bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family History of Convulsions in Candidates for Immunization With Pertussis-Containing Vaccines (Diphtheria, Tetanus, Pertussis)
Authors:   Committee on Infectious Diseases
Published: December 2021

Family history of convulsions is not presently a contraindication to the use of pertussis vaccine.1,2 It was suggested in a recent report that there might be an increased risk of seizures following diphtheria, tetanus, pertussis (DTP) vaccination in individuals who have a "family history of convulsions." Unfortunately, the degree of relatedness was not specified in the questionnaire from which these results were derived.3 A subsequent questionnaire specifying relatedness only to siblings and parents also indicated an increased risk. A family history of convulsions was obtained in 17.3% and 16.7% of children who had febrile and nonfebrile convulsions, respectively, following DTP vaccine as compared with 4.8% in vaccinees who had nonneurologic complications following DTP vaccination (Centers for Disease Control, unpublished data, 1987).
The risk of seizures following DTP vaccination is approximately one in 1,750 doses. These are usually febrile seizures.4,5 Follow-up of these patients had indicated that they rarely, if ever, have sequelae.5 Convulsions of this type (DTP vaccination induced) are differentiated from encephalopathy which occurs once in about 1:140,000 doses, one third of which result in permanent sequelae.6 Recent studies have demonstrated that the administration of acetaminophen, 15 mg/kg per dose, at the time of immunization with DTP and four and eight hours later, reduces febrile reactions.7 Although this study was too small to allow determination of the effect on seizures following DTP, it is reasonable to expect that reduction in fever also would decrease the likelihood of febrile seizures following DTP.
Local pertussis epidemics in the United States occur in unpredictable fashion.
Newborn Screening for Congenital Hypothyroidism: Recommended Guidelines
Authors:   American Academy of Pediatrics,   American Thyroid Association
Published: December 2021

During the past decade newborn screening for congenital hypothyroidism has become an important health activity in most developed countries. These screening programs have not only benefited patients and their families but also have produced new information about the epidemiology, pathophysiology, diagnosis, and treatment of thyroid disease in infancy and childhood. During this period of implementation and growth of the screening programs, a variety of issues and questions arose. Some of these have been resolved, and some have not. The point has now been reached where collation of the combined experiences of the North American programs can address these issues. The reader should understand that what follows reflects current opinion and may require changes when the results of the next decade of screening are reviewed.
SCREENING METHOD
Thyroxine (T4) and Thyroid-Stimulating Hormone (TSH)
Most North American programs use a two-tiered laboratory approach. An initial T4 measurement is followed by measurement of TSH in specimens with low T4 values. In addition to detecting infants with primary hypothyroidism (low or low normal T4 level with elevated TSH value; prevalence 1:3,500 to 4,500 newborns), this approach can also identify infants with thyroxine-binding globulin deficiency and some with hypothalamic-pituitary hypothyroidism (low or low normal T4 level with normal TSH value; prevalence 1:5,000 to 10,000 and 1:50,000 to 150,000 newborns, respectively). Programs that quantify T4 values also have the option of identifying newborns with hyperthyroxinemia (1:20,000 to 40,000 newborns).
On the other hand, this approach will miss infants who have normal T4 values but elevated TSH values. Such infants are relatively commonplace in European programs where initial screening is done by measurement of TSH.
Care of Uncircumcised Penis
Authors: WATSON STAN J. 
Published: December 2021

To the Editor.—
The controversy regarding circumcision and urinary tract infections following the article by Dra Wiswell and Roscelli has not addressed one important factor—what kind of care is appropriate for the uncircumcised boy. After 40 years of pediatric practice, I am firmly convinced that the best hygiene is to keep hands off and leave the prepuce alone. I have had many infants with problems fro inadequate and poorly done circumcisions; similarly, I have had many uncircumcised infants who got into trouble when a "helpful" nurse, doctor, or grandmother forcibly retracted and cleaned a tight prepuce.
Dr Glueck and Co-Authors' Letter of Withdrawal
Authors: GLUECK CHARLES J. , LASKARZEWSKI PETER , MELLIES MARGOT J. , PERRY TAMMY 
Published: December 2021

