bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Look-alikes’
Authors:   Committee on Drugs
Published: December 2021

Pediatricians should be aware that adolescents and young adults are abusing medication that is regarded as sufficiently benign to be available without prescription. Obtained through legitimate over-the-counter channels or the purchase of "look-alikes" and used in place of controlled substances, these drugs can cause serious problems.
A decade ago, tightening of drug laws restricted production and availability of popularly abused stimulants, setting the stage for an increased use of nonprescription, sympathomimetic drugs. Amyl nitrite was restricted to availability by prescription in 1969, and the Controlled Substance Act of 1972 may have reduced the manufacture of amphetamine 95% from the levels of the 1960s. In 1974, methaqualone, a hypnotic, was added to the list of substances covered by the 1972 Act. These changes and the upsurge of cocaine use during the 1970s fostered the production of a legion of new drugs popularly known as look-alikes. Most often, look-alikes closely resemble amphetamine tablets or capsules in size, color, numbering, and trademarking; they also exist as cunning counterfeits of well known medications. Adolescents and young adults who abuse look-alikes usually locate sources of supply in magazine advertisements that emphasize the "-amine" or "-caine" component of the drug. They receive more than a placebo, but not what they expect. Some look-alikes contain the stimulants phenylpropanolamine (deleted from some new look-alike formulations), ephedrine, and caffeine; others have lidocaine (to cover some advertising claims) or a hodge-podge of other substances—all of which are commonly found in over-the-counter preparations marketed for the treatment of allergic symptoms, upper respiratory infections, or obesity, or as "pick-me-ups."
Medical Treatment of Intestinal Agangliosis
Authors: POTTS S. R. , BROWN S. , SMYTH B. T. 
Published: December 2021

To the Editor.—
We wish to report our recent experience with the use of the decapeptide caerulein in managing a case of total intestinal aganglionosis. The child, a male born at term, had had multiple intestinal biopsies and had had two previous laparotomies (one for obstruction mistakenly thought to have been mechanical and the other for enterocolitis at which a double-barrelled enterostomy was fashioned) when a diagnosis of intestinal agangliosis was made at 31 days of age. Prior to the third intervention, Hirschsprung's disease was suspected but preoperative rectal suction biopsies although aganglionic did not show acetylcholinesterase staining.
Revision of Recommendation for Use of Rifampin Prophylaxis of Contacts of Patients with Haemophilus influenzae Infection
Authors:   Committee on Infectious Diseases
Published: December 2021

A review of the data from a trial sponsored by the Centers for Disease Control to evaluate the effectiveness of rifampin for the prevention of secondary cases of invasive Haemophilus influenzae type b disease and the recognition of failure of rifampin prophylaxis in some day care centers and families prompted the changed recommendations listed below. An increased risk of invasive H influenzae type b disease in household contacts, particularly in those less than 49 months of age had been demonstrated. Although nursery school and day care center contacts may also be at increased risk of secondary disease, the magnitude of this is uncertain at this time. Preliminary data from ongoing studies suggest that the risk of secondary disease among nursery school contacts may vary widely between centers. Asymptomatic colonization with H influenzae type b is frequent in household contacts of all ages. Rifampin, 20 mg/kg (600 mg maximum dose) given once daily for four days, eradicates H influenzae type b in approximately 95% of carriers.
In the trial conducted by the Centers for Disease Control, household and day care center contacts were randomized to receive rifampin prophylaxis or placebo. There was a significant diminution in secondary cases among rifampin recipients if the treated household and day care centers were combined. Four secondary cases occurred among the 800 placebo-treated contacts in contrast to no cases among the 1,166 rifampin-treated contacts (P = .03). Analysis of attack rates among children less than 48 months of age showed a trend toward efficacy in household contacts (3/131 placebo recipients V 0/162 rifampin recipients, P = .08).
Buttock Bruises = Mongolian Spot
Authors: ASNES RUSSELL S. 
Published: December 2021

