bluuebunny/crossref_metadata_2025_split huggingface dataset:
Report of the Subcommittee on Disease-Related Pain in Childhood Cancer
Authors: Berde C. , Ablin A. , Glazer J. , Miser A. , Shapiro B. , Weisman S. , Zeltzer P. 
Published: December 2021

OVERVIEW: CANCER PAIN SYNDROMES IN CHILDREN
Pain due to cancer may be caused by tumor infiltration or invasion of bone, soft tissues, viscera, and nerves. Disease-related pain is especially common on with metastatic cancer, although there is no predictable relationship between the tumor burden and the intensity of pain. Conversely, exacerbation of pain or dramatic increase in analgesic requirements is often a clue to the occurrence of disease progression.
As with all forms of pain, management of disease-related pain requires a thorough investigation and the establishment of specific diagnoses. There has been detailed study of cancer pain syndromes in adults, and preliminary efforts have been made in this regard in pediatric cancer.10 Specific diagnosis and etiology for the pain are important to document, because more effective systemic or local therapies may be applied. This assessment must be broad-based, and it must take into consideration both disease mechanisms in the narrow sense as well as psychosocial factors which modify the experience of pain.
MANAGEMENT APPROACH FOR DISEASE-RELATED PAIN
In adults, a stepwise approach to the management of the pain associated with cancer using the "analgesic ladder" has been useful. This approach should not be regarded as a " cookbook" to be followed by rote; specific and symptomatic management of pain must be tailored to the needs and wishes of the individual patient.
An algorithm for management of pain is shown in Figure 2.
Effectiveness of Modalities of Cancer Treatment in Pain Relief
A primary means for controlling pain due to cancer lies in specific cancer treatments, especially chemotherapy and radiation.
Unintended Injuries in Children: The French Situation
Authors: Manciaux M. , Tursz A. 
Published: December 2021

The French situation with respect to mortality from unintentional injuries in children is far from satisfactory. International comparison is made difficult by statistical bias, but although excess injury mortality is decreasing in France, rates are higher than in most advanced European countries. Many regulations have been enacted during the past 30 years to reduce the economic and social burden of injuries, but political will is insufficient to establish a consolidated national program and enforcement of existing legislation is inadequate. Evaluation of preventive and educational programs is less than optimal; many attempts have not met basic methodologic requirements.
The situation is improving, partly because of growing social concern. New regulations are in preparation, but solution of this major public health problem also demands behavioral change, which is much more difficult to effect than other measures. Greater commitment to research, proper evaluation of sound programs, and enforcement of existing law doubtless would reduce the excess morbidity and mortality resulting from unintended injuries to children.
Postneonatal Mortality in Norway: A Study of Recent Trends and Comparison With Other Mortality Rates in Norwegian Children
Authors: Lie Sverre O. 
Published: December 2021

Postneonatal mortality in Norway decreased rapidly from 1956 to 1980 but subsequently remained stable. In recent years the postneonatal death rate appears to be increasing, primarily due to greater numbers of deaths attributed to the Sudden Infant Death Syndrome.
During the same period, mortality among older children has also decreased, with the decline evident in all leading causes. Only among people aged 15 to 19 years have recent trends been less than encouraging, with the number of fatal traffic accidents in particular remaining stable or increasing. Although there is room for continued improvement, the widely held belief that the health status of Norwegian children is good is supported by the trends in mortality.
Annual Summary of Vital Statistics—1989
Authors: Wegman Myron E. 
Published: December 2021

