bluuebunny/crossref_metadata_2025_split huggingface dataset:
VINYL CHLORIDE
Authors: Miller Robert W. 
Published: December 2021

A 1½-day international symposium was held in New York primarily on liver disease from heavy industrial exposure to vinyl chloride. Worldwide, 19 workers are known to have developed hepatic angiosarcoma: 13 in the United States, two in West Germany, two in Sweden, and one each in Great Britain and Norway. The interval between first vinyl chloride exposure and diagnosis was 11 to 30 years. Duration of exposure was the same-11 to 30 years.
According to a New York Times report on June 1, 1974, a review of cases of hepatic angiosarcomas in the New York and Connecticut Tumor Registries yielded two of special interest. One was a 62-year-old woman who for nearly 30 years lived four blocks (about 0.3 km) from a factory where polyvinyl chloride (PVC) was made. The other was a worker who for 30 years used PVC resin to make insulation for electrical wire. A causal relation in these cases cannot be established. They do suggest, however, the possibility (perhaps remote) that carcinogenic exposures may occur from living in the neighborhood of a vinyl chloride factory or from certain polyvinyl plastics that contain the vinyl chloride monomer.
PARACELSUS ON WHAT THE PHYSICIAN SHOULD KNOW
Authors: C. T. E. 
Published: December 2021

Paracelsus (1493?-1541) was one of the most remarkable figures in medicine. He firmly opposed the humoral theory of disease championed by Galen. He was first to write on miners' diseases, to establish the relationship between cretinism and endemic goiter and to note the geographic differences in disease.
Osler said that Paracelsus was "the Luther of medicine, for when authority was paramount he stood for independent study." Paracelsus believed the physician should know the following things:
The physician should know what is useful and what is harmful to unfeeling creatures to sea monsters and fish: what is pleasing and what is hateful to animals bereft of reason; what is healthy for them and what is unhealthy. This is what we must learn about Nature. What else? The powers of magic formulas, their origin and source, their nature: who is Melusina; who the Siren is; what is permutation, transplantation and transmutation; how to grasp them and how to understand them perfectly; what surpasses nature, species, life; the nature of the visible and of the invisible, of sweet and bitter; what has a good taste; what death is; what is used by the fisherman, the leather-worker, the tanner, the dyer, the blacksmith, the wood carver; what goes into the kitchen, in the cellar, in the garden; what concerns weather, the hunter's art and the miner's trade; the life of the vagabond and the homelover, the needs of the countryside and the causes of peace; the interests of the layman and the cleric; the occupations and the nature of different states, their origin; the nature of God and of Satan, poison and antidote, feminine nature and masculine nature; the difference between women and maidens, between yellow and buff; what is white, black, scarlet and grey; the reason for multiplicity of colours, for short and for long, for success and for failure; and how to obtain all these results.1
The Pediatrician in Community Dental Health
Authors: Leske Gary S. , Leske M. Cristina Vera 
Published: December 2021

Dental disease in children is one of the most common health problems encountered.1-3 Fifty percent of children have one or more carious teeth by the age of 2 years. Gingivitis occurs in a major portion of the child population and may lead to periodontal disease, the leading cause of tooth loss in adults. Cleft palate, with or without cleft lip, occurs once in every 700 births. Half of the school-age population has some form of malocclusion. So prevalent are these problems and so great is the backlog of dental neglect, that treatment of these defects is beyond the capabilities of the limited dental manpower we have in this country. In addition, treatment is time-consuming and expensive and the costs of dental services are constantly rising. It is obvious from these facts that dental disease cannot be controlled by treatment alone. It is only by preventing the occurrence of new disease, beginning with the child, that the problem of dental disease can be brought into a manageable form.
Pediatricians are in a unique position to have a significant impact on the dental health of their patients and communities. Since the pediatrician gives care to the child from birth, he can detect any existing abnormality early in life and promptly refer or treat the problem. Control of dental disease can best be accomplished if preventive measures are started shortly after birth. It is interesting to note that few children are seen by the dentist at the recommended age of 2½ to 3 years.
JACOB A. RIIS ON CHILDREN LIVING IN TENEMENTS (1892)
Authors: C. T. E. 
Published: December 2021

