bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idiopathic Hypothalamic Dysfunction and Impaired Control of Breathing
Authors: DURIVAGE S. KENT , WINTER ROBERT J. , BROUILLETTE ROBERT T. , HUNT CARL E. , NOAH ZEHAVA 
Published: December 2021

Hayek and Peake1 described a syndrome of hypothalamic dysfunction consisting of obesity, hypodipsia, recurrent hypernatremia, hyperprolactinemia, and hypothyroidism without evidence of a structural hypothalamic lesion. We report two additional children with this syndrome of hypothalamic dysfunction, both of whom also had central hypoventilation syndrome. 2 The concurrence of hypothalamic dysfunction and central hypoventilation syndrome suggests that common pathophysiologic mechanisms may be involved. The future study of additional patients may help in determining the fundamental cause of the endocrine and respiratory dysfunction.
CASE REPORT
Case 1
A 4-year-old white girl referred for obesity, had a height age of 4.5 years and a weight age of 11 years.
Adolescent Pregnancy and Childbearing: New Data, New Challenges
Authors: MCANARNEY ELIZABETH R. 
Published: December 2021

According to a study published by Zelnik and Kantner in 1980,1 approximately 70% of unmarried young women reported having had coitus by 19 years of age. In a recent study by Clark and colleagues,2 approximately 87% of black male adolescents attending an inner-city school in Baltimore reported having had coitus. An estimated 1 million adolescent pregnancies result from this coital activity; approximately two thirds eventuate in births and one third in abortion.3 Most pregnant adolescents are unmarried; of those who give birth, most keep their children.
Even though the demographic data have not changed over time, our understanding of the risks of adolescent childbearing has improved.
Too Long for Too Little
Authors: OSKI FRANK A. 
Published: December 2021

In 1974, the National Institute of Child Health and Human Development initiated a six-institution collaborative study to evaluate phototherapy as a therapeutic modality for the management of neonatal hyperbilirubinemia. The first phase of the study was completed in 1976; the results of this work were published in 1985. Too long to wait.
The study was undertaken primarily, we are told, to answer two important questions: (1) "Is phototherapy effective in preventing brain injury from hyperbilirubinemia, when employed to lower serum bilirubin levels?" and (2) "Is phototherapy as effective as exchange transfusion at predetermined serum bilirubin levels for preventing brain damage from neonatal hyperbilirubinemia?" The answers to these questions are not provided in the published report.
Health Education and Schools
Authors:   Committee on School Health
Published: December 2021

Health education is a key element in comprehensive health care. The primary purpose of health education is to establish patterns of living that will discourage disease and enhance well-being. Beginning in early childhood and throughout life we make decisions that affect our health. For the most part, these decisions are made without much contact with a health care system; yet, their cumulative impact has a greater effect on the length and quality of life than the effect of all of our medical care combined. Many of our nation's major health problems are caused by or are exacerbated by personal practices (life-styles) detrimental to health. Modification of these practices might improve health more than any spectacular biomedical breakthrough.
The Committee on School Health believes that community health education programs are a viable method of changing poor health practices; therefore, the Committee makes the following recommendations:
1. Health education is a subject that should be taught as part of basic education. Health education deserves the same priority in the curriculum as the traditional subjects that are taught in school.
2. Planned integrated programs of comprehensive health education should be a requirement for students from kindergarten through grade 12. Instruction should be given by teachers specifically qualified and, if possible, certified to teach health education. The health curriculum should be appropriate for the children's age and maturity at each grade level. A comprehensive health education program should include in integrated fashion the following subjects: physiology, genetics, accident prevention, venereal disease, alcoholism, mental health, parenting, sex education, medication and drug use and abuse, environmental and consumer health, nutrition, exercise, preventive medicine, anatomy, and bacteriology. The comprehensive approach to health education is more successful in developing positive health habits than approaching health education by isolated health subjects, such as "Drug Abuse Control" or "Venereal Disease Control."
Extrahepatic Biliary Atresia in One Human Leukocyte Antigen Identical Twin
Authors: MOORE THOMAS C. , HYMAN PAUL E. 
Published: December 2021

