bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Cholesterol Levels in American (Pima) Indian Children and Adolescents
Authors: Savage Peter J. , Hamman Richard F. , Bartha Gregory , Dippe Stephen E. , Miller Max , Bennett Peter H. 
Published: December 2021

Serum cholesterol levels from birth to adulthood in a population of North American (Pima) Indians are described and compared to those of Caucasian populations.
Cholesterol levels at birth (mean ± SEM, 87 ± 2.6 mg/100 ml) were similar in Pimas and Caucasians, but levels in Pimas from 5 to 16 years (148 ± 4.6 mg/100 ml) were 20 to 30 mg/100 ml lower than among most white populations. The levels showed little rise with age from 5 to 16, then rose significantly in both sexes from ages 17 to 25. Cholesterol levels in adult Pimas (190 ± 1.5 mg/100 ml) were up to 50 to 60 mg/100 ml lower than in American whites, and showed little increase after age 25. Two cohorts of children followed prospectively for six years indicated that the prevalence data reflect sequential changes in the population. Cholesterol levels of those subjects were significantly correlated at the first and last examinations.
The Pima, in contrast to Caucasian American populations, have relatively low levels of serum cholesterol and low rates of coronary heart disease, but evidence of a causal relationship with the latter remains to be established.
Comments on Urology Section on Myelomeningocele
Authors: Lebowitz Robert L. , Colodny Arnold H. 
Published: December 2021

We are delighted that the Section on Urology of the American Academy of Pediatrics has formed the Action Committee on Minimum Necessary Surveillance of the Child with Myelomeningocele and that guidelines have been formulated and are being publicized.1 In our experience this emphasis is long overdue and we heartily endorse the committee's recommendations.
However several clarifications of the committee's guidelines are in order.
(1) The committee recommends that baseline blood urea nitrogen and serum creatinine determinations be done shortly after birth.
Dr. Silver Replies
Authors: Silver Larry B. 
Published: December 2021

It is difficult to reply to Dr. Browder's comments for he suggests that I said certain things in my paper that I did not say and he suggests that I should have said other things which I did state in the paper.
I do not feel that the field of learning disorders is outside the expertise of the physician. I refer to the physician as key to the coordinated efforts to help these children. My purpose in reviewing the literature was to assist the family physician.
Comment on Medication for Hyperkinetic Children
Authors: Oettinger Leon 
Published: December 2021

The article of the Council on Child Health referring to medication for hyperactive children1 contains several misleading or confusing statements:
(1) The hyperkinetic behavior syndrome (minimal brain dysfunction) appears in children of below-average intelligence as well as in children of average or above-average intelligence. This was generally agreed on at a recent meeting in Alta, Utah, where a number of investigators, including Paul Wender and C. K. Conners, were present. In an article presented for the Workshop on Evaluating Long-Term Effects of Stimulant Drug Therapy, I presented data showing that minimal brain dysfunction occurred at essentially all levels of intellect.2
Evaluation of the Child With a Learning Disorder
Authors: Hogan Gwendolyn R. , Ryan Nell J. 
Published: December 2021

In order to appreciate our approach to the evaluation of a child with a learning disorder it is necessary to provide some background material. The total population of the state of Mississippi consists of 2.2 million people of which 900,000 did not complete high school and 400,000 did not complete grade school. There are no publicly financed kindergartens and no compulsory school attendance laws in this state. Eighty-eight percent of the children who attend school are, however, educated in the public school system. The state is divided into 150 separate school districts and 1,140 special education teachers are provided for the entire state. Of these special education teachers, 1,000 are assigned to classes for the mentally retarded and the remaining 140 teachers provide instruction for children with specific learning disorders. In the Jackson Separate School District which includes the largest metropolitan area in the state there are 27,496 students enrolled in the public school system and of that number 852 students are in special education classes. Of these 852 students in special education, 644 are classified as educable mentally retarded, 100 are classified as trainable mentally retarded, and 108 are classified as having specific learning disabilities. This figure for children with specific learning disabilities is well below the estimated figure of 15% which has been determined by other surveys.
The vast majority of children entering the first grade have been exposed to no structured learning situation. Routine testing for school readiness is not done in the public school system. Firstgrade students do receive vision and hearing screening tests which are administered by volunteers through the PTA.
Inferior Vena Cava Obstruction Secondary to Indwelling Venous Catheters: Two Cases
Authors: Riggs Thomas , Hirschfeld Stephen , Borkat Gordon , Liebman Jerome 
Published: December 2021

