bluuebunny/crossref_metadata_2025_split huggingface dataset:
Was It a Type II Error?
Authors: Pascoe John M. 
Published: December 2021

Dr Oski's controlled study (Pediatrics 66:168, 1980) comparing the gastrointestinal (GI) symptoms of a group (N = 44) of infants receiving formula with iron and a group (N = 49) receiving formula with no iron was well conceived and practical. However, his concluding statement "...our study failed to provide any evidence for the commonly held belief that iron-fortified formulas produce gastrointestinal side effects in infants," was not supported conclusively by his data.
A recent review article emphasizes the importance of type II errors in clinical controlled trials.1
Letters to the Editor
Authors: Shearer Madeleine H. 
Published: December 2021

On the basis of 13 premature births to mothers who were given cans of protein-rich supplement, Rush et al (Pediatrics 65:683, 1980) conclude that "... the supplement produced growth retardation." The data do not support this conclusion.
The authors calculate that women on the protein sypplement actually increased their mean daily caloric intakes by only 261 calories to 2,326—still below the Recommended Daily Allowances (RDA) for the average pregnant women (AND the malnourished one).
Be Prepared!
Authors: Schowalter John E. 
Published: December 2021

The survey of hospitals' preparation practices for children by Azarnoff and Woody in this issue of Pediatrics1 raises a number of important questions, again. I say again, because the discrepancy between what is known about the usefulness of preparation and the status it is given in most hospitals has long been present.
The survey shows that most pediatric preparation in acute care hospitals is done by nurses. The characteristics of hospitals that tend to offer preparation are that they are larger than average, have staff trained in psychosocial care, and primarily serve Anglo-American patients. One third of the hospitals that responded to the survey stated that they had some sort of regular preparation program.
Committee on Nutrition and the WHO Code of Marketing Breastmilk Substitutes
Authors: Barness Lewis A. 
Published: December 2021

Many have questioned the decision of the American Academy of Pediatrics not to support all of the provisions of the International Code of Marketing of Breastmilk Substitutes of the World Health Organization. Some have attributed the AAP stance to allegiances other than to children, but the AAP has long been known for its support of breast-feeding. The AAP has already expressed its concern for the adequacy of the WHO code in a press release and elsewhere. Some of the deliberations of the AAP Committee on Nutrition (CON), while I was its chairman, may be of interest.
The AAP Committee on Nutrition has unofficially considered the various drafts of the Code during the past three years and has voiced its suggestions for further revisions, without notable effect.
THE PUBLISHING GAME
Authors: M. E. K. 
Published: December 2021

In 1958, when James D. Watson worked his way up to the rank of Associate Professor at Harvard, the young biochemist had on his curriculum vitae eighteen papers ... today the bibliography of a candidate ... often lists 50 or even a hundred papers.
... Paper inflation has become a fact of academic life during the past two decades.... The increases stem not from a sharp rise in productivity but rather from changes in the way people publish. Co-authorship is on the rise, as is multiple publication of the same data. The length of papers, meanwhile, has been decreasing.
A researcher publishes four short papers rather than one long one. This fragmentation contributes to a host of problems not the least being the sheer growth of the literature. One estimate holds that the Index Medicus for 1985 will weigh more than one ton.
Diet and Theophylline
Authors: Weinberger Miles , Smith Gary , Milavetz Gary 
Published: December 2021

The recent article by Feldman et al1 demonstrating the effect of diet on theophylline elimination is qualitatively consistent with a previous report in adults2 but contains quantitative inaccuracies that distort the clinical relevance of the data. Specifically, the apparent volumes of distribution and the half-life of elimination were inappropriately determined, resulting in specious values that are not consistent with the more appropriately calculated clearance values.
The authors state that the apparent volume of distribution was calculated by dividing the serum concentration extrapolated to zero time into the dose of the drug.
Letters to the Editor
Authors: Spino M. , Thiessen J. J. , Isles A. , Levison H. , MacLeod S. M. 
Published: December 2021