US infant mortality continued to decline slowly and the provisional 1989 rate, 9.7 per 1000 live births, was the lowest ever recorded. Final 1988 data showed no change in cause of death distribution or in the wide discrepancy between white and black infant mortality. State rates varied from 6.8 in Vermont to 12.6 in Georgia. Worldwide, the US rate of 10.0 was bettered by 21 other countries, with Japan lowest at 4.8.
Births increased in number and rate, because of a higher fertility rate and more women in the childbearing years. The birth rate to mothers 17 years of age and younger increased again. The proportion of women who had no or inadequate prenatal care was essentially unchanged.
Deaths, crude death rate, and age-adjusted death rate decreased. The excess of births over deaths added almost 1.9 million persons to the US population, the highest rate of natural increase since 1971. The marriage rate was essentially unchanged, whereas the divorce rate decreased slightly, to the lowest level since 1973.
With the exception of human immunodeficiency virus infection, homicide, and pulmonary malignancies, rates for most causes of death declined from 1988 to 1989. In comparison with 1940, most declines were substantial, led by pneumonia, down about 80%, and perinatal conditions, down about 75%. The only large-scale increases among major causes in the half century were in two diseases related to cigarette smoking: chronic obstructive pulmonary disease, up eightfold, and respiratory cancer, up almost sixfold. Death rates from all other cancers, as a group, decreased by some 20% and from cardiovascular diseases by some 60%.
Does Nasogastric Tube Cause Pulmonary Aspiration in Children?
Authors: BAR-MAOR JEHUDA ADONIRAM , LAM MENACHEM 
Published: December 2021

Aspiration pneumonia due to gastroesophageal reflux is a serious and frequently encountered problem in pediatrics and pediatric surgery.1-3 Occasionally aspiration may be silent and minimal, yet chronic unexplained respiratory symptoms may appear.4
A number of authors have reported another cause of aspiration in children, namely aspiration of gastric juice while the child is receiving mechanical ventilation by means of a respirator, especially if an uncuffed endotracheal tube is used.5-7
Nasogastric tubes are frequently used in pediatrics and pediatric surgery. It was found that the incidence of postoperative pneumonia in adults was 10 times higher in patients in whom nasogastric tubes were used.8
Safe Transportation of Premature Infants
Authors:   Committee on Injury and Poison Prevention and Committee on Fetus and Newborn
Published: December 2021

Increasing survival rates and earlier hospital discharge of premature infants have resulted in babies weighing less than 2500 g being transported frequently in the family car. Provision for safe motor vehicle transportation of this vulnerable population of infants is a major concern of parents and health professionals. The American Academy of Pediatrics Committee on Injury and Poison Prevention and the Committee on Fetus and Newborn believe that specific guidelines should be followed to ensure proper selection and use of car seats and other occupant restraint devices for low-weight infants.
Currently, Federal Motor Vehicle Safety Standard 213, which established design and dynamic performance requirements for child restraint systems, applies to children weighing up to 50 lb, but no minimum weight limit is established in the standard. Most safety restrains on the market are designed for infants weighing more than 7 lb (3.1 kg), and only recently have studies been done which allow some prediction of the protective capabilities of restraint devices for infants weighing less than 7 lb.1,2 Initial research has indicated that some infants, particularly premature, low-weight infants, may be subject to oxygen desaturation when placed in an upright position in car safety seats.3,4 Both rate of growth and neurologic maturation may influence potential risk of respiratory compromise in these and other seating devices. Further investigations will be necessary to precisely define the population at risk and the variety of situations in which risk occurs.
Proper positioning of small infants in car seats is important to minimize the risk of respiratory compromise while providing protection for the infant in the event of a crash or sudden stop.
Daddy MD
Authors: Avner Jeffrey R. 
Published: December 2021

It's been almost two years since the weekend my daughter couldn't breathe.
It started Thursday evening with a runny nose and low-grade fever, not unlike the times she's had colds before. Even when she developed the barking cough, which heralded the onset of the croup, we weren't concerned. We had seen this many times with other children and knew that it was uncommon for a child with croup to be seen in the emergency room. Still, before we went to bed that night we turned on the intercom in Arly's room; it was the first time we'd used it in a year.
By three in the morning we were awakened by Arly's harsh breathing, which seemed to vibrate the entire apartment. We went to her room. She was only half asleep because she was working so hard to breathe. My wife, Rhonda, carried Arly into the bathroom and turned on the hot water in the shower. During my pediatric residency I had given many of my clinic patients' parents the same advice. Arly got only a little better. We didn't take her to the emergency room that night, even though if she had been someone else's child I would have admitted her. Perhaps I was afraid her condition would improve after the car drive to the emergency room and my fellow residents would think I was overreacting. You would think doctors would be more attuned to the dangers of their children's illnesses, yet, all too often, we wait too long.
Risks of Alternate-Day Prednisone in Patients With Cystic Fibrosis
Authors: Rosenstein Beryl J. , Eigen Howard 
Published: December 2021

