bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Pediatrician and Genetic Screening (Every Pediatrician a Geneticist)
Authors:   AAP Task Force on Genetic Screening
Published: December 2021

From time to time, the American Academy of Pediatrics has issued statements1-3 on the role of screening infants for certain types of hereditary disease. Although these statements remain valid in their broadest objective, some of the specific ways and means have altered with the passage of time. Moreover, society is now more concerned about genetic screening as a public endeavor with a potential not only for good but also for harm. There has been much debate about genetic screening-some of it informed, some of it emotional. In response to the growing concerns about genetic screening, the National Academy of Sciences (NAS) published a comprehensive report on the topic.4 Its recommendations are published as an Appendix to this statement. The American Academy of Pediatrics has convened a Task Force to consider the specific implications of the NAS report and its relevance for pediatricians and their associates. The Task Force's most important recommendation is that a standing committee be established to provide expert, ongoing advice on this pervasive and complex subject.
DEFINITIONS AND RATIONALE
Screening in the medical context can be informally defined as an investigation initiated for reasons other than in response to a patient's problem or request for help. The formal definition3-7 considers screening as "the presumptive identification of unrecognized disease or defect by the application of tests, examinations or other procedures which can be applied rapidly. Screening tests sort out apparently well persons who probably have a disease from those who probably do not." The screening may be large-scale, and encompass a whole population (mass screening); or it may be selective and directed at a high-risk subgroup.
Helpful Hint From a Sage
Authors: Lightwood Reginald 
Published: December 2021

Most pediatricians question the wisdom of random use of antibiotics for upper respiratory tract infections in children. However, there are still many physicians who make routine recourse to such treatment, perhaps without awareness that most upper respiratory tract infections are viral illnesses unaffected by antibiotic treatment.
The results and conclusions by Soyka et al.1 provide good evidence. Their conclusions are that "Indiscriminate antibiotic therapy cannot substitute for proper diagnostic evaluation of the patient who may have a bacterial or, far more likely, a viral illness."
The American Board of Pediatrics: Reflections on its mission
Authors: Brownlee Robert C. 
Published: December 2021

The American Board of Pediatrics has undergone monumental changes during the 25 to 30 years that I have been in pediatrics. From a small group, almost self-perpetuating, operating out of John and Nora Mitchell's den in suburban Philadelphia, this organization has become a complex force affecting child care the world over.
In the early days, examiners brought their own case materials for use at Board examinations. You may have heard the story of Professor Horton Casparis, then department chairman at Vanderbilt, who brought records of a patient whose X-ray films of the chest resembled tuberculosis. The child was not ill and nobody, including Casparis, ever made a correct diagnosis.
Premature Commercialism
Authors: Rowe Jonelle C. , Belenky David A. , Flanagan William J. 
Published: December 2021

We agree with Stein and Shannon1 who concluded in the May 1975 issue that continuous analog recording of respiration and heart rate in the premature infant has investigational value beyond that of conventional apnea monitoring.
It is most unfortunate that commercial interests have plunged prematurely into the area. We were surprised and disturbed by the advertising enclosure that we received with a reprint of Stein and Shannon's article, which itself was marked "Compliments of Clinical Data, Inc."
Dr. Janeway and American pediatrics
Authors: Smith Clement A. 
Published: December 2021

Most readers of this journal need no commentary to tell them that Charles A. Janeway has contributed much to American Pediatrics. But they may not realize the full extent of those contributions, nor that they began nearly 40 years ago.
Pediatricians old enough to have been in training or practice in the late 1930's will surely never forget the advent of the sulfonamide drugs. Dr. Janeway, then a Research Fellow and Harvard Medical School Instructor in Bacteriology and Infectious Diseases, was a young yet well-trained authority on these amazing new tools. But even while his expert counsel on chemotherapy and the still newer antibiotics continued to be in demand at the Children's Hospital in Boston and by the medical world at large through review articles and postgraduate courses, we turned to him only a few years later for guidance on another broad advance, made possible by the separation and purification of the blood proteins.
Microcephaly in a Normal School Population
Authors: Sells Clifford J. 
Published: December 2021

