bluuebunny/crossref_metadata_2025_split huggingface dataset:
Birth Weight and Blood Cholesterol Level: A Study in Adolescents and Systematic Review
Authors: Owen Christopher G. , Whincup Peter H. , Odoki Katherine , Gilg Julie A. , Cook Derek G. 
Published: August 2004

Objective. To examine the relationship between birth weight and blood total cholesterol (TC) and to compare its strength with that of the relationship between current body mass index and TC.Methods. 1) Cross-sectional study of adolescents, with retrospective ascertainment of birth weight from birth records or parental recall; 2) systematic review of studies examining the relations between birth weight and cholesterol at all ages.Participants. 1) 1532 individuals (92% white, 55% male) in 10 British towns; 2) 28 studies with 32 observations showing the change in TC per 1 kg increase in birth weight—6 in infancy, 14 in adolescents, 12 in adults.Results. In the cross-sectional study, there was a weak inverse relation between birth weight and TC level (−.061 mmol/L fall in TC per kg increase in birth weight, 95% confidence interval −.131 to .008 mmol/L per kg) which was little affected by adjustment for current body size. The difference in TC corresponding to an interquartile range increase in birth weight (−.03 mmol/L) was approximately a quarter of that for an equivalent increase in body mass index (.11 mmol/L). In the systematic review, an inverse association between birth weight and TC of a similar size to that in the cross-sectional study was observed (−.048 mmol/L per kg, 95% confidence interval −.078 to −.018 mmol/L per kg) similar in strength at all ages.Conclusion. The relation of fetal nutrition to TC appears to be weak and is probably of limited public health importance when compared with the effects of childhood obesity.
Facilities and Equipment for the Care of Pediatric Patients in a Community Hospital
Authors: Sigrest Ted D. ,   Committee on Hospital Care
Published: August 2004

This Clinical Report was revised. See https://doi.org/10.1542/peds.2020-0204.
Many children who require hospitalization are admitted to community hospitals that are more accessible for families and their primary care physicians but vary substantially in their pediatric resources. The intent of this clinical report is to provide basic guidelines for furnishing and equipping a pediatric area in a community hospital.
Physician Knowledge of Catch-up Regimens and Contraindications for Childhood Immunizations
Authors: Cohen Nicole J. , Lauderdale Diane S. , Shete Priya B. , Seal John B. , Daum Robert S. 
Published: August 2004

Objectives. To determine physician success at designing catch-up regimens for children delayed in immunizations and physician knowledge regarding contraindications to immunization.Methods. A self-administered survey was completed by pediatricians, general practitioners, and family practitioners in Cook County, Illinois. Surveys included 6 open-ended vignettes describing hypothetical children delayed in immunization for whom participants were asked to design catch-up regimens. Bivariate and multivariate logistic regression were used to determine predictors of correct response. The surveys also inquired about management of scenarios that might be perceived as contraindications to immunize with the Haemophilus influenzae type b or measles-mumps-rubella vaccines.Results. The mean score of correct responses was 1.83 of a possible 6.0. Almost one third of respondents answered all 6 vignettes incorrectly. The proportion of incorrect responses was high for all 6 vignettes (39%–86%), but higher for questions that addressed the immunization of children older than 12 months. Errors in vaccine administration were most commonly attributed to omitted vaccines, with varicella-zoster vaccine and pneumococcal conjugate vaccine omitted most frequently. Pediatricians were &gt;4 times more likely to answer correctly than were family practitioners. Participants in the Vaccines for Children (VFC) program were more than twice as likely to answer correctly than were non-VFC providers. Knowledge of contraindications was inconsistent, particularly for measles-mumps-rubella vaccine.Conclusions. Childhood vaccine providers have substantial knowledge deficits of recommended immunization schedules and vaccine contraindications that may contribute to missed opportunities to immunize. Pediatricians and participants in the VFC program were more successful at designing catch-up regimens for children with immunization delay.
Continuous Subcutaneous Glucose Monitoring Improved Metabolic Control in Pediatric Patients With Type 1 Diabetes: A Controlled Crossover Study
Authors: Ludvigsson Johnny , Hanas Ragnar 
Published: August 2004

