bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Mononuclear and Polymorphonuclear Chemotaxis in Human Newborns,Infants, and Young Children
Authors: Klein Robert B. , Fischer Thomas J. , Gard Sherrie E. , Biberstein Michael , Rich Kenneth C. , Stiehm E. Richard 
Published: December 2021

A new method, chemotaxis under agarose gel, was used to assess the directed motility of polymorphonuclear (PMN) and mononuclear (MN) phagocytes of 21 newborns, 71 infants and children, and 50 adults. This assay requires only small quantities of cells and is rapid, easy, reproducible, and provides a permanent record. The chemotactic substance was zymosan-activated human serum.
Monocyte chemotaxis in the newborn was approximately 50% of adult control values, using the Boyden chamber (8.1 ± 2 cells per high-power field[HPF] [SE] in newborns compared to 17 ± 3 cells per HPF in adults), and 25% of adult control values, using the agarose method (50 ± 10 cells in newborns compared to 216 ± 15 cells in adults). Both are significant differences (P &lt; .005). MN chemotaxis remains extremely low through age 5, and remains moderately reduced until age 10. PMN chemotaxis in the newborn was 82 ± 21 cells compared to adult controls of 300± 42 cells, also a significant difference (P &lt; .05). PMN chemotaxis remains markedly depressed through age 2. Thereafter, PMN chemotaxis increases but remains significantly less than in adults until age 16.
These chemotactic defects may play an important role in depressed delayed hypersensitivity skin tests, diminished inflammatory reactions, and increased susceptibility to infection present in the newborn and young infant.
Self-initiation and self-help: Promises and pitfalls
Authors: STARFIELD BARBARA 
Published: December 2021

Self-help is in vogue. Stimulated at least partly by the purported inadequacies of our health care system, it promises better results if only people would take responsibility for their own destinies. The Lewises and their colleagues (p. 499), in their customary fashion, have added an innovative twist to the idea. Why not start the process in childhood?
In their article they describe a demonstration project in which children enrolled in an elementary school could initiate their own care from a school nurse. The nurse was trained to involve the children in the decisions required to cope with their problems. If
Nasoduodenal vs. Nasogastric Feeding
Authors: AVERY GORDON B. 
Published: December 2021

To the Editor:
The article by Drs. Van Caillie and Powell entitled “Nasoduodenal Versus Nasogastric Feeding in the Very Low Birthweight Infant”(Pediatrics 56:1065, December 1975) represents a phenomenon all too common in the literature: investigation of an important question with inadequate numbers of patients and poor statistical control, resulting in conclusions based on insufficient data. The issue of how to feed the very small premature infant is indeed a significant one. A valid physiological
Old Answer Still Correct?
Authors: ARENA JAY M. 
Published: December 2021

To the Editor:
I am writing in reply to the letter of Drs. Mofenson and Greensher(Pediatrics 59:788, May 1977), “The New Correct Answer to An Old Question on Kerosene Ingestion.” A correct quote from the third edition of my book, Poisoning: Toxicology-Symptoms, states that“treatment of kerosene ingestion without lavage or emesis is not only preferable, but actually the only logical course to follow.” I shall continue to use this statement in the fourth
Drs. Ivey and Kattwinkel Reply
Authors: IVEY HALLAM H. , KATTWINKEL JOHN 
Published: December 2021

In reply to Drs. Grossman and Safir, we offer the following comments.
The purpose of our original communication was not to debate the advisability of suppressing cough (by itself a highly controversial area), but rather to point out the “potentially dangerous recommendations concerning the dosage of Actifed-C.” Nelson's Textbook of Pediatrics recommends a codeine dosage range of 1 to 1.5 mg/kg/24 hr (not “per dose”). It seems clear that the recommended dose for cough in
Dr. Thaler Replies
Authors: THALER M. MICHAEL 
Published: December 2021

Dr. Glasgow's updating of developments since my article was submitted is much appreciated. It may serve to stimulate further exploration of the possibility that aberrant ammonia metabolism is involved in the pathogenesis of Reye's syndrome. This, after all, was my aim in proposing a“working” hypothesis.
The points raised by Dr. Glasgow deserve serious attention. Certainly, once various defects which manifest clinically as Reye's syndrome are recognized,each may require a specific form of therapy.
Fragmentation of Care and the Medical Home
Authors: HUGHES JAMES R. , GRAYSON ROBERT , STILES FRANK C. 
Published: December 2021

