bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Follow-up X-rays Necessary
Authors: Smith Wilbur L. 
Published: December 2021

Grossman, Wald, Nair, and Papiez have reported an interesting study on roentgenographic follow-up of acute pneumonia (Pediatrics 63:30, 1979). Their data suggest that routine follow-up radiographs are not reliably normal until six weeks to three months after initial diagnosis despite the patient's clinical improvement. Their emphasis on not radiographing a clinically well pediatric patient until a significant time interval after onset of disease is certainly reasonable.
From this data base they go on, however, to recommend that routine follow-up radiographs in pneumonia patients are only needed if clinical symptoms persist.
Overwhelming Infection with Group B β-Hemolytic Streptococcus Associated with Circumcision
Authors: Cleary Thomas G. , Kohl Steve 
Published: December 2021

The lack of valid medical indications has caused routine neonatal circumcision to fall into disrepute in recent years.1-3 However, despite the substantial arguments against continuation of this therapy, it still ranks as one of the most common surgical procedures.3,4
Significant infection is rarely solely attributed to circumcision because a clear-cut cause and effect relationship is difficult to establish. There have been reports5-7 of newborns who have been circumcised and then developed life-threatening infection within several days of this procedure. However, the fact that in these infants infection has occurred at an age when the incidence of infection is high due to other factors complicates interpretation of these reports.
PICKWICKIAN SYNDROME
Authors: Yirka M. 
Published: December 2021

A classic description of the association of the signs and symptoms of the PICKWICKIAN SYNDROME was written by Charles Dickens. The author refers to "a fat and red-faced boy in a state of somnolency." This boy was subsequently addressed as YOUNG DROPSY, YOUNG OPIUM-EATER AND YOUNG BOA CONSTRICTOR—no doubt in reference to his obesity, his somnolence and his excessive appetite.
A characteristic of these patients is an extraordinary degree of somnolence in which sleep may overcome the patient while he is sitting up or even while he is engaged in conversation or other muscular activity.
House Officer Training Programs
Authors: Geertsma M. Alex 
Published: December 2021

Werner et al's recent article (Pediatrics 63:491, 1979) on pediatric intern attitudes and interpersonal skills comes at a most fortuitous time for pediatrics. It raises an educational point worth special attention, particularly in light of the report of the Task Force on Pediatric Education.1
Within the last two years, several articles and commentaries have attempted to review the efforts of pediatric educators in the biobehavioral sphere. Anders' survey of pediatric training programs2 has revealed widespread interest in the topic, and yet disappointment with the actual incorporation of behavioral and developmental knowledge in house officer education.
Asymptomatic Bacteriuria in Adolescent Girls: I. Epidemiology
Authors: Emans S. Jean , Grace Estherann , Masland Robert P. 
Published: December 2021

Because the incidence of bacteriuria in asymptomatic school girls is low (1% to 2%), we examined possible risk factors in adolescents, such as previous history of urinary tract infection (UTI) and sexual intercourse (previous and recent).
Eight (1.6%) of 500 adolescent girls were detected with asymptomatic bacteriuria (ABU). Of 47 patients reporting a previous UTI, four (9%) were bacteriuric. Two other patients detected with bacteriuria had a history of enuresis; thus 6/8 adolescents with ABU had a history that suggests a need to screen for infection. A history of sexual activity was not helpful in case detection.
Of the 500 girls, 133 had a routine pelvic examination at the time of the visit. The procedure was not associated with bacteriuria, as measured by a home nitrite test each day for three days following the clinic visit.
Glossoptosis Revisited: On the Development and Resolution of Airway Obstruction in the Pierre Robin Syndrome
Authors: Mallory Susan Bayliss , Paradise Jack L. 
Published: December 2021

The principal complication of the Pierre Robin syndrome is glossoptotic obstruction of the airway. Many infants so affected experience stormy courses, and some eventually die.1-3 In these severe cases the most familiar clinical features are asphyxia and inanition,4 but cor pulmonale5-7 and congestive heart failure2 have also been described.
We report here a case that seems noteworthy in two major respects. First, it constitutes only the third reported instance of Pierre Robin syndrome in which cor pulmonale and congestive heart failure developed, and subsequently, following relief of upper airway obstruction, resolved. Second, the course of clinical events provided new evidence bearing on both the mechanism of airway obstruction in the Pierre Robin syndrome and the nature of its resolution with increasing age.
Care of the Newborn in the Delivery Room
Authors: Brann Alfred W. , Cefalo Robert C. 
Published: December 2021

