bluuebunny/crossref_metadata_2025_split huggingface dataset:
Controversial Techniques in Allergy
Authors: SHAPIRO GAIL G. , ANDERSON JOHN A. 
Published: December 2021

Ten years ago a commentary appeared in Pediatrics entitled "Allergy Skin Testing: Science or Quackery?"1 This statement was a rejoinder to a commentary in Pediatrics in 19752 that included allergy skin testing in a list of laboratory procedures that are abused for financial gain. The gist of the reply was that allergy skin tests themselves were not the problem because they were valid bioassays for IgE antibody to specific antigens. Abuse and quackery set in when numerous, indiscriminately chosen skin tests were performed instead of an appropriate history, physical examination, and carefully selected tests based on that evaluation.
The allergy skin test was at that time and remains today the most sensitive test for specific allergic antibody in the skin, its presence there reflecting its presence in the blood and respiratory tract.
Passive Immunization Against Varicella in Children Receiving Cancer Chemotherapy
Authors: FELDMAN SANDOR , LOTT LENNIE 
Published: December 2021

In Reply.—
Our review1 did not reveal or imply that passive immunoprophylaxis was not effective in preventing or modifying varicella in children with cancer. Individual patients benefited from immunoprophylaxis. Overall, this form of prevention cannot be expected to statistically decrease the frequency of varicella in a childhood cancer population. The number of children at risk is large, whereas the number of children in whom the infection develops is relatively small. Too few children receive prophylaxis to have a statistical impact on the number of cases relative to the large number of children at risk.
Adolescent Pregnancy
Authors:   COMMITTEE ON ADOLESCENCE
Published: December 2021

There is a continuing nationwide concern regarding the high prevalence of adolescent/teenage/ school-aged pregnancy. The terms adolescent pregnancy, teenage pregnancy, and school-aged pregnancy all have been applied to pregnancy at an age and/or developmental stage that is considered premature or inappropriate, especially with respect to outcome. Whereas fertility is determined by biologic factors, the impact of pregnancy and its consequences have biologic, psychosocial, and environmental determinants. The term "adolescence" is applied to the period of psychosocial development from childhood to adulthood that corresponds to chronologic ages 10 or 12 to 21 years. Adolescent pregnancy has different implications for the 18- or 19-year-old high school graduate who is married or planning marriage than for the 13-or 14-year-old middle school student who may be beginning the process of adolescence. Although recognizing this broad spectrum, the Committee on Adolescence has chosen the term "adolescent pregnancy" for this and related statements. Our primary concern is the individual in early to middle adolescence (younger than the age of 18 years) who is biologically and/or psychosocially immature, and for whom pregnancy is, often unplanned, if not unwanted.
Explanations for the high prevalence have ranged from inadequate sex education to sexual promiscuity. In this statement current research data will be reviewed and relevant information will be provided so that pediatricians and others responsible for the health care of adolescents can appreciate the implications and consequences of adolescent sexual activity and early childbearing.
SEXUAL ACTIVITY
The current problems resulting from teenage pregnancy cannot be appreciated fully without understanding adolescent sexual behavior and the secular changes that have taken place.
Counseling the Adolescent About Pregnancy Options
Authors:   COMMITTEE ON ADOLESCENCE
Published: December 2021

Sexuality is part of adolescent development, but some of its consequences, including premature sexual intercourse, pregnancy, and sexually transmitted diseases, have emerged as major health concerns for pediatricians. One million adolescent girls are estimated to become pregnant annually, and one third of these pregnancies end in abortion. The frequency with which pediatricians may encounter issues of pregnancy and abortion is high, and the reality of having to deal with these problems must be appreciated.
The Committee on Adolescence has prepared this statement with three guiding principles: (1) it should represent an unbiased guide to Academy Fellows faced with the problems of adolescent pregnancy and abortion; (2) none of the options offered will be universally preferred by either patients or physicians and, indeed, all carry the potential for patient disability; (3) the pediatrician, the adolescent patient, and other concerned individuals must be given adequate freedom of action to achieve their cumulative working decision.
The pediatrician should examine his or her own attitudes and beliefs about sexuality in the adolescent. Feelings about premarital sex, pregnancy, and abortion are personal, individual, and deeply rooted. Pediatricians and other health professionals must refrain from allowing their own sexual and moral standards to interfere with optimal care. For pediatricians who wish to counsel young people but lack the experience or confidence, there are numerous regional and national educational opportunities to learn about counseling teenagers. Some pediatricians may wish to participate in preceptorship training with professionals knowledgeable concerning pregnancy counseling. If pediatricians decide not to counsel their teenage patients about sexual matters such as pregnancy and abortion, they have a responsibility to refer their patients to counseling facilities experienced and sensitive to the needs of adolescents.
DOES PERTUSSIS VACCINE CAUSE PERMANENT BRAIN DAMAGE? UNITED KINGDOM COURT RULES
Authors: Student  
Published: December 2021