To the Editor:
In stating that its goal shall be “the attainment by all children of the Americas of their full potential for physical, emotional and social health,” the Constitution of the American Academy of Pediatrics provides that the Academy shall seek to “foster measures and conduct activities directed toward establishing and maintaining the highest possible standards of quality and acceptability in the delivery of health care to children.”Implicit in these standards is a
Do What You Can Do
Authors: SHAW EDWARD B. 
Published: December 2021

To the Editor:
No one can disagree with the report by Weber et al. (Pediatrics57:152, January 1976), which agrees with a similar article by Battaglia and Lockhart1 and the comments of Sydney Gellis in the 1976 Yearbook and which demonstrates that in ideal surroundingsthe use of endotracheal intubation is the appropriate emergency room method for affording an airway for the child with epiglottitis, replacing an older statement by Berenberg and Kery,2 i.e., “in
One Chairman's View
Authors: VAN LEEUWEN GERALD J. 
Published: December 2021

To the Editor:
I read Dr. Haggerty's commentary entitled “Departments of Pediatrics” (Pediatrics 57:303, March 1976) with intense interest,having recently resigned after seven years as chairman of the Department of Pediatrics at the University of Nebraska. As always, Dr. Haggerty's comments are concise and accurate. He is essentially correct in all areas; I should like to emphasize, too, that academic pediatricians do look upon teaching as an opportunity rather than a “load,” and that
The case for day-care surgery
Authors: Brownlee Robert C. 
Published: December 2021

In a very interesting article elsewhere in this issue (p. 600), El-Shafie and Shapiro have outlined their experience with outpatient or "day-care" surgery in a developing country (Jamaica). It is important to remember that in 1909 Nicoll1 of Glasgow, Scotland, was the first in the era of "modern medicine" to record experience with outpatient surgery on children. While one's definition of a developing country might not apply equally to Jamaica in 1973 and Scotland in 1909, it is possible that the medical conditions might have been more primitive in Scotland at that time.
It is unfortunate that Nicoll's recommendations were not followed.
Acute and Chronic Theophylline Therapy in Exercise-Induced Bronchospasm
Authors: Bierman C. Warren , Shapiro Gail G. , Pierson William E. , Dorsett Carol S. 
Published: December 2021

This study examined the effectiveness of theophylline therapy in modifying exercise-induced bronchospasm (EIB) in children with perennial asthma and evaluated whether tolerance to theophylline developed with prolonged use.
Twenty-one children between 7 and 16 years of age were studied by a standardized treadmill exercise test carried out before administration of theophylline, 90 minutes after administration of theophylline, and again after three weeks of round-the-clock theophylline treatment. Changes in forced expiratory volume at one second, forced expiratory flow between 25% and 75% of vital capacity, and peak expiratory flow rate were measured before and after each exercise test.
Theophylline inhibited EIB in 20 of 21 subjects. There was considerable intersubject variation in the response to theophylline, however, ranging from complete inhibition in five subjects to no inhibition at all in one subject, even though theophylline controlled perennial asthma in all subjects, and all but one had theophylline levels between 10 and 22 µg/ml when tested. On repeated testing after three weeks of therapy, no tolerance developed to theophylline.
These findings suggest that EIB and perennial asthma may result from different causes and that theophylline's ability to control asthma will not predict its effect on EIB. Subjects who have severe EIB should be retested after theophylline pretreatment to evaluate the effectiveness of therapy.
Leigh's Encephalomyelopathy in a Patient With Cytochrome c Oxidase Deficiency in Muscle Tissue
Authors: Willems J. L. , Monnens L. A. H. , Trijbels J. M. F. , Veerkamp J. H. , Meyer A. E. F. H. , van Dam K. , van Haelst U. 
Published: December 2021

