bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epiglottitis: Incidence of Extraepiglottic Infection: Report of 72 Cases and Review of the Literature
Authors: Molteni Richard A. 
Published: December 2021

A review of 72 cases of epiglottitis seen at the Children's Hospital of Denver was undertaken to determine the incidence of extraepiglottic and septic foci in this disease. A parallel review of the literature was also undertaken. The clinical, bacteriologic, laboratory, and radiologic findings of this patient population are described.
A 25% incidence of both pneumonia and cervical lymphadenitis was found to be associated with this illness. Exudative tonsillitis and otitis media were the only other complications, although they were infrequently noted. No cases of septic arthritis or meningitis were encountered, although 50% of these patients were recognized as bacteremic. A low incidence of septic complications (eight cases of meningitis and one case of periarticular abscess) is noted in a review of the literature. Recommendations for antibiotic management and definition of the population at risk for septic complications are given.
Near-Drowning in Children: Clinical Aspects
Authors: Fandel Ivar , Bancalari Eduardo 
Published: December 2021

Drowning is the third most common cause of death in the pediatric age group in Florida. The clinical presentation, laboratory data, modes of therapy and outcome of 34 cases of near-drowning in children under the age of 14 years were reviewed. The most common clinical findings on admission were a history of cardiopulmonary resuscitation, tachypnea, pulmonary edema, and acidosis.
Twenty-eight (82%) patients survived. Twelve (35%) required mechanical ventilation. Of these only six survived, four of them with severe neurological sequelae. Modern management of respiratory failure is important for the ultimate survival of these patients; however, the final neurological outcome seems to be related to brain damage at the time of the asphyxia rather than to subsequent management.
Pseudobattering in Vietnamese Children
Authors: Yeatman Gentry W. , Shaw Constance , Barlow Matthew J. , Bartlett Glenn 
Published: December 2021

Until recently the presence of linear bruising on children in America was synonymous with child abuse.1 With the large influx of Vietnamese children, physicians should be aware of the practice of coin-rubbing.2
While providing medical care for Vietnamese children at Fort Indiantown Gap, Pennsylvania, we commonly saw petechiae and frank purpura of the chest and back. These lesions were often linear and resembled trauma. Indeed, we received one report of alleged trauma from an outside physician who was not familiar with the condition.
The lay practice of Cäo Gió is quite commonly used among the Vietnamese for several symptoms including fever, chills, and headaches.
Municipal Child Health Services: A Ten-Year Reorganization
Authors: Porter Philip J. , Leibel Rudolph L. , Gilbert Cynthia K. , Fellows Judith A. 
Published: December 2021

There has been increasing interest within the medical community in developing primary care programs in teaching hospitals that meet the medical needs of a community.19,20 The Cambridge Hospital system provides a working model for such a mutually beneficial interaction. Based on principles of administrative centralization and utilization of the pediatric nurse practitioner, the neighborhood health centers operate as part of a cost-effective series of concentric circles. Administrative centralization within the Department of Pediatrics at the Cambridge Hospital has permitted the elimination of duplicate medical services and the development of a responsive community health service. The pediatric nurse practitioner, under close senior staff supervision, serves as the primary caretaker in the neighborhood centers. In addition to her role as the provider of a protocol determined, age-related series of physical, psychometric, and laboratory examinations, the pediatric nurse practitioner also cares for minor injuries and illnesses of childhood. Any child deviating from a clearly established range of norms for any physical, developmental, or laboratory parameter is immediately referred to the senior staff pediatrician for further evaluation. Finally, any patient requiring subspecialized inpatient care is referred to the Massachusetts General Hospital. The senior pediatric staff of the Cambridge Hospital serves the function of coordinating and supporting the rapid interlevel communication which must occur between community service, primary hospital, and a tertiary care facility.
This neighborhood health care system is, we feel, a medically sound, educationally exciting, and fiscally responsible solution to a problem facing many urban areas and their academic medical institutions.
Clonidine Poisoning
Authors: Pai G. S. , Lipsitz David J. 
Published: December 2021

