bluuebunny/crossref_metadata_2025_split huggingface dataset:
COUNSELING OPPORTUNITIES IN HUMAN REPRODUCTION
Authors: Hazard Sprague W. , Allen V. Robert , Eisner Victor , Garell Dale C. , Hammar S. L. , Shaffer Thomas E. , Shen Jerome T. Y. , Tanner Natalia M. , Welty John Allen 
Published: December 2021

Problems relating to human reproduction are among the critical issues of our time, and it is appropriate that pediatricians contribute to the solution of these problems. The changing dimensions of comprehensive pediatric care, more specifically the significant numbers of pregnancies being reported in young persons, support this position. For example, national statistics show that 44% of all pregnancies occur in persons under 20, and one out of four mothers on Aid to Families with Dependent Children in New York is pregnant before 16.
At least four roles can be identified for the pediatrician:
1. Genetic counseling: the pediatrician has already become proficient in giving knowledge to parents of the incidence of inborn errors of metabolism, chromosomal abnormalities, and other problems associated with genetic inheritance patterns.
2. Sex education: he often provides sex education to individual patients, families, and parents, in addition to teaching groups in his own practice and in schools, churches, or youth organizations.
3. Family planning and pregnancy counseling: he may provide assistance in these areas in behalf of the parents or adolescents. This assistance may involve a wide range of clinical advice and treatment, including the concept of spacing (rhythm method), contraceptive devices, or oral medication, whatever is considered most suitable for the individual. All alternatives for dealing with an unwanted pregnancy should be seriously discussed with the teenage girl and the other persons involved, including the parents if feasible. The pediatrician is in a unique position by the nature of his close association and relationship with the adolescent patient to provide this important personal service.
The Interrelationship Between the Patient, His Family, the Referring Physician, and the Pediatric Allergist
Authors: Halpern Salmon R. , Vaughan Victor C. , Glaser Jerome 
Published: December 2021

Dr. Howard Rapaport's attack on the report of the Committee on Allergy of the American Academy of Pediatrics is unrealistic; only by the most active cooperation between allergists and other health workers can the large number of allergic children receive needed attention.
His concern runs counter to the advances made in many areas of community medicine. Lay people are taught to administer injections, to take readings of temperature, pulse, and blood pressure. Pediatricians's assistants are increasingly involved in history taking, physical examinations, and prescribing medications.
Report of Severe Herpes Zoster in a 13½-Year-Old Boy Whose Chickenpox Infection May Have Been Acquired In Utero
Authors: Lyday Joseph H. 
Published: December 2021

The onset of this present illness may have occurred 13½ years ago when D.L. was of about 7 months' gestation in the uterus of his mother who had contracted chickenpox from her then 4- and 7-year-old children.
Mrs. L. was severely affected with chickenpox and required hospitalization at Colorado General Hospital. She developed a confluent eruption over her entire body. She was febrile, delirious, and comatose for several days with chickenpox pneumonia, and was attended by Dr. C. Henry Kempe. Mrs. L. recalls that Dr. Kempe had requested that if her unborn child ever developed chickenpox he would like to hear about it.
DRUG INTERACTIONS—PART IV
Authors: Riley Harris D. 
Published: December 2021