It has been common practice to leave an indwelling venous catheter with its tip in the inferior vena cava (IVC) following cardiac catheterization in ill infants who are to subsequently undergo corrective or palliative surgery. A polyvinyl chloride catheter may be conveniently inserted into the same vein employed for the diagnostic catheterization in order to monitor central venous pressures and deliver intravenous fluids.
Two instances of thrombosis of the IVC which occurred following the use of indwelling femoral venous catheters, placed after cardiac catheterization, are reported. Not only is this complication particularly serious from the standpoint of potential thromboembolism, but it also eliminates the use of the IVC approach in a group of patients who require repeated cardiac catheterizations.
Drs. Soyka and Robinson Reply
Authors: Soyka Lester F. , Robinson Donald S. 
Published: December 2021

The letter of Dr. Wineberg makes four points and then deteriorates to a diatribe. While not wishing to participate in a town-gown quarrel, it might be pointed out that Dr. Wineberg would not qualify as an academic because not even 50% of what he has said is true.
First, the children seen in the emergency room at the Boston City Hospital are in no way comparable to those seen in a routine office visit. The presence of bacteremia in these children is an indication for appropriate intensive antibacterial therapy, and treatment with the usual antibiotics in the usual doses that are all too routinely employed for upper respiratory tract infections would be inadequate.
Are You Seeing Enlarged Breasts in Infants?
Authors: Dreyfus Norma , Lipper Evelyn 
Published: December 2021

We have observed a high incidence of enlarged breast tissue in a small group of well female infants followed since birth for health care maintenance in a pediatric program.
Of 64 infants followed for one year, ten between the ages of 8½ and 12 months were noted to have enlarged breast tissue. The size of the tissue ranged from 1 x 1 cm to 4.5 x 4 cm. Since breast measurements were not recorded in these infants throughout infancy, it cannot be said with certainty whether this was de novo breast development or continuation of neonatal hypertrophy.
Dr. Beckwith Replies
Authors: Beckwith J. Bruce 
Published: December 2021

Dr. Cunningham's well-researched and carefully worded statement is not one with which I can quibble. To do so would be to label myself as being both antimammary and unscientific. Our misgivings, as I tried to express in the commentary to which he refers, relate to those zealots who, unlike Dr. Cunningham, in effect blame the bottle-feeding mother for the death of her baby.
Obviously, until the final answer is in, all clues, however fragmentary, must be carefully milked.
You Can Lead a Fellow to PACE, But Can You Make Him Think?
Authors:   Student
Published: December 2021

Few would argue that the half-life of medical "truths" is not shrinking at an accelerating rate.1 Under these circumstances, it would seem prudent to encourage physicians to question answers; instead, the AAP has now launched a campaign to supply Fellows with answers to questions!
Leaving aside a call for evidence concerning the efficiency of the slick, gimmicky, PACE package in accomplishing the avowed purpose of inculcating "the answers," a heretical ("Thank God there are no free schools or printing . . . for learning has brought disobedience and heresy into the world, and printing has divulged them...."
The Hidden Cost Dilemma
Authors: Sparling David 
Published: December 2021

The commentary by Steigman amid Kendig1 on frequency of tuberculin testing, found in the August 1975 issue, presents a basic dilemma common to all preventive health procedures incorporated into office pediatrics. The cost of tuberculin testing is not in the material, but in the personnel time to administer and explain. If the patient is to return to the office for measurement and documentation, there are additional requirements of personnel time and office space.
In our own office, where around 2,500 tuberculin tests are done each year, we have continued tuberculin testing at each annual health examination.
THE DECADENCE OF THE AMERICAN FAMILY AS VIEWED IN 1884
Authors: C. T. E. 
Published: December 2021

