bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRAFFIC ACCIDENTS INVOLVING CHILD PEDESTRIANS: A PROGRAM FOR THEIR PREVENTION
Authors: Read John H. 
Published: December 2021

The two papers that follow report the results of painstaking epidemiological work on pedestrian accidents involving children. Because these papers relate the age of the child to specific behavior patterns that result in accidents and to specific injury patterns that result from such accidents, they would appear to offer a sound empirical base for the development of a variety of countermeasures, whether such countermeasures are intended to reduce accidents or to limit the severity of the resulting injuries.
Unfortunately, however, the ability to generalize such data is extremely limited. A given pattern of child-pedestrian behavior is the result of a highly complex set of variables: the social class and ethnicity of the child, the ecological characteristics of the neighborhood and the broader community, the characteristics of the traffic pattern and the types and density of the vehicles that make it up, the current enforcement policy, climatic conditions, road and highway characteristics, and a host of other conditions that combine and interact in various ways. Consequently, few localities are sufficiently similar to justify the application of data from one to another. The injury patterns described by Ryan, for example, are those produced by Australian vehicles on children walking, playing, and cycling in a specific Australian city. It seems quite unlikely that the injury patterns produced in an American urban environment would resemble those that Ryan reports. Indeed, data from another Australian city might show striking differences.
For the same reasons, such data as Read presents cannot be used reliably as a before-and-after measure to assess the effectiveness of a specific countermeasure. Any significant changes in the data after the introduction of a countermeasure might well be attributable not to the countermeasure itself but to changes in traffic patterns, ecology, the weather, or other events which operated to reinforce or counteract the countermeasure in question.
The overwhelming obstacle to systematic research in vehicular accidents and on the assessment of countermeasure effectiveness is the investigator's inability to control the numerous variables that affect both the incidence and the consequences of accidents. The present papers, despite their inherently interesting data, are seriously limited by this problem.
CHILDHOOD INJURY AND PEDIATRIC EDUCATION: A CRITIQUE
Authors: Meyer Roger J. 
Published: December 2021

The medical school, the school of engineering, the liberal arts college, and the high school all share a common problem today: the exponential growth of knowledge and the increasing complexity of contemporary society have caused numerous demands for further crowding their already crowded curriculums. Thus, there are those who believe that high school students "must" get driver education, that engineering students "must" learn something about the social sciences, that liberal-arts students "must" have a course in computer technology. Often these needs are "felt" by their proponents rather than demonstrated objectively, and often the proponents seem unaware that the subject matter they advocate might be acquired with equal or greater effectiveness outside a formal curriculum.
The paper that follows, however, distinguishes itself in several ways from the hortatory pleadings characteristic of special-interest groups. To begin with, it demonstrates the cost-benefits of sound injury-control teaching in departments of pediatrics. Secondly, it points out that much needs to be done in the development of materials and methods before a demonstrably sound program can be proposed. (In both these respects the author provides a sharp contrast with the proponents of driver education, who have successfully lobbied into the American high school curriculum a program whose methods and materials have never been subjected to systematic evaluation and whose outcomes have been questioned by responsible research.) Lastly, the paper does not propose that the departments of pediatrics is the "ideal" or "inevitable" site for the teaching of injury control; rather, the responsibility for the program is seen as shared among many community institutions and agencies.
The paper does not, unfortunately, address itself to the question of the role of the pediatrician in injury control, although this question needs to be answered before adequate materials and methods can be fully developed. Should the pediatrician's role be a purely preventive one? And, if so, should he focus his efforts on the patient and his family or on environmental hazards in the community as a whole or on the broad social, cultural, and technological factors found to be related to accidental injury in children? Should he be sufficiently trained in research methodology to carry on his own investigations or should he be taught to work with other specialists in an interdisciplinary context? A number of papers in this volume demonstrate the methodological inadequacies of even the most dedicated pediatrician. On the other hand, interdisciplinary research, despite the lip service which it constantly receives, is beset with problems and has produced few findings that can be incorporated into action programs or that offer clear guidelines for the teaching of injury control-in medical schools or elsewhere.
As the paper makes clear, the student in a medical school today learns little to make him effective in reducing childhood injury. But, what, when, and how he is to be taught remain unanswered questions.
ANNUAL SUMMARY OF VITAL STATISTICS—1968
Authors: Wegman Myron E. 
Published: December 2021