Extrahepatic biliary atresia is a neonatal disorder of unknown etiology that occurs approximately once in every 10,000 births. The absence of biliary atresia in stillborn infants suggests an acquired cause for this malformation. The nature of its occurrence in twins clearly would be helpful in gaining a better insight into the pathogenesis of biliary atresia.
Only three reports of biliary atresia in twins have appeared in the literature. In two reports, biliary atresia occurred in only one of nonidentical twins.1,2 In one report, in the Russian literature, biliary atresia occurred in both twins of unknown zygosity.3 We now report the occurrence of operatively established extrahepatic biliary atresia in only one HLA identical twin.
Extracorporeal Membrane Oxygenation and the Play the Winner Rule
Authors: PANETH NIGEL , WALLENSTEIN SYLVAN 
Published: December 2021

The therapeutic trial comparing extracorporeal membrane oxygenation with conventional treatment in neonatal respiratory failure reported by Bartlett et al (Pediatrics 1985;76:479-487) uses a method of comparing treatments unlikely to be familiar to most pediatricians. Known as the "randomized play the winner" method, it has thus far been little used in clinical research. Most clinical investigators consider the conventional randomized clinical trial to be the last word in treatment comparisons.
But randomized clinical trials are costly, cumbersome, and to some observers less than ideal ethically. The ethical problem arises from the fact that during a "successful" randomized clinical trial (ie, one that demonstrates a significant advantage to one treatment) about half of the trial subjects will receive a treatment which, at the end of the trial, will be known to be inferior.
Prevention of Pertussis—Are We Failing?
Authors: BRUNELL PHILIP A. 
Published: December 2021

Through the years, a system has evolved to assure that children are protected against pertussis and other infectious diseases. Its success is attested to by the dramatic decline in diseases caused by the organisms these vaccines are designed to prevent. The infrastructure upon which this system is dependent has been invisible. Components become apparent only as we become concerned about its viability. It is useful to identify each of these and attempt to assess how it is performing in order to identify specific problems.
Pertussis vaccine is one of the oldest vaccines in continuous use. It is an experiential preparation. Its use is based on the observation that a given number of injections of vaccine, which has been standardized by the vaccine's ability to protect mice against intracerebral challenge with virulent pertussis organisms, reduces the risk and severity of pertussis in those who are exposed.
Propylene Glycol Plasma Level
Authors: GLASGOW ALLEN M. , BOECKX ROGER L. , MILLER MARILEA K. , MACDONALD MHAIRI G. , AUGUST GILBERT P. , GOODMAN STEPHEN I. 
Published: December 2021

In Reply.—
We thank Dr Hall and his associates for pointing out the typographical error in our formula for estimating propylene glycol concentration from osmolal gap.1 The correct formula is, as presumed by Hall et al, propylene glycol (mg/dL) = 47.5 + (osmolal gap x 9.2).
It is important to remember that both our formula and that developed by Fligner et al2 are determined from linear regression analysis of experimentally derived data and are not theoretical calculations based on chemical properties of propylene glycol.
Fiftieth Anniversaries Are Special
Authors: HAGGERTY ROBERT J. 
Published: December 2021

Golden anniversaries are very special. The 50th anniversary of Title V of the Social Security Act of 1935 has extra significance for the American Academy of Pediatrics. The Academy owes its existence in large part to the events leading up to the Act and the current implementation of the Act has been greatly influenced by the Academy. The story deserves telling again.1,2
Maternal and Child Health (MCH) received national visibility with the first White House conference in 1909, which led to the formation of the Children's Bureau in 1912. The first studies done by this organization highlighted the high rate of infant mortality and severe handicaps among children.
Worldwide Control of Hepatitis B Virus: An Approaching Reality?
Authors: FRANCIS DONALD P. 
Published: December 2021

