bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inadequate Breast Feeding and Jaundice
Authors: KEMPER KATHI J. 
Published: December 2021

In Reply.—
Dr Newman suggests that jaundice may be a symptom of inadequate breast-feeding and that the correct treatment of this problem is to encourage increased breast-feeding, rather than interrupting it. Although there are no studies which definitively demonstrate the cause and effect relationship between inadequate breast-feeding and hyperbilirubinemia, I agree with Dr Newman that a rational, common-sense approach would be to encourage early and frequent breast-feeding. Supplementation of breast milk with devices such as that described by Dr Auerbach also makes sense to me.
Extraordinary Urinary Frequency
Authors: ZOUBEK JAROSLAVA , BLOOM DAVID A. , SEDMAN AILEEN B. 
Published: December 2021

Frequency is the predominant disturbance of micturition and suggests inflammation, obstruction, or a foreign body in the urinary tract. Frequency occurs in two-thirds of all cases of infection of the urinary tract and is almost always present when intravesical obstruction or inflammation of the posterior urethra exists.
Frequency may also result from inadequate training, nervousness, excitement, or mental defectiveness.
—Meredith Campbell, 19371p8
Urinary frequency is a classic hallmark of genitouninary disease. Extraordinary urinary frequency sometimes develops in children without any other symptoms or signs. There is rarely a physical basis for this condition. The typical patient is a previously toilet-trained child with a sudden onset of distressing urgency and urinary frequency as often as every 5 minutes.
Cholesterol Screening?
Authors: DENNISON BARBARA A. 
Published: December 2021

To the Editor.—
The paper by Drs Garcia and Moodie is the third article in the past 4 months to question the efficacy of family history as the first step in a screening strategy to identify children with hypercholesterolemia.1-3 Their finding that 50% of the children they identified with elevated low-density lipoprotein (LDL) cholesterol did not have a family history of premature cardiovascular disease or hyperlipidemia is essentially the same as that of Griffen and colleagues.2
Recommendations for Developmental Monitoring: The Role of Surveillance
Authors: CUNNINGHAM ROBERT D. 
Published: December 2021

To the Editor.—
Dr Dworkin raises many good points in his review, "British and American Recommendations for Developmental Monitoring: The Role of Surveillance." However, I am skeptical that the concept of "surveillance" is actually different from what physicians have practiced in the past. Dr Dworkin acknowledges "that mild mental retardation is not typically identified until the child is confronted with the cognitive demands of school...," especially when physicians rely on subjective impressions. With the concept of "surveillance," "eyeball" estimates will continue to be made of a child's development; and with each well-child visit and frequently each acute illness visit being of relatively brief duration, I strongly suspect that the overwhelming majority of mildly retarded children will continue to elude detection.
Language Growth in Children With Expressive Language Delay
Authors: RUBEN ROBERT J. 
Published: December 2021

To the Editor.—
The article entitled "Language Growth in Children with Expressive Language Delay" by Fischel et al1 reports a clinical study that lacks the one most important control, audiometric evaluation. This lack brings into question any conclusions drawn from their data. A most common cause for expressive language delay in young children is conductive hearing loss.2 In Table 2 of the article by Fischel et al, it was noted that the number of treatments for ear infections had a high positive correlation with language delay.
Language Growth in Children With Expressive Language Delay
Authors: FISCHEL JANET E. , WHITEHURST GROVER J. , LONIGAN CHRISTOPHER , JORDON REBECCA SEMENAK 
Published: December 2021

In Reply.—
Dr Ruben raises concerns about our publication in this journal on language growth in children with expressive language delay.1 Ruben's position is that hearing loss accounts "for much of the expressive language delay seen in children at this age" and that, because we did not include that variable in our study, this "brings into question any conclusions drawn from their data."
We are pleased that Ruben has raised the issue of the role of conductive hearing loss because we have gathered relevant data since the publication he questions.
Adult Respiratory Distress Syndrome in Full-Term Newborns
Authors: PFENNINGER J. , TSCHAEPPELER H. 
Published: December 2021

