bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Oral Antibiotics Prevent Meningitis and Serious Bacterial Infections in Children WithStreptococcus pneumoniaeOccult Bacteremia? A Meta-analysis
Authors: Rothrock Steven G. , Harper Marvin B. , Green Steven M , Clark Mark C. , Bachur Richard , McIlmail Daniel P. , Giordano Philip A. , Falk Jay L. 
Published: August 2004

Objective. To determine whether oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia.Data Sources. Using the Medline database, the English-language literature was searched for all publications concerning bacteremia, fever, or S pneumoniae from 1966 to April 1996.Study Selection. All studies that included a series of children with S pneumoniae occult bacteremia containing orally treated and untreated groups. Children were excluded from individual studies if they were immunocompromised, had a serious bacterial infection, underwent a lumbar puncture, or received parenteral antibiotics.Data Extraction. Three authors independently reviewed each article to determine the number of eligible children and the outcome of children meeting entry criteria.Data Synthesis. Eleven of 21 studies were excluded, leaving 10 evaluable studies with 656 total cases of S pneumoniae occult bacteremia identified. Patients who received oral antibiotics had fewer serious bacterial infections than untreated patients (3.3% vs 9.7%; pooled odds ratio, 0.35; 95% confidence interval, 0.17 to 0.73). Meningitis developed in 3 (0.8%) of 399 children in the oral antibiotic group and 7 (2.7%) of 257 untreated children (pooled odds ratio, 0.51; 95% confidence interval, 0.12 to 2.09).Conclusion. Although oral antibiotics modestly decreased the risk of serious bacterial infections in children with S pneumoniae occult bacteremia, there was insufficient evidence to conclude that oral antibiotics prevent meningitis. Published recommendations that oral antibiotics be administered to prevent serious bacterial infections in children with possible S pneumoniae occult bacteremia should be reevaluated in light of the lower risk of sequelae from S pneumoniae occult bacteremia and newer data concerning side effects from treatment.
Increasing Prevalence of Recurrent Otitis Media Among Children in the United States
Authors: Lanphear Bruce P. , Byrd Robert S. , Auinger Peggy , Hall Caroline B. 
Published: August 2004

Background. The number of visits for otitis media, the most common diagnosis among preschool children, has increased during the past decade. This study was undertaken to determine whether there has been a concurrent increase in the prevalence of recurrent otitis media among children in the United States and to identify risk factors or demographic changes to explain the increase.
Methods. Secondary analyses of cross-sectional data from the Child Health Supplement to the 1981 and 1988 National Health Interview Surveys (n = 5189 [1981] and n = 6209 [1988]) were done to identify temporal changes in the prevalence and any associated risk factors of recurrent otitis media among children &lt;6 years of age.
Results. Recurrent otitis among preschool children increased from 18.7% in 1981 to 26% in 1988 (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.4, 1.7). Although the prevalence of recurrent otitis increased with age, the greatest increase in recurrent otitis media occurred in infants (OR = 1.9, CI = 1.3, 2.9). Factors independently associated with recurrent otitis were any allergic condition (OR = 1.9, CI = 1.7, 2.2); survey year (OR = 1.7, CI = 1.5, 1.9); Black race (OR = .6, CI = .5, .7); Hispanic ethnicity (OR = .8, CI = .6, .9); day care (OR = 1.5, CI = 1.3, 1.7); out-of-home care by an unrelated sitter (OR = 1.3, CI = 1.1, 1.6); and male gender (OR = 1.2, CI = 1.1, 1.3). From 1981 to 1988, there were significant increases in some risk factors associated with recurrent otitis media, including day care (11% vs 21%) and allergic conditions (14% vs 18%).
Conclusions. We conclude that there has been a significant increase in the prevalence of recurrent otitis media among children in the United States, particularly in infants. The increased prevalence of recurrent otitis media was associated with an increase in the use of child care and a higher prevalence of allergic conditions among children. otitis media, recurrent otitis media, day care, child care, infection, otitis, children, allergies, infants, National Health Interview Survey, Child Health Supplement.
Circulating Neutrophils in Septic Preterm Neonates: Comparison of Two Reference Ranges
Authors: Engle William D. , Rosenfeld Charles R. , Mouzinho Anna , Risser Richard C. , Zeray Fiker , Sanchez Pablo J. 
Published: August 2004

