Identification of children at risk for lead poisoning: an evaluation of routine pediatric blood lead screening in an HMO-insured population.

Abstract:

OBJECTIVES:To estimate the prevalence of elevated blood lead levels in children receiving well-care checkups; and to evaluate the effectiveness of certain key risk factors in detecting children at higher risk for elevated blood lead levels. DESIGN:Cross-sectional study. SETTING:Two facilities of the Kaiser Permanente Medical Care Program (KPMCP) health maintenance organization (HMO), northern California region. PATIENTS:Six hundred thirty-six children, aged 12 to 60 months, who were seen at four KPMCP facilities in two subregions for a well-care checkup from September 1991 through August 1992. INTERVENTIONS:Blood samples were collected from each child and analyzed for lead content. Participating parents completed a questionnaire that included questions recommended by the Centers for Disease Control and Prevention (CDC) about the child's and the parents' lead exposure via home, workplace, and hobbies. RESULTS:Ninety-six percent of the children had blood lead levels under 10 micrograms/dL. Blood lead levels declined with increasing age and were higher for black children compared with whites. Age of residential housing, mother's education, and residence in an old house with peeling paint had low sensitivity and positive predictive value for identifying children with blood lead levels over 10 micrograms/dL. CONCLUSION:Universal routine screening for elevated blood lead levels in children in an employed, HMO-insured population is not warranted on grounds of prevalence. Responses to CDC questions do not effectively identify high-risk children in this population.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Haan MN,Gerson M,Zishka BA

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

79-83

issue

1

eissn

0031-4005

issn

1098-4275

journal_volume

97

pub_type

杂志文章,多中心研究
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    abstract::Epigenetics, the study of functionally relevant chemical modifications to DNA that do not involve a change in the DNA nucleotide sequence, is at the interface between research and clinical medicine. Research on epigenetic marks, which regulate gene expression independently of the underlying genetic code, has dramatica...

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    doi:10.1542/peds.2013-1032F

    authors: Wright R,Saul RA

    更新日期:2013-12-01 00:00:00

  • Congenital fibrosarcoma and history of prenatal exposure to petroleum derivatives.

    abstract::Congenital fibrosarcoma (CFS) is a rare fibrous tissue malignancy that usually presents in the first few years of life. It is unique among human sarcomas in that it has an excellent prognosis. We describe a temporal clustering of a number of cases of CFS and investigate the possible associated prenatal risk factors. T...

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    更新日期:2012-10-01 00:00:00

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    authors: Leduc DG,Pless IB

    更新日期:1982-10-01 00:00:00

  • American Academy of Pediatrics. The role of the school nurse in providing school health services. Committee on School Health.

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    doi:10.1542/peds.108.5.1231

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    更新日期:2001-11-01 00:00:00

  • Early diagnosis of coarctation of the aorta in children: a continuing dilemma.

    abstract:UNLABELLED:Because late repair of coarctation of the aorta (COA) is associated with premature cardiovascular disease in adult life, early detection and treatment is important. OBJECTIVES:To determine the timing of referral to see whether early detection of COA has improved in the past decade, to evaluate the pattern o...

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    更新日期:1996-09-01 00:00:00

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  • Improved outcomes associated with medical home implementation in pediatric primary care.

    abstract:OBJECTIVE:The medical home model with its emphasis on planned care, care coordination, family-centered approaches, and quality provides an attractive concept construct for primary care redesign. Studies of medical home components have shown increased quality and reduced costs, but the medical home model as a whole has ...

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Greer FR,Mummah-Schendel LL,Marshall S,Suttie JW

    更新日期:1988-01-01 00:00:00

  • Isolated sulfite oxidase deficiency: a case report with a novel mutation and review of the literature.

    abstract::Isolated sulfite oxidase deficiency is a rare but devastating neurologic disease that usually presents in early infancy with seizures and alterations in muscle tone. Only 21 cases have been reported in the literature. We report a case of a newborn infant boy with isolated sulfite oxidase deficiency who presented with ...

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  • Systemic candidiasis in extremely low birth weight infants receiving topical petrolatum ointment for skin care: a case-control study.

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    pub_type: 杂志文章

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    更新日期:2000-05-01 00:00:00

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    abstract::Routine use of the 7-valent pneumococcal conjugate vaccine (PCV7), available since 2000, has resulted in a dramatic reduction in the incidence of invasive pneumococcal disease (IPD) attributable to serotypes of Streptococcus pneumoniae contained in the vaccine. However, IPD caused by nonvaccine pneumococcal serotypes ...

    journal_title:Pediatrics

    pub_type: 杂志文章

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    更新日期:2010-07-01 00:00:00

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  • Left atrial myxoma: association with acute coronary embolization in an 11-year-old boy.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

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    更新日期:1979-05-01 00:00:00

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    journal_title:Pediatrics

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    doi:

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    更新日期:1980-10-01 00:00:00

  • Treatment outcomes of overweight children and parents in the medical home.

