and 40% with behavioural and/or learning disability.Results: Two hundred and seventy‐nine caregivers responded (91% response rate). In the scenario that only presented gestational age, 21% of respondents would resuscitate. In the scenario that only presented prognostic statistics, 51% of respondents would resuscitate (p < 0.05).Conclusions: Providers of perinatal health care respond to vignettes differently depending upon the format in which information is provided. The relative unwillingness to resuscitate a baby of 24‐week gestation is surprising since outcomes for such babies are the same or better than those we described in the scenario that provided only outcome data without specifying gestational age. Two explanations are possible: (1) respondents have irrational negative associations with low gestational ages or (2) respondents are unaware of actual outcomes.
Longitudinal study of the growth of infants with isolated Robin sequence considered being severe cases
Authors: Marques Ilza L , Bettiol Heloísa , De Souza Luiz , Barbieri Marco A , Bachega Maria I 
Published: February 2008

AbstractAim: To study the growth of infants with isolated Robin sequence (IRS) considered being severe cases during the first 6 months of life.Methods: Twenty infants with IRS, considered being severe cases were followed in a pure prospective longitudinal study. Feeding facilitating techniques were applied to all infants after airway disobstruction and a hypercaloric diet was offered. Weight and length were measured at birth and at 2‐month intervals until 6 months of age.Results: The infants with severe IRS under study showed impaired weight and length growth from birth to 6 months of age when the values were compared to the NCHS2000 reference.Conclusions: Malnutrition persisted in infants with severe IRS during the first 6 months of life despite the use of special diet and techniques developed for clinical recovery of this anomaly.
Prevalence of the metabolic syndrome in secondary school adolescents in Beijing, China
Authors: Yi‐Qun XU , Cheng‐Ye JI 
Published: February 2008

AbstractAim: To estimate the prevalence and distribution of the metabolic syndrome and to determine the risk factors associated with the metabolic syndrome in secondary school adolescents.Methods: In 2006, we conducted a school‐based survey in Beijing, China. Questionnaire data, anthropometric, blood pressure, and biochemical measurements were available for 2020 adolescents aged 14–16 years. The metabolic syndrome was assessed using the National Cholesterol Education Program's (NCEP) Adult Treatment Panel (ATP) criteria modified for age.Results: The overall prevalence of the metabolic syndrome among adolescents was 3.3%. In Beijing, 4.2% of boys and 2.5% of girls were affected (p < 0.05). The syndrome was present in 28.1% of obese adolescents compared with 6.0% of overweight and 0.2% of normal status (p < 0.001). Abdominal obesity and elevated blood pressure were the most common components of the metabolic syndrome in boys, and elevated triglyceride (TG) and abdominal obesity were the most common in girls. The prevalence of the metabolic syndrome was influenced by body mass index (BMI) status, father's educational degree and pubertal development.Conclusion: The metabolic syndrome and its components are frequent in overweight and obese adolescents in Beijing. Early identification and treatment of these risk factors may help target intervention to improve future cardiovascular health.
The burden of unintentional injuries among the under‐five population in South Asia
Authors: Hyder Adnan A. , Wali Salman , Fishman Steven , Schenk Ellen 
Published: February 2008

AbstractBackground: Childhood injuries are a growing global concern, one that falls disproportionately on developing countries where public health systems are least prepared to address this problem.Aim: This study assesses the impact of childhood injuries in the developing region of South Asia in order to set forth an agenda for improving child health in that region.Methods: A systematic review was conducted for literature with quantitative data on unintentional injuries in children 0–4 years of age published between 1980 and 2007. The information was collated to estimate the mean, weighted mean and mortality rate for each type of injury. The rates were then applied to the 2000 UN projected population to estimate the number of childhood deaths due to unintentional injuries.Results: Unintentional injuries are estimated to cause 389 000 annual child deaths in South Asia. This premature mortality results in the annual loss of 74 healthy life years (HeaLYs) per 1000 population.Conclusion: The current burden of childhood injuries in South Asia is unacceptably high and calls for efforts from all sectors involved in research, policy and funding to not only assess the impact of childhood injuries but to strengthen the health systems to stem this preventable loss of healthy life.
Crying behaviour in early infancy is associated with developmental outcome at two years of age in very low birth weight infants
Authors: Munck Petriina , Maunu Jonna , Kirjavainen Jarkko , Lapinleimu Helena , Haataja Leena , Lehtonen Liisa ,   the PIPARI Study Group
Published: February 2008

