bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutrition and Lactation
Authors: Barness Lewis A. , Dallman Peter R. , Anderson Homer , Collipp Platon Jack , Nichols Buford L. , Walker W. Allan , Woodruff Calvin W. 
Published: December 2021

Lactation is a continuation of intrauterine gestation. In both processes, maternal diet plays an active role in the provision of nutrients, maternal nutritional stores and endocrine adaptations serve to buffer the short-term variations in maternal nutritional intake, blood flow plays an overriding role in nutrient transfer to the fetus and newborn infant, and the nutrient demands of the recipient are the highest of any stage in human development.
Human milk is remarkable in its variability. Recent data suggest that the variability often improves the nutrient composition as part of a complex adaptation to the infant's specific needs. A comprehensive survey of the literature on lactation and human milk is provided in two review articles.1,2
NUTRIENTS
Lipids
Milk lipids provide the major fraction of calories in human milk, yet they are the most variable constituent.3 Preceding a nursing, the fluid phase of milk stored within the gland resembles skimmed milk. During the course of a nursing, the contraction of smooth muscle launches the fat droplets. This draught reflex is essential for caloric adequacy for the breast-fed infant.2
Women living under unfavorable socioeconomic conditions have reduced total milk lipid.4-6 There is evidence that supplementing the diets of these women leads to increased milk fat. Under controlled metabolic ward conditions, a high-caloric, high-fat diet can be demonstrated to increase milk fat production.7 The distribution of the spectrum of fatty acids in human milk also is responsive to dietary changes.7-13
Women who are malnourished also produce an excess of 12:0 and 14:0 fatty acids.14
Use of Intravenous Fat Emulsions in Pediatric Patients
Authors: Barness Lewis A. , Dallman Peter R. , Anderson Homer , Collip Platon Jack , Nichols Buford L. , Walker W. Allan , Woodruff Calvin W. , Heird William C. , Tomarelli Rudolph M. , Benson John D. , Purvis George A. , LiCari Jerome , Lockhart Haines B. , Saperstein Sidney , Taif Betty , White Philip L. , Egan Mary C. , Cheney Margaret , Pencharz Paul , Moore Melinda , Chopra Joginder , Brown Myrtle L. , Fjellstedt Thorsten J. , Teply L. J. , Kennedy Eileen , Darby William J. , Lewy Peter 
Published: December 2021

Intravenous fat preparations are used in the nutrition of those requiring parenteral alimentation. Although parenteral nutrition is recognized as a limited substitute for oral alimentation, and should be used for as short a time as possible, widespread use has resulted in some adverse effects.
Fat has the highest caloric density of any nutrient. In addition, intravenously infused fat emulsions exert negligible osmotic effects. Thus, for a number of years, the possibility of providing calories by the intravenous administration of fat emulsions has been an attractive one. In fact, one of the first attempts at intravenous nutrition was infusion of various nonemulsified oils.1 Approximately 30 years ago, a fat emulsion suitable for intravenous use was developed and used extensively. Although it was efficacious as an intravenous calorie source, it was unstable and the serious, short-term effects of this instability resulted in its withdrawal from the market in the late 1960s.
Subsequently, advances in manufacturing technology allowed preparation of stable fat emulsions, and several such preparations are available today. All currently available emulsions are efficacious calorie sources; moreover, they appear to be extremely stable and have been associated with relatively few adverse effects.2-5 All allow delivery of lipid to patients requiring parenteral nutrition. In fact, they may make it possible to deliver adequate nutrients solely by peripheral vein, thus avoiding in many patients the use of central vein catheters and their associated complications.6 This possibility, plus the possibility of providing linoleic acid and thereby preventing essential fatty acid deficiency, which occurs with fat-free total parenteral nutrition,7,8 has generated considerable enthusiasm for these products.
Hypertrichosis Pinnae in Babies of Diabetic Mothers
Authors: Rafaat Massoud 
Published: December 2021

Congenital hypertrichosis of external ears is commonly seen among some populace of Pacific Islands and babies with XYY syndrome. However, we have observed this condition among most of our babies born of diabetic mothers (Figure).
In all of the textbooks of pediatrics and endocrinology, the physical characteristics of these infants are described as follows: "Large and plump babies with increased body
See Images in the PDF File
fat and enlarged viscera with puffy, plethoric facies resembling those of patients who have been receiving corticotropin or a corticosteroid (cushingoid or tomato facies)."
Questions Value of Name Change: RLF/ROP and IF
Authors: Day Richard L. 
Published: December 2021

