bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Mineral Status Measured by Direct Photon Absorptiometry in Childhood Renal Disease
Authors: Chesney Russell W. , Mazess Richard B. , Rose Philip G. , Jax Diane K. 
Published: December 2021

Bone width (BW), bone mineral content (BMC), and their ratio (BMC/BW ratio) were measured in renal patients using direct photon absorptiometry.
Serial measurements were made on the radius and ulna in 74 children with renal diseases. Values were compared to age-, sex-, height-, and weight-matched controls. The SD from the mean in normal subjects is ± 10%. Significant demineralization (&gt; -2 SD) was found in 42% of all patients and in 75% with tubulointerstitial disease. Twelve patients with nephrotic syndrome and two with systemic lupus erythematosus, all of whom were receiving prednisone therapy and had a serum creatinine level less than 1.0 mg/dl, and three treated with anticonvulsants had significant demineralization. Severe demineralization (&gt; -3 SD) was found in four rachitic patients with tubulointerstitial disease. Normal mineralization was present in 32 patients with various primary glomerular diseases, seven of whom had a serum creatinine level greater than 1.5 mg/dl.
BMC declined with daily prednisone therapy but increased with alternate-day dosage in seven patients.
This study suggests that demineralization is more common in patients with tubulointerstitial disease and in patients with primary glomerular disease who are receiving prednisone (16 patients) or anticonvulsants. Photon absorptiometry appeared more useful than conventional radiographic evaluation in assessing skeletal involvement in childhood renal disease.
Hepatoportal Arteriovenous Fistula and Portal Hypertension in an Infant
Authors: Helikson M. A. , Shapiro D. L. , Seashore J. H. 
Published: December 2021

Hepatic vascular lesions are rare, particularly in children. Hemangioendotheliomas frequently cause congestive heart failure secondary to systemic arteriovenous shunting of blood, whereas fistulas between the hepatic artery and portal vein usually produce portal hypertension and its complications. We report the fourth, and youngest, child with hepatoportal arteriovenous fistula (AVF). The clinical presentation of acute portal hypertension mimicking intestinal obstruction is unique.
CASE REPORT
A 5-week-old, 3.7-kg girl was admitted to Yale-New Haven Hospital with a one-week history of vomiting, diarrhea, and abdominal distention. Pregnancy and delivery had been uncomplicated. Findings of the physical examination were normal except for the abdomen which was distended and tympanitic, with high-pitched bowel sounds.
CHILDHOOD IN CHINA
Authors: Kessen W. 
Published: December 2021

If our observations were at all representative, the outstanding feature of childhood in China, and that which raises the lower basic problem, is the high level of concentration, orderliness, and competence of the children. The docility did not seem to us to be the docility of surrender and apathy; the Chinese children we saw were emotionally expressive, socially gracious, and adept. . . .
Over and over we asked ourselves how the very young Chinese child was brought competence, social grace, and restraint.
Put in its most simplifying form, Chinese children behave the way they do because that is the way children behave! The contrast with common American practice can be easily made. An American teacher (or parent) considers how he or she will effect a change in a child, what should be done with the child to make a difference. This attitude, which runs across many different theories of education, sees teaching as instrumental, as a set of procedures for the purpose of changing behavior. If the instruments of education, whether they are problem setting, positive reinforcement, or modeling, are ineffective, then change is difficult or distorted. Such a consciously instrumental attitude seems far less prevalent in Chinese schools. Rather, we formed the impression that Chinese teachers have uniform expectations of what children at one or another age can do and that they behave with the virtually certain knowledge that the children would come to behave in the expected way—and, critically, it did not much matter whether the children got there early or late.
CREATING PATIENTS
Authors: Spiro H. ,   Student
Published: December 2021

