bluuebunny/crossref_metadata_2025_split huggingface dataset:
Career Satisfaction in Pediatrics
Authors: BOSLEY WARREN 
Published: December 2021

To the Editor.—
It would be interesting to see what Dr Simon (Pediatrics. 1990;86:488)1 will write in about 15 years, but I doubt that I shall be here to read it.
You are familiar, I am sure, with surveys of the degree of satisfaction among physicians that have been published occasionally in the past 35 years—Medical Economics, for one, and the study by Jim Schunk2 most recently. Pediatrics does not come off too well. Because the number of "satisfied" pediatricians, especially those in practice, has remained at about 65%, one can predict that Dr Simon will have different thoughts.
Carnitine Deficiency
Authors: KAHLER STEPHEN G. 
Published: December 2021

To the Editor.—
I read with interest the report by Treem and Stanley concerning carnitine deficiency in an infant with cystic fibrosis (Pediatrics. 1989;83:993-997). The hypothesis that renal loss of carnitine can be due to tubular defects induced by secondary hyperparathyroidism is plausible.
The finding of no carnitine in the urine in the recovery phase is unprecedented in my experience. The control values reported do not include 0. I would expect to find urine carnitine concentrations in the normal range, when the plasma level was normal.
Carnitine Deficiency
Authors: TREEM WILLIAM R. 
Published: December 2021

In Reply.—
The absence of carnitine in the urine during the recovery phase of secondary carnitine deficiency is unusual as pointed out by Dr Kahler. During this time the infant was being treated with a high carnitine diet (formula plus beef broth) and was regaining weight lost during his acute illness. Because values of urine and plasma carnitine were random spot samples and not obtained with the infant fasting, the discrepancy between a normal plasma total carnitine and zero urinary excretion may have been somewhat artifactual.
Turner Syndrome
Authors: LEVIN SOLOMON E. , HARRISBERG JEFF , KELLY ALLAN 
Published: December 2021

To the Editor.—
We read with great interest the study of Moore et al1 in which they suggest that there may be a significant association of 45,X Turner syndrome and partial anomalous pulmonary venous drainage. We recently encountered a further case with this association lending support to their contention.
Our patient was noted at birth to have the phenotypic features of Turner syndrome together with lymphedema. Chromosomal analysis confirmed the Karyotype 45 X0. At 4 months of age a diagnosis of coarctation of the aorta was made when her femoral pulses became impalpable.
Urinary Tract Infections
Authors: ROSCELLI JOHN D. 
Published: December 2021

To the Editor.—
The recent article by Crain et al1 on urinary tract infections (UTIs) in febrile infants younger than 8 weeks of age covers many important features of urinary tract infections in young infants. It confirms data suggesting that uncircumcised males have an increased incidence of positive urine cultures. It confirms that infants may have positive urine cultures in the absence of a positive urinalysis. The study also demonstrates, again, that some infants with positive urine cultures can have positive blood cultures.
Urinary Tract Infections
Authors: CRAIN ELLEN F. , GERSHEL JEFFREY C. 
Published: December 2021

In Reply.—
Dr Roscelli calls attention to the 16 infants in our sample with positive urine cultures but negative urinalyses and admission diagnoses other than urinary tract infection (UTI). These patients, Dr Roscelli suggests, could have had asymptomatic bacteriuria with a different source for their fever. Although we doubt that these infants had asymptomatic bacteriuria, in theory it is possible that the bacteriuria was not the cause of the fever. However, as Dr Roscelli states, "at this time there no way to determine if the bacteriuria is causing the patient's fever or is simply an incidental finding."
Extraordinary Urinary Frequency
Authors: ASNES RUSSELL S. , MONES RICHARD L. 
Published: December 2021

To the Editor.—
It was with considerable interest that we read the article "Extraordinary Urinary Frequency" by Zoubek et al which was published recently in Pediatrics.1 Pediatricians frequently encounter children who have a main complaint of pollakiuria, the descriptive term which refers to an increase in the frequency of urination during a specified time period. We previously reported a small group of children with this complaint and discussed it's differential diagnosis and an approach to treatment.2
Extraordinary Urinary Frequency
Authors: BLOOM DAVID A. , SEDMAN AILEEN B. , ZOUBEK JAROSLAVA 
Published: December 2021

