bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Ventricular Structure and Function in Obese Adolescents: Relations to Cardiovascular Fitness, Percent Body Fat, and Visceral Adiposity, and Effects of Physical Training
Authors: Mitchell Brett M. , Gutin Bernard , Kapuku Gaston , Barbeau Paule , Humphries Matthew C. , Owens Scott , Vemulapalli Sarita , Allison Jerry 
Published: August 2004

Objective. Little is known about the relations of fitness and fatness to left ventricular structure and function in obese adolescents. This project had 2 purposes: 1) to determine the correlations of cardiovascular fitness and adiposity to left ventricular parameters in obese adolescents; and 2) to see the effect of 8 months of physical training (PT) at low and high intensities.
Design. Obese 13- to 16-year-olds (N = 81) were tested at baseline and then randomly assigned to lifestyle education (LSE) alone, LSE plus moderate-intensity PT, or LSE plus high-intensity PT. Follow-up testing was conducted 8 months later. Because no significant differences were found between moderate-intensity and high-intensity PT, the groups were combined to form a LSE + PT group.
Intervention. Eight months of PT, offered 5 days per week with the target energy expenditure for all PT participants being 250 kcal/session, and LSE every 2 weeks.
Outcome Measures. Left ventricular mass divided by height to the 2.7th power (LVM/Ht2.7), midwall fractional shortening (MFS), and relative wall thickness (RWT) were measured using M-mode echocardiography. Cardiovascular fitness was measured by a maximal multistage treadmill test; percent body fat (%BF) with dual-energy radiograph absorptiometry; and visceral adipose tissue (VAT) with magnetic resonance imaging.
Results. At baseline, high levels of VAT were associated with higher RWT (r = 0.30) and lesser MFS (r = −0.29). Compared with the LSE-alone group, the LSE + PT group significantly improved in cardiovascular fitness and decreased in %BF and VAT. However, there were no significant differences between groups on changes in LVM/Ht2.7, MFS, or RWT. Individual changes in cardiovascular fitness, %BF, and VAT did not correlate significantly with interindividual changes in left ventricular structure and function.
Conclusions. High levels of VAT were associated with unfavorable left ventricular structure and function. However, no evidence was provided that an 8-month PT program, which improved cardiovascular fitness and reduced general and visceral adiposity, improved left ventricular structure and function. Future studies consisting of longer training programs and/or greater weight reductions are needed to see whether the adverse left ventricular effects of obesity can be ameliorated by exercise training.
An English-Language Clinic-Based Literacy Program Is Effective for a Multilingual Population
Authors: Silverstein Michael , Iverson Leslie , Lozano Paula 
Published: August 2004

Objective.To assess the effectiveness of a clinic-based pediatric literacy intervention on a multilingual population.
Background.Clinic-based literacy interventions are effective among English- and Spanish-speaking children. No data exist for multilingual populations.
Setting.Pediatric clinic in an urban county hospital.
Design/Methods.Reading practices of 2 cross-sectional groups were assessed by standardized interview before and after the intervention. The intervention consisted of waiting-room volunteers reading to children, literacy counseling, and gift of a children’s book at each well-child visit from 6 months to 5 years. Outcomes were assessed separately for primary English-speaking and primary non-English-speaking families.
Results.The baseline (N=85) and postintervention (N=95) groups were similar with respect to child age and sex, parental education, and length of time in the United States. Fourteen languages were represented in total, the most common being English (41%), Somali (28%), Spanish (9%), Vietnamese (7%), Oromo (3%), and Tigrinyan (3%). Compared with baseline, postintervention respondents were more likely to report reading as a favorite activity for the child (10% vs 25%) and parent (18% vs 40%), to read to their child before bed at least weekly (45% vs 71%), and to possess over 10 children’s books at home (49% vs 63%). Among English-speaking families (N=30 baseline, N=40 postintervention), weekly bedtime reading increased (63% to 93%), reading as child’s favorite activity increased (7% vs 30%), and reading as the parent’s favorite activity to do with child increased (33% vs 58%). The proportion of English-speaking families possessing over 10 books at home and those reading with their children at least weekly showed no difference between the baseline and postintervention groups. Among non-English-speaking families (N=55 baseline, N=55 postintervention), weekly bedtime reading increased (36% vs 56%), reading as the parent’s favorite activity increased (11% vs 27%), and the number of families to possess &gt;10 children’s books in the home increased (31% vs 49%). Reading as child’s favorite activity (13% vs 24%) and weekly book sharing (60% vs 76%) showed nonsignificant trends between the non-English-speaking baseline and postintervention groups.
Conclusions.This clinic-based literacy intervention influences home literacy behavior in this multiethnic setting, in both English-speaking and non-English-speaking families. Although efforts should be made to make such programs more appropriate for linguistic minorities, non-English-speaking families do stand to benefit from English-language-oriented programs. literacy, Reach Out and Read, pediatrics, reading, child development.
Ultrasonographic Evaluation of Cervical Lymph Nodes in Kawasaki Disease
Authors: Tashiro Norimichi , Matsubara Tomoyo , Uchida Masashi , Katayama Kumiko , Ichiyama Takashi , Furukawa Susumu 
Published: August 2004