To the Editor.—
Because of our longstanding interest in adult respiratory distress syndrome in the pediatric age group, it was a pleasure to read the article about neonatal adult respiratory distress syndrome by Faix et al.1 However, our experience with the neonatal form of the syndrome differs quite substantially from that reported by Faix; and, therefore, we would like to report just briefly our data from the last 20-month period. During this time the diagnosis of adult respiratory distress syndrome according to classcial criteria was made in 5 newborn infants.
Diagnosis of Human Immunodeficiency Virus Infection in Infants and Children
Authors: Husson Robert N. , Comeau Anne M. , Hoff Rodney 
Published: December 2021

Since its initial description at the beginning of this decade,1-3 the acquired immunodeficiency syndrome (AIDS) has become one of the major medical, public health, and social issues of our times. Since the isolation of the retrovirus human immunodeficiency virus (HIV) from patients with AIDS and AIDS-related complex,4,5 major advances have been made in understanding the biology of the virus and the disease it causes. Diagnosis of HIV infection in adults and older children, and screening of blood products, have become routine and reliable with the use of licensed tests that detect HIV-specific antibody.6 Antiretroviral drugs, as well as new agents active against AIDS-associated opportunistic infections, have been developed and the first steps in the treatment of HIV infection and its associated illnesses have been taken.
Whereas most HIV infection has occurred in adults, it has become an increasing problem among children, particularly in certain geographic areas and populations, reflecting the changing nature of the epidemiology of the disease in the United States. In contrast with the early predominance among homosexual males,7 at present the most significant increases in both HIV infection and AIDS are occurring in users of illicit intravenous drugs, in heterosexual contacts of infected individuals, and in infants born to HIV-infected mothers.8 Nationwide the prevalence of HIV infection in childbearing women remains low; however, rates as high as 1% to greater than 4% have been reported from some urban areas.9,10 Although widely disparate rates of vertical transmission have been reported,11 ongoing prospective studies indicate that the rate of transmission from HIV-infected mother to infant appears to be in the range of 24% to 35%.12-14
Drugs and Breast Milk
Authors: KAUFFMAN RALPH E. 
Published: December 2021

In Reply.—
In response to Dr Dorfman's concern regarding naproxen, the revised commentary included information only on drugs for which there was peer-reviewed published information. Information in the 1983 commentary which was based on personal communications, unpublished files, or secondary references and which could not be corroborated was not included in the revised commentary. We were unable to find published data on naproxen excretion in breast milk or absorption by the nursing infant. As stated in the current commentary, "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... but indicates that there are no reports in the literature."
I.B.C.L.C
Authors: TANIS ARNOLD L. , COLEMAN ALLAN B. , GROSS LEON 
Published: December 2021

To the Editor.—
With the increased emphasis by the American Academy of Pediatrics on infant nutrition, and especially on fostering breast-feeding, the availability of trained and credentialled persons to advise and support breast-feeding mothers and to assist pediatricians in this endeavor must be noted. The International Board of Lactation Consultant Examiners, Inc. (IBLCE) completed its fifth annual examination cycle in July, 1989. To date, 1231 candidates have been certified worldwide with more than 80% in the United States and Canada.
Routine Cholesterol Surveillance in Childhood
Authors: FELDMAN WILLIAM 
Published: December 2021

To the Editor.—
The article by Garcia and Moodie1 on cholesterol screening in childhood is likely to receive considerable attention and may have an impact on pediatric practice. The observation of these authors that the usual high-risk family characteristics may, if used as sole criteria for screening, allow some hypercholesterolemic children to remain undetected is valid. However, their recommedation that "all children older than 3 years of age should have a cholesterol test" cannot go unchallenged.
Tin-protoporphyrin in the Management of Children With Crigler-Najjar Disease
Authors: RUBALTELLI FIRMINO F. , JORI GIULIO 
Published: December 2021

