bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Fibrinolytic Treatment of Arterial Thrombosis and Hypertension in a Cocaine-Exposed Neonate
Authors: REZNIK VIVIAN M. , ANDERSON JACK , GRISWOLD WILLIAM R. , SEGALL MICHAEL L. , MURPHY JEROME L. , MENDOZA STANLEY A. 
Published: December 2021

CASE REPORT
The patient was a 2800-g black girl delivered by primary cesarean section because of fetal distress and meconium aspiration after 42 weeks' gestation. Her mother's pregnancy had been complicated by cocaine use. The baby's Apgar score was 5 at 1 minute and 7 at 5 minutes. Maternal and neonatal urine toxicology screens were positive for cocaine, and the infant was treated with phenobarbital because of withdrawal symptoms. She was transferred to Children's Hospital and Health Center for treatment of CO2 retention and probable meconium aspiration syndrome. She was mechanically ventilated, and an umbilical artery catheter was inserted. The infant improved and was extubated after 4 days; the umbilical catheter was removed on day 8 of life. She did well until 11 days of life when she became tachypneic and acidotic with a systemic blood pressure of 130/106 mm Hg.
Taurine Supplementation of Formulas
Authors: STURMAN JOHN A. , RASSIN DAVID K. 
Published: December 2021

The Special Article by Dr Gaull (Pediatrics 1989;83:433-442) was a comprehensive review of the current thoughts about functions of taurine; Dr Gaull concluded: "Experimental findings in animal models and in human cell models provide further justification for taurine supplementation of infant formulas."
Our concern is that this is not necessarily an unbiased conclusion, even though it may be a correct one. Your readers may not be aware that Dr Gaull is the personal owner of US patent 4 303 692 which covers the addition of taurine to human infant formula and stands to gain financially only if taurine supplementation of baby formula is scientifically and legally upheld.
DEPRESSING STATISTICS
Authors: Student  
Published: December 2021

About 7 million children do not receive routine medical care.
Only 60 percent of children under age 4 have received the complete basic series of immunizations.
The number of children with acquired immune deficiency syndrome is rapidly increasing, with 10,000 to 20,000 pediatric cases of AIDS or AIDS-related complex likely to be diagnosed in children by 1991.
Reported deaths from child abuse and neglect jumped 23 percent from 1985 to 1986, and estimated deaths range from 2,000 to 5,000 each year.
QUESTION FOR META-ANALYSTS: CAN YOU MAKE A SILKEN PURSE OUT OF A SOW'S EAR?
Authors: Student  
Published: December 2021

Choice of dose [in 196 double-blind trials of treatments for rheumatoid arthritis], multiple comparisons, wrong calculation, sub-group and within-group analyses, wrong sampling units. . . , change in measurement scales before analyses, baseline difference, and selecting reporting of significant results were some of the verified or possible causes for the large proportion of results that favored the [newly proposed] drug.
Doubtful or invalid statements were found in 76% of the conclusions or abstracts. Bias consistently favored the new drug in 81 trials, and the control in only one trial.
It is not obvious how a reliable meta-analysis could be done [reliably] in these trials.
DIAPER DERBY
Authors: L. J. F. 
Published: December 2021

Is Junior bored with his plain white diapers?
Try the magenta or orange....Or there's the subtle peach and lavender from the Los Angeles company's spring line of pastels.
So it goes in the diaper derby, where color, fancy fasteners and other features offer the best bet for getting consumers to pay a premium for a rather mundane product.
The stakes in the diaper war are high: Manufacturers sell $3.5 billion each year in the US alone. Kimberly-Clark's Huggies has 30% of the market, while P&G has 25% with Pampers and 24% with its Luvs brands.
Prices of premium diapers have climbed between 12% and 15% in the past two years, and could rise a further 4% to 6% this spring, analysts estimate.
Transfer of Drugs and Other Chemicals Into Human Milk
Authors:   COMMITTEE ON DRUGS
Published: December 2021