Activity of one drug may be modified by prior or simultaneous administration of another, and improved therapy is sometimes possible by concurrent medication. However, serious adverse effects may also arise from drug interaction.1 Interactions are caused by altered absorption, distribution, biotransformation or excretion of drugs, or from adjunctive action. In this communication certain known interactions affecting antimicrobial agents will be reviewed briefly and their mechanisms noted.
Preadministration Interactions
Besides chemical actions between drugs themselves before administration, as in infusion preparations, there may also be interaction between infusion vehicle and drug, and even between a drug and the container. Tetracyclines are photoxidized by the riboflavin in vitamin B complex and become inactive and change color in alkaline solutions. Kanamycin and methicilin inactivate each other, and bisulfite inactivates penicillin G.
Postadministration—Carrier Site Displacements
Interactions may take place after drugs have been absorbed and metabolized. Most antibiotics circulate in the blood reversibly bound to serum albumin. Each albumin molecule has several binding sites and the extent of binding varies from almost none with certain drugs, such as cephaloridine, kanamycin, vancomycin, polymyxin B and colistin, to 90% or more for oxacillin, cloxacillin, dicloxacillin, demeclocycline, novobiocin, and some of the long-acting sulfonamides.2,3 The protein-bound portion is metabolically inactive, but the free portion is active. When highly bound drugs compete for the same binding site, one or both may be displaced.4,5
Clinically significant responses may result when the bound fraction of one drug is displaced from its binding site by a second drug of greater affinity.6
VISION SCREENING OF PRESCHOOL CHILDREN
Authors: Kugel Robert B. , Bartram John B. , Bost Roger B. , Cavanaugh James J. A. , Hanson Virgil , Kennell John H. , Lorincz Andrew E. , McMahon Jean , Pearson Paul H. , Scott Roland B. , Scurletis Theodore D. , Browder J. Albert , Halpern Daniel , Martin Edwin W. 
Published: December 2021

Ideally, an eye examination should be performed immediately after birth and periodically during the preschool years. These years are important because it is at this time that much of a child's relationship to his environment is being established through visual channels and treatment for visual disorders is most successful.
At present, this is an impossible goal due to the large reservoir of preschool children, limited trained personnel and financial support, and lack of understanding by the publie of the importance of early eye care.
As an interim measure, the most practical approach seems to be one of vision screening as part of the total health supervision of the preschool child. This would encompass children from 3 to 5 years of age and could be performed by trained paramedical personnel or volunteers with a minimum of equipment.
For a successful program there must be community cooperation, approval, organization, education, and financing. A real effort must be made to contact that large group of children who are unknown to any service (physician) or agency. The screening itself has little value unless it is accompanied by adequate follow-up and resources to accept the referral and supervise the provision of proper care.
CONDITIONS DETECTED BY SCREENING
1. Refractive errors.
2. Muscle imbalance.
3. Amblyopia.
4. Some eye diseases.
SCREENING PROCEDURES
A. Observation or history-applicable from birth.
1. Unusually large eyes, sensitivity to light, excessive tearing, cloudiness, inflammation, hemorrhage, abnormal eye movements, i.e., nystagmus.
2. Difficulty with focusing or persistent deviation of one eye after 6 months of age.
The Respiratory Distress Syndrome: Bronchial Arteries and Catecholamines
Authors: Holm William W. 
Published: December 2021

Physiologically immature infants prone to the respiratory distress syndrome (RDS) have decreased endocrine reserve to cope with stresses of extrauterine life. Hormones beneficial in utero may possibly be detrimental to the newborn infant.
Historically, the heart and lungs were considered separate entities; eventually the "heartlung" concept evolved.
If we now consider the bronchial arteries and ductus arteriosus as a prenatal unit (with the former providing perfusion of the lung parenchyma) the "intrapulmonary shunting" and hypoperfusion found in RDS can be explained, and possibly the pathological findings of SIDS.
THE CHILD HEALTH ASSOCIATE: COMMENTS OF A PRACTICING PEDIATRICIAN
Authors: Ross Ralph A. 
Published: December 2021

As one of the early practitioners of the "New Pediatrics," first talked about in the 1950s, I have been asked to give some of my reflections on recent developments in pediatric practice which Silver and Ott describe in the paper under review.
The satisfactions of long-term care of children and their families have been extolled frequently and are very real to those of us who have pursued this type of practice. The failures of too large a number of youngsters under our care to reach satisfactory adjustment in adult society offer frustrations equally real and even more poignant. The gnawing doubt that anything we have done is responsible for the good results is alleviated somewhat by our feeling that factors beyond our control are the cause of the failures.
Despite all the testimonials from patients and their families to our skill in helping, and the opposing and rather more vocal diatribes of others against the "permissiveness" allegedly fostered by Benjamin Spock, I sometimes ask myself: Has the output of 80% of my time in many years of pediatric practice really made use of the large input in time and effort by school, hospital, and individual? It is clear that the skills learned during training years have been a boon to the 20% of patients who required expert care in diagnoses, treatment, and preventive pediatrics. But what about that other 80%?
From comments in periodicals by dissatisfied pediatricians, from the large number of young and not so young practitioners who year by year give up the "New Pediatrics," and from annoyances expressed with the demands made by and material returns available from pediatric practice, I assume that many of my colleagues have found the balance of frustrations weighing heavily against the satisfactions.
Vitamin K, Hepatic Fatty Infiltration, and Reye's Syndrome
Authors: Boon Donald J. , Eveloff A. Raymond , Pilapil Virgilio R. 
Published: December 2021