Jacob A. Riis (1849-1914), a Danish-American journalist and social reformer, shocked the American conscience in his book How the Other Half Lives (1890), by his exposé of the horrors of New York City slums and the abuses of lower-class urban life. The following quotation from his book, The Children of the Poor (1892) unfortunately is still applicable today-82 years later!
The tenement and the saloon, with the street that does not always divide them, form the environment that is to make or unmake the child. The influence of each of the three is bad. Together they have power to overcome the strongest resistance. But the child born under their evil spell has none such to offer. The testimony of all to whom has fallen the task of undoing as much of the harm done by them as may be, from the priest of the parish school to the chaplain of the penitentiary, agrees upon this point, that even the tough, with all his desperation, is weak rather than vicious. He promises well, he even means well; he is as downright sincere in his repentance as he was in his wrongdoing; but it doesn't prevent him from doing the very same evil deed over again the minute he is rid of restraint. He would rather be a saint than a sinner; but somehow he doesn't keep in the rôole of saint, while the police help perpetuate the memory of his wickedness. After all, he is not so very different from the rest of us.
The Fetoplacental Circulation During Parturition: Evidence From Residual Placental Blood Volume
Authors: Klebe Joachim G. , Ingomar Carl Johan 
Published: December 2021

The volume of blood left in the fetal part of the placenta after early clamping of the umbilical cord (residual placental blood) was measured in 24 deliveries, and found to be larger among infants born by the vaginal route compared to those born by cesarean section. The result is interpreted as an evidence of a temporary depositing of blood in the placenta during the second stage of labor. As early clamping of the umbilical cord, therefore, among cases of vaginal deliveries, amounts to a blood-letting of about 30 ml of the newborn infant's own blood, it is considered not to be a physiological procedure. The investigation has also demonstrated that the residual placental blood, among cases of vaginally delivered and early clamped infants, fails to represent the intrauterine distribution of the fetoplacental blood volume. Finally, the investigation shows that the placental transfusion, which takes place in late clamped infants, partly originates from previously deposited fetal blood, partly from placental blood.
See table in the PDF file.
See image in the PDF file.
See image in the PDF file.
ACETAMINOPHEN POISONING—A CRITICAL COMMENT
Authors: Matthew Henry 
Published: December 2021

Editor, Pharmacology for the Pediatrician:
In the December 1973 issue of Pediatrics there appeared an article attempting to summarize the British experience of acetaminophen overdosage.1 This drug has caused considerable concern in Britam, largely because, having been advocated as a substitute for salicylate,2 little thought was given when advising such change that it is more dangerous in overdose than aspirin.3 More than 30 informative papers have appeared in the British literature since 1966 on acetaminophen overdose. However, little toxicity has been reported from the United States where I understand it is usually regarded as a benign ingestion. This attitude would suggest that the diagnosis of acetaminophen overdose is being missed in patients with jaundice or severe hepatic damage of apparently unknown etiology. However, Dr. Barry Rumack, of the University of Colorado Medical Center, has pointed out to me that 68 overdosings were encountered there during the past year, with three deaths, two of adolescents.
The paper by Goulding in the December issue requires critical comment regarding some of the factual information, certain omissions, and the views expressed. His statements regarding numbers of children involved in acetaminophen and aspirin poisoning in the United Kingdom are maccurate and misleading. In the first place, his reference 3 contains no mention of admissions of children to hospital for acetaminophen overdose. Under his reference 4 he states that admissions to hospital in England and Wales for accidental aspirim overdose in children under 5 years during 1970 was "about 6,000." Consultation of the reference shows that the total number in the age group mentioned admitted for all analgesic overdose was but 626!
Misconceptions Regarding Grasshopper Allergy
Authors: Bergner Renée K. 
Published: December 2021

