bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Diet Wasn't Controlled
Authors: Miller James S. 
Published: December 2021

While the article of Conners et al. (Pediatrics 58:154, August 1976) is not the worst you have published, it is surely in active competition. The fundamental point relates to the diets. In what real sense is the second diet a "control" so as to permit the appellation "double blind"?
I list in the Table the principal foods to he omitted in each diet. Dr. Conners et al. do not tell us what their 15 children did eat, before or during the diets.
Drs. Levine and Liden Reply
Authors: Levine M. D. , Liden Craig B. 
Published: December 2021

In response to the letter from Dr. Miller, we feel we should make a few points about our commentary, "Food for Inefficient Thought."
Your correspondent somehow implies that we were not hard enough on the study of Conners et al. with respect to food additives. This is clearly a very charged issue at the moment, and it seems important to take a very sober and fair look at the factors involved. The study should really be regarded as the first of a series of organized and disciplined approaches to the problem.
Who Delivers Higher Quality Care?
Authors: Sparling David 
Published: December 2021

Access by all children to high-quality medical care must be the goal of all pediatricians. There are many reasons why all of this care cannot in the foreseeable future be given by pediatricians. These include factors of geography, economics, family education, and comfort, and episodic versus continuity medical care, as well as aggregate manpower figures.
Dr. Hoekelman's presentation (Pediatrics 59:315, March 1977) addresses the issue, but his argument is poorly served by the undocumented statement that "there are no data to show that pediatricians do a better job in delivering primary care to children than do family practitioners."
Child Abuse Can Be Prevented
Authors: Rako Jules 
Published: December 2021

The article by Elmer (Pediatrics 59:273, February 1977) brings up some alarming findings. Children of low-income families, abused and nonabused controls, all had severe developmental lags. Drs. Cupoli and Newberger in thier commentary (Pediatrics 59:311, February 1977), are optimistic about these abused children because they see strength in the fact that the abused children had no greater developmental lag than the controls.
I would like to be as optimistic as these workers in the field of child abuse, but as a practicing pediatrician I must confess that many of our low-income children are being denied access to pediatric care and must rely on fragmental health care, usually during crisis situations.
Dr. Travis et al. Reply
Authors: Travis Kenneth W. , Todres I. David , Shannon Daniel C. 
Published: December 2021

While florid pulmonary edema can follow direct instillation of hydrochloric acid into the lungs,1,2 we have not encountered such dramatic pulmonary edema in cases of aspiration pneumonitis in children. Nor has it exhibited such even bilateral distribution. Furthermore, pulmonary edema from a chemical injury of such severity is not likely to regress as rapidly as did the pulmonary lesions of cases 1 and 2.
We concluded, therefore, that mechanisms other than aspiration of gastric contents were operable.
PRODUCTION AND DEPLETION
Authors: Leonard John 
Published: December 2021

According to Marvin Harris, a Columbia University Anthropologist . . . we have been going downhill since the Stone Age. Paleolithic man (and woman) got along fine on a combination of animal protein and infanticide, working just three or four hours a day. When at the end of the Pleistocene Epoch, the "megafauna" disappeared, not even an infanticide rate as high as 50 per cent could maintain an adequate diet for all the available people.
And so we turned from animal to plant protein; from a "mode of production" that was primarily hunting to one primarily agricultural; from roving bands to settled villages, then cities and states. Agriculture is more "labor efficient" than hunting. But the trouble with efficiency we're told is that as it intensifies production it also speeds up depletion of resources. Producing and reproducing we overpopulate our space and use up its capacity to sustain us. Then we go off to war with neighboring villages, and back to infanticide at home, while waiting for a new mode of production to suggest itself, which mode will in its turn, intensify and deplete.
Classes of Pediatric Care: Point-Counterpoint
Authors: Mebane William N. 
Published: December 2021