Objective. To study the effect of sepsis on circulating neutrophils in very low birth weight neonates and to assess the usefulness of recently revised reference ranges for circulating neutrophils in the diagnosis of sepsis in this population by comparison with previously reported reference ranges.Methods. Neutrophil parameters (absolute total neutrophils, absolute total immature neutrophils, and the immature:total neutrophil proportion) were analyzed retrospectively in 202 sepsis episodes in 192 neonates (birth weight = 1055 ± 246 g, X ± SD; estimated gestational age = 29 ± 2 weeks) between birth and 30 days of age. The percentage of values lying outside the reference ranges reported recently by Mouzinho et al32 and previously by Manroe et al24 were compared. To more accurately assess possible differences in specificity between the two reference ranges, neonates with early-onset group B streptococcal infection (n = 19) were compared with a matched control group (n = 51) using conditional logistic regression.Results. Greater sensitivity was observed using the previous reference ranges of Manroe et al24 over the entire study period (0 to 720 hours) both for the initial and the second complete blood count (CBC). The previous reference ranges also were more sensitive than the revised ranges for the initial CBC at 0 to 72 and at 73 to 720 hours and for infections attributable to coagulase-negative staphylococci. However, specificity in neonates without group B streptococcal infection was significantly greater with the revised reference ranges compared with those of Manroe et al24 (initial CBC, 73% vs 45%; serial CBCs, 59% vs 10%).Conclusion. The observed differences in sensitivities may be of limited clinical significance because very low birth weight infants often are begun on antibiotic therapy regardless of laboratory values. However, the striking differences in specificity using the revised reference ranges suggest that these ranges may be clinically useful in determining length of antimicrobial therapy in infants in whom cultures remain sterile. sepsis, very low birth weight neonate, neutrophils.
The Questionnaire for Identifying Children with Chronic Conditions: A Measure Based on a Noncategorical Approach
Authors: Stein Ruth E. K. , Westbrook Lauren E. , Bauman Laurie J. 
Published: August 2004

Objective. To report on the development of the Questionnaire for Identifying Children with Chronic Conditions (QuICCC). This new instrument identifies children and adolescents who have chronic health conditions based on the noncategorical conceptual framework outlined in our earlier work. It uses the consequences of conditions as a method for identifying children with chronic health conditions and is completely independent of diagnosis.
Method. Through a combination of techniques, we developed and piloted items and created 39 brief question sequences that were designed to be administered to a parent or guardian of children &lt;18 years of age. The prototype was field tested extensively and refined using data from local hospital-based samples representing 318 households and 666 children. The instrument was then administered to two large representative samples (local: 657 households, 1275 children; national: 712 households, 1388 children) to establish validity and reliability.
Results. Content, convergent, construct, and criterion validity each have been demonstrated. The QuICCC has good test-retest reliability. Parents find the questions easy to answer. It took 7 to 8 minutes on average to obtain information about all the children in a family. The QuICCC successfully identified children with a wide range of different conditions that are usually considered chronic, and excluded those with acute illnesses and those with conditions but no current consequences.
Conclusions. The Questionnaire for Identifying Children with Chronic Conditions is a practical instrument that can be used for epidemiological purposes. It offers considerable flexibility and has many potential applications in health care delivery research.
Parents' Concerns About Children's Development: Prescreening Technique or Screening Test?
Authors: Glascoe Frances Page 
Published: August 2004