Since the first publication of this statement, much new information has been published concerning the transfer of drugs and chemicals into human milk. This information, in addition to other research published before 1983, makes a revision of the previous statement necessary. In this revision, lists of the pharmacologic or chemical agents transferred into human milk and their possible effects on the infant or on lactation, if known, are provided (Tables 1 to 7). The fact that a pharmacologic or chemical agent does not appear in the Tables is not meant to imply that it is not transferred into human milk or that it does not have an effect on the infant but indicates that there are no reports in the literature. These tables should assist the physician in counseling a nursing mother regarding breast-feeding when the mother has a condition for which a drug is medically indicated.
The following questions should be considered when prescribing drug therapy to lactating women. (1) Is the drug therapy really necessary? Consultation between the pediatrician and the mother's physician can be most useful. (2) Use the safest drug; for example, acetaminophen rather than aspirin for oral analgesia. (3) If there is a possibility that a drug may present a risk to the infant (eg, phenytoin, phenobarbital), consideration should be given to measurement of blood concentrations in the nursing infant. (4) Drug exposure to the nursing infant may be minimized by having the mother take the medication just after completing a breast-feeding and/or just before the infant has his or her lengthy sleep periods.
In Reply: Internationally Adopted Children and Cytomegalovirus
Authors: HOSTETFER MARGARET K. 
Published: December 2021

The prevalence of cytomegalovirus excretion in internationally adopted children was unknown before our prospective study, in which 23% of international adoptees were found to be actively shedding cytomegalovirus at the time of examination. This figure has remained constant in our subsequent prospective analysis of an additional 100 internationally adopted children.
Drs Barton and Friedman are correct in that approximately 45% of North American women of childbearing age in middle and upper income groups are not immune to cytomegalovirus.
CHILDREN WITH AIDS
Authors: L. J. F. 
Published: December 2021

Hundreds of children with AIDS are suffering or dying prematurely because they are unable to obtain AZT, a drug that could prolong and improve the quality of their lives....
Experts say AZT, or azidothymidine, the only AIDS drug approved for use in adults and teen-agers, has been tested in children and shown to be just as active in them, prolonging life and even dramatically reversing mental deterioration.
Yet the Burroughs Wellcome Company, the drug's manufacturer, has not yet applied for approval to market AZT to children under the age of 12 or to make it available to them under "compassionate use" procedures before marketing approval is granted. As a result, AZT is not available in a pediatric dose, except in clinical trials, and insurance companies and government programs will not pay for its use in children...
A company official said Burroughs Wellcome was working as fast as possible to prepare material needed for Federal approval.
But Dr. Samuel Broder, director of the National Cancer Institute, who was a key figure in demonstrating that AZT could slow the spread of the AIDS virus, said he was "very disturbed" that Burroughs Wellcome had not applied for approval to market the drug to children....
Nearly, 1,800 cases of children under 12 with AIDS have been reported to the Federal Centers for Disease Control, but experts say many more have gone unreported. About 800 of these children have died. About 300 children are enrolled in clinical trials...
The Secret
Authors: ZIEGLER JOHN M. 
Published: December 2021

On Mother's Day 1975, just as I returned home from my second year in college, my mother told me that she was scheduled to have a lump removed from her breast and that it was thought likely to be cancerous. I told her I loved her, and we hugged each other.
The biology major understood the implications and potential outcomes. The sensitive son felt a vague sense of uneasiness.
The mass was indeed malignant, and a modified radical mastectomy was performed. All node biopsies were negative. After a 2½-year disease-free interval, and now widowed, she saw an internist for an unrelated problem.
The freshman medical student thought it ironic that he was studying for an anatomy examination covering the head and neck. The worried son had difficulty concentrating on the course work.
The node biopsy was positive; a workup for further metastasis was negative, and chemotherapy was begun. Just over one year later, during the Christmas holidays, severe, intermittent abdominal pain developed. A liver scan demonstrated several areas of decreased uptake. During the next months, despite intensification of the chemotherapeutic regimen, the cancer spread further to involve bone and brain. My mother died on April 10, 1979.
The sophomore medical student observed the erratic breathing arid palpated the diminishing pulse. The loving son held his mother's hands, told her, "I love you, Mom," and acknowledged her smile as she closed her eyes peacefully for the last time. The medical student announced to the small group of friends and family at the bedside, "There's no pulse . . . no respirations." The anguished son kissed his mother's forehead, already growing cold, and wept bitterly.
Schools and Sex Education
Authors: SENDEROWITZ JUDITH 
Published: December 2021

