bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allergic Reactions to Measles-Mumps-Rubella Vaccination
Authors: Patja Annamari , Mäkinen-Kiljunen Soili , Davidkin Irja , Paunio Mikko , Peltola Heikki 
Published: August 2004

Objective.Immunization of egg-allergic children against measles, mumps, and rubella (MMR) is often deferred or even denied, although the safety of this vaccination has been clearly shown. Moreover, the majority of severe allergic reactions have occurred in egg-tolerant vaccinees. Other allergenic vaccine components have been sought, and gelatin has been suggested as one cause of allergic adverse events. The aim of this study was to further characterize the actual allergenic vaccine components.Methods.Serum samples from 36 recipients of MMR vaccine with anaphylaxis, urticaria with or without angioedema, asthmatic symptoms, or Henoch-Schönlein purpura were analyzed by CAP System radioallergosorbent test (RAST) and immunospot methods to detect the allergenic vaccine component. To evaluate the correspondence between the findings in the CAP System RAST or the immunospot and clinical symptoms, histories of allergies and present hypersensitivity symptoms were assessed.Results.Of the 36 participants, 10 were demonstrated to be allergic to gelatin. Seven of them had persistent allergic symptoms, possibly attributable to foods containing gelatin or cross-reactive allergens. The results of the immunospot suggested concomitant allergy to gelatin and egg, chicken, and feathers, as well as cow's milk, or they reflected allergen cross-reactivity.Conclusions.Although severe allergic adverse events attributable to MMR vaccination are extremely rare, all serious allergic reactions should be further assessed to detect the likely causative vaccine component, including gelatin. The current recommendation for immunization of egg-allergic persons according to standard MMR vaccination schedules is reinforced. measles, mumps, and rubella vaccine, immunization, adverse effects, allergic reactions, gelatin allergy, CAP System, radioallergosorbent test, immunospot, immunoglobulin E.
Microstructural Brain Development After Perinatal Cerebral White Matter Injury Assessed by Diffusion Tensor Magnetic Resonance Imaging
Authors: Hüppi Petra S. , Murphy Brendan , Maier Stephan E. , Zientara Gary P. , Inder Terrie E. , Barnes Patrick D. , Kikinis Ron , Jolesz Ferenc A. , Volpe Joseph J. 
Published: August 2004

Objective.Brain injury in premature infants is characterized predominantly by perinatally acquired lesions in the cerebral white matter (WM). The impact of such injury on the subsequent development of cerebral WM is not clear. This study uses diffusion tensor magnetic resonance imaging (MRI) to evaluate the effects of cerebral WM injury on subsequent microstructural brain development in different WM areas of the brain.Methods.Twenty premature infants (gestational age: 29.1 ± 1.9 weeks) were studied by conventional MRI within the first 3 weeks of life and again at term, with the addition at the latter time of diffusion tensor MRI. Ten of the preterm infants had cerebral WM injury identified by the early MRI and were matched with 10 premature infants of similar gestational age and neonatal course but with normal neonatal MRI scans. Diffusion tensor MRI at term was acquired in coronal and axial planes and used to determine the apparent diffusion coefficient, a measure of overall restriction to water diffusion, and the relative anisotropy (RA), a measure of preferred directionality of diffusion, in central WM, anterior frontal WM, occipital WM, temporal WM, and the posterior limb of the internal capsule. Diffusion vector maps were generated from the diffusion tensor analysis to define the microstructural architecture of the cerebral WM regions.Results.At term, the diffusion tensor MRI revealed no difference in apparent diffusion coefficient among preterm infants with or without perinatal WM lesions. By contrast, RA, the measure of preferred directionality of diffusion and thereby dependent on development of axonal fibers and oligodendroglia, was 25% lower in central WM, the principal site of the original WM injury. However, RA was unaffected in relatively uninjured WM areas, such as temporal, anterior frontal, and occipital regions. Notably, RA values in the internal capsule, which contains fibers that descend from the injured cerebral WM, were 20% lower in the infants with WM injury versus those without. Diffusion vector maps showed striking alterations in the size, orientation, and organization of fiber tracts in central WM and in those descending to the internal capsule.Conclusions.Perinatal cerebral WM injury seems to have major deleterious effects on subsequent development of fiber tracts both in the cerebral WM and more distally. The ultimate impact of brain injury in the newborn should be considered as a function not only of tissue destruction, but also of impaired subsequent brain development.
Residential Exposures Associated With Asthma in US Children
Authors: Lanphear Bruce P. , Aligne C. Andrew , Auinger Peggy , Weitzman Michael , Byrd Robert S. 
Published: August 2004

