bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EVIL EYE
Authors: McNamara John J. 
Published: December 2021

Poorly understood cultural practices may mystify the pediatrician. The wearing of "charms" to ward off the evil eye is common among many cultures. In our area a large number of Cape Verdean infants wear a small black ceramic bead with twenty-four white dots on a cord either around the waist or around the arm.
Recently, in changing an IV, a nurse cut off this charm to the extreme consternation of the parents. The bead is viewed as an early warning device to alert the parents to the existence of an evil eye directed at their child. I am told that if "twenty-four evil eyes have been applied" the ceramic bead will burst.
Letters to the Editor
Authors: Clark Frank I. 
Published: December 2021

I have grouped and answered the issues raised by Drs De Ville and Moskop as follows:
1. I have previously noted that the Federal Child Abuse Amendments (FCCA) can be construed as a funding statute.1 The reference quoted by Drs De Ville and Moskop came as dicta in a civil rights case and is not a holding. However, the majority viewpoint suggests the act has additional significance. An authoritative review found the FCAA "were designed to prevent the withholding of medically indicated treatment" and refers to them as "The Federal Standard."2
A Summary of Conference Recommendations on Dietary Fiber in Childhood
Authors: Williams Christine L. , Dwyer Johanna , Agostoni Carlo , Hillemeier Craig , Kimm Sue Y. S. , Kwiterovich Peter O. , McClung Juhling , Nicklas Theresa A. , Saldanha Leila 
Published: December 2021

Fiber Has Important Health Benefits in Childhood
Diet in childhood and adolescence influences not only the health of the child, but also the future health of the adult. Therefore, the optimal diet during these formative years must be adequate to support normal growth and development during childhood, as well as to establish a nutritional foundation for the prevention of diet-related chronic diseases among adults, such as coronary heart disease, some cancers, stroke, adult-onset diabetes, obesity, and hypertension.1-10
During the course of this conference the current diet of US children was reviewed. Compared with national guidelines, children consume higher than recommended amounts of total and saturated fat and cholesterol and less than recommended amounts of complex carbohydrate and fiber (Table 1, Figs 1-6). Data on trends over time reveal that children's diets are currently lower in total fat, particularly saturated fat, compared with previous years. From 1974 to 1988 the percent of energy from total fat in children's diets has decreased from 38% to 36% and from 16% to 13% for percent of energy from saturated fat. Total sodium intake has increased slightly from 3.3 g (1974) to 3.7 g (1988), but there have been virtually no changes in dietary fiber intake, averaging about 12 g/d or 5 g/1000 calories (kcal).11-17
National food consumption surveys show that consumption of vegetables among children has decreased significantly between 1977 and 1987. In addition, although there have been positive changes in children's diets toward reduced fat intake, approximately 73% still have fat intakes greater than 30% kcal; 66% had saturated fat intake greater than 10%; and 54% had dietary cholesterol intake greater than 100 mg/1000 kcal.11,12
A Community-based Survey of Infant Sleep Position
Authors: Chessare John B. , Hunt Carl E. , Bourguignon Cheryl ,   Pediatric Research in Office Practices Network
Published: December 2021

Objective. To determine prevalent infant sleep positions before and after the American Academy of Pediatrics position statement of 1992 and to identify determinants of sleep position.
Method. Design: cross-sectional survey. Setting: private and hospital-sponsored general pediatric offices. Participants: parents of infants younger than 7 months of age.
Results. Eight hundred fifty-two care givers completed surveys during the 5-week study. Fifty-four percent of the study infants were put to sleep in the prone position. In 416 families with more than one child, however, 75% of the youngest siblings had been put to sleep in the prone position at the same age. Gender, race, family income, maternal smoking, and birth weight were not associated with choice of sleep position.
Conclusions. There has been a change in infant sleep positioning in the desired direction since the American Academy of Pediatrics statement. However, 54% of the study infants were still being put to sleep prone.
DOCTORS FOR SALE
Authors: L. J. F. 
Published: December 2021

