bluuebunny/crossref_metadata_2025_split huggingface dataset:
School Bus Seat Belts?
Authors: WIDOME MARK DAVID 
Published: December 2021

In Reply.—
Dr Laws has a good idea. Sound public health concepts often gain wide acceptance because they appeal to different constituencies for different reasons. In fact, the demonstration that passenger restraint systems improve behavior of preschool children has been used successfully in the promotion of car safety seat use.1 No doubt, the perennial concern regarding student behavior might be used to advantage by those of us convinced that seat belts offer crash protection. Although there have been occasional intervention studies addressing deportment on the school bus,2 I am unaware of any in which the effect of seat belts has been looked at specifically.
Factitious Hematuria With Underlying Renal Abnormalities
Authors: SALMON RICHARD F. , ARANT BILLY S. , BAUM MICHEL G. , HOGG RONALD J. 
Published: December 2021

Factitious hematuria is a well-described cause of hematuria in adult patients but is rarely seen or considered in children.1-6 In this article, a 5-year-old girl with a history of gross hematuria with more than one pathologic explanation for recurrent hematuria is described. Because of persistent symptoms despite appropriate therapy, a factitious cause was considered.
CASE REPORT
The patient was the healthy product of the uncomplicated full-term pregnancy of an unmarried woman who reared the child in the home of her mother and sister. The diagnosis of urinary tract infection was made first at 2 years of age. In subsequent radiographic studies, two normal kidneys were identified, with complete duplication of the left collecting system and bilateral grade 2 vesicoureteric reflux.
Public Disclosure of Private Information About Victims of Abuse
Authors:   Task Force on Child Abuse and Neglect
Published: December 2021

Publication of information about child abuse victims and their families may be detrimental to the victims. This is particularly true of sexual abuse but may be just as serious in some cases of physical abuse and neglect. Many states lack laws that restrict publicity on child abuse victims and their families. As a result serious harm to children has occurred.
The American Academy of Pediatrics recommends that all states adopt laws forbidding public disclosure in the mass media of information that identifies victims of child abuse, their families, and perpetrators, who may be minors, unless ordered by a judge who has jurisdiction, as in a dependency hearing or in the trial of a perpetrator. The judge's criteria for public disclosure should be that the public interest in the case is already great and that the risk of harm to the child is small. Furthermore, the Academy recommends that the media exercise great caution in publishing any information that includes the names of victims of sexual or physical abuse.
Reye Study Criticized
Authors: ORLOWSKI JAMES P. 
Published: December 2021

In Reply.—
I appreciate Dr Hall's thoughtful and thorough critique of our article. I will address each of her points to show that our conclusions are just as logical and based on as much scientific data as her alternate interpretations.
First, Reye syndrome should be the same disease in Australia (and anywhere else in the world) as it is in the United States. As Hall points out, our series1 is remarkably similar not only to the original series of Reye et al2 but also to her own series in Great Britain,3 studies from Asia,4 a study from Ireland,5 a recent study from Spain,6 a report from France,7 and a recent study from West Germany.8
Molybdenum Cofactor Deficiency: Another Inborn Error of Metabolism With Neonatal Onset
Authors: MATSUO MASAFUMI , MAEDA EISAKU , NAKAMURA HAJIME , SAIKI KAYOKO 
Published: December 2021

To the Editor.—
We agree with Dr Burton1 that the practicing physician has the responsibility for the initial recognition of inborn errors of metabolism. Because we have experienced many cases of inborn errors of metabolism in neonates who might have died soon after birth without a proper diagnosis, we advocate that every neonatologist has the responsibility of recognizing these disorders. To promote the early recognition, we must know the initial signs or symptoms of neonatal cases of inborn errors of metabolism and we have collected neonatal case reports in the literatures during the last 5 years.
Massive Levothyroxine Overdose: High Anxiety—Low Toxicity
Authors: GORMAN RICHARD L. , CHAMBERLAIN JAMES M. , ROSE S. RUTHERFOORD , ODERDA GARY M. 
Published: December 2021

