bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemophilus influenzae Type b Capsular Polysaccharide Vaccine in Children: A Double-Blind Field Study of 100,000 Vaccinees 3 Months to 5 Years of Age in Finland
Authors: Peltola Heikki , Käythy Helena , Sivonen Aulikki , Mäkelä P. Helena 
Published: December 2021

A recently developed Haemophilus influenzae type b capsular polysaccharide vaccine was given to 48,977 children 3 months to 5 years of age; an equal number of children receiving group A meningococcal vaccine served as controls. The protection as well as serum antibody response was strongly age-dependent. Among children who had received the H. influenzae type b vaccine when 18 months of age or older, there were no cases of bacteremic disease caused by H. influenzae type b in the first year after vaccination. At the same time 11 such cases were seen in the control group of the same age, a highly significant difference. In the second year after vaccination two cases occurred in the H. influenzae type b-vaccinated group, five in the meningococcal-group A vaccinated group. No protection was seen among children who had been younger than 18 months when vaccinated, even if they received a booster dose of the vaccine.
The serum antibody response to the H. influenzae type b polysaccharide, measured by radioimmunoassay, was poor in children below 18 months of age and good in those above it. No effect of the vaccine could be seen on the nasopharyngeal carriage of H. influenzae type b, which was approximately 6% in this age group. Adverse effects of the vaccine were mild.
Estimation of the Age of Cutaneous Contusions in Child Abuse
Authors: Wilson E. F. 
Published: December 2021

Estimation of the age of a cutaneous contusion on an abused child is probably more often requested of pediatricians and family practitioners than of pathologists. Guidelines for this estimation are not easily found and are not available in a standard textbook on child abuse.1 Some previously reported guidelines are presented below, modified only by being placed in tabular form (Table).2-6
A contusion of the skin follows the application of blunt force sufficient to disrupt vessels, usually capillaries, from which blood escapes and accumulates in the corium and/or subcutis, without loss of the integrity of the surface of the skin. The bleeding usually starts immediately following disruption of the vessel wall and may continue only briefly or persist for hours.
Dr. Miller Replies
Authors: Miller Robert W. 
Published: December 2021

Pediatricians are well aware of the special susceptibility of the fetus and child to chemical pollutants.1 Methemoglobinemia may occur in infants exposed to nitrates from well water2; congenital Minamata disease (cerebral palsy) has occurred from intrauterine exposure to methylmercury in fish from contaminated seawater.3 There is no doubt about the need for safe water.
In its statement, the Committee on Environmental Hazards considered the evidence then available on the carcinogenicity in man of chemical contaminants of water.
Drs. Shanis and Moshang Reply
Authors: Shanis Bonnie S. , Moshang Thomas 
Published: December 2021

We appreciate the interest and attention of Dr. Pombo et al. to the use of propranolol and exercise as a provocative test of growth hormone (GH) release. Since publication of our article, we have studied an additional 24 normal short children and three Gil-deficient children. Twenty-two of the 24 normal children had GH levels greater than 10 ng/ml. Therefore, among the total 56 normal children evaluated, the incidence of false-negative responses was 3.6%, slightly lower than the one in 15 reported by Maclaren et al. and the one in 17 reported by the above authors.
See table in the PDF file
Accepted Standards?
Authors: Johnson Donald F. 
Published: December 2021

I read with interest the article entitled "Treatment of Acute Sore Throats: A Comparison of Pediatricians and General Physicians" by Dr. Gordis et al. (Pediatrics 57:422, March 1976), but was distressed to find that my style of management may have been considered "below generally accepted standards."
Past experience has shown that a single throat culture may yield a false-negative result in 10% to 15% of otherwise documented streptococcal sore throats. This false-negative percentage can be improved by careful adherence to technique, but points up the necessity for the clinician to rely on his judgment as well as the culture result.
Commentary on Acetaminophen
Authors:   Committee on Drugs
Published: December 2021

