Pediatrics
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Multicenter Study
Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data.
It has been suggested that thimerosal, a mercury-containing preservative in vaccines, is a risk factor for the development of autism. We examined whether discontinuing the use of thimerosal-containing vaccines in Denmark led to a decrease in the incidence of autism. ⋯ The discontinuation of thimerosal-containing vaccines in Denmark in 1992 was followed by an increase in the incidence of autism. Our ecological data do not support a correlation between thimerosal-containing vaccines and the incidence of autism.
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Multicenter Study
Admission to the intensive care unit for respiratory syncytial virus bronchiolitis: a national survey before palivizumab use.
Preterm infants, especially those with chronic lung disease (CLD), are considered more susceptible to severe respiratory illness from respiratory syncytial virus (RSV) infection than healthy term infants, and are therefore targeted for prophylactic administration of immune globulins. The impact of this practice on the more severe cases of bronchiolitis (i.e., pediatric intensive care unit [PICU] admission, mechanical ventilation, mortality) has not been reported to date. The aim of this study was to evaluate PICU admissions, need for mechanical ventilation, and mortality attributable to RSV bronchiolitis in Israel before the introduction of RSV prophylaxis to the country. ⋯ Most of the infants with severe RSV bronchiolitis were born at term and did not have CLD. The great majority of patients admitted to the PICU for bronchiolitis were not candidates for RSV prophylaxis. Administration of RSV prophylaxis to the predefined high-risk population could be expected to yield no significant change in PICU admissions or number of infants needing mechanical ventilation. New risk-stratified guidelines for RSV prophylaxis are needed.
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Comparative Study
Nature of conflict in the care of pediatric intensive care patients with prolonged stay.
To determine the frequency, types, sources, and predictors of conflict surrounding the care of pediatric intensive care unit (PICU) patients with prolonged stay. ⋯ Efforts to reduce and manage conflicts that arise in the care of critically ill children should be sensitive to the distinctive features of these conflicts. Knowledge of risk factors for conflict may also help to target such interventions at the patients and families who need them most.
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To evaluate the influence of average family income in a geographic area on the effectiveness of helmet legislation on observed helmet use by children (5-14 years). ⋯ This study showed that bicycle helmet use by children increased significantly after helmet legislation. In this urban area with socioeconomic diversity and in the context of prelegislation promotion and educational activities, the legislative effect was most powerful among children who resided in low-income areas.
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This article presents a brief overview of the effects of social, economic, and political factors on child health. It starts by highlighting child poverty in rich nations, in particular the United Kingdom and the United States, and identifies the economic and political factors underlying this phenomenon. The evidence linking socioeconomic status and child health is briefly reviewed with particular attention to birth weight and child mental health-2 of the most important public health challenges in the 21st century. The implications for pediatricians of high levels of child poverty and the effect that these have on children are discussed.