bluuebunny/crossref_metadata_2025_split huggingface dataset:
PRESIDENT'S ADDRESS
Authors: BEAVEN PAUL W. 
Published: December 2021

IT IS now, 21 years since the American Academy of Pediatrics was founded. It is not inappropriate at this time to call attention to this significant anniversary of our birth. In June 1930, at Detroit, its organization was completed and officers were elected. A year later, the first annual meeting was held in Atlantic City. It was made clear at that time that pediatricians were now convinced that a society was needed whose principal objective would be not solely to promote social and scientific needs of its members, but which would exist primarily to promote child welfare. The means by which this major objective would be gained would be to raise the standards of pediatric education and pediatric research; to encourage better pediatric training in medical schools and hospitals; to promote scientific contributions to pediatric literature; and to relate the private practice of pediatrics to the larger field of the welfare of all children. The society should cooperate with others whose objectives were similar, but would he the democratic forum for pediatric thought and endeavor.
Following is a quotation from the constitution adopted at the first meeting:
"The object of the Academy shall be to foster and stimulate interest in pediatrics and correlate all aspects of the work for the welfare of children which properly come within the scope of pediatrics. The Academy shall endeavor to accomplish the following purposes: to maintain the highest possible standards of pediatric education in medical schools and hospitals, in pediatric practice, and in research; ... to maintain the dignity and efficiency of pediatric practice in its relationship to public welfare; to promote publications and encourage contributions to medical and scientific literature pertaining to pediatrics."
UNILATERAL PARALYSIS OF THE DIAPHRAGM IN THE NEWBORN INFANT DUE TO PHRENIC NERVE INJURY, WITH AND WITHOUT ASSOCIATED BRACHIAL PALSY
Authors: SCHIFRIN NATHAN 
Published: December 2021

The literature on diaphragmatic paralysis in the newborn infant due to phrenic nerve injury is reviewed. Four additional cases are described. Fluoroscopic as well as roentgenographic examination of the chest is urged in the diagnosis of thoracic pathology in the newborn period.
Stimulation of the phrenic nerve is believed to be an aid in determining the prognosis. If the diaphragm contracts one can infer that the nerve is intact below the level of stimulation and that the diaphragm has not undergone atrophy of disuse, and that the muscle fibers are capable of contraction when adequately stimulated. Failure of the diaphragm to contract means that the nerve has been compromised below the level of stimulation or that the muscle fibers of the diaphragm are too atrophic to contract. The prognosis in the latter cases must be guarded.
CHRONIC EOSINOPHILIA DUE TO VISCERAL LARVA MIGRANS
Authors: BEAVER P. C. , SNYDER C. H. , CARRERA G. M. , DENT J. H. , LAFFERTY J. W. 
Published: December 2021

Three cases of chronic extreme eosinophilia with granulomatous lesions in the liver have been studied. A larval nematode observed in sections from the liver of one patient has been identified either as Toxocara canis or Toxocara cati, common cosmopolitan ascarids of dogs and cats; available evidence favors the former.
The term visceral larva migrans is proposed for this type of parasitism, known in animals but not previously described in humans. It is related to better known cutaneous larva migrans, in that both are usually caused by infective stage larvae of nematode parasites of other animals. Man being an abnormal host, either has unfavorable tissue reactions or otherwise fails to provide stimuli for usual tissue migration and development of the parasite. As a result, larvae remain active for variable periods in various tissues. Similar but less severe and less prolonged reactions occur when the larvae of normal nematode parasites of man invade the tissues of a hyperimmune individual.
Visceral larva migrans is usually a relatively benign disease, characterized chiefly by sustained eosinophilia, pneumonitis and hepatomegaly, and probably is due both to direct tissue damage by migrating larvae and to allergic responses to their products. Its severity varies with the number of larvae in the tissues and the immune or allergic state of the infected individual.
DUPLICATIONS OF THE ALIMENTARY TRACT
Authors: GROSS ROBERT E. , HOLCOMB GEORGE W. , FARBER SIDNEY 
Published: December 2021