Objective. To improve metabolic control and prevent complications, both acute and late, we need to adjust treatment on the basis of the blood glucose (BG) profile, as not even the most active BG self-monitoring gives sufficient information.
Design. We have used Continuous Glucose Monitoring System (CGMS; Medtronic MiniMed, Northridge, CA) in a controlled crossover study including 27 diabetic patients aged 12.5 ± 3.3 (mean; standard deviation; range: 5–19) years. All patients were treated with intensive insulin therapy, 14 with multiple injections, and 13 with pumps. The patients were randomized into an open or blind study arm. Both arms wore the CGMS sensor for 3 days every 2 weeks. CGMS profiles were used in the open study arm to adjust insulin therapy at follow-up visits every 6 weeks. Both the patients and the diabetes team were masked to the CGMS profiles in the blinded arm, and insulin therapy adjustments were based solely on 7-point BG profiles performed by the patients. At 3 months the 2 study arms were crossed over.
Results. Despite initial problems with a device new to both patients and the diabetes team, hemoglobin A1C decreased significantly in the open arm (from 7.70%–7.31%) but not in the blind arm (7.75%–7.65%). A total of 26/27 patients experienced daytime low subcutaneous glucose (&lt;3.0 mmol/L; .8 episodes/day; duration 58 ± 29 minutes; 5.5% of total time), and 27/27 patients had at least 1 nocturnal episode of low subcutaneous glucose (.4 episodes/night; duration 132 ± 81 minutes; 10.1% of total time).
Conclusions. Use of CGMS facilitated an improved treatment, and patients received new insight and increased motivation. In this study, we found CGMS to be a useful tool for education and improving metabolic control.
Regional Brain Volumes and Their Later Neurodevelopmental Correlates in Term and Preterm Infants
Authors: Peterson Bradley S. , Anderson Adam W. , Ehrenkranz Richard , Staib Lawrence H. , Tageldin Magdi , Colson Eve , Gore John C. , Duncan Charles C. , Makuch Robert , Ment Laura R. 
Published: August 2004

Objective. To compare regional brain volumes measured in term and preterm infants, and to correlate regional volumes with measures of neurodevelopmental outcome.Methods. High-contrast, high-resolution magnetic resonance imaging scans were acquired in 10 preterm and 14 term infants who were scanned near term. The cerebrum was segmented into cortical gray matter, white matter, cerebral ventricles, subcortical gray matter, cerebellum, and brainstem. The cortical gray matter, white matter, and ventricles were further divided into specific anatomic subregions, and the volumes were compared across groups. Measures of cognitive and motor development were acquired between 18 and 20 months of corrected age. Correlations of regional brain volumes with developmental outcome were assessed in the preterm group.Results. Volumes in preterm infants were reduced in parieto-occipital gray matter and increased in the midbody, occipital horn, and temporal horns of the lateral ventricles. Gray matter volumes were also less prominently reduced in the sensorimotor and inferior occipital cortices. Normal lateralization of white matter volumes were altered in the parieto-occipital region in the preterm infants, who had significantly larger left-sided and smaller right-sided structures. White matter volumes in the sensorimotor and midtemporal regions correlated strongly with measures of neurodevelopmental outcome.Conclusions. These findings of reduced volumes in sensorimotor and parieto-occipital regions in preterm infants, and the prospective correlations of regional volumes with cognitive outcome, confirm and extend findings previously reported in a cross-sectional study of 8-year-old prematurely born children. The data suggest that regional brain volumes near term are a promising marker for predicting disturbances of cognitive outcome in preterm infants. Further prospective, longitudinal studies of neonatal brain volumes and developmental indices into later childhood are required to confirm the utility of regional brain volumes as predictors of longer term outcome.
Ten-Year Prospective Study of Public Health Problems Associated With Early Drinking
Authors: Ellickson Phyllis L. , Tucker Joan S. , Klein David J. 
Published: August 2004

Objective. To compare early nondrinkers, experimenters, and drinkers on the prevalence of problem behaviors at grades 7 and 12 and at age 23 (N = 6338, 4265, and 3369, respectively).Methods. Results are based on longitudinal self-report data from individuals who were originally recruited from 30 California and Oregon schools at grade 7 (1985) and assessed again at grade 12 (1990) and at age 23 (1995). Logistic regression was used to develop weighted estimates of the prevalence of academic difficulties, employment problems, substance use, and delinquent and violent behaviors within the 3 drinking status groups at grades 7, 12, and/or at age 23. Huber variance estimates, which adjust for weighting and clustering of observations, were used to assess the statistical significance of differences across groups.Results. Early drinkers and experimenters were more likely than nondrinkers to report academic problems, substance use, and delinquent behavior in both middle school and high school. By young adulthood, early alcohol use was associated with employment problems, other substance abuse, and criminal and violent behavior.Conclusions. Early drinkers do not necessarily mature out of a problematic lifestyle as young adults. Interventions for these high-risk youth should start early and address their other public health problems, particularly their tendency to smoke and use other illicit drugs.
Psychopathology and Social Competencies of Adolescents Who Were Extremely Low Birth Weight
Authors: Saigal Saroj , Pinelli Janet , Hoult Lorraine , Kim M. Marie , Boyle Michael 
Published: August 2004