Objective.Residential exposures are recognized risk factors for childhood asthma, but the relative contribution of specific risk factors and the overall contribution of housing to asthma in US children is unknown. The objective of this study was to identify risk factors and estimate the population attributable risk of residential exposures for doctor-diagnosed asthma for US children.Methods.A cross-sectional survey was conducted from 1988 to 1994. Survey participants were 8257 children who were &lt;6 years old and who participated in the Third National Health and Nutrition Examination Survey, a survey of the health and nutritional status of children and adults in the United States. The main outcome measure was doctor-diagnosed asthma, as reported by the parent.Results.Six percent of children had doctor-diagnosed asthma. The prevalence of asthma was higher among boys (6.7%) than girls (5.1%) and was higher among black children (8.9%) than white children (5.2%). Risk factors for doctor-diagnosed asthma included a family history of atopy (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.5, 3.1), child's history of allergy to a pet (OR: 24.2; 95% CI: 8.4, 69.5), exposure to environmental tobacco smoke (OR: 1.8; 95% CI: 1.2–2.6), use of a gas stove or oven for heat (OR: 1.8; 95% CI: 1.02–3.2), and presence of a dog in the household (OR: 1.6; 95% CI: 1.1, 2.3). The population attributable risk of ≥1 residential exposure for doctor-diagnosed asthma in US children &lt;6 years old was 39.2%, or an estimated 533 000 excess cases, whereas having a family history of atopy accounted for 300 000. The attributable cost of asthma as a result of residential exposures for children &lt;6 years old was $402 million (95% CI: $296–$507 million) annually.Conclusions.The elimination of identified residential risk factors, if causally associated with asthma, would result in a 39% decline in doctor-diagnosed asthma among US children &lt;6 years old.
Sudden Infant Death Syndrome, Bedsharing, Parental Weight, and Age at Death
Authors: Carroll-Pankhurst Cindie , Mortimer Edward A. 
Published: August 2004

Objective.To assess the role of parental bedsharing in sudden infant death syndrome (SIDS)-like deaths, this study examines the hypothesis that, compared with other SIDS cases, the age distribution of deaths associated with bedsharing should be lower in younger, less vigorous infants.Methods.For 84 SIDS cases in Cleveland, Ohio, 1992 to 1996, age at death, maternal weight, and other risk factors for SIDS were compared for cases grouped according to bedsharing status.Results.Mean ages at death were 9.1 weeks for 30 bedsharing and 12.7 for 54 nonbedsharing cases, counting 10 with missing information as nonbedsharing. Mean pregravid weights of bedsharing mothers exceeded those of nonbedsharing mothers (84.1 vs 67.0 kg). Mean ages at death for nonbedsharing infants, bedsharing infants of smaller mothers, and bedsharing infants of larger mothers were 12.7, 10.3, and 7.6 weeks, respectively. Large maternal size did not affect age at death in the absence of bedsharing.Conclusions.By demonstrating that among an urban population at high risk for SIDS, bedsharing is strongly associated with a younger age at death, independent of any other factors, this study provides evidence of a relationship between some SIDS-like deaths and parent-infant bedsharing, particularly if the parent is large.
International Experience With Trisomy 21 Infants Placed on Extracorporeal Membrane Oxygenation
Authors: Southgate W. Michael , Annibale David J. , Hulsey Thomas C. , Purohit Dilip M. 
Published: August 2004

