bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Intussusception-Associated Hospitalizations and Deaths Among US Infants
Authors: Parashar Umesh D. , Holman Robert C. , Cummings Kate C. , Staggs N. Wayne , Curns Aaron T. , Zimmerman Christopher M. , Kaufman Stephen F. , Lewis Jon E. , Vugia Duc J. , Powell Kenneth E. , Glass Roger I. 
Published: August 2004

Context.
The newly licensed tetravalent rhesus-human reassortant rotavirus vaccine has been withdrawn following reports of intussusception among vaccinated infants.

Objective.
To describe the epidemiology of intussusception-associated hospitalizations and deaths among US infants.

Design.
This retrospective cohort study examined hospital discharge data from the National Hospital Discharge Survey for 1988–1997, Indian Health Service (IHS) for 1980–1997, California for 1990–1997, Indiana for 1994–1998, Georgia for 1997–1998, and MarketScan for 1993–1996, and mortality data from the national multiple cause-of-death data for 1979–1997 and linked birth/infant death data for 1995–1997.

Patients.
Infants (&lt;1 year old) with anInternational Classification of Diseases, Ninth Revision, Clinical Modification code for intussusception (560.0) listed on their hospital discharge or mortality record, respectively.

Results.
During 1994–1996, annual rates for intussusception-associated infant hospitalization varied among the data sets, being lowest for the IHS (18 per 100 000; 95% confidence interval [CI] = 9–35 per 100 000) and greatest for the National Hospital Discharge Survey (56 per 100 000; 95% CI = 33–79 per 100 000) data sets. Rates among IHS infants declined from 87 per 100 000 during 1980–1982 to 12 per 100 000 during 1995–1997 (relative risk =7.6, 95% CI = 3.2–18.2). Intussusception-associated hospitalizations were uncommon in the first 2 months of life, peaked from 5 to 7 months old, and showed no consistent seasonality. Intussusception-associated infant mortality rates declined from 6.4 per 1 000 000 live births during 1979–1981 to 2.3 per 1 000 000 live births during 1995–1997 (relative risk = 2.8, 95% CI = 1.8–4.3). Infants whose mothers were &lt;20 years old, nonwhite, unmarried, and had an education level below grade 12 years were at an increased risk for intussusception-associated death.

Conclusions.
Intussusception-associated hospitalization rates varied among the data sets and decreased substantially over time in the IHS data. Although intussusception-associated infant deaths in the United States have declined substantially over the past 2 decades, some deaths seem to be related to reduced access to, or delays in seeking, health care and are potentially preventable.intussusception, hospitalizations, deaths, risk factors, infants.
Improving Preschoolers' Self-Regulation of Energy Intake
Authors: Johnson Susan L. 
Published: August 2004

Background.Children exhibit individual differences in their ability to self-regulate energy intake. Feeding strategies that focus on external signals, like the time of day or amount of food left on a plate, tend to diminish children's ability to respond to internal cues of hunger and fullness.Objectives.We investigated whether children could be taught to focus on internal cues of hunger and satiety, and consequently improve their self-regulation of energy intake. We explored whether parents' eating behaviors and adiposity were related to their children's self-regulation skills and adiposity.Design.In a pretest and posttest design, preschoolers participated in single-meal protocols to assess their individual ability to self-regulate food intake. During a 6-week intervention period, children took part in individual and group activities designed to help them recognize internal cues. Parents completed questionnaires regarding adult dietary restraint and disinhibition.Results.At baseline, we found a large individual variability in children's regulation: some children overate, some regulated accurately, and others underate. At baseline, children's eating related to their adiposity and to mothers' disinhibition: heavier children and children whose mothers' reported difficulty controlling food intake showed less evidence of self-regulation. Both overeaters and undereaters responded to the intervention, improving their ability to self-regulate, and children's eating was no longer significantly related to mother's eating.Conclusions.Children's disregulated energy intake is related to mothers' weight status and mothers' perceived control over eating. Cues can be provided that help children to focus on internal signals and improve their ability to self-regulate energy intake.
Do Obese Inner-City Children With Asthma Have More Symptoms Than Nonobese Children With Asthma?
Authors: Belamarich Peter F. , Luder Elisabeth , Kattan Meyer , Mitchell Herman , Islam Shaheen , Lynn Henry , Crain Ellen F. 
Published: August 2004

Objective.
To test whether obesity is associated with decreased peak expiratory flow rates (PEFR), increased asthma symptoms, and increased health service use.

