bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate) (PedvaxHIBTM): Clinical Evaluation
Authors: Ahonkhai Vincent I. , Lukacs Linda J. , Jonas Leslie C. , Matthews Holly , Vella Philip P. , Ellis Ronald W. , Staub Joan M. , Dolan Kathleen T. , Rusk Cynthia M. , Calandra Gary B. , Gerety Robert J. 
Published: December 2021

Although systemic infections caused by Haemophilus influenzae type b occur worldwide, detailed epidemiologic data are available in but a few countries.1-3 The public health impact of morbidity, mortality, and serious sequelae from disease caused by H influenzae type b has stimulated the search for control strategies. In the United States now, active immunoprophylaxis is largely favored over treatment or prophylaxis with antibiotics. This preference stems from three major observations: that high mortality and morbidity persist despite the availability of potent antimicrobial agents, that antibiotic-resistant strains of H influenzae type b have emerged, and that implementation of antimicrobial prophylaxis on a large scale has been unsatisfactory. Moreover, universal vaccination has been projected as offering a higher economic benefit than other control strategies.4
A matter of more proximate importance, however, is the search for H influenzae type b vaccines that will confer protection to all age groups, including infants younger than 18 months of age and subpopulations specifically at risk for invasive disease caused by H influenzae type b. Haemophilus b conjugate vaccine (meningococcal protein conjugate), PedvaxHIBTM (PRP-OMPC), is a conjugate H influenzae type b vaccine developed at Merck Sharp & Dohme Research Laboratories that now is undergoing extensive clinical evaluation to assess its prospects for disease control when first administered in early infancy. This is an interim report of results obtained in studies conducted in diverse locations throughout the United States.
METHODS
Study protocols were approved by Merck Sharp & Dohme Research Laboratories and the Institutional Review Board of each center. Written informed consent was obtained from the parents of subjects at the time of enrollment into each study.
Opsonophagocidal Activity in Sera From Infants and Children Immunized With Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate)
Authors: Gray Barry M. 
Published: December 2021

Immunization with Haemophilus influenzae type b capsular polysaccharide (polyribosylribitol-phosphate [PRP]) has resulted in limited and variable antibody radioimmunoassay in infants younger than 2 years of age. Although an H influenzae type B vaccine has been in use for several years, it is not used now for the age group at greatest risk for disease. In an effort to enhance immunogenicity, PRP has been coupled to various carrier proteins and to an outer membrane protein complex (OMPC) from Neisseria meningitidis group B.1,2 The latter approach has yielded a vaccine that elicits a good antibody response after a single 15-µg dose of vaccine in infants as young as 2 months of age, as measured by radioimmunoassay and immune bacteriolysis.3,4 In this report we describe the results of a pilot study using this H influenzae type B conjugate vaccine, PedvaxHIB, in children from 2 months to 4 years of age. Three different vaccine lots were examined for consistency of response. Sera were measured for antibody levels by radioimmunoassay and for functional activity using an opsonophagocytic assay using human adult neutrophils. These assays correlated well and demonstrated the excellent immune response and biologic activity of sera from infants vaccinated with this unique H influenzae type B conjugate vaccine.
MATERIALS AND METHODS
Subjects
Infants and children were part of a multicenter study to assess the safety and immunogenicity of PedvaxHIB.3 They ranged in age from 2 to 51 months and were from various socioeconomic backgrounds and geographic areas of the United States. All were in good health, and informed consent was obtained from the parents of all participants.
Role of Stereotactic Radiosurgery With a Linear Accelerator in Treatment of Intracranial Arteriovenous Malformations and Tumors in Children
Authors: Loeffler Jay S. , Rossitch Eugene , Siddon Robert , Moore Matthew R. , Rockoff Marc A. , Alexander Eben 
Published: December 2021