Objective. Kawasaki disease (KD) is one of the common causes of cervical lymphadenopathy during early childhood. The purpose of this study was to compare the ultrasonographic feature of cervical lymph nodes in patients with KD, bacterial lymphadenitis, and infectious mononucleosis.Design. We studied 22 patients with KD, 8 with presumed bacterial lymphadenitis, and 5 with Epstein-Barr virus infectious mononucleosis. We examined the cervical nodes by ultrasonography using a 7.5-MHz or 10-MHz transducer of a B-mode sector scanner in all patients with a chief complaint of fever and a visible cervical mass during a fixed time interval (July 1995-March 2000).Results. In KD patients, transverse ultrasonograms demonstrated multiple hypoechoic-enlarged nodes forming one palpable mass, which resembled a cluster of grapes. The ultrasonographic appearance of these nodes was similar in patients with acute Epstein-Barr virus infection, but differed from the pattern in presumed bacterial lymphadenitis. Five KD patients had had fever and cervical lymphadenopathy for several days before other manifestations of KD were noted. In these patients, it was possible to differentiate by ultrasonography between KD and presumed bacterial lymphadenitis at an early stage.Conclusion. Ultrasonographic features of cervical lymph nodes were different for KD than for presumed bacterial lymphadenitis. Ultrasonographic evaluation might be of value for diagnosis of KD patients with cervical lymphadenopathy at an early stage of the disease.
Mortality Associated With Congenital Syphilis in the United States, 1992–1998
Authors: Gust Deborah A. , Levine William C. , St. Louis Michael E. , Braxton Jim , Berman Stuart M. 
Published: August 2004

Objective. To summarize national trends in the incidence of congenital syphilis (CS) and associated mortality.
Methods. We analyzed CS surveillance data reported to the Centers for Disease Control and Prevention by 50 states and the District of Columbia from 1992–1998.
Results. From 1992–1998, 942 deaths, including 760 stillbirths, were reported among 14 627 cases of CS, yielding a case fatality ratio (stillborns and deaths/all cases) of 6.4%. Untreated, inadequately treated, or undocumented treatment of syphilis during pregnancy accounted for 87.4% of reported cases. Among CS cases, there was an inverse relationship between the number of prenatal care visits (0, 1–4, 5–9, ≥10) and risk of fatal outcome. Among deaths, 52% of deliveries occurred by 30 weeks’ gestation. Among live born infants with CS, death occurred more often in infants for whom no radiograph or cerebrospinal fluid evaluation was reported. Although both cases and deaths from CS declined from 1992–1998, there was no significant change in the case fatality ratio.
Conclusion. Mortality associated with CS continues to be an important public health problem that will resurge if adult syphilis rates increase. Because a large proportion of deaths occur at low gestational age, earlier diagnosis and treatment of maternal syphilis may substantially reduce the case fatality ratio.
Black-White Differences in Health Care Utilization Among US Children With Frequent Ear Infections
Authors: Park Christina H. , Kogan Michael D. , Overpeck Mary D. , Casselbrant Margaretha L. 
Published: August 2004