A patient is described with subacute necrotizing encephalomyelopathy proven by autopsy. A slight increase of blood pyruvate and lactate levels with an increased lactate/pyruvate ratio and frequently increased β-hydroxybutyrate/acetoacetate ratio suggested a disorder of mitochondrial oxidation.
A cytochrome c oxidase deficiency was shown in peripheral muscle tissue with some residual cytochrome c oxidase activity in heart muscle. Normal cytochrome c oxidase activity was present in liver tissue. Because of the markedly higher levels of pyruvate and lactate in CSF compared with blood and an increased lactate/pyruvate ratio in CSF, there may also have been defective activity of cytochrome c oxidase in brain tissue. After a period of apparently normal development, the child's clinical condition gradually deteriorated and she died at age 6 years due to respiratory insufficiency. This study illustrates the fact that Leigh's disease is not linked to a single inherited molecular defect.
Hospital-Based Group Practice and Comprehensive Care for Children of Indigent Families
Authors: Ullman Ralph , Kotok David , Tobin James R. 
Published: December 2021

The replacement of a community hospital's pediatric outpatient clinics with a physicians' group practice is described, and the effects of this development on the receipt of services by children of indigent families are analyzed. An expanded patient population, frequent telephone utilization, decreased emergency room use, and satisfactory parental perceptions are found. A comparative measure of effectiveness is obtained from a record review of the preventive care received by infants delivered by the hospital's staff obstetricians. The latter data show the group practice to be more successful than the clinics in initiating and maintaining well-child care in its facility, and in achieving the timed completion of immunizations and screening procedures.
The experience indicates an acceptance by low-income families of an outpatient service that emphasizes the physician-patient relationship with limited use of outreach services and nonphysician providers. It also indicates that such a system of care can be provided to a heterogeneous patient population within the same facility.
Complement Activation and Group B Streptococcal Infection in the Newborn: Similarities to Endotoxin Shock
Authors: Fenton Lawrence J. , Strunk Robert C. 
Published: December 2021

Serial measurements of CH50, C3, C4, and factor B were performed on three newborn infants with group B streptococcal sepsis. Two of the septic infants had a colonized but noninfected identical twin. All three infants with group B streptococcal sepsis had hypotension, prolonged coagulation times, neutropenia, and respiratory failure. During the course of the sepsis, factor B was depressed 30% to 35%, C3 was depressed 40% to 60%, and CH50 was depressed by 100% when compared to their cord blood levels. Two of the infants also had a 50% to 70% depression of C4. In contrast, no significant decrease in complement levels occurred in the siblings of the twins or in two additional control infants.
These data are characteristic of older patients with Gramnegative sepsis and strongly suggest that the group B Streptococcus has endotoxin-like properties.
Childhood Cancer and the Jehovah's Witness Faith
Authors: Frankel Lawrence S. , Damme Catherine J. , Van Eys Jan 
Published: December 2021

The argument here, however, is not that these patients prove that transfusions need be given less frequently, because that would constitute a post hoc justification on medical grounds of what was an ethical decision.
The final decision to abide by or try to override a patient's wishes must rest with the physician, who alone can perceive the unique needs and sensitivities (both medical and emotional) of his patient. The tendency often is to downplay the emotional needs and excessively magnify the medical needs. This group of patients constitutes a challenge to bring the issues into sharp focus and into true perspective.
Triglyceride Levels After Intralipid Infusion in Children With Cystic Fibrosis
Authors: Allué Xavier , Sanjurjo Pablo 
Published: December 2021

Infusions of soybean oil emulsion (Intralipid) have been reported to correct essential fatty acid (EFA) deficiency in patients with cystic fibrosis of the pancreas (CF).1 The Intralipid dosage used by Elliot1 was 2 gm/kg of body weight given over a period of four hours. This article reports the immediate effects of Intralipid infusion in patients with CF in an attempt to ascertain through biochemical data whether the use of Intralipid at the reported dose is free of untoward effects.
MATERIALS AND METHODS
Six patients with CF were placed in a protocol that called for periodic infusions with soybean oil emulsion containing EFAs.
Food additives and hyperkinesis: Are there nuts among the berries?
Authors: Bierman C. Warren , Furukawa Clifton T. 
Published: December 2021

