bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatricians Do Matter
Authors: OSKI FRANK A. 
Published: December 2021

To the Editor.—
The American Academy of Pediatrics expressed concern when the Mead Johnson Division of Bristol-Myers began a direct advertising campaign to sell their Gerber brand infant formula.
The Academy believed that pediatricians should counsel parents about infant nutrition and choice of formula, and these important nutritional decisions should not be made in response to advertising on television or in the print media.
Marketing surveys validate the concerns of the Academy. The most recent A.C. Nielsen survey (October 22, 1991) indicates that only 56% of the Gerber infant formula that currently is purchased by customers is iron-fortified, as contrasted with 88.2% for SMA, 82% for Similac, and 81.6% for Enfamil.
Iron Syrup Concentration Error
Authors: FIKAR CHARLES R. 
Published: December 2021

To the Editor.—
There is an error in the new edition of The Harriet Lane Handbook concerning the concentration of iron in Fer-in-sol syrup.1 The text states that the number of milligrams of elemental iron is 18 milligrams per milliliter. According to the package insert, the concentration is actually 18 milligrams per 5 milliliters.
Children being treated with this iron preparation potentially would be greatly underdosed if the printed information in the handbook is used by a physician in determining a treatment plan for iron deficiency anemia.
National Cholesterol Education Program (NCEP): Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents
Authors:   NCEP Expert Panel on Blood Cholesterol Levels in Children and Adolescents
Published: December 2021

Compelling evidence exists that the atherosclerotic process begins in childhood and progresses slowly into adulthood, at which time it leads frequently to coronary heart disease (CHD), the major cause of death in the United States. Despite substantial success in reducing CHD mortality in the past two decades, the disease is still responsible for more than 500 000 deaths annually. About 20% of hospital discharges for acute CHD are for premature disease, ie, in patients younger than 55 years of age. Many of these adults have children who may have CHD risk factors that need attention. Estimates of the annual cost of CHD range from $41.5 to $56 billion.
The Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents (which appears as a supplement to this issue of the journal) reviews the evidence that atherosclerosis or its precursors begin in young people; that elevated cholesterol levels early in life play a role in the development of adult atherosclerosis; that eating patterns and genetics affect blood cholesterol levels and CHD risk; and that lowering levels in children and adolescents will be beneficial. Cholesterol is the focus of the report, but other risk factors for atherosclerosis and CHD may originate early in life and should be addressed as well. Specifically, cigarette smoking should be discouraged; hypertension should be identified and treated; obesity should be avoided or reduced; regular aerobic exercise should be encouraged; and diabetes mellitus should be diagnosed and treated.
SIGNIFICANCE OF BLOOD CHOLESTEROL LEVELS IN CHILDHOOD AND ADOLESCENCE
Horseback Riding and Head Injuries
Authors:   Committee on Sports Medicine and Fitness
Published: December 2021

This Policy Statement was retired May 2004.
Horseback riding accidents can cause head injuries resulting in death or permanent residual defects. These riding injuries occur most frequently in riders younger than 21 years of age.1 Approximately 20% of injuries in young riders are to the central nervous system.2,3 The majority of these injuries are cerebral contusions, concussions, or skull fractures.3 Use of approved helmets has been associated with a decline in the occurrence of severe head injuries.4
In the early 1980s, numerous organizations (American Horse Shows Association, United States Pony Club, United States Combined Training Association, and the United States Equestrian team) began requiring all competitors to use helmets meeting the United States Pony Club Standard. This standard was developed by the National Operating Committee on Standards for Athletic Equipment.5 In 1988, the American Society for Testing and Materials (ASTM) passed new standards (ASTM F-1163) for equestrian helmets that required helmets to provide a higher level of protection than previous models.6 This is an industry-wide standard that replaces previous standards. As of March 1990, the United States Pony Club required use of these new helmets for all activities.7
New helmets that meet the ASTM standard will be certified by the Safety Equipment Institute (SEI), a compliance organization responsible for certifying industrial products. The SEI seal, containing the date and manufacturer's lot number, must be permanently applied to the inside of the helmet so the buyer will know it is an approved equestrian helmet.7
The American Academy of Pediatrics (AAP) recommends the following steps for preventing and/or lessening the severity of horseback riding-related injuries:
Little League Baseball and Head Injury
Authors: HART EDWARD J. 
Published: December 2021