Design/Methods.
Secondary analysis of data from a cross-sectional convenience sample.

Setting.
Emergency departments (EDs) and primary care clinics in 8 inner-city areas in 7 cities.

Participants.
One thousand three hundred twenty-two children aged 4 to 9 years with asthma.

Measures.
Obesity was defined as a body mass index (BMI, weight/height2) &gt;95th percentile. Nonobese children were those with a BMI between the 5th and 95th percentile. Underweight children with a BMI &lt;5th percentile were eliminated from the study. Demographic and anthropometric data were obtained during a baseline interview with the primary caretaker and the child. Symptoms, health service use data and measurements of PEFR were obtained by parental report during the baseline interview and at 3-month intervals by telephone interview over the following 9-month period.

Results.
Obese (n = 249) and nonobese (n = 1073) children did not differ in terms of age, gender, family income, passive smoke exposure, caretaker's mental health, and skin test reactivity to indoor allergens. Obese children were more often Latino (28% vs 17%) and, in the 3 months before the baseline interview, were more likely to have used oral steroids (30% vs 24%). There were no differences between groups in terms of baseline PEFR scores. During the 9 months after baseline assessment, the obese group had a higher mean number of days of wheeze per 2-week period (4.0 vs 3.4), and a greater proportion of obese individuals had unscheduled ED visits (39% vs 31%). There were no differences between the groups in terms of frequency of hospitalization, or in nocturnal awakening.

Conclusions.
In our sample of inner-city children with asthma, obese children used more medicine, wheezed more, and a greater proportion had unscheduled ED visits than the nonobese children.
Bronchial Hyperresponsiveness Before and After the Diagnosis of Bronchial Asthma in Children
Authors: Mochizuki Hiroyuki , Shigeta Makoto , Arakawa Hirokazu , Kato Masahiko , Tokuyama Kenichi , Morikawa Akihiro 
Published: August 2004

Objective.
To assess at what age bronchial hyperresponsiveness (BHR) is acquired in children with asthma.

Background.
A relationship between BHR and infantile wheezing diseases has been reported. Infants with a genetic predisposition to atopy are more likely to wheeze with respiratory viral infection or bronchiolitis, and it is suspected that the continued BHR after the first attack of asthma may be induced or triggered by some viral infections. Also, recent studies have reported the existence of atopic and BHR-related genes. However, whether BHR is congenital or acquired after asthma attacks, and when BHR in children with asthma is established or acquired remain unclear.

Methods.
We performed methacholine inhalation challenge using a transcutaneous oxygen pressure (tcPO2) monitoring system in 205 children without asthma from 6 months to 6 years of age. During follow-up, 18 of these participants were diagnosed with asthma (group N-A). This group and 15 age-matched children without asthma (group N-N) were tested twice using methacholine inhalation challenge. For comparison, 39 age-matched atopic-type asthmatic children (group A-A) were also given the inhalation challenge twice. Methacholine inhalation challenge using a tcPO2 monitoring system was performed while the participants were asleep in the supine position. Sequential doses of inhaled methacholine delivered by oxygen mask were doubled until a 10% decrease in tcPO2 from the baseline was reached. The cumulative dose of methacholine at the inflection point of tcPO2 (minimal dose of methacholine [Dmin]-PO2) was considered to represent BHR.

