bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diet Quality, Nutrient Intake, Weight Status, and Feeding Environments of Girls Meeting or Exceeding Recommendations for Total Dietary Fat of the American Academy of Pediatrics
Authors: Lee Yoonna , Mitchell Diane C. , Smiciklas-Wright Helen , Birch Leann L. 
Published: August 2004

Objectives.To compare the diet quality and weight status of girls consuming diets meeting the recommendation of the American Academy of Pediatrics for dietary fat with those of girls consuming &gt;30% of energy from fat and to examine relationships between girls' dietary fat intake, mothers' nutrient intakes, and mothers' child-feeding practices.Design.Participants were 192 white girls and their mothers, who were divided into 2 groups: &gt;30% of energy from fat (high fat [HF]) or ≤30% of energy from fat (low fat [LF]), based on girls' 3-day dietary recalls. Girls' food group and nutrient intakes, Healthy Eating Index, body mass index, and mothers' nutrient intakes and child-feeding practices were compared.Results.Girls with HF diets consumed fewer fruits, more meat, and more fats and sweets and had lower Healthy Eating Index scores than did the girls in the LF group. Mothers of girls in the HF group had higher fat intakes than did those in the LF group. Girls and mothers in the HF group had lower intakes of fiber and vitamins A, C, B6, folate, and riboflavin. Mothers in the HF group reported using more restriction and pressure to eat in feeding their daughters. Girls in the HF group showed greater increase in body mass index and skinfold thickness from age 5 to 7 years.Conclusion.These findings provide additional support for the recommendation of the American Academy of Pediatrics to limit total dietary fat. Findings reveal that mothers' use of controlling feeding practices are not effective in fostering healthier diets among girls and that mothers' own eating may be more influential than their attempts to control the intake of their daughters. dietary fat, dietary quality, nutrient intake, overweight, feeding practices, children.
A Randomized Comparison of Helium–Oxygen Mixture (Heliox) and Racemic Epinephrine for the Treatment of Moderate to Severe Croup
Authors: Weber Jim Edward , Chudnofsky Carl R. , Younger John G. , Larkin G. Luke , Boczar Michael , Wilkerson Mark D. , Zuriekat George Y. , Nolan Brian , Eicke David M. 
Published: August 2004

Objective.
To compare the additive effect of a helium–oxygen mixture (Heliox) or racemic epinephrine (RE) on croup scores (CSs) in children with moderate to severe croup treated with humidified oxygen and steroids.

Design.
A prospective, randomized, double-blind trial.

Setting.
Emergency department and pediatric intensive care unit of an urban level I trauma center.

Participants.
Randomly assigned, consecutive children ages 6 months to 3 years presenting with moderate to severe croup (CS: ≥5).

Interventions.
After cool humidified oxygen and 0.6 mg/kg of intramuscular dexamethasone, patients were randomized to receive either Heliox or RE. Vital signs, oxygen saturation, and CSs were recorded at regular intervals.

Outcome/Analysis.
Reductions in CSs were compared using repeated-measures analysis of variance.

Results.
Thirty-three patients were enrolled. Three were excluded because of protocol violations, and 1 was excluded because of lack of documentation, leaving 29 patients for final analysis. The average age was 24.2 months, 20 were male (68.8%). Both Heliox and RE were associated with improvement in CSs over time. There were no significant differences in mean CS, oxygen saturation, respiratory rate, or heart rate between groups at baseline or at the end of the treatment period.

Conclusion.
In patients with moderate to severe croup, the administration of Heliox resulted in similar improvements in CS compared with patients given RE.
Intussusception Among Recipients of Rotavirus Vaccine: Reports to the Vaccine Adverse Event Reporting System
Authors: Zanardi Lynn R. , Haber Penina , Mootrey Gina T. , Niu Manette T. , Wharton Melinda ,   the VAERS Working Group
Published: August 2004

Background.
Rotavirus vaccine was licensed on August 31, 1998, and subsequently recommended for routine use among infants. To assess rare adverse events, postlicensure surveillance was conducted.

Objective.
To describe the cases of intussusception among rotavirus vaccine recipients reported to the Vaccine Adverse Event Reporting System from October 1998 through December 1999.