RATIONALE
The first minutes of life may determine the quality of that life. Prompt, organized, and skilled response to emergencies in this period requires that institutions delivering maternal-infant care have written policies delineating responsibility for immediate newborn care, resuscitation, selection and maintenance of necessary equipment, and training of personnel in proper techniques. These policies should be approved by the medical staff of the hospital. Each institution should develop a list of maternal and fetal complications that require the presence in the delivery room of an individual qualified in newborn resuscitation.
The individual who delivers the baby is responsible for the immediate postdelivery care of the newborn unless another person assumes this duty. Commonly, routine care of the healthy newborn may be delegated to appropriately trained nurses.
Recognition and immediate resuscitation of the distressed infant require an organized plan of action and immediate availability of qualified personnel and equipment. In general, the individual who resuscitates the newborn should be the one who is best qualified to do so.1
Planning for the provision of such services and equipment should be carried out jointly by the directors of obstetrics, anesthesia, and pediatrics with the approval of the medical staff. A physician must be designated to assume primary responsibility for the establishment of standards of care, review of practices, maintenance of appropriate drugs, and training and evaluation of personnel. Planning must include specific identification and immediate in-house availability of qualified personnel 24 hours a day.
RESPONSIBILITY
Responsibility for identification and resuscitation of the distressed infant may rest with a physician or may be delegated to appropriately trained nurse anesthetists, labor and delivery room nurses, nurse midwives, nursery nurses, or respiratory therapists.
Medical Alternative for Students
Authors: Stuckey Allen , Puczynski Mark , Palfrey Judith S. , Hunt-Glover Jemetta 
Published: December 2021

Nearly 1 million teenagers drop out of high school each year.1 The failure of our public schools to design innovative and relevant curriculum is underscored in academic and lay literature as partially responsible for the enormously high drop-out rate.2-6 "Alternative education"7,8 which allows youngsters to choose particular topic areas,
has been suggested as an approach to this critical problem.
At the English High School in Boston, a very successful alternative program called M*A*S*H (Medical Alternative for Students in Hospitals) has been in existence for four years.
HARRIET MARTINEAU AND THE MANNERS OF AMERICAN CHILDREN, AS VIEWED IN 1834
Authors: C. T. E. 
Published: December 2021

Harriet Martineau (1802-1876) was an enormously popular English writer as well as a prominent figure in literary circles. A visit to America in 1834 inspired several unflattering words on the American way of life. However, her comments about the manners of American children were almost always favorable, as this excerpt will indicate.1
For my on part, I delight in the American children; in those who are not overlaid with religious instruction. There are instances, as there are everywhere, of spoiled, pert, and selfish children. Parents' hearts are pierced there, as elsewhere. But the independence and fearlessness of children were a perpetual charm in my eyes. To go no deeper, it is a constant amusement to see how the speculations of young minds issue, when they take their own way of thinking, and naturally say all they think. Some admirable specimens of active little minds were laid open to me at a juvenile ball at Baltimore. I could not have got at so much in a year in England. If I had at home gone in among eighty or a hundred little people, between the ages of eight and sixteen, I should have extracted little more than "Yes, ma'am," and "No, Ma'am." At Baltimore, a dozen boys and girls at a time crowded round me, questioning, discussing, speculating, revealing in a way which enchanted me. In private houses, the comments slipped in at table by the children were often the most memorable, and generally the most amusing part of the conversation.
THE FIRST MENTION OF TIC DE SALAAM IN AMERICAN MEDICAL LITERATURE (1896)
Authors: C. T. E. 
Published: December 2021