The trouble is, doctors trail a nimbus of disease like Typhoid Mary. Talk with doctors socially, and the talk often turns to disease. Let a stranger at a cocktail party find out what you do, and you are engulfed by his complaints. No wonder the physician tends to view life as a sequence of disorders requiring his attention, and his mission as bringing perfect health. Taught as a medical student to "see one, do one, teach one," no wonder he has the strongest faith in his technologic ministrations.
For example, if current controlled trials confirm that gallstones can be dissolved, even at the cost of continued monitoring, 20 million persons in the United States run the risk of having their lives revolve around a few stones, which they might have carried about to the grave with about as much ill-effect as a rabbit's foot. Some gallstones cause trouble, for many cholecystectomies are carried out each year; yet surely many gallstones must be innocent bystanders in persons who do not know that they have them, or else physicians would not still be finding them at autopsy. Even if all gallstones can be dissolved, physicians must still wonder whether they need to be and whether the large evangelical survey necessary to find the gallstones will create patients out of previously asymptomatic and functioning persons. Time and much money will tell, but I await the mobile vans in the streets reminding persons of their hidden gallstones with the same fervor as Jonathan Edwards might have urged repentance pressing Telpaque tablets and x-ray appointments upon the bystanders.
A 17TH CENTURY ENGLISH CURE FOR RICKETS
Authors: C. T. E. 
Published: December 2021

Sir Thomas Browne (1605-1682) in an essay written probably in 1663 left the curious information that in Norwich, England, the livers of rooks were used for the cure of rickets:
Spermalegous rooks which by reason of the great quantity of cornfields and rook groves, are in great plenty. The young ones are commonly eaten; sometimes sold in Norwich market, and many are killed for their livers, in order to cure the Rickets.
This therapeutic note is of particular historical significance because it was written less than 20 years after Glisson's classic description of the disease (1650) and more than 150 years before the first report of the value of cod liver oil in the treatment of rickets (1824).
DR. WILLIAM DOUGLASS' DESCRIPTION OF SCARLET FEVER IN 1736—AN AMERICAN MEDICAL CLASSIC
Authors: C. T. E. 
Published: December 2021

Dr. William Douglass (1691-1752) was born in Scotland and received his medical education in Paris and Leyden. He came to Boston in 1716, and for a long time was the only physician in Boston with a medical degree. His description of a typical case of scarlet fever as he encountered it during the epidemic of "throat distemper" of 1735-1736 is the earliest description of scarlet fever in American medical literature and has been called "the first adequate clinical description of scarlet fever in English."1 It was vulgarly called the Throat Illness, or a Plague in the Throat.
The first attack is somewhat of a chill or shivering; soon after follows Head ake or some other versatile spasmodick pains, as pain in the back, joints, side etc; a vomiting or nausea, or in some constitutions, which are not easily provoked to vomit, only a certain uneasiness or sickness at Stomach; at the same time the Uvula, but chiefly the Tonsils, were tumified, inflamed and painful, with some white specks, then follows a flush in the Face and some miliary eruptions there with a benign mild fever, the same efflorescence soon after appears on the neck, chest and extremities; the 3d or 4th Day, Eruption is at the hight [sic] and well defined with fair intervals; the flushing goes off gradually with a general itching and in a Day or two more the cuticle scales or peels off, especially in the extremities: At the same time the cream coloured sloughs or specks in the Fauces become loose and cast off, and tumeffactions there do subside.
Cerebral Echinococcosis, a Pediatric Disease: Report of Two Cases With One Successful Five-Year Follow-up
Authors: Pearl Marilyn , Kotsilimbos Dimitrios G. , Lehrer Harold Z. , Rao Andavolu Hanumanth , Fink Harold , Zaiman Herman 
Published: December 2021

Two cases of cerebral echinococcosis in children emphasize the need to consider the Echinococcus in the differential diagnosis of children with CNS signs and symptoms. One patient died because of delay in seeking medical attention. The other is now a 22-year-old college student with no evidence of recurrence more than five years after removal of Echinococcus cysts from both brain and liver.
The newer modalities available for diagnosis are discussed.
Therapy with mebendazole is reviewed; this relatively new, highly effective anthelmintic is well tolerated and has been apparently highly effective in a small number of cases.
PEDIATRIC COMMANDMENTS
Authors: Schnitzker William F. 
Published: December 2021

