bluuebunny/crossref_metadata_2025_split huggingface dataset:
Violence Exposure and Substance Use in Adolescents: Findings From Three Countries
Authors: Vermeiren Robert , Schwab-Stone Mary , Deboutte Dirk , Leckman Peter E. , Ruchkin Vladislav 
Published: August 2004

Objective. To investigate relationships between exposure to community violence (witnessing and victimization) and reported substance use (cigarettes, alcohol, marijuana, and hard drugs) in a cross-national sample of adolescents, after controlling for the level of the adolescents’ own violent behavior.
Method. A self-report survey was conducted in 3380 14- to 17-year-old adolescents in urban communities of 3 different countries: Antwerp, Belgium (N = 958); Arkangelsk, Russia (N = 1036); and New Haven, Connecticut (N = 1386).
Results. In all 3 countries, levels of reported smoking, alcohol use, marijuana use, and hard drug use showed increases with adolescent exposure to violence. Although positively related, substance use was increased less markedly in US adolescents who witnessed violence.
Conclusion. Current findings further emphasize the association between violence exposure and potential severe physical and psychosocial health problems in adolescents. In addition, the findings suggest that violence exposure and its consequences are a worldwide urban phenomenon. Cross-national differences were found, however, that warrant additional research, and prospective studies are needed to investigate the pathways from violence exposure to substance abuse.
Continuity of Care for Children in Foster Care
Authors: DiGiuseppe David L. , Christakis Dimitri A. 
Published: August 2004

Objective. To compare the continuity of care experienced by children who are in foster care with that of children who are not in foster care and are covered under Medicaid managed care and Medicaid fee-for-service (FFS).Methods. This retrospective cohort study used Medicaid claims/encounter data from Washington state. A total of 903 children who were in foster care and continuously enrolled in Medicaid for 24 months (1998–1999) were matched by age, gender, and rural/urban residence to 903 Medicaid managed care enrollees and 903 FFS beneficiaries who were not in foster care. Indices of the continuity of primary care experienced were calculated for each patient, and differences in continuity among the cohorts were assessed by running 3 multiple linear regression models for all possible pairings of cohorts, controlling for age, gender, rural/urban residence, and total number of primary care visits.Results. Foster care status was associated with decreased continuity of care relative to nonfoster managed care status (β = −0.12; 95% confidence interval [CI]: −0.15 to −0.09). Nonfoster FFS status was associated with lower continuity than managed care (β = −0.09; 95% CI: −0.12 to −0.06) and slightly higher continuity than foster care status (β = 0.03; 95% CI: 0.01–0.06).Conclusion. Although not dramatically different, continuity seems somewhat lacking for children in foster care. It is unclear to what degree the observed difference is confounded by the managed care/FFS distinction. As the enrollment of children in foster care into managed care plans has been controversial, efforts to promote the consistency of contact with providers while maintaining the flexibility afforded by FFS coverage seem warranted.
Central Venous Catheter Removal Versus In Situ Treatment in Neonates With Enterobacteriaceae Bacteremia
Authors: Nazemi Kellie J. , Buescher E. Stephen , Kelly Robert E. , Karlowicz M. Gary 
Published: August 2004