I believe the following description of tic de salaam, or infantile spasms, published in 1896, was the first mention of this condition in American medical literature.1
A convulsive form of disease, little known and but rarely described...is the form of epilepsy known to the French writers as Tic de Salaam, a condition which is observed almost exclusively in first infancy. Text-books of pediatrics in the English language contain no reference to it, either under this name or any other. Two or three cases which have recently come under the observation of the writer prompt him to a few remarks anent this condition.
In the forms usually observed, the disease is made up of a series of rapid, oscillating movements of the head and superior part of the body (spasmus salutans), which occur with a rapidity varying from 10 to 30 times per minute. In some instances, during the height of the attack, the upper extremities are shot into the air, and for the moment remained fixed, while the eyeballs are rolled up, and the face has a fixed, non-expressive appearance. Whether or not consciousness is entirely lost during this period cannot be said with certainty—first of all, because of the tender age of the patient, and secondly, because the rapid, fluctuating movements prevent the patient from answering or communicating. In marked contrast to the ordinary epileptic convulsions, whether they be of the "petit mal" or "grand mal" form, is the absence of any warning, and the rapidity with which the little sufferer regains his composure after an attack—that is, there seems to be none of the customary drowsiness, stupidity and desire to be left severely alone, as after an attack of epilepsy....
DR WILLIAM A. ALCOTT ON MATERNAL DOSING AND DRUGGING AS THE MAJOR CAUSE OF INFANT MORTALITY IN 1854
Authors: C. T. E. 
Published: December 2021

Among the most outspoken of American health reformers of the mid-nineteenth century was Dr William A. Alcott of Boston. The health reformers offered an alternative to a public dissatisfied with the heroic practice of most physicians of this period by emphasizing that the individual had it in his or her own power to keep all members of the family in good health by forgoing most of the drugs prescribed by allopathic physicians.
Alcott1 was particularly concerned with the huge extent of infant mortality caused by "maternal dosing and drugging." He wrote:
But whether ignorant or somewhat enlightened, the vast majority of our mothers doctor, more or less, their own children. At least, if they refuse to call it doctoring, they give them a vast amount of small elixirs, cordials, etc. The closets of not a few house-keepers are a complete apothecary's shop. They may, it is true, have smaller parcels then the regular apothecary; but they have almost as great an assortment. And they not only keep it; they administer it. They may not intend it; they do not mean to give much; sometimes they really think they do not give much. But it comes to pass, in the course of the year, that much is given by somebody; and I greatly fear that the mother must be held responsible for it....
But now for the consequences of this maternal dosing; for this it is with which medical men have chiefly to do. Next to bad food and wretched cookery, as I have before intimated, this error is productive of more sickness and premature death than any other.
All Is Well in Perinatal Land
Authors: Grossman Lindsey K. 
Published: December 2021

Dr William A. Silverman's review of the career of Dr Martin A. Couney1 as an exhibitor of premature infants in the late nineteenth and early twentieth centuries was interesting. I found it difficult to imagine, however, how this exploitation was permitted to go on as long as it did.
I am even more amazed at Dr Silverman's concluding remarks. Although I agree that there is indeed a "disturbing detachment from reality" present for parents, patients, and staff in today's intensive care nurseries, I heartily disagree that, when compared with the technical energy expended to save the child's life, no similar "effort is mounted to deal with the enormous problems which face the graduate at home and in the community."1
Letters to the Editor
Authors: Silverman William A. 
Published: December 2021

For my peace of mind (and for the readers of Pediatrics) I fervently hope that Dr Grossman can demonstrate that my fears are groundless and my criticism unjustified. But we will need more than the bland assurances he makes in his letter.
I will be looking for something in the nature of an "environmental impact report" to document his implied claim that all is well in perinatal-land. Present-day actions in this field of medicine create public policy—unreviewed and unlegislated.
They Don't Do Very Well
Authors: Wallace Sheila J. 
Published: December 2021

I have read the article by Nelson and Ellenberg (Pediatrics 61:20, 1978) on febrile convulsions with considerable interest and cannot agree with Dr J.W. Freeman (Pediatrics 61:806, 1978) that they show "these children do well—even without therapy." Nelson and Ellenberg's study did not record prophylaxis with anticonvulsants, and they are therefore not able to know whether those children who were at greatest risk of further seizures had them prevented.
In their initial report, Nelson and Ellenberg1 found that 22% of the whole group of 1,706 children were neurologically suspect or abnormal prior to their first fit, but they do not say how many of the children who did not have convulsions were considered other than normal at comparable ages.
Hypertension and Hematuria Secondary to Parapelvic Cyst
Authors: Chan James C. M. , Kodroff Michael B. 
Published: December 2021

