bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing Child Compliance with Nebulized Respiratory Treatment
Authors: Reimers Thomas M. , Piazza Cathleen C. , Fisher Wayne W. , Parrish John M. , Page Terry J. 
Published: November 2007

A 2.7-year-old developmentally delayed boy diagnosed as having chronic lung disease, severe hyaline membrane disease, and persistent pulmonary hypertension with interstitial emphysema was referred in hopes of modifying his refusal to wear a mask during nebulized administrations of Chromolyn. The child was prescribed four 20-minute nebulized treatments daily but resisted treatment and removed the mask by turning his head and pushing the mask away with his hands. A procedure was implemented to gradually teach the child that turning his head and pushing the mask would not result in mask removal, and that by wearing the mask he would receive positive attention. By the end of treatment, the child was consistently wearing his mask for the required 20-minute intervals. Follow-up at 3 months confirmed maintenance of treatment effects.
Thyroiditis
Authors: Szabo Susan M. , Allen David B. 
Published: November 2007

Acute suppurative thyroiditis is rarely seen during childhood. The classic clinical features of this illness (fever, neck pain, and a swollen, tender mass over the thyroid gland) can differentiate acute thyroiditis from the more common subacute thyroiditis. In less typical cases, however, this distinction can be difficult. An adolescent male presented with a swollen, tender thyroid gland. Atypical laboratory findings and the lack of fever and toxicity delayed the diagnosis and treatment of acute suppurative thyroiditis. A review of the pediatric literature summarizes clinical and diagnostic features valuable in the differential between acute suppurative thyroiditis and subacute thyroiditis in childhood. The important contribution of fistulae between the piriform sinus and thyroid gland to the pathogenesis and acute suppurative thyroiditis is emphasized. Such a fistula should be sought in every patient in whom this entity is diagnosed.
Hyperactivity and Inattentiveness
Authors: Safer Daniel , Krager John M. 
Published: November 2007

The school health folders of all students receiving stimulant medication for hyperactivity/inattentiveness from five public elementary and two middle schools in Baltimore County were evaluated to 1) record pre-treatment teacher ratings of those on stimulant medication; 2) assess, using the rating scales, the initial and subsequent effectiveness of the medication; and 3) to identify treatment subgroups. Major findings were 1) three-fourths of the 176 students on stimulant medication in 1987 had pre-treatment ratings consistent with moderate to severe hyperactivity /inattentiveness; 2) over 90 percent of the students evidenced at least 50 percent improvement initially following stimulant treatment by teacher ratings; 3) 76 percent of the medicated students continued to show this level of improvement at the end of the 1987 school year; 4) medication improvement and compliance declined in middle school; 5) 15 percent of the students on stimulant medication in 1987 were inattentive but not hyperactive on baseline teacher ratings, but their degree of improvement with stimulants was equivalent to that of hyperactives; 6) in the county-run hyperkinetic clinic, the subpopulation of inattentive/non-hyperactive students on stimulants rose from 7 percent to 18 percent of the total between 1976 and 1987.
Use in Newborn Infants
Authors: Taylor John , Shannon Reaner , Kilbride Howard W. 
Published: November 2007

The heparin lock technique has been available for parenteral access in older children and adults but has not yet been described for use in newborns. We randomized 39 newborns who needed parenteral medication in the intermediate care nursery to receive a heparin lock catheter (17) or an intravenous line kept patent by continuous low infusion rate (22). There were no differences between study groups with regard to birthweight, gestational age, or distribution of diagnoses. Infants in the heparin lock group were enrolled in the study on average 1 day longer than the continuous intravenous group (p < 0.05). Subcutaneous infiltration occurred twice as frequently with the continuous intravenous line (p = 0.0015), and the life span was significantly less than heparin lock (1.0 ± 0.5 days versus 2.1 ± 1.0 days, p = 0.0003). Infants with continuous intravenous lines received approximately 20 ml/kg/day greater quantity of fluid (p < 0.0001). There was no difference between groups with regard to mean heparin activity level. None of the infants developed hemorrhagic complications, thrombophlebitis, or documented nosocomial infection. Nurses significantly favored heparin locks over continuous intravenous lines for ease of use. The heparin lock technique is a safe and reasonable alternative to a continuous low infusion intravenous line for administering parenteral medications to intermediate care newborns.
Pediatric Bronchoscopy
Authors: Puhakka Heikki , Kero Pentti , Valli Päivi , Iisalo Eila , Erkinjuntti Matti 
Published: November 2007

