bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mushroom Poisoning: Identification, Diagnosis, and Treatment
Authors: Hall Alan H. , Spoerke David G. , Rumack Barry H. 
Published: December 2021

Mushroom poisoning can cause a wide range of symptoms including gastroenteritis, euphoria or hallucinations, cholinergic or anticholinergic syndromes, disulfiram-like reactions (flushing, anxiety, palpitations, possible hypotension) when the mushrooms are ingested with ethanol, fulminant hepatic failure, seizures, hemolysis, and methemoglobinemia.
More than 5,000 species of wild mushrooms grow in the United States. It is not known what percentage of these mushroom species are potentially toxic. Some species are "toxic" to some individuals but not to others. Species identification can often be difficult, and the percentage of toxic species within genera varies considerably. More than 75% of Amanita species may contain some toxic substance, whereas less than 10% of Morchella species are potentially harmful. The frequency of occurrence of toxic species in a locale also changes the percentage encountered during any collecting foray.
Given the natural curiosity and hand-to-mouth behavior of young children, the desire of many to partake of "natural" foodstuffs, and the interest of some in ingesting "magic mushrooms" for their mind-altering properties, clinicians may easily be faced with the need to treat mush-room-poisoned patients.
In 1984, 4,742 of 5,806 total cases of mushroom exposure reported to the American Assiciation of Poison Control Centers National Data Collection System were in children less than 6 years of age.
Discipline and Permissiveness
Authors: Rosenfeld Alvin , Levine Dorothy 
Published: December 2021

Discipline is education, not punishment. Be a good example to your children.
Numerous factors determine the child-rearing style individual parents select. Other than the overtly abusive, hostile, on grossly inconsistent style, no empirical research has shown some style of rearing to cause children serious damage or to be vastly superior. Much depends on the type of person the parents hope to rear.
Avoid the need to punish whenever possible. Reasonable limits and parental warmth and consistency are helpful to the child.
Although love may not be enough to enable a child to grow well, when it is combined with the child's day-to-day experience with an orderly adult who treats him or her warmly and fairly, the child will over the years, all by him or herself, with no great special effort from the parents, imitate that parents' behavior and incorporate their standards.
Oral Rehydration Therapy and Dietary Therapy for Acute Childhood Diarrhea
Authors: Santosham Mathuram , Brown Kenneth H. , Sack R. Bradley 
Published: December 2021

1. Oral rehydration therapy can be used to treat acute diarrhea of all ages, regardless of etiology and initial serum sodium value.
2. Vomiting is not a contraindication for oral rehydration therapy.
3. Intravenous fluids must be used in the initial management of children with severe dehydration.
4. Enteral feeding should be continued during diarrhea. If anorexia or malabsorption prevents sufficient intake during illness, compensatory nutritional therapy must be provided during convalescence to assure complete nutritional recovery.
5. Breast-fed infants should continue nursing during illness.
6. Infants who usually receive only cow milk or lactose-containing milkderived formula should be monitored for lactose malabsorption during diarrhea. Reduction in milk intake or a temporary change to a lactose-limited formula may be necessary in some cases.
Conversion Reactions in Adolescents
Authors: Prazar Gregory 
Published: December 2021

Few situations in practice present as more frustrating for a busy pediatrician than an adolescent who appears for a ten-minute walk-in visit with a prolonged history of unexplained abdominal pain or headache. Obtaining a brief history of the symptom may contribute little to a timely diagnosis, and physical examination is often unrewarding in understanding the symptom. If the adolescent's demeanor suggests little discomfort, the pediatrician is often left with the impression that the pain is "psychosomatic" and/or that the adolescent is exploiting a physical symptom for some secondary gain. A diagnosis of conversion reaction is seldom considered. The focus of this article will be to aid the pediatrician in identifying conversion reactions, differentiating conversion reactions from other disorders (eg, hypochondriasis, malingering), and outlining an approach to the treatment and referral of patients with conversion reactions.
DESCRIPTION AND PREVALENCE
Conversion reactions represent a form of communication of the uncomfortable, or as Engel1 writes: "a psychic mechanism whereby an idea, fantasy, or wish is expressed in bodily rather than in verbal terms and is experienced by the patient as a physical symptom rather than as a mental symptom." The idea or wish is psychologically threatening to the individual or unacceptable for him or her to express directly.
The Pediatrician As Wage Earner
Authors: Nazarian Lawrence F. 
Published: December 2021

