bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISORDERS OF GLYCOGEN METABOLISM
Authors: LANGEWISCH WILLIAM H. , BIGLER JOHN A. 
Published: December 2021

Five cases have been presented with evidence of disordered glycogen metabolism.
Two cases of glycogen storage disease of the liver are included which were confirmed by biopsy, together with clinical and laboratory evidence. Treatment of one of the cases with adrenocorticotropic hormone resulted in a disappearance of hypoglycemia and acetonuria during the period of therapy.
Two cases of glycogen storage disease of the heart are reported together with clinical histories and necropsy reports. An ECG which was recorded on one of the patients is included.
A case of galactosemia is reported together with extensive laboratory evidence of marked galactose intolerance.
The criteria for the diagnosis of these entities are reviewed and the symptomatology, physical findings, treatment, prognosis and pathologic manifestations are discussed.
ACTH, CORTISONE AND ALLIED SUBJECTS
Authors: CONN JEROME W. 
Published: December 2021

Congenital adrenal hyperplasia in females causes pseudohermaphroditism which must be differentiated on the one hand from various types of genetic intersexuality and on the other from virilization due to adrenal tumor. In males it causes macrogenitosomia precox which must be differentiated from other types of sexual precocity and from adrenal tumor. The major manifestations of the disorder are due to the excessive secretion of adrenal androgen which causes progressive virilization throughout embryonic and postnatal life. In some cases there is a defect of electrolyte regulation which may head to death with Addisonian symptoms or heart block.
Partial adrenalectomy and the administration of estrogens or inert androgens have failed to check the progressive virilization, but cortisone has succeeded in doing so by suppressing the excessive activity of the abnormal adrenals. This effect of cortisone can be accomplished with small doses which do not exceed physiologic requirements, whereas in the treatment of hypersensitivity states and various other conditions large doses of cortisone are required for its pharmacodynamic action.
We have now treated 11 patients continuously for periods of 6 to 17 months without ill effects. It is important to determine in each case the minimum dose required to maintain adequate suppression of the adrenals. This is measured by the level of urinary 17 ketosteroids. In patients over 8 years the ketosteroid excretion should be maintained below 8 mg. per day (preferably 4 to 6 mg. per day) and in young infants at 0.5 to 1.5 mg. per day. This degree of suppression can be brought about rapidly in older children by the administration of 25 to 50 mg. of intramuscular cortisone daily.
PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK
Authors: SOLOMON MILDRED WHITE 
Published: December 2021

The child with rheumatic fever presents a problem that involves not only himself, his joints and his heart, but the entire family, the parents and the other children as well. All families normally have problems of various kinds; some manage them and some don't. But having a child come down with a serious long-term illness can mobilize these problems, can become the straw that breaks the camel's back. The child and his illness can become the focus not only of the related but all the unrelated and pent-up feelings in the family.
The mother who was previously overprotective of her child will react to the illness in one way; the mother who previously neglected her child will react in another way. Some mothers feel that they must give up their former life entirely, friends and social activities, and devote their entire time to watching over the child and doing things for him. They are being "good" mothers. Others give up nothing, refuse to accept the fact that the child has rheumatic fever and completely ignore it. These I know sound like pretty extreme points of view, but I have found that it is not too rare to find mothers fitting into these pictures.
Panel Discussion
Authors: HILL LEE FORREST , CLINE GERALD M. , SENN MILTON J. E. , RAMCHARAN S. , MCKHANN CHARLES F. , WEECH A. ASHLEY , MITCHELL JOHN MCK. , COE HERBERT E. 
Published: December 2021

