bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intestinal Lymphangiectasia: A Reappraisal
Authors: Vardy Peter A. , Lebenthal Emanuel , Shwachman Harry 
Published: December 2021

Intestinal lymphangiectasia (IL) may vary widely in its manifestations and severity. Fifteen children seen between 1960 and 1974 with histologically proven IL are analyzed by clinical, laboratory, radiologic, and histologic criteria. Remissions occurred in most patients and none died. Exacerbations occurred in five children.
Diarrhea was present in 14 patients and in 13 appeared before the age of 3 years. Vomiting occurred in nine patients and growth retardation in seven. Four children had associated peripheral lymphedema and two of these had a family history of lymphedema, both had affected fathers and one had affected siblings and paternal cousins. Seven had hypoproteinemic edema, and, of these, four suffered from hypocalcemic seizures. Chylous effusions were present in five. Hypoproteinemia was present in 12 although five had no hypoalbuminemic edema. Six had lymphopenia which was related to the severity of the disease and was the last abnormality to disappear after clinical remission. Lymphopenia may first appear years after the protein loss begins. Upper gastrointestinal tract series were performed in 13 children and had diagnostic supportive value in seven. Six children had two or more small-intestinal biopsies done. They all showed great variation from one examination to the other, ranging from a normal appearance to severe changes.
Lymphatic block may occur at different sites-in the lamina propria only, generalized (lamina propria, submucosa, serosa, and mesentery), or conversely in the mesentery alone with minimal changes in the lamina propria. In three patients intravenous hyperalimentation was necessary.
Specific treatment with a high-protein, low-fat diet with added medium-chain triglyceride (MCT) is valuable. Surgical resection was of benefit in one patient, and anastomosis of mesenteric to para-aortic lymph nodes in another.
Recurrent Caffey's Cortical Hyperostosis and Persistent Deformity
Authors: Blank Eugene 
Published: December 2021

A boy, age 12 years, who had infantile cortical hyperostosis has continued to have occasional aches and new cortical thickenings in his arms and legs. His mandible is undergrown and his ribs have an abnormal slope.
Recurrence of Caffey's cortical hyperostosis and persistent deformity have been observed in other children and young adults. Some unexplained cases of late cortical thickening and pain may be due to Caffey's disease.
Clinical Manifestations of Crohn's Disease in Children and Adolescents
Authors: Burbige Eugene J. , Huang Shi-Shung , Bayless Theodore M. 
Published: December 2021

Crohn's disease (regional enteritis) is a chronic disorder which usually appears in adolescence or early adulthood.1-8 The average age of onset reported in the adult literature is 27 years.9 Although it has not been reported frequently in children, Van Patter et al., found that 14% of 600 patients observed at the Mayo Clinic had an onset of symptoms occurring before the age of 15.10 Rogers et al.,11 utilizing a computerized analysis of their files, found that 21% of 489 patients with the diagnosis of Crohn's disease had the onset before age 15. In fact, the first patient that attracted Dr. Crohn's attention to this entity was a 16-year-old boy.12 Among the patients in the 7 to 15-year-age range at the Mount Sinai Hospital in New York, the maximum incidence was at 10 to 14 years of age.5 The current communication summarizes the clinical features of 58 patients with Crohn's disease of the small intestine and/or of the colon whose disease appeared before they were 15 years of age and emphasizes the prominence of the extra-intestinal manifestations. The mode of presentation of these younger patients was often such that the clinician's attention was diverted from the gastrointestinal tract.
PATIENTS STUDIED
During a 20-year period (1952 to 1972) at the Johns Hopkins Hospital, 376 patients were discharged with the diagnosis of regional enteritis or Crohn's disease. Forty-eight of them, or 12.7%, were under the age of 15. The diagnosis was based on pathological and/or roentgenographic cnteria.
The study group included these 48 patients plus 10 others seen in the outpatient department or at other Baltimore hospitals (Sinai Hospital and the Greater Baltimore Medical Center).
A review of Antihistamines and the Common Cold
Authors: West Sheila , Brandon Brenda , Stolley Paul , Rumnll Richard 
Published: December 2021

