bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letters to the Editor
Authors: Goldberg Frederick , Berne Alfred S. 
Published: December 2021

We were interested to read of Dr. DeNicola's experience with ultrasound in a patient with orbital cellulitis. We have no personal experience with this technique and know of no studies using it for this particular clinical problem.
It does seem, however, that orbital sonography should define proptosis and displacement of the globe and establish the presence of any sizeable intraorbital mass (abscess). However, we doubt that sonography has the resolution to provide the detailed information about sinus disease and its relationship to orbital disease that computed tomography (CT) can.
Pathogenesis of Brain Edema and Hemorrhage: Role of the Brain Capillary
Authors: Goldstein Gary W. 
Published: December 2021

It has recently been shown that the endothelial cells in brain capillaries are the anatomic site of the blood-brain barrier, and that these endothelial cells act to maintain a constant composition and volume of brain interstitial fluid.1-3 Defects in brain capillary function appear to play a role in the pathogenesis of brain edema and hemorrhage in a wide variety of diseases. Conditions as diverse as intraventricular hemorrhage of the premature, asphyxia neonatorum, lead poisoning, head injury, Reye's syndrome, osmolar coma, and the brain edema surrounding a tumor or abscess may all share the common feature of brain capillary failure. In this review, I will consider some recent advances in our understanding of the brain microvasculature that may explain their unusual susceptibility to injury.
Brain capillaries have a number of important differences from capillaries in other organs. A schematic of a typical brain capillary is shown in the Figure. Unlike systemic capillaries, the endothelial cells in brain capillaries are joined together by tight junctions.3 These cellular junctions are present around the entire circumference of the capillary tube. The result is a continuous layer of endothelial cells that effectively separate the plasma from the interstitial fluid of the brain. The tight junctions are composed of a series of complex interdigitations that create a barrier so complete that water-soluble molecules and ions are unable to move into the brain between the endothelial cells. In other organs, the capillaries do not have tight junctions, and sugars, amino acids, ions, and drugs readily diffuse between endothelial cells into the interstitial fluid.
Vagal Myocardial Necrosis?
Authors: Bachman David S. 
Published: December 2021

A recent article in Pediatrics1 indicates an association of multifocal myocardial necrosis with pancreatic diseases in children. Three possible pathologies of the myocardial lesions are discussed: (1) the possibility of some type of deficiency; (2) a consequence of release of an active enzyme; or (3) secondary to acute destruction of the pancreas with release and activation of mediators.
We recently reported identical myocardial lesions in a primate following vagal stimulation.2 This finding can imply a quite different association between pancreatic disease and myocardial necrosis.
Annual Summary of Vital Statistics—1978
Authors: Wegman Myron E. 
Published: December 2021

Continued decrease in infant mortality and relative stability in the other major indices highlight 1978 vital data (Table 1)2. The provisional infant mortality rate of 13.6 deaths in the first year of life per 1,000 live births set a new record, 3.5% below the final rate of 14.1 in 1977. Births in 1978 were slightly higher in number but, with the natural increase in the population, the birth rate was slightly lower than in 1977. The crude death rate, marriage rate, and divorce rate were all up slightly.
BIRTHS
Estimated live births in 1978 totaled 3,329,000,2 fractionally higher than the final figure for 1977.
Letters to the Editor
Authors: Weinshank Annette B. 
Published: December 2021

A child may have the right not to be taught to read in the conventional manner, but Dr Snyder (The Right Not To Read, Pediatrics, May 1979) does not have the right to be so uninformed on an issue that impacts so many of the patients whom pediatricians treat.
1. Dr Snyder makes the error of misusing standardized reading tests whose function is to rank large groups of children, with diagnostic reading tests whose function is to provide specific information to individual teachers about the strengths and weaknesses of individual children.
Letters to the Editor
Authors: Snyder Russell D. 
Published: December 2021

The following letter from a parent is in response to the article in Pediatrics (63:791, 1979). The letter expresses extremely well the dilemma faced when a child is identified as a poor reader and illustrates why our educational attitudes toward reading are in need of modification.
I had a personal interest for reading your report because my son was left-handed, slow to walk and slightly awkward when he did. That and other small differences distinguished him from his brothers and sisters.
Understanding Children's Advocacy in the Health Sector
Authors: Tompkins Richard F. 
Published: December 2021