Clonidine (Catapres, Boehringer Ingelheim) is a relatively new hypotensive agent with complex pharmacologic actions on the autonomic nervous system. Little is known about its effects and side effects in children. An interesting combination of these were seen in a child who accidentally ingested an unknown quantity of this drug. Noteworthy was the lack of its main action and exaggeration of side effects in this child.
Experience with hypertensive adults has shown it to be an effective hypotensive agent with relatively mild side effects. Drowsiness and dryness of the mouth due to decreased salivation have been common. Transient sodium retention and weight gain occur.
Intussusception in Twins
Authors: Thomas Gareth G. , Zachary R. B. 
Published: December 2021

The risk of intussusception occurring in the siblings of patients with intussusception is thought to be low, and there is no previous report of the condition occurring in twins.
In our case the second twin was affected within 36 hours of the onset in the first. Adenovirus was cultured from the one twin who was investigated.
See image in the PDF.file
CASE REPORT
The twins were identical boys of West Indian descent, 25 months of age, born and bred in England. They were perfectly well until the early hours of May 26, 1972, when twin A began to scream with acute abdominal pain.
Encephalitis in Infectious Mononucleosis: Diagnostic Considerations
Authors: Lange Beverly J. , Berman Peter H. , Bender Joseph , Henle Werner , Hewetson John F. 
Published: December 2021

Four atypical cases of presumed infectious mononucleosis (IM) encephalitis are presented. To establish an etiologic diagnosis, Paul-Bunnell-Davidsohn heterophil titers (PBD), antibody titers to the antigens of the Epstein-Barr virus (EBV), and oropharyngeal excretion of EBV were determined. Criteria for a primary EBV infection are (1) an antiviral capsid antigen titer of 1:160 or greater, (2) the presence of antibody to the diffuse component of the early antigen, (3) absence of antibody to the nuclear antigen, and (4) excretion of the virus from the oropharynx. Three of the four cases met these criteria; of the three, one did not have a positive heterophil titer. The fourth case turned out not to be IM; there was a positive PBD heterophil, but there was no evidence of primary EBV infection.
Although the PBD heterophil is usually a reliable test to diagnosis IM, it is not always present in children, and it is sometimes nonspecifically elevated. Some EBV titers can be nonspecifically elevated as well; however, the above criteria are diagnostic of primary EBV infection.
Megavitamin Therapy for Childhood Psychoses and Learning Disabilities
Authors: Barness Lewis A. , Mauer Alvin M. , Anderson Arnold S. , Dallman Peter R. , Forbes Gilbert B. , Haworth James C. , Jesse Mary Jane , Scriver Charles R. , Winick Myron , Heird William C. , Kline O. L. , O'Brien Donough , Tomarelli Rudolph M. , Benton Duane A. , Celender Ivy M. , Purvis George A. , Saperstein Sidney , Smith Robert E. , Anderson Betty E. , Brown Myrtle L. , Cheney Margaret , Chopra Joginder , Darby William J. , Egan Mary C. , Lane J. Michael , McLean Harold T. , Read Merrill S. , Sarett Herbert P. , Teply L. J. , White Philip L. 
Published: December 2021

Vitamins have long been recognized for their unique role in human nutrition. Most of these low-molecular weight, organic substances are precursors of coenzymes, and adequate amounts to meet the known nutritional needs of healthy persons of all ages have been defined by the Food and Nutrition Board of the National Academy of Sciences as the "Recommended Dietary Allowances" (RDA). The consistent opinion of the Committee on Nutrition of the American Academy of Pediatrics has been that normal children receiving a normal diet do not need vitamin supplementation1 over and above RDA levels.
However, there are a variety of clinical entities in which the daily intake of vitamins needs to be significantly increased. This is true, for example, with the fat-soluble vitamins A, D, E, and K in the steatorrhoeas2 and in the autosomally recessive selective malabsorption of vitamin B12.3 Rarely, children treated with isoniazid require increased pyridoxine; and, when treated with diphenylhydantoin sodium (Dilantin), they need increased folic acid and vitamin D.4 Finally, there are a number of rare inborn errors of metabolism affecting the apoenzyme at the cofactor binding site or involving the metabolism of the vitamin itself to its biologically active derivative.5 In these so-called dependency syndromes, the metabolic defect may completely or partially be overcome by greatly increasing vitamin or cofactor availability.
Set against a background of wide public belief in the benefits of vitamins, the accounts of dramatic amelioration of deficiency states, the easy and relatively inexpensive availability of these substances, and the occasional, remarkable benefit of large doses (both in the dependency syndromes and in certain other clinical situations), it is not surprising that a cult developed in the use of large doses of water-soluble vitamins to treat a wide spectrum of disease states.
Acetaminophen and Reye's Syndrome?
Authors: Little Joseph A. 
Published: December 2021

