Pediatrics
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Comparative Study
Low birth weight and lung function in adulthood: retrospective cohort study in China, 1948-1996.
The goal was to determine whether the components of low lung function in adulthood were associated with low birth weight in a Chinese population. ⋯ Low birth weight may increase the prevalence of and risk for low lung function in adulthood in the Chinese population. The development of lung function may be affected by hypogenesis in utero.
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This technical report reviews and synthesizes the published literature on racial/ethnic disparities in children's health and health care. ⋯ Racial/ethnic disparities in children's health and health care are extensive, pervasive, and persistent, and occur across the spectrum of health and health care. Methodologic flaws were identified in how such disparities are sometimes documented and analyzed. Optimal health and health care for all children will require recognition of disparities as pervasive problems, methodologically sound disparities studies, and rigorous evaluation of disparities interventions.
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Comparative Study
Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated.
In January 2008, an intentionally unvaccinated 7-year-old boy who was unknowingly infected with measles returned from Switzerland, resulting in the largest outbreak in San Diego, California, since 1991. We investigated the outbreak with the objective of understanding the effect of intentional undervaccination on measles transmission and its potential threat to measles elimination. ⋯ Despite high community vaccination coverage, measles outbreaks can occur among clusters of intentionally undervaccinated children, at major cost to public health agencies, medical systems, and families. Rising rates of intentional undervaccination can undermine measles elimination.
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Comparative Study
Outcome of early-onset sepsis in a national cohort of very low birth weight infants.
Early-onset sepsis (EOS) is associated with significant morbidity and mortality among infants with a very low birth weight (VLBW); however, there is a sparse amount of complete data on large cohorts. ⋯ Although only 2.4% of VLBW infants had an episode of EOS, these infants were at an approximately threefold excess risk of death or major neurologic morbidities.
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Computed tomography (CT) is used often in the evaluation of orbital infections to identify children who are most likely to benefit from surgical intervention. Our objective was to identify predictors for intraorbital or intracranial abscess among children who present with signs or symptoms of periorbital infection. These predictors could be used to better target patients for emergent CT. ⋯ We confirmed that patients with proptosis and/or pain or limitation of extraocular movements are at high risk for intraorbital abscess, yet many do not have these predictors. Other features can identify patients who do not have such obvious predictors but do have significant risk of disease. A recursive partitioning model is presented.