Differences in mortality characteristics in neonates with Down's syndrome.

Objective: Neonates with Down's syndrome (nDS) may have multiple medical issues that place them at increased risk for mortality during the newborn period. Goal of this study was to determine if there are differences in baseline characteristics, medical complications or procedures performed during hospitalization between nDS who survived versus those who died during initial hospitalization.

Study Design: Data from 2000 to 2014 were reviewed using the Pediatric Health Information Systems (PHIS) database on all DS patients admitted to the hospital <30 days postnatal life.

Pharmacokinetic comparison of acetaminophen elixir versus suppositories in vaccinated infants (aged 3 to 36 months): a single-dose, open-label, randomized, parallel-group design.

Background: Because of practical problems and ethical concerns, few studies of the pharmacokinetics (PK) of acetaminophen (ACET) in infants have been published.

Objective: The goal of this study was to compare the PK of an ACET rectal suppository with a commercially available ACET elixir to complete a regulatory obligation to market the suppository. This study was not submitted previously because of numerous obstacles related to both the investigators and the commercial entities associated with the tested product.

Chest sonography in children: current indications, techniques, and imaging findings.

Ultrasound of the thorax is particularly rewarding in children, because their unique thoracic anatomy provides many available acoustic windows into the chest. Newer ultrasound techniques can allow better understanding of lung disease. With minimum effort and creativity, chest ultrasound can provide important clinical information without radiation exposure or sedation sometimes required for computed tomography and magnetic resonance imaging.

Treatment of short stature and growth hormone deficiency in children with somatotropin (rDNA origin).

Somatotropin (growth hormone, GH) of recombinant DNA origin has provided a readily available and safe drug that has greatly improved management of children and adolescents with GH deficiency (GHD) and other disorders of growth. In the US and Europe, regulatory agencies have given approval for the use of GH in children and adults who meet specific criteria. However, clinical and ethical controversies remain regarding the diagnosis of GHD, dosing of GH, duration of therapy and expected outcomes.

The modified Koyanagi hypospadias repair for the one-stage repair of proximal hypospadias.

Perineal and penoscrotal hypospadias were often managed by two-stage urethroplasty with variable results and significant number of these may need third surgery. Though modified Koyanagi one-stage repair has a learning curve, it has all the advantages of two-stage repair. The aim was to review the results of modified Koyonagi repair from the literature and our own centre experience.

MAP Kinase Phosphatase-1 and Septic Shock.

Mitogen-activated protein (MAP)(§) kinase cascades are crucial signal transduction pathways in the biosynthesis of proinflammatory cytokines. MAP kinase phosphatase (MKP)-1, an archetypal member of the MKP family, plays a pivotal role in the feedback control of p38 and JNK. In vitro studies using cultured macrophages have provided strong evidence for a critical role of MKP-1 in the restraint of pro-inflammatory cytokine biosynthesis.

Should fear of malpractice dissuade dentists from caring for children?

Purpose: Little information is available on malpractice related to dentistry for children. The purpose of this report was to examine characteristics of malpractice allegations related to dentistry for children from the National Practitioner Databank (NPDB) from February 1, 2004 to November 22, 2006.

Methods: The public use file of the NPDB was obtained and transformed into a searchable database and allegations involving children were sorted and characterized by payment size, reason, practitioner type, and location.

Neuroglial heterotopia causing neonatal airway obstruction: presentation, management, and literature review.

Neuroglial heterotopias are rare congenital masses that are thought to represent encephaloceles that become sequestered on the extracranial side of the skull base. Although most often adjacent to bony skull base defects, they lack communication to the subarachnoid space. They contain mature neuroglial tissue and specialized central nervous system elements, such as a functioning choroid plexus.

Weight loss and asthma: a systematic review.

Epidemiological studies first demonstrated the association between obesity and asthma and they have begun to provide additional evidence to support causality: a dose-effect relationship, consistency across studies (especially among women) and the correct temporal order (ie, obesity before asthma). To date, relatively few studies have addressed reversibility, an important but less frequently demonstrated epidemiological criterion of causality. Reversibility suggests that if excessive weight is a risk factor for asthma, then reducing body weight should decrease the prevalence of asthma, or at least decrease asthma related symptoms or health care utilisation.

Barriers to care among US school-aged children with disabilities.

Objective: We examined financial barriers to care experienced by US school-aged children with disabilities.

Methods: Data from the 2005 National Health Interview Survey were analyzed. Children aged 5 to 17 years were classified into 4 health condition groups: children with activity limitations, disabling conditions, chronic asthma, or no health conditions.

Procedural sedation for fracture reduction in children with hyperactivity.

Objective: Children with attention-deficit/hyperactivity disorder (ADHD) have a higher rate of more severe injuries than the general population. However, their ADHD may cause them to respond differently to procedural sedation required for treatment. The purpose of this article is to compare procedural sedation for children with and without ADHD.

Foot problems in the adolescent.

