bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outpatient Pediatric Surgery in a Developing Country
Authors: El-Shafie Mohamed , Shapiro Robert P. 
Published: December 2021

A total of 5,522 outpatient surgical procedures were performed at the Children's Hospital in Kingston, Jamaica, West Indies, between 1968 and 1973. This included 2,662 general surgical procedures. There were no deaths or major complications. Parents participated actively in the preoperative and postoperative care.
Outpatient surgery can be a safe, inexpensive, and effective means of health care delivery. It is of special value in developing countries with limited facilities for inpatient care.
Recurrent Adolescent Suicidal Behavior
Authors: McIntire Matilda S. , Angle Carol R. , Wikoff Richard L. , Schlicht Marilyn L. 
Published: December 2021

Suicide is the third leading cause of death among people in the age group 15 to 25 years.1 Self-destructive behavior in children and adolescents is a continuum that ranges from drug intoxications to gestures of low lethality to suicide attempts with high lethality of intent. In our survey of 1,100 self-poisonings in people aged 6 to 18 who were seen at poison control centers we found an incidence of 220 self-poisonings for every fatality.2 This is higher but comparable to other estimates of 50 to 150 suicide gestures for every reported death from suicide in the adolescent.3-6 Suicide attempts may account for 12% of all emergency room visits.7 This represents a public health problem of the first magnitude.
It is ironically tragic that many of the adolescent suicide deaths are unintentioned-the victim did not really intend to die. In our collaborative poison study, for example, none of the six deaths could be called intended. The adolescents were not victims of suicide but of pharmacologic roulette.
The single best correlate of suicidal risk appears to be lethality of intent. A diagnosis of suicide attempt, as contrasted to a gesture, implies both a lethality of intent coupled with a mature concept of death as an irreversible state. Lethality is defined by Shneidman8 as the probability of an individual's killing himself in the immediate future. In classifying all deaths as intentioned, subintentioned, and unintentioned as contrasted to the traditional classifications of natural, accidental, suicidal, and homicidal he has used the dimension of lethality to cut across the terms attempted, threatened, and completed suicide.
Child Psychiatry and Pediatrics: The State of the Relationship
Authors: Anders Thomas F. 
Published: December 2021

A great deal of attention has been focused on the notion that child psychiatry and pediatrics should develop strong ties. Yet, a review of the literature suggests that, in spite of exhortations to the contrary, little true collaboration has developed between the two disciplines.
This study surveys the major pediatric teaching and training centers throughout the country in an attempt to assess the current state of the relationship between child psychiatry and pediatrics. Of the 82 centers surveyed, 68% responded. Although enthusiasm and desire for closer collaboration were expressed repeatedly, actual successful efforts remain minimal. Psychiatric consultations on pediatric inpatient units continue to be the predominant child psychiatry service provided. A method for achieving closer relationships between the two disciplines is proposed.
Child psychiatry and pediatrics
Authors: Rothenberg Michael B. 
Published: December 2021

Anders' survey, the report of which appears in this issue of Pediatrics (p. 616), was much needed, and I am grateful to him for it. The data that he presents certainly reflect my own experience in three major training centers during the last 25 years.
I have some trouble with his contention that "the source of the difficulty stems from the fact that neither child psychiatrists nor behavioral pediatricians have defined their areas of collaborative responsibility and effectiveness sufficiently." Also, I am not comfortable with his recommended solution to this problem.
The American tendency to stand in awe of the "scientific," especially on a molecular level, leaves many pediatric faculty members with a conscious or unconscious feeling that they would somehow lose prestige and status were they to focus their teaching efforts in the behavioral pediatrics arena.1
"We Won't Leave You"
Authors: Schowalter John E. 
Published: December 2021