To the Editor.—
Pediatricians have come to recognize the classic skin lesions of inflicted trauma such as strap or cord marks, hand prints, cigarette burns, and other unusual appearing burns. Occasionally, a child may be suspected of having been abused when, in fact, the dermatologic findings are the result of an acute disease process or a "folk medicine" treatment. Examples include the cutaneous lesions seen in hypersensitivity vasculitis1 and the ecchymotic markings resulting from Cao gio (coin rubbing)2 and cupping.3 Adler and Kane-Nussen4 recently described three children who had erythema multiforme and who were mistakenly considered to have been abused.
Bacterial Flora of Breast-Fed Infants
Authors: YOSHIOKA H. , FUJITA K. , ISEKI K. 
Published: December 2021

In Reply.—
We read Rose's comments with much interest. As he mentioned, some English researchers reported that the predominant fecal organisms in infants were coliforms and Bacteroides but not bifidobacteria even if the infants were exclusively breast-fed. It is a mystery why the breast milk of English women does not stimulate growth of bifidobacteria in the intestine of their babies, but a possible explanation is, as Simhon et al1 have pointed out, that the chance of a baby's acquiring bifidobacterial flora from the mother has diminished because of recent changes in obstetric techniques, which are continually becoming more aseptic.
Problems with Human Milk and Infant Formulas
Authors: Miller Sanford A. , Chopra Joginder G. 
Published: December 2021

EXAMPLES OF PROBLEMS WITH HUMAN MILK
Nutritional Problems
The adequacy of breast milk as the sole food for the baby is related to the mother's diet during pregnancy and lactation, to maternal calorie reserves in the form of subcutaneous fat, to fetal stores (mainly hepatic), and to birth weight.
Although human milk is commonly believed to be a complete, perfect food for infants, deficiencies of vitamin K, vitamin D, and iron may develop in normal, full-term infants breast-fed by apparently healthy women consuming conventional diets. Other nutrient deficiencies may occur in breast-fed infants as a consequence of special conditions existing in the infant, the mother, or both.
Normal infants consuming human milk or commercially prepared formulas will receive adequate vitamin K, except in the immediate neonatal period. Because this initial vitamin K deficiency does not become manifest until two or three days after birth, all full-term infants should receive 0.5 to 1 mg of water-soluble vitamin K preparation at delivery.31
Because human milk provides less vitamin K than fortified formulas do, and because breast-fed infants consume relatively small amounts of milk during the first few days of life, vitamin K deficiency in the newborn period is more common is breast-fed than in formula-fed infants.43,69 Thus, parenteral administration of a water-soluble vitamin K preparation to the newborn soon after birth is particularly desirable for breast-fed infants.
A report42 that human milk contains appreciable but variable amounts of a water-soluble vitamin D sulfate suggests that the vitamin D content of human milk may be greater than was previously recognized.
Trends in Infant Feeding in Developing Countries
Authors: Notzon Francis 
Published: December 2021

In recent years, interest in breast-feeding and infant-supplementation practices in the developing world has been growing. Numerous community, regional, and national studies have described the patterns of breast-feeding and, to a lesser extent, of supplementation in a wide range of low-income countries. Nevertheless, adequate documentation of national trends in breast-feeding is available for only a small number of developing countries, and trends in supplementation remain to be described.
The apparent decline in breast-feeding in the developing world has been the subject of numerous articles describing the impact of this trend on infant morbidity and mortality, fertility levels, and family finances. Frequently, the examples used to illustrate the decrease in breast-feeding are methedologically flawed; they use nonrepresentative or noncomparable samples, for example, or make implicit assumptions about past breast-feeding practices. In spite of such shortcomings, the consistent reports of important declines appear to indicate that some basic changes are taking place in breast-feeding practices in certain areas of the developing world. The fact that these changes seem to be following the general pattern of breast-feeding decline that occurred at earlier times in developed countries adds to their plausibility.
Although a general awareness of changes in lactation in the developing world now prevails, the documentation of this trend is far from complete. Even for those countries in which trends have been appropriately measured, the amount and pattern of change may vary widely from country to country. In most of the countries with information on breast-feeding trends, recent declines have occurred, although the decreases range from sharp to moderate.
Phenobarbital and Intraventricular Hemorrhage
Authors: BOYNTON BRUCE R. , MERRITT T. ALLEN 
Published: December 2021