I wish to disagree with the Second International Retrolental Fibroplasia Conference. They wish, as they have written in a recent issue of Pediatrics (67:751, 1981), to "dislodge the established misnomer, RLF." They wish to substitute two names, ROP and IF. I refrain from mentioning what ROP and IF, abominable acronyms, stand for, and go on to what is more important.
The purpose of a name is to describe something so that, in one brief word, a future scholar, investigator, or bookworm can quickly grasp what the writer has in mind.
Nutritional Aspects of Obesity in Infancy and Childhood
Authors: Barness Lewis A. , Dallman Peter R. , Anderson Homer , Collipp Platon Jack , Nichols Buford L. , Walker W. Allan , Woodruff Calvin W. , Tomarelli Rudolph M. , Benson John D. , Purvis George A. , LiCari Jerome , Lockhart Haines B. , Saperstein Sidney , Anderson Betty E. , White Philip L. , Egan Mary C. , Cheney Margaret , Roy Claude , Moore Melinda , Chopra Joginder , Brown Myrtle L. , Sarett Herbert P. , Fjellstedt Thorsten J. , Teply L. J. , Kennedy Eileen , Darby William J. , Lewy Peter 
Published: December 2021

Obesity is characterized by an excess of adipose tissue relative to lean body mass. With rare exceptions, it simply reflects a long-term imbalance in energy intake vs expenditure. The excess energy is stored as fat. The known metabolic correlates of this state are, for the most part, secondary events.1 The day-to-day "error" in intake or expenditure necessary to derange long-term energy balance is smaller than the accuracy with which either factor currently can be measured over long periods; therefore, the question of etiologies remains unanswered.
The systems regulating mammalian fuel homeostasis and food intake are complex, and many potential "lesions" could alter long-term energy balance. There are a number of experimental and genetic animal models in which regulatory or apparent metabolic disturbances result in obesity, but no similar abnormalities have been consistently demonstrated in individuals with simple obesity.2 However, the traditionally accepted causes of obesity, relative overeating and/or physical underactivity, may not be operating in all instances of simple obesity.3,4
ANTHROPOMETRY
Criteria for the diagnosis of obesity are difficult to establish because "optimal fatness is a conditional state. A man preparing for an emergency trek, a population entering a period of famine, a child entering a febrile illness or a growth spurt or a woman becoming pregnant will have physiological advantages from abundant stored fat."5 Medical considerations suggest that excessive adiposity (or leanness) is unhealthful; but cosmetic and other social considerations are generally preeminent in determining the acceptable range of body composition within a culture.
A variety of definitions of obesity have been devised for adults (weight-height indices that produce relative independence of weight from height).
Advantage of Latex Agglutination Over Countercurrent Immunoelectrophoresis in the Detection of Haemophilus influenzae Type b Antigen in Serum
Authors: Scheifele David W. , Ward Joel I. , Siber George R. 
Published: December 2021

Detection of bacterial antigens has proved to be a valuable adjunct to early diagnosis of certain invasive infections. In the case of Haemophilus influenzae type b infections, capsular polysaccharide antigen (PRP) has been detected by a variety of techniques including countercurrent immunoelectrophoresis (CIE),1-3 latex particle agglutination (LPA),3,4 radioimmunoassay,5 and enzyme-linked immunosorbent assay (ELISA).6,7 There have been few prospective comparisons3,7,8 by which to establish the sensitivities and idiosyncrasies of these techniques. This report compares the two simplest techniques, CIE and LPA, in children with H influenzae b infections, drawing attention to a shortcoming of CIE in those with nonmeningeal infections.
METHODS
Posttransfusion Cytomegalovirus Infections
Authors: Sandler S. Gerald , Grumet F. Carl 
Published: December 2021

