bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care Pediatrics and Child Psychopathology: A Review of Diagnostic, Treatment, and Referral Practices
Authors: Costello Elizabeth J. 
Published: December 2021

The quality of mental health care for children depends not only on specialist mental health services, but also on how effectively primary care providers identify, treat, and refer children with emotional and behavioral problems. Recent research has shown that primary care practitioners are the sole providers of mental health care to the majority of people with a mental disorder. For example, Regier et al1 calculated that in 1975 54.1% of persons with a mental disorder were treated only in a primary care or outpatient medical setting, with another 6% receiving care from both specialist mental health and primary care medical facilities. An additional 21.5% were not in treatment or received treatment from nonmedical agencies. If the data were extrapolated for all age groups, these rates would imply that only one child in five with a mental disorder is receiving specialist treatment, three are in the care of a pediatrician, and one is receiving no treatment. This would lead to the conclusion that pediatricians are, according to Regier et al,1 the de facto mental health service for most children in need of such care. It would lend support to the drive to increase pediatricians' awareness of, and training for, the mental health component of their work.2 In this paper, we review the published evidence as it applies to children.
SCOPE
This review includes the published studies of mental health problems diagnosed by primary care pediatricians, family practitioners, or pediatric nurse practitioners working in outpatient settings in the United States. These include private pediatric practices, group practices, health maintenance organizations (HMOs), and other types of prepaid group practices.
The questions addressed are: (1) What proportion of the children seen by primary care pediatricians and their colleagues are diagnosed by them as having a mental disorder? (2) What proportion of children are referred for specialist evaluation and treatment? (3) What risk factors are associated with a higher probability of receiving a diagnosis of psychopathology? (4) How accurate are primary care pediatricians' diagnoses of mental health problems?
Low Birth Weight, Vital Records, and Infant Mortality
Authors: WEGMAN MYRON E. 
Published: December 2021

About one tenth of all infant deaths occur in babies weighing less than 500 g at birth, almost all of whom die very shortly thereafter. In 1983, when the United States reported 3,638,933 live births, 4,368 of them were less than 500 g; that year there were 26,507 neonatal deaths. This means that slightly more than 0.1% of all live births contributed to 17% of neonatal mortality. Given this order of magnitude, any change in the numbers relating to these tiny babies can have a disproportionate influence on reported infant mortality and on interstate comparisons. Two questions promptly arise. How accurate and meaningful are the data regarding babies born weighing less than 500 g? What can be done to decrease the deaths in this category?
Wilson et al1 call attention to how the number of very low birth weight infants reported by a state may be affected by the state's definition of a live birth.
Use and Abuse of the Apgar Score
Authors:   Committee on Fetus and Newborn
Published: December 2021

The Apgar score, devised in 1952 by Dr Virginia Apgar, is a quick method of assessing the state of the newborn infant.1,2 The ease of scoring has led to its use in many studies of outcome. However, its misuse, as in current International Classification of Diseases, revision 9, coding, has led to an erroneous definition of asphyxia.* Although the Apgar score continues to provide a convenient shorthand for reporting the state of the baby and the effectiveness of resuscitation, the purpose of this statement is to place the Apgar score in its proper perspective as a tool for assessing asphyxia and for prognostication of future neurologic deficit.
The Apgar score is comprised of five components: heart rate, respiratory effort, tone, reflex irritability, and color, each of which can be given a score of 0, 1, or 2 (Table).
FACTORS THAT MAY AFFECT THE APGAR SCORE
Although rarely stated, it is important to recognize that elements of the score such as tone, color, and reflex irritability are partially dependent on the physiologic maturity of the infant. The normal premature infant may thus receive a low score purely because of immaturity with no evidence of anoxic insult or cerebral depression.
Maternal sedation or analgesia may decrease tone and responsiveness. Neurologic conditions such as muscle disease or cerebral malformations may decrease tone and interfere with respiration. Cardiorespiratory conditions may interfere with heart rate, respiration, and tone. Thus, to equate the presence of a low Apgar score solely with asphyxia represents a misuse of the score.
High-Frequency Ventilation and Tracheal Injuries
Authors: WISWELL THOMAS E. , CLARK REESE H. , CORNISH J. DEVN 
Published: December 2021