CHILD ADVOCACY
Children cannot always articulate their own interests or make their own decisions; even though their abilities increase substantially and predictably throughout childhood, society is forced to find ways to make decisions for children. Children's advocacy is an attempt to improve the lives of children through attention to the decisions that affect children. Advocacy is "intervention on behalf of children in relation to those services and institutions that impinge on their lives."1
During the late 1960s and early 1970s, different enterprises have been conducted under the rubric of children's advocacy. They have been initiated or funded by both public and private sources at all levels: national, state, and local. Surveys of children's advocacy activities, most notably a national base line survey conducted by Kahn et al,1 have attempted to define children's advocacy activities. After extensive field work, Kahn and colleagues summarized the diversity of children's advocacy activities:
...affirming new concepts of legal entitlements; offering needed services in areas where none existed; persisting in the provision of services when other more conventional programs dropped cases; assuring access to entitlements and help; mediating between children or families and institutions such as schools, health facilities, and courts; and facilitating self-organization among deprived community groups, adolescents, or parents of handicapped children.1(p9)
Health care is an area where society has a considerable interest in good decision-making on behalf of children. On humanitarian grounds, society has a caretaker interest and responsibility. On economic grounds, society benefits from the healthy development of its children, who represent a resource pool.
HEROIC DRUG THERAPY OF PNEUMONIA IN CHILDHOOD RECOMMENDED BY JACOBI IN 1917
Authors: C. T. E. 
Published: December 2021

Abraham Jacobi (1830-1919), the first professor of pediatrics in America, and the first president of the American Pediatric Society, did more than any other physician to place pediatrics in America on a firm and lasting basis. Nonetheless, his treatment of pneumonia in childhood, even as late as 1917, was as heroic, and as unscientific, as that practiced by physicians in the mid 1800s. He wrote:
I rarely treated a child pneumonia without digitalis. American practitioners have gradually ceased to be cowardly. If faint-heartedly you wait for changes or chances to turn up, you lose your patient. Pneumonias have no stomach for waiting. In treating pneumonia some American doctors have learned to know that hearts lose strength by the hour, unless they are stimulated at once and persistently. Small doses are insufficient; big ones are demanded, and they must be reliable drugs. Digitalis alone may not be sufficient. Spartein sulphate should accompany it in good doses. The modern American pharmacopeia is no guide for you or your patients. Ignorance of apothecaries has been presiding over it. I read in it that ⅙ grain of spartein sulphate is proclaimed to be the dose for an adult. But very rarely ⅙ or ¼ is sufficient as a baby's dose, provided you want it to be efficient; and you want it repeated frequently. Caffein is one of the efficient drugs, that means 4 or 6 or more grains a day for a baby. Camphor has been neglected by us. A year old baby may require 2 or 4 or 8 or 10 grains a day.
Communication
Authors: Kendig Edwin L. 
Published: December 2021

As far as can be determined, the first medical organization was founded in the year 1518, when Dr Thomas Linacre, physician to Henry VII and Henry VIII, proposed and arranged the establishment of the College of Physicians (now the Royal College of Physicians). There is no recording as to differences of opinion among the membership, but it seems more than likely that complete accord and harmony did not always exist. According to the old adage, "That's what makes horseracing."
Good communication (the exchange of information) can bridge most disagreements or differences of opinion. The most frequently discussed and the most important question faced by the Executive Board of the American Academy of Pediatrics has concerned the best means by which to develop and utilize communication. Examples indude the President's letter to the membership (December 1978) listing 32 AAP accomplishments and activities over the past five years; and still another is the Academy program for the International Year of the Child, "The AAP Speaks Up for Children."
Communication, then, is the way to begin to solve most problems and that leads us to the theme of this discussion today: communication between practicing pediatricians and those engaged in academic pediatrics, and communication between those groups and both the Federal government and the public sector. Pediatric practitioners could not exist without pediatric teaching programs and research; conversely, the latter would be pragmatically useless without the practicing pediatricians. Both groups must recognize that they exist interdependently and that their mutual growth and development is equally interdependent.
Reye Syndrome in Children Less than 1 Year Old: Some Epidemiologic Observations
Authors: Sullivan-Bolyai John Z. , Nelson David B. , Morens David M. , Schonberger Lawrence B. , Marks James S. , Johnson Deane , Holtzhauer Frank , Bright Frank , Kramer Taylor , Halpin Thomas J. 
Published: December 2021

