bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nature and Nurture in Childhood Weight
Authors: Philippe Pierre 
Published: December 2021

The genetic and mesologic fractions governing the variability of biological characters such as blood pressure and weight must be determined in order to establish how these characters function. If it is true that hypertension as well as obesity are extreme deviations of a natural variability of these biological parameters, knowledge of the genetic and mesologic processes could guide the treatment.
Biron et al.1 from the University of Montreal showed that family similarities in children's weight from ages 1 to 21 are linked to primarily genetic factors.
Urinary Tract Infection in Childhood
Authors: Rapkin Richard H. 
Published: December 2021

The physician interested in primary care must recognize his responsibility in correctly diagnosing and properly treating children with urinary tract infections (UTIs). Despite some recent reviews,1,3 physicians may be confused and unsure of themselves in this area. They have been told by pathologists that chronic pyelonephritis is not usually due to UTI,4 that screening for UTI in females is5 (is not6) valuable, that aggressive urologic evaluation is of questionable importance,7-9. that there is danger in overdiagnosis3 (underdiagnosis2), and that the prognosis of UTI is unknown.5 What can the clinician do to help (and not inadvertently harm) his patient in the face of such controversy? One possible approach is to present the areas of controversy and to allow each practitioner the opportunity to draw his own conclusions. The following review is intended as a discussion of the problems presented by children with UTI and a statement of one physician's principles of management.
INCIDENCE
The incidence of UTI varies with age. The only careful prospective studies that have been done have assessed the prevalence (number positive at one point in time) of asymptomatic bacteriuria (ABU). The frequency of symptomatic UTI is less than ABU at each age, but precise data are not available. Estimates are that as many as 50% of patients with ABU may have had previous symptomatic UTI.10 In premature newborns, the prevalence of ABU is approximately 3%11; in term infants, 1%11; in the age group 1 to 5 years, 1%12; and in the school-age child,1.5%.6.13-16 Except for the
Office Records Are Useful!
Authors: MARGOLIS CARMI Z. 
Published: December 2021

To the Editor:
Long and Rogers (Pediatrics 56:295, August 1975) report important data that indicate an imperfect correlation between performance and recording by pediatric practitioners of procedures necessary for adequate management of suspected streptococcal pharyngitis. The authors conclude that office records have limited value for evaluation of health care. However, although this conclusion seems valid for the records studied, at least for suspected streptococcal pharyngitis, two other conclusions supported by the data may be more
A Different Opinion
Authors: MURPHY F. GERTRUDE HURLEY 
Published: December 2021

To the Editor:
The “AAP Code of Ethics for the Use of Fetuses and Fetal Material for Research” (Pediatrics 56:304, August 1975), albeit arrived at after diligent effort on the part of its authors, is not acceptable to this pediatrician or to a growing body of aroused pediatricians.
I object to the task force recommendation regarding “research on the fetus in utero (where delivery of a previable fetus is not contemplated).” Despite informed consent, do
Academic Assumptions Annoy Practitioner
Authors: GROSSMAN ELMER R. 
Published: December 2021

To the Editor:
The letters on the danger of Actifed-C (Pediatrics 57:164, January 1976) exemplify an academic assumption of superior knowledge that annoys me no end. Drs. Ivey and Kattwinkel assert that “there is no condition in infancy for which codeine would be indicated.” I infer from this that they have never been called upon to relieve the pain of otitis media or a burn or a fracture-all occasionally known to befall infants, nor have
Potential Hazard of Therapy for Reye's Syndrome With Urea Cycle Intermediates
Authors: GLASGOW ALLEN NI. 
Published: December 2021

To the Editor:
In the December 1975 issue (Pediatrics 56:1081, 1975), Thaler presents a working hypothesis of the pathogenesis of Reye's syndrome. Included in the report is a section on therapeutic implications, where it is suggested that ornithine, arginine, or citrulline might be a specific treatment for this disorder. However, this treatment potentially could make the hyperammonemia worse.1 Therefore, I would like to point out several difficulties with the hypothesis and review the potential hazard
Dr. Barness Replies
Authors: BARNESS LEWIS A. 
Published: December 2021