Hepatitis B virus (HBV)-related diseases, which include acute hepatitis, chronic hepatitis and cirrhosis, and primary liver cancer, are major problems throughout much of the world. During the past several years, safe and effective HBV vaccines have been produced that have opened the way for the eventual control of these diseases.
Although of use throughout the world, the greatest need for HBV vaccine is in east Asia and subsaharan Africa where the vast majority of the population is infected with this virus by early adulthood.1 Early in HBV vaccine history, the late Dr Maupas and his colleagues2 showed that the control of HBV infection in the developing world was possible.
Black Patients—White Doctors
Authors: KAMINER RUTH KAHAN 
Published: December 2021

To the Editor.—
Dr Levy's article, "White Doctors and Black Patients: Influence of Race on the Doctor-Patient Relationship" (Pediatrics 1985;75:639-643), addresses an important topic but concludes by giving contradictory advice. The underlying issue is one of cross-cultural communication between doctors and patients who belong to different subcultures in the same society. The physician needs to know and respect the usual pattern of beliefs and behaviors in the patient's subculture in order to know which premises are shared with him or her, to recognize deviation, and to communicate effectively.
Black Patients—White Doctors
Authors: LEVY DAVID R. 
Published: December 2021

In Reply.—
My article on white doctors and black patients represent a modest attempt to address a complex and neglected issue in pediatric practice. I certainly do not regard myself as an expert and some might go further and say it is presumptious for a white, middle class male to write about black, indigent females. Thus, Dr Kaminer's comments and approaches are much appreciated and assuredly enhance the relationship between doctors and patients. I believe I can justify my contention that the advice I gave was not contradictory, but rather than highlight our minor differences, I would much rather welcome and endorse Dr Kaminer's valuable contribution based on her extensive and varied experiences in treating a truly multiethnic community in the Bronx.
Epidemiology of Neonatal Hyperbilirubinemia
Authors: LAU S. P. , FUNG K. P. , FOK T. F. 
Published: December 2021

To the Editor.—
The reported positive associations between certain factors (use of contraceptive at the time of conception, premature rupture of membrane, and bleeding in the first trimester) and neonatal hyperbilirubinemia are puzzling and difficult to explain by present date knowledge of the relevant pathophysiology (Pediatrics 1985;76:770-774). The authors offer no explanation for their findings. The pertinent question is whether the statistical associations between one or more variables and neonatal jaundice occur simply by chance. It must be appreciated that the likelihood of statistical type I error can be considerable in this type of exercise when a multitude of 19 variables is analyzed simultaneously.1,2
Bifid Uvula
Authors: SHPRINTZEN ROBERT J. 
Published: December 2021

In Reply.—
I would like to acknowledge in a very positive way Dr Eavey's letter. I will represent my own opinions as well as those of my co-authors with whom I have consulted. He has made several very good points. We regret that he believes we have been a bit too overstated in our approach to the potential problems presented by bifid uvula. Toward this end, his comments regarding the removal of adenoids to relieve obstructive sleep apnea (OSA) are well taken.
Elevation in Systemic Blood Pressure in the Neonate During Abdominal Examination
Authors: SINKIN ROBERT A. , PHILLIPS BARRY L. , ADELMAN RAYMOND D. 
Published: December 2021

Systemic BP is a function of circulating blood volume, cardiac output, and total peripheral vascular resistance. Important variables affecting an infant's BP include sodium and water balance, cardiac function, especially myocardial contractility, and neurohumoral factors.1
External devices that increase intraabdominal pressure such as abdominal binders,2 pneumatic trousers3,4 and manual abdominal compression5,6 also increase systemic BP, presumably by increasing venous return and intrathoracic pressure. Their benefit in improving cardiac output has been demonstrated during cardiopulmonary resuscitation.7,8
Because of these studies and the casual observation of an increase in BP in a newborn infant following abdominal palpation, we evaluated the effect of routine abdominal examination such as palpation of the liver, kidney, and bladder on systemic BP in the neonate.
Woodticks
Authors: COCHRAN WILLIAM D. 
Published: December 2021