Much of the epidemiology of Reye syndrome is still not well understood, particularly in the age group &lt;1 year of age. Huttenlocher and Trauner1 recently reported the clinical findings in a series of patients &lt;6 months of age. They noted that a disproportionate number of infants came from lower socioeconomic areas.
A 1973 to 1977 epidemiologic study of Reye syndrome in Ohio by the Ohio State Department of Health and the Center for Disease Control (CDC) has shown different age-specific attack rates for black children and for white children.2 Although the overall attack rates of Reye syndrome for black and for white children were not significantly different, among children &lt;1 year old, black children had a rate of Reye syndrome approximately eight times the rate for whites.
School Nurse Practitioner
Authors: Cook Donald E. , Andringa Conrad L. , Hess Karl W. , Kishner Leonard L. , Leavitt Samuel R. , Novak Stanley F. , Rogers Kenneth D. , Stackpole J. Ward , Wiggins Casper , Kolb Weldon G. , Newton Jerome , Carlyon William , Sanders Joe M. 
Published: December 2021

These issues and others are being addressed by projects conducted over the next five years in four states, with the financial support of the Robert Wood Johnson Foundation. Through these projects, the role and effectiveness of the SNP in different geographic and socioeconomic settings in the United States will be better defined and determined. The Committee applauds these efforts and eagerly awaits their conclusions.
Because of the increased scope of health care and evaluation practiced by SNPs, which includes some areas of primary health care, the Committee presently endorses SNP participation in school health programs only when they function under the direct supervision of a physician.
Differential Diagnosis of Variant Forms of Hyperphenylalaninemia
Authors: Kaufman Seymour 
Published: December 2021

In 1975, a form of hyperphenylalaninemia was described in which neurologic deterioration occurs despite dietary control of the elevated blood phenylalanine levels.1 Subsequently, it was demonstrated that this condition can be caused by defects in the phenylalanine hydroxylase system other than in phenylalanine hydroxylase itself, ie, by a tissue deficiency of dihydropteridine reductase (DHPR)2,3 or of biopterin.4 Since then, research in the field of these newer, unresponsive variants of phenylketonuria (PKU) has moved ahead swiftly.
The treatment for these forms of hyperphenyl-alaninemia, which have been estimated to account for about 10% of the total, is different from that used for classic PKU.
Letters to the Editor
Authors: Miller John F. 
Published: December 2021

I want to thank the Committee on Adolescence for sharing with me your personal, individual, and deeprooted attitudes in "Pregnancy and Abortion Counseling" (63:920, 1979). Following the reading of your article, I am more committed than ever to touch my adolescent patients with all the love, all the compassion and all the wisdom that flows from our Judeo-Christian heritage.
First, I will tell my kids that God loves them, that they are basically good, and that they have a lot going for themselves.
Protest of a Misquote
Authors: Kirkman Henry N. 
Published: December 2021

In their report on ABO hemolytic disease of the newborn (ABO HDN), Peevy and Wiseman1 confirm that the frequency of the disorder is higher in black than in white neonates. Coupled with earlier reports,2-8 their observations are valuable in showing that the difference is not just a local phenomenon. The cumulative evidence for a racial difference in frequency of ABO HDN is now overwhelming.
Peevy and Wiseman1 state, however, ". . . we show no evidence for increased severity, unlike Kirkman,8 who found an increase in severity of ABO HDN in black infants."
Letters to the Editor
Authors: Littman Bruce 
Published: December 2021

