bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letters to the Editor
Authors: Schell Norman B. 
Published: December 2021

The editorial, "A New Role for the School Physician," by Dr. John Menkes1 in the June issue of Pediatrics intrigued me. Its theme parallels that of my paper: "School Physicians: A Weakening Breed" which will appear in a forthcoming issue of the Journal of School Health.2
I fully agree on the need for retreading the present-day school physician who is woefully inept in many areas affecting school children. He is being gradually replaced by many non-medical disciplines within the schools who have greater expertise in the spheres of behavior, learning, special education, speech therapy, health education, physical conditioning, sports medicine, etc.
Letters to the Editor
Authors: Menkes John H. 
Published: December 2021

Dr. Menkes commented as follows on the three letters printed above:
In their justifiably indignant letters both Dr. Frothingham and Dr. Brown indicate their ability and willingness to evaluate the child with a learning disorder, and to set up the school contacts necessary for an adequate follow-up. More power to them! I suspect, however, that many pediatricians do not share their interest in the problem of learning disorders.
I agree with Dr. Brown that school officials are most amenable to an exchange of information with pediatricians, but believe that the "reasonable effort" required to achieve all the contacts is very time-consuming, probably even more so in a large city than in a small community, where there is far more opportunity for physician-school meetings.
Clinical Evaluation of the VMA Test Strip
Authors: Helson Lawrence , Bethune Victor , Schwartz Morton K. 
Published: December 2021

The VMA test strip, based upon detection of increased amounts of vanillylmandelic acid (VMA) and metanephrine in urine has had wide publicity as a reliable screening test for neuroblastoma. Its authors report that of a total of 20,000 tests administered, 50, or roughly one per 400 were false-positives. Of these false-positive tests, 15, or 30% were in children with other cancers. Urines from each of 24 children with neuroblastoma tested positive.1
We evaluated the test strip in an ambulatory group of 50 children with cancer, which included eight children with disseminated neuroblastoma and seven other children with histologically proven, treated, and clinically inactive neuroblastoma.
An Improved Ear Syringe
Authors: Schmitt Barton 
Published: December 2021

Most ear wax succumbs to the well-directed ear currette. When this technique fails because the cerumen is too soft or the ear canal too narrow, one must usually resort to irrigation. The following comments describe an efficient ear syringe that one can quickly assemble when none seems available.
The unit consists of a 10- to 12-cc plastic syringe plus a piece of small plastic tubing. The tubing can be made from any size scalp vein needle set by cutting off the needle about 3 inches from the female connector.
EXAMINATION OF THE HYPOTHESIS OF A CRITICAL WEIGHT AT MENARCHE IN AMBULATORY AND BEDRIDDEN MENTALLY RETARDED GIRLS
Authors: Osler David C. , Crawford John D. 
Published: December 2021

The ages, weights, and calculated total body water and body fat contents as menarche of 44 mentally retarded, institutionalized girls were examined to determine whether they were in accord with the hypothesis that menarche is dependent upon achievement of a critical weight or body water content. The findings in the 35 ambulatory children were in accord with the hypothesis, menarche being achieved later but at attainment of the same weight and body water content as in normal girls. The mean age at menarche of the nine bedridden retarded children was slightly less than that of their ambulatory counterparts and their weights and calculated body water and fat contents were substantially below those of normal girls at menarche.
It is suggested that the effect of being bedridden may be to lower the metabolic rate, thus hastening the time when it falls to the level of 28 calories/kg/24 hr, a characteristic parameter of normal girls at menarche.
HEAD AND NECK TUMORS IN CHILDREN
Authors: Jaffe Burton F. , Jaffe Norman 
Published: December 2021

This report is a review of 178 children with malignant head and neck tumors seen during a ten-year period at the Children's Hospital Medical Center and the Children's Cancer Research Foundation in Boston, Massachusetts. Each tumor type is analyzed to display its unique features. When a neck mass occurs, a complete ENT examination is needed to identify an occult primary in the nasopharynx, in the nose, or in some other site that is difficult to see. A total physical examination is needed to detect a systemic disease or a primary below the clavicle.
Many of the tumors of the head, unfortunately, are internal and present with common symptoms, like an earache, a stuffy nose, or a headache. They only become identified when the tumor greatly enlarges or metastasizes.
Treatment with surgery, cryosurgery, radiation therapy, and chemotherapy may be used alone or in various combinations of them.
WHY DO SICKLE SCREENING IN CHILDREN?
Authors: Fost Norman , Kaback Michael M. 
Published: December 2021