1. REMEMBER THE GENES ARE ALL POWERFUL; in habitus, size, and often in drug reactions.
2. ALWAYS BE CONSIDERATE OF THE PARENTS; they are upset out of proportion to the magnitude of the problem.
3. NEVER USE THE WORD HURT; it creates more apprehension and fear.
4. PLEASE HOLD THE CHILD SECURELY; when necessary, it is much more considerate than to have to repeatedly restrain.
5. BE EXTREMELY CAREFUL ABOUT ADVICE FROM FRIENDS, RELATIVES OR NEIGHBORS.
6. NO ONE LIKES A SPOILED CHILD; what may be considered cute in a toddler usually becomes flip and nasty with age.
7. IT IS DANGEROUS TO HAVE CHEWING GUM AND CANDY IN THE MOUTH OF DISTURBED CHILDREN; please don't bring crackers, cookies or soda to the office.
8. PLEASE WATCH INFANTS AT ALL TIMES WHILE ON THE EXAMINING TABLE; no climbing on furniture, it is embarrassing and painful to sustain an injury.
9. KEEP APPOINTMENTS ON TIME; in consideration of others and the doctor.
10. DON'T ABUSE THE TELEPHONE; your doctor is available at all times, however, he appreciates receiving routine calls during office hours.
First Aid for Choking Children: Back Blows and Chest Thrusts Cause Complications and Death
Authors: Heimlich Henry J. 
Published: December 2021

In the article "First Aid for the Choking Child" (Pediatrics 67:744, 1981), advice is given that is contrary to the vast majority of studies and reports in the medical literature. The methods recommended in the article not only have little scientific support, but also have led to serious complications and death as evidenced by numerous well-documented cases.
BACK BLOWS
The first treatment for the choking child according to the Pediatrics article is forceful administration of four back blows. No reference has been found to indicate why four back blows are better or worse than one or ten.
From the time of the study by Gross1 in 1854, to the present, there have been many published studies warning against the use of back blows.2-22
O TEMPORA, O MORES!1—Cicero
Authors:   Student
Published: December 2021

1954: "All premature infants were alternately placed in a group to be [gradually] weaned from oxygen (Group A) and a group to be suddenly withdrawn from oxygen (Group B)....
If an infant was thought to be developing the disease [progressive RLF] the infant was placed back in oxygen at the same concentration from which he had been removed. Because our results with oxygen therapy had been uniformly successful, we did not feel it was fair to withhold treatment in order to obtain control cases."2
1981: "We undertook a double-blind clinical study to determine the efficacy of vitamin E in preventing the development of severe retrolental fibroplasia.... Any infant found to have Grade III was removed form the study and treated surgically."3
1981: "In this center, surgical intervention with cryotherapy and scleral buckling procedures have produced favorable responses in RLF cases."4
‘Hide-a-bed’ Hideaways: A Potential Source of Entrapment
Authors: Cavanaugh Robert M. 
Published: December 2021

Although there have been many recent advances in the field of pediatrics, accidents still remain a significant cause of morbidity and mortality. Adolescents are particularly challenged by adventuresome activities that are potentially dangerous. This is especially true when peer pressure is applied. The following case is presented to alert clinicians to another source of entrapment and potential suffocation. It should also remind us that the role of the physician caring for adolescents, as well as infants and children, includes effective counseling concerning possible sources of injury. Ultimately, prevention is more important than treating the injury itself.
CASE REPORT
J.D., a 14-year-old boy who was in good health, was playing in the house with two friends who coaxed him into lying on the ‘hide-a-bed’ and allowing them to close the bed completely.
A New Age For Pediatrics: Change, Challenge, and Cost
Authors: Austin Glenn 
Published: December 2021

The motif for the Academy's current campaign to promote pediatrics and pediatricians is A New Age for Pediatrics. One of the implications of this campaign and motif is that we will officially state that US pediatricians, the specialists in growth and development, take better care of the health needs of infants, children, adolescents, and young adults, and that the scope of our practice is broadening. Another implication is that pediatrics is in a new era of increasing strength, vigor, assertiveness, and provision of satisfaction to both its patients and practitioners. Realization of these goals spells change, challenge, and cost.
Neither change nor challenge are new to our field. The early pediatricians were sick-baby specialists. Pioneers such as Abraham Jacobi recognized the need to emphasize prevention, particularly among the underprivileged. Others were later farsighted enough to recognize the importance of extending the concept of well-child care to all children and began to convince parents to bring their children for visits when they were well so that immunizations could be given, growth and development could be assessed, and advice on matters of diet and hygiene could be given. Immunization rates went up and the frequency and severity of contagious diseases began to diminish. Recognizing the intrinsic value and distinct promise of pediatrics as a field, medical schools expanded their pediatrics departments, and an increasing number of young physicians began to enter pediatrics, especially in the post-World War II years. All were superbly trained in the care of sick children and, to a considerable degree, they functioned as consultants to general practitioners.
Letter to the Editor
Authors: Colletti Richard B. 
Published: December 2021

