bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single Umbilical Artery
Authors: Van Leeuwen Gerry 
Published: December 2021

Dr. Gellis, in 1971 Pediatric Yearbook, indicated that nothing very new was being learned about the missing umbilical artery and decided to say no more about it.1
In the July 1973 issue of Pedaitrics, there is an article and a commentary on single umbilical artery.2 I would like to make a couple of comments relevant to the report of nearly 40,000 infants reported in the collaborative study. In the Journal of Pediatrics in 1967 and 1968,3,4 we reported, in mixed black and white infants, an incidence of 0.3% single umbilical artery.
Routine Chest Radiography in Children
Authors: Thomas H. P. , Schiller Ruth P. , Girone Joseph A. C. , Rothstein Edward P. , Schlackman Neill 
Published: December 2021

Brill et al., in a recent report, suggested that chest radiography is not indicated as a screening procedure in healthy children. Their conclusion seems justified, since the study included 1,000 healthy children. Most important, however, was the qualification that these children had no abnormality on physical examination, presumably performed by experienced physicians.
We have recently been involved with two cases in which unsuspected conditions were unmasked by "routine" chest x-rays done before the physical examination.
A Pediatric Nurse-Practitioner for the Neonate
Authors: Slovis Thomas L. , Comerci George D. 
Published: December 2021

We have been impressed with the relative laxity in the care of newborns between delivery and first observation by a pediatrician. Especially during this critical period of transition, careful monitoring is required.
A program for the training of a neonatal nurse practitioner (NNP), therefore, was developed at a regional Air Force hospital and 14 registered nurses and one licensed practical nurse have since been trained. Formal instruction consisted of 24 hours of cribside activity including presentation of factual material, demonstration of physical findings and discussion of pathophysiology.
Questions That Worry Children with Exstrophy
Authors: Feinberg Todd , Lattimer John K. , Jeter Katherine , Langford William , Beck Leah 
Published: December 2021

It was apparent in the work with patients and their families that children who have exstrophy and epispadias have many more psychologic problems, particularly during adolescence, than the average child. The chief areas of conflict centered around wetness and concern for sexual adequacy. The anxieties of the children were also reflected in the parental attitudes.
In our opinion, there should be an ongoing guidance team which becomes involved with the family at the birth of the infant with this abnormality and which extends its services into young adulthood. The focus of the work should be to help these patients and their parents understand the nature of the problems. Guidance should be at many levels, from the care of the stoma to the inevitable emotional conflicts (Table IV).
At the Babies Hospital on the Columbia University Pediatric Urology Service, one of us (K.J. and family) has instituted a program of writing booklets for the information of the parent and the patient as to the best way to care for a stoma or a urine collection device. Booklets of advice and counsel for the parents are also being developed. Discussion groups are being set up with our nurses under one of us (L.B.) who is a child psychiatrist, to help parents and children ventilate their feelings and fantasies and to help them resolve some of their conflicts as to allow for maximal growth on the part of the child. In addition, in these groups counselling can take very concrete forms as to hobbies and activities for the children and even the best device for collecting the urine. The group tends to be very supportive of and helpful to its individual members.
Grasshopper Allergy
Authors: Schnitzker William F. 
Published: December 2021

Allergic reactions to insects may occur from saliva or injected toxins, patient sensitization to body protein of the insect, sensitization to the emanation, scale, or powder of the insect, or allergy to pollen carried by the insect.
Generalized urticaria, angioedema, anaphylaxis and death may occur in sensitized persons following sting by: Hymenoptera—bees, wasps, hornets, and ants; and Diptera—mosquitoes.
Eczema or urticaria may occur from contact with insects. Allergic rhinitis and asthma may result from inhalation of insects or their products. Mites are contributary factors to house dust allergy. The May and Caddis fly can cause epidemic respiratory allergy by inhalation.
Toxic Effects of Anticonvulsants: General Principles
Authors: Hooshmand H. 
Published: December 2021