In this issue of Pediatrics, two studies focus on the subject of food additives and hyperkinesis. They represent a scientific approach to a current pediatric dilemma: Do food additives cause children to be hyperactive? Unfortunately, concerns about additives and hyperkinesis developed as a result of feelings, beliefs, fads, and emotions and had little to do with science.
At the annual meeting of the American Medical Association in June 1973, Dr. Benjamin F. Feingold presented a paper correlating children's hyperactivity with their consumption of food additives such as artificial flavors, colors, and preservatives, as well as natural salicylates. He claimed that 30% to 50% of children that he treated with special additive-free diets had striking behavioral improvement.
Pericarditis in Juvenile Rheumatoid Arthritis
Authors: Pearl William 
Published: December 2021

I read with interest the excellent article by Yancey et all1 reviewing their experience with pericarditis in juvenile rheumatoid arthritis. I have a patient who has been followed up much longer than their patients, and unlike their patients, did develop constrictive pericarditis as a late complication of juvenile rheumatoid arthritis.
The patient is a 19-year-old white man who is known to have had juvenile rheumatoid arthritis since 12 years of age. Although acute pericarditis was never diagnosed, at 17 years of age he came to the hospital complaining of shortness of breath, increasing abdominal girth, and a weight gain of 15 lb (6.8 kg) in one week.
THE FIRST ENGLISH ACCOUNT OF APNEIC ATTACKS IN THE NEWBORN INFANT (1799)
Authors: C. T. E. 
Published: December 2021

Michael Underwood (1737-1820), the most advanced writer on diseases of children in the eighteenth century, gave the first English account of apneic attacks in the newborn infant in the fourth edition of his Treatise on the Diseases of Children (1799).
He wrote:
Mr. Hey, senior surgeon to the Infirmary at Leeds, ... reports that an infant born at the full time lay moaning and languid for four or five hours, and was then seized with a fainting fit: in which it continued for half an hour. In this state Mr. Hey found it. It had ceased to breathe except now and then giving a gasp, or sob, and was as pale as a corpse. There was however a sensible pulsation of the heart though feeble and slow, but whether the circulation had been kept up all the time previous to his visit could not be ascertained. As soon as Mr. Hey had time to consider the case he directed the infant's nostrils and temples to be stimulated with the volatile alkali, and when it became capable of swallowing, a few drops of the tinctura valerian. volat. were administered in a teaspoonful of water and repeated at proper intervals; it likewise took a teaspoonsful of the ol. ricini [castor oil].
The child had three other similar attacks in the course of the day, though it had slept composedly between whiles and sucked at the breast. It had seven more fainting fits in the night, two of which were severe ones; but Mr. Hey was not called again till the next morning.
PEDIATRIC PSYCHOPHARMACOLOGY
Authors: Haggerty R. J. 
Published: December 2021

In this issue the editors conclude a two-part special section. Of the five papers in the second part, four center on conduct disturbances. Conduct disturbances have not received the attention that their high prevalence rate and poor prognosis merit, despite the fact that they are probably also the most common reason that psychotropic drugs are prescribed for children and adolescents.
The first paper is a useful review which concludes with a pilot study that is of interest because it adds to our knowledge of the place of lithium in child psychiatry.
The second paper reports an interesting serendipitous observation arising out of a study of depressed children. While in some cases depression may present as conduct disorder, and therefore respond to antidepressant medication, this study suggests the possibility of an independent role for antidepressant drugs in conduct disorder.
The next paper is a short report on the use of a new drug (or a new use for an old drug) propranolol in rage reactions in brain-damaged patients. All three of these studies, however, are uncontrolled or otherwise methodologically flawed. This is justifiable only in pilot studies such as these, which must be taken only as signposts to future possibilities of the use of pharmacologic agents in behavior disturbances.
PRAGMATIC ATTITUDES IN THERAPEUTIC TRIALS
Authors:   Student
Published: December 2021

