bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Reactions to Measles-Mumps-Rubella Vaccine Skin Testing
Authors: PUVVADA LAKSHMI , SILVERMAN BERNARD , BASSETT CLIFFORD , CHIARAMONTE LAWRENCE T. 
Published: December 2021

In this report, we describe our recent experience with measles-mumps-rubella (MMR) vaccine skin testing and desensitization, including the occurrence of systemic reactions to intradermal testing, which to our knowledge has not been reported previously. We also review the literature on MMR reactions and the controversies regarding testing and administration in the egg-sensitive individual, emphasizing the need for a cautious approach.
Ten children with history of egg allergy, ranging in age from 6 to 18 months, were referred to us for further evaluation regarding MMR vaccine administration. Six of 10 had a history of mild to moderate egg sensitivity, which consisted of pruritis, eczema, localized urticaria, on immediate vomiting.
Summary of the Annual Meeting of the Section on Urology, American Academy of Pediatrics
Authors: Roth David R. 
Published: December 2021

The Section on Urology of the American Academy of Pediatrics met for 2½ days in conjunction with the 61st annual meeting of the American Academy of Pediatrics in San Francisco, CA, October 10 through 12, 1992.
As in the recent past, this conference was one of the premiere conferences for pediatric urology throughout the world. Participation was international and more than 500 individuals attended the sessions. The presiding officer for the meeting was Dr Edmond Gonzales, Jr, of Baylor College of Medicine, Scott Department of Urology, Houston, TX. All papers presented at the meeting are summarized in the following review, which is organized according to topic.
TESTIS
Several papers were presented by the group led by Hutson from Melbourne concerning the relationship of various substances to the gubernaculum and testicular descent. Their presentations stressed the importance of calcitonin gene-related peptide as a mediator in testicular descent by its relationship to the gubernaculum. Huff described a failure of maturation of Ad spermatogonia in undescended testes when compared to their normally descended partners. These changes were noted before the end of the first year of life. Hadziselimovic and Bica from Basel and Rio de Janeiro investigated the effects of hormonal treatment on the undescended gonad. Low-dose luteinizing hormone-releasing hormone increased both serum follicle-stimulating hormone and the number of Sertoli cells in cryptorchid testes. Human chorionic gonadotropin administration, on the other hand, induced Sertoli cell damage, which was reversed by the addition of luteinizing hormone-releasing hormone. Choi et al from the Seoul National University Children's Hospital looked at the effects of testicular torsion and subsequent detorsion on the contralateral testicle in rats.
Neonatal Genital Prolapse
Authors: PORGES ROBERT F. 
Published: December 2021

To the Editor.—
In regard to the brief report in the September 1992 issue of Pediatrics on "Neonatal Genital Prolapse" by Dr Mahin Bayatpour et al,1 I offer a polyp, arising either from the cervix or vagina, as a more likely diagnosis. Figure 1 of the article fails to show any structure resembling a cervix. Ultrasonographic demonstration of a normal uterus and cervix, presumably in their normal location, is not consistent with the diagnosis of prolapse.
Neonatal Genital Prolapse
Authors: BAYATPOUR MAHIN , MCCANN JOHN , HARRIS TONI , PHELPS HOPE 
Published: December 2021

In Reply.—
We appreciate Dr Porges's suggestion of a possible diagnosis of polyp for the case published in September. In considering a differential diagnosis of interlabial mass during neonatal period, the partial list includes polyps, urethral prolapse, paraurethral cyst, and rhabdomyosarcoma (Botryoid sarcoma). However, the clinical findings in our case were relatively clear, which unfortunately was not revealed clearly in the published photograph. The photograph showed the circumferential prolapse of vaginal wall through the introitus and was not the cervix.
Lead Screening
Authors: GOLDMAN LYNN R. 
Published: December 2021

To the Editor.—
Dr Edgar J. Schoen does not like lead screening.1 In a letter to Pediatrics, "Lead Toxicity in the 21st Century: Will We Still Be Treating It?" he refers to a study my colleagues at the California Department of Health Services and I conducted in Oakland, California as "a vivid example of how poor methodology and biased selection of subjects can lead to greatly exaggerated prevalence rates," accusing me of having a "serious omission" in a submission to Morbidity and Mortality Weekly Report.
Lead and IQ
Authors: NEEDLES CARL F. 
Published: December 2021

