bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Tuberculin Screening in an Urban Pediatric Clinic
Authors: Kraut J. R. , Christoffel K. K. , Berkelhamer J. E. , Boddie-Willis C. 
Published: December 2021

The American Lung Association (ALA) and Center for Disease Control (CDC) have stated that routine screening of children is an inefficient and ineffective method for detection of tuberculosis in the United States. This is at variance with prior recommendations. Our objective, therefore, was to assess prospectively tuberculin screening for our urban, primarily low socioeconomic, clinic population. A prior chart review revealed that only 36% of tuberculin tests had written documentation of results. The following improvements were made: (1) One trained technician administered all tests and recorded data. (2) One hospital mail box was used for receiving tuberculin test postcard results. (3) Telephone follow-up was begun. This resulted in an increase of results documented to 84% (P .001). After these improvements, we prospectively studied the next 1,233 routine screening tests over a period of eight months. The written documentation rate during the study was 90%. Thirteen positive tuberculin tests were found. Three patients had subsequent negative tuberculin tests. One patient received Calmette-Guérin bacillus (BCG) as an infant and had multiple positive tuberculin tests in the past. One patient was lost to follow-up. Eight positive patients were confirmed as new converters. Of these eight patients, six had histories of prior positive tuberculin tests, recent TB exposure, foreign travel, or symptoms.
We conclude that: (1) Prior to the study, recording of tuberculin tests was severely deficient. (2) Reorganization significantly increased the documentation rate. (3) Of 1,233 consecutive tests, eight unsuspected cases were found. This is below the 1% conversion rate recommended by the CDC for routine TB screening in children. (4) The data support the ALA-CDC statement regarding the low yield of routine tuberculin testing of healthy children. (5) However, abandoning tuberculin screening of healthy children would leave undetected a few children with unsuspected tuberculosis infection, who would then be in danger of developing serious illness.
Complete Biliary Obstruction Due to Erythromycin Estolate Administration in an Infant
Authors: Krowchuk Daniel , Seashore John H. 
Published: December 2021

Cholestatic jaundice occurring as the result of treatment with erythrornycin estolate is a well known entity in adults, but less than 2% of all reported cases occur in children under 12 years of age.1 Rarely has this adverse reaction been noted in infants less than 1 year of age.2 We present the case of a young infant who manifested clinical findings suggestive of biliary atresia following a course of treatment with erythromycin estolate.
CASE REPORT
A previously healthy 6-week-old infant was evaluated by his private physician for an acute illness characterized by fever (100.5 C) and irritability. There was no jaundice noted at this time, and other family members were well.
Love, Logic, and Other Approaches to Prevention
Authors: Starfield Barbara 
Published: December 2021

Baker's1 on accidents to passengers in motor vehicles inform us that infants, particularly young infants, are at greatest risk of death. Most pediatricians would have guessed otherwise, knowing that toddlers' newly acquired locomotion skills, independence, and inquisitiveness generally make them the most vulnerable target. Why, in this case, is the youngest most likely to suffer?
It is possible that young infants are at greatest risk because they are passengers in cars more often than older children, but Baker1 cites evidence that they are actually less likely to travel in cars than older children. This means that the youngest, exposure for exposure, are even more at risk, probably because they are more vulnerable anatomically and because they are held in arms rather than in proper infant carriers.
Catecholamine Metabolites in Congenital Sensory Neuropathy with Anhydrosis
Authors: Shekim Walid O. , Daniel Anasseril E. , Koresko Richard L. , Dekirmenjian Harutoune 
Published: December 2021

Congenital sensory neuropathy with anhydrosis is a rare syndrome in childhood, characterized by disturbed thermoregulation and by absence of pain and sweating.1,2 The etiology is unknown, but researchers postulate the presence of a disorder in the function of the autonomic sympathetic nervous system.3 From among the numberous etiologies considered to play a role in the pathophysiology of the syndrome, we list a few that are relevant to this report: (1) disturbance of catecholamine metabolism,3 (2) an inborn error of metabolism involving a minor pathway of tyrosine metabolism,4 and (3) low biological activity of nerve growth factor (NGF).5
Clinicians have used urinary catecholamine metabolites in the diagnosis of the syndrome.3
Abetalipoproteinemia Presenting as Severe Vitamin K Deficiency
Authors: Caballero Fernan M. , Buchanan George R. 
Published: December 2021