Objective.To characterize the international experience concerning neonates with trisomy 21 (T21) managed with extracorporeal membrane oxygenation (ECMO), and to compare and contrast this group of patients to the neonatal ECMO population as a whole.Methods.Data from the Extracorporeal Life Support Organization for newborn infants placed on ECMO between January 1984 and June 1999 were analyzed. Infants with T21 were compared with the group of infants without T21.Results.Fifteen thousand nine hundred forty-six infants, including 91 (n = 91) with the diagnosis of T21, were placed on ECMO for neonatal respiratory failure during the 14.5-year period. T21 infants were overrepresented in the ECMO population by several-fold when compared with the incidence of T21 in the general population. Eighty-seven of the 91 T21 infants were placed on ECMO after 1989. The distribution of primary diagnoses leading to ECMO differed between the groups (T21 vs non-T21): primary persistent pulmonary hypertension, 47.3% versus 13%; meconium aspiration syndrome, 23.1% versus 32.9%; sepsis, 7.7% versus 13.2%; congenital diaphragmatic hernia, 7.7% versus 19.9%; and respiratory distress syndrome, 3.3% versus 7.9%. Although survival to discontinuation of ECMO was similar in the 2 groups, likelihood of survival to discharge was decreased for T21 infants (65.9% vs 75.6%) because of increased post-ECMO mortality.Conclusions.Extracorporeal Life Support Organization registry data suggests that T21 infants are at a significantly higher risk of being placed on ECMO for neonatal respiratory failure than the general population, perhaps as a result of delayed extrauterine pulmonary vascular adaptation, as manifested in the high rate of primary persistent pulmonary hypertension as the primary diagnosis. There may have been a shift in attitude regarding the use of ECMO in the T21 patient after 1989. Although most T21 patients placed on ECMO will survive, the prognosis is more guarded in this population when compared with all infants so managed. The long-term neurodevelopmental outcome of this group of T21 ECMO survivors is currently unknown.
Technical Report: Alternative Dispute Resolution in Medical Malpractice
Authors: Fraser John J. ,   the Committee on Medical Liability
Published: August 2004

This Technical Report was retired January 2011.
The purpose of this technical report is to provide pediatricians with an understanding of past crises within the professional liability insurance industry, the difficulties of the tort system, and alternative strategies for resolving malpractice disputes that have been applied to medical malpractice actions. Through this report, pediatricians will gain a technical understanding of common alternative dispute resolution (ADR) strategies. The report explains the distinctions between various ADR methods in terms of process and outcome, risks and benefits, appropriateness to the nature of the dispute, and long-term ramifications. By knowing these concepts, pediatricians faced with malpractice claims will be better-equipped to participate in the decision-making with legal counsel on whether to settle, litigate, or explore ADR options.
Head Lice Infestation: Single Drug Versus Combination Therapy With One Percent Permethrin and Trimethoprim/Sulfamethoxazole
Authors: Hipolito Ronaldo B. , Mallorca Florinda G. , Zuniga-Macaraig Zoraya O. , Apolinario Patricia C. , Wheeler-Sherman Jan 
Published: August 2004

Background.
Head lice infestation (HLI) is a vexing problem for pediatricians and families because lice are becoming resistant to approved antipediculosis agents.

Objective.
This study compared the efficacy of 3 different treatments for HLI and determined whether combination therapy reduced treatment failures.

Design and Setting.
A randomized, clinical trial performed in 3 private practices.

Participants.
The population was children ranging in age from 2 to 13 years.

Methods.
HLI was diagnosed by direct inspection of the hair and scalp. Children were assigned to 1 of 3 groups: 1) 1% permethrin creme rinse (1% PER; n = 39); 2) oral administration of trimethoprim/sulfamethoxazole (TMP/SMX;n = 36); and 3) a combination of 1% PER and TMP/SMX (n = 40). Follow-up visits were done 2 and 4 weeks later, and parents or caregivers of those who did not return were interviewed by telephone. If HLI was present at the 2-week follow-up, the child was retreated per their protocol. We defined successful treatment as the absence of adult lice and nymphal stage or eggs (nits). The presence of nits alone was not considered a treatment failure.

Results.
At the 2-week follow-up visit, successful treatment for groups 1, 2, and 3 was 79.5%, 83%, and 95%, respectively. At the 4-week follow-up, successful treatment was 72%, 78%, and 92.5% for groups 1, 2, and 3, respectively. The absolute risk reduction for recurrence comparing group 1 versus group 2 was 6%, group 2 versus group 3 was 14%, and group 1 versus group 3 was 20%. No major adverse complications were seen in any treatment group.