Heights, weights, and head circumferences were obtained on 1,006 students, ages 5 to 18 years, attending regular classes in four schools in a suburban Seattle school district. From the 1,006 students initially examined, 19 (1.9%) had a head circumference two or more standard deviations below the mean for age and sex.
Intelligence quotients and academic achievement scores were obtained on these children and compared with normal controls. No significant difference was found between mean IQs of the study subjects and the controls (99.5 vs. 105), but mean academic achievement scores were significantly lower in the study subjects (49 vs. 70; P &lt; .001). In addition, although mean IQs were not significantly different between those subjects whose head circumference was proportional and those whose head circumference was relatively small, mean academic achievement scores were significantly higher (60 vs. 39; P &lt; .02) in those subjects whose head size was proportional.
ON THOMAS ARNOLD, THE CELEBRATED HEADMASTER OF RUGBY SCHOOL, AND HIS VIEWS ON THE EDUCATION OF BOYS
Authors: C. T. E. 
Published: December 2021

Thomas Arnold (1795-1842), Mathew Arnold's father, served as headmaster of Rtigby School from 1828 until 1841. During his stiperintendence Rugby attained a widespread reputation as a place of intellectual, moral, and religiotis discipline, where healthy characters were formed, and young men were trained for the duties, struggles, and responsibilities of life.
Lytton Strachey in his Eminent Victorians1 writes as follows about Arnold's ideas of education:
He was convinced of the necessity for reform. But it was only natural that to one of his temperament and education it should have been the moral rather than the intellectual side of the question which impressed itself upon his mind. Doubtless it was important to teach boys something more than the bleak rigidities of the ancient tongues; but how much more important to instil into them the elements of character and the principles of conduct! His great object, throughout his career at Rugby, was, as he repeatedly said, to "make the school a place of really Christian education." To introduce "a religious principle into education," was his "most earnest wish," he wrote to a friend when he first became headmaster; "but to do this would be to succeed beyond all my hopes; it would be a happiness so great, that, I think, the world would yield me nothing comparable to it." And he was constantly impressing these sentiments upon his pupils. "What I have often said before," he told them, "I repeat now: what we must look for here is, first, religious and moral principle; secondly, gentlemanly conduct; thirdly, intellectual ability."
Morbidity of Childhood Near-Drowning
Authors: Peterson Bradley 
Published: December 2021

An assessment of morbidity in near-drowning was made from a review of emergency room and hospital records of 72 patients, ages 9 months to 20 years, who suffered near-drowning during the period January 1972 through June 1974. Fifteen patients (21%) evidenced severe anoxic encephalopathy; the remainder had no detectable neurologic deficits. Hypoxemia was demonstrated in 56 patients. Severe acidosis was not present unless respiratory failure occurred. Neither electrolytes, red blood cell hemolysis, nor cardiac arrhythmias presented a problem. Respiratory complications included pulmonary edema, aspiration pneumonia, atelectasis, shock lung, pneumothorax, and pneumomediastinum.
All children requiring cardiopulmonary resuscitation in the emergency room suffered anoxic encephalopathy. The occurrence of seizures, fixed and dilated pupils, flaccid extremities, and lack of response to deep pain in the emergency room had almost universal correlation with resultant severe anoxic encephalopathy, as did a submersion period of six or more minutes.
The morbidity of near-drowning is significant with regard to the number of children affected and the severity of the central nervous system insult received. The statement by the American Heart Association that resuscitative efforts in children should be continued for periods longer than ten minutes needs reevaluation, since neurologic recovery did not occur in any child requiring cardiopulmonary resuscitation (CPR) in the emergency room. More importantly, new methods of cerebral resuscitation need to be developed and established. In short, medical personnel need to think in terms of cardiopulmonary cerebral resuscitation (CPCR) rather than in terms of CPR.
Remarks on Receiving the C. Anderson Aldrich Award
Authors: Provence Sally 
Published: December 2021