The acute toxicity of levothyroxine ingestion is influenced by the dose ingested, the rate of conversion of thyroxine (T4) to triiodothyronine (T3), and the level of medical intervention. Approximately 21 million prescriptions for thyroid products were dispensed in the United States in 1986, accounting for 1.4% of all prescriptions. This wide availability leads to frequent acute overdoses. In 1986, the American Association of Poison Control Centers Data Collection System documented 2,231 acute toxic exposures to thyroid preparations.1
Several articles have appeared in the past few years concerning the relative toxicity and treatment of a patient with an acute ingestion of levothyroxine preparations.2-7
Religion and Child Abuse
Authors: FLETCHER JAMES L. 
Published: December 2021

To the Editor.—
I read with interest in the January issue the statement by the American Academy of Pediatrics' Committee on Bioethics1 regarding religious exemptions from child abuse statutes. The Committee is to be commended for making it clear that they seek no vendetta but rather desire the "even" application to all caretakers of preventive measures for neglect and abuse of children. It is also well-stated that there are "two important sets of interest ... in apparent opposition—those of children in the benefits of proven medical and health care and those of parents in making decisions about their children's well being."1(p170)
Dosage of Acetylcysteine in Acetaminophen Poisoning
Authors: RUCK BRUCE , CARACCIO THOMAS R. , MOFENSON HOWARD C. 
Published: December 2021

To the Editor.—
We received several calls from physicians planning to treat acetaminophen overdoses in adolescents with five doses of N-acetylcysteine (Mucomyst), orally. These physicians indicated that they obtained these guidelines from the Harriet Lane Handbook.1
The Harriet Lane Handbook1(p248) states the following "PO or NG: Mucomyst diluted 1:4 in a carbonated beverage as a loading dose of 140 mg/kg, then 70 mg/kg Q 4h for 5 doses (some recommend 18 doses)." The references cited in the handbook2,3 do not recommend five oral doses of N-acetylcysteine as stated and we could not find this recommendation in any other references.
Dosage of Acetylcysteine in Acetaminophen Poisoning
Authors: BRENT JEFFREY , RUMACK BARRY H. , KULIG KENNETH W. 
Published: December 2021

To the Editor.—
The current (11th) edition of the Harriet Lane Handbook contains several serious errors we wish to bring to your attention. These are (1) an incorrect and inadequate 24-hour oral dosage regimen for which there is no scientific basis, (2) a dangerous recommendation for administering oral Mucomyst intravenously, (3) a suboptimal intravenous dosage regimen, (4) the erroneous assertion that N-acetylcysteine (NAC or Mucomyst) therapy is ineffective if initiated longer than ten hours postingestion, and (5) an incorrectly adapted nomogram for determining acetaminophen toxicity.
A Catch in `a Catch in the Reye'
Authors: ORLOWSKI JAMES P. 
Published: December 2021

In Reply.—
Remington and his colleagues fail to explain why, if aspirin use increases the risk of Reye syndrome developing by 20-fold, the incidence of Reye syndrome in Australia is approximately the same as in the United States. To find that Reye syndrome is just as common in a medically sophisticated country where pediatric aspirin use is practically nonexistent contradicts aspirin as a risk factor.
Remington et al continue to relate the decline in the use of aspirin in the United States with a decrease in the incidence of Reye syndrome.
AIDS-Associated Lymphoma of the Brain in a Child
Authors: COCCHI PIETRO , CALABRI GIUSEPPE , SALVI GIUSEPPE , NIERI ROSSELLA , DE MARTINO MAURIZIO , DI LOLLO SILVIA 
Published: December 2021

To the Editor.—
Non-Hodgkin primary lymphoma of the CNS in children with human immunodeficiency virus (HIV) infection has now been included by the Centers for Disease Control in the classification system of pediatric acquired immunodeficiency syndrome (AIDS).1 We report here a lymphoma of the brain associated with AIDS in a 12-month-old child.
The patient was a male infant, weighing 3,000 g at birth, born to a former intravenous drug-addict HIV-seropositive mother. His growth had always been poor.
Congenital Absence of the Hymen Only a Rumor?
Authors: MOR NAOMI , MERLOB PAUL 
Published: December 2021

