bluuebunny/crossref_metadata_2025_split huggingface dataset:
ORTHODONTIC PROBLEMS IN PEDIATRIC PRACTICE
Authors: GRABER T. M. 
Published: December 2021

ONE of the most important phases of oral health is the form and function of the oral mechanism. That specialty of dentistry which has as its goal the correction of dental malformations and restoration of the continuity and proper function of the teeth and jaws is called orthodontics. While parents have long been concerned with the obvious esthetic disabilities of malposed teeth, the pathologic implications of these malposed teeth have been the primary concern of the orthodontist. Frequently, tooth malpositions or dental malocclusions reflect growth and developmental disturbances of the upper and lower jaws. Crooked teeth are unsightly, but more important, they probably are functioning improperly, or not at all, which seriously impairs the health and longevity of the teeth and investing tissues.
Recent studies of facial growth indicate that dental malocclusions may be grouped in three morphologic categories, on the basis of jaw development and individual tooth malpositions. First, are those types of disturbances which are primarily skeletal in nature. These are problems where the maxilla or mandible has assumed an abnormal relationship to one another, usually through an upset in the timetable of normal development. The teeth in each dental arch may be normal in their position when compared to their respective jaws, but the abnormal jaw relationship means that the upper and lower teeth meet improperly during mastication, deglutition and speech. The second group consists of relatively local disturbances, with the teeth malposed, but with normal jaw relationship. The third group is a combination of the first two, with both improper jaw relationship and with teeth in abnormal positions. Within these three broad categories one may find all sorts of tooth malpositions and jaw relationships; the premaxillary segment may be displaced anteriorly, the whole lower dental arch may be retruded, the upper cuspids may be erupting in the palate, etc. Such conditions may be separate or occur in combination.
STUDIES OF THE IMMUNOLOGY OF THE NEWBORN INFANT
Authors: OSBORN JOHN J. , DANCIS JOSEPH , JULIA JUAN F. 
Published: December 2021

Forty infants from 1 week to 6 months of age who had no circulating antitoxin were immunized with one injection of a high titer diphtheria toxoid on alum and their antitoxin responses were followed at regular intervals up to six months afterwards.
The ability to form antitoxin improved significantly during the first two months of life. No significant difference could be demonstrated between the response of infants 2 to 4 months of age and that of infants 6 months of age. (In the statistical tests, the 5% level was adopted as indicating significance.)
Twenty-seven of these infants were immunized at the same time in the opposite arm with a single dose of tetanus toxoid on alum. The response to tetanus immunization was faster and better in infants from 2 to 6 months of age than in infants 1 month of age and younger. The response to the tetanus toxoid preparation was faster and better than the response to the diphtheria toxoid preparation.
The following conclusions are drawn: A. The infant can form antibodies from birth. B. The ability to form antibodies improves during early life. For diphtheria and tetanus antitoxin, the improvement is rapid during the first two months and then is much slower. C. The advisability of early immunization is related to the potency of the antigen to be used.
ECMO for Infection
Authors: FISHER DAVID G. 
Published: December 2021

To the Editor.—
Dr Hocker and his colleagues1 are to be commended for taking on the difficult task of evaluating the success of ECMO in early-onset group B streptococcal infection when a controlled trial is ethically and practically not feasible. In their study they used historical controls (a commonly criticized method, but all that is realistically available) to identify risk factors for early-onset group B streptococcal sepsis and to evaluate the effectiveness of ECMO intervention.
Ibuprofen Safety
Authors: CASTEELS-VAN DAELE MARIA 
Published: December 2021

To the Editor.—
I read with great interest the Letters to the Editor on ibuprofen and fever. In Europe the pharmaceutical companies also are active in promoting ibuprofen for the treatment of fever in children; and here too the debate goes on. Most physicians agree that young febrile children should be given antipyretics.3 We are left with a major problem. We banned aspirin because we were told it induces Reye's syndrome, and so we prescribe paracetamol despite its well-known hepatotoxicity.
Neonatal Screening for Dependents of Active-Duty Military Personnel
Authors: MCCABE EDWARD R. B. 
Published: December 2021