To the Editor.—
The article by Bellinger et al1 claims to show a dose-related toxicity of lead on intellectual functioning, ie, 5.8 IQ points and 8.9 K-TEA points per 10 µg% of blood lead (at 2 years). Yet the Figure (on page 858) shows nearly identical scores for subjects with blood leads of 10.0 to 14.9 and more than 15.0. This certainly is a surprise, because one would expect pronounced effect on the brain where the toxin levels are highest.
Controversies Concerning Vitamin K and the Newborn
Authors:   Vitamin K Ad Hoc Task Force
Published: December 2021

Vitamin K deficiency may cause unexpected bleeding (0.25% to 1.7% incidence) during the first week of life in previously healthy-appearing neonates (classic hemorrhagic disease of the newborn [HDN]). The efficacy of neonatal vitamin K prophylaxis (either oral or parenteral) in the prevention of classic HDN is firmly established. It has been the standard of care since the recommendation by the Committee on Nutrition was adopted as policy by the American Academy of Pediatrics in 19611
Late HDN, a syndrome defined as unexpected bleeding due to severe vitamin K deficiency in infants aged 2 to 12 weeks, occurs primarily in exclusively breast-fed infants who have received no or inadequate neonatal vitamin K prophylaxis. In addition, infants who have intestinal malabsorption defects (cholestatic jaundice, cystic fibrosis, etc) may also present with late HDN. The rate of late HDN (often manifested by sudden central nervous system hemorrhage) ranges from 4.4 to 7.2 per 100 000 births based on reports from Europe and Asia. When a single dose of oral vitamin K has been used as neonatal prophylaxis, the rate has decreased to 1.4 to 6.4 per 100 000 births. Parenteral neonatal vitamin K prophylaxis prevents the development of late HDN, with the rare exception of infants with severe malabsorption syndromes. Oral regimens that have a similar efficacy as parenteral vitamin K in prevention of late HDN include the repeated administration of oral vitamin K1 (Germany) or K2 (Japan) at birth, 1 week, and 2 to 4 weeks.
In 1990 Golding et al2 reported a study of a 1970 birth cohort in Britain in which they noted an unexpected association between childhood cancer and pethidine given in labor and the neonatal administration of vitamin K. Subsequently, Golding and others3 conducted a case-control study designed to examine the risk of cancer associated with intramuscular vitamin K administration among infants born in two hospitals in Avon between 1965 and 1987 and diagnosed with cancer between 1971 and 1989.
Role of the Pediatrician in Prevention and Management of Substance Abuse
Authors:   Committee on Substance Abuse
Published: December 2021

The past three decades have been marked by an increasing recognition of the responsibility of pediatricians to their patients and their patients' families regarding the diagnosis and management of abuse of tobacco, alcohol, and other substances of abuse including prescription drugs. Because of the harmful consequences, substance abuse is an obvious concern for all those who care for infants, children, adolescents, and young adults. When it occurs during pregnancy, it has been associated with an increased incidence of prematurity; congenital defects, including brain damage; and even death. The pediatrician must be prepared to address this commonplace issue as a part of routine health care, starting with the prenatal visit and continuing as a part of all anticipatory guidance. Familiarity with the extent and nature of drug use, as well as the health and social consequences, has become a necessary part of the body of pediatric knowledge.1-9 The pediatrician should possess or develop the skills necessary to determine which young patients are at risk for substance abuse and chemical dependence and should also be able to offer appropriate prevention or treatment counseling to the child, adolescent, and his or her family, or make a referral to a source where such counseling can be obtained.
PERVASIVENESS OF DRUG USE
The pattern of substance abuse among teenagers has undergone significant change during the past 25 years. Prior to the late 1960s, the abuse of psychoactive drugs and alcohol was predominantly an adult phenomenon. In the late 1960s and early 1970s, substance abuse became widespread among adolescents and, more recently, preadolescents.
Stewart Smiled
Authors: TOBIAS JOSEPH D. , PHIPPS SEAN , MULHERN RAYMOND K. , SMITH BRUCE 
Published: December 2021