Any drug, regardless of how benign and well tolerated, is potentially toxic. The toxicity may be due to (1) dosage; (2) the size of the patient; (3) drug interaction; (4) drug specificity for the disease; (5) the nature of the disease for which the drug is used; and (6) the mode and frequency of medication.
DOSE OF ANTICONVULSANT
Dose of anficonvulsant is very important (Table I). Any anticonvulsant in higher than therapeutic doses has toxic potential. It is well known that anticonvulsants in large enough doses can act as convulsants. This is especially true for diphenylhydantoin, benzodiazepines, and lidocaine.
THE SIZE OF THE PATIENT
The size of the patient should be considered in dosage. It is safer and more accurate to adjust dosage to body surface than to weight (Table I). As the child grows, there may be a need to gradually increase the dose of anticonvulsants if seizure control is poor, or if the serum level of the anticonvulsant starts to decline.
DRUG INTERACTION
The relationship. of multiple drug therapy and its toxic effects on the brain is quite complicated, and many forms of toxicity can result.
Toxicity may be the result of a combination of pharmacologically similar drugs. Such a combination may enhance the side effects of drowsiness and ataxia. The patient may suffer from these side effects without attaining therapeutic levels of individual anticonvulsants in the blood. In other words, a combination of drugs such as phenobarbital and primidone may result in severe ataxia and drowsiness.
Letter to the Editor
Authors: Kattwinkel John 
Published: December 2021

I certainly agree with Drs. Harris, Stevens, and Nugent that the most efficient nasal CPAP delivery system would be the one which offers the least resistance to flow. Since such resistance is dependent not only on the diameter of the tubing, but also on tubing length, we feel that the short Silastic cannulae described in our article offer advantages over previous systems which have involved cannulation of the nares to the postetior pharynx.
Regarding the accuracy of pressures obtainable by the nasal technique, we have not found the mouth leak to be significant until a system pressure of approximately 10 to 12 cm of H2O is achieved.
Encephalopathy Following CNS Prophylaxis in Childhood Lymphoblastic Leukemia
Authors: Muriel Federico Sackmann 
Published: December 2021

Common acute toxicities from intrathecal methotrexate are well known. The paper by McIntosh et al.1 is important because it emphasizes an intrathecal methotrexate (and radiation) toxicity which is more often observed than reported (we believe that in clinical practice of chemotherapy the common toxicity is overlooked and underreported).
In a recent publication, Aur et al.2 stated: "Five to eight weeks following irradiation approximately 10% of the children experienced fever and somnolence, sometimes accompanied by dizziness or spinal fluid pleocytosis, which lasted 1-2 wk.
THE CASE OF A MALE CHILD BORN WITHOUT AN ANUS (C. 1745)
Authors: C. T. E. 
Published: December 2021

The case history below written by a Scottish surgeon is a good example of the linguistic style of mid-eighteenth century clinical presentations in the English language.
Paul of Aegina, a seventh century Byzantine physician, is usually credited with having successfully incised the perineum of an infant without an anus1
The first recorded American operation was performed in Flemingsburg, Kentucky, in 1800 by Dr. J. P. Campbell.2 The defect was an anorectal atresia without fistula, and the child was living three months after operation.
Mr. James Jamieson of Kelso, Scotland gave this description of his unsuccessfully treated patient:
Some years ago Mrs. Hannah, midwife in this Town was called to one Mrs. Stevenson in Plowland five miles distant from this Place, whom she delivered of Twins, the one Female, the other Male; and discovering in the later no Appearance of an Anus, came home and sent me to see the Child, whom I found otherwise sprightly, and seemingly in perfect Health, but not the least Vestige of an Anus to be seen or felt, but equally firm and solid from the Coccix (sic) to the Scrotum: whereupon I told the Grandmother, who only was acquainted therewith by the midwife, that it was preternatural, and that though I had twice seen the Anus covered by a membrane, which was easily cured, I could not propose to do the like in this; but if she pleased, I should try to reach the Gut by Incision which she, with the mother's Consent fondly agreed to: whereupon I made an incision pretty deep in the most reasonable Part, then introduced my little Finger into the Wound, to find the Gut, but in vain.
Double-Blind Study of the Effectiveness of a Broad Spectrum Antibiotic in Status Asthmaticus
Authors: Shapiro Gail G. , Eggleston Peyton A. , Pierson William E. , Ray C. George , Bierman C. Warren 
Published: December 2021