To the Editor.—
"Baseball is far more dangerous than we realize; and for some it may be deadly." (Walters B. "20/20" Television Program. July 12, 1991)
Recently, I have discharged from the hospital a 12-year-old boy whose intracerebral hematoma was sustained while playing Little League baseball and whose injury raises many questions about current safety policies in organized youth baseball.
The boy was struck on the left side of his head by a pitched ball while up at bat; although stunned, he did not lose consciousness and in fact completed the game.
Infimary-Style Sick Child Day Care
Authors: AUERBACK MARVIN L. 
Published: December 2021

To the Editor.—
Dr Furman raises a number of issues about potential hazards of hospital-based sick child day care. She is worried about nosocomial infection and the two-way spread of disease between the "healthy ill" in the sick day care program, and the really ill hospital inpatients. So far, I have found practically no real evidence that such a risk exists. Her concern about spread of infection to compromised children (eg, immunosuppressed children) would be true if sick care centers were to be established in tertiary care or university hospitals.
Curmudgeon Strikes
Authors: SILVERMAN JOSEPH A. 
Published: December 2021

To the Editor.—
This curmedgeon almost had a GTC SZ1.p487 while reading the September 1991 issue of Pediatrics.
First of all, why use such terms as "mother-neonate pairs" and "primary care providers?"2.p444 Whatever happened to "baby, new-born, doctor, and nurse?"
Second, a co-author of one paper is described by you as not only an MD, and an MPH; he is also a *, ‡, §, ¶, and a #!3.p572 Perhaps Pediatrics should sponsor an appendage contest each year to determine which author has the longest tail!
Third, abbreviations are getting out of hand.
Disposable Diapers vs the Environment
Authors: SEITZ MICHELE L. 
Published: December 2021

To the Editor.—
In the August issue of Pediatrics, Sutton, Weitzman, and Howland published a commentary on disposable diapers and the environmental concerns raised by their use.1 They presented a very one-sided argument in favor of cloth diapers and used data from a 1987 article in Consumer Reports (1987;52:510-512) to support their position.
The 1987 price they quoted for using cloth diapers with a laundering service was approximately $26 per month, while the quoted cost for disposables was $84 per month.
Lead Toxicity in the 21st Century: Will We Still Be Treating It?
Authors: NEEDLEMAN HERBERT L. , JACKSON RICHARD J. 
Published: December 2021

Clinical pediatric practice has not kept pace with the explosive growth in scientific understanding of lead poisoning during the past decade. The report by Glotzer and Bauchner in this issue1 demonstrates the widely differing approaches to treatment of lead toxicity found at many centers. Primary prevention of lead poisoning, the most effective response, continues at a pedestrian pace, even though in the United States we now possess both the knowledge and means to eradicate the disease permanently.
Our understanding of lead's role in human health has changed profoundly during the past five decades. In that period, pediatricians have discarded the
Graft versus Host Disease in Extremely Low Birth Weight Neonate
Authors: FLIDEL ORNA , BARAK YIGAL , LIFSCHITZ-MERCER BEATRIZ , FRUMKIN AZRIEL , MOGILNER BENJAMIN M. 
Published: December 2021

To the Editor.—
Graft vs host disease (GVHD) in extremely low birth weight neonates following multiple blood transfusions is probably more frequent than is generally thought.1 Recently, such a case was described by Funkhouser et al.2 We wish to report our experience with an extremely low birth weight neonate with GVHD, presumably induced by blood transfusions. Immunotherapy with rat antilymphocyte monoclonal antibody(Campath 1G) failed to induce any clinical change.
The patient was a boy,
Physician Reimbursement Under Medicaid
Authors: LEE PHILIP R. , NEWACHECK PAUL W. 
Published: December 2021

