bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comments on Blood Pressure II
Authors: Repice Joseph P. 
Published: December 2021

I would like to comment on the commentary by Mitchell et al.1
While the authors admit that their data in Table I ("Percentile Values for Blood Pressure by Age") are "neither ideal nor perfect" and cite three references from which their data were obtained,2-4 several facts should be known by the reader.
The 50th and 95th percentiles for the systolic and diastolic pressures for the age group 0 to 6 months are apparently from one study3 and are not an average of the three studies as stated, since the studies of Zinner et al.2 and Londe4 were reported for age groups 2 to 14 years and 4 to 15 years, respectively.
Epidemiologic Studies of Measles, Measles Vaccine, and Subacute Sclerosing Panencephalitis
Authors: Modlin John F. , Jabbour J. T. , Witte John J. , Halsey Neal A. 
Published: December 2021

Histories obtained in 350 of 375 clinically confirmed cases of subacute sclerosing panencephalitis (SSPE) reported to a national registry showed that 292 patients had measles and 58 had no history of measles. Forty of the latter patients received live, attenuated measles virus vaccine. In patients with a history of measles, measles illness occurred before age 2 years in 46%, and a mean of 7.0 years before onset of SSPE. In contrast, there was no relationship of SSPE with age at vaccination in 35 of the 40 patients historically associated with measles vaccine, and SSPE occurred a mean of 3.3 years after vaccination.
Based on estimated national measles morbidity data and national measles vaccine distribution data, the risk of SSPE following measles vaccination (0.5 to 1.1 cases/106) appears to be less than the risk following measles (5.2 to 9.7 cases/106). Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969.
Scabies: Transcutaneous Poisoning During Treatment
Authors: Lee Beulah , Groth Paul 
Published: December 2021

The FDA Drug Bulletin (6:28, 1976) alerted physicians and other health professionals to the possibility of adverse central nervous system (CNS) side effects, particularly in children, that may occur from high doses of the commonly employed scabicides. The American Academy of Pediatrics has requested its members to report adverse reactions from scabicides to the AAP, which, in turn, will keep the FDA informed.
Following the FDA Drug Bulletin alert and the announcement by the AAP, the FDA's Division of Drug Experience received the following clinical reports of suspected CNS toxicity to gamma benzene hexachloride (GBH, Kwell, Gamene, lindane).
Auditory and Visual Defects Resulting from Symptomatic and Subclinical Congenital Cytomegaloviral and Toxoplasma Infections
Authors: Stagno Sergio , Reynolds David W. , Amos Catherine S. , Dahle Arthur J. , McCollister Faye P. , Mohindra Indra , Ermocilla Rufino , Alford Charles A. 
Published: December 2021

Sensorineural hearing loss was present in ten of 59 (17%) patients with congenital cytomegalovirus (CMV) infection (three of eight born with symptomatic and seven of 51 born with subclinical infection). The defect was bilateral in eight, moderate to profound in eight, and of progressive nature in two. Hearing loss did not occur in 21 patients with natal CMV infection nor in seven of 12 patients with congenital toxoplasmosis. Histopathologic and immunofluorescent studies of the inner ear in two of three neonates who died with severe infection revealed that viral antigens were widely distributed in cochlear structures.
Eye pathology was associated only with congenital Toxoplasma (nine of 12) and CMV (seven of 43) infections. Visual impairments were more prominent and severe in those born with symptomatic infections, exclusively so with CMV. However, ocular defects, in particular chorioretinitis, developed after birth in five of eight patients born with asymptomatic congenital toxoplasmosis.
These data firmly establish clinically inapparent congenital CMV infection as a major public health problem and confirm the fact that congenital toxoplasmosis may be associated with late-appearing, debilitating chorioretinitis.
Pulmonary Edema Associated With Croup and Epiglottitis
Authors: Travis Kenneth W. , Todres I. David , Shannon Daniel C. 
Published: December 2021