To the Editor.—
Our paper (Pediatrics 1986; 78:338) was seriously flawed by unintentional errors, which we profoundly regret. The committee that reviewed the patient charts found errors and inconsistencies in our use of some of the lipid data but not the height and weight data. When we corrected the errors, they were found to be nonsystematic and random. The clarified data led to the same conclusion as the original paper: long-term therapy with cholesterol-lowering diet and/or bile acid-binding resin did not affect normal growth and development in children.
Annual Summary of Vital Statistics—1986
Authors: Wegman Myron E. 
Published: December 2021

Data from this article, as in previous reports,1 are drawn principally from Monthly Vital Statistics Report, published by the National Center for Health Statistics (NCHS).2-6 The international data come from the Demographic Yearbook7 and the quarterly Population and Vital Statistics Report,8 both published by the Statistical Office of the United Nations, which has also been kind enough to provide directly more recent data. Except for mortality data by cause and age, which are based on a 10% sample, all the US data for 1986 are estimates by place of occurrence, based upon a count of certificates received in state offices between two dates, 1 month apart, regardless of when the event occurred. Experience has shown that for the country as a whole the estimates, with few exceptions, are close to the subsequent final figures. There are considerable variations in some states, however, particularly in comparing provisional figures by place of occurrence and final data by place of residence. State information should be interpreted cautiously.
Careful attention should be paid to the denominator when studying rates presented in this article. For overall rates, like the birth rate or death rate, the standard denominator is 1,000 total population. In instances where more refined analysis is possible, the denominator may be 100,000 and the character of the population specified. The particular denominator is indicated in the table or in the context.
Financing Health Care for the Medically Indigent Child
Authors:   Committee on Child Health Financing
Published: December 2021

Children should not be denied access to the health care system because of financial barriers or preexisting medical conditions, and yet evidence suggests that for millions of children this is the case. The American Academy of Pediatrics (AAP) in its 1986 "Medicaid Policy Statement" and its 1983 "Principles of Child Health Financing" espoused the belief that all children have a right to receive comprehensive and quality health care.
Regrettably, no national policy exists which addresses medical indigency among children and their families. Although most state legislatures have considered the indigent care issue, they have focused primarily on hospitals1 uncompensated care burdens and not on ambulatory care needs. Moreover, because of budget implications and the lack of federal revenues, these state initiatives appear to be limited measures and are not intended to support comprehensive, long-range health care plans for the medically indigent.
Data show that lack of ambulatory care, is a significant problem for medically indigent children. Comparisons of average numbers of visits to physicians for uninsured and insured children point to measurable service gaps.1 In particular, medically indigent children are not receiving the primary preventive care promulgated by the AAP and its "Recommendations for Preventive Pediatric Health Care."
The AAP believes that equitable financing solutions for the medically indigent child must be developed immediately. The purpose of this statement is to inform AAP Fellows and health policymakers of the growing numbers of underserved children and to recommend remedial action by the federal, state, and local governments, as well as the private sector.
Teach Pediatrics in Private Offices
Authors: CROOK WILLIAM G. 
Published: December 2021

To the Editor.—
I liked the commentary by the late Joseph W. St Geme, Jr, MD (Pediatrics 1987;79:287-288), and his recommendation for more clinic-side teaching. He pointed out that the offsite conference room is not the best place to teach. Instead, he said that "bright energetic young men and women ... will find their pediatric adventure where the children are."
During the 1960s, I served on the Council on Pediatric Practice of the American Academy of Pediatrics.
Transcutaneous Oxygen Monitoring and Retinopathy of Prematurity
Authors: GRYLACK LAWRENCE J. 
Published: December 2021

To the Editor.—
In response to the article by Bancalari et al (Pediatrics 1987;79:663-669) on transcutaneous oxygen monitoring
[See table in the PDF file]
and retinopathy of prematurity, I would like to share information on this subject from our nursery population. The incidence of retinopathy was evaluated retrospectively in a group of 288 preterm newborns during a 7-year period (1975 to 1982) in relationship to birth weight and transcutaneous oxygen monitoring. Of 57 babies with birth weights &lt;1,000 g, 3.5% had cicatricial retinopathy of prematurity and 15% had proliferative disease.
Right to Refuse Life-Sustaining Treatment
Authors: GUSTAITIS RASA 
Published: December 2021