Physician payment under Medicaid has been a cause of growing concern among physicians because of the low levels of reimbursement in relation to private payors and the Medicare program in many states. This is particularly important to physicians caring for children because of the growing dependence of poor children on Medicaid and the evolution of Medicaid policies since the mid 1980s.
Beginning in the mid 1980s Congress began legislating a series of laws that expanded Medicaid eligibility for poor and near poor children. This series of legislation culminated with the Omnibus Budget Reconciliation Acts of 1989 and 1990. These acts required all states to establish minimum Medicaid income eligibility thresholds at 133% of the federal poverty level for children less than 6 years of age and then subsequently to phase-in coverage, 1 year at a time, for all children through 18 years of age with family incomes less than 100% of poverty level.
The Academic Generalist: An Endangered Subspecies?
Authors: HAGGERTY ROBERT J. 
Published: December 2021

In Reply.—
Drs Robinson and St. Peter raise an important issue. The General Pediatric Academic Development Program did not exclude projects on health services research; but its main emphasis clearly was by design on research training in clinically related issues, because it is clear that there are many clinical problems in General Pediatrics that have not been studied adequately. The basic research skills that most of the fellows in this program achieved were in epidemiology, biostatistics, and behavioral science, and these are the basic sciences of health sciences research.
Acute Diarrhea Therapy—Suboptimal?
Authors: SIMPSON A. CATHERINE , MCINTYRE LYNN , STE-MARIE MICHELINE 
Published: December 2021

To the Editor.—
Snyder1 found that the reported use of glucose-electrolyte solutions by pediatricians was not in accordance with the American Academy of Pediatrics Committee on Nutrition's recommendations on oral rehydration therapy (ORT) for acute diarrhea. To determine actual physician practices, we conducted an audit of diarrhea management, including use of ORT, in the Emergency Room of our pediatric hospital. Our 4-month audit period included an epidemic of viral gastroenteritis, during which we expected to see optimal case management.
`New' Bilirubin Recommendations Questioned
Authors: MERENSTEIN GERALD B. 
Published: December 2021

Newman and Maisels are to be congratulated on their diligence in ferreting out information relevant to the evaluation, toxicity, and treatment of neonatal hyperbilirubinemia. Their reviews should be read by all physicians caring for jaundiced newborns so that they can be fully informed of the data now available.1,2
The identification of jaundiced infants can result in the cessation of breast-feeding and the view of the infant as being at increased risk for other illnesses.3,4 This must be balanced against the risk of bilirubin toxicity.
In this issue of Pediatrics, Newman and Maisels5 make recommendations for changes in the evaluation and treatment of jaundiced infants.
Cricopharyngeal Dysfunction Associated with Chiari Malformations
Authors: Putnam Philip E. , Orenstein Susan R. , Pang Dachling , Pollack Ian F. , Proujansky Roy , Kocoshis Samuel A. 
Published: December 2021

Dysphagia due to upper esophageal sphincter (UES) dysfunction can be a manifestation of Chiari malformation. We evaluated five young children with dysphagia and a Chiari malformation before and after craniocervical decompression.
Preoperatively, esophageal manometry with a multilumen perfused catheter revealed failure of complete relaxation of the UES in three patients, pharyngo-UES incoordination in one patient, and both abnormalities in the last patient.
Preoperative barium esophagograms were obtained in four of the patients and were normal in two. One patient had nasal regurgitation of barium and delayed passage of barium through the UES. One patient had a posterior pharyngeal impression (bar) at the level of the UES and delayed transit of barium.
All patients had clinical and manometric resolution of UES dysfunction following surgical decompression of the Chiari malformation. All swallows were coordinated, and UES relaxations were complete.
However, the posterior pharyngeal bar persisted on postoperative esophagogram in the only patient who had had the abnormality preoperatively, although it no longer interfered with passage of barium. Another patient had a narrowed UES with decreased relaxation. Swallowing was radiographically normal in three patients postoperatively.
Conclusion: Surgical decompression of Chiari malformation may lead to complete clinical and manometric resolution of dysphagia due to upper esophageal sphincter dysfunction. Esophageal manometry is more likely than barium swallow to demonstrate the abnormality, and correlates better with symptomatic improvement postoperatively.
Neonatal Scrub Typhus: A Case Report
Authors: WANG CHIH-LU , YANG KUENDER D. , CHENG SHIN-NAN , CHU MONG-LING 
Published: December 2021