Two children, ages 9 and 2½ years, with clinical diagnoses of laryngotracheitis (croup) and epiglottitis, respectively, developed florid pulmonary edema without evidence of cardiac enlargement. Both children responded to vigorouS therapy, which included endotracheal intubation, mechanical ventilation with high oxygen concentrations and positive end expiratory pressure, diuretics, and support of the intravascular volume with colloid infusions.
Swan-Ganz catheterization was performed in the child with epiglottitis to elucidate any hemodynamic malfunction. Pulmonary artery occluded pressure was found to be normal.
We postulate that pulmonary edema may be the result of any of three major physiologic alterations: alveolar hypoxia, increased alveolar-capillary transmural pressure gradient, and a catechol-mediated shift of blood volume from the systemic to the pulmonary circulation. These alterations acting in concert would increase the volume of blood presented to the pulmonary capillaries, the pore size in those capillaries, and the hydrostatic pressure gradient promoting transudation. Failure of pulmonary lymphatics to effectively clear this fluid would result in pulmonary edema.
Although pulmonary edema associated with acute upper airway obstruction is unusual, physicians should be alerted to its possible appearance and the need for early and vigorous therapeutic measures.
Intractable Diarrhea in a Boy With Vasoactive Intestinal Peptide-Producing Ganglioneuroblastoma
Authors: Jansen-Goemans Annelice , Engelhardt J. 
Published: December 2021

A 1-year-old boy had intractable diarrhea and symptoms of the watery-diarrhea-hypokalemia-achlorhydria (WDHA) syndrome, a well-known entity in adults. Resection of a ganglioneuroblastoma situated in the neck caused prompt relief of symptoms.
The ganglioneuroblastoma in this instance contained the enterohormone vasoactive intestinal peptide (VIP); blood levels of this peptide were elevated preoperatively. After tumor resection, the VIP level returned to normal, and the diarrhea ceased OIl the day of the operation. The genesis of the diarrhea in relation to the production of polypeptides from neuroendocrine origin is discussed (APUD-cell concept).
VIP may be the mediator in the WDHA syndrome in ganglioneuroblastoma.
FEELING PAIN
Authors: Kozol Jonathan 
Published: December 2021

Physical pain for most young people in the U.S. is not easy to "believe," for the excellent reason that it is no longer present in their lives. Technological anaesthesia fends off almost all explicit physical ordeal. Ether balms a visit to the surgeon's office. Music and carpets quiet and absorb the panic of the pediatric office. The built-in auto air-conditioner refrigerates our minds and cools our bodies as we speed across the desert of New Mexico at sixty-five polite degrees. Terror and longing, in the aftermath of devastation at the loss of someone that we love, are calmed and quieted by a ten-grain capsule (Librium): half-black, half-green. The sharpest pain that many millions of young people in this nation ever undergo is the brief incision of the Novocain needle that arrests all further pain. It is an ideal metaphor.
No one wishes to see children placed within a field of needless pain: manufactured sickness, fever, panic, devastation. Yet it is true that lifelong technological insulation-unbroken barriers of self-protection from the taste of terror-do benumb our power to fathom, and our capability to feel. The man or woman who never has known pain is oftentimes incapable of pity. This is the case. above all, when there is an excellent reason to be grateful for the barrier of self-protection. "If I feel nothing," Robert Lifton has observed, "then death is not taking place. . . . If I feel nothing, I cannot be threatened by the death all around me. . . . If I feel nothing, then I am not responsible for you or for your death."
Infant Strangulation
Authors: Bergeson Paul S. , Hernried Lucy S. , Sonntag Paul L. 
Published: December 2021

All the tragedies described in this paper were avoidable and all involved healthy children. The ages ranged from 17 days to 2 years, but the majority were 2 to 9 months. In this age range children become increasingly agile but may lack the ability to extricate themselves from potentially dangerous situations. The head is large, relative to the body, and may become entrapped if a child's body slides through an opening. Cribs and high chairs should be constructed with this concept in mind. There should be no existing or potential space large enough for the baby's body to slide through. No screws or nails should protrude on which a baby could become suspended. Repairs may be dangerous and must be done carefully; however, cribs and high chairs must be kept in good condition, especially in regard to loose parts. Homemade items may be dangerous. Restraining devices have been responsible for many fatalities as described and should generally be avoided. Ribbons and strings used to hang a pacifier around a child's neck should be strictly avoided as should strings and cords attached to playthings in the crib.
Legislation has been passed which addresses itself to the problems of distance between crib slats and space between the mattress and side rails.22-24 We commend the work but point out that cribs manufactured before the present law became active will be in use for many years. A crib safety education campaign has been launched that provides excellent advice on purchasing new cribs and reconditioning old ones.25 We only regret that the information has not been further disseminated. Infant strangulation is a poorly publicized problem that warrants attention of physicians, parents, and manufacturers to help avoid further needless tragedies.
Neonatal Respiratory Distress From Hemothorax
Authors: Mazzi Eduardo , White John J. , Nishida Hiroshi , Risemberg Herman M. 
Published: December 2021