Vitamin K deficiency has occasionally been observed in infants after the immediate neonatal period when one or more of the following features is present: diet consisting entirely of breast milk, failure to receive prophylactic vitamin K shortly after birth, therapy with broad-spectrum antibiotics, or chronic diarrhea accompanying malabsorption due to cystic fibrosis or to various acquired causes.1-7 In this report we describe for the first time an infant with the uncommon autosomal recessive disorder abetalipoproteinemia whose major presenting manifestation in early infancy was hemorrhage due to vitamin K deficiency.
CASE REPORT
A 6-week-old baby was brought in for evaluation because of a two- to three-week history of easy bruising.
The Conscience of Pediatricians in Sweden and the United States
Authors: Observer Perplexed 
Published: December 2021

The relationship between pediatricians and the infantfood/pharmaceutical industry in Sweden seems to be different than it is in the United States. The contrast is highlighted by two sets of observations:
1. The Swedish Paediatric Association has criticized the role of the infant-food industry in poor countries and it has published a code of ethics for marketing infant foods.1 On May 18, 1979, the Association issued a statement2 indicating that it intends to monitor the activities of the Swedish companies in Turkey.
Criteria for Early Infant Discharge and Followup Evaluation
Authors: Brann Alfred W. , Hall Robert T. , Harper Rita G. , Little George A. , Maisels M. Jeffrey , McCracken George H. , Poland Ronald L. , Sunshine Philip , Whittinghill John A. 
Published: December 2021

INTRODUCTION
It is cautioned that there is an element of risk in early discharge insofar as medical supervision during the infant's transitional period must, of necessity, be intermittent rather than continuous. With this in mind, the following guidelines are suggested.
CRITERIA FOR EARLY INFANT DISCHARGE
1. Attendance at prenatal childbirth education and infant care classes where problems of the first three to five days of life are included.
2. Identification of a supporting person to assist with care at home in the neonatal period.
3. Identification of physician-directed source of continuous medical care following hospital discharge. This should include an appointment at 2 to 3 days of age.
4. Uncomplicated antepatum, intrapartum, and postpartum course of both mother and infant.
5. Term infant (38 to 41 completed weeks) who is normally growrn (2,500 to 4,500 gm) and who is examined by a physician prior to discharge and found normal.
6. A minimum of six hours of hospitalization during which time the infant has achieved thermal homeostasis and fed successfully (demonstrated a normal suck and swallowing mechanism).
7. Laboratory data: (a) maternal or cord blood serologic test for syphilis; (b) cord blood (or infant blood) type and Coombs if mother Rh negative or type O. A Coombs test should be performed on all infants if a screening test for irregular antibodies was not performed during pregnancy; and (c) hemoglobin and blood sugar determinations as clinically indicated.
8. Maternal skill and demonstrated ability with: (a) feeding technique; (b) skin care, including cord care; (c) temperature assessment and measurement with thermometer and (d) assessment of infant well being and recognition of illness.
Metrication and SI Units
Authors: Hohn Arno R. , Amler Alfred B. , Bergeson Paul S. , Gold Harvey R. , Griggs Stewart L. , Shattuck Gerald B. , Singer Stanford A. , Smith Edwin Ide , Wingert Willis A. 
Published: December 2021

Because of the increasing international use of the SI system (International System of Units) in medicine, the Committee on Hospital Care has written this statement to familiarize pediatricians with this concept. The current state of the system, its derivation, purported advantages, and controversial aspects are described; and the Committee has made specific recommendations for consideration regarding its future use and development.
BACKGROUND
The British Imperial System of Weights used in the United States today derives from a variety of ancient cultures. A Roman contribution is the use of the awkward number 12 as a base. Royal decree established the yard as the distance from the tip of the nose to the end of the thumb of King Henry I. The inch was based on the size of three grains of barley "dry and round." Equally illogically derived units evolved to eventually form the irrational English "system."1
The metric system with its "base-10" or "decimal" system derived its units of mass and volume from its units of length, thus correlating its basic units to each other. The need for further refinement of metrics and a single worldwide and interdisciplinary system of measurements led to the development of the International System of Units (le Systeme International d'Unités) with the international abbreviation "SI." This is sometimes referred to as "the modern metric system" and is said to complete the process of metrication.2
Seventeen countries, including the United States, signed the Metre Convention in 1870. This led to the establishment of the International Bureau of Weights and Measures at Sèvres, France, which acts as an international standards reference laboratory and as the permanent secretariat for the Metre Convention.
Effects of Televised Drug Commercials on Children
Authors: Sheiman Deborah J. 
Published: December 2021