Scrub typhus called tsutsugamushi disease, is a mite-born acute febrile disease caused by Rickettsia tsutsugamushi. To our knowledge, neonatal scrub typhus has not been reported in the literature. We report on a 26-day-old newborn with aseptic meningitis. The newborn showed an increased specific 1gM antibody to R.tsutsugamushi conjointly with his mother's 1gM titer to the organism. This is the first case in the literature documenting neonatal scrub typhus and may be related to infection in the mother.
CASE REPORT
A 26-day-old male newborn was well until 4 days prior to this admission. He suffered from intermittent high fever, abdominal distention, and skin pallor.
Summary of the Annual Meeting of the Section on Urology, American Academy of Pediatrics
Authors: Skoog Steven J. , Rushton H. Gil 
Published: December 2021

The Section on Urology of the American Academy of Pediatrics met for 2½ days in conjunction with the 60th annual meeting of the American Academy of Pediatrics in New Orleans, LA, October 26 through 28, 1991. This conference remains the most important meeting in the United States for pediatric urology. The number and quality of papers presented continue to grow and there is a rich, international participation. The meeting was presided over by Chairperson Edward S. Tank, Jr, MD, of the University of Oregon Health Sciences Center, Portland, OR. The papers presented at this meeting that are of interest to the practicing pediatrician are summarized here according to topic.
OBSTRUCTION
Investigation of structural, biochemical, and functional changes in both the developing bladder and in the upper urinary tract were studied in the fetal lamb model of bladder outlet obstruction by Peters et al from Boston Children's Hospital and by Cendron et al from Johns Hopkins Hospital. Their findings included an increase in bladder weight due to hypertrophy and hyperplasia, increase in the cholinergic receptor density of the smooth muscle cells of the bladder, and alterations in the myosin heavy-chain isomer ratio. Following birth these alterations in growth and differentiation resulted in functional bladder abnormalities as measured by urodynamic studies. These abnormalities included an increase in bladder capacity, an increase in maximal intravesical pressure with filling, and an increase in postvoid residual urine volumes. Further study in this model should allow better understanding of the spectrum of bladder dysfunction resulting from in utero outflow obstruction of the bladder.
Endothelin and Hemolytic Uremic Syndrome
Authors: SIEGLER RICHARD E. 
Published: December 2021

In Reply.—
Yasutomo is correct. We were careful to point out that endothelin is produced not only by endothehial cells, but also by cultured rat mesangial cells and porcine renal epithelial cells, and that its elevation in the urine of children with the hemolytic uremic syndrome may only be a marker of renal injury.
Showing that elevated urine levels are limited to hemolytic uremic syndrome would certainly strengthen (but not prove) the argument that it plays a role in the pathogenesis of the acute renal failure of the syndrome.
Case Fatality Rates Associated with Conditions Originating in the Perinatal Period: United States, 1986 through 1987
Authors: BECERRA JOSÉ E. , ROWLEY DIANE L. , ATRASH HANI K. 
Published: December 2021

In 1986, two thirds (65%) of all infant deaths in the United States occurred within the first 27 days of life. The underlying cause of death in almost one-half (47%) of all infant deaths was nonteratologic conditions originating in the perinatal period. Maternal complications of pregnancy was the fifth leading cause of infant mortality.1
National estimates of morbidity associated with conditions originating in the perinatal period have been examined in a study using the National Hospital Discharge Survey (NHDS).2 A high proportion (33.7%) of newborns experienced morbidity due to conditions arising in the perinatal period.2
In the present study, we sought to quantify the severity of conditions originating in the perinatal period by estimating the proportion of deaths that occur among them.
Poisoning by Pickup Truck
Authors: MOFENSON HOWARD C. , CARACCIO THOMAS R. 
Published: December 2021

To the Editor.—
The policy statement,1 "Children in Pickup Trucks," was useful and constructive. However, the statement failed to mention the exposure to carbon monoxide of children who ride in the back of pickup trucks and station wagon vans.
We recently saw two healthy children who had developed acute carbon monoxide poisoning from a defective exhaust system after riding in the back seat of an air-conditioned station wagon van. Their initial carboxyhemoglobin levels were 21.3% and 10%, respectively.
ANOMALIES OF THE PULMONARY VEINS AND THEIR SURGICAL SIGNIFICANCE
Authors: PARSONS HARRY G. , PURDY ANN , JESSUP BRUCE 
Published: December 2021

