bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRENDS
Authors: HUBBARD JOHN P. 
Published: December 2021

It is increasingly evident that the American Academy of Pediatrics has no intention of being carried along passively in the flow of events which are continuously being directed toward the improvement of child health. The Academy has demonstrated its forthright attitude in undertaking a nation-wide Study of Child Health Services and in appointing a Committee for the Improvement of Child Health to implement the findings. Its members, in participating in this project, have indicated that the broader aspects of child health are just as much a doctor's responsibility as are care of the sick, teaching, and research.
In step with this trend within the Academy, the editors of Pediatrics believe it appropriate to keep readers posted on what is happening; and, in so far as possible, on what is likely to happen concerning child health, particularly in federal agencies and congressional circles. This and subsequent descriptions of events and trends are intended to be unbiased and factual, presenting both sides of controversial matters so that conclusions may be formed from critical appraisal of things as they are.
Pending Legislation
By the time that these pages are published, the 80th Congress will have reconvened for its second session. Important unfinished business related to health legislation will soon appear—may already have appeared—on the congressional agenda. The hot controversy over a national health program will be resumed in the hearings before the Committee on Labor and Public Welfare and will bear watching.
When, over a year ago, congressional leadership changed from Democratic to
THE AVERAGE LENGTH OF STAY IN THE HOSPITAL OF INFANTS BORN PREMATURELY
Authors: WALLACE HELEN M. , BAUMGARTNER LEONA , PARK MOLLY L. 
Published: December 2021

Any public or private agency administering a medical care program needs certain basic medical data to plan its program. In the field of maternal and child health, one fact of importance is the average length of hospital stay of newly born premature infants. This basic data assists in planning for such budgetary items as: reimbursement for hospital care; payment for pediatric consultation service; and estimation of the number of beds(incubators, heated cribs and bassinets) needed to care for the total number of premature infants born annually in any community.
A review of the American literature for the past twenty years reveals that there is relatively little information on the average length of stay of newly born premature infants in hospitals. Table I summarizes the information available.
It will be seen from Table I that there is considerable variation in the method of reporting. Some authors do not include premature infants weighing more than 5 pounds at birth; others include premature infants weighing more than 5½ pounds. There is also variation as to whether a particular series includes the premature infants who die in the hospital, as well as those who are discharged alive.
Table I shows that, for the series including only those infants who survived in the hospital, the average stay ranges from 17.3 to 28.8 days, with the majority falling between 24 and 28 days. For the series including both the premature infants who survived and those who died in the hospital, the average stay ranges from
SPECIAL ARTICLE
Authors: PARK EDWARDS A. 
Published: December 2021

Dr. Grover F. Powers, New Haven, Conn.: Mr. President, Dr. Park, Members and Guests of the American Pediatric Society:
"What shall be done unto the man whom the king delighteth to honour?"
This regal question from Ancient Scripture is answered for this day and in this goodly company by the presentation on behalf of the Society of the first John Howland Medal and Award to Edwards A. Park!
Upon no other person could this admirable tribute of honor and respect be so fittingly bestowed. These two great leaders of pediatrics became colleagues when both were working in the New York Foundling Hospital. When Howland (1912) assumed his duties as head of the Department of Pediatrics in the Johns Hopkins University and as Pediatrician-in-Chief of the Harriet Lane Home for Invalid Children, Park joined Kenneth Blackfan there and the original Hopkins pediatric triumvirate was formed: Park, chief of out-patient service; Blackfan, chief resident on the in-patient service; and Howland, chief of chiefs! In 1921, Park moved to New Haven and became chairman of the newly organized full-time Department of Pediatrics in the Yale University School of Medicine. After six fruitful years, he returned to Baltimore as successor to those pediatric luminaries, Clemens von Pirquet and John Howland. From this post he has retired to gracious, wise and distinguished elder statesmanship—and to his microscope and slides!
I count it one of the major blessings of my own life that I have had the friendship of this first Howland laureate since I interned in the Harriet Lane Home in 1913.
SPECIAL ARTICLE
Authors: DODS LORIMER 
Published: December 2021