Dr. Maurice Ross's commentary entitled "Classes of Pediatric Care" (Pediatrics 60:542, October 1977) suggests that medical care of children by family practitioners is second-class care. He extends his line of reasoning to suggest that pediatric care by pediatric nurse associates, pediatric nurse practitioners, physicians' assistants, or extenders is third-class care. Further extension of this reasoning might suggest that care by mothers is fourth-class care.
We are asked to acknowledge that there are different classes of pediatric care and that there are some children who receive little or no care.
Dr. Ross Replies
Authors: Ross Maurice 
Published: December 2021

Credentials and even training or study do not make a competent, concerned, warm-hearted physician. As one of my respected mentors taught, we must always strive to develop empathy for all, in spite of personality differences, if we are to be good healers and counselors.
Dr. Mebane and I probably live and practice in different environments. Before my pediatric residency, I completed a rotating internship at a teaching hospital with a respected pediatric department. After my pediatric residency (also in a "prestigious" teaching hospital), I opened my office for the private practice of pediatrics in a small community where medicine was dominated by general practitioners.
Immunity to Diphtheria in an Urban Population
Authors: Nelson Lois A. , Peri Barbara A. , Rieger Christian H. L. , Newcomb Richard W. , Rothberg Richard M. 
Published: December 2021

Immunity against diphtheria is poorly understood since protection is the result of a complex interaction between host and environment, and technical problems with the present antitoxin assays exist. A radioimmunoassay which permits a reproducible estimation of antitoxin concentration and relative avidity was employed to characterize the immunological response to diphtheria of 195 healthy urban children. The antitoxin concentration in cord serum was equal to or greater than the concentration in maternal serum and decreased rapidly during the first two months of life. The first diphtheria-tetanus-pertussis inoculation was not immunogenic enough to initiate significant antitoxin production in infants without maternal antitoxin or in older children. A significant increase in antibody concentration and affinity was found after the second, third, and fourth toxoid administrations. More than four injections did not alter concentration, affinity, or duration of active immunity.
Correlation with recent epidemiologic studies suggested that a serum contained a "protective" concentration of antitoxin if it bound more than 100 ng of diphtheria toxin nitrogen per milliliter of serum (approximately 0.1 IU of antitoxin). By this criterion, among the study group only 74% of the healthy children who had received three immunizations and 84% of the children who had received four or more inoculations were "protected." Antitoxin concentrations observed in serum from children with chronic diseases who had received appropriate immunizations were lower than in serum from appropriately immunized healthy children. These observations suggest that the immunologic status of urban children against this disease is not optimal and should serve as a stimulus to improve both patient education and immunization practices.
HOW THE REVEREND JOHN BARNARD'S SCARLET FEVER WAS CURED BY ABSENT TREATMENT IN 1693
Authors: C. T. E. 
Published: December 2021

The Rev. John Barnard of Marblehead, Massachusetts, an 18th century Puritan, is little known except to those who have read his autobiography. President Stiles of Yale wrote to Barnard on October 3, 1767: "with great pleasure I have read your life again and again. It has proved a feast to me."
Mr. Barnard's fascinating description of how he was cured of scarlet fever follows:
. . . In June, 1693, in my twelfth year, Sir Francis Wheeler, with his fleet, which had in vain made an attempt upon Martinico, came to Boston, and brought with him a violent and malignant distemper, called the scarlet fever, by which he lost many hundreds of his men. The distemper soon spread in Boston, of which many persons died, and that within two or three days of their being taken ill. It pleased God I was seized with it, and through the rampancy of the fever, and a violent pain at my heart, which rendered every breath I drew to be as though a sword had pierced me, I was so bad that life was despaired of. On the third night, (I think) it seemed to me that a certain woman, wife of a doctor, who used to supply my father's family with plasters upon occasion, came and brought me some small dark colored pills, and directed me to put one in my mouth, and hold it there till it grew mellow, then squeeze it flat betwixt my thumb and finger and apply it to my right nipple; it would soak in and before I had used them all so, I should be well.
Medical Management of Serous Otitis in Children
Authors: Bierman C. Warren , Furukawa Clifton T. 
Published: December 2021