In Reply.—
When we published our recent study concerning the use of oral ketamine, we anticipated that the response would be mixed, and therefore we are thankful for the opportunity to respond to our advocates and our critics. The poignant essay "Stewart Smiled" eloquently demonstrates the benefits of sedation and stands alone without the need for further comment.
The criticisms and concerns of Drs Kibelbek, Schwartz, and Tenedios are welcomed. However, their major objection to our study does not seem to contradict our thoughts at all.
HIV and Smooth Muscle Tumors
Authors: MURPHY SHARON B. , CHADWICK ELLEN G. 
Published: December 2021

To the Editor.—
We read the article by Mueller et al,1 which adds to the evidence confirming the remarkable association of tumors of smooth-muscle origin in children infected with the human immunodeficiency virus (HIV), an association we first reported in 1990.2
We wish to set the record straight with regard to the number of cases of leiomyosarcoma previously reported in children with HIV infections. Mueller et al quite understandably conveyed an error which was the result of duplicate publication of a case.
HIV and Smooth Muscle Tumors
Authors: MUELLER BRIGITTA U. , PIZZO PHILIP A. 
Published: December 2021

In Reply.—
We appreciate the comments of Murphy et al, and we agree that a total of eight cases of leiomyomas/leiomyosarcomas in children with human immunodeficiency virus (HIV) infection (including a case published by Sabatino et al1) have been published, and there are several unpublished observations (personal communications with several centers). This is a more than 400-fold higher incidence than seen in the general pediatric population. Soft tissue tumors are thus the third most common malignancy, after non-Hodgkin's lymphomas and Kaposi's sarcomas, that can occur in the HIV-infected child.
General Comments
Authors: McPherson Merle 
Published: December 2021

As the year 2000 approaches, we as a nation face unique challenges in facilitating the development of systems of services for children and their families which support and nurture our next generation in healthy, productive lives.
Title V of the Social Security Act has a proud history of leadership in response to needs of children and families and has worked to improve the health of underserved women, infants, children, and youth, including children with special health care needs.
In 1989, amendments were enacted to the Title V Maternal and Child Health Grant (MCH block grant). These amendments redefine the mission of the state Children With Special Health Care Needs programs (CSHCN programs). The MCH block grant mandates the state CSHCN programs to assume a leadership role in developing community-based systems of services for children with special health care needs and their families.
The mandate in the MCH block grant to the CSHCN programs to assume a leadership role with respect to systems development reflects the national goal of building systems of services for children with special health care needs and their families that are family-centered, community-based, and coordinated. This goal was first enunciated in 1987 by the US Surgeon General's office and the federal Bureau of Maternal and Child Health. In accordance with this national goal, the recently issued Year 2000 National Health Promotion and Disease Prevention Objectives includes objective 17.20, which specifically calls for the building of family-centered, community-based, coordinated systems of services for this population.
The national initiative to develop systems of services for children with special health care needs and their families can and should be seen as part of a larger national movement to develop community-based systems of services.
Race and Ethnicity: Issues for Adolescents With chronic Illnesses and Disabilities. An Annotated Bibliography
Authors: Geber Gayle , Latts Elizabeth 
Published: December 2021

