bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are “Accidental” Gun Deaths as Rare as They Seem? A Comparison of Medical Examiner Manner of Death Coding With an Intent-Based Classification Approach
Authors: Schaechter Judy , Duran Isis , De Marchena Jacqueline , Lemard Glendene , Villar Maria Elena 
Published: August 2004

Objectives. Unintentional firearm death is often considered a nearly negligible proportion of overall gun death. These rates are based on medical examiner (ME) and coroner death classifications, which affect derived epidemiologic data and subsequent prevention measures. The aim of this study was to compare the proportion of pediatric unintentional gun deaths in Miami-Dade County based on manner of death coding by the ME with an intent-based classification of child gun deaths.
Methods. ME and police records for all pediatric firearm fatalities in Miami-Dade County from 1994 to 1998 were reviewed. The ME’s assignment of manner of death as homicide, suicide, or accident was compared with an intent-based classification of intentional homicide, intentional suicide, and unintentional firearm death based on expressed or implied evidence of intent to harm.
Results. There were 123 pediatric firearm deaths in Miami-Dade County from 1994 to 1998. A significant difference between ME coding and the intent-based classification was found for homicide (94 vs 78) but not for suicide. A significant difference was also found between the ME’s coding for “accident” and the investigator’s classification of “unintentional” firearm death (4 vs 26).
Conclusions. The incidence of unintentional pediatric firearm deaths is significantly underreported by the Miami-Dade County ME when the classification of “accidental” firearm death is used. Reviewing the manner of death classification criteria or establishing an intent code on official death documentation is recommended. Furthermore, clinicians should be aware that the true incidence of unintentional gun death may be higher than that reported as accidental.
Influence of Iodine-131 Dose on the Outcome of Hyperthyroidism in Children
Authors: Rivkees Scott A. , Cornelius Eugene A. 
Published: August 2004

Objectives. Iodine-131 is an effective treatment for Graves’ hyperthyroidism in children and adults. Yet the responses to treatment as related to iodine-131 dose in children are not well-defined. The objective of this study was to examine the relationship between the dose of iodine-131 in children with hyperthyroidism and thyroid status 1 year after treatment.
Methods. We examined the outcome of iodine-131 treatment in children and adolescents with Graves’ disease, as related to dose. Three iodine-131 doses were compared: 72 to 108 Gy (80–120 μCi/g), 180 to 225 Gy (200–250 μCi/g), and 270 to 364 Gy (300–405 μCi/g) in 31 patients ranging in age from 7 to 18 years old. Thyroid status was assessed &gt;1 year after therapy.
Results. We found that doses of 100 Gy (110 μCi/g), 200 Gy (220 μCi/g), and 300 Gy (330 μCi/g) resulted in hypothyroidism in 50%, 70%, and 95% of treated individuals, respectively. These data show that to insure ablation of thyroid tissue doses, &gt;270 Gy (300 μCi/g) is needed, especially when the thyroid is large.
Phase 1 Trial of Prevention of Hydrocephalus After Intraventricular Hemorrhage in Newborn Infants by Drainage, Irrigation, and Fibrinolytic Therapy
Authors: Whitelaw Andrew , Pople Ian , Cherian Shobha , Evans David , Thoresen Marianne 
Published: August 2004

Objective. Treatment of posthemorrhagic ventricular dilation in premature infants is fraught with failures and complications. We have piloted a new treatment aimed at removing intraventricular blood and the cytokines associated with hydrocephalus.Methods. Twenty-four infants were enrolled with ventricular width enlarged to 4 mm over the 97th centile after a large intraventricular hemorrhage. Sixteen had parenchymal brain lesions before treatment. Median gestation was 28 weeks, and birth weight was 1150 g. At a median postnatal age of 17 days, 2 ventricular catheters (1 right frontal, 1 left occipital) were inserted with 13 infants also having a reservoir frontally. Tissue plasminogen activator 0.5 mg/kg was given intraventricularly 8 hours before the ventricles were irrigated with artificial cerebrospinal fluid at 20 mL/h for a median of 72 hours.Results. Seventeen of 23 survivors (74%) did not require a ventriculoperitoneal shunt. One infant (of 23 weeks’ gestation) died. Two infants developed reservoir-associated infection, and 2 infants had a second intraventricular hemorrhage. Of the 19 survivors aged &gt;12 months postterm, 8 were normal, 7 (37%) had single disability, and 4 (21%) had multiple disabilities.Conclusions. Shunt surgery was reduced compared with historical controls with similar treatment criteria. Mortality and single and multiple disability rates all showed downward trends. Reducing pressure, free iron, and proinflammatory and profibrotic cytokines may reduce periventricular brain damage and permanent hydrocephalus. Additional advances will require a controlled trial and better knowledge of the mechanisms of hydrocephalus.
Population-Based Analyses of Mortality in Trisomy 13 and Trisomy 18
Authors: Rasmussen Sonja A. , Wong Lee-Yang C. , Yang Quanhe , May Kristin M. , Friedman J. M. 
Published: August 2004

