bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional Factors That Affect the Postnatal Metabolic Adaptation of Full-Term Small- and Large-for-Gestational-Age Infants
Authors: de Rooy Laura , Hawdon Jane 
Published: August 2004

Objective. To document metabolic adaptation to ex utero life in small- (SGA) and large-for-gestational-age (LGA) infants in relation to fetal nutrition and postnatal feeding practices.
Methods. In a prospective study, 65 SGA (≤second centile) and 39 LGA (≥98th centile) full-term infants were recruited. Anthropometry was performed within the first 48 hours. There was full support of breastfeeding and close clinical observation. Blood glucose and ketone body (kb) concentrations were measured prefeed for the first 7 postnatal days. Infants were exclusively breastfed (BF), breastfed with formula milk supplementation (FS), or exclusively formula milk fed (FF).
Results. Within the SGA group, a measure of “thinness,” the midarm circumference/head circumference ratio, was significantly correlated to the number of episodes of blood glucose &lt;2.00 mmol/L. Epoch (age at sampling) analysis in this group showed no difference in blood glucose levels across the different feeding groups but revealed a statistically significant greater kb concentration for infants who were exclusively breastfed. For SGA infants, the median peak kb concentration (peak kb) was significantly different for BF, FS, and FF groups. Multiple regression analysis for the SGA group demonstrated that peak kb concentration was negatively related to the volume of formula milk, independent of blood glucose levels and neonatal anthropometry. For LGA infants, low blood glucose levels were offset by kb concentrations equivalent to those observed in infants who were appropriate for gestational age.
Conclusion. Neonatal ability to generate kb when blood glucose values are low depends more on successful breastfeeding than on size for gestational age or neonatal nutritional status. Routine blood glucose monitoring of LGA infants with no additional risk factors is not necessary. Routine formula milk supplementation for LGA and SGA infants should not be recommended.
Hypoplasia of Medullary Arcuate Nucleus in Unexpected Late Fetal Death (Stillborn Infants): A Pathologic Study
Authors: Matturri Luigi , Minoli Iolanda , Lavezzi Anna Maria , Cappellini Anna , Ramos Simone , Rossi Lino 
Published: August 2004

Objectives. To evaluate the frequency, morphology, and pathogenesis (primary or secondary) of the abnormally developed medullary arcuate nucleus (ARCn) in stillbirths.
Methods. We examined 26 stillbirths (24 antepartum, 2 intrapartum) that had a gestational age between 25 and 40 weeks and a normal karyotype. All of the stillborns were described as well-developed, with body length and weight proportional to their gestational age. Each case was submitted to complete autopsy examination, which included a systematic gross and microscopic evaluation of the body, the placental disk, and the umbilical cord and membranes. The brainstem was the particular focus of the histologic examination. The study of the various nuclei (nucleus hypoglossus, dorsal vagus motor nucleus, tractus solitarii nucleus, nucleus ambiguus, trigeminal tractus and nucleus, arcuate nucleus, and ventrolateral reticular formation and its neurons and parabrachial/Kölliker-Fuse complex) was performed on transversal serial sections through the entire pons and medulla oblongata. The histologic analysis was supplemented by volumetric reconstruction and immunohistochemical detection of both apoptosis and proliferating cell nuclear antigen.
Results. Histologic examination showed abnormalities of the medulla oblongata ARCn in 9 fetuses (35%). In 8, a marked hypoplasia was evident, characterized by a volume reduction of the nucleus accompanied by neuronal depletion, whereas in 1 fetus the nucleus was completely absent (agenesis). The absence of gliosis, the negativity of the proliferating cell nuclear antigen analysis, and the similarities in apoptotic indices between the hypoplastic and well-developed arcuate are in keeping with a primary developmental defect. This anomaly is frequently associated with hypoplasia of the reticular formation and chronic hypoxia.
Conclusions. A high frequency of hypoplasia of the ARCn occurs in fetuses who have died “sine causa,” ie, in a similar manner to that observed in sudden infant death syndrome. Chemoreceptors, although not involved in reflexogenic oxygenation in fetal life, become of vital importance intrapartum and postpartum; therefore, whenever impaired in the course of development, chemoreceptors may underlie cardioventilatory abnormalities critical to sudden infant death syndrome.
Increased Activity of Lysosomal Enzymes in the Peritoneal Fluid of Bacterial Peritonitis
Authors: Beratis Nicholas G. , Georgiou George , Eliopoulou Maria 
Published: August 2004

