bluuebunny/crossref_metadata_2025_split huggingface dataset:
Position Statement 1982
Authors:   Joint Committee on Infant Hearing
Published: December 2021

Early detection of hearing impairment in the affected infants is important for medical treatment and subsequent educational intervention to assure development of communication skills.
In 1973, the Joint Committee on Infant Hearing Screening recommended identifying infants at risk for hearing impairment by means of five criteria, and suggested follow-up audiologic evaluation of these infants until accurate assessments of hearing could be made (AAP Newsletter Supplement, October 1973). Since the incidence of moderate to profound hearing loss in the at-risk infant group is 2.5% to 5.0%, audiologic testing of this group is warranted. Acoustic testing of all newborn infants has a high incidence of false-positive and false-negative results and is not universally recommended.
Recent research suggests the need for expansion and clarification of the 1973 criteria. This 1982 statement expands the risk criteria and makes recommendations for the evaluation and treatment of the hearing-impaired infant.
I. IDENTIFICATION
A. Risk criteria
Factors that identify those infants who are at risk for having hearing impairment include the following:
1. Family history of childhood hearing impairment
2. Congenital perinatal infection (eg, cytomegalovirus, rubella, herpes, toxoplasmosis, syphilis)
3. Anatomic malformations involving the head or neck (eg, dysmorphic appearance including syndromal and nonsyndromal abnormalities, overt or submucous cleft palate, morphologic abnormalities of the pinna)
4. Birth weight &lt; 1,500 gm
5. Hyperbilirubinemia at level exceeding indications for exchange transfusion
6. Bacterial meningitis, especially Haemophilus influenzae
7. Severe asphyxia which may include infants with Apgar scores of 0 to 3 or who fail to institute spontaneous repiration by ten minutes and those with hypotonia persisting to 2 hours of age
Testosterone Need Questioned
Authors: ROSENFELD RON G. , HINTZ RAYMOND L. 
Published: December 2021

In Reply.—
We thank Dannenhoffer and Crawford for their thoughtful comments on our recent study of testosterone treatment of constitutional delay. We agree that the size of the study population was relatively small, and that subject randomization resulted in a significant difference in mean height at the time of entry into the study. Nevertheless, we believe the data still support the conclusion that short-term testosterone treatment can result in significant growth acceleration in this population. In general, linear growth in children correlates better with bone age than with chronologic age, and the skeletal ages of the two groups in this study were not significantly different.
Circumcision Continues
Authors: BRENNEMAN GEORGE 
Published: December 2021

To the Editor.—
The conclusions made in "The Role of Parental Information in the Incidence of Circumcision"1 do not agree with my experience. Parental information prenatally is important, but it must compete with routines and attitudes of all personnel who work in the postpartum and nursery areas. The authors apparently did not evaluate these important sources of influence.
Excretion of Technetium in Human Milk
Authors: MAISELS M. JEFFREY , GILCHER RONALD O. 
Published: December 2021

The radioisotope technetium-99m(99mTc) is widely used in nuclear medicine for a variety of scanning procedures. On occasion, it may be necessary to perform such studies on a nursing mother, and it is important to know what dose of radioactive material a nursing infant might receive and how soon after the isotope administration the mother may resume breast-feeding.
Technetium is one of the halide elements and is handled, biologically, much like iodine.1 Like iodide,2,3 the pertechnetate ion (99mTcO4-) is concentrated in the thyroid gland1,4 and stomach5,6 and in the breast milk of nursing mothers4-6 and women with the amenorrhea-galactorrhea syndrome.7 In this report we present studies on 99mTcO4- in breast milk, including its binding to milk protein, biologic half-life, and calculations of radioactivity that might be ingested by a nursing infant.
Bad Effects of Patterning
Authors: BOLTON JOHN C. 
Published: December 2021

To the Editor.—
I would like to commend the American Academy of Pediatrics for its updated and strong statement against the "patterning" treatment of neurologically handicapped children.1
Certainly one of the problems with the promoters of this type of treatment has been their insistence that the therapy be carried out 365 days a year and as much as 22 h/day. In the best of circumstances, this will totally disrupt family life and divert attention from other children in the family, while at the same time, providing no benefits to the patient in question.
Flaws in Study of Management of Children with Febrile Illness
Authors: CLUB JOURNAL 
Published: December 2021