The term "duplication" should be used when describing those spherical or tubular structures found along the alimentary tract whose walls contain well-developed muscular layers and whose lining is a mucosa similar to that of some part of the alimentary tract. They should not be confused with mesenteric lymphatic cysts, or anomalies arising from a Meckel's diverticulum.
Symptoms produced by these lesions usually vary according to their location, their size, and the type of fluid secreted by their mucosa.
Duplications should almost invariably be removed, even though they are incidentally discovered and have not as yet given rise to symptoms. The pitfalls met with surgical treatment of these lesions are discussed. In this series, cases treated prior to 1940 carried fatality rates which were quite high; in the 20 cases treated in the last four years there have been no deaths.
Sixty-eight examples of duplications from one institution are briefly listed; 45 of these have not appeared in the literature before. This amount of material coming from one hospital would seem to indicate that these abnormalities must occur with sufficient frequency to warrant the attention of pediatrician, roentgenologist, and surgeon so that they can be recognized promptly and treated suitably.
THERAPEUTIC MEASURES PROMOTING RECOVERY FROM THE PHYSIOLOGIC DISTURBANCES OF INFANTILE DIARRHEA
Authors: DARROW DANIEL C. 
Published: December 2021

ALTHOUGH the improvements in fluid therapy have seemed to result largely from recent clinical observations, actually the fundamental ideas were developed by research on experimental animals in laboratories of physiology, biochemistry, pharmacology and clinical medicine. In many aspects, the progress has depended on laboratory work using physiologic and biochemical methods but applied with a point of view arising from clinical experience. The opportunities for this type of research came largely with full-time medicine in clinical departments.
I was led to the use of potassium in fluid therapy by studies which were carried out on experimental animals throughout a period of 10 years in association with Drs. Yannet, Harrison and Miller. We had the excellent technical assistance of Miss Carey, Miss Coville and Mr. lannucci and Mr. Barringham. During these years, the knowledge of the metabolism of water and electrolyte was advancing rapidly under the leadership of Gamble, Van Slyke, Peters, Loeb, Hastings, Fenn, Adolph, Butler, Homer Smith, and Newburg to mention only a few. In 1945, I summarized this knowledge of body water and electrolytes as related to clinical problems. Through the courtesy of Dr. Park, I came to Baltimore on VJ day to work for 60 days with the facilities of the pediatric department at Johns Hopkins. The study of diarrhea was made possible by the nurses, the resident, Dr. Govan, the head of the laboratory, Dr. Kaydi, and a superb technician, Mrs. Radcliffe. Through Hansen's generosity, Flett, Pratt, Wiese, Alice Gamble and I later extended these observations in Texas. We were able to show that deficiency of potassium occurs in diarrhea, that potassium may safely be used parenterally or orally and that improved results follow its use.
TRENDS
Authors: COLLINS-WILLIAMS C. 
Published: December 2021

ACCIDENTS, at the present time, are one of the principal causes of death, particularly among children. In Canada approximately 1,500 children die each year as the result of accidents, a mortality greater than that due to the 10 acute infectious diseases of childhood combined. During the five year period 1942-46 inclusive, in Canada, accidents stood in eighth place as a cause of death during the first year of life, in third place during the second year, and in first place during each year after infancy up to the fifteenth birthday. During the same period, 21% of the deaths between the first and fifteenth birthdays were due to accidents.
In this age of preventive medicine when our chief purpose as physicians is the prevention of morbidity and mortality, we, as pediatricians, cannot neglect this extremely important phase of child care. In any campaign to reduce the number of accidents, there are three ways in which the physician can play an important part. Firstly, the general public must be made aware of the seriousness of the situation and must be educated in the ways in which they, as citizens and parents, can help to reduce accidents. Secondly, the medical profession, working through its associations and publications, must stimulate all physicians to a concerted effort to reduce the number of accidents. Finally, and most important, the physician must concentrate on an educational program for his own private patients. A few words from the physician who looks after the child will do more to impress parents than will reams of propaganda published by someone unknown to them.
Statement on Cholesterol
Authors:   Committee on Nutrition
Published: December 2021