Between 1986 and 1988, 16 children were treated for 10 arteriovenous malformations and 6 recurrent intracranial tumors with stereotactic radiation therapy using a modified Clinac 6/100 linear accelerator. The median age of our patients was 10.5 years. For the group with arteriovenous malformation, follow-up ranged from 6 months to 37 months (median was 20 months). No patient bled during the follow-up period. Five of eight patients with follow-up longer than 12 months have achieved complete obliteration of their arteriovenous malformation by angiogram. The four remaining patients who have not achieved a complete obliteration are awaiting their 2-year posttreatment angiogram. The other patient has been treated within the year and have not yet been studied.
Five of the six recurrent tumor patients are alive with a median follow-up of 8 months. The remaining patient was controlled locally, but he died of recurrent disease outside the area treated with radiosurgery. The radiographic responses of these patients have included three complete responses, two substantial reductions in tumor volume (&gt;50%) and one stabilization. Despite previous radiotherapy, there have been no significant complications in these patients.
We conclude that stereotactic radiation therapy using a standard linear accelerator is an effective and safe technique in the treatment of selected intracranial arteriovenous malformations and tumors in children. In addition, stereotactic radiosurgery may have unique applications in the treatment of localized primary and recurrent pediatric brain tumors.
Adoption of Hepatitis B Virus-Infected Foreign-Born Children
Authors: SOKOL RONALD J. 
Published: December 2021

To the Editor.—
Hostetter et al1 confirmed recent reports2-5 of the relatively high incidence of hepatitis B virus (HBV) infection among foreign-born children who are adopted in the United States. Approximately 5% to 15% of adopted infants from Asia, India, and Central/South America are found to have active HBV infection or to be asymptomatic carriers.1-5 Although some information is provided to prospective parents by adoption agencies discussing the possibility of a number of diseases (including HBV infection) in the foreign-born infants, few parents, in our experience, felt that they were adequately informed about the true risk and the potential social and medical consequences of HBV infection before the placement of the child in their home.
Cousin Cases of Kawasaki Disease Suggesting Person-to-Person Transmission
Authors: IMADA YOSHIO , KAWASAKI TOMISAKU , NAKAMURA YOSIKAZU 
Published: December 2021

To the Editor.—
Kawasaki disease is a disease of unknown etiology affecting infants and young children. Its epidemiology as observed in Japan and in many other countries suggests that the etiology is infectious.1
We wish to report two cases of Kawasaki disease in first cousins that strongly suggest person-to-person transmission.
The first patient was a Japanese boy, aged 3 years and 8 months, living in Tokyo. He had been in excellent health until February 17, 1989 when he had a sudden fever which continued for 6 days.
Esophagitis, Epiglottitis, and Cocaine Alkaloid ("Crack"): "Accidental" Poisoning or Child Abuse?
Authors: KHARASCH SIGMUND , VINCI ROBERT , REECE ROBERT 
Published: December 2021

Acute effects of cocaine abuse have been frequently described in the medical literature. Myocardial infarction, angina, chest pain, dysrhythmias, pneumothorax, seizures, and hypertension are not uncommonly seen with the growing number of drug abusers in this country.1,2 Other systemic effects of cocaine toxicity, including malignant hyperthermia, rhabdomyolysis, and cerebral vascular accidents have been described with acute cocaine intoxication.3
With the recent cocaine alkaloid ("crack") epidemic, a new spectrum of medical as well as social consequences have occurred. Teenage violence and death have been given emphasis by the lay press as accounts of drug wars continue to appear in print. There is little information, however, identifying children as victims of abuse and neglect while they are in the care of persons abusing crack.
Pediatric Dermatology Update
Authors: Krowchuk Daniel P. , Tunnessen Walter W. , Hurwitz Sidney 
Published: December 2021

