bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventilator-Induced Pneumoperitoneum—A Rapid Diagnosis
Authors: Chang Jack H. T. , Hernandez Jacinto 
Published: December 2021

Pneumoperitoneum found on abdominal roentgenography in the newborn usually indicates intestinal perforation. With the increased use of high pressure ventilation, pneumoperitoneum secondary to air dissecting transdiaphragmatically is being encountered with greater frequency.1-3 Accurate differentiation between respirator-associated pneumoperitoneum and perforated viscus can save the neonate a needless surgical exploration at a time when an operation is least able to be tolerated.
This report reviews our recent experience with six neonates and suggests a rapid method to differentiate a surgical from a nonsurgical cause of pneumoperitoneum.
CLINICAL DATA
Six neonates with positive pressure ventilationinduced pneumoperitoneum were encountered at The Children's Hospital, Denver, between 1976 and 1979.
Vincristine Poisoning
Authors: Barna Peter 
Published: December 2021

Vincristine is an effective and potent antileukemic agent. Its FDA-approved labeling, ie, its package insert, does not contain directions for treatment of overdose. Several recent communications1-7 report accidental overdoses whose outcome was often fatal (Table).
Although treatment is thougth to be symptomatic and supportive only,1 folinic acid (leucovorin calcium, citrovorum factor), a well-known methotrexate antidote, was used successfully by Grush and Morgan5 and Wakem and Bennett7 on overdosed patients. The treatment, on the part of Grush and Morgan, was based on a brief description of folinic acid rescue of vincristine-poisoned mice.8
Is the Study Flawed?
Authors: Forsyth Brian 
Published: December 2021

I commend Cohen and colleagues1 for taking another look at the practice of managing patients with chronic nonspecific diarrhea (CNSD) with elimination diets. However, their report proposes yet another abnormal diet for this condition and I feel that we should be sure that this treatment is truly efficacious before it is used as widely as the dietary practices which it is intended to replace.
For this reason, I wish to point out some possible serious flaws in the study presented.
Letters to the Editor
Authors: Shull Margaret W. , Dwyer Johanna T. 
Published: December 2021

Dr Dillard has interpreted our results as an attempt to show adverse effects of prolonged breast-feeding. In studying the less than 2-year-old vegetarians we found it necessary to note the effects of breast-feeding. The breastfed infants had reduced weight, but not length velocities. These velocities were compared to Harvard growth norms and a reduced weight velocity does not necessarily imply a health hazard.
What appears to be unique among this group is the extended breast-feeding and reduced weight gain velocity up to 2 years of age.
Letters to the Editor
Authors: Tinanoff Norman 
Published: December 2021

There is presently some difficulty with fluoride supplementation for a child in the first year of life. The American Academy of Pediatrics regimen for supplemental fluorides produced mild fluorosis in some subjects (Aasenden R, Peebles IC: Arch Oral Biol 19:321-326, 1974), and infant formulas may presently have variable amounts of fluorides.
See Table in the PDF File
This regimen is needed only in areas that do not have optimally fluoridated water, and when infants are ingesting commercial infant formula, no supplementation may be necessary.
Children's Blood Pressure in the United States
Authors: Blumenthal Sidney , Smith W. McFate , Tarazi Robert C. , Lauer Ronald , Jesse Mary Jane 
Published: December 2021

We have read Dr Forrest Adams' note entitled "Blood Pressure of Children in the United States" (Pediatrics
See Table in the PDF File
61:931, 1978) in which he comments on specific sections of a report of a Task Force on Blood Pressure Control in Children. Knowledge concerning the relationship between blood pressure in children and subsequent health in adult life should be of continuous interest to all pediatricians.
Dr Adams states that it is misleading to present percentile graphs of US children's blood pressures for reference because US children's blood pressures increase with age while other cultures fail to show an increase from infancy to 50 years.
On Death, Dying, and Decisions
Authors: Freeman John M. , Rogers Mark C. 
Published: December 2021