I was most interested to read the article "Acetaminophen Poisoning and Toxicity" by Rumack and Matthew.1 This article is well worth reading by any pediatrician who prescribes acetaminophen.
I should like to call your attention particularly to the description of the clinical course of overdose reactions. I was struck with the similarity between this and the description of the findings in Reye's syndrome. Is it possible that many of the children seen with Reye's syndrome were actually reacting to this drug? I should think that this possibility would be well worth considering.
PEDIATRIC PRIORITIES
Authors: Morley David ,   Student
Published: December 2021

Although three-quarters of the population in most developing countries live in rural areas, three-quarters of the spending on medical care is in urban areas, where three-quarters of the doctors live. Three-quarters of the deaths are caused by conditions that can be prevented at low cost, but three-quarters of the medical budget is spent on curative services, many of them provided for the elite at high cost.
I have suggested that teaching hospitals, or "disease palaces", and the specialist approach to health care that such institutions foster, have over the past 20 years hampered progress in health care in developing countries. Such teaching hospitals do not train the type of health personnel required; they do not act as referral centres; nor do they undertake the type of research that the community which supports them requires. Despite these deficiencies, a teaching hospital can absorb a quarter, a third, or even more of the total health budget of the country.
Syndrome of infant botulism
Authors: Berg Bruce O. 
Published: December 2021

Since the initial recognition of infant botulism,1 seven additional patients have been identified in California and there are documented reports from other regions of the United States. The syndrome of infant botulism appears to be more common than is recognized, and the attention of physicians who attend patients should be directed to this syndrome of acute weakness.
Each of the first two cases reported was a product of a normal, full-term gestation, labor, and delivery. They were breast-fed and appeared normal until 6 and 11 weeks, respectively, when, over a period of one to two days, each became unable to suck and swallow and was generally weak.
Frequency and Etiology of Gross Hematuria in a General Pediatric Setting
Authors: Ingelfinger Julie R. , Davis Alvin E. , Grupe Warren E. 
Published: December 2021

Since the frequency of gross hematuria in general, unselected, pediatric outpatient settings has not been reported, we reviewed all patients with this symptom or sign at a pediatric emergency walk-in clinic during 24 consecutive months. Of a total of 128,395 patient visits, gross hematuria was proven in 158 (1.3/1,000 visits).
Fifty-six percent of all patients had readily apparent causes for their gross hematuria. Twenty-six percent of all hematuric patients had documented urinary tract infections, but only 9% had apparent glomerular disease.
SHORT FOLLOW-UP OF PREVIOUSLY REPORTED NEWBORN PERSON—1984 VERSION
Authors: C. T. E. 
Published: December 2021

This short follow-up note was inspired by Edwin Newman's two books about the dreadful things all of us are doing to our language.1,2
Once again the reader will judge whether my contrived 1984 version, made up entirely of words and phrases found in recent professional journals, enriches or debases the English language.
The newborn person previously reported3 was included in a nonelitist, ongoing, low profile, broad programmatic and conceptualized interdisciplinary study, mounted as a double-barreled major research thrust to determine if body weight alterations are best parameterized by changes in caloric intake, and as a spin-off interface, whether the family unit is a microcluster of structured role expectations, or put in another way, whether the family is a bounded plurality of role-playing individuals. Hard questions and in depth dialogue by well-rounded, self-realized, self-composed, group-effective individuals with strong and proven track records characterized this project.
Resultwise the researched data base must wait for viable information inputs from the investigatees, thruputs between earlier studies and the researchers at this point in time, and outputs from the fundee to obviate possible politicization and inferiorization of the integrated results from utilization of nonfinalized computerized print-outs. Shifting paradigm analysis was also programmed into the investigation. Since new data inconsistent with operating images can challenge those images, it soon became perfectly clear that this research eventuated into a perpetual dynamic of re-imaging the "real."
The vulnerable small airway
Authors: Chernick V. 
Published: December 2021