Chairman Hill:. In 1944, the Academy inaugurated a Study of medical services available to the children of America. Included in the Study was a detailed survey of the Pediatric Departments of the 70 medical schools in the U.S. Out of this Study, requiring some 4 years and costing over a million dollars, a vast amount of important information was assembled. As might be expected, the Study clearly showed the enormous advantages possessed by the majority of American children in quantity and quality of medical care, but it also revealed gaps and deficiencies not only in medical care in the field but in the teaching of pediatrics in the medical schools.
In undertaking its Study the Academy assumed a position of leadership among organizations interested in the health and welfare of children. This phase of the Academy's work is now in progress, and while not as spectacular as the Study, it nevertheless is proceeding along a number of fronts on a sound basis. In 1950 and 1951, day-long conferences were held in 9 areas in the U S. in which pediatric educators, state and regional chairmen participated. This year for the first time in history, the heads of pediatric departments of the Canadian medical schools met under the sponsorship of the Academy's Committee on Medical Education for a 2 day conference.
It seems fitting, therefore, that a place should be made on the program of the Academy's national meeting for consideration by the entire membership of some of the more pressing problems which come under the heading of pediatric education used in a broad sense.
IDIOPATHIC HYPOPROTEINEMIA
Authors: WYNGAARDEN JAMES B. , CRAWFORD JOHN D. , CHAMBERLIN HARRIE R. , LEVER WALTER F. 
Published: December 2021

A 3½ year old Negro boy with an obscure syndrome of inexplicable, transient, acquired hypoproteinemia, involving plasma albumin and especially gamma globulin, has been observed. Edema, oliguria and weight gain were noted 10 days following an attack of acute tonsillitis. Hypertension, renal impairment, proteinuria and hematuria were conspicuously absent, and an associated eosinophilia subsided as recovery progressed. Plasma protein regeneration was complete in 10 weeks. The patient has since developed mild asthma but has otherwise remained well.
This appears to be an unusual case of transient derangement of plasma protein metabolism. Possible relationships to the syndromes of acute nephritis without proteinuria, nephrosis, serum sickness and idiopathic acquired hypoproteinemia are discussed.
CONVULSIONS AND DEAFNESS FOLLOWING INGESTION OF DDT
Authors: CUNNINGHAM ROBERT E. , HILL FONTAINE S. 
Published: December 2021

A case of DDT Poisoning in a two year old child is presented. Transitory deafness and severe convulsive seizures dominated the clinical picture, but uneventful recovery ensued.
Effects of DDT intoxication on the nervous system are discussed.
Retinoid Therapy for Severe Dermatological Disorders
Authors:   Committee on Drugs
Published: December 2021

This Policy Statement was retired January 2006.
Isotretinoin is approved for the treatment of severe recalcitrant cystic acne, and etretinate is approved for the treatment of severe recalcitrant psoriasis. Women of childbearing age place their infants at risk should these compounds be used during pregnancy and, in the case of etretinate, even before pregnancy. The purpose of this statement is to describe the indications for the use of these drugs and to advise physicians of their common side effects and their teratogenic potential.
Isotretinoin, 13-cis-retinoic acid (Accutane, Hoffmann-LaRoche), is a vitamin A derivative that is effective in the treatment of severe cystic acne. This type of acne, affecting adolescents and young adults, is severe, nodular, cystic, and conglobate—a scarring disease that resists treatment with topical or systemic antibiotics, benzoyl peroxide, all-trans-retinoic acid, and intralesional corticosteroids. Adolescents with less severe forms of acne who learn about the therapeutic triumphs of isotretinoin in severe recalcitrant nodular and cystic acne may assume that the drug also would be beneficial for them. Physicians should explain to these adolescents why isotretinoin is not indicated in the treatment of typical acne.
Another retinoid, etretinate (Tegison, Hoffmann-La Roche), is now available for the treatment of severe psoriasis that is unresponsive to standard therapies (topical tar with UVB light, anthralin, UVA light and psoralens, systemic corticosteroids and methotrexate). Etretinate is used for severe psoriasis of both the erythrodermic and generalized pustular types. Individualization of etretinate dosage is important. Most patients are started at a dosage of 0.75 to 1.0 mg/kg of body weight per day in divided doses.
Acellular Pertussis Vaccines: Recommendations for Use as the Fourth and Fifth Doses
Authors:   Committee on Infectious Diseases
Published: December 2021