1. The preliminary issue to be determined by the court is, can pertussis vaccine cause permanent brain damage in young children? The question relates to pertussis vaccine manufactured in the United Kingdom and applies to all children whether or not they were neurologically normal before vaccination. The burden of proof rests on the Plaintiff and the standard of proof is that of the balance of probability. It must be shown that it is more likely than not that the vaccine can cause permanent brain damage.
2. The medical and expert opinion is deeply divided on the issue.
3. The question is not answered by showing that there is a respectable and responsible body of medical opinion that the vaccine can, albeit rarely, cause permanent brain damage, or that this view is/may be more widely held than the contrary.
4. Similarly the advice contained in the contra-indications against pertussis vaccination . . . cannot be relied upon as though it were evidence . . . that the vaccine in fact causes permanent brain damage.
5. Reports of . . . encephalopathy resulting in . . . brain damage or death where the onset occurs shortly after DTP vaccination, raises the hypothesis that the vaccine may cause brain damage or death. It does not prove the hypothesis. Such reports do not take account of events occurring by chance, for which no explanation can be found. What they do establish is that encephalopathy resulting occasionally in permanent brain damage or death does sometimes occur in close temporal proximity to pertussis vaccination.
6. I have reviewed the evidence and reasoning of the Plaintiffs and Defendants' expert witnesses . . . . I have found myself more impressed both by the cogency and quality of the evidence and reasoning of the experts called on behalf of the Defendants.
7. When I embarked on consideration of the preliminary issue, I was impressed by the case reports and what was evidently a widely held belief that the vaccination could, albeit rarely, cause permanent brain damage. I was ready to accept that this belief was well founded. But over the weeks that I have listened to and examined the evidence and arguments, I have become more and more doubtful that this is so. I have now come to the clear conclusion that the Plaintiff fails to satisfy me on the balance of probability that pertussis vaccine can cause permanent brain damage in young children. It is possible it does, the contrary cannot be proved. But in the result the Plaintiff's claim must fail.
DELUGE OF THROW AWAYS IN HOSPITALS
Authors: Student  
Published: December 2021

Yesterday, after finishing a routine thoracic operation, I looked in dismay at the three large (30 gallon size) plastic bags filled with refuse generated during the three-hour procedure.
What was inside those bags?
Disposable paper items: surgical gowns, surgical drapes, envelopes, bags of all sizes.
Sponges, small and large.
Disposable plastic items: syringes, pumps, boxes of various sizes, tubing, bottles, bags, staplers, suction fluid containers, esophageal temperature probes.
Disposable metal items: needles, staples, cartridges, scalpels, electrical cautery tips and wiring, scissors, electrocardiogram pads and wiring.
Disposable rubber items: gloves, bottle stoppers, tubing, urinary catheters.
In addition, a large variety of other disposable items, too many to mention, are thrown away as garbage.
This deluge of disposable equipment is quite new. Fifteen to 20 years ago, very little disposable equipment was used, and I am not wrong in saying that this same operation, at that time, would not have generated more than a handful of refuse.
WHY IS THE SCHOOL DROP-OUT RATE SO HIGH?
Authors: Student  
Published: December 2021

Eighty percent of students entering school feel good about themselves and who they are. By the fifth grade only 20 percent have high self-esteem. By the time students become seniors in high school, the percentage who have managed to keep a positive level of self-esteem has dropped to 5 percent.
Students encounter the equivalent of 60 days each year reprimanding, nagging and punishment. During 12 years of schooling a student is subject to 15,000 negative statements. That's three times the amount of positive statements received.
Newborn Screening Fact Sheets
Authors:   COMMITTEE ON GENETICS
Published: December 2021

These newborn screening fact sheets were developed by the Committee on Genetics of the American Academy of Pediatrics with considerable assistance and consultation from many individuals. The fact sheets were not designed to advocate specific newborn screening tests but rather to inform pediatricians about these tests. Many states are considering addition of new tests to their screening batteries, whereas others may be reviewing their current screening panel to reduce the number of disorders for which tests are offered. This information should assist pediatricians in developing appropriate positions based on the needs of their patients and of their geographic regions.
In addition, the information in these fact sheets may assist the pediatrician in understanding the individual tests, their characteristics, and their strengths and weaknesses. Such information is important for evaluating policies and procedures.
Our knowledge base regarding newborn screening is changing rapidly and there are numerous areas of controversy. We have attempted to provide a consensus viewpoint, but it must be recognized that experts in this field do not always agree. Pediatricians who desire additional information should contact the specialists in their region or those involved at a national level. Brief bibliographies have been provided to assist the clarification of some of these points.
These fact sheets will require revision in the future. Your comments and suggestions will be appreciated.
NOTE ON COST: The costs quoted here are those for the screening tests in a regionalized laboratory. There is a program cost of approximately $1 to $2 for specimen handling, administration, equipment depreciation, and overhead that has been traditionally ascribed to phenylketonuria.
WHO IS AT FAULT?
Authors: Student  
Published: December 2021