Dr. Ainbender et al. are correct in questioning the clinical evidence indicating that human milk provides protection from necrotizing enterocolitis.
We would be very interested in seeing their publication, which apparently is in conflict with many others, e.g., those of Gyorgy1 and Winberg and Wessner,2 regarding gastrointestinal bacterial flora.
Patriotic Eyes
Authors: FRAZIER CLAUDE A. 
Published: December 2021

To the Editor:
Seeing children in my allergy practice and with the bicentennial year in the back of my mind, I thought this syndrome appropriate: “patriotic eyes”—red, white, and blue. “Patriotic eyes” are readily identified by the red conjunctiva, white sclera, and blue circles under the eyes.
This represents a common enough allergic condition, “allergic shiners.” The discussion of this syndrome presented in my book Parents' Guide to Allergy in Children (Double-day) follows:“dark puffy
Pro Spanking
Authors: SCHREIN DANIEL D. 
Published: December 2021

To the Editor:
In response to Dr. Ris on spanking by the school officials(Pediatrics 57:293, February 1976), I wish to offer the following observations.
1. Spanking need not be a form of violence.
2. At certain ages, prior to the age of reason, physical force is the most effective mode of reprimand.
3. Children must learn that society, starting with the family and school,will take whatever steps are necessary to obtain compliance with
Is Adult Immunization More Appropriate Than Immunization of Infants?
Authors: SIEBER OTTO F. , FULGINITI VINCENT A. 
Published: December 2021

To the Editor:
The report of Weibel et al. (Pediatrics 56:380, September 1975)concerning long-term antibody levels after monovalent or combined measles,mumps, and rubella virus vaccines presents numerous observations, but leaves one of the more interesting ones incompletely explored.
Of particular interest to us is an apparent disparity in levels of rubella antibody five years after rubella immunization of seronegative children and adult women. Among 74 children followed up for duration and level of
A Way of Handling Circumcisions and Consent Forms
Authors: FEEHAN EDWARD B. 
Published: December 2021

To the Editor:
One would have to be an ostrich not to run across controversies about whether circumcision in infancy is indicated or not. One would also have to be an ostrich not to run across discussions of informed consent. Three years ago I attended a conference in Palm Springs at which Henry Kempe recommended getting a permit whenever kanamycin was to be used. It seems he had to go out into the wilds of
Periosteal Reaction Due to Foreign Body-Induced Inflammation of Soft Tissue
Authors: Kleiman Martin B. , Elfenbein Dianne S. , Wolf Ellen L. , Hemphill Michael , Kurlinski J. Parker 
Published: December 2021

Bone lesions resulting from embedded plant thorns or wooden splinters have been reported,1-7 though rarely. Despite the fact that the majority of cases have occurred in children, no description appears in the English pediatric literature. We have recently seen a child with an osteomyelitis-like lesion in whom, after a considerable delay in diagnosis, an embedded wood fragment was found. A search of the literature revealed a striking similarity in the presenting signs and symptoms of our patient to those described, prompting this report and literature review.
CASE REPORT
A 12-year-old boy was admitted to the pediatric service with a two-week history of swelling and erythema of the dorsum of the left foot.
RESEARCHING
Authors: Barzun J. ,   Student
Published: December 2021

The private reasons for "researching" are . . . plain: it is the shortest path to promotion and prestige; it frees the able young from drudgery and often entails paid travel. For an organization man to be "put on research" is the same as for a horse to be put out to grass-no stated hours or set duties. The very essence of research is that no precise result can be specified. The sense of privilege and of exceptional status that comes with research also obtains in the academic world to which it is native. It explains the popularity of honors work in colleges. It is a cause of the flight from teaching in universities-and of the many other flights to meetings and conferences across the world. The motive is not laziness or cynicism, any more than it is a passion for knowledge. Rather, it is a desire to escape the boredom of ordinary non-work. The flight is not so much from classroom study or from teaching as such, or from executive responsibility in a business or government office; it is from an excess of people, paper, confusion, conferring, and frustration.
Research affords the further pleasure of any specialism, that is, a comfortable monopoly, the emotional protection of "my subject": an adroit researcher manages to have a field as nearly as possible to himself. Society favoring an infinite division of labor, it is the mark of the second-rate to generalize, as it is of the depraved to popularize. But specialism need not mean solitary confinement.
ABRAHAM JACOBI ON JUVENILE DIABETES MELLITUS-1896
Authors: C. T. E. 
Published: December 2021

