bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Syndrome in Cats
Authors: ROCHLITZ I. 
Published: December 2021

To the Editor.—
I read with interest the article on acquired postganglionic cholinergic dysautonomia.1 It bears a striking similarity to a syndrome recently recognized in cats in the United Kingdom; the syndrome is known as the Key-Gaskell syndrome, feline autonomic polyganglionopathy or dilated pupil syndrome.
The first clinical cases were reported in February 1982. Since then more than 35 cats with this condition have been treated at the University of Bristol. I have reports of more than 200 cases from veterinary surgeons in practice throughout the United Kingdom.
Pertussis Vaccine
Authors:   Committee on Infectious Diseases
Published: December 2021

The "Red Book," as the Report of the Committee on Infectious Diseases has come to be known, is not a static document, but is subject to frequent revision. Not only does each edition contain new information available to the Committee, but between editions the Committee communicates further changes to the medical profession via Pediatrics. These communications constitute "Updates" to the Red Book. As everyone knows, scientific information proliferates exponentially, and so the Updates have appeared more frequently in recent years.
The Update that follows concerns pertussis vaccine, and therefore, it supplements information in the 1982 edition of the Red Book. To place it in context, the entire Red Book section on Pertussis (pp 198 to 202) should be reviewed, as well as the general sections on immunization, particularly the section on Informed Consent (p 4) and the section on Vaccine Dose (p 10).
Like many preventable childhood diseases, pertussis is now infrequently reported in this country. Although more than 200,000 cases were reported annually in the 1930s before pertussis vaccine was introduced, only about 2,000 cases are now recognized each year. The success of the vaccine has resulted in the remarkable decline of a formerly feared illness. As the incidence of the disease has declined, adverse reactions attributed to pertussis vaccine have received greater attention and prominence.
In the United Kingdom, following Professor G. T. Stewart's alarming reports of brain damage due to pertussis vaccine, immunization rates fell profoundly, and as a result widespread outbreaks of pertussis began to occur.
Total Calcium and Q-oTc Determinations Are Not Useful in the Intensive Care Unit
Authors: MOYA FERNANDO , REKEDAL KIRBY , GETTNER PATRICIA , CHAMBERLIN MILDRED , GERTNER JOSEPH , EHRENKRANZ RICHARD 
Published: December 2021

To the Editor.—
Neonatal hypocalcemia (total calcium &lt;7 mg/dL or ionized calcium &lt;3.0 to 3.5 mg/dL) has been reported to be present during the first week after birth in approximately one third of premature infants, asphyxiated newborns, and infants of diabetic mothers.1 Colletti et al2 suggested that the Q-oTc interval of the ECG is a reliable screening test for hypocalcemia in these infants. Several hormonal and metabolic disturbances have been proposed to explain the occurrence of neonatal hypocalcemia.3
Who Should Provide Primary Health Care to Children: Pediatricians or Family Medicine Physicians?
Authors: Hoekelman Robert A. , Klein Michael , Strain James E. 
Published: December 2021

INTRODUCTION
—Robert A. Hoekelman, MD
This debate is one of a series entitled "Controversies in Child Health and Pediatric Practice." In 1978 and 1979, the Department of Pediatrics at the University of Rochester conducted 12 such debates, which were published in book form in 1981.1 It is interesting that of these 12 controversies, not one has been resolved. That may prove to be the case for the controversy presented in this debate, "Who should provide primary health care to children: pediatricians or family medicine physicians?"
Our guest speakers are Dr Michael Klein and Dr James E. Strain. Dr Klein is Professor of Family Medicine and Assistant Professor of Pediatrics at McGill University School of Medicine. He is also Director of the Department of Family Medicine and of the Herzl Family Practice Center at the Sir Mortimer B. Davis Jewish General Hospital in Montreal. Dr Klein received his medical degree at Stanford University in 1966, and he was his class's recipient of the pediatric Harold K. Kaiser Award. Dr Klein served his internship at Bronx Municipal Hospital Center at Albert Einstein University and his pediatric residency at Montreal Children's Hospital. During his last year, he served as Senior Resident in Neonatology under Robert Usher at the Royal Victoria Hospital. He then became a fellow in biochemical genetics under Charles Scriver and the Chief Medical Resident at Montreal Children's Hospital under Mary Ellen Avery. In 1970, he came to Rochester as a Fellow in Ambulatory Pediatrics.
Dr Klein's practice experience is extensive. He was the pediatric coordinator of the St Jacques Clinic in Montreal during the late 1960s and the medical director of the Westside Health Services in Rochester from 1971 to 1975, after which he assumed his current position.
Coronavirus?
Authors: ROUSSET SOLANGE , CHANY CHARLES , LEBON PIERRE , MOSCOVICI OTTO 
Published: December 2021