Objective. Although trisomy 13 and trisomy 18 are generally considered to be lethal, long-term survival of patients has been reported. We sought to evaluate mortality in people with trisomy 13 or 18 using 2 population-based strategies.Methods. In the first analysis, infants who had trisomy 13 or 18 and were born during 1968–1999 were identified using the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects surveillance system. Dates of death were documented using hospital records, Georgia vital records, and the National Death Index. In the second analysis, we used the Multiple-Cause Mortality Files compiled from US death certificates from 1979 through 1997. Using these 2 analyses, we examined median survival time or median age at death, survival beyond 1 year of age, and factors associated with longer survival.Results. Using Metropolitan Atlanta Congenital Defects Program, we identified 70 liveborn infants with trisomy 13 and 114 liveborn infants with trisomy 18. Median survival time was 7 days (95% confidence interval [CI]: 3–15) for people with trisomy 13 and 14.5 days (95% CI: 8–28) for people with trisomy 18. For each condition, 91% of infants died within the first year. Neither race nor gender affected survival for trisomy 13, but for trisomy 18, girls and infants of races other than white seemed to survive longer. The presence of a heart defect did not seem to affect survival for either condition. Using MCMF, we identified 5515 people with trisomy 13 and 8750 people with trisomy 18 listed on their death certificates. Median ages at death for people with trisomy 13 and trisomy 18 both were 10 days; 5.6% of people with trisomy 13 and 5.6% of people with trisomy 18 died at age 1 year or greater. Race and gender seemed to affect survival in both conditions, with girls and blacks showing higher median ages at death.Conclusions. Although survival is greatly affected by trisomy 13 and trisomy 18, 5% to 10% of people with these conditions survive beyond the first year of life. These population-based data are useful to clinicians who care for patients with these trisomies or counsel families with infants or fetuses who have a diagnosis of trisomy 13 or 18.
Efficacy of Methylprednisolone and Urokinase Pulse Therapy for Severe Henoch-Schönlein Nephritis
Authors: Kawasaki Yukihiko , Suzuki Junzo , Nozawa Ruriko , Suzuki Shigeo , Suzuki Hitoshi 
Published: August 2004

Objective. To evaluate the efficacy of methylprednisolone and urokinase pulse therapy (MUPT) for severe Henoch-Schönlein nephritis, we examined the clinical manifestation and prognosis of patients with MUPT on long-term observation.
Methods. We enrolled 56 patients with Henoch-schönlein nephritis who had been diagnosed with at least type IIIb from 1980 to 1998 on long-term observation and had been treated with MUPT. The clinical features, laboratory data, and pathologic findings between “pre-MUPT” and “post-MUPT,” and the prognosis of these patients on long-term observation were retrospectively investigated.
Results. The mean urinary protein excretion after 6 months of treatment had decreased significantly compared with “pre-MUPT.” Hypercoagulant state in “after the completion of urokinase pulse therapy” improved compared with “pre-MUPT.” First renal biopsies were performed in all patients and second biopsies were performed in 27 patients. The activity index decreased significantly from 4.1 ± 1.9 at first biopsy to 2.5 ± 1.7 at second biopsy, while the chronicity index did not differ between first and second biopsy. None had renal insufficiency and renal survival rate was 100% for the decade.
Conclusions. Although uncontrolled, our study suggested that MUPT is effective for those patients with the risk of progression of their nephropathy, especially if started early during the course of the disease before the crescents become fibrous.
Use of the GlucoWatch Biographer in Children With Type 1 Diabetes
Authors: Chase H. Peter , Roberts Mary D. , Wightman Clare , Klingensmith Georgeanna , Garg Satish K. , Van Wyhe Michelle , Desai Shashi , Harper Wesley , Lopatin Margarita , Bartkowiak Miroslaw , Tamada Janet , Eastman Richard C. 
Published: August 2004

