bluuebunny/crossref_metadata_2025_split huggingface dataset:
Round Table Discussion
Authors: LINCOLN EDITH M. , SCRIVER J. B. , BIGGS A. D. 
Published: December 2021

Chairman Lincoln:We will try to stay as close to the subject matter as possible and then if we have time and you want to go off into other subjects connected with tuberculosis, we can. I think there is plenty of material for discussion in early diagnosis and the treatment of the early phases of tuberculosis, that is, primary and postprimary tuberculosis. This will take up our time without going into the discussion of chronic pulmonary tuberculosis, since that is not a form of tuberculosis which is common in children.
Specific therapy has changed the attitude of pediatricians to tuberculosis. Formerly a pediatricians took the attitude that the great majority of children who had primary infection, evidenced by positive tuberculin tests without or with positive x-rays, would get better without ever having any symptoms; that a few of them might develop complications such as tuberculosis of the cervical nodes, or of the bones or joints, which could be turned over to a specialist and not be seen again by the pediatrician. A few cases would develop fatal complications such as meningitis or miliary and promptly die. Therefore, there was little of interest to the clinician in the story of tuberculosis in the child. As recently as 5 years ago, just before chemotherapy, I talked to pediatricians in many teaching centers and I was repeatedly told that the diagnosis and the care of tuberculous children was a minor problem and that tuberculosis was practically never seen in their services.
Since chemotherapy there has been a new interest in tuberculosis and I think this is shown partly by this round table discussion.
THE PEDIATRICIAN AND THE PUBLIC
Authors: WISHROPP EDWARD A. , MARTMER EDGAR E. 
Published: December 2021

At the annual meeting of the State Chairmen of the American Academy of Pediatrics in 1952, Dr. Edward A. Wishropp made a brief report of the plan for giving comprehensive pediatric care in Windsor, Ontario. This had been studied by the Academy's Committee on Medical Care Plans.
In order that the membership of the Academy might have more information about the work of this important committee, the editor of this column requested Dr. Wishropp and Dr. Edgar E. Martmer to prepare a communication on this subject.
INSURANCE PLAN REPORT
THERE are many programs throughout the United States, Canada and several foreign countries, providing some degree of medical services for infants and children. These range from governmentally financed programs, offering supposedly complete care, to those furnished by individual pediatricians having agreements between the pediatrist and the parents.
Because no comprehensive review of these various plans has been made, the Executive Board of the American Academy of Pediatrics created a committee to study insurance plans and programs.
The president, Dr. Warren Quillian, appointed a Committee on Medical Care Plans as a fact-finding group. Serving with Dr. Edward A. Wishropp, chairman, are:[See Table In Source PDF]
Some basic considerations, presented by Dr. S. J. Axelrod, Assistant Professor of Public Health at the University of Michigan, can be outlined as follows and these must serve as a working nucleus in determining a worth while and workable plan.
Systemic Reaction to Human Growth Hormone Treated With Acute Desensitization
Authors: WALKER SUSANNAH B. , WEISS MICHAEL E. , TATTONI DIANA S. 
Published: December 2021

Recombinant DNA technology has led to increased production and widespread use of recombinant growth hormone. Systemic allergic reactions to recombinant growth hormone such as urticaria, angioedema, or anaphylaxis have not been described in the literature. We report a patient who developed generalized urticaria from recombinant human growth hormone (Humatrope, Eli Lilly and Company) in whom we successfully desensitized to growth hormone using a protocol modified from an insulin desensitization schedule.1
CASE REPORT
A 12-year-old girl with hypopituitarism and short stature had been treated with 2 mg to 5 mg of Humatrope (depending on her weight and responsiveness to treatment) intramuscularly 6 days a week for 3 years without any problems.
ECMO and Sepsis
Authors: LEBLANC MICHAEL H. 
Published: December 2021