In Reply.—
In both of our papers,1,2 we referred to coronavirus-associated disease and termed the particles "coronavirus-like." In order to make our position even less equivocal, we stated in our first paper (pages 213-214)1: "At present, because of the lack of viral propagation in tissue culture, the virions found in the stools are only identified on the basis of their morphologic appearance (see Figure). These differences could either represent various aspects of one virus, or different viruses presently classified as coronaviruses.
A Believer in Phototherapy
Authors: ROSENBAUM RICHARD J. 
Published: December 2021

To the Editor.—
The impassioned plea by Hein1 to stamp out the use of phototherapy in healthy, term infants with bilirubin levels less than 20 to 25 mg/dL is premature to say the least. To then remark that malpractice fears per se is the main reason physicians treat jaundice of the newborn is incorrect. The main reason that 5+% of all healthy term infants receive phototherapy is that there is reasonable evidence to indicate that (1) bilirubin levels &gt;20 mg/dL in full-term infants may be associated with kernicterus in a percentage of cases;
Treatment of Disabled Infants
Authors: WEHRLE PAUL F. 
Published: December 2021

In Reply.—
I am concerned that the Academy's position on treatment decisions regarding seriously ill newborns may have been construed to be one in alliance with the government's hard-line stand on interventionism and insistence upon treatment. It has always been our position that neither the government nor the courts should interfere in decisions best made by parents in consultation with medical professionals. The Academy is as committed to this concept today as it was when it first challenged the Department of Health and Human Services (DHHS) and successfully struck down the first "Baby Doe" rule which ignored the role of parents in this critical decision-making arena.
Annual Meeting of the Section on Pediatric Urology
Authors: Gonzales Edmond T. 
Published: December 2021

Summary of the Meeting, Oct 22-27, 1983 Received for publication Feb 27, 1984; accepted March 8, 1984. This summary of our proceedings is prepared for the practicing pediatrician, who often finds it impossible to attend all the sessions going on simultaneously at the annual meeting. The Section on Urology of the American Academy of Pediatrics met for three days in conjunction with the 52nd annual meeting of the Academy in San Francisco, and many topics of interest to both pediatricians and urologists were discussed. This summary will only include those papers. Papers dealing with particular surgical techniques will not be included, except when they have bearing on the ultimate management of particular problems that may be of interest to the practicing pediatrician.
As has been customary in the past, the section meeting was topic oriented; this year stressed current research interests in pediatric urology. These topics included vesicoureteral reflux, prenatal ultrasound and renal dysplasia, urinary diversion, disorders of the testis, adjunctive diagnostic techniques in the evaluation of ureteral obstruction, and current status of management of posterior urethral valves.
VESICOURETAL REFLUX
Vesicoureteral reflux, despite its prevalence and voluminous literature, continues at times to present a management dilemma. One of the continuing problems facing the clinician is the observation that many children are seen for evaluation with about as much parenchymal atrophy as they seem likely to get. Studies by Ransley1 and Hodson et al2 have proposed that certain areas of the kidney are more vulnerable to parenchymal atrophy because of the presence of intrarenal reflux and that in the presence of infection and vesicoureteral reflux, these particular areas scar quickly and severely.
Administration of Thyroxine to Very Low-Birth-Weight, Premature Infants
Authors: SCHWARTZ ROBERT P. , HICKEY DOCIA E. , RATHBUN MARY ANNE 
Published: December 2021