Although cytomegalovirus (CMV) infection has been recognized as a potential hazard of blood transfusion since 1966,1 few transfusion services provide blood components that have been selected specifically for low risk of infectivity with CMV. The objective of this commentary is to provide a review of the epidemiology of posttransfusion CMV infections with special reference to recent recommendations for its control by donor antibody screening and other blood bank procedures.
In the healthy immunocompetent child or adult, posttransfusion CMV infection usually results in asymptomatic seroconversion or is manifested as a mild heterophile-negative mononucleosis syndrome. There is minimal morbidity associated with these transfusion-related infections and, therefore, minimal need for special CMV-free blood components.2
Letters to the Editor
Authors: Eisenberg Leon 
Published: December 2021

Mittleman insists upon the difference between words that obscure and those that accurately communicate reality. It is one of the few points on which we agree. He transmutes my phrase "right to reproductive freedom" to his phrase "murder ... unborn children." To him "it is self-evident" that abortion is murder and that human life begins at conception. He adds: "There are no legitimate arguments about these facts!"
Despite his assertion of absolute rectitude on these questions, there is continuing public debate on precisely these issues.
Immersion Accidents in Hot Tubs and Whirlpool Spas
Authors: Monroe Byron 
Published: December 2021

Accidents are currently the single greatest cause of death for children in the United States.1 Twenty percent of these accidental deaths of children less than age 5 years and 5% of the accidental deaths of children 5 to 19 years of age are due to drowning.2 For each drowning, there are other nonfatal immersion accidents in which there is a high morbidity.3,4
Immersion accidents in whirlpool spas (Jacuzzi) and hot tubs present several types of danger to children. This paper reviews experience in this area and describes several unique injuries associated with these recreational facilities.
During the last five years there were 23 admissions to Cottage Hospital of children less than age 18 for drowning or near drowning in the Santa Barbara, CA area (population 180,000).
Probable Graft-Versus-Graft Reaction
Authors: BUCKNER C. DEAN 
Published: December 2021

To the Editor.—
The report by Lauer et al "Probable Graft-vs-Graft Reaction in an Infant after Exchange Transfusion and Marrow Transplantation" deserves comment. Proof of initial engraftment from the random blood donor depends on the HLA type of the donor. The HLA typing of the patient's lymphocytes rules out engraftment unless the donor was fortuitously HLA matched and this is conceivable as the HLA phenotype is a relatively common one. It is also suggested from other reports that some degree of donor-recipient compatibility is necessary for engraftment via blood transfusions.
Likelihood Ratio, Skull Roentgenograms, and Clinical Decision-Making
Authors: LEVENTHAL JOHN M. , LEMBO ROBERT M. 
Published: December 2021

To the Editor.—
In the February 1982 issue of Pediatrics, Leonidas et al1 examined the relationship between clinical findings and skull fractures in children evaluated with skull roentgenograms to develop reliable criteria for the ordering of roentgenograms in patients with head trauma. In their analysis, the authors used the liklihood ratio (LR) to characterize quantitatively the relationship between a clinical finding and the presence of a skull fracture. As defined by the authors, the LR is that ratio between the probability of a certain clinical finding occurring in the presence of a fracture and the probability of the same clinical finding occurring in the absence of a fracture.
Preoperative Chest Radiographs
Authors:   Committee on Hospital Care
Published: December 2021

Review of the medical literature indicates that routine preoperative chest radiographs identify few children with unsuspected significant disease. Therefore, the Committee on Hospital Care of the American Academy of Pediatrics recommends that these examinations should not be considered mandatory and should be performed only at the discretion of the attending physician. Chest radiographs should not be a substitute for a complete medical history and physical examination, which remain the most effective methods for determining those patients who are at risk for complications associated with surgery.
Preoperative chest radiographs may be indicated when, for example, the history or physical findings suggest respiratory, cardiovascular, chronic renal, immune deficiency, or certain hematologic disease, or malignancy with possible pulmonary involvement. Similarly, these examinations may be helpful whenever it is anticipated that their results will be needed for comparison with postoperative radiographs. In any case, the attending physician should have the freedom to request preoperative chest radiographs under any circumstances in which his/her clinical judgment dictates the procedure to be appropriate.
Decreased Prostacyclin Levels in Sickle Cell Disease
Authors: MEHTA PAULETTE , ALBIOL LORETO 
Published: December 2021