We found the report by Feldman et al1 interesting with potential clinical application. However, we would like to point out an error in their determination of the apparent volume of distribution (V) and comment on both their methodology and results.
They state that V was calculated by dividing the dose of the drug by the extrapolated y intercept for drug concentration at time 0. This method is correct for a drug which exhibits monoexponential elimination following a single intravenous dose.
OUR FIRST JOURNAL DEVOTED EXCLUSIVELY TO PEDIATRICS (1884)
Authors: C. T. E. 
Published: December 2021

By the 1880s American articles pertaining to diseases of children had become so numerous and so scattered through the medical literature that a group of five rather young New York physicians, whose practices leaned heavily toward pediatrics, became convinced of the need for a special American journal devoted exclusively to pediatric topics. In 1883 a publisher was found and in January 1884 the Archives of Pediatrics made its debut with William Perry Watson (1854-1925) as the editor. (Figure shows title page.) The Archives of Pediatrics continued until September 1962, when it merged with the American Practitioner and the Quarterly Review of Pediatrics to appear under the new name of Clinical Pediatrics.
See Images in the PDF File
The first paper published in the first issue was on convulsions in children. The paper was filled with practical hints about how the young physician should evoke order from chaos when he made a house call to see a convulsing child. The secret was to keep everyone busy in preparing a warm bath, moving the patient to a larger bedroom, removing his clothing, wrapping him in a flannel blanket, and looking for mustard to put in the hot bathwater. By the time all these had been done the convulsion would probably have abated.
Let's Speak Up for Pediatricians
Authors: St Geme Joseph W. 
Published: December 2021

I am concerned about the self-image of pediatricians. I am concerned that those physicians whose professional careers surround the consummate health and welfare of our children consider themselves to be leveled among their professional colleagues with the same perspective as their patient populations, that is, second-rate, less important, and less distinguished in their capabilities and professional objectives than the classic "adult" physicians, the internists and surgeons. The obstetrician-gynecologist shares some of the same perceptual problems, a mind-set of subliminal second-class professional citizenship, consistent with the still attenuated role of women, their professional clientele.
Oh, there are exceptions! There are pediatricians who take charge of their professional practice groups, hospital staffs, national societal organizations, teaching hospitals, and medical schools.
DISADVANTAGES OF HAVING DIABETES–AND ADVANTAGES
Authors: Keltner Robert William 
Published: December 2021

About three years ago I became a diabetic, and since then I have been very interested in learning all I can about the disease. I am interested in the medical profession and am considering going into diabetes research.
As with other diseases, there are disadvantages to having diabetes. I have found that I must maintain a delicate balance between insulin injections, diet, and exercise in order to keep my blood sugar at a normal level. The maintenance of this balance requires a great deal of my attention, so occasionally I am unable to concentrate completely on some activity. I must always be conscious of my sugar level and be ready to make adjustments if my level is too high or too low. Another problem I have experienced is that other people do not understand diabetes. I have encountered people who think diabetics are sick and cannot lead normal lives. Other disadvantages of diabetes are the daily insulin injections I must take and the complications that can occur if proper control is not maintained. Although I have not experienced complications, some diabetics experience slow healing of wounds and impairments of eyesight and circulation.
Despite the disadvantages of diabetes, I have found that having it is advantageous in some aspects. My healthy diet and regular exercise have allowed me to stay in good shape. Some doctors consider diabetes "the healthiest disease." Another advantage of diabetes actually stems from the disadvantages of the disease. In some ways the problems involved with diabetes have made me more determined to excel at whatever I do.
A VICTORIAN CHILD AND THE CHILDREN'S HOSPITAL (1881)
Authors: C. T. E. 
Published: December 2021