Antihistamines, used alone and in combination with other drugs, were initially promoted for the treatment of a viral upper respiratory infection (URI) during the late 1940's. Their popularity grew with the claim that these drugs aborted further development of a cold if taken shortly after the onset of symptoms. Increasing use of antihistamines resulted from subsequent claims that they appeared to shorten the duration of a cold and, at present, antihistamines and combination cold preparations containing these agents are promoted for the symptomatic relief of colds.
Current use and expenditure reflects the general acceptance of these drugs by both patients and physicians for use in treating a cold. National marketing research data estimate that approximately 94% of office visits for a cold result in prescriptions for the patient, of which one third are prescriptions for antihistamimc combination preparations. Other data estimate that 3.5 million prescriptions were written for cough and cold preparations containing antihistamines in 1972. Consumer expenditures were over $600 million a year for nonprescription cough and cold remedies in 1972. Despite their apparent popularity, many cough and cold remedies contaming antihistamines have been deemed less than effective by the National Academy of Science, and the Food and Drug Administration has begun an inquiry which may result in action to require manufacturers of these agents to comply with limitations on components and advertising claims.
Although there are a number of reports in the literature regarding the effectiveness of antihistamines for the treatment of the common cold, the conflicting nature of the results has led to considerable confusion over the merits of these drugs.
Immunization "dyspractice": The need for "no fault" insurance
Authors: Krugman Richard D. 
Published: December 2021

We are on a collision course in many areas of the United States. A number of states have passed compulsory immunization laws for school children, yet the majority of the vaccines required in fulfillment of these laws have a specific incidence of adverse reactions. These range from mild fever or irritability to encephalitis or paralysis. True, the incidence is small, but it is real. For live oral trivalent poliovirus vaccine, for example, the package insert cautions that "the possible low level of risk to the vaccinated subject or to close contacts [should] be considered at all times."
Yet what recourse does the one person in tens of thousands suffering an adverse reaction have?
Early Growth and Development in Low-Birthweight Infants Following Treatment in an Intensive Care Nursery
Authors: Fitzhardinge P. M. 
Published: December 2021

Sixty-seven appropriate-for-date infants with gestations less than 33 weeks were followed for 12 months after their term dates. All had been born after September 1970. None received hypercaloric alimentation as neonates. Growth from the expected date of delivery was compared with that of 24 normal full-term infants and with accepted growth standards. The boys did not differ from the controls or the standard in mean weight, length, and head circumference, in weight and height indices, or in velocity of weight and linear growth. The girls had a slower velocity of weight growth for the first six months and had significantly lower weight indices at 12 months than did their controls. Velocity of linear growth, height indices, and mean length and head circumference for the girls were similar to those of the control standards.
Gross central nervous system defects occurred in 22.5% of the boys but in none of the girls. More than one half of the abnormalities were hydrocephaly. The mean post-conceptional developmental quotient was 110 for the girls and 108 for the boys.
Medex: A Time-Motion Study
Authors: Sells Clifford J. , Herdener Richard S. 
Published: December 2021

Six Medex working with family practitioners were followed by an observer for a total of 18 days to gain an objective profile of how Medex spent their workday.
Medex on the average spent 30% of their time with office patients and saw 38% of all office patients. Medex saw between 25% and 100% of all pediatric office patients and spent on the average 37% of their office patient time with pediatric patients. On the average, Medex saw 8 pediatric and 11 adult office patients per day.
Well-child examinations, the largest pediatric diagnostic category, accounted for 30% of Medex pediatric office patient time. Minor surgery accounted for the second largest portion of pediatric office patient time (21%) while respiratory illness ranked third (11%).
In view of the increasing role family practitioners and their assistants will undoubtedly play in the provision of child health care, pediatricians are urged to work closely with family physicians in developing and implementing health care services for children.
Nutrition, Growth, Development, and Maturation: Findings From the Ten-State Nutrition Survey of 1968-1970
Authors: Garn Stanley M. , Clark Diane C. , Lowe Charles U. , Forbes Gilbert , Garn Stanley , Owen George M. , Smith Nathan J. , Weil William B. , Nichaman Milton Z. , Johansen Erling , Rowe Nathaniel 
Published: December 2021