Background. We have previously shown that infants who were extremely low birth weight (ELBW) are particularly vulnerable to problems related to inattention and hyperactivity at school age. It is not known whether these problems persist to adolescence.Objective. To explore and compare the levels of psychopathology in a regional cohort of ELBW infants and sociodemographically matched term controls as reported by teens and their parents.Design/Methods. Cross-sectional cohort study/geographically defined region.Participants. Teens: ELBW 141/169 (83%) and control 122/145 (84%), aged 12 to 16 years. Parents: ELBW 143/169 (85%) and control 123/145 (85%). Both cohorts and their parents completed the Ontario Child Health Study-Revised questionnaire with 6 behavioral subsca1es: conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), overanxious, separation anxiety, and depression.Results. By teen self-report, there were no significant differences between ELBW and control teens on any of the 6 subscale scores. However, parents of ELBW teens reported significantly higher scores than parents of control for depression and ADHD based on 2-way analysis of variance (group × gender). Comparison within teen/parent dyads showed that both cohorts of teens reported significantly higher scores than their parents. Multivariable analyses on behavioral subscale scores demonstrated a number of variables that were significant predictors by parent report: group (ELBW vs control), gender, family function, developmental quotient, maternal mood, and socioeconomic status; no predictors were significant by teen report. There were no statistically significant interaction effects for any of the models. These models explained a greater percent of the variance in behavioral scores for parents than for teens (12.5%–22.0% vs 3.4%–8.2%). Results were similar when teens with neurosensory impairment were excluded.Conclusions. This study is unique in the inclusion of both parent and teen self-report of behaviors. Significant differences were apparent only by parent report for ADHD and depression among ELBW teens. Significant predictors of behavioral scores for parents include group, gender, family function, developmental quotient, maternal mood, and socioeconomic status.
Resident Documentation Discrepancies in a Neonatal Intensive Care Unit
Authors: Carroll Aaron E. , Tarczy-Hornoch Peter , O’Reilly Eamon , Christakis Dimitri A. 
Published: August 2004

Context. Medical errors are common and potentially dangerous. Little is known about the role of documentation errors.Objective. To determine the proportion of resident physician progress notes that contained discrepancies, and to identify predictors of such discrepancies.Design/Methods. We conducted a retrospective cross-sectional chart review of resident physician progress notes over 40 random days in a 4-month period in a neonatal intensive care unit. Using predetermined criteria, we compared resident documentation of patient weights, medications, and vascular lines to other sources of information and recorded the numbers of documentation discrepancies.Results. There were discrepancies in 209 (61.7%) notes with respect to weight, vascular lines, or medications. Discrepancies occurred in the documentation of medications in 103 (27.7%) progress notes, of vascular lines in 119 (33.9%) progress notes, and of weights in 45 (13.3%) progress notes. Notes both omitted information regarding medications (18.2%) and vascular lines (13.9%) and documented inaccurate information regarding medications (18.6%) and vascular lines (30.1%). Patients with more medications or vascular lines, and with longer lengths of stay, were significantly more likely to have higher rates of documentation errors.Conclusions. Daily progress notes written by resident physicians in the neonatal intensive care unit often contain inaccurate, or omit pertinent, information. Alternative means or methods of documentation are warranted.
Herbal Therapy Use in a Pediatric Emergency Department Population: Expect the Unexpected
Authors: Lanski Steven L. , Greenwald Michael , Perkins Amanda , Simon Harold K. 
Published: August 2004

Background. In recent years investigators have reported widespread use of alternative medicine. Some herbal therapies have potentially harmful side effects as well as adverse interactions with medications. Data are lacking on the use in children and caregiver understanding of these products.Objectives. To determine the reported use of herbal products among a pediatric emergency department population and to evaluate the caregivers’ understanding and source of information concerning these products.Design/Methods. A convenience sampling of pediatric emergency department patients and their caregivers occurred during a 3-month period in 2001. The interview consisted of 18 questions regarding the types of non-Food and Drug Administration-regulated herbal products and home remedies used, general product knowledge and sources of information used by the child’s caregiver (including discussions with their child’s primary physician).Results. One hundred forty-two (93%) of 153 families approached participated in the study. The mean patient age was 5.3 years (range: 3 weeks-18 years). Forty-five percent of caregivers reported giving their child an herbal product, and 88% of these caregivers had at least 1 year of college education. Of the children receiving these therapies, 53% had been given 1 type and 27% were given 3 or more in the past year. The most common therapies reportedly used were aloe plant/juice (44%), echinacea (33%), and sweet oil (25%). The most dangerous potential herbal and prescription medication combination reported was ephedra and albuterol in an adolescent with asthma. The most unusual products reportedly used included turpentine, pine needles, and cowchips. Of all people interviewed, 77% did not believe or were uncertain if herbal products had any side effects and only 27% could name a potential side effect. Sixty-six percent were unsure or thought that herbal products did not interact with other medications and only 2 people correctly named a drug interaction. Of the people who used these therapies, 80% reported either friends or relatives as their primary source of information. Only 45% of those giving their children herbal products report discussing the use with their child’s primary health care provider.Conclusion. Herbal and home therapies are commonly used in this pediatric population. An unexpectedly wide variety of products were reportedly given to this patient population. Caregivers reported limited knowledge regarding potential adverse medication interactions and side effects. Limited discussions with the child’s primary health care provider were reported. It is therefore important for health care providers to have knowledge about herbal medications, to inquire about their use and to educate families about the risk/benefit as well as potential interactions these products may have with over-the-counter and prescription medications.
Nutritional State and Growth and Functional Maturation of the Brain in Extremely Low Birth Weight Infants
Authors: Hayakawa Masahiro , Okumura Akihisa , Hayakawa Fumio , Kato Yuuichi , Ohshiro Makoto , Tauchi Nobuo , Watanabe Kazuyoshi 
Published: August 2004