Increased blood cholesterol levels have been found to be a risk factor for coronary vascular disease in adult populations, and the reduction of cholesterol levels in adults decreases the risk. Because no comparable studies have been carried out in childhood populations, the significance of cholesterol as a risk factor for coronary vascular disease must be inferred from less direct evidence. It is also important to note that a number of other factors including cigarette smoking, hypertension, obesity, and diabetes mellitus are important in their causative relationship to atherosclerotic vascular disease. A family history of premature coronary vascular disease is also a risk factor for early onset coronary vascular disease.
The American Academy of Pediatrics (AAP) last published its recommendations regarding dietary fat and cholesterol in 19861 and suggested indications for cholesterol testing in children and adolescents in 1989.2 Very recently the Expert Panel on Blood Cholesterol Levels in Children and Adolescents of the National Cholesterol Education Program (NCEP), in a comprehensive report, recommended that all children and adolescents eat a diet that on average contains no more than 30% of total calories from fat, less than 10% of total calories from saturated fat, and less than 300 mg of cholesterol per day.3 The panel recommended screening blood cholesterol levels only in those children and adolescents whose risk of developing coronary vascular disease as adults could be identified by family history or by the coexistence of several risk factors. In this statement the earlier recommendations of the AAP are reviewed in the context of the recent NCEP report and provide current guidelines regarding dietary fat and cholesterol, cholesterol screening, and management of elevated blood cholesterol levels in children.
Access to Emergency Medical Care
Authors:   Committee on Pediatric Emergency Medicine
Published: December 2021

More than 60 000 children seek emergency care each day in the United States. However, inequities in our present health care system often preclude the prompt and appropriate access to emergency care necessary to treat these infants, children, and young adolescents—hereafter referred to as children. Several important obstacles exist. (1) As of 1990, there were more than 12 million uninsured American children.1 (2) Many children are declared uninsurable because of chronic illnesses, disabling conditions, or other preexisting conditions. (3) Although emergency departments are required to evaluate all patients who seek care, it is well known that lack of insurance can serve as an obstacle to prompt access to, transport to, and treatment at appropriate-level emergency and critical care facilities. (4) There is not yet universal availability and appropriate use of the 911 access number.2 (5) The extent to which pediatrics is included in the educational and training content of paramedic and basic emergency medical technician programs has been shown to be less than adequate.3,4 (6) Finally, children have special needs, requiring services not always available in every hospital. Therefore, the obstacles to prompt access are magnified at a critical time for the child seeking emergency care.
Several recent developments have increased the recognition and understanding of the unique emergency medical care needs of children.
Temperature Measurement—Gold Standard
Authors: FREED GARY L. , FRALEY J. KENNARD 
Published: December 2021

In Reply.—
We thank Dr Weiss for his insightful comments regarding the controversial issue of a "gold standard" in temperature assessment. However, the purpose of our paper was not to define a gold standard, nor to judge the acceptability of conventional methods of temperature assessment. Rather, we attempted to place a new technology in perspective with currently accepted methods. While Dr Weiss raises some important points about the adequacy of rectal, oral, or axillary temperatures, we feel our work provides useful "clinical" information for practitioners who struggle to decide between methods of temperature assessment.
Temperature Measurement
Authors: ALEXANDER DAVID , TERNDRUP THOMAS 
Published: December 2021

To the Editor.—
In the March 1992 issue of Pediatrics, Freed and Fraley published an article entitled, "Lack of Agreement of Tympanic Membrane Temperature Assessments with Conventional Methods in a Private Practice Setting."1 This study concluded that the FIRST Temp thermometer was unreliable, compared with conventional methods of temperature-taking in the private pediatric setting. I would like to raise two methodologic concerns which may have influenced their results. Under "Methods," the authors state that their tympanic thermometer provided a choice of two modes: "tympanic" and "surface," They further state that the tympanic mode was used for all temperature measurements.
Guidelines for Prevention of Group B Streptococcal (GBS) Infection by Chemoprophylaxis
Authors:   Committee on Infectious Diseases and Committee on Fetus and Newborn
Published: December 2021