Objective. To determine whether use of the GlucoWatch biographer improves glucose control in children and adolescents with type 1 diabetes.
Methods. Forty children in poor glucose control (glycohemoglobin [HbA1c] &gt;8%) were randomized to diabetes management with or without glucose monitoring using the biographer. Conventional glucose monitoring was performed 4 times daily in both groups. Those randomized to the biographer group were asked to wear the device 4 times per week for 3 months (intervention phase) and to perform blood glucose monitoring if the biographer alerted them that glucose was ≤70 mg/dL (3.9 mmol/L) or ≥300 mg/dL (16.7 mmol/L). After 3 months, all patients received biographers and were followed for 6 months (observation phase). HbA1c values were determined at baseline and after 1, 3, 6, and 9 months.
Results. The median HbA1c was 8.6% and 8.9% (control versus biographer) at baseline and was significantly lower in the biographer group after 3 months (8.4% vs 9%). More hypoglycemia was detected when subjects were wearing the biographer, especially at night. No severe hypoglycemia occurred. During the observation phase, HbA1c values at 6 months were 8.5% and 8.3% and at 9 months were 8.6% and 8.4% in the control and biographer groups, respectively. Two children dropped out of the study, 1 because of skin irritation from using the device.
Conclusions. The GlucoWatch biographer was well tolerated by children and adolescents and significantly improved glucose control compared with standard therapy. The use of the biographer with an alarm to detect nocturnal hypoglycemia has the potential to increase the safety of diabetes management in children.
Nighttime Child Care: Inadequate Sudden Infant Death Syndrome Risk Factor Knowledge, Practice, and Policies
Authors: Moon Rachel Y. , Weese-Mayer Debra E. , Silvestri Jean M. 
Published: August 2004

Background. Millions of children in the US have parents who work alternative shifts. As a result, extended-hour and nighttime child care centers have increased in number to meet the needs of parents working nonstandard hours. Recognizing that 20% of sudden infant death syndrome (SIDS) occurs in child care settings and that child care providers may place infants prone, it is important to determine sleep position practices in nighttime child care centers.Objective. To determine if nighttime child care centers 1) follow Back to Sleep recommendations; 2) are aware of the need for a safe sleep environment; and 3) have written policies directing proper SIDS risk reduction practices.Design. A descriptive, cross-sectional survey of licensed child care centers in the US offering evening and nighttime care. All nighttime centers caring for infants &lt;6 months old were recruited for the study.Results. Out of 153 eligible centers, 110 centers in 27 states completed the survey. Infants were placed prone in 20% of centers, although only 1 center placed infants exclusively prone. Infants slept in cribs in 53.6% of centers, but slept in uncluttered sleep environments in only 18.2% of centers. Smoking was prohibited in 86.4% of centers. The most commonly cited reason for avoiding prone altogether was SIDS risk reduction; however, 10 centers that cited SIDS risk reduction continued to place infants prone at least some of the time, because of parental request or concerns about infant comfort. Over half (59%) of the centers had written policies; however, presence of written policy was not associated with avoidance of prone position. In over one third of centers with written policies, providers were unaware of the content of the policy.Conclusions. Twenty percent of nighttime child care centers place infants prone at least some of the time. Most providers who place infants prone do so because of lack of awareness or misinformation about safe sleep environment. Although the Back to Sleep campaign has been effective in communicating the risks of sleeping prone, nonprone positioning is not universal among nighttime child care providers. Additional educational efforts toward child care providers remain necessary. In addition, parents as advocates for their own infants need to be proactive in assuring that safe sleep practices are implemented in child care settings.
Relationship Between Age at Initiation of Toilet Training and Duration of Training: A Prospective Study
Authors: Blum Nathan J. , Taubman Bruce , Nemeth Nicole 
Published: August 2004