A parapelvic cyst is a well encapsulated collection of fluid outside of the renal parenchyma. It may give rise to urinary tract obstruction. Such a cyst at the renal pelvis may cause localized hydronephrosis, cortical thinning from intrarenal compression, and secondary hypertension remediable by surgical correction. However, to our knowledge, such a case has not been previously reported in the pediatric literature.
CASE REPORT
An 8-year-old black boy was evaluated for asymptomatic microscopic hematuria of six months' duration. There was no history of renal or cardiovascular diseases or of hypertension in the family. Blood pressure, which was 100/60 mm Hg initially, rose to 140/94 mm Hg at six-month follow-up visit.
Progress in Phenylketonuria: Defects in the Metabolism of Biopterin
Authors: Berlow Stanley 
Published: December 2021

Although progress in a major biological frontier, the neurosciences, has been both rapid and broadly based, it has offered little to the practical pediatrician. Some recent reports may forecast a change. Careful study of an old subject, phenylketonuria (PKU), has opened up a new area of research that has great potential significance.
Five years ago in London, Smith et al1 described three children with "PKU" who had an unusual clinical course. Despite early diagnosis and treatment with a low phenylalanine diet, these patients developed progressive neurological disease and died. The atypical course, a high tolerance for phenylalanine, and normal phenylalanine hydroxylase activity on liver biopsy in one of the children led them to the astute speculation that this syndrome was a new form of "hyperphenylalaninemia" probably due to a defect in the metabolism of biopterin.
Infant Apnea Syndrome
Authors: Lewak Norman 
Published: December 2021

Enough is enough! I protest the continued use of the inaccurate diagnostic abomination, "Near Miss for Subden Infant Death Syndrome Infants," as found on page 369 of your September 1979 issue. The predictable result of using that unfortunate term is found on the cover of that issue—the babies were "promoted" from "near miss" to just plain "sudden infant death syndrome infants."
The "Infant Apnea Syndrome" is long overdue. You, I am certain, understand the consequences of connecting by nomenclature all the infants with SIDS and all the infants with severe apnea (and thus with apnea monitoring).
Who Gives Nutritional Advice? Who Follows It?
Authors: Barness Lewis A. 
Published: December 2021

Nutritional advice is rampant. Nutritional books, nutritional articles, specialty magazines, health food stores, and weight reduction institutes all give advice. Proposed national dietary guidelines have been published and more are likely to follow. Some respite from the flood may occur following a lawsuit against the estate of Adele Davis and her publishers following the death of an infant who was treated by his parents according to information they gleaned from one of Adele Davis' books.
Many reasons have been given for the proliferation of "nutritional experts." Hard data, easily verifiable, are hard to obtain. The minimal needs for vitamins and minerals can be verified in animals and confirmed by elimination of disease symptoms.
Prophylaxis and Treatment of Neonatal Gonococcal Infections
Authors: Segal Sydney , Anyan Walter B. , Hill Reba M. , Kauffman Ralph E. , Mofenson Howard , Pruitt Albert W. , Shinefield Henry R. , Singer Harvey S. , Weinberger Miles M. , Brann Alfred W. , Hall Robert T. , Harper Rita G. , Little George A. , Maisels M. Jeffrey , McCracken George H. , Poland Ronald , Sunshine Philip , Whittinghill John A. , Mortimer Edward A. , Fulginiti Vincent A. , Brunell Philip A. , Calderon Ernesto , Cherry James D. , Ector Walton L. , Gershon Anne A. , Gotoff Samuel P. , Hughes Walter T. , Peter Georges 
Published: December 2021