BACKGROUND
For two decades streptococci classified serologically as Lancefield group B Streptococcus agalactiae (GBS) have been a leading cause of perinatal infections. In neonates and young infants these infections include congenital pneumonia, sepsis, or meningitis; in pregnant women they include urinary tract infection, chorioamnionitis, early postpartum endometritis, postcesarean section febrile morbidity, and—less frequently—pelvic thrombophlebitis or endocarditis. Although the incidence varies somewhat by geographic region, 12 000 infants and 50 000 pregnant women in the United States are estimated to develop GBS-associated morbidity or mortality annually.1 Overall mortality for early-onset (less than 7 days of age) and late-onset (7 days to 3 months of age) infant disease is approximately 15% and 10%, respectively.2-4 Gestational age significantly correlates with mortality among early-onset cases and is approximately 25% to 30% in preterm infants and 2% to 8% in term infants. Thus, every year approximately 1 600 infants die and an equal number have permanent neurologic sequelae following meningitis.1 This substantial GBS-associated perinatal mortality and morbidity make prevention strategies imperative. Among proposed strategies, including chemoprophylaxis and immunoprophylaxis, only intrapartum maternal chemoprophylaxis has been evaluated for safety and efficacy.
EPIDEMIOLOGY
GBS are frequently harbored in the genitourinary and lower gastrointestinal tracts of adults. When sensitive culture methods are used for their detection (ie, antibiotic-containing or selective broth media) and both lower vaginal and anorectal sites are sampled, GBS are found in 15% to 40% of pregnant women.5-8 Direct plating of swabs from body surfaces onto solid media or sampling of the cervix as a single genital tract site fails to identify as many as 50% of women who are culture-positive for GBS.4
Introduction
Authors: SCHEIDT PETER C. , KESSEL SAMUEL S. 
Published: December 2021

An effort to improve the health of children must consider challenges to a healthy body, mind, and spirit. It must recognize the importance of the family, community, and environment. Consequently, the very nature of pediatrics has evolved from a primary focus on acute care and the treatment of infectious disease to one of promoting health, preventing disease, and optimizing development. Clinicians and researchers concerned with children and adolescents increasingly acknowledge the importance of behavior as a determinant and an outcome of health and disease. Indeed, the major causes of morbidity and mortality of childhood and adolescence (injuries, suicide, sexually transmitted disease, and others) are primarily related to behavior. Spurred by the recognition of these behaviorally related threats to children and youth, health agencies are directly and increasingly confronted with the urgency to study, understand, and modify behavior as it influences and interacts with physical health.
In response to this urgency, the National Institute of Child Health and Human Development and the Maternal and Child Health Bureau jointly sponsored a conference on Research in Behavioral Pediatrics in Columbia, MD, on May 22 to 24, 1989. The purposes of the conference were (1) to identify directions and approaches that are likely to be productive for future research in behavioral pediatrics; (2) to stimulate increased research activity and successful competition for support; and (3) to increase interdisciplinary collaborative research efforts within the field of behavioral pediatrics.
The planning committee developed an agenda to present and explore models for behavioral pediatric research that could serve to define challenges and approaches for the field.
Questions about Bilirubin
Authors: STEIN MICHAEL L. 
Published: December 2021

To the Editor.—
The collaborative study of Dr van de Bor and associates1 on the effects of hyperbilirubinemia in low birth weight infants in the March issue of Pediatrics was a beautifully executed study that inexplicably has left out a critical piece of information.
There are no details as to the etiology of the hyperbilirubinemia, ie, ABO or Rh incompatibility or so-called physiological.
Because there is considerable discussion concerning the potential pathogenicity of bilirubin as it relates to the source of this material, this information should be included in the analysis of hyperbilirubinemia effects.
Overtreatment of Neonates
Authors: HUNT ANDREW D. 
Published: December 2021