Abraham Jacobi (1830-1919) was the first in the United States to specialize in the teaching of pediatrics. In 1862 he founded the first pediatric clinic in New York City. Probably no other pediatrician in America had a greater influence than Jacobi on the development of American pediatrics. This is how Jacobi treated juvenile diabetes mellitus 80 years ago and 26 years before Banting and Best had isolated insulin.
... The disease runs a more rapid course in infants and children than in adults, and terminates more readily in coma and death. Therefore the treatment must be enforced. Fortunately, the young, with very rare exceptions, are apt to live on milk mostly. Thus less difficulties are encountered in them than in adults. For these also milk, skimmed or not, forms a principal and beneficial part of their nutriment. The medicinal treatment of the young requires some modifications. The facility with which cerebral symptoms ("coma") are developed, renders the persistent use of alkalies advisable (mineral waters), and forbids the use of opium. lodoform, which I have seen to render fair service in adults, in daily doses of from ten to twenty grains internally, is seldom tolerated by the young, even in proportionately small doses. Arsenic may be given in increasing doses a long time, the bromide as well as other preparations, one drop and more of Fowler's solution [potassium arsenite], largely diluted, after meals, three times daily, the dose to be increased gradually until doses of from two to four drops are taken.
FRANÇOIS MAURICEAU ON TEETHING
Authors: C. T. E. 
Published: December 2021

François Mauriceau (1637-1709) was the leading obstetrician of his day. His remarks on teething in his Traité des Maladies des Femmes Grosses et Accouchées (1668), a book that established obstetrics as a science, show that he was ahead of many of his contemporaries in rejecting centuries of superstitions; he even had the boldness, according to G. F. Still (The History of Paediatrics, Oxford, England, Oxford University Press, 1931), to deny any special virtue to hare's brain.
The child may it self be helpful if they give it a little stick of Liquorice to champ or a little end of a small new wax-candle, which is very good to soften the Gum: There is ordinarily made use of a Silver Coral, furnished with small Bells, to divert the Child from the pain it then feels. Sometimes instead of Coral they put a Wolfs [sic] tooth in. One must not however believe that these things have any peculiar property, as many Women imagine; but if they are helpful in this case it is because of their solidity, evenness and smoothness; for the Child rubbing his Gums with it to ease the Itching which it feels there, doth by degrees diminish the thickness of them, and so they are at length insensibly cut by the Teeth which are under. If these things do no good because the gums are either too hard or too thick, that the Child may not suffer so much nor, by reason of the great pain, fall into those accidents above mentioned, let the Gums be cut with a Lancet where the teeth are ready; Nurses use to do it with their nails but 'tis better to be done with a Lancet because 'tis not painful.
Dr. Jacobson Replies
Authors: Jacobson Jay A. 
Published: December 2021

Dr. Marks has misconstrued the point of our article. Although we agree with him that data on the national prevalence of ampicillin-resistant Haemophilus influenzae type b would be valuable, we feel that the significance of the problem is clear from the wide geographic distribution, the potential virulence of the organism, and continuing reports that it may represent up to 10% of strains of H. influenzae type b isolated within particular institutions.1
Discussion of therapy seems quite appropriate in a report detailing the emergence of an organism resistant to standard treatment.
Why Wasn't Radionuclide Diagnosis of Bleeding Meckel's Diverticulum Mentioned?
Authors: Schussheim Arnold , Moskowitz Gerard , Levy Lester 
Published: December 2021

The article on pediatric nuclear medicine by the Committee on Radiology of the American Academy of Pediatrics (Pediatrics 58:459, September 1976) had as its intention to update "the expanding role that radionuclide techniques have in the management of pediatric patients." It also noted the ideal properties of technetium 99m for imaging. It did not, however, include any mention of its use in the preoperative diagnosis of bleeding Meckel's diverticulum in children.
Rectal bleeding in children due to Meckel's diverticulum is not uncommon, it is often massive, and the failure of standard techniques to make this diagnosis is well known.
Urethral Meatal Stenosis in Males
Authors:   Committee From the Urology Section, Belman A. Barry , Filmer B. Bruce , Immergut Mark A. , Schoenberg Harry W. 
Published: December 2021