Objective. Due to the limitations of previous studies, parents' concerns have been recommended as a prescreening technique, a brief method for identifying a subset of children in need of more in-depth developmental screening. The purpose of this study was to assess whether parents' concerns could: (1) serve instead as a screening measure; (2) aid in making focused referral decisions; and (3) help pediatricians target families for developmental promotion and in-office counseling. An additional goal was to determine why most parents' concerns are accurate although some are not.Design Survey/Setting. Public schools and day care centers in four diverse geographic sites representing the northern, central, southern and western United States.Patients and Other Participants. A total of 408 children between 21 and 84 months of age and their parents, whose socioeconomic and demographic characteristics reflect proportions in the 1990 United States Census.Main Outcome Measures. Licensed psychological examiners and educational diagnosticians elicited parents' concerns about children's development and measured children's development with a broad battery including measures of intelligence, language, motor, and school skills.Results. Certain concerns, ie, motor, language, global/cognitive, and school (in children 4 years and older) had high levels of sensitivity and identified 79% of the 56 children with disabilities. Accurate referrals could be made for 70% of the 56 children. The absence of concerns or concerns in other areas, ie, socialization, self-help, or behavior, had reasonable specificity and identified 72% (N = 255) of the 352 typically developing children. Of the remaining 28% (N = 97) of parents with significant concerns but whose children did not have disabilities, most had children with substantially lower performance in almost all developmental areas than the children of the 255 parents without significant concerns. Further, more than half of the 97 children could be distinguished by a single concern (usually about expressive language) whereas the majority of accurately concerned parents had multiple concerns. A significant proportion of the 12 parents of disabled children who did not raise concerns could be identified by difficulties communicating in either English or Spanish.Conclusion. If systematically elicited, parents' concerns approach standards for screening tests and can be used to make reasonably accurate referral decisions. Over-referrals can be significantly reduced by administered screening tests to the small group of children (16%) whose parents have a single significant concern. Those who pass screening or whose parents have nonsignificant concerns can be targeted for developmental promotion and in-office counseling. Under-referrals can be minimized by administering screening tests (with the help of an interpreter as needed) to children whose parents have communication difficulties.
Single Rope Tree Swing Injuries Among Children
Authors: Albanese Craig T. , Gardner Mary J. , Adkins Michael A. , Schall Laura , Lynch James M. 
Published: August 2004

Objective. To examine the scope and severity of injuries sustained from falls from single rope tree swings among children.
Methods. Twenty-six children formed the basis of this retrospective study. Patients were divided into three groups based on the estimated distance of their fall (one, two, or three stories). Data were analyzed with respect to mechanism of injury, age, gender, length of hospital stay, injury severity score, number and type of injuries, and mortality.
Results. Eighteen patients fell from ropes, and 8 from vines (all onto packed dirt). Fourteen falls occurred from one story or less, 8 from two stories, and 4 from three stories. One death occurred from intracranial injury following a two-story fall. No difference in age, gender, injury severity score, or length of hospital stay with respect to the height of the fall was observed. Falls from lower heights resulted in equally severe injuries as falls from higher heights. Overall, head trauma was the most common injury (58%) followed by long bone fractures (42%), axial skeletal fractures (23%), and intra-abdominal visceral injuries (8%).
Conclusions. The present study demonstrated that recreational single rope tree swing injuries among children resulted in significant morbidity regardless of the height of the fall. This activity carries a substantial risk for serious injury. The mechanism of injury, clinical data, and the importance of medical awareness and patient education are emphasized.
The Clinical Phenotype of Succinic Semialdehyde Dehydrogenase Deficiency (4-Hydroxybutyric Aciduria): Case Reports of 23 New Patients
Authors: Gibson K. Michael , Christensen Ernst , Jakobs Cornelis , Fowler Brian , Clarke Michael A. , Hammersen Gerhard , Raab Klaus , Kobori Joyce , Moosa Allie , Vollmer Brigitte , Rossier Eva , Iafolla A. Kimberly , Matern Dietrich , Brouwer Oebele F. , Finkelstein Janice , Aksu Fuat , Weber Hans-Peter , Bakkeren Jan A. J. M. , Gabreels Fons J. M. , Bluestone Daniel , Barron Todd F. , Beauvais Pierre , Rabier Daniel , Santos Cesar , Umansky Richard , Lehnert Willy 
Published: August 2004