Your letter suggests that commercially manufactured crash-tested child restraint devices meeting strict Federal standards are too expensive for many families to obtain and that home-made substitutes can provide adequate protection. I believe both premises are incorrect.
State-wide networks of car seat rental programs are developing throughout the country (including your home state, Washington1). These rental programs, operated by volunteers or state health departments, provide infant car seats for little or no cost. In Vermont, for example, 98% of babies are born in a hospital that rents car seats for $1 per month (3.3 cents per day) or less.
Letter to the Editor
Authors: Odell Gerard B. 
Published: December 2021

I read with curiosity the articles and editorial concerning bilirubin in the March issue of Pediatrics.
Levine et al1 are apparently espousing a view that bilirubin is nontoxic to CNS tissue unless it is bound to albumin. There are serious deficiencies in his arguments:
1. Patients with analbuminemia do survive neonatal life, but no one has reported albumin concentrations in such infants during the first two weeks of life. Since the molecule is only 69,000 daltons in molecular size, it is conceivable the fetus could acquire albumin from the maternal circulation during the last trimester and could have protective concentrations of albumin in the circulation during neonatal life, since t1/2 of passively infused albumin is actually prolonged in analbuminemic patients.2
Agoraphobia and Imipramine Withdrawal?
Authors: Shrand Hyman 
Published: December 2021

A recent report calls attention to antidepressant withdrawal effects in the newborn when these drugs are taken by the mother. We recently had a patient with imipramine withdrawal.
Baby F. was born at term after a normal vaginal delivery; Apgar scores were 8 and 9. Findings from the newborn examination were normal. Rapid breathing, which reached 100/mm, began at age 5 hours. Baby F.'s color remained pink in air, but the infant became terribly irritable, crying all the time, and could not be consoled. At all times the baby looked well and fed avidly.
DEATH AND LAWYERS
Authors: Student  
Published: December 2021

It is perhaps difficult to write dispassionately about the constant intrusions of the legal profession into the practice of medicine, . . . yet what is one to think of thugs roaming the streets unpunished and the backlog in the criminal courts mounting to high heaven while judges tinker with respirators and ponder on the indications for dialysis? Even some of the legislators in Congress are now beginning to think that the courts are all too often exceeding the bounds of their prerogatives in a variety of social issues.
. . . so skewed are the prevailing arrangements that doctors are constantly being told that they must not play God, while judges, being "detached but passionate," always may.
INPATIENT STATISTICS AT THE HOPITAL DES ENFANTS MALADES IN PARIS FOR THE YEAR 1822
Authors: C. T. E. 
Published: December 2021

The HÔpital des Enfants Malades, the world's first children's hospital, was founded in Paris in 1802. Twenty years later it contained 560 beds, 491 for medical and 69 for surgical patients.
In 1822, 2,641 patients were admitted; their diagnoses were as follows: [SEE TABLE IN SOURCE PDF.]
The overall mortality among inpatients was about 27 percent. The mortality for smallpox was 47 percent, and for measles 35 percent.
Contrary to current practice in our children's hospitals, inpatients at the Hôpital des Enfants Malades, at least in 1822, were hospitalized for exceedingly long periods. For example, patients with scabies spent between 21 and 69 days in the hospital; for tinea the average hospital stay was 156 days; and for scrofula 288 days.
Abnormal Platelet and Vascular Prostaglandin Synthesis in an Infant with Hemolytic Uremic Syndrome
Authors: STUART MARIE J. , SPITZER ROGER E. , COPPE DAVID 
Published: December 2021