The Section on Urology of the American Academy of Pediatrics has charged this committee with the task of evaluating the status of the question of meatal stenosis in boys (excluding those with hypospadias). The objective information on the subject is limited; however, our conclusions, based on review of available literature and the committee's deliberations, are as follows.
Etiology
Meatitis, an inflammation generally secondary to ammoniacal diaper irritation, has been cited as the underlying cause of secondary meatal stenosis.1 The lack of protection by the foreskin in the circumcised male is thought to correlate with an increased incidence of meatitis. Meatal narrowing has been noted to occur more commonly in the circumcised male.1,2 The formation of a ventral lip of tissue is characteristic of secondary meatal narrowing and may cause deflection of the urinary stream upward. Campbell, however, suggested that congenital meatal stenosis is the underlying cause of meatitis,3 whereas Allen and Summers believe meatitis can be either the cause or the effect of meatal stenosis.2 Other factors which have been stated to influence the development of secondary meatal stenosis include abrasions and diet.2
Incidence and Measurement
Calibration of the urethral meatus by Allen et al.4 demonstrated that 9% of newborn boys have a meatus tight to 4F which the authors consider to be congenital meatal stenosis. In a later article the same authors reported the results of visual inspection in a group of 1,800 boys, ages 6 to 10 years. Thirty-two percent were considered to have a "pinpoint meatus."
Late Effect of Nocturnal Mist Tent Therapy Related to the Severity of Airway Obstruction in Children With Cystic Fibrosis
Authors: Bureau Michel A. , McDougall Dianne M. , Beaudry Pierre H. , Belmonte Mimi M. 
Published: December 2021

To evaluate the long-term effect of nocturnal mist tent therapy on the progression of airway obstruction in children with cystic fibrosis (CF) of varying severity, two matched groups each consisting of 24 children with CF were studied during 18 months on mist tent therapy and 18 months off therapy. The progression in airway obstruction was measured by change in serial measurements of maximal midexpiratory flow (MMEF), from which a regression equation of MMEF against time was obtained for each individual. Changes in MMEF value with or without therapy were compared in patients matched for severity of disease as indicated by initial MMEF values.
For the group as a whole no differences were found in the progression of the airway obstruction whether the patients received mist tent therapy or not. This therapy failed to benefit any of the groups of children with CF who had early, moderate, or advanced airway obstruction as judged from their initial MMEF value.
It is concluded that nocturnal mist tent therapy neither decreases airway obstruction nor prevents its progression in children with CF.
Granulopoiesis in Chronic Myeloproliferative Disorders in Children
Authors: Crist William M. , Ragab Abdel , Moreno Hernan , Pereira Fabio , Foster John C. 
Published: December 2021

Four children with chronic myeloproliferative disorders (three with Philadelphia [Ph1] chromosome-positive chronic myelogenous leukemia [CML]) were studied with soft agar culture at diagnosis (before therapy) in an attempt to define abnormalities in granulopoiesis. The three patients with CML had elevated peripheral blood colony-forming cells (CFCs) and/or normal or decreased bone marrow CFCs (in those studied). Colony-stimulating activity (CSA) was markedly decreased or absent at diagnosis in all three. Maturation of myeloid cells within the colonies in agar was normal, indicating that no block in myeloid maturation was present. These findings are in general agreement with results previously reported in untreated adults with Ph1 chromosome-positive CML and further define the similarity with the adult form of the disease.
One Ph1 chromosome-negative patient with a clinically similar chronic myeloproliferative disorder was studied and had similarly elevated peripheral blood CFCs. She had normal CSA with a similarly high WBC count. This finding was unexpected and suggests that, unlike the patients with CML, her monocytes were capable of elaborating CSA. This difference might prove helpful in the classification of this type of disorder in cases where the Ph1 chromosome abnormality is not present.
Educating Postpartum Women About Car Restraints
Authors: Reisinger Keith S. 
Published: December 2021