CULTURAL COMPETENCE RESOURCES
The following are selected resources providing general information about the issues of cultural competence and cultural diversity. While they are not specific to adolescents with chronic illness on disabilities, these resources are relevant across the age span and contain important information for health care professionals, educators, parents, and program planners.
Asbury CA, Walker S, et al. Disability prevalence and demographic association among race/ethnic minority populations in the United States: implications for the 21st Century
A study that examined the status of ethnic/racial minority persons with chronic health conditions; physical, sensory, and language impairments; and nervous disorders. Areas of focus include income level, education, geographic location, employment, health status, and future trends. Available from Howard University Research and Training Center, 2900 Van Ness St NW, Holy Cross Bldg, Ste 100, Washington, DC 20008.
Baca L, Bransford J. An appropriate education for handicapped children of limited English proficiency. Special education in America: its legal and governmental foundations series. The Council for Exceptional Children, 1982: 31 pages
One of a series of publications addressing the legal and governmental foundations of bilingual special education for children with handicaps. Also discussed are significant issues affecting the provision of bilingual special education. (EDRS: ED #224 265. To order, call 1-800-433-3742.)
Baca L. Policy options for insuring the delivery of an appropriate education to handicapped children who are of limited English proficiency. The Council for Exceptional Children, 1980: 58 pages
This article provides a historical overview of policy issues (litigation and legislation) involved in the provision of an appropriate education for bilingual children with handicaps.
Factors Associated With Condom Use by Sexually Active Male Adolescents at Risk for Sexually Transmitted Disease
Authors: Orr Donald P. , Langefeld Carl D. 
Published: December 2021

Objective. The purpose of this study was to identify the predictors of condom use in a population of male adolescents at risk for sexually transmitted diseases (STDs).
Design. Cross-sectional cohort study.
Setting. Clinical sites (school-based, adolescent and STD clinics) providing reproductive health care to male adolescents in a midwestern city.
Participants. One hundred sixteen male adolescents 15 to 19 years of age were enrolled consecutively.
Outcome measures. Subjects completed a multi-instrument questionnaire examining sexual behaviors attitudes, and beliefs about STDs and condoms, cognitive maturity, and health risk behaviors; urethral specimens were cultured for Chlamydia trachomatis and Neisseria gonorrhoeae.
Results. The median age was 17; 31% were white and 69% were African-American. Thirty-seven percent had urethral infections: 21% were infected with C trachomatis, 11% with N gonorrhoeae, and 5% with both organisms. More than 60% reported some experience with condoms and 23% reported condom use at last coitus. Consistent with the Health Belief Model, condom use for STD prevention was less likely among those reporting other health risk behaviors (odds ratio [OR] = 0.53; 95% confidence interval [CI] = 0.36 to 0.78; P &lt; .001) and more STD risk behaviors (OR = 0.65; CI = 0.45 to 0.96; P = .03). Adolescents who were more highly motivated (OR = 1.58; CI = 1.09 to 2.30; P = .02) and who were more positive about condoms (OR = 1.83; CI = 1.25 to 2.68; P &lt; .001) were more likely to report condom use for contraception. Adolescents using condoms for acquired immunodeficiency syndrome (AIDS) protection engaged in fewer behavioral (OR = .62; CI = 0.42 to 0.92; P = .02) and STD risks (OR = .67; CI = 0.45 to 0.99; P = .04). Three specific reasons for condom use were highly predictive of condom use at last intercourse: STD prevention (OR = 8.9; CI = 3.13 to 25.4; P &lt; .001), birth control (OR = 2.1; CI = 1.05 to 4.25; P = .03), and AIDS prevention (OR = 2.4; CI = 1.05 to 5.42; P = .03).
Conclusion. Condom use among adolescent males is influenced by perceived benefit, namely prevention of pregnancy & avoidance of STDs including AIDS. Non-use is associated with other risk-taking behavior.
Child Day Care, Smoking by Caregivers, and Lower Respiratory Tract Illness in the First 3 Years of Life
Authors: Holberg Catharine J. , Wright Anne L. , Martinez Fernando D. , Morgan Wayne J. , Taussig Lynn M. ,   Group Health Medical Associates
Published: December 2021