In Reply.—
We read with interest the letter by Longenecker and Mankad regarding measurements of prostacyclin metabolites in patients with sickle cell disease. The major difficulty in this area has been variability of measurements inasmuch as radioimmunoassay measurements of 6-keto-PGF1α of less than 100 pg/mL are considered unreliable.
The data given by Longenecker and Mankad raise some important questions. The normal levels of 6-keto-PGF1α, which they found, are similar to those detected by us. In contrast to our findings, patients with sickle cell disease had even lower concentrations which are in undetectable range for this assay and are therefore not reliable.
Cholelithiasis in a 3-Week-Old Small Premature Infant
Authors: BOYLE ROBERT J. , SUMNER THOMAS E. , VOLBERG FRANK M. 
Published: December 2021

Cholelithiasis is an extremely unusual finding in infancy. Hemolytic disease, infection, ileal disease, and anatomic deformity of bile ducts have been implicated.1 Recently, an association of prematurity, bronchopulmonary dysplasia, total parenteral nutrition, and furosemide has been reported.2
We have observed a small premature infant who developed cholelithiasis early in his hospital stay after a very short course of parenteral nutrition.
CASE REPORT
The patient was an 810-g male infant of 28 weeks' gestation (by Dubowitz examination) born to a 25-year-old gravida 2, para 1, abortus 1. The pregnancy was complicated only by premature rupture of membranes followed by labor. The mother had no fever or other signs or symptoms of infection prior to delivery.
Hyperosmolality in Small Infants Due to Propylene Glycol
Authors: GLASGOW ALLEN M. , BOECKX ROGER L. , MILLER MARILEA K. , MACDONALD MHAIRI G. , AUGUST GILBERT P. , GOODMAN STEPHEN I. 
Published: December 2021

Propylene glycol (1,2-propanediol) is used in many drug preparations. Although propylene glycol is regarded as having low toxicity in adults, in humans and animals there have been reports of CNS, renal, hematologic, and cardiac toxicity.1-5 The absorption of propylene glycol through large burn wounds has recently been documented as a cause of serum hyperosmolality.6,7
Investigation of the cause of unexplained hyperosmolality in a premature infant led to the finding that several infants in our nursery were hyperosmolar due to administration of propylene glycol in a multivitamin preparation used in parenteral nutrition. This finding raises concern about the relatively large dose of propylene glycol that may be received by very small infants, especially those receiving multiple medications.
Soy-Protein Formulas: Recommendations for Use in Infant Feeding
Authors:   Committee on Nutrition
Published: December 2021

Many infant formulas are available as alternatives to breast-feeding. These formulas are necessary and valuable resources in the nutriture of infants, but it is important to evaluate their use and efficacy periodically. Soybean preparations were suggested as a milk substitute by Hill and Stuart1 in 1929.
Since then, the use of these products has expanded appreciably, and they are used for an estimated 10% to 15% of all formula-fed infants. This increase in use has prompted examination of the following critical issues about the indications for use of soy-protein formulas in infants. (1) Are soy-protein formulas an adequate nutritional substitute for cow's milk-based formulas in full-term infants? (2) Is it appropriate to recommend soy-protein formulas to provide a lactose-free formula, or are there better alternatives? (3) Are soy-protein formulas ever indicated for use in premature infants? (4) What is the evidence for and against the use of soy-protein formulas in the management of cow's milkprotein allergy? (5) What is the role of soy-protein formulas in prophylaxis of allergic disease? (6) What is the evidence for and against the use of soy-protein formulas in the management of "colic"?
Examination of these issues will hopefully, provide a more clear-cut basis for decisions regarding the use of soy-protein formulas and updated recommendations for the role of soy-protein formulas in feeding human infants.
COMPOSITION OF SOY-PROTEIN FORMULAS
Soy-protein formulas, although different in carbohydrate and protein source, are similar in composition to cow's milk-protein formulas following the American Academy of Pediatrics, Committee on Nutrition, 1976 recommendations for nutrient levels in infant formulas.2
Hazards of Battery Ingestions
Authors: MOFENSON HOWARD C. , GREENSHER JOSEPH , CARACCIO THOMAS R. 
Published: December 2021

