bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHILDREN OF THE COUNTERCULTURE
Authors: HOWARD MAUREEN 
Published: December 2021

In these modern times, when neither economic advantages nor the nation's good is well-served by fecundity, we reproduce mainly to project ourselves, in some form, into the future not via time machine but by the transmission of our own values, culture and traditions. If the next generation rejects these in toto, we lose that rickety bridge to a kind of immortality that makes the often dreary business of child-rearing worthwhile.
What had turned the recent past into a nightmare for many middle-class parents was the loss of their future in just such terms. Here was the legend given flesh in which their own fine children were stolen from the hearth by the elf thieves of the counterculture who left in their place changelings—bewitched mystics, madmen, bombers and junkies—none of whom would take a place in the continuum of the traditional community....The children of those changelings [are being reared in] urban and rural communes, and institutes of the new religions (those of Lamas and Hare Krishnas). [In one] a 10-year-old girl managed to keep an immaculately conventional bedroom—gingham bedspread, curtains, mirror and hairbrushes carefully placed on a dressing table. "If you want to have a straight kid, then be a freaky mother" her mother, everlastingly spaced, complained one day.
Feline Rhinotracheitis-Calici-Panleukopenia Vaccine
Authors: Bittle James L. 
Published: December 2021

With reference to Dr. Turner's letter on feline rhinotracheitis-calici-panleukopenia vaccine (Pediatrics 61:675, April 1978) and his concern for its potential infection in man, I believe he has overreacted to the coincidental occurrence of herpetic-type dermatitis in children from two households in which cats had received FVR C-P vaccination.
It has been shown that the virus of feline viral rhinotracheitis is a herpesvirus, but is highly specific for the feline species. Numerous attempts have been made to propagate the virus in the tissues of other animals, including man, without success.
SOMETHING REALLY NEW TO WORRY ABOUT
Authors: Adler Cy A. 
Published: December 2021

We live in mortal danger of being struck dead by watermelons inadvertently dropped from passing airplanes. Technology is obviously to blame for this hazard to life, because, if technologists had not developed airplanes, we would not have to worry about the danger of falling watermelons. However, when we examine the probability that a person will be struck by a falling watermelon, we must conclude that this environmental danger is not worth worrying about.
It is not easy to compute the probability of rare and unlikely events, such as death from eating mercury in tuna fish, cancers in human beings due to DDT ingestion, or the likelihood that polychlorinated biphenyls will have a deleterious effect on the environment. But many people prefer to conclude that new methods and new substances "may" be harmful and therefore should be banned until—if ever—they are proved innocuous.
The belief of many that the environmental impact of new chemicals and processes be studied before being released into the environment is commendable in theory. But more than a million products now result from man's activities. There are at least two million species of fauna and flora on the earth. Assuming that a team of biologists can assess the environmental impact of a man-made product on a species in one-year's time, it would require some two trillion biologist-person years to complete this worthy evaluation.
Health Care for the Underprivileged in the Land of Affluence: California Native Americans
Authors: Montgomery Theodore A. 
Published: December 2021

The American Indian has demonstrated all too clearly, despite his recent move to urban centers, that he is not content to be a poverty statistic. He has demonstrated the strength and fiber of strong cultural and social ties by maintaining an Indian identity in many of the nation's largest metropolitan centers. At the same time, he aspires to the same goal of all citizens—a life of decency and self-sufficiency.
The non-Indian population of California needs to keep in mind that at the time the Indians agreed (under coercion in most cases) to turn their ancestral lands over to the white man, treaties were signed by the Indians which promised that, in exchange for Indian lands, the white man would provide for the health care, education, and welfare of Indians.
Indians are attempting to achieve a life-style compatible with individual dignity and personal peace—the base of Native American culture. There must be rediscovery and preservation of that culture to insure the physical, mental, and environmental well-being of its members.
A Question About a Committee Statement
Authors: Homan William E. 
Published: December 2021