Hemothorax that produces acute respiratory distress in a newborn occurs rarely; only ten cases have been reported.1-9 We report another case (associated with hypoprothrombinemia and anemia) in a full-term infant. Thoracentesis successfully relieved the respiratory distress, and transfusion and parenteral vitamin K therapy reversed the bleeding diathesis.
CASE REPORT
A girl, weighing 3,070 gm, was born to a 30-year-old woman, after spontaneous labor and uncomplicated delivery. The Apgar score was 7 at one and five minutes. The infant was brought to the nursery at 10 minutes of age, where she was found to be a cyanotic black girl with grunting respirations and intercostal retractions.
Is intensive care becoming too intensive?
Authors: L. J. F. 
Published: December 2021

Each month some new iatrogenic complication of intensive care is reported.1,2 One begins to wonder if our care may not be getting too intensive, to the point that we are paying no attention to the possible therapeutic value of rest and sleep.
The sleeping, quiescent fetus develops in an intrauterine environment of low, but relatively stable, oxygen tension. The sick, prematurely born infant enters an environment vastly different from that to which he/she is accustomed.
Picture yourself in a brightly lit room, nude, defenseless, and your eyes hurting from silver nitrate. You are blindfolded, chilly, and surrounded by a tepid fog.
Renal Failure During the First Year of Life
Authors: Reimold Ekkehard W. , Don Tran Dinh , Worthen Howard G. 
Published: December 2021

All cases of persistent renal failure in infants less than 1 year of age were reviewed to determine whether the prognosis has improved equally for infants as for adults. During a ten-year period, 52 infants were treated by applying uniform therapy; 28, more than half, were less than 4 weeks old. All cases were separated into two groups: 19 infants without and 33 infants with congenital renal or urinary tract anomalies. In 20 patients of the latter group, additional serious anomalies of other organs were present. The age distribution was strikingly different: in 18 of 21 infants, renal anomalies were present, as diagnosed on the first day of life. In contrast, only 3 of 11 infants, 4 to 12 months old, had urinary tract anomalies.
In infants without renal anomalies, renal failure was caused by hypotension or shock in 10 of 19 cases, by pyelonephritis or sepsis in 6 of 19. Of this group, eight infants (42%) recovered completely, nine (47%) died. Death occurred within one to two days of hospitalization in all but three cases, caused by shock or sepsis. In this group medical problems that are amenable to therapy have caused either renal failure or contributed to the infant's death.
In infants with renal or urinary tract anomalies, renal failure was caused by renal dysplasia or agenesis in 16 of 33 infants, by urinary tract obstruction in 12 of 33. Only three patients (9%) recovered, all older than 4 months, 20 (61%) died, and 10 are living with signs of chronic renal failure. Death usually occurred within one week of hospitalization and, in 16 of 20, it was caused by renal failure and multiple additional anomalies. The multiplicity and complexity of the congenital anomalies in most instances precluded effective, lifesaving therapy.
Renal failure in infants is still a serious disease accompanied by a high mortality rate in which therapeutic possibilities are limited. No improvement in prognosis can be expected in the near future.
PaO2 Levels and Retrolental Fibroplasia: A Report of the Cooperative Study
Authors: Kinsey V. Everett , Arnold Harvey J. , Kalina Robert E. , Stern Leo , Stahlman Mildred , Odell Gerard , Driscoll John M. , Elliott James H. , Payne John , Patz Arnall 
Published: December 2021