To the Editor.—
In their study of the effect of prophylactic phenobarbital on intraventricular hemorrhage, Bedard and coworkers1 utilize a powerful and efficient statistical method known as sequential analysis. In addition to performing the analysis correctly, it is important to describe this method clearly and accurately since it may be unfamilar to nonstatisticians. We believe there are errors in the illustration of the sequential plan (their figure, p 436) that may confuse others who wish to use this experimental design or who are trying to interpret their results.
Formula Fixed
Authors: BHATIA JATINDER 
Published: December 2021

To the Editor.—
We have previously reported1 the loss of calcium and phosphorus from premature infant formulas during simulated feedings. Since the time of that report, one of the products has been reformulated (Similac Special Care 24, Ross Laboratories, Columbus, OH).
Utilizing the procedures used in our study,1 the new formula was studied under simulated conditions (syringe-pump and bolus gavage feeding) using both No. 5 French and No. 8 French polyvinylchloride tubing (Argyle Laboratories, St Louis). Aliquots of formula were obtained (during stirring) before and after each of the feeding studies.
Unconvinced of Value of Antenatal Transfer to Level 3 Intensive Care Units
Authors: SEPKOWITZ SAMUEL 
Published: December 2021

To the Editor.—
Paneth et al1 have focused on neonatal deaths occurring at less than 4 hours of age in their extensive analysis of singleton deaths (birth weight 501 to 2,250 g) during 1976 to 1978 in New York City. Despite a well-developed transfer service, 33.6% (655/1948) of all neonatal deaths in this weight category and 42% of all deaths among infants with birth weight less than 1,001 g occurred in the first four hours of life and nearly all occurred in the hospital of birth.
Misleading Editorial
Authors: GREENE WILLIAM H. 
Published: December 2021

To the Editor.—
In the editorial on the placement of ventilation tubes,1 three articles were referenced as showing controlled studies in which children had unilateral tube placement. In the paper by Kilbey et al,2 54 children between the ages of 4 and 12 years had a grommet placed in one ear and a myringotomy done in the other. In the paper by Lildholdt,3 90 children, between 1 and 10 years of age (average age 4 years), with recurrent suppurative otitis media excluded, were treated with unilateral grommet placement and adenoidectomy.
Interaction Between Digoxin and Commonly Coadministered Drugs in Children
Authors: Koren Gideon 
Published: December 2021

Quinidine and digoxin had been coadministered in cardiac patients for several decades before their interaction was reported in 1978. During the last few years, monitoring of increased digoxin serum concentration when several drugs are commonly coadministered with digoxin has led to reports of toxic accumulation of the cardiac glycoside. Because digoxin toxicity is frequently associated with severe morbidity and mortality, close monitoring of clinical and laboratory signs are mandatory whenever the cardiac glycoside is coadministered with quinidine, verapamil, amiodarone, nifedipine, and indomethacin.
Because many of the children receiving a combination of digoxin and interacting drugs are outpatients, it is mandatory to take steps to ensure that toxicity will be detected and treated in its early stages.
Proposed Guidelines on Genetic Engineering
Authors:   Council on Research
Published: December 2021

The American Academy of Pediatrics has become aware of a proposal to National Institute of Allergy and Infectious Diseases (NIAID) that "NIH [National Institutes of Health] prohibit any experimentation involving the transfer of a genetic trait from one mammalian species into the germ cell of another, unrelated mammalian species." An advisory committee rejected this proposal on Oct 29, 1984.
For the record and in any event of further attempts to impose such a prohibition, the Academy, on recommendation of its Council on Research, has the following statement:
Without specific study of the referenced experiments by Dr Ralph Brinster of the University of Pennsylvania, the American Academy of Pediatrics believes that such a blanket prohibition would be scientifically dangerous and detrimental to research efforts into understanding human disease, including cancer, and potentially to the development of new therapies.
There is no true scientific basis for the proposed prohibition. The fact is that a large number of molecular structures, including complex ones, are held in common among the mammalian species. In reality, the species are much more similar than they are different. The species borders that the proposer talks about are a continuum and a blend rather than a sharp demarcation (as is evidenced in cell culture by the ability to fuse cells from many species).
The prohibition would militate against certain possibilities for research and therapy related to inborn errors of metabolism. A gene for the production of an enzyme in one species often makes an enzyme that would produce the same kind of product found in the human.
Pediatricians and Lactation Management
Authors: COREIL JEANNINE 
Published: December 2021

