bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resuscitation With Room Air Instead of 100% Oxygen Prevents Oxidative Stress in Moderately Asphyxiated Term Neonates
Authors: Vento Máximo , Asensi Miguel , Sastre Juan , Garcı́a-Sala Fernando , Pallardó Federico V. , Viña José 
Published: August 2004

Background.
Traditionally, asphyxiated newborn infants have been ventilated using 100% oxygen. However, a recent multinational trial has shown that the use of room air was just as efficient as pure oxygen in securing the survival of severely asphyxiated newborn infants. Oxidative stress markers in moderately asphyxiated term newborn infants resuscitated with either 100% oxygen or room air have been studied for the first time in this work.

Methods.
Eligible term neonates with perinatal asphyxia were randomly resuscitated with either room air or 100% oxygen. The clinical parameters recorded were those of the Apgar score at 1, 5, and 10 minutes, the time of onset of the first cry, and the time of onset of the sustained pattern of respiration. In addition, reduced and oxidized glutathione concentrations and antioxidant enzyme activities (superoxide dismutase, catalase, and glutathione peroxidase) were determined in blood from the umbilical artery during delivery and in peripheral blood at 72 hours and at 4 weeks' postnatal age.

Results.
Our results show that the room-air resuscitated (RAR) group needed significantly less time to first cry than the group resuscitated with 100% oxygen (1.2 ± 0.6 minutes vs 1.7 ± 0.5). Moreover, the RAR group needed less time undergoing ventilation to achieve a sustained respiratory pattern than the group resuscitated with pure oxygen (4.6 ± 0.7 vs 7.5 ± 1.8 minutes). The reduced-to-oxidized-glutathione ratio, which is an accurate index of oxidative stress, of the RAR group (53 ± 9) at 28 days of postnatal life showed no differences with the control nonasphyxiated group (50 ± 12). However, the reduced-to-oxidized-glutathione ratio of the 100% oxygen-resuscitated group (OxR) (15 ± 5) was significantly lower and revealed protracted oxidative stress. Furthermore, the activities of superoxide dismutase and catalase in erythrocytes were 69% and 78% higher, respectively, in the OxR group than in the control group at 28 days of postnatal life. Thus, this shows that these antioxidant enzymes, although higher than in controls, could not cope with the ongoing generation of free radicals in the OxR group. However, there were no differences in antioxidant enzyme activities between the RAR group and the control group at this stage.

Conclusions.
There are no apparent clinical disadvantages in using room air for ventilation of asphyxiated neonates rather than 100% oxygen. Furthermore, RAR infants recover more quickly as assessed by Apgar scores, time to the first cry, and the sustained pattern of respiration. In addition, neonates resuscitated with 100% oxygen exhibit biochemical findings reflecting prolonged oxidative stress present even after 4 weeks of postnatal life, which do not appear in the RAR group. Thus, the current accepted recommendations for using 100% oxygen in the resuscitation of asphyxiated newborn infants should be further discussed and investigated.
Effect of Caffeine on Oxygen Consumption and Metabolic Rate in Very Low Birth Weight Infants With Idiopathic Apnea
Authors: Bauer Jacqueline , Maier Kathrin , Linderkamp Otwin , Hentschel Roland 
Published: August 2004

Objective.Methylxanthines are among the most commonly prescribed drugs in neonatal intensive care. This study evaluates the effect of caffeine on oxygen consumption and metabolic rate in premature infants with idiopathic apnea.Methods.Eighteen preterm infants at gestational ages from 28 to 33 weeks and birth weights of 890 to 1680 g were enrolled in the study. Nine preterm infants received caffeine therapy, and 9 served as a control group. Oxygen consumption and energy expenditure were examined before, during, and after caffeine treatment.Results.Oxygen consumption increased significantly from 7.0 ± 0.9 before caffeine to 8.8 ± 0.7 mL/kg/min after 48 hours of caffeine therapy, and energy expenditure increased from 2.1 ± 0.3 to 3.0 ± 0.2 kcal/kg/hour. During the observation period of 4 weeks of caffeine treatment, oxygen consumption increased significantly in the caffeine group compared with the control patients. In the caffeine group, a lower environmental temperature was sufficient to maintain a normal body temperature. With similar caloric intake in both groups during the study period, daily weight gain in the control group was significantly higher (21 ± 4 vs 42 ± 2 g/d). None of the other parameters recorded changed during caffeine therapy.Conclusion.Long-term administration of caffeine in preterm infants is associated with an increase in oxygen consumption and with a reduction of weight gain. This may have implications for clinical practice as nutritional regimens need to be adjusted during this therapy.
Continuation of the Decline in Prevalence of Anemia in Low-Income Infants and Children in Five States
Authors: Sherry Bettylou , Mei Zuguo , Yip Ray 
Published: August 2004