Objective. It is well-known that an undernutritional status influences central nervous system development in the fetal and early neonatal period. On the other hand, the maturational delay of the central nervous system is reflected as dysmature pattern (DMP) in the neonatal background electroencephalograph (EEG). Therefore, we hypothesized that the postnatal nutritional status influenced electrophysiologic maturation in extremely low birth weight infants (ELBWIs).
Methods. ELBWIs between 24 and 27 weeks of gestational age who were admitted to Ogaki Municipal Hospital NICU from April 1997 to December 2000 were considered eligible. From the condition of enteral feeding, infants were divided into 2 groups: 1) normal nutritional group (group N), where enteral feeding had been established (100 mL/kg/d) by 3 weeks after birth; 2) undernutritional group (group U), where enteral feeding had not been established by 3 weeks after birth or was discontinued because of clinical problems. Weekly average body weight and head circumference gains were evaluated as nutritional status. EEG records were performed every 2 to 4 weeks until postnatal 15 weeks of age. DMP was defined as the appearance of immature EEG patterns for postconceptional age.
Results. Twenty-one infants had serial EEG recordings; 11 infants belonged to group N and 10 infants to group U. Gestational age, birth weight, and head circumference at birth were not different between the 2 groups. The body weight of group N was significantly heavier than that of group U after 5 postnatal weeks. Similarly, the head circumference of group N was larger than that of group U after 6 weeks of postnatal age. Nine infants demonstrated DMPs. One infant belonged to group N and 8 to group U. DMPs were significantly more frequently found in group U than group N (80% vs 9%). In 6 of the 9 cases, the DMPs lasted until 38 to 40 weeks of postconceptional age. Five of the 6 infants with persistent DMPs suffered from severe undernutritional conditions. The other, who belonged to group N, was treated with corticosteroid for chronic lung disease. In 3 cases, DMPs were observed transiently and their undernutritional status was not so severe.
Conclusions. Our study indicated that a postnatal undernutritional condition was associated with DMPs in ELBWIs. Undernutritional status may affect electrophysiologic maturation.
Missed Opportunities for Sexually Transmitted Diseases, Human Immunodeficiency Virus, and Pregnancy Prevention Services During Adolescent Health Supervision Visits
Authors: Burstein Gale R. , Lowry Richard , Klein Jonathan D. , Santelli John S. 
Published: August 2004

Objective. To describe prevention counseling on pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), received by sexually experienced youth in the primary care setting and to test associations between recent sexual risk behaviors and preventive counseling.Methods. Using data from the 1999 Youth Risk Behavior Surveillance survey, a nationally representative survey (N = 15 349) of high school students, we analyzed responses to questions about sexual experience, time since last preventive health care visit, and discussion of STD, HIV, or pregnancy prevention with a doctor or nurse during their last preventive health care visit. Logistic regression was used to test associations; students’ demographic characteristics were controlled.Results. More than half of the US high school students surveyed reported a preventive health care visit in the 12 months preceding the survey: 60.4% (95% confidence interval [CI]: 57.2%–63.6%) of female students and 57.5% (95% CI: 53.9%–61.1%) of male students. For female students, sexual experience was positively associated with a preventive health care visit (odds ratio [OR]: 1.3; 95% CI: 1.1–1.6), but for male students, sexual experience had a negative effect (OR: 0.8; 95% CI: 0.7–0.9). Of the students who reported a preventive health care visit in the 12 months preceding the survey, 42.8% (95% CI: 38.6%–47.1%) of female students and 26.4% (95% CI: 22.7%–30.2%) of male students reported having discussed STD, HIV, or pregnancy prevention at those visits. Sexual experience was associated with a higher likelihood of engaging in a dialogue about sexual health once a student entered the health care system: female students (OR: 3.8; 95% CI: 3.0–4.9) and male students (OR: 1.9; 95% CI: 1.3–2.7).Conclusion. Primary care providers miss opportunities to provide STD, HIV, and pregnancy prevention counseling to high-risk youth.