The Ten-State Nutrition Survey of 1968-1970 contributed far more information on nutrition and growth than was originally anticipated. In addition to quantification of the relationship between economic level and size and growth progress and demonstrating the concomitants of obesity and the effects of leanness, the results pointed out major gaps in our knowledge and provided a new body of substantive important information.
The survey did not find pot-bellied, spiderlimbed malnutrition of the starvation level. It did not suggest the prevalence of "hunger" of a kind widely advertised in a 1967 television spectacular. What it did show was that the dimensions of poverty could be spelled out in smaller size and lesser growth. It also showed interactions between economic level and size and growth performance in blacks and whites.
Among the novel and serendipitous findings were those showing dimensional, developmental, and temporal differences between black and white children who were carefully matched for economic level. The study showed the simple effect of level of fatness on both tempo and amount of growth. It demonstrated the antecedents of obesity in socioeconomic context. And it showed the differing participation of different organ systems and measures of somatic and skeletal development.
The Ten-State Nutrition Survey has been criticized first for directing attention to the poor, and second because it was not exclusively a survey of the poor. Yet, we now have data that never before existed. These data show the exact dimensional and developmental comparisons, both of the children of the poor and those of median incomes.
Lettrt To The Editor
Authors: Kawasaki Tomisaku 
Published: December 2021

On behalf of the authors of our paper, I appreciate a very interesting and important comment raised by Dr. Cheek.
Although acrodynia was in our mind as a disease to be differentiated from mucocutaneous lymph node syndrome, a difference in clinical pictures (Table I) and measurement of mercury concentration in the hair of the patients with the syndrome (Table II) lead us to exclude acrodynia.
It is also worthwhile to note that acrodynia has been very rare in Japan up to the present, probably due to the fact that mercury-containing products such as teething powders and lotions have never been habitually used in this country.
Welcome to our new Spanish language edition
Authors: Lucey Jerold F. 
Published: December 2021

Beginning with this month's issue, Pediatrics will be translated into Spanish. Angel Ballabriga, M.D., Professor of Pediatrics in the Autonomous University and Chairman of the Children's Hospital of the Seguridad Social, Barcelona, Spain, will be the guest editor. Our Spanish edition will be published and distributed by Ediciones Doyma in Spain to approximately 15,000 physicians caring for children.
We hope that our new readers in Spain will find Pediatrics useful in their practices. Professor Ballabriga will select, for highlighting, those articles he believes to be of particular interest to Spanish physicians.
If this venture is judged to be mutually successful, we hope that it will be but the first of several steps planned to bring Pediatrics to a wider international audience.
A Therapeutic Trial of Fatty Acid Supplementation in Cystic Fibrosis
Authors: Elliott Robert B. 
Published: December 2021

Seven children with cystic fibrosis (CF) have been treated for at least one year with intravenously administered soya oil emulsion. In all, an improvement of at least one biochemical abnormality in character with the disease appeared. The children's clinical course remains benign. This course is remarkably better than that of other children with CF treated without Intralipid in Auckland in the same period, though a placebo effect cannot be discounted.
It is postulated that intravenous supplementation with essential fatty acid in CF may in turn partially correct an error of metabolism of prostaglandins present in the disease.
Relationship of Allergy, Enuresis, and Urinary Infection in Children 4 to 7 Years of Age
Authors: Siegel Sharon , Rawitt Leslie , Sokoloff Burton , Siegel Bernard 
Published: December 2021