Objective.To examine whether there is a continuation of the decline in prevalence of anemia among low-income infants and children 6.0 to 59.9 months old from the early 1980s to the mid-1990s.Study Design.Cross-sectional trend analysis of data from the Centers for Disease Control and Prevention's Pediatric Nutrition Surveillance System from the 5 states (Colorado, New Mexico, Oklahoma, Utah, and Vermont) that have been using the same laboratory method for anemia screening since 1984 or earlier.Results.The overall prevalence of anemia decreased substantially in each state from the early 1980s to the mid-1990s as follows: Colorado by 52%; New Mexico by 75%; Oklahoma by 67%; Utah by 57%; and Vermont by 48%. In each state, the prevalence of anemia declined for children of different age groups, birth weights, genders, type of pediatric care visit (screening or follow-up), and most race/ethnic groups.Conclusions.The decline in the prevalence of anemia initially observed in the 1980s continued well into the 1990s. This decline is likely attributable to better iron nutrition related to greater usage of iron-fortified products and possibly better iron bioavailability in some of the food products.
Growth of Preterm Infants Fed Nutrient-Enriched or Term Formula After Hospital Discharge
Authors: Carver Jane D. , Wu Paul Y. K. , Hall Robert T. , Ziegler Ekhard E. , Sosa Roberto , Jacobs Joan , Baggs Geraldine , Auestad Nancy , Lloyd Beate 
Published: August 2004

Objective.At hospital discharge, preterm infants may have low body stores of nutrients, deficient bone mineralization, and an accumulated energy deficit. This double-blind, randomized study evaluated the growth of premature infants with birth weights &lt;1800 g who were fed a 22 kcal/fl oz nutrient-enriched postdischarge formula (PDF) or a 20 kcal/fl oz term-infant formula (TF) from hospital discharge to 12 months' corrected age (CA).Methods.Infants were randomized to PDF or TF a few days before hospital discharge with stratification by gender and birth weight (&lt;1250 g or ≥1250 g). The formulas were fed to 12 months' CA. Growth was evaluated using analysis of variance controlling for site, feeding, gender, and birth weight group. Interaction effects were also assessed. Secondary analyses included a repeated measures analysis and growth modeling.Results.One hundred twenty-five infants were randomized; 74 completed to 6 months' CA and 53 to 12 months' CA. PDF-fed infants weighed more than TF-fed infants at 1 and 2 months' CA, gained more weight from study day 1 to 1 and 2 months' CA, and were longer at 3 months' CA. There were significant interactions between feeding and birth weight group—among infants with birth weights &lt;1250 g, those fed PDF weighed more at 6 months' CA, were longer at 6 months' CA, had larger head circumferences at term 1, 3, 6, and 12 months' CA, and gained more in head circumference from study day 1 to term and to 1 month CA. The repeated measures and growth modeling analyses confirmed the analysis of variance results. The PDF formula seemed to be of particular benefit for the growth of male infants. Infants fed the PDF consumed less formula and had higher protein intakes at several time points. Energy intakes, however, were not different.Conclusions.Growth was improved in preterm infants fed a nutrient-enriched postdischarge formula after hospital discharge to 12 months' CA. Beneficial effects were most evident among infants with birth weights &lt;1250 g, particularly for head circumference measurements.
Thermal Stress in Sudden Infant Death: Is There an Ambiguity With the Rebreathing Hypothesis?
Authors: Guntheroth Warren G. , Spiers Philip S. 
Published: August 2004