Almost a century ago editorials such as the one below expressed the fear that the American family was in serious trouble.
We do not like to be doleful, but it is impossible to ignore some of the facts that have been presented with the last year or two [1882] by Dr. Goodell, Dr. Nathan Allen, and others. These facts relate to...the decadence of family life among Americans. Dr. Allen, who has been studying this subject for many years, presents the case very directly in an article entitled "The New England Family" (The New Englander). It is asserted that the objects of the institution of the family are three: the propagation of children, the preservation of chastity, mutual help and company. In each of these respects the American family, especially the New England family, shows a marked and progressive deterioration, since one hundred years ago.
As regards the propagation of children, it is shown that the average native New England family is very much less productive than formerly.... The birthrate in New England families has been steadily declining until now it is lower than that of any European country except France. One additional element in this, no doubt, is the habit of delaying marriages-a habit made almost necessary by the more expensive style of living which is demanded, and by what some consider the selfishness of young men who prefer not to sacrifice their liberty to the responsibility and expense of domestic life.
Another indication of family deterioration is the increase of divorces.
INDIVIDUAL ACTION
Authors: Hirsen F. ,   Student
Published: December 2021

Considered in isolation, the individual's demand for education . . . , for an auto, for a country cottage, can be taken as genuinely individual wants. . . . Acting alone, each individual seeks to make the best of his or her position. But satisfaction of these individual preferences itself alters the situation that faces others seeking to satisfy similar wants . . . there is an "adding up" problem. . . . What each of us achieve, all cannot.
A break between individual and social opportunities may occur for a number of reasons; excessive pollution and congestion are the most commonly recognized results. A neglected general condition that produces this break is competition for performance. Advance in society is possible only by moving to a higher place among one's fellows, that is, by improving one's performance in relation to other people's performances. If everyone stands on tiptoe, no one sees better. Where social interaction of this kind is present, individual action is no longer a sure means fulfilling individual choice. . . .
DID THE Rh FACTOR CHANGE THE COURSE OF ENGLISH HISTORY?
Authors: C. T. E. 
Published: December 2021

Sir Hector Maclennan, a Scottish gynecologist, has come tip with an intriguing theory about the failure of the marriage of Henry VIII to his first wife, Catherine of Aragon, and its effect on the religious and political history of England.
Henry was married to Catherine for 19 years; happily married, according to Sir Hector, to begin with and, had she been able to bear him a son, there seems little doubt and general agreement on the part of the historians of the period that he would have remained married to hen for the rest of his life. But by the time Catherine was 40 she had had a number of miscarriages and premature labors; she had produced five babies who died within days and weeks of delivery, amongst them three sons. The sole survivor was a girl, Many, born in 1518 and upon her the safety of Tudor throne and the tranquility of the country depended. It was not enough and Catherine had not been pregnant for seven years. Her failure to produce a son jeopardized the succession and so Henry looked for an excuse to get rid of her.
Sir Hector's hypothesis to explain Catherine's bad obstetric history is this:
If Queen Katherine [sic] was Rh negative and either of her two husbands [Katherine had first married Henry's brother Arthur who died within a year of his marriage] Rh positive, antibodies might have been set up which prejudiced her future deliveries. If we admit such a possibility, and it's not very far-fetched, then of course this would explain the neonatal deaths which followed.
Hospital-Acquired Viral Respiratory Illness on a Pediatric Ward
Authors: Wenzel Richard P. , Deal E. Chandler , Hendley J. Owen 
Published: December 2021