To the Editor.—
We read with interest the study of Mammel et al.1 However, we wish to address several aspects of the report regarding the design of the investigation, their interpretation of the results and of other reports, and the conclusions they make.
First, we take exception to the title itself. Unfortunately, many pediatricians and neonatologists do not make any distinction between the various types of nonconventional, high-frequency ventilators. High-frequency ventilation is a generic term encompassing several very different modalities of ventilation including high-frequency positive pressure ventilation, high-frequency flow interruption, high-frequency jet ventilation, and high-frequency oscillatory ventilation.
Tactile/Kinesthetic Stimulation Effects on Preterm Neonates
Authors: FIELD TIFFANY 
Published: December 2021

In Reply.—
In response to Saigal and Whyte, we would agree that there are some methodologic weaknesses in our study. Indeed, we acknowledged these as caveats in our paper. But we will try to clarify the "perplexing problems" raised by Saigal and Whyte.
First, Saigal and Whyte suggest that they did not understand our stratification procedure. Because matching infant-for-infant on critical variables is virtually impossible with neonates in a neonatal intensive care unit (NICU), stratification is used as a close-to-matching process.
Questions About Early Enteral Feeding Study
Authors: LA GAMMA EDMUND F. 
Published: December 2021

In Reply.—
Response to Edwards and Johnson: From a statistical perspective, we are aware of the potential risk of false-negative results based on a straight forward power analysis of the data we presented. However, due to the number of known, and perhaps greater number of unknown, variables, the level of complexity, and the diversity of clinical approaches to the medical problems in critically ill neonates, we sought to execute our protocol during an 8-month period of "stable staffing and management approaches."
Influenza: A Shot or Not?
Authors: Hall Caroline Breese 
Published: December 2021

Few viruses have acquired over decades such notoriety as influenza and such interesting sobriquets as "Lady Influenza," "The Last of the Great Plagues," "The Spanish Flu," and "Blitz Katarrh." Each year, sages convene to predict the Lady's itinerary and wardrobe, her antigenic cloak for the next season's debut and to thus pick the comparable components for the vaccine. Each fall, reminders and recommendations for immunization are issued, and sentinels across the country pronounce her pace to physicians, public, and press.
Despite this annual concern and cost, the vaccine against influenza is poorly used. Less than 20% of those recommended for yearly immunization receive the vaccine, and in children the estimates are as low as 1% to 7%. Influenza vaccine, thus, has the dubious distinction of being associated with the lowest compliance rate of any recommended vaccine in pediatrics.
SYNDROME OF OVARIAN AGENESIS (CONGENITALLY APLASTIC OVARIES)
Authors: SILVER HENRY K. 
Published: December 2021

A proved case of the syndrome of ovarian agenesis, short stature, multiple congenital abnormalities and high urinary gonadotropins in a 2 year, 8 month old female is presented.
Congenital anomalies included webbed neck, abnormalities of the feet, a moderate degree of cubitus valgus and defects of the vertebrae.
Only slight retardation of epiphyseal development was present by the fourth year of life.
Because of the marked variations in the levels of urinary gonadotropins in this patient, it is suggested that more than one assay should be performed in a preadolescent girl before it is concluded that the gonadotropins are not increased.
FIBROUS STERNOMASTOID TUMOR OF INFANCY
Authors: GRUHN JOHN , HURWITT ELLIOTT S. 
Published: December 2021

A case of sternomastoid tumor of infancy is described which presented clinically as a neck mass without torticollis and simulated a neoplasm.
Four aspects of the problem are discussed: (1) the relationship of tumor and torticollis; (2) the etiology and pathogenesis; (3) the differential diagnosis from sarcoma; and (4) the treatment.
Prophylactic resection of the mass to exclude a possible malignant tumor or to prevent the subsequent development of torticollis, is not justified, since in about 80% of cases spontaneous regression occurs without sequelae.
The institution of passive neck exercises over a period of several months during and following degression of the mass may contribute to a decreased incidence of deformities.
CLINICAL OBSERVATIONS ON TRICHOCEPHALUS TRICHIURUS (WHIPWORM) INFESTATION IN CHILDREN
Authors: JUNG RODNEY C. , BEAVER PAUL C. 
Published: December 2021