Recent judicial actions expanding individual rights to refuse life-prolonging medical intervention serve to call attention to the absence of similar development regarding severely damaged, critically ill newborns. Whereas courts have provided guidelines that will allow adults to choose death when hope for meaningful life is lost, hopelessly ill infants continue to be treated aggressively, even in violation of their physicians' reasonable judgment and parental choice.
Significant rulings that allow adults to refuse life-supporting treatment grow from the same perception as gives rise to the ethical dilemmas posed by severely damaged newborns: that it is inhumane, indeed morally indefensible, to prolong life when "the burden of maintaining a corporeal existence degrades the very humanity it was meant to serve" (The New York Times, Sept 12, 1986, p A10).
Anesthesia and Intraventricular Hemorrhage
Authors: COLAVITA RICHARD D. 
Published: December 2021

To the Editor.—
The study by Goddard-Finegold and Armstrong1 demonstrated a decreased incidence in intraventricular hemorrhage in hypertensive beagle puppies pretreated with phenobarbital. However, there was no discussion of the possible effects of the anesthetic agent, ketamine, on their results.
Dawson et al2 demonstrated an 80% increase in cerebral blood flow in dogs after receiving ketamine, 2 mg/kg, IV. Blood flow returned to baseline levels after 30 minutes. This effect of ketamine on cerebral blood flow was blocked by prior treatment with thiopental.
Bacteremia: Occult or Nonoccult?
Authors: MAURO ROBERT D. 
Published: December 2021

To the Editor.—
For those many pediatricians who have wondered whether antigen detection would provide a superior means for screening febrile children for bacteremia, Rubin and Carmody (Pediatrics 1987;80:92-96) have provided a thoughtful and needed study. Unfortunately, their results lead one to the conclusion that current technique is not sufficiently discriminating, when applied to all infants at risk for occult bacteremia, to be clinically valuable.
I am concerned, however, whether their study did in fact address the question of occult bacteremia, and I request a clarification of the authors' methods.
Vaginal Discharge of `Beads' and the New Diapers
Authors: RIMSZA MARY ELLEN , CHUN JAMES J. 
Published: December 2021

To the Editor.—
We report on a "new morbidity" associated with "supra-absorbent" paper diapers, which we term "beaded" vaginal discharge.
A 4-month-old girl was referred to Maricopa Medical Pediatric Gynecology Clinic because of "discharging clear beads" from her vagina. This discharge had been a daily occurrance. The beads were described by the mother as being approximately 1 mm in diameter, clear, colorless, firm, but compressible.
The child had been in good health since birth. Growth and development were normal.
Palpable Lymph Nodes
Authors: EMBREE JOANNE , MURIITHI JANET , BRADDICK MICHAEL , PLUMMER FRANCIS A. 
Published: December 2021

To the Editor.—
We read with interest the article by Bamji et al (Pediatrics 1986;78:573-575) concerning the presence of palpable lymph nodes in 24% of healthy newborns. Information of this nature is valuable in the assessment of the likelihood that congenital infections are present in neonates if lymph nodes are palpable during the first days of life. We have also conducted a survey of palpable lymph nodes in healthy young term infants. Sixty-five neonates born at the Pumwani Maternity Hospital in Nairobi, Kenya, were examined for the presence of palpable axillary and inguinal lymph nodes within 24 hours of birth.
Lack of Evidence of Retroviral Involvement in Kawasaki Disease
Authors: OKAMOTO TAKASHI , KUWABARA HIROYO , SHIMOTOHNO KUNITADA , SUGIMURA TAKASHI , YANASE YOSHIO , KAWASAKI TOMISAKU 
Published: December 2021

To the Editor.—
Microbes have long been suspected to be a causative agent of Kawasaki disease since the original report by Kawasaki.1 Yanagawa et al2 described an epidemic wave of Kawasaki disease spread from central Japan to the entire nation in 6 months. This strongly suggests that an infectious agent might be involved. Furthermore, recent studies by Shulman and Rowley3 and Burnes et al4 have independently demonstrated retrovirus-specific reverse transcriptase activities in the culture supernatants of peripheral mononuclear cells from US patients with Kawasaki disease.
Chlamydia and Suspected Sexual Abuse
Authors: NEINSTEIN LAWRENCE S. , FUSTER C. DANIEL 
Published: December 2021

