bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letters to the Editor
Authors: BAKWIN HARRY 
Published: December 2021

Dr. Jacques May's experience with his autistic twins is not unique. Fortunately the leaders in psychiatry are coming to appreciate the role of psychiatry in increasing parental feelings of anxiety and guilt and a change of attitude is in the air.
I would agree with Dr. Grunebaum that the parents are important for the child as his first environment and that their influence On personality and character formations is profound. But this is not to say that the parents, as environment, are of prime importance in the genesis of serious behavior disorders in children. There are many reasons why children misbehave and it is for the clinician to approach a behavior problem as he does a problem in other branches of clinical medicine, namely by trying to make a diagnosis.
CLINICAL AND EPIDEMIOLOGIC OBSERVATIONS ON ENTEROVIRUS INFECTION IN A CIRCUMSCRIBED COMMUNITY DURING AN EPIDEMIC OF ECHO 9 INFECTION
Authors: Lepow Martha Lipson , Carver David H. , Robbins Frederick C. 
Published: December 2021

A clinical, epidemiologic and laboratory study was undertaken in a housing development during an epidemic of illness due to ECHO virus, type 9.
The clinical manifestations varied with age. The younger children exhibited an exanthem while older persons frequently had evidence of irritation of the central nervous system. Multiple cases occurred within families, with the incidence of illness highest in the younger age groups. No serious consequences of the illness were seen.
Echo 9 virus was recovered with greater frequency from the intestinal contents of young children with illness than from ill adults, although serologic evidence of recent infection in these adults could be demonstrated. The rate of inapparent infection with ECHO 9 virus was low. Virus rarely persisted in the feces beyond 14 days after onset of illness.
Group B Coxsackie viruses, type 4 and type 5, were found also to be the cause of many infections within the same population at the same time. Illnesses due to these viruses were similar to those due to ECHO 9 virus, except that no eruption was observed. The rate of inapparent infection was higher than that observed with ECHO 9 virus. Simultaneous infection with ECHO 9 virus and Coxsackie B4 or B5 virus was rare.
PROGNOSIS OF INFANTS BORN OF TUBERCULOUS MOTHERS
Authors: Kendig Edwin L. 
Published: December 2021

Of 41 infants born of mothers with supposedly inactive tuberculosis, 20 became infected with the disease. Of the 16 infants who were separated at birth from their mothers for periods ranging from 7 weeks to 2 years, 8 developed tuberculous infection.
This study suggests that isolation of infants until the mother's sputum is negative for tubercle bacilli and she is considered to have inactive disease may not be enough to prevent infection in the infant.
Supportive evidence is not presented here but, on the basis of studies by others with BCG vaccine, it is suggested that temporary isolation from the mother and BCG vaccination appear to constitute the best approach to prevention of infection of the infant.
Special Devices as Aids in the Management of Child Self-Mutilation in the Lesch-Nyhan Syndrome
Authors: Letts R. M. , Hobson Douglas A. 
Published: December 2021

The Lesch-Nyhan syndrome is a rare inborn error of purine metabolism associated with hyperuricacidemia, mental retardation, and an insatiable urge for self-mutilation, especially of the extremities. Insensitivity to pain and severe muscle spasms create very difficult management problems, especially for children being cared for at home. Fortunately this syndrome is rare (1 per 380,000 live births). Four known patients are under treatment in Manitoba, of which two brothers are the subject of this study.
In general, the medical management of these patients has been unsuccessful, especially in controlling self-mutilation. It therefore was decided to manage these children by the use of mechanical aids. Through the utilization of custom-designed seating devices control of the self-mutilation has been obtained, reducing the burden of family care. It is now possible for the children to attend regular school on a half-day basis. They are also able to engage in community activities without the fear that a mishap will occur when not under the vigilance of the immediate family.
Acetaminophen Poisoning and Toxicity
Authors: Rumack Barry H. , Matthew Henry 
Published: December 2021