Drs Stout and Rivara (Pediatrics. 1989;83:375-379) make some sound observations and then draw conclusions that are not only misleading and potentially damaging but also contradict their astute analysis. They correctly identify adolescent pregnancy as a "multifactorial problem" that demands a "multifactorial solution." They also note that sex education cannot, by itself, reverse the barrage of sexual influences in an adolescent's world and that we may be asking too much to expect otherwise.
Those of us at the Center for Population Options agree.
Intraosseous Fluids in Emergencies
Authors: MACGREGOR D. F. , MACNAB A. J. 
Published: December 2021

To the Editor.—
Despite several publications advocating the used of intraosseous fluids in emergency situations, current use remains limited.1-3 Seigler et al4 have underlined the success of their procedure in one of the most difficult situations possible, namely, the young child with cardiopulmonary arrest in the prehospital setting. This method of intravascular access can be of value in a number of related situations where intravenous fluids are required quickly but access is limited due to circulatory collapse, severe dehydration, hemorrhage, burns, trauma, and allergy.5
Acquired Immunodeficiency Syndrome and Adolescence
Authors: GOODMAN ELIZABETH , COHALL ALWYN T. 
Published: December 2021

In Reply.—
Dr Parker raises some interesting questions about a volatile and highly controversial issue. Human immunodeficiency virus screening does strike at not only the root of medical philosophy, but also the basic structure and value systems of contemporary American society. Our intent, however, was not to pose a question or argue the pros and cons of human immunodeficiency virus testing, but to make a descriptive statement of the powerful emotional response which accompanies this issue.
Infants and Children With Acquired Immunodeficiency Syndrome: Placement in Adoption and Foster Care
Authors: DIX DOUGLAS 
Published: December 2021

To the Editor.—
The Task Force on Pediatrics Acquired Immunodeficiency Syndrome underestimates both the risk of human immunodeficiency virus infection in children available for adoption and foster care and the dangers in placing human immunodeficiency virus positive children in normal homes.1 Maternal transmission is only one route of human immunodeficiency virus acquisition. Many children become eligible for adoption or foster care as victims of abuse by methods that can transmit the virus. These methods include not only sexual activity with human immunodeficiency virus positive perpetrators, but battery and neglect in human immunodeficiency virus-contaminated environments.
Pseudoephedrine Dangers
Authors: CLARK RICHARD F. , CURRY STEVEN C. 
Published: December 2021

To the Editor.—
Pseudoephedrine is an over-the-counter amphetamine commonly used as a decongestant. Pseudoephedrine is a mixed-acting sympathomimetic amine, causing both the release of neurotransmitters from adrenergic nerve endings and the direct stimulation of adrenergic receptors.
While overdoses of other amphetamines can produce a life-threatening adrenergic crisis comprising hypertension, tachycardia, hyperthermia, agitation, and convulsions, serious overdoses with pseudoephedrine alone are rare.1-3 We report the case of a child who suffered a generalized seizure after ingesting pseudoephedrine tablets, a finding not previously reported after isolated pseudoephedrine ingestions.
Effect of Cholestyramine on Activity of Gentamicin in Vitro
Authors: COLTMAN D. , MANN M. D. , Bowie M. D. 
Published: December 2021

To the Editor.—
A combination of oral gentamicin and the basic anion exchange resin, cholestyramine is effective in the treatment of infants who have severe diarrhea for 7 days.1 Both drugs decrease the severity of the diarrhea and there is a considerable, beneficial interaction between them.2 The mode of action is not known, but we postulated that gentamicin acts by eliminating the abnormal bacterial microflora in the small bowel and cholestyramine by binding toxins or deconjugated and dehydroxylated bile salts.2
Retinal Hemorrhage After Cardiopulmonary Resuscitation in Children: An Etiologic Reevaluation
Authors: GOETTING MARK G. , SOWA BONNIE 
Published: December 2021