Infant mortality declined again in 1968, for the third successive year, and there is some evidence of a more rapidly downward trend in the unacceptably higher infant death rates which have existed among some population groups. The birth rate also declined again, but the marriage rate showed rather a sharp rise ( Table I ). With an excess of births over deaths of 1.55 million persons, the rate of natural increase was 7.8 per 1,000 population.
Births Once more there was a decline in annual number of births, although a smaller one than last year. Nevertheless, with a rising population the birth rate fell to 17.4, the lowest ever recorded in the United States.
Drug Abuse in Adolescence
Authors: Tapper Theodore S. 
Published: December 2021

The report of the Committee on Youth concerning "Drug Abuse in Adolescence" (PEDIATRICS, 44: 131, 1969) has many valid points to make. However, there are several issues which the report raises which concern me.
Virtually no mention at all is made of the two prime offenders among the abused drugs:alcohol and tobacco. Simply because their use is legal and their deleterious effects are more of a chronic nature is no reason to ignore them. Far more deaths and chronic, debilitating illness, as well as acute trauma in auto accidents, are caused by these agents than by those mentioned in the report.
Currents in American Medicine: A Developmental View of Medical Care and Education, by Julius B. Richmond, M.D., with a foreword by Ward Darley, M.D. Cambridge, Massachusetts: Harvard University Press, 1969. 138 pp., $5.50
Authors: Cone Thomas E. 
Published: December 2021

In only 138 pages, the author, a distinguished pediatrician, as well as the Dean of one of our major medical schools, offers a succinct historical review of the turbulent changes in American medicine since 1940. No period in our history has seen more dramatic transitions; in fact, the tempo and thrust of events since this century began have drastically altered every facet of medicine.
All medical schools are in a Sisyphean struggle to make their curriculum "relevant" and in keeping with the pace of social change.
The Young Male Prostitute
Authors: Hick John F. 
Published: December 2021

After reading Deisher's article, "The Young Male Prostitute" (Pediatrics,43:936, 1969) and the companion editorial by Solnit, "Bisexuality Gone Astray," many a subscriber must have mused over the prospect of a sequel editorial taking "Pediatrics Gone Astray" for its title.
The only distinction Deisher claims for his study is that it is the first sociologic investigation of the professional male deviant. No other distinction is in sight, yet Solnit strains with sometimes meaningless grandiloquence to reach for a profound implication arising from the study.
MODERN CONCEPTS OF LOWER URINARY TRACT OBSTRUCTION IN PEDIATRIC PATIENTS
Authors: Shopfner Charles E. 
Published: December 2021

Awidely recognized concept in pediatric uroradiology is that urinary tract infection is usually secondary. A consultation request commonly suggests, "urinary tract infection—rule out obstruction." Vesicoureteral reflux and hydronephrosis are the abnormalities most often found by the radiologist. The conclusion that the infection is secondary comes from old concepts that reflux and hydronephrosis are always secondary to obstruction, and, therefore, that the infection itself is also thus produced.
The bladder neck, the meatus, and the distal urethra are widely recognized as sites of obstruction, because the reflux and hydronephrosis are usually bilateral and require an obstruction that causes symmetrical back pressure.
THE FIRST DETAILED DESCRIPTION OF MUMPS BY ROBERT HAMILTON, M.D. (1721-1793), PUBLISHED IN 1790
Authors: C. T. E. 
Published: December 2021