Acetaminophen is being promoted as the preferred analgesic-antipyretic, particularly for pediatric use, with suggestions that it is safer and perhaps more efficacious than aspirin. The claim that acetaminophen is less toxic than aspirin is based on a lower incidence of certain side effects and toxic manifestations observed with acetaminophen than with aspirin. Although in therapeutic doses acetaminophen does not share the adverse gastrointestinal, hemorrhagic, and acid-base side effects of aspirin, it does have its own unique toxicity. When ingested in excessive quantities, it may be more lethal than aspirin, and considerably more difficult to treat.
Available studies indicate that acetaminophen and aspirin given in equal milligram doses are equally effective in relieving pain and fever.1,2 In contrast to aspirin, acetaminophen has little anti-inflammatory effect.
Animal toxicity studies, although helpful in elucidating mechanisms of toxicity, have failed to provide conclusive answers to the question of relative toxicity of acetaminophen and aspirin. Acute toxicity studies in several animal species have produced widely varying results. The degree of acetaminophen toxicity varies not only among different species3 but also among different strains within the same species.4 Additional determinants of acetaminophen toxicity are the nutritional status5 of the animals and pretreatment with microsomal enzyme inducers or inhibitors6 Furthermore, it is unknown which animal species, if any, best reflect toxicity in humans.
A large number of serious acetaminophen poisonings, including fatalities, have been reported from Great Britain during the past decade.7-9 Reports of acetaminophen toxicity have been less common in the United States. However, one major poison control center in the United States recently reported 156 acetaminophen ingestions, with four fatalities, during a one-year period.10
Radiation of Pregnant Women
Authors:   Committee on Radiology
Published: December 2021

If a patient is to be examined even if pregnant, scheduling serves no useful purpose and may be counterproductive. If an examination can be postponed to the end of pregnancy, the need for that examination is questionable, even if the patient is not pregnant.
Two alternatives to the foregoing procedure for these situations, which require special consideration, are offered.
1. The examination can be postponed until after the pregnancy, or it can be conducted at the next menstrual period when the patient is known not to be pregnant.
2. Modification of an examination to reduce the radiation dose can be considered without necessarily compromising the thoroughness of the study. This option can be exercised for any patient when indicated by the judgment of the attending physician who, in consultation with the radiologist, can determine the examination protocol.
All physicians who request and conduct radiologic examinations should familiarize themselves with the pertinent radiologic information. The attending physician should carefully consider the need for the examination and record the decision in the patient's record. And, the x-ray consultation request should carry a notation that the matter of potential or actual pregnancy has been taken into account in the decision to request the examination.
Tracking Correlations of Blood Pressure Levels in Infancy
Authors: Levine Robert S. , Hennekens C. H. , Klein B. , Gourley J. , Briese F. W. , Hokanson J. , Gelband Henry , Jesse Mary Jane 
Published: December 2021

The association between elevated blood pressure levels in adults and increased risk of coronary and cerebrovascular disease has been well documented.1,2 Prospective studies of blood pressure in both adults and children have also shown strongly positive tracking correlations,3-5 tracking correlations being defined as the relationship between blood pressure measurements obtained at two points in time from the same individuals.
In adults 35 to 70 years of age, tracking correlations of 0.6 for systolic pressure3,4 and 0.5 for diastolic pressure4 have been reported over four-year follow-up intervals. In children, Zinner et al.5 reported correlations of 0.25 for systolic pressure and 0.14 for diastolic pressure over a four-year follow-up interval.
In Reply: Suggests More Tests for Chest Pain Diagnosis
Authors: Driscoll David J. 
Published: December 2021

I am grateful for your comments regarding our article "Chest Pain in Children: A Prospective Study."
Two of the 43 children in that study had a history suggestive of gastrointestinal dysfunction and appropriate studies, including upper gastrointestinal contrast series and screening for occult blood in the stool, were done. Evidence for ulcers, esophagitis, or gastric reflux was not found in either patient.
We did not intend to imply a psychogenic origin for idiopathic chest pain.
Pneumocystis carinii Infection: Evidence for High Prevalence in Normal and Immunosuppressed Children
Authors: Pifer Linda L. , Hughes Walter T. , Stagno Sergio , Woods Diane 
Published: December 2021