Medpartners Inc, a fast-growing company that manages the practices of doctors' groups in the Southeast and Midwest, said yesterday that it had agreed to acquire Mullikin Medical Enterprises LP, which has a similar business in the West.
The deal, in which Medpartners agreed to pay $360 million in stock for Mullikin, would create, in terms of revenue, the nation's largest physician-management company. Revenue in 1996 is projected to reach about $1 billion. A merged company would also be in a position to build a national network of doctors' group practices.
The Medpartners move is part of a wave of consolidations that is reshaping all quarters of the health industry. Many anxious doctors—fearful of being squeezed by cost-control efforts—have decided to heal themselves by contracting out for management services.
Parental Leave for Residents and Pediatric Training Programs
Authors:   Committee on Early Childhood, Adoption, and Dependent Care Resident Section
Published: December 2021

The Family and Medical Leave Act of 19931 and a growing number of state laws will have an impact on training programs and their policies regarding parental leave for pediatric residents. As an advocate for children and their families, the American Academy of Pediatrics (AAP) supported the Family and Medical Leave Act and is concerned with the need to ensure healthy outcomes for pediatricians and their families. In accord with its expertise in the areas of child development and family dynamics, the Academy is committed to the development of rational, equitable, and effective parental leave policies that enable parents to spend adequate and good quality time with their new children.
At least half of all female physicians are having their first children during their residency or fellowship training years.2,3 Furthermore, an increasing number of male residents are requesting parental leave to spend more time with their newborns. In 1989, a position statement on parental leave for residents by the American College of Physicians noted the increasing number of residents having children and raised concerns about both the health outcomes of the children and the emotional outcomes of their parents.4 The AAP believes that each residency training program should establish specific written guidelines on parental leave to address these concerns. Most program directors, however, have preferred to deal with the circumstances of each pregnancy leave on an individual basis. In 1990, the American Medical Association adopted a policy on maternity leave for residents.5
SUIT CLAIMS RESEARCH-HOSPITAL DOCTORS SUBMITTED PHONY BILLS TO GET U.S. FUNDS
Authors: L. J. F. 
Published: December 2021

Physicians at dozens of prominent research hospitals nationwide allegedly submitted phony bills and sometimes even falsified patients' records to obtain as much as $1 billion in federal payments for sophisticated, but still experimental, cardiac procedures, a newly unsealed whistleblower suit claims.
The allegations of years of systematic fraud involving as many as 130 major medical centers nationwide, accusations that already have prompted a previously reported criminal investigation, are likely to shine a spotlight on the controversial issue of which cutting-edge devices and procedures currently are, or should be, eligible for Medicare or Medicaid claims.
Existing regulations say that the government generally won't pay for treatment considered to be "experimental" or for the use of medical devices that haven't been formally approved by the Food and Drug Administration...
DISEASE AND WELLNESS MANAGEMENT FIRMS!?
Authors: L. J. F. 
Published: December 2021

In 1993 Eli Lilly publicly announced that it was turning itself from a drug firm into a "disease-management" one. The idea is that rather than focusing a company on a specific part of the health-care market, such as drugs or hospitals, a firm should deal with all aspects of a disease. Chronic diseases that require lots of attention could produce the biggest savings (and hence profits). Eli Lilly has launched five disease-management programmes, for asthma, pulmonary disease, depression, diabetes, and ulcers. Several small firms are already thriving in "disease management"...
The "wellness-management" school is led by KPMG and Andersen Consulting. They believe that the disease-management approach fails in several respects. Health care involves maintaining health as well as treating diseases; patients often suffer from several diseases, which cannot easily be isolated and managed separately; and "disease-management" is an unappealing notion for companies that want to associate themselves with health, not illness.
Instead, companies that promote "wellness" should organize their product portfolios around groups of patients, trying to deal with all their medical needs. Some drug firms are doing this.
Neurologic Manifestations in Children With Lyme Disease
Authors: Bingham Peter M. , Galetta Steven L. , Athreya Balu , Sladky John 
Published: December 2021