Setting and Participants.
Infants vaccinated with rotavirus vaccine in the United States.

Outcome Measures.
Intussusception confirmed by radiology, surgery, or autopsy report with medical record documentation or confirmed by a primary health care provider.

Results.
There were 98 confirmed cases of intussusception after vaccination with rotavirus vaccine reported to the Vaccine Adverse Event Reporting System; 60 of these developed intussusception within 1 week after vaccination. Based on calculations using vaccine distribution data and intussusception incidence rates from 2 separate databases, an estimated 7 to 16 cases would have been expected to occur in the week after vaccination by chance alone.

Conclusion.
Using a passive surveillance system for vaccine adverse events, we observed at least a fourfold increase over the expected number of intussusception cases occurring within 1 week of receipt of rotavirus vaccine. Other studies were initiated to further define the relationship between rotavirus vaccine and intussusception. In light of these and other data, the rotavirus vaccine manufacturer voluntarily removed its product from the market, and the recommendation for routine use of rotavirus vaccine among US infants has been withdrawn.
Fluctuations in Symptoms in Human Immunodeficiency Virus-Infected Children: The First 10 Years of Life
Authors:   The European Collaborative Study
Published: August 2004

Objective.To describe patterns of clinical and immunologic progression in children who are vertically infected with the human immunodeficiency virus.Methods.Children who were born to mothers who were infected with the human immunodeficiency virus in 11 European centers were enrolled at birth in a prospective study and followed according to a standard protocol. At each visit, a clinical and immunologic class was allocated according to guidelines of the Centers for Disease Control and Prevention (CDC). Progression to serious disease and death was assessed, allowing for available and actual antiretroviral therapy (ART). CDC class at each visit was assessed cross-sectionally.Results.More than 15% of infected children will have progressed to category C or death by age 1 year and nearly 50% by 10 years. Just under 20% of children will have evidence of severe immunodeficiency by age 1 and 75% by 10 years. In general, immune status poorly reflected clinical condition. Children who were born after 1994, when the recommendation of earlier initiation of more active therapy was introduced, were significantly less likely to progress than those who were born when treatment was not widely available or was largely confined to zidovudine monotherapy. Estimated progression to CDC class C or death initially was faster in untreated than in treated children, but by 10 years estimated cumulative progression was similar in both groups. Treatment started before class C disease was associated with significantly slower progression. Cross-sectional analysis showed that children largely are symptom-free throughout their lives. After 4 years of age, fewer than 25% of infected children had symptoms at any one time, irrespective of ART received.Conclusion.Vertically infected children are without serious symptoms or signs for most of the time. The prognosis has improved with more widespread availability and use of combination ART. These findings have implications for health, education, and other support-service provision.
Outcome at 5 Years of Age of Children 23 to 27 Weeks' Gestation: Refining the Prognosis
Authors: Doyle Lex W. ,   for the Victorian Infant Collaborative Study Group
Published: August 2004

Objectives.
To determine the changes with postnatal age for survival, with and without major sensorineural disability, to 5 years of age in very preterm infants and to contrast their prognosis with normal birth weight (NBW) control participants.

Methods.
A geographically determined cohort study was conducted in Victoria, Australia. Consecutive live births of 23 to 27 weeks' gestational age born during 1991 to 1992 and randomly selected contemporaneous NBW control participants were studied. The main outcome measures were survival and rates of major disability at 5 years of age, determined for those offered intensive care, after day 7, after day 28, and at hospital discharge.

Results.
Of 401 live births of 23 to 27 weeks' gestation, 225 (56.1%) survived to 5 years of age. The survival rate rose significantly with increasing gestational age at birth in those offered intensive care and by day 7 but not by day 28. The survival rate free of major disability rose significantly with increasing gestational age at all postnatal ages but was not an independent predictive variable by day 28; other adverse events were more important. In the absence of adverse events, the rate of survival free of major disability for very preterm infants who had survived to discharge was 93.2%, similar to the rate of 95.5% for NBW control participants.