Using Pneumocystis carinii organisms propagated through three passages in embryonic chick epithelial lung cultures, specific antigens and antisera were prepared for use in counterimmunoelectrophoresis and indirect immunofluorescent antibody techniques. These methods proved to be specific and sensitive for the detection of P. carinii antigen and antibody, respectively, in sera, and were applied to the study of cancer patients with P. carinii pneumonitis (PCP), cancer patients without pneumonitis, and normal children. Antigenemia was detected in 95% of patients with PCP, in 15% of cancer patients without pneumonitis, and in none of the normal children tested.
In cross-sectional and longitudinal studies of normal infants and children, acquisition of serum antibody to P. carinii was demonstrated to occur progressively with increase in age. By 4 years of age two thirds of the normal children were found to have antibody to P. carinii in titers of 1:16 or greater. These studies indicate that subclinical P. carinii infection is highly prevalent in normal children, analogous to other opportunistic infections where active disease is manifest predominantly in the compromised host.
SPECIAL CONSIDERATION FOR HUMANS
Authors: Dawkins R. ,   Student
Published: December 2021

Recently there has been a reaction against racialism and patriotism, and a tendency to substitute the whole human species as the object of our fellow feeling. This humanist broadening of the target of our altruism has an interesting corollary....
The feeling that members of one's own species deserve special moral consideration as compared with members of other species is old and deep. Killing people outside war is the most seriously regarded crime ordinarily committed. The only thing more strongly forbidden by our culture is eating people (even if they are already dead). We enjoy eating members of other species, however. Many of us shrink from judicial execution of even the most horrible human criminals, while we cheerfully countenance the shooting of other harmless species as a means of recreation and amusement. A human foetus, with no more human feeling than an amoeba, enjoys a reverence and legal protection far in excess of those granted to an adult chimpanzee. Yet the chimp feels and thinks and-according to recent experimental evidence-may even be capable of learning a form of human language. The foetus belongs to our own species, and is instantly accorded special privileges and rights because of it....
The muddle in human ethics [is] over the level at which altruism is desirable-family, nation, race, species, or all living things....
The Williams Elfin Facies Syndrome: The Psychological Profile as an Aid in Syndrome Identification
Authors: Bennett Forrest C. , LaVeck Beverly , Sells Clifford J. 
Published: December 2021

The Williams syndrome is a sporadic disorder generally characterized by a peculiar pattern of craniofacial abnormalities (elfin facies), prenatal and postnatal growth deficiency, mental retardation, variable congenital heart disease (including supravalvular aortic stenosis), and occasionally infantile hypercalcemia.1 Its etiology, pathogenesis, and possible relationship to vitamin D and calcium metabolism have not as yet been determined.2
Previous reports of children with this syndrome make reference to their overall mental retardation as determined by IQ as measured by various psychological tests.1,3 Frequent mention is also made of these children's tendency to an unusual, outgoing personality.1,3 Other observers describe a unique type of mental deficiency with poor motor coordination but an unusual command of language, often resulting in a superficial overestimation of cognitive abilities.3
Dr. Kozak et al. Reply
Authors: Kozak Peter P. , Cummins Leo H. , Gillman Sherwin A. 
Published: December 2021

Based on a very limited study, we have been able to demonstrate significant changes in theophylline levels in patients receiving three different types of erythromycin preparations. Elevated theophylline levels were associated with administering erythromycin ethylsuccinate, erythromycin stearate, and erythromycin estolate.
We were not able to detect any pattern of alterations in theophylline levels associated with either temperature elevations or other medications being administered concomitantly.
Tricuspid Insufficiency Associated With Aneurysm of the Ventricular Septum
Authors: Eshaghpour Eshagh , Kawai Nobuyoshi , Linhart Joseph W. 
Published: December 2021