Acetaminophen (paracetamol in British literature) is a metabolite of phenacetin which has become increasingly popular as a substitute for salicylates.1 The popularity of acetaminophen has been encouraged by the medical profession because it is allegedly safer than aspirin.2 However, experience in Britain indicates that acute acetaminophen overdosage is both common and significantly more toxic than of salicylates.3-7 Although it is widely used in the United States, only one report describing a single American patient has appeared in the literature.8 This is a puzzling situation. It is axiomatic that if you do not look for something you will not diagnose it. This may provide the answer as there is apparently a general lack of knowledge in the United States concerning the toxicity of acetaminophen. Indeed, one of us (B.H.R.) contacted nine American University poison services in the spring of 1973 and discovered that none had clinical experience or analytical methods in operation. During the past year, however, with a high index of suspicion in Denver, 156 ingestions with four fatalities have been recorded.
Because of the nonspecific initial features of acute overdosage, the lack of coma, the delay in onset of jaundice and the rapid fall in detectable plasma levels of acetaminophen, the cause-and-effect relationship may be missed in even a floridly ill or dying patient. Hepatoxicity is the most remarkable feature and the question must be raised as to how many cases of "jaundice of unknown etiology" are actually due to this drug.
This review is intended to provide an understanding of the current knowledge of this drug. It should be noted that although toxicity and fatalities have occurred in the adolescent age group, only one death in younger children has been recorded.
Cosmetic Nasal Deformities Complicating Prolonged Nasotracheal Intubation in Critically III Newborn Infants
Authors: Baxter Richard J. , Johnson John D. , Goetzman Boyd W. , Hackel Alvin 
Published: December 2021

Complications following prolonged endotracheal intubation in neonates have been widely reported.1-4 With increasing intact survival of infants who have received prolonged ventilatory assistance, these complications assume greater importance. This report concerns the particular complication of cosmetic nasal deformities secondary to nasotracheal intubation in critically ill newborn infants. A high incidence of this complication has not been previously reported.
The secure fixation of endotracheal tubes in neonates for long periods of ventilatory assistance is difficult. Techniques for fixation of both orotracheal and nasotracheal tubes2,6,7 have been described. Those utilizing adhesive tape are not entirely satisfactory. Secretions invariably dampen the tape, rendering the fixation ineffective.
Fetal Addiction to Pentazocine
Authors: Kopelman Arthur E. 
Published: December 2021

A case of neonatal withdrawal symptoms following maternal use of pentazocine was recently reported.1 This is the report of a second case with severe withdrawal symptoms which were successfully treated with phenobarbital.
CASE REPORT
A 2,180-gm, small-for-date, black female infant was delivered by cesarean section at 37 weeks' gestation. The mother, a 26-year-old gravida 3, para 0 woman with sickle cell anemia, had several painful sickle cell crises, congestive heart failure, pneumonia, and a urinary tract infection during this pregnancy. The two previous pregnancies had ended in abortion. In the second half of this pregnancy, she was treated with frequent packed-cell transfusions in order to decrease to less than 50% the number of her erythrocytes with sickle hemoglobin and hence the risk of clinical sickling.
What's Going On With Car Seats?
Authors: Weiss Jeffrey 
Published: December 2021

I was recently asked by a patient's mother for help in choosing a car seat for her child. Although I had seen advertisements for this type of product, none of my pediatric journals contained any information about the child automobile restraint devices available. Looking elsewhere, I found only confusing and conflicting statements.
The material from the American Medical Association pointed out that although car seats built after April 1971 had to meet federal standards, many unsafe models built earlier could still be purchased.
Another Case of Disseminated Candidiasis
Authors: Liberti John H. Di , Hughes Roberta A. 
Published: December 2021