The treatment of foot problems in the adolescent should be nonsurgical whenever possible. Surgical treatment should be considered when medical treatment does not relieve pain. Surgical corrections to prevent problems in adulthood may cause complications and lead to an undesirable outcome.

Overuse injuries in adolescents.

The incidence of overuse injuries in young athletes is on the rise and accounts for a significant number of visits to the primary care office. There are distinctive intrinsic and extrinsic factors that place young athletes at risk for overuse injuries. These injuries vary in severity from being a temporary inconvenience to having potential lifelong morbidity.

Young children (<5 yr) and adolescents (>12 yr) with type 1 diabetes mellitus have low rate of partial remission: diabetic ketoacidosis is an important risk factor.

Objective: To determine whether there are different rates of partial remission in preschool, school-age children, and adolescents with type 1 diabetes mellitus (T1DM) and to identify clinical characteristics that are associated with increased rate of partial remission.

Design/methods: A total of 152 consecutive patients with newly diagnosed T1DM in 2004 were studied. Clinical characteristics at diagnosis, hemoglobin A1C (HbA1C), and total daily insulin dose (TDD) at 3-month interval follow-up for 1 yr were analyzed in each age-group (group 1, aged <5 yr; group 2, aged 5-12 yr; and group 3, aged >12 yr).

Prevalence of vitamin D deficiency and insufficiency in children with osteopenia or osteoporosis referred to a pediatric metabolic bone clinic.

Objectives: The purpose of this work was to determine the prevalence of vitamin D deficiency and insufficiency in children with osteopenia or osteoporosis and to evaluate the relationship between serum 25-hydroxyvitamin D levels and bone parameters, including bone mineral density.

Materials And Methods: Serum 25-hydroxyvitamin D, 1,25 dihydroxyvitamin D, parathyroid hormone, and other bone markers, as well as bone mineral density, were obtained for 85 pediatric patients with primary osteoporosis (caused by osteogenesis imperfecta or juvenile idiopathic osteoporosis) and secondary osteopenia or osteoporosis caused by various underlying chronic illnesses. Pearson's correlation was used to assess the relationship between vitamin D levels and different bone parameters.

Myocardial tissue Doppler changes in patients with bronchopulmonary dysplasia.

Objective: To determine whether tissue Doppler measurements provide sensitive measures of right ventricular function that correlate with the severity of bronchopulmonary dysplasia (BPD).

Study Design: 21 subjects (6 control subjects with no/mild BPD, 7 patients with moderate BPD, and 8 patients with severe BPD) underwent limited echocardiograms with standard M-mode, mitral and tricuspid inflow velocities, and tissue Doppler features measured. BPD severity was scored by using the NICHD/NHLBI/ORD workshop rating scale by physicians blinded to the echocardiogram results.

The increasing incidence of snowboard-related trauma.

Purpose: To investigate injuries among children and adolescents who participate in downhill sports.

Methods: We collected trauma registry data (January 1999-May 2006) from a level 1 pediatric trauma center with an average snowfall of 28 in (71 cm)/y. Cases were analyzed for injury mechanism, injury type, organ injured, Injury Severity Score, age, sex, and whether or not an operation was required.

Using multiple imputation and propensity scores to test the effect of car seats and seat belt usage on injury severity from trauma registry data.

Background: Missing data and the retrospective, nonrandomized nature of trauma registries can decrease the quality of registry-based research. Therefore, we used multiple imputation and propensity scores to test the effect of car seats and seat belt usage on injury severity in children involved in motor vehicle crashes.

Methods: All children admitted after injury from motor vehicle crashes who had complete data on seat belt or car seat usage from 2003 to 2006 were included in the study.

Predictive accuracy of standard computed tomography scanning in the diagnosis of Chiari malformation Type I in children.

Object: In this study, retrospective data analysis was performed to analyze the utility of head computed tomography (CT) scanning in the diagnosis of Chiari malformation Type I (CM-I) in the pediatric population.

Methods: The authors conducted a retrospective review of radiology charts describing head CT results obtained at Columbus Children's Hospital between January 2004 and January 2005. The records were searched for the key words "Chiari," "cerebellar ectopy," or "tonsillar ectopy.

Parent-Child Interactions During the Initial Weeks Following Brain Injury in Young Children.

Objective: To understand how traumatic brain injury (TBI) affects parent-child interactions acutely following injury.

Participants: Young children hospitalized for TBI ( = 80) and orthopedic injuries (OI; = 113).

Method: Raters coded videotaped interactions during free play and structured tasks for parental warmth/responsiveness and negativity and child warmth, behavior regulation, and cooperation.

A decision rule for predicting bacterial meningitis in children with cerebrospinal fluid pleocytosis when gram stain is negative or unavailable.

Objectives: Among children with cerebrospinal fluid (CSF) pleocytosis, the task of separating aseptic from bacterial meningitis is hampered when the CSF Gram stain result is unavailable, delayed, or negative. In this study, the authors derive and validate a clinical decision rule for use in this setting.

Methods: This was a review of peripheral blood and CSF test results from 78 children (< 19 years) presenting to Children's Hospital Columbus from 1998 to 2002.