Brain death is a concept of recent concern. Formerly, death was validated when the heart stopped beating. With modern technology, such as pacemakers, ventilators, and cardiopulmonary machines able to sustain the heart, physicians and the public have become concerned about prolonging existence after massive brain destruction. Out of this concern came the concept of "death with dignity" and the "right to die."
Since cardiac transplantation required a viable heart, and since the brain was found to be the key to "meaningful existence," a new definition of death was derived. That definition included "sufficient damage to the brain that it would not recover."
Letters to Editor
Authors: Greydanus Donald E. , McAnarney Elizabeth R. 
Published: December 2021

We thank Dr Emans for her comments and compliment. We shall address the two issues raised: oligomerorrhea and sickle cell trait.
Many relative and absolute contraindications to oral contraceptives were listed in our review of contraception.1 Certainly each of these difficulties deserves a careful evaluation, whether the physician is dealing with severe headaches, collagen vascular disorders, epilepsy, diabetes mellitus, or others. Irregular menstruation can be a complex process, requiring a thorough diagnostic assessment before a prescription of oral contraceptives is given.
Blood Pressure of Children in the United States
Authors: Walker Alexander R. P. , Walker B. Faith 
Published: December 2021

Professor F. A. Adams1 has criticized data published by the Task Force of the National Heart, Blood and Lung Institute,2 averring that the cross-sectional data used to produce the blood pressure standards for children "cannot define the optimal or medically normal; they only describe the status of the population at that moment in time." Adams believes that, ideally, "beyond infancy the normal aging process is unaccompanied by an increase in blood pressure."
There are many populations living primitively to whom this applies, although our experience of blacks living in very remote parts of Southern Africa is that it is only beyond adolescence, not infancy, that blood pressure does not rise significantly.
Letters to the Editor
Authors: Sassaman Edward , Mulick James A. 
Published: December 2021

The article by Vining and Freeman (Pediatrics 62:850, 1978) regarding sterilization of retarded females is a thoughtful consideration of a difficult subject. Unfortunately, we feel that the authors have oversimplified several issues and thereby created more confusion among practicing pediatricians.
First, it is a debatable value judgment to say that sexuality and menstruation in a retarded female is undesirable or abnormal. Normalization is what we in developmental pediatrics want for our patients. It is contradictory, therefore, to maintain that routine physiologic functions are abnormal.
Letters to Editor
Authors: Freeman John M. , Vining Eileen P. G. 
Published: December 2021

We are delighted to respond to the letter concerning "Sterilization and the Retarded Female" (Pediatrics 62: 850, 1978). If we provoke thoughtful debate we will have partially accomplished our purpose.
Several points from our commentary require emphasis, because they have been misunderstood by the correspondents.
1. It is imperative that the "retarded" not be lumped, but must be evaluated individually on the basis of functional skills, IQ, and total environment. What is appropriate for those with higher levels of function may not be appropriate for those with very low function.
Is the Fluorometric Method for Blood Bilirubin Accurate?
Authors: Cembrowski George , Garber Carl C. 
Published: December 2021

The article by Brown et al1 interested us greatly. Direct fluorometric measurement of whole blood bilirubin, if accurate and precise, will help in the care of the jaundiced neonate. The accuracy and precision of this technique, however, cannot be readily assessed from the authors' data.
Consider the comparison of the fluorometric method to the Jendrassik-Grof method for total bilirubin. To assess accuracy, the authors use the correlation coefficient, r, and the slope of the linear regression line through the method comparison data. There are two problems with this data analysis.
CHARLES DICKENS DESCRIBES THE FEELINGS OF THE MOTHER OF A MENTALLY RETARDED CHILD
Authors: C. T. E. 
Published: December 2021