Objective. To examine differences in patterns of and barriers to health care utilization between black and white children who have frequent ear infections (FEI).Methods. Analysis was conducted using the 1997 and 1998 National Health Interview Survey-Sample Child Files. Data on 25 497 children under 18 years of age and 1985 who were reported by the parent/guardian to have had “3 or more ear infections during the past 12 months” were analyzed. The data were weighted and analyzed to represent all black and white children nationwide, accounting for the complex survey design.Results. Of white and black children under 18 years of age in the United States, 8.0 and 6.6%, respectively, had FEI in the past year. Among those with FEI, whites and blacks exhibited significantly different patterns in the type of health insurance they had and in the usual source of care. After accounting for sociodemographic factors, health insurance, and usual source of care, there were still significant differences in health care use between whites and blacks. The affected black children had an increased risk of getting delayed care because of transportation problems (odds ratio [OR]: 2.32) and a reduced likelihood of seeing a medical specialist (OR: 0.49) and having surgery (OR: 0.39) in comparison to white children.Conclusion. Although black children with FEI were as likely as white children to be covered by health insurance and have a usual place of health care, they were significantly more likely to face barriers in obtaining the care, especially the more specialized care.
Is More Neonatal Intensive Care Always Better? Insights From a Cross-National Comparison of Reproductive Care
Authors: Thompson Lindsay A. , Goodman David C. , Little George A. 
Published: August 2004

Background. Despite high per capita health care expenditure, the United States has crude infant survival rates that are lower than similarly developed nations. Although differences in vital recording and socioeconomic risk have been studied, a systematic, cross-national comparison of perinatal health care systems is lacking.Objective. To characterize systems of reproductive care for the United States, Australia, Canada, and the United Kingdom, including a detailed analysis of neonatal intensive care and mortality.Design/Methods. Comparison of selected indicators of reproductive care and mortality from 1993–2000 through a systematic review of journal and government publications and structured interviews of leaders in perinatal and neonatal care.Results. Compared with the other 3 countries, the United States has more neonatal intensive care resources yet provides proportionately less support for preconception and prenatal care. Unlike the United States, the other countries provided free family planning services and prenatal and perinatal physician care, and the United Kingdom and Australia paid for all contraception. The United States has high neonatal intensive care capacity, with 6.1 neonatologists per 10 000 live births; Australia, 3.7; Canada, 3.3; and the United Kingdom, 2.7. For intensive care beds, the United States has 3.3 per 10 000 live births; Australia and Canada, 2.6; and the United Kingdom, 0.67. Greater neonatal intensive care resources were not consistently associated with lower birth weight-specific mortality. The relative risk (United States as reference) of neonatal mortality for infants &lt;1000 g was 0.84 for Australia, 1.12 for Canada, and 0.99 for the United Kingdom; for 1000 to 2499 g infants, the relative risk was 0.97 for Australia, 1.26 for Canada, and 0.95 for the United Kingdom. As reported elsewhere, low birth weight rates were notably higher in the United States, partially explaining the high crude mortality rates.Conclusions. The United States has significantly greater neonatal intensive care resources per capita, compared with 3 other developed countries, without having consistently better birth weight-specific mortality. Despite low birth weight rates that exceed other countries, the United States has proportionately more providers per low birth weight infant, but offers less extensive preconception and prenatal services. This study questions the effectiveness of the current distribution of US reproductive care resources and its emphasis on neonatal intensive care.
How Good Is the Evidence Linking Breastfeeding and Intelligence?
Authors: Jain Anjali , Concato John , Leventhal John M. 
Published: August 2004