Objective.To assess the role of thermal stress in the cause of sudden infant death syndrome (SIDS), and to compare risk factors with those of rebreathing.Methodology.Analysis of publications concerning the epidemiology and physiology of thermal stress in SIDS.Results.A strong association between thermal regulation and ventilatory control was found, specifically for prolonged apnea. Infections, excessive room heat and insulation, and prone sleeping produce significantly increased odds ratios for SIDS. Although some of the risk factors for rebreathing could be explained by the effects of thermal stress, several factors for thermal stress could not reasonably be explained by the rebreathing hypothesis.Conclusions.Although the risk of thermal stress is widely accepted abroad, it has received relatively little attention in the United States. The incidence of SIDS in the United States can likely be further reduced by educating the public against the dangers of overheating, as an integral part of the back-to-sleep campaign.
Neonatal Thyroxine Supplementation in Very Preterm Children: Developmental Outcome Evaluated at Early School Age
Authors: Briët Judy M. , van Wassenaer Aleid G. , Dekker Friedo W. , de Vijlder Jan J. M. , van Baar Anneloes , Kok Joke H. 
Published: August 2004

Objective.Transient hypothyroxinemia in very premature infants is associated with developmental problems. A randomized, placebo-controlled trial of thyroxine (T4) supplementation was conducted in a group of 200 infants &lt;30 weeks' gestation. T4 supplementation improved mental outcome at 2 years old in children of 25/26 weeks' gestation only. The effect of T4 supplementation beyond 2 years of age is unknown. We present the effects of neonatal T4 supplementation on outcome at early school age.Methods.Standardized measurements were used to assess cognitive, behavioral, and motor outcome, as well as a qualitative assessment of neurologic functioning. Survivors of the T4trial were assessed at the age of 5.7 years.Results.Ninety-nine percent of the 157 survivors participated. Outcome on all domains was comparable between the T4 group and placebo group. In children &lt;27 weeks' gestation, a 10 IQ point difference was found in favor of the T4 group, whereas in children of 29 weeks' gestation, a difference of 15 IQ points was found in favor of the placebo group. Teachers' reports showed less behavioral problems in the T4-treated children of 25/26 weeks' gestation, but more behavioral problems in the T4-treated children of 27 weeks' gestation. Differences in motor outcome and neurologic outcome were in favor of the T4-treated children &lt;29 weeks' gestation, but not of the T4-treated children of 29 weeks' gestation.Conclusions.We found benefits of T4supplementation for children &lt;29 weeks' gestation, and especially in children of 25/26 weeks' gestation. However, in children of 29 weeks' gestation T4 supplementation is associated with more developmental problems.
Impact of the Joint Statement by the American Academy of Pediatrics/US Public Health Service on Thimerosal in Vaccines on Hospital Infant Hepatitis B Vaccination Practices
Authors: Hurie Marjorie B. , Saari Thomas N. , Davis Jeffrey P. 
Published: August 2004

Objective.
To determine the impact of the American Academy of Pediatrics/US Public Health Service (AAP/USPHS) joint statement on thimerosal in vaccines on hospital infant hepatitis B vaccination policies in Wisconsin.

Methods.
The nurse managers of hospital newborn nurseries (n = 110) were surveyed by mail. Nonresponders were resurveyed. Twelve hospitals no longer provided obstetric services. Of the remaining 98 hospitals, 84 (86%) responded to the initial mailing and 14 (14%) responded to the second mailing. The number of hospitals that offered hepatitis B vaccine to infants before July 1999 was compared with that in March 2000. The number of hospitals that had policies in place to vaccinate infants whose mothers' hepatitis B surface antigen status (HBsAg) was positive or unknown during the thimerosal alert (July 1999 through November 1999) was compared with that in March 2000.