To the Editor.—
The article by Hocker et al, "Extracorporeal Membrane Oxygenation and Early Onset Group B Streptococcal Sepsis,"1 purports to show that extracorporeal membrane oxygenation (ECMO) is effective in Group B Sepsis. The study begins comparing results prior to ECMO therapy with results after ECMO therapy. The incidence of death from Group B Sepsis went from 3 of 28 or 11% prior to the institution of ECMO to 9 of 53 or 17% after the institution of ECMO.
Serum Enzyme Monitoring in Asthma Patients
Authors: CHOI YOUNG S. 
Published: December 2021

To the Editor.—
Maguire et al1 have recommended serial monitoring of serum creatine phosphokinase isoenzyme (CPK-MB) levels and electrocardiograms (ECG) for all children requiring admission to an intensive care unit for treatment of severe asthma. I wish to point out what I believe are inaccurate observations and invalid conclusions.
In this study 20 admissions to intensive care units occurred for "severe bronchial obstruction despite standard initial therapy." Six necessitated use of intravenous isoproterenol for Pco2, values of 50 mm Hg or higher.
Baby's First Spring Water
Authors: GOLDSMITH RICHARD 
Published: December 2021

To the Editor.—
I wish to bring to the attention of the readers of Pediatrics, who are not already aware of it, the latest in a long list of absurdities. The Beech-Nut Company has now stooped to marketing a product called "Baby's First Spring Water." This product is simply water of presumed and unquestioned purity and subsequently sterilized and to which has been added 1 ppm of fluoride. Surrounding the Beech-Nut Baby Logo on the label is a blue band in which is written "fluoridated."
Physicians' Interactions with Pharmaceutical Companies
Authors: KOHRMAN ARTHUR F. 
Published: December 2021

Comment.—
Dr Procopio's letter raises and outlines the complexity of making ethical decisions in a market-driven economy; free samples are often the only source of medication for patients with limited incomes. In addition, they may offer opportunity for the physician to initiate therapy more rapidly in areas where access to pharmacies is limited. Dr Procopio's letter also raises some of the bigger issues which this debate should move to, and suggests that, if we are going to continue with a competitive market economy for pharmaceutical distribution, we may have to resort to either voluntary or mandatory constraints.
Meconium Aspiration Pneumonitis and/or Persistent Fetal Circulation
Authors: REYNOLDS DAVID W. 
Published: December 2021

To the Editor.—
While reviewing the literature on neonatal illness associated with meconium-stained amniotic fluid (MSAF), it became clear to me that a change in nomenclature would be helpful. The term, meconium aspiration syndrome, appears to encompass the entire spectrum of cardiopulmonary disease occurring with MSAF. The presumption then is that persistent fetal circulation which develops in a neonate with MSAF is caused by the aspiration of meconium into the lungs. There is substantial evidence that speaks against a major role for meconium in the genesis of pulmonary hyperreactivity in this condition and very little to support a causal effect.1
Caveats on Abdominal Central Venous Pressure Measurement
Authors: LLOYD THOMAS R. , DONNERSTEIN RICHARD L. , BERG ROBERT A. 
Published: December 2021

In Reply.—
We appreciate Dr Tong's kind comments on our study. As we stated, "Abdominal vena cava pressure may be significantly higher than right atrial pressure...(in) patients with extrinsic compression of the inferior vena cava," and this may well occur in patients with severely elevated intraperitoneal pressure due to the presence of fluid or air. It is worth pointing out that the same caveat applies to intrathoracic venous pressure measurement in the presence of extrinsic compression of the superior vena cava or right atrium (eg, by pneumomediastinum).
Estimated Number of AIDS Orphans in the United States
Authors: CALDWELL M. BLAKE , FLEMING PATRICIA L. , OXTOBY MARGARET J. 
Published: December 2021

To the Editor.—
The human immunodeficiency virus (HIV) epidemic in child-bearing women impacts our society in a number of ways. One of these is the legacy of uninfected children left without their mothers when these women succumb to acquired immunodeficiency syndrome (AIDS). We have calculated a crude estimate of the current and future number of these AIDS orphans.
As of December 31, 1991, 21 225 women (≥13 years of age) with AIDS were reported to the Centers for Disease Control from the United States, Puerto Rico, and the Trusts and Territories; 17 910 (84%) were of reproductive age (15 to 44 years) at the time they were diagnosed with AIDS.
Day Care Center Attendance and Diarrheal Morbidity in Colombia
Authors: Hillis Susan D. , Miranda Clarybel M. , McCann Margaret , Bender Deborah , Weigle Kristen 
Published: December 2021