Objective. Lyme disease (LD) is a tickborne spirochetal infection with a wide range of neurologic and non-neurologic manifestations. The clinical diversity of LD and limitations in serologic diagnosis often make it difficult to document the diagnosis of neurobor-reliosis with certainty.
Methods. We reviewed clinical manifestations in 97 seropositive children with particular attention to neurologic manifestafions. Diagnostic criteria used in other case surveys were applied to determine how often a definitive diagnosis of neuroborreliosis could be made in children.
Results. Of 69 children who met criteria for LD, 32% (22) had new neurologic signs, 73% (16) of which were accounted for by facial palsy and aseptic meningitis. Five of those with neurologic findings also had erythema migrans (EM), and one had both EM and arthritis. Among those with neurologic involvement, boys outnumbered girls two to one. Neurologic abnormalities resolved spontaneously in five children before their serologic results were known.
Conclusion. In our series, only 27% of children with neurologic abnormalities due to LD had a history of EM or arthritis. Seropositivity commonly constituted the primary basis for diagnosis of LD. Despite its nonspecificity, seropositivity for LD in children with neurologic symptoms usually signifies active neuroborreliosis.
Psychological Response to HIV Positivity in Hemophilia
Authors: Drotar Dennis D. , Agle David P. , Eckl C. Lucy , Thompson Paul A. 
Published: December 2021

Objective. To compare the psychological and family adaptation of children and adolescents with hemophilia who were seropositive for human immunodeficiency virus type 1 (HIV-1) with an HIV-negative group of comparable age, demographic characteristics, and disease severity in a multi-site study.
Design. Cross-sectional, controlled study.
Setting. Thirty-three hemophilia treatment centers throughout the United States.
Sample. Ninety-one children and adolescents with hemophilia who were seropositive for HIV and 92 children and adolescents with hemophilia who were seronegative and of comparable age, demographic characteristics, and disease severity.
Results. HIV-seropositive children and adolescents reported less positive affect [(lower well being) (P &lt; .05) ], and more frequent hemophilia-related school absences were identified among HIV-infected patients (P &lt; .005). However, the two groups demonstrated surprisingly comparable levels of psychological, social, hemophilia-related adjustment, general family relations, and hemophilia-related family adaptation, as reported by patients and parents. However, mothers of HIV-seropositive children and adolescents reported higher levels of general psychological distress (P &lt; .008) and higher levels of distress related to hemophilia (P &lt; .0002) than parents of HIV-negative children.
Conclusions. Seropositive children and adolescents with hemophilia demonstrate psychological resilience and levels of psychological adjustment that were comparable to seronegative counterparts. However, mothers of seropositive children were more distressed than mothers of HIV-negative children. Practitioners should ensure that stressed mothers obtain necessary psychological support.
Failure to Identify Human Immunodeficiency Virus-Seropositive Newborns: Epidemiology and Enrollment Patterns in a Predominantly White, Nonurban Setting
Authors: Coplan James , Dye Timothy D. , Contello Kathie A. , Cunningham Coleen K. , Kirkwood Kim , Weiner Leonard B. 
Published: December 2021

Objective. To describe the epidemiology of newborn seroprevalence for human immunodeficiency virus (HIV) in a predominantly white, nonurban population, and to determine the factors associated with enrollment at a regional pediatric acquired immunodeficiency syndrome (AIDS) center serving that population.
Design. Retrospective case series of children enrolled at a regional pediatric AIDS center during a 6-year period and comparison with universal blind newborn screening data collected by the state of New York during the same time interval.
Setting. The Pediatric AIDS Center at State University of New York-Health Science Center at Syracuse, which serves as the only source of HIV-related pediatric care for children in a 16-county region of upstate New York totaling 1.8 million population.
Results. One hundred thirty-nine HIV-seropositive infants were born in the region during the 6-year study period; complete blind screening data were available for 138. Sixty-five (47%) of these infants were white. Thirty-nine (28%) of 138 had been enrolled at the Pediatric AIDS Center within the first 90 days of life. An additional 22 (16%) were enrolled at older than 90 days of life. The remaining 77 (56%) have never been seen at the center and are presumed to be unidentified. County enrollment rates varied from 0% to 100% and correlated with percent nonwhite births (r = .58; 95% confidence interval, 0.04-0.86). Children in outlying counties were at greater risk for nonenrollment than children from Onondaga County (site of the Pediatric AIDS Center) (adjusted relative risk, 1.38; 95% confidence interval, 1.05-1.85). White infants residing outside of Onondaga County were at the greatest risk of nonenrollment; of 50 seropositive white infants residing outside of Onondaga County, only 7(14%) were enrolled at the center within the first 90 days of life.
Conclusions. Local demographic factors can skew the racial distribution of HIV-seropositive infants dramatically compared with the national experience. White race and residence in counties away from the medical center each constituted risk factors for nonenrollment at the Pediatric AIDS Center. The epidemiology of HIV in this predominantly white, rural population, coupled with physician practices, probably contributed to low identification and enrollment rates. As the AIDS epidemic spreads into similar populations elsewhere, HIV infection in pregnant women or newborn infants is likely to become progressively harder to detect, unless universal screening is adopted.
Oxandrolone Therapy in Constitutionally Delayed Growth and Puberty
Authors: Wilson Darrell M. , McCauley Elizabeth , Brown David R. , Dudley Robert ,   Bio-Technology General Corporation Cooperative Study Group
Published: December 2021