Doctors, lawyers, architects, and other professionals strike a bargain with society: Leave us alone, they say, and we will take care of you ...
But do professionals warrant the trust placed in their hands?
Headlines shout of bridges and buildings toppling. Health care cost escalate. Our children compare poorly in knowledge of science, math, and foreign languages with those of other countries. Malpractice suits skyrocket. Greed corrupts Wall Street. America has lost the industrial muscle that was once the envy of the world.
Has our army of experts, whom we entrust to take care of us, let us down?
Or, on the other hand, have we let them down, shackling them in regulation, keeping them from doing their jobs, impeding them in the free exercise of their expertise?
Growth Plate: Roentgenologic Findings in a Case of Tyrosinosis
Authors: MORRISON S. , KERR D. 
Published: December 2021

Widening and cupping of the metaphysis together with dense bony spicules projecting from the metaphysis into the epiphyseal plate were originally described in patients with phenylketonuria. Later, similar changes were also identified in patients with homocystinuria. The frequency of these changes is far greater in patients with homocystinuria than in those with phenylketouria, however. We describe a case in which similar but not identical findings were found in a patient with tyrosinosis. To our knowledge, this has not been previously described.
CASE REPORT
Persistent diarrhea developed in a baby girl when she was approximately 6 weeks of age. Abdominal distention developed, with flatulence, although there was no change in her appetite.
Science of Reading
Authors: OXMAN ANDY 
Published: December 2021

There is a scientific basis on which to make decisions about clinical reading just as there is for decisions about clinical practice. Recognizing this does not make coping with the clinical literature or coping with clinical practice a less formidable challenge. It can, however, help clinicians to arrive at answers that are more likely to be valid and clinically applicable and to do so with greater efficiency.
Proper utilization of the medical literature, like proper research methodology, is essential for ensuring that medical care does more good than harm. Like science in general, it "consists in the creation of simplicity out of complexity" and it rewards us with the joy of discovery.
In Reply: Pseudomonas Meningitis Therapy Recommendation Questioned
Authors: MCCRACKEN GEORGE H. 
Published: December 2021

Savarino et al are correct in pointing out that cefotaxime is an inappropriate antibiotic for treatment of pseudomonas infections, especially of the CNS. The erroneous recommendation in the Committee's statement (Pediatrics 1988;81:904-907) was a typographical error that was not discovered when the galley proof was reviewed.
Pseudomonas meningitis is best treated, at least initially, with a combination of an aminoglycoside and either ceftazidime or on anti-Pseudomonas penicillin such as ticarcillin or piperacillin.
In Reply: Statistical Power
Authors: GRAVEL JUDITH S. , MCCARTON CECELIA M. , RUBEN ROBERT J. 
Published: December 2021

We appreciate the concern expressed by Dr Mauro and agree that power is an important consideration both before a study has been initiated and when discussing one's results. Dr Mauro has done a service to both readers and authors alike by reminding us that when one does not find an effect it is appropriate to report the power of the finding.
Accordingly, the power information for our study is as follows. Based on the literature we reviewed in our introduction, we postulated that we would find a large difference between the two groups studied.
Pertussis Immunization
Authors: EMERSON BRIAN P. 
Published: December 2021

The Task Force on Pertussis and Pertussis Immunization should be congratulated for a timely and thorough review of some difficult issues. Although the authors have done a commendable job in objectively presenting the controversial areas, they have unfortunately not maintained a clear distinction between protection from clinical disease (that which is recognized and notified) and protection from infection (all pertussis caused illness, much of which is "mild, often unrecognized disease". That the vaccine likely protects much more against clinical disease than infection has been well discussed by Fine and Clarkson.
The Task Force did acknowledge this distinction ("Control v Eradication"; however, they subsequently ignored it when they suggested that an adult dose "would reduce transmission of B pertussis in adults and could help in the eradication of pertussis in our population."
Fictitious Crystalluria
Authors: ABU-ARAFEH I. A. , STUART C. , SMAlL P. J. 
Published: December 2021

The use of disposable nappies with high absorptive power caused confusion in the past leading to the erroneous diagnosis of oligunea. We report crystalluria as another confusing condition in association with the use of a new brand of nappies, Ultra-Pampers.
A 13-month-old infant, receiving regular treatment with theophylline for recurrent wheezing, was admitted to the hospital because of a three-day history of passing crystals in his urine. Each time his diaper was changed, his mother noticed crystals and jelly-like particles about 5 to 10 mm in diameter in his wet nappies.
In Reply: Residency Training and Child Abuse
Authors: DUBOWITZ HOWARD 
Published: December 2021