When the statistics on physicians' earnings come out each year, the pediatricians are close to the cellar. Our colleagues in general practice make a little less; everyone else makes more. We were ahead of the psychiatrists, but they passed us a few years ago. Many of our colleagues have incomes that are multiples of ours.
I doubt whether the general public is aware of these figures. When the newspaper prints the median income for physicians, I wager that many readers would estimate ours even higher. They see our busy offices and decide, "He's rolling in it!" They are right, of course, except for what it is we are rolling in.
An Agenda for Improving Physician Reimbursement
Authors: Don Blim R. 
Published: December 2021

In his commentary, "The Pediatrician as a Wage Earner," Dr Nazarian has expressed a concern well-known to all pediatricians. And, although most of us were aware of the economic facts of life before entering pediatrics, we were idealistic and/or altruistic enough that we ignored or at least minimized those facts. Subsequently, with long hours and hard work, most of us have managed to receive adequate monetary compensation, as well as extraordinary personal satisfaction—so much so that, if we had it to do over again, we would make the same choices.
Having said this, I would hasten to add that I think many physicians, particularly those dealing with procedural specialties, although equally dedicated, talented, and altruistic, receive an unconscionable income as a result of excessive charges.
Atonic Seizures
Authors: Duchowny Michael S. 
Published: December 2021

Seizures consisting of rapidly arrested movement are relatively common and account for approximately 12% of all episodes. Atonic seizure is the preferred designation for this form of clinical presentation, although more descriptive terms such as "drop attack" and "epileptic fall" are also popular. Many clinicians still use the term "akinetic seizure," but this is inaccurate because attacks of behavioral immobility with preserved muscle tone and consciousness cannot be differentiated from absence seizures. Furthermore, it is unlikely that neurophysiologic mechanisms can arrest behavior without altering muscle tone or compromising consciousness.
The accurate diagnosis and management of atonic seizures constitutes an important challenge for the practicing pediatrician. Whereas grand mal and petit mal seizures are well-known manifestations of epilepsy in childhood, seizures limited to the loss of muscle tone are more likely to go unrecognized. The large variety of nonepileptic conditions that mimic atonic seizures further adds to the difficulties of correct identification.
DESCRIPTION
Atonic seizures show considerable variation in presentation and severity. Typically, without warning, the voluntary muscles synchronously increase and then lose resting tone. No aura precedes these muscular changes. Both the myoclonic and atonic seizure components can cause the child to collapse limply to the ground. Massive myoclonus and loss of tone may even precipitate a violent fall from a sitting position (Fig 1), resulting in craniofacial injury, skull fracture, facial laceration, or dental trauma.
Nazarian's Response
Authors: Nazarian Lawrence F. 
Published: December 2021

Dr Conn is right. Sometimes we do assume a parenting role in our dealings with the families under our care. Certain families encourage this attitude more than others, and some pediatricians are more comfortable with the situation than others. When this kind of relationship occurs, I believe it is more often helpful than harmful.
As a parent and as a teacher of parents, I practice and preach the establishment of limits and internalization of external controls, while encouraging the development of a child's personality and independence. The same principles apply to nurturing young parents as they struggle with unfamiliar responsibilities. I certainly do not encourage my children to make inappropriate demands, and the same goes for the parents of my patients.
Acute Respiratory Infections in Children: Etiology and Epidemiology
Authors: Denny Floyd W. 
Published: December 2021