We would like to report a case of disseminated candidiasis quite similar to the one reported by Hill et al. in Pediatrics.1
CASE REPORT
A 1,350-gm infant girl developed severe idiopathic respiratory distress syndrome shortly after delivery. An umbilical artery catheter was inserted. By 7 hours of age mechanical ventilation was required. Cultures were obtained and antibiotic therapy instituted
Mechanical ventilation continued for about six weeks. During this time peripheral hyperalimentation was given along with continuous nasogastric tube feeding.
Effects of Marihuana on Man
Authors: Yaffe Sumner J. , Bierman C. Warren , Cann Howard M. , Cohen Sanford N. , Freeman John , Segal Sydney , Soyka Lester F. , Weiss Charles F. , Chudzik Gregory , Ballin John C. , Del Prato Pierre S. , Done Alan K. , Farchione Louis , Oakley Godfrey , Sawchuk Steven , Scott C. P. , Simopoulos Artemis P. 
Published: December 2021

The Committee on Drugs has reviewed the pharmacology of marihuana with special emphasis on effects in man because of the enormous impact of this drug on society. Much of modern day society's reaction to and attitudes about this psychoactive agent does not reflect its pharmacology, and it is only recently that pertinent biologic facts about marihuana have become known. The Committee reports these facts here, in part, to inform the Academy membership of these facts and, in part, to provide a perspective with which to consider the various societal controls (i.e., laws) on the use of marihuana.
COMPOSITION
Marihuana is a mixture of leaves and flowering tops of the plant Cannabis sativa L. It contains approximately 1% Δ-9-tetrahydrocannabinol (THC), the principal psychoactive substance in marihuana. Street preparations tend to vary in Δ-9-THC content; the range is 0% to 5%. An average marihuana cigarette contains 500 mg of marihuana and, therefore, about 5 mg of Δ-9-THC. Hashish, usually used in Eastern (Asiatic) countries and in North Africa, is the resinous substance of the flowers and leaves of Cannabis sativa L in which Δ-9-THC is found. Hashish contains 5% to 15% Δ-9-THC and is usually smoked as a mixture of the resin and tobacco. Generally, marihuana cigarettes do not contain tobacco, although some street preparations do.
USERS
In considering adverse effects of marihuana, it is important to appreciate some pertinent epidemiologic facts. It is estimated that 24,000,000 Americans have tried marihuana at least once and that there are 8,300,000 current users in this country.1 Approximately 70% of adults and youth (12 through 17 years) who were found by the National Commission on Marihuana and Drug Abuse1 to use marthuana used it so infrequently as to be considered experimental users.
A Chart Audit Peer Review System in an Ambulatory Service
Authors: Russo Raymond M. , Gururaj Vymutt J. , Laude Teresita A. , Rajkumar Solomon V. , Ventre Susan A. 
Published: December 2021

A system of providing rapid review of ambulatory patient records using a set of criteria was developed and tested. Of 337 records selected for review, 25% were not reviewable. Of the remaining 75%, virtually one half proved to be lacking in one or more of the established criteria. Deficiencies tended to occur most often in criteria related to the physical examination of the child.
Physician compliance with the criteria could not be conclusively shown to improve during the five-month study period, although physician acceptability was judged as good.
A large percentage (47.3%) of deficient records could be corrected by the responsible health professional.
The chief advantages of the system are that it is rapid and easy to perform. It focuses on the major service provided by the facility, i.e., acute medical care, and on the performance of the individual providing that service.
Acute Suppurative Otitis Media
Authors: Rowe D. Stewart 
Published: December 2021

Most pediatricians recognize and treat acute otitis media several times each day. Yet there is wide disagreement about certain aspects of its diagnosis and treatment, despite a large and growing literature on the subject. This review attempts to summarize what is known about acute otitis media in children.
DEFINITION
Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. Suppurative otitis media can be diagnosed positively only by aspiration of purulent fluid from the middle ear, but this procedure is rarely necessary for initial diagnosis and management. Clinical findings helpful in distinguishing suppurative from secretory otitis media are discussed below.
INCIDENCE
In a study of 847 British children during the first five years of life, 19% had at least one episode of otitis media; one third of these had more than one episode. This was considered to be a minimal estimate in these children, since otorrhea was the chief criterion for diagnosis.
AAP Code of Ethics for the Use of Fetuses and Fetal Material for Research
Authors: Hodes Horace L. , Brown Rowine H. , Holliday Malcolm A. , James L. Stanley , Katcher Avrum L. , Katz Samuel L. , Sparling David , Yaffe Sumner J. , Kretchmer Norman 
Published: December 2021