Conclusions.
The prognosis for very preterm infants changes substantially with postnatal age. Counseling of families should be repeated at intervals, and the advice offered should vary with perinatal events.
Childhood Neglect and Cognitive Development in Extremely Low Birth Weight Infants: A Prospective Study
Authors: Strathearn Lane , Gray Peter H. , O'Callaghan FRCPI‡; Michael J. , Wood David O. 
Published: August 2004

Objective.To examine the relationship between child maltreatment and cognitive development in extremely low birth weight infants, adjusting for perinatal and parental risk factors.Methods.A total of 352 infants with birth weight of &lt;1000 g were followed prospectively for 4 years. The data were analyzed with regard to perinatal and parental risk factors and referrals for suspected child maltreatment to government agencies. Perinatal risk factors included birth weight, gestation, gender, periventricular hemorrhage, ventricular dilation, home oxygen requirement, and necrotizing enterocolitis. Parental risk factors included maternal age, race, marital status, education, and hospital insurance status. Cognitive z scores were calculated at 1, 2, and 4 years, and head circumference z scores were calculated at birth, 2 years, and 4 years.Results.Fifteen percent of infants were referred to child protective services for suspected child maltreatment. The adjusted general cognitive index at 4 years was significantly reduced in infants who were referred for neglect (−17.6; 95% confidence interval: −3.3, −31.9). Infants whose neglect was substantiated had a progressive decline in their cognitive function over time (cognitivez scores: −0.97, −1.37, and −2.05 standard deviations at 1, 2, and 4 years, respectively), compared with non-neglected infants (z scores: −0.04 to −0.36). They had a significantly smaller head circumference at 2 and 4 years but not at birth (adjusted z score at 4 years: −0.812; 95% confidence interval: −0.167, −1.458). Perinatal risk factors and physical disability were not related to maltreatment referral; only parental factors were independent predictors.Conclusions.Childhood neglect is associated significantly with delayed cognitive development and head growth. Addressing risk factors antenatally and in early childhood may improve outcomes.
Lead Poisoning Among Refugee Children Resettled in Massachusetts, 1995 to 1999
Authors: Geltman Paul L. , Brown Mary Jean , Cochran Jennifer 
Published: August 2004

Objective.
Lead poisoning has been reported among immigrant and refugee populations in the United States; however, prevalences of elevated blood lead (BPb) and risk factors have not been described fully among newly arrived refugee children. This study was conducted to address this lack of data.

Methods.
We performed analysis of BPb levels among a cohort of refugee children, aged &lt;7 years, who arrived in Massachusetts between July 1, 1995, and December 31, 1999. Gender, age, birthplace, time of year of lead testing, intestinal parasitoses, anemia, and growth retardation were examined as predictors of elevated BPb.

Results.
BPb levels ≥10 μg/dL were found in 11.3% of 693 children shortly after their arrival in the United States. Children from developing countries had the highest prevalences, including 27% of Somalis and Vietnamese. Country of birth was the strongest predictor of elevated BPb. No association between elevated lead and age was found. Among 213 children with BPb tests ≥6 months after the initial test, 7% had newly elevated levels of ≥10 μg/dL.

Conclusions.
The prevalence of elevated BPb levels in recently arrived refugee children is more than twice that of US-born children. Children who are at particular risk are those from developing countries where environmental exposures are more ubiquitous. In addition, a significant percentage of refugees acquired elevated levels after arrival, thus suggesting the importance of follow-up testing of refugee children. Refugee status should be considered a risk factor for lead poisoning.
A Randomized Trial to Reduce Passive Smoke Exposure in Low-Income Households With Young Children
Authors: Emmons Karen M. , Hammond S. Katharine , Fava Joseph L. , Velicer Wayne F. , Evans Janet L. , Monroe Alicia D. 
Published: August 2004