To the Editor.—
Our residency's journal club recently reviewed your October issue and the article on management of febrile illness.1 We found it to be misleading and inconclusive for the following reasons.
First, the study presented itself as a comparison of the management of fever in children by pediatricians and "general practitioners." Based on introductory statements the term "general practitioner" implies family physician, but this is not clearly stated. As the article progresses, we find the data collected are based on experience in emergency rooms at a children's hospital v a "general" hospital, each staffed by residents or interns.
Nephrocalcinosis: Detection by Ultrasonography
Authors: ALON URI , BREWER WILLIAM H. , CHAN JAMES C. M. 
Published: December 2021

Abdominal plain radiography has long been regarded as an excellent noninvasive method for the diagnosis of nephrocalcinosis.1 However, to be detected by radiography, the calcium deposition in the kidneys must be quite large. Thus, in the early stages of renal calcification, radiography often fails to detect nephrocalcinosis.2,3 In most cases treatment can arrest the pathologic process and prevent further damage to the kidneys; therefore, early detection is of crucial importance4,5 and diagnostic methods that are more sensitive than abdominal plain radiography are needed.
We hearby describe our experience in two children in whom plain abdominal radiographs failed to document nephrocalcinosis. In constrast, ultrasonography clearly demonstrated the nephrocalcinosis, which was subsequently confirmed histologically by percutaneous needle biopsy.
Sudden Infant Death Syndrome and Phenothiazines
Authors: STANTON A. N. 
Published: December 2021

To the Editor.—
Kahn and Blum1 discuss the relationship between phenothiazines and the sudden infant death syndrome (SIDS) but do not mention the potentially important anticholinergic side effects of this group of drugs. Phenothiazines impair temperature regulation, including the ability to sweat, and are implicated in many reports of heatstroke2,3 and hypothermia. Any temperature rise tends to occur early in treatment4 and may bee provoked by standard dosage.5 Studies in mice given a single 1-mg/kg dose of chlorpromazine show that younger animals become hyperthermic, whereas older ones becomes hypothermic.6
BCG Vaccine and Isoniazid Prophylaxis
Authors: LE CHINH T. 
Published: December 2021

To the Editor.—
The 1982 edition of the Report of the Committee on Infectious Diseases (Red Book) contains the specific statement that "BCG vaccine should not be given during INH administration because INH inhibits the multiplication of BCG organisms." This statement is apparently made in reference to the study by Narain et al1 (P. A. Brunnell, personal communication, Jan 19, 1983). It is estimated that isoniazid (INH) kills 90% of the bacilli in bacillus Calmette-Guerin (BCG) vaccines. However, the clinical implication of this observation is controversial.
Venipuncture Fits: A Form of Reflex Anoxic Seizure
Authors: RODDY SARAH M. , ASHWAL STEPHEN , SCHNEIDER SANFORD 
Published: December 2021

Blood banks and hospital laboratories all too often observe the phenomenon of a syncopal episode associated with bloodletting in an otherwise healthy patient. However, during the syncopal episode it is unusual for these patients to develop a generalized seizure. We recently studied a child who had a history of seizures following venipuncture. Utilizing ECG and EEG monitoring during venipuncture, we determined that these episodes were not true epileptic seizures but rather anoxic convulsions secondary to vagal asystole.
CASE REPORT
D.D., an 11-year-old girl, had her first generalized seizure following blood drawing at age 3 years. At least ten similar episodes have occurred with the seizure beginning one to two minutes after venipuncture.
Rape and the Adolescent
Authors:   Committee on Adolescence
Published: December 2021