MR. PRESIDENT, Ladies and Gentlemen: May I begin by telling you how very much I appreciate the honor of being invited to address your society and by thanking you for the compliment to Australian pediatrics which this invitation implies. Your President, Dr. Hodes, has just referred to my maternal American genes and I hope that the presence of these chromosomes may help in some little way to improve my status as an amateur ambassador of Australian pediatrics in this country. Just in case your President's other kind remarks have given you the wrong impression, I feel that I should begin by offering you some sort of explanation of my present professorial act which is a new and very shaky one.
During the past 10 or 15 years, a form of animal life, well-known in your country for at least half a century, has appeared with increasing frequency in various universities of the British Isles, a new species of "homo medicus"—in other words, the professional pediatric pedagogue complete with chalk and blackboard. For the past two years I have had the honor and the rather doubtful pleasure of being the first example of this new form of animal life to appear in the Australian pediatric jungle. As most of you know, pediatrics is a very young and Cinderella-like specialty in our country. A little more than 25 years ago when I first faced the general public as a would-be physician it was regarded as impossible for a young man to earn an adequate living as a pediatrician, and as a result, almost half of my professional life has been spent in general practice.
EVALUATION OF MEAT IN THE INFANT DIET
Authors: JACOBS HOWARD M. , GEORGE GEORGE S. 
Published: December 2021

A commercially prepared lean meat was fed to young infants as a supplement to a diet already adequate in all food factors.
In those infants first fed meat under 2 months of age, there was improvement in physical growth as determined by weight and height measurements. The same group demonstrated an improvement in hemoglobin levels; the elimination of the physiologic drop in total protein levels of the serum, with a prompt sustained rise in values, the greater part of which was composed of the globulin fraction.
In those infants first fed meat after 2 months of age, there was a slight improvement in average weight gain, but no significant difference was noted in other body measurements, total protein, albumin or globulin fractions, or hemoglobin levels.
Illness rates for the two years of the study demonstrated a 40% lower morbidity rate in the meat-fed group as compared to the control group.
In striving for the optimum in infant nutrition protein requirements should be evaluated both quantitatively and qualitatively.
ADRENOCORTICOTROPHIC HORMONE (ACTH) THERAPY OF THE NEPHROTIC SYNDROME IN CHILDREN
Authors: METCOFF JACK , RANCE CHARLES P. , KELSEY WESTON M. , NAKASONE NOBUYUKI , JANEWAY CHARLES A. 
Published: December 2021

The clinical and physiologic features characterizing the administration of 56 courses of ACTH therapy to 45 children with the nephrotic syndrome have been reviewed.
The intramuscular administration of ACTH in daily doses of 150 to 200 mg./sq.m./ 24 hours for at least 8 and usually 10 days resulted in complete diuresis in 38 of 47 (81%) such courses, in 68% of all courses, and in 34 of 45 (75%) patients treated. Approximately 50% of the patients undergoing diuresis have maintained clinical remissions of three months or longer. Twelve of 16 such patients have been in clinical remission for over 6 months; 6 of these, for over 12 months. Induced diuresis and remission were associated with considerable improvement in renal function, particularly glomerular filtration rate and filtration fraction. Some diminution of proteinuria and increased serum protein levels were observed after diuresis, and serum cholesterol fell toward normal levels. Rather consistent but minimal changes in serum electrolyte patterns were noted. An increase of 2 to 4 mM/1. in Na, slight alkalosis and a fall in serum K were usual responses.
ACTH therapy of the nephrotic syndrome in children may be hazardous. Four patients died as a result of complications associated with therapy. The principal complications were infection, severe hypertension and hypotonicity of the extracellular fluid. Prompt recognition and treatment of these disorders with immediate withdrawal of ACTH therapy required constant vigilance and careful supervision. For this reason, this method of treatment is not considered to he a safe outpatient procedure.
The mechanisms responsible for diuresis and remission induced by ACTH therapy are not yet clear. Adequate dosage, normal diet without salt restriction but without added or excessive salt, and possibly a limited period of reduced renal function appear to favor diuresis. Neither the age of the patient nor the (chronologic) duration of disease appear to influence the outcome in children.
Although ACTH therapy may not effect a cure, it does appear to alter the course favorably in a relatively significant number of patients treated, and therefore at the present time appears to be the treatment of choice for the active phase of the nephrotic syndrome in children. A preventive or curative agent is still to be found.
PSYCHOSOMATIC STUDY OF INFANTILE ECZEMA
Authors: ROSENTHAL MAURICE J. 
Published: December 2021