The case report, "Grasshopper Allergy,"1 was of interest. However, it suggested several misleading conclusions
1. That "testing proved a definite sensitivity to grasshopper extract."1 It should be pointed out that positive immediate skin tests may perhaps present some evidence for the existence of IgE antibodies in the skin—only. Testing did not prove a cause and effect relationship between the presence of such antibodies and the patient's symptoms of hives and angioedema.2 The hives and angioedema may have been mediated by other innumerable, inhalant antigens commonly found on football fields, or by mechanisms other than antigen-IgE hypersensitivity.3
Athletic Activities for Children Who Are Mentally Retarded
Authors: Thornton Melvin L. , Diamond Eugene F. , Garvin John P. , Heffelfinger John C. , Kennell John H. , Poncher John R. , Schell Norman B. , Shackleford E. C. , Shaffer Thomas E. 
Published: December 2021

Recreation and athletic activity are important for all children, regardless of their mental capacity. A physician's recommendation about athletic activity for mentally retarded children, as is true with other children, must take into account differences in size, coordination, degree of physical fitness, and physical health. The stage of maturation, the level of mental development, and the emotional stability of the child are all important considerations when organizing activities for children who are mentally retarded. Children with average mental development usually have multiple opportunities for athletic activities and recreation without special planning. In contrast, there is a tendency for parents and children in most communities to exclude the mentally retarded child so he completely lacks the type of exercise and personal experiences he needs. Children who are mentally retarded frequently are not physically fit, have poor coordination, and are obese. These conditions become progressively more severe as the retarded child grows older, partly as a result of limited opportunity for athletic activity. The majority of mentally retarded children can and should participate safely and productively in athletic activities when appropriate supervision is provided.
Parents of children who are mentally retarded are often confused and uncertain about what to expect from their child. Some tend to restrict their youngsters from physical activities, and others may push their children at too rapid a pace. However, most parents are anxious for guidance to help determine what is best for their child. The pediatrician is in a unique position to advise these parents because he is likely to know the family and to know the emotional and personal needs of the child and his physical capabilities.
Interspersed Advertising
Authors: Hervada Arturo R. 
Published: December 2021

I have carefully read Dr. Frazier's statement1 in the December issue regarding the publication of Pediatrics. I have also read Dr. Wineberg's letter on the same matter.2
I personally agree with Dr. Wineberg. A very important question on this whole issue, unfortunately unanswered by Dr. Frazier in his commentary, is why, on what grounds, the decision to intersperse pharmaceutical advertising was made? Because, if the real reason—as I can sense between the lines—was the pharmaceutical industry's threat to withdraw their advertisements unless you publish them all over the Journal, then I object to such a decision.
CESAREAN SECTION PERFORMED WITH SUCCESS BY AN ILLITERATE IRISH MIDWIFE IN 1738
Authors: C. T. E. 
Published: December 2021

To read about major surgical operations being performed by untrained laymen before the discovery of anesthesia and the beginning of modern medical practice fills one with profound sympathy for the patient's harrowing ordeal.
Imagine the suffering of poor Alice O'Neal on whom a cesarean section was performed in January 1738 by an illiterate midwife as described below by Mr. Duncan Stewart, Surgeon in Dungannon in the County of Tyrone, Ireland.
(I believe this is the first reported cesarean section performed in the United Kingdom from which the mother recovered.)
Alice O'Neal, aged about 33 years, Wife to a poor Farmer near Charlemont, and Mother of several Children, in January 1738 took her Labour-Pains; but could not be delivered of her Child by several Women who attempted it. She remained in this Condition twelve Days; the Child was judged to be dead after the third Day. Mary Donally, an illiterate Woman, but eminent among the common People for extracting dead Births, being then called, tried also to deliver her in the common Way: And her Attempts not succeeding, performed the Caesarian Operation, by cutting with a Razor first the containing Parts of the Abdomen and then the Uterus; at the Aperature (sic) of which she took Out the Child and Secundines. The Part of the Incision was an Inch higher, and to a Side of the Navel, and was continued about six Inches downwards in the Middle betwixt the right Os Ilium and the Linea alba. She held the Lips of the Wound together with her Hand, till one went a Mile and returned with Silk and the common Needles which Taylors (sic) used: with these she joined the Lips in the manner of the Stitch employed ordinarily for the Hare-lip, and dressed the Wound with whites of Eggs, as she told me some days after, when led by Curiosity I visited the poor Woman who had undergone the Operation.
Ultrasonography in Children
Authors: Grossman Herman , Felman Alvin , Kirkpatrick John A. , Shopfner Charles H. , Swischuk Leonard E. , Taber Paddy , Tefft Melvin , Goldberg Barry B. 
Published: December 2021

