bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive Assessment of Left Ventricular Function Related to Serum Digoxin Levels in Neonates
Authors: Sandor George G. S. , Bloom Kenneth R. , Izukawa Teruo , Patterson Michael W. H. , Rowe Richard D. 
Published: December 2021

Eighteen neonates in heart failure were investigated to assess whether high or low serum digoxin levels had differing effects on left ventricular function as determined by systolic time intervals obtained by echocardiography. Nine patients had digoxin levels of 1.99 ± 0.35 ng/ml (group 1). Nine others had levels of 3.62 ± 0.95 ng/ml (group 2). Systolic time intervals were obtained by echocardiography before and at 5 days after digoxin and correlated with serum levels. The heart rate, preejection period (PEP), left ventricular ejection time (LVET), electromechanical systole (QS2) and the PEP/LVET ratio were measured. LVET and electromechanical systole were indexed. These measurements were analyzed, and the two groups were compared using Student's t test.
The clinical improvement in both groups was similar and no difference in ECG changes were noted. Therapy with digoxin produced changes in heart rate and systolic time intervals in both groups. Both showed significant shortening of electromechanical systole index; group 1 significantly shortened the LVET index and PEP/LVET ratio, whereas group 2 significantly shortened the PEP. Statistical analysis comparing the two groups showed no difference between them.
Digoxin produces measurable changes in the indices of left ventricular function. The magnitude of these changes suggests no therapeutic advantage to the higher levels.
Familial Asplenia, Other Malformations, and Sudden Death
Authors: Katcher Avrum L. 
Published: December 2021

Two families have been presented. In one, asplenia occurred with and without gastrointestinal malformations. In the other, cardiovascular malformations occurred in one member and Ivemark syndrome in the other. All three children with asplenia died in infancy, two with evidence of sepsis. Sudden death in infancy may be due to sepsis in a child with isolated asplenia syndrome and impaired resistance to infection. Both isolated asplenia and some cases of congenital heart disease without asplenia may be related to Ivemark syndrome.
New infants born in families with a history of congenital cardiovascular malformations, visceral heterotaxy, or other malformations associated with Ivemark syndrome should be tested for asplenia, primarily by searching for Howell-Jolly bodies. infants with asplenia should be protected with prophylactic antibiotics. Pneumococcal polysaccharide vaccine is indicated at the age of 2 years.
It would appear worthwhile for pediatric surgical or pediatric cardiologic services to perform a screening program for Howell-Jolly bodies.
Injuries to Young Athletes
Authors: Flynn Thomas G. , Kennell John H. , McLeod Robert N. , Shaffer Thomas E. , Strong William B. , Thornton Melvin L. , Van Rooy Clemens W. , Wilkins Kaye E. , Baker Fred W. , Malacrea Richard F. 
Published: December 2021

Numerous factors must be considered in protecting the health of athletes. Of fundamental importance to physicians are (1) the prepaticipation medical examination for authorization to enter a sports program, and (2) the prevention, recognition, and treatment of injuries incurred in sports. The purpose of this statement is to call attention to the subject of sports injuries so that pediatricians can take measures to protect their young patients and set up a system for diagnosing and treating athletic injuries.
Young athletes present special problems that are perhaps more familiar to pediatricians than to other physicians and supervisors of sports programs:
1. Their strength is not proportional to their size, resulting in wide differences in physical performance of individuals of the same age.
2. Young athletes are impatient about restrictions on activities, even when restrictions are necessay for the diagnosis and the healing of injuries.
3. Flexible ligamentous structures and open epiphyses result in susceptibility to musculoskeletal injuries that should have prompt evaluation and treatment.
4. Some children and adolescents have unrecognized congenital conditions that make them more susceptible to athletic injuries.
5. Young athletes usually lack motivation to work hard to condition their bodies for endurance, strength, and acclimatization to heat.
6. Many young athletes are disinterested and indifferent about the fitting, adjustment, and care of their protective equipment.
7. Young athletes in sports programs sponsored by schools or community agencies rarely have the benefit of supervision and advice from a qualified athletic trainer. The duties of an athletic trainer are usually assumed by a coach or parents, or by a physician who at times may be available only by telephone.
Breast Pumps
Authors: Hervada Arturo R. 
Published: December 2021

I would like to recommend two breast pumps that we have found to be very useful to nursing mothers. From correspondence with pediatricians in various parts of the country, I have gotten the impression that many of them are not aware of these useful adjuncts to human lactation.
The first one, the "Loyd-B-Pump" (Fig 1) is a simple, hand-triggered pump that we have found very helpful for the working, nulsing mother who needs to pump her breasts once or twice daily to collect her own milk.
ON AIR INSUFFLATION FOR THE TREATMENT OF INTUSSUSCEPTION– AS REPORTED IN 1864
Authors: C. T. E. 
Published: December 2021

