bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study of Anxiety, Depression, Somatization, Functional Disability, and Illness Attribution in Adolescents With Chronic Fatigue or Migraine
Authors: Smith Mark S. , Martin-Herz Susanne P. , Womack William M. , Marsigan Julie L. 
Published: August 2004

Objective. To compare adolescents with migraine, unexplained profound chronic fatigue of &gt;6 months duration, and normal school controls on measures of anxiety, depression, somatization, functional disability, and illness attribution.Methods. Adolescents referred to Children’s Hospital and Regional Medical Center for behavioral treatment of migraine (n = 179) or evaluation of chronic fatigue (n = 97) were compared with a group of healthy controls of similar age and sex from a middle school (n = 32). Subjects completed the Spielberger State-Trait Anxiety Inventory-Trait Form, the Children’s Depression Inventory, the Childhood Somatization Inventory, and estimated the number of school days missed in the past 6 months because of illness. Migraine and fatigued subjects completed an illness attribution questionnaire.Results. Subjects in the 3 groups were 56% to 70% female and ranged from 11 years old to 18 years old with a mean age of 14.0 ± 2.0. Forty-six of the 97 chronically fatigued adolescents met 1994 Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome (CDC-CFS), while 51 had idiopathic chronic fatigue syndrome (I-CFS) that did not meet full CDC criteria. Adolescents with migraine had significantly higher anxiety scores than those with I-CFS or controls and higher somatization scores than controls. Adolescents with CDC-CFS had significantly higher anxiety scores than those with I-CFS or controls, and higher depression and somatization scores than all other groups. There were significant differences between all groups for school days missed with CDC-CFS more than I-CFS more than migraine more than controls. Parents of adolescents with unexplained I-CFS had significantly lower attribution scores relating illness to possible psychological or stress factors than parents of adolescents with CDC-CFS or migraine.Conclusions. Adolescents referred to an academic center for evaluation of unexplained chronic fatigue had greater rates of school absenteeism than adolescents with migraine or healthy controls. Those meeting CDC-CFS criteria had higher anxiety scores than controls and higher depression and somatization scores than migraineurs or controls. Parents of adolescents with I-CFS were less likely to endorse psychological factors as possibly contributing to their symptoms than parents of adolescents with CDC-CFS or migraine.
Receipt of Psychological or Emotional Counseling by Suicidal Adolescents
Authors: Pirkis Jane E. , Irwin Charles E. , Brindis Claire D. , Sawyer Michael G. , Friestad Christine , Biehl Michael , Patton George C. 
Published: August 2004

Objective. This study examined utilization of psychological or emotional counseling by suicidal adolescents to answer questions about the extent to which health services can contribute to the prevention of adolescent suicide.
Method. The study used data from Wave 1 of the National Longitudinal Study of Adolescent Health, which involved a household-based interview with a nationally representative sample of 15 483 adolescents from grades 7 to 12. Of these, 2482 adolescents were classified as suicidal, as indicated by an affirmative response to the question “During the past 12 months, did you ever seriously think about committing suicide?” For this group, the study asked the following questions: 1) What proportion receives psychological or emotional counseling? 2) What are the sources of this counseling? 3) What factors are associated with receipt of such counseling?
Results. Less than one third (28%) of suicidal adolescents received psychological or emotional counseling. The most common sources of care were private doctors’ offices (37%) and schools (34%). Factors associated with receipt of counseling in the past 12 months included age, race, degree of suicidality, depression status, and having had a physical examination during the same period.
Conclusions. Only one third of those who report suicidal ideation and behavior receive psychological or emotional counseling. Although not all of these young people may identify a need for counseling, this finding still suggests that many of those at risk of harming themselves do not receive professional help. However, on the positive side, those who do use counseling services tend to do so on the basis of their being in the greatest need, rather than their parents’ capacity to pay for services. Counseling services have an important role to play in suicide prevention, and a variety of sources of care need to be available. Although counseling services are vital, a range of other strategies is necessary to reduce the youth suicide rate.
The Effect of Zinc Supplementation on Linear Growth, Body Composition, and Growth Factors in Preterm Infants
Authors: Díaz-Gómez N. Marta , Doménech Eduardo , Barroso Flora , Castells Silvia , Cortabarria Carmen , Jiménez Alejandro 
Published: August 2004

