Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 2: What to Look for and How to Recommend an Effective Fiber Therapy.

Dietary fiber that is intrinsic and intact in fiber-rich foods (eg, fruits, vegetables, legumes, whole grains) is widely recognized to have beneficial effects on health when consumed at recommended levels (25 g/d for adult women, 38 g/d for adult men). Most (90%) of the US population does not consume this level of dietary fiber, averaging only 15 g/d. In an attempt to bridge this "fiber gap," many consumers are turning to fiber supplements, which are typically isolated from a single source.

Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 1: What to Look for and How to Recommend an Effective Fiber Therapy.

Dietary fiber that is intrinsic and intact in fiber-rich foods (eg, fruits, vegetables, legumes, whole grains) is widely recognized to have beneficial effects on health when consumed at recommended levels (25 g/d for adult women, 38 g/d for adult men). Most (90%) of the US population does not consume this level of dietary fiber, averaging only 15 g/d. In an attempt to bridge this "fiber gap," many consumers are turning to fiber supplements, which are typically isolated from a single source.

Antecedents of neonatal encephalopathy in the Vermont Oxford Network Encephalopathy Registry.

Background: Neonatal encephalopathy (NE) is a major predictor of death and long-term neurologic disability, but there are few studies of antecedents of NE.

Objectives: To identify antecedents in a large registry of infants who had NE.

Methods: This was a maternal and infant record review of 4165 singleton neonates, gestational age of ≥ 36 weeks, meeting criteria for inclusion in the Vermont Oxford Network Neonatal Encephalopathy Registry.

Analysis of chromosome 7 in adult and pediatric ependymomas using chromogenic in situ hybridization.

Few studies have yielded reliable data that distinguish between ependymal neoplasms based on molecular genetic attributes. The present study utilizes chromogenic in situ hybridization (CISH), a relatively recent hybridization technique, to retrospectively examine chromosome 7-copy number in pediatric and adult ependymomas. Of the 27 hybridizations, polysomy of chromosome 7 was detected in 10 out of 15 (66%) adult ependymomas, and in only three out of 12 (25%) pediatric lesions.

Spinal cord malignant astrocytomas. Clinicopathologic features in 36 cases.

Background: Malignant astrocytomas of the spinal cord are uncommon neoplasms with a dismal prognosis. To the authors' knowledge, little information has been published to date regarding the prognostic impact of clinicopathologic factors.

Methods: The authors studied 36 cases to investigate the prognostic effect of the World Health Organization (WHO) tumor grade, tumor localization, cell proliferative activity, p53 expression, and therapy.

Biochemical, cellular, and molecular mechanisms in the evolution of secondary damage after severe traumatic brain injury in infants and children: Lessons learned from the bedside.

OBJECTIVE: To present a state-of-the-art review of mechanisms of secondary injury in the evolution of damage after severe traumatic brain injury in infants and children. DATA SOURCES: We reviewed 152 peer-reviewed publications, 15 abstracts and proceedings, and other material relevant to the study of biochemical, cellular, and molecular mechanisms of damage in traumatic brain injury. Clinical studies of severe traumatic brain injury in infants and children were the focus, but reports in experimental models in immature animals were also considered.

Advances in the diagnosis, molecular genetics, and treatment of pediatric embryonal CNS tumors.

Embryonal central nervous system (CNS) tumors are the most common group of malignant brain tumors in children. The diagnosis and classification of tumors belonging to this family have been controversial; however, utilization of molecular genetics is helping to refine traditional histopathologic and clinical classification schemes. Currently, this group of tumors includes medulloblastomas, supratentorial primitive neuroectodermal tumors, atypical teratoid/rhabdoid tumors, ependymoblastomas, and medulloepitheliomas.

The anticonvulsant effect of electrical fields.

The use of electrical fields to treat epilepsy is undergoing increased scrutiny as an alternative to medications and resective surgery. Much recent attention has been focused on ionic channels and seizure control; however, nonsynaptic mechanisms may be crucial for seizure onset, raising the possibility of using electrical field application to abort seizures. Furthermore, the inhibitory effects may outlast the immediate treatment and possibly be a prophylactic intervention.

Respiratory syncytial virus immune globulin treatment of RSV lower respiratory tract infection in previously healthy children.

Objective: To evaluate the efficacy of high titer respiratory syncytial virus (RSV) immune globulin (RSVIG) in the treatment of previously healthy children hospitalized with proven RSV lower tract infection (LRI).

Method: Infants and young children /=2. 5 were enrolled.

Respiratory syncytial virus (RSV) immune globulin intravenous therapy for RSV lower respiratory tract infection in infants and young children at high risk for severe RSV infections: Respiratory Syncytial Virus Immune Globulin Study Group.