In Reply.—
Thank you for the second letter regarding our paper on extraordinary urinary frequency. We would like to respond to this as well.
We thank Drs Asnes and Mones for their comments. Pollakiuria and pollakisuria are synonyms for urinary frequency. Pollakis is a Greek term for often, although it has rather infrequent application in medical English, being limited only to pollakiuria and pollakidipsia in Dorland's Dictionary.1 The Oxford English Dictionary employs this prefix only in one word, the botanic term, pollakanthic.2
Butterfly-Shaped Mark
Authors: OAKES W. JERRY 
Published: December 2021

To the Editor.—
I write to take strong exception with the recent article by Metzker and Shamir describing butterfly-shaped flat capillary hemangiomas occurring over the midline of the lumbar spine.1 The authors conclude that these lesions have not been described before, that they do not warrant further investigation, and that when seen in conjunction with a myelomeningocele that there was "no apparent relationship between the two entities."
Flat capillary hemangiomas occurring over the lumbar spine are one of the four long recognized cutaneous stigmata of occult spinal dysraphism.2-6
Survival After Neonatal Myocardial Infarction
Authors: BOULTON JOHN , HENRY RICHARD , RODDICK LAURENCE G. , ROGERS DAVID , THOMPSON LINDA , WARNER GARRY 
Published: December 2021

These are case reports of two children with structurally normal hearts and with normal coronary arteries, who survived myocardial infarction in the early neonatal period. They are only the third and fourth reported survivors of neonatal myocandial infarction and the first in which hypercholesterolemia is postulated to have played an important role.
The most likely cause of the myocardial infarction was thrombosis or thromboembolism. Changes in hemostatic function associated with hypencholesterolemia may be relevant.
Prescription Drug Advertising Direct to the Consumer
Authors:   Committee on Drugs
Published: December 2021

There is a rapidly growing practice within the pharmaceutical industry of advertising prescription products directly to the general public through media, such as television, radio, newspapers, and popular magazines. Proponents of direct-to-consumer advertising of prescription drugs have asserted that advertising is a source of useful information for the patient. However, it is the position of the Academy that patient education regarding prescription drugs is provided best by the physician within the context of patient care and not through advertising that is designed primarily to promote the sale and consumption of a specific product. Such advertising contributes little, if anything, to the quality of health care while posing multiple problems that may be counterproductive to the provision of optimal pharmacotherapy for pediatric patients.
The Academy's opposition to direct-to-consumer advertising of prescription drugs stems from its long tradition of advocacy for children and young people, along with a concern regarding the potential negative impact of such advertising on the health care of children and adolescents. The Academy's objection to consumer advertising of specific prescription products does not apply to general health information provided through public service announcements sponsored by the pharmaceutical industry.
Prescription drugs are unique in the marketplace in that they are selected for use by the physician rather than by the consumer. They are designated by law to be used within the patient-physician relationship for the protection and welfare of the patient. In choosing a therapeutic agent for a particular patient's illness, a physician takes into consideration a multitude of complex factors, including the patient's diagnosis, medical history, previous medication interolances, adverse drug reactions, possible drug interactions, chemical dependency, and the array of products that potentially may be used.
Topics in Chronic Granulomatous Disease
Authors: UMEKI SHIGENOBU 
Published: December 2021

To the Editor.—
Such phagocytic cells as neutrophils and macrophages are crucial elements in the host defense against bacterial
[See table in the PDF file]
and fungal infections. Microbicidal activity depends to a large extent on NADPH oxidase system, which can be activated by stimuli (bacteria, fungi) and which generates the superoxide anion and other highly reactive forms of reduced oxygen.1,2 The neutrophil NADPH oxidase system is composed functionally of membrane-bound catalytic components (which consist of at least two constituents, the low potential cytochrome b5583-5 and flavoprotein5) and soluble cytosolic components6,7 which participate as either catalytic or regulatory elements.
AAP Task Force Report Erratum
Authors: STRAIN JAMES E. 
Published: December 2021