To the Editor.—
We question the advisability of administering thyroxine to premature infants with low thyroxine (T4) levels as reported by Chowdhry et al.1 The low T4 levels noted in this report would be expected in infants of 26 to 28 weeks of gestation. The serum thyrotropin (TSH) values were normal as was the response to thyrotropin-releasing hormone. Hadeed et al2 noted a prevalence of T4 levels less than 6.5 µg/dL in 52% of infants of 28 to 30 weeks of gestational age, 33% of infants of 31 to 33 weeks of gestational age, and 11% of infants of 34 to 36 weeks of gestational age.2
Thyroid Hormone Poisoning: Therapy Questioned
Authors: KIRKLAND REBECCA T. , KIRKLAND JOHN L. , GREGER NANCY G. , EBERLE ANDREA , MARSHALL ROBERT 
Published: December 2021

To the Editor.—
We are concerned about the implications of the report of aggressive management of a child with acute ingestion of thyroid hormone. The vigorous treatment of one of two children reported to have ingested large amounts of levothyroxine prompted us to make a telephone call to the Poison Control Center in Houston regarding overdosage with thyroid hormones. The recommendations of the Harris County Poison Control Center with acute thyroid hormone ingestion includes ipecac ifthe ingestion is early and oral charcoal.
A Call for Clinical Prudence in Use of DTP and Other Vaccines
Authors: GERAGHTY KEVIN C. 
Published: December 2021

To the Editor.—
I read with great interest the recent editorial by the new chairman of the "Red Book" Committee, Dr Brunell,1 commenting on the impact of litigation on manufacturers and physicians. Brunell quite correctly points out that litigation directed against manufacturers may serve to have an adverse effect on the availability of vaccines. Physicians faced with increasing reports of litigation against colleagues can, as Brunell points out, be expected to demonstrate reluctance in their use of certain vaccines.
Cutis Laxa, Ligamentous Laxity, and Delayed Development
Authors: KARRAR Z. A. 
Published: December 2021

To the Editor.—
Sakati and colleagues, at the end of their article state that "All of these observations raise the possibility that the disorder is determined by a gene on the X chromosome which is expressed as an X-linked lethal gene in the hemizygous male and as this syndrome in the heterozygous female."
Our experience following up eight children in five Saudi families from the same area in Central Saudia Arabia compels us to disagree with that speculation.
Introduction to Common Pediatric Complaints
Authors: Lucey Jerold F. 
Published: December 2021

Those who have tried to organize a different kind of conference know how difficult that can be. Many presenters can be programmed congenital lecturers. Once on a platform, they dim the lights, flash the first slide, and deliver a 40-minute lecture.
That's not what we wanted in this conference. The goal was to teach pediatricians how to teach. Although this is something most practitioners have been doing, it is unlikely that they ever took courses in how to educate patients. That's a very important part of a practice.
If this effort is successful, the reader will learn some of the tricks of the trade from the masters. Our presenters were selected not just because they are experts on their respective subjects, but also because they are effective teachers. In the following six papers, they teach us how to provide effective education for patients with common pediatric complaints.
Weaning Time
Authors: LAWS HARRY F. 
Published: December 2021

To the Editor.—
There seems to be a great deal of argument as to when a child should be switched from breast/formula to cow's milk. Supportive data are difficult to come by for an exact age, although recommendations abound. The consensus appears to favor the concept that excess cow's milk can lead to problems, especially if started at a very early age.
Here is a method that I have been using in my practice for the last few years: Observing that weaning from the breast/bottle to a cup results in decreased milk consumption and overall caloric intake becomes supplemented with solid foods, this weaning time becomes a logical time to suggest starting cow's milk (as a decreased intake, decreases the "risks" associated with cow's milk intake).
Treatment of Occult Bacteremia
Authors: CARROLL WILLIAM L. 
Published: December 2021

In Reply.—
I appreciate Feldman's comments about our study. Although physicians' assessment has proved useful in predicting which children have serious bacterial infections such as meningitis, this appears not to be applicable to children with occult bacteremia. In most of the studies cited by Feldman, the number of children with bacteremia was too small to determine the physicians' ability to predict which children were bacteremic.1 In the study by Waskerwitz and Berkelhamer,2 physicians were able to predict bacteremia in only eight of 17 cases, and five of these eight patients had meningitis.
Intellectual Functioning and Ectodermal Dysplasia
Authors: TANNER BARRY A. 
Published: December 2021