Objective. The aim of our study was to evaluate the effect of zinc supplementation on linear growth, body composition, and growth factors in premature infants.
Design. Thirty-six preterm infants (gestational age: 32.0 ± 2.1 weeks, birth weight: 1704 ± 364 g) participated in a longitudinal double-blind, randomized clinical trial. They were randomly allocated either to the supplemental (S) group fed with a standard term formula supplemented with zinc (final content 10 mg/L) and a small quantity of copper (final content 0.6 mg/L), or to the placebo group fed with the same formula without supplementation (final content of zinc: 5 mg/L and copper: 0.4 mg/L), from 36 weeks postconceptional age until 6 months corrected postnatal age. At each evaluation, anthropometric variables and bioelectrical impedance were measured, a 3-day dietary record was collected, and a blood sample was taken. We analyzed serum levels of total alkaline phosphatase, skeletal alkaline phosphatase (sALP), insulin growth factor (IGF)-I, IGF binding protein-3, IGF binding protein-1, zinc and copper, and the concentrations of zinc in erythrocytes.
Results. The S group had significantly higher zinc levels in serum and erythrocytes and lower serum copper levels with respect to the placebo group. We found that the S group had a greater linear growth (from baseline to 3 months corrected age: Δ score deviation standard length: 1.32 ± .8 vs .38 ± .8). The increase in total body water and in serum levels of sALP was also significantly higher in the S group (total body water: 3 months; corrected age: 3.8 ± .5 vs 3.5 ± .4 kg, 6 months; corrected age: 4.5 ± .5 vs 4.2 ± .4 kg; sALP: 3 months; corrected age: 140.2 ± 28.7 vs 118.7 ± 18.8 μg/L).
Conclusions. Zinc supplementation has a positive effect on linear growth in premature infants.
Reduced Bone Mineralization in Infants Fed Palm Olein-Containing Formula: A Randomized, Double-Blinded, Prospective Trial
Authors: Koo Winston W. K. , Hammami Mouhanad , Margeson Dean P. , Nwaesei Chuks , Montalto Michael B. , Lasekan John B. 
Published: August 2004

Objective. Palm and palm olein (PO) oils are used in some infant formula fat blends to match the fatty acid profile of human milk, but their presence has been shown to lower calcium and fat absorption. We aimed to determine if the reported differences in calcium absorption could affect skeletal development by comparing bone mineral accretion in healthy term infants fed a milk-based formula with (PMF) or without PO.
Methods. Whole body bone mineralization was evaluated in healthy term infants fed 1 of 2 coded, commercially available, ready-to-feed infant formulas in a randomized, double-blind, parallel study. Subjects were fed either 1) PMF formula (Enfamil with iron; Mead Johnson Division of Bristol Myers, Evansville, IN; N = 63) containing PO/coconut/soy/high-oleic sunflower oils (45/20/20/15% oil); or 2) milk-based formula without PO (Similac with iron; Ross Products Division Abbott Laboratories, Columbus, OH; N = 65), containing high-oleic safflower/coconut/soy oils (40/30/30% oil) from enrollment by 2 weeks after birth until 6 months. Anthropometrics and formula intake were determined monthly; total body bone mineral content (BMC) and bone mineral density (BMD) were measured at baseline, 3, and 6 months of age using dual energy x-ray absorptiometry.
Results. Intent-to-treat analyses indicated no significant differences between feeding groups in weight, length, head circumference, or formula intake throughout the study. BMC and BMD were not different at baseline but repeated measures analyses show that infants fed PMF had significantly lower BMC and BMD at 3 and 6 months.
Conclusions. Healthy term infants fed a formula containing PO as the predominant oil in the fat blend had significantly lower BMC and BMD than those fed a formula without PO. The inclusion of PO in infant formula at levels needed to provide a fatty acid profile similar to that of human milk leads to lower bone mineralization.
The Ecology of Medical Care for Children in the United States
Authors: Dovey Susan , Weitzman Michael , Fryer George , Green Larry , Yawn Barbara , Lanier David , Phillips Robert 
Published: August 2004