To the Editor.—
I was half charmed and half appalled to read the article about how to get rid of woodticks in Pediatrics (1985; 75:997-1002). Charmed because I could understand it all, appalled that it received such status. In the days of yore on Cape Cod when mostly the dogs, but occasionally us, got woodticks, we would pull them out vigorously (sometimes 50 at a setting), skin and all coming if they were firmly enough attached.
Forgotten Full-Term Infant Mortality Rate
Authors: DUJARDIN B. , VANDENBUSSCHE P. , BUEKENS P. , BECKERS R. , VERLINDEN M. , WOLLAST E. 
Published: December 2021

To the Editor.—
In a recent article,1 Bloom discussed the problem of future reductions in infant mortality. He has proposed three ways of meeting this problem: by determining the efficacy, effectiveness, and cost of each intervention in medical care, by substituting less expensive interventions in place of more expensive care, and by separating social solutions from medical solutions for illness.
We appreciate his proposals, but we find that such an approach rules out the following two steps: (1) It is necessary to have a better understanding of the current changing trends in neonatal and postneonatal mortality.
Farm Accidents
Authors: PAULSON JEROME A. 
Published: December 2021

To the Editor.—
I hope the article by Cogbill et al1 (and the companion piece by Rivara2) will become the seminal work in an area that needs to become better described and evaluated.
There are two issues that I would like to raise. First, I question the low incidence of major long-term disability (1%) that they describe. It is not clear the length of time after the injury that was covered in the retrospective review of the outpatient charts.
Fresh Frozen Plasma Partial Exchange Transfusion and Necrotizing Enterocolitis
Authors: WISWELL THOMAS E. , CORNISH J. DEVN 
Published: December 2021

To the Editor.—
In their article, Black et al1 cite a surprising incidence of complications of polycythemia in their partial exchange transfusion-treated v their nonexchange populations. Of particular note is the remarkable incidence of necrotizing enterocolitis (eight of 43 patients or 18.6%) in the exchange group. In the nonexchanged group, no infants were so affected. In a previously reported prospective study of 7,133 consecutive live births at Tripler Army Medical Center, Hawaii, a total of 82 infants were identified as having neonatal polycythemia (venous hematocrit 65% or greater).2
Views of Graham Challenged
Authors: CHRISTOFFEL KATHERINE K. 
Published: December 2021

To the Editor.—
I am writing with a correction concerning the recently published Letter to the Editor,1 challenging George Graham's commentary on poverty and malnutrition.2 Readers may be confused by mention of Dr Lattimer in Dr Graham's reply,3 as Dr Lattimer's name is not among the signers whose names appear under the challenge letter. This is because the names of seven signers were somehow omitted. The omitted signatures were those of Agnes D. Lattimer, MD, Myrtis Sullivan, MD, Kinfe Gebeyehu, MD, Parviz Danesh, MD, Naomi Kistin, MD (all from Cook County Hospital), Frank K. Thorp, MD, PhD (University of Chicao/Wyler Child's Hospital), Yolanda Hall, RD (Rush-Presbyterian St. Luke's Medical Center).
Biochemical, Clinical, Epidemiologic, Genetic, and Pathologic Data in the Pediatric Age Group Relevant to the Cholesterol Hypothesis
Authors: KWITEROVICH PETER O. 
Published: December 2021

The recent National Institutes of Health Concensus Conference on Lowering Blood Cholesterol to Prevent Heart Disease made several recommendations for healthy children older than 2 years of age.1 These recommendations are summarized in Table 1.
In a commentary in Pediatrics, A. M. Mauer2 outlined three major concerns regarding the proceedings and recommendations of this consensus conference. First, he concluded from the proceedings that "the significance of serum cholesterol levels as an independent variable could not be definitely assigned." Second, data from adults were being extrapolated to children; "there are no available data on children." Third, he questioned the safety, feasibility, and efficacy of the dietary recommendations for children and adolescents.
Home Phototherapy Recommendations Questioned
Authors: POLAND RONALD L. 
Published: December 2021