In Reply.—
We have considered carefully the points raised by Dr McDonagh and answer as follows: Regarding points 1 and 2, Fig 2 (second plot from the bottom) of our paper clearly shows that administration of SnPp to the patient with Crigler-Najjar type 1 disease reduces the serum bilirubin concentration to values ranging between 12 and 15 mg/dL for at least a week. In the absence of SnPp treatment, the infant never reached such low levels even during sunny seasons, unless phototherapy was performed.
Escherichia coli Sepsis and Prolonged Hypophosphatemia Following Exertional Heat Stroke
Authors: KAY MARK A. , MCCABE EDWARD D. B. 
Published: December 2021

Because of the increasing emphasis on physical activity, sports medicine represents a growing proportion of medical care. Climatic heat stress, including heat stroke, is of sufficient concern that its preventability has been addressed by the American Academy of Pediatrics.1 Although heat stroke is defined by the triad of hyperpyrexia, anhydrosis, and altered mental status, the clinical course of these patients may include multiple complications.2-8 In this article we describe a previously unrecognized etiologic relationship between two of these complications, which may permit early identification and prevention of life-threatening consequences to heat stroke.
Two cases of Gram-negative sepsis have been described in previously healthy young adults suffering from fatal exertional heat stroke.7,8
Diagnosis and Management of Psychogenic Stridor Caused by a Conversion Disorder
Authors: GEIST ROSE , TALLETT SUSAN E. 
Published: December 2021

Psychogenic stridor, a recently reported cause of acute upper-airway obstruction, is also known as paradoxical vocal cord motion.1-3 Although reported to occur predominantly among young women,1,2 it has been recognized in both male adolescents and adults,3 as well as in older women.4,5 Several authors1,3,4,6 have associated psychogenic stridor with conversion disorder, but few have included a discussion of the diagnostic criteria or elaborated on the underlying mechanisms of the conversion process.
In the case of a female adolescent with a diagnosis of paradoxical vocal cord motion presented here, we have included a discussion of the diagnostic psychological criteria. We also present the combined psychophysiological approach we used to identify and release the underlying affect, which resulted in the complete, immediate, and to date, lasting remittance of our patient's symptoms.
Another View of Cholesterol Screening
Authors: STAINES ANTHONY 
Published: December 2021

To the Editor.—
Drs Garcia and Moodie, in their paper on "Routine Cholesterol Surveillance in Childhood," propose that "routine cholesterol screening in all children is appropriate,"1 and advise us that "current recommendations" (the American Academy of Pediatrics recommendations),2 could miss 50% of significantly hypercholesterolemic patients who are at risk for future premature ischemic heart disease. Is this a fair conclusion from their data?
For another pediatrician, the natural question is "Can I generalize from these results to the children whom I see?" The authors say that their study population was the first 6500 white, middle class children attending for well child visits, "randomly included."
Information on Nicotine Abuse
Authors: BERLIN CHESTON M. 
Published: December 2021

In Reply.—
We appreciate the opportunity to respond to Dr Moore's letter and to add to the documentation of nicotine and its metabolite cotinine in the milk of nursing mothers who smoke. Luck and Nau1,2 have published a series of papers that demonstrate that infants of smoking mothers have measurable concentrations of both nicotine and cotinine in their serum and urine. Transfer of nicotine from maternal serum to milk is rapid (increase can be seen within minutes of a mother smoking a cigarette) and dose-dependent; the more cigarettes smoked per day, the higher the milk concentrations of nicotine and cotinine.2,3
NURSES' DUTIES ONE HUNDRED YEARS AGO
Authors: Marcuse Edgar K. 
Published: December 2021

The following job description was given to floor nurses by a hospital in 1887:
In addition to caring for your fifty patients, each nurse will follow these regulations:
1. Daily sweep and mop the floors of your ward, dust the patient's furniture and window sills.
2. Maintain an even temperature in your ward by bringing a scuttle of coal for the day's business.
3. Light is important to observe the patient's condition. Therefore, each day fill kerosene lamps, clean chimneys and trim wicks. Wash the windows once a week.
4. The nurse's notes are important in aiding the physician's work. Make your pens carefully; you may whittle nibs to your individual taste.
5. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m. except on the Sabbath on which day you will be off from 12 noon to 2 p.m.
6. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes or two evenings a week if you go regularly to church.
7. Each nurse should lay aside from each pay day a goodly sum of her earning for her benefits during her declining years so that she will not become a burden. For example, if you earn $30 a month you should set aside $15.
8. Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop, or frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity.
Letter to the Editor
Authors: Cornish J. Devn , Dudell Golde G. 
Published: December 2021