To the Editor.—
The Task Force Report on the Future Role of the Pediatrician in the Delivery of Health Care (Pediatrics. 1991;87:401-409) contains two errors. On page 402, column 2, paragraph 1, the sentence reads "A 24% increase in total patient contacts ..." The sentence should read: "A 7% increase in total patient contacts ..." The citation for this is Marder WD, Kletke PR, Silberger AB, et al. Physician Supply and Utilization by Specialty: Trends and Projections.
Low-Dose Zidovudine in Children With an Human Immunodeficiency Virus Type 1 Infection Acquired in the Perinatal Period
Authors: Blanche Stephane , Duliege Anne-Marie , Debré Marianne , Griscelli Claude , Navarette Maria Soledad , Kouzan Serge , Tardieu Marc , Rouzioux Christine , Seldrup Jorgen 
Published: December 2021

This report describes the one-year results of a noncomparative study designed to assess the safety and tolerance of low-dose zidovudine (azidothymidine) given orally to 60 human immunodeficiency virus type 1-infected infants and children. At baseline, the mean age was 1.9 years (±1.4), and all were symptomatic: 43% were P2A and 57% were P2B to F according to the Centers for Disease Control classification. All the patients received zidovudine for at least 6 months, and 52 of them (87%) completed a full year of therapy. The mean duration of follow-up was 346 days (±42) (range, 183 to 366 days).
The initial therapy consisted of four daily doses of 100 mg/m2 (400 mg/m2 per day, equivalent to 20 mg/kg per day). However, this treatment was modified when neutropenia or anemia was observed. Twenty-nine children (48%) remained at the initial therapy for the entire study. Zidovudine dosage was adjusted 92 times in the other 31 children (52%), mostly due to neutropenia (83%). Altogether, the time under full-dose therapy represented 81% of the total duration of the protocol for all patients. Children with mild symptoms, P2A at study entry, were more likely to remain under full-dose therapy than children with severe symptoms, P2B to F: the time under full-dose therapy represented 91% of the duration of the protocol for the former group and only 74% for the latter one (P &lt; .02). No clinical adverse experiences were attributed directly to zidovudine. Thirty-seven children were prescribed trimethoprim-sulfametoxazole as a prophylaxis for Pneumocystis carinii pneumonia. In a multivariate analysis, this comedication had no influence on the hematologic tolerance of zidovudine.
Shoes for Children: A Review
Authors: Staheli Lynn T. 
Published: December 2021

1. Optimum foot development occurs in the barefoot environment.
2. The primary role of shoes is to protect the foot from injury and infection.
3. Stiff and compressive footwear may cause deformity, weakness, and loss of mobility.
4. The term "corrective shoes" is a misnomer.
5. Shock absorption, load distribution, and elevation are valid indications for shoe modifications.
6. Shoe selection for children should be based on the barefoot model.
7. Physicians should avoid and discourage the commercialization and "media"-ization of footwear. Merchandizing of the "corrective shoe" is harmful to the child, expensive for the family, and a discredit to the medical profession.
The Academic Generalist: Still an Endangered Species? A Response
Authors: HAGGERTY ROBERT J. 
Published: December 2021

I shared the commentary by Taussig and Ey1 with the Project Directors of the six participating sites of the General Pediatrics Academic Development Program. The authors of the commentary raise several important questions, which we collectively answer.
1. Three years of fellowship training (rather than the two provided in the program) should be required. All of us agree enthusiastically with this statement and believe that at least half of fellowship training time should be protected for research. In the 2-year program of the General Pediatrics Academic Development Program, at least 50% of the fellows' time was dedicated to research, more than many fellowships in subspecialities.
Summary of the Annual Meeting Section on Urology, American Academy of Pediatrics
Authors: Kogan Barry A. 
Published: December 2021