Research on the fetus and newborn is of the greatest importance in contributing to the health and welfare of the entire population. Such research, motivated by humane concern, should be continued and fostered, subject to adequate and clearly defined safeguards.*
The American Academy of Pediatrics recognizes that through research involving previable fetuses, new knowledge may be gained which would ultimately benefit viable infants. The American Academy of Pediatrics also recognizes that some of these areas of research, while not jeopardizing the health and welfare of the fetus, are not of direct benefit to that particular fetus. In such cases express consent should be obtained from the parent. "The whole previable fetus has offered an important opportunity that cannot be obtained in any other way for making observations of great value on the transfer of substances across the human placenta, the reaction of the immature fetus to drugs, and on the endocrinological development of the fetus and the development of the placenta."1
Research activities involving the fetus in utero or pregnant women may be undertaken1 for the purpose of benefiting that particular fetus or to respond to the health needs of the mother,2 as part of the procedure to terminate the pregnancy, and for the purpose of evaluating or improving methods of prenatal diagnosis, methods of prevention of premature birth, or methods of intervention to offset the effects of genetic abnormality or congenital injury or to ascertain the safety and efficacy to the fetus of drugs which might be needed by pregnant women.2
Overview Statement on Medical Records
Authors: Thompson Hugh C. , Barron Stanton J. , Connelly John P. , Margileth Andrew , Olmsted Richard , Rectanus Daniel R. , Ushkow Martin C. , Osborne Charles E. 
Published: December 2021

Historically, medical records have been maintamed by individual physicians to record specific information concerning patients. This information was often understandable only to the writer. The data were of outstanding events. This was thought to be sufficient documentation for patient care.
Records are now read by others than the individual physicians. Groups of physicians working together often share the same patients and their records. Patients may have multiple sources of care. Our population has become more mobile which makes it necessary to transfer vast amounts of medical information. The medical record many times is the one instrument which gives a complete and continuous documentation of the patient's medical history.
Third-party payers are requesting access to medical records to document services provided. Chart audit is being tested as a mechanism for evaluating physician performance. Records must reflect what the physician does in order to be useful in such an appraisal. Much clinical research on the delivery of health care depends on accurately kept records which are easily interpreted. A chart is also a legal document for the protection of the physician as well as the patient. Thus, records will be used in other than traditional ways. Proper confidentiality must be maintained when such uses are necessary.
Physicians generally agree as to the essential content of a medical record. However, there is little unanimity as to the structure of the chart. No one system of keeping records is now appropriate for all situations.
The maintenance of adequate charts requires additional cost in both time and money.
Remarks on Receiving the C. Anderson Aldrich Award
Authors: Freud Anna 
Published: December 2021

I take the honour which is being bestowed on me today as another welcome sign that the estrangement between pediatrics and child psychology is nearing its end and the partners on either side are contemplating a serious engagement, if not the propect of future marriage with each other. There are many other indications which point in the same direction. I only need to mention the fact that there are now places of learning where the head of the department combines in his own person training and functions in physical as well as mental child care; or that pediatricians are considered essential consultants in child guidance clinics, or that some pediatricians participate in the discussions of interdisciplinary hospital groups, or that, occasionally, child psychiatrists and even child analysts are called to the bedside of hospitalized children for consultation.
There is no reason, on the other hand, to feel entirely optimistic and to relax efforts towards further re-alignment. Cooperative attitudes between the two disciplines can also be regarded still as few and far between and, above all, confined to selected medical specialities and a small number of selected, furthest advanced, and enlightened centers. There exist still many children's wards where bodily care is so paramount that any thought about the child's mental concerns is excluded as intrusive and disruptive. There are, above all, the many surgeons who, rightly or wrongly, feel that their difficult task cannot be accomplished except by determined and exclusive concentration on the defective body part which needs repair.
Locomotor Skills and School Accidents
Authors: Angle Carol R. 
Published: December 2021