In Reply.—
We thank Dr Hammerschlag for her thoughtful comments. We wholeheartedly agree with her about the use of cultures in the setting of suspected sexual abuse. As other studies have indicated, the sensitivity and specificity of the direct fluorescent antibody test are too low in a population with low prevalence rates such as a population with suspected child abuse.
We also agree with Dr Hammerschlag about the possibility of perinatal infection in a young child.
Clinical Spectrum of Mucolipidosis Type IV
Authors: AMIR NAOMI , ZLOTOGORA JOEL , BACH GIDEON 
Published: December 2021

In Reply.—
Drs Weitz and Kohn refer to a 15-month-old boy with moderate generalized hypotonia and elevated muscle enzyme levels in which the opportunistic finding of corneal opacities led to the diagnosis of mucolipidosis type IV. Although they provided no information about the visual behavior or psychosocial developmental level of the patient, they conclude that clinical evidence of muscle disease may be the presenting sign of mucolipidosis type IV. They refer to the article by Zlotogora et al (Neuropediatrics 1983;14:104-105) who reported a child whose profound global retardation began to be evident in infancy and the muscle disorder was clearly part of an extensive CNS disease.
Diagnosis of Meningitis
Authors: EGUIGUREN LUIS , CHERNOW BART , TODRES I. DAVID 
Published: December 2021

To the Editor.—
In reviewing the medical literature about meningitis in infants, we found the review article by the Academy's Task Force on Diagnosis and Management of Meningitis1 to be helpful. However, we noted two important errors in Tabe 2: (1) The table (which is adapted from another article2) should be properly entitled, "Cerebrospinal Fluid Findings in Infants Without Meningitis" or "CSF Findings in Normal Infants." (2) The fifth age category in the table should be &gt;12 months instead of 7-12 months.
Multiple Cutaneous Hemangiomas and Coarctation of the Aorta With Right Aortic Arch
Authors: VAILLANT LOÏC , LORETTE GÉRARD , CHANTEPIE ALAIN , MARCHAND MICHEL , ALISON DANIEL , VAILLANT MARIE-CATHERINE , LAUGIER JEAN 
Published: December 2021

Strawberry hemangiomas are the most common congenital vascular malformation seen in infants. Usually, they appear as a raised bright or purplish red lobulated tumor with well-defined borders and capillaries protruding from its surface. They are not present at birth. They develop during the first weeks of life, grow rapidly during the first 6 months, remain stationary for awhile, and then undergo complete or partial involution and resolution without treatment. Usually, these hemangiomas are solitary or in small number1 and are not associated with congenital anomalies.
We report a case of strawberry hemangiomas that is unusual because of the multiplicity and extension associated with laryngeal hemangioma and coarctation with right aortic arch.
Child Life
Authors: BRAZELTON T. BERRY , THOMPSON RICHARD H. 
Published: December 2021

This past May more than 250 members of the Child Life Council gathered in Halifax, Nova Scotia, Canada, for their annual conference and celebrated the fifth anniversary of the organization. Established in 1982 under the auspices of the Association for the Care of Children's Health, this young organization has grown steadily and now numbers nearly 700 members. In another indication of the development of the profession of child life, more than 300 individuals were granted certification as child life specialists in 1986/1987, the first year in which certification was available.
As the Child Life Council enters its second half-decade, and because the profession shows additional signs of maturation, it would be wise to reflect on the contributions made by this relatively new member of the pediatric health care team.
First Aid for the Choking Child, 1988
Authors:   Committee on Accident and Poison Prevention
Published: December 2021