Though pediatricians have long been concerned with the problem of fluid in the middle ear as it pertains to infection or temporary conductive hearing loss, it is only recently that they have begun to be aware of the long-term consequences of middle ear fluid. Brannon and Murray,1 for instance, studied language skills in children with hearing impairments and found deficits in five specific areas including total words, words per sentence, total errors, words per corrected sentence, and syntax score. Nation2 studied children of normal intelligence with cleft palate. Even with the exclusion of children with a hearing loss of 30 dB or greater, he found a significant deficiency of vocabulary comprehension and usage in the children with cleft palates, suggesting that even a mild hearing loss may affect vocabulary development. Holm and Kunze3 studied children with fluctuating hearing loss from chronic otitis media. They found problems of deficient vocabulary, articulation skills, ability to receive and express ideas through spoken language, use of grammar, syntax, and auditory memory skills. Since resolution of serous otitis restores normal hearing, early diagnosis is essenhal to prevent persisting long-term behavioral, social, and educational handicaps. In this article we will focus on changes within the ear, Eustachian tube, and nose which predispose to serous otitis, on methods of diagnosing serous otitis, and on options in management.
Serous and Secretory Otitis Media
When nonsanguinous middle ear effusions are cultured, approximately one fourth to one third will be sterile4 and will not respond to antibiotic therapy. The pediatrician diagnoses this condition as serous otitis media.
Islet Cell Tumor in a Neonate: Diagnosis by Selective Angiography and Histological Findings
Authors: Kirkland John , Ben-Menachem Yoram , Akhtar Mohammad , Marshall Robert , Dudrick Stanley 
Published: December 2021

Congenital islet cell adenomas of the pancreas are rare. Fewer than 20 cases have been documented.1,2 The purpose of this article is to present what we believe is the first case in which a preoperative diagnosis of an insulinoma was established by selective angiography in a neonate and to describe the histological findings.
CASE REPORT
A girl weighing 2,759 gm was the product of a normal 38-week pregnancy with an uncomplicated labor and delivery. The one- and five-minute Apgar scores were 8 and 9. At 19 hours of age she was observed to be cold, pale, and diaphoretic. A sepsis evaluation was initiated.
New Canadian Institute of Child Health
Authors: Law John T. 
Published: December 2021

On July 1, 1977, the Canadian Institute of Child Health (Institut canadien de la santé infantile) began operation in Ottawa. The mission of this new institute is to be an effective and useful force to improve the health and, therefore, the quality of life of Canadian children. Health is defined as complete physical, mental, and social well-being, and the target population will be all children from conception to 18 years of age, or approximately 8 million Canadians.
In June 1975, The Hospital for Sick Children Foundation commissioned Shirley E. Post to examine the need for an institute of child health and to prepare a report for the Foundation.
Home Care for Children Dying of Cancer
Authors: Martinson Ida M. , Armstrong Gordon D. , Geis Dorothy P. , Anglim Mary Ann , Gronseth Evangeline C. , Maclnnis Helen , Kersey John H. , Nesbit Mark E. 
Published: December 2021

Hospitals have traditionally provided the setting for the treatment of children with cancer, including those in the terminal stage of their illness. However, when treatment that requires hospitalization has been discontinued and the child's cancer is still not under control, then the wisdom of continued hospitalization is questionable.
If the care that is required by the patient could be provided as effectively by the parents and by nurses at home, then it would be reasonable to make a home care option available to the families who desired it. The possible advantages of such home care would be improved satisfaction of the child, better adjustment to the situation by the family, and reduced cost. It is more comforting to the child to be in familiar surroundings with the parents at hand during the terminal stages of his or her illness. Most of the specialized and expensive sive facilities provided by the hospital are no longer needed by the child.
The preliminary findings from a research project dealing with home care of children with cancer are reported in this article. The feasibility and desirability of the home as an alternative to the hospital for children whose death from cancer was impending were examined. Administration of the home nursing service was at the time of the study separate from existing nursing services. Home care nurses were hired on an hourly basis and were recruited from hospitals and public health agencies. Two project staff nurses oriented the home care nurses to the special functions that they would serve, and also provided consultation and some of the actual home care.
A CASE OF CHOLERA INFANTUM CURED BY LUNAR CAUSTIC IN 1829
Authors: C. T. E. 
Published: December 2021