Acute respiratory infections are the most common affliction of humans, and their tendency to occur with much greater frequency in children makes them especially important to the pediatrician. A host of microbial agents can cause acute respiratory infections but only a few are responsive to antimicrobial agents. Because of the paucity of definitive laboratory tools that allow the easy recognition of the cause of acute respiratory infections, it is important for the practicing pediatrician to have other methods that aid in the clinical management of children with these infections. It is the purpose of this review to discuss the etiology and epidemiology of acute respiratory infections with emphasis on how this knowledge can guide the clinician in their management. The groundwork for the major emphasis of the paper will be laid by suggesting a classification of upper and lower respiratory tract infections. Causative agents will be enumerated and put into perspective. The major factors associated with the occurrence of acute respiratory infections will be discussed in some detail and several risk factors will be evaluated.
It is important for the reader to understand that the field of acute respiratory tract infections is so extensive and complex that a complete discussion of the entire field is not possible in this review.
Advances in Pediatrics
Authors: Zisman A. 
Published: December 2021

A number of advances in behavioral and development pediatrics have occurred during the last 20 years that have changed pediatric practice. They should be added to the list of major advances by Dr Rapkin published last year (Pediatr Rev 1987;8:248).
Infant Temperament
The concept of infant temperament was formalized by Chess, Birch, and Thomas and popularized for pediatrics by Dr Carey. There are nine categories of temperament (activity level, rhythmicity or regularity of bodily functions, approach or withdrawal, adaptability, intensity of reaction, threshold of responsiveness, quality of mood, distractibility, and attention span and persistence). From this there has been a characterization of the difficult child: one who shows irregularity of bodily functions, intensity of reaction (of the negative kind), tendency to withdraw from new stimuli, and nonadaptability.
Attention Deficits in Adolescence: Description, Evaluation, and Management
Authors: Coleman William L. , Levine Melvin D. 
Published: December 2021

Attention deficits may persist through childhood and into adolescence or they first may become manifest in adolescence. Their manifestations are often more subtle but Severe enough to exact a significant toll on academic performance. Associated learning disabilities, behavioral problems, and affective dysfunction, especially low self-esteem, are frequent concomitants or complications. On the other hand, some traits (such as creativity) of attention deficits may serve as redemptive features.
Evaluation necessitates a systematic gathering, synthesis, and interpretation of a vast amount of information as well as direct testing and observation. Compensatory strengths and other positive attributes should be elicited and mobilized.
Management should be individually tailored to the adolescent's specific needs and resources and implemented in a stepwise fashion. Intervention is usually multimodal, because attention deficits invariably affect several areas of function: academic, behavioral, social, and emotional. Management might include educational interventions, counseling, cognitive behavior therapy, behavior modification, and pharmacotherapy. Management should always include demystification, construction of a functional profile, specific advice-giving, encouragement, advocacy, and long-term follow-up, roles for which the pediatrician is especially qualified.
With increased awareness of the plight of adolescents with attention deficits, the pediatrician, working closely with other professionals, has an extraordinary opportunity to minimize the accusations, suffering, and maladaptive, self-destructive behaviors that have been so much a part of the adolescent's condition in the past. As we become more sensitive to the effects of endogenous dysfunction during adolescence, it will become increasingly possible to redeem the struggling young people in their own eyes and in the eyes of important adults in their lives.
Optimal evaluation and treatment is likely to be taxing, time-consuming, and expensive for all involved. However, the price of neglect, false attributions, and failure will be far higher.
A study using psoriasis knowledge assessment questionnaire in psoriasis affected patients
Authors: Kumar N. Ashok , Srinivasan Shreya , Reddy Duttala Indira , Sangaiah Sivaramakrishnan 
Published: December 2021