The dosage of 1:1,000 aqueous epinephrine is incorrectly given in the article by Shapiro et al. in the June issue (Pediatrics, 53:867, 1974). The cor- rect dosage is 0.01 cc/kilo instead of 0.1 cc/kilo as given.
The patient's serum IgE level in the article by Albrecht et al. in the June issue (Pediatrics, 53:907, 1974) is incorrect. It should be given as 205 nanograms per milliliter instead of 205 mg/ml.
The Implications of Minor's Consent Legislation for Adolescent Health Care: A Commentary
Authors: Hazard Sprague W. , Eisner Victor , Garell Dale C. , Heald Felix P. , Hofmann Adele D. , James W. Scott , Shen Jerome T. Y. , Tanner Natalia M. , Thornton Melvin L. , Wasserman Martin P. , Wolfish Martin G. 
Published: December 2021

The increasing emergence of legislation providing for minors' consent for health care furnishes a range of basic medical, legal, and social issues which require the thoughtful consideration of physicians caring for youth. The legislative provisions referred to account for a variety of consent situations ranging from the care of a specific illness or disorder to the dramatic lowering of the age for which consent for health care can be given.
The ultimate conflict in the matter of minor's consent is between the basic rights and responsibilities of parents concerning their children and the emergence of the concept that youths have the right to make decisions relating to their bodies and their care. When the preservation of privacy and confidentiality affects the utilization of health care by youth, the conflict must be resolved. Not only have state legislatures provided varying opportunities to resolve some of these issues, but also two major health organizations concerned with the health of youth have provided model acts which would serve as a basis for enabling young people to consent for confidential, comprehensive health care.
In recent years society has demonstrated a tendency to permit young people to determine a variety of aspects of their own affairs well before the traditional age of majority. In regard to health decisions, a number of situations have emerged in which the rights of youths deserve consideration. These include circumstances in which the person might avoid health care if the parents have to be informed, when a communication breakdown between the young person and the parents has taken place, if a need for emergency care occurs when parents cannot be reached, or when young people are living away from home in an adult life style.
Legislative responses to the sociohealth concerns affecting youth do not take a moral or judgmental position, nor do they infer a lessening of the importance of family integrity. They do respond to a number of reality health matters with high incidence which have emerged, particularly in the past decade. These laws do not require physicians to treat young people on their own consent, nor do they forbid physicians from informing parents if this is considered in the best interest of the patient. Furthermore, it is important for the physician to persuade youths to involve their parents and gain their support and understanding. Minors' consent can serve to restore interrupted communication between young people and their families.
The appearance and evolution of the "emancipated minor" and the "mature minor" concepts is recognition of the capacity of the adolescent to determine his own affairs and give an informed consent. The age at which human beings reach maturity is variable, and competent decision making is not assured by arrival at a certain chronological age.
Comment on Meningomyelocele Treatment
Authors: Sherman Sanford 
Published: December 2021

Pediatrics has obviously placed Dr. Lorber's commentary (53:307, 1974) and Dr. Freeman's paper (53:311, 1974) in a prominent position in order to provoke response. I hereby rise to the "bait." At Children's Hospital Medical Center in Oakland, California, there is an active program for managing spina bifida. Our clinic, which meets weekly, has the regular attendance of a pediatrician, neurosurgeon, orthopedists, urologist, physical therapist, occupational therapist, social worker, Public Health nurse and brace maker.
Our ten-year experience is small compared with Dr. Lorber's and others, but it has had great continuity of professional personnel.
DR. ABRAHAM JACOBI ON THERAPEUTICS OF INFANTS AND CHILDREN
Authors: C. T. E. 
Published: December 2021