Data for this article were obtained from a retrospective analysis of 386 pediatric bronchoscopies from 1979 through 1986. Endoscopic procedures were carried out under general anesthesia using a rigid open bronchoscope. There were 235 boys (61 %) and 151 girls (39%). The mean age was 2 years, 3 months. Eight percent of the girls were under 1 month of age, compared with only 4 percent of the boys. The lightest patient weighed 650 g. In children under 1 year of age, the most common indications were dyspnea (32%) and anomaly or suspicion of anomaly (20%). In children over 1 year of age suspected foreign body (32%) and recurrent respiratory infections (30%) were the most common indications. In 15 percent of patients, laryngomalacia and/or an abnormal epiglottis was confirmed. Subglottic stenosis, congenital or acquired, was confirmed in 9 percent and tracheal compression in 12 percent of cases. Seventeen percent of the children showed totally normal findings. There were only eight complications in the whole series and no death or cardiac arrest. The authors confirm the safety of bronchoscopy when careful attention is paid to preoperative investigations, selection of the instruments used, and postoperative care.
Child Abduction
Authors: Forehand Rex , Long Nicholas , Zogg Carolyn , Parrish Elizabeth 
Published: November 2007

The functioning of 17 children who had been abducted by one parent but subsequently returned was examined. The parent to whom the child was returned completed a behavior rating scale on the child for each of three time periods: pre-abduction, immediately post-abduction, and follow-up (the present time). The parents also completed a measure regarding the coping strategy they utilized while the child was missing and a measure of their own functioning at each of three times: pre-abduction, during the abduction, and follow-up. The results indicated that the child was rated as functioning worse immediately post-abduction than at pre-abduction and at follow-up was functioning between that reported at pre-abduction and post-abduction. However, the level of maladjustment was not in the severe range at any of the assessments. Parents reported using a problem-focused or action style of coping. Parents also reported that their psychological functioning decreased during abduction and then improved at follow-up. Again, functioning was not in the severe range at any assessment. Variables such as age at the time of abduction and length of abduction were only minimumally related to parent or child functioning.
Initial Treatment of Cystic Fibrosis
Authors: Roach E.S. , Sinal Sara H. 
Published: November 2007

Four infants with newly diagnosed cystic fibrosis developed a bulging anterior fontanel within days of starting enzyme replacement treatment. In the same time period, 41 hospitalized patients less than 1 year of age were diagnosed as having cystic fibrosis and treated, suggesting that increased intracranial pressure is common in this setting (9.7%). The clinical course of the four infants was similar: the bulging fontanel became apparent 1-6 days after initiation of pancreatic enzyme replacement and resolved within 1 week in three patients and within 4 months in the other patient. Two patients became mildly irritable. Computed cranial tomography and lumbar puncture were done in three patients, with completely normal findings except elevated cerebrospinal fluid pressure in two infants. There was no apparent difference in the treatment or clinical course before diagnosis between the four infants who developed a transient bulging fontanel compared with the overall group of cystic fibrosis patients.
Failure to Thrive
Authors: Wilcox W.D. , Nieburg P. , Miller D.S. 
Published: November 2007

The term "failure to thrive" (FTT) has been used for more than 50 years to describe the infant or young child whose growth falls substantially behind that of his or her peers. Currently, the predominant use of FTT is to describe a child's growth failure resulting from caloric or maternal deprivation or both. Despite widespread use, the term FTT lacks a clarified definition. In this study the authors review 22 current reference texts in general pediatrics, pediatric nutrition, and pediatric gastroenterology and 13 recent journal articles addressing FTT. Only 9 of the 22 texts and 9 of the 13 journal articles describe FTT in quantitative terms, but even these references lack consensus on the anthropometric indices used and their criteria for abnormality. The absence of a standard, scientifically credible definition for FTT, which reflects the dynamic nature of this syndrome, continues to produce an ambiguous body of literature on the subject.
The Infant Feeding Decision in Low and Upper Income Women
Authors: Grossman Lindsey K. , Fitzsimmons Sharon M. , Larsen-Alexander Janet B. , Sachs Larry , Harter Christina 
Published: November 2007