The Committee on Nutrition is to be commended for the excellence of "Iron Supplementation for Infants" (Pediatrics 58:765, November 1976). This modification and modernization of their 1969 and 1971 recommendations is invaluable to practicing pediatricians.
I would appreciate clarification of the article "Iron Sufficiency in Breast-Fed Infants and the Availability of Iron From Human Milk" by McMillan et al. (Pediatrics 58:686, November 1976). The authors' carefully stated conclusion is that "human milk ... was adequate to preserve a positive iron balance in four infants."
Parent-Child Associations at Upper and Lower Ranges of Plasma Cholesterol and Triglyceride Levels
Authors: Morrison John A. , Kelly Kathe A. , Mellies Margot J. , deGroot Ido , Glueck Charles J. 
Published: December 2021

This study examines the hypothesis that children of parents who have very high and very low levels of cholesterol and triglyceride are more likely than other children to have cholesterol and triglyceride levels at the same ends of the distribution as their parents. For each lipid studied (cholesterol and triglyceride), 1,944 households were separated into three categories: "low," "intermediate," and "high," based on parental fasting plasma levels and using the fifth (low) and 95th (high) percentiles of the parental distributions. The children were first categorized according to the classification of their parents and then further classified on the basis of their own levels, again using the fifth and 95th percentiles as cutoff points. The agreement between parental and child classifications was then measured. Children from high-cholesterol-level households were 2.7 times more likely than children from the total pediatric population to have cholesterol levels above 205 mg/dl, the pediatric 95th percentile, (P &lt; .01). Children from high-triglyceride-level households were 2.1 times more likely than children from the general pediatric population to have elevated triglyceride levels (P &lt; .01).
By the simple expedient of focusing on parental cholesterol and triglyceride levels, which are commonly quantitated in adults, a pediatric sample was identified that contained significant numbers of hypercholesterolemic and hypertriglyceridemic children.
Urinary Tract Infection in the Infant: The Unsuspected Diagnosis
Authors: Berger Michael , Warren Michael M. , Hayden C. Keith 
Published: December 2021

Urinary tract infection (UTI) in childhood is surpassed only by the usual fevers and upper respiratory tract infections in its frequency of occurrence,1 yet a high index of suspicion, aggsiveesive treatment, and conscientious follow-up is not common.2 Although most infants with UTI have few residua, others require urinary tract diversion and still others develop end-stage renal disease.1
Perhaps the reason that UTIs are often overlooked in children is because of the emphasis that is put on flank pain, dysuria, or frequency as signs of UTI, with little regard to the age variables associated with these symptoms. However, nonspecific symptoms such as jaundice, anorexia, vomiting, failure to thrive, enuresis, and abdominal pain may signal UTI in a young child.1
Are Mental Health Teams Necessary in Cardiac Clinics?
Authors: Sissman Norman J. 
Published: December 2021

Although Kupst et al. acknowledge some of the limitations of their study of the role that mental health teams can play in helping parents cope with the diagnosis of congenital heart defects in their children, they seem to have ignored some of the broader implications of their work
Most conspicuously omitted from consideration is the obvious influence on reactions to visiting a pediatric cardiac clinic for the first time (or at any time, for that matter) of the idividual differences on one or both parts of the doctor-patient dyad.
Mitral Valve Prolapse Syndrome in Children With Duchenne's Progressive Muscular Dystrophy
Authors: Sanyal Shyamal K. , Leung Richard K. F. , Tierney Ralph C. , Gilmartin Richard , Pitner Samuel 
Published: December 2021