This study was designed to determine whether day care center attendance was associated with increased risk of diarrheal disease among poor children in an urban, developing country setting. From July 17 to December 18, 1988, mothers of 493 Colombian children less than 5 years old (241 attendees and 252 nonattendees) were interviewed weekly about diarrheal events during the previous week.
The incidence of diarrhea was greater for day care center attendees than for nonattendees (3.2 vs 2.0 episodes per child-year, P &lt; .0005). For children less than 2 years of age, attendees experienced 7.2 episodes/child-year vs 3.5 episodes per child-year for nonattendees (P &lt; .0005). Analyses controlling for water source and availability, excreta disposal, socioeconomic status, and duration of follow-up showed that the increased diarrheal risk was limited to children younger than 3 years of age spending more than 30 hours per week in the centers. In addition, although the risk among attendees of suffering diarrheal episodes of longer duration was fairly constant across levels of socioeconomic status, this risk was inversely proportional to socioeconomic status for nonattendees. In summary, the increase in risk of diarrhea among young, full-time day care attendees was modest, yet important, because diarrhea continues to be a major cause of morbidity and mortality in Colombian children.
Lupus Nephritis Study—Questions
Authors: LEHMAN THOMAS J. A. , MCCURDY DEBORAH K. 
Published: December 2021

In Reply.—
The comments on the statistical methodology are well thought out by Rabinovich et al. There are a large number of statistical models which can be created in evaluating any problem which may yield slightly different results. To quote a well-respected colleague in the field, "If I have to look at the footnotes to your table to see whether or not the finding was statistically significant, I'm not going to be impressed by your data no matter what the methodology you used.
The "Dose" Question
Authors: JONES R. A.K. , GRANT A. M. ,   the Collaborative Dexamethasone Trial Group
Published: December 2021

To the Editor.—
In our recent report of the collaborative trial of dexamethasone therapy for chronic neonatal lung disease1 we quoted a dosage schedule for dexamethasone of 0.6 mg/kg/d and omitted stating that the product used (Decadron, Merck, Sharp & Dohme) is supplied as dexamethasone sodium phosphate. After allowing for the sodium and phosphate, this is equivalent to a dose of 0.5 mg/Kg/d dexamethasone base.
Mammel and colleagues2 in the first published report of a controlled trial of dexamethasone for chronic neonatal lung disease, stated that they gave dexamethasone in a dose of 0.5 mg/kg/d.
Sleeping Positions
Authors: ORDWAY NELSON K. 
Published: December 2021

To the Editor.—
Among the reasons for recommending that infants be placed in the prone position has been the assurance that symmetry of the head will be preserved—or even achieved. Many years ago Charles Chapple (inventor of the Chapple Incubator, the "Womb with a View"—later the Isolette) described the newborn's "position of comfort," ie, its previously intrauterine position. That position is not always symmetrical. A not infrequent asymmetry of the head and face occurs when the infant's head has been rotated to one side and flexed to the other.
Bronchopulmonary Dysplasia Criteria: A Mathematical Impossibility
Authors: SCHWARTZ Roy E. , STAYER STEPHEN A. , PASQUARIELLO CAROLINE A. 
Published: December 2021

To the Editor.—
In the commentary "Bronchopulmonary Dysplasia: Twenty-five Years Later,"1 Dr Northway cited the diagnostic criteria for bronchopulmonary dysplasia. One of the criteria stated was a requirement for supplemental oxygen longer than 28 days of age to maintain a Pao2 above 500 mm Hg. Clearly, this was a misprint but it is important to realize why a Pao2 above 500 mm Hg in 21% oxygen at sea level is unachievable. The alveolar air equation is as follows:
Pao2 = (Pb - Ph2o)Fio2 - Paco2/.8
Salem Comes to the National Institutes of Health: Notes From Inside the Crucible of Scientific Integrity
Authors: Needleman Herbert L. 
Published: December 2021

