bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letter to the Editor
Authors: Silverman William A. 
Published: December 2021

I don't want to denigrate the views expressed by Ziegler, but I wonder about the relevance of attitudes and preferences of professionals in the trying circumstances under discussion. The important question to ask is, "What do parents want?"
In this connection, I am reminded of George Bernard Shaw's advice: "Do not do unto others as you would have them do unto you. They may have different tastes."
The Silent Patent Ductus Arteriosus
Authors: KASHANI IRAJ A. , SWENSSON RICHARD E. , MERRITT T. ALLEN 
Published: December 2021

To the Editor.—
We read with interest the article by Ellison et al1 on evaluation of preterm infants for patent ductus arteriosus. While commending the study for its elaborate design, we believe that in the modern neonatal intensive care unit there is a need for a less cumbersome and more practical approach to this common problem.
The criteria for detecting patent ductus arteriosus (PDA) in the presence of a continuous or systolic murmur presented in this paper are well founded, and the figures on the incidence of PDA are in agreement with some studies that have primarily relied on the murmur as the key feature.2,3
Vitamin K Deficiency in Infancy in Japan
Authors: NAGAO TAKESHI , NAKAYAMA KENTARO 
Published: December 2021

To the Editor.—
Lane et al1 reported a case of fatal intracranial hemorrhage in a normal infant who was retrospectively determined to have had vitamin K deficiency. This paper rings the alarm against the tendency toward cessation of routine prophylactic administration of vitamin K at birth for full-term infants. We support this opinion because there are many cases of intracranial hemorrhage due to "idiopathic" vitamin K deficiency in infancy in Japan and this may be related to abandonment of routine vitamin K administration at birth.
Bacterial Flora of Breast-Fed Infants
Authors: ROSE STEPHEN J. 
Published: December 2021

To the Editor.—
I read with interest the article on the development of neonatal intestinal flora by Yoshioka et al,1 but found myself at variance with them on several points. Early workers2 described marked differences in the bacterial flora of breast-fed and formula-fed infants with bifidobacteria and lactobacilli predominating in the former group and enterobacteria in the latter. However, the formula then used was a high-solute feed and more recently, other workers3-5 (including myself) have not confirmed these results.
High-Dose Intravenous Immunoglobulin for Severe Platelet Alloimmunization
Authors: BECTON DAVID L. , KINNEY THOMAS R. , CHAFFEE SARA , KURTZBERG JOANNE , FRIEDMAN HENRY S. , FALLETTA JOHN M. 
Published: December 2021

The development of platelet alloimmunization is a common and potentially severe consequence in patients who receive frequent platelet transfusions. The use of single-donor pheresis units or human lymphocyte antigen (HLA)-matched platelets to prevent or delay the onset of alloimmunization is often unsuccessful. Once sensitization occurs and refractoriness to platelet transfusions develops, patients are at risk of severe bleeding which may be difficult to manage. There has been no reliably effective therapy for such patients once alloimmunization occurs.
High-dose intravenous (IV) immunoglobulin therapy has been used to treat patients with autoimmune thrombocytopenia,1-4 autoimmune neutropenia,5,6 and posttransfusion purpura.7 Because of its success in these disorders, IV immunoglobulin was given to two patients with hemorrhagic symptoms who were refractory to platelet transfusions because of alloimmunization.
The Face in Otitis Media
Authors: SHAPIRO GAIL G. 
Published: December 2021

In Reply.—
Sharon's impression that children with a specific facies might be more prone to otitis, if true, might mean that there is an association between certain facial growth pattern and aberrant Eustachian tube function. Along the same lines, there is limited evidence and much discussion about the incidence of ear problems being higher in allergic children; their Eustachian tubes are compromised by the changes induced by hypersensitivity reactions in the contiguous area.
As intimated by Sharon, perhaps the sequelae of chronic rhinitis are twofold: facial growth abnormalities and Eustachian tube dysfunction.
Summary-The Weaning Process
Authors: Finberg Laurence 
Published: December 2021