An approximate desire to "do something" about sickle cell disease has produced a plethora of sickle screening programs. While the advantages of early identification of individuals with sickle cell disease is apparent, the purpose of identifying children with sickle trait is less clear. There is uncertainty about the clinical significance of sickle trait, and there are ethical and legal hazards in being so identified. The demonstrated failure of genetic counseling to successfully transmit information in other population groups also dictates a reexamination of the presumed benefits of sickle screening programs.
Screening programs should be initiated after pilot studies have resolved these issues, not before.
Letters to the Editor
Authors: Liggins G. C. 
Published: December 2021

Although we try to limit Letters to 300 words, the writers were allowed more space in view of the importance of their subject. Comments by Drs. Liggins and Howie, and Drs. Baden and Stern follow:
The observation of Drs. Farrell and Zachman that corticosteroid treatment of fetal rabbits enhances lecithin biosynthesis by induction of the enzyme PCGT should not obscure the possibility that other effects of steroids share in the accelerated maturation of treated lungs.
ANTIBIOTIC STABILITY IN SOLUTIONS USED FOR INTRAVENOUS NUTRITION AND FLUID THERAPY
Authors: Feigin Ralph D. , Moss Kanneth S. , Shackelford Penelope G. 
Published: December 2021

The present study was designed to assess the stability of ampicillin, carbenicillin, clindamycin, kanamycin, cephalothin, methicillin, and penicillin in three parenteral hyperalimentation mixtures as reconstituted for delivery to the patient in the clinical setting.
Stability at 4C, 25C, and 37C was tested in parenteral hyperalimentation mixtures containing either crystalline amino acids or a protein hydrolysate. In two series of experiments the stability at 4C, 25C, and 37C of ampicillin, cephalothin, and kanamycin also was assessed in Isolyte M (ISO M), Isolyte P (ISO P), Ringer's lactate (LR), 5% dextrose in water, (D5W), 10% dextrose in water (D1OW), dextrose in normal saline (D5S), and normal saline (NS) to which hydrocortisone or heparin had been added. All antibiotics retained their effectiveness at an acceptable level in the hyperalimentation solutions at 4C. At 25C and 37C, all antibiotics except clindamycin lost activity by 24 hours. Kanamycin was least stable in these solutions and ampicillin also lost a significant degree of antimicrobial activity. Addition of heparin or hydrocortisone imparted stability to ampicillin in the seven parenteral solutions although significant loss of activity was noted at 37C in D5W, D1OW, D5S, and LR. Most solutions containing heparin or hydrocortisone and cephalothin turned yellow by 24 hours. A precipitate appeared in solutions containing heparin and kanamycin but there was minimal loss of antimicrobial activity. Kanamycin was stable in all solutions containing hydrocortisone except in D5W and D10W at 37C.
EPIDEMIOLOGY OF SLIPPED CAPITAL FEMORAL EPIPHYSIS: A REVIEW OF THE LITERATURE
Authors: Kelsey Jennifer L. 
Published: December 2021

From a review of the literature on the epidemiology of slipped capital femoral epiphysis it is concluded that the incidence is greatest in males around the ages of 12 to 15 years and in the females at about the ages of 10 to 13 years, that males are more susceptible than females, that the incidence is greater in Blacks than in whites, that in many localities symptoms are more likely to begin in spring and summer than in fall and winter, that familial aggregation of cases occurs more often than would be expected by chance, that the left hip is affected more frequently than the right in males but not in females, that children with slipped epiphysis are usually overweight, that there is a slight tendency for them to be tall for their age, and that they tend to have undergone slower-than-average skeletal maturation. There is some suggestion that members of low socioeconomic classes are more likely to be affected than those in higher classes, and that incidence is highest in the Midwestern, Middle Atlantic, and Southeastern states, and lowest in the Mountain and Great Plains states.
Most of these risk factors have been found to play a role in either decreasing the strength of the epiphyseal plate or in increasing the amount of shearing stress to which the plate is subjected at the time it is most vulnerable.
Management of the Decision to Die
Authors: Menzer Lawrence L. 
Published: December 2021