To the Editor.—
The considerable but scattered literature on the ectodermal dysplasias contains little information on the intellectual aspects of that family of disorders. With two exceptions dealing with youngsters suffering from especially rare, mixed forms of dysplasias,1,2 what information exists tends to occur in passing references, eg, a sentence on a child's school performance or a physician's impression of intellectual functioning.3-5
My experience is that parents are hungry for information about all aspects of their child's disorders, and that they are likely to turn to their pediatrician for such information, including likely intellectual development.
Intellectual Functioning and Ectodermal Dysplasia
Authors: HOYME H. EUGENE 
Published: December 2021

In Reply.—
Tanner raises some interesting points with respect to the ectodermal dysplasias which deserve further comment: "Ectodermal dysplasia" is not a specific diagnosis. Malformations of ectoderm are frequent manifestations of a host of multiple malformation syndromes. An accurate, specific overall diagnosis is essential for the dysmorphologist or pediatrician to discuss prognosis and recurrence risks with parents in a knowledgeable fashion. Therefore, of paramount importance is the assignment of an accurate diagnosis in a child with an ectodermal dysplasia.
Levothyroxine Poisoning
Authors: LEHRNER LAWRENCE M. , WEIR MICHAEL R. 
Published: December 2021

In Reply.—
The letter by White and Litovitz raises the important issue of the reliability of basing medical decisions on case reports. When our patients were examined, we found nine case reports in the literature describing the toxicity of acute thyroid hormone ingestions. The message of the majority of the case reports is that thyroid hormones are toxic and that therapy is indicated. White and Litovitz cite two additional reports (one is an abstract) which predate our article.
Phenobarbital and Intraventricular Hemorrhage
Authors: BEDARD MARY P. , POLAND RONALD L. 
Published: December 2021

In Reply.—
We thank Boynton and Merritt for pointing out the error in the figure in our paper.1 The abscissa should be labeled "Total number of united pairs" as they have indicated. When using sequential analysis, a plan is constructed that takes into account the probability of erroneously rejecting the null hypothesis ( ), the probability of erroneously accepting the null hypothesis (β), and the degree of change sought (0).2 Only pairs in which the outcomes are different ("untied pairs") are plotted on the sequential plan.
Neonatal Intensive Care: Cost-Benefit Analysis
Authors: NEUSPIEL DANIEL R. 
Published: December 2021

To the Editor.—
Walker et al1 have contributed to the recent plethora of studies applying cost-benefit analysis to the provision of health care. In using this dangerous method to determine the value of neonatal intensive care, they legitimize the acceptance of cost criteria for the rationing of health services. This approach reduces the measurement of human life to economic productivity and accepts the unproven contention of dwindling societal resources available for health care.
Walker et al divided their subjejcts according to their neurodevelopmental evaluation into four categories: normal, (midly imapired, moderately impaired, or severely handicapped).
The National Institutes of Health Point of View
Authors: RANDOLPH JUDSON G. 
Published: December 2021

To the Editor.—
I write to applaud John R. Lilly's commentary in the July 1985 issue ("Biliary Atresia and Liver Transplantation: The National Institutes of Health Point of View," Pediatrics 1984;74:159-160) and to congratulate the editors of Pediatrics publishing this bold, refreshing essay. All of us who pay the bills for the National Institutes of Health (NIH) and who labor in the clinical vineyards, have a collective responsibility to see that the many and varied clinical efforts undertaken in Bethesda, MD are properly oriented and reach sound conclusions.
Concurrent Agenesis of the Corpus Callosum and Ureteroceles in Siblings
Authors: LACHIEWICZ AVE M. , KOGAN STANLEY J. , LEVITT SELWYN B. , WEINER RICHARD L. 
Published: December 2021

Agenesis of the corpus callosum is an uncommon anomaly that exists in complete and partial forms. It has been associated with other cerebral malformations as well as facial, genitourinary, musculoskeletal, cardiac, and respiratory anomalies.1 Agenesis of the corpus callosum is generally sporadic but it has been reported in several families.2 Ureteroceles frequently occur in association with duplications of the ureters.3 The hereditary occurrence of ureteroceles has been reported in five families.4-8 In this report, we describe two brothers with the simultaneous occurrence of agenesis of the corpus callosum and orthotopic ureteroceles.
Two brothers were seen at The Hospital of the Albert Einstein College of Medicine for evaluation of urologic abnormalities.
Stop Home Phototherapy
Authors: DELOACHE WILLIAM R. 
Published: December 2021