To the Editor.—
The authors of a recent article1 examined the hymenal anatomy in 1,131 newborn infants without major anomalies of the urogenital tract. Congenital absence of the hymen was not observed in this study, and its frequency was Calculated to be 0.00265 or less than 0.3%. They concluded that the lowest estimation of the frequency of this genital anomaly would be essentially zero.
As part of our monitoring system to determine the incidence of congenital malformations in our newborn population, we examined2 25,068 female newborns between 1974 and 1987.
Bilirubin Measurement Problems
Authors: MAISELS M. JEFFREY 
Published: December 2021

In Reply.—
It is difficult to measure small concentrations of direct-reacting bilirubin accurately, particularly in the presence of significant indirect hyperbilirubinemia.1 Dr Pleasure's report draws attention to an important issue that has plagued us for many years, and it is distressing to note that there is little evidence that the situation has improved significantly during the last three decades.2-4
Two recent surveys disclosed high levels of interlaboratory variation in the measurements of total and direct serum bilirubin concentrations in neonatal sera.3,4
Transient Renal Dysfunction of the Neonate
Authors: HIJAZI ZIYAD , KELLER MARC S. , GAUDIO KAREN M. , SIEGEL NORMAN J. 
Published: December 2021

We recently observed three neonates with transient oliguric acute renal failure associated with characteristic ultrasonographic findings. Their clinical courses, laboratory values, and ultrasonographic findings are discussed. The purpose of this report is to alert those who care for newborn infants to this entity of transient renal dysfunction and its characteristic ultrasonographic findings in the kidney.
CASE REPORTS
Case 1
A full-term girl weighed 3,770 g at birth and was delivered by vacuum extraction because of shoulder dystocia. Her mother's pregnancy was complicated by premature rupture of membranes of greater than 24 hours' duration and maternal fever with amnionitis at delivery. At birth the baby had a weak cry, decreased tone, and Apgar scores of 6 and 8, at one and five minutes, respectively.
Care of Adolescent Parents and Their Children
Authors:   COMMITTEE ON ADOLESCENCE
Published: December 2021

Adolescent parents and their children represent populations at increased risk for medical, psychologic, and social problems. The scope of the problem of adolescent pregnancy and the attendant obstetric/ perinatal complications are summarized in the American Academy of Pediatrics' paper, "Adolescent Pregnancy." Despite a decline in the rate of births to adolescents, the absolute number remains relatively constant because of the increase in adolescent girls. The number of children living with teenage mothers, therefore, remains significant. The health, psychosocial, and educational risks for children of young parents and the role of the pediatrician in prevention or early intervention to reduce those risks will be emphasized here.
MEDICAL RISKS TO INFANT AND MOTHER
Despite dramatic declines in maternal mortality and neonatal death rates in the past 40 years, related at least in part to improved availability and accessibility of obstetric and perinatal care, disproportionately high rates of both maternal and neonatal deaths continue to occur in young adolescents. This is especially true among nonwhite adolescents. Infant mortality coded with reference to the age of the mother varies among different localities, but some reports indicate that babies born to mothers aged 19 years and younger have a death rate higher than that of infants born to older women. Improvements in perinatal care have resulted in decreases in medical complications among babies born to teenage mothers, but mothers aged 14 years and younger continue to experience unacceptably high rates of adverse outcomes.
The most significant medical risks for infants of teenage mothers are likely related to the parental care those infants receive after the first year of life.
Duration of Pediatric and Internal Medicine Practice in Oregon
Authors: SCHUNK GEORGE J. , OSTERUD HAROLD T. 
Published: December 2021

This study was prompted by the perception that there were few pediatricians older than 60 years of age in the state of Oregon who were practicing primary care pediatrics. The hypothesis that there was a high practice attrition rate of primary care pediatricians was suggested by this observation. This could be the result either of early retirement or career change.
Data concerning attrition rates in medical specialties are sparse. Manpower studies of the medical profession have described the entry of students into medicine and the entry of young physicians into medical practice but have not offered information regarding the exit from practice or the frequency of career changes.
Status Epilepticus: It's Not What We've Thought or Taught
Authors: FREEMAN JOHN M. 
Published: December 2021