I was quite moved and impressed by the thought-provoking article, "The Adolescent Patient's Decision to Die" by Schowalter et al.1 In the face of great medical advances we are still far behind in solving the great emotional, religious, and ethical problem of passive and active euthanasia.
I sincerely hope that the author's suggestion to "gather a body of medical literature of individual cases" will be heeded and that your journal will aid by offering its pages as a means of communication.
Play And Development (A Symposium with contributions by Jean Piaget, Peter H. Wolff, René A. Spitz, Konrad Lorenz, Lois Barclay Murphy and Erik H. Erickson), edited by Maria W. Piers. New York: W. W. Norton & Company, 1972, 176 pp., $5.95
Authors: Friedman David Belais 
Published: December 2021

The title Play and Development describes the unifying theme of this book but may mislead the unwary and the unsophisticated. The list of contributors should provide clues to the fact that Play and Development is not a simple exposition of children's play and developmental patterns. Actually, a background in developmental theory and practice is essential if one is to appreciate the subtleties of this excellent volume.
In the opening paper, Jean Piaget discusses the origins and development of "operations" in children and defines "operations" as internalized, reversible actions.
Neurology Of Childhood Learning Disorders, by Richard J. Schain, M.D. Baltimore: The Williams & Wilkins Co., 1972, 144 pp., $9.25
Authors: Gascon Generoso G. 
Published: December 2021

This publication is a landmark because it is the first systematic exposure of an approach to diagnosis and management of learning problems in children written by a pediatric neurologist. It, therefore, deserves careful critical attention.
The author details his neurological examination techniques, discusses the concept of a brain damage behavioral syndrome, examines hyperactivity, minimal brain dysfunction, and developmental dyslexia, discusses other etiological conditions, then ends with chapters on general management and a diagnostic classification system.
Herbert Birch
Authors: Barnett Henry L. , Belmont Ira , Eisenberg Leon 
Published: December 2021

Pediatrics suffered a grievous loss in the sudden death of Dr. Herbert G. Birch, Research Professor at the Albert Einstein College of Medicine, on February 4, 1973, at the age of 54. For us, the loss was personal as well as professional; we will miss a friend whose like will not be found soon again and a champion of the best traditions of American pediatrics.
Herb was simply head and shoulders above just about anyone we knew, his knowledge was encyclopedic, his intelligence prodigious, his productivity unmatched.
Letters to the Editor
Authors: Steinschneider Alfred 
Published: December 2021

Dr. Steinschneider comments as follows. We are particularly impressed by his second, third, and fourth sentences:
The possibility of child abuse should be considered in every case of sudden infant death. However, extreme restraint must be exercised that this diagnosis not become one of exclusion. Failure to define the cause of a sudden death can never be used as support for the diagnosis of child abuse. Humanity as well as logic dictates the need for positive evidence as well as extreme sensitivity in the collection of such information.
Screening for Lead Poisoning: Measurements and Methodology
Authors: McLaren Gordon D. , Barthel William F. , Landrigan Philip 
Published: December 2021

Piomelli et al.1 have presented an extensive experience in comparison of free erythrocyte porphyrin (FEP) levels with blood lead concentrations. Their finding that an FEP ≥ 250µg/100 ml RBC was invariably associated with a blood lead concentration ≥ 6Oµg/100 ml is consistent with data obtained in our laboratory2 using a somewhat different microfluorometric method for FEP determination.3
We must, however, take issue with the conclusion of Piomelli et al.1 that only FEP levels above 250µg/100 ml RBC should be considered "positive."
CARDIAC DISEASE IN CHILDREN
Authors: Ferencz Charlotte , Craft Joan , Sultz Harry 
Published: December 2021