Comparisons of findings in interviews with the mothers of 25 infants with infantile eczema and of 18 control cases revealed that in a significantly higher proportion among the eczema cases the mother tended to let the baby cry without picking it up unless there was some obvious physical discomfort present in the infant. This was taken to indicate that most eczematous infants received inadequate caressing and cuddling. (Spitz, in an independent investigation, came to a similar conclusion.) While the study was designed to test the possibility of a quantitative lack of maternal-child physical contact (which was demonstrated), the study did not rule out the possibility that qualitative aspects of the contacts were also significant.
The lack of cuddling and caressing of the child was found to result most commonly from an attitude on the part of the mother of wishing to be free from being burdened with the care and responsibility of raising a child. These mothers would generally try to justify their infant-rearing practices by saying that they did not wish "to spoil" their babies. In a smaller group of mothers it seemed likely that their relative lack of caressing was due to physical fatigue or weakness.
The lack of cuddling and caressing in most of the cases studied was felt to be an important factor in causing the eczema. However, other factors such as constitutional predisposition and allergy were possibly equally important. Certain therapeutic suggestions were made on the basis of the hypothesis.
USE OF I131-LABELED PROTEIN IN THE STUDY OF PROTEIN DIGESTION AND ABSORPTION IN CHILDREN WITH AND WITHOUT CYSTIC FIBROSIS OF THE PANCREAS
Authors: LAVIK PAUL S. , MATTHEWS LEROY W. , BUCKALOO G. W. , LEMM FRANCES J. , SPECTOR SAMUEL , FRIEDELL HYMER L. 
Published: December 2021

A method is described for evaluating protein digestion and absorption by measuring the fecal excretion of isotope after the administration of a test meal of I131-labeled protein. Application of this method to 10 children without gastrointestinal disase and to five with cystic fibrosis of the pancreas revealed the following:
1. Less than 6% of the ingested isotope was excreted in the feces of the "control" subjects.
2. A 10 to 40% (av. 22.5%) fecal excretion of the ingested isotope occurred in the children with cystic fibrosis of the pancreas.
3. A 50% decrease in the fecal excretion of isotope resulted in 2 of 4 children with cystic fibrosis of the pancreas when pancreatin was fed with the test meal.
4. One patient with cystic fibrosis of the pancreas, who after receiving pancreatin still excreted 40% or more of the ingested isotope in the feces, excreted only 8% when the test was repeated with prehydrolyzed protein.
Adult Height in Growth Hormone Deficiency: Historical Perspective and Examples From the National Cooperative Growth Study
Authors: Frindik J. Paul , Baptista Joyce 
Published: December 2021

There are few historical data on final or adult heights after the completion of long-term growth hormone (GH) therapy in children with GH deficiency (GHD). Adult height has been defined as that achieved at chronologic ages ranging from 18 to 30 years, at bone ages ≥13 years (girls) and ≥15 years (boys), at growth velocities ≤1 to 2 cm per 6 to 12 months, at the “cessation of growth,” at “1 year after the completion of pubertal development,” and that at which patients are either “satisfied with their height” or have attained an “accept adult stature.”Without GH treatment, children with GHD have a mean adult height standard deviation score of −4.7 (range, −6.1 to −3.9). After treatment, the standard deviation score range from −4.7 to −1.2 (pituitary GH [pitGH] 2–4 times a week) and from −1.4 to −0.5 (recombinant human [rhGH] GH 3 times a week to daily) in women and from −3.6 to −1.1 (pitGH) and from −1.3 to −0.7 (rhGH) in men. Because there is no uniformly applied definition of adult height, comparisons are difficult, but historical data suggest that posttreatment heights are greater with rhGH than with pitGH.Using the National Cooperative Growth Study database, we found that the criteria used to define adult height affected the apparent outcome. When chronologic age ≥20 years for men and ≥18 years for women was the only criterion, 27% of patients grew ≥5 cm after having reached this age. Adding the requirement of advanced puberty before adult height could be considered to have been attained reduced the proportion of those who later grew ≥5 cm to &lt;10%, but also decreased the number of patients available for analysis. A combination of criteria for adult height (chronologic and bone age ≥16 years for boys and ≥14 years for girls plus advanced puberty plus growth rate of &lt;2 cm per year) left only 1% of patients with later growth of ≥5 cm.
The Impact of a Brief Intervention on Maternal Smoking Behavior
Authors: Groner Judith A. , Ahijevych Karen , Grossman Lindsey K. , Rich Leslie N. 
Published: December 2021

Objective.To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than 1) mothers receiving routine smoking cessation advice or 2) a control group.Design.Randomized, controlled trial.Setting.Primary care center in a large urban children's hospital.Intervention.Four hundred seventy-nine mothers were randomly assigned to a smoking cessation intervention either aimed at their child's health or their own health, or to a control group receiving safety information.Outcome Measures.Smoking status, stage of change, cigarettes/day, location smoking occurred, and knowledge of ETS effects.Results.Complete data (baseline and both follow-ups) were available for 166 subjects. There was no impact of group assignment on the quit rate, cigarettes/day, or stage of change. The Child Health Group intervention had a sustained effect on location where smoking reportedly occurred (usually outside) and on improved knowledge of ETS effects.Conclusions.Further research is needed to devise more effective methods of using the pediatric health care setting to influence adult smoking behaviors.
Shared Vision: Concordance Among Fathers, Mothers, and Pediatricians About Unmet Needs of Children With Chronic Health Conditions
Authors: Perrin Ellen C. , Lewkowicz Corinne , Young Martin H. 
Published: December 2021