Results.
In groups N-N and A-A, there was no difference in Dmin-PO2 between the first and second challenge. However, the Dmin-PO2 in group N-A significantly decreased from the first challenge to the second challenge. There was no significant difference between the Dmin-PO2 in group N-N and the first Dmin-PO2 in group N-A; or between the Dmin-PO2in group A-A and the second Dmin-PO2 in group N-A.

Conclusions.
These data suggest that BHR in many infants with asthma is acquired after several asthma attacks.bronchial hyperresponsiveness, childhood asthma, methacholine inhalation challenge, transcutaneous oxygen pressure.
Fomepizole Treatment of Ethylene Glycol Poisoning in an Infant
Authors: Baum Carl R. , Langman Craig B. , Oker Elif E. , Goldstein Craig A. , Aviles Sandra R. , Makar Jasmin K. 
Published: August 2004

The enzyme alcohol dehydrogenase metabolizes ingested ethylene glycol (EG) to the toxic compounds glycolic and oxalic acids. Renal failure, acidosis, hypocalcemia, and death may follow. Traditional treatment of EG poisoning may require ethanol, a competitive substrate of alcohol dehydrogenase, and hemodialysis, that removes both EG and its toxic metabolites. A new alcohol dehydrogenase inhibitor, fomepizole (4-methylpyrazole), was approved in 1997 for patients at least 12 years old with suspected or confirmed EG poisoning.
Fomepizole has not been studied adequately in the pediatric population. We present a case of an 8-month-old male infant who drank up to 120 mL of EG and developed acidosis and oxalate crystalluria. He was treated with fomepizole and hemodialysis. Even after the completion of hemodialysis, fomepizole appeared to effectively block the production of EG toxic metabolites and to allow the resolution of acidosis; the patient recovered within 48 hours. This is the first report of fomepizole treatment of EG poisoning in an infant.4-methylpyrazole, fomepizole, poisoning, ethylene glycol, hemodialysis, infant, child, pediatrics.
Missed Opportunities for Preventing Tuberculosis Among Children Younger Than Five Years of Age
Authors: Lobato Mark N. , Mohle-Boetani Janet C. , Royce Sarah E. 
Published: August 2004

Objectives.Childhood tuberculosis (TB) is an important indicator of public health success in interrupting and preventing TB transmission. To determine the frequency and types of missed opportunities for preventing TB among children &lt;5 years of age.Methods.We collected data from the public health records of child TB cases and their adult source cases. These children were from health jurisdictions where TB case rates in children were higher than the California average for this age group.Results.We reviewed the records for 165 children reported with TB (20% confirmed by culture). These children were evaluated for TB because of signs or symptoms of illness (32%), a contact investigation (26%), screening (22%), a source case investigation (4%), and unknown reasons (16%). Excluding 4 children infected byMycobacterium bovis, only 59 of 161 children (37%) had a source case found. Children found in a contact investigation, born in the United States, &lt;1 year of age, or who were black were more likely to have a source case found than children who did not have one of these characteristics. Of 43 children found in a contact investigation, improvements in contact investigations may have prevented TB in 17 of these children (40%). Among the 43 adult source cases, factors that may have facilitated transmission include delayed reporting in 23%, a delayed contact investigation in 21%, and delayed or nondocumented bacteriologic sputum conversion in 42% of culture-positive cases.Conclusions.Important missed opportunities to prevent TB in children include the failure to find and appropriately manage adult source cases and failure to completely evaluate and properly treat children exposed to TB. Improvements in case detection, case management, and contact investigations are necessary to eliminate TB in children.
Elevated Blood Lead Levels and Blood Lead Screening Among US Children Aged One to Five Years: 1988–1994
Authors: Kaufmann Rachel B. , Clouse Timothy L. , Olson David R. , Matte Thomas D. 
Published: August 2004