In Reply.—
COL Pettett is to be applauded for bringing attention to the issue of newborn screening among dependents of military personnel. He provides the opportunity to reemphasize several points made in the statement from the Committee on Genetics1 including: the need for a standardized policy or program for these dependents, particularly those born outside the US; the value of dedicated regionalized labonatory facilities in a newborn screening program; and the components that require consideration in any such policy or program, which include not only the laboratory, but also educational, administrative, follow-up, management, and evaluative components.
Would Breast-Feeding Decrease Risks of Lead Intoxication?
Authors: GRAEF JOHN W. , SHANNON MICHAEL 
Published: December 2021

In Reply.—
We thank Dr Newman for his comments and agree that, for many reasons, more can and should be done to encourage breast-feeding. Unfortunately, it is unclear that this practice protects infants from lead in any way and, inevitably, there will be some women who choose formula. While time did not permit us to rereview these cases, we estimate that, based on current data in our area, 60% to 70% of the infants in our study were breast-fed.
INTRODUCTION
Authors: DANCIS JOSEPH , PARKS WADE 
Published: December 2021

One of Saul Krugman's favorite photographs recalls the day in 1965 when he handed his predecessor at New York University, L. Emmett Holt, Jr., a copy of the Festschrift in his honor. Some 25 years later, it is our privilege to similarly honor Saul. It continues a long tradition at Bellevue Hospital. A Festschrift was dedicated to Abraham Jacobi, the first Director of Pediatrics, some 100 years ago. Tradition plays an important role in Saul Krugman's life and in the history of medicine in New York City.
New York hospitals have long been involved with the sequestration and care of patients with infectious diseases. In fact, many municipal hospitals were established because of epidemics of smallpox, measles, typhus, yellow fever, cholera, and typhoid fever. To protect the general population from infections arriving on ships, quarantine sites were established on islands in New York Harbor and the East River. These quarantine hospitals became the pest houses. The word "pest" derives from the first of the three great scourges of mankind: pestilence, famine, and war. As New York's municipal hospital system became better established, the pest houses evolved into infectious disease hospitals. The most famous of these was Willard Parker Hospital located on the East River on Manhattan's lower East side.
Saul was discharged from the Air Force in 1946 and joined an army of veterans seeking hospital training. Because of a delay in procuring a Pediatric residency at NYU-Bellevue, he took an interim position as resident physician at Willard Parker for six months. At the time all patients with infectious diseases in New York were funnelled into three specialty hospitals. Waves of children arrived at Willard Parker with scarlet fever, measles, pertussis, croup, and polio, filling wards to overflowing. Saul became an expert in infectious disease even before he began his pediatric residency! He maintained his affiliation with Willard Parker until it was closed 10 years later, signaling the end of an epoch as the result of medical advances. During those momentous years, Saul sharpened his clinical skills to an extraordinary degree, laying the groundwork for his future career in research and accumulating the experience that made the Krugman and Ward text, Infectious Diseases of Children, now in its 9th edition, an international success. The past 100 years has seen the conquest in this country of most of the dreaded infections that concerned us at the opening of the century. Saul Krugman participated in many of those advances. It is part of the irony of medical progress that, as we congratulate ourselves on our success, a new threat has emerged which will tax our energies and resources for many years to come. The frightening dimensions of AIDS will stalk the 21st century.
Postneonatal Vitamin B6-Dependent Epilepsy
Authors: COKER STEVEN B. 
Published: December 2021