Fundamental physiological work in the late 1960s provided for the first time a clear understanding of (1) the role of the small airways (&lt; 2 mm in diameter) in determining overall airway resistance to gas flow and (2) the relationship between central and peripheral airway resistance and lung growth.1,2 Involvement of the small airways early in the course of cystic fibrosis has been previously commented upon and documented in Pediatrics.3-5
After the age of about 5 years, the flow resistance of peripheral airways constitutes only about 10% to 20% of total pulmonary flow resistance,2 a fraction so small that conventional measurement of total resistance cannot detect small changes in the peripheral component.
The New Correct Answer to An Old Question on Kerosene Ingestion
Authors: Mofenson Howard C. , Greensher Joseph 
Published: December 2021

The Personal Assessment for Continuing Education (PACE), part I, appears to be living up to its expectations of providing a guide for areas that need reinforcement, clarification, and updating.
See table in the PDFfile.
Since its distribution in our area we have had a number of calls from colleagues inquiring about question 75 of part I, multiple-choice questions: "Treatment of acute kerosene poisoning should include which of the following?" The correct answer (E) includes "(4) Administration of ipecac." It came as a surprise to many practicing pediatricians that emesis was now being advised for a petroleum distillate ingestion.
DUNCAN'S DISEASES OF METABOLISM: ENDOCRINOLOGY, ed 7. Edited by Philip K. Bondy and Leon E. Rosenberg. Philadelphia, WB Saunders Co, 1974, $26; 736 pp
Authors: Soyka Lester F. 
Published: December 2021

The endocrinology section of Duncan's Diseases of Metabolism comprises 736 pages, or about 44% of the total text. The division of this seventh edition of a classic text in the field is perhaps a logical expression of the splitting of endocrinology from metabolism as each field has grown tremendously in the past decade. The endocrinology portion is compact and easy to use because of this division, aided by the employment of thin, though substantial paper and small, but easily readable type. These combine to avoid the feeling of consulting a big-city telephone directory, which is so common with use of many of the standard textbooks of today. The illustrations are generally excellent and the 54-page index, which covers both sections of the book, is unusually thorough.
As in all textbooks, many sections are outdated before they appear in print. Although the editors, Philip K. Bondy and Leon E. Rosenberg, propose to avoid this by means of a "last-minute" addendum, only two of the 13 chapters bear such, and one of these lists only three references, all dating to 1972. The other recent-developments section is longer and more helpful.
The content is essentially that of general clinical endocrinology, each chapter using the standard approach of considering normal structure and function and then diseases in a gland arrangement, starting with the hypothalamus and traveling downward to the testis and ovary. A small chapter on acid-base balance seems out of place, whereas those on nonendocrine-secreting tumors and serotonin and the carcinoid syndrome are useful extensions of the scope of endocrinology.
Topical Antibiotics
Authors:   Committee on Drugs, Segal Sydney , Cohen Sanford N. , Freeman John , Kagan Benjamin M. , Kauffman Ralph E. , Pruitt Albert W. , Soyka Lester F. 
Published: December 2021