The Society for Pediatric Dermatology conducted its 14th Annual Meeting in Quebec City, Quebec, Canada, June 21 to 24, 1989, and the Section on Dermatology of the American Academy of Pediatrics met during the Academy's Annual Fall Meeting in Chicago, Illinois, October 13, 1989. Topics presented at these meetings that are of interest to pediatricians are presented in summary form below.
MEETING OF THE SOCIETY FOR PEDIATRIC DERMATOLOGY
Advances in the Treatment of Hemangiomas
Hemangiomas occur in approximately 10% of infants and children. Although most of these lesions have a benign course, various complications may occur. Raised hemangiomas (capillary or cavernous forms) may obstruct the airway or visual fields, trap platelets, or be responsible for cardiac failure. Both raised and flat hemangiomas (port wine stains) may be of considerable cosmetic significance. Until recently, few options existed for the treatment of these vascular nevi. However, advances in the understanding of vascular proliferation offer the promise of new and more effective therapeutic modalities.
Judah Folkman, MD, Professor of Surgery, Pediatric Surgery, and Anatomy of Harvard Medical School, reviewed the biochemical basis of angiogenesis and discussed the potential role of angiogenesis inhibitors in the treatment of hemangiomas. Although the mechanisms of initiation and proliferation of hemangiomas are not yet entirely understood, possible treatment appears to be relatively close at hand. A number of naturally occurring substances have been identified that possess the ability to halt capillary proliferation. The most potent of these are a group of cortisol metabolites termed angiogenic steroids, of which tetrahydrocortisol is a major example.
Contraception and Adolescents
Authors:   Committee on Adolescence
Published: December 2021

Pediatricians should be active participants in the effort to reduce the negative consequences of adolescent sexual activity. Preventive measures include counseling teenagers and their families on responsible sexual decision-making, including abstinence, and providing contraceptive services for sexually active patients, when requested. In previous statements, the American Academy of Pediatrics has addressed the impact of adolescent pregnancy,1 counseling the pregnant adolescent,2 and management of sexually transmitted diseases.3 This statement provides information on adolescent sexual and contraceptive behavior, and it presents guidelines for counseling teenagers on sexual activity and contraceptive methods, including abstinence. Because of differences in the needs and circumstances of each adolescent, the practitioner should use these guidelines to develop an individualized approach suitable for young persons. Due to concern about acquired immunodeficiency syndrome, among other risks, a renewed emphasis on careful and informed decision-making regarding sexual activity is reflected in this revised statement.
ADOLESCENT SEXUAL AND CONTRACEPTIVE BEHAVIOR
Since 1970, there has been a distinct increase in the percentage of adolescents reporting nonmarital sexual activity. By 14 years of age, 10% to 20% of boys and 5% to 10% of girls report having had sexual intercourse. By 17 years of age, approximately half of all adolescents are reported to have had intercourse at least once. By 19 years of age, the majority are reported to have done so.4
The factors most strongly associated with age at first intercourse appear to be biology (age at onset of puberty), opportunity (dating behavior), peer group influences, personal expectations (academic achievement, educational goals, religiousness), and family characteristics (parental support and controls).5
Half-Dose Immunization for Diphtheria, Tetanus, Pertussis
Authors: BERNBAUM JUDY , POLIN RICHARD A. 
Published: December 2021

In Reply.—
We appreciate your comments regarding our article in which we reported on the response of preterm infants to half-dose diphtheria, tetanus, pertussis immunizations. Although your points are well taken, it would be difficult logistically to carry out a study in which the serologic responses to 6 (or more) doses of half-dose vaccine are measured. At the very least, it would be hard to obtain informed parental consent. In our study, we attempted to show how poor the serologic response was to a reduced dosage of vaccine.
Half-Dose Immunization for Diphtheria, Tetanus, Pertussis
Authors: PLOTKIN STANLEY A. 
Published: December 2021

In Reply.—
I am afraid the Red Book Committee can give no encouragement to the practice of reducing the dosage of diphtheria, tetanus, pertussis vaccine. Although giving six doses might result in good immune responses, the risk of sensitization may also be increased. Moreover, if a child has the mild reactions described by Dr Rogers, why not give full doses? Low-grade fever occurs in almost half of the recipients of diphtheria, tetanus, pertussis vaccine, and about half also have fretfulness.
Persistent Bacteremia
Authors: NOEL GARY J. , EDELSON PAUL J. 
Published: December 2021