To the Editor.—
The important contribution of pediatricians in the promotion of breast-feeding has been noted.1-4 In these discussions, the pediatrician's instrumental activities have been described primarily in terms of influence on the choice of feeding method, intervention in hospital postpartum routine, communication of support for the lactating mother, and provision of advice regarding the introduction of other infant foods. Little attention has been given to the role of pediatricians in the practical and maternal aspects of lactation management.
Pediatrics and the Malpractice Crisis
Authors: CURTIS PAUL 
Published: December 2021

To the Editor.—
Pediatricians, like all physicians, are increasingly becoming targets of malpractice suits. Pediatricians, however, are likely to find themselves at special risk. In most states, the statute of limitations allows 2 years for discovery procedures. An infant plaintiff has an added allowance simply because of youth. In effect, a case may be allowed to brew for 21 years before the attorney considers it ripe.
Deferring a medicolegal attack is good strategy. Medical standards and procedures change.
Vitamin E and Complement
Authors: RUDENSKY BERNARD , ISACSOHN MEYER , EIDELMAN ARTHUR I. 
Published: December 2021

To the Editor.—
The pros and cons of vitamin E therapy for premature infants have been quite extensively written about during the past year, especially in Pediatrics.1-4 We were interested in the report of Johnson et al,5 showing increased incidence of sepsis and necrotizing enterocolitis in neonates with elevated serum vitamin E levels. Major et a16 reported that vitamin A inhibited complement-induced hemolysis of sensitized erythrocytes, at concentrations similar to those for vitamin E, implicated by Johnson et al as resulting in increased sepsis rates.
Are Granulocyte Transfusions of Value in Septic Neonates Without Neutrophil Storage Pool Depletion?
Authors: CAIRO MITCHELL S. 
Published: December 2021

In Reply.—
We have reviewed the records of our patients who died in the nontreated granulocyte septic newborn group and have not found an increased I/T ratio, suggesting that these patients went on to NSP depletion prior to their deaths. Although we did not do repeat bone marrow evaluations on the four patients who died, judging from their peripheral complete blood cell counts and I/T ratios, we find no suggestion that they went on to NSP depletion.
Vietnamese Are Not Genetically Short
Authors: STICKLER GUNNAR B. 
Published: December 2021

In Reply.—
Dr Deinard's opinion about the growth pattern of children from Southeast Asia is of interest and hopefully will hold up. Just looking around the Rochester soccer fields, this is doubtful. His opinion is in contrast to that repeatedly misquoted information about the Japanese who migrated to California. It is true that earlier studies showed better growth in California in comparison to those Japanese born in Japan, but this did not prove to be true with remeasurements in 1971.
Bromate Poisoning From Hair Permanent Preparations
Authors: WARSHAW BARRY L. , CARTER MELODY C. , HYMES LEONARD C. , BRUNER BARBARA S. , RAUBER ALBERT P. 
Published: December 2021

Potassium bromate is a tasteless, odorless, and colorless chemical found in the neutralizing solution of cold wave home hair permanents and profesional solutions. Toxic ingestions of this substance were initially reported during the 1940s and 1950s and are characterized primarily by gastrointestinal symptoms, hearing impairment, and acute renal failure.1 Although many manufacturers have now substituted less toxic substances as neutralizers, use of potassium bromate in some hair permanent solutions continues, and poisonings from this substance still occur.2-4
Because renal failure from potassium bromate intoxication may be severe, dialysis may be necessary for replacement of renal function. Moreover, a major toxicology reference presently suggests that "if readily available, the prompt use of hemodialysis or peritoneal lavage may serve to remove absorbed but unreacted bromate in significant amounts."1
Views of Graham Challenged
Authors: CHRISTOFFEL KATHERINE K. , JAFFE DAVID , LISTERNICK ROBERT , TANZ ROBERT , ZIESERL EDWARD , DAVID RICHARD , ESTERLY NANCY , MCLONE DAVID , SMITH ALICE 
Published: December 2021