Myocardial function was evaluated prospectively by noninvasive methods in 20 boys with clinical, biochemical, muscle biopsy, and electromyographic evideuce of Duchenne's progressive muscular dystrophy, Auscultatory evidence of a nonejection systolic click suggested mitral valve prolapse (MVP) syndrome in seven patients. Phonocardiography disclosed that the click was mid-systolic ill four patients and early in three. Echocardiographic features consistent with this diagnosis were identifled in all seven patients and in an additional four. One of these had an apical pansystolic murmur, suggestive of mitral regurgitation. whereas in the other three, prolapse of the mitral valve was ‘silent."
Echocardiographic findings included an abrupt midsystolic, posterior motion (greater than 3 mm beyond the CD line) in five patients. multiple sequence echoes in six, and posterior coaptation of the mitral valve near the left atrial wall in six. The feature most characteristic of MVP syndrome was a smooth, pansystolic, anteriorly concave (hammocklike) posterior motion deviating more than 3 mm beyond the CD line. Among the remaining nine patients who did not have echocardiographic evidence of prolapsing mitral valve, none had an early, middle or late nonejection systolic click or a heart murmur, although four patients in this group had moderate to severe scoliosis.
These observations document the occurrence of MVP syndrome in children with Duchenne's muscular dystrophy and indicate that its prevalence is high. We speculate that prolapse of the mitral valve in these patients is an expression of the underlying cardiomyopathy characteristic of Duchenne's muscular dystrophy rather than an isolated, dystrophic involvement of the mitral valve leaflets.
A TEACHING TOOL
Authors: Mason Edward A. 
Published: December 2021

THAT OUR CHILDREN MAY NOT DIE. 60 minutes, color, 1978, by Joyce Chopra for Ford Foundation, 320 E. 43rd Street, New York, NY 10017.
Nigeria has one of the highest death rates for young children and in some sections of that country "half of the children never reach their fifth birthdays." These are the opening comments in a film with Prof. O. Ransome-Kuti, head of pediatrics at the Institute of Child Health, University of Lagos. Realizing that more was necessary for good maternal and child health than modern facilities in the capital, he has embarked on developing clinics, field stations, and community health activities in areas throughout the country. This film illustrates many of the preventive efforts being launched in well child care, sanitation, nutrition, immunization, and child spacing in suburban, rural, and village settings. Its focus is on the training of health workers drawn from the area where they will serve and given skills for preventive and some simple curative procedures. Much use is made of role play and drama as well as on-the-job training.
Nurse clinicians provide total care, diagnosing and treating most children in some areas by following a set of carefully developed standing orders. Other distinctive practices include prepackaged drugs and mothers carrying their babies' health records. Many questions are stimulated and the film will have value far beyond its primary intended audience in Nigeria. For those involved in international maternal and child health, it is an excellent introduction and training aid. It will also be useful in training paraprofessionals, even in the United States, because it covers key issues in mobilizing community participation in improved health care.
Disseminated Intravascular Coagulation With Trauma: Treatment With Exchange Transfusion
Authors: Sarnaik Ashok P. , Stringer Kenneth D. , Jewell Patrick F. , Sarnaik Sharada A. , Ravindranath Y. 
Published: December 2021

Disseminated intravascular coagulation (DIC) may complicate hypovolemic shock secondary to trauma.1 Treatment with heparin in such cases is contraindicated because of the risk of bleeding at the site of trauma. Replacement therapy with clotting factors and platelets alone may be inadequate2 or result in volume overload in the presence of compromised renal function. We describe here a patient with multiple intraabdominal traumatic injuries whose severe bleeding diathesis secondary to DIC was successfully treated with exchange transfusion.
CASE REPORT
A 10-month-old black boy weighing 10 kg was brought to Children's Hospital of Michigan, Detroit with a history of grunting for three hours and "not feeling well" for three weeks.
An Unusual Etiology of Urticaria
Authors: Tinkelman David G. , Tinkelman Carl L. 
Published: December 2021

Urticaria, while a very common disorder in pediatrics, is infrequent, if not rare, in the practice of dental medicine. Generally, once hives occur, trying to determine the etiology proves to be very difficult. In fact, some authors suggest that up to 75% of cases go undiagnosed. However, in some of these undiagnosed cases, the cause may literally be under the patient's nose. In this report, we describe a case of urticaria in a child following the application of orthodontic bands.
CASE REPORT
A 14-year-old white girl, previously in good health, was referred for evaluation and treatment of her chronic urticaria.
Califano's Body Counts
Authors: Bergman Abraham B. 
Published: December 2021