To the Editor.—
Dr Silverman's elegant paper raises questions that have resisted resolution and have serious implications for practice and political involvement of pediatrics in the United States.
Regarding ethics in the neonatal intensive care unit (NICU) he mentions the ". . . fulfillment of an eager team's dream of rescue bring(ing) about the real-life enactment of a family's worst nightmare . . ." Brody1 recently has developed the concept of the "Rescue Fantasy" undergirding many of medicine's heroic ministrations.
The Pediatrician's Role in Setting Standards of Day Care for Children
Authors: Wender Esther H. 
Published: December 2021

The goal of pediatric practice is to promote optimal health, growth, and development of infants, children, and adolescents, and pediatric training is aimed at this goal. Thus, pediatrics has long been involved in establishing optimal health practices affecting nutrition, supervision of the environment, preventive health services, and the promotion of practices that optimally enhance social and emotional development. These generic areas of expertise apply in unique ways to children cared for in groups, especially very young children. A large body of research has been produced by pediatricians and other health professionals that addresses the specific health needs of infants and children in group care. Studies have especially addressed the spread and control of infectious disease and the prevention of injury in groupcare settings. Pediatric research, often in collaboration with psychologists, educators, and other professionals, has also addressed issues pertinent to optimal cognitive stimulation and behavioral management of the developing child, as well as the prevention of abusive practices. Thus, much of what constitutes the body of pediatric knowledge is crucial to the optimal care of young children in group settings.
In the traditional practice of pediatrics, pediatricians apply their expertise to the care of individual children in the context of the family. The unwritten contract for pediatric care is between the parents and the pediatrician on behalf of the child. However, the school, day-care, or other community-based programs become an extension of the family, and the pediatrician relates to those community programs on behalf of children and their families. What the pediatrician recommends on behalf of the individual child becomes a recommendation to the program as well as to the child's family.
Scandinavian Experience in Providing Alternative Care
Authors: Hwang C. Philip 
Published: December 2021

What are Swedes like? Recently, this question received a great deal of attention in the Swedish media, because of an article published in the Daily Mail by an English journalist, Geoffrey Levy. He described Swedes as being lazy, sick, and totally unable to enjoy anything nice in life. In addition, Swedish cars are wrecks, Swedes dress sloppily, and, if you do not want to work, you do not need to—but you are still fully paid. Finally, he described family policy in Sweden: "Just imagine a country where mothers as well as fathers can stay at home 12 months, with almost full pay after a baby is born, or a country where the state pays almost 6000 pounds for every child that goes to a day-care center—this would be totally impossible in Britain."
How did the Swedish public react to Geoffrey Levy's article? Surprisingly, most people agreed with his description of the Swedes. Yes, we are lazy, too many people are sick, and we are unable to enjoy the good things in life. There was only one major issue where most people disagreed with Geoffrey Levy. Very few were negative about family policy in Sweden. On the contrary, most people took parental leave, the possibility of staying at home with a sick child, and publicly funded day care for granted.
In the first part of this presentation, I will describe family policy in Sweden and, in particular, how the society supports and provides care for children under school age (which in Sweden starts at 6-7).
The Changing Role and Responsibilities of a Chairman—Letters
Authors: MESROBIAN HRAIR-GEORGE 
Published: December 2021

To the Editor.—
I greatly enjoyed the special article entitled: "The Changing Role and Responsibilities of Chairmen in Clinical Academic Departments: The Transition from Autocracy" (Pediatrics. 1992;90:50-57). It was realistic but refreshing and very useful to young academic people contemplating chairmanship positions.
The Changing Role and Responsibilities of a Chairman—Letters
Authors: RILEY HARRIS D. 
Published: December 2021

To the Editor.—
I enjoyed the article, "The Changing Role and Responsibility of Chairmen in Clinical Academic Departments: The Transition from Autocracy" which appeared in Pediatrics (1992;90:50-57). It contains much of interest. It is hard to believe that Dr Brent has been chairman for some 26 years at Jefferson.