Objectives.To estimate the proportion of children 1 to 5 years of age who received blood lead testing during 1988–1994 and to assess whether predictors of testing coincided with predictors of elevated blood lead levels.Design.Cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey.Participants.US children 1 to 5 years of age.Outcome Measures.Prevalence of blood lead testing and elevated blood lead levels among children 1 to 5 years of age and odds ratios for factors predicting blood lead testing and elevated blood lead levels.Results.Overall, 6.3% had elevated blood lead levels and 10.2% had undergone previous blood lead tests. Being of minority race/ethnicity, living in an older home, residing in the Northeast or Midwest regions of the United States, being on Medicaid, having a head of household with &lt;12 years of education, and having a history of anemia were significant factors in both models. Additional independent risk factors for an elevated blood lead level included being sampled in phase 1 of the survey, being 1 to 2 years of age, not having a regular doctor, and being sampled during the summer months. Additional independent correlates of a previous blood lead test included having moved less than twice in one's lifetime, having a female head of household, and having parents whose home language was English. Of an estimated 564 000 children 1 to 5 years of age who had elevated blood lead levels and no previous screening test in 1993, 62% were receiving Medicaid, 40% lived in homes built before 1946, and 34% were black, non-Hispanic.Conclusions.Lead screening was more frequent among children with risk factors for lead exposure. However, among children with elevated blood lead levels, only one third had been tested previously. In 1993 an estimated 564 000 children 1 to 5 years of age had elevated blood lead levels but were never screened. Physicians should screen Medicaid-eligible children and should follow state or local health department recommendations about identifying and screening other at-risk children. In areas where no health department guidelines exist, physicians should screen all children or screen based on known risk factors.
Attitudes Toward Secondhand Smoke, Smoking, and Quitting Among Young People
Authors: Glantz Stanton A. , Jamieson Patrick 
Published: August 2004

Objective.
To assess the impact of attitudes toward secondhand smoke among young people.

Methods.
Three hundred nonsmokers and 300 smokers (smoked a cigarette in last 30 days) 14 through 22 years of age in the United States were surveyed with random-digit dialing. The results of this cross-sectional survey were analyzed using logistic regression to determine predictors of nonsmoking and intent to stop among current smokers.

Results.
Controlling for age, ethnicity, and education, nonsmokers were more likely to consider smoking risky than smokers (odds ratio [OR] = 3.46). Nonsmokers were twice as likely to consider secondhand smoke dangerous than smokers (OR = 1.47). Among the variables in our model, the only statistically significant predictor of planning to stop smoking or having actually stopped was believing that secondhand smoke harmed nonsmokers, which more than doubled the chances of planning to stop or having stopped smoking (relative risk = 2.17).

Conclusions.
Educating young people about the dangers of secondhand smoke and empowering nonsmokers to speak out should be a strong element of any tobacco control program.
Effects of Cisapride on Corrected QT Interval, Heart Rate, and Rhythm in Infants Undergoing Polysomnography
Authors: Benatar Avram , Feenstra Arjen , Decraene Tine , Vandenplas Yvan 
Published: August 2004

Objective.To evaluate the effects of cisapride, a prokinetic gastrointestinal drug, on the electrocardiographic QT interval, heart rate, and rhythm in infants during routine 8-hour polysomnography. Reported electrocardiogram (ECG) and rhythm disturbances in a small number of patients with the use of cisapride provided the impetus for this prospective study.Study Design.Two hundred fifty-two infants born at term were enrolled. Of these, 134 were on cisapride therapy for suspected gastroesophageal reflux and 118 were not on cisapride and served as controls. Cisapride-treated and control infants were from the outset divided into 3 age groups; group 1: under 3 months of age; group 2: between 3 and 6 months of age; and group 3: &gt;6 months of age. Continuous ECG bipolar limb lead I recording, saturation monitoring, and electroencephalography were conducted. QT intervals and heart rate were measured at hourly intervals.Results.Cisapride doses were: group 1 mean, 0.80 mg/kg/day (range: 0.38–1.55); group 2 mean, 0.80 mg/kg/day (range: 0.23–1.38); and group 3 mean, 0.72 mg/kg/day (range: 0.32–1.41). Heart rate was higher in the younger infants, with a gradual decrease with age. No difference in heart rate was detected between the cisapride and control groups. The QTc interval in patients in group 1 was statistically longer than the controls, when applying both Bazett's and Hodges' formulae for QT correction. The other age groups did not differ. No arrhythmia or atrioventricular conduction abnormalities were observed.Conclusion.Infants under 3 months of age on cisapride treatment had significantly longer QTc intervals (with Bazett's formula, the 98th percentile was 504 ms in the cisapride group vs 447 ms in controls). The clinical significance and risk of the increased QTc interval in these infants are unclear and need further evaluation and risk stratification. Meanwhile, cisapride should be judiciously prescribed in infants &lt;3 months of age.
Circumstances Leading to a Change to Prone Sleeping in Sudden Infant Death Syndrome Victims
Authors: Côté Aurore , Gerez Teresa , Brouillette Robert T. , Laplante Séverine 
Published: August 2004