Many readers of Pediatrics may have only a dim idea of the combative arena in which environmental research is conducted. Probably, very few have had the experience of being investigated for scientific misconduct. My aim in reviewing these two topics is to provide a preventive road map to others and to reveal some inadequacies and inequities in the investigative process. It is necessary, to accomplish this, to be direct and specific. Tact is sacrificed here for the sake of clear instruction.
In 1972 I published 700 words in Nature reporting that Philadelphia inner-city children had higher dentine lead levels than suburban children.1 The paper suggested that the tooth might be a useful marker to estimate body lead burden after exposure had ended. I did not know then that I was taking the first step toward being investigated for scientific misconduct by my university and the National Institutes of Health (NIH) Office of Scientific Integrity.
The Environmental Protection Agency (EPA) asked me to present the 1972 tooth lead paper in Amsterdam at an international meeting on lead. I was unprepared by my past attendance at pediatric meetings for what I encountered there. This was no scholarly debate on the toxicology and epidemiology of lead; this was war. The speakers did not behave like academics hoping to embellish their reputations by parading the results of their last 6 months in the lab. These stakes were much higher.
Arrayed against each other were a small and defensive group of environmentalists and health scientists on one side, and on the other the representatives of the gasoline companies, including such formidable entities as EI DuPont, Associated Octel, Dutch Shell, and Ethyl Corporation of America.
Mythology of Lead Poisoning
Authors: BANNER WILLIAM , VUIGNIER BARBARA I. , PAPPAS JANNETTE B. 
Published: December 2021

To the Editor.—
The commentary offered by Needleman and Jackson1 has raised some interesting points for discussion regarding the mythology surrounding the issue of lead poisoning and its treatment. Whereas the opening statement of the authors suggests that standards of practice are falling behind the scientific understanding of lead, the article under discussion by Glotzer and Bauchner makes it clear that both the science and standards of practice are very much lacking in the area of treatment for low level lead exposure.
SSI Benefits and Functional Assessment
Authors: BHUSHAN V. 
Published: December 2021

To the Editor.—
Perrin and Stein1 have done a commendable job of informing the pediatric community about the recent changes in the adjudication of Supplemental Security Income (SSI) claims for children. The process of assessing disability in children has been streamlined further since the publication of this article. It now involves sequential analysis of medical impairments followed by analysis of functional limitations in five domains of development: cogntive, communicative, motor, personal-social, and behavioral. The later is called individual functional assessment (IFA), and involves comparing a child's function in various domains with an average child of that age.
Aural, Oral, or Rectal—Does It Make Any Real Difference?
Authors: ROSCELLI JOHN D. 
Published: December 2021

To the Editor.—
I read with interest, the recent article by Freed et al1 in a recent issue of Pediatrics. This article was another in a seemingly endless series of articles which ask the interesting, but probably clinically irrelevant, question of whether there is a good correlation between aural temperatures and temperatures measured at other body sites, ie, rectal, oral, or axillary.2-8
The whole point of trying to determine if a patient has "an abnormal temperature," ie, fever (however that is defined), is that this fever hopefully would be a clue to the existence of some pathological process which is affecting the patient's thermoregulatory process.
New Recommendations Not Very Different from Current Practice
Authors: ALLEN RICHARD J. 
Published: December 2021

To the Editor.—
In the "Evaluation and Treatment of Jaundice in the Term Newborn: A Kinder, Gentler Approach," Newman and Maisels1 focus on "unnecessary testing and treatment of many jaundiced term infants."1,p809 Although "routine screening with a more specific test" was suggested for galactosemia, none was mentioned in any of the five tables. In the follow-up commentaries only one other author mentioned galactosemia in the differential diagnosis of neonatal jaundice.2 After reading these several interesting papers it is still unclear to me whether reducing the frequency of tests for neonatal jaundice or excluding individual specific tests (ie, direct bilirubin) will benefit cost-effective analysis or be "a kinder, gentler approach" for babies.
Immunization of Preterm Infants
Authors: PETER GEORGES 
Published: December 2021