1. In most instances, gentle, thorough cleansing of minor wounds and burns, and protection of the area until healing occurs is sufficient treatnient. The literature available at the time this statement was prepared indicates that topical antibiotics may prevent infection after minor cuts, abrasions, and burns. Thus, their use in such conditions may be appropriate as an adjunct to cleansing.
2. Systemic antibiotics rather than topical antibiotics are recommended for the treatment of chronic pyodermas, such as impetigo.
3. Allergic reactions to topical antibiotics, including neomycin, are uncommon. However, when a patient is known to be sensitive to neomycin, the systemic use of any of the aminoglycoside antibiotics should be avoided if possible.
4. Topical aminoglycosides should not be used on large denuded skin surfaces (such as those that result from burns) because of possible absorption and systemic toxicity and because, when used topically, these agents encourage the growth of resistant organisms.
Oxygen Supplement During Endotracheal Intubation of the Infant
Authors: Wung Jen-Tien , Stark Raymond I. , Indyk Leonard , Driscoll John M. 
Published: December 2021

Endotracheal intubation is indicated for maintaining an efficient airway, for preventing aspiration and permitting pulmonary toilet, and for prolonged administration of mechanical ventilation or general anesthesia for many types of operations.1,2 Laryngoscopy and intubation may result in injury to the lips, gums, tongue, nasal passage, larynx, or trachea. Additional complications include mediastinal and subcutaneous emphysema and pneumothorax.3 These complications can be minimized if hypoxia can be prevented and laryngoscopy is performed in an unhurried manner.
Patients who require a high ambient oxygen concentration in order to maintain an adequate PO2 usually react rapidly to an interruption of the oxygen supply by developing bradycardia and hypoxia.
See Image in the PDFfile
Staphylococcal Septicemia Resulting in Embolic Small Bowel Perforation
Authors: Heller Daniel , Keim Daniel E. , Todres I. David , Donahue Patricia 
Published: December 2021

Intestinal perforation has not to our knowledge been reported as a complication of staphylococcal sepsis during infancy. We report a case in which staphylococcal bacteremia resulted in multiple metastatic abscesses of the small bowel with subsequent perforation.
CASE REPORT
A 4-month-old boy in previously good health was admitted to a local hospital with a two-day history of discharge from both ears. He had a temperature of 38.5 C (101.4 F), was lethargic, and had a distended abdomen. His pulse was 230 beats per minute and his respiratory rate 60 breaths per minute. A chest roentgenogram showed a right lower lobe pneumonia, and an abdominal film revealed dilated loops of small and large bowel.
See Image in the PDFfile
Persistent Interstitial Pulmonary Emphysema: Another Complication of the Respiratory Distress Syndrome
Authors: Stocker J. Thomas , Madewell John E. 
Published: December 2021

Persistent interstitial pulmonary emphysema (PIPE) was observed in 22 infants during the neonatal period. All of the infants experienced respiratory distress during the first few days of life, and 21 of them were treated for the respiratory distress syndrome with artificial ventilation or oxygen or both. Ten infants developed a localized form of PIPE, with air-filled interstitial cysts measuring up to 3.0 cm in diameter confined to one or more lobes of lung. The involved segment of lung was resected in seven of these infants, all of whom survived. The remaining three died and autopsies were performed.
A diffuse form of PIPE was observed in the other 12 infants. Numerous cysts that were predominantly small (less than 0.3 cm) were seen in all lobes of both lungs. These infants received high concentrations of oxygen for prolonged periods, resulting in bronchopulmonary dysplasia in 11 of the infants. All 12 infants died. PIPE is characterized histologically by air-filled interstitial cysts partially lined by multi-nucleated giant cells.
PROMISING TREATMENT
Authors:   Boston Interhospital Virus Study Group
Published: December 2021

It is often suggested that controlled trials of promising treatments are unwarranted in conditions of very high mortality; severe respiratory distress syndrome has been used as an example. This is completely logical if the arguments are confined to the category of inevitably fatal conditions, but the situation is rarely this simple.
A Boston group wrote about this issue as follows:
"Patients with severe and fatal . . . disease merely represent the ‘tip of an iceberg’ for there are almost always many more with milder or even asymptomatic processes. Furthermore, the increased interest in diagnosis that accompanies the introduction of any new mode of therapy invariably results in the recognition of less severe cases that would previously have gone undiagnosed. Consequently, there is sure to be a lower morbidity and mortality in currently treated patients than in otherwise comparable historical controls, even when the treatment is without effect or actually deleterious."