Search

Catheters to the umbilical cord artery or vein are useful in treating sick newborns. However, use of these umbilical catheters can lead to complications such as systemic infection (sepsis) in up to 16 percent of cases. To determine the elements influencing catheter-related sepsis (CRS), 225 infants for whom 357 umbilical catheters in place at least three days were evaluated. The infants were treated in a neonatal intensive care unit; the average infant weight was 3.4 pounds, and the average gestational age was 31 weeks. Fourteen newborns developed CRS, 10 of whom had an arterial catheter (UAC) and 4 of whom had venous catheters (UVC). Bacteria could be isolated from catheters of 87 newborns. Staphylococcus bacteria were the most common type found in catheters and in cases of CRS. Very low birth weight (VLBW) infants, with birth weights of less than 3.3 pounds, were at highest risk for CRS among infants with UACs. Use of antibiotic therapy during catheter removal and the duration of antibiotic therapy were also related to a significantly higher risk for CRS. Use of hyperalimentation (feeding) fluid infused through UACS was associated with a higher risk for CRS, but this was dependent on other risk factors such as infantile birth weight and duration of UAC use. Larger infants tended to have hyperalimentation fluid given through UVCs, and so UVC-related CRS was significantly associated with larger birthweight, catheter duration, and hyperalimentation fluid infusion. (Consumer Summary produced by Reliance Medical Information, Inc.)

An infrared tympanic membrane thermometer (FIRST temp) said to approximate core temperature accurately is being marketed as noninvasive, quick, and easy-to-use clinical instrument. The determination of tympanic membrane temperatures by this device was compared with the determination of oral, rectal, or axillary temperatures by a conventional glass thermometer. Subjects were patients of a pediatric group practice in Houston, Texas. FIRST temp and conventional temperature determinations on individual patients were completed within5 minutes of each others. The presence or absence of otitis media was noted by the examining physician. Agreement between the two methods of temperature determination was assessed by calculating limits of agreement within which 95% ([+ or -] 2 standard deviations) of individual differences would fall. The location of conventional thermometer (oral, rectal, axillary), time interval between the two separate measures, and the presence or absence of otitis media were entered into a multiple regression analysis to determine whether these factors influenced the observed differences between the two methods. A total of 144 patients were enrolled in the study; oral comparisons were obtained in 92 (57%) patients, rectal in 35 (24%), and axillary in 29 (19%). The upper and lower limits of agreement between temperature methods were 1.12 [degrees] C and 0.89 [degrees] C and the mean difference was -0.12 [degrees] C. Regression analysis revealed that only the site of conventional thermometer location (oral, rectal, axillary) was a significant predictor of FIRST temp/conventional differences. Each site had a range of agreement greater than 1.65 [degrees] C; axillary temperatures had the greatest range (-0.94 [degrees] C to +1.30 [degrees] C). Although ease and time reduction with use are attractive properties of the FIRST temp device, these data show that it is unreliable compared with conventional methods of temperature determination. Pediatrics 1992;89:384-386; tympanic membrane thermometer, aural temperature, temperature assessment.

Objective. Clinical observations suggested that growth abnormalities may be present in children with ectodermal dysplasia (ED) syndromes. This study characterizes the longitudinal pattern of growth in a cohort of children with the ED syndromes. We hypothesized that (1) linear and ponderal growth abnormalities are present in children with ED from infancy through adolescence, and (2) linear and ponderal growth abnormalities differ among the clinical variants of these disorders. Methods. We studied 138 children who had ED and were registered with the National Foundation for Ectodermal Dysplasias, 74% of whom had clinical features consistent with the hypohidrotic EDs (HEDs). Height (or length) and weight measurements were obtained by standardized techniques and from review of available medical records. We converted these measurements to weight-for-height (children younger than 5 years and Results. Mean weight-for-age, weight-for-height, and BMI-for-age z scores but not height-for-age z score, were significantly lower in children with the ED syndromes than in the reference population. Mean weight-for-age and weight-for-height z scores but not BMI-for-age or height-for-age z scores increased significantly with increasing age. The mean height-for-age z score of children with the ED syndromes other than the HEDs was significantly lower than that of children with the HEDs. Conclusions. Growth abnormalities, measured as weight deficits, were present at an early age in children with the ED syndromes and persisted through adolescence. Height deficits were seen only in children with ED syndromes other than HEDs. Clinicians should evaluate carefully children with ED syndromes for growth abnormalities. Pediatrics 2005;116:e229-e234. URL: www. pediatrics.org/cgi/doi/10.1542/peds.2004-2830; height, weight, malnutrition, growth failure, failure to thrive, short stature.

The internal consistency of the Test of Variables of Attention (TOVA) was examined in a cohort of 6- to 12-year-old children (N = 63) strictly diagnosed with ADHD. The internal consistency of errors of omission (OMM), errors of commission (COM), response time (RT), and response time variability (RTV) of different test conditions (stimulus infrequent condition [Q1 vs. Q2] and stimulus frequent condition [Q3 vs. Q4]) was assessed via correlation analyses. All TOVA index scores under investigation assessing its internal consistency exhibited statistically significant correlations. All correlations fell in the moderate-high range. [ABSTRACT FROM AUTHOR]