Aspiration of a foreign body is a common hazard in infancy and childhood. In the last 6 years, there has been a great effort to educate the public concerning the prevention of choking due to accidental aspiration of foods or small objects by children. Concomitantly, there has been a campaign to teach the first aid measures essential for evaluation and treatment of choking.
HISTORIC OVERVIEW
Much of the existing data regarding treatment of the choking child is anecdotal. In 1981, the Committee on Accident and Poison Prevention of the American Academy of Pediatrics1 reviewed the available literature. The committee recommended that a foreign body in the upper airway be considered an immediate threat to life and that such a foreign body required urgent removal. In addition, the committee recognized the effectiveness of natural coughing and recommended that, if a choking child could breath and was able to speak and/or cough, all maneuvers were unnecessary and potentially dangerous. If the choking child could not breathe, cough, or make a sound, a series of back blows and chest thrusts was recommended. The committee recommendations resulted in a spirited controversy concerning the most effective management of the choking child.2-6
At the July 1985 National Conference on Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care, the American Heart Association, American College of Cardiology, and the American Red Cross convened a panel on Management of Foreign Body Airway Obstruction to review and revise the past recommendations.
Benign Epilepsy of Childhood and Gowers's Statements
Authors: BOUMA P. A.D. , PETERS A. C.B. 
Published: December 2021

To the Editor.—
Is there a group of children whose seizures have an excellent prognosis without any treatment whatsoever? The recent article by Freeman et al1 clearly favors a positive answer. They suggest that children who are likely to remain seizure free when medication is discontinued after 2 years without seizures2 might be good candidates for withholding any treatment.
Our findings3 may support this suggestion. Anticonvulsant medication was stopped in a prospective study in 116 children with epilepsy (defined as two afebrile seizures or more) who had had no seizures for 2 years.
Fetal Therapy: Ethical Considerations
Authors:   Committee on Bioethics
Published: December 2021

The practice of caring for a pregnant woman and her fetus has always had the dual goal of good outcome for both parties. Furthermore, the pregnant woman has always had to consider undergoing risks or discomforts for the sake of her fetus. With recent advances in perinatal medicine, the pregnant woman and her fetus are increasingly viewed as two treatable patients.1 The fetus is less surrounded in mystery and is more accessible to diagnostic procedures and treatment in utero. The area of fetal evaluation and therapy has created a variety of ethical questions.
Decisions concerning fetal therapy have several important aspects. The field of fetal medical and surgical treatment is new and evolving at such a rapid rate that most techniques involving fetal intervention are clouded in more uncertainty than is the case for many other therapeutic decisions. Some fetal therapeutic interventions, such as intrauterine transfusion or cesarean delivery for placenta previa, are standard practices of proven efficacy. Other interventions, such as cesarean delivery for fetal distress, are routine practices but have a more ambiguous data base upon which to make decisions. Still other fetal interventions, such as shunt diversions for hydrocephalus or obstructive uropathy, are considered research procedures and are not standard medical practices. An international registry has been established to record experience with these experimental surgical interventions.2
Although decisions concerning a fetus require surrogate decision makers, as in the case of infants and children, decisions by pregnant women concerning their fetuses involve more than considerations of the best interests of their offspring.
Emergency Drug Dosage Guides
Authors: OKSTEIN CHARLES J. , ODAL MARCIA , KELLY RONALD W. 
Published: December 2021

Successful cardiopulmonary resuscitation of pediatric patients is complicated by the fact that physicians perform such therapy infrequently, and resuscitative efforts resulting in death or serious disability are common. For example, in one study of 91 children who were treated in an emergency department for cardiopulmonary arrest, only two survived without neurologic handicaps or death.1 These statistics are particularly discouraging when it is noted that 14 of those children had their arrests in the emergency department itself.
One factor complicating resuscitation of pediatric patients is that dosages of emergency medications must be adjusted accurately and quickly for each patient's body weight.
Directory of Overseas Service Opportunities for Pediatricians
Authors: Ledbetter Edgar O. 
Published: December 2021

The following directory contains more than 80 organizations that recruit US pediatricians for both long- and short-term service opportunities overseas. This list was compiled by the staff of the Task Force on International Child Health of the American Academy of Pediatrics. Facts concerning each program were obtained through correspondence and telephone interviews with organization representatives. We have tried to make the list as complete and current as possible.
Anyone knowing of a service organization that has been omitted is encouraged to supply the necessary information to: