Cortisol circadian rhythms and stress responses in infants at risk of allergic disease.

Altered hypothalamic-pituitary-adrenal function associated with allergic disease has generally been thought to be secondary to the stress of chronic disease. However, recent studies suggest that altered cortisol circadian rhythm and cortisol stress hyper-responsiveness precede the inception of allergic disease and are possible links between preventive factors associated with the hygiene hypothesis and the development of allergies. Elevated endogenous cortisol responses to stressful stimuli could predispose susceptible hosts to atopy and allergic disease by biasing the developing immune system to a T helper 2-predominant immune response, greater total and allergen-specific serum immunoglobulin E responses, and/or inhibition of peripheral immune tolerance.

Cortisol circadian rhythms and stress responses in infants at risk of allergic disease.

Background: The cortisol circadian rhythm and response to stressful stimuli are altered in children and adults with allergic disease, including asthma. It is not known whether these alterations precede or follow the onset of allergic disease.

Objective: We sought to evaluate the cortisol circadian rhythm and stress response among infants at risk for the development of allergic disease.

Effectiveness of gun-safety counseling and a gun lock giveaway in a Hispanic community.

Objective: To evaluate the effectiveness of gun-safety counseling, a gun-safety brochure, and a free gun lock in subsequent gun removal and safe storage.

Methods: In a predominantly Hispanic pediatric clinic, gun-owning families were identified and assigned to either an intervention group (gun-safety counseling, gun-safety brochure, and a free gun lock) or a control group (usual anticipatory guidance). Families were resurveyed 1 month later for changes in the proportion of gun owners, changes in frequency of unloaded and locked gun storage, and changes to the use of locked storage.

Clinic-based screening for domestic violence: use of a child safety questionnaire.

Background: Domestic violence affects many women during their lifetime. Children living in homes where they are or have been exposed to violence are at increased risk for adverse outcomes. The American Academy of Pediatrics, the American Academy of Family Practice, and the American College of Obstetrics/Gynecology have recently joined in recommending routine screening of all families for the presence of domestic violence.

A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain in children.

Few effective therapies are available for children with recurrent abdominal pain (RAP). Relaxation and guided imagery have been shown to impact the autonomic nervous system, which is altered in patients with functional gastrointestinal disorders. Ten children with RAP were enrolled in the study after evaluation by a pediatric gastroenterologist.

Pediatricians' evaluations of their residency curriculum in emergency medicine.

Objective: To describe residency graduates' perceptions of their preparation for providing pediatric emergency medical care.

Methods: The design was a cross-sectional survey set in a university-affiliated pediatric residency program. Twenty residency graduates from 1994 and 1995 who did not have an emergency department (ED) rotation (pre-ED group) and 24 graduates from 1998 and 1999 who had an ED rotation (post-ED group) participated in the study.

Is there a common cold constitution?

Objective: Constitutional factors might play a role in the susceptibility to clinical illness during the common cold. This study seeks to determine if the likelihood of developing frequent common colds persists during childhood.

Design: The Tucson Children's Respiratory Study involves 1246 children enrolled at birth and followed prospectively since 1980 and 1984.

Influence of attendance at day care on the common cold from birth through 13 years of age.

Objective: To describe trends in the occurrence of the common cold during the first 13 years of life among children who attended different childcare settings early in life.

Design: The Tucson Children's Respiratory Study involves 1246 children enrolled at birth and followed up prospectively since May 1980 through October 1984. Children with data regarding day care use during the first 3 years of life were included in this investigation (n = 991).