Cholera infantum was the name Benjamin Rush gave to the so-called summer diarrhea of infants and children. This disease was also known as "the vomiting and purging of children" or "the disease of the season" because of its regularity in appearing during the summer months.1 The mortality from this malady during the early 19th century was appalling and its treatment unscientific as this case history by Dr. Joseph Skinner of North Carolina of his daughter's illness will show.
My daughter Cornelia, aged seventeen months, was attacked about the middle of June, 1829, with the usual symptoms of cholera infantum, . . . occasional vomiting, particularly when any fluid was taken in the stomach; the matter ejected was sometimes tinctured with bile, but more commonly it was merely the fluid taken in the stomach; the bowels were exceedingly irritable, the evacuations copious, frequent, and very offensive; sometimes of a clay colour, at other times resembling coagulated milk; fever of a remittent form; skin hot and dry, &c. . . .On examination of the mouth, I found the gums tumefied and four molares [sic] making their way through, which was believed to be the exciting cause of the train of symptoms which I have described.
In the treatment of the case my first object was to remove all sources of irritation; accordingly the gums were freely scarified, and the bowels were purged with calomel and calcined magnesia and injections of common salt and warm water. This practice was steadily adhered to for several days, but failing to produce the desired effect, the symptoms of prostration fast approaching, the pulse indicating a great degree of debility, and the fever assuming a more decided remittent type, indicating the influence of miasmata,.
Impedance Audiometry: It Is Useful!
Authors: de C. Magian V. 
Published: December 2021

Dr. Mortimer's commentary "Impedance Audiometry: Is It a Wise Investment?" (Pediatrics 58:151, August 1976) certainly expresses concerns which might appear valid. However, I cannot agree with his statement deploring the widespread use of impedance screening of school-age children until such time as we can prove that serous otitis causes learning impairment or that the condition can be treated favorably.
One of the concerns is with cost. Cooper et al.,1 taking into account salaries, equipment, and its maintenance and life expectancy, have shown that impedance screening is less expensive than traditional pure tone screening, once the number of children screened per year exceeds 1,239.
Letter To The Editor
Authors: Mortimer Edward A. 
Published: December 2021

Perhaps the best way to clarify my position for Dr. Magian is to consider the benefit/cost ratio of impedance audiometry for routine screening of children. (As a research tool I support its use strongly.) Let us first consider the benefit of routine screening and how firmly established this benefit is.
The major benefit claimed is that tympanometry identifies eustachian tube dysfunction with greater sensitivity than other techniques. To quantitate this benefit one needs to know the proportion of children identified by this, but not by other, techniques.
It Doesn't Work!
Authors: Thompson Hugh C. 
Published: December 2021

In the April 1977 issue of Pediatrics (59:636, 1977), Dr. Cunningham recommends that the patient's medical record be given to the family to keep. He urges that the Committee on Standards of Child Health Care consider this subject.
For at least 20 years the American Academy of Pediatrics has published for this very purpose, a "Child Health Record." This is publication HE-4 of the Academy and was last revised in 1968. The central office of the Academy tells me that, at the present time, between 50,000 and 100,000 of these are sold annually to physicians for the distribution that Dr. Cunningham recommends.
DR. J. QUIER DESCRIBES KOPLIK'S SPOTS 122 YEARS BEFORE KOPLIK
Authors: C. T. E. 
Published: December 2021