Background. Male adolescents with constitutional delay of growth and puberty may have significant psychosocial difficulties related to their sexual immaturity and short stature. The purpose of this study was to test the hypothesis that 1 year of oxandrolone therapy would increase growth velocity and thereby improve psychosocial functioning in boys with constitutional delay of growth and pubertal development.
Methods. Forty boys (ages 11 to 14.7 years) with delayed pubertal development and short stature were recruited from the pediatric endocrine clinics of 14 medical centers. The boys were randomized using a block design stratified for age to receive either oxandrolone (0.1 mg/kg daily for 1 year) or an identical-appearing placebo tablet, using a double-masked design.
Results. Growth velocity in the oxandrolone-treated boys was significantly greater than in the control boys (9.5 vs 6.8 cm/y). Likewise, the mean height SD score increased 0.41 in the oxandrolone group, whereas it decreased 0.03 in the control group. Those in the oxandrolone group gained 2.4 kg more than those in the placebo group. Mean predicted adult heights did not change in either group. The mean rates of pubertal progression were equivalent in both groups. Self-image (Piers-Harris Self Concept Scale) and social competence (Child Behavior Profile) were normal at baseline in both groups and did not change significantly over the course of the study in either group. No complications of oxandrolone therapy were identified.
Conclusions. This randomized, placebo-controlled trial demonstrates that low-dose oxandrolone can increase both height and weight velocity in boys with delayed puberty safely. Under the conditions of this study, however, the increased growth velocity in the oxandrolone-treated boys was not associated with a greater improvement in psychosocial status compared with the control boys.
Comparison of Immunogenicity and Efficacy of Rhesus Rotavirus Reassortant Vaccines in Breastfed and Nonbreastfed Children
Authors: Rennels Margaret B. , Wasserman Steven S. , Glass Roger I. , Keane Virginia A. ,   US Rotavirus Vaccine Efficacy Group
Published: December 2021

Objective. To evaluate whether breastfeeding affected the immunogenicity and/or efficacy of candidate rhesus-human rotavirus reassortant vaccines.
Methods. A total of 989 healthy infants between 4 and 26 weeks of age were enrolled into a 23-center, prospective, randomized, double-masked, controlled study of the safety, immunogenicity, and efficacy of three doses (4 x 104 plaque-forming units) of monovalent rhesushuman viral protein 7, or G, serotype 1 reassortant vaccine, (RRV-S1) or tetravalent vaccine (RRV-TV) consisting of rhesus-human reassortant G serotypes 1, 2, and 4, and the parent RRV G serotype 3. Vaccine efficacy was compared in the breastfed and nonbreastfed children as well as seroconversion rates and postvaccination geometric mean titers (GMTs) of neutralizing antibodies to human serotypes 1, 2, 3, and 4, RRV, and immunoglobulin A to RRV. GMTs in the two feeding groups were compared with and without adjustment for age at initiation of vaccination, prevaccination antibody titers, and the age and prevaccination titer interaction.
Results. The seroconversion rates to both vaccines by one or more assays were similar for the breastfed and the nonbreastfed groups (RRV-S1, 84% and 85%, respectively; RRV-TV, 94% and 93%, respectively). There were no significant differences in postvaccination GMTs to either vaccine, measured by any serologic assay, in the two feeding groups. The efficacy of the RRV-S1 vaccine was not significantly lower among the breastfed children than the nonbreastfed children (28% and 39%, respectively). RRV-TV, which is the vaccine being further evaluated for licensure, was equally protective in breastfed and nonbreastfed infants (50% and 51%, respectively). Logistic regression analysis, taking into account differences in age at vaccination and day 1 titer, revealed no evidence of differential vaccine efficacy in the two feeding groups for either vaccine.
Conclusions. These results indicate that the RRV-TV vaccine, given as three doses of 4 x 104 plaque-forming units, induces similar seroresponses and protection in breastfed and nonbreastfed US children.
Managed Care, Re-engineering and Downsizing: Will Medical Education Survive Change?
Authors: Greenberg Larrie W. 
Published: December 2021