Members of the Section on Urology of the American Academy of Pediatrics met for 2½ days in conjunction with the 59th Annual Meeting of the American Academy of Pediatrics in Boston, Massachusetts, October 6 to October 8, 1990. The meeting was presided over by Chairperson David T. Mininberg of Cornell University, New York. The papers presented at this meeting that are of interest to the practicing pediatrician are summarized here according to topic.
The Pediatric Urology Medal, awarded to an individual who has made outstanding contributions to the field of pediatric urology, was presented to Dr Frank Hinman, Jr. of the University of California. San Francisco. Dr Hinman was recognized for his many years of work dedicated to improving the urologic care of children. A foremost clinician, teacher, and researcher, he has contributed particularly to the understanding of urinary tract infections and bladder dysfunction in children, particularly those children who have "Hinman Syndrome," the non-neurogenic neurogenic bladder. Dr Hinman has been a strong advocate for the specialized urologic care of children for many years.
GENITOURINARY NEOPLASMS
Wilms' tumor is one disease in which there has been impressive progress in recent years, particularly with the advent of effective chemotherapy that has enabled these children to have increased disease-free survival. Montgomery and co-workers from the Mayo Clinic reviewed the experience of patients with bilateral Wilms' tumor during the past 16 years. Ten-year survival was 69%. Seventy-five percent of the failures resulted from recurrent disease (which generally occurred early), and 25% resultes from treatment complications.
Encouraging the Use of Bicycle Helmets
Authors: GOLDSMITH RICHARD 
Published: December 2021

To the Editor.—
The recent statement by the Committee on Accident and Poison Prevention,1 in support of the use of bicycle helmets, is a thoroughly appropriate and timely pronouncement. Statistics on cycling accidents have been published in Pediatrics and elsewhere for many years, and it is certainly not a revelation that helmets will reduce serious risk in bicycle injuries. If one rides enough miles for enough years a spill is virtually inevitable. As an avid cyclist, I have sustained my own fair share of falls in the past.
The Use of Dexamethasone in Premature Infants at Risk for Bronchopulmonary Dysplasia or Who Already Have Developed Chronic Lung Disease: A Cautionary Note
Authors: FRANK LEE 
Published: December 2021

To the Editor.—
The distressingly high incidence of bronchopulmonary dysplasia (BPD) in today's very low birth weight premature infant population and the prolonged morbidity and tumultuous clinical problems associated with BPD in these tiny infants have led to a trial usage of dexamethasone treatment to try to assuage these problems in this patient population. The report of Kazzi et al1 is noteworthy because the authors not only indicate in clear fashion the failure of relatively prolonged dexamethasone treatment to ameliorate the hospital course of infants with BPD (in a randomized prospective double-blind study), but they also clearly identify potential risk factors associated with dexamethasone treatment that are of concern to them as clinical investigators, risk factors based both on clinical and experimental animal studies.
The Use of Dexamethasone in Premature Infants at Risk for Bronchopulmonary Dysplasia or Who Already Have Developed Chronic Lung Disease: A Cautionary Note
Authors: AVERY GORDON B. 
Published: December 2021

In Reply.—
Beauty, it is said, is in the eye of the beholder. One can read the literature on treatment of early bronchopulmonarly dysplasia (BPD) with dexamethasone and make the case either that the lady is beautiful or that she is ugly. On the beautiful side, most observers have noted a rapid improvement in lung compliance and a higher incidence of acute weaning off the respirator. Some studies have shown shortened time in oxygen and even shorter hospitalization.
Fever under 8 Weeks of Age and Urinary Tract Infection
Authors: CRAIN ELLEN F. , GERSHEL JEFFREY C. 
Published: December 2021

In Reply.—
Dagan suggests that the infants in our sample with normal results of urinalysis may have had some other cause for their fever, although they had urine culture results that met Hellerstein's1 criteria for urinary tract infection (UTI). Five infants with catheter or suprapubic specimens identified as being at low risk for sepsis had normal urinalysis results. Dagan notes that in only two of these cases was the bacterial count &gt; 105 colony-forming units (CFU).
Nosedrops and S.I.D.S
Authors: HICKSON GERALD B. 
Published: December 2021

In Reply.—
The purpose of our paper was to examine the question of safety concerning over-the-counter (OTC) release of promethazine.1 Our stated opinion, that the drug is not appropriate for OTC release, was based on more than a suggested relationship with SIDS, but also on the drug's common side effect of sedation, ability to act as a cerebral stimulant even in therapeutic doses inducing hallucinations, convulsions and encephalopathy in some children, case reports concerning promethazine use and apparent life-threatening events, the potential for families to misuse this drug due to its sedative and antiemetic properties, and most importantly, FDA standards of safety for OTC medications which require "a low potential for harm which may result from abuse under conditions of wide spread availability."2
Reviews of Lay Literature in Child-Care: What Parents Are Reading
Authors: GLASCOE FRANCES PAGE , MOORE WILLIAM O. , BAUMGAERTEL ANNA 
Published: December 2021