The first successful surgical operation for intussusception in an infant was reported in 1874.1 Prior to this date, infants with intussusception were occasionally treated by introducing air into the rectum by means of a tube attached to a common pair of bellows.
In 1864 David Grieg2 of Dundee, Scotland published the first detailed report of the successful treatment by insuffiation of several infants with intussusception. This is how he described his first case.
Case I.—M.S.G., a stout, healthy, female child, 6 months old, always enjoyed good health, never having had a day's sickness; never had any food except breast milk; never troubled with diarrhoea or bowel complaint. Was in her usual good health on Monday, 13th October 1862, up to 6 o'clock in the evening, when, without any obvious cause, she suddenly became fretful, kicking with her feet, bending the body backwards, and screaming. In about ten minutes she became very sick and vomited severely. The skin became cold and clammy, the countenance pale, and the lips livid.... She seemed to have great pain in the abdomen, which came on in paroxysms, and to increase in intensity until she vomited, when she would seem relieved a little, or at least so faint and sick as not to scream. When given the breast, she would take it readily; but as the sickness and vomiting, with a paroxysm of pain, immediately came on, she latterly refused it. Immediately when she was seized a spoonful of castor oil was given, and hot fomentations were applied to the abdomen.
HYDROPATHY, OR THE WATER-CURE, AS AN ESCAPE FROM THE PITFALLS OF ALLOPATHIC PRACTICE, AS VIEWED IN 1851
Authors: C. T. E. 
Published: December 2021

During the nineteenth century many medical sectarians arose to challenge the heroic treatment of the allopaths with their insistence on bleeding, blistering, purging, and dosing with calomel. The hydropaths, one of the most influential of these sects, rejected all drugs and placed their faith solely in natural cures such as fresh air, sunshine, exercise, natural diet (often vegetarian), and above all, water, which they used in every conceivable way.
Mrs Mary Gove Nichols, a nonphysician health reformer, opened a water-cure establishment in New York City about 1848. She believed that the spread of hydropathy would eventually make physicians obsolete.
Mrs Nichols1 described how a friend's child was "murdered by the ignorance, and the time-honored death-dealing system of Allopathy." This event led her to embrace the "water-cure" method which she forcefully popularized during the middle part of the last century. She wrote:
A mother...mourned all the time for a child of four years, who had been seized with croup. The mother was thrust out of the room, and the door locked by her family physician, because she was averse to bleeding, and then the child was bled into a dead fainting fit, and revived to take dose after dose of calomel, till the doctor gave her up to die, and another distinguished allopathic physician was sent for. He decided that the only chance of saving the child was to compel it to breathe the fumes of burning calomel. This was done five times; the child struggled so as to escape from the father, who held her with all his force, and ran across the room.
Professional Courtesy
Authors: Bass Lee W. , Wolfson Jerome H. 
Published: December 2021

Professional courtesy is a practice that has outlived its usefulness. Today it stands in the way of a physician and his family getting the best care available. It is an anachronism which in the modern medical milieu defeats the noble purpose it was originally intended to serve. Physician attitudes toward each other and their patients should be an integral part of the ongoing ethical discussion, starting at the beginning of medical school and continuing on throughout one's medical career. The concept and implications of professional courtesy should be included in these discussions because they go to the heart of getting and giving the best care available.
Major criticisms against doing away with professional courtesy are that this somehow denigrates the medical profession, removes the aura of medicine, casts a shadow on its nobility, and somehow translates itself into the idea that money is what is good about medical care. We feel the central concept of the doctor-patient relationship (no matter who the patient is) should be a special sense of caring. However, not charging for care makes it different for the patient and the physician. Both may feel compromised. Both may feel the loss of freedom to react. Charging for care says that the patient's needs are significant, deserve attention, and that the doctor's services have value.
Pediatrics, perhaps more than any other specialty, requires frequent communication and visits between physician and patient and entails extensive use of the telephone. We feel that because of professional courtesy many physician-parents and their spouses are deterred from using pediatric services appropriately by timely office visits or telephone calls. They therefore do not receive optimal care.35
In starting practice, the young physician must make a decision when he sees his first doctor-patient. Although he may have never been taught about the concept, somewhere in the back of his mind is a thought that Hippocrates said physicians should not charge other physicians for care, and so he establishes a precedent of professional courtesy that usually remains through a lifetime of practice and is very difficult to change or abandon. It is therefore at the start of practice that the disadvantages of professional courtesy should be most carefully considered. We recommend not starting the custom. But even if it has already been started, we recommend that this anachronism be abandoned.
Pulmonary Edema and Croup
Authors: Hurley R. Morrison , Kearns J. R. 
Published: December 2021