Results.
Before July 1999, 81% of the hospitals representing 84% of reported Wisconsin births routinely offered hepatitis B vaccine to all infants. By March 2000, 50% of hospitals, representing 43% of births, had resumed routine infant hepatitis B vaccination. Physician decision to use a combination Haemophilus influenzae type b hepatitis B vaccine was the most frequently given reason for not reinstituting infant hepatitis B vaccination. During the thimerosal alert, 23% of hospitals did not have policies to vaccinate infants whose mothers were HBsAg-positive and 51% did not have policies to vaccinate infants whose mothers' HBsAg status was unknown. By March 2000, 6% of hospitals still did not have policies to vaccinate infants whose mothers were HBsAg-positive and 24% did not have policies to vaccinate infants whose mothers' HBsAg status was unknown.

Conclusion.
The AAP/USPHS joint statement on thimerosal in vaccines has resulted in a 38% decrease in the number of hospitals routinely offering infants hepatitis B vaccine. Although thimerosal-free hepatitis B vaccine is now available, some hospitals still do not have appropriate policies in place for vaccinating infants whose mothers' HBsAg status is positive or unknown. In the future, policymakers should include anticipated consequences that may result from changes in immunization policy in their recommendations.
Variation in Clinician Recommendations for Multiple Injections During Adoption of Inactivated Polio Vaccine
Authors: Lieu Tracy A. , Davis Robert L. , Capra Angela M. , Mell Loren K. , Quesenberry Charles P. , Martin Kathleen E. , Zavitkovsky Ann , Black Steven B. , Shinefield Henry R. , Thompson Robert S. , Rodewald Lance E. 
Published: August 2004

Objectives.To describe variation in clinician recommendations for multiple injections during the adoption of inactivated poliovirus vaccine (IPV) in 2 large health maintenance organizations (HMOs), and to test the hypothesis that variation in recommendations would be associated with variation in immunization coverage rates.Design.Cross-sectional study based on a survey of clinician practices 1 year after IPV was recommended and computerized immunization data from these clinicians' patients.Study Settings.Two large West Coast HMOs: Kaiser Permanente in Northern California and Group Health Cooperative of Puget Sound.Outcome Measures.Immunization status of 8-month-olds and 24-month-olds cared for by the clinicians during the study.Results.More clinicians at Group Health (82%), where a central guideline was issued, had adopted the IPV/oral poliovirus vaccine (OPV) sequential schedule than at Kaiser (65%), where no central guideline was issued. Clinicians at both HMOs said that if multiple injections fell due at a visit and they elected to defer some vaccines, they would be most likely to defer the hepatitis B vaccine (HBV) for infants (40%). At Kaiser, IPV users were more likely than OPV users to recommend the first HBV at birth (64% vs 28%) or if they did not, to defer the third HBV to 8 months or later (62% vs 39%).In multivariate analyses, patients whose clinicians used IPV were as likely to be fully immunized at 8 months old as those whose clinicians used all OPV. At Kaiser, where there was variability in the maximum number of injections clinicians recommended at infant visits, providers who routinely recommended 3 or 4 injections at a visit had similar immunization coverage rates as those who recommended 1 or 2. At both HMOs, clinicians who strongly recommended all possible injections at a visit had higher immunization coverage rates at 8 months than those who offered parents the choice of deferring some vaccines to a subsequent visit (at Kaiser, odds ratio [OR]: 1.2; 95% confidence interval [CI]: 1.0–1.5; at Group Health, OR: 1.8; 95% CI: 1.1–2.8).Conclusions.Neither IPV adoption nor the use of multiple injections at infant visits were associated with reductions in immunization coverage. However, at the HMO without centralized immunization guidelines, IPV adoption was associated with changes in the timing of the first and third HBV. Clinical policymakers should continue to monitor practice variation as future vaccines are added to the infant immunization schedule.
Effectiveness of a High School Smoking Cessation Program
Authors: Adelman William P. , Duggan Anne K. , MS Patricia Hauptman , Joffe Alain 
Published: August 2004