Status epilepticus has been defined as `seizures so severe as to constitute a fixed and lasting condition." Prevention of status epilepticus is one of the reasons given for administering anticonvulsant drugs to children. Because status epilepticus is widely believed to be capable of producing neurologic deficit, seizures are believed to require emergency treatment to prevent status epilepticus that might cause brain damage.
However, when was the last time you saw a child with status epilepticus who died or had residual encephalopathy? Certainly, there was the child who nearly drowned; the drowning caused both damage to the brain and status epilepticus. I would attribute the residual brain damage to the drowning, not to the status epilepticus.
ORPHAN TRAINS
Authors: Student  
Published: December 2021

What were these children like, these waifs who hustled New York City streets or lived in squalid orphanages with names like Home for the Friendless? What was it like to have been one of the more than 100,000 urban ragamuffins scooped up, put on trains and shipped to strange new lives on Midwestern farms [in] an exceedingly ambitious child-aid operation, the Orphan Trains. Starting in 1854 and continuing for the next 75 years, the Children's Aid Society, later joined by other agencies, took whole trainloads of children from vermin-infested city slums to new tomorrows in the heartland. The first participants and the majority of those to come later were from New York.
Once arrived, they were lined up to be picked over by townspeople. Younger ones were adopted by families; older ones taken in and educated in return for work, and the unchosen shipped to the next town. One historian observed that not since the Children's Crusade in the 13th century had there been such a movement of children over such vast distances.
APPEALS COURT AFFIRMS VERDICT THAT BENDECTIN DOES NOT CAUSE BIRTH DEFECTS
Authors: L. J. F. 
Published: December 2021

Cincinnati, OH.—In a major ruling today the U.S. Court of Appeals for the Sixth Circuit, Cincinnati, upheld a jury verdict that Bendectin does not cause birth defects in a case involving approximately 1,150 plaintiffs. ...
There have been 22 jury verdicts of judgments in favor of Merrell Dow Pharmaceuticals Inc. in cases alleging the drug was responsible for birth defects including this trial which consolidated approximately 1,150 plaintiffs. Four trial verdicts currently stand in favor of individual plaintiffs which Merrell Dow believes are reflections of sympathy for the children. The company is taking appropriate steps to reverse these verdicts and obtain rulings in its favor.
ALL CONVICTED IN E-FEROL TRIAL
Authors: L. J. F. 
Published: December 2021

Two former drug company executives and a drug company were convicted ... of conspiring to market an unapproved, misbranded drug linked to the deaths of 38 infants.
Jurors deliberated 12½ hours over three days before reaching a verdict in the case, which began Aug. 8 in U.S. District Court.
Found guilty of conspiracy were Larry K. Hiland, former president of O'Neal, Jones & Feldman Pharmaceuticals in Maryland Heights; Ronald M. Carter, former president of Carter-Glogau Laboratories Inc., of Glendale, AZ.; and the Carter-Glogau Company.
O'Neal, Jones is now called O'Neal Inc.; Carter-Glogau is now called Retrac Inc.
Klinefelter Syndrome and Fire-Setting Behavior
Authors: EBERLE ANDREA J. 
Published: December 2021

The description by Miller and Sulkes of fire-setting behavior in four individuals with Klinefelter syndrome attracted my attention because I recently found an additional case.
An 18-year-old boy was seen by his family physician because of the sudden onset of violent temper outbursts and suicidal thoughts. He set fire to a neighbor's house and stole a car. There were no previous behavior problems, but he was developmentally delayed, required speech therapy, and learned slowly.
In Reply: Klinefelter Syndrome and Fire-Setting Behavior
Authors: MILLER MARVIN E. , SULKES STEPHEN 
Published: December 2021

We appreciate the comments of Dr Eberle that provide further anecdotal experience for an association between Klinefelter syndrome and fire-setting behavior. In addition, her observation and Sorenson's observations which she notes provide additional evidence that testosterone may be helpful in individuals with Klinefelter syndrome who have fire-setting behavior or other antisocial behavior including stealing and violence toward others.
We have also seen an additional individual with variant Klinefelter syndrome, similar to Dr Eberle's patient.
In Reply: Is Hypaque Dangerous?
Authors: CRONAN JOHN J. , DORFMER GARY S. 
Published: December 2021

