bluuebunny/crossref_metadata_2025_split huggingface dataset:
T.A.C.
Authors: DEAN ROGER 
Published: December 2021

To the Editor.—
As a pharmacist at a pediatric hospital which uses tetracaineadrenaline-cocaine (TAC), I was interested in the article by Bonadio and Wagner.1 I have often wondered about the relative anesthetic contribution of tetracaine in this arbitrarily developed extemporaneous product.2
The use of TAC in our emergency department has increased greatly during the last year, and the physicians have accepted it as a safe and effective anesthetic alternative to injections of lidocaine. As in
HIV and Day Care
Authors: FENSTER DIANE LIND 
Published: December 2021

To the Editor.—
I read with interest the article in Pediatrics by Morrow et al on children with HIV in day care centers.1 The tone of the article is patronizing: the authors suggest that if parents were better educated, they would accept the presence of HIV-infected children in their day care centers.
I agree that increased education of parents and day care providers is highly desirable. In keeping with the decline of paternalism in medicine,
Battery Ingestions
Authors: RUMACK CAROL M. , RUMACK BARRY H. 
Published: December 2021

The proliferation of battery-operated devices has provided a new source of hazards for children. "Button batteries" are small cells used in hearing aids, cameras, watches, and a wide variety of miniaturized electronic marvels. They are ingested by children who either remove them from the device by themselves or find them left in their environment.
The article by Litovitz and Schmitz in this issue represents the culmination of 7 years' worth of tenacious research.1 Though it was made clear by an earlier report from this study that an initial roentgenogram is required following ingestion,2 they found 13.4% of patients never had a diagnostic roentgenogram.
Firearms and Adolescents
Authors:   Committee on Adolescence
Published: December 2021

Firearms play a major role in childhood morbidity and mortality in the United States, especially among adolescents. The American Academy of Pediatrics is committed to reducing firearm death and injury of children and youth and has published policy statements on handgun control (1985),1 "toy" firearms (1987),2 and "Firearm Injuries Affecting the Pediatric Population" (1992).3 The purpose of this statement is to identify major firearm issues that specifically address adolescents.
Reducing injuries and deaths from firearms is an essential priority for adolescent health. Of all firearm deaths among children from birth to age 19 years, 80% occur in older youths aged 10 to 19 years. Firearms are involved in 70% of teen homicide and 63% of teen suicide. Firearms are the second beading cause of death (after motor vehicle accidents) among all teenagers aged 15 to 19 years.4,5 Risk factors for firearm death seem particularly related to age, as rates of firearm violence peak in bate adolescence (ages 15 to 24 years) and decrease in young adulthood (ages 25 to 34 years).6 Therefore, special characteristics of adolescent development must be considered in designing effective countermeasures to prevent injury and death.
ADOLESCENT MORTALITY AND MORBIDITY
The statistics on firearm death and injury in adolescents emphasize the severity of the problem.
Mortality
Firearms account for 20% of deaths among all older youth, with almost 3200 US youths aged 15 to 19 years fatally shot each year.4 In the last 20 years, the rate of firearm deaths among teenagers has increased 75%, from 10.1/100 000 to 17.7/100 000.4
Does the Commercial Type of IVIG Used Make a Difference?
Authors: HAQUE KHALID H. 
Published: December 2021

To the Editor.—
I read with interest the article "Intravenous Immunoglobulin Therapy for Prevention of Infection in High-Risk Premature Infants: Report of a Multicenter, Double-Blind Study."1 I would agree with the authors that to date none of the published studies2-10 have shown "absolute and unquestionable efficacy" in the prevention of neonatal infections in all preterm babies, but like others I feel there does seem to be a beneficial trend for the under 1500 g baby.2,3,5,8,10 What worries me about this paper is that contrary to all the previous studies, Magny et al found greater incidence of proven or suspected infection 54% vs 41% in the intravenously administered Ig (IVIG)-treated group.
Does the Commercial Type of IVIG Used Make a Difference?
Authors: BREMARD-OURY CLOTHILDE , MAGNY JEAN-FRANÇOIS 
Published: December 2021