Few studies have described the woman who chooses breast-feeding by more than simple demographics. The purpose of our study was to characterize new mothers by their infant feeding decisions, by demographic and obstetrical data, and by sources of personal support they received during their pregnancies and in making their infant feeding decisions. To this end, 220 were interviewed, including 116 who chose to breastfeed. Breast-feeding women were more likely to be older, more educated, married, more affluent, experienced with breast-feeding, to have demonstrated good prenatal habits, and to have received support from other sources than those who chose bottle feeding. Participation in Lamaze classes, previous successful breast-feeding, and maternal education were significant predictors of feeding choice, and mode of delivery predicted duration of breastfeeding. Low income women who chose breastfeeding resembled low income bottle feeders in certain medical/social factors, but they showed support patterns similar to middle to upper income women.
In Chinese Newborn Infants
Authors: Leung Alexander K. C. , Ma Kenneth C. H. , Oswald Siu T. , Robson W. Lane M. 
Published: November 2007

The palpebral fissure length was measured in 60 normal Chinese term infants in the first 48 hours of life. The measurement of the palpebral fissure length was performed with a vernier caliper by placing it across the greatest horizontal axis of the eye from the medial to the lateral canthus. The head circumference was measured by placing a tape anteriorly just above the eyebrows and posteriorly at the maximum point of the occiput. There was no difference according to sex or between the measurements in the right and the left eye. The palpebral fissure length was 1.94 ± 0.17 cm (mean ± standard deviation (SD)) and the head circumference was 34.0 ± 1.3 cm (mean ± SD). These data suggest that Chinese neonates have a shorter palpebral fissure length than do black American neonates and a longer palpebral fissure length than do white American and Turkish neonates.
Diabetic Ketoacidosis
Authors: Rogers Brian , Sills Irene , Cohen Michael , Seidel F. Glen 
Published: November 2007

Diabetic Ketoacidosis (DKA) remains the leading cause of death in children with type I diabetes mellitus. Complications occurring during DKA treatment include cerebral edema and neurologic collapse. Developmental outcomes following neurologic deterioration during DKA have varied from no sequelae to severe developmental disabilities. A total of three children developed neurologic deterioration during treatment of DKA at Buffalo Children's Hospital between 1984 and 1987. The authors treated aggressively for cerebral edema. Characteristic findings on the computed tomography (CT) scans and magnetic resonance imaging (MRI) of the brain included hemorrhagic infarctions of the thalami, basal ganglia and lentiform nuclei. The authors conducted developmental follow-up examinations between 1-1/2 - 3 years following recovery from DKA coma. Although they noted significant recoveries over time, developmental disabilities persisted. The clinical courses and neuroradiographic findings of these patients are compatible with sequelae of central brain stem herniation and cytotoxic brain injury. Continued efforts are needed in the prevention and early detection of clinically significant cerebral edema during treatment of DKA.
Clinical Evaluation of a New Chest Tube Used in Neonates
Authors: Jung August L. , Nelson James , Jenkins M. Bruce , Hodson W. Alan 
Published: November 2007

We report preliminary experience with a newly designed chest tube (JCT), for evacuation of neonatal pneumothorax. The catheter has a unique pigtail configuration at the distal end, intended to simplify placement and minimize chest wall and lung trauma by reduced tube size and depth and insertion. Thirty-eight JCTs were placed in neonates with pneumothoraces. Neonates' birth weights ranged from 400 to 3,595 grams. All 38 tubes immediately relieved clinical signs of pneumothoraces. Thirty-five (92%) tubes immediately fully evacuated the pneumothoraces as evidences on chest radiograph. Twelve pneumothoraces partially reoccurred at a mean of 24 hours following JCT placement. These tubes were either irrigated or replaced. This newly configured chest tube functions effectively in the treatment of neonatal pneumothorax.
The Effect of the Initial Family Interview on a Pediatric Practice
Authors: Karofsky Peter S. , Rice Richard L. , Hoornstra Lois L. , Slater Cathy J. , Kessinich Cheryl A. , Goode Joel R. 
Published: November 2007