Conclusion.
Our findings indicate that a combination of 1% PER and TMP/SMX is an effective alternative therapy for HLI. We recommend that the dual therapy with 1% PER and oral TMP/SMX be used and reserved in cases of multiple treatment failures or suspected cases of lice-related resistance to therapy.
Racial and Temporal Variations in the Prevalence of Heart Defects
Authors: Botto Lorenzo D. , Correa Adolfo , Erickson J. David 
Published: August 2004

Background.Documenting the prevalence and trends of congenital heart defects provides useful data for pediatric practice, health-care planning, and causal research. Yet, most population-based studies use data from the 1970s and 1980s. We sought to extend into more recent years the study of temporal and racial variations of heart defects occurrence in a well-defined population.Methods.We used data from the Metropolitan Atlanta Congenital Defects Program, a population-based registry with active case ascertainment from multiple sources. Heart defects were identified among liveborn infants up to 1 year old, among stillborn infants, and among pregnancy terminations to mothers residing in metropolitan Atlanta.Results.From 1968 through 1997, the registry ascertained 5813 major congenital heart defects among 937 195 infants, for a prevalence of 6.2 per 1000. The prevalence increased to 9.0 per 1000 births in 1995 through 1997. The prevalence of ventricular septal defects, tetralogy of Fallot, atrioventricular septal defects, and pulmonary stenosis increased, whereas that of transposition of the great arteries decreased. For some defects, prevalence and trends varied by race.Conclusions.The prevalence of congenital heart defects is increasing. Whereas most findings likely result from improved case ascertainment and reporting, others might be because of changes in the distribution of risk factors in the population. The basis of the racial variations is incompletely understood.
Incidence and Remission of Asthma in Schoolchildren: Report From the Obstructive Lung Disease in Northern Sweden Studies
Authors: Rönmark Eva , Jönsson Elsy , Platts-Mills Thomas , Lundbäck Bo 
Published: August 2004

Objective.An increasing prevalence of asthma has been reported worldwide as well as in Sweden. In 1996, the prevalence of asthma and type 1 allergy was investigated in a cohort of 3525 children 7 and 8 years old in 3 areas of northern Sweden. The aim of the present study was to estimate the incidence of asthma and to identify risk factors for incident cases over 1 year.Methods.The study started with a parental questionnaire, the International Study of Asthma and Allergies in Childhood questionnaire with additional questions, a skin prick test, and a validation study. The cohort was followed up after 1 year with the same questions. The response rate to the questionnaire was 97% in 1996, and 3339 children (97%) participated both in 1996 and 1997.Results.The incidence of physician-diagnosed asthma was 0.9/100/year; of wheezing, 3.8/100/year; and of new frequent or daily users of asthma medicines, 1.1/100/year. There was no difference by sex. The risk factor pattern based on incident cases of asthma was different from that based on prevalent cases. Significant risk factors for incident asthma were a positive skin test (odds ratio [OR]: 9.3; 95% confidence interval [CI]: 3.8–22.7); low birth weight (OR: 7.4; 95% CI: 2.2–24.5); and family history of asthma (OR: 2.6; 95% CI: 1.1–6.3). Having or having had pets at home was associated with a decreased risk for asthma and wheezing based on prevalent cases, although it was associated with an increased risk for incidence of wheezing (OR: 2.9; 95% CI: 1.3–6.2). Remission of asthma, which was reported by 10% of the children with current asthma during 1 year, was associated with a negative skin test.Conclusion.The incidence of asthma at the age of 8 years was high, but remission was also common. Important risk factors for the development of asthma at this age were type 1 allergy, low birth weight, and family history of asthma. Furthermore, the results suggest that in a region where sensitivity to domestic animals is a strong risk factor for asthma, the presence of pets in the home may have different effects in early childhood compared with later in childhood.
Incidence of Congenital Rubella Syndrome at a Hospital Serving a Predominantly Hispanic Population, El Paso, Texas
Authors: Zimmerman Laura , Reef Susan E. 
Published: August 2004

Objective.
The current epidemiology of rubella reveals an increase in the number of cases among adult Hispanics and an increase in the number of congenital rubella syndrome (CRS) cases among infants of Hispanic mothers. Recent rubella outbreaks have occurred primarily among adult Hispanics, many of whom are foreign-born natives of countries where rubella vaccination is not routine or has only recently been implemented. The objective of this study was to estimate the incidence of CRS in a hospital serving a predominantly Hispanic population.