In Reply.—
Dr Grabert provides me with an opportunity to relate some of the process that the Committee on Fetus and Newborn went through in constructing the statement on home phototherapy. Most statements start with the request of a practicing pediatrician who wants guidelines for a problem that is not well-defined in available texts and articles. In this case, guidelines were being sought for a procedure that had the potential of saving a substantial part of the costs of hospitalization or rehospitalization of neonates just for phototherapy.
Infants With Severe Respiratory Failure and Persistance of the Fetal Circulation, Without Hyperventilation
Authors: LEVIN DANIEL L. 
Published: December 2021

To the Editor.—
I just finished reading the article by Wung et al Pediatrics 1985;76:488-494). I was quite surprised at the publication of this article. There are several problems that make it such that I question its appropriateness in the article section of Pediatrics. The most important objection is that it is a retrospective collection of patients who were treated by some general treatment plan with no prospective analysis or control group. The data collected are dubious at best; for example, the authors do not state where the O2 samples were drawn and they do not define what they mean by the patient's oxygenation being improved with tolazoline.
Role of the Pediatrician in Prevocational and Vocational Education of Children and Adolescents With Developmental Disabilities
Authors:   Committee on Children With Disabilities
Published: December 2021

The majority of developmentally disabled adolescents who were once considered unemployable have now been demonstrated to have employment potential if appropriate educational support, family support, and medical services and planning are combined to encourage maximum independence.1,2 Concern for a child's eventual vocational placement may not traditionally be seen as part of the pediatrician's responsibility; however, pediatricians are in a unique position to be advocates for children with disabilities and for their families. Pediatricians are often the first to identify the disability for the family, and they assist in the family's adjustment to the child's special needs while providing ongoing care to both the child and family. With an enlightened eye to the child's eventual ability to function in society, the pediatrician can make a great contribution to the disabled child's future through the traditional functions of (1) diagnosis and management of medical problems, (2) education and counseling of parents, and (3) patient advocacy.
As part of health maintenance, pediatricians provide or coordinate the diagnosis and management of medical problems such as vision impairment, hearing loss, communication disorders, seizures, and motor disabilities. As members of interdisciplinary groups that generate a health services plan, pediatricians join in the evaluation and treatment planning for children. Pediatricians should also provide information for medical and therapeutic plans for these children and material for family discussions on long- and short-term personal goals for such children.
No matter how skillful the professional services, the family's culture has the strongest influence on patient behavior. For vocational planning, in addition to the ability to be trained in and to master specific technical skills, social behavior is a major variable in determining success.
Hazards of Baby Powder
Authors: MOFENSON HOWARD C. , CARACCIO THOMAS R. , OKUN SHARON , GREENSHER JOSEPH 
Published: December 2021

To the Editor.—
In a recent letter to the editor, Cotton and Davidson1 have brought the hazards of baby powder aspiration to the attention of the medical community.
We have been monitoring episodes of possible powder inhalation and ingestion in our community (population 3 million) since 1980, when two infants were hospitalized
[See table in the PDF file]
for powder aspiration and one required ventilator therapy for two days. Our recent data (Table) shows a progressive decrease in the number of possible inhalations and ingestion episodes since 1981 when our article2 was published in Pediatrics and the American Academy of Pediatrics publicized the hazard of baby powder.
Statistics and Sudden Infant Death Syndrome
Authors: ORAN JOSEPH , CARLEY DAVID , KELLY DOROTHY , SHANNON DANIEL 
Published: December 2021

In Reply.—
Although the contingency tables noted by Dr LeBlanc each contain one cell with an expected frequency of less than 5, the Yates correction, which applies to all 2 by 2 tables irrespective of expected frequencies, does not address this issue. Furthermore, we agree with Grizzle1 that this correction produces an extremely conservative test and should not be used. Fisher exact test, however, is germane to the problem of small numbers. The results of this test are in good agreement with our published values.