In recent years an immune-mediated inflammatory process has been implicated in the genesis of the pulmonary damage seen in patients with cystic fibrosis.1,2 A 4-year double-blind, placebo-controlled trial of alternate-day prednisone (2 mg/kg) was conducted in 45 cystic fibrosis patients with mild-to-moderate pulmonary disease to assess the effect of this drug on the pulmonary inflammatory process.3 The patients in the prednisone group showed better growth and pulmonary function and less morbidity compared with those in the placebo group. No complications were reported among the prednisone-treated patients. To extend these observations, the United States Cystic Fibrosis Foundation sponsored a multicenter double-blind, placebo-controlled trial of alternate-day prednisone. Since March 1986, 283 patients with cystic fibrosis, followed up at 15 centers in the United States and Canada, have been enrolled in this trial. Patients 5 through 14 years of age with mild-to-moderate pulmonary disease were randomly assigned to receive prednisone 2 mg/kg (high-dose) every other day, prednisone 1 mg/kg (low-dose) every other day, or placebo. On entry into the study, patients in the three groups were closely matched by a variety of clinical and laboratory parameters (Table 1).
Patients are closely monitored at 3-month intervals for both efficacy and side effects. An interim analysis is carried out every 6 months and the results are reviewed by an unblinded study ombudsman. Initially, 95 patients were randomly assigned to the high-dose group, 94 to the low-dose group, and 94 to the placebo group. At the time of the most recent interim analysis, mean duration in the study was 33.9 months for the high-dose group, 35.3 months for the low-dose group, and 36.8 months for the placebo group.
Fetal Hemoglobin in Neonatal Anemia
Authors: KOELLER DAVID M. 
Published: December 2021

To the Editor.—
A recent paper in Pediatrics by Bard and Prosmanne1 described an elevation of fetal hemoglobin (Hb-F) production in infants with bronchopulmonary dysplasia (BPD) and oxygen dependency. The authors described a novel approach to the evaluation of occult hypoxemia in infants, with potential application in a wide range of disorders. However, in their paper the etiology of the elevation of Hb-F production in BPD patients may have been due to factors other than pulmonary disease.
Fetal Hemoglobin in Neonatal Anemia
Authors: BARD HARRY 
Published: December 2021

In Reply.—
The hypothesis being tested was that increased HbF synthesis which is an erythropoietic response to hypoxemia could occur in infants with BPD. Hypoxemia as a result of anemia should result in the same phenomena. Dr Koeller is correct in noting that newborn infants requiring intensive care have frequent blood sampling; however, because intensive care also includes maintaining physiological blood volume and hematocrit, anemia was not a factor for the increased production of HbF reported in this study.
Encopresis Caused by Mother's Stoma
Authors: PILAPIL VIRGILIO R. 
Published: December 2021

In Reply.—
I appreciate the opportunity to comment on the case report "Encopresis Caused by Mother's Stoma" by de Vos et al. The situation that led to constipation and encopresis in their case, although differing from that of mine,1 nevertheless created the same effect of producing severe anxiety in the child when she needed to assume her bowel function in the usual manner and setting. I have no doubt that there could be many other parallel situations in which bowel function is impaired by fearful thoughts and anxiety as a consequence of a viewed or imagined situation that may relate to bowel function or use of the toilet.
Outcome of ≤800-Gram Birth Weight Infants
Authors: HOFFMAN EDWARD L. , BENNETT FORREST C. 
Published: December 2021

In Reply.—
We welcome the comments of Drs Kilbride and Daily, former teachers of Dr Hoffman. As survival of extremely low birth weight infants has increased,1 more attention has been focused on neurodevelopmental morbidity trends in this birth weight group. Conclusions are hampered by the small numbers in follow-up studies, the lack of standardization of confounding variables across different study sites, and the continuing changes and improvements in prenatal, perinatal, and neonatal care. Drs Kilbride and Daily's early study period, 1980 to 1982, is later than the study period of Dr Bennett et al,2 1977 to 1980.
Fetal Vascular Disruption With Prenatal Exposure to Cocaine or Methamphetamine
Authors: BAYS JAN 
Published: December 2021