Retinal hemorrhage detected after cardiopulmonary resuscitation has important medical, social, and legal implications. When a child is brought to the hospital in circulatory arrest, these hemorrhages raise the question of preceding trauma, frequently child abuse.1 Several authors have suggested that retinal hemorrhage may be virtually pathognomonic of child abuse.2,3 We have questioned this belief because our experience, as well as that of others,4,5 suggests that retinal hemorrhage may result from resuscitative efforts. We therefore undertook a prospective study to evaluate whether cardiopulmonary resuscitation can cause retinal hemorrhage.
MATERIALS AND METHODS
During a 4-month period, all children admitted to the Pediatric Critical Care Medicine Service who underwent cardiopulmonary resuscitation were considered for inclusion in the study.
A Horrifying Television Commercial That Led to Constipation
Authors: PILAPIL VIRGILIO R. 
Published: December 2021

I would like to call attention to an unusual event that led to constipation in a child I recently examined.
CASE REPORT
A 3-year-old boy who had been constipated for 6 weeks was brought to my office. He had previously moved his bowels approximately once a day and had been toilet trained for at least 6 months. However, the frequency of bowel movements had decreased to approximately every 4 days and his stools were usually hard. He had initially complained of anal discomfort and refused to move his bowels. Eventually, he began to move his bowels but only infrequently, while standing up, and while wearing a diaper.
Hereditary Fructose Intolerance in the Vomiting Infant
Authors: EDSTROM CYNTHIA S. 
Published: December 2021

Hereditary fructose intolerance is one of numerous entities included in the differential diagnosis of vomiting in infancy. Caused by a deficiency of fructose-1-aldolase, it is inherited as an autosomal recessive trait.1 The symptoms are often subtle and may be confused with more common disorders such as gastroesophageal reflux, milk protein allergy, or improper feeding practices. The following case emphasizes the need to consider the diagnosis of hereditary fructose intolerance in the vomiting infant.
CASE REPORT
A 9-week-old male infant was admitted with vomiting that was unresponsive to outpatient management. The first child of unrelated parents, he was born full term, with a birth weight of 4.1 kg, after an uncomplicated pregnancy and delivery.
Intensive Care Management of Acute Asthma in Children
Authors: CANNY GERARD J. , LEVISON HENRY 
Published: December 2021

In Reply.—
We appreciate Dr Krohn's interest in our review of the intensive are management of acute asthma in children. We certainly agree that the death of the 17-year-old boy, while he was working a a restaurant, may have been due to acute anaphylaxis, possibly related to ingestion of sulfites and monosodium glutamate.
Solar Intensity and Sun Protection
Authors: WEYRAUCH KARL F. , BOIKO PATRICIA E. 
Published: December 2021

To the Editor.—
Weinstock et al1 observed "a significant association of melanoma with latitude of residence during the teenage years," thereby implying a direct relationship between solar radiation intensity and increasing tropical latitude. However, for specific locations, this relationship may not be true. For example, average daily solar radiation in Spokane, WA (latitude 47 degrees, 40 minutes, elevation 2400 feet), was 1314 BTU during July, compared to 862 BTU in Charleston, SC (latitude 32 degrees, 53 minutes, elevation sea level).2
Evaluating Persistent Sleeplessness in Children
Authors: SCHMITT BARTON D. 
Published: December 2021

To the Editor.—
Kahn's recent study on persistent sleeplessness in children is an important addition to the sleep disorder literature.1 Some elaboration on the presenting symptoms of these children would help the reader implement these findings in clinical practice. In the abstract, the authors state that for 17 children (who later proved to be allergic to cow's milk protein) initially "no explanation was found for the sleep difficulties in spite of an extensive workup." Yet in Table 2 we see that 5 of the 17 children had at least three episodes of wheezing at night, 7 of 17 had eczema, 8 of 17 had diarrhea and vomiting, and 10 of 17 had chronic rhinitis and otitis.
Evaluating Persistent Sleeplessness in Children
Authors: KAHN A. , MOZIN M. J. , REBUFFAT E. , SOTTIAUX M. , MULLER M. F. 
Published: December 2021

In Reply.—
Dr Schmitt's questions address the difficulty of evaluating the origin of persistent sleeplessness in children, and more precisely of differentiating between the cases of sleeplessness due to food intolerance and the much more frequently encountered situations in which a child's insomnia is the result of parental sleep mismanagement. The medical evaluation is complicated by the fact that a dissociation can at times exist between the families' initial complaints and the final diagnosis of food intolerence.
Clinical Experience With Haemophilus influenzae Type b Conjugate Vaccines
Authors: Mäkelä P. Helena , Eskola Juhani , Peltola Heikki , Takala Aino K. , Käyhty Helena 
Published: December 2021