We are attempting to increase our coverage of important policy issues in child health. The recent ruling on immunization goals for federally funded health centers is such an issue. The articles and commentaries in this issue of Pediatrics speak to the problem. Our "political pediatrician," Abraham B. Bergman, MD, has highlighted the problem in a way that will not bore you!
It is hard to conceive that such an "apple pie issue" as immunizing children would become controversial, but such thinking fails to reckon with the involvement of Joseph A. Califano, secretary of the Department of Health, Education and Welfare (HEW).
Letter To The Editor
Authors: Halkin H. 
Published: December 2021

Excessive serum digoxin concentrations do not establish the diagnosis of digitalis intoxication but certainly mark the subgroup of digitalis-treated patients who are at high risk of intoxication. True, seven of ten infants tolerated high serum concentrations without adverse effect, but intoxication was nonetheless highly prevalent (30%) among these infants.
The choice of the 2 ng/ml level was not arbitrary but rather represents the well-established lower limit of the toxic range in adults. Our findings support the statement that it is of the same significance in the agc group studied.
THE ISOLATED PROFESSIONS
Authors: Belknap R. L. , Kuhns R. 
Published: December 2021

Professions used to be called mysteries, and certain skills must necessarily remain esoteric. But this practical training in a profession surprisingly seldom entails ideas and methods that are inexplicable, ineffable, or beyond the grasp of a genuinely educated layman. True experts seek ways to communicate. Psuedoexperts rely on the secrecy of their data for their place in society, claiming that disclosure of their secret lore would make them helpless, when actually it might only show them to be useless. . . .
Within these isolated professions the patronizing attitude toward outsiders becomes increasingly hard to avoid. Specialization in recent decades has made the old divisions of knowledge and the old careers even narrower and more excluding, with a consequent reduction of the number of people with whom the specialist feels any solidarity. This intellectual fragmentation has made it virtually impossible for universities to function as social units. The misplaced emphasis on career training and the isolation of the professions have produced a pair of effects which every teacher has seen in class. The first effect emerges in all on a given subject because they are not experts on it. Such people are the destined victims of false experts. The second effect emerges in those students who believe that anything they say sincerely is true. Much modern school teaching encourages this belief out of a fear of discouraging the free flow of creativity. These two forms of mindlessness reflect one another. By neglecting their intellectual contact with the untrained majority of humanity, our experts have driven that majority into a dim realm where, as nonexperts, they cannot think, but only feel. . . .
Neonatal Ticarcillin Dosage
Authors: Nelson John D. 
Published: December 2021

We recently reported our experience with ticarcillin in neonates.1 We concluded that the dosage schedule tested, which is currently in the package insert, was needlessly complex and probably excessive. Based upon thepharmacokinetics, a simplified dosage schedule was proposed.
The proposed schedule was intended to produce peak serum concentrations one hour after a dose of 125 to 150 µg/ml and trough concentrations of 25 to 50 µg/ml immediately before a dose. The simplified schedule has been tested in neonates being treated for presumed sepsis and, as shown in the Table, the results are consistent with the predictions. The higher peak levels found in low birth weight babies in the first week of life are desirable in that they assure that adequate serum concentrations persist through most of the 12-hour interval between doses.
The Role of the MHC Antigens in the Mature and Immature Host
Authors: Gatti Richard A. , Kempner David H. , Leibold Wolfgang 
Published: December 2021