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    更新日期:2014-08-01 00:00:00

  • Post-varicella epiglottitis and necrotizing fasciitis.

    abstract::Varicella is a nearly ubiquitous acquired childhood disease. Infectious complications of varicella can be life- or limb-threatening. These complications appear 3 to 4 days after the appearance of varicella exanthem and are heralded by fever, pain, and erythema of the overlying skin. Airway complications of varicella a...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.105.1.e13

    authors: Slack CL,Allen GC,Morrison JE,Garren KC,Roback MG

    更新日期:2000-01-01 00:00:00

  • Diagnostic imaging and negative appendectomy rates in children: effects of age and gender.

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2011-3375

    authors: Bachur RG,Hennelly K,Callahan MJ,Chen C,Monuteaux MC

    更新日期:2012-05-01 00:00:00

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    更新日期:1989-07-01 00:00:00

  • Case Report: When an Induced Illness Looks Like a Rare Disease.

    abstract::The recognition of fabricated illness (FI) in a child represents a diagnostic challenge. The suspicion of FI often arises from the discrepancy between laboratory tests and clinical history. For instance, (unnecessary) insulin injections by caregivers has been widely described as a common cause of factitious hypoglycem...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2014-4165

    authors: Rabbone I,Galderisi A,Tinti D,Ignaccolo MG,Barbetti F,Cerutti F

    更新日期:2015-11-01 00:00:00

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Gaudreault P,Parent M,McGuigan MA,Chicoine L,Lovejoy FH Jr

    更新日期:1983-05-01 00:00:00

  • Population-based study of the incidence, complexity, and severity of neurologic disability among survivors weighing 500 through 1250 grams at birth: a comparison of two birth cohorts.

    abstract::Mortality and incidence, complexity, and severity of early childhood neurodevelopmental disability are reported for two cohorts of preterm infants of 500 through 1250 g birth weight. Comparing 1978-1979 (cohort 1) and 1988-1989 (cohort 2), 1-year survival improved from 82 (36%) of 226 to 197 (67%) of 291. Cohort 1 sur...

    journal_title:Pediatrics

    pub_type: 杂志文章

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    更新日期:1992-11-01 00:00:00

  • Health outcomes of a community-based therapy program for children with cancer--a shared-management approach.

    abstract::Critical to providing cancer therapy to children in rural areas is finding dependable sources of therapy near the patients' homes. In this study, comparison was made of 668 visits by 24 patients to nearby private practitioners, who carried out 70% of the therapy, with 712 visits by 22 other patients for whom all care ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Kisker CT,Strayer F,Wong K,Clarke W,Strauss R,Tannous R,Janco R,Spevak J

    更新日期:1980-12-01 00:00:00

  • Unclear speech: recognition and significance of unintelligible speech in preschool children.

    abstract::Clarity of speech normally improves throughout the first few years of life, with acquisition of complete intelligibility by 4 years of age. Delayed emergence of intelligibility, or frankly unintelligible speech, often signify the presence of a major disturbance of language, overall cognitive development, or hearing. N...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

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    更新日期:1988-09-01 00:00:00

  • Acute disseminated encephalomyelitis in children.

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    pub_type: 杂志文章

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    authors: Murthy SN,Faden HS,Cohen ME,Bakshi R

    更新日期:2002-08-01 00:00:00

  • A parent questionnaire for developmental screening in infants born late and moderately preterm.

    abstract:BACKGROUND:The Parent Report of Children's Abilities-Revised (PARCA-R) is a questionnaire for assessing cognitive and language development in very preterm infants. Given the increased risk of developmental delay in infants born late and moderately preterm (LMPT; 32-36 weeks), this study aimed to validate this questionn...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2014-0266

    authors: Blaggan S,Guy A,Boyle EM,Spata E,Manktelow BN,Wolke D,Johnson S

    更新日期:2014-07-01 00:00:00

  • Circumcision policy statement.

    abstract::Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy's 1999 r...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2012-1989

    authors: American Academy of Pediatrics Task Force on Circumcision.

    更新日期:2012-09-01 00:00:00

  • MIS-C and Cardiac Conduction Abnormalities.

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  • Pediatric Orphan Drug Indications: 2010-2018.

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    更新日期:2017-05-01 00:00:00