Background. We conducted a critical review of the many studies that have tried to determine whether breastfeeding has a beneficial effect on intellect.
Design/Methods. By searching Medline and the references of selected articles, we identified publications that evaluated the association between breastfeeding and cognitive outcomes. We then appraised and described each study according to 8 principles of clinical epidemiology: 1) study design, 2) target population: whether full-term infants were studied, 3) sample size, 4) collection of feeding data: whether studies met 4 standards of quality— suitable definition and duration of breastfeeding, and appropriate timing and source of feeding data, 5) control of susceptibility bias: whether studies controlled for socioeconomic status and stimulation of the child, 6) blinding: whether observers of the outcome were blind to feeding status, 7) outcome: whether a standardized individual test of general intelligence at an age older than 2 years was used, and 8) format of results: whether studies reported an effect size or some other strategy to interpret the clinical impact of results.
Results. We identified 40 pertinent publications from 1929 to February 2001. Twenty-seven (68%) concluded that breastfeeding promotes intelligence. Many studies, however, had methodological flaws. Only 2 papers studied full-term infants and met all 4 standards of high-quality feeding data, controlled for 2 critical confounders, reported blinding, used an appropriate test, and allowed the reader to interpret the clinical significance of the findings with an effect size. Of these 2, 1 study concluded that the effect of breastfeeding on intellect was significant, and the other did not.
Conclusion. Although the majority of studies concluded that breastfeeding promotes intelligence, the evidence from higher quality studies is less persuasive.
Persistent Infant Crying and Hyperactivity Problems in Middle Childhood
Authors: Wolke Dieter , Rizzo Patrizia , Woods Sarah 
Published: August 2004

Objective. To investigate whether persistent infant crying is associated with an increased risk for externalizing behavior problems in childhood.Methods. Sixty-four infants who were referred for persistent crying in infancy (PC; mean age: 3.8 ± 1.3 months) were reassessed at 8 to 10 years of age and compared with 64 classroom controls (CC). The major outcome measure was pervasive hyperactivity or conduct problems defined as parent, child, and teacher ratings that across informants were within the borderline/clinical range according to the Strengths and Difficulties Questionnaire (SDQ). Ratings of other behavior problems, parent ratings of temperament, and teacher assessment of academic achievement were also obtained.Results. Ten (18.9%) of 53 PC had pervasive hyperactivity problems (child, parent, and teacher reported) compared with 1 (18.9%) of 62 CC (odds ratio: 14.19 [1.75–114.96]). Parents (29 [45.3%] of 64 vs 11 [17.2%] of 64; 4.00 [1.77–9.01]) and children (30 [46.9%] of 64 vs 17 [26.6%] of 64; 2.44 [1.16–5.12]) but not the teachers reported more conduct problems. Parents of PC rated the temperament of their children to be more negative in emotionality (PC mean: 3.0 ± 1.0; CC: 2.4 ± 1.0; effect size: 0.6) and difficult-demanding (PC mean: 5.2 ± 1.3; CC: 6.3 ± 0.9; effect size: 1.0). Academic achievement was reported by teachers to be significantly lower for PC than CC, in particular for those children with pervasive hyperactivity problems.Conclusions. Infants who are referred for PC problems and associated sleeping or feeding problems are at increased risk for hyperactivity problems and academic difficulties in childhood.
Natural History and Familial Relationships of Infant Spilling to 9 Years of Age
Authors: Martin A. James , Pratt Nicole , Kennedy J. Declan , Ryan Philip , Ruffin Richard E. , Miles Helen , Marley John 
Published: August 2004