Background. Day-care attendance has been associated with an increased risk of hospitalization for lower respiratory tract illnesses (LRIs). This study examines, in a health maintenance organization population of children, the associations between child day care and the occurrence of LRIs in the first 3 years of life. Smoking by caregivers and a possible protective effect of longer day-care enrollment in relation to LRIs are also addressed.
Methods. Information on day-care arrangements was elicited from 1006 parents of infants for five age intervals in the first 3 years of life: birth through 3 months, 4 to 6 months, 6 to 12 months, 1 to 2 years, and 2 to 3 years. Data on LRIs in the first 3 years of life were recorded by pediatricians at the time of the acute illnesses.
Results. After controlling for other risk factors, the presence of three or more unrelated children in the care setting was associated with significant risks of LRI of up to twofold or more from 4 months of age to 3 years. Type of care setting was not a significant risk factor during this time period. In the third year of life, the risk of wheezing LRI in the presence of a smoking caregiver was more than threefold for those in another residential home setting. No significant protective effect against LRIs in the third year of life associated with longer prior day-care enrollment was demonstrated.
Conclusion. The presence of three or more unrelated children in the care setting and the presence of a smoking caregiver were significant independent risk factors for LRIs during the first 3 years of life. Prolonged day-care did not protect against LRIs in the third year of life.
Evaluation of Two Iron-Fortified, Milk-Based Formulas During Infancy
Authors: Bradley Christi K. , Cordano Angel , Hillman Laura ,   Pennridge Pediatric Associates, Sherman Adria Rothman , Leedy Donald ,   Caylor-Nickel Research Institute, Inc
Published: December 2021

Objective. Compare milk-based, ironfortified formulas containing 7.4 and 12.7 mg/L iron and breast-feeding during the first year of life.
Design. Partially randomized, double-blind trial: non-breast-fed infants randomly assigned to receive one of two coded formulas, identical except for iron content; infants discontinuing breast-feeding between 1 and 8 weeks of age randomly assigned to a formula late-start group.
Setting. Five general community pediatric practices in Missouri, Indiana, Illinois, and Pennsylvania.
Participants. Sample of 347 healthy, term infants, enrolled within 1 week after birth; 172 included in statistical analyses.
Outcome measures. Length, weight, and indicators of formula intolerance recorded at clinic visits; formula consumption, bowel movements, stool consistency, and other tolerance indicators recorded by parents on daily and weekly report forms; hemoglobin, hematocrit, and serum ferritin, iron, zinc, and copper measured at 6 and 12 months.
Results. No significant differences between formula-fed groups in growth, attrition, formula consumption, bowel movements, hematocrit, hemoglobin level, and serum iron, zinc, and copper levels (P &gt; .05); first 6-month weight and length changes of the breast-fed group significantly less than in both formula-fed groups (P &lt; .008); serum ferritin level of the formula-fed, high-iron group significantly higher than that of the low-iron and breast-fed groups (P &lt; .008), although all groups' values were normal; no apparent differences between formula groups in formula tolerance and stool characteristics but data were not analyzed statistically.
Conclusions. Milk-based formulas containing either 7.4 or 12.7 mg/L iron support normal growth and iron status of healthy, term, normally fed infants during the first year and both are well tolerated and accepted.
New Postnatal Growth Grids for Very Low Birth Weight Infants
Authors: Wright Kelly , Dawson Joan P. , Fallis Donna , Vogt Elanita , Lorch Vichien 
Published: December 2021

Objective. To generate contemporary postnatal growth curves for hospitalized very low birth weight infants.
Design. Retrospective survey.
Setting. Tertiary intensive care nursery.
Patients. All surviving singleton, appropriate-for-gestational age infants with birth weight ≤1500 g, born January 1, 1987, to May 31, 1991, who did not develop necrotizing enterocolitis (N = 205).
Measurements and results. Macronutrient intakes and body weights were recorded daily, with crown-heel length and occipital-frontal head circumference recorded weekly up to 105 days of age or hospital discharge, whichever occurred first. Growth curves were generated for four birth weight ranges: 501 through 750, 751 through 1000, 1001 through 1250, and 1251 through 1500 g. Compared to previously published growth curves, the current infants regained birth weight more quickly and exhibited larger average daily weight gains. These differences were most apparent in infants of lowest birth weight.
Conclusions. The "premature growth grid" constructed by Dancis et al more than 40 years ago may no longer be a useful standard of early postnatal growth for present-day very low birth weight, appropriate-for-gestational-age infants. The new weight curves are a more accurate reflection of current in-hospital growth trends, especially for infants weighing ≤1000 g at birth.