The importance of Haemophilus influenzae type b as the main cause of serious bacteremic infections in young children and the consequent need for preventive measures have been widely appreciated since the 1970s. The knowledge that serum antibodies to the polysaccharide capsule of H influenzae type b increase with age and correlate with resistance to this infection1-3 encouraged work toward a vaccine based on the H influenzae type b polysaccharide. Such a vaccine2,4 was used in 1974 in a field trial in Finland.3,5 Two important lessons were learned. First, vaccine-induced antibodies to the polyribosylribitol-phosphate (PRP) polysaccharide correlated with protection from disease caused by H influenzae type b, so that the serum anti-PRP concentration predicting protection could be estimated as 1 µg/mL.6 Second, the vaccine was not effective in infancy; protection and serum antibody concentrations above 1 µg/mL were not observed before 18 to 24 months of age.
The poor immunogenicity of PRP in infancy has been observed in a large number of studies2-8 and is shared by other bacterial polysaccharides.9 Although the reason for this is not known, the most likely hypothesis associates poor immunizing ability in infancy with the "T-independent" nature of these polysaccharide antigens. Such antigens would be unable to stimulate T lymphocytes; therefore, immunity to them would depend exclusively on B cells and antibodies produced by them. If infants, by and large, lack B cells that could be stimulated directly by a polysaccharide antigen, they cannot respond to the polysaccharide vaccine.
This hypothesis immediately suggests possibilities for improvement of the vaccine.
Commentary: Results of Efficacy Trials in Alaska and Finland of Haemophilus influenzae Type b Conjugate Vaccine
Authors: Ward Joel 
Published: December 2021

One of the currently licensed Haemophilus influenzae type b polysaccharide conjugate vaccines currently recommended for use in children 18 months of age and older, polyribosylribitol-phosphate-diphtheria toxoid (PRP-D, Connaught Laboratories), has been evaluated in two studies for its protective efficacy in children immunized before 6 months of age.1 The peak incidence of invasive disease caused by H. influenzae type b occurs in children 6 to 18 months of age; therefore, prevention of this disease depends on the efficacy of vaccines in this younger age group.
In a large, randomized, unblinded trial conducted in Finland, relatively low levels of antibody were induced after a series of three primary PRP-D immunizations at 3, 4, and 6 months of age. Despite these limited immunogenicity results, a high level of protective efficacy was shown during a 3-year period (protective efficacy of 87%, 95% confidence intervals 50% to 96%).
Another trial, which was randomized, double blind, and placebo controlled, was conducted among 2113 Native Alaskan infants immunized (20 µg/0.5 mL) at 2, 4, and 6 months of age as part of their routine childhood immunizations. This population was chosen for the trial because it has the highest known incidence of invasive disease caused by H influenzae type b, and a trial in such a high-risk population could be conducted more carefully, with fewer study subjects, and in a shorter period of time. As in the Finnish trial, in this younger age group immune responses to PRP-D vaccine were meager, apparent only after the third dose of vaccine at 6 months of age.
Evaluation of an Infrared Tympanic Membrane Thermometer in Pediatric Patients
Authors: KENNEY RICHARD D. , FORTENBERRY JAMES D. , SURRATT S. SUZETTE , RIBBECK BETH M. , THOMAS WILLIAM J. 
Published: December 2021

Body temperature measurement provides important information for evaluation of pediatric patients. Because of the role that central nervous system thermoreceptors play in temperature homeostasis, accurate measurement at core body sites has long been sought.1 Rectal temperature, often considered the "gold standard" for clinical use, does not correlate well with deep measurements.2,3 Pulmonary artery catheters and deep rectal probes measure core temperature accurately4 but are not practical for clinical use.
The tympanic membrane shares the same vascular supply that perfuses the hypothalamus and is an excellent, readily accessible site for core temperature measurement.1 Although indwelling contact-type tympanic membrane temperature probes provide accurate data, patient discomfort and complications such as perforation have restricted their use.4,5