Objective. The activity of lysosomal enzymes is increased in the cerebrospinal fluid of bacterial meningitis, suggesting that inflammation may cause leakage of lysosomal enzymes into the extracellular fluid. Our objective was to study the activity of 3 lysosomal enzymes in cell-free peritoneal fluid of patients with peritoneal inflammation.
Methods. The β-galactosidase, β-glucuronidase, and α-mannosidase activity (nmol 4-methylumbelliferone/mL/h); the total, polymorphonuclear, and mononuclear cell number; and chemical parameters were determined in the peritoneal fluid of 26 patients with culture-positive acute bacterial peritonitis, 13 patients (under antibiotic treatment) with culture-negative bacterial peritonitis, 6 patients with acute mesenteric lymphadenitis, and 26 control subjects who were operated on for surgical conditions without peritoneal inflammation.
Results. The median β-galactosidase activity in the culture-positive bacterial peritonitis, mesenteric lymphadenitis, and controls was 175 (range: 63–2210), 50 (range: 37–56), and 16 (range: 8–32), respectively. The β-glucuronidase was 488 (range: 79–998), 53 (range: 27–98), and 15 (range: 3–22), respectively. The α-mannosidase was 801 (range: 100-3172), 78 (range: 33–157), and 41 (range: 16–63), respectively. The differences of the enzyme activities among the groups of the subjects studied were significant, with the exception of the α-mannosidase activity between mesenteric lymphadenitis and controls. There was no significant correlation between the enzyme activities and the cytologic or chemical parameters studied.
Conclusions. The elevation of the lysosomal enzymes’ activity in the peritoneal fluid of patients with bacterial peritonitis seems to be a reliable index of peritoneal infection. Of the enzymes studied, the β-glucuronidase and β-galactosidase activities provide the best means for diagnosing bacterial inflammation of the peritoneal cavity.
Maternal Influences on 5- to 7-Year-Old Girls’ Intake of Multivitamin-Mineral Supplements
Authors: Lee Yoonna , Mitchell Diane C. , Smiciklas-Wright Helen , Birch Leann L. 
Published: August 2004

Objective. To examine diet quality of girls who do or do not take multivitamin-mineral (MVM) supplements and to evaluate predictors of girls’ MVM use, including maternal eating behaviors, MVM use, beliefs, attitudes, and perceptions about child feeding, eating, and health.
Design. Participants were 192 mother and daughter pairs. Daughters were categorized as MVM supplement users or nonusers based on whether girls were consistently given MVM supplements at 5 and 7 years. Girls’ and mothers’ nutrient and food group intakes, maternal child-feeding practices, and maternal eating behavior were compared between the groups.
Results. Mothers who used MVM supplements were more likely to give MVM supplements to daughters. Excluding nutrients from MVM supplements, MVM users and nonusers did not differ in vitamin and mineral intake, either for girls or mothers, and patterns of food group intake were similar for users and nonusers. Mothers of MVM users reported the following: higher levels of pressuring their daughters to eat healthier diets, more monitoring of daughters’ food intake, more success in dieting for weight control, more positive evaluations of their success in eating healthy diets, and lower body mass indexes than mothers who did not give MVMs to daughters.
Conclusions. Daughters’ MVM supplement use was predicted by mothers’ beliefs, attitudes, perceptions, and practices regarding mothers’ own eating and child feeding practices, rather than by daughters’ diet quality. For both MVM users and nonusers, daughters’ food group servings were below recommendations, whereas vitamin and mineral intakes exceeded recommendations, a pattern indicative of girls’ relatively high intakes of fortified foods. Mothers should be encouraged to foster healthier patterns of food intake in daughters, rather than providing MVM supplements.
Adolescent Reports of Physician Counseling for Smoking
Authors: Alfano Catherine M. , Zbikowski Susan M. , Robinson Leslie A. , Klesges Robert C. , Scarinci Isabel C. 
Published: August 2004