Objectives. To further define the clinical spectrum of the disease for pediatric and metabolic specialists, and to suggest that the general pediatrician and pediatric neurologist consider succinic semialdehyde dehydrogenase (SSADH) deficiency in the differential diagnosis of patients with (idiopathic) mental retardation and emphasize the need for accurate, quantitative organic acid analysis in such patients.
Patients. The clinical features of 23 patients (20 families) with SSADH deficiency (4-hydroxybutyric aciduria) are presented. The age at diagnosis ranged from 3 months to 25 years in the 11 male and 12 female patients; consanguinity was noted in 39% of families.
Outcome Measurements. The following abnormalities were observed (frequency in 23 patients): motor delay, including fine-motor skills, 78%; language delay, 78%; hypotonia, 74%; mental delay, 74%; seizures, 48%; decreased or absent reflexes, 39%; ataxia, 30%; behavioral problems, 30%; hyperkinesis, 30%; neonatal problems, 26%; and electroencephalographic abnormalities, 26%. Associated findings included psychoses, cranial magnetic resonance or computed tomographic abnormalities, and ocular problems in 22% or less of patients. Therapy with vigabatrin proved beneficial to varying degrees in 35% of the patients. Normal early development was noted in 30% of patients.
Conclusions. Our data imply that two groups of patients with SSADH deficiency exist, differentiated by the course of early development. Our recommendation would be that accurate, quantitative organic acid analysis in an appropriate specialist laboratory be requested for any patients presenting with two or more features of mental, motor, or language delay and hypotonia of unknown cause. Such analyses are the only definitive way to diagnose SSADH deficiency; the diagnosis can be confirmed by determination of enzyme activity in white cells from whole blood. We think that increased use of organic acid determination will lead to increased diagnosis of SSADH deficiency and a more accurate representation of disease frequency. As additional patients are identified, we should have a better understanding of both the metabolic and clinical profiles of SSADH deficiency.
Safety and Immunogenicity of Three Doses of a Five-Valent Pneumococcal Conjugate Vaccine in Children Younger Than Two Years With and Without Human Immunodeficiency Virus Infection
Authors: King James C. , Vink Peter E. , Farley John J. , Smilie Martha , Parks Marie , Lichenstein Richard 
Published: August 2004

Objective. To assess the safety and immunogenicity of three doses of a five-valent (types 6B, 23F, 14, 18C, and 19F) pneumococcal conjugate vaccine (PCV) among children younger than 2 years who are and are not infected with human immunodeficiency virus (HIV).Methods. A convenience sample of 18 HIV-infected children 2 years and younger (mean, 12.9 months) received three doses (each separated by 2 months) of PCV. An additional convenience sample of 33 non–HIV-infected children of virtually identical age, race, and sex as the HIV-infected group were randomized in a double-blind fashion to receive three doses of PCV or saline placebo. Safety data were collected for 72 hours after each vaccination. Sera were obtained before each and 1 month after the third vaccination to determine vaccine type-specific immunoglobulin G pneumococcal antibody titers by an enzyme-linked immunosorbent assay.Results. Seventeen HIV- and 30 non–HIV-infected children completed the study. The PCV was well tolerated by both HIV- and non–HIV-infected children. No significant differences in local or systemic reactions were noted between HIV- and non–HIV-infected PCV or placebo recipients. Three doses of PCV were immunogenic, as evidenced by 16- to 659-fold increases in type-specific geometric mean antibody titers over prevaccination levels in HIV- and non–HIV-infected children. With respect to an arbitrary protective level, 78% of the antibody titers from HIV-infected children and 88% of the titers from non–HIV-infected children were 1.0 μg/mL or greater 1 month after the third PCV dose. HIV-infected children with milder disease (Centers for Disease Control and Prevention classes N1–2, A1–2, and B1) were more likely to have protective antibody titers after the first and second PCV doses than HIV-infected children with more advanced disease (Centers for Disease Control and Prevention classes N3, A3, B2–3, and C1–3). However, after the third PCV dose, these differences disappeared.Conclusion. Three doses of PCV seem safe and immunogenic in both HIV- and non–HIV-infected children younger than 2 years. This type of vaccine should result in a marked reduction in systemic pneumococcal disease in both HIV- and non–HIV-infected children. Given the high incidence of invasive pneumococcal disease in HIV-infected children, this vaccine may markedly improve the quality of life for this unfortunate group of children.
Pediatric Home Health Care in King County, Washington
Authors: Clemens Conrad J. , Davis Robert L. , Novack Alvin H. , Connell Frederick A. 
Published: August 2004