In Reply.—
We agree with Dr Haque that our paper has shown a nonsignificant greater incidence of proven or suspected infections and weakly higher mortality in the IVIG-treated group. However, the results of various studies hardly can be compared because different treatment protocols were used by different investigators. Moreover the clinical features of newborns were not the same in all the series (gestational age, birth weight, risk factors ...), and the IVIG preparations used are different in their characteristics.
Velo-Cardio-Facial Syndrome Associated With Ventricular Septal Defect, Pulmonary Atresia, and Hypoplastic Pulmonary Arteries
Authors: Jedele Kerry B. , Michels Virginia V. , Puga Francisco J. , Feldt Robert H. 
Published: December 2021

We report on 15 patients with velo-cardio-facial syndrome who had a severe form of tetralogy of Fallot (pulmonary atresia, ventricular septal defect, and hypoplastic pulmonary arteries). Noncardiac anomalies in these patients included typical facial and ear anomalies in 15, nasal speech in 13, palate anomalies in 10, and developmental delay in 10. Seven patients had significant bronchospasm, which has not been reported in association with the velo-cardio-facial syndrome.
All 15 patients had severe abnormalities of the arborization of the pulmonary arterial tree, which also has not been reported in velo-cardio-facial syndrome. All patients underwent staging operations to prepare the true pulmonary vascular tree for complete repair of the defect (five underwent complete repair and three survived). Of the remaining 10 patients, 6 are awaiting further operation, 3 are not candidates for complete repair, and 1 has died.
Collaborative Research in Pediatric Practice
Authors: Haggerty Robert J. 
Published: December 2021

Research in practice has a long and distinguished history. Pickles,1 a general practitioner in Yorkshire, deduced the difference between infectious and serum hepatitis through careful clinical observation of hundreds of patients in his own practice. In recent years, pediatricians such as Breese2,3 and his colleagues in Rochester, New York, outlined effective methods for the diagnosis and treatment of streptococcal disease in children as a result of studies in their practice, and Carey4 in his suburban Philadelphia practice developed a widely used scale for assessing temperament in children.
In the 1970s, Charney and his colleagues in Rochester, New York, developed a more systematic approach to collaborative research in practice, enlisting a large number of the practicing pediatricians who kept registries of their patients with data on visits, laboratory studies, and diagnoses in easily retrievable form.
Hepatitis B Immunization
Authors: FARBER JON MATITHEW 
Published: December 2021

To the Editor.—
As a practicing pediatrician, I have two major reservations with the current recommendations of the Committee on Infectious Diseases for universal Hepatitis B virus (HBV) immunization. The first reservation is practical, and the second is theoretical.
The Committee realized that administering three injections of different vaccines at the same time is something most parents and pediatricians would wish to avoid, and also that requiring an extra office visit for HBV vaccination was not attractive.
Injury Illiteracy
Authors: WIDOME MARK D. 
Published: December 2021

If you already find talking with parents about injury prevention a frustrating exercise, you may not want to read the article on bucket-related drowning published in this issues of Pediatrics.1 However, for readers, the article will strike a familiar chord. Bucket drownings are reminiscent of other serious or fatal injuries occurring in superficially benign circumstances: children becoming entrapped in household appliances and picnic coolers,2 children and adults suffering serious and fatal injuries from toothpicks,3 and teenagers being crushed to death beneath commercial soda-vending machines.4
Now, add to this list reports of injury associated with more hostile-appearing fixtures and products: entrapment by electrically operated garage doors,5 piercing skull injuries due to law darts,6 and esophageal burns caused by caustic pipeline cleaner used on dairy farms.7
Poisoning by Pickup Truck
Authors: WIDOME MARK D. 
Published: December 2021

In Reply.—
The risks to children riding in other than the standard seating positions of motor vehicles are multiple. In a vehicle crash, the unrestrained child in the cargo bed of a truck can become an "unguided missile," crashing into the sides of the cargo bed. Alternately, cargo in the cargo bed can become the "missile," and the child then becomes the target. Worse, there is a high probability in a crash that the child will be ejected from the cargo bed onto the highway.1
CONGENITAL AND INFANTILE APHASIA
Authors: VAN GELDER D. W. , KENNEDY L. , LAGUAITE J. 
Published: December 2021