Pediatric quality care must consider the effects of psychological and sociological influences on the child. One such influence that should be brought to the attention of pediatricians is the effects on children of televised commercials for nonprescription drugs. The average American child views an estimated 1,000 commercials for nonprescription drugs each year.
Children are more vulnerable than adults to television commercial advertising. Under the age of 5, they have very little, if any, comprehension of the selling intent of commercials.
A Simplified Procedure for Pediatric Vaginal Examination: Use of Veterinary Otoscope Specula
Authors: Billmire M. Elaine , Farrell Michael K. , Dine Mark S. 
Published: December 2021

Examination of the prepubertal vagina is not part of the routine pediatric examination. However, there are situations in which adequate visualization and examination of the vagina are necessary. Frequently vaginal examination is hampered by examiner insecurity and lack of adequate instruments. Nasal specula, eye droppers for aspirating secretions,1 a test tube illuminated by a penlight,2 and a vaginoscope or cystoscope3 have been recommended but have been used with limited success.
Pediatric residency training underemphasizes gynecology.4 Many pediatricians feel inadequate and uncomfortable when faced with a patient with a vaginal complaint. They either avoid the examination or undertake it with such trepidation that the child's anxiety is increased.
Antidepressant Effect of Vitamin C
Authors: Cocchi Pietro , Silenzi Mario , Calabri Giuseppe , Salvi Giuseppe 
Published: December 2021

Mental disturbances are not an uncommon complication of therapy with various corticosteroids and ACTH.1,2 We have found that ascorbic acid relieves the depression syndrome associated with ACTH in one patient being treated for chronic hepatitis.
A 5-year-old girl was admitted to the Clinic because of HB8Ag-positive chronic hepatitis. Since a liver biopsy revealed an active process, she underwent prolonged long-acting synthetic ACTH therapy given in different courses. On the first week of treatment the patient appeared "depressed" and less sociable to the ward nurses.
Otitis Media in Infants and Children
Authors: Paradise Jack L. 
Published: December 2021

EDITOR'S NOTE. This review article was recruited for Pediatrics in Review. It proved longer than anticipated and too long for Pediatrics in Review, but all who reviewed it agreed that it covers the important subject of otitis media in such a comprehensive fashion that it should be published intact. We are publishing it in Pediatrics, but listing the Educational Objectives from the 1979-80 PREP and indexing it in April 1980 Pediatrics in Review in order for readers to find it readily when reviewing for recertification or the self-administered graded exam. (R.J.H.)
EDUCATIONAL OBJECTIVES: (1) Appropriate knowledge to evaluate and manage the child with chronic or recurrent otitis media (Recent Advances 79/80); (2) Appropriate knowledge to evaluate middle-ear disease in children suspected of having impaired hearing (Recent Advances 79/80); (3) Appropriate knowledge to evaluate and manage the child with cleft palate and otitis media (Recent Advances 79/80); (4) Appropriate evaluation of a child with recurrent upper respiratory infections and impaired hearing, and knowledge to diagnose and manage: (a) sensorineural hearing loss, (b) otitis media, (c) obstruction of the auditory canal, (d) perforation of tympanic membranes, or (e) cholesteatoma (Topics 79/80).
Pediatrics 65:917-943, 1980; otitis media, cleft palate and otitis media, myringotomy, tympanometry, tympanostomy tubes, hearing deficit due to otitis media.
Otitis media, next to the simple upper respiratory infection, is the most common organic disease confronting the practicing pediatrician.1-3 Moreover, otitis media has important economic and health care implications for a variety of other reasons: it must be considered in the differential diagnosis of obscure fevers; it is often the basis for prescribing commonly used agents such as antimicrobials, decongestants, and antihistamines; it may be involved in the development of bacterial meningitis and other central nervous system infections; and it often constitutes the basis for undertaking one or more of the most frequently performed operations of infancy and childhood, namely, myringotomy with or without tympanostomy tube insertion, adenoidectomy, and tonsillectomy.
On the Feeding of Supplemental Foods to Infants
Authors: Barness Lewis A. , Dallman Peter R. , Anderson Homer , Collipp Platon Jack , Nichols Buford L. , Walker W. Allan , Woodruff Calvin W. , Roy Claude 
Published: December 2021