Ultrasound is the manifestation of a high frequency mechanical vibration. The sound waves produced are beyond the range of human hearing, i.e., 1 to 10 mHz. The sound waves travel through liquids and solids but cannot pass through air or vacuum. Ultrasonic energy is produced by a transducer, the power to which is supplied by a high-voltage pulsing circuit in an amplifier (ultrasonoscope). Ultrasonography has been used successfully in the examination of pediatric patients. One of the most common uses has been to measure shifts of the midline structures of the brain. By utilizing the standard echoencephalographic approach established for adults, and positioning the transducer above the ears in the temporoparietal regions, echoes are recorded from the midline structures. Ultrasonography is used as a preliminary study prior to more definitive procedures such as pneumoencephalography or arteriography, particularly in the presence of localizing signs. It has also been used to detect hydrocephalus and to follow changes in ventricular size which occur after ventricular shunting procedures. In fact, this is the easiest way to serially monitor the response to decompression.
In many hospitals, ultrasonagraphy is considered to be the primary diagnostic study for the detection of pericardial effusion. Ultrasonic examination of the heart of pediatric patients with suspected congenital or acquired heart disease appears to be a promising new diagnostic technique. It has been successfully used to evaluate a number of abnormalities: great vessel transposition, cardiac chamber size and position, valve motion, and ventricular wall thickness. Extensive research is in progress to establish both normal values and patterns for differentiating various congenital abnormalities.
TRANSPLACENTAL CARCINOGENESIS
Authors: Miller Robert W. 
Published: December 2021

An overview of experimental studies concerning transplacental chemical carcinogenesis and their possible implications for man has been published by J. M. Rice (Teratology, 8:113, 1973).
Ulfelder (Amer. J. Obstet. Gynec., 17:794, 1973) believes that there may have been 10,000 to 16,000 persons exposed in utero to diethylstilbestrol, 1960 to 1970. He estimates the probability of developing adenosis or other minor morphologic anomalies in girls at not less than 30%, and guesses the risk of adenocarcinoma of the cervix or vagina to be about one in 1,000. A more precise estimate from a prospective study at the Mayo Clinic is less than seven per 1,000 by age 13 and less than 13 per 1,000 by age 22 (Lanier, A. P., et al., Mayo Chin. Proc., 48:793, 1973).
Letter to the Eitor
Authors: Henderson Arvin T. , Dahlin Irmeli , Partridge Cloyd R. , Engelsing Elizabeth Lyman 
Published: December 2021

We agree with Dr. Oettinger that considerations of etiology are highly important. We regard the etiology of hyperactivity as a "chain of events" with at least primary and secondary sources of the symptom behavior.
As primary factors we include characteristics of normal individual genetic differences in reactivity and arousability, plus intra-uterine, birth and postbirth introduced pathology.
However, we think these basic characteristics constitute only a partial explanation for the hyperactive child's typical or atypical development.
Another Unusual Complication of Amniocentesis
Authors: Jones James F. , Woodall John B. , Selter Phyllis R. , Neal Gary L. , Carter Samuel C. 
Published: December 2021