AbstractAim: To evaluate the association between infant fussing and crying and developmental outcome in very low birth weight (VLBW) infants.Methods: Hundred and seventeen VLBW infants were followed up to 24 months of corrected age. The duration of fussing and crying and frequency of fuss/cry bouts were measured at term 6 weeks and 5 months of corrected age. Cognitive and motor development was assessed at 24 months of corrected age.Results: The increased duration of combined fuss/cry at term associated with lower psychomotor developmental index (PDI), [regression coefficient (b) =−0.83, p = 0.025]. Crying at term associated negatively with mental developmental index (MDI) (b =−0.91, p = 0.040) and PDI (b =−1.10, p = 0.015). The associations between fuss/cry and PDI, and crying and PDI persisted in multiple regression analysis (b =−0.89, p = 0.030 and b =−1.23, p = 0.018, respectively). Excessive fuss/cry (≥180 min/day) at term associated with lower PDI (p = 0.005) and at 6 weeks with lower MDI (p = 0.024) and PDI (p = 0.012). Increase in the frequency of fuss/cry bouts at 5 months associated with higher PDI in both simple (b = 2.90, p = 0.045) and in multiple regression analysis (b = 3.60, p = 0.019).Conclusions: In VLBW infants, longer duration of fussing and crying in very early infancy, but not at 5 months, is associated with less optimal development at 24 months of age.
Relationship between oral health, nutrient intake and nutritional status in a sample of Brazilian elderly people
Authors: De Andrade Fabiola Bof , De França Caldas Jr Arnaldo , Kitoko Pedro Makumbundu 
Published: February 2008

Objective:  To evaluate the relationship between the oral health condition, the nutrient intake and the body mass index (BMI) in elderly people.Background:  Impaired dentition has been associated with an inadequate consumption of key nutrients and with changes in nutritional status in elderly people.Materials and methods:  The sample comprised 887 elderly people, aged 60 and over, of whom 816 underwent a clinical oral examination and were allocated into groups according to the numbers of teeth and number of posterior occluding pairs of natural teeth. Nutritional status was determined using the BMI. Dietary intake was assessed by a 24‐h diet recall interview and the data from these records were converted to nutritional intake using DietPro software. Differences between means were evaluated using anova, together with the Tukey test or Dunnet test, according to the normality of the data. Associations between categorical variables were tested using chi‐square analysis.Results:  Ages ranged from 60 to 96 years (mean, 71.46 years), with 47% of the respondents in the 60‐to 69‐year‐old group. A high DMFT index (mean, 27.81) was observed with the missing component accounting for 88.8% of the index. Significant differences were observed between the mean intake of nutrients and the number of posterior occluding pairs of natural teeth (p < 0.05). No significant differences were found between the number of teeth and BMI.Conclusion:  Nutrient intake is associated with the oral health status as defined by clinical measures.
Effects of Azumolene on Normal and Malignant Hyperthermia‐Susceptible Skeletal Muscle
Authors: Sudo Roberto Takashi , Carmo Paula Lima do , Trachez Margarete Manhães , Zapata‐Sudo Gisele 
Published: February 2008

Abstract:  Malignant hyperthermia is a pharmacogenetic disease of skeletal muscle in which a life‐threatening, hypermetabolic syndrome is induced by exposure of susceptible patients to halogenated general anaesthetics and/or succinylcholine. Dantrolene sodium, the only drug effective for treatment of malignant hyperthermia, has low water solubility that makes its clinical use difficult. The aim of this study was to investigate the potency of azumolene, a 30‐fold more water‐soluble analogue, in comparison to the prototype dantrolene sodium, on mammalian and human skeletal muscles. The twitches of extensor digitorum longus and soleus muscles from mice were inhibited by azumolene with IC50of 2.8 ± 0.8 and 2.4 ± 0.6 µM, respectively. The IC50of dantrolene sodium in these muscles was 1.6 ± 0.4 and 3.5 ± 1.2 µM, respectively, with no difference in comparison to azumolene. Previousin vitroexposure of mouse soleus muscle to azumolene and dantrolene sodium (10 µM) significantly inhibited 8 mM caffeine‐induced contractures. Azumolene was just effective as dantrolene sodium in relaxing caffeine‐induced contractures of mouse soleus muscle. Intravenous injection caused dose‐dependent decreases in twitches of guinea pig gastrocnemius muscle with IC50of 1.2 ± 0.1 and 1.5 ± 0.2 mg/kg for azumolene and dantrolene sodium, respectively. Azumolene, 10 µM, was effective in blocking and reversing caffeine‐induced contracture of human malignant hyperthermia susceptible skeletal musclein vitro. These studies provide evidence that azumolene is equipotent to dantrolene sodium in blocking pharmacologic‐induced muscle contractures and that azumolene should be efficacious for treatment/prevention of malignant hyperthermia.