Background. Medical care ecology has previously been investigated for adults, but no similar exploration has been made specifically for children.
Objective. To describe proportions of children receiving care in 6 types of health care setting on a monthly basis and to identify characteristics associated with receipt of care in these settings.
Methods. Nationally representative data from the 1996 Medical Expenditure Panel Survey were used to estimate the number of children per 1000 per month who received care at least once in each type of setting. Multivariate analyses assessed associations between receiving care in various settings and children’s sociodemographic factors (age, sex, ethnicity, poverty, parent’s education, urban or rural residence, insurance status, and whether or not the child had a usual source of care).
Results. Of 1000 children aged 0 to 17 years, on average each month 167 visited a physician’s office, 82 a dentist’s office, 13 an emergency department, and 8 a hospital-based outpatient clinic. Three were hospitalized and 2 received professional health care in their home. Younger age was associated with increased proportions of children receiving care in all health care settings except dentists’ clinics. Poverty, lack of health insurance, black race, and Hispanic ethnicity were associated with decreased receipt of care in physicians’ and dentists’ offices. Only age (&lt;2 years and 13–17 years) and poverty status were associated with hospitalization (P &lt; .05 for each). Rural residence was not associated with any significant variation in proportions of children receiving care in any setting. Having a usual source of care was associated with increased receipt of care in all settings except hospitals.
Conclusions. The ecology of children’s medical care is similar to that of adults in the United States in that a substantial proportion of children receive health care each month, mostly in community-based, outpatient settings. In all settings except emergency departments, receipt of care varies significantly by children’s age, race, ethnicity, income, health insurance status, and whether they have a usual source of care.
Height and Weight Development During Four Years of Therapy With Cyclical Intravenous Pamidronate in Children and Adolescents With Osteogenesis Imperfecta Types I, III, and IV
Authors: Zeitlin Leonid , Rauch Frank , Plotkin Horacio , Glorieux Francis H. 
Published: August 2004

Objectives. Treatment with pamidronate improves the clinical course in children with osteogenesis imperfecta (OI), but theoretically might affect longitudinal growth. In this study we analyzed growth during cyclical intravenous pamidronate treatment in children and adolescents (age .04–15.6 years at baseline) with moderate to severe forms of OI types I, III, and IV.
Methods. The effect of 1 year of pamidronate treatment on height and weight was analyzed in 116 patients (OI-I, N = 29; OI-III, N = 42; OI-IV, N = 45). The results of 4 years of therapy were evaluated in 41 children (OI-I, N = 12; OI-III, N = 14; OI-IV, N = 15).
Results. Baseline height was low for age in all OI types. After 1 year of pamidronate therapy, height z scores had increased significantly in OI-III (by 0.3 ± 0.8, mean ± standard deviation; P = .04) and did not change in OI-I and OI-IV. Weight z scores increased significantly in OI-I (by 0.2 ± 0.4, P = .01). After 4 years of pamidronate therapy, mean height z scores increased significantly in OI-IV (by 0.41 ± 0.71, P = .04), whereas nonsignificant trends to increase were found for OI-I and OI-III. When height was expressed as a percentage of the result expected for untreated patients with the same OI type, long-term pamidronate therapy was associated with a significant height gain in all 3 OI types (P &lt; .001). Eight patients who reached final height after 3.0 ± 1.0 years of treatment were taller on average than expected for untreated patients (P = .04).
Conclusions. Four years of cyclical intravenous pamidronate treatment led to a significant height gain in moderately to severely affected OI patients.
Factors Influencing Parental Consent in Pediatric Clinical Research
Authors: Rothmier Justin D. , Lasley Mary V. , Shapiro Gail G. 
Published: August 2004

Background. Although previous studies have looked at the motivation behind enrollment in clinical trials of adults and healthy subjects, little is known about the factors influencing parental consent in pediatric clinical studies where the subjects themselves do not provide consent.
Objective. This study was conducted to define a group of factors that impact parental consent in the pediatric clinical trial. This may allow investigators to identify a subset of specific appealing aspects of clinical trials that will promote participation while also bringing ethical issues to light that may require further consideration.
Methods. Forty-four parents or guardians of children currently participating in clinical asthma research completed questionnaires from July 1999 to September 1999 pertaining to motives for allowing their child to participate in clinical trials. The responses were then rated on a Likert numerical scale.
Results. The most important motive for parents is learning more about their child’s illness. Next important was the motive of helping medical knowledge. Availability of free medication was negatively correlated with family income.
Conclusions. Although altruistic motives are present in pediatric asthma research, most parents/guardians gave consent for their child to learn more about their child’s asthma. Access to free medication was more important in families with lower incomes than in families with higher incomes.
Immunogenicity of a Three-Component Acellular Pertussis Vaccine Administered at Birth
Authors: Belloni Cesare , Silvestri Annalisa De , Tinelli Carmine , Avanzini Maria A. , Marconi Massimo , Strano Fabio , Rondini Giorgio , Chirico Gaetano 
Published: August 2004