Objectives. To determine the natural history of infant spilling (regurgitation/vomiting) during the first 2 years of life and to determine the relationship between infant spilling and gastroesophageal reflux (GER) symptoms at 9 years of age.
Methods. A prospective birth cohort was followed with daily symptom diaries during the first 2 years of life and reviewed at 9 years of age (range: 8–11 years). The prevalence of infant spilling during the first 2 years of life, the prevalence of GER symptoms between 8 and 11 years of age (mean age: 9.7 years), relative risk of infant spilling predisposing to GER symptoms at 9 years of age, and prevalence of maternal GER symptoms and relationship with infant spilling and GER at 9 years of age were measured.
Results. A total of 693 children who represented 83% of an original sample of 836 children and were followed for 2 years from birth with daily symptom diaries were contacted at 9 (8–11) years of age. Spilling of most feeds each day was common in infancy and reached a peak prevalence of 41% between 3 and 4 months of age and thereafter declined to &lt; 5% between 13 and 14 months of age. Infants with spilling on 90 days or more during the first 2 years of life (classified as frequent spilling) were more likely to have GER symptoms at 9 years of age. Children with frequent infant spilling, compared with those with no spilling, had a relative risk of 2.3 (95% confidence interval [CI]: 1.3–4.0) of 1 or more GER symptoms at 9 years of age, 4.6 (95% CI: 1.5–13.8) for heartburn, 2.7 (95% CI: 1.4–5.5) for vomiting, and 4.7 (95% CI: 1.6–14.0) for acid regurgitation. Gender, breastfeeding, and environmental tobacco smoke exposure were not significant factors related to infant spilling. Prepregnancy smoking and smoking in the same room as the child at the 9-month and 18-month follow-ups had a significant effect on GER symptoms at 9 years of age. Infant spilling and GER at 9 years of age were significantly related to maternal GER symptoms but not to paternal GER symptoms.
Conclusions. Spilling in infancy is very common, but the majority of children settle by 13 to 14 months of age. However, those with frequent spilling (&gt;90 days) are more likely to have GER symptoms at 9 years of age. In addition, a maternal history of GER was significantly related both to infant spilling and to GER at 9 years, suggesting that a genetic component may be involved. Physicians should consider studying children with a history of frequent infant spilling to determine whether this group is at increased risk for GER disease.
Second Varicella Infections: Are They More Common Than Previously Thought?
Authors: Hall Susan , Maupin Teresa , Seward Jane , Jumaan Aisha O. , Peterson Carol , Goldman Gary , Mascola Laurene , Wharton Melinda 
Published: August 2004

Objective. To describe the epidemiology and clinical characteristics of varicella reinfections reported to a surveillance project.Methods. We investigated varicella cases reported to a surveillance project between January 1, 1995, and December 31, 1999—with more extensive investigation of cases reporting previous varicella with onset between January 1, 1998, and September 30, 1998—to provide a more detailed description of first and second varicella infections. A simple decision tree was used to assess the likelihood that reported first and second infections were varicella.Results. Among varicella cases reported to the surveillance project, 4.5% of cases in 1995 and 13.3% of cases in 1999 reported previous varicella. More than 95% of first infections were physician diagnosed, epidemiologically linked to another case, or had a rash description consistent with varicella; the same was true for reported second infections. People who reported reinfections were generally healthy. There was a family history of repeat infections in 45% of people who reported reinfections.Conclusions. Clinical varicella reinfections may occur more commonly than previously thought. Additional studies of the predictive value of a positive varicella history and laboratory studies of reported reinfections are indicated to guide varicella vaccination policy.
A Clinical Study to Evaluate the Efficacy of ELA-Max (4% Liposomal Lidocaine) as Compared With Eutectic Mixture of Local Anesthetics Cream for Pain Reduction of Venipuncture in Children
Authors: Eichenfield Lawrence F. , Funk Ann , Fallon-Friedlander Sheila , Cunningham Bari B. 
Published: August 2004

Objective. A double-randomized, blinded crossover trial was performed to assess the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics (EMLA) for pain relief during pediatric venipuncture procedures. Safety was assessed by evaluation for topical or systemic effects and measurement of serum lidocaine concentrations.Methods. A total of 120 children who were scheduled for repeat venipuncture for non–study-related reasons at 2 sites participated in the study. Patients were doubly randomized to treatment regimen (study medication application time of either 30 or 60 minutes) and to the order of application of the topical anesthetics for each venipuncture. The primary outcome measures were the child’s rating of pain immediately after the venipuncture procedures using a 100-mm visual analog scale (VAS) tool and the parent’s and blinded research observer’s Observed Behavioral Distress scores.Results. Both ELA-Max and EMLA seemed to alleviate venipuncture pain. There was no clinically or statistically significant difference in the patient VAS scores within the 30-minute or 60-minute treatment groups, and there was no clinical or statistical difference in VAS scores between the 30-minute ELA-Max treatment without occlusion and the 60-minute EMLA treatment with occlusion. There were no clinically or statistically significant differences between treatment with ELA-Max and EMLA in parental or blinded researcher Observed Behavioral Distress scores, the most frequent response at any observation time being “no distress.”Conclusion. This study demonstrates that a 30-minute application of ELA-Max without occlusion is as safe and as effective for ameliorating pain associated with venipuncture as a 60-minute application of the prescription product EMLA requiring occlusion.