The relation between PaO2 and retrolental fibroplasia (RLF) was studied prospectively in 719 premature infants born in or treated in the intensive care units of a group of university hospitals. Blood gas studies were performed on 589 of these infants, 66 of whom had a diagnosis of RLF; in 27 of these 66, some grade of mostly nonblinding cicatricial disease developed. The frequency of RLF was highest among infants of lowest birth weight. A multivariate statistical method was used to analyze simultaneously the effect of possible etiologic factors associated with RLF.
The occurrence of RLF was found to be unrelated to PaO2, as determined by the limited information available from intermittent sampling. RLF is associated with concentration of oxygen administered in the lightest birth weight group, but the strongest association, aside from birth weight, was with time in oxygen. None of the other variables involving blood chemical values appeared to be associated with RLF. The severity of cicatricial RLF is clearly greater in infants weighing less than 1,200 g at birth.
Conservative administration of oxygen may have been responsible for failure to demonstrate quantitative association between Pao2 levels and disease. Agreement between the observed and predicted numbers of infants with RLF demonstrates the strength of the multivariate technique employed in making the statistical analyses.
Persistent Pulmonary Hypertension in a Newborn With Congenital Diaphragmatic Hernia: Successful Management With Tolazoline
Authors: Levy Robert J. , Rosenthal Amnon , Freed Michael D. , Smith Charles D. , Eraklis Angelo , Nadas Alexander S. 
Published: December 2021

Persistent elevation of pulmonary vascular resistance represents a major cause of death in infants with congenital diaphragmatic hernia.1 The present report describes an infant with diaphragmatic hernia in whom persistent pulmonary hypertension associated with severe hypoxemia was successfully treated with tolazoline hydrochloride.
CASE REPORT
A 3,250-g term boy was born at Boston Hospital for Women to a 31-year-old, gravida 2, para 1 woman. Pregnancy was unremarkable and labor lasted 12 hours. At delivery, Apgar scores were 5 at one minute and 7 at three minutes. There was extreme respiratory distress and hypoxemia. Intubation and a subsequent chest x-ray film led to the diagnosis of a diaphragmatic hernia.
Caution on Aerosol Use
Authors: Bergner Arthur , Bergner Renée K. 
Published: December 2021

Drs. Wittig and Leifer comment in their letter on the insignificance of the Pao2 drop after use of adrenergic aerosols (Pediatrics 57:579, April 1976). They state "... that properly administered, these agents are a great aid to many asthmatics and should not be denied to them."
Since patients do not usually consider or fear sprays as medicine and frequently exceed recommended doses in spite of physicians' and package warnings, the studies and statements claiming "safety" when "properly administered in recommended doses" are too often meaningless in clinical reality.
Letter to the Editor
Authors: Kafka H. L. 
Published: December 2021

There is no need for highly qualified, highly paid personnel like public health nurses and health assistants to monitor access to care and to encourage the use of the services. Lesser trained, but well known persons in the community, such as a community health worker, would be better received by the community and, therefore, would do a better job. It may be possible in some areas to use volunteers.
A study using such a group of people in a well-defined area would certainly help to establish this kind of health worker as a permanent institution in the public health services.
Questions About PDQ
Authors: Perrin James M. 
Published: December 2021

The Prescreening Developmental Questionnaire (PDQ) (Pediatrics 57:744, May 1976) may be a useful device to diminish some of the demands of developmental screening among preschool children. There has been some reluctance to recommend routine developmental screening of all children,1 and the PDQ, by diminishing the number of false positives in low-prevalence populations, may make such screening more appropriate for these populations.
There are some apparent inaccuracies in the presentation of the predictive value of a positive screen2 throughout the article.
Drs. McCarthy and Dolan Reply
Authors: McCarthy Paul L. , Dolan Thomas F. 
Published: December 2021

It is true that the occurrence rate of bacteremia in healthy afebrile children is not known. However, our data suggest that there is a direct correlation between height of fever and bacteremia.
We have recently completed a prospective study of children less than 2 years of age with a temperature of greater than or equal to 40 C (104 F).1 We asked the resident physicians to predict the presence of bacteremia from clinical evaluation and prior to knowledge of complete blood cell count and ESR.
Dr. Bergman Replies
Authors: Bergman Abraham B. 
Published: December 2021