Few things compare in sluggishness to institutional inertia. Changing hospital procedures to better care for the physical and emotional needs of children is more often advocated than done. A recently released film, "We Won't Leave You,"1 produced by Dr. Edward Mason at the Massachusetts General Hospital, raises in a positive but provocative way a number of important issues in this regard.
Briefly, in cinema verité technique the 17-minute film follows a 5-year-old girl from two days before her outpatient surgery for bilateral hernias through her eight-hour stay in the hospital to her recollection of the experience that same evening. The girl's mother, a nurse, is adamant about wanting to be with her child as much as possible during the ordeal, and this leads her to agree to the daughter's one-day surgery.
THE THERAPEUTIC VALUE OF BLOODLETTING IN A CHILD SUFFERING FROM SEVERE COMPLICATIONS OF POSTSCARLATINA GLOMERULONEPHRITIS IN 1897: THE FALLACY OF POST HOC, ERGO PROPTER HOC REASONING
Authors: C. T. E. 
Published: December 2021

Bloodletting until as late as the end of the 19th century was falsely considered by many physicians to have a curative effect on poststreptococcal glomerulonephritis in children because few, if any, i9th century physicians were aware that this form of acute glomerulonephritis has a very favorable prognosis, irrespective of its initial severity. An excellent example of the fallacy of post hoc, ergo propter hoc reasoning is the following case history, published in 1897.
A boy, 8 years old, well developed, was affected with a mild form of scarlatina. The disease had about abated when a grave nephritis supervened. The eyelids were edematous; the urine contained about 1 per cent albumin and showed, microscopically, white and red blood-cells, renal epithelia and numerous granular casts. The heart was normal, the pulse 96 per minute; the general condition, which was fair at the onset, became worse. Without somnolence or other distinct premonitory symptoms uremia supervened suddenly, with four rapidly succeeding convulsive attacks, one of which lasted about half an hour and affected particularly the right half of the body. Chloroform inhalations caused momentary relief but did not prevent repetition of the convulsive attacks, which ensued with greater frequency and intensity. The child was apparently moribund. As the pulse was still strong, however, venesection was resorted to, though very little hope was held out for recovery. About 100 cc. of blood were withdrawn from the right median cephalic vein. The result was more striking than any the observer had ever noticed following therapeutic intervention.
Increased Incidence of Gram-Negative Neonatal Sepsis With Intramuscular Iron Administration
Authors: Barry D. M. J. , Reeve A. W. 
Published: December 2021

During a five-year period the incidence of neonatal sepsis was 20 times higher in Polynesian newborns compared with European newborns (11 per 1,000 vs. 0.6 per 1,000 total births). This high incidence in Polynesians was confined to a period when the infants were being given intramuscular iron dextran. When the iron administration was stopped the incidence of disease in Polynesians decreased from 17 per 1,000 to 2.7 per 1,000 total births.
An analysis of the Polynesian iron-treated and non-iron-treated groups showed a statistically significant difference in the incidence of sepsis, the type of causative organism, and mortality.
The data suggest that the iron dextran injections have impaired the immunity of the treated infants, making them more susceptible to Escherichia coli sepsis.
Dr. Hennekens et al. Reply
Authors: Hennekens Charles H. , Jesse Mary Jane , Blumenthal Sidney , Klein Barbara E. , Gourley Janet E. 
Published: December 2021

Both of these letters concern the general issue of the influence of genetic determinants on elevated cholesterol levels. A general comment relevant to the concerns of both letters is that our findings reflect those of a descriptive, not an analytic study. Our purpose does not include etiologic considerations (i.e., relative roles of genetics and environment in elevated childhood cholesterol level).
Dr. Williams first suggests the possibility that our findings of higher mean levels of cholesterol among children of affected men compared with children of healthy men may be attributable to our failure to exclude kindreds with hypercholesterolemia.
COST-BENEFIT RATIO OF RAISING CHILDREN
Authors: Harris Martin 
Published: December 2021