A group of 234 children, 4 to 7 years old, in a middle- to upper-middle-class Caucasian population, were divided into four groups and matched for age and sex. Group 1 consisted of 50 children previously treated for urinary infection; control group 1 contained 55 well children; group 2 consisted of 69 children treated for respiratory allergy; and control group 2 contained 60 well children.
There was no statistical difference in persistent enuresis (night wetting every week), persistent day wetting (every week), allergy, or family history of enuresis, when group 1 and control group 1 were compared. A family history of urinary infection was higher (P &lt; .05) in group 1.
There was no statistical difference in persistent enuresis, persistent day wetting, previous urinary infection, or family history of enuresis or urinary infection when group 2 and control group 2 were compared.
This study suggests that there is no relationship between respiratory allergy, enuresis, and urinary infection.
Persistent Mullerian Structures in a Male Neonate
Authors: Stallings Martin W. , Rose A. Hewitt , Auman George L. , Cunningham Russell D. 
Published: December 2021

A 2-week-old male infant was diagnosed as having persistent Mullerian structures. Microscopically normal testes were found, as well as a uterus, cervix, and fallopian tubes. Plasma testosterone values responded normally to human chorionic gonadotrophin stimulation. This condition at times is familial, and genetic counseling is indicated.
CASE REPORT
A 2-week-old white boy presented with a history of a mass in the left groin. This mass was not present at birth. There is no family history of inguinal mass and the patient has no siblings. Physical examination revealed a normal male infant with a 2-cm to 3-cm hard mass in the left inguinal area.
Septic Arthritis in an Infant Due to Clostridium ghoni and Hemophilus parainfluenzae
Authors: Renne James W. , Tanowitz Herbert B. , Chulay Jeffrey D. 
Published: December 2021

Clostridium ghoni and Hemophilus parainfluenzae are uncommon causes of human infection. Both of these agents were isolated from joint fluid in a child with septic arthritis.
CASE REPORT
An 8-month-old white girl was admitted with a three-day history of irritability, fever, and inability to lie on her right side. Ten days prior to admission bilateral otitis media was treated with 600,000 units of benzathine penicillin intramuscularly and sulfisoxazole suspension (1 gm daily until admission). Fever and irritability from otitis abated by the fifth day of therapy.
On admission the infant appeared acutely ill and had a temperature of 39.7 C.
A Question on Chart Audits
Authors: Thorpe Helene S. , Thorpe James H. 
Published: December 2021

Outpatient chart audit, as performed by Russo et al.'s faculty,1 demonstrates the problems of measurement as much as that which is measured.
By now, with national emphasis on inpatient audit,2 it is evident that medical education and practice have neglected documentation of care given–this despite a long-time need for accurate, concise, legible record-keeping to assist in care by multiple professionals, to support disability evaluations, to avoid malpractice claims, to effect third-party reimbursement, and to enhance clinical investigation, among others.
Designing a Child's Safety Seat
Authors: Meyer Robert P. , Lavenson Jack I. , deCastro Fernando J. 
Published: December 2021

There is an increasing need for understanding human elements in the development of commercially successful products for children.1-4 We have generated and utilized human factors data in the design of a child's safety seat.
Thirty-five children, aged 6 to 42 months, were randomly selected from a Midwestern population. Anthropometric data were obtained by recording age, height, head width, shoulder width, buttock width, arm length, and leg length. Each child was photographed standing and sitting against a grid.
Abdominal Distension Following Ritual Circumcision
Authors: Horwitz Jonathan , Schussheim Arnold , Scalettar Howard E. 
Published: December 2021

The report of the Ad Hoc Task Force on Circumcision1 and the letter by Dr. W. Berman2 appearing in the same issue presented us with an unusual diagnostic and therapeutic problem.
An 18-day-old infant was brought to us with a ten-hour history of mild, green, watery diarrhea and refusal to eat. There was no fever or vomiting, and on close questioning it was learned that he had been voiding normally. Over this period of time he refused to take any milk or liquids and it was this feature that had the parents particularly concerned.
Management Criteria, Documentation, and Peer Review of Initial Urinary Tract Infection
Authors: Margileth Andrew M. , Thompson Hugh C. , Osborne Charles E. ,   Joint Committee on Quality Assurance
Published: December 2021