Objective.Passive smoke exposure among children is widespread in the United States; estimates suggest that almost 40% of children who are younger than 5 years live with a smoker. Few randomized studies of passive smoke exposure reduction among children have been conducted, and the impact of interventions that have been evaluated has been limited. The objective of this study was to determine whether a motivational intervention for smoking parents of young children will lead to reduced household passive smoke exposure.Methods.Project KISS (Keeping Infants Safe From Smoke), a theory-driven exposure reduction intervention targeting low-income families with young children, was a randomized controlled study in which participants—smoking parents/caregivers (N = 291) who had children who were younger than 3 years and who were recruited through primary care settings—were randomly assigned to either the motivational intervention (MI) or a self-help (SH) comparison condition was used. Follow-up assessments were conducted at 3 and 6 months. The MI condition consisted of a 30- to 45-minute motivational interviewing session at the participant's home with a trained health educator and 4 follow-up telephone counseling calls. Feedback from baseline household air nicotine assessments and assessment of the participant's carbon monoxide level was provided as part of the intervention. Participants in the SH group received a copy of the smoking cessation manual, the passive smoke reduction tip sheet, and the resource guide in the mail. Household nicotine levels were measured by a passive diffusion monitor.Results.The 6-month nicotine levels were significantly lower in MI households. Repeated measures analysis of variance across baseline, 3-month, and 6-month time points showed a significant time-by-treatment interaction, whereby nicotine levels for the MI group decreased significantly and nicotine levels for the SH group increased but were not significantly different from baseline.Conclusions.This study targeted a large sample of racially and ethnically diverse low-income families, in whom both exposure and disease burden is likely to be significant. This is the first study to our knowledge that has been effective in reducing objective measures of passive smoke exposure in households with healthy children. These findings have important implications for pediatric health care providers, who play an important role in working with parents to protect children's health. Providers can help parents work toward reducing household passive smoke exposure using motivational strategies and providing a menu of approaches regardless of whether the parents are ready to quit.
Technical Report: Mercury in the Environment: Implications for Pediatricians
Authors: Goldman Lynn R. , Shannon Michael W. ,   the Committee on Environmental Health
Published: August 2004

This Technical Report was retired May 2012.
Mercury is a ubiquitous environmental toxin that causes a wide range of adverse health effects in humans. Three forms of mercury (elemental, inorganic, and organic) exist, and each has its own profile of toxicity. Exposure to mercury typically occurs by inhalation or ingestion. Readily absorbed after its inhalation, mercury can be an indoor air pollutant, for example, after spills of elemental mercury in the home; however, industry emissions with resulting ambient air pollution remain the most important source of inhaled mercury. Because fresh-water and ocean fish may contain large amounts of mercury, children and pregnant women can have significant exposure if they consume excessive amounts of fish. The developing fetus and young children are thought to be disproportionately affected by mercury exposure, because many aspects of development, particularly brain maturation, can be disturbed by the presence of mercury. Minimizing mercury exposure is, therefore, essential to optimal child health. This review provides pediatricians with current information on mercury, including environmental sources, toxicity, and treatment and prevention of mercury exposure.
Estimated Prevalence of Noise-Induced Hearing Threshold Shifts Among Children 6 to 19 Years of Age: The Third National Health and Nutrition Examination Survey, 1988–1994, United States
Authors: Niskar Amanda Sue , Kieszak Stephanie M. , Holmes Alice E. , Esteban Emilio , Rubin Carol , Brody Debra J. 
Published: August 2004

Objective.
This analysis estimates the first nationally representative prevalence of noise-induced hearing threshold shifts (NITS) among US children. Historically, NITS has not been considered a common cause of childhood hearing problems. Among children, NITS can be a progressive problem with continued exposure to excessive noise, which can lead to high-frequency sound discrimination difficulties (eg, speech consonants and whistles).

Methods.
The Third National Health and Nutrition Examination Survey (NHANES III) was conducted from 1988 to 1994. NHANES III is a national population-based cross-sectional survey with a household interview, audiometric testing at 0.5 to 8 kHz, and compliance testing. A total of 5249 children aged 6 to 19 years completed audiometry and compliance testing for both ears in NHANES III. The criteria used to assess NITS included audiometry indicating a noise notch in at least 1 ear.

Results.
Of US children 6 to 19 years old, 12.5% (approximately 5.2 million) are estimated to have NITS in 1 or both ears. In the majority of the children meeting NITS criteria, only 1 ear and only 1 frequency are affected. In this analysis, all children identified with NITS passed compliance testing, which essentially rules out middle ear disorders such as conductive hearing loss. The prevalence estimate of NITS differed by sociodemographics, including age and sex.