Objective.To evaluate the impact of a school-based smoking cessation program targeting adolescents interested in quitting.Design.Randomized clinical trial over one school year.Setting.Large public high school.Participants.Students interested in quitting smoking.Intervention.Seventy-four students were randomized to receive either: 1) a 6-week, 8-session, classroom-based, smoking cessation curriculum designed for adolescents (n = 35) or 2) an informational pamphlet on how to quit smoking with promise of the classroom curriculum in 3 months (n = 39).Outcome Measures.Change in smoking behavior measured by: 1) self-reported smoking cessation and exhaled carbon monoxide &lt;6 parts per million (smoke-free); 2) self-reported quit attempts; and 3) change in cigarettes per day (cpd) at the end of the 6-week curriculum and then 4, 10, and 20 weeks later. Saliva cotinine was also measured at these points to validate these outcome measures.Analysis.Intention-to-treat.Results.Participants in the classroom group attended an average of 4.4 sessions. At the end of the curriculum, the classroom group was significantly more likely to be smoke-free (59% vs 17%), to have tried to quit smoking (82% vs 54%), and to reduce mean cpd (7.0 vs 1.0). Four weeks later, these differences persisted: smoke-free (52% vs 20%), quit attempt (85% vs 60%), and reduction in mean cpd (6.6 vs 1.6). Changes in saliva cotinine were consistent with reported outcome measures; those who were smoke-free had a significant reduction in saliva cotinine at the end of the intervention, and at 4 weeks. At 10 and 20 weeks after the curriculum, 41% and 31%, respectively, of the classroom group remained smoke-free. Once participants in the pamphlet group underwent the classroom intervention (average attendance of 2.2 sessions) their cessation rates were similar to the initial group: 31% at the end of the curriculum and 27% 10 weeks later.Conclusion.A school-based curriculum for adolescent smoking cessation is more effective than an informational pamphlet alone and reduces cigarette use by adolescents. More research is needed to test the reproducibility, sustainability, and generalizability of this curriculum to offer more smoking cessation options to teenagers.
Short-Term Hyperthyroidism Followed by Transient Pituitary Hypothyroidism in a Very Low Birth Weight Infant Born to a Mother With Uncontrolled Graves' Disease
Authors: Higuchi Ryuzo , Kumagai Takeshi , Kobayashi Masakazu , Minami Takaomi , Koyama Hirofumi , Ishii Yuki 
Published: August 2004

Transient hypothyroxinemia in infants born to mothers with poorly controlled Graves' disease was first reported in 1988. We report that short-term hyperthyroidism followed by hypothyroidism with low basal thyroid-stimulating hormone (TSH) levels developed in a very low birth weight infant born at 27 weeks of gestation to a noncompliant mother with thyrotoxicosis attributable to Graves' disease. We performed serial thyrotropin-releasing hormone (TRH) tests in this infant and demonstrated that TSH unresponsiveness to TRH disappeared at 6.5 months of age.The maternal thyroid function was free triiodothyronine (FT3), 21.1 pg/mL; free thyroxine (FT4), 8.1 ng/dL; TSH, &lt;0.03 μU/mL; thyroid-stimulating hormone receptor antibody, 52% (normal: &lt;15%); thyroid-stimulating antibody, 294% (normal: &lt;180%); and thyroid-stimulation blocking antibody, 9% (normal: &lt;25%) on the day of delivery. A nonstress test revealed fetal tachycardia &gt;200 beats per minute, and a male infant weighing 1152 g was born by emergency cesarean section. Thyroid-stimulating hormone receptor antibody was 16% and thyroid-stimulating antibody was 370% in the cord blood. We administered 10 mg/kg per day of oral propylthiouracil from day 1. Tachycardia along with elevated FT4 and FT3 levels in the infant decreased from 200/minute to 170/minute, 4.7 ng/dL to 2.9 ng/dL, 7.0 pg/mL to 4.8 pg/mL, respectively, in the first 33 hours. At 5 days, FT4and FT3 were 1.1 ng/dL and 2.9 pg/mL, respectively, and we stopped propylthiouracil administration. Although FT4decreased to 0.4 ng/dL, TSH was quite low and did not respond to intravenous TRH by 14 days of age. We began daily levothyroxine 5-μ/kg supplementation. The responsiveness of TSH to TRH did not become significant until 4 months old and normalized at 6.5 months old. At this time, levothyroxine was stopped.We conclude that placental transfer of thyroid hormones may cause hyperthyroidism in the fetal and early neonatal periods and lead to transient pituitary hypothyroidism in an infant born to a mother with uncontrolled Graves' disease.