Disease played a considerable part in the novels of Dickens. He looked on disease with the observing eye of the astute clinician, and recorded faithfully what he saw and what was told to him.1
A strikingly sensitive passage in Dickens' Barnaby Rudge is the following description of the feelings of Mrs Rudge toward her mentally retarded son.2
Two-and-twenty-years. Her boy's whole life and history. The last time she looked back upon those roofs among the trees, she carried him in her arms, an infant. How often since that time had she sat beside him night and day, watching for the dawn of mind that never came; how had she feared, and doubted, and yet hoped, long after conviction forced itself upon her!...
His older childhood, too; the strange imaginings he had; his terror of certain senseless things—familiar objects he endowed with life; the slow and gradual breaking out of that one horror, in which, before his birth, his darkened intellect began; how, in the midst of all, she had found some hope and comfort in his being unlike another child, and had gone on almost believing in the slow development of his mind until he grew a man, and then his childhood was complete and lasting...
Getting the Most Out of the Periodic "Checkup"—The View from Canada
Authors: Goldbloom Richard B. 
Published: December 2021

How often should noncomplainant, ostensibly healthy North Americans of all ages be medically examined? By whom? What procedures should the examination include? Does the yield of improved health justify the cost and effort, and does each maneuver included in the examination result in more good than harm?
The questions are not new. Many of the answers have been suggested previously, and some are mindlessly presumed. However, a task force commissioned by Canada's Department of Health and Welfare has recently taken a long, hard look at these questions. The published report of their findings and recommendations1 is important because it reflects a new and useful approach to providing rational, appropriately qualified answers that serve the best interests of everyone's health.
The Taboo Zone
Authors: Jelliffe Derrick B. , Jelliffe E. F. Patrice 
Published: December 2021

The recent letter by "Perplexed Observer" (Pediatrics 65:369, 1980) opens up the taboo zone that exists in pediatrics—or, indeed, in any other aspect of medicine. Discussion of the ethics of the interaction between the infant food1 (or pharmaceutical) industries2,3 and the health profession is not considered "nice"—nevertheless, it exists.
Pediatricians in the United States will react strongly and negatively to the suggestion that they have been "bought off" by the infant food and pharmaceutical industries. Yet how mant of us at various stages of our careers have been subtly "influenced off" or "muted off"—very often without being aware of it—by means of various forms of "manipulation by assistance," leading to "endorsement by association."4,5
Letters to the Editor
Authors: Crook William G. 
Published: December 2021

I appreciate the comments of Dr Marino and Dr Altenburger; and I agree with Dr Marmno that a significant part of the advances in medicine ("from the realm of magic to that of science") have taken place because accepted scientific methods, including double-blind studies, have been carried out which have confirmed (or rejected) impressions gained from anecdotal data.
I can also understand how Dr Altenburger would be "disappointed" that the editors of the official publication of the American Academy of Pediatrics would choose to publish what he feels to be an "unscientific" commentary.
ON THE IMPORTANCE OF LANCING THE TEETHING INFANT'S GUMS, AS VIEWED IN 1857
Authors: C. T. E. 
Published: December 2021

John Arbuthnot (1667-1735),1 physician to Queen Anne, claimed that "above a tenth part of Infants die in Teething by Symptoms proceeding from the irritation of the tender parts of the Jaws." He, along with many others, including Ambroise Paré (1510-1590),2 recommended lancing the gums in difficult cases.
The same recommendation was found in many American medical journals well into the nineteenth century, as is evident in this quotation published in 1857.3
The principal thing in the treatment of these cases, is to lance the gums freely. A superficial incision will be of no avail; the gums must be cut down until the lancet impinges on the approaching tooth. The only caution required, is that the incision be inclined outwards, in order to avoid the tissues which connect the permanent and temporary teeth. . . . The operation requires considerable skill and caution to ensure its safe and effectual performance. The terrors of the mother and the restlessness of the infant, frequently render it by no means an easy operation; and the careless operator is apt to wound either the cheeks or tongue, to make the incisions too superficially to be of the slightest use.
The prejudices of former writers against this invaluable operation scarcely require comment; but as we still find a few, and we are happy to say a very few individuals, who retain a bigoted faith in the absurd dogmata of their forefathers, we will briefly refer to the objections which have been urged against the utility of lancing the gums.
A NEW METHOD OF RESUSCITATING STILLBORN CHILDREN AS DESCRIBED BY A NEW YORK PHYSICIAN IN 1814
Authors: C. T. E. 
Published: December 2021