To the Editor.—
We found the report from Temple and McNeese1 on the hazards of small flat disc batteries very timely. The management of these ingestions has been controversial and in recent months, the pendulum of recommendations for therapy has swung from nonintervention to very early endoscopic or surgical intervention.
The Nassau County Medical Center's Long Island Regional Poison Control Center has reviewed its battery ingestion experience and statistics for the past 16 months.2 Only 1/30 cases of small flat disc battery ingestions required surgical intervention for removal of an intact battery.
Expanded Guidelines for Use of Varicella-Zoster Immune Globulin
Authors:   Committee on Infectious Diseases
Published: December 2021

I. BACKGROUND INFORMATION
1. Zoster Immune Globulin
Zoster immune globulin (ZIG) can prevent clinical chickenpox in exposed, susceptible, normal children.1 In a collaborative study2 in which 15 susceptible children at high risk received ZIG within three days following exposure, there were no deaths and only one child developed progressive varicella. At that time, a mortality of 7% and a rate of progressive varicella of 30% were reported in similar children who failed to receive prophylaxis.3 At the present time, varicella may be even more hazardous for children with leukemia, possibly because of the use of more intensive therapy.
2. Varicella-Zoster Immune Globulin
The use of plasma obtained from patients convalescing from zoster to prepare ZIG resulted in a limited supply of this material. The finding that plasma from normal donors with high varicella-zoster (V-Z) antibody could be used to prepare a globulin of similar potency, referred to as varicella-zoster immune globulin (VZIG),4 now assures ample supply. The availability of this material, through the American Red Cross, permits us to recommend it for additional indications. The major deterrent to the use of VZIG is its cost, which in August 1983 was approximately $75 per 125 units (approximately 1.25 mL), the dose for a 10-kg child. The recommended adult dose of 625 units costs about $375.
3. Morbidity from Varicella in Adults
Adults suffer greater morbidity from chickenpox than do children. Although less than 2% of reported cases occur in individuals after the second decade, nearly one quarter of all the reported mortality occurs in this group.5
Of particular concern are pregnant women who develop chickenpox.
Growth Hormone in the Treatment of Children with Short Stature
Authors:   Ad Hoc Committee on Growth Hormone Usage, The Lawson Wilkins Pediatric Endocrine Society, and Committee on Drugs
Published: December 2021

Therapeutic use of growth hormone (GH) in the United States generally has been restricted to GH-deficient children who, with their families, agree to participate in research. The limited supply and the considerable expense of commercially prepared GH have restricted the number of children who have received such therapy. As the medical community and public become more aware of the therapeutic potential of GH, practicing physicians are faced with mounting pressure to prescribe GH for short children who are not GH deficient. Furthermore, the promise that abundant supplies of biosynthetic GH prepared by recombinant DNA methods will soon be available adds to the fever for uncontrolled experimentation.
Twenty-five years of experience indicate that therapeutic replacement of GH is safe for GH-deficient children. Nevertheless, using GH in the treatment of children who are not deficient in GH should not be engaged in lightly, as GH is a potent metabolic agent that might have significant side effects. Because there is so little experience with the therapeutic use of GH at the pharmacologic doses that may be required to accelerate growth in non-GH-deficient children, information on side effects is limited. It is appropriate, therefore, to review (1) the accepted indications for the therapeutic use of GH (GH-deficient children), (2) the disorders in which GH has been shown to lack beneficial effect, (3) the issues to be considered in selecting for therapy patients who do not appear to have classic GH deficiency, and (4) the side effects that might occur when GH is administered as a pharmacologic agent.
TREATMENT OF GROWTH HORMONE DEFICIENT CHILDREN
Growth failure due to GH deficiency is the only universally accepted therapeutic indication for GH treatment.
Biostatistics in Pediatrics
Authors: KLESH KENNETH W. 
Published: December 2021

To the Editor.—
I read with great interest the recent article by Hayden1 concerning the expanding use (and misuse) of biostatistics. in the medical literature. Having little background in statistics, I indeed have found it increasingly difficult to critically evaluate research presentations—the "auto-cerebrectomy" of which Feinstein2 spoke is both familiar and personally troubling.
While a series of instructional articles on statistical topics as has appeared in the New England Journal of Medicine, is most welcome, I suspect that an approach more intimately associated with a well-established continuing medical education effort would reach the greatest number of practicing pediatricians and could be more directly tailored to their needs.