The following description of life in a children's hospital appeared in The Children's Sunday Album, published in London in 1881.1 The wide difference between the rich and the poor child was usually accepted in the Victorian era as part of the Divine order of things.
Look at this picture well, you little, bright, happy children, who are well and strong, or even any afflicted like these, and be grateful for the cheerful homes, the loving friends, the comforts which surround you! Good generous people, pitying and loving little children, have sent enough money to support them, and have them taught trades to enable them to lead useful lives, though they are cripples.
See how busily at work this big girl is at the end of the form; but her crutches lying beside her tell only too plainly of her misfortune. Bad nursing in their babyhood, joyless unchildlike lives in crowded dirty streets, cause the children of the London poor to be wretched sufferers; and it is a piteous, touching sight to visit the hospitals which have been built for these poor little creatures. Everything is done for them that skill and kindness can do; but it is not like you at home in your beautiful nurseries, with your toys and books, your loving mother, and healthy little brothers and sisters making merry round. In each little bed is some poor, suffering child, tended by kind nurses certainly, but no mothers. Think of this, little ones, when inclined to be fractious and cross, and troublesome, and bless God who has made your lot so bright.
Transcutaneous Bilirubinometry: A New Light on an Old Subject
Authors: Hegyi Thomas 
Published: December 2021

The role of bilirubin as a cause of central nervous system morbidity in the newborn infant has been well recognized for several decades. The specific serum concentration that leads to cellular injury, as well as the precise mechanism of damage, are as yet unclear but general principles of therapy have been established. Early detection of hyperbilirubinemia is based on the clinical assessment of dermal icterus followed by appropriate serum tests to determine the degree of serum bilirubin elevation.
The relationship of dermal icterus and serum bilirubin concentration has intrigued clinicians for more than a century.1 In an attempt to utilize skin color as an index of hyperbilirubinemia many techniques have been investigated.
Lead Study Questioned
Authors: Spector Steven , Brown Kevin E. 
Published: December 2021

The recent article by Drs Ernhart, Landa, and Schell1 regarding developmental deficits resulting from subclinical levels of lead displays serious inaccuracies of data interpretation and measurement. Although their rigorous attempt to improve the methodology in this area of research is commendable, there are major shortcomings in their research.
These investigators "question reports of positive findings" and conclude that the effects of subclinical lead levels "are minimal." They dismiss the few significant results and would have us believe that it was mere coincidence or artifact that these few significant results were obtained on the "critical intelligence test set."
ARMAND TROUSSEAU ON THE TREATMENT OF ENURESIS (c1850)
Authors: C. T. E. 
Published: December 2021

Armand Trousseau (1801-1867), in his time considered the foremost clinician of the Hôtel-Dieu (the oldest hospital in Paris), made many significant advances in the treatment of diphtheria, scarlet fever, typhoid fever, and rickets.
In one of his clinical lectures at the Hôpital des Enfants-Malades, Trousseau gave the following suggestions for the treatment of enuresis.
This infirmity [enuresis] I consider a neuralgia or névrose, and it is much more common than is generally believed. It has been thought nearly incurable, but with belladonna, is one of the most easily cured of all diseases.
Those children who are troubled in the daytime are not cured by belladonna.
A child going to bed with an empty bladder will pass his water during the first two hours, sometimes during the first hour; placed in bed at 9 o'clock, the bladder will throw off its contents at 10 o'clock, and then retain them until 8 o'clock the following morning, being full at that time. The accident generally happens once only during the night, but sometimes twice. During the first hours of sleep, you generally find in young men and children an erection. The question may be asked, whether something of the same kind may not take place in the bladder. This complaint is most common among young girls, and is generally cured spontaneously at the age of puberty; but when this is not the case, do what chance has shown to be efficacious.
Treatment—The first precaution is to break up the bad habit of the organs. Wake the child at the end of an hour, and make him pass his water; after several days, make him at the end of an hour and a half. This is only accessory.
Quinacrine Hydrochloride-Induced Yellow Discoloration of the Skin in Children
Authors: Sokol Ronald J. , Lichtenstein Philip K. , Farrell Michael K. 
Published: December 2021