"...the motivation to restrict fertility is essentially a question of the balance between the benefits and costs of parenthood. With industrialization, the cost of rearing children increases—especially after the introduction of child labor laws and compulsory education statutes—because the skills which a child must acquire in order to earn a living and be of benefit to its parents take longer to learn. At the same time, the whole context and manner in which people earn their livings becomes transformed. The family ceases to be the locus of any significant form of production activity (other than that of cooking meals and begetting children). Work is no longer something done by family members in or near the family or business. Rather, it is something done at an office, store, or factory in the company of other people's family members. Hence the return flow of benefits from rearing children hinges more and more on their economic success as wage earners and their willingness to help out in the medical and financial crises that parents can expect in their waning years.
The availability of painless contraception and the altered structure of economic tasks—the contraception revolution and the job revolution—provide the key to many puzzling aspects of contemporary social life. Longer life spans and spiraling medical costs make it increasingly unrealistic to expect children to give comfort and security to their aging parents. Thus we are in the process of substituting old-age and medical insurance programs for the preindustrial system in which children took care of their aged parents.
Bacterial Vaccines and Infectious Asthma
Authors: Mueller Harry Louis 
Published: December 2021

In the article that reviewed the rational management of allergic disease (Pediatrics 60:320, September 1977), Twarog and Colten's statements, made as though factual, are in reality opinions; they also attempted by innuendo to turn a simple fact into a questionable state. I refer to the use of the label "so-called" as an adjective describing bacterial vaccines. These vaccines are in fact bacterial vaccines. I believe their bias is showing.
An article that reviews the work of others, in a field where the reviewers have done no investigative studies themselves, should certainly quote accurately and then indicate that their conclusions are opinions.
Insulin Allergy in a 19-Month-Old Boy with Newly Diagnosed Diabetes Mellitus
Authors: Wishner Kathleen L. , Fisher Lynda K. , Kumar Dinesh 
Published: December 2021

Systemic insulin allergy is rare and usually occurs in adults with diabetes mellitus following reinstitution of insulin therapy.1,2 The present case is unusual in that the systemic symptoms appeared 23 days after initial continuous treatment with insulin in a very young child.
CASE REPORT
An 18-month-old boy was seen by his pediatrician six weeks after a severe episode of varicella, with a monilial diaper rash and a three-week history of polyuria, polydipsia, polyphagia, and weight loss. The blood glucose concentration was 534 mg/100 ml and serum ketones were present. Diabetes mellitus was diagnosed. He was hospitalized and insulin therapy was instituted without incident; the patient was discharged on a daily mixed dose of regular and isophane (NPH) insulins (single-peak, beef-pork mixture, Eli Lilly & Co).
Cardiac Tamponade from Central Venous Catheterization: Two Cases in Premature Infants with Survival
Authors: Opitz James C. , Toyama William 
Published: December 2021

Cardiac tamponade is a well-recognized complication of cardiac catheterization. It is also a known complication of central venous catheters that have been inserted for nutritional as well as other purposes.1-8 Dudrick et al9 first documented the clinical application of total parenteral nutrition and, since that description, hyperalimentation has been used with increasing frequency.
This paper describes two infants of very low birth weight who survived after developing pericardial tamponade caused by perforation by a central venous catheter. To our knowledge, only two premature infants are reported to have survived this complication. When rapid deterioration is noted in any infant with a central venous catheter in place, this perforation must be rapidly considered in the differential diagnosis.
Letter to the Editor
Authors: Ramamurthy Rajam S. , Brans Yves W. 
Published: December 2021

The comments of Shohat and colleagues are well taken. The change in peripheral venous hematocrit with postnatal age observed by them is a well known phenomenon that has been reported previously.1 The changes in viscosity should be expected in the newborn as the blood viscosity determination parallels the hematocrit. The assumption that the umbilical venous hematocrit level would parallel these changes is not entirely correct.
In a preliminary investigation involving 32 infants we determined the correlation between mixed cord blood hematocrit, peripheral venous (PVHct), and umbilical venous hematocrit (UVHct).
Blood from All Newborns
Authors: Therrell Bradford L. 
Published: December 2021