The clinical features of infantile aphasia include failure or delay in development of speech. When speech develops, it is frequently garbled. Hearing and intelligence may be normal although both are difficult to evaluate. Abnormal behavior may appear in these children simply because they lack normal opportunities to express themselves.
It is pointed out that many of the children of 4 to 5 years of age with delayed speech development may not simply be "deviates from the norm" but may actually suffer from mild degrees of aphasia. Earlier recognition and proper guidance for milder types of aphasia will depend ultimately on better definition of the pattern and rate of normal speech development.
At present, there apparently is little or no agreement either as to frequency or actuality of this syndrome in childhood. Unfortunately, mild cases are apt to be passed over and more severe ones are often tragically mislabeled as mental defectives.
SOME ASPECTS OF THE CHEMICAL COMPOSITION, PHYSIOLOGY AND PATHOLOGY OF INTRACELLULAR FLUID
Authors: WALLACE WILLIAM M. 
Published: December 2021

I ACCEPT the Mead Johnson Award for 1951 with gratitude tempered with the sense of the future obligation that your choice imposes. The preparation of a presentation such as this accentuates the realization of how many of one's own thoughts are but those of others phrased in the terms of individual experience. The present award must be considered as given to many. Dr. James L. Gamble has pointed to the problems and, by his presence and work in the laboratory, provided the stimulus and guidance for pursuing the work to be discussed. Dr. Charles A. Janeway has carried the difficult and unseen and, so often, unthanked burden of seeking and providing the means for carrying on the work and, by his wide field of interest and knowledge, suggested many of the ideas pursued. To my contemporaries in the laboratory, Dr. Jack Metcoff, Dr. Leonard Eliel, Dr. Malcolm Holliday, Dr. Robert Schwartz, Dr. Ernest Cotlove, Dr. William Schwartz, Drs. George and Nancy Nichols and Dr. William Bergstrom must go the credit for the great bulk of the work done. Any credit that may accrue must also be shared with those who did so much of the analytic and secretarial work and provided the nursing care in the clinical studies. Work of the type to be discussed requires substantial financial support and appreciation must be expressed to the Mead Johnson Company, the United States Public Health Service and the Grant Foundation for supplementing the liberal opportunities for research at the Children's Medical Center.
It is the purpose of this paper to consider some concepts of the electrolyte composition, physiology and pathology of the intracellular fluid and to inquire into their application to clinical problems.
COAGULATION STUDIES IN THE NEWBORN INFANT
Authors: GROSSMAN BURTON J. , HEYN RUTH M. , ROZENFELD IRVING H. 
Published: December 2021

Data on the whole blood clotting time, platelet count, prothrombin concentration, protamine titration and gross observation for clot lysis are presented on 21 normal newborn infants within six hours of birth, and on the third and fifth days of life.
The whole blood clotting time within the first six hours of life ranged from 7 to 38 minutes with an average of 14 minutes. On the third day of life the range was from 10 to 60 minutes with an average of 25 minutes. On the fifth day of life the range was from 6 to 38 minutes with an average of 16 minutes.
Protamine titration was increased as compared to normal adult values in 6 of 26 infants within the first six hours of life. On the third day 7 of 26 showed an increase. All titrations were normal on the fifth day.
The prothrombin concentration showed all variations of patterns, the average pattern being high on the first day, lower on the third day, and high on the fifth day.
Platelet values for the three days studied were all within normal limits, for adults.
Further data on 35 normal newborn infants, studied in groups of five through the first seven days of life using the above technics with the addition of the heparin sensitivity test, are presented.
The significance of the data is discussed.
CHEMICAL COMPARISON OF NORMAL MECONIUM AND MECONIUM FROM A PATIENT WITH MECONIUM ILEUS
Authors: BUCHANAN DOROTHY J. , RAPOPORT S. 
Published: December 2021