Because of the anatomic relation of an aneurysm of the membranous ventricular septum (AMVS) to the tricuspid septal leaflet or because of the tricuspid septal leaflet involvement in the aneurysm formation, dysfunction of the tricuspid valve is likely to occur in patients with AMVS. The auscultatory manifestations of the resultant tricuspid insufficiency (TI) could be masked by the systolic murmur of the ventricular septal defect (VSD), which is often present in these patients.
The presence of TI is suggested by phonocardiographic findings in five patients with AMVS and is further supported by intracardiac phonocardiography and angiocardiography. After inhalation of amyl nitrite, a pansystolic murmur appeared in three patients, and the intensity of the pansystolic murmur increased significantly in two patients. Inhalation of amyl nitrite reduces the systemic resistance, resulting in decreased systemic pressure and diminished intensity of the murmur of a small VSD. Augmentation of the systemic venous return is reponsible for increased intensity of TI murmur.
Chromosome 3 Duplication q/Deletion p Syndrome
Authors: Fineman Robert M. , Hecht Frederick , Ablow Ronald C. , Howard Rufus O. , Breg W. Roy 
Published: December 2021

This report describes the clinical, chromosomal, and radiological findings in four unrelated families with different recombinant chromosome 3 abnormalities. On the basis of the phenotypic and cytogenetic findings seen in our six patients and those noted in two recent reports, we concur with Allderdice et al. that the syndrome in which the long arm (q) of chromosome 3 is duplicated and the short arm (p) is deleted is a distinct clinical entity. The psychomotor retardation found in this syndrome appears to be caused mostly by monosomy of the region 3pter→3p25, while severity of the physical malformations (and hence the lethality) is apparently proportional to the amount of extra chromosome 3q material present. That is, patients who are trisomic for larger segments are physically more affected than patients who are trisomic for smaller amounts of the long arm of chromosome 3. Features common to the chromosome 3 duplication q/deletion p syndrome are mental and growth retardation, microcephaly, seizures, prominent and/or asymmetric frontal bossing, ocular hypertelorism, ptosis, upward-slanting palpebral fissures, and low-set and/or malformed ears. Other anomalies frequently seen are short webbed neck, various types of congenital cardiovascular disorders, omphalocele, cryptorchidism, spina bifida, short digits, hypotonia, and digital impressions on skull x-ray examination which are presumably caused by trisomy for the distal band (3q28) of the long arm of chromosome 3.
In addition, the importance of doing chromosome studies in persons who are mildly affected, both mentally and physically, is illustrated by the study of one of these families.
Tularemia Pneumonia in Urban Children
Authors: Halsted Crystie C. , Kulasinghe Hareen P. 
Published: December 2021

Tularemia pneumonia occurred simultaneously in five children in urban Baltimore. The features of this outbreak are reported to document the mild nature of the pneumonic illness and thus to emphasize the variability of the pulmonary manifestations of Francisella tulareusis infection. These cases also serve as a reminder to physicians that tulareniia, an infrequently encountered illness, is endemic in the United States.
CASE REPORT
Three previously healthy brothers, T.W., J.W., and R.W., 8, 10, and 14 years of age, were seen at the Baltimore City Hospital Outpatient Clinic with a history of fever of ten days' duration. The temperatures, compulsively documented by their mother, ranged from 37.8 to 40.0 C (100 to 104 F) daily and did not abate with antipyretics or the oral administration of penicillin prescribed by the family physician at the onset of fever.
Close encounters with SIDS
Authors: Stark Ann R. , Mandell Frederick , Taeusch H. William 
Published: December 2021

The use of apnea monitors at home to prevent sudden infant death syndrome (SIDS) in infants at risk is a debated issue. Several very difficult questions await answers: (1) Who should be monitored? (2) What kinds of monitors would be most effective? (3) Does monitoring work? (4) Are other approaches apt to be simpler and more efficacious, e.g., respiratory stimulants?
What is known about SIDS is mostly epidemiologic information. The incidence is 2 to 3 per 1,000 live births, with a peak age distribution between 2 and 4 months. Most deaths are silent and occur when the infant is supposedly asleep.
Primary Care Supplement
Authors: Rivara Frederick P. 
Published: December 2021

I was very excited and pleased when I received my October 1977 issue of Pediatrics and found a supplement on primary care. However, with much disappointment I found that the articles included were, at best, focused on very narrow areas in pediatrics and, at worst, completely irrelevant to the current issues faced by primary care pediatricians in this country.
The precise definition of primary care has been a difficult problem. One operative definition is a system of health care that provides for unselected problem care; comprehensive care; entry point care; preventative care; ambulatory care; and majority care.1
ODE TO THE HIPPIE
Authors: Bridges Thomas 
Published: December 2021