Psoriasis is a chronic disease, which is potentially controllable but cannot be cured. Treatment is long term and requires continuous effort by the patient. Patient education is important for a chronic disease like psoriasis and this involves acquiring knowledge about the disease. With knowledge gained, the patient will be able to cope better with improved decision making and comply with treatment. To assess the knowledge about psoriasis in patients diagnosed with psoriasis attending skin outpatient department (OPD) of Sree Balaji Medical College and Hospital, Chennai. This was a cross sectional study, which was conducted at dermatology OPD in Sree Balaji Medical College and Hospital, Chennai 2021 after ethical committee approval. About 80 patients with psoriasis attending OPD were included in study to whom questionnaire with sixteen questions was asked and data was collected and analysed. A total of 80 individuals were included in this study, out of which 43 were males and 37 were females .79% of study population answered that psoriasis is a long life disease. About 75% and 71% of patients answered that climatic conditions and stress aggravates psoriatic lesions respectively. Results were taken from various questions asked in survery and tabulated. The results of the present study suggest that an educational intervention may be helpful in improving the knowledge, give psychological relief to patients with psoriasis and improves quality of their life .
A study to evaluate the efficacy and safety of intradermal and intralesional Purified Protein Derivative (PPD) for treatment of common warts in children
Authors: Mehta Karaninder Singh , Chandel Monika , Chauhan Pushpinder Singh , Mahajan Vikram K. , Verma Yograj , Sharma Hitender Kumar , Sharma Anuj , Sharma Reena 
Published: December 2021

: Viral warts are common dermatological diseases with wide range of treatment modalities. Utilization of various vaccines and skin test antigens has broadened the horizon of available immunotherapeutic agents for the treatment of warts. In this study, we compared efficacy and safety of intradermal and intralesional purified protein derivative (PPD) for treating common warts in children.Toevaluate efficacy and safety of intradermal and intralesional PPD in treatment of common warts in children.: 180 children (aged 5-15 years) with common warts were randomly divided to receive intradermal (n=90) PPD 10 TU/0.1 ml at middle third of right forearm or intralesional PPD (n=90) 0.1 ml in the largest wart once in 2-weeks till there is complete clearance or maximum of five injections whichever is earlier. Patients were followed at 4 week after last injection for assessment of response, adverse effects, and recurrence of common warts.: Complete, partial clearance and no response in 51.2%, 45.3% and 2.3% children was observed in intradermal group as compared to 54.2%, 42.5% and 1.1% response in intralesional group respectively. Recurrence of warts was observed in 1.2% and 2.2% children in intradermal and intralesional group respectively. Pain was the most common adverse effect in both groups followed by erythema lasting for 2-3 days not warranting for discontinuation of treatment in any patient.: Overall 96.5% and 96.7% patients in both intradermal and intralesional group responded to treatment respectively. We conclude that immunotherapy with PPD appears safe, effective, and acceptable treatment modality for common warts in children. Although intralesional group showed slightly higher efficacy for warts (0.2%), intradermal PPD has advantage of less pain, high patient satisfaction, less spillage of injection material onto surroundings and better compliance over intralesional group and hence can be considered as valuable first line treatment in children in resource poor developing countries.
The clinical type and etiological agents of superficial dermatophytosis: A cross sectional study
Authors: Agrahari Sushmita , Shivam  , Goel Shitij , Maddali Gopi Krishna 
Published: December 2021