To the Editor.—
A recent communication from a manufacturer of phototherapy devices sought the opinion of pediatricians regarding home use of phototherapy for hyperbilirubinemia. My reply to the company was in strong opposition to this proposal. I am concerned that this manufacturer and others may advertise and promote home use of a form of therapy that is even now often prescribed in spite of inadequate knowledge with regard to indications, poor understanding of how or whether therapy is effective, and unfounded assumptions regarding safety.
Asthma and Pneumomediastinum
Authors: HEN JACOB 
Published: December 2021

To the Editor.—
An important piece of clinical information to add to Sturtz's recent review of spontaneous mediastinal emphysema in children1 is that mediastinal emphysema may be the first clinical clue to the presence of childhood asthma. Over the past 4 years, we have seen four children with cough and subcutaneous emphysema in the neck and no previous history of respiratory problems or asthma. These children had hyperinflated lungs and mediastinal emphysema demonstrated on admission chest roentgenograms and physical examination revealed wheezing.
Flexible Residency Programs for Women
Authors: UCHIYAMA NAOMI 
Published: December 2021

To the Editor.—
I am a member of the Committee on Women in Pediatrics of the American Academy of Pediatrics. The Committee recently studied the availability of flexible training and retraining programs in pediatric residency programs in the United States. We sent a questionnaire to the directors of the 292 pediatric training programs listed in the Directory of Residency Training Programs.
At present, 200 of the 292 (68.5%) have a flexible training program. However, only two of these programs have this as a written policy; one such program was developed in 1973 and, in practice, this program was individually designed.
In Reply: Heparinization of Alimentation Solutions
Authors: ALPAN G. , EYAL F. 
Published: December 2021

We thank Poland and Bedard for their interest in our findings and for pointing out an error of omission in our reporting of the data.
The infants in the heparinized group did indeed receive intravenous alimentation for a longer (mean) duration. The difference is due to skewing ofthe data by a subgroup of infants who required intravenous treatment for prolonged periods. Bronchopulmonary dysplasia developed in three infants in the heparmnized group v one infant in the nonheparinized group.
White Blood Cell Transfusions
Authors: DEKAT LAURETTE , STUTMAN HARRIS R. 
Published: December 2021

We recently reviewed the paper by Cairo et al on leukocyte transfusions for sepsis at our Pediatric Journal Club and several questions arose.
The enrollment criteria suggest that all eligible infants were included, yet it is difficult to believe that only nine infants with clinical deterioration and negative cultures were found compared with 14 culturally documented cases. In most centers, the ratio of suspected to proven neonatal sepsis is more like 10:1 than 0.6:1. If most infants for whom sepsis is suspected were not enrolled, then the results can be applied only to culturally proven cases.
Protein Quality in Feeding the Normal Infant: Do Whey-Predominant Formulas Offer Nutritional Advantages?
Authors: RÄIHÄ NIELS C. R. 
Published: December 2021

To the Editor.—
In a recently published paper, I have discussed milk proteins and the question of protein requirement of the normal infant.1 This paper was reviewed in a summary in the same supplement of Pediatrics.2
Because this summary contains some statements that are not in complete agreement with those in the original paper, I would like to clarify a few points concerning the quality of protein in infant formula.
The whey proteins make up the majority, about 70% of proteins in human milk whereas caseins are the primary proteins of bovine milk.
Unnoticed Change
Authors: STOLLER KENNETH P. 
Published: December 2021

To the Editor.—
It has been brought to my attention that after the publication of my report, "Inadvertent Intra-arterial Injection of Penicillin: An Unseen Danger" (Pediatrics 1985;75:785-786), Wyeth made certain modifications to the Tubex syringe delivery system. Specifically, Wyeth bent back the needle so that aspirate could potentially be visualized at a certain point on the glass cartridge. This was commendable; however, almost no one knows about it. Furthermore, this spot is very hard to find even if one is looking for it.