The concerns raised by Dr Kitterman regarding potential inaccuracies of and risks related to umbilical venous catheterization are true and well stated. Indeed, the authors have great respect for the points he makes.
Nonetheless, it is still the case that arterial oxygen tension is an indirect and a potentially misleading indicator of the adequacy of oxygenation in newborn patients. Although the placement of such catheters is associated with significant risks, these risks are at most comparable to and may in fact be significantly less than those associated with umbilical artery catheterization.
Lactose-Reduced Formulas for the Treatment of Persistent Diarrhea
Authors: Caballero Benjamin , Solomons Noel W. 
Published: December 2021

To the Editor.—
Intestinal lactase activity in childhood can be reduced transiently by several diseases. In developing countries, the most common of these diseases are protein-energy malnutrition and persistent diarrhea. Under these conditions, the use of microbial β-galactosidase for predigestion of dietary lactose is being used as a means of reducing lactose intake while maintaining the quality of the therapeutic diets.
In a report by Penny et al,1 the effects of intact and lactose-hydrolyzed formulas on stool output and nutrient absorption in 63 Peruvian children with &gt;4 days of postenteritis diarrhea were compared.
Sex-Specific Dysanapsis and the Effect of Passive Smoking Among Asthmatics
Authors: Kauffmann Francine 
Published: December 2021

To the Editor.—
From a study conducted on 415 asthmatic children aged 1 to 17 years, Murray and Morrison1 observed a greater effect of passive smoking on lung function in boys than in girls and in older than in younger children. They interpret their findings by the cumulative effect of maternal smoking and the known susceptibility of boys to asthma. Different growth patterns between boys and girls may be an additional hypothesis to explain their observations.
Neonatal Choreoathetosis Following Prenatal Exposure to Oral Contraceptives
Authors: Profumo Robert , Toce Suzanne , Kotagal Suresh 
Published: December 2021

To the Editor.—
This report describes a hitherto unrecognized complication of neonatal choreoathetosis following accidental use of oral contraceptives by the mother during most of pregnancy.
A 10-day-old infant was examined for feeding difficulties. The 28-year-old gravida 2, para 2 mother was unaware of the pregnancy until its 30th week and took Ortho-Novum 10/11-28 (containing 0.5 mg of norethindrone and 0.035 mg of ethinyl estradiol) continuously until then. She denied drug abuse. The infant was born at 36 weeks gestation following a normal delivery with a birth weight of 2470 g and Apgar scores of 5 and 7 at 1 and 5 minutes, respectively.
Retinal Hemorrhage After Cardiopulmonary Resuscitatíon
Authors: Hertle Richard W. , Quinn Graham E. , Duhaime Ann-Christine 
Published: December 2021

To the Editor.—
We read with interest the report of Drs Goetting and Sowa on "Retinal Hemorrhage After Cardiopulmonary Resuscitation in Children: An Etiologic Reevaluation." The authors have provided valuable insight into the etiology and incidence of retinal hemorrhages after resuscitative efforts. This is an important observation, because some authors and clinicians equate the presence of retinal hemorrhages with child abuse.1-3,5 However, we feel that the 10% (2 of 20) incidence of retinal hemorrhages in their study population may be an underestimate due to a technical difficulty.
Retinal Hemorrhage After Cardiopulmonary Resuscitatíon
Authors: Goetting Mark G. 
Published: December 2021