Dermatophytosis are fungal infections caused by three genera of fungi that have the unique ability to invade and multiply within keratinized tissue (hair, skin, and nails). Although dermatomycoses are globally distributed, the endemic and most prevalent species of dermatophytosis differ strikingly from one geographic locality to another. Changing trend has been noticed in last few years with dermatophytic infections presenting as chronic, treatment unresponsive and recurrent. Also various microscopic and fungal culture studies have shown shift in identification of causative fungal species in recent years. Numerous studies have been done on the occurrence of dermatophytes in various parts of our country illustrating the range and changing pattern of fungal infection as well as causative fungal species. Total number of 150 patients attending outpatient department of our hospital who were clinically diagnosed as having superficial dermatophytosis were enrolled into the study. Patients were carefully screened as per inclusion and exclusion criteria and then enrolled in the study. Samples were taken from all the patients and examined for KOH direct microscopy and sent for fungal culture on Sabouraud’s Dextrose Agar as well as on Dermtophyte Test Medium. Results were then analyzed using standard statistical methods. Out of total 150 patients, 101 were males and 49 were females. Most common age group was 21-30 years (37.3%). 58 patients (38.7%) showed positivity to KOH microscopy as well as fungal culture. Additionally 25 more samples demonstrated positivity to KOH microscopy (total 83 patients) but negativity to culture, while 9 patient samples were positive to culture but negative to direct microscopy. Predominant fungal species isolated on culture was Trichophyton mentagrophytes (50.7%) while next common species isolated was T. tonsurans (29.9%). No significant association was found between dermatophyte isolate on culture and clinical type. Trichophyton mentagrophytes and Trichophyton tonsurans were the most common species isolated among subjects with Tinea faciei, Tinea cruris and Tinea corporis. The study showed a male preponderance and T. corporis was the commonest clinical type found. Majority of patients were in the 3rd decade and came within a duration of 1 month to 6 months of getting an infection. In patients diagnosed with tinea corporis, tinea cruris, tinea pedis and tinea manuum, T. mentagrophytes was the most predominant species isolated.
A zöldinfrastruktúra-fejlesztés célterületei Magyarországon
Authors: Török Katalin , Csőszi Mónika , Vaszócsik Vilja , Schneller Krisztián , Teleki Mónika , Kollányi László , Keszthelyi Ákos , Máté Klaudia , Csecserits Anikó , Halassy Melinda , Kertész Miklós , Szitár Katalin 
Published: December 2021

A biodiverzitás pusztulásának visszafordítása érdekében a természeti tőke növelésére van szükség. Ennek módját az EU Biodiverzitás Stratégiája a zöldinfrastruktúra fejlesztésében látja. Az országos zöldinfrastruktúra-elemek meghatározása és állapotuk értékelése, valamint a fejlesztési javaslatok kidolgozása három pilléren alapul: az ökológiai állapot, az ökoszisztéma-szolgáltatást nyújtó képesség és a térbeli összekapcsoltság értékelésén. Az itt ismertetett, egy KEHOP projekt keretében végzett kutatás során egységes értékelés készült a térképezett ökoszisztéma-típusokra, ami alapján meghatározták a védelemre, potenciális állapotjavításra vagy ökoszisztématípus-váltásra alkalmas területeket. A potenciális beavatkozási területek - a restauráció célterületei, az ország 88%-a - tovább priorizálhatók a különböző konfliktusterületek lehatárolásával. A restauráció során kialakítandó célélőhelyek meghatározása modellezéssel történt. Az eredmények a természetvédelemben és a területhasználatot befolyásoló ágazati döntéshozásban alkalmazhatóak.
Absence of virological and epidemiological evidence that SARS-CoV-2 poses COVID-19 risks from environmental fecal waste, wastewater and water exposures
Authors: Sobsey Mark D. 
Published: December 2021

Abstract
This review considers evidence for infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presence and COVID-19 infection and illness resulting from exposure to environmental fecal wastes and waters. There is no documented evidence that (1) infectious, replication-capable SARS-CoV-2 is present in environmental fecal wastes, wastewater or water, and (2) well-documented epidemiological evidence of COVID-19 infection, illness or death has never been reported for these exposure media. COVID-19 is transmitted mainly by direct personal contact and respiratory secretions as airborne droplets and aerosols, and less so by respiratory-secreted fomites via contact (touch) exposures. While SARS-CoV-2 often infects the gastrointestinal tract of infected people, its presence as infectious, replication-capable virus in environmental fecal wastes and waters has never been documented. There is only rare and unquantified evidence of infectious, replication-capable SARS-CoV-2 in recently shed feces of COVID-19 hospital patients. The human infectivity dose–response relationship of SARS-CoV-2 is unknown, thereby making it impossible to estimate evidence-based quantitative health effects assessments by quantitative microbial risk assessment methods requiring both known exposure assessment and health effects assessment data. The World Health Organization, Water Environment Federation, US Centers for Disease Control and Prevention and others do not consider environmental fecal wastes and waters as sources of exposure to infectious SARS-CoV-2 causing COVID-19 infection and illness.