In the March 1974 issue of Pediatrics, Drs. Cook et al. describe an infant with a pneumothorax secondary to a diagnostic amniocentesis.1 We have recently treated a similar case, but with an additional, unusual finding.
A 25-year-old black woman (gravida 4, para 2, abortus 1) with sickle cell trait, previous cesarean section due to cephalopelvic disproportion, left renal calculi, and recurrent urinary tract infection, was admitted December 24, 1973 with pyelonephritis and intrauterine pregnancy. She was treated with gentamycin and progressed satisfactorily.
Nurse Practitioners for Children—Past and Future
Authors: McAtee Patricia A. , Silver Henry K. 
Published: December 2021

During the past decade there has been a significant expansion in the role of the nurse in providing patient care. Studies have shown that nurse practitioners can, by themselves, care for approximately three fourths of all those who come to ambulatory settings, and that nurse practitioners are well accepted, highly competent in assessing health status, and provide improved as well as increased health care.
It is recommended that there be more meaningful and extensive incorporation of the teaching of nurse practitioner concepts, training, and goals into undergraduate curricula of schools of nursing; that nursing students should have an opportunity to apply nurse practitioner concepts and practices in a supervised orientation and practical experience (a nursing "internship"); that less well-trained health workers (licensed practical nurses, nurse's aides, etc.) should be trained as "assistant nurse practitioners" to meet many basic health assessment and management needs; and that the scope of nursing needs to be expanded further so that its practitioners can give even more comprehensive, direct, and responsible health care to the public.
Screening in Child Health Care: Where Are We Now and Where Are We Going?
Authors: North A. Frederick 
Published: December 2021

The preceding papers1-7 in this symposium discuss criteria for evaluating screening tests and screening programs and demonstrate how these criteria can be applied to several screening techniques of particular current interest. This paper will briefly review how a number of procedures measure up to the suggested criteria for screening tests and suggest some future directions which must be pursued if screening is to be based on science rather than on polemic.
WHERE ARE WE NOW?
Table I lists a number of diseases, functions and tests which have been considered to be of use in screening. For each of these it also gives my own estimate of how well each disease meets the criteria listed by Frankenburg2 and how well the available tests meet his criteria for effectiveness, direct costs, costs of false positives, and costs of false negatives. In the following paragraphs some of the considerations which led to these judgments are discussed.
Phenyketonuria
Despite its low frequency, the cost effectiveness of screening for PKU is well demonstrated, tests are adequately sensitive and specific, and with expert management the potentially high costs of false-positive tests can largely be eliminated.3
Galactosemia
Though even rarer than PKU, current methods make routine neonatal screening both feasible and cost effective, provided that the test is combined with routine PKU screening.8
Other Inborn Metabolic Errors
With the kind of regionalized facilities and planning discussed by Scriver,3 testing for these diseases can be added to routine neonatal screening at very little additional cost. Some of them lend themselves to effective early treatment; with others, genetic counsulling is the only currently available useful intervention.
Further Analysis of Minor's Consent Bill
Authors: Ris Hania W. 
Published: December 2021

Two model bills for minors' consent for health services have been published in Pediatrics in 1973, one espoused by the Youth Committee of AAP, the other by the Society of Adolescent Medicine.1-2
In my endeavor to promote the concept of the bills among pediatricians, I became aware that an important discrepancy regarding birth control in the AAP bill is not clearly evident to the reader. One should be cognizant of it before initiating legislation.
Although "contraceptive advice and devices" are included in the definition of "Health Services" in the AAP bill, section three dealing specifically with minors' consent limits it to "any minor who professes or is found to be pregnant."
Idiopathic Hyperbilirubinemia and Phototherapy—Evidence Suggesting a Decreased Incidence of Kernicterus
Authors: Petrich C. , Göbel U. 
Published: December 2021

The recent article by Lewak1 dealing with hyperbilirubinemia and phototheraphy prompted us to try to answer the following three questions:
1. Does phototherapy reduce the incidence of kernicterus? Although Lewak's article concerns full-term healthy infants, we believe our experience with premature infants is important. From 1965 to 1967 only those premature infants whose serum bilirubin level rose higher than 18 mg/100 ml received exchange transfusions. As Table I indicates, pathologists found kernicterus in two to four children every year.