To the Editor.—
Hoyme et al1 have described seven children from four states with congenital limb reduction defects associated with prenatal exposure to cocaine. I am concerned that digit and limb reduction following cocaine or methamphetamine exposure in utero may be much more common than the nine existing case reports1,2 indicate and that a Ross Laboratories patient education brochure is correct in stating, "cocaine can make a baby have missing fingers."3
We began recognizing cocaine-exposed infants in 1986.
Ingestion of a Laryngoscope Light Bulb During Delivery Room Resuscitation
Authors: NAUMOVSKI LOUIE , SCHAFFER KEVIN , FLEISHER BARRY 
Published: December 2021

To the Editor.—
Neonatal resuscitation involves management of the airway and at times requires laryngoscopy and endotracheal intubation. These procedures can be associated with iatrogenic complications, one of which is described below.
The patient was intubated at the referring hospital because of meconium staining of the amniotic fluid. He required mechanical ventilation and was transported to our hospital. A bullet-shaped radiopaque object was noted on the chest roentgenogram from the referring hospital. Its presence was confirmed on subsequent films at our hospital (Figure).
Managing Hemangiomas
Authors: ENJOLRAS ODILE 
Published: December 2021

In Reply.—
We read carefully the two papers from Alkalay et al1 and Hurvitz et al,2 and thank them for their letter to the editor.
They emphasize the efficacy of cyclophosphamide therapy for vascular tumors in infancy. In our series of 25 cases,3 all 25 infants had hemangiomas, defined4 by a postnatal cellular and capillary proliferation, either cutaneous or cutaneous and visceral, undergoing rapid growth and then slow spontaneous regression. Liver localizations appeared to be particularly life-threatening (three of our infants died).
Problem With Pulse Oximeters
Authors: ALBERSHEIM SUSAN , RODE TIM 
Published: December 2021

To the Editor.—
We have discovered recently a major problem with the pulse oximeters which we have been using in our Neonatal Intensive Care Unit. We felt that there was some urgency in alerting other neonatologists and pediatricians to this problem.
The incident which led us to discover this problem involved a low birth weight infant who on admission was stabilized according to our Nursery protocol. In these very small neonates, who are at greatest risk of skin breakdown and yet require close monitoring, we recently have used the Fastrac monitor (SensorMedics Corporation, Anaheim, CA) which combines transcutaneous Pco2 and pulse oximetry.
Family History: A Special Opportunity for Psychosocial Intervention
Authors: ZUCKERMAN BARRY 
Published: December 2021

Family history traditionally has been important in the diagnosis of rare genetic disorders. Recently, due to the development of potential interventions, the role of family history has expanded to identify potential risk factors for myocardial infarction or the presence of certain genetically determined birth defects. I would like to suggest that routine family history be expanded to highlight two common mental health problems that affect children: major depression and alcoholism. Major depression occurs in 3% of adult men and 4% to 9% of adult women.1 Alcoholism occurs in 1 of 8 adults in the United States,2 and 1 of 6 children has an alcoholic parent.3 Identification of these problems in parents and grandparents provides a special opportunity for intervention by pediatricians during health care supervision visits or when examining children with behavioral or developmental problems.
The presence of either disorder in one or both parents is a good predictor of future psychiatric disorder in the child. Although some specificity of transmission has been shown, children may develop other problems.4 Two possible mechanisms may account for the transmission of either of these problems. The first is genetic transmission.
Prenatal and Perinatal Factors in the Etiology of Autism
Authors: Nelson Karin B. 
Published: December 2021