A survivor of Reye's syndrome in whom vitamin K restored the prothrombin time to normal was previously reported.1 The use of vitamm K was suggested to be of value in prognosis, as well as indicating that the fatty liver was still functional. Recently, another case allowed evaluation of this question and in addition pointed to the importance of a liver biopsy for diagnosis.
The patient was a healthy 15-month-old white girl who developed an upper-respiratory tract infection five days before admission, with subsequent associated vomiting and lethargy.
Letters to the Editor
Authors: Bland Richard D. 
Published: December 2021

To Dr. Ziering and Dr. Glaser, Dr. Bland comments as follows:
To begin, let me apologize to Dr. Ziening and to any of his colleagues who may have interpreted my previous comments as irreverent. Moreover, I regret that intellectual honesty has been mistaken as "intellectual pompousness," that unchallenged dogma in the literature has been read as scientific fact. My intent was not to deny the existence of allergy or the relationship between otitis media and dietary intolerance, but to emphasize our ignorance in this field, to encourage more meaningful investigation, and to discourage blind acceptance of the opinions of "fifty million Frenchmen."
Autistic Children: A Guide for Parents and Professionals, by Lorna Wing, M.D., D.P.M. New York: Brunner/Mazel, Inc., 1972, 157 pp., $7.50
Authors: Work Henry H. 
Published: December 2021

While the subtitle of this book suggests that it is written for ‘parents and professionals,’ the writing would seem to be designed chiefly for the former. Since, however, it is not at all sinful for a physician to gain medical knowledge from a lay journal, this text on a 20-year-old but still cloudy subject, has much to recommend it.
Dr. Wing, experienced with this group of children, sets forth not only a clear picture of the symptomatology but equally a good exposition of the current controversies on etiology, with a well-supported bias towards the organic source.
LEARNING EXPERIENCES DURING THE INTERNSHIP YEAR: AN EXPLORATORY STUDY OF PEDIATRIC GRADUATE EDUCATION
Authors: Alpert Joel J. , Youngerman Joseph , Breslow Jan , Kosa John 
Published: December 2021

Two interns at two institutions studied their perception of learning internship, using the critical incident technique. The majority of these experiences were technical, and only a few were interpersonal. Full-time staff, including other residents and senior staff, made the greatest contribution to their learning. Most learning took place in the ward and relatively less in the ambulatory services. Patients were involved in most of the experiences usually because of their diseases. While there were differences between the two interns there were many similarities.
The conclusion of the study is that current training does not provide a basis for dealing with human problems because of the present orientation of the hospital, but also that further study is needed to determine the amount of hospital training needed to become a practicing physician.
RENAL ABNORMALITIES IN THE RUSSELL-SILVER SYNDROME
Authors: Haslam Robert H. A. , Berman Wulfred , Heller Richard M. 
Published: December 2021

There has been a recent report of five children with the Russell-Silver syndrome. It was suggested that the clinical features were well-established, and the only laboratory investigation necessary was a fasting blood glucose to exclude hypoglycemia.
This study is a review of the status of the genitourinary system in six patients with the Russell-Silver syndrome. Four had abnormal excretory urograms or cystograms. These abnormalities included bilateral chronic pyelonephritis, unilateral ureteralpelvic obstruction and severe reflux, and unilateral pyelonephritis.
The finding of significant potentially treatable anomalies in the genitourinary system of patients with Russell-Silver syndrome indicates that an intravenous pyelogram and cystogram be included in the investigation of these patients.
Choledochal Cyst Presenting as Recurrent Pancreatitis
Authors: Karjoo Manouchehr , Bishop Harry C. , Borns Patricia , Holtzapple Philip G. 
Published: December 2021