. . . most therapeutic trials are inadequately formulated, and this from the earliest stages of their conception. Their inadequacy is basic, in that the trials may be aimed at the solution of one or other of two radically different kinds of problem: the resulting ambiguity affects the definition of the treatments, the assessment of the results, the choice of subjects and the way in which the treatments are compared . . . .
Consider a trial of anti-cancer treatments in which radiotherapy alone is to be compared with radiotherapy preceded by the administration of a drug which has no effect by itself but which may sensitise the patient to the effects of radiation. Suppose the drug is to be administered over a 30-day period. The "radiotherapy alone" group may then be handled in two different ways: (a) radiotherapy may be preceded by a blank period of 30 days, so that it is instituted at the same time in each group; (b) radiotherapy may be instituted at once, thereby carrying it out at what is most probably the optimal time.
Neither procedure can be said to be "better" than the other. The first allows us to compare two groups which are alike from the radiotherapy point of view and which differ solely in the presence or absence of the drug. It therefore provides an assessment of the sensitising effect of the drug and gives valuable information at a biological level. The second procedure enables us to compare two treatments under the conditions in which they would be applied in practice.
‘Red Book’ Update
Authors: Fulginiti Vincent A. , Brunell Philip A. , Cherry James D. , Ector Walton L. , Gershon Anne A. , Gotoff Samuel P. , Hughes Walter T. , Mortimer Edward A. , Peter Georges , Plotkin Stanley A. 
Published: December 2021

UPDATE
The Red Book Committee met on May 10, 1982 and considered a number of issues, including:
1. The 1982 edition (19th) of the Red Book has been distributed beginning on June 4, 1982. We welcome comments and suggestions for the 20th edition.
2. IMPORTANT REVISION IN RED BOOK RECOMMENDATIONS: After the Committee meeting it came to our attention that three children who had anaphylactoid reactions to egg ingestion experienced immediate allergic reactions to chick-embryo-grown live measles virus vaccine; two had difficulty breathing and one had hypotension. Persons who are egg-allergic but do not have a history of anaphylactoid reactions appear to be at little or no risk from live measles virus (LMV) vaccine (See Morbidity Mortality Weekly Rep 31:217-231, May 7, 1982). Because previous experience indicated no adverse reactions in egg-allergic children given vaccine prepared in chick embryo tissue culture, the 1982 Red Book contains the following statement:
The vaccine currently used in the United States is prepared in chick embryo tissue culture by inoculation with a further attenuated passage of the Edmonston B strain of measles virus. This preparation is virtually devoid of allergenic substances derived from the chick embryo cell cultures used for growth of the live vaccine viruses. However, there is a remote potential risk of hypersensitivity reactions in patients allergic to eggs, chicken, or chicken feathers; large scale use of the vaccine for more than a decade has resulted in only rare, isolated reports of minor allergic reactions. In a study in which children known to be allergic to eggs, chicken, or chicken feathers were vaccinated with a chick embryo cell culture-derived vaccine, no allergic reactions were observed.
Letter to the Editor
Authors: Block Stanley Hoyt 
Published: December 2021

Bourgeois, Dodson, and Ferrendelli appropriately list additional reported interactions between isoniazid and primidone; isoniazid and certain barbiturates; nicotinamide and primidone; and nicounamide and carbamazephine. These are in addition to the interaction mentioned in my recent report in Pediatrics (69:494, 1982) between isoniazid and carbamazepine. These reports should serve as warning that the levels of several anticonvulsant drugs can be altered when other medications (such as isoniazid) are added to the regimen.
My report and the letter of Bourgeois et al emphasize that this can be a clinical as well as theoretical problem.
Bilirubin Toxicity Model Questioned
Authors: Poland Ronald L. 
Published: December 2021

Levine and associates1 have produced data that confirm two well-accepted concepts. First, acutely injured tissues swell, releasing increased quantities of serum albumin into extravascular, extracellular spaces. Second, bilirubin is transported in the body extensively bound to serum albumin. These two concepts account for all of their observations. They have speculated on a "blood-brain barrier" which, in the context of their experiments seems to be nothing more complex than a semipermeable membrane.
These authors have not, however, produced evidence that supports their speculations concerning the neurotoxicity of bilirubin.
Ultrasonography in Subcapsular Hematomas of the Liver in the Newborn
Authors: MOUZARD ALAIN , COHEN JEAN YVES , HUAULT GILBERT 
Published: December 2021

French and Waldstein determined the clinical parameters associated with subcapsular hematomas of the liver in the newborn. The authors describe two cases with diagnosis made during life, but they are not precise about clinical findings. Hemoperitoneum may be due to other bleeding sites.
We have observed 19 cases of hemoperitoneum in the newborn, 16 with subcapsular hematoma of the liver and three with splenic rupture. The different etiologic factors are birth injury, prematurity with neonatal rescuscitation, particularly external cardiac massage, and epileptic mothers treated with phenobarbitone.