The drug of choice for treatment of giardiasis in children has changed over the past several years. Metronidazole (Flagyl) has been found to be carcinogenic in mice and mutagenic in bacteria,1 and is, therefore, no longer approved by the Food and Drug Administration for the treatment of giardiasis. Thus, quinacrine hydrochloride (Atabrine) is the recommended alternative drug for the treatment of giardiasis in children. The purpose of this report is to remind physicians of a common side effect of quinacrine hydrochloride and to call attention to a simple clinical method for its confirmation.
CASE REPORT
S.W., a 3-year-old white boy, had a three-week history of three to six loose, watery bowel movements per day.
Echocardiography in Aspergillus Endocarditis
Authors: Kleiman Martin B. 
Published: December 2021

In an extensive review1 of endocarditis caused by Aspergillus in children, Barst et al found no cases in which the presence of vegetations was proven by echocardiography. We present the case report of a child in whom the two-dimensional echocardiogram first established the presence of a mycotic aneurysm and associated intracardiac and intra-aortic vegetations.
Case Report. An 11-year-old girl with severe congenital aortic stenosis underwent aortic valvulotomy on Dec 17, 1977. Fever developed on the 11th day after surgery and daily spikes to 38.8 C (102 F) continued for the ensuing several weeks.
Neural Tube Defects: Prevention by Vitamin Supplements
Authors: Smithells R. W. 
Published: December 2021

Neural tube defects (NTD) have been the object of more intense epidemiologic study than any other kind of birth defect. This is in part because of their ready recognition at birth (and, in recent years, before birth) and in part because their consequences are usually catastrophic: they kill or they cripple.
Regarding their cause, no single genetic or environmental agent has been identified (or is likely to be) and a multifactorial basis is assumed. If failure of neural tube closure results from the additive effects of several adverse factors, removal or correction of any one might shift the developmental balance across the threshold from NTD to normality.
Eagle-Barrett Syndrome
Authors: Dorst John P. , Seidel Henry M. 
Published: December 2021

Eponyms may at times have an unexpected value when they are used to designate syndromes or specific diseases. We would suggest, for example, that Eagle-Barrett1 syndrome is a kinder and more appropriate designation than "prune belly syndrome."
Our experience tells us that the latter designation is disturbing to parents of children who have the problem. Unfortunately, these children are sometimes referred to as "prune bellies." The designation does lend itself at times to an unintended but nevertheless demeaning overtone.
OLIVER WENDELL HOLMES ON TELLING THE PATIENT THE WHOLE TRUTH
Authors: C. T. E. 
Published: December 2021

Oliver Wendell Holmes (1809-1894), in an address delivered to the graduating class of the Bellevue Hospital Medical College on March 2, 1871, had this to say about telling all the truth to patients1:
Your patient has no more right to all the truth than he has to all the medicine in your saddle-bags, if you carry that kind of cartridge-box for the ammunition that slays disease. He should get only just so much as is good for him. I have seen a physician examining a patient's chest stop all at once, as he brought out a particular sound with a tap on the collar-bone, in the attitude of a pointer who has just come on the scent or sight of a woodcock. You remember the Spartan boy, who, with unmoved countenance, hid the fox that was tearing his vitals beneath his mantle. What he could do in his own suffering you must learn to do for others on whose vital organs disease has fastened its devouring teeth. It is a terrible thing to take away hope, even earthly hope from a fellow-creature. Be very careful what names you let fall before your patient.
Mental Retardation in the Bannayan Syndrome
Authors: Saul Robert A. , Stevenson Roger E. , Bley ROGER 
Published: December 2021

Bannayan syndrome, first reported in 1971, is characterized by macrocephaly and multiple softtissue and visceral hamartomas.1 Two reports have documented autosomal dominant inheritance and an altered rate of linear growth.2,3 An intracranial tumor occurred in one patient.3 We report a third family with Bannayan syndrome with a significant additional feature, mental retardation.
CASE REPORT
The proband, a 1710½-year-old white male adolescent, was noted shortly after a normal birth to have a large head, diagnosed as "hydrocephalus." No specific intervention was initiated. Skin tumors developed within the first year, and a 5x6x7-cm lipoma (confirmed by histologic examination) was removed from the right axilla at 2 years of age.
Letters to the Editor
Authors: Versmold Hans T. 
Published: December 2021