This is a report of the association of immature or deficient locomotor skills with school accidents, predominantly falls, in children aged 6 to 9. An association of superior physical skills with increased accidents was not apparent until grades 4 to 6 (ages 9 to 12).
Medical care of an accidental injury is given each year to 30% of children aged 5 to 15. Falls and collisions account for 60% of annual accidental injuries. The frequency of injury from falls is highest in the young boy; fatalities, however, increase at the extremes of the age spectrum and relate to the poor locomotor skills and decreased tissue resistance of the very young and the very old.
Rucksack Palsy
Authors: Rothner A. David , Wilbourn Asa , Mercer Robert D. 
Published: December 2021

In recent years there has been an increase in the use of backpacks and rucksacks by nonmilitary ary personnel. An estimated 3 million individuals engage in hiking and mountain climbing, and countless others use these packs on campus. We report a case of brachial plexus injury sustained by an individual wearing such a pack.
CASE REPORT
A 15-year-old right-handed white boy was examined for pain in the left shoulder of two weeks' duration. The youngster had been well, but two weeks' before evaluation was on a hiking expedition. During this trip he wore a rucksack which when filled weighed 20.4 kg (Fig. 1).
The Significance of the Babinski Sign in the Newborn—A Reappraisal
Authors: Ross Elliott D. , Velez-Borras Jesus , Rosman N. Paul 
Published: December 2021

A study of the clinical significance and the stimulus methods used to elicit the Babinski sign in normal newborns has been carried out. Although the most frequent response to cutaneous nociceptive stimulation of the lateral sole in neonates was extension of the great toe, a small but significant number of flexor responses were obtained. Consequently, the Babinski sign has limited clinical usefulness as a reflex indicating the presence or absence of neurological disease in the newborn.
In reviewing previous studies in the literature, it was apparent that the widely differing percentages of extensor plantars reported in newborns was related directly to differences in the technique of examination.
Hepatic Hemangioendothelioma: Hemodynamic Observations and Treatment
Authors: Rocchini Albert P. , Rosenthal Amnon , Issenberg Henry J. , Nadas Alexander S. 
Published: December 2021

The clinical course of five infants with hepatic hemangioendothelioma is reviewed. Hemodynamic abnormalities observed at cardiac catheterization included an increased cardiac output (range, 9.2 to 10.5 liters/min/sq m) with over 50% of this output being shunted through the arteriovenous malformation, an elevated right and left end diastolic pressure (8 to 10 mm Hg and 9 to 15 mm Hg respectively), a small systolic pressure gradient across the pulmonary outflow tract (4 to 6 mm Hg), and mild elevation of pulmonary artery pressure (range, 35/16 to 37/12 mm Hg).
All four patients treated with prednisone improved while on therapy; three are well one to three years after cessation of therapy. One patient died from unrecognized congestive heart failure following discontinuation of prednisone and another before prednisone was started. We conclude that prednisone in high doses (2 to 4 mg/kg/day) with the addition of digitalis and diuretics for control of congestive heart failure is an effective treatment regimen for infants with hepatic hemangioendothelioma.
Dr. North Replies
Authors: North A. Frederick 
Published: December 2021

I can only agree with Dr. Thorpe that the advice given in "Screening in Child Health Care"1 and "A Guide to Screening, EPSDT, Medicaid"2 has numerous limitations. I would argue, however, that these limitations are clearly described in both publications, along with the reasons for the limitations.
The interview schedules (and physical examination forms) published in the guide and summarized in the symposium were derived through an extensive set of correspondence and interviews with the panel of experts listed in the guide.