Choledochal cyst, or congenital cystic dilatation of the common bile duct, is a rare anomaly usually presenting in the first decade with pain, jaundice, and an abdominal mass. The following is a report of a child with recurrent abdominal pain who showed clinical and biochemical evidence of recurrent pancreatitis. Investigation revealed a congenital choledochal cyst. The abdominal pain and biochemical abnormalities abated after choledochocystojejunostomy.
Case Report
J.J., a 4-year-old white girl, was admitted to the Children's Hospital of Philadelphia because of recurrent abdominal pain. This pain, located in the epigastrium, first started at the age of 1.5 years and was associated with fever, nausea, and vomiting.
A MODEL ACT PROVIDING FOR CONSENT OF MINORS FOR HEALTH SERVICES
Authors: Hazard Sprague W. , Allen V. Robert , Eisner Victor , Garell Dale C. , Hammar S. L. , Shaffer Thomas E. , Shen Jerome T. Y. , Tanner Natalia M. , Welty John Allen 
Published: December 2021

Whereas, certain minors are not obtaining adequate medical, dental, or other health care due to current legal and medical obstacles,
Whereas, providers of medical, dental, and other health care are now vulnerable to legal action for giving care to minors,
Whereas, there is a need for coordination, stimulation, and support of access to medical, dental, and other health care for certain minors in need of such care without violating the rights of parents to protect and promote their minors' health,
Be It Enacted by the Legislature of the State of-----,as follows:
Section 1. For the purposes of this act:
(1) "Minor" means any person under the age of majority as defined by the State statute or under 18 years of age, whichever is lower;
(2) "Health Professional" means state licensed physician, psychologist, dentist, osteopathic physician, nurse, and other licensed health practitioner;
(3) "Health Services" means health services specified by the state, appropriately delivered by different health professionals including examination, preventive and curative treatment, operation, hospilization (admission or discharge), giving or receiving blood and blood derivatives, receiving organ transplantation, pledging donation of organs after death, the use of anesthetics, and receiving contraceptive advice and devices;
(4) The masculine shall include the feminine.
Section 2. Any person who reaches the age of majority or 18 years of age or is on active duty with or has served in any branch of the Armed Forces of the United States shall be considered an adult in so far as the consent for health services is concerned.
Cryptorchidism in the Newborn
Authors: Santesteban Alfredo 
Published: December 2021

The incidence of cryptorchidism in newborn infants is stated to be 3% to 4% by Curran and Curran in a recent article.1 The reference cited is a report by Scorer published in 1957.2 However, a review of the literature shows that the incidence of cryptorchidism in the full-term new born infant is slightly lower and in the low birth weight infant (birth weight 2,500 gm or less), it is considerably higher.
Up until 1955 there was much confusion regarding the incidence of undescended testes in the newborn.
Package Inserts and Noncompliance With Doctor's Orders
Authors: Gorlich Gary M. 
Published: December 2021

Noncompliance, i.e., patient refusal to take doctor-perscribed medication, is very important in pediatric practice. Recent literature in Pediatrics and other pediatric-oriented journals has addressed itself to the frequency and significance of this behavior.
In recent discussions with colleagues in dermatology I have learned of another "etiology" for noncompliance and wish to bring it to the attention of those in pediatrics not familiar with it, to wit: physician samples of medications usually contain a package insert which is intended for the physician's knowledge of the preparation in question.1
THE INCIDENCE OF INFECTIONS IN NURSERIES SINCE THE DISCONTINUATION OF HEXACHLOROPHENE BATHING
Authors: Campbell Alexander G.M. , Pitkewicz Janice S. 
Published: December 2021

An increase in the number of infants with clinical staphylococcal infection (primarily Group II Staphylococcus aureus) was observed in a newborn nursery following discontinuation of daily hexachlorophene bathing of infants in December 1971. An increase was also apparent among infants seen at the hospital outpatient services. These infections were generally superficial, mild, and there were no deaths. A review of all nursery infections indicated that there was a slight overall increase in the infection rate which was entirely due to S. aureus.
Weekly colonization surveys were undertaken while hexachlorophene emulsion was reintroduced as a control measure in part of the nursery population. Hexachlorophene was effective in reducing the incidence of colonization even when rinsed off the skin at the end of each bath and when used to a maximum of five baths for each infant. The reintroduction of limited use of hexachlorophene was followed by a reduction in the number of staphylococcal infections.
COMMENT
Authors: Sutherland James M. 
Published: December 2021