This paper will review studies on prenatal and perinatal factors and the etiology of autism. It will focus on whether identified risk factors have been consistent from report to report, the extent to which identified risk factors are likely to be causal, and the extent to which identification of these factors can contribute to the development of strategies for the prevention of autism.
Autism is one of a group of disorders often described as the developmental disabilities. Other disorders in this group are mental retardation, cerebral palsy, epilepsy, and learning disorders. Like these other disorders, autism is delineated by a set of observable dysfunctions and to some extent also by a shared natural history.
Like these other disorders, autism is not a disease in the sense of having known biologic markers or known major etiologic factors in common. It is probable that autism is not the result of a single etiologic factor.
Before examining the literature on autism, it may be useful to consider briefly what is known about maternal, pregnancy, and birth factors in the other developmental disabilities.
EXPERIENCE WITH OTHER DEVELOPMENTAL DISABILITIES
Contrary to expectations based on a hypothetical "continuum of reproductive causality," different developmental disabilities often have different major predictors. For example, the major known predictors of mental retardation and learning disorders are family characteristics such as educational level of the parents and measures of socioeconomic status.1,2 These characteristics are not important risk factors for cerebral palsy3 or epilepsy.4,5 Low birth weight is related to cerebral palsy but not to epilepsy in persons without cerebral palsy.6
Envenomation by the Scorpion Centruroides exilicauda (C sculpturatus): Severe and Unusual Manifestations
Authors: BERG ROBERT A. , TARANTINO MICHAEL D. 
Published: December 2021

Scorpion envenomation continues to be a common occurrence in the southwestern United States. The only medically important scorpion in the United States is Centruroides exilicauda (also known as C sculpturatus), a scorpion found mainly in Arizona, but also found in parts of Texas, New Mexico, California, and northern Mexico.1
Envenomation by C exilicauda is clinically significant because of potent neurotoxins injected from the terminal tail segment of the scorpion into its prey.2 Clinical effects include tachycardia, local pain, restlessness, roving eye movements, hypertension, respiratory distress, tachypnea, hypersalivation, slurred speech, and stridor. These signs and symptoms are usually more severe in children, especially those younger than 5 years of age.3,4
The Great God Cholesterol
Authors: HOLTZMAN NEIL A. 
Published: December 2021

Several recent reports maintain that healthy children with elevated concentrations of cholesterol and low-density lipoprotein cholesterol (LDL-C) in their blood will prove to be adults with high levels and, consequently, at high risk of coronary artery disease (CAD).1-3 Two of these studies advocate screening of all children for elevations of cholesterol1,2; one of them goes so far as to call healthy children with elevated LDL-C concentrations "severely affected."1 This is unjustified.
Consider the data: Two studies have tracked cholesterol levels from childhood into adulthood.4,5 In the Beaver County study, only 48% of 11- to 14-year-olds whose cholesterol levels were at or above the 80th percentile had levels in that range 9 years later.
Surfactant Replacement Therapy for Respiratory Distress Syndrome
Authors:   Committee on Fetus and Newborn
Published: December 2021

It is now clearly established that respiratory distress syndrome (RDS) is associated with prematurity-related surfactant deficiency. Since its discovery,1 there has been a considerable amount of research defining the biochemical composition of surfactant and its relationship to pulmonary function. A considerable amount of research has also been performed on animals to formulate the scientific basis for surfactant replacement therapy in premature infants to prevent or reduce the severity of RDS.
Clinical trials began with the rescue therapy by Fujiwara et al2 and were followed by several single institution or multicenter trials using bovine, human, or synthetic surfactants. Many of these clinical trials have been published,3-11 and others have been submitted for publication. Many of these trials were randomized, and the form of surfactant therapy was either prevention (endotracheal instillation of surfactant at birth) or rescue (treatment after RDS is diagnosed). Based on the published data, it appears that in both prevention and rescue trials, there is early improvement in respiratory status as evidenced by decreased inspired oxygen concentration and mean airway pressure requirements during the first 3 days of life. Some, but not all, published series suggest a reduction in mortality rates and incidence of pulmonary air leaks3,7 during the first 28 days of life, but none of the published series appear to show an improvement in the incidence of such morbidities as bronchopulmonary dysplasia, necrotizing enterocolitis (NEC), infections, patent ductus arteriosus (PDA), and intraventricular hemorrhage (IVH). In fact, one series showed increased incidence of NEC in the surfactant-treated group,6 the European trial showed an increased incidence of IVH,12 and one series showed an increased incidence in PDA9 in the surfactant-treated group.