Early in this symposium, Räihä (p 136) called attention to the biologic truism that breast-feeding evolved so that the composition of human milk would be optimal for the survival of the species, which must include the mother's survival as well as the infant's. However, optimal for survival in infancy may not be the same as optimal for life in the fifth, sixth, and subsequent decades of modern life. Therefore, as we consider approaches to infant feeding, these considerations, unanswerable at present, should be continuously in our thinking, at no time more than when we consider the weaning period, which, though variously defined, presents the most important nutritional challenge of modern times.
Whitehead has provided us with the news that our understanding of energy requirements for infants is surprisingly imperfect. His data suggest that sole breast-feeding by well-nourished mothers has sufficient calories for optimal growth on the average for 3 months. After this point, the average infant requires another source of calories. This conclusion comes from calculations derived from the National Center for Health Statistics growth curves on the one hand and actual milk production on the other. Although there is room for improvement of the data base, there is certainly a suggestion that weaning should begin at about 3 months of age in the breast-fed infant.
This point is underscored by Underwood, who views weaning as a long-term process in which calories from other foods complement human milk until the infant moves to the family diet. In some societies, such a process may extend over several years, and the presence in human milk of the digestive enzymes amylase and lipase adds an aura of naturalness to such a process.
Infant Bioethics Committees
Authors: DONOVAN EDWARD F. 
Published: December 2021

To the Editor.—
The American Academy of Pediatrics Guidelines for Infant Bioethics Committees1 appeared in the midst of increasing public attention on patients such as the Indiana and Long Island Baby Does and in the maze of adopted, invalidated, and newly proposed federal regulations regarding the care of handicapped and otherwise compromised infants. That the AAP guidelines, the Baby Does, and the federal regulations are unrelated events seems unlikely. That the latter two are sufficient justification for the imperfect first is problematic.
Asthma and Pneumomediastinum
Authors: ZWERDLING ROBERT G. 
Published: December 2021

To the Editor.—
Sturtz's case report and brief review of the literature on spontaneous mediastinal emphysema is interesting.1 However, he neglects to mention what is perhaps the most common cause of this condition in childhood—asthma. Indeed, reports of this complication have occurred over the past 130 years.2-4 Recognition of this fact often results in an understanding of the cause for the pneumomediastinum as well as tipping the clinician off to a possibly undiagnosed but readily treatable condition.
Fifth Versus Fourth Korotkoff Phase
Authors: LONDE SOL 
Published: December 2021

It is well known that neither the fourth Korotkoff phase (muffling of sounds) nor the fifth (disappearance of sounds) represent intraarterial diastolic pressure. I agree with Moss1 that whether or not a particular Korotkoff phase reflects true intraarterial pressure is not relevant. What both phases represent is a value for diastolic pressure as determined by the indirect auscultatory method. Clinical measurements should be referred to normal standards established with the same phase used in the determinations.
The question is which is preferable.
Most screening programs in adults and many in children have used the disappearance of sounds for the diastolic criterion because there was much less intraobserver variation.
Propylene Glycol Plasma Level
Authors: HALL ALAN H. , BRONSTEIN ALVIN C. , SMOLINSKE SUSAN C. , DOUTRE' WILLIAM H. , KULIG KENNETH W. , RUMACK BARRY H. , SPOERKE DAVID G. 
Published: December 2021

To the Editor.—
In reviewing recent publications on hyperosmolality in infants due to the excipient propylene glycol, we detected a major discrepancy between formulas for estimating the propylene glycol plasma level from the osmol gap as presented by Glasgow et al1 and by Fligner et al.2 Both detail similar propylene glycol apparent half-lives (Glasgow et al, 19.3 hours; Fligner et al, 16.9 hours) indicating similarly sloped elimination curves. However, the two predictive formulas give different results using the same osmol gap:
Using 74 mosm/kg as the osmol gap for comparison, Glasgow et al formula (r = .96)1:
Smoking and Asthma
Authors: BERKOWITZ SHELDON 
Published: December 2021

To the Editor.—
I want to thank Pedreira and his colleagues1 for providing us with more evidence to convince parents to quit smoking or, at least, not to smoke near their young children. However, although the authors looked at the passive effect of parental smoking on the incidence of lower respiratory tract infections, they did not mention its effect on children with asthma.
It has been my experience that young children with asthma have less problems if their parents stop or reduce their amount of cigarette smoking.
Adolescent Sexuality: Elements and Genesis
Authors: Calderone Mary S. 
Published: December 2021