The first of these two papers (Dixon) describes an anlysis and study of nursery outbreaks. Thirty-one percent of the reports reached the CDC through the efforts of drug manufacturers. Some reports were solicited, others unsolicited and still others detected by means other than direct reports. Dr. Dixon and co-workers report statistical significance in the discontinuation of variable hexachlorophene bathing techniques between randomly selected hospitals and hospitals reporting staphylococcal nursery outbreaks.
In the second paper, Kaslow and co-workers (Kaslow) analyze results from a survey of 266 of 296 randomly selected hospitals. In this study, infants who developed the disease after discharge from the nursery were excluded. Relative to the Academy-FDA warning in December 1971, staphylococcal disease rates rose sixfold in nurseries in which hexachlorophene bathing was discontinued while disease rates were unchanged in hospitals continuing hexachlorophene bathing. However, disease rates rose in hospitals when hexachlorophene was not used for bathing infants either before or after the warning.
In neither of these papers, do the authors present data on the inverse relationship between hexachlorophene bathing in the nursery and disease caused by gram negative organisms. Authors of both papers address themselves to some of the uncontrolled variables inherent in these types of retrospective studies and caution against too firm conclusions based on their data alone. For example:
(1) In the first paper, the CDC authors note that at least 31% of the reports of epidemics received by them were facilitated in some fashion by the manufacturers. They suggest that the conclusions of the first study are also limited by the fact that hospitals continuing or discontinuing hexachlorophene without recognized problems were not studied.
TO TAP OR NOT TO TAP (Further Comments)
Authors: Byers Randolph K. 
Published: December 2021

To my mind, the suspicion of a cerebral or cerebellar abscess is a contraindication to lumbar puncture until and unless technetium scan and electroencephalogram are both negative. In brain abscess, more than in any other lesion, severe and unpleasant lumbar puncture reactions have been particularly likely to occur. I suppose distortion of the brain rather than increased pressure alone may add to the risks. Two general situations seem to me also to contradicate lumbar puncture.
One is the suspicion of lead poisoning with encephalopathy. We have here for several years absolutely interdicted lumbar punctures when this diagnosis is under suspicion, pending estimations of blood lead or x-ray examinations of the gastrointestinal tract for lead chips.
THE PEDIATRICIAN AND IATRIC INFECTIOUS DISEASE
Authors: Weller Thomas H. 
Published: December 2021

The privilege of presenting the second R. Cannon Eley Memorial Lecture permits acknowledgment of personal indebtedness to an individual who was a pediatrician's pediatrician.
In 1939, with a primary interest in infectious and parasitic disease, I was faced with the choice of an internship. The decision was not difficult for the superb teaching of communicable and infectious diseases by the group composed of Charles F. McKhann, R. Cannon Eley, Leroy Fothergill, and John Davies at the Children's had a magnetic quality and the diversified program of research on infectious agents then in progress was unique in Boston. In the McKhann-Eley laboratory, extraction of gamma-globulin from human placentas was to provide the first preparation for the prevention or modification of measles in the exposed child. From 1946 to 1963, when Cannon resigned his Children's and Harvard appointments to become Professor of Pediatrics at Brown University and Chairman of the Department of Pediatrics at Roger Williams Hospital in Providence, Rhode Island, he was our pediatrician. Thus our affection for Cannon and appreciation for his depth of clinical experience in the communicable disease field, stems from an association that transcended that customarily achieved between a senior staff man and his junior. As a consequence, we, perhaps more than others, had partial insight into Cannon's numerous unpublicized acts of kindness to generations of house staff and graduate students, as he assisted in the resolution of their personal crises, be they professional, economic or social.
From the foregoing remarks it is apparent that the request to present this Eley lecture has evoked memories of my own years at the Children's, and in turn reflection on changes that have occurred in the interim in the teaching and handling of infectious diseases.