During part of a national study to formulate criteria for chart audit of quality assurance of child health care, criteria were developed for diagnosis and management of urinary tract infections. These criteria were validated by pediatricians and family physicians in academic medicine and in practice. They were judged relevant to the medical care process and patient outcome by both. The selected criteria were also recommended by the majority of two large physician groups for use in peer review.
An important aspect of the study assessed the frequency of performing and recording indicated procedures or tests. In the first three phases of the study these criteria were said to be performed and recorded by a large majority of physicians. However, in the fourth (community) phase, when charts of 166 primary care physicians were actually audited, documentation was so poor that peer review by chart audit would be impractical at present.
Assuming proper documentation of the medical care process, similar criteria could be used for chart audit, clinical research, and educational purposes. Since the diagnostic and management process of initial urinary tract infection is established, development of structured health care forms and education in proper record-keeping are two important challenges for those interested in the evaluation of ambulatory care.
The Hazards of Skateboard-Riding
Authors:   Hawaii Chapter, American Academy of Pediatrics, Atienza Fernando , Sia Calvin 
Published: December 2021

Skateboard-riding has become increasingly popular among Hawaii's children. The thrill of the ride and the challenge of keeping one's balance and working intricate maneuvers while speeding down a hill captures the fancy of many of our young.
This sport, however, has produced an alarmingly high toll of injury and illness. Pediatricians and emergency departments of our major hospitals have seen and taken care of large numbers of patients (aged between 3 years and 35 years, but with a distribution overwhelmingly pediatric) with significant injuries which include cerebral concussion, fractures, soft tissue injuries of varying degrees of severity and complications, and injury to internal organs.
During a three-month period at the Kauikeolani Children's Hospital, July to August 1975, there were 16 patients admitted with the following: seven cerebral concussions, one skull fracture, five assorted bone fractures, one soft tissue injury and infection, one retroperitoneal hemorrhage, and one instance of major surgery for removal of the spleen.
During the months of August and September 1975 the Emergency Department of Straub Clinic reported the following skateboard injuries: 14 fractures, 14 soft tissue injuries, 5 lacerations, and 2 cerebral concussions. Of the 35 patients seen, three were admitted—one with an open fracture, one with cerebral concussion, and one with a skull fracture.
During a four-week period (two weeks in June and July and two weeks in August and September) at the Emergency Department of Kaiser Medical Center, 66 cases of skateboard injuries were seen with six patients requiring admission for fractures and brain concussion.
The Pediatric Nurse Associate
Authors: Burnett Robert D. ,   Committee on Pediatric Manpower
Published: December 2021

During the past several years as Chairman of the American Academy of Pediatrics' Committee on Pediatric Manpower I have witnessed the development of the concept of the pediatric nurse associate (PNA) within the specialty of pediatrics. In addition, I have also been aware of the controversies within the AAP membership regarding the role of the PNA in child health care delivery.
Many of you will recall the concern of the mid-1960's which widely publicized an impending catastrophic shortage of pediatricians.
What Makes a Good Growth Chart?
Authors: North A. Frederick 
Published: December 2021

Owen and Garn, in their recent editorial,1 extensively discuss the nature of the data used to derive the norms or standards used on the growth chart, but they dismiss the format of the chart with only a few words. I would argue that for usefulness in the health care of children the format of the chart is much more important than the data used to derive the standards.
What is it that the clinician expects, or should expect, to learn from measurements plotted on a chart?
Mercury Poisoning and MLNS
Authors: Nishida Goro 
Published: December 2021

The course and symptoms of MLNS which Dr. Kawasaki et al. described in the September 1974 issue of Pediatrics1 are similar to those described by Dr. Currie.2 Lymph node enlargement can occur in acrodynia.3 Sudden death due to cardiac failure is also reported.4-6
I suggest that MLNS is the "acute febrile form" of infantile acrodynia. Mercury sources in the disease could be inactivated vaccines, in addition to polluted food and old mercury-containing preparations (such as diphtheria vaccine, Japanese encephalitis vaccine, influenza vaccine and globulin) which contain .05 mg of mercury per milliliter if thiomersal is the preservative.