In recent years the problem of rape and sexual abuse of young persons has begun to receive appropriate medical attention. Nearly 50% of reported rape victims are adolescents1,2 Whereas the vast majority of offenses involve girls, the incidence of sexual assaults on young males also appears to be increasing.
Although community resources may vary considerably, most metropolitan areas now have special programs or facilities to assist the victims of sexual assault. Such assistance usually includes advice as to the management of the acute crisis as well as guidelines for the collection of evidence and the preparation for trial should legal action follow. Because so many of the victims are adolescents, they are being seen with increasing frequency in pediatric emergency rooms.
The adolescent who is forcibly assaulted may display a wide range of behaviors, such as hysterical crying or giggling, agitation, feelings of degradation, anger and rage, helplessness, nervousness, and rapid mood swings. Alternatively, the adolescent may appear calm and controlled, masking internal turmoil. She is often angry, confused, and filled with self-blame. In cases of forcible assault, longterm sequelae such as fears, nightmares, and sleep disturbances, disturbed peer and sexual relationships, and psychosomatic complaints may develop. Some fear retaliation from their attacker and develop ritualistic behavior as a defense. Some believe their bodies to be permanently damaged, and may even fear death as a consequence of the violent act they have experienced.
For the victim, the circumstances of the initial medical evaluation may be frightening and stressful. Police interrogation, repeated questioning by health professionals, and the physical examination itself all have the potential to add to the trauma of the sexual assault.
Use of Erythromycin in Pertussis Outbreaks
Authors: BASS JAMES W. 
Published: December 2021

To the Editor.—
With two outbreaks of pertussis recently observed and soon to be reported in Maryland (41 cases) and Hawaii (24 cases), it is appropriate that all means to curb spread of infection from individuals involved in these outbreaks be properly utilized. In this regard, I would like to take issue with a recommendation in the current Red Book.1 Certainly, erythromycin is presently the drug of choice for pertussis but the recommended duration of treatment of seven to ten days is inadequate.
Bonding, Humanism, and Science
Authors: LAMB MICHAEL E. 
Published: December 2021

In Reply.—
I have consistently emphasized1-3 that the changes in birthing practices that Klaus and Kennell helped bring about are laudable, and that the failure to demonstrate clear, enduring, universal, and clinically significant effects attributable to early contact should in no way justify a return to dehumanizing birthing practices. In this respect, I am entirely in agreement with Emde and Osofsky, as well as Klaus and Kennell.4.5 As Emde and Osofsky suggest, it is unfortunate that policy-relevant research and reviews of it lend themselves to misuse by those whose agenda is set regardless of the scientific evidence.
Neonatal Drug Withdrawal
Authors:   Committee on Drugs
Published: December 2021

Symptoms of neonatal drug withdrawal consist of: W = wakefulness; I = irritability; T = tremulousness, temperature variation, tachypnea; H = hyeractivity, high-pitched persistent cry, hyperacusia, hyperreflexia, hypertonus; D = diarrhea, diaphoresis, disorganized suck; R = rub marks, respiratory distress, rhinorrhea; A = apneic attacks, autonomic dysfunction; W = weight loss or failure to gain weight; A = alkalosis (respiratory); L = lacrimation (Fig 1); also, hiccups, vomiting, stuffy nose, sneezing, yawning, photophobia, twitching, myoclonic jerks, opisthotonos, or seizures.
When these symptoms are seen in a newborn infant, the physician should consider a diagnosis of withdrawal from maternal drugs. Narcotics reported to cause these symptoms in the neonate are heroin,1 methadone,2 meperidine,3 morphine, codeine,4 pentazocine,5,6 and propoxyphene.7 A glossary of drugs is provided in Fig. 2.
The onset of symptoms may be present at birth or may begin within four days of delivery. In some instances, symptoms may not become obvious until 10 days of age. This depends upon the drug the infant was exposed to in utero and the pharmaco-kinetic excretion of the drug. Subacute symptoms of narcotic drug withdrawal may last for 4 to 6 months.8
Rosen and Pippenger9 have demonstrated that infants born to mothers maintained on methadone do not begin to manifest withdrawal symptoms until the plasma level is less than 0.06 µg/mL. In utero exposure to multiple drugs may cause a biphasic pattern of withdrawal symptomatology in the neonate.10 Polydrug abusers frequently use as many as two to five drugs in combination; these might include phenobarbital, diazepam, marijuana, pentazocine, tripelennamine, phencyclidine, and codeine.11 A physician who is unaware of a mother's drug ingestion may initially make an erroneous diagnosis of colic in the infant; therefore, a detailed maternal drug history should be obtained, including prescription and nonprescription drugs received, social habits of the parents, and whether the mother is breast-feeding.
What Is the Best Test for Iron Deficiency?
Authors: OSKI FRANK A. 
Published: December 2021