To the Editor.—
In their paper published in the January 1992 Pediatrics, Langkamp and Langhough1 present their findings on the assessment of the knowledge of primary care providers about diphtheria-tetanus-pertussis (DTP) immunization recommendations for preterm infants. Their findings indicate the need for more explicit recommendations, specifically that birth weight is not a criterion for administration of DTP. In the 1991 edition of the Red Book, however (which was published after their manuscript was accepted), the recommendation on immunization of preterm infants was revised from the 1988 edition to include birth weight and is as follows: "Prematurely born infants should be immunized at the usual chronological age even if the infant was very small at birth" (indicates the change).
Overtreatment of Neonates
Authors: GARTNER LAWRENCE M. 
Published: December 2021

To the Editor.—
Dr William Silverman's insightful commentary "Overtreatment of Neonates? A Personal Retrospective"1 correctly reminds us of how easily we slip into dangerous waters and find ourselves drowning either alone or with our colleagues, often without even realizing it. Dr Silverman raises many valid and extremely important questions about the "life at any cost" policy which has dominated neonatal intensive care for many years. He challenges us to "determine the extent to which an arbitrary, as opposed to a discretionary rescue policy is sensitive to a complex balance of interests" represented by the neonate, the family, and the community.
Deliberate Misrepresentations
Authors: ERNHART CLAIRE 
Published: December 2021

Dr Herbert Needleman1 made numerous incorrect or misleading statements about his misconduct investigation, about my role in his misconduct hearing, and about research support by industry.
Misconduct. Dr Needleman stated that his Hearing Board "found no evidence of scientific misconduct." He did not go on to say that the Board found that he had engaged in deliberate misrepresentation, nor has he made the report public. The admission of the finding of misrepresentation is now publicly available because he made it in an amendment to his lawsuit against National Institutes of Health (NIH), his University, and officials thereof.2
Impact of Day Care on the Child
Authors: Caldwell Bettye M. 
Published: December 2021

In the world of day-care research, the status of our knowledge is sufficiently shaky that we must continue to keep an open mind about the service. The knowledge base is growing rapidly, but the conceptual structure that supports it is flimsy and insubstantial. Fortunately, current research efforts are improving this situation.
Regardless of whether we like or dislike day care, it is, like the family, here to stay. That realization alone should strengthen our resolve not to compromise on the type of service we create. We have to continue to identify parameters of quality and become good matchmakers in terms of child care, family, and child characteristics. Through such efforts, a network of educare programs that will foster favorable development in children can become a national and global reality.
Care of the Ill Child in Day-Care Settings
Authors: Giebink G. Scott 
Published: December 2021

Children experience many minor illnesses during the toddler and preschool years, and illness frequency is compounded by attendance in out-of-home child care programs. Although most of these illnesses are uncomplicated, some lead to complications that require medical evaluation and treatment. A majority of working parents of childbearing age have children in day care, and these illnesses have an impact on both the child's health and the parents' attendance at work. As a result, in-home and out-of-home sick-child care programs have emerged.
The common infectious diseases of children in child day care are also common among children not in out-of-home care. They can be identified as those primarily affecting the respiratory system, gastrointestinal system, and skin and those that may affect multiple organs. Respiratory infections predominate, followed by vomiting and diarrheal illnesses. Wald et al1 followed a cohort of children through the first 3 years of life; 97 received exclusive care at home, 23 received care in a group setting out of the home, and 33 attended day-care centers. During the first year of care, children in center care experienced significantly more infections than children in home care. Children in group care and center care were significantly more likely than children in home care to experience six or more infections and four or more severe illnesses. The majority (76% to 89%) of infections were respiratory, and otitis media complicated 28% to 44% of these respiratory infections.2 Children in nonparental home care experienced an average of 41 days of illness during the year; the average increased to 78 days in group care, and 96 days in center care.