My daily reading of the Washington Post newspaper invariably leads me to the business section where I find, more often than not, articles about how companies in the business world are in a constant state of change. They are either merging, downsizing, reengineering or reducing in force their employees to stay competitive and, more importantly, survive. This is an example of how the change environment has permeated all areas of our lives and it is, in fact, not a passing fancy but a reality.
The health care industry has not been immune from this mindset although few would have believed that medicine in the 1980s would follow this path.
If HMOs Want Evidence-Based Medicine, They Should Pay for Studies!
Authors: L. J. F. 
Published: December 2021

Some managed-care organizations are keen to support research. Kaiser-Permanente (which started life in California during the 1930s and now operates in many states) and Group Health Co-operative of Puget Sound (in Seattle) have for decades entered their patients in NIH-sponsored trials and conducted their own studies ... Several newer managed-care firms have followed suit.
... In the insurance industry, attitudes to research range from lukewarm to hostile. Lee Newcomer, medical director of United Health Care, a huge managedcare organization based in Minneapolis, says his firm would be more enthusiastic about paying for it if fewer clinical trials were "too small, too poorly designed, and too poorly organized" to answer questions about which treatments—particularly the most complex and costly—are worthwhile.
William Roper, a former health official in the Reagan and Bush administrations who is now Dr Newcomer's counterpart at the Prudential Health Care System in Roseland, New Jersey, goes further. He agrees that research is important, but he also argues that researchers have been too little accountable for how they have spent the public dollars that have flowed their way. "Why," he asks, "should society be paying extra for the delivery of health care at academic institutions merely on the presumption that it is getting something of value?" Prudential's position—unless Congress decides to tax all managed-care companies to support research—is that it will not pay for experimental medicine.
Increased Plasma Levels of Pancreatic Polypeptide and Decreased Plasma Levels of Motilin in Encopretic Children
Authors: Stern H. Patrick , Stroh Suzanne E. , Fiedorek Stephen C. , Kelleher Kelly , Mellon Michael W. , Pope Sandra K. , Rayford Phillip L. 
Published: December 2021

In the article entitled "Increased Plasma Levels of Pancreatic Polypeptide and Decreased Plasma Levels of Motilin in Encopretic Children" by H. Patrick Stern et al (Pediatrics, 1995;96:111-117), the hormone "thyroxine" was incorrectly listed in Figure 5 and in the text on page 115. The words "thyroid-stimulating hormone" should replace "thyroxine" in the Table and all subsequent references in the text.
H. Patrick Stern, MD, FAAP
Chief, Section of Behavioral Pediatrics
Arkansas Children's Hospital
Little Rock, AR 72202-3591
An Every Other Year Cyclic Epidemic of Infants Hospitalized With Respiratory Syncytial Virus
Authors: Lyon Joseph L. , Stoddard Gregory , Ferguson David , Caravati Martin , Kaczmarek Allison , Thompson Geraldine , Hegmann Kurt , Hegmann Christine 
Published: December 2021

We identified an every other year cyclic epidemic of infants hospitalized with respiratory syncytial virus (RSV) with peaking in even-year winters. Our observation agrees with every other year cyclic RSV epidemics reported by others who observed peaking in the winters of even-numbered years.1-3
We estimated rates of hospitalization for children less than age 1 for eight counties in the state of Utah, all counties being served by a single hospital system, Intermountain Health Care (IHC).