Recommendations and practices of feeding solid foods to infants are widely divergent in the United States and in other countries. Although few differences in health are noted from such divergent practices, the consequences may be subtle or may require long-term, careful observations.
The previous Committee on Nutrition statement1 on this subject reviewed the history of the use of solid foods and showed that solid or supplemental foods were seldom offered to infants before 1 year of age until about 1920. Breast milk, for the most part, or modified cow's milk formulas supplied all or most of the nutritional needs of infants during the first year. The first supplements to the diet were cod liver oil to prevent rickets and orange juice to prevent scurvy.
Over the next 50 years recommendations were made that some cereals and strained vegetables and fruits be introduced at about 6 months of age to: (a) supply iron, vitamins, and possibly other factors; and (b) help prepare the infant for a more diversified diet. A much wider variety of infant foods became available, and these were introduced into the infant's diet earlier and earlier. Some of the reasons for earlier introduction of solid foods were the desire of mothers to see their infants gain weight rapidly, the ready availability of convenient forms of solid foods, and the mistaken assumption that added solid foods help the infant to sleep through the night.
INFANT FEEDING PERIODS
Infant feeding should be considered in three overlapping stages: the nursing period, during which breast milk or an appropriate formula is the source of nutrients; a transitional period, during which specially prepared foods are introduced in addition to breast milk or a formula; and a modified adult period, during which the majority of the nutrients come from the foods available on the family table.
Financing Training in Pediatric Ambulatory Care
Authors: McKay R. James 
Published: December 2021

The article "An Economic Analysis of a Pediatric Housestaff Practice," which appears in this issue of Pediatrics,1 focuses on a subject of major current concern to academic, practicing, and future practicing pediatricians.
The faculties of departments of pediatrics traditionally have been oriented toward inpatient and subspecialty care, on the basis that only in this way is it possible to provide the expertise and experience necessary for the care of patients ill with serious or rare diseases and for optimal teaching of students and housestaff about these conditions.
Now these same departments, faced with a societal emphasis on delivery of health care to all children, must somehow convert their traditional educational approach to one that is more consonant with the times.
Teenage Suicide
Authors: Cohen Michael I. , Bright George , Dudenhoeffer Frank , Guthrie Andrew , Hammar Sherrell , Ice Anne-Marie , Jenkins Renee R. , Long William A. , Shen Jerome T. Y. , Klein Luella , Felice Marianne E. 
Published: December 2021