Dr. Dershewitz is a few jumps ahead of us. We consider our study to be in the realm of basic accident research, i.e., searching for etiologic factors. He's into practical application. That's okay! Jenner came up with a means to prevent smallpox long before the virus was identified.
The existence of accident-prone children is widely assumed with little solid supporting data. There is even less information available on effective methods of altering behavior that leads to accidents.
Pathology of the Heart in Kawasaki Disease
Authors: Fujiwara Hisayoshi , Hamashima Yoshihiro 
Published: December 2021

Pathologic studies were done on 20 hearts of patients who had typical clinical signs and symptoms of Kawasaki disease. The cardiac lesions were classified according to the duration of illness at the time of death. Stage I (zero to nine days) was characterized by acute perivasculitis and vasculitis of the microvessels (arterioles, capillaries, and venules) and small arteries, and acute perivasculitis and endartenitis of the three major coronary arteries (MCAs). Penicarditis, myocarditis, inflammation of the atrioventricular conduction system, and endocarditis with valvulitis were also present. Stage II (12 to 25 days) was characterized by panvasculitis of the MCAs and aneurysm with thrombus in the stems. Myocarditis, coagulation necrosis, lesion of the conduction system, pericarditis, and endocarditis with valvulitis were also present. In stage III (28 to 31 days), granulation of the MCAs and disappearance of inflammation in the microvessels were noted. Patients in stage IV (40 days to 4 years) had scarring with severe stenosis in the MCAs. Fibrosis of the myocardium, coagulation necrosis, lesions of the conduction system, and endocardial fibroelastosis were also present.
The features observed revealed Kawasaki disease to be acute and inflammatory. The angiitis begins in the microvessels and fibrinoid necrosis of the media is rare. The disease is one with a pathologic pattern previously unknown.
Infant Radiant Warmers
Authors:   Committee on Environmental Hazards
Published: December 2021

Radiant warmers are frequently used in delivery rooms and neonatal care units when open access and external heat are simultaneously required.1 The sale of more than 13,000 units by U.S. manufacturers during the past ten years attests to the acceptance of these devices by pediatricians.2 However, some concern about the use of the warmers stems from potential hazards and the lack of information regarding possible effects of the devices. This concern was recently expressed by a panel of consultants to the Bureau of Medical Devices in the Food and Drug Administration (FDA) who recommended that the FDA obtain additional information to assist it in evaluating radiation warmer safety.3 If this recommendation is accepted by the FDA, current procedures require that additional information regarding the effects of radiant warmers on infants must be provided within a period of 30 months.4 Therefore, pediatricians should be aware of the issues involved.
The most serious complication of radiant warmers is extreme hyperthermia, which may occur from improper use or from dislodgement of the sensor probe. Hyperthermia may result in death or permanent neurological damage (T. Peebles, personal communication). Insensible water loss increases markedly when infants are placed in the warm, dry, open environment under radiant warmers, and may increase by 50% to 200% over that observed among infants in incubators, depending on the maturity of the infant and the type of warmer.5 First-degree burns have been attributed to radiant warmer heating of plastic-lined disposable diapers which were placed next to the skin for urine collection.6
A promising answer
Authors: Olmsted Richard W. 
Published: December 2021

"A Tale of Two Doctors" is intended to document the weaknesses in the schema for medical education between the developed and the developing world countries. More importantly, the plight of the foreign physician returning home with no provision for his continuing education illustrates the fundamental problem of continuing education for all physicians in all countries. The problem, as stated by Dr. Fisher, is that "the commitment to postgraduate medical education overseas must continue beyond the provision of the core training experience." Modifying the statement by eliminating "overseas" more precisely defines the true dimensions of the problem.
It is no mere cliché to say that the half-life of a physician's knowledge is five or seven or ten years.
Seat Restraints Don't Fit
Authors: Hall Caroline Breese 
Published: December 2021

Your articles on automobile safety for children1-6 are most heartening. Few, if any other, areas in pediatrics have such potential to produce a major and immediate improvement in the health of our children. However, such articles have neglected mentioning the older sibling, the school-aged child.
Children weighing 22 kg or more remain vulnerable orphans, not adopted by the presently available restraint systems. Adult lap belts are not adequate for these children with their different bulges, proportions, and pelvises.6