Of about 2000 hospitalized children whose stools were examined routinely, 18% were infested with Trichocephalus trichiurus. The heavy infestations (over 30,000 eggs/ cc.), which consistently produced diarrhea and dysentery, were most common in children 2 to 4 years of age. A significant correlation existed between worm-burden and incidence of amebiasis.
A successful technic for the treatment of trichocephaliasis is described. The importance to the clinician of measuring worm burden is emphasized.
ATRESIA OF THE INTRAHEPATIC BILE DUCTS
Authors: AHRENS EDWARD H. , HARRIS RUTH C. , MACMAHON H. EDWARD 
Published: December 2021

Case histories of four patients with atresia of the intrahepatic interlobular bile ducts are reviewed. Three of the four also had anomalies of the extrahepatic bile ducts. All had secondary biliary cirrhosis. The course of disease was distinguished by a relatively long life span, all patients surviving more than three years and one remaining alive at five years. Generalized skin xanthomatosis occurred in all patients, together with a marked and characteristic elevation of the serum lipids.
There was no indication on postmortem examination that intrahepatic bile ducts had developed and then become obliterated. The evidence presented in this study suggests that absence of interlobular bile ducts is a developmental anomaly, and that the embryologic development of biliary epithelium is normally independent of the growth of hepatic trabeculae.
SPECIAL REVIEWS
Authors: HAMMON W. McD. 
Published: December 2021

AMONG a large group of neurotropic viral infections of man, poliomyelitis is currently of greatest importance to pediatricians of most countries. In all areas of the temperate and tropical zones where surveys have been made, poliomyelitis infection rates, as measured by the neutralization test, are approximately the same as those for rubeola or other common acute infectious diseases of childhood. In many countries the fatal and paralytic cases assume considerable importance in pediatric practice and, above all, in public interest and demand for control, In many tropical and subtropical areas, however, paralytic rates are reputedly low, and this disease is not recognized as a problem of any importance.
In some areas of the world other neurotropic viruses assume an importance equal to or greater than that of poliomyelitis. Epidemics of these other viruses may occur at intervals as frequent as those of poliomyelitis epidemics or at longer or shorter intervals, but when epidemics do occur they are occasionally of major proportions. Outbreaks of Japanese B encephalitis have occurred principally in children in the past 15 years in Japan, Okinawa and certain other Far Eastern areas. Western equine encephalitis virus has been responsible for important outbreaks in children in the central valley areas of California, and the St. Louis virus has also been responsible for local outbreaks involving principally children in the western United States. These viruses are all members of the arthropod-borne group of viral encephalitides.
Epidemic parotitis, although not usually listed among the neurotropic viruses, has come to occupy a more and more important position as the serologic tests for its diagnosis have received more widespread use in the diagnosis of cases of the nonbacterial meningoencephalitides.
School Performance and Theophylline
Authors: WEINBERGER MILES , LINDGREN SCOTT , JOAD JESSE 
Published: December 2021

To the Editor.—
Dr Rachelefsky and his colleagues reported, first in USA Today (Dec 2, 1986, p 1) and later in Pediatrics (1986;78:1133-1138) that theophylline adversely affected school performance. Specifically, they stated, "Teachers said kids couldn't sit still, they weren't remembering as well, they were acting up, and their handwriting had changed" (USA Today). They concluded that "the short-term administration of theophylline to asymptomatic asthmatic children not receiving oral bronchodilators can adversely affect school performance and behavior" (Pediatrics).
Gift to a Litigious Society
Authors: GARSON ARTHUR 
Published: December 2021

In Reply.—
I sincerely appreciate the letter from Dr Sapire and his colleagues because it permits me to reemphasize the conclusion of my article "None of the suggested management strategies for these patients should be taken as an absolute rule because there may be differences of opinion among various pediatric cardiologists. Nonetheless . . . a great deal of consideration should be given to these patients." There certainly is room for disagreement on the verapamil issue, as well as other points in the article.
Child Health and the 1987 Nobel Peace Prize
Authors: HANSON LARS Å. 
Published: December 2021