Methods.
Hospital charts of infants &lt;1 year old discharged between January 1, 1994 and December 31, 1996 withInternational Classification of Diseases, Ninth Revision(ICD-9) discharge codes consistent with CRS were reviewed; we looked for cataracts, deafness, congenital heart defects, dermal erythropoiesis, microcephaly, meningoencephalitis, and other defects associated with CRS. We abstracted data on maternal and infant ethnicity, maternal age, gestational age, infants' birth weight, infants' clinical characteristics, and laboratory evaluation. Cases were categorized according to the Council of State and Territorial Epidemiologists' case classification for CRS.

Results.
Of the 182 infants with 1 or more ICD-9 codes consistent with CRS, 6 (3.3%) met either the confirmed or probable case definition for CRS. Two infants met the definition for confirmed CRS. Although laboratory tests for rubella immunoglobulin M antibodies were positive for both of these infants, only 1 of the cases had been reported to the state health department. Four other infants had clinical presentations that met the definition for a probable case. One of these had been tested for rubella immunoglobulin M antibodies, and the test was negative. The other 3 had not been tested. The rate of infants meeting the definition of confirmed and probable CRS was 3.1 per 10 000 hospital births. All confirmed and probable cases were among infants born to Hispanic mothers. Maternal country of origin was Mexico for the 2 confirmed cases and 1 of the probable cases, and unknown for the remaining 3 probable cases.

Conclusions.
The rate of confirmed and probable CRS among infants in this predominantly Hispanic population is higher than the reported rate in the United States in the vaccine era, which has been reported to range from approximately 0.01–0.08 per 10 000 live births. These findings indicate a need for heightened awareness of CRS among physicians who serve populations at risk for rubella. Physicians should report all confirmed and probable CRS cases to the state health department. The lack of appropriate laboratory testing in 3 infants with probable CRS indicates that physicians should consider a diagnosis of CRS in infants with some signs consistent with CRS, particularly in areas serving high numbers of individuals at risk for rubella.
A Randomized, Placebo-Controlled Trial of Antimicrobial Treatment for Children With Clinically Diagnosed Acute Sinusitis
Authors: Garbutt Jane M. , Goldstein Marion , Gellman Elliot , Shannon William , Littenberg Benjamin 
Published: August 2004

Objective.
Although antimicrobial treatment for children with acute sinusitis is used commonly, it is unclear whether it offers significant clinical benefit. The purpose of this study was to evaluate the effectiveness of antimicrobial treatments for acute sinusitis as they are used in community pediatric practice.

Methods.
We conducted a randomized, placebo-controlled trial in 3 community pediatric practices in St Louis, Missouri. A total of 188 patients who were between the ages of 1 and 18 years and who had had 10 to 28 days of persistent sinus symptoms and a clinical diagnosis of acute sinusitis were randomized to receive 14 days of amoxicillin (40 mg/kg/d in 3 daily doses), amoxicillin-clavulanate (amoxicillin 45 mg/kg/d in 2 daily doses), or placebo. Change in sinus symptoms was assessed both by a quantitative symptom score (the S5 score) and subjectively by the parent. Secondary outcomes included adverse effects of treatment and recurrence or relapse of sinus symptoms. Outcomes were assessed by telephone interviews over a 2-month period.

Results.
Of the 161 patients who were included in the analysis, 58 received amoxicillin, 48 received amoxicillin-clavulanate, and 55 received placebo. Day 14 improvement rates were 79%, 81%, and 79%, respectively. There were no differences in the 14-day change in S5 score among treatment groups. The rates of adverse events (amoxicillin, 19%; amoxicillin-clavulanate, 11%; placebo, 10%), relapse (amoxicillin, 12%; amoxicillin-clavulanate, 13%; placebo, 13%), and recurrence (amoxicillin, 9%; amoxicillin-clavulanate, 13%; placebo, 13%) of sinus symptoms were similar among treatment groups.

Conclusion.
Neither amoxicillin nor amoxicillin-clavulanate offered any clinical benefit compared with placebo for children with clinically diagnosed acute sinusitis.