The treatment of asphyxia neonatorum was rarely mentioned in American medical literature until the second half of the last century. A few anecdotal papers were published in the early 1800's, including one by Dr. Gilbert Smith, Physician and Surgeon to the New York Almshouse. His "new method" was described as follows1:
About three years since I was called upon to attend a lady with her first child; it being a breech presentation, the labor was of course tedious and the head was retained such an unusual length of time after the body was delivered, that, apprehending the most serious consequences, I directed a warm bath to be in readiness, into which the child was placed immediately after delivery. At this time there was no pulsation in the chord [sic], or the smallest sign of life. Its legs and spine were frequently rubbed with stimulating applications, which I was assiduously employed in endeavoring to excite action in the lungs by breathing into them, and pressing out the air alternately. This process was carried out for the unprecedented period of two hours, when my strength failing, I was upon the point of discontinuing any farther effort as useless; when one of the attendants, by whose importunity I was, perhaps, induced to persevere for such a length of time, proposed by taking some brandy and water; after having drank, I resumed my labors, when the idea forcibly struck me that the alcohol might be volatilized by the heat of the mouth and breathed into the lungs.
Minibikes
Authors: Van Rooy C. W. 
Published: December 2021

Minibikes—which are basically miniature motorcycles—are being bought for and ridden by children who are too young to be permitted to obtain a driver's license. Because the increasing use of minibikes by young children is accompanied by an increase in minibike-related accidents, pediatricians should become aware of the accident potential of these vehicles and precautions to be taken by the parents or other care-givers of young riders.
Rivara and Berger1 found that minibike riders received 20,000 injuries from 1975 to 1976. Children 5 to 9 years old accounted for 83% of these injuries, and children 10 to 14 years old accounted for 17%.
Who Will Buy?
Authors: Hoekelman Robert A. 
Published: December 2021

In the late 1960s Henry Silver1 and his colleagues in Colorado, recognizing a then current shortage of physicians available to provide health care to children, developed educational programs to prepare two new types of child health professionals—the pediatric nurse practitioner and the child health associate.
The pediatric nurse practitioner model has been replicated throughout the United States. By mid- 1980 there were in operation 53 graduate and continuing education programs to prepare nurses to assume an expanded role in the provision of health care to children, and an estimated 4,000 to 5,000 nurses have been so prepared (M. K. Willian, personal communication, July 1980).
‘Negligible Results of Early Intervention’
Authors: Holm Vanja A. , Robinson Nancy M. , Sells Clifford J. 
Published: December 2021

We are writing to express our concern about the lead article in the March issue of Pediatrics (65:463, 1980), which reported the negligible results of a program of early intervention with Down syndrome infants.1 The topic of infant programs is a controversial one on which valid scientific information is scarce. This report might be used as proof that early intervention with handicapped children is ineffective.
The authors discuss some of the weaknesses of their study.
Early Beikost
Authors: Sullivan Cary E. 
Published: December 2021

Before the report of the Committee on Nutrition (Pediatrics 65:1178, 1980) settles into unquestioned orthodoxy, I wish to comment for myself and, perhaps, other die-hard empiricists on the matter of "early" beikost.
Given a caloric need of 115 calories per kilogram and a weight of 5 kg, a 2-month-old infant on 26 oz of proprietary formula is already incurring a caloric shortfall and registering his deprivation in no uncertain terms. My practice, at this point, is to introduce cereals and, sequentially over the next several months, fruits and vegetables.
THE SAD FATE OF DR MICHAEL UNDERWOOD'S WIDOWED DAUGHTER
Authors: C. T. E. 
Published: December 2021