In December 1991, the US Food and Drug Administration (FDA) licensed the first diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) for administration to children as the fourth and fifth doses of diphtheria, tetanus, and pertussis immunization. The product consists of an acellular pertussis vaccine produced by Japan's Takeda Chemicals and diphtheria and tetanus components produced by Lederle Laboratories, Division of American Cyanamid. It is expected that one or more additional acellular pertussis vaccine(s) will be licensed in the future.
The American Academy of Pediatrics (AAP) recommends that children routinely receive a series of five doses of vaccine against diphtheria, tetanus, and pertussis before 7 years of age.1,2 The FDA-approved DTaP vaccine (ACEL-IMUNE) is licensed for use only as the fourth and fifth doses for children who have been immunized previously with at least three doses of diphtheria and tetanus toxoids and whole-cell pertussis (DTP) vaccine. It is not licensed for the initial series of three doses in infants and children or for use in children younger than 15 months of age or after the seventh birthday. The following recommendations supplement previous AAP guidelines for use of whole-cell pertussis vaccines as the fourth and fifth doses and provide a follow-up to a previous AAP statement on acellular pertussis vaccines,3 which contains more complete background information.
BACKGROUND
The whole-cell pertussis vaccines currently used in the United States are prepared from inactivated cells of Bordetella pertussis and contain multiple antigens (Table 1). In contrast, the acellular vaccines contain one or more immunogens derived from the B pertussis organism.
ECMO and Sepsis
Authors: HOCKER JAMES R. , SIMPSON PIPPA M. , RABALAIS GERARD P. , STEWART DAN L. , COOK LARRY N. 
Published: December 2021

In Reply.—
In reviewing our experience with Early Onset Group B Streptococcal Sepsis infection, we attempted to determine which clinical factors best predict mortality in this subset of patients and to evaluate the outcome of patients who receive this relatively new therapy. We acknowledge that there are many problems inherent in performing this type of study. However, we were not willing to randomize prospectively this group of newborns to one therapy or the other.
The outcome data shown for all patients from Phases 1 and 2 are included to give the reader an idea of the severity of illness of newborns with Early Onset Group B Streptococcal Sepsis infection treated at Kosair Children's Hospital and to show the relative numbers from each phase.
Would Breast-Feeding Decrease Risks of Lead Intoxication?
Authors: NEWMAN JACK 
Published: December 2021

To the Editor.—
As Shannon and Graef1 point out, lead intoxication may be an important public health problem in young infants. And it is indeed likely that some babies receive too much lead from formula feeding. But this may be due to more than the fact that the lead content of the water is too high. Lead concentration of the formula itself, before dilution and even when packed in lead-free cans, may be several times that of human milk.2
The Bilirubin Debate
Authors: NEWMAN THOMAS B. , MAISELS M. JEFFREY 
Published: December 2021

To the Editor.—
We would like to respond to Dr Lois Johnson's commentary1 on our paper "Evaluation and Treatment of Jaundice in the Term Newborn: A Kinder, Gentler Approach."2 One of Dr Johnson's concerns was that summarizing the effect of bilirubin on IQ in the Collaborative Perinatal Project (CPP) with linear regression could be misleading if the relationship between bilirubin and IQ were nonlinear. We are able to reassure her on this point. Since the submission of our paper, Newman and Klebanoff have re-analyzed the CPP data and found no association between bilirubin and IQ (adjusted for confounding variables) in either linear or nonlinear models.3
Pediatric Dermatology Update
Authors: Krowchuk Daniel P. , Tunnessen Walter W. , Hurwitz Sidney 
Published: December 2021