To the Editor.—
The recent article by Patrick et al1highlights a problem of increasing clinical importance. However, their approach to the issues these patients raise is short of the usually meticulous standards we have come to associate with this group.
The differential diagnosis of persistent bacteremia is in general quite straightforward: (1) inappropriate or inadequate antibiotics, (2) a potentially drainable or removable focus of infection, or (3) endocarditis.
We and others have shown that these same categories apply in the case of coagulase-negative staphylococci.
Drugs and Breast Milk
Authors: NEWMAN JACK 
Published: December 2021

To the Editor.—
The American Academy of Pediatrics Committee on Drugs has performed an invaluable service in publishing and updating the "Transfer of Drugs and Other Chemicals into Human Milk."1 This service is one for which we who try to advise breast-feeding women can only be grateful. Although there are some medications about which not everyone would agree, I was shocked to find that nicotine (smoking) was included in Table 2 (Drugs of Abuse That Are Contraindicated During Breast-feeding).
The Influence of Perinatal Instruction About Breast-Feeding on Neonatal Weight Loss
Authors: AVOA AWUTSE , FISCHER PHILIP R. 
Published: December 2021

It is normal for newborn babies to lose weight during the first days of life.1 Although much of this weight loss is thought to be due to changes in the volume and distribution of water in the body,2 it is clear that feeding practices also influence the degree of weight loss.3,4
In North America, breast-fed babies lose 6.9% of their birth weight before beginning to gain weight.3 Bottle-fed American babies, on the other hand, lose only about 4.2%.3 In Lesotho, breast-fed babies lose just 3% of their birthweight.5 These findings prompted questions about the factors that influence the degree of neonatal weight loss.
Speak up for Children
Authors: LEE JUNE PATRICIA 
Published: December 2021

To the Editor.—
In the February 1990 issue of Pediatrics, The New York Times was quoted in "Pro-Life? Then Pay Up."1 They are correct in implying that those of us who are pro-life bear a responsibility to the children of teenagers. However, the article is in error when it states that "The cruelest irony of the antiabortion movement is that many of its proponents have so little interest in the health and welfare of the resulting children after they are born."1
New Colorimetric Test for Rapid Diagnosis of Streptococcal Pharyngitis: A Warning
Authors: Gerber Michael A. , Facklam Richard R. , Randolph Martin F. , DeMeo Kathleen K. 
Published: December 2021

During the last few years there has been a dramatic proliferation of rapid tests for the diagnosis of group A β-hemolytic streptococcal pharyngitis.1 It is important for physicians to realize that the Food and Drug Administration does not approve these diagnostic tests as it would approve a pharmacologic agent, but simply permits a manufacturer to sell the test. Consequently, unacceptably inaccurate rapid tests for group A streptococci have been marketed in the past and could potentially appear again at anytime.
In 1986, we studied a new enzyme fluorescence procedure (Strep-A-Fluor, Bio-Spec Inc, Dublin, CA) for the rapid diagnosis of group A β-hemolytic streptococcal pharyngitis.2
Osteoporosis: A "New Morbidity" for Dieting Female Adolescents?
Authors: Kreipe Richard E. , Forbes Gilbert B. 
Published: December 2021

Almost half of the adult skeletal mass is laid down during the adolescent years. The concept of the "bone bank" reminds us that "deposits" of calcium are normally made to the skeleton until about 35 years of age in females. Subsequently, there are continuous "withdrawals" of bone mineral and loss of skeletal mass, eventually resulting in osteopenia (significantly reduced bone mass) and osteoporosis (osteopenia associated with atraumatic fractures) in more than 20 million postmenopausal women, at an annual cost of $7 to 10 billion in the United States.1
Because there is no cure, prevention of the most common and conspicuous physical finding of adult osteoporosis, the so-called "dowager's hump" (marked thoracic kyphosis due to vertebral compression fractures), as well as the more serious complications, such as hip fractures, must focus on optimizing the peak bone mass and maintaining the skeletal mass.
Safe Transportation of Newborns Discharged From the Hospital
Authors:   Committee on Accident and Poison Prevention
Published: December 2021