Dr Johnson provides interesting data indicating the need for improved training in child maltreatment for pediatric residents. I agree with most of his suggestions and would like to make several additional observations.
Even when pediatricians might see themselves in a screening role, it is apparent that a report of child abuse can have far-reaching ramifications, such as removal of the child from the family. Frequently, the state agencies involved in child protection give enormous weight to the medical opinion, perhaps too much at times, and so it becomes important that the initial report be reasonably justified.
Techniques' Comparison and Report of the North Carolina Experience
Authors: Kinney Thomas R. , Sawtschenko Martha , Whorton Mary , Shearin Jean , Stine Christy , Hofman Lindsay , Safko Robbi , Vitaglione Thomas , Kaufman Russel E. 
Published: December 2021

Controversy still exists as to the best laboratory method to use to screen newborns for sickle cell disease and other hemoglobinopathies. The proposed methods include hemoglobin electrophoresis, column chromatography, isoelectric focusing, and high performance liquid chromatography. There is also debate concerning the preferred method of sample collection. The proposed methods of sample collection include cord blood or blood obtained from the infant collected in a tube with anticoagulant or on filter paper.
We compared hemoglobin electrophoresis patterns from infant blood samples collected in heparinized capillary tubes and on filter paper. This comparison was performed because hemoglobin electrophoresis of dried blood samples collected on filter paper has been advocated as a practical, reliable, and inexpensive method for mass screening programs, although the limitations of this technique have not been explored fully. We also summarize data from the North Carolina Newborn Hemoglobinopathy Screening Program, which relates to the advantages and limitations of hemoglobin electrophoresis from filter paper blood specimens.
MATERIALS AND METHODS
Specimens
Four sets of specimens were used for this study: (1) specimens collected at Duke University Medical Center to compare hemoglobin electrophoresis patterns of hemolysates from filter paper and heparinized capillary tubes, (2) specimens collected by the North Carolina program for hemoglobinopathy screening, (3) specimens routinely collected at Duke University in heparinized capillary tubes for newborn hemoglobinopathy screening, and (4) samples for retesting to examine the error rate of the state program and to confirm screening results compatible with a hemoglobinopathy.
Samples for Direct Comparison Between Filter Paper and Heparinized Specimens
ISSUES TO BE CONSIDERED
Authors: Andrews Lori B. 
Published: December 2021

The main purpose of screening is to identify infants with sickle cell anemia so that appropriate health care might be given to such infants. The following four types of legal issues will be considered: the extent to which existing state newborn screening laws can accommodate sickle cell anemia, the malpractice concerns related to sickle cell anemia screening, the need for protection of the confidentiality of the data collected by such testing, and the legal issues raised by discrimination against sickle cell carriers.
These legal issues cannot be considered in a vacuum, however. Attention must be given to the history of sickle cell screening laws in this country. When state laws mandating sickle cell anemia screening were passed in the early 1970s, they were aimed at giving people information that was helpful for making reproductive choices. Two carriers who were married, for example, had a 25% risk of giving birth to a child with sickle cell anemia. However, because there were no health care measures that could be taken to cure an affected fetus or even to safely diagnose the condition prenatally, the only potential effect of the law was to deter such couples from having children altogether, a tactic criticized as genocidal. Moreover, the early laws lacked provisions for counseling and, thus, fostered misunderstanding and anxiety. The information collected by screening programs apparently also served as a basis for discrimination against people with sickle cell trait.
The issues presented by sickle cell anemia screening of newborns are somewhat different because screening is not for the primary purpose of changing reproductive behavior but rather to identify infants who then can be treated.
US WARNS DOCTORS AGAINST AGREEMENTS ON FIXING OF PRICES
Authors: L. J. F. 
Published: December 2021

The Justice Department issued a stern warning to the nation's doctors today that they are under surveillance for evidence of price fixing and other violations of the antitrust laws.
Assistant Attorney General Charles R. Rule, head of the Justice Department's antitrust division, told members of the American Medical Association's House of Delegates that agreements by doctors to reduce medical competition and thus harm their patients' interest "can be hazardous to your personal freedom."
"You can go to jail," he said.
The Justice Department's enforcement policy "is necessary to insure that society's decision to rely on competition to hold down health care costs will not be frustrated by a handful of greedy individuals."
The assistant attorney general gave . . . advice to doctors: Do not make any agreement with any competing independent doctors on prices or fee schedules, on patients you will serve or locations from which you will draw patients or on joint refusal to offer services to alternative health delivery systems.