To examine the effect of initial family interviews by health care providers on patients' use of health services, 177 patients and their families were randomly assigned to an interviewed (I) or a non-interviewed (NI) subgroup. Initial interviews would encourage families to bring their children in for health supervision visits, but discourage families from making after-hour telephone calls, using the emergency room and bringing the children to the clinic frequently for problem visits. The I families had an initial interview, attended by all family members. Both a physician and a nurse elicited patient histories and explained use of the emergency room, when to make after-hour calls, how to schedule appointments and other information about the clinic. If I families failed to have an initial interview, they were deleted from the study. In the NI subgroup, patient histories were elicited during a routine health supervision visit without the entire family in attendance, and information about emergency room visits, after-hour calls and appointment scheduling was provided during the same visit. After one year (1987) into the study and two years (1988) into the study, all patient charts were examined. Data analysis was performed using analysis of variance for repeated measures (ANOVA) and step-wise multiple regression of Statistical Analysis System. For 1987, the interview intervention explained a significant (p=0.01) amount of variance in the number of problem visits (less in I) after controlling for months in the study and age of the child. Time produced a significant effect on the total number of problem visits for both subgroups, which decreased significantly (p=0.005) between 1987 (4.2 ± .36) and 1988 (2.9 ± .40). For 1988 the intervention explained a significant (p=0.02) amount of variance in health supervision visits (more in I) after controlling for months in the study and age of the child. Time did not produce a significant effect on the health supervision visits. These data suggest that initial family interviews decrease problem visits and increase health supervision visits in a pediatric practice.
Delay in Obstetrical Care in Newly Diagnosed Teenage Pregnancy
Authors: Pomeranz Albert J. , Matson Steve C. , Nelson David B. 
Published: November 2007

A retrospective study of 42 adolescent patients diagnosed as being pregnant between June 1987 and February 1990 at the Downtown Health Center (DHC), an inner city pediatric primary care clinic, was conducted to determine whether patients referred to a hospital-based Teen Pregnancy Clinic (TPC) were seen within a reasonable period of time. The frequency of sexually transmitted diseases (STDs) was also determined when these women were initially seen at TPC. Only 5 of the 42 patients seen at DHC had a pelvic exam prior to referral. Of the 40 patients seen at TPC, 20% were not seen until four weeks or more after initial diagnosis. Fifty percent had a STD. Pediatricians should recognize that pregnant teenagers may have a significant delay between diagnosis of pregnancy and entry into obstetrical care. Pelvic exam including cultures for STDs is recommended prior to referral.
The mass balance of the Greenland ice sheet: sensitivity to climate change as revealed by energy-balance modelling
Authors: Oerlemans J. 
Published: November 2007

The sensitivity of the mass balance of the Greenland ice sheet to climate change is studied with an energy-balance model of the ice/snow surface, applied at 200 m elevation intervals for four characteristic regions of the ice sheet. Solar radiation, longwave radiation, turbulent heat fluxes and refreezing of melt water in the snow pack are treated separately. The daily cycle is fully resolved. For the climatology chosen as input (mainly from work by A. Ohmura), the mean specific balance produced by the model is 0.079 m/yr (water equivalent). Comparing this with the total accumulation, 0.313 m/yr, it is obvious that the ablation is quite large. However, a 1 K decrease of the imposed annual mean temperature leads to a specific balance of 0.147 m/yr, a 1 K increase to 0.003 m/yr. Because of this large sensitivity, it appears that the present state of balance cannot be determined from climatological data. The calculations show that changes in the earth's orbit during the Holocene must have had a significant effect on the mean specific balance of the Greenland ice sheet. The balance was smaller than today during most of the last 10 000 years, probably by as much as 0.05 m/yr. Further experimentation showed that the changes in the specific balance can be related to changes in summer insolation. The difference between a typical high latitude minimum in insolation (e.g., 25 000 BP) and a high latitude maximum in insolation (e.g., 10 000 BP) is equivalent to the effect of a 2 K difference in annual mean temperature. So when considering mass balance changes for a particular glacier during the Holocene, it is important to consider the orbital and climatic effects separately, because they may work in the same or in the opposite direction, depending on the location. In a warmer world, ablation will increase, but this will be compensated to some extent by increased snowfall. For a uniform warming of 1 K, and including a precipitation rate proportional to maximum possible atmospheric water content, the model predicts a contribution to sea level rise of 0.27 mm/yr.
Palynological and sedimentological records of Holocene human impact from the Etang de Berre, southeastern France
Authors: Laval H. , Medus J. , Roux M. 
Published: November 2007