Objectives: To evaluate the efficacy of high-titer intravenous respiratory syncytial virus immune globulin (RSVIG) in the treatment of children at high risk for severe RSV infection who were hospitalized with proven RSV.

Methods: Infants and young children younger than 2 years with bronchopulmonary dysplasia, chronic lung disease, congenital heart disease, or prematurity (<32 weeks' gestational age), hospitalized with a history of lower respiratory tract infection (LRI) of less than 4 days, were enrolled in this study. Patients were randomized in a blinded fashion to receive either 1500 mg/kg RSVIG or placebo in equal volumes.

Prevalence of primary monofixation syndrome in parents of children with congenital esotropia.

The prevalence of primary monofixation syndrome (MFS) in the general population is approximately 1%. This study was performed to determine the prevalence of primary monofixation in biological parents of children with congenital esotropia. Ninety children with congenital esotropia were seen between November 1991 and June 1992 by one ophthalmologist (M.

Latex allergy in children.

Natural latex, a product of the tropical rubber tree, Hevea brasiliensis, has been shown to cause allergic reactions in an increasing number of individuals. Severity of reaction has ranged from mild contact dermatitis to anaphylaxis. Individuals with spina bifida, congenital urogenital anomalies, health care workers, and those employed in the rubber industry are at highest risk for immediate hypersensitivity to latex.

Pediatric intensive care units: results of a national survey.

Objective: To describe the structure and organization of pediatric intensive care units (ICUs) in the United States.

Survey Methods: We directed a mail survey to pediatric ICU medical and nursing directors and hospital quality assurance officers. A total of 201 of 301 hospitals with pediatric ICUs initially responded.

Hematopoietic engraftment and graft failure after bone marrow transplantation.

Purpose: This article reviews the complex process of establishing functional long-term hematopoiesis required for successful clinical bone marrow transplantation. The failure to establish sustained hematopoiesis, either primary or secondary graft failure, is defined and multiple etiologic factors involved are discussed.

Design: Data from published studies of experimental and clinical BMT, as well as in vitro stem cell biology, were used to elucidate the elements required for establishing functional hematopoiesis.

Cranial fasciitis of childhood.

We present a child with a rapidly growing mass and lytic skull lesion that on pathologic evaluation was diagnosed as cranial fasciitis. This disease entity is not widely known by radiologists, and should be included in the differential diagnosis of lytic skull lesions.

Staging and treatment of primary and persistent (recurrent) osteoid osteoma. Evaluation of intraoperative nuclear scanning, tetracycline fluorescence, and tomography.

The purposes of this study were (1) to evaluate the various methods of preoperative staging of osteoid osteomas, (2) to compare the different methods of intraoperative localization and excision of the tumor, and (3) to develop a clinical strategy for the treatment of persistent (recurrent) lesions. From 1978 until 1986, 14 consecutive patients had excision of osteoid osteomas. All patients' operative reports, roentgenograms, bone scans, computed tomographic scans and histologic studies were reviewed.

Plasma thromboxane and pulmonary artery pressure in neonates treated with extracorporeal membrane oxygenation.

To examine whether neonates with persistent pulmonary hypertension are subject to a thromboxane-mediated exacerbation of their pulmonary hypertension during extracorporeal membrane oxygenator therapy (a form of partial cardiopulmonary bypass), we performed serial measurements of plasma thromboxane B2 and pulmonary artery pressure before, during, and after extracorporeal membrane oxygenation. Pulmonary artery pressure was high before extracorporeal membrane oxygenation, did not increase after the start of this therapy, but began to decrease after 48 hours of extracorporeal membrane oxygenation. During the course of extracorporeal membrane oxygenation, mean pulmonary artery pressure decreased by 50% and mean plasma thromboxane B2 levels decreased by 70%.

Role of early fluid resuscitation in pediatric septic shock.

Objective: To examine the association of the volume of fluid administered at 1 and 6 hours after presentation, with survival and the occurrence of the adult respiratory distress syndrome, cardiogenic pulmonary edema, and persistent hypovolemia during the resuscitation of children with septic shock.

Setting And Patients: All pediatric patients with septic shock presenting to the emergency department over a 6-year period and having a pulmonary artery catheter inserted by 6 hours after presentation were identified.

Methods: Patients were analyzed together and in three groups based on fluid volume in the first hour: group 1, less than 20 mL/kg; group 2, 20 to 40 mL/kg; and group 3, more than 40 mL/kg.

Malignancy supervening on an intramedullary nail.

A primary, malignant, fibrous histiocytoma of bone occurring in association with a Hansen Street intramedullary nail occurred in a 39-year-old man. The physical and chemical characteristics of materials, in relation to the generation of secondary neoplasia are reviewed, but the problem of coincidence is difficult to exclude.