Suicide is the fourth leading cause of death during the teenage years, preceded in frequency only by trauma, malignancy, and homicide.1 Recent statistics indicate that the number of suicides in adolescents has risen dramatically in the past decade, resulting in approximately 5,000 deaths per year. For youths 15 to 19 years old, the figures have actually doubled from 1968 to 1976; 11 boys per 100,000 in the population are now dying by suicide each year.2 Even among adolescents 10 to 14 years old, the trend is increasing and went from 116 to 158 deaths per year between 1968 and 1976. As distressing as these data appear, it is more alarming to realize that suicides are notoriously under-reported.
Suicide affects youngsters from all races and socioeconomic groups. For every suicide completed, between 50 and 200 are attempted. Boys succeed in their suicide attempts more frequently than girls, mainly because they use more lethal methods, such as firearms or hanging. Girls generally attempt suicide by ingesting pills and are more frequently resuscitated. The pediatrician can provide a significant resource in preventing adolescent suicide by identifying youngsters at high risk and recognizing behavioral clues in youngsters contemplating suicide.
CLINICAL PRESENTATIONS OF ADOLESCENTS CONTEMPLATING SUICIDE
Youngsters planning suicide frequently provide behavioral clues to their intent, such as giving away prized possessions or writing notes or poems expressing death themes. If the pediatrician suspects that a teenager is contemplating suicide, he should ask the adolescent directly about suicidal thoughts. Inquiring about suicide does not cause suicide! Quite the contrary, the adolescent may be relieved that someone has heard his cry for help.
Perinatal Herpes Simplex Virus Infections
Authors: Brann Alfred W. , Hall Robert T. , Harper Rita G. , Little George A. , Maisels M. Jeffrey , McCracken George H. , Poland Ronald L. , Sunshine Philip , Whittinghill John A. , Allen James R. , Alper Milton A. , Cefalo Robert C. , Hasselmeyer Eileen , Heerens Robert E. , Hey Dennis , Mortimer Edward A. , Fulginiti Vincent A. , Brunell Philip A. , Calderon Ernesto , Cherry James D. , Ector Walton L. , Gershon Anne A. , Gotoff Samuel P. , Hughes Walter T. , Peter Georges , Hinman Alan R. , Jordan William S. , Larke R. P. Bryce , Meyer Harry M. 
Published: December 2021

Because of the relative paucity of data on the epidemiology and management of perinatal herpes simplex virus (HSV) infections, the following recommendations represent the best current judgments of the Committees on Fetus and Newborn and Infectious Diseases of the American Academy of Pediatrics.
HSV infection of the newborn is associated with a case fatality rate of 60% and at least half of the survivors have significant neurologic or ocular sequelae, or both. Approximately 75% of isolates from affected neonates are HSV-2 and 25% are HSV-1. Although preliminary data suggest that antiviral chemotherapy is effective in reducing mortality and morbidity resulting from neonatal HSV infections, measures designed to prevent infection of newborns are currently the most important means of controlling neonatal infections.
A maternal source of infection can be found in about 90% of neonatal cases. Maternal HSV infection is usually caused by type 2 strains and involves the labia, cervix, and/or vagina. The majority of genital infections are asymptomatic and difficult to recognize on clinical examination, making identification of women whose infants are in jeopardy very difficult.
EPIDEMIOLOGY
Maternal Infection
Primary HSV infection during pregnancy may be associated with spontaneous abortion, prematurity, and rarely with congenital anomalies. The risk of infection to the newborn appears to be the highest in primary genital infection of the pregnant woman, but is also high in recurrent infection. Women with a history of recurrent genital HSV infection, those with active disease during the current pregnancy, and those whose sexual partners have proven genital HSV infection should be monitored with virologic or cytologic studies, or both, at least twice during the last six weeks of pregnancy.
Adolescent Suicide: On Taking Arms Against a Sea of Troubles
Authors: Eisenberg Leon 
Published: December 2021

Suicide imposes a triple burden on the family: grief at loss, as with any death; rage at desertion, for this was a deliberate death; and guilt at having failed the victim. When the suicide is a young person, the distress among the survivors is the greatest; it shakes us all to be forced to recognize that the despair of youth can be so profound. The doctor is plagued by the question: Could I have forestalled it? All are frightened. Few go through life without at least fleeting thoughts of suicide. Confrontation with its cold actuality makes us shudder at ourselves. Suicide is a disorder for which there can be no treatment.
Religion, law, and medicine are at one in agreeing that suicide should be prevented. But "should" is not the same as "can." The problem is daunting: Is prevention possible?
Any serious attempt at an answer requires us to put the problem in epidemiologic perspective by examining national data on rates and secular trends in adolescent suicide. So informed, we can then consider the opportunities for effective intervention through public health measures as well as at the level of personal encounter medicine in clinical practice.
DEATHS FROM VIOLENCE
Although the health of American adolescents, as measured by most indicators of morbidity and mortality, improved rapidly over the first 60 years of this century, mortality rates among those between 15 and 24 years of age have actually risen by 11% during the past 20 years. This is principally because of increasing deaths from violence (accidents, homicides, and suicides) which account for three fourths of all deaths in this age group.1