In Reply.—
Dine raises a very important question which is continuously posed by the pediatrician in practice-what is the best (simple, inexpensive, and sensitive) test to determine whether an infant or child has iron deficiency?
If there were an easy answer, this question would not be repeatedly asked. No single laboratory test is sufficiently sensitive and specific to detect all patients with iron deficiency or even iron deficiency anemia.1 For example, it has been demonstrated that close to one third of infants with hemoglobin in the low-normal range (11.0 to 11.4 g/dL) will display a significant increase in hemoglobin following a therapeutic trial of iron.2
Gastroesophageal Reflux and Apnea
Authors: ROSEN CAROL LYNN , FROST JAMES D. , HARRISON GUNYON M. 
Published: December 2021

In Reply.—
In our study of polygraphic recordings in infants with unexplained apnea, esophageal pH was monitored continuously uously and all infants were fed standard infant formula approximately every four hours during the polygraphic studies. Orenstein has questioned the absence of gastroesophageal reflux (GER) in 36% of the pH recordings, and has suggested that nonacid feedings may have masked some episodes of GER. Other studies utilizing nonacid feedings during extended esophageal pH monitoring have shown that some normal children do not reflux and that nonacid feeds do not necessarily mask GER.
Adolescent Chest Pain
Authors: PANTELL ROBERT H. , GOODMAN BENJAMIN W. 
Published: December 2021

In Reply.—
We did not conduct urine testing for cannabinoids but did inquire about the use of marijuana. Adolescents were questioned about use of all street drugs, including manjuana. Patients with chest pain did not admit to using drugs (5%) any more frequently than patients in our control groups with abdominal pain (8%) or without pain (4%).
The above letters highlight the importance of considering the importance of psychologic, situational and environmental conditions when evaluating an adolescent with chest pain.
Congenital Leukemia: Two Transient Regressions Without Treatment in One Patient
Authors: WARRIER R. P. , RAVINDRANATH Y. , INOUE S. , KAPLAN J. , EMAMI A. 
Published: December 2021

To the Editor.—
The article by Chu et al1 has prompted us to report briefly our experience with cytochemical, chromosomal, and immunologic marker studies in four patients with congenital leukemia. The clinical and laboratory findings for the four cases are summarized in Tables 1 and 2.
Congenital leukemia is extremely rare. 2-4 In our experience, only four cases have been reported during the last 15 years; at the same time approximately 500 cases of acute leukemia were seen at Children's Hospital of Michigan. Although the number is small, half the patients in these series had acute lymphatic leukemia, suggesting that even in this age group, acute lymphatic leukemia may be more common than previously appreciated when "transient leukemia" 56 associated with Down's syndrome is excluded.
Cold-Induced Urticaria in Infancy
Authors: TING STANISLAUS 
Published: December 2021

The following account describes one case of cold-induced urticaria.
CASE REPORT
C.S., a 3.5-kg baby girl, was born after an uneventful pregnancy. She is one of three siblings, born to unrelated parents, with no familial history of cold-related medical disorders. At 3 months of age, generalized urticarial lesions developed after immersion for a few minutes in an outdoor swimming pool. She was immediately removed from the water. The hives disappeared completely within 30 minutes. There was no evidence of joint swelling, fever, or irritability. Similar urticarial lesions occurred at 6 months of age, once again associated with exposure to cold water in a swimming pool.
Postmortem Protocol
Authors: WHELAN DONALD T. 
Published: December 2021

To the Editor.—
The article by Knonick et al1 illustrates the advantage of having a "penimortem protocol" that includes an assembled kit to obtain appropriate diagnostic specimens from the dying infant or just after death has occurred.
I agree with the philosophical and practical approach taken by the authors. However, I would like to comment further on techniques we have found helpful under similar circumstances. At McMaster University Medical Centre, a total body radiograph is added to the protocol in all stillborn infants when unusual clinical signs are observed.
Short Children and Growth Hormone
Authors: JOHANSON ANN J. , BRIGHT GEORGE M. , ROGOL ALAN D. , BLIZZARD ROBERT M. 
Published: December 2021

In Reply.—
Copeland raises some interesting questions and speculation regarding the treatment of "normal short" children with growth hormone that many, if not all, of the pediatric endocrinologists who treat short children are currently considering.
Regarding the ethical question of who should or should not receive growth hormone, who should give it, who should pay for it, and what are the side effects: information is being gathered and will be forthcoming in stages. A statement prepared by the Ad Hoc Committee on Growth Hormone Usage of The Lawson Wilkins Pediatric Endocrine Society, chaired by Dr Louis E. Underwood, has recently been published.1
Prevention of Perinatal Transmission of Chronic Hepatitis B Surface Antigen (HBsAg) Carrier State
Authors: CHIN JAMES 
Published: December 2021