The letter from Dr Coplan was read with great interest and this opportunity to reply to his inquiry is much appreciated. The questions posed by him are pertinent ones and I shall try to provide some answers.
In regard to his first concern it should be stated that historically there has always been interest to relate perinatal life events and medical complications to later outcome. In fact methods used in earlier research attempted to correlate such occurrences on a single one-to-one basis to subsequent developmental performance.
Colorless Babies Mature Late
Authors: Harris Howard B. 
Published: December 2021

The apparent earlier fetal pulmonary maturation of infants from a black African population demonstrated in a recent article by Olowe and Akinkugbe1 had been previously shown in a black American population in a review of lecithin/sphingomyelin (L/S) ratios from complicated pregnancies by Dyson et al.2
Both these studies provide biochemical evidence to substantiate the clinical observations of a lower incidence of hyaline membrane disease in the black population.3,4 The reason for this acceleration of lung maturity in blacks is unclear, but it may well be racial, as suggested by Olowe and Akinkugbe.
THE APPEARANCE OF AMERICAN GIRLS, AS VIEWED BY MOREAU DE SAINT-MÉRY ABOUT 1795
Authors: C. T. E. 
Published: December 2021

The French jurist, Méderic Louis Élie Moreau de Saint-Méry (1750-1819), was driven into exile during the French Revolution by Robespierre's accession to power.
From 1794 to 1798 Moreau lived in the United States. In the journal he kept during these years, he described American young girls as follows:
American girls are pretty, and their eyes are alive with expression; but their complexions are wan, bad teeth spoil the appearance of their mouths, and there is also something disagreeable about the length of their legs. In general, however, they are of good height, are graceful, and, in enumerating their charms, one must not forget the shapeliness of their breasts.
Philadelphia has thousands of beauties between fourteen and eighteen. To offer but a single proof: on the north side of Market Street, between Third and Fifth Street, on a single winter's day I saw four hundred young maidens promenading, each one of whom would surely have been followed in Paris, a seductive tribute that could be offered by perhaps no other city in the world.
But these girls soon became pale, and an indisposition which is reckoned among the most unfavorable for the maintenance of the freshness of youth is very common among them. They have thin hair and bad teeth, and are given to nervous illnesses. The elements which embellish beauty, or rather which compose and order it, are not often bestowed by the graces. Finally, they are charming, adorable at fifteen, dried up at twenty-three, old at thirty-five, decrepit at forty or fifty.
Vascular Malformation of Hypothalamus: A Cause of Isolated Growth Hormone Deficiency
Authors: Russell J. D. , Wise P. H. , Rischbieth H. G. 
Published: December 2021

The etiology of pituitary dwarfism is varied.1 The majority of cases are idiopathic (with an observed increase in history of birth trauma), and approximately one third are associated with radiologic changes of craniopharyngioma or pituitary tumor. A number are associated with midline embryonal defects, histiocytosis, basilar meningitis, and sarcoidosis. An increasingly reported cause is craniospinal irradiation for oncologic disease. An unusual, and previously unreported, cause is described.
CASE REPORT
A male child, born Aug 8, 1961, was investigated at the Royal Adelaide Hospital for shortness of stature. He was the second of four siblings; gestation and delivery were normal with a birth weight of 2.6 kg.
Clouds, Skin Color, and Rickets
Authors: O'Connor P. A. 
Published: December 2021

The article by Bachrach et al,1 on vitamin D deficiency rickets (Pediatrics 64:871, 1979) presents interesting data expanding the number of reported recent cases of vitamin D deficiency rickets in breast-fed infants. Of particular interest are the large number of cases of varying degrees of severity in a community where concerned parents are committed to natural methods of feeding.
These cases are similar to two children I reported in 1977.2 These were two cases of vitamin D deficiency rickets in breast-fed infants who were not receiving vitamin D supplementation as had been advised.
Touché
Authors: Reader Hopeful 
Published: December 2021