To address the topic of adolescent sexuality and the elements that go into its genesis and evolution, it is necessary to determine when human sexuality, as a body system functioning independently from the human reproductive system, begins to function. In the case of the male, this has been shown by ultrasound technology to be at approximately 17 weeks of gestation, and subsequent developmental stages in both sexes are based on the three primary areas in human development: body, mind, sexuality. Positive aspects of sexual socialization are shown to depend on attitudes of parents, of society, of health and caring professionals, and of the child itself, to whom it is as important a part of its being as are body and mind.
Significant research carried out in different parts of the world on childhood sexuality is cited and discussed with its possible long-term meanings, effects, and possible prevention of the current apparent increase in childhood sexual molestation. The need for a massive paradigm shift on the parts of professionals, parents, and society in viewing, nurturing, and protecting the sexuality of infancy and early childhood is emphasized.
Can Fussy Babies Be Spoiled?
Authors: JONES J. ALBRIGHT 
Published: December 2021

To the Editor.—
I was disturbed by several aspects of the article by Dr Taubman1 on colic among infants in his practice. I have been in pediatric practice more than 50 years and, therefore, have had my share of babies to test my skill and patience.
It is my understanding that colic means abdominal pain and not just fussiness without a demonstrable cause. And there certainly are a number of causes of colic that can be diagnosed by appropriate studies and a thorough clinical examination.
Bifid Uvula
Authors: EAVEY ROLAND D. 
Published: December 2021

To the Editor.—
The recent article on the significance of bifid uvula was very thorough and thoughtful.1 The authors are to be complimented on their ideas and efforts. However, I believe three points should be addressed.
The first is the caveat that "... removal of the adenoids should be avoided because of the risk that hypernasality may develop postoperatively in patients with abnormalities of the palate." This statement rings with a tone of an absolute contraindication to surgery in the face of a bifid uvula.
Committee Statement on Nutrition Corrected
Authors:   Committee on Nutrition American Academy of Pediatrics
Published: December 2021

In Reply.—
It has been called to our attention that there is a typographical error in the Committee on Nutrition statement, "Nutritional Needs of Low-Birth-Weight Infants" (Pediatrics 1985;75:976-986). On p 982, column 2, line 7, the references cited should be 16, 44, and 65. The meaning of the sentence, supported by these references, is that each of the special formulas for premature infants listed in Table 4, Enfamil Premature, SMA "Preemie," and Similac Special Care, has been shown to be associated with adequate growth and metabolic stability.
Percutaneous Endoscopic Gastrostomies in Children
Authors: BENKOV KEITH J. , KAZLOW PHILLIP G. , WAYE JEROME D. , LELEIKO NEAL S. 
Published: December 2021

Our ability to maintain the nutritional status of acute and chronically ill children is enhanced by advances in special enteral feedings.1-3 When compared with parenteral nutrition, enteral feedings are accompanied by fewer complications, the ability to deliver large quantities of nutrients, relative ease of administration, and lower cost.2,3 Nasogastric feedings are very manageable for short-term therapy; however, in those patients requiring long-term support, a feeding gastrostomy can offer several advantages.4
Feeding gastrostomies have traditionally been placed via laparotomy under general anesthesia.5
We would like to describe our experience, as pediatric gastroenterologists and endoscopists, in the use of this technique in children.
Academic Hubris
Authors: BERGMAN ABRAHAM B. 
Published: December 2021

Envy and pique and vanity, all the passions of self-regard. You could not live long in a society of men and not see them weigh down the rest.
—C.P. Snow in The Masters
I have always liked the word hubris ever since I heard it on my first day of college from a humanities professor as he talked about the ongoing feuds between Sparta and Athens. Professor Arragon of Reed College defined hubris as "stiff-necked." Webster's New World Dictionary1 defines it as "wanton insolence or arrogance resulting from excessive pride." Lewis Thomas2 writes that hubris first turned up in popular English use as a light piece of university slang at Oxford in the late 19th century, with the meaning of intellectual arrogance and insolence.
Prepuce Care
Authors: MALLESON PETER 
Published: December 2021