The successful operations upon abnormalities of the outflow tracts of the heart suggest that surgical measures may also be applied to the correction of abnormal inflow tracts.
Technically the anastomosis of veins to the auricle has been proved feasible in the experimental animal. Therefore, it should be possible to correct abnormally placed pulmonary veins in man.
A wide variety of such anomalies occur. In 55 of 136 reported cases, all the oxygenated blood from the lungs was returned to the right heart through anomalous vessels. Thirty-five per cent of these cases of complete diversion were accompanied by other major cardiac defects. It is estimated that 50% or more of the return flow from the lungs must reach the right heart to produce clinical symptoms.
Two cases are presented of persistence of the left superior vena cava which transmitted all the freshly oxygenated blood to the right auricle, by way of the left innominate and the right superior vena cava.
The clinical picture was that of growth retardation, minimal cyanosis, a huge hyperactive heart, a loud left mesocardial systolic murmur, pulsating shadows in both upper pulmonary fields, and nearly identical oxygen-saturation of blood obtained from the right heart and femoral artery.
One case is reported in which all the oxygenated blood from the lungs is carried to the right auricle by way of the ductus venosus.
Surgical correction of the abnormality of these cases by transplantation of one or more of the veins would have been possible. However, no case known to the authors has yet been successfully corrected.
FURTHER STUDIES ON THE INFLUENCE OF HISTAMINE ON PLATELET ACTIVITY, WITH ESPECIAL REFERENCE TO ITS ACTION ON THE BLOOD OF THE HEMOPHILIAC PATIENT
Authors: SANFORD HEYWORTH N. , HALL F. RICHARD , BUTLER STUYVESANT 
Published: December 2021

Clinically and experimentally intravenous and subcutaneous injections of histamine increase directly the qualitative disintegrative ability of the blood platelets. It has no effect on the total platelet count (quantitative action) until shocklike levels are obtained. It then causes a decrease in the number of the circulating platelets in the blood.
This qualitative action may be in part due to an antagonistic action between heparin and histamine. Heparin in high concentrations does not inhibit completely the increased tendency toward in vitro agglutination of the platelets exposed in vivo to histamine.
In 22 hemophiliac boys, intravenous and subcutaneous injections of histamine decreased the coagulation time of the blood by increasing the platelet disintegration in 19 patients. It was a complete failure in three of the boys. The action of the histamine is not permanent, and tends to become less efficient as more injections are given. However, it is sufficient to cause a cessation of bleeding and to decrease the coagulation time of the blood to its normal value for that person in the majority of instances.
Round Table Discussion
Authors: WHEATLEY GEORGE M. , ARENA JAY M. , KOTTE ROBERT H. , HOYER BENJAMIN J. 
Published: December 2021

Chairman Wheatley: Our theme is a discussion of prevention. We want to discuss the question: How can we help prevent accidents in children? The meeting will be divided into 2 parts. Dr. Arena and I will outline the accident problem for the first part. For the second part, we will discuss the preventive aspects and what pediatricians can do about preventing accidents. We want you to do most of the talking in this part.
I would like to give you a brief picture of the dimensions of the accident problem.
1. It is the leading cause of deaths ages 1-14; kills about 14,000 at these ages annually—more than the next 6 combined (pneumonia, congenital anomalies, cancer, tuberculosis, leukemia, heart disease).
2. Every year between ages 1-5 kills twice as many children as rubeola, scarlet fever, pertussis, diphtheria, dysentery, tuberculosis and poliomyelitis combined.
3. For every fatal accident, it is estimated there are 90-150 severe injuries. No comprehensive studies are available to show the magnitude in terms of injury, cost of treatment, permanent disability in the United States child population. English hospital admission study showed 22% of the accidents requiring hospital treatment happened to children under the age of 5 years, though this age group constituted only 8% of the population.
4. About a third of all fatal accidents to children (1-14) occur in the home; for those under 5 years of age, nearly half the fatal accidents are home accidents. The home is a much more important site than this for injury to children, if we include nonfatal accidents because deaths caused by motor vehicles influences the fatal accident picture.