Abraham Jacobi (1830-1919), often called the Father of American Pediatrics, was the first to establish systematic and special clinics for the diseases of children. In 1896 when he wrote the practical note below, drug therapy for infants and children was far from a settled issue.
Therapeutics of infants and children have enjoyed, or suffered from, their fate like "books" and those of adults. They have had their stages between the era of dull and ignorant prescribing and that of impotent and conceited nihilism. But neither a deluge nor an absence of drugs make a physician, when by themselves alone, to the welfare of a single individual or the community. The ailments of children are but rarely complicated, and a single diagnosis tells the whole story. If it be not made, it is perhaps best for the practitioner not to attempt much doctoring and for the patient to be left alone. For, happily, most diseases have a tendency to get well, either completely or partially, and many will run a more favorable course when not meddled with.
This does not mean to say, however, that I discourage treatment even in such ailments as run a typical course extending over a number of days or weeks. On the contrary, I am opposed to the practice—much too common—of those who do not, for instance, wish to interfere with a whooping-cough because it finds its natural termination after several months. This is true, but many of the children find their natural termination also during these months.
Chronic Pulmonary Disease in Neonates With Assisted Ventilation
Authors: Rhodes Philip G. , Hall Robert T. , Leonidas John C. 
Published: December 2021

Chronic lung disease in the form of stage III or IV bronchopulmonary dysplasia (BPD) was found to occur among nine of 188 infants receiving intermittent positive pressure ventilation for respiratory insufficiency. None occurred in infants ventilated with a mask alone. The duration of endotracheal intubation was not significantly longer in patients developing BPD; however, the duration of exposure to inspired oxygen &gt; 60% was significantly longer in that group (mean, 141 hours.).
A previously undescribed form of chronic lung disease was found to occur among nine of 150 infants ventilated because of underlying idiopathic respiratory distress syndrome. A radiographic appearance of diffuse haziness with loss of identifiable lung markings occurred at 5 to 15 days of age and was not associated with clinical signs or symptoms or increased oxygen needs. These changes disappeared in one to five days.
100 YEARS ON, and STILL NO ANSWER
Authors: P. A. G.S. 
Published: December 2021

The reader (researcher) who pursues a subject often discovers that "new" and "original" ideas may have been lying dormant for many years. The questions posed in the past were frequently left unanswered, until the development of more modern and sophisticated techniques. This year (1975) marks the 100th anniversary of the publication by Pierre Budin, in Paris, of an article posing the question, literally translated from the French, "At what moment ought one to practice ligating the umbilical cord?" (Progr. Med. [Paris] 3:765, 1875). He was asking the same question the following year, and obstetricians and pediatricians have been asking that question ever since. The last decade has witnessed a considerable number of investigations relating to the transfer of blood from the placenta to the infant at the time of delivery, much of it carried out at the Karolinski Institute in Stockholm. For the most part, the baby born at term who is appropriate for gestational age seems to be able to compensate for either excess or deprivation of blood (depending upon one's viewpoint). Despite widespread interest in the problem, the question with regard to the low-birthweight infant remains unresolved 100 years later.
Budin was a most inquisitive physician, and wrote on a wide variety of subjects, as evidenced by his book The Nursling published in 1907. One might thus attribute the question posed in 1875 to his fertile mind. However, he was preceded by almost 75 years by Erasmus Darwin who linked placental transfusion to onset of respiration in 1801.
Infectious Mononucleosis in Children
Authors: Nakao Tooru , Chiba Shunzo , Ikeda Shugeru 
Published: December 2021