To the Editor.—
In the article by Wiswell et al, "Decreased Incidence of Urinary Tract Infections in Circumcised Male Infants" (Pediatrics 1985;75:901-903), the authors' comment "The parents of uncircumcised male infants were additionally counseled to gently retract the foreskin to allow the easily exposed portion of the glans to be cleaned." As it is generally accepted that the prepuce is adherent to the glans penis and that retracting the foreskin in an infant may traumatize the penis and prepuce, I would wonder whether this advice may have contributed to the increased urinary tract infection rate seen in the uncircumcised male infants.
Prepuce Care
Authors: WISWELL THOMAS E. 
Published: December 2021

In Reply.—
In our initial report,1 we counseled parents to cleanse the noncircumcised penis after gentle retraction. We recommended that they wash the foreskin area as they would any part of the infant's body and emphasized that the prepuce should only be pushed back if it could be easily performed, never with any force. If the baby demonstrated any discomfort or if any resistance was felt, gentle retraction should be stopped. This was not an attempt to separate the prepuce.
In Defense of Circumcision
Authors: FINK AARON J. 
Published: December 2021

To the Editor.—
Do circumcisions need infant consent? Two northern California mothers seem to think so. They recently brought "landmark" lawsuits on behalf of their circumcised infant sons, alleging, among a number of claims, that the removal of the foreskin is an inhumane act, has no medical basis, is a forcible removal, done with ill will, for traditional, cultural, and religious reasons unrelated to medicine and that the plaintiff is entitled to exemplary and punitive damages.
Circumcision and Urinary Tract Infections
Authors: CUNNINGHAM NICHOLAS 
Published: December 2021

To the Editor.—
Wiswell, Smith, and Bass (Pediatrics 1985;75:901-903) reported an association between circumcision and decreased urinary tract infections in infancy. There being no plausible physiologic explanation for such a finding, before we accept any cause and effect relationship and the possible consequence (reversal of the worldwide trend away from routine circumcision of the newborn), we should seek alternative explanations. Several suggest themselves: (1) the two populations, having self-selected themselves (to have or not havecircumcision) differed in some way, socioculturally, in their prenatal habits or in their child-rearing behavior and these differences, not the circumcision, resulted in the discrepancy in incidence of urinary tract infection;
Handguns: Risks versus Benefits
Authors: CHRISTOFFEL KATHERINE K. , CHRISTOFFEL TOM 
Published: December 2021

THE ISSUE
There are an estimated 40 to 50 million handguns in the United States, with approximately 2 million more being manufactured annually1 (The New York Times, July 9, 1985, p 16). The high prevalence of handgun injury in the United States is unique in all the world and is increasing. Children are among the growing legions of US citizens harmed by the handgun epidemic.2 The effort to control handguns is focussed on developing laws to control their manufacture, importation, purchase, possession, and use. Opponents of these legal approaches claim that gun control endangers constitutional freedoms. When asked, the US Supreme court has consistently rejected that position in favor of the view that the Second Amendment protects a collective, not a personal, right to bear arms.3,4
Dangers of Chicken Soup
Authors: CHU EDWARD 
Published: December 2021

To the Editor.—
Chicken soup has long been regarded as a popular treatment for a wide variety of ailments. The 12th century philosopher and physician, Moses Maimonides, extracting from ancient Greek writings, recommended chicken broth for "rectifying corrupted humors,"1 which meant it was good for everything. Recently, chicken soup has again received attention in the medical literature, some of it serious2 and some of it tongue in beak [sic].3-6 The serious study demonstrated a significant increase in nasal mucous velocity following the ingestion of hot chicken soup, suggesting a therapeutic effect in the common cold.
Light and Transcutaneous Po2 Device = Problem?
Authors: TRUEBLOOD DAVID M. 
Published: December 2021