Objective. To determine how often neonates with Enterobacteriaceae (ENTB) bacteremia can be treated successfully without removing central venous catheters (CVCs).Methods. A retrospective cohort study was conducted of ENTB bacteremia and CVCs in infants in a neonatal intensive care unit during a 7-year period (1994–2000). Cases of ENTB bacteremia were identified from a microbiology database and limited to late-onset cases occurring after 3 days of age.Results. There were 53 cases of ENTB bacteremia in infants with CVCs. Blood cultures were positive for ENTB within a median of 10 hours (range: 5–43). Timing of CVC removal was at the discretion of attending neonatologists. Fifteen cases had early-removal CVC (ER-CVC) within 2 days, and 38 cases had late-removal CVC (LR-CVC) &gt;2 days after the first positive blood culture for ENTB. There were no significant differences between infants in the ER-CVC and LR-CVC groups for case fatality, recurrence, or duration of ENTB bacteremia. Although 16 (42%) of 38 (95% confidence interval [CI]: 26%–59%) LR-CVC cases required CVC removal to resolve ENTB bacteremia, 17 (45%) of 38 (95% CI: 29%–62%) LR-CVC cases were treated successfully without removal of CVCs. ENTB bacteremia was successfully treated without CVC removal in 85% of 13 LR-CVC cases with 1 day of bacteremia in contrast to 24% of 25 LR-CVC cases with &gt;1 day of bacteremia (relative risk: 3.5; 95% CI: 1.7–7.4). CVC removal was required to resolve ENTB bacteremia in 9 (82%) of 11 LR-CVC cases with severe thrombocytopenia compared with 7 (32%) of 22 LR-CVC cases without severe thrombocytopenia (relative risk: 2.6; 95% CI: 1.3–5.0).Conclusions. Retention of CVCs was successful in 45% of cases of ENTB bacteremia in which it was attempted, but success was unlikely when bacteremia lasted &gt;1 day. ENTB bacteremia cases associated with severe thrombocytopenia rarely resolved unless CVCs were removed.
Helicobacter pylori, Gastrointestinal Symptoms, and Metabolic Control in Young Type 1 Diabetes Mellitus Patients
Authors: Candelli Marcello , Rigante Donato , Marietti Giovanni , Nista Enrico C. , Crea Francesca , Bartolozzi Francesco , Schiavino Alessandra , Pignataro Giulia , Silveri Nicoló Gentiloni , Gasbarrini Giovanni , Gasbarrini Antonio 
Published: August 2004

Objective. The role of Helicobacter pylori infection in metabolic control and gastrointestinal symptoms in type 1 diabetes mellitus (DM1) patients has been debated. The aim of this study was to investigate the prevalence of H pylori, of the more cytotoxic Cag-A-positive strains, and the effects of infection on gastrointestinal symptoms and metabolic control in young DM1 patients.Research Design and Methods. H pylori infection was investigated by using the 13C-urea breath test in 121 DM1 patients (65 males, 56 females; mean age: 15 ± 6 years) and 147 matched controls. In positive patients, an assay for specific immunoglobulin G against Cag-A was performed. Glycosylated hemoglobin A, daily insulin requirement, and duration of illness were established; a questionnaire concerning the presence of dyspeptic symptoms was administered.Results. No difference in H pylori infection rate between patients and controls was observed. Thirty-four (28.1%) of 121 patients and 43 (29.25%) of 147 controls were infected. Twenty-one patients and 24 controls were positive for Cag-A. Glycosylated hemoglobin A, daily insulin requirement, and duration of illness were not affected by infection nor by Cag-A status. Among gastrointestinal symptoms, only halitosis was related to H pylori infection, but this association disappeared after correction for age. Positive patients with halitosis showed a worse glycemic control than uninfected patients with halitosis.Conclusions. H pylori infection and Cag-A-positive strains do not affect metabolic control in DM1 patients. With regard to gastrointestinal symptoms studied, H pylori infection, when present in participants with halitosis, seems to predict a worse metabolic control than in H pylori-negative patients with halitosis.
Glucose and Lipid Metabolism in Small For Gestational Age Infants at 48 Hours of Age
Authors: Bazaes Rodrigo A. , Salazar Teresa E. , Pittaluga Enrica , Peña Verónica , Alegría Angélica , Íñiguez Germán , Ong Ken K. , Dunger David B. , Mericq M. Verónica 
Published: August 2004

Objective. To study the consequences of low birth weight on glucose and lipid metabolism 48 hours after delivery.
Methods. We studied 136 small for gestational age (SGA) and 34 appropriate for gestational age (AGA) term neonates who were born in Santiago, Chile. Prefeeding venous blood was obtained 48 hours after birth for determination of glucose, free fatty acids, β-hydroxy butyrate, insulin, C-peptide, leptin, sex hormone-binding globulin, insulin-like growth factor-binding protein-1 (IGFBP-1), and cortisol.
Results. SGA newborns had lower glucose (SGA versus AGA, median [interquartile range]: 3.6 mmol/L [2.9–4.1 mmol/L] vs 3.9 mmol/L [3.6–4.6 mmol/L]) and insulin levels (31.3 pmol/L [20.8–47.9 pmol/L] vs 62.5 pmol/L [53.5–154.9]) than AGA infants, and they had higher glucose/insulin ratios (13.9 mg/dL/uIU/mL [8.6–19.1 mg/dL/uIU/mL] vs 8.2 mg/dL/uIU/mL [4.6–14.1 mg/dL/uIU/mL]). SGA infants also had higher levels of IGFBP-1 (5.1 nmol/L [4.4–6.7 nmol/L] vs 2.9 nmol/l [1.4–4.2 nmol/L]), free fatty acids (0.72 mEq/L [0.43–1.00 mEq/L] vs 0.33 mEq/L [0.26–0.54 mEq/L]) and β-hydroxy butyrate (0.41 mEq/L [0.15–0.91 mEq/L] vs 0.09 mEq/L [0.05–0.13 mEq/L]). Sex-hormone binding globulin levels were not significantly different between the 2 groups.
Conclusions. In early postnatal life, SGA infants display an increased insulin sensitivity with respect to glucose disposal but not with respect to suppression of lipolysis, ketogenesis, and hepatic production of IGFBP-1. It will be important to determine how these differential sensitivities to insulin vary with increasing age.
Percent Body Fat at Age 5 Predicts Earlier Pubertal Development Among Girls at Age 9
Authors: Davison Kirsten Krahnstoever , Susman Elizabeth J. , Birch Leann Lipps 
Published: August 2004