The Center for Disease Control (CDC), after consultation with a panel of experts, has revised its recommendations for prevention of gonococcal ophthalmia neonatorum. These recommendations now state, "ophthalmic ointment or drops containing tetracycline or erythromycin or a 1% silver nitrate solution" are effective and acceptable.1-3 This is a change from previous recommendations which highlighted silver nitrate as the primary agent for prophylaxis.4 The American Academy of Pediatrics' committees support these recommendations.
The prevalence of largely asymptomatic genital gonococcal infection in pregnant women and the occurrence of gonococcal ophthalmia in untreated infants (estimated at 28%)5 born to infected women indicate the need for continued prophylaxis for all newborn infants.
Nasal CPAP and Work of Breathing Study Questioned
Authors: Kattwinkel John 
Published: December 2021

The paper by Goldman et al (Pediatrics 64:160, 1979) comparing the mechanics of breathing in neonates treated with nasal vs mask continuous positive airway pressure (CPAP) recommends that, since nasal CPAP appeared to increase the work of breathing, "other methods be considered for the delivery of CDP (continuous distending pressure)." As a strong proponent of nasal CPAP, I would like to express several concerns with the study and its interpretation.
First, according to the authors' drawing, the nasal device used for the study had been modified with a PE 20 sampling catheter inserted through one of the prongs.
Age and Blood Pressure
Authors: Krovetz L. Jerome 
Published: December 2021

This is written in corroboration of a recent editorial by Dr Forrest H Adams on blood pressure in children in the United States. Dr Adams stated that "the blood pressure should remain stable for life in the absence of disease.... The normal aging process is unaccompanied by an increase in blood pressure."
In 1972, we published a study on hemodynamic data1 obtained on normal subjects undergoing cardiac catheterization. A total of 365 normal subjects, 1 day to 69 years of age, were analyzed.
Evaluation of Perinatal Care Education Programs
Authors: Hein Herman A. , Ferguson Norma N. 
Published: December 2021

Dr Kattwinkel, et al,1 are to be congratulated on their approach to improved perinatal care in rural community hospitals. They state that their study "represents the first attempt to systemically examine the problems hindering the delivery of optimal perinatal care in the community hospital and then to design a program around these problems."
In June 1975, we published an article in this journal describing "an evaluation of perinatal care practices in Iowa community hospitals."2 The evaluations were accomplished by a perinatal team during visits to the hospitals.
LEUKEMIA AND RADIATION
Authors: Miller Robert W. 
Published: December 2021

A report of leukemia incidence in a cohort of atomic-bomb survivors in Hiroshima and Nagasaki, 1950-1971, has revealed that the larger the exposure dose and the younger the age at exposure, the greater was the rate of leukemia and the shorter the interval to occurrence (Ichimaru M, Ishimaur T, Belsky JL: J Radiat Res 19:262-282, 1978). Chronic granulocytic leukemia passed its peak occurrence in all age groups within ten years of exposure, the peak being greater among persons who were under 15 years of age at the time of the bomb (ATB). The excess was exhausted by the 15th year after exposure among them and among the next older cohort (15 to 29 years ATB).
Acute leukemia peaked soonest among persons exposed under 15 years of age ATB, and progressively later in successive age groups. Each peak was of similar amplitude, but the decline in rates was slower as age ATB increased. After childhood exposure, the excess was no longer discernible 15 years after the bomb, but persisted among older groups more than 25 years after exposure, in proportion to their age at the time of the bomb.
The vast majority of the excess involved nonlymphocytic leukemia, except among persons exposed before 20 years of age (12 cases), as compared with persons above this age (four cases). Thus, age is very much related to susceptibility and the type of leukemia that is induced by radiation exposure.
Rubella Immunization: Present Status and Future Perspectives
Authors: Krugman Saul 
Published: December 2021

Sixteen years have elapsed since the last major epidemic of rubella in the United States. Prior to 1964, extensive outbreaks occurred at about six- to nine-year intervals. These outbreaks were associated with the birth of many thousands of infants with one or more of the following defects: cataracts, deafness, cardiac malformations, and brain damage causing mental retardation, cerebral palsy, or severe behavior disorders. In addition, many pregnancies were terminated by spontaneous or therapeutic abortions. This devastating "rubella problem" provided the motivation for the development of rubella vaccine.
The live attenuated rubella vaccine was licensed for use in 1969—two to four years before the next anticipated epidemic.