Context.In addition to usual prone sleeping, unaccustomed prone sleeping represents a significant risk factor for sudden infant death syndrome (SIDS). However, little information is available regarding the circumstances leading caretakers to change the infant's sleep position to prone position in SIDS victims.Objective.To determine, in a population of SIDS victims, the timing of a change to prone sleeping and the reason for that change in infants who were originally nonprone sleepers.Design and Setting.Case series analysis from a questionnaire administered between 1991 and 1997 to parents and other caretakers of SIDS victims in the province of Quebec (Canada).Subjects.One hundred fifty-seven SIDS cases occurring in the province during the study.Results.Of the 157 SIDS cases studied, 139 were found in the prone position, although only 93 infants usually slept prone. Of the 64 nonprone sleepers, 34 had been changed to prone by the parents or another caretaker before death, and 18 had apparently turned to prone for the first time. In the 34 cases changed to prone, the change occurred &lt;1 week before death for 21 infants; for 16 of those infants, death occurred the first or second time that they slept prone. In 56% of the cases changed from a nonprone to prone sleeping position, a caretaker other than the parents had precipitated the change.Conclusions.Ongoing campaigns to decrease the risk of SIDS should emphasize the risk of unaccustomed prone sleeping to both parents and secondary caretakers.
In Utero Exposure to Coumarins and Cognition at 8 to 14 Years Old
Authors: van Driel Dieneke , Wesseling Judit , Sauer Pieter J. J. , van der Veer Eveline , Touwen Bert C. L. , Smrkovsky Mila 
Published: August 2004

Objective.
To assess the cognitive abilities in school-aged children who have been exposed to coumarins in utero.

Background.
Coumarin derivatives are an effective option for anticoagulant therapy in pregnant women. However, case reports describe anomalies of the fetal central nervous system after in utero exposure to coumarins. It is unclear whether prenatal exposure has an effect on cognitive functioning later in childhood.

Methods.
The exposed cohort consisted of 291 children from mothers who were prospectively registered because of coumarin treatment during pregnancy. The nonexposed cohort included 253 age-matched peers. An IQ was estimated using subtests of the Weschler Intelligence Scale for Children-Revised. Educational achievement was examined with tests for reading, spelling, and arithmetic. In addition, schoolteachers were asked to judge performance on language and arithmetic. The observers were not aware of the exposure status of the child.

Results.
No differences in mean IQ were found between the exposed and nonexposed cohort (mean difference: −1.1; 95% confidence interval [CI]: −3.2–1.1), but an IQ score below 80 was found in 11 children in the exposed compared with 3 children in the nonexposed cohort (odds ratio [OR] = 3.1; CI: 0.8–11.6). Regarding the tests for educational achievement, exposed children as a group performed as well as nonexposed controls. Exposed boys, in comparison with nonexposed boys, showed a higher frequency of poor performance on reading (OR = 2.9; CI: 1.1–7.4) and spelling (OR = 2.5; CI: 1.0–6.0).

Conclusion.
Cognitive functioning in coumarin-exposed children does not differ from nonexposed controls, but a minority of children seem to be prone to the potential negative effects of coumarins during pregnancy.