Background. Pediatric home health care is one of the fastest growing segments of our health care system. However, our knowledge of the extent and quality of the services provided in this field is generally limited. Despite this shortcoming, pediatric health care providers are increasingly expected to participate in the home health care of their patients.
Objective. To describe the agencies and services that constitute pediatric home health care in a large metropolitan setting.
Methods. During the summer of 1995, home health care agencies in King County, WA, were surveyed if they had provided any pediatric services within the preceding 6 months. The agencies were queried about their characteristics and services provided, as well as referral and reimbursement sources. Survey data were supplemented by interviews with agency and state health personnel.
Results. Fourteen (88%) of the 16 agencies providing pediatric home health care services completed the survey. Agencies were predominantly for-profit, free-standing, and in business fewer than 10 years. Although there were uniform licensing requirements for agencies, no pediatric-specific regulations existed. In addition, many agencies lacked internal methods to ensure the provision of quality pediatric care. Eighty percent of all pediatric home health care services were provided by only 5 agencies. For intermittent (acute) services, agencies served approximately 450 children per month. The average number of visits per child was two, with 40% receiving only one visit. Services included skilled nursing (60%), infusion (27%), and respiratory therapy (9%). Maintenance (chronic) home health care services, for 156 chronically ill children, were provided almost exclusively by skilled nursing for an average of 9 hours per patient per day. The majority of referrals to agencies (75%) originated from health care providers, although a small number came from insurance companies or individual families. Reimbursement for intermittent care services was divided among commercial insurance (35%), captitated contracts (35%), and Medicaid (20%). In contrast, 90% of reimbursement for the chronically ill was from Medicaid.
Conclusions. In King County, WA, pediatric home health care is predominantly an unregulated, for-profit industry, with most agencies having little actual experience in pediatric home health care. In addition, the unique features of pediatric home health care necessitate both a greater understanding of this field and the consideration of more specific guidelines.
Prevalence of Overweight Among Preschool Children in the United States, 1971 Through 1994
Authors: Ogden Cynthia L. , Troiano Richard P. , Briefel Ronette R. , Kuczmarski Robert J. , Flegal Katherine M. , Johnson Clifford L. 
Published: August 2004

Objective. To examine the prevalence of overweight among US preschool children 2 months through 5 years of age between the years 1971 through 1974 and 1988 through 1994.Design. Nationally representative cross-sectional surveys with a physical examination, including measurement of stature, length, and weight. Between 1200 and 7500 children younger than 6 years were examined in each of four different surveys during 1971 through 1974 (first National Health and Nutrition Examination Survey [NHANES I]), 1976 through 1980 (NHANES II), 1982 through 1984 (Hispanic Health and Nutrition Examination Survey), and 1988 through 1994 (NHANES III).Results. The prevalence of overweight increased among some sex and age groups of preschool children between 1971 through 1974 and 1988 through 1994. More than 10% of 4- and 5-year-old girls were overweight in 1988 through 1994 compared with 5.8% in 1971 through 1974. However, there was no change during this period in the prevalence of overweight among 1- and 2- to 3-year-old children. During 1988 through 1994, the prevalence of overweight among children 2 months through 5 years of age was consistently higher in girls than boys. Mexican-American children had a higher prevalence of overweight than non-Hispanic black and non-Hispanic white children. These results parallel what has been reported for older children and adults in the United States.Conclusion. These results show that in the last 20 years the prevalence of overweight has increased among 4- and 5-year-old children but not among younger children. These findings suggest that efforts to prevent overweight, including encouragement of physical activity and improved diets, should begin in early childhood. overweight, anthropometry, preschool children.