In October 1979, a meeting was convened in Geneva by WHO/UNICEF to consider the development of measures to improve infant and young child feeding practices.1 Among the recommendations concerning marketing and distribution of infant formula and weaning foods, the following statement was made: "Promotion to health personnel should be restricted to factual and ethical information."
How will this recommendation be implemented in the United States? Can we, for example, hope that (1) a single issue of Pediatrics will be published with no advertisements, and (2) a single annual meeting of the American Academy of Pediatrics will be held without the carnival atmosphere of advertising hoopla, industry-hosted cocktail parties...ete?
CASE REPORTS OF TWO INFANTS ADMITTED TO THE BABIES HOSPITAL IN NEW YORK CITY IN THE FALL OF 1888
Authors: C. T. E. 
Published: December 2021

The Babies Hospital in New York City opened to receive patients in a temporary home at 161 East 36th Street on June 16, 1888.
The following case reports of two infants, who were among the first patients admitted, will graphically show the modern pediatrician that acutely ill infants in 1888 could survive by virtue of the vis mediatrix naturae rather than by the drug therapy prescribed for them.1
Case 1—Cecilia, aged fifteen months; entered in November with pneumonia of lower lobe, left side, and pleurisy of both sides. The father had been carrying her around the city all day in a cold storm, trying to find a hospital which would admit her. The mother had been intemperate for several years, and was at the time suffering from a two weeks' debauch. The child was not yet weaned, and was presented with its clothing saturated and in collapse. Temperature, 104.8° F.; respiration, 60; pulse, 140. Tr. digitalis, gt. one, every four hours, and brandy, one-half drachm, every one-half hour, produced but little improvement in the pulse. Nutritive enemata, containing one drachm of brandy, every two hours were added. Four and one-half ounces of brandy were given each twenty-four hours, for three days, the pulse remaining 136 to 148, and compressible, while the temperature had fallen to 99° F. Musk and camphor were then added, but the pulse continued at 148 and intermittent. The child was seen in consultation with Dr A. H. Smith, who suggested the tincture of strophanthus, one-half drop every two hours.
Immunodeficiency in Congenital Chyluria
Authors: Arnold Watson C. , Steele Russell W. 
Published: December 2021

Chronic thoracic duct drainage in the experimental animal has been employed to deplete thymic dependent lymphocytes with resultant cellular immune deficiency.1-3 The human clinical correlate is the patient with chylothorax or even more analogous, chronic chyluria. The most common cause of chyluria worldwide is filariasis. Other causes include trauma, tuberculosis, neoplasms, infections, lymphactic aneurysm, and thoracic duct stenosis.4 We recently evaluated a child with this defect, giving us the opportunity of evaluating the effect of chronic T-cell depletion on immune reactivity.
CASE REPORT
J.K. is a 6-year-old Korean boy who was adopted at 2 years of age. Family history is unknown.
Questions About tcPo2 Transport Study
Authors: Ferrara Angelo 
Published: December 2021

The introduction of noninvasive oxygen monitoring equipment for sick neonates has facilitated the stabilization and care of such patients. The field experience of this technology as described by Clarke and colleagues ("Transcutaneous Oxygen Monitoring During Neonatal Transport," Pediatrics 65:884, 1980) is both timely and important to evaluate. In an attempt to understand this study more fully, I would like some elucidation of the research design and results.
First of all, it is difficult to appreciate the randomization process.
More Comments on Early Intervention
Authors: Crain Lucy S. , Hanson Marci J. 
Published: December 2021

Piper and Pless (Early Intervention for Infants with Down Syndrome: A Controlled Trial. Pediatrics 65:463, 1980) present a very controversial topic in an unfortunately negative frame. This could lead the majority of primary pediatricians to view their article as a damning indictment of any meritorious effect of early intervention programs for children with Down syndrome.
While critiques regarding selection factors, use of assessment instrument (the Griffiths scale), and duration and timing of intervention could be directed toward this study, more important points are at stake.
Comment on Burnout
Authors: Gordon Harry H. 
Published: December 2021

The "quote attributed to Hillel" (Pediatrics 65:1161, 1980) is an incorrect translation from the Hebrew. The quote (p 1163) should read: "He used to say; if I am not for myself, who will be for me? And if I am only for myself, what am I? And if not now, when?" The saying is customarily used to encourage consideration of others.
Implementing the individual and organizational strategies recommended by Marshall and Kasman should help personnel develop a desirable "detached concern."1