Although Hippocrates mentioned orchitis as a complication of mumps, a full description of this disease did not appear in print until 1790 when Dr. Robert Hamilton described the clinical course of mumps as follows:
A lassitude, a heaviness, a general restless uneasiness not easily described are perceived several days before the swelling which characterizes the disease begins to appear. These disagreeable feelings are attended with . . . some degree of fever, which being slight is commonly disregarded. Then a stiffness with obtuse pain, is felt in one or both sides of the articulation of the lower jaw, impending its motion and of course mastication: which symptoms increasing, a swelling appears upon the parts the following day, and quickly extends to the parotid glands, the neighbouring skin, and cellular membrane. Here in some it stops without discolouring the skin . . . the tumor becomes more diffuse and sometimes increases so suddenly in size that on the third day from its first appearance it occupies the salivary glands and surrounding cellular membrane on the side; and if both sides are affected, the parts are so much swelled and the tumor descends so low, that the countenance is rendered of a frightful enormous magnitude; and now deglutition becomes more or less impeded. All this is frequently without much pain; but . . . commonly there is . . . a considerable degree of fever. In many subjects here it ends . . . And it seems probable from the natural resolution of the disease, which now immediately follows, that the tumor has attained its greatest magnitude and the distemper it came from about the morning of the fourth day from the first appearance of the swelling.
CELLULAR GROWTH, NUTRITION AND DEVELOPMENT
Authors: Cheek Donald B. , Graystone Joan E. , Read Merrill S. 
Published: December 2021

Traditionally, the biological sciences have focused their attention on the whole organism, on organs as functional units, or on individual tissues in the quest for knowledge of mechanisms controlling development. Alternatively, the biochemist and endocrinologist have explored enzymes and metabolic pathways seeking the same goals. Improved methodologies now permit convergence of these approaches in the study of cells as fundamental units of structure and function. As this review has emphasized, the preliminary results are encouraging and exciting.
The concept of critical periods in development has been repeatedly emphasized. Systematic exploration of the effects of imposed nutritional variables on cell ploidy, the appearance or disappearance of enzyme systems, and the production and/or functional expression of hormones will shed light on imprinting effects of early deficiencies on the growing organism. Sex and age differences in these parameters are most thought provoking, as is the potential application of cell methods to diagnosis or monitoring progress of childhood diseases. Particularly exciting are the studies seeking to explain the consequences of malnutrition on nerve cell development, an understanding of which may perhaps identify a biological basis for subsequent behavioral abnormalities. A potentially fruitful area for study is the aging process, with emphasis on improved understanding of cellular changes associated with maturation and decline in cellular function.
Acceleration of progress in this field will depend on refinements in methods for counting cells and estimating cell size or functionality. Special attention needs to be given to DNA as the index for cell function in the light of recent questions concerning the nature and location of DNA in different cells. More direct measures of cell function are needed inasmuch as large cells may not in fact be more functional cells.
Comparability of findings from experimental animals to developmental processes in subhuman primates and humans need clarification. The need for new experimental models (including invertebrates) for research on cellular aging is particularly pressing. The adaptation of cell culture techniques to nutritional problems is another promising area for expanding research.
The cellular approach to nutrition promises new explanations for nutritional influences on development. The data presently available partly explain why nutritional insults at a given time have permanent repercussions throughout life. These and future findings will be significant beyond the laboratory setting, having impact upon clinical diagnosis as well as on the design and implementation of improved nutrition service programs.
Low Birth Weight and Subsequent Development
Authors: Illingworth R. S. 
Published: December 2021

I was most interested to read the paper by Eaves, et al. They have helped to remedy the defects of most earlier papers on the prognosis of "prematurity" by carefully distinguishing small-for-dates babies from true premature babies.
They found that Griffith's infant test scores correlated badly with test scores at 4 years. I would not expect them to have a high predictive value, apart from the effect of environmental variables in the intervening period, because several of the Griffiths tests have no bearing on intelligence, and the method does not allow one to take into consideration the factors which may have affected the score and which are unrelated to intelligence.
Letter To The Editor
Authors: Urschel Harold C. 
Published: December 2021