Vitamin B6 acts as coenzyme in decarboxylation and transamination of amino acids. Pyridoxal phosphate is the coenzyme for a glutamic decarboxylase and γ-aminobutyric acid transaminase, enzymes necessary in production and metabolism of brain γ-aminobutyric acid. Vitamin B6 deficiency has been known to produce peripheral neuritis, dermatitis, anemia, and convulsions in infants.1 Administration of isonicotinic acid hydrazide may produce a vitamin B6-responsive neuropathy. Convulsions from vitamin B6 dependency occur despite normal vitamin B6 levels. These seizures, according to pediatric and neurological texts, occur immediately after birth up to 6 months.1-4
In 1985, Goutieres and Aicardi5 described three patients with atypical pyridoxine-dependent seizures with onset at 7 weeks, 5 days, and 4 months.
Control of Hepatitis B: To Be or Not To Be?
Authors: HALL CAROLINE BREESE , HALSEY NEAL A. 
Published: December 2021

The needs of children should not be made to wait.
—John F. Kennedy, 1963
The recent recommendations of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases and the Immunization Practices Advisory Committee of the Centers for Disease Control to immunize all infants against hepatitis B virus (HBV) infection have engendered concerns and questions which should not eclipse the import and intent of these recommendations.1,2 Behind these statements lay much deliberation and expertise drawn from those in pediatrics, medicine, infectious diseases, and public health. The undeniable conclusions of both committees are that control of HBV infection and its consequences (1) is necessary, (2) requires a new approach, and (3) must include universal infant immunization and should include immunization of adolescents whenever resources permit.
Managed Care
Authors: CARTLAND JENIFER D. C. , YUDKOWSKY BETH K. 
Published: December 2021

In Reply.—
Doctors Sapin and Laws raise fundamental concerns about our article that was recently published in Pediatrics.1 We feel that these concerns are addressed adequately in the paper, but we would like to take this opportunity to clarify our findings.
Dr Sapin argues that our study characterizes all managed care plans, such as the Kaiser Permanente Medical Care Program in which he practices, as having ineffective referral mechanisms. He holds that pediatricians at Kaiser experience "no barriers to appropriate referrals" and indicates that we did not stress this finding adequately.
Managed Care
Authors: ROBBINS KENNETH M. 
Published: December 2021

To the Editor.—
At a time when many of us are trying to understand and evaluate the effects of the influence of managed care on medical practice, it was with significant dismay that I read the unscientific, anecdotal, and frankly inflammatory report that formed the second article in the February 1992 issue of Pediatrics.1
The article, based solely on a self-reporting physician survey, conduded that some managed care patients were denied benefits for some referrals and admissions (surprise!—that is what managed care is expected to do) and that some doctors didn't like having their decisions questioned (also no surprise).
Physicians' Interactions with Pharmaceutical Companies
Authors: PROCOPIO LAWRENCE 
Published: December 2021

To the Editor.—
I was pleased to see Dr Margolis' article1 on the ethics of physician interactions with pharmaceutical companies that appeared in the December 1991 issue of Pediatrics. I applaud the author for making such a clear statement of his opinion. It is not often easy for physicians to escape the conflicts of interest which are, I believe, inherent in our fee-for-service system.
For my part, I often have conflicting thoughts about the ethics of accepting samples of medication from pharmaceutical company representatives.
Recognizing the Identifiers of Child Abuse as a Syndrome
Authors: RENZULLI FRANCESCO , CARDI ETTORE 
Published: December 2021

To the Editor.—
This July marked the thirtieth anniversary of the well-known paper by Kempe et al,1 "The Battered Child Syndrome," which described two infants with traumatic lesions, malnutrition, and poor hygiene.
We wish to draw attention to the fact that, simultaneously, in 1962, Rezza and De Caro,2 two Italian pediatricians, reported the case of an infant with inflicted physical injuries and malnutrition. Furthermore, the authors found that the infant had marked mental retardation, which regressed to a great extent in the course of a lengthy hospitalization.
Meconium and Tracheal Aspiration
Authors: BULL DALE H. , SOLA AUGUSTO , WAKELEY ANN 
Published: December 2021