Evaluation of patients newly referred to a pediatric cardiology clinic revealed that approximately twothirds of the children did not have heart disease. Of the other third, those with significant heart disease, 77% had congenital malformations and most were in the first year of life when diagnosed. Those in the first month of life had the highest mortality rate. Among newly referred school-aged children rheumatic heart disease was the major diagnosis.
Screening constituted a high proportion of the service's work load. Pediatricians did not differ significantly from other referral sources in the preselection for referral of cardiac cases.
The annual incidence of pediatric heart disease was comparable for different geographic areas surrounding the medical center and for racial groups. However, significant differences were found in the circumstances leading to referral. In disadvantaged black children, referral depended principally on hospital clinics visited for noncardiac illness. White children were predominantly referred in the course of routine examinations performed by pediatricians.
The findings reveal a need to plan specialty services in relation to the population base and with consideration of the accessibility and performance of the professionals who will select the patients for referral.
A NEW RETROGRADE METHOD FOR ADMINISTERING DRUGS INTRAVENOUSLY
Authors: Benzing George , Loggie Jennifer 
Published: December 2021

A new technique for administering drugs, especially antibiotics, intravenously to pediatric patients is described. By insertion of a segment of tubing between two three-way stopcocks in the patient's intravenous line, drugs diluted for intravenous administration may be pushed retrograde.
After turning both stopcocks for infusion, diluted drugs are administered intravenously and automatically followed by maintenance fluids. If two or more drugs are given, their separation is accomplished by introducing a barrier volume of 5% glucose water. Nursing time and effort for intravenous drug administration are reduced to one-fifth to one-third of that required by the piggyback method. Preparation of diluted antibiotics in capped syringes by the hospital pharmacy additionally decreases time consumed by the registered nurse for drug administration. The I.V. Retrograde system has been used successfully for more than one year in a two hundred and thirty bed children's hospital.
COOLING IN THE EMERGENCY TREATMENT OF BURNS
Authors: Epstein Michael F. , Crawford John D. 
Published: December 2021

Recent correspondence in the Lancet1-3 has called attention to the benefit of immediate cooling in the treatment of thermal injuries. This simple form of first aid can be provided as well by the layman as by the health professional and, more importantly, sooner. Given the same thermal stimulus, prompt cooling can mean the difference between extensive deep burns and more limited superficial injuries.
What is the evidence to back this claim? The studies of Henriques and Moritz4 and Ofeigsson5 indicate that after hot water or flame exposure the temperature of skin and of the deeper tissue layers remains high enough to result in a period of extension of coagulation necrosis.
Thyroid Abscess in Childhood
Authors: Olambiwonnu N. Olatunji , Penny Robert , Frasier S. Douglas 
Published: December 2021

In a recent article by Kirkland et al.1 describing the nature of solitary thyroid nodules in 30 children, one child with thyroid abscess was reported. The authors reviewed 35 cases of abscesses in childhood, four of which were reported after 1950. We recently studied a child with thyroid abscess in whom the clinical course was characterized by multiple recurrences.
The patient was a 5 4/12 year-old-girl who developed progressive swelling in the anterior portion of the neck two weeks after the onset of intermittent low grade fever, rhinorrhea, and cough.
Stimulant Drugs and Growth of Hyperactive Children
Authors: Bates Talcott 
Published: December 2021

The excellent and timely study by Drs. Safer and Allen,1 indicating suppression of longitudinal growth with dextroamphetamine, does not mention dosage.
Would the authors comment on this? Do all doses of dextroamphetamine sulphate suppress longitudinal growth in children or may there be a dose level which is nonsuppressive?
Letters to the Editor
Authors: Safer Daniel , Allen Richard P. 
Published: December 2021

You are quite correct; the dose of dextroamphetamine was not included in the paper.1 The daily dose range for dextroamphetamine was 5 to 40 mg. The average daily dose was 12.4 mg. Fifty-four percent of the children received this medication during the summer, and 10% received the medication three times daily.
There was no significant relationship between the dose of dextroamphetamine and growth suppression, a finding presented in Table IV of the paper. We do not know if doses less than 5 mg daily are nonsuppressive of growth.
Causes of Pyloric Atresia
Authors: Szalay Glenn C. 
Published: December 2021