Dr. Urschel comments as follows:
We were not aware of Mr. Carré's contributions, and we wish to apologize for not including his work in the background material.
Our thinking has been influenced by Mr. Ronald Belsey, who in 1952 first made reference to gastroesophageal reflux with or without hiatal hernia producing pulmonary symptoms in adults, children, and infants.
We agree with Mr. Carré on most points although his experience with infants and smaller children is far greater than ours, which has been with older children and approximately 2,000 adults.
THE TREATMENT OF CHRONIC UREMIA IN CHILDHOOD I. TRANSPLANTATION
Authors: Potter Donald , Belzer Folkert O. , Rames Linda , Holliday Malcolm A. , Kountz Samuel L. , Najarian John S. 
Published: December 2021

Twenty-seven renal allotransplants were performed in 25 children less than 17 years of age between April 1964 and September 1969. Sixteen were from living, related donors, and 11 were from cadaver donors. There was one death and one rejection in the living donor group, and five deaths and one rejection in the cadaver donor group. Ten recipients weighed less than 20 kg, and all but two received adult kidneys. Four children received transplants because of bilateral Wilms' tumor.
Complications included infection, immunologic rejection, pulmonary disease, recurrence of glomerulonephritis, and aseptic necrosis of bone. Growth retardation occurred in 7 of 10 children and sexual development was delayed in 2 of 3 children following transplantation. These factors were best correlated with steroid administration. Rehabilitation was generally good, however; and the results of transplantation in children equalled or surpassed those in adults.
Chronic Urinary Tract Infections in Children: A Double-Blind Study of Medical Management
Authors: RAY C. George , Ching Yi-Chuan , Shurtleff David B. , Hill Margaret L. , Ansell Julian S. , Wedgwood Ralph J. 
Published: December 2021

Nine children with nonobstructive urinary tract infections, 10 children with neurogenic bladders secondary to meningomyeloceles, and 2 children with ileal bladders have been studied in a double-blind program of medical management for recurrent urinary tract infections.
Observations indicate that some patients with nonobstructive recurrent UTI's may benefit from long-term chemoprophylaxis; however, the effective drug may vary from patient to patient. Furthermore, not all patients need continuous therapy, although initial clinical differentiation is not currently possible. In all patients, the essence of management consists of frequent, careful evaluation, with periodic assessment of anatomic and functional status of the urinary tract.
Among children with anatomic and physiologic abnormalities of the urinary tract, neither continuous chemotherapy nor therapy of asymptomatic bacteriuria appears beneficial.
Valium in Management of Status Epilepticus: A Correction
Authors: Carter Sidney , Gold Arnold 
Published: December 2021

In relation to our article, "Care of the Critically Ill Child: Management of Status Epilepticus" (Pediatrics, 44:732, 1969), it has been brought to our attention that the addition of diazepam (Valium) to sterile water results in a cloudy mixture. Since diazepam is insoluble in water and might result in an unequal dispersion of the compound, the manufacturer recommends that injectable diazepam not be diluted.
For this reason, we wish that Pediatrics would modify our recommendation by stating that injectable diazepam should only be administered in the undiluted form.
THE FIRST DESCRIPTION OF CHICKENPOX AS A DISEASE, BY WILLIAM HEBERDEN THE ELDER (1710-1801) IN 1767
Authors: C. T. E. 
Published: December 2021

Both Rosén von Rosenstein (1706-1773)1 and François Boissier de Sauvages (1706-1767)2 came close to differentiating varicella from variola. But, it was left to William Heberden3 to give the first detailed description of chickenpox as a disease sui generis in 1767 as follows:
These pocks break out on many without any illness or previous sign: in others they are preceded by a little degree of chillness, lassitude, cough, broken sleep, wandering pains, loss of appetite and feverishness for three days. In some patients I have observed them to make their first appearance on the back, but this perhaps is not constant. Most of them are of the common size of the smallpox but some are less. I never saw them confluent nor very numerous. The greatest number which I ever observed was about twelve in the face, and two hundred over the rest of the body.
On the first day of the eruption they are reddish: on the second day there is at the top of most of them a very small bladder about the size of a millet seed. This is sometimes full of a watery and colourless, sometimes of a yellowish, liquor contained between the cuticle and the skin.
On the second or at the farthest on the third day from the beginning of the eruption as many of the pocks as are not broken seem arrived at their full maturity, and those which are fullest of that yellow liquor very much resemble what the genuine smallpox are on the fifth or sixth day especially where there happens to be a larger space than ordinary occupied by the extravasated serum.
RESEARCH ISSUES IN CHILD HEALTH. II. SOME MEDICAL AND ECONOMIC ISSUES
Authors: Haggerty Robert J. 
Published: December 2021