Drs Schlechter and Besserman have raised an interesting point concerning the use of diatrizoate sodium in abdominal trauma CT scans. We believe strongly that it is important to obtain excellent bowel opacification in order that injuries to the bowel can be delineated. Without bowel opacification, CT has little possibility of actually being able to discern mesenteric injuries, bowel hematomas, and areas of bowel laceration.
Diatrizoate sodium is an ideal medium in this need because it provides excellent bowel opacification even in the setting of slowed bowel motility achieving a rapid transit time.
NO TEAM PLAYER
Authors: Student  
Published: December 2021

In 1927, the story goes, a Detroit secretary burst excitedly into her boss's office and cried, "Mr. Smith! A man has just flown across the Atlantic all by himself!" Smith engrossed in reports did not respond.
She tried again: "Mr. Smith, you don't understand—all by himself a man has flown the Atlantic!" This time he looked up. "All by himself a man can do anything," he said, "When a committee flies the Atlantic, let me know."
THEOPHYLLINE AND SCHOOL PERFORMANCE
Authors: L. J. F. 
Published: December 2021

After review of the clinical literature, FDA has concluded, in agreement with its Pulmonary-Allergy Drugs Advisory Committee, that there is insufficient data to state that theophylline produces an adverse effect on the school performance of children. However, the agency encourages further well-controlled studies on this subject.
Agency Review
Because of questions about the methodology used in these studies and the statistical interpretation of the results, in October 1987 FDA's Pulmonary-Allergy Drugs Advisory Committee reviewed all the studies and made recommendations to the agency.
In accordance with the recommendations of this committee and after further agency review, FDA concludes that the present data do not support the conclusion of an adverse effect of theophylline on the performance of school children.
However, consistent with the recommendations of the Advisory Committee, further well-controlled studies are needed. Such studies should include welldefined psychological parameters and be carried out by individuals familiar with the best psychological tests available. The goal of these studies should be to clarify whether any association exists between theophylline and learning behavior or school performance.
Radon Exposure: A Hazard to Children
Authors:   COMMITTEE ON ENVIRNOMENTAL HAZARDS
Published: December 2021

BACKGROUND
In December 1984, a construction engineer who lived in Boyertown, PA, triggered radiation monitors while entering the Limerick nuclear power plant near Philadelphia. He had not been contaminated by radioactive materials at the plant; therefore, his home in nearby Berks County was tested. The concentration of radon gas there was 2,700 pCi/L of air, a level much higher than had ever been measured in a residence in the United States. In January, the engineer, his wife, and their two small children were advised to leave the home immediately. The family had been exposed to radiation levels more than 50 times the annual occupational limit for uranium miners. Radon levels in an adjacent house were low but were extremely high in other nearby houses. This region of the country, known as the Reading Prong, which encompasses parts of Pennsylvania, New Jersey, and New York, has geologic deposits of low-grade uranium ore.
Radon gas, a relatively common natural indoor air pollutant is a radioactive decay product of uranium. Radon and its decay products have been shown to increase the risk of lung cancer in underground miners. More recently, radon has been recognized to be widespread in homes in the United States. An estimated 13,000 lung cancer deaths per year may be attributed to residential exposure to radon gas. In this statement the hazards of exposure to radon and its decay products, known as radon progeny or radon daughters, are reviewed.
NATURE AND SOURCES OF RADON
Radon is a colorless, odorless, inert radioactive gas.
Residency Training and Child Abuse
Authors: JOHNSON CHARLES P. 
Published: December 2021

The special pediatric practice issue of Pediatrics was an appropriate forum for the articles by Dubowitz and Chastain et al and the response by Morrow. In all three commentaries, various aspects of pediatric residency training were discussed, whereas the need for a "supplement" represented the overload of continuing education of the practitioner.
Dubowitz suggested that there is a need for additional pediatric residency training in child maltreatment. Chastain et al questioned pediatricians about perceived increases in adolescent medicine skills acquired since the Task Force on Pediatric Education called for more emphasis on adolescent medicine during residency training.