Objective. This study examines the causal direction of the relationship between weight status and pubertal timing in girls using a longitudinal sample of 183 white girls followed from ages 5 to 9.
Methods. Girls’ weight status (body mass index percentile, percent body fat, waist circumference) was assessed when they were 5, 7, and 9 years old, and their pubertal development was assessed when they were 9 years old (breast development, Estradiol, Pubertal Development Scale). Information from all measures of pubertal development at 9 years was combined to identify girls exhibiting earlier (N = 44) and later (N = 136) pubertal development relative to the sample. Girls’ weight status at each age (5, 7, and 9 years old) and change in weight status across the ages of 5 to 9 years were used to predict their pubertal timing at 9 years of age.
Results. Girls with higher percent body fat at 5 years, and girls with higher percent body fat, higher BMI percentile, or larger waist circumference at 7 years, were more likely to be classified with earlier pubertal development at 9 years. In addition, girls showing larger increases in percent body fat from 5 to 9 years of age, and larger increases in waist circumference from 7 to 9 years of age, were more likely to exhibit earlier pubertal development at 9 years. Results were still present after controlling for accelerated growth.
Conclusions. Girls with higher weight status in early childhood were more likely to exhibit earlier pubertal development relative to peers at 9 years, indicating that weight status preceded pubertal timing in girls.
Clinical, Autoimmune, and HLA Characteristics of Children Diagnosed With Type 1 Diabetes Before 5 Years of Age
Authors: Hathout Eba H. , Hartwick Noelle , Fagoaga Omar R. , Colacino Anna Rita , Sharkey Jeannine , Racine Michael , Nelsen-Cannarella Sandra , Mace John W. 
Published: August 2004

Background. Little is known about auxologic, autoimmune, and HLA characteristics specific to children with early-onset diabetes (EOD). HLA subtypes have been shown to play an important part in the determination of islet-cell autoimmunity and in the pace and intensity of the β-cell destructive process.
Objectives. Our goals were to: 1) outline auxologic, autoimmune, and HLA class II characteristics of children diagnosed with type 1 diabetes before 5 years of age (EOD); 2) evaluate differences between EOD and later-onset or non-age-stratified type 1 diabetes; and 3) investigate the relation between type 1 diabetes-related HLA subtypes and markers of diabetic autoimmunity in EOD.
Methods. Forty children with EOD were studied. Auxologic and antibody radioimmunoassay data were obtained by retrospective analysis of records. HLA diabetes-related class II alleles were typed by polymerase chain reaction using sequence-specific primers.
Results. At diagnosis, the average age of the EOD study patients was 2.6 years, body mass index was 16.9 kg/m2, and weight was 106% of average weight for height. When compared with a matched subgroup of children with later-onset type 1 diabetes, preschoolers did not significantly differ in terms of birth weight or body mass index. The frequency of positive islet cell antibodies 512 and glutamic acid decarboxylase 65 antibodies was significantly less in EOD (28.6% and 31.6%, respectively). There were significant differences in the frequencies of some diabetes-related HLA alleles and haplotypes between the early-onset group and a large non-age-stratified type 1 diabetes group. None of the patients with EOD had either of the protective DRB1*1501 or DQB1*0602 alleles. There was a negative correlation between glutamic acid decarboxylase and the predisposing haplotype DR3/DQ2.
Conclusions. Children diagnosed with type 1 diabetes before 5 years of age may have different diabetes-related autoimmune and genetic characteristics from those diagnosed at a later age.
The Role of Meat to Improve the Critical Iron Balance During Weaning
Authors: Hallberg Leif , Hoppe Michael , Andersson Maria , Hulthén Lena 
Published: August 2004