The hemolytic-uremic syndrome (HUS) is a disorder characterized by a microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Pathologic examination reveals thrombotic occlusions in the microcirculation, with the kidney being the main target organ involved. Recently, Remuzzi et al1,2 have demonstrated abnormalities in vascular prostacyclin or prostaglandin I2 (PGI2) formation in HUS. We report further characterization of the abnormality in PGI2 synthesis in a patient with HUS. An abnormality in platelet prostaglandin endoperoxide formation was also observed.
CASE REPORT
A 4-month-old male infant was hospitalized with anemia, thrombocytopenia, and proteinuria. The neonatal period had been complicated by hyperbilirubinemia necessitating an exchange transfusion.
Acute Urinary Retention as Presenting Symptom of Ascaris lumbricoides Infection in Children
Authors: HEYMAN H. , ALADGEM M. , LAVER J. , BEER S. 
Published: December 2021

In endemic areas, Ascaris lumbricoides is one of the most common causes of helminthic infections of the intestinal tract. Acute intestinal, pancreatic, or biliary tract obstruction due to the physical presence of the adult parasites has been reported previously.1 Extraintestinal manifestations such as acute respiratory diseases, due to the migration of the larvae to the lung, or intrahepatic or pericholangitis abscesses, due to the deposition of ova in the liver, have also been described.1,2
Urinary retention as a manifestation of intestinal ascariasis has not, to the best of our knowledge, been previously reported. We describe two children with urinary retention and intestinal ascariasis. Clinical and nadiologic evaluation excluded any other cause for urinary retention.
Children with Sinusitis
Authors: FURUKAWA CLIFTON T. , SHAPIRO GAIL G. , RACHELEFSKY GARY S. 
Published: December 2021

Inasmuch as the paranasal sinuses hide within the calvarium, they are literally out of sight and too often out of mind. Although the pediatrician is quick to recognize an abnormal eardrum or an impetiginous rash, the presence of copious purulent rhinorrhea may be labeled an upper respiratory tract infection even when the history suggests chronic duration. Frequently these children are dismissed as being "just" allergic.
Why is sinus disease the source of confusion today? Much of the problem relates to radiologic studies that showed a significant incidence of abnormal sinus films in asymptomatic children1-3 as well as the casual comment in Caffey's radiologic textbook4 that any child who is crying would probably have cloudy sinuses, a statement never actually verified.
Theophylline-Furosemide Inactivation?
Authors: TOBACK JAMIE W. , GILMAN MILES E. 
Published: December 2021

To the Editor.—
A recent report by Nakagawa1 suggested a possible increased theophylline clearance when furosemide was concomitantly administered. He postulated a decreased hepatic congestion with furosemide which increased theophylline clearance. Conlon et al2 originally investigated this possible interaction but reported an increase in serum theophylline levels, probably due to the apparent volume of distribution contraction associated with diuresis. Conversely, we have observed premature neonates whose serum theophylline concentrations have decreased when furosemide was administered simultaneously.
Febrile Neonates
Authors: JENISTA JERRI ANN , MENEGUS MARILYN A. 
Published: December 2021

To the Editor.—
Voora et al1 report an interesting study of fever in the full-term newborn during the first four days of life. One percent of the infants had fever but only 0.1% had a proven bacterial etiology, an incidence similar to those reported.2 However, only one third of the febrile infants were studied for viral infection; no viruses were isolated although these data are difficult to interpret since there is no description of the culture techniques used.
Cancer Risks Following Diagnostic Radiation Exposure
Authors: BRENT ROBERT L. 
Published: December 2021

Parents of children in the intensive care nursery or pediatric intensive care area are frequently made anxious by the repeated diagnostic radiologic studies that have to be performed. Because of the known risks of cancer following high doses of radiation,1 it can easily be understood why both physicians and lay individuals may become uneasy if patient care necessitates repeated roentgenographic studies.
Much of this anxiety could be allayed if more physicians were aware of the quantitative risks of radiation exposure and would, therefore, be in a position to explain these risks to the inquiring famlies.
Spengler and colleagues (in this issue)2 have undertaken an important and difficult epidemiologic study and are to be congratulated on this effort.