Objective. To evaluate within the first 6 months of birth the immunogenicity of a 3-component acellular pertussis (aP) vaccine containing filamentous hemagglutinin (FHA), pertactine (PRN), and genetically detoxified pertussis toxin (PT) in infants who received a dose of vaccine at birth, in addition to the recommended schedule administered at 3, 5, and 11 months. Furthermore, we investigated the influence of maternal antibodies on aP vaccine response.Methods. We used enzyme-linked immunosorbent assay to evaluate immunoglobulin G antibody levels in 45 infants immunized at birth and at 3, 5, and 11 months (group 1) and in 46 infants immunized at the ages of 3, 5, and 11 months (group 2). All mothers were also tested at delivery.Results. At the age of 5 months the geometric mean titer of anti-PT, anti-FHA, and anti-PRN was significantly greater in group 1 (who had received 2 doses) than in group 2 (1 dose). At 6 months geometric mean titers were significantly higher in group 1 than in group 2 for anti-PRN and anti-FHA, whereas no significant differences were observed for anti-PT.Conclusions. Immunization at birth may be important for an earlier prevention of the pertussis disease in infants under 6 months, especially in Italy, where the recommended ages for aP vaccine administration are 3, 5, and 11 months.
Who Gets Diagnosed With Asthma? Frequent Wheeze Among Adolescents With and Without a Diagnosis of Asthma
Authors: Yeatts Karin , Davis Kourtney Johnston , Sotir Mark , Herget Casey , Shy Carl 
Published: August 2004

Objective. 1) To describe the factors associated with not receiving an asthma diagnosis among children with frequent wheezing symptoms and 2) to determine risk factors for frequent wheezing in the population.Methods. The North Carolina School Asthma Survey provided self-reported questionnaire data on respiratory health from 122 829 children ages 12 to 18 years enrolled in 499 public middle schools in North Carolina during the 1999–2000 school year. Questions from the International Survey of Allergies and Asthma in Childhood were used to estimate the prevalence of asthma and wheezing-related illness and associated factors.Results. Factors independently associated with undiagnosed frequent wheezing versus asymptomatic children included female gender (odds ratio [OR]: 1.45; 95% confidence interval [CI]: 1.35–1.54), current smoking (OR: 2.60; 95% CI: 2.43–2.79), exposure to household smoke (OR: 1.59; 95% CI: 1.50–1.70), low socioeconomic status (OR: 1.52; 95% CI: 1.42–1.63), and African American (OR: 1.25; 95% CI: 1.15–1.34), Native American (OR: 1.35; 95% CI: 1.11-1.62), and Mexican American (OR: 1.32; 95% CI: 1.17–1.48) race/ethnicity. Urban residence showed a weak negative association (OR: 0.91; 95% CI: 0.85–0.96). A similar pattern of results was observed for analyses comparing odds of undiagnosed frequent wheeze versus diagnosed asthmatics. Report of allergies was less likely in frequent wheezers (70%) compared with diagnosed asthmatics (86%), but much higher than in asymptomatic children (36%). Thirty-three percent of children with undiagnosed frequent wheezing reported 1 or more physician visits in the last year for wheezing or breathing problems compared with 71% of children with diagnosed asthma, and 4% in asymptomatic children. The prevalence of any inhaler use in the past 12 months was 12% for undiagnosed frequent wheezers versus 78% for diagnosed asthmatics. The proportion of undiagnosed frequent wheezers with fair or poor self-rated health (23%) was slightly higher than diagnosed asthmatics (20%) and much higher than asymptomatic children (4%).Conclusions. In one of the largest adolescent asthma surveys ever reported in the United States, undiagnosed frequent wheezing was independently associated with female gender, current smoking, exposure to household smoke, low socioeconomic status, allergies, and African American, Native American, and Mexican American race/ethnicity. Children with undiagnosed frequent wheezing were not receiving adequate health care for their asthma-like illness. Clinicians who treat adolescents should consider asking adolescents specifically about wheezing. This information may assist primary care physicians in identifying children with undiagnosed asthma in need of treatment.
Treatment for Congenital Hypothyroidism: Thyroxine Alone or Thyroxine Plus Triiodothyronine?
Authors: Cassio Alessandra , Cacciari Emanuele , Cicognani Alessandro , Damiani Grazia , Missiroli Giuliana , Corbelli Elena , Balsamo Antonio , Bal Milva , Gualandi Stefano 
Published: August 2004