A series of chemical analyses comparing normal meconium with meconium from a patient with meconium ileus demonstrated the following differences:
a. Normal meconium contained over four times the amount of total reducing sugar found in the meconium from a patient with meconium ileus. About 15% of the reducing sugar of both the normal and the abnormal meconium was dialyzable.
b. Normal meconium contained less total nitrogen than meconium from a patient with meconium ileus. Most of this was found to be nonprotein, while that of the abnormal meconium was mostly protein in nature.
c. The phosphorus and purine contents were minimal in both samples.
The ammonium sulfate fractionation of normal meconium differed from that of meconium from a patient with meconium ileus.
Alcohol fractionation of normal meconium gave precipitates whose reducing sugar to nitrogen ratios rose from 3.2 to 6.6 with increasing alcohol concentrations. Meconium from a patient with meconium ileus gave precipitates whose reducing sugar to nitrogen ratios rose from 0.47 to 0.86 with increasing alcohol concentrations.
The action of pepsin and trypsin on normal meconium was not significant; on meconium from a patient with meconium ileus trypsin increased the per cent of nonprotein nitrogen twice and pepsin, six-fold.
The reducing sugar to nitrogen ratio of meconium from a premature infant was shown to increase as it proceeded down the intestinal tract.
Round Table Discussion
Authors: BLOOMER HARLAN , STROTHER CHARLES , BREESE BURTIS B. , GLEASON A. L. 
Published: December 2021

Chairman Bloomer: In leading this round table I have with me Dr. Charles Strother, Professor of Clinical Psychology in the College of Medicine of the University of Washington at Seattle. I am from the University of Michigan Speech Clinic in Ann Arbor. We are very glad to be with you at this round table because it suggests the close relationship between the fields of speech pathology and pediatrics.
We come to the American Academy of Pediatrics as representatives of the American Speech and Hearing Association which is the national organization for professional people interested in the study of speech disorders, their causes and their methods of treatment. Perhaps you are familiar with the official publication of the Association, the Journal of Speech and Hearing Disorders. We bring you greetings from the Association.
I think you may be interested in a brief outline of our general plan of discussion for the afternoon. The first part of our discussion will review the importance of a knowledge of speech disorders to specialists in pediatrics. Next we shall discuss in some detail the nature of these disorders and the etiologic factors which are frequently encountered, and then we shall suggest methods for handling the speech problems which the individual child may present. We shall be glad to have your participation, your questions, and your comments at any time during our discussion.
We feel that this subject is particularly timely because of the steadily increasing interest of pediatricians in the general aspects of child growth and development rather than in only the medical care of children.
SPECIAL ARTICLE
Authors:   THE EXAMINATIONS COMMITTEE
Published: December 2021

STATISTICAL analysis of the January 1951 written examination of the American Board of Pediatrics has been completed. The following comments are offered for general information.
Like the examination of January 1950 (see Pediatrics 8:598, 1951), this examination also consisted of 200 false and true statements. It was a completely new examination, that is, none of the statements contained in it had appeared in previous examinations. Tabulation of the responses of all the candidates to each of the 200 items disclosed the fact that some of the statements had been poorly phrased, that some of them dealt with details of disease with which the vast majority of candidates were unfamiliar, that some few were answered correctly by 99% of the candidates. Such statements do not contribute to the accuracy of grading. They are, however, unavoidable before new statements have been tested on the candidates. The committee charged with preparing the examination is aware of this weakness and will continue to assemble statistics and comments toward the objective of reducing the number of poor questions to a minimum.
The examination was taken by 366 candidates. The method of grading was the same as has been used in the past, that is, to the number of correctly answered statements is added half the number of unanswered statements and from the total 100 is subtracted; the remainder is the grade. The distribution of these grades is shown graphically in the histogram (see chart 1). Superimposed on the histogram is a normal frequency curve the ordinates of which were computed from the mean and standard deviation of all the grades.[See chart 1 in Source Pdf]
THE PRESIDENT'S PAGE
Authors: QUILLIAN WARREN W. 
Published: December 2021