In Reply.—
When the sensor in question was reported to the SensorMedics Hot-Line, it was replaced within 24 hours. SensorMedics' standard procedure is to have any reported malfunction or report of less than optimum performance resolved within 24 hours. When the "photosensitive" sensor was returned, it was determined to, indeed, be sensitive to electromagnetic interference, due to the fact that the cable had been subjected to sufficient force to cause the sensor shield to separate from the cable shield.
A Shadchin in Academe
Authors: PLESS I. B. 
Published: December 2021

The Yiddish word shadchin is best translated as marriage broker. In the old days, in the small communities or shtetls where many Eastern European families lived, such an individual emerged, probably self-appointed, to help arrange marriages. One assumes that both parties were eager to get married, but either were unaware of the other's intentions or simply required the help of a third party to sort out some of the obstacles that lay in the path of eternal bliss.
Academia today bears some semblance to the shtetl of the past. The communities of the Ivory Tower consist, more or less, of like-minded individuals with similar backgrounds, goals, and aspirations.
Junctional Epidermolysis Bullosa of the Larynx
Authors: KENNA MARGARET A. , STOOL SYLVAN E. , MALLORY SUSAN B. 
Published: December 2021

Epidermolysis bullosa is a rare genetically determined, dermatologic disease in which minor trauma causes blister formation.1 A new variant of hereditary epidermolysis bullosa, generalized atrophic benign epidermolysis bullosa, junctional form, has been recently reported.2 Airway involvement has not been a notable feature of this disease. We report the first case of an infant having benign junctional epidermolysis bullosa with laryngeal involvement.
CASE REPORT
An 11-month-old white boy with known junctional epidermolysis bullosa and mild stridor since birth was referred by his dermatologist for increasing stridor of 24 hours duration. He was initially thought to have croup; however, conservative treatment with mist and racemic epinephrine did not improve his symptoms.
Steroid Abuse by Adolescents
Authors: KWASMAN ALAN 
Published: December 2021

To the Editor.—
I would like to call attention to my suspicion that there is significant steroid abuse among adolescents and offer a short case report. I have been surprised at the number of adolescent boys who come in for physical examinations and ask about steroids. None of these patients have asked for steroids, but they openly state that they can get them from "friends." All of them appear concerned about the side effects.
I would like to present the salient features of one case of steroid abuse.
Variation on Tick Removal
Authors: KAMMHOLZ LARRY P. 
Published: December 2021

To the Editor.—
Recently, Needham described a method of tick removal involving grasping the head of the tick with a blunt curved forceps or tweezers and applying steady traction (Pediatrics 1985;75:997-1002). In a letter (Pediatrics 1986;77:261), Cochran mentioned pulling the tick out vigorously, skin and all, to the accompaniment of an "eech" sound.
Some of us might prefer not to elicit such sounds from our smaller subjects. During the past few years, I have removed ticks relatively easily in the following way. The point of a suture needle (FS-2 cutting) is positioned in the face of the tick just above the attachment to the skin.
Variation on Tick Removal
Authors: WUNG JEN-TIEN , JAMES L. STANLEY , KILCHEVSKY EITAN , JAMES EDWARD 
Published: December 2021

In Reply.—
We would like to respond to Dr Levin's letter which questions the appropriateness of publishing our article on the management of infants with severe respiratory failure and persistence of the fetal circulation (PFC), without hyperventilation (Pediatrics 1985;76:488-494). Dr Levin may take exception to the opinions expressed as to how we manage severe respiratory failure, but he cannot take exception to the results.
Induction of profound hypercarbia using both a high ventilator rate and a high inspiratory pressure for the treatment of PFC has resulted in a survival rate of less than 60%, an incidence of air leak in excess of 50%, and the development of bronchopulmonary dysplasia in 25% of the patients.
Use of Otoscope for Cranial Transillumination of the Infant Skull
Authors: KARNIK DILIP J. , KARNIK SHUBA D. 
Published: December 2021

To the Editor.—
Transillumination of the head is a simple and useful technique for evaluating intracranial content in very young children. For detecting suspected hydrocephalus, subdural effusions, and large intracranial cysts, this procedure remains inexpensive and very easy to perform.1 High intensity transilluminators have been used for this procedure; however, they are not readily available at the bedside in the office. Therefore, in such situations an otoscope can be used for such a purpose.
A Welch Allen wall model was used for this purpose with good success.