Objective. To compare the effects of therapy with thyroxine (T4) plus triiodothyronine (T3) versus T4 alone from the first days of life in screened congenital hypothyroid (CH) infants.Methods. We examined 14 CH infants diagnosed by neonatal screening and a group of control infants. CH patients were divided randomly into 2 groups, 1 treated with T4 alone (group 1) and the other treated with T4 plus T3 (liothyronine; group 2). In all patients electrocardiography and thyroid hormone evaluations were performed before and 15 and 30 days and 3, 6, and 12 months after the beginning of therapy. Psychological tests were also performed at 6 and 12 months of age in CH patients and in other matched controls.Results. After 15 days of treatment, serum thyrotropin (TSH) levels become normal in 5 of 7 cases of group 1 (median TSH level 10.7 μU/ml) and in 1 of 7 cases of group 2 (median TSH level 72.5 μU/ml). At the same period, serum-free thyroid hormone levels were within the normal range in both groups, but free T4 values were significantly higher in group 1 than in group 2 and in controls. At the subsequent examinations, free T4 values were within the upper normal limit in group 1, whereas they remained within the normal range in group 2. No clinical or electrocardiographic signs of heart disease were found in any of the patients. The psychometric quotient in CH infants was significantly lower than in controls, but similar in patients of group 1 and group 2.Conclusions. The combined treatment with T4 plus T3 seems not to show significant advantages, at least in our experimental conditions, compared with the traditional treatment with T4 alone in early treated CH infants. A further longer and more extensive follow-up is mandatory.
Utilization of Pediatric Hospitals in New York State
Authors: Kanter Robert K. , Egan Matthew 
Published: August 2004

Background.Little published information is available regarding the proportion of hospitals that offer pediatric services at specified levels, or the actual utilization of such services.Objective.To determine if an existing national accreditation process created for educational purposes identifies hospitals with a distinct utilization pattern, in a sample of pediatric inpatient activity from one state.Methods.Hospitals in New York State were classified as “pediatric” hospitals according to their sponsorship or major participation with an accredited pediatric residence program. Institutions not affiliated with pediatric residencies were considered to be the “other” hospitals. Data on hospital discharges and interhospital transfers were studied for children from 0 to 14 years old, excluding neonatal Diagnosis-Related Groups. Data were obtained from the New York Statewide Planning and Research Cooperative System for 1996, 1997, and 2000.Results.Sixteen percent of hospitals were considered to be “pediatric” facilities (42 of 257) by study criteria. Annual pediatric inpatient activity per “pediatric” hospital significantly exceeded that in “other” institutions, including hospitalizations (2249 ± 1284 vs 258 ± 348), number of interhospital transfers received (153 ± 88 vs 18 ± 26), and number of hospitals referring interhospital transfers to each receiving hospital (36 ± 17 vs 5 ± 7; mean ± standard deviation; for each comparison). Statewide, “pediatric” hospitals served two thirds of all hospitalized children and 70% of all children’s hospital days. “Pediatric” hospitals cared for 26.5 patients per hospital day, compared with only 2.2 per day at “other” institutions. Although statewide hospitalizations of children fell by 14.3% the proportion of all pediatric hospitalizations served by “pediatric” hospitals increased by 3.8% from 1996 to 2000.Conclusions.Although intended for educational purposes, hospital affiliation with an accredited pediatric residency program identifies a subgroup of facilities with a distinct utilization pattern, which provides care for the majority of pediatric inpatients, and serves as a resource to other hospitals.