Background. Iron requirements during the weaning period are the highest per unit body weight during human life, and diet is often insufficient to cover iron needs. For the first time in infant nutrition the absorption of both nonheme and heme iron from a typical weaning gruel after addition of meat with and without ascorbic acid (AA) to improve bioavailability was studied.Methods. Nonheme and heme iron absorption from gruel was measured in 33 adults using 2 radioiron isotopes—an inorganic iron salt to label nonheme iron, the other biosynthetically labeled rabbit hemoglobin to label heme iron. Iron absorption was measured from the basal gruel (based on milkpowder and cereals) and from basal gruel added 20 g red powdered meat, alone and together with 20 mg AA in 4 different trials.Results. Nonheme iron absorption from the basal meal was 0.33 mg/1000 kcal and the increase from added 20 mg AA was 39%, whereas addition of red meat increased nonheme iron absorption by 85%. This latter increase was unexpectedly high. Total iron absorption was further increased by heme iron absorption of 0.23 mgFe/1000 kcal. When adding both meat and AA, total iron absorption amounted to 1.08 mg iron/1000 kcal, ie, exceeding 1 mg/1000 kcal, a level estimated to correspond with daily iron requirements in 95% of infants aged 12 months.Conclusions. Addition of powdered red meat to weaning gruels markedly increased total iron absorption. A weaning diet with added powdered meat and AA may serve as a viable option to satisfy the body’s high iron requirements during this critical period.
School-Age Outcomes of Very Low Birth Weight Infants in the Indomethacin Intraventricular Hemorrhage Prevention Trial
Authors: Vohr Betty R. , Allan Walter C. , Westerveld Michael , Schneider Karen C. , Katz Karol H. , Makuch Robert W. , Ment Laura R. 
Published: August 2004

Objective. The cohort consisted of 328 very low birth weight infants (600–1250 g birth weight) who were enrolled in the low-dose prophylactic indomethacin prevention trial and were intraventricular hemorrhage (IVH) negative at 6 postnatal hours. The objective was to determine the effects of both IVH and indomethacin on cognitive, language, and achievement performance at 8 years of age.Methods. The cohort was divided into 4 subgroups for analysis: indomethacin plus IVH, indomethacin no IVH, saline plus IVH, and saline with no IVH. The children were evaluated prospectively at 8 years of age with a neurologic assessment, history of school performance, and a battery of cognitive, academic, behavioral, and functional assessments.Results. Children in both IVH groups had more cerebral palsy; more hearing impairment; lower daily living skills scores; lower IQ, vocabulary, and reading and mathematics achievement test scores; and greater educational resource needs. With logistic regression analyses grade 3 to 4 IVH, periventricular leukomalacia and/or ventriculomegaly, male gender, maternal education, and language spoken in the home contributed to outcomes. No effects of indomethacin or gestational age were identified.Conclusions. Although biological factors including IVH, ventriculomegaly, and periventricular leukomalacia contribute significantly to school age outcomes among very low birth weight survivors at 8 years of age, social and environmental factors including maternal level of education and primary language spoken in the home are also important contributors to outcome.
Does Federal Funding for Breastfeeding Research Target Our National Health Objectives?
Authors: Brown Linda P. , Bair Angel H. , Meier Paula P. 
Published: August 2004