All newborns discharged from hospitals should be transported home in infant car safety seats that are designed appropriately to safely transport healthy newborns, premature infants, or infants with special needs.
Assuring that newborns are restrained properly when riding for the first time sets the stage for continued compliance with a measure that can save their lives or prevent serious injury. Correctly used infant/child safety seats are 71% effective in preventing fatalities due to car crashes, and 67% effective in preventing injury requiring hospitalization.1 With 100% correct use, about 53 000 injuries and 500 deaths could be prevented each year in the United States among children from birth to 4 years of age.2
Although the Every Ride, Safe Ride program of the American Academy of Pediatrics has made major contributions to child passenger safety, including the passage of legislation in all 50 states requiring infants and children to ride properly restrained, newborns continue to be discharged from hospitals without infant car safety seats or in ones that are not being used correctly. A recent study of hospital discharge policies and procedures has shown that only 26% of hospitals with obstetric services have a policy concerning the discharge of newborns in car safety seats. Of those hospitals that have a policy, 64% waive the requirement that newborns be discharged in a car safety seat if the parents do not supply a seat upon discharge.3 A similar study of hospitals accounting for 90% of annual births in Michigan showed that only 24% of hospitals discuss the use of car safety seats with parents, and only 4% demonstrate their use.4
$125 MILLION QUESTION: WHAT DO DRUGS COST?
Authors: L. J. F. 
Published: December 2021

How much do new drugs cost to develop?
Ask officials at U.S. pharmaceutical companies how much they spent taking a drug from test tube to market and they invariably will say "about $125 million." The figure's accuracy, however, is hotly disputed by regulators and industry critics.
Indeed, the amount isn't derived from direct accounting of the spending on a specific drug. Instead, it is based on an academic study, sponsored by drug makers in the late 1970s, which added up total R&D costs and divided it by the number of drugs produced. Back then, the study said the bill for a new drug was $80 million. It was updated to $125 million a few years ago by adding in inflation...
...A Food and Drug Administration official contends that half the 30 drugs for use in life-threatening illnesses approved in the 1980s were first discovered abroad, and that much of the testing was done by foreign companies. Moreover...much of the research for the drugs first came out of university labs partly sponsored by federal grants.
Children With Health Impairments in Schools
Authors:   Committee on Children with Disabilities,   Committee on School Health
Published: December 2021

Chronic illnesses are defined as conditions that last at least 3 months, require extensive hospitalization or in-home health services, or at the time of diagnosis are likely to do so. Chronic illnesses affect at least 10% to 15% of American children.1 Two to four percent of children have severe illnesses that interfere daily with the usual activities of childhood.2 Rheumatoid arthritis, asthma, leukemia and other malignancies, spina bifida, seizure disorders, neuromuscular diseases, acquired immunodeficiency syndrome, and other chronic conditions are found most frequently in this population. There are also small but increasing numbers of children dependent on specific technologies, such as respirators, and children who require procedures, such as tube feeding or bladder catheterization.
Recent medical and surgical advances have improved markedly the morbidity and mortality rates of chronically ill children. Increasing numbers of children with many diverse conditions now survive to adulthood and are able to attend school and pursue their educational and social development.3 Children, including those with chronic health conditions, deserve the opportunity to develop to their fullest potential through the benefits of education and health care.
CHRONICALLY ILL CHILDREN IN SCHOOLS
What most distinguishes chronically ill children and their families is their need for access to coordinated specialized health care services to a degree not required by other children. Individualized attention to their special health needs in school is of critical importance. The illnesses and their treatments frequently lead to greater than usual school absence and may hinder educational progress.4 Illness or mediations may also limit alertness or diminish physical stamina.