Pollen and sedimentological analyses of Holocene sediments from the Etang de Berre, close to the Rhone Delta, allow human impact on the Holocene vegetation and hence on the landscape of the Lower Rhone Valley to be considered from c. 5600 BP to 1000 BP. Data, from three Holocene cores provide evidence of erosion layers connected with reductions in the tree cover. These layers, distinguished by a peak in the angle of smectite (θSm) and a decline in the smectite/illite ratio, are interpreted as soil-derived materials transfered to lowland sites by runoff enhanced by forest clearances that repeatedly occurred during the mid- and late-Holocene. This changed the vegetation, lowering the protection of the landscape against anthropic and/or climatic factors.
Holocene climatic and human influences on lakes of the Yucatan Peninsula, Mexico: an interdisciplinary, palaeolimnological approach
Authors: Whitmore Thomas J. , Brenner Mark , Curtis Jason H. , Dahlin Bruce H. , Leyden Barbara W. 
Published: November 2007

We used palaeolimnological techniques to examine effects of Holocene climate change and human influence on lakes of the Yucatan Peninsula, Mexico. The three study lakes are located along a west-east transect that represents a gradient of increasing modern precipitation and density of former Maya settlement. At Lake Coba, an 880-cm sediment core yields a complete record of lacustrine sedimentation that began when the lake first filled ∼8000 BP as groundwater level rose in response to rising sea level and increased precipi tation. Diatom, ostracod, and δ 18O evidence indicate that Lake Coba was initially shallow and saline. Coba, presently in the region of greatest rainfall, showed more episodic water-level changes than Lake San Jose Chulchaca or Lake Sayaucil. High lake level and fresh water were evident at 440 cm (∼2600 BP), followed by a decline in water levels and an increase in total ionic salinity to the present time. In a 613-cm core from Sayaucil, in the intermediate precipitation zone, total salinity was high between 600 and 400 cm (∼3050 and 2000 BP), followed by consistently higher water levels. Salinity was high in the lower portion of a 110-cm San Jose Chulchaca core (beginning ∼1860 BP), followed by a gradual and consistent freshening of water to the present time. Trophic state changes and human influence on lakes were evaluated using diatom, δ13C, total P, sedimentary organic matter, and preliminary pollen data. Maximal human disturbance at Lake Coba, a densely settled Maya urban site, occurred during a deep-water event at 440 cm, followed by a decline in human influence and trophic state to the present time. Trophic state and linear sedimentation rates in Sayaucil increased significantly above 400 cm (after ∼2000 BP), probably associated with initial Maya settlement near Xtojil and subsequent small- scale farming. Limnological disturbance may have preceded the period of maximal human occupation because initial land clearance and consequent soil erosion probably affected water quality substantially. San Jose Chul chaca lacks archaeological evidence of human occupation in the drainage, and shows gradual changes in trophic state not caused by human disturbance. With the exception of a 14C date on wood from the base of the Coba core, 14C dates and chronologies may be artificially old as a consequence of hard-water-lake error. Trophic state changes in the study lakes were generally consistent with known patterns of human settlement and popu lation change. Late-Holocene water-level fluctuations were most pronounced in Lake Coba in eastern Yucatan, where modern rainfall is currently greatest, but lake level is generally lower than during much of the past. Lake level was relatively constant in Sayaucil in the central peninsula, whereas lake level in San Jose Chulchaca in the arid western portion of the peninsula increased gradually over time.