All 171 patients admitted to four study rooms containing cribs were under surveillance during the winter and spring for development of nosocomial respiratory viral infection. One sixth of the 90 children at risk acquired respiratory illness while in the hospital. Viruses were isolated from two thirds of the patients with nosocomial infections: rhinovirus, respiratory syncytial virus, parainfluenza, and influenza A and B.
Serial viral cultures of the children under surveillance suggested that nine of 11 virus-positive nosocomial infections were not acquired from a roommate. Furthermore, the risk to a patient of becoming infected with a virus being shed by a roommate was only 3%. The need for isolation of all children with a respiratory illness in a single room with a separate air exhaust system is not suggested by these data.
We Should Stop Misuse of P Value
Authors: Cook David 
Published: December 2021

Dr. Jekel's commentary "Should We Stop Using the P Value in Descriptive Studies? (Pediatrics 60:124, July 1977) is a gentle jeremiad about misuses of statistics in medicine. His intentions are laudable. However, he may persuade physicians who are uncomfortable with statistical manipulations that these should be abandoned, rather than that misusage should be abandoned.
The main points made by the commentary are three. The first notes that mindless data-dredging can result in large number of spurious, supposedly "significant" results.
CONTRASTS IN HMO AND FEE-FOR-SERVICE PERFORMANCE
Authors: H. R. J. 
Published: December 2021

This study compares various aspects of HMO performance in 10 plans with that of the fee-for-service system for the Medicaid population. Additionally, it examines utilization differences between several types of HMO's, grouped according to organization and provider payment. Four areas of behavior were studied—enrollment selectivity, utilization of services, accessibility of care, and satisfaction.
The only significant difference between the two systems was in hospital utilization. Group-practice HMO's had significantly lower hospital utilization than the fee-for-service groups; foundation HMO's did not. This difference seems to indicate that capitation payment to an HMO alone is not significant enough to produce major changes in utilization and that the organized multispecialty group-practice arrangement with largely salaried physicians may be more significant. For the other variables—previous health status, ambulatory-care use (including preventive care), accessibility, and satisfaction-the two groups were remarkably similar.
Modern motor milestones
Authors: Berger Lawrence R. 
Published: December 2021

In child development circles, a motor milestone is a discrete event in a person's progressive mastery of control over the body's movements. To most parents, each milestone-sitting up without support, grasping a raisin between thumb and forefinger, holding a cup, taking the first step all by herself—is a joyous occasion in their child's life. Children of the seventies, however, exhibit a new set of motor milestones made possible by our affluent society. None of these is cause for celebration. The modern milestones are discrete events marking the child's progressive involvement with engine-driven vehicles.
As early as 4 years of age, children may ride their first minibike.
Asthma and allergists: A modern perspective
Authors: Bergner Renee K. 
Published: December 2021

In the current issue of Pediatrics (page 1061), Leffert elegantly reviews the theories of asthma pathogenesis, while identifying areas of our continued ignorance. He also calls for pediatricians to assume a more central role in the management of this condition rather than resort to the traditional, often near automatic practice of referring and deferring to allergists. It would be a pity to obscure the important theme of Leffert's article by an intramural fight for "turf" between pediatricians and allergists.
The noteworthy points of Leffert's article are: (1) Not all asthma is due to allergy. (2) Dramatic developments in asthma therapy have taken place in recent years.1-4
Complications of Prenatal Therapy With Diethyistilbestrol
Authors: Herbst Arthur L. , Scully Robert E. , Robboy Stanley J. , Welch William R. 
Published: December 2021