IT IS axiomatic to say that recent achievements in medical science have greatly improved the quality of medical care. One of the fields of study, constituting an important area of activity in which progress can be cited, is the care of the prematurely born infant. Not only has there been general utilization of new drugs and equipment, but a better knowledge and application of methods employed in reduction of the hazards confronted by the infant during this critical age period. Perhaps the most important single factor destined to influence favorably the morbidity and mortality statistics of prematures is the proper training of professional personnel assigned to their care.
During recent years many changes have developed both in the character and the content of medical education. There is little value in planning for more and better health services unless consideration is first given to providing well-trained physicians to render those services. Assumption of responsibility, with the application of fundamental principles to specific cases, is the foundation of good medical judgment. The service rendered in their local communities by practicing physicians can be only so good as the training, skills and abilities of the individuals who give it. An encouraging trend since World War II has been the very widespread effort on the part of pediatricians to avail themselves of additional training in medical centers, to acquire there the skills and modern methods so necessary for utilization in their own practice. There is general recognition of the principle that better preparation for the care of sick children and the health supervision of well children will necessarily be reflected in improved standards of practice—a step along the way toward our Academy goal of better health for more children.
Round Table Discussion
Authors: COLLINS-WILLIAMS C. , RATNER BRET , MORRISON HOWARD J. , KEITER W. EUGENE 
Published: December 2021

Specific Diagnostic Practice
Chairman Collins-Williams: The specific diagnosis of the child with respiratory allergy comprises the following: (1) general pediatric care; (2) careful allergic history; (3) complete physical examination; (4) indicated laboratory procedures including nasal smears; (5) skin testing.
Skin testing is necessary in order to help determine the specific etiologic allergens. The allergens tested with should include the common foods and the common inhalants, pollens and molds in the environment.
Eosinophiles and Eosinophilia
Eosinophilia occurs in a great many conditions other than allergy and these must be taken into account in interpreting differential blood counts.
The nasal smear is a useful laboratory test in the diagnosis of nasal allergy. Eosinophiles may temporarily appear in considerable numbers in the nasal smear of the nonallergic child during recovery from a respiratory infection, but otherwise a predominance of eosinophiles in the nasal smear is diagnostic of nasal allergy.
Office Treatment of Respiratory Allergy
The office treatment of a child with respiratory allergy includes the following: (1) general pediatric care; (2) symptomatic relief of allergic symptoms; (3) removal of incriminated foods from the diet; (4) as complete an elimination of environmental allergens as possible; (5) specific desensitization.
Specific Desensitization
Dr. Ratner: The method of specific desensitization which we use in practice is as follows:
The treatment extract consists of a 1:5,000 dilution of each of the inhalants, pollens and molds with which the patient gave a positive reaction. Each week the patient receives one injection from a tuberculin syringe containing 0.15 cc. of this treatment extract, 0.15 cc. of a 1:20 dilution of mixed bacterial vaccine, 0.15 cc. of a 1:20 dilution of pertussis vaccine, and 2 minims of adrenaline.
Symposium
Authors: JASPER HERBERT H. , MCEACHERN DONALD , RABINOVITCH REUBEN , HAWKE WILLIAM A. , MCRAE DONALD L. , PENFIELD WILDER , JASPER HERBERT H. , ROBB JAMES PRESTON , MCNAUGHTON FRANCIS L. 
Published: December 2021

It is indeed with great pleasure that neurologists of Canada have accepted the invitation of the Academy to participate in its meeting in Toronto and we take this occasion to express our sincere welcome to all our colleagues from south of the border.
When Dr. Orr asked me to organize this Symposium, he added that he would like it to be an "all Canadian show." I objected seriously to usurping the program in this manner and not inviting several outstanding speakers from among our colleagues in the United States who would have added greatly to this program. But finally we have yielded to Dr. Orr's persuasiveness in giving you a sample of some of the work being done in this country. We have the good fortune of possessing, in Canada, a Neurological Institute which is rapidly becoming a Canadian National Institute, established in Montreal under the direction of Dr. Wilder Penfield, who is to participate in the Symposium today, speaking on his favourite subject, epilepsy, with particular emphasis on a new conception of focal epilepsy in children. Dr. William Hawke, of the Hospital for Sick Children in Toronto, whom we like to claim as an adopted member of the staff of the Montreal Neurological Institute, will present some of the results of his life long studies of behaviour problems in children. Dr. McEachern, who was unable to attend this meeting because of ill health, has been replaced by Dr. Rabinovitch, who will present a summary of his extensive experience in the study of neuromuscular diseases, a subject which presents puzzling problems to most pediatricians.