Objective. To study the relationship between age at initiation of toilet training, age at completion of toilet training, and the duration of toilet training.Methods. A total of 406 children seen at a suburban private pediatric practice were enrolled in a study of toilet training between 17 and 19 months of age, and 378 (93%) were followed by telephone interviews with the parents every 2 to 3 months until the child completed daytime toilet training. Information obtained at follow-up interviews included how often parents were asking their child to sit on the toilet or potty and where the child urinated and defecated. Parents were considered to have initiated toilet training when they first took out a potty chair and discussed some aspect of training with the child. Intensive toilet training was defined as asking the child to use the toilet or potty &gt;3 times per day.Results. Age of initiation of toilet training correlated with age of completion of training (r = 0.275). The correlation between age at initiation of intensive training and age at completion was even stronger (r = 0.459). Younger age at initiation of intensive toilet training was not associated with constipation, stool withholding, or stool toileting refusal. However, age at initiation of intensive toilet training was negatively correlated with duration of toilet training (r = −0.481), indicating that initiation of training at younger ages was associated with a longer duration of training. In addition, the correlation between age at initiation of intensive toilet training and age at completion of training was not significant for those who began intensive training before 27 months of age (r = 0.107).Conclusions. Early initiation of intensive toilet training correlates with an earlier age at completion of toilet training but also a longer duration of toilet training. Although earlier toilet training is not associated with constipation, stool withholding, or stool toileting refusal, initiation of intensive training before 27 months does not correlate with earlier completion of toilet training, suggesting little benefit in beginning intensive training before 27 months of age in most children.
Predictors of Low Back Pain in British Schoolchildren: A Population-Based Prospective Cohort Study
Authors: Jones Gareth T. , Watson Kath D. , Silman Alan J. , Symmons Deborah P.M. , Macfarlane Gary J. 
Published: August 2004

Objective. To determine the onset of low back pain (LBP) in schoolchildren and to investigate the role of mechanical and psychosocial factors as risk factors for its onset.Methods. A prospective population-based cohort study was conducted of 1046 schoolchildren, aged 11 to 14 years at baseline, identified as being free of LBP, from 39 secondary schools in Northwest England. New onset of LBP at 1-year follow-up was measured.Results. Children who reported high levels of psychosocial difficulties were more likely to develop LBP than their peers (relative risk: 1.6; 95% confidence interval: 1.1–2.3). An excess risk was, in particular, associated with conduct problems (2.5; 1.7–3.7). Similarly, children who reported high numbers of somatic symptoms at baseline were at greater risk of developing LBP: abdominal pain (1.8; 1.1–3.0), headaches (1.6; 0.97–2.8), and sore throats (1.5; 0.8–2.6). In contrast, we have been unable to demonstrate a strong association between daily mechanical load (schoolbag weight) and the short-term risk of new-onset LBP (highest versus lowest quintile: 1.2; 0.7–2.1).Conclusions. In children who were initially free of LBP, adverse psychosocial factors and the presence of other preexisting somatic pain symptoms were predictive of future LBP, reflecting findings in adults. In contrast, there was little evidence of an increase in short-term risk associated with mechanical load across the range of weights commonly carried by children to school.
Food Protein-Induced Enterocolitis Syndrome Caused by Solid Food Proteins
Authors: Nowak-Wegrzyn Anna , Sampson Hugh A. , Wood Robert A. , Sicherer Scott H. 
Published: August 2004