The Society for Pediatric Dermatology conducted its 15th Annual Meeting in San Diego, CA, August 8 to 11, 1990, and the Section on Dermatology of the American Academy of Pediatrics met during the Academy's Annual Fall Meeting in Boston, MA, October 7, 1990. Topics presented at these meetings that are of interest to pediatricians are presented in summary form below.
MEETING OF THE SOCIETY FOR PEDIATRIC DERMATOLOGY
Advances in the Treatment of Infestations
Head lice and scabies are common infestations affecting infants and children. Until recently, the preferred treatment for these conditions was the application of 1% lindane (Kwell) to the scalp in cases of pediculosis capitis, and to the body in cases of scabies. However, questions about lindane's safety and efficacy have been raised. First, neurotoxicity may occur as the result of systemic absorption of lindane during the treatment of scabies, though such adverse reactions have been reported only rarely and, in nearly all instances, were associated with excessive use of the product.1 Second, recent reports of lindanetolerant infestations have questioned the product's efficacy. As a result, considerable effort has been devoted to the development of newer treatments that offer enhanced safety and efficacy.
David Taplin, Professor of Dermatology and Cutaneous Surgery, Epidemiology and Public Health of the University of Miami School of Medicine, reviewed cutaneous infestations in children and emphasized the therapeutic advantages offered by permethrin. Permethrin is a synthetic pyrethroid, an agent related to pyrethrins, naturally occurring insecticides found in flowers of the genus Chrysanthemum.2 In the United States, two new permethrin formulations are being marketed, Nix Creme Rinse (1 % permethrin) for use in treatment of head lice and Elimite cream (5% permethrin) for use in scabies.
Serum Enzyme Monitoring in Asthma Patients
Authors: COLAN STEVEN D. , MAGUIRE JAMES F. 
Published: December 2021

In Reply.—
Dr Choi has raised the very important issue of interpretation of electrocardiographic and serum enzyme changes. We agree entirely that these findings are not definitive, that is, diagnostic of ischemia. As we carefully stated, they are "consistent with" myocardial ischemia. Interpretation of these results, as with virtually any laboratory result, depends on the clinical setting and the probability of the various possibilities. As noted, elevation of creatine kinase (CK) activity can occur in a number of situations including vigorous exercise.
Physicians' Interactions with Pharmaceutical Companies
Authors: MARGOLIS LEWIS H. 
Published: December 2021

In Reply.—
In my essay1 I suggested that the acceptance of gifts from pharmaceutical companies violates a duty of justice because gifts represent resources inappropriately taken from patients through the added costs of the drugs that they buy. Dr Procopio raises the larger question of how other types of promotional activities increase the cost of drugs in particular and medical care in general. His letter makes clear, however, that the contribution of an activity such as the distribution of samples to the cost of care is difficult to determine because several different purposes are served.
Recognizing the Identifiers of Child Abuse as a Syndrome
Authors: SILVERMAN FREDERIC N. 
Published: December 2021

In Reply.—
The letter of Drs Renzuilli and Cardi is appropriate to call attention to two of their compatriots who published an excellent report on the subject of child abuse at the time the landmark paper "The Battered Child" appeared 30 years ago,1 but whose publication apparently has not been recognized in current bibliographies on the subject. Their letter also explains why this oversight occurred as the journal in which it was published was a nonindexed one.
Meconium and Tracheal Aspiration
Authors: WISWELL THOMAS E. 
Published: December 2021

In Reply.—
Doctors Bull et al, Denk, and Reynolds all bring out an important aspect of our investigation...meconium-stained newborns whose tracheae were not intubated and suctioned were significantly more likely subsequently to develop the meconium aspiration syndrome (MAS).
I disagree with Dr Reynolds' contention that intratracheal suctioning of newborns is uniformly unnecessary among neonates born through thin meconium. Although babies born through "thin" meconium are less likely to develop MAS, as many as 38% to 41%1,2 of neonates with the disorder are born through thin-consistency fluid.
Lead Toxicity in the 21st Century: Will We Still Be Treating It?
Authors: SCHOEN EDGER J. 
Published: December 2021

To the Editor.—
In the April 1992 issue of Pediatrics, Needleman and Jackson1 claimed that asymptomatic blood lead levels—those ≥10 µg/dL—represent a serious health problem, affecting three to four million children in the United States, and referred to lead contamination in children as a "man-made epidemic" as well as "a blunter of children's cognition and silent thief of their futures."1, p680 These authors recommended that all infants and young children be screened for blood lead, arguing that infants are screened routinely for conditions such as phenylketonuria which are much less common.
Underestimation of the Incidence of Mental Retardation
Authors: CUNNINGHAM ROBERT D. 
Published: December 2021