Objective.These analyses were undertaken to investigate the number and types of services and assistance believed to be useful to children with a chronic health condition and their families. The perspective of mothers, fathers, and primary care physicians were sought separately and compared.Methods.Families that include at least 1 child with a chronic health condition were selected from pediatric practices in Central Massachusetts. All 3 respondents completed a questionnaire describing their own perspective of current needs and of the severity of the child's condition. The 3 perspectives are compared statistically and areas of agreement/disagreement are described.Results.Mothers, fathers, and physicians described children's and families' needs with a surprising degree of concordance. On the other hand, pediatricians identified fewer needs, despite rating the severity of children's illnesses as greater than did parents. Mothers and fathers agreed substantially about the level of severity of their child's condition and about their unmet needs.Conclusions.It is important that pediatric practice systems include effective mechanisms to assess parents' opinions regarding the unmet needs of their child/family in the face of a child with a chronic health condition. Without input from families, pediatricians are aware of only some of the needs that parents identify. Pediatrics 2000;105:277–285;children, chronic health condition.
A Systematic Review of Treatments for Infant Colic
Authors: Garrison Michelle M. , Christakis Dimitri A. 
Published: December 2021

Objective:To conduct a systematic review of rigorously evaluated treatments for infant colic.Methods.Online bibliographic databases were searched for the term “colic” in articles classified as clinical trials or randomized controlled trials and conducted in infants. Reference lists from review articles, meta-analyses, and the selected articles were also reviewed for potential studies. The abstracts or full-text articles of 57 relevant studies were examined, of which 22 met the selection criteria. The methodology and findings of all retrieved articles were critically evaluated. Data were extracted from each article regarding study methods, intervention studied, outcomes measured, and results.Results.Four of the interventions studied had data of adequate quality and statistically significant numbers needed to treat (NNT): hypoallergenic diet (NNT = 6), soy formula (NNT = 2), reduced stimulation (NNT = 2), and herbal tea (NNT = 3).Conclusions.There are some effective therapies for infant colic, but additional rigorous studies of existing and alternative therapies are needed.
EFFECT OF MAGNESIUM SULFATE ON RENAL DYNAMICS IN ACUTE GLOMERULONEPHRITIS IN CHILDREN
Authors: HARRIS JEROME S. , DEMARIA WILLIAM J. A. 
Published: December 2021

Renal function was determined in children before and during the intravenous administration of MgSO4. These studies were performed on normal children and on children with acute nephritis; in the latter, both during the acute hypertensive phase of the disease and during convalescence 1 to 3 weeks later. Glomerular filtration rates and effective RPF were markedly subnormal during the hypertensive stage and increased toward normal during convalescence. The intravenous administration of MgSO4 caused marked rises in GFR and in effective RPF when given during the hypertensive stage. Magnesium produced smaller rises in effective RPF but no changes in GFR when given during convalescence. Changes in renal function were not caused by Mg in normal children.
The implications of these findings are discussed with reference to the treatment and pathophysiology of acute nephritis. It is suggested that renal vasospasm is present in children with acute glomerulonephritis and that adequate therapy with MgSO4 relaxes this vasospasm.
IDIOPATHIC CELIAC DISEASE
Authors: ANDERSEN DOROTHY H. , DI SANT'AGNES PAUL A. 
Published: December 2021

The acute phase of idiopathic celiac disease was studied in 58 patients. The criteria for selection of these cases are stated.
The frequency and severity of gastrointestinal symptoms in siblings and other relatives appeared to exceed expectation unless the disease is familial.
In the majority of patients studied, symptoms began before the age of 6 months, in 14 at birth. Vomiting was a frequent prodromal symptom. Breast feeding for more than two months was shown to delay the onset of diarrhea. The early onset of symptoms in the present series is believed to be related to the prevalence of formula feeding from early infancy in New York City at present.
Severe retardation in growth of the skull was common and occurred at an earlier age than retardation in height. This, at times, led to disproportion between measurements for total body length and head circumference. Ultimate head measurements were normal.
The following laboratory procedures were performed in the patients under consideration and their results recorded: pancreatic trypsin and amylase estimation on duodenal drainage, glucose tolerance tests, fecal fat determination, total serum protein, serum carotene and vitamin A levels and vitamin A absorption test. The diagnostic usefulness of these procedures is discussed.
Various diseases of infancy which may lead to an erroneous diagnosis of idiopathic celiac disease are discussed.