Conclusions.
These findings suggest that children are being exposed to excessive amounts of hazardous levels of noise, and children's hearing is vulnerable to these exposures. These data support the need for research on appropriate hearing conservation methods and for NITS screening programs among school-aged children. Public health interventions such as education, training, audiometric testing, exposure assessment, hearing protection, and noise control when feasible are all components of occupational hearing conservation that could be adapted to children's needs with children-specific research.
Diagnostic Accuracy of Screening Electrocardiograms in Long QT Syndrome I
Authors: Miller Misha D. , Porter Co-burn J. , Ackerman Michael J. 
Published: August 2004

Objective.
Inherited long QT syndrome (LQTS) may present with syncope, seizures, and/or sudden death as a result of ventricular tachyarrhythmias. Identification of family members who are at risk because they harbor the genetic substrate for LQTS is critical. Presently, such identification relies on the 12-lead electrocardiogram (ECG). The purpose of this study was to evaluate the efficacy of the automated ECG as a screening tool for LQTS.

Method.
Molecular testing of a proband and 22 additional family members for the KVLQT1 mutation and symptomatic status facilitated the classification of each family member into the following patient groups: noncarriers (13), asymptomatic carriers (5), and symptomatic carriers (5). Each individual had a standard 12-lead ECG from which the computer and manual (lead II) corrected QT interval were determined. In addition, we determined the accuracy of the computer ECG diagnostic interpretation for each patient group.

Results.
With the use of a corrected QT interval of ≥460 ms as a diagnostic cutoff, the positive and negative predictive values for identifying at-risk individuals were 100%. Despite this, the computer-generated ECG diagnostic interpretation erroneously classified 6 of 23 family members. Moreover, half of the family members, proved to have the ion channel defect, received the diagnostic interpretation “normal ECG.”

Conclusion.
Reliance on the computer-generated ECG diagnostic interpretation alone will fail to identify many at-risk family members. It is suggested that all first-degree relatives of an identified LQTS proband have a 12-lead ECG that is reviewed independently by a physician who is familiar with LQTS in an effort to improve screening for this potentially lethal syndrome.electrocardiogram, long QT syndrome, QT interval, sudden death.
Where Children Drown, United States, 1995
Authors: Brenner Ruth A. , Trumble Ann C. , Smith Gordon S. , Kessler Eileen P. , Overpeck Mary D. 
Published: August 2004

Context.Drowning is the second leading cause of unintentional injury death among children ages 1 to 19 years. Details about the specific site of submersion are important for implementation of primary prevention efforts, but are not routinely available from national data.Objectives.To provide national data about the specific sites of drowning among US children and to examine site-specific drowning rates by age, race, and gender.Setting.United States, 1995.Design.Information was abstracted from death certificates for unintentional drownings among children &lt;20 years of age. The site of drowning was coded from free text on death certificates. Proportional distributions of the site of drowning by age, region, gender, and race were examined. Site-specific drowning rates were calculated by age, race, and gender. Denominators were based on US Census Bureau, June 1995 estimates of the US population.Results.For 1995, death certificates were obtained for 1420 unintentional drownings among children &lt;20 years of age, 98% of the number of drowning deaths reported by the National Center for Health Statistics for the same year. Site of drowning was specified on 1308 (92%) death certificates. Fifty-five percent of infant drownings were in bathtubs. Among children between the ages of 1 to 4 years, 56% of drownings were in artificial pools and 26% were in other bodies of freshwater. Among older children, 63% of drownings were in natural bodies of freshwater. Site-specific drowning rates varied by race. Importantly, after the age of 5 years, the risk of drowning in a swimming pool was greater among black males compared with white males with rate ratios of 15.1 (95% confidence interval: 6.7–38.5) among 10- to 14-year-olds and 12.8 (95% confidence interval: 6.5–26.9) among 15- to 19-year-olds.Conclusion.The variety of sites in which children drown, even within specific age groups, emphasizes the need for a multifaceted approach to prevention. Reductions in the relatively high rates of drowning among black adolescent males will require targeted interventions to prevent swimming pool drownings among this group.