The most advanced writer on diseases of children in the 18th century, according to G. F. Still, was Michael Underwood.1 He was the first to describe sclerema neonatorum, apneic attacks in the newborn, "malignant familial jaundice" of the newborn, and the first to write about congenital heart disease of children. His Treatise on the Diseases of Children (1784) passed through at least 17 editions and remained in favor for more than 60 years; the last American edition appeared in 1842.
Unfortunately, Underwood apparently received no royalties from his textbook and died without being able to provide for his widowed daughter. Friends tried to help her by putting together a book entitled Extracts from the Diary of the Late Michael Underwood, M.D. (1823) that would then be sold to subscribers.
In the prospectus for this book Underwood's friends poignantly described their reasons for publishing this book as follows:
It is confidently hoped that the Friends of the late Dr Underwood, and more especially those in the Profession who are acquainted with the estimable works which he published on the "Diseases and Disorders of Children" &c. will feel an interest in the case of his widowed Daughter, who now stands in need of the benevolent exertions of her Friends. She is in her fiftieth year, and is borne down by an accumulation of troubles, arising partly from the loss of relatives and friends, and partly from serious mental debility, which frequently incapacitates her for the humble and precarious employment of needlework, in which she is at other times engaged.
The Private Worlds of Dying Children by Myra Bluebond-Langner. Princeton, Princeton University Press, 1978, $12.50, 282 pp
Authors: Wessel Morris A. 
Published: December 2021

These quotations from Myra Bluebond-Langner's perceptive study of 40 leukemic patients between the ages of 3 and 9 reveal that even when adults hope to protect children from the tragic truth, they acquire accurate knowledge about their disease, its treatment process, and fatal prognosis.
The author, an anthropologist interested in how children acquire the knowledge and values of the adults in the world they live in, believes that all young patients learn in various ways of the seriousness and the anticipated outcome of their illness.
Hypersensitivity Vasculitis Presenting as Suspected Child Abuse: Case Report and Literature Review
Authors: Waskerwitz Steven , Christoffel Katherine K. , Hauger Sarmistha 
Published: December 2021

As awareness of child abuse and neglect increases, children with medical causes for their presenting problems may, on occasion, be initially diagnosed as victims of suspected child abuse. Although a review of the Index Medicus from 1970 to 1978 revealed only two reports of this type of misdiagnosis,1,2 we suspect it occurs frequently. This report describes a child who initially was thought to be battered, but who, in fact, had a vasculitis unrelated to his social problems.
CASE REPORT
H.P., a 2½-year-old black boy, was seen at the Wyler Emergency Room with unexplained "swelling and bruising all over his body." He was accompanied by his father who appeared intoxicated and gave a changing and confusing history.
The 55 Miles per Hour Maximum Speed Limit
Authors: Holroyd H. James , Garrettson Lorne K. , Greensher Joseph , McIntire Matilda S. , Krassner Leonard S. , Chi Wing Ng Raymond , Overbach Avrin M. , Rumack Barry H. , Widome Mark D. , Armstrong George D. , l'Archeveque Andre , Otherson H. Biemann 
Published: December 2021

When the 55 mph national speed limit became a law in 1973, the first significant reduction in the number of highway deaths in this country occurred. When this speed limit has been maintained, the number of automobile accident fatalities and injuries has continued to decrease. However, recent statistics1 indicate that the legal speed limit is again being exceeded, and the number of automobile accidents are again beginning to rise.2-4 The United States is in the midst of a worse energy crisis than the one which prompted the enactment of the 55 mph speed limit in 1973, and we should be more aware of attempts to save energy as well as save lives.
The Committee published comments on the incidence of mortality and morbidity in automobile accidents and the speed limit in its 1975 and 1976- 1977 newsletters.5,6 Because of recent statistics, the Committee wishes to reemphasize its previous statements.
The Committee strongly endorses the national, maximum speed limit of 55 mph as an effective method of lowering the incidence of automobile accidents, injuries, and fatalities. Pediatricians should make every effort to reinforce this form of accident prevention by personal example and by education of pediatric patients and their parents.