The recent National Symposium on Laboratory Aspects of Newborn Screening addressed many of the issues reflected in the recently published recommendations regarding newborn screening.1 These guidelines are extremely important and represent a great deal of thought and effort on the part of the Committee on Genetics.
All of the published recommendations were whole-heartedly endorsed by the Symposium participants and unanimous support was given to a resolution concerning the importance of Recommendation 2 (a recommendation concerning the importance of testing).
OUR AMERICAN DAUGHTERS (1856)
Authors: C. T. E. 
Published: December 2021

The following editorial published in 1856 in Hall's Journal of Health, a well- read publication of the 1850s, will vividly demonstrate how much our attitude toward rearing our daughters has changed since 1856.
OUR DAUGHTERS
Are the hope of our country's future. Their physical, moral and domestic education, are of an importance which no array of figures can express, which multitudes of ponderous tomes could not adequately portray.
As is the mother, so is the man. If she be a woman of physical vigor, a high guaranty is given of healthy children. If her moral character is pure, formed in the mould of Bible piety, we may anticipate for her offspring, lives of the self same piety, with its benevolent influences spreading far and wide, from all their habitations.
If the mother in her domestic relations, be a pattern for all that is cleanly and systematic, and punctual and prompt and persevering, with womanly dignity and lovingness pervading all, then may we look for every son of such a woman to be a man of mark for his time, and for every daughter, to become a wife well worthy of a king.
When such destinies hang upon the future of our daughters, ought they to be hurried from a loving mother's side at seventeen, at fifteen, at twelve, to be purchased care of a governess? To the herded tuition of fashionable boarding schools, where glitter and superficiality and empty show predominate; where nothing that is radically useful and good is thorough; where associations are inevitable, with the children of the parvenue, as well as with the scion of the decayed aristocrat, thus exposing the pure heart to the withering and corrupting examples of mere pretence and of baseless pride?
AN APPEAL TO THE PRESIDENT OF THE UNITED STATES OF AMERICA AND THE CHAIRMAN OF THE PRESIDIUM OF THE U.S.S.R. SUPREME SOVIET
Authors:   Student
Published: December 2021

The growing threat of thermonuclear war and the continued development and proliferation of nuclear weapons have compelled us as physicians to examine in detail the consequences such a war would have on the people of our nations and of the world, whose health and survival are our professional commitment.
During the past several days, physicians and scientists from 31 countries have gathered to consider relevant data on the immediate and long term effects of a nuclear conflict. We were unanimous in concluding that:
. . . The growth in sheer numbers of nuclear weapons and the increasing complexity and sophistication of delivery systems increase the possibility that a nuclear conflict may be triggered by tragic accident.
Physicians are aware from their daily work that technologic systems are liable to malfunction and that human performance may fail because of mental derangement or even simple error. Whereas such failures in medicine may jeopardise a single life, the malfunctioning of military systems may now endanger the existence of humanity....
ARE THE MENTAL PECULIARITIES OF A NURSE PARTAKEN BY HER NURSLING?
Authors: C. T. E. 
Published: December 2021

Most of the writers on infant feeding until the late eighteenth century repeated the time-worn stories of character in humans, as well as in the lower animals, being transmitted by breast milk. However, as late as 1830, the highly respected Boston Medical and Surgical Journal was still perpetuating this belief, as is evident in the following quotation.1
We read, in the Spectator, of a certain very worthy man, who, having been bred with the milk of a goat, was extremely shy and timid in public, but that, nevertheless, he had frequently an hour in private, when, giving loose to his goatish propensities, he would enjoy a few frisks and capers. It is reported of Caligula, that he did not inherit his cruel and murderous disposition from either father or mother, but that his nurse was of a barbarous savage temper. Tiberius' nurse was unhappily a little too fond of tippling, and the Emperor proved a notorious drunkard. A bitch suckled a pig, which, when grown, would hunt as well as an ordinary hound; and the philosophical Phavorinus observes that, if a lamb be reared with goat's milk, or a kid with that of an ewe, the wool of the one will become hard, and the hair of the other soft. Further we may state, that, in the purest ages of Greece and Rome, this influence of the nurse in instilling her own good and bad qualities into the infant she suckled, was no less known than guarded against; and we find it particularly remarked, that, when Rome flourished as a commonwealth, "children were not suckled by mercenary nurses, but by the chaste mothers that bore them; thus were the Gracchi reared by their mother Cornelia, and Augustus by his mother Attia.
Digoxin and Low-Birth-Weight Infants
Authors: OLANDER DAVID S. , MAURER MICHAEL 
Published: December 2021