During the past ten years, we have witnessed an explosion of knowledge regarding the histocompatibility antigens of man. Following the realization that the inheritance of this information was localized to one major histocompatibility complex (MHC) in each species, bone marrow transplantation was reassessed as a treatment for primary immunodeficiencies, aplastic anemia, and leukemia.1-3 Not long thereafter, disease associations with particular HLA alleles and phenotypes began to be appreciated.4,5 More recently, studies of 5everal complement deficiencies have linked the genes coding for such components to this same genetic complex, in man and in rhesus monkey, guinea pig, mouse, and chicken.6,7
The MHC of man is located on the short arm of chromosome 6. At this writing, it includes approximately ten boci with several others mapping nearby (Fig 1). The alleles at four loci are identified on lymphocytes by classical complement-dependent cytotoxicity: HLA-A, -B, -C, and -DR. HLA-D typing involves leukocyte interactions. (The relationship between the HLA-D and HLA-D related (HLA-DR) loci is presently unclear.) Three complement components (C2, C4, and Bf) and 21-hydroxylase deficiency have been mapped to the human MHC by linking serum deficiencies with particular MHC haplotypes. Allotypes for GLO-1 (glyoxylase) and PGM-3 (phosphoglucomutase) are defined by electrophoretic patterns.
The associations of MHC antigens with diseases such as ankylosing spondylitis, multiple sclerosis, cebiac disease, dermatitis herpetiformis, diabetes mellitus, rheumatoid arthritis, and psoriasis have renewed interest in the pathogenetic mechanisms of these diseases and raised the question of what primary functions these genes serve. For the complement loci, we know that the products translate into complement components. It is provocative that each of these complement components are directly involved in the activation or production of C3, a pivotal component in both the alternate and classical pathways.
Gastric Reflux and Asthma
Authors: Leape Lucian L. 
Published: December 2021

The article by Shapiro and Christie (Pediatrics 63:207, 1979) may mislead readers to the conclusion that gastroesophageal reflux (GER) is of no significance in the etiology of asthma, or that treatment of reflux is of no value. Both of these conclusions are open to question.
Although the authors rightfully point out that theophylline may have caused the reflux by decreasing lower esophageal sphincter pressure, such reflux would be none the less real, and this effect of theophylline must be kept in mind in treating patients with asthma.
Excretory Urography for Evaluation of Enuresis
Authors: Seibert Joanna J. , Felman Alvin H. , Glazer Norman , McSweeney William , Merten David F. , Northway William , Goldman Harold S. , Grossman Herman 
Published: December 2021

Enuresis is the involuntary discharge of urine occurring beyond the age when control of the urinary bladder should have been acquired.1 Eighty percent of children with enuresis have problems staying dry at night, 5% in the day, and 15% both day and night.2 The age at which children can be expected to stay dry at night is not well established and is often cause for extreme concern for parents and children alike. Most children are still not dry at night by age 2 years. In a study of 315 children, Klackenberg reported 87% dry by 3 years and 96% dry by 6 years. Essen and Peckham,4 reviewing the records of 12,000 children, found enuresis more prevalent in older ages. More than 10% of their patients were enuretic between ages 5 and 7 years and almost 5% were still having problems at 11 years of age.
The etiology of enuresis is also difficult to define, and many different theories have been advanced. Bindelglas5 grouped these into five major categories: (1) organo-urogenic, including urologic malformations; (2) psychogenic; (3) developmental; (4) genetic; (5) environmental. The first of these categories must be of primary concern to the physician when confronted with an enuretic child, ie, could the symptoms possibly reflect a surgically correctable urologic abnormality? Radiologic procedures such as excretory urography and mictunition cystourethrography are the studies usually relied on to exclude an underlying anatomic lesion. Because of the potential risk and expense of any radiologic procedure as well as the possible low yield in this condition, the Committee on Radiology examined the utility of these studies in the routine evaluation of enuresis.
Role of Pediatrician in Fostering Good Parenting
Authors: Thomas Howard P. 
Published: December 2021

More and more articles have appeared on the negative consequences of poor parenting. Klaus and Kennel studied the impact of early separation or loss on family development. C. Henry Kemp has related the observation of faulty parent-child bonding to the subsequent occurrence of child abuse. In the April 1977 issue of Pediatrics (59:489, 1977) appeared a plea by William Turtle for group prenatal pediatric counseling to prevent childhood behavior problems.
On the consumer side of the picture, groups such as the Childbirth Education Association have promoted the coming together of husband and wife in joint preparation for a more natural childbirth.