There have been two reports of children1 and adults2 developing acute pulmonary edema secondary to acute upper airway obstruction. We are reporting a similar case which demonstrates the same association.
A 5-year-old girl had a mild upper respiratory tract infection and harsh cough two days prior to admission in April 1975. She awakened suddenly the evening of admission unable to breathe. She improved slightly in the cold outside air en route to hospital, but on arrival she developed acute distress with laryngeal stridor suprasternal and intercostal indrawing.
Overconcern and Overtreatment
Authors: Volpe Frank J. 
Published: December 2021

Recently I received the pamphlet "Age 3 - Age 7" from the American Association of Orthodontists. It strikes me as a not-so-subtle marketing effort to increase the business of orthodontists. Could it be that pediatricians are being asked to do their marketing for them?
At a time when health care professionals should be doing their utmost to decrease costs and unnecessary utilization of health services, this pamphlet encourages increased utilization of services of questionable worth.
‘Knocked Out’—An Early Sign of Intussusception
Authors: Thurston Don L. , Thurston Jean Holowach , McCoy Ernest E. 
Published: December 2021

In the July 1979 issue of Pediatrics, Singer reported two cases of intussusception in which altered consciousness was an early manifestation. Singer considered that such findings were atypical except in the case of moribund children with prolonged intussusception, fluid and electrolyte imbalance, blood loss, and/or strangulation of the bowel.
Actually it has long been known that neurologic signs and symptoms are commonly seen early in this disorder. More than 30 years ago, in a study of acute intussusception in 95 infants and children, Oberhelman and Condon reported that "shock or impending shock as an early (the italics are ours) symptom is not adequately stressed in the literature" (Surg Clin North Am 27:3-22, 1947).
The Role of the Practicing Pediatrician in Resident Education
Authors: Greenberg Larrie W. 
Published: December 2021

Pediatric practitioners have always participated in resident education activities; in fact, they have been the prime teachers of residents and medical students in many pediatric centers. They accepted without hesitation the dual responsibility of teaching without remuneration and patient care. During the last ten to 15 years, however, a number of factors have altered this traditional role:
1. The development of sophisticated subspecialties, although strengthening pediatric centers throughout the country, has weakened the role of general pediatricians. As pediatric departments and children's hospitals have become more specialized, the role of the general pediatrician has become less well defined. The pediatric practitioner has felt alienated and excluded and may become an endangered species in the academic setting.
Revised Recommendations on Rubella Vaccine
Authors: Mortimer Edward A. , Fulginiti Vincent A. , Brunell Philip A. , Calderon Ernesto , Cherry James D. , Ector Walton L. , Gershon Anne A. , Gotoff Samuel P. , Hughes Walter T. , Peter Georges , Hinman Alan R. , Jordan William S. , Larke R. P. Bryce , Meyer Harry M. , Easton James G. 
Published: December 2021

The following recommended changes are similar to, but not identical with, those recommended by the US Public Health Service Advisory Committee on Immunization Practices in November 1978.1 These changes focus on more effective delivery of the vaccine to older individuals, in particular to females in the childbearing age group. All comments related to the vaccine and its use pertain to all licensed vaccines available in the United States, including the recently licensed RA27/3 vaccine.
The major objective of the National Rubella Immunization Program is the prevention of rubella infection in early pregnancy, which in turn will prevent infection of the fetus and consequent congenital rubella. Prior to vaccine licensure in 1969, approximately 15% of women of childbearing age were susceptible to rubella. At the present time, more than 83 million doses of live, attenuated rubella virus vaccine have been distributed in the United States, which has clearly resulted in a widespread reduction of epidemic rubella in preschool-and elementary school-aged children. However, since the use of rubella vaccine has not been universal in the target population (only about two thirds of the children 1 to 12 years old have been immunized) and since vaccine usage has disrupted the epidemic nature of rubella, the population for whom antibody protection is desired (women of childbearing age) is still suspected of being as susceptible, or more so, than in the prevaccine era. Indeed, serologic surveys indicate that persons in this age group have a percentage of susceptibility similar to that noted prior to 1969.
Letters to the Editor
Authors: Diamond Eugene F. 
Published: December 2021

I am writing with regard to the statement by the Committee on Adolescence "Pregnancy and Abortion Counseling" (Pediatrics 63:920, 1979). While this statement is, in many ways, forthright and sensitive, it nevertheless tends to perpetuate some of the unfortunate fallacies which surround a much controverted issue.
First of all it identifies abortion as a "sexual matter." While it is true that sexual activity leads to pregnancy which may, in turn, lead to a request for abortion, the controversies regarding abortion are not merely sexual or even primarily sexual.
Letters to the Editor
Authors: Cohen Stanley A. , Hendricks Kristy , Walker W. Allan 
Published: December 2021