No infant with a birth weight less than 1,000 gm is normal. Therefore, there will be a continuing controversy about the criteria for electing infants as a "normal" reference group.
The crucial difference between infants in the study of Feldman et al1 and our "well babies" is that we systematically excluded transfused infants, because we usually transfuse infants for suspected hypovolemia, hypotension, or anemia, conditions excluding them from our analysis to eliminate the bias of blood pressures artificially elevated by volume expansion.
Chloramphenicol Interactions
Authors: Zaret Gary M. 
Published: December 2021

In a recent report describing chloramphenicol pharmacokinetics1 it was stated that patients changing from intravenous to oral administration of the antibiotic exhibited prolonged half-life (t½ = 6.5 ± 2.5 [SD] hours) compared with values obtained during intravenous administration ( t½ = 4.0 ± 1.4 [SD] hours). These findings, consistent with an earlier study,2 are said to indicate that oral administration of chloramphenicol may be at least as effective as administration via the intravenous route.
One aspect not considered in this report concerns the concurrent use of other (nonantibiotic) medications.
Letters to the Editor
Authors: Winter William D. 
Published: December 2021

Joseph W. St. Geme, Jr, has written of the pediatrician's self-image and sense of "worth" (Pediatrics 68:734, 1981). I quite agree with his sense that we should not feel that we are small doctors because we treat small patients. And I quite agree that the newly graduated resident should not allow his special skills to fade in deference to those of other specialists.
But when his emphasis on the "worth" of a pediatrician focuses ultimately on the monetary, I take issue:
Response to Letters on Infant Botulism
Authors: Arnon Stephen S. 
Published: December 2021

Few would disagree with the concern expressed by Shaw1 and echoed by Thompson2 that ". . . if unsupported hypotheses are repeated often enough, they may become accepted as fact." But what of hypotheses that appear unsupported because evidence on which they rest has been overlooked?
Except for work by Thompson and colleagues,3 the literature cited by both correspondents does not go beyond 1977, by which time infant botulism was recognized as an infectious disease in which ingested spores of Clostridium botulinum multiply in the gut and produce botulinal toxin in vivo.4,5
ELECTRIC BUNTING TO MAINTAIN BODY TEMPERATURE DURING EXCHANGE TRANSFUSION IN THE NEWBORN INFANT
Authors: VOGEL P. , ROSENFIELD R. E. , STEINBERG M. 
Published: December 2021

THE maintenance of proper body temperature has been a serious problem in the performance of exchange transfusions on newborn infants suffering from hemolytic disease. Many of these infants are in such poor condition that extreme care in their handling is required, including incubation, oxygen and tracheal aspiration. The many procedures necessary create the hazard of prolonged exposure to room temperature, and a number of deaths may have resulted directly or indirectly from hypothermia. In the Children's Hospital in Boston, the entire exchange transfusion is carried out with the infant lying in a Hess bed; this is an ideal situation which undoubtedly is not readily available in most institutions where an exchange transfusion must be performed. The maintenance of body temperature with electric heating pads and/or hot water bottles has proved cumbersome and unsatisfactory, and has resulted in a number of burns, particularly about the buttocks.
A washable electric blanket bunting has been designed (see Figs. and 2) to maintain the temperature of newborn infants throughout the procedure of an exchange transfusion, as well as for a period following the procedure, if a heated crib is not available. This bunting was constructed by the General Electric Company using water-proof washable material and employing the principles of the commercial electric blanket. The bunting can be regulated to any desired temperature although the maximum temperature obtainable is 42°C., which avoids the possibility of skin burns. The design of the bunting is simple: it is a bag with a zipper along one side to allow for easy insertion and removal of the baby, and a "U" shaped zippered flap which can be opened to provide a window at the approximate position of the umbilical cord.