The Nobel Peace Prize for 1987 was awarded to Dr Oscar Arias, President of Costa Rica. Almost all of the comments referring to this have related to Dr Arias' peace plan for Central America. This important peace plan was probably a significant factor for the Nobel Committee but not the only argument for awarding the prize to the foremost representative of the remarkable country of Costa Rica. I proposed the nomination of Dr Arias for the last 5 years and a major reason was his accomplishments in Costa Rican child health.
Costa Rica is located between Panama and Nicaragua.
Too Much Lead, Too Little Iron
Authors: CLARK MARGARET 
Published: December 2021

In Reply.—
We appreciate the work of Carraccio et al which confirms our findings that the anemia found in children with lead poisoning results from coexistent iron deficiency. The discrepancy between the two studies concerning the predictive value of blood lead in elevations of erythrocyte protoporphyrin bears further exploration. What is striking, however, is that in both series more than 50% of the variability in erythrocyte protoporphyrin remains unexplained. Now the public health focus is on detecting children with low blood lead levels—before even subtle CNS damage has occurred.
DR JOHN BROWN OF EDINBURGH ON THE DANGERS OF GIVING LAUDANUM TO CHILDREN (1858)
Authors: C. T. E. 
Published: December 2021

John Brown, M.D. (1810-1882), remarkable for his close and accurate clinical observations, was the author of a three-volume collection of essays entitled Horae Subsecivae (i.e."leisure hours"). Many consider these essays to be among the greatest of humanistic essays on medicine published during the 19th century.
Brown in his warning below stressed the terrible consequences of dosing children with laudanum.
There is another practice which I must notice, and that is giving children laudanum to make them sleep, and keep them quiet, and for coughs and windy pains. Now, this is a most dangerous thing. I have often been called in to see children who were dying, and who did die, from laudanum given in this way. I have known four drops kill a child a month old; and ten drops one a year old. The best rule, and one you should stick to, as under God's eye as well as the law's, is never to give laudanum without a doctor's line or order. (Brown was directing his comments to parents).
Genital Lichen Sclerosus Mistaken for Child Sexual Abuse
Authors: JENNY CAROLE , KIRBY PHILIP , FUQUAY DIANE 
Published: December 2021

Because of heightened awareness about sexual abuse, it is important for physicians to differentiate between genital lesions associated with abuse and those associated with "natural" disease processes.
Lichen sclerosus is a disease of the skin most often found in the vulvar and perianal areas of postmenopausal women. It is less commonly seen in prepubertal female children and premenopausal adult women. Cases of lichen sclerosus have also been reported on the male genitalia, and it is an uncommon cause of phimosis in boys.
One of the clinical manifestations of lichen sclerosus is cutaneous bleeding causing lesions resembling "blood blisters" or bruises.
Nursing Perspective
Authors: Earles Ann 
Published: December 2021

Newborn screening may be the single most important recent advance in the treatment of sickle cell disease. However, the efficacy of newborn screening depends on adequate patient education, counseling, and follow-up medical care. In large part, it is the nurse's responsibility to ensure that these follow-up services are provided.
The Northern California Comprehensive Sickle Cell Center at Children's Hospital, Oakland, has a regional newborn hemoglobinopathy screening program that identifies approximately 15 newborns with sickle cell disease annually. Obstetrical nurses collect an umbilical cord blood sample from all babies born at the ten participating institutions. Samples are sent to the reference hemoglobinopathy laboratory at Children's Hospital, and diagnostic results are available within 1 week of birth.
When a diagnosis of sickle cell disease is made, the genetic counselor discusses the case with the sickle cell nurse coordinator and physician. The responsible private physician and obstetrician are personally notified. In most cases, the family receives a telephone call from the genetic counselor approximately 1 week after the birth. An appointment is then made in the next week for laboratory confirmation of diagnosis and initiation of counseling. At the confirmation appointment, the family and patient are introduced to the sickle cell nurse coordinator, and a comprehensive sickle cell clinic appointment is made for the following week. At this appointment, a "new family letter" introducing the rest of the sickle cell staff is reviewed with the family by the nurse, and a copy is given to the family. This letter outlines the comprehensive services available to patients and contains information to familiarize them with our particular clinical services and policies.
DROWNING DRUG RESEARCH
Authors: L. J. F. 
Published: December 2021