Cancer of the vagina is a rare type of genital malignancy that usually occurs as squamous cell carcinoma in postmenopausal women. Vaginal clear cell adenocarcinoma (Fig. 1), which used to be termed "mesonephroma," is an extremely rare type of genital cancer and was almost never encountered in younger patients until recently. In 1970, a clinical and pathologic study of seven cases of clear cell adenocarcinoma of the vagina in females between the ages of 14 and 22 years was published; all of them had been seen or treated in the late 1960s. These seven cases exceeded the total number of this type of cancer that had been previously reported in this age group.1 The next year, a retrospective epidemiologic study was conducted that included an additional case, and this cohort of eight was compared to 32 controls. It was found that the risk of development of these carcinomas was significantly associated with intrauterine exposure to diethylstilbestrol.2
Diethylstilbestrol therapy for high-risk pregnancy to reduce fetal wastage had been very popular in the late 1940s and 1950s. However, its use was stated to be contraindicated in 1971 by the Food and Drug Administration after the results of the initial epidemiological studies were confirmed.3 Clear cell adenocarcinoma of the cervix has also been associated with intrauterine exposure to diethylstilbestrol.4,5 In addition, other similar nonsteroidal synthetic estrogens such as dienestrol and hexestrol have also been implicated in the association.
Studies of the clinical, epidemiological, and pathologic aspects of these neoplasms have been centralized in the Registry for Research on Hormonal Transplacental Carcinogenesis (formerly the Registry of Clear Cell Adenocarcinoma of the Genital Tract in Young Females).
PRINCESS ELIZABETH, SECOND DAUGHTER OF KING CHARLES I, AND RICKETS
Authors: C. T. E. 
Published: December 2021

In 1856 the coffin of Princess Elizabeth (1635-1650) was discovered during the demolition of old St. Thomas's Church at Newport, Isle of Wight, England.
Mr. Ernest P. Wilkins, MRCS, examined the remains of the Princess and noted:1
The bones of the upper arm were slightly curved outwards—more particularly the right humerous—while those of the forearm were somewhat twisted and considerably curved outwards. The spinal column, retaining the relative position of the vertebrae during life, presented an extremely curved condition constituting the double lateral or S curvature of pathologists, which must have caused considerable projection of the right shoulder-blade and its attendant deformity ....
The condyles of the lower extremities were very large in relative proportion. The femur or thigh bone of the left side was curved forwards and inwards, that of the right side was more distorted than any other long bone. It was very much curved forwards and inwards. This bone was much flattened, its greatest diameter being from before, obliquely outwards and backwards; the concavity of the curve was somewhat filled in, and the bone thus strengthened by additional osseous deposit in accordance with the natural reparative tendency of Nature's laws. The bones of the leg, the tibia and fibula, were much curved outwards.
The bones of the skeleton indicate the great deformity which existed during life—there was evidently considerable "growing out" of the right shoulder-blade and corresponding flattening of the left side of the back. The lower extremities were contorted and of unequal length, the knees were what is termed "knocked"; below the knees the legs were bowed, the heels thrown outwards and the toes inverted.
Survival after Massive Aminophylline Overdose in a Premature Infant
Authors: Wells David H. , Ferlauto Jerry J. 
Published: December 2021

The use of theophylline preparations for treating apnea in premature infants has gained popularity in many neonatal intensive care units.1,2 Toxocity of aminophylline in premature infants is not well studied. We present a case of severe aminophylline intoxication in a premature infant secondary to a pharmacy error. We call attention to the massive overdose tolerated by this infant and relate how the error was made so that other hospitals might avoid such incidents.
CASE REPORT
Baby girl C.E. was a 1.2 kg 30 weeks gestation, second born twin of a 23-year-old gravida 1, para 0, abortus 0 Rh negative mother.
Comparison of Urinary Lactic Dehydrogenase with Antibody-Coated Bacteria in the Urine Sediment as Means of Localizing the Site of Urinary Tract Infection
Authors: Lorentz William B. , Resnick Martin I. 
Published: December 2021

Two noninvasive methods of localizing the site of urinary tract infection, urinary lactic dehydrogenase (LDH) isoenzymes and antibody coating of bacteria in the urinary sediment, have been prospectively compared with the bladder washout technique in a series of children with urinary tract infection.
Fifteen children had infection localized in the upper tract. Urinary LDH isoenzymes correctly localized the infection in 14 children; however, the infection was correctly localized by the antibody coating of bacteria in only eight patients (P &lt; .02). Fourteen children had lower tract infection by the bladder washout technique. Urinary LDH isoenzymes localized the infection in all 14 children, whereas the antibody coating correctly localized the infection in ten children (P &lt; .05). This study shows the urinary LDH isoenzyme pattern to be a more accurate technique than the detection of antibody-coated bacteria for localizing the site of urinary tract infection.