As Pediatric News celebrates 50 years of publication, we’re taking a look back at our first year: 1967.
A review of the 1967 issues of the journal Pediatrics offers a snapshot of the state of the science and some surprising similarities with pediatric medicine today.
A commentary in the November issue entitled “Pediatrics at a Crossroad” described an accelerating trend toward pediatric group practice and noted that full-time hospital employment of pediatricians was an emerging pattern of pediatric practice. The author, Richard Smith, MD, of the University of Florida, Gainesville, expressed concern about certain practices, such as the wide employment of antibiotics for uncomplicated respiratory infections and “routine use of gamma globulin in community hospital nurseries supposedly to treat sepsis or its regular injection in putatively allergic children.” He also was concerned about a quality gap in pediatric specialty education (Pediatrics. 1967 Nov;40[5]:783-7).
Articles of interest in the infectious disease area included an article demonstrating the response of infants to trivalent polio vaccine (Dec;40[6]:980-5); a new antibody test for rubella (Dec;40[5]:787-8, 789-97); and a live attenuated mumps vaccine (Dec;40[5]:798-803). And as we deal with emerging infectious diseases on a large scale, a fatal case of dengue hemorrhagic fever was reported in an American child (Dec;40[5]:804-7).
In a commentary, Starkey D. Davis, MD, and Ralph J. Wedgwood, MD, of the University of Washington, Seattle, said that the annual tuberculosis infection rate was low and falling, and that new cases were decreasing. Sufficient beds were available to isolate infectious cases, and effective chemotherapy made most cases noninfectious quickly. Isoniazid was cheap and effective, and it decreased complications of asymptomatic primary tuberculosis in children by 85%. “Pediatricians can expect to see tuberculosis in children become a medical curiosity in this country as infection rates continue to fall, if isoniazid prophylaxis is energetically used,” they predicted (Jun;39[6]:809-10).
D. Holdaway of the Royal Victoria Infirmary in Newcastle Upon Tyne, England, and associates reported on 211 children with acute bronchiolitis and 295 controls with nonrespiratory illness. Of the children with bronchiolitis, 59% had respiratory syncytial virus (RSV), compared with 1% of the controls, which confirmed the etiological significance of RSV in bronchiolitis, the researchers said. They also maintained that “oxygen is vitally important in bronchiolitis and there is little conclusive evidence that any other therapy is consistently or even occasionally useful” (Jun;39[6]:924-8).
In a commentary, Leon Eisenberg, MD, of the division of child psychiatry at the Johns Hopkins Hospital, Baltimore, called for more training in child development for pediatricians (May;39[5];645-7). Today, pediatricians are calling for more training in child psychiatry.
A report by the American Academy of Pediatrics Committee on Nutrition on obesity in childhood was prescient. They said, despite much research, that “our ignorance concerning the etiology, pathogenesis, and treatment is remarkable” (Sep;40[3]:455-67). The committee acknowledged that morbidity and mortality for diabetes and cardiovascular disease were higher in obese adults than in those of average weight, and that obese children tended to remain obese as adults. The committee also wrote that no treatments had achieved more than minor success of weight reduction. It suggested prevention of weight gain as the likely best approach, with initiation by the pediatrician in high-risk families – advice that still holds true today 50 years later.
Throughout 2017, Pediatric News will celebrate its 50th anniversary with exclusive articles looking at the evolution of the specialty, including changes in child psychiatry, pediatric dermatology, and infectious disease medicine, changes in residency training, and the transformation of the well-child visit. Look for these articles and more special features on the pages of Pediatric News and here online.