In Reply.—
It is well documented that the risk of a pregnant woman—who is a hepatitis B surface antigen (HBsAg) carrier and who also has detectable hepatitis Be antigen (HBeAg)—transmitting a hepatitis B virus (HBV) infection to her infant at birth, which would result in chronic HBsAg carriage, is very high (up to 90%). Women who are HBsAg positive but HBsAg negative and who have no detectable antibody to HBeAg (anti-HBe) are considered of intermediate infectivity.
Marijuana: A Crude Drug with a Spectrum of Underappreciated Toxicity
Authors: Schwartz Richard H. 
Published: December 2021

The unthinkable happened to our family. Our son Keith, aged 15 years, experimented with marijuana and quickly became obsessed with getting "high." Keith soon sought out only those friends of a similar ilk and within a few months we began to notice progressive fatigue, disinterest in family life and school work (grades plummeted), loss of academic and vocational goals, a couldn't-care-less attitude, and compulsive dishonesty.
Keith had always been a difficult child but we were hopeful that time and love would help him outgrow his poor self-image and impulsive behaviors. Perhaps, without marijuana, we might have seen him mature and become a motivated selfsufficient citizen without the need for intensive drug rehabilitation.
For the past 8 months, Keith has been a client at a unique drug rehabilitation program, Straight, Inc, where he is learning that he is a worthwhile, basically good person; that his family loves and needs him; and that he will have a life-long fight against the seductive malignant influence of alcohol, marijuana, and other drugs. He is making progress. We take one day at a time.
The word marijuana derives from the indigenous Mexican or Central-American word maraguango, a general term meaning any intoxicating substance.1 Marijuana, the dried particles of leaves, small stems, flowers, and achenes (seeds), is a crude drug which owes its psychoactive properties primarily to Δ9-THC, a mixture of nine psychoactive isomers produced by resin-secreting glands of the medicinal varieties of the hemp plant (Cannabis sativa).2 These glands are particularly abundant in the upper leaves and flowering tops of plants of both sexes but are highest in the pistillate (female) plants.
Suctioning and Cerebral Blood Flow
Authors: TREVATHAN EDWIN 
Published: December 2021

To the Editor.—
The report by Perlman and Volpe1 meticulously describes a relationship between suctioning of the preterm infant and temporally associated increases in intracranial pressure and cerebral blood flow velocity. Perlman and Volpe further suggest that the increased pressure-flow stresses on the cerebral capillary beds, associated with suctioning, could precipitate intraventricular hemorrhage (IVH) in preterm infants. Surprisingly, Perlman and Volpe decided not to use the incidence of IVH as a measurement of outcome. The failure to obtain ultrasound studies before suctioning is unfortunate, because a totally new prospective study is now indicated, rather than a simple extension of their reported study. In spite of the lack of ultrasound data prior to suctioning, further analysis of the present data would be helpful.
Intravenous Vitamin E and Deaths in the Intensive Care Unit
Authors: BODENSTEIN CARL J. 
Published: December 2021

To the Editor.—
Three patients in our neonatal intensive care unit during December 1983 are described below. The outcome for these patients was very unusual for our nursery and prompted investigation of any new practices started recently. The case histories briefly reviewed as follows:
Patient 1. This white male neonate had birth weight of 1,021 g and estimated gestational age of 30 weeks. Apgar scores were 5 and 7. He had hyaline membrane disease requiring the use of a ventilator and he was weaned to room air in seven days, although he later required ventilation for apnea.
Suctioning and Cerebral Blood Flow
Authors: PERLMAN JEFFREY M. , VOLPE JOSEPH J. 
Published: December 2021

In Reply.—
Marshall misread a critical piece of information in the text. His interpretation of the data would be correct, if the intracranial pressure, arterial blood pressure, and cerebral blood flow velocity changes occurred simultaneously. However, as we stated in the text (see section on "Temporal Features of Changes with Suctioning"), the intracranial pressure fell to base-line values immediately following suctioning, whereas the changes in arterial blood pressure and cerebral blood flow velocity occurred more slowly over an approximately two-minute period.