Dr. Forsyth's letter and insightful comments are appreciated. It provides the impetus and forum to clarify some potentially confusing statements in our recent publication.
A statistical attrition bias is possible since only 26 complete dietary records were available for follow-up. The patients were drawn from a total population of 500 outpatients seen in our clinic over a 2½-year period. They were examined by various physicians and dieticians during that time. Although vigorous attempts were made to obtain initial and follow-up data on all of the patients with chronic nonspecific diarrhea, those data were not obtainable from all of the patients.
Rising Antibody Titer to Mycoplasma pneumoniae in Acute Pancreatitis
Authors: Oderda Giuseppina , Kraut Jerome R. 
Published: December 2021

Biliary tract disease and alcohol abuse are the most common causes of acute pancreatitis in adults.1 This is in contrast to children in whom the majority of cases were due to steroid therapy, trauma, biliary tract disease, and infection.2 The idiopathic form comprises 20% of the cases.2 Uncommon causes include other drugs, diabetes mellitus, duodenal ulcer, cystic fibrosis, hyperlipoproteinemia, hyperparathyroidism, septic shock, pregnancy, porphyria, kwashiorkor, and scorpion bites.2
Mycoplasma pneumoniae has recently been recognized as a possible cause of pancreatitis in adults.3-6 This paper reports a child who had acute pancreatitis associated with a rising antibody titer to M pneumoniae.
The Pediatrician and Corporal Punishment
Authors: Wessel Morris A. 
Published: December 2021

Concern about child abuse causes many pediatricians to question the widespread use of corporal punishment as a method of disciplining children.
The "spare the rod and spoil the child" philosophy is deeply ingrained in American child rearing. This allows—indeed encourages—many parents and other adults caring for children to spank or hit with the hand, belt, or paddle, or to force a child to stand for long periods of time or to institute other immoderate measures when disciplining seems to be necessary. This acceptance of corporal punishment as a way of dealing with children poses an important question: Why is this true in America while in Luxemburg, Holland, Austria, France, Finland, Sweden, Denmark, Belgium, Cyprus, Japan, Ecuador, Iceland, Italy, Jordan, Mauritius, Norway, Israel, The Philippines, Portugal, and Russia, legislation prohibits the use of corporal punishment by educational personnel? And in Sweden, this prohibition now includes parents!1
Inexpensive Method of Increasing Immunization Rates
Authors: Chilton Lance A. 
Published: December 2021

Recently an 18-month old child with an ear infection was brought to our clinic for treatment. The medical student who saw the patient and who had been taught to be complete found that the child had had no immunizations. She was told by the mother that the child had had a cold every time he had an appointment for "shots." The child received diptheria-pertussis-tetanus, oral polio, and measlesmumps- rubella immunizations in addition to amoxicillin.
Had the mother made a real effort to obtain the immunizations or was this merely a convenient excuse? Although we could not know the answer to this question, we do know that the policy of many public health nurses and other health-care providers in our community is that a child must be in perfect health before an immunization can be given.
Screening for Biopterin Disorders in PKU
Authors: O'Brien Donough 
Published: December 2021

It is now recognized (Pediatrics 65:806, 1980) that a small proportion of cases of phenylketonuria (PKU) may be due to abnormalities in the metabolism of biopterin. These cases do not respond to the restriction of dietary phenylalanine, but may be benefited by neurotransmitter replacement therapy. A specific diagnosis is therefore desirable.
The Nutrition Committee of the American Academy of Pediatrics, in conjunction with the Society for Inherited Disease, announces the availability of an exploratory screening program for new cases of PKU for urinary biopterins.
Infant Enrichment Programs
Authors: Denhoff Eric 
Published: December 2021

The recent article by Piper and Pless1 typifies studies necessary to help place early infant intervention programs on a more objective basis. There is a great need for controlled studies on the effects of various treatments and/or education methods on biologically handicapped babies. This point is emphasized in a current review being prepared for the members of the Committee on Children with Handicaps, American Academy of Pediatrics.
One anticipates both favorable and adverse reactions to the Piper-Pless article.
Inverted Tandem Duplication of the Middle Segment of the Long Arm of Chromosome 14
Authors: Strain James E. , Smith Ann C. M. , Ward Brian E. , Robinson Arthur 
Published: December 2021

Inverted tandem duplications in man are a rare form of structural rearrangements involving a single chromosome.1 We describe a patient with partial trisomy of chromosome 14 due to an inverted tandem duplication of the long arm.
CASE REPORT
The proband was a term product of a 24-year-old mother's second pregnancy. The first terminated in a miscarriage at six weeks. After the birth of the proband, the mother had two miscarriages at six weeks' gestation followed by two term pregnancies resulting in the delivery of normal female infants.
The proband was a male infant whose birth weight was 5 lb 0 oz.