I found disturbing the methodology, treatment of data, and the unjustified assumptions in Allen and Bergman's article on the outcome of educating postpartum women about car restraints for their infants (Pediatrics 58:323, September 1976).
The authors base their estimate of outcome on the results of a questionnaire administered six weeks after delivery. However, in discussing outcome, they repeatedly refer to "use" (of infant care restraints) rather than reported use. While referring to Pless et al.,1 Allen and Bergman failed to mention that Pless et al. found a significant difference between reported auto safety practices and observed behavior.
OPHTHALMOLOGISTS' BLIND SPOT
Authors:   Student
Published: December 2021

[A blind person has poignantly summarized] his impression of ophthalmologists' attitudes toward patients who are becoming blind: "We are interested in vision but have little interest in blindness."
In one of Shakespeare's most horrifying scenes, Lear's monstrous daughter Regan, having just incited Cornwell into tearing old Gloucester's eyes from their sockets, commands her servants, "Go thrust him out at gates, and let him smell his way to Dover" [King Lear, iii. 7.92-2]....
Assuredly, no ophthalmologist would be anything but appalled at the prospect of bidding a nearly blind patient to "smell his way to Dover." Yet, from what [has been reported] about the paucity of help. . .received from the professionals in coping with blindness, the effect is much the same. . . .
Some years ago my son, a victim of congenital glaucoma, received expert surgical treatment at a major New England medical center, but when he was ready to learn how to see with what vision remained, the response of staff ophthalmologists ranged from bored indifference to crude and insensitive (and unhelpful) improvisation.
Dealing with one of nature's most isolated and self-contained organs, ophthalmologists—perhaps more than their brethren in other specialties—can be forgiven for not seeing "the person for the eyes." One hopes that they will take [these] observations to heart.
Early Detection of Wilms' Tumor in a Child with Hemihypertnophy and Ovarian Cysts
Authors: Tolchin Deborah , Koenigsberg Mordecai , Santorineou Maria 
Published: December 2021

There have been many reports of the association between hemihypertrophy and intraabdominal masses, including Wilms' tumor, hepatoma, and adrenal cortical neoplasias.1 The present report describes a patient with segmental hemihypertrophy, multiple ovarian cysts, and bilateral Wilms' tumor and suggests a screening regimen for patients with hemihypertrophy.
CASE REPORT
The patient was a 9 lb 14 oz product of a term pregnancy, who was well until a mass filling the entire right side of the abdomen was discovered on routine examination at 4 months of age. Intravenous pyelogram (IVP) confirmed a large prerenal mass which on ultrasound was felt to be an ovarian cyst.
What Should Blood Pressure Be in Healthy Children?
Authors: McCrory Wallace W. 
Published: December 2021

In a recent commentary,1 Adams and Landaw propose the novel concept that normally growing children need not have an associated progressive increase in blood pressure (BP).
Noting that the National Heart, Lung and Blood Institute Task Force graphs to be used for plotting of pressure during growth and maturation show a continual increase of BP levels with age, they state that "Any implication that this is a healthy phenomenon associated with the aging process . . . is unjustified."2 To support this concept they cite data from studies in unacculturated tribes (ie, the Yanomamo Indians) showing that mean BP levels of these indians aged 0 to 50+, except for a slight increase from ages 0 to 9 years to 10 to 19 years, show no increase with age; this pattern is unlike that found in the United States and other Western cultures.
Historical Controls
Authors: Farewell V. T. 
Published: December 2021

The use of concurrent controls in clinical trials has been advocated for a considerable period of time and by a large number of researchers. Nevertheless, the nature of clinical investigations appears to lead to continuing interest in the use of historical controls. The two opposing views are enunciated in papers by Byar et al1 and Gehan and Freireich.2
When a clinical trial is viewed as a scientific experiment, the use of concurrent controls, and especially randomized concurrent controls, is to be preferred based on long-standing principles of experimental design. There is little doubt that the ethics of clinical experimentation rightly impose constraints on what might otherwise be viewed as ideal experimental design.