Objective. To determine the number and dollar amount of federally funded research projects in the area of infant nutrition/breastfeeding/lactation from 1994 to 1996, and the impact of these funded projects on the achievement of our national goals for increasing the rates of breastfeeding initiation and duration.
Methods. Data were obtained from the Computer Retrieval of Information on Scientific Projects database, available through the National Institutes of Health. Abstracts of funded projects were identified, printed, and subjected to content analysis. Key information identified from the abstracts included: National Institutes of Health institute, center, or division funding the project; type of extramural funding; amount of federal dollars awarded; and a classification of the project’s impact (direct, indirect, or none) on achievement of the Healthy People 2000 goals for breastfeeding.
Results. The final sample consisted of 362 abstracts in the broad category of infant nutrition/breastfeeding/lactation, which were awarded approximately $40.4 million in federal research funds over the 3 years addressed in this study. Of this amount, only 13.7% ($5.6 million) was awarded to projects determined to have either a direct or indirect impact on achieving the Healthy People 2000 goals for increasing the incidence and duration of breastfeeding. A total of 27 (7.5%) funded projects in this category, reflecting $4.1 million, had no relationship to breastfeeding per se, as they involved the use of human milk composition and technologies to improve artificial milks and develop new pharmaceuticals and therapies.
Conclusions. These findings suggest an incongruity between the national priorities for breastfeeding and the funding of scientific research in this content area, and provide important information for researchers and policymakers with respect to identification and redirection of funding priorities.
Growth Deficits and Attention-Deficit/Hyperactivity Disorder Revisited: Impact of Gender, Development, and Treatment
Authors: Biederman Joseph , Faraone Stephen V. , Monuteaux Michael C. , Plunkett Elizabeth A. , Gifford Julie , Spencer Thomas 
Published: August 2004

Objective. Although the relationship between putative growth deficits and attention-deficit/hyperactivity disorder (ADHD) has been examined in boys, this issue has not been evaluated in girls.Methods. Height and weight were examined in 124 female ADHD children and 116 female controls using age and parental height corrections, attending to issues of pubertal stage and treatment. Also, we examined the interaction between ADHD status and gender on growth outcomes using data from 124 ADHD and 109 control males.Results. The ADHD-growth association was not moderated by gender. No deficits in age-adjusted height or age and height-adjusted weight were detected in ADHD girls. Also, we found no association between growth measurements and psychotropic treatment, malnutrition, short stature, pubertal development, family history of ADHD, or psychiatric comorbidity, except for major depression: ADHD girls with major depression were on average 7.6 kg heavier than ADHD girls without depression, adjusting for age and height.Conclusions. No growth deficits appear to be associated with ADHD or its treatment in females. These findings add to a growing literature supporting the notion that stimulant treatment does not have an adverse impact on ADHD children’s growth and development.
Antibiotic Treatment of Acute Otorrhea Through Tympanostomy Tube: Randomized Double-Blind Placebo-Controlled Study With Daily Follow-up
Authors: Ruohola Aino , Heikkinen Terho , Meurman Olli , Puhakka Tuomo , Lindblad Niklas , Ruuskanen Olli 
Published: August 2004

Objective.The role of routine antimicrobial treatment of acute middle-ear infections is under debate, because the efficacy of antimicrobials in the resolution of middle-ear fluid has not been unambiguously proven. Acute tube otorrhea is regarded as evidence of acute otitis media, and for methodologic reasons it was chosen to provide objectivity for diagnostics and outcome assessment. The objective of this study was to assess whether amoxicillin-clavulanate accelerates the resolution of acute tube otorrhea.Design and setting.Randomized, double-blind, placebo-controlled study in outpatient setting.Patients.Volunteer sample of basically healthy 6- to 72-month-old children with a tympanostomy tube. Eligibility required having acute tube otorrhea of &lt;48 hours’ of duration and no prior treatment within the last 2 weeks. The mean age of the participants was 25 months; they had a history of 3 episodes of acute otitis media (median), and 99% had manifestations of a concomitant respiratory infection. Of 79 randomized patients, 7 were withdrawn because of adverse events; 66 patients completed the study.Interventions.Amoxicillin-clavulanate (N = 34; 45 mg/kg/d) or matching placebo (N = 32) for 7 days and daily suction of middle-ear fluid through tympanostomy tube.Main outcome measures.Duration of acute tube otorrhea and duration of bacterial growth in middle-ear fluid.Results.The median duration of tube otorrhea was significantly shorter in amoxicillin-clavulanate than in the placebo group (3 vs 8 days). At the end of the 7-day medication period, tube otorrhea was resolved in 28 of 34 children receiving amoxicillin-clavulanate compared with 13 of 32 children on placebo (treatment-control difference 41%; 95% confidence interval, 20%–63%; number needed to treat, 2.4). The median duration of bacterial growth in middle-ear fluid was shorter in amoxicillin-clavulanate than in the placebo group (1 vs 8 days).Conclusions.Oral antibiotic treatment significantly accelerates the resolution of acute tube otorrhea by reducing bacterial growth in middle-ear fluid.