A woman files a lawsuit against a pharmaceutical company, claiming that her baby's birth defects were caused by the use of one of the company's products, a contraceptive gel. The Food and Drug Administration earlier had reviewed the data concerning the product, and concluded that it was safe. The scientific evidence notwithstanding, an appellate court awarded the woman $4.7 million. Stories such as the outcome of Wells v. Ortho Pharmaceutical Corp. have of course become routine news today. Not so familiar to the public, however, is the effect such lawsuits are having on pharmaceutical innovation in the U.S.
The discounting of medical evidence in court is only one of the problems that has inhibited medical research and testing, according to a report released by the American Medical Association. "The Impact of Product Liability on the Development of New Medical Technologies" argues that research and testing of vaccines, contraceptives and other medical therapies are in a state of paralysis because of the explosion of product-liability litigation. . .
REVIEWS OF LAY LITERATURE ON CHILD CARE: WHAT PARENTS ARE READING
Authors: Glascoe Frances P. , Moore William R. , Henderson James , Martin Elaine D. 
Published: December 2021

Caplan F, ed. The First Twelve Months of Life: Babies Growth Month by Month. 3rd ed. New York, NY: Bantam; 1984; list price $4.95 (#14 on the 1988 bestseller list of books on child care of the Ingram Book Co, distributors of trade books).
Covering prenatal and infant development, the author relies on a multivariate theory of development in which the parents' roles include controller of environments, model of ideal behavior, nurturer, and instructor. Parents have identical roles. Management methods are generally behavioral and include positive reinforcement, both social and tangible, as well as punishment. Methods are designed to be preventive, corrective, and instructive. Specific practices in child-rearing and development are covered in detail and are based on empirical studies. The author is sensitive to parents' needs and fears and addresses other social issues such as environmental pressures, but not the needs of exceptional children. Intact families and material resources are presumed. The text is wellorganized, and development is detailed in month-by-month charts, photographs, and descriptions. It is moderately difficult to read. The medical content was rated as excellent with the exception of the outdated immunization schedule.
Plasma Aluminum Measurements in Term Infants Fed Human Milk or a Soy-Based Infant Formula
Authors: LITOV RICHARD E. , SICKLES VIRGINIA S. , CHAN GARY M. , SPRINGER MARY A. , CORDANO ANGEL 
Published: December 2021

Aluminum is the most abundant metal in the earth's crust. There is a constant environmental exposure to this element because it is ubiquitous. Under usual conditions, dietary aluminum has not been shown to have any deleterious effects because aluminum is poorly absorbed and readily excreted in the urine. However, aluminum may be a health concern in patients with compromised kidney function and those receiving total parenteral nutrition. Aluminum, if retained, results in an increase in the concentration of body aluminum.
There has been some recent interest in the exposure of infants to aluminum, especially in those infants with immature or impaired renal function.
Bone Marrow Transplants
Authors: OGDEN ANGELA KENT , STEUBER C. PHILIP 
Published: December 2021

To the Editor.—
Bone marrow transplantation has been increasingly undertaken and found effective for a variety of otherwise incurable diseases. As with all new therapies, the economic and ethical impact of the procedure requires continuing reevaluation. Durbin1 clearly stated the dilemmas faced by transplantation centers, insurance carriers, government agencies, and the public in general. Furman2 offered a limited view of transplantation and stated that bone marrow transplantation "may be neither ethical nor imperative as a therapy for dying children."
Infant Feeding and Infectious Disease
Authors: AGRE FRED 
Published: December 2021

To the Editor.—
In the article "Relationship Between Infant Feeding and Infectious Illness: A Prospective Study of Infants during the First Year of Life" the authors comment on the methodologic failures of other studies.1
These failures include: (1) prospective data on infection and feeding, (2) specifying what is meant by infectious illness and breast-feeding, (3) controlling for other variables, and (4) exposure to illness through time.
Such a study accounting for the above methodologic flaws was conducted by me and reported in the American Journal of Diseases of Children.2