To the Editor.—
We share the concerns of Wiswell and Henley1 that the adoption of a selective approach to the management of meconium-stained newborns is premature and may increase the risk of such infants for serious sequelae of meconium aspiration syndrome (MAS). Their analysis was motivated by a recent proposal that delivery room intubation and suctioning of meconium-stained newborns be reserved for those neonates who are depressed and require positive-pressure ventilation.2 We acknowledge that the data presented by Wiswell and Henley are limited by their retrospective design, but nevertheless, we wish to point out one result contained in their review that was neither emphasized nor discussed.
Behavior Management of Pediatric Dental Patients
Authors:   AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON CHILD ABUSE AND NEGLECT, 1991 TO 1992, Krugman Richard D. , Bays Jan , Chadwick David L. , Levitt Carolyn J. , McHugh Margaret T. , Whitworth J. M. 
Published: December 2021

To the Editor.—
It has been brought to the attention of The American Academy of Pediatric Committee on Child Abuse and Neglect that some dentists continue to use the hand-over-mouth technique with airway restriction (HOMAR) for behavioral management of pediatric patients. We have received two case reports of children who were adversely affected by this technique. One was left with bruises and petechiae and the other lost consciousness and bladder control.
The original literature on the hand over mouth (HOM) technique is alarming as it indicates that "once in a great while a patient's nostrils can be closed until he really needs air, as indicated by his color" and that 19 of 35 pediatric dentists surveyed in 1969 "felt it is permissible to completely close off a child's airway in special circumstances."
Naftifine (Naftin) in Pediatrics
Authors: RABINOWITZ LINDA G. , ESTERLY NANCY B. 
Published: December 2021

To the Editor.—
We recently examined two children with tinea corporis who were unresponsive to naftifine therapy. Fungal cultures grew Trichophyton tonsurans and their clinical lesions subsequently cleared with clotrimazole. This experience and the presence of naftifine advertisements in Pediatrics (March 1992) prompted us to share information regarding this medication with fellow pediatricians.
Naftifine hydrochloride (Naftin) 1% cream, an allylamine antifungal agent, the first of its kind available in the United States, has been reported to be highly effective in the treatment of tinea pedis, tinea cruris, and tinea corporis.
Lupus Nephritis Study—Questions
Authors: RABINOVICH C. EGLA , COLBERT ROBERT A. , KREDICH DEBORAH W. 
Published: December 2021

To the Editor.—
We read with great interest the article entitled "Lupus Nephritis: Prognostic Factors in Children" by McCurdy et al.1 The authors examined multiple factors as possible prognostic indicators of eventual tual renal failure in 90 children with lupus nephritis. This represents a large cohort of patients with pediatric lupus nephritis and the authors should be commended on their efforts. However, we feel it is important to point out some shortcomings of this study.
The patients initially were seen between 1970 and 1983.
Kernicterus in Preterm Infants; Lest We Forget (To Turn on the Lights)
Authors: IVES N. KEVIN 
Published: December 2021

Watchko and Oski have a reputation for stimulating debate on the topic of neonatal jaundice. As scriptwriters of "Vigintiphobia: a one-act play,"1 they questioned the `standard practice' applied to the management of jaundice in otherwise healthy term infants. In the current issue of Pediatrics2 they again court controversy by turning their attention to treatment thresholds and the risk of kernicterus in jaundiced preterm infants.
We are provided with a thoroughly researched historical review of the risk of kernicterus in the preterm infant from 1950 to the 1990s. The story is presented as a journey of experience from the pre-intensive care era, through the so-called `low bilirubin kernicterus era' (1965 through 1982), to the present.
Gastric Juice, Drugs, and End-Tidal Carbon Dioxide Detectors
Authors: BHENDE MANANDA S. , THOMPSON ANN E. 
Published: December 2021

To the Editor.—
Since publishing our article "Utility of an End-Tidal Carbon Dioxide Detector During Stabilization and Transport of Critically Ill Children (Pediatrics. 1992;89:1042-1044), it has been brought to our attention,1 and we also have observed that contamination of the end-tidal CO2 detector with gastric acid causes permanent yellow discoloration of the detector. The same is true of direct contact of the detector with resuscitation drugs (epinephrine, atropine, lidocaine).1 Such discoloration has not been observed with deep intratracheal drug administration.2,3
Money Alone Won't Do It
Authors: MILLER C. ARDEN 
Published: December 2021