I have in this discussion advanced the notion that we should combine our humanitarian principles with our critical research questions and carry out the bold medical care experiment characteristic of Head Start's educational goals. We should ensure that children receive a basic comprehensive medical care program and then combine it with controlled experiments to answer some of the high priority questions about which we have so little data, such as manpower innovations, medical needs, screening tests, attitudes, utilization, prevalence data, and costs.
The solution, as in so much of life, is not a rigid adherence to a limited, parsimonious program or a totally uncritical and wasteful approach, but a middle ground. The middle is always hard to find and even more difficult to maintain. A comprehensive care program with certain guidelines, requirements of quality, and restrictions on unnecessary procedures is my middle ground with simultaneous stimulation through incentives to carry out specific research projects on top of this.
Tuberculous Meningitis During Chemotherapy for Pulmonary Tuberculosis
Authors: Steiner Morris , Steiner Phillip 
Published: December 2021

The report of a case of tuberculous meningitis developing during the course of chemotherapy for pulmonary tuberculosis, by Lintermans and Seyhnaeve,1 illustrates the importance of drug susceptibility testing of the infecting organism. Initial cultures isolated from the gastric washings in this case were not tested for drug susceptibility, but subsequent cultures isolated from the spinal fluid after 33½ months of therapy proved to be isoniazid resistant.
The authors state that "this complication (meningitis) developed despite specific chemotherapy and corticosteroids for active pulmonary tuberculosis."
Letter To The Editor
Authors: Lintermans John P. , Seyhnaeve Victorine 
Published: December 2021

Drs. Lintermans and Seyhnaeve commented as follows:
We agree with Drs. Morris and Phillis Steiner that the use of corticosteroids on our reported case1 might have contributed to the development of tuberculous meningitis 3½ months after the initiation of specific therapy for pulmonary tuberculosis. The fact that the infecting organism was isoniazid resistant seems to substantiate this possibility.
On the other hand, documented cases of tuberculous meningitis, due to isoniazid susceptible organisms, developing during the course of chemotherapy (including isoniazid) for pulmonary tuberculosis have been described.2-4
Child Health and Community Health Centers in the Americas
Authors: Elbualy M. S. 
Published: December 2021

Those of us interested in the health (health in its widest sense) of the masses, especially those masses which are underprivileged, are delighted with the appearance of more and more articles in medical journals related to this subject.
However, it pains me to see the Committee on International Child Health1 propose and recommend more studies in order to delineate the most effective elements of community comprehensive child care. It seems we keep doing studies and then either never apply what was found or recommend further study of the study.
CONTINUING MEDICAL EDUCATION THROUGH SELF-EVALUATION
Authors: Daeschner C. W. , Hughes Gerald E. 
Published: December 2021

In the late spring of 1970 the American Academy of Pediatrics will offer to its Fellows (and to interested nonmembers) a new continuing educational opportunity. Similar programs have been developed by other specialty societies for their members (American College of Physicians, American Psychiatric Association, and American Society of Anesthesiologists). Parenthetically, it should be explained that the more familiar term, postgraduate education, is now generally reserved for house staff-oriented, hospital-based programs, while continuing medical education is the preferred term for educational offerings directed to the practitioner.
Behind a broad resurgence of interest in the continuing education of the practitioner lies a growing body of criticism from professional and lay groups.