Objective. Physicians can play an important role in reducing adolescent smoking by counseling their adolescent patients. The appropriate delivery of smoking prevention and cessation messages depends on adequate screening of adolescents, identification of smokers, and adolescents’ willingness to disclose their smoking. The present study assessed adolescent reports of physician screening and counseling and adolescents’ willingness to disclose smoking, as well as demographic and health status differences in these rates.
Methods. Adolescents (n = 5016), ages 16 to 19, completed a survey on smoking and health. Reports of the prevalence of physician screening, counseling, and adolescents’ willingness to disclose their smoking were examined, and logistic regression analyses assessed demographic and health status differences in these prevalence estimates.
Results. Overall, 43.4% of the sample reported physician screening, 42.1% reported receiving counseling, and only 28.8% of adolescents reported both. Furthermore, 79.3% of smokers reported that they would admit their smoking if asked. Screening, counseling, and disclosure rates differed by gender, neighborhood income level, smoking status, and asthma status.
Conclusions. More intensive provider-delivered intervention is needed. Efforts should focus on helping providers to identify smoking correctly and to communicate appropriate prevention or cessation messages. Persistence and sensitivity with boys, experimental smokers, and youths with chronic health conditions should be a focus of provider training, because the lower willingness of these youths to disclose their smoking may be a barrier to their identification and intervention.
Sequential Acquisition of Toilet-Training Skills: A Descriptive Study of Gender and Age Differences in Normal Children
Authors: Schum Timothy R. , Kolb Thomas M. , McAuliffe Timothy L. , Simms Mark D. , Underhill Richard L. , Lewis Marla 
Published: August 2004

Objective. To compare the ages, by gender, at which normally developing children acquire individual toilet-training skills and to describe the typical sequence by which children achieve complete toileting success.Methods. A longitudinal survey was conducted of a cohort of children who were 15 to 42 months of age and attending 4 pediatric practices in the Milwaukee area (2 inner city and 2 suburban) from 1995 through 1997. Parents completed background surveys, and each child’s development was assessed using the Bayley Scales of Infant Development II. Each week for 12 to 16 months, parents completed a training status survey (TSS). The TSS, designed for this project, included information on daily toilet-training status (eg, number of urine successes on a 5-point scale) and 28 weekly toilet-training behaviors rated on a 5-point Likert scale from 1 (never) to 5 (always). Children were considered to have acquired a particular skill when they received a rating of 4 or 5 on the TSS scale. The median age and interquartile range for children for each toilet-training skill are reported for girls and boys separately using survival curve analysis. Ages at which each gender achieved these skills are compared using a log-rank test.Results. The study included 126 girls and 141 boys; 88% were white. Parents submitted a total of 10 741 weekly surveys (range: 1–73; median: 49 per child). Girls demonstrated toilet-training skills at earlier ages than boys. The median ages for “staying dry during the day” were 32.5 months (95% confidence interval: 30.9–33.7) and 35.0 months (95% confidence interval: 33.3–36.7) for girls and boys, respectively. The median ages for readiness skills for girls and boys, respectively, were as follows: “showing an interest in using the potty,” 24 and 26 months; “staying dry for 2 hours,” 26 and 29 months; “indicating a need to go to the bathroom,” 26 and 29 months. There was a marked concordance in the sequences in which girls and boys achieve individual skills. In addition, the interquartile ranges of the toileting skills varied from 6.9 to 11.4 months in girls and from 7.5 to 14.6 months in boys.Conclusions. In this study population, girls achieve nearly all toilet-training skills earlier than boys, including successful completion. Most children do not master the readiness skills until after the second birthday. The range of normalcy for the attainment of individual skills may vary by as much as a year.
Comparison of Nasogastric and Intravenous Methods of Rehydration in Pediatric Patients With Acute Dehydratio
Authors: Nager Alan L. , Wang Vincent J. 
Published: August 2004

