Alpha-1-antitrypsin (a1AT) deficiency is caused by homozygosity for the a1AT mutant Z gene and occurs in one 2000 Americans. The mutation confers an abnormal conformation on protein, resulting accumulation within endoplasmic reticulum of hepatocytes chronic liver injury. Autophagy several proteolytic mechanisms activated to cope with this hepatocellular protein burden, likely important disposal unique polymerized which thought be especially injurious cell. Recent data indicate that rapamycin...

Our goal was to estimate the quarterly prevalence of and evaluate trends for chronic medication use in children.A cross-sectional study ambulatory prescription claims data from 2002 2005 conducted a nationally representative sample >3.5 million commercially insured children who were 5 19 years old. Prevalence measured antihypertensives, antihyperlipidemics, type 2 antidiabetics, antidepressants, attention-deficit disorder attention-deficit/hyperactivity medications, asthma-controller...

Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income to complete, particularly given numerous barriers families face.Among low-income, primarily racial, and ethnic minority with postpartum depression, our aim was evaluate (1) feasibility of sending supportive text messages, (2) perception receiving private, messages depression.Mothers found be at risk...

To estimate the effect of race on perinatal outcomes in obese women.Retrospective cohort study birth records linked to hospital discharge data for all live born singleton infants ≥37 weeks gestation African-American or Caucasian Missouri residents from 2000 2006. We excluded major congenital anomalies and women with diabetes chronic hypertension. Obesity was defined as pre-pregnancy body mass index ≥30 kg/m(2).There were 312 412 births meeting criteria. 27.1% (11 776) mothers 19.1% (49 415)...

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Disruptive behaviors can be of comparable or greater concern to parents than the core symptoms Autism Spectrum Disorder (ASD). Provision effective interventions address these within first year initial diagnosis holds great potential for improving child's, parents', and family's functioning. We piloted a four-session, manualized, positive parenting program on 21 newly diagnosed children ages 2 through 12 years using mixed methods design. Seventy-five percent completed four sessions, with 100%...

Objective: To estimate the sensitivity and specificity of pure-tone audiometry hearing screening in primary care setting.Design: Prospective cohort study.Setting: Eight academic private pediatric practices.Participants: A subset children from a convenience sample 1061 between 3 19 years age were screened for loss using audiometry.Intervention: Formal audiologic evaluations (gold standard) those referred by their physician (28 children) random not (102 children).Main Exposure: Pure-tone...

To determine the effect of increasing maternal obesity, including superobesity (body mass index [BMI] ≥ 50 kg/m2), on perinatal outcomes in women with diabetes.Retrospective cohort study birth records for all live-born nonanomalous singleton infants 37 weeks' gestation born to Missouri residents diabetes from 2000 2006. Women either pregestational or gestational were included.There 14,595 births meeting criteria, 7,082 a BMI > 30 kg/m2 (48.5%). Compared normal-weight diabetes, category,...

Radiation therapy is often considered the treatment of choice for low-grade gliomas. However, given long-term effects radiation on developing brain, appropriate use in pediatric patients remains controversial. The purpose this study was to evaluate progression-free survival (PFS) glioma treated with therapy. Data were obtained through a retrospective chart review between 1991 and 2008 from single tertiary care center midwest. population consisted 17 patients, whom 8 (47%) had tumor...

Youth with autism spectrum disorder (ASD) experience significant challenges transitioning to adulthood. We utilized Photovoice better understand youth's desires for and perspectives on becoming adults.Youth ASD (N = 11) photographed their life experiences, attended group individual photo-sharing discussion sessions, exhibited work publicly. Thematic analysis was used identify salient recurring patterns in the data.Thematic identified important topics session transcripts 184 photographs....

<h3>Objectives</h3> To determine hearing screening failure rates in primary care settings and to examine the referral practices response an abnormal test. <h3>Methods</h3> We enrolled a convenience sample of children between 3 19 years age who were undergoing during well-child visit. A was defined as missing any frequency (1000, 2000, or 4000 Hz) either ear at 20-dB level. The pediatrician made decision whether refer patient for further evaluation. <h3>Results</h3> Three academic 5 private...

Cellulitis is defined as an “acute spreading infection of the skin that extends deeper than erysipelas and involves subcutaneous tissues.”1 In last 2 decades, we have seen increase in cellulitis overall soft tissue (SSTI) diagnoses. During this time, rate emergency department (ED) visits for SSTI has doubled, there been a 50% ambulatory visits.2,3 addition, exponential rise community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections occurred.4 The cause or...

Objective. To evaluate the prevalence of atypical antipsychotic use in privately insured children and diagnoses associated with treatment. Study design. Claims were used to conduct a retrospective cohort study aged 2 through 18 years Midwest, covered by private insurance between 2002 2005 (n = 172 766). The 1-year receiving antipsychotics was determined along diagnoses. Results. ranged from 7.9 per 1000 9.0 2005. leading disruptive behavior disorders (67%), mood (65%), anxiety (43%).The...

We sought to examine perinatal outcomes in women with a body mass index (BMI) of 25 kg/m(2) comparing those whose weight gain met 2009 IOM guidelines meeting 1990 guidelines.This is retrospective cohort study utilizing birth records linked hospital discharge data for all term, singleton infants born overweight, Missouri residents (2000-2006) BMI kg/m(2). excluded congenital anomalies, mothers diabetes, hypertension, or previous cesarean delivery.Fourteen thousand nine hundred fifty-five...

<h3>Background</h3> While birth asphyxia is the leading cause of neonatal mortality in sub-Saharan Africa, accounting for 23% deaths, little known morbidity developing countries. Survivors are at risk adverse neurodevelopmental outcomes. The purpose this study was to determine diagnoses and early outcomes infants evaluated a intensive care unit (NICU) follow-up clinic country Africa. <h3>Design/Methods</h3> All inborn outborn admissions University Zambia NICU who survived discharge were...