Alas, former flower children are a social oddity. The threatening phenomenon known as the hippie is little more than a ghost of the 1960's-seldom thought about by the 60's generation and hardly known by 70's people. Ten years have scraped too many minds clean. Those optimistic child-people who danced through the streets of San Francisco have even faded out of the memories of their present selves. Metamorphosed into practical human beings? Or have they just grown up? Or do they remember too clearly?...
Most tried to rejoin the establishment. As if they could just walk back into their former selves. But the alienation was too complete.
The most sensitive and enthusiastic (intelligent?) minds of the 1960's will always be drop-outs or partly-ins—the most ambitious and durable working within the system to gather up whatever they need to get out of it again.
Our alienation has settled to the bone. Terminal. We walk around incognito. Up front is our get-along face. One must survive, you know. Inside, we still don't believe in any of it. Do you?
THE GREAT ELECTRONIC DICTATOR
Authors: Boorstin Daniel J. ,   Student
Published: December 2021

. . . television regulates not only our opinions on almost everything, but also: how, when, and what we eat; when we sleep; how we raise our children; what our children think of us; what we do or don't buy; what (and whether) we think of lawyers, doctors, policemen and lawbreakers; how we act in matters of sex and race; how we debate our national issues; what we believe (or imagine) to be our national issues. Most important, television has transformed our perception of what problems (an unhappy marriage, an upset stomach, catching a bank-robber or a mugger, preserving a near-extinct animal species) are soluble and how easily they can be solved.
We now lead a double life. The man-made experiences that we see on the tube have become more real than our everyday experiences. Television has brought an inversion of our consciousness. Nothing is really real unless it "happens" on television. When we take our eyes off the tube we see things that are not quite authentic—or, rather, which gain authenticity only by their resemblance to how things happen on television. Prosecuting attorneys, defense lawyers, jurors, criminals, potential criminals, witnesses are shaped by the "Perry Mason Syndrome." No crime remains unsolved (within the hour). The snail's pace of usual court procedure, like the long-term suffering of the victim or of the imprisioned criminal, goes unseen. Constitutional guarantees (which would bore viewers or slow the action) are depicted only perfunctorily, or as a nuisance in Kojak's way. Off the television screen most crimes are actually never solved, in fact most criminals are never even prosecuted and of those convicted only a small percentage go to jail.
THE 12-YEAR-OLD ANNA WINSLOW WRITES IN HER DIARY ON FEBRUARY 9, 1772, ABOUT HER PROBLEMS WITH A WHITLOW AND MULTIPLE BOILS
Authors: C. T. E. 
Published: December 2021

In the year 1770, a bright little 10-year-old girl, Anna Green Winslow, was sent from her home in Nova Scotia to Boston, the birthplace of her parents, to be "finished" at Boston schools by Boston teachers. For a few years following her arrival in Boston, Anna kept a diary in which she recorded the daily events in her life. She was a sensitive and intelligent girl and her comments offer a vivid view of the life of a preadolescent girl in colonial Boston.
The entry below from her diary dated February 9, 1772, written when she was 12 years old, describes her problems with a whitlow and multiple boils. Her spelling has been retained.
Feb. 9th [1772]—My honored Mamma will be so good as to excuse my useing the pen of my old friend just here, because I am disabled by a whitloe on my fourth finger & something like one on my middle finger, from using my own pen; but altho' my right hand is in bondage, my left is free; & my aunt says, it will be a nice oppertunity if I do but improve it, to perfect myself in learning to spin flax. I am pleased with the proposal & am at this present, exerting myself for this purpose. I hope, when two, or at most three months are past, to give you occular demonstration of my proficiency in this art, as well as several others. My fingers are not the only part of me that has suffer'd with sores within this fortnight, for I have had an ugly great boil upon my right hip & about a dozen small ones—I am at present swath'd hip & thigh, as Samson smote the Philistines, but my soreness is near over.