Objective. To assess the safety, efficacy, and cost-effectiveness of rapid nasogastric hydration (RNG) and rapid intravenous hydration (RIV) administered in the emergency department (ED) to young children suffering with uncomplicated, acute moderate dehydration.
Methods. Ninety-six children aged 3 to 36 months, who presented with signs and symptoms of uncomplicated, acute moderate dehydration caused by vomiting and/or diarrhea, presumed to be caused by viral gastroenteritis, were randomly assigned to receive either RNG with a standard oral rehydration solution or RIV with normal saline. Each solution was administered at a rate of 50 mL/kg of body weight, delivered over a 3-hour period in our urban pediatric ED. All participants were weighed pretreatment and posttreatment and underwent initial and final measurements of their serum electrolytes, blood urea nitrogen, creatinine, and glucose levels, along with urine chemistry and urine specific gravity. Telephone follow-up by completion of a standardized questionnaire was obtained approximately 24 hours after discharge from the ED.
Results. Ninety-two of 96 enrolled patients completed the study. Three patients failed treatment (2 RIV and 1 RNG) and were excluded and hospitalized because of severe, intractable vomiting, and 1 patient was withdrawn secondary to an intussusception. Among 92 evaluable patients, 2 were found to be severely dehydrated (&gt;10% change in body weight) and were excluded from analysis, leaving 90 patients (RNG: N = 46 and RIV: N = 44), who completed the study. Both RNG and RIV were found to be a safe and efficacious means of treating uncomplicated, acute moderate dehydration in the ED. Determinations of electrolytes, blood urea nitrogen, creatinine, or glucose were not found to be of value on an intent-to-treat basis in the care of these patients. The urine specific gravity and incidence of ketonuria declined from levels commensurate with moderate dehydration in the RNG group, but not as consistently so in the RIV group. Both RNG and RIV were substantially less expensive to administer than standard care with intravenous fluid deficit therapy in-hospital, and RNG was more cost-effective to administer over RIV in the outpatient setting.
Conclusion. RNG and RIV administered in the ED are safe, efficacious, and cost-effective alternatives to the standard treatment for uncomplicated, acute moderate dehydration in young children. RNG is as efficacious as RIV, is no more labor intensive than RIV, and is associated with fewer complications. In addition, we found that most routine laboratory testing is of little value in these patients and should be avoided, except when clearly clinically indicated.
Infant Acceptance of Breast Milk After Maternal Exercise
Authors: Wright Kc S. , Quinn Timothy J. , Carey Gale B. 
Published: August 2004

Objective. Previous research reported that breast milk lactic acid (LA) levels increase after lactating women complete a bout of exhaustive exercise, resulting in poor infant acceptance of the postexercise breast milk. This highly publicized finding may not apply to more practical, everyday exercise conditions of lactating women. The purpose of the present study was to reexamine the composition and infant acceptance of postexercise breast milk while controlling maternal diet, exercise intensity, and the method, timing, and assessment of infant feeding.Research Design and Methods. Twenty-four women, 2 to 4 months’ postpartum, completed 3 test sessions: a maximal oxygen uptake test, a 30-minute bout of moderate exercise, and a resting control session. One hour before and 1 hour after each session, participants fully expressed their milk, placed it in a bottle familiar to the infant, fed their infant, and rated their infant’s acceptance of the milk. Each feeding was videotaped and viewed individually by 3 lactation consultants who rated infant acceptance; consultants were blinded to the test sessions. Milk was analyzed for LA and infant milk consumption was measured.Results. There were no differences in presession versus postsession values for maternal skin temperature, breast milk temperature, and infant milk acceptance as judged by either the mothers or lactation consultants. These results prevailed despite a small but significant increase in breast milk LA premaximal versus postmaximal exercise (0.09 vs 0.21 mM, respectively); there was no difference in milk LA premoderate versus postmoderate exercise, or prerest versus postrest.Conclusion. These data support the hypothesis that moderate or even high-intensity exercise during lactation does not impede infant acceptance of breast milk consumed 1 hour postexercise.
Breastfeeding Is Analgesic in Healthy Newborns
Authors: Gray Larry , Miller Lisa W. , Philipp Barbara L. , Blass Elliott M. 
Published: August 2004