In Reply.—
Dr David Copeland rightfully emphasizes that family-oriented social supports and interventions, necessary and beneficial as they may be, are unlikely to compensate fully for the social dysfunction that results from unwanted childbearing. Approximately 12% of childbearing in the US is unwanted, about every eighth newborn. Another 27% of births are mistimed, wanted but not just now.1 The trend in unwanted childbearing has moved upward by about 29% since 1982. This is the same period when public funding of contraceptive services was diminished by one-third and when access to abortion was constrained.2
Lack of Money—Barrier to Immunization
Authors: ANDERSON RON J. 
Published: December 2021

In Reply.—
I reviewed the letter from Drs Zimmerman, Giebink, and Street concerning our article authored by Shulte et al (Pediatrics. 1991;87:204-207) which studied patterns of referral for immunization in Dallas County, Texas. We believe their comments are insightful and agree that financial barriers are a major reason that these children are referred. Their experience documents a financial gradient from the uninsured to the Medicaid to the fully insured population as concerns treatment or referral decisions from primary care physicians.
Lead Ingestion and X-rays
Authors: MATTE THOMAS D. , BINDER SUE , McELVAINE MICHAEL D. , COPLEY CHARLES C. , DE UNGRIA ESTILITA G. 
Published: December 2021

In Reply.—
We agree with Dr O'Connor's assertion that radiopaque foreign bodies seen on abdominal radiographs of children with pica are not necessarily leaded paint chips. However, we consider it reasonable to infer that essentially all of the densities noted in the lead-poisoned children whose records we reviewed were, in fact, leaded paint chips.1 For the great majority of lead-poisoned children in St. Louis, deteriorated leaded paint is found in their primary residence or in other residences the children frequent.
Is the Denver II Developmental Test Worthwhile?
Authors: ADESMAN ANDREW R. 
Published: December 2021

To the Editor.—
The recent study by Glascoe et al1 assessing the accuracy of the Denver II is undoubtedly the first of many which will look at the clinical utility of this new, unvalidated developmental screening instrument. I am writing to express concerns about the methodology of this study and, more importantly, to express caution regarding use of the Denver II as a screening test prior to its validation.
Glascoe et al examined the accuracy of the Denver II using several different approaches to test interpretation and found that it generally led to overreferral.
Annual Summary of Vital Statistics—1991
Authors: Wegman Myron E. 
Published: December 2021

Between 1990 and 1991, provisional data show that the infant mortality rate decreased again, from 9.1 to 8.9, a decline of 2% in contrast to the 7% decline from 1989 to 1990. Birth, death, and marriage rates were also lower, but the divorce rate stayed at about the same level as in 1990. Natural increase in the population, excess of births over deaths, was less than 2 million, 4% less than the increase in 1990.
Detailed analysis of changes and of the influence of factors like age and race requires final data; at the time of preparation of this report final birth and death data were available only through 1989. For a variety of reasons, including staff shortages and delays in receipt of state data by the National Center for Health Statistics (NCHS), final data for 1990, which would usually have been available in late August 1992, are not expected before early 1993.
Unlike recent years, the decline in the infant mortality rate was only in the neonatal component, which decreased 3.6%. Postneonatal mortality increased, for the first time in many years, by 1.6%, suggesting that the decline in the total is related more to therapeutic advances in neonatology than to improved prevention.
Internationally, newly independent Latvia was added to the list of countries with rates less than 15, but Costa Rica was deleted. With the reunification of Germany the list shrank to 28 and, by default, the United States moved up from 21st to 20th.
Some 12.5 million births, less than 9% of the world total, took place in countries with under-5 mortality rates of less than 20 per 1000. At the other end of the scale, 42% of the world's births occurred in countries with under-5 mortality rates of more than 140 per 1000. The median under-5 mortality rate for those countries in 1990 was 189 per 1000, meaning that almost 20% of the infants born alive in these countries died before their fifth birthday.