We agree with the opinion of Tamir et al.1 that the Paul-Bunnell and mononucleosis tests are of little value in children.
In Japan, infectious mononucleosis is not common. Illness caused by Epstein-Barr virus (EBV) infection is rare after infancy because the positive antibody sera to EBV is 30% to 40% in the sera of infants between 1 and 24 months old. This increases rapidly to about 80% by 3 years of age.2 Primary EBV infection may occur before the age of 3 years.
SPORTS: INTRODUCING THE "HAPPY NON-HOOKER"
Authors: Maugh T. H. 
Published: December 2021

Two scientists from California have used their technical ingenuity to make a significant improvement in the golf ball. They have invented a ball that resists hooking or slicing.
They used a principle from Newtonian physics that might be called "the spinning dumbbell rule." Two rigidly connected weights tend to spin around only one axis at a time-like a baton.
In this new ball the dimples cover 50% of the surface confined to a band around the equator with the poles smooth and with weight slightly concentrated in the poles.
In tests the "Happy Non-Hooker" achieved more than 90% of the distance of a conventional ball while reducing slicing by 75% to 80%.
Questions and Comments on Asthma Therapy
Authors: Sloan Earle R. 
Published: December 2021

I would like to submit some questions and comments on Drs. Bierman and Pierson's protocol for the management of status asthmaticus published in the August issue of Pediatrics
(1) Is every child admitted to the hospital who does not respond to epinephrine injections (how many? frequency?)? Of the patients who are admitted, are all of them given intravenously administered corticosteroids as was suggested by the protocol? It would seem more desirable to try to break the asthma attack in the outpatient clinic by the use of aerosolized sympathomimetics, oxygen, and intravenously administered aminophylline in order to avoid frequent, costly hospitalizations and reliance on corticosteroids.
Comments on Asthma Therapy
Authors: Goldstein Nathan 
Published: December 2021

For the most part, the approach of Drs. Bierman and Pierson to the pediatric patient with status asthmaticus appears sound; however, I feel the following comments are in order.
It has been my experience and that of others that it is seldom necessary to correct an arterial pH of 7.25 to 7.35; I would recommend bicarbonate therapy only if the arterial pH is less than 7.252, 3 Though the authors have indicated their desire for intravenously administered fluids containing 5% glucose, it is worthwhile to stress the importance of glucose administration to younger children since it has been found that patients with status asthmaticus under the age of 4 years have significant ketonemia.2
Endotracheal Tube Placement in Infants Determined by Suprasternal Palpation: A New Technique
Authors: Bednarek Francis J. , Kuhns Lawrence R. 
Published: December 2021

In order to decrease complications of improper endotracheal tube positioning, a method of placing the tube by palpation within the suprasternal notch was devised. The method proved to be simple and effective. The accuracy was verified by fluoroscopy and a clinical study comparing this technique with others is reported. No complications of the technique were noted.
Once palpation was reliable, the proper position of the tube tip was defined. From measurements taken from routine inspiratory chest radiographs on 142 infants, it was found that a point midway between the medial ends of the clavicle (IMP) was a good position because it approximates the true tracheal midpoint and, therefore, is a good landmark on a chest radiograph. This point allows for movement of the tube tip with head positioning and of carina with respiration. The tube tip can be placed near the IMP by the suprasternal palpation technique. This method, therefore, is useful in emergency situations or on initial intubations to avoid improper position of the tube tip prior to radiograph verification.
Lettrt To The Editor
Authors: Maisels M. Jeffrey , Varano Lottie A. 
Published: December 2021

The infants described in our report were ventilated with the Baby Bird ventilator. In addition to intermittent positive pressure, a continuous distending pressure of 5 to 10 cm H2O was used in all of the cases. Peak airway pressures ranged from 25 to 35 cm H20, and the rate of ventilation was usually 30 to 40 breaths per minute with an inspired/expired ratio of 1:1.
The idea that a decrease in diastolic filling may decrease intrapericardial pressure, and thus create a pressure gradient which encourages the development of pneumopericardium, is certainly intriguing.