Background. Infantile food protein-induced enterocolitis syndrome (FPIES) is a severe, cell-mediated gastrointestinal food hypersensitivity typically provoked by cow’s milk or soy. Solid foods are rarely considered a cause.Objective. To describe the clinical characteristics and natural history of FPIES provoked by solid foods.Methods. Patients with FPIES induced by solid foods were identified and their clinical course compared with a control group with FPIES caused by cow’s milk and/or soy evaluated over the same time period.Results. Fourteen infants with FPIES caused by grains (rice, oat, and barley), vegetables (sweet potato, squash, string beans, peas), or poultry (chicken and turkey) were identified. Symptoms were typical of classical FPIES with delayed (median: 2 hours) onset of vomiting, diarrhea, and lethargy/dehydration. Eleven infants (78%) reacted to &gt;1 food protein, including 7 (50%) that reacted to &gt;1 grain. Nine (64%) of all patients with solid food–FPIES also had cow’s milk and/or soy-FPIES. Initial presentation was severe in 79% of the patients, prompting sepsis evaluations (57%) and hospitalization (64%) for dehydration or shock. The diagnosis of FPIES was delayed, after a median of 2 reactions (range: 2–5). Thirty patients with typical cow’s milk- and/or soy-FPIES were identified for comparison. Overall, 48% of the 44 infants with FPIES were reactive to &gt;1 food protein, and the risk for multiple food hypersensitivity approached 80% in the infants with solid food or soy-induced FPIES. None of the patients developed FPIES to maternally ingested foods while breastfeeding unless the causal food was fed directly to the infant.Conclusions. Cereals, vegetables, and poultry meats, typically regarded as of low allergenic potential, must be considered in the evaluation of FPIES, particularly in infants previously diagnosed with FPIES to cow’s milk or soy, and as an initial cause in patients who have been exclusively breastfed. Infants with FPIES are at risk for multiple dietary protein hypersensitivities during an apparent period of immunologic susceptibility. Pediatricians should consider FPIES in the differential diagnosis of shock and sepsis.
One-Year Changes in Activity and in Inactivity Among 10- to 15-Year-Old Boys and Girls: Relationship to Change in Body Mass Index
Authors: Berkey Catherine S. , Rockett Helaine R. H. , Gillman Matthew W. , Colditz Graham A. 
Published: August 2004

Objective. Cross-sectional studies have suggested that children who were less physically active and children who watched more television (TV) had more excess body weight, but no large nationwide longitudinal studies have addressed whether children who change their personal levels of activity or inactivity, from one year to the next, experience changes in adiposity. Our objective is to study the association between change in body mass index (BMI) over 1 year and same year change in recreational physical activity and change in recreational inactivity (TV/videos/video games).
Design. Cohort study using data from 2 mailed questionnaires, 1 year apart.
Participants. A total of 11 887 boys and girls, aged 10 to 15, who returned questionnaires in both 1997 and 1998 as part of the Growing Up Today Study.
Outcome Measure. Change in BMI from 1997–1998, accounting for increases in BMI associated with growth and development.
Results. An increase in physical activity from 1997–1998 was associated with decreasing relative BMI in girls (−0.06 kg/m2 per hour increase in daily activity; 95% confidence interval [CI]: −0.11, −0.01) and in overweight boys (−0.22 kg/m2; CI: −0.33, −0.10). An increase in inactivity was associated with increasing BMI in girls (+0.05 kg/m2 per hour increase in daily TV/videos/video games; CI: +0.02, +0.08). Effects were generally stronger among overweight children. Increasing time doing aerobics/dancing and walking were associated with BMI declines for some groups of children.
Conclusions. Many children may benefit by increasing their physical activity and by reducing time watching TV or videos and playing video games. In particular, 2 activities accessible to most children, aerobics/dancing and walking, also appeared beneficial.
Relative Weight and Race Influence Average Age at Menarche: Results From Two Nationally Representative Surveys of US Girls Studied 25 Years Apart
Authors: Anderson Sarah E. , Dallal Gerard E. , Must Aviva 
Published: August 2004

Objectives. 1) To establish with nationally representative US data whether menarche occurred earlier in the 1990s than it had 25 years before. 2) To assess whether the occurrence of menarche in relation to weight status and race had changed over this time period.
Methods. Relative weight, race, and menarcheal status of girls in the National Health Examination Survey cycles II and III (1963–1970) were compared with results from the Third National Health and Nutrition Examination Survey (1988–1994). Probit analysis was used to determine the average age at menarche during the 2 survey periods. Logistic regression was used to assess the association of relative weight to likelihood of having reached menarche.
Results. The average age at menarche dropped from 12.75 to 12.54 years, and the percentage of girls between 10 and 15 years old who were above the 85th percentile for body mass index increased from 16% to 27% over the 25 years between the 2 surveys. Higher relative weight was strongly associated with increased likelihood of having reached menarche after controlling for age and race. Black girls had a lower average age at menarche than did white girls, which was independent of the effect of relative weight.
Conclusions. These analyses from 2 nationally representative samples of US girls suggest a drop of about 2½ months in the average age of menarche during the time period between 1963–1970 and 1988–1994. This was paralleled by a concurrent shift in the population distribution of body mass index z-score toward higher relative weights.