In Reply.—
Doctor Hertle and associates raise an important point regarding the incidence of retinal hemorrhages after cardiopulmonary resuscitation. It seems likely that the true incidence of retinal hemorrhages may be higher than we reported, because our method of detection is less sensitive than indirect ophthalmoscopy. However, there is a good reason for using direct ophthalmoscopy, because this is the method by which most clinicians would detect retinal hemorrhage. The purpose of our paper was to demonstrate that these hemorrhages can occur following cardiopulmonary resuscitation and are not necessarily due to preceding trauma.
Aluminum and Infants
Authors: Goyens Philippe , Brasseur Daniel 
Published: December 2021

To the Editor.—
Litov and co-workers1 address an important question regarding aluminum loading in infants. Aluminum is a toxic element. Its retention results in an increase in the body burden of aluminum. This has been shown to be a health hazard in patients with compromised kidney function and in those receiving total parenteral nutrition.
The aluminum content of soy-based infant formulas is known to be high.2 The authors report their finding of normal plasma aluminum levels in infants fed a soybased formula during the first 3 months of life, and they suggest that the ingestion of "amounts of aluminum severalfold greater than that found in human milk" is of no clinical relevance.
Risks in Distance Running for Children
Authors:   Committee on Sports Medicine
Published: December 2021

In recent years, there has been a surge in the participation of children in distance running. It is not unusual for an aspiring prepubescent athlete to run 10 to 15 miles daily and to participate in distance races, including marathons (26.2 miles).
Although running is a natural activity that can maintain and improve aerobic fitness, racing and particularly training for long distances have their risks. Distance running may induce musculoskeletal, endocrine, hematologic, thermoregulatory, and psychosocial damage. Most reports on such potential damage have not been evaluated with proper epidemiologic scrutiny. It is unknown whether the risk is greater for children than for adults. Nevertheless, the American Academy of Pediatrics wishes to alert the physician to the presence of such risks. Even without established guidelines and extensive documentation, physicians can give children, parents, and coaches advice that fosters healthy physical and psychosocial growth.
The most common musculoskeletal problems in the young runner are overuse injuries (ie, those that result from a mechanical stress repeated during a long period). These include epiphyseal plate injuries, stress fractures, patellofemoral syndrome, and chronic tendonitis.1-4 The incidence of such injuries seems to be related to the total distance covered in training and competition.4 Such overuse injuries may lead to a chronic disability (eg, chronic arthritis and growth deformity). Therefore, early medical intervention is important.
Female distance runners often experience delayed menarche.5 Its etiology and relevance to health have yet to be established. In most cases, menarche will occur several months after cessation or reduction in volume of training.
Sports Deficit Disorder
Authors: CROOK WILLIAM G. 
Published: December 2021

To the Editor.—
The commentary by Burke and McGee, "Sports Deficit Disorder," prompts me to write. These pediatricians said, "Once these children and their parents understand that it is not the child's fault that he is athletically inept, but rather that he suffers from a definite disease, then we feel that progress can be made to restore the child's damaged self-image."
Although they wrote their delightful commentary "tongue-in-cheek," in my opinion, labeling other children with the diagnosis of "attention deficit disorder" and prescribing Ritalin may also need to be ridiculed.
Sports Deficit Disorder
Authors: FISCHER HOWARD 
Published: December 2021

To the Editor.—
At last, a diagnosis! I am a 42-year-old pediatrician, and I believe I have Sports Deficit Disorder with Hypoactivity (SDDH), residual type. The McGee-Burke criteria are easily fulfilled by my childhood sports history. As an adult, my indifference to sports is so great that colleagues ask me if I was born in this country. Whenever I feel the urge to exercise, I lie down until it passes. Last year I was heard asking my 9-year-old daughter what teams were playing in the World Series.
Pediatric Emergencies
Authors: DIBONA FRANCIS J. 
Published: December 2021

To the Editor.—
I read with interest the article "Pediatric Emergencies" in the May 1990 issue of Pediatrics in Review.1
I wonder why the levels described in the article are the reverse of those commonly used. When we talk about level III in newborn intensive care units, we are talking about the highest level, and level I refers to the lowest level. Would it not make more sense to insist on a uniformity in these levels?