I should like to take the first few moments to express my thanks to the members of the Child Development Section of the American Academy of Pediatrics for this honor. I can think of no recognition of my interest and work in the field that would mean as much to me as this one. Though I can no longer claim to be an up-to-date pediatrician in the treatment of physical illness, in my own mind I remain a pediatrician.
I am firmly convinced of the importance of what I call clinical child development to the practice of pediatrics. I will give an illustration of its relevance. This is a clinical observation I began to make years ago about which I have not heretofore reported, except in discussions with trainees and staff. Because of the ease of observing this phenomenon and its diagnostic implications I should like to share it with you at this time. One might call it "The Toddler's Kiss" or alternatively, phrased as a question, "Can He Pucker?"
By somewhere around 18 months the healthy, well-cared for toddler is well established in the process of giving and receiving affection. Months earlier he has learned to give a hug upon request and by 18 months most toddlers are able to purse their lips and plant a kiss on the adult's cheek. It is easy, when you have child and parents together, to determine the presence or absence of this ability. It gives you certain kinds of information about the child's development and its absence at age 2 years should lead you to ask yourself certain questions.
Remarks on Receiving the C. Anderson Aldrich Award
Authors: Parmelee Arthur H. 
Published: December 2021

I have described several coincidental changes in behavior, neuroanatomy, and neurophysiology. All reflect in some way the rapid development of cybernetic systems that permit greater control over external stimulation by suppression of extremes of reaction. The result is more organization and focus of behavior. In Figure 9, left, there is the baby the pregnant mother and expectant father dream they are going to have when their baby is born; at right is the baby they will actually get and will have to put up with until they get past the 6-week nodal point when many aspects of behavior begin to improve. Not until 3 or 4 months will they have the baby they expected at birth (Fig. 9, left).
With our knowledge of the maturational transformation of normal babies in the first 4 months, we can guarantee parents that if they can survive this period the outcome will be good. They will not fail as parents nor will the baby fail to fulfill their expectations.
Ineffectuality of Hexachlorophene Bathing Reexamined
Authors: Haley Robert W. 
Published: December 2021

In the article entitled, "Recurrence of Skin Disease in a Nursery: Ineffectuality of Hexachlorophene Bathing," Ghelbach et al.1 interpreted their data as showing that hexachlorophene (HCP) bathing was ineffective in controlling an epidemic of skin disease in their newborn nursery. Upon reexamination, however, it appears that the data contained in the article more strongly support the opposite conclusion.
The authors' paradoxical interpretation seems to have resulted from a confusion between the concepts of epidemic skin disease and asymptomatic colonization with staphylococci or group A streptococci.
Prevention of Recurrent Urinary Tract Infections in Girls
Authors: Lohr Jacob A. , Nunley Donna H. , Howards Stuart S. , Ford Raymond F. 
Published: December 2021

Eighteen girls between the ages of 3 and 13 years—with a history of at least three culture-documented episodes of bacteriuria in the previous year, but without radiologic evidence of major urinary tract abnormality—were placed on a double-blind, crossover study comparing the effectiveness of nitrofurantoin macrocrystals against a placebo in preventing the recurrence of bacteriuria. Each child was placed on a daily low dose of nitrofurantoin (1.2 to 2.4 mg/kg/day) or an identical-appearing placebo for six months. Each child was then placed on the opposite capsule for a similar period.
There were 35 episodes of bacteriuria (4.2 episodes/patient/yr) in the patients taking the placebo, which compared with a rate of 3.8 episodes/patient/yr during the year prior to the study. Only two episodes (0.2 episodes/patient/yr) occurred in the patients taking the drug. The difference in the rate of recurrent bacteriuria between the girls on placebo and on medication is significant at the 0.01 level using the Wilcoxin matched-pairs test. There were no adverse reactions to the drug.
Nitrofurantoin macrocrystals in a single daily low dose appear to be a safe, effective method of preventing recurrent bacteriuria in girls at high risk.
Postnatal Head Shrinkage in Small Infants
Authors: Williams John , Hirsch Norma J. , Corbet Anthony J. S. , Rudolph Arnold J. 
Published: December 2021

