American Journal of Diseases of Children

LEUNG, ALEXANDER K. C.

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100008001

Abstract Sir.—I read with interest the excellent article entitled "The Academic Pediatrician and the Practicing Pediatrician" by Dr McKay.1 I agree with Dr McKay that both academic and practicing pediatricians have important roles to play in the education of medical students, interns, and residents as well as in providing care to their patients. Because of their limitations, they do these in different ways. A practicing pediatrician is more likely to encounter patients with minor ailments such as roseola infantum or Monilia dermatitis in his office than an academician would encounter in a hospital setting. Exposure of medical students and residents to these common conditions would be of tremendous help to them, as a majority of them may end up in private practice and providing service to the general public. Practicing pediatricians, because of the large number of patients they examine every day, would be in a better position to References 1. McKay RJ Jr: The academic pediatrician and the practicing pediatrician . AJDC 1985;139: 39-40.

LEUNG, ALEXANDER K. C.

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100008002pmid: 4025246

Abstract Sir.—I enjoyed reading the editorial entitled "Duplicate Publication Is Boring" by Ms Radulescu.1 I agree with Ms Radulescu that academic appointment, tenure, and the related economic rewards may hinge on the length, if not the quality, of one's bibliography. However, it is not always the author's intention to lengthen his/her bibliography or to pad his/her curriculum vitae by duplicate publication. I wonder whose fault it is—should blame rest with the author or the editor? I have had more than 70 publications in various medical journals in the last 12 years, and I would like to share with you some of my personal experiences. On June 25, 1984, I wrote a letter to the editor of another journal in response to an interesting article that appeared in that journal one month earlier. In October 1984, I wrote a second letter to that editor inquiring about the fate of my previous letter. References 1. Radulescu G: Duplicate publication is boring . AJDC 1985;139:119-120. 2. 'Methemoglobin as a sign of cyanosis': Duplicate publications , editorial. Can Med Assoc J 1984;131:1436.

GEMSON, BENNETT L.

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100009006

Abstract Sir.—Regarding the recent article by Burg,1 today's pediatric residents in teaching hospitals are being trained almost exclusively by pediatric subspecialists, practically all of whom are full-time academicians with little or no experience in general pediatrics. As a consequence, the residents are both adept at ordering batteries of sophisticated (and expensive) laboratory tests in the workup of patients and skilled in the management of rare and/or complicated diseases. However, their training in general pediatrics is, for the most part, inadequate. Their history-taking is often poor, their physical examinations cursory or incomplete, and their skill in differential diagnosis minimal. At a time when there is a real need for practicing pediatric generalists, a majority of residents are choosing pediatric subspecialties and academic careers, in large part because their role models are the full-time academic subspecialists. Greater involvement of the practicing pediatric generalist in the teaching of pediatric residents, especially in References 1. Burg FD: The education and evaluation of the pediatric resident . AJDC 1985;139:198-199.

RADULESCU, GABRIELA

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100009005

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In Reply.—I wish to express my pleasantly surprised regrets to Ms Klein and any other readers who have found my editorial sufficiently interesting to look up its references but... find some of them in error. The correct page numbers of these references are given elsewhere in this issue of AJDC (p 782). The errors were completely unintentional but I can see how they may yield an unexpected humorous reward for those diligent enough to pursue the bibliography. Finding an article about spine injuries where one expected an editorial about duplicate publication may be construed as a hint of drastic punitive action contemplated by the editor. Authors beware!

KLEIN, E. ROSELAND

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100009004pmid: 4025247

Abstract Sir.—I was delighted to read the editorial by Radulescu1 and found it pertinent to the policies of our editorial office. Indeed, duplicate publication is boring, but it is a recurrent temptation for young investigators. These same young scientists must be reminded to verify all references against original documents.2-4 Therefore, it was surprising and disappointing to discover that the inaccuracies in the reference citations that followed the editorial precluded further exploration of this topic. Three of the articles found did not correspond to the references listed. Moreover, the format recommended for citations of editorials in American Medical Association journals was not followed.5 Nevertheless, the editorial itself is a valuable teaching tool. The disparities in the reference section provide an unintentional, but humorous, dividend for the students and confirm that even editors are fallible. References 1. Radulescu G: Duplicate publication is boring . AJDC 1985;139:119-120. 2. Woodford FP (ed): Scientific Writing for Graduate Students: A Council of Biology Editors Manual . Bethesda, Md, Council of Biology Editors, 1981, pp 167-178. 3. Huth EJ: How to Write and Publish Papers in the Medical Sciences . Philadelphia, ISI Press, 1982, p 144. 4. Day RA: How to Write and Publish a Scientific Paper . Philadelphia, ISI Press, 1983, p 42. 5. Manual for Authors and Editors: Editorial Style and Manuscript Preparation , ed 7. American Medical Association, Los Altos, Calif, Lange Medical Publications, 1981, pp 128-129.