Context. This study identifies a behavioral and nonpharmacologic means of preventing newborn pain.
Objective. To determine whether breastfeeding is analgesic in newborn infants undergoing heel lance—a routine, painful, hospital procedure.
Design. A prospective, randomized, controlled trial.
Setting. Hospital maternity services at Boston Medical Center, Boston, Massachusetts, and Beverly Hospital, Beverly, Massachusetts.
Participants. A random sample of 30 full-term, breastfed infants.
Interventions. Infants in the intervention group were held and breastfed by their mothers during heel lance and blood collection procedures for the Newborn Screening Program Blood Test. Infants in the control group experienced the same blood test while receiving the standard hospital care of being swaddled in their bassinets.
Outcome Measures. Crying, grimacing, and heart rate differences were analyzed between the breastfeeding and the control infants before, during, and after blood collection.
Results. Crying and grimacing were reduced by 91% and 84%, respectively, from control infant levels during the blood collection. Heart rate was also substantially reduced by breastfeeding.
Conclusions. Breastfeeding is a potent analgesic intervention in newborns during a standard blood collection.
Use of Sleep Aids During the First Year of Life
Authors: Burnham Melissa M. , Goodlin-Jones Beth L. , Gaylor Erika E. , Anders Thomas F. 
Published: August 2004

Objective. In an attempt to foster self-soothing during the night, a novel sleep aid infused with maternal odor was introduced to 4 groups of infants ranging in age from 3 to 12 months. Infants’ use of parent-provided sleep aids also was examined.Methodology. Nighttime sleep and waking behaviors were videotaped for 2 consecutive nights on 3 occasions over a 3-month interval. Using all-night video recording, the study examined the infant’s use of a novel sleep aid and parent-provided sleep aids during sleep onset and after nighttime awakenings.Results. Results indicated that infants of different ages differed in the types of sleep aids used when falling asleep either at the beginning of the night or after awakenings in the middle of the night. More 3-month-olds used their thumbs/fingers/hands, whereas more 6-month-olds used soft objects. The 6-month-olds were most likely to use the novel sleep aid. Almost all of the infants at all 4 ages used some type of object during the night. Intra-individual analyses showed that infants tended to change their pattern of sleep aid use over the 3-month study period.Conclusions. The data provide evidence that infants during the first year of life use sleep aids frequently and interchangeably rather than a specific favorite object.
Infant Sleep Placement After the Back to Sleep Campaign
Authors: Pollack Harold A. , Frohna John G. 
Published: August 2004

Objectives. The Back to Sleep campaign has been credited with recent declines in the incidence of sudden infant death syndrome. Using survey data for the 1996–1998 birth cohorts, this epidemiologic study examines infant sleep position in a large, population-based sample.Data and Methods. Data concerning infant sleep position are drawn from the 1996–1998 Pregnancy Risk Assessment Monitoring System for 15 states. Weighted multiple logistic regression analysis is used to examine correlates of infant sleep position.Results. The prevalence of prone infant sleeping significantly declined between 1996 and 1998 (adjusted odds ratio [AOR] = 0.70; 95% confidence interval [CI] = [0.63, 0.78]). African Americans were more likely than non-Hispanic whites to sleep prone, (AOR = 1.45; 95% CI = 1.33,1.59), and were less likely to sleep supine (AOR = 0.52; 95% CI = 0.48, 0.57). Hispanic/Latinos were less likely overall than non-Hispanic whites to sleep prone (AOR = 0.81; 95% CI = 0.69, 0.95), but were also less likely to sleep supine (AOR = 0.78; 95% CI = 0.69, 0.87). Adherence to sleep position recommended by the American Academy of Pediatrics increased sharply among Hispanic/Latino infants. Very low birth weight infants and infants in larger families were less likely to sleep in the recommended supine position. Infants born between 1001 and 1500 g (AOR = 0.67; 95% CI = 0.57, 0.79), and extremely low birth weight infants between 500 and 1000 g (AOR = 0.57; 95% CI = 0.45, 0.72) were especially unlikely to sleep supine. Infants in households with more than 3 other children (AOR = 1.72; 95% CI = 1.08, 2.74) were more likely to sleep prone.Conclusions. The prevalence of supine infant sleep increased between 1996 and 1998. Low adherence to sleep position recommendations of the American Academy of Pediatrics among African Americans, very low birth weight infants, and infants in large families remain public health concerns.