The fronto-occipital circumference, fronto-occipital and biparietal diameters, degree of suture overriding, and weight were measured daily during the first week of life in 50 infants of birth weight under 2,000 gm. In a second similar group of 21 infants, fronto-occipital circumference, weight, and sodium balance were measured daily during the first week of life. Head volumes were estimated from the circumference and diameters of the head.
The parameters of head size and derived volumes changed maximally and significantly in the direction of intracranial shrinkage around 3 days of age. The degree of shrinkage was significantly correlated (P &lt; .005) with the degree of weight and cumulative sodium losses, and decreasing gestational age.
We postulate that postnatal head shrinkage results from shift of sodium and water outward from the intracranial cavity as a transient phenomenon during the first week of life. The significance of head shrinkage is discussed.
More on T & A
Authors: Paradise Jack L. 
Published: December 2021

The treatment of three important issues relating to tonsillectomy and adenoidectomy (T & A)—(1) the essential nature of the T & A research question, (2) certain ethical requirements of clinical trials of T & A, and (3) the advisability of T & A in the light of current knowledge—in the review by Shaikh et al.1 calls for comment.
Nature of the Research Question. For health professionals concerned with the T & A problem, clarity about the scientific status of T & A is important.
Hyperthermia From Malfunctioning Radiant Heaters
Authors:   Committe on Environmental Hazards,   Committee on Fetus and Newborn,   Committee on Accident and Poison Prevention
Published: December 2021

The use of infant radiant warmers poses a hazard of neonatal hyperthermia. Serious overheating can result from mechanical failure of the controls, from dislodgment of the sensor probe, or from manual operation without careful monitoring. Deaths have been associated with hyperthermia induced by radiant warmers (reports will be published).
Therefore, when a warmer is purchased, adequacy of the safety mechanisms to prevent overheating should be given prime consideration. Radiant warmers should be used with caution and awareness of this lethal potential.
POINT OF VIEW
Authors: Postman N. 
Published: December 2021

I cannot vouch for the story, but I have been told that once upon a time, in a village in what is now Lithuania, there arose a most unusual problem. A curious disease afflicted many of the townspeople. It was mostly fatal (although not always), and its onset was signaled by the victim's lapsing into a death-like coma. Medical science not being quite so advanced as it is now, there was no definite way of knowing if the victim was actually dead when it appeared seemly to bury him. As a result, the townspeople feared that several of their relatives had already been buried alive and that a similar fate might await them-a terrifying prospect, and not only in Lithuania. How to overcome this uncertainty was their dilemma.
One group of people suggested that the coffins be well stocked with water and food and that a small air vent be drilled into them just in case one of the "dead" happened to be alive. This was expensive to do, but seemed more than worth the trouble. A second group, however, came up with an inexpensive and more efficient idea. Each coffin would have a twelve-inch stake affixed to the inside of the coffin lid, exactly at the level of the heart. Then, when the coffin was closed, all uncertainty would cease.
There is no record as to which solution was chosen, but for my purposes, whichever it was is irrelevant. What is mostly important here is that the two different solutions were generated by two different questions.
Bullous Pemphigoid in Infancy: A Case Report
Authors: Gould William M. , Zlotnick David A. 
Published: December 2021

Bullous pemphigoid occurs rarely in children. Bean and Jordan1 found only eight cases reported as of 1974 and the youngest of these patients was 2 years of age. Presented here is the case of a 3½-month-old infant who developed this disease.
CASE REPORT
A 3½-month-old boy developed a progressively spreading bullous eruption (Fig. 1 and 2). Within a week the hands and feet were covered with large, tense bullae lying on a base of erythema, and scattered vesicles appeared on the back of the neck, the trunk, and the rims of the ears. There were no oral lesions. The child was fussy and irritable but had no fever.
Case Reports Are Valuable
Authors: Shaw Edward B. 
Published: December 2021