B. Ingersoll. Your Hyperactive Child: A Parents' Guide to Coping with Attention Deficit Disorder. New York: Doubleday, 1988; list price $8.95 (No. 19 on the 1990 bestseller list of books on child care from Ingram Book Co., distributor of trade books).
This scholarly book offers thorough coverage of current research on the medical aspects of attentional problems and yet manages to lend clarity to the topic. The description and inclusion of various behavior rating scales is quite helpful. Several of the fad treatments such as optometric training and dietary restrictions are thoughtfully discussed although rather gently dismissed. The book also offers brief but quality advice for teachers and parents on improving communication between home and school, keeping track of assignments, and use of token economies and other reward systems. Other valuable approaches such as self-monitoring and self-reinforcement, tutoring, summer school, and counseling receive insufficient attention. The most serious omission is the lack of emphasis on attentional problems in relation to academic deficits and the need to rule out learning problems as a part of making the diagnosis of Attention Deficit/Hyperactivity Disorder. Otherwise, the author offers excellent recommendations for parents on managing children's behavior and helping them with peer relationships.
BOY AWARDED $28.7 MILLION
Authors: L. J. F. 
Published: December 2021

PHOENIX—A jury awarded $28.7 million to a 5-year-old boy, who contracted AIDS through an unauthorized blood transfusion, and his parents in what his attorney believes is the largest award of its kind.
The Maricopa County Jury on Friday awarded $26.7 million to Alex Edwards and $1 million to each of his parents, Roy and Pat Edwards.
The jury on May 23 found [the physician and his group] liable for Alex's AIDS infection through the unauthorized transfusion shortly after the boy's birth in 1985.
Small Bowel Evisceration: Unusual Manifestation of Child Abuse
Authors: PRESS SHIRLEY , GRANT PENNY , THOMPSON VALERIE T. , MILLES KAREN L. 
Published: December 2021

More than 2.4 million cases of child abuse were reported in the 48 states and the District of Columbia in 1989.1 Of these, 55% were classified as neglect, 30% as physical abuse, 16% as sexual abuse, and 8% as emotional maltreatment.1 These percentages include cases in which more than one type of abuse was reported. Common manifestations of child abuse include bruises; burns; and central nervous system, intra-abdominal (blunt as well as penetrating), and genital injuries. Unusual manifestations of child abuse have included sudden infant death syndrome, apnea, poisonings, and bizarre illnesses stemming from Munchausen syndrome by proxy.
In recent years, there has been a marked increase in the number of reported cases of child abuse, especially sexual abuse.
Primary Central Hyperventilation in a Child With a Brainstem Glioma: Management With Continuous Intravenous Fentanyl
Authors: TOBIAS JOSEPH D. , HEIDEMAN RICHARD L. 
Published: December 2021

Alveolar ventilation and respiratory rate are regulated by central respiratory centers in the pons and medulla, which are influenced by both neural and humoral input. Aberrations in control mechanisms can lead to apnea, hypoventilation, or hyperventilation. Although hyperventilation usually occurs as a compensatory mechanism for metabolic derangements, primary central hyperventilation (CHV) has been reported with brainstem gliomas, central nervous system lymphoma, supratentorial lesions, and head trauma.1-3
We present an 11-year-old boy with a brainstem glioma whose initial symptoms included CHV. When CHV became unresponsive to primary tumor management with radiation therapy and administration of dexamethasone, oral morphine was administered in an attempt to decrease his respiratory rate.
Should Promethazine Be Available Without Prescription?
Authors: HICKSON GERALD B. 
Published: December 2021

In Reply.—
Dr Rosefky is correct, promethazine lacks antidopaminergic activity. This represented an oversight on our part and we appreciate his attention to detail. We did point out correctly that due to the presence of a branch side chain and absence of a ring substitution, promethazine lacks significant antipsychotic effects.1 However, we do have to take exception with Dr Rosefky's contention that "promethazine has few neurologic side effects." Essentially all patients who take the drug experience sedation, a neurologic side effect, not to mention those children who have seizures, dystonic responses, agitation, and hallucinations.