On June 28, 1774, Dr. J. Quier wrote a letter to Dr. Donald Monro of Edinburgh in which he gives an account of an epidemic of measles in Jamaica. His description of "Koplik's spots" equals that of Koplik himself.1
The usual symptoms, (of cough, inflamed eyes and throat, anxiety and restlessness,) were observed here in a very great degree. But the most certain diagnostic of the disease in its beginning, (and which I do not remember to have found mentioned by any author that I have met with,) was the appearance of the white aphthous specks about the gums; which were always visible several days before the eruption, and not unfrequently before the fever began. By this symptom, I discovered several to be affected with the measles, before they were themselves sensible of any indisposition.2
Research Involving Children: Recommendations of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research
Authors: Jonsen Albert R. 
Published: December 2021

Throughout history, children have been subjects of research. A legendary Persian prince is said to have isolated newborn babies from all human speech in hopes of discovering whether language was natural and spontaneous. Queen Caroline of England recruited children from a foundling hospital in order to test Jenner's vaccination on them before it was applied to her own royal progeny. The modern controversy over research with children and the retarded can be traced to events at Willowbrook State Hospital for the Mentally Retarded where, during the 1950s and 1960s, healthy mentally retarded children were infected with mild hepatitis in order to study the natural history of the disease. That research aroused great public controversy and its merits and faults are debated even today. It initiated a discussion within and without the medical profession over whether any invasion or manipulation of the body or person of a nonconsenting subject could ever be ethically justified, apart from expectation of benefit to that subjct.1
The prevailing codes of ethics governing the use of human subjects for experimentation are curiously ambivalent about children. The progenitor of these codes, The Code of Nuremberg, if taken literally, would exclude children as subjects, for it requires the voluntary consent of the subject "as absolutely essential," without any provision for proxy consent.1 The World Medical Association's Declaration of Helsinki, on the other hand, states that for nontherapeutic research involving legally incompetent subjects, "the consent of the legal guardian should be procured."3(p277) This position has been adopted by the American Medical Association:
Mesmerism, magic, and medicine
Authors: Schowalter John E. 
Published: December 2021

The appearance of Olness and Gardner's article, "Some Guidelines for Uses of Hypnotherapy in Pediatrics" (p. 228), must strike many readers as something far out, while for some others there is relief that Pediatrics has finally recognized a phenomenon that is a fact of everyday life.
Hypnosis is not easy to define. It need not produce a trance, but is a state in which the subject is extremely suggestible to the wishes of the hypnotist and in which there is a heightening of the powers of concentration.
The use of the hypnotic state dates back to early in the history of the individual and of medicine.
Potentially Toxic Theophylline Dose Recommendations
Authors: Hendeles Leslie , Wyatt Richard , Weinberger Miles 
Published: December 2021

We are alarmed by the theophylline dosage recommendation published in a recent Quibron advertisement in Pediatrics (61:A8-A9, April 1978) and labeled as "New Pediatric Dosage" on the outside of sample packages of Quibron Elixir that are mailed to pediatricians. These recommendations, in some cases, approach the excessive doses that produced seizures and death in children during the 1950s.1
Some patients who are rapid metabolizers may require the larger doses recommended in the Quibron advertisement in order to achieve peak serum concentrations in the therapeutic range of 10 to 20 µg/ml.
BUREAUCRATIC LEARNING
Authors: Nisbet Robert 
Published: December 2021

Through the application of science, human beings in America and other parts of the world have been liberated from plagues, pestilences, threats of famine, hardship and torment that once seemed an unalterable part of the human condition.
And until recently, all of this was rewarded by public and governmental respect.
In the past few years, however, disenchantment has set in, with the public concluding that the post-war promises of learning were inflated and misleading.
Much of science and scholarship has become obsessed with what it likes to think is a public-policy role, with the individual scholar only too happy to serve as policy maker. Unhappily, as the policy maker advances, the man of learning recedes.
Bureaucratic learning has also become commercial. The large grant, the entrepreneurially established institute have come to wield great power. Thus a substantial amount of research that does not really require great amounts of money and complex organizations, that is indeed retarded in inspiration by them, demands them anyhow. Grantsmanship, at first a wry joke among academics, is by now a publicly recognized source of banality, trivialization and pretentiousness.
Bureaucratic learning has lost its sense of proportion and of the true roots of knowledge.