To the Editor.—
As pointed out by Yeargin-Allsopp et al,1 the prevalence of mental retardation differs with the population studied and the definition of retardation used. But it may also differ with the amount of effort put out in the attempt to identify individuals with mental retardation.
In this current study, children who were found by the school systems in metropolitan Atlanta to have an IQ of 70 or less on psychometric tests were defined as mentally retarded.
European Surfactant Trial: Questions About the Protocol
Authors: DEICHSEL GUNTRAM , GMBH KARL THOMAE , VON SEEFELD FRAU DR 
Published: December 2021

To the Editor.—
The paper by Speer et al in the January 1992 issue of Pediatrics1 gives an impressive insight into current European surfactant research. What I missed, however, is a remark on the loopholes which inevitably occur during the conduct of a trial with intensive care patients.
A note on protocol violations certainly would explain the following discrepancy: 65% of the patients in the multiple-dose group required more than one dose, where an additional dose is to be given if there is need for supplementary oxygen (FIO2 &gt; 0.21) after 12 or 24 hours (cf, middle of right column on pages 14 and 15).
Money Alone Won't Do It
Authors: COPELAND DAVID 
Published: December 2021

To the Editor.—
After reading the supplement, "Preventive Health Care for Young Children" (Pediatrics. 1992;89:983-998),1 I was left with the conclusion that the authors believe more money together with improved tracking and delivery will raise US standards to the level of other industrialized countries. It seems more probable, however, that the current rate of production of welfare babies has the capacity to stay ahead of any system we are likely to fund. Further, this burgeoning dependent subculture is a problem which similarly burdens no other country with whom we are being compared.
Cystic Fibrosis Manifested as Undescended Testis and Absence of Vas Deferens
Authors: GOSHEN RAN , KEREM EITAN , SHOSHANI TZIPORA , KEREM BAT-SHEVA , FEIGIN ELAD , ZAMIR ODED , YAHAV YAAKOV 
Published: December 2021

Cystic fibrosis (CF) is the most common autosomal recessive inherited disease in whites. Among whites of European ancestry, approximately 1 in 2000 live births are affected, implying a carrier frequency of 1:25.1 The disease is characterized by chronic lung disease, which usually leads to the patient's death. Furthermore, patients with CF suffer from pancreatic insufficiency and other less common manifestations, such as meconium ileus, hepatobiliary abnormalities, diabetes mellitus, and musculoskeletal problems.1 Almost all males with CF are infertile. Absence of the vas deferens has been reported in 70% to more than 90% of male patients affected by CF.2
Although 4% of full-term male neonates have un-descended testes at birth, 0.8% to 1.0% of 1-year-old boys have cryptorchism and may be subjected to a later surgical intervention.3
Group B Streptococcal Infections: An Obstetrical Viewpoint
Authors: LARSEN JOHN W. , DOOLEY SHARON L. 
Published: December 2021

Group B Streptococcus (GBS) was first identified as a cause of puerperal sepsis during the late 1930s. However, concern regarding GBS was diminished in part by the greater pathogenicity of the group A Streptococcus, which was described in the same studies. Clinical research regarding GBS infections resumed during the 1960s. Data regarding the perinatal transmission of GBS have now accumulated to an extent that education of all obstetric and pediatric care providers is imperative.
During the past 2 years, committees of both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) have considered the issues of perinatal transmission of GBS. Each group had input from the other by a series of meetings and document exchanges.
Retraction of the Umbilicus During Voiding as an Initial Sign of a Urachal Anomaly
Authors: ROWE PETER C. , GEARHART JOHN P. 
Published: December 2021

The early identification and surgical correction of urachal anomalies helps to avoid potentially serious sequelae, including infection, rupture of urachal cysts into the peritoneal cavity, and neoplastic change in adult life.1-5 Retraction of the umbilicus during urination has not been described as a physical finding in those with urachal anomalies, but it was an important clinical clue in the patient we describe below.
PATIENT REPORT
A 12-year-old boy complained of pain at the umbilicus, beginning just after he started to urinate and persisting until approximately 30 seconds after he had finished voiding. The pain had begun abruptly 3 days earlier. It caused him to bend forward and was accompanied by retraction of the umbilicus.