To the Editor.—
George Graham's recent commentary on poverty and nutrition lambasts the public policy that supports food supplementation for poor women and children.1 His challenge, he argues, is based on lack of a scientific basis for the policy. We believe his position is both wrong and dangerous, and that it is based on faulty logic.
Dr Graham's argument is also rather difficult to follow. It is so rambling, emotional, and sarcastic in tone that it was a challenge to these readers to understand why the editors of Pediatrics agreed to publish the piece.
ERRATUM
Authors: Cole Cynthia H. 
Published: December 2021

There is a new typographical error in the "corrected" theophylline dosage printed on page 813 in the November 1985 (vol 76, No. 5) issue of Pediatrics concerning theophylline dosage in The Harriet Lane Handbook.
The correct dosage for infants 6-52 weeks old should be 0.2 x age in weeks + 5.0 (not 1.2 x age in weeks + 5.0).
Rehydration
Authors: MACLEAN WILLIAM C. 
Published: December 2021

To the Editor.—
The recent well-done study by Santosham et al1 seems to be mistitled, "Oral Rehydration Therapy for Acute Diarrhea in Ambulatory Children in the United States. . ." Rehydration was not studied. The average gain in weight in the first 24 hours of fluid therapy was 1% or less and indicated that dehydration was generally absent. The investigators studied the situation as it exists in the United States, ie, well-nourished, generally well-hydrated children with diarrhea.
Halifax and the Precipitate Birth of Pediatric Surgery
Authors: Goldbloom Richard B. 
Published: December 2021

Several years ago, while attending the annual music festival in Marlboro, VT, I had the good fortune to renew acquaintanceship with Dr Robert Gross, who was living nearby in retirement. When I had been a Senior Medical Resident at Children's Hospital Medical Center in Boston in 1951, Dr Gross was Chief of Surgery and was justifiably regarded as the leading pediatric surgeon of his era. The textbook on pediatric surgery, which he had co-authored years earlier with his predecessor, Dr William Ladd, was considered the authoritative reference on the subject. In those days, we medical residents did not have too much contact with the senior surgeons, and we were certainly overawed by Dr Gross. Thus, I was amazed that some 25 years later Dr Gross seemed to remember that I had moved from Montreal to Halifax a few years earlier.
"I suppose you know," he said, "that Halifax was the birth place of pediatric surgery as a specialty."
This announcement came as a revelation, and on subsequent inquiry, I discovered that it was also news to fellow pediatric Haligonians, both medical and surgical. Dr Gross informed me that the seminal event was the great Halifax Explosion of 1917—a tragedy whose anniversary is still marked annually in Halifax.
On December 6, 1917, a French munitions ship, the Mont Blanc collided with the Norwegian vessel, Imo, in the narrows of Halifax harbor. There resulted the most powerful man-made explosion in history prior to the detonation of the first atomic bomb at Hiroshima. Almost 2,000 men, women, and children were killed and 9,000 were injured, including 199 who were blinded.
An Unusual Ocular Finding Associated With Chromosome lq Deletion Syndrome
Authors: WRIGHT LINDA L. , SCHWARTZ MARCIA F. , SCHWARTZ STUART , KARESH JAMES 
Published: December 2021

To the Editor.—
We report an unusual ocular finding associated with the chromosome lq deletion syndrome in a full-term black girl for whom there was no family history of congenital anomalies, fetal wastage, consanguinity, or drug ingestion. The infant was overtly microcephalic (third percentile) with a sloping forehead, metopic sutures open to the brow, and a large posterior fontanel. She had a low anterior hair line, depressed nasal bridge, bulbous nose, thin down-turned lips, prominent philtrum, malformed ears, and a webbed neck.
Vitamin E: What Should We Do?
Authors: NEWPORT MARY T. 
Published: December 2021

To the Editor.—
Regarding the report of the American Academy of Pediatrics Committee on Fetus and Newborn concerning vitamin E and the prevention of retinopathy of prematurity (Pediatrics 1985;76:315-316), we are very concerned about the strong statement made in the final sentence that "the committee regards prophylactic use of pharmacologic vitamin E as experimental and cannot recommend that high doses of vitamin E be given routinely to infants weighing less than 1,500 g ....."
First, could you define "pharmacologic vitamin E," ie, what vitamin E levels are considered to be pharmacologic by the committee, and do "sufficient" or "physiologic" levels, which are terms used by some authors in this area, fall into this category?