Saw et al.1 refer to two reports of familial pyloric atresia; another example was recently reported by Keramidas and Voyatzis.2 Saw and co-authors state that 30 cases of pyloric atresia have been reported in the literature; Keramidas and Voyatzis mention a report in the German literature3 that "refers to 47 reported cases, and adds two reports."
Another rare cause of nonbilious emesis is pyloric duplication, which may more closely mimic pyloric stenosis.4 Saw et al. bring up the "vascular" theory, i.e., intrauterine ischemic infarction, to explain pyloric atresia but I questioti5 whether this theory can be used to explain either pyloric atresia, pyloric duplicalions, or gastric duplications.
POTENTIAL THERAPEUTIC PITFALLS IN REYE'S SYNDROME
Authors: Brown R. E. , Mullick F. G. , Madge G. E. 
Published: December 2021

Reye's syndrome1 is no longer considered to be a rare disease, even though it was not described in medical school to those who graduated more than 10 years ago. This is probably the result of several factors, including the education of the pediatrician and pathologist to recognize the cardinal manifestations of the syndrome and their better appreciation of the spectrum of this disease process.
The essential features of this disease process which affects children are easily recognized. These include, in many instances, an antecedent, viral-type illness followed by protracted vomiting; the development of an encephalopathy without a concomitant encephalitis or meningitis; some evidence of hepatic dysfunction, usually in the absence of jaundice; and biopsy or autopsy evidence of fatty accumulation in the viscera, primarily the liver.
LONG-TERM EFFECTS OF OTITIS MEDIA A TEN-YEAR COHORT STUDY OF ALASKAN ESKIMO CHILDREN
Authors: Kaplan Gary J. , Fleshman J. Kenneth , Bender Thomas R. , Baum Carol , Clark Paul S. 
Published: December 2021

Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children who have been followed through the first ten years of life. Seventy-six per cent had experienced one or more episodes of otitis media since birth. Of these, 78% had their first attack during their first two years of life. Perforations and scars were present in 41%. A hearing loss of 26 decibels or greater was present in 16%, and an additional 25% were in the normal range but had a measurable air-bone gap. Children with a history of otitis media prior to 2 years of age and a hearing loss of 26 decibels or greater had a statistically significant loss of verbal ability and were behind in total reading, total math, and language. In addition, children who had an early onset of otitis media but now had normal hearing with a conductive component were also adversely affected in verbal areas. The number of otitis media episodes was related to tympanic membrane abnormalities, hearing loss, and low verbal and achievement scores.
These findings indicate that otitis media has been a significant cause of morbidity in Alaskan Eskimo children, and its onset during the critical years of language development as well as the number of episodes play an important role in impairing verbal development.
Phenergan® Is No Longer Available for Topical Use
Authors: Silverio John 
Published: December 2021

I have read in a recent issue of Pedistrics (February 1973) the review of the Committee on Drugs entitled "Antihistamines in Topical Preparations."
I was surprised to see that the Committee mentions that Phenergan® (promethazine hydrochloride) "is available as a topical preparation."
For your information (and the information of the Committee on Drugs), I would like to state that the marketing of Phenergan Cream was discontinued over one year ago (January 13, 1972).
I am sure that the Committee on Drugs is willing to make the appropriate acknowledment so that the the readers of Pediatrics would not be mislead.
Meningococcal Meningitis Presenting As Acute Cerebellar Ataxia
Authors: Yabek Steven M. 
Published: December 2021

Acute cerebellar ataxia is a well-described, benign syndrome characterized by an acute dramatic onset of truncal ataxia, hypotonia, nystagmus, intention tremor, irritability and vomiting. The patients, generally under 5 years of age, usually have a preceding viral infection and undergo spontaneous cure without specific treatment within weeks or months of the onset. They remain afebrile and the cerebrospinal fluid shows only a mild pleocytosis and protein elevation later in the course of the disease.1-4
Although purulent meningitis can present with a wide variety of central nervous system manifestations, there have been no reports of bacterial meningitis manifesting as cerebellar ataxia until recently. This report will describe such a case.