In their recent communication, Johnson et al suggested that conventional digoxin use may be sufficiently toxic forlow-birth-weight infants to prompt consideration of alternative therapies. This conclusion was supported by their detection of digitalis associated illness in 9/18 small premature infants receiving digoxin in doses of 0.003 to 0.005 mg/kg twice per day. The documentation of abnormally elevated serum digoxin concentrations in 7/9 patients further supports the possibility of clinically significant digoxin toxicity.
Akin to the findings of Berman et al and Pinsky et al, this investigation only confirms the observation that overdosage of infants with digoxin may result in digitoxicity.
Creatinine Excretion
Authors: SUTPHEN JAMES L. 
Published: December 2021

In Reply.—
The questions posed by Harkavy allow me to expand on the initial presentation of the data in my previous report.1 As documented by numerous previous reports, urinary creatinine excretion does, in fact, reflect body muscle mass.2 Furthermore, it has been documented in older infants that creatinine excretion per kilogram increases with the age, weight, and length of the infant.3 The regression data in my report are not expressed in terms of creatinine per kilogram as the dependent variable as this multiplies the error of creatinine measurement by including the error in weight measurement (hydration states etc).
Asymmetric Crying Facies: Which Is the `Right-Wrong' Side?
Authors: EVERS KARL-GEORG , GRONECK PETER 
Published: December 2021

To the Editor.—
Congenital asymmetric crying facies is generally considered to be due to unilateral agenesis or hypoplasia of the anguli oris depressor muscle (HAODM). Electromyographic (EMG) examinations of the affected sides have revealed absent spontaneous activity or diminished motor unit activity.1-3 Association of HAODM syndrome with congenital heart disease, the "cardiofacial syndrome," has been described.4 Major defects of other organ systems and minor congenital defects may be associated with asymmetric crying facies as well.5
Monreal6 reported five patients with asymmetric congenital crying facies syndroms who besides this anomaly displayed juxtaoral defects, egm atresia of one side of the jaw and soft palate, cleft lip, hypoplasis of mandible and ear.
Dimethyl Sulfoxide (DMSO)
Authors:   Committee on Drugs,   Committee on Sports Medicine
Published: December 2021

Dimethyl sulfoxide (DMSO) is an industrial solvent that has become a legend in its own time. In 1963, Dr Stanley Jacob introduced DMSO to reduse the swelling and pain of arthritis. Quickly, a wide variety of unsubstantited claims were made, and enthusiasm apprently precluded careful studies.
In fact, the compound has a number of interesting pharmacologic properties that may be beneficial to patients. Its ability to penetrate intact skin, carrying a variety of chemicals, offers hope for eliminating many painful injections; its inhibition of certain prostaglandins offers hope that various inflammatory diseases may be suppressed; its local analgesic properties may reduce cutaneous pain from burns and injuries; its ability to dissolve compounds such as amyloid and collagen might be harnessed; and DMSO's ability to reduce increased intracranial pressure in head injuries could reduce morbidity if not mortality.
But research has not yet demonstrated that the potential of DMSO can be safely fulfilled. Clinical research was suspended in 1965 when injury to the lens was found in animals, but inasmuch as no human injury was detected, limited studies were permitted again in 1968. Asked for an opinion in 1972, the National Academy of Sciences stated that the compound should remain an investigational drug. During this period many papers detailed anecdotal results of cutaneous, intravenous, or oral use, and in 1978 the FDA approved Rimso (50% solution of DMSO) for the treatment of interstitial cystitis, the only approved use of the drug today. In the same year the Arthritis Advisory Committee to the Food and Drug Administration rejected the new drug application approval of DMSO based on the submitted studies.