The excellent case report "Mucocutaneous Lymph Node Syndrome (MLNS) in the Continental United States" by Goldsmith et al. (Pediatrics 57:431, March 1976) is an example of the importance of the report of a single case. This should alert others to this syndrome in their own practices.
I am reminded of a note by Roger Lee1 in 1952: "Are three cases enough to make a series? Parenthetically I have a fondness for the carefully reported single case, which in the days before mass production was a feature of a medical journal .... a series of three cases leads to statistical atrocities and aberrations and deductions."
Drug Toxicity From Breast Milk?
Authors: Mortimer Edward A. 
Published: December 2021

Recently I was consulted about a 3-month-old girl with a curious but distinct story of irritability, excessive crying, and disturbed sleeping patterns of five days' duration. These phenomena represented a striking change from her normal behavior. There were no other symptoms, and she was feeding normally at breast. Examination by her pediatrician on the second or third day of the episode yielded no abnormal findings.
On close questioning it turned out that a day or so before onset of these symptoms in the infant a long-acting oral decongestant had been prescribed twice daily for the mother because of allergic rhinitis.
Role of the Nurse in Peripheral Vein Needle Replacement
Authors: Babson S. Gorham , Benda Gerda I. , Shenai Jayant P. 
Published: December 2021

We agree with Taeusch and Heafitz in their letter to the editor (Pediatrics 57:977, June 1976) that total or near total parenteral nutrition can be given through needles placed in peripheral veins for weeks and even months. Whether one uses the "Usher" needles or the "butterfly" model, the success in maintaining infusions depends on the ability and availability of the operator.
In the NICC at the University of Oregon Health Sciences Center, neonatal nurses have had the responsibility of maintaining peripheral intravenous infusions in both medical and surgical infants for nearly ten years, involving several thousand neonates referred for critical care.
Regional Obstetric Anesthesia and Newborn Behavior
Authors: Fanaroff Avroy A. , Kennell John H. , McClelland Charles Q. , Mortimer Edward A. 
Published: December 2021

We have read the study of regional obstetric anesthesia and newborn behavior by Tronick et al. (Pediatrics 58:94, July 1976) with interest. However, we are concerned that a methodologic defect exists in the study that invalidates the conclusion that the effects of these drugs on the behavior of the infants were minimal.
The investigators excluded infants born following complicated pregnancies of various types. The problem is that they also excluded infants whose behavior after birth included Apgar scores less than 7 at one and five minutes or severe illness during the study (including seizures).
Fiberoptic Endoscopy Endorsed
Authors: Liebman William M. 
Published: December 2021

I would like to report two cases of the endoscopic removal of foreign bodies from the esophagus and stomach in addition to those reported in the article by Christie and Ament (Pediatrics 57:931, June 1976).
Both patients were girls, 2 years old. Patient 1 had ingested a quarter which remained in a fixed position on the greater curvature of the stomach for almost four weeks. Fiberoptic endoscopy under general anesthesia with the standard adult instrument (Olympus GIF-D1) demonstrated the quarter.
α1-Antitrypsin and Membranoproliferative Glomerulonephritis
Authors: Roy L. P. , Webster H. L. 
Published: December 2021

Although associations of apparently disparate diseases are worthy of reporting, the possibility of chance associations warrants examination. The report of Moroz et al. (Pediatrics 57:232, February 1976) of an association between α1-antitrypsin (α1AT) deficiency and membranoproliferative glomerulonephritis (MPGN) is such a situation.
Levels of α1AT were measured by radial immunodiffusion in eight patients with MPGN. Seven patients, including two with partial lipodystrophy, are persistently hypocomplementemic. Five have "dense deposit disease," two have subendothelial deposits with mesangial interposition, and one has not had electron microscopy study.
Why Don't American Authors Read the European Literature?
Authors: Fontaine Pr. G. 
Published: December 2021

I read with interest the article by Paxson and Brown, "Post-Traumatic Anterior Hypopituitarism" (Pediatrics 57:893, June 1976). I find, as is usual in American articles, a mistake concerning a missed reference.1 I am afraid that American authors are affected by severe blindness for European bibliography!
I'd suggest the authors read Fontaine et al.1