RADULESCU, GABRIELA

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100008003

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In Reply.—Dr Leung's frustrations with what may be lax procedures in some editorial offices and negligent or even discourteous treatment of authors are easy to sympathize with. An author thus treated is justified in withdrawing his manuscript and resubmitting it somewhere else. A letter of withdrawal takes less time to prepare than the cosmetic revamping of an article usually seen in repetitive publications. There is no justification in failing to inform the next editor about prior submission while the manuscript is still, at least technically, under consideration by the first editor. Finally, Dr Leung's experience illustrates numerically what can be safely said about scientific journals in general, namely, that such cases of cavalier treatment of authors by the editors appear to be by far the exception rather than the rule, much less the cause, of duplicate publication. If in a series of "more than 60" patients you fail to

ROGERS, WILLIAM B.

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100010009pmid: 4025249

Abstract Sir.—Bubble bath urethritis in both the male and female child is now well known by all pediatricians and family doctors. We continue, however, to see many youngsters with dysuria and urinary frequency who are not using bubble bath and have no other obvious urinary disease. Searching for some explanation of this problem, I asked mothers of affected children about anything else that they might be adding to their child's bathwater, such as detergents, bath salts, water softeners, etc. Their answer was always negative. It was not until three years ago that I learned to ask the specific question: "Do you shampoo your child's hair in the tub?" I almost invariably received the reply: "Why yes, but I didn't think of that!" Trying to discover if there were any common ingredients in both bubble bath and shampoo, I wrote to the American Medical Association. I received from Robert H. Wheater, References 1. Gosselin R, Smith RP, Hodge HC, et al: Clinical Toxicology of Commercial Products , ed 4. Baltimore, Williams & Wilkins Co, 1976, pp 112, 118. 2. Chappel LH, Lundin L: A pitfall in urine cytology: Case report . Acta Cytol 1976;20:162.

BURG, FREDRIC D.

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100009007

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In Reply.—Dr Gemson raises an important concern that should be addressed by the Residency Review Committee for Pediatrics (RRC/Ped), the body responsible for accrediting programs in general pediatrics. This organization has recently redefined the essentials for the education of the pediatrician. These new essentials define the recommended educational and experiential backgrounds for faculties, as well as criteria for the preferred sites for resident education. The purpose of my original report was to begin a dialogue between those with the responsibility for educating and evaluating the pediatricians of the future and those with ideas about how these processes might be enhanced. I suggest that the chairman of the RRC/Ped, Donald Dunphy, MD, be invited to respond to the particulars of Dr Gemson's letter. Also, I believe it would be valuable for the AJDC to publish either the entire new essentials in pediatrics or a summary of the critical elements

DUNPHY, DONALD

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100009008

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In Reply.—Dr Burg, blessed as he is with superb pedagogic skills, has asked several rhetorical questions, rhetorical in that he knows the answers. His intent, it would appear, is to have the answers set forth to educate or alert others. One of his concerns in relation to the RRC/Ped is as follows: "The techniques used to analyze the quality of educational programs should be subjected to periodic scrutiny by a broad and representative constituency of medical educators and knowledgeable persons both within and outside the community of physicians." This is exactly the process that exists. The accreditation of programs for residency training is the responsibility of the Accreditation Council for Graduate Medical Education (ACGME). The ACGME may accredit programs on the recommendation of a Residency Review Committee (RRC), or it may delegate this authority to such an organization. The ACGME has delegated such authority to the RRC/Ped subject to

ÖZSOYLU, ŞINASI;KOÇAK, NURTEN

1985 American Journal of Diseases of Children

doi: 10.1001/archpedi.1985.02140100011010

Abstract Sir.—The prognosis of hepatic encephalopathy in general is extremely guarded. By using levodopa (100 mg/kg), 23 of 39 patients with hepatic encephalopathy related to different liver diseases responded to treatment, and 17 of them were discharged in an uncontrolled study.1 We administered naloxone (0.1 mg/kg intravenously) to eight patients with hepatic encephalopathy who did not respond to levodopa administration. The ages of the patients ranged between 1.5 and 15 years (mean, 7.4 years; median, 7 years) and, with one exception, all were girls. With one exception (the youngest one with chronic hepatitis), all of the patients had fulminant hepatitis, which was also shown morphologically in three who died. Two of them had fulminant hepatitis 2.5 and four months after operations but hepatitis B surface antigen was found only in one. Alanine (150 to 1,330 units) and aspartate (125 to 980 units) aminotransferase levels, total (3.4 to 20.4 mg/dL) References 1. Özsoylu Ş, Koçak N, Gürgey A: Levodopa in hepatic coma in children . Turk J Pediatr 1975;17: 5-14. 2. Lovejoy FM, Smith AL, Bresman MJ, et al: Clinical staging in Reye syndrome . AJDC 1974; 128:36-41.