November 2013 ORIGINAL ARTICLES

malabsorption in patients with diarrhoea: correlation to SeHCAT test.

Gut 1993;34:698-701.

12. Bajor A, Kilander A, Fae A, et al. Normal or increased bile acid uptake in

isolated mucosa from patients with bile acid malabsorption. Eur J Gas-

troenterol Hepatol 2006;18:397-403.

13. Wales PW, de Silva N, Kim JH, Lecce L, Sandhu A, Moore AM.

Neonatal short bowel syndrome: a cohort study. J Pediatr Surg 2005;

40:755-62.

14. Weaver LT, Austin S, Cole TJ. Small intestinal length: a factor essential

for gut adaptation. Gut 1991;32:1321-3.

15. D‘Agostino RB, D‘Agostino RB Jr. A suggestion for using powerful and

informative tests of normality. Am Stat 1990;44:316-21.

50 Years Ago in THE JOURNAL OF PEDIATRICS

Serum 7-Alpha-Hydroxy-4-Cholesten-3-One as a Marker for Bile

16. Galman C, Angelin B, Rudling M. Bile acid synthesis in humans has a

rapid diurnal variation that is asynchronous with cholesterol synthesis.

Gastroenterology 2005;129:1445-53.

17. Kovar J, Lenicek M, Zimolova M, Vitek L, Jirsa M, Pitha J. Regulation of

diurnal variation of cholesterol 7alpha-hydroxylase (CYP7A1) activity in

healthy subjects. Physiol Res 2010;59:233-8.

18. Bajor A, Kilander A, Sjovall H, Rudling M, Ung KA. The bile acid

turnover rate assessed with the (75)SeHCAT test is stable in chronic

diarrhoea but slightly decreased in healthy subjects after a long period

of time. Dig Dis Sci 2008;53:2935-40.

19. Wales PW, Christison-Lagay ER. Short bowel syndrome: epidemiology

and etiology. Semin Pediatr Surg 2010;19:3-9.

Cigarettes, School Children, and Lung CancerMedovy H. J Pediatr 1963;63:1060-2

As a child in the 1960s, I remember being particularly pleased with myself if I could score a pack or 2 of candycigarettes, and maybe even a gum cigar, in my haul at Halloween. Smoking was admirable. Today such seems

patently absurd. However, 50 years ago in The Journal, Medovy bemoaned the continuous-exposure of school-agechildren to television commercials and programs glorifying cigarette smoking with social and material success,romance, and even physical perfection. He blamed parents, the general public, government, and even the medicalprofession for allowing escalating numbers of children to embrace smoking. The Surgeon General’s report was yeta year away, even though lung cancer death rates were skyrocketing and the United Kingdom’s Medical ResearchCouncil had already acknowledged in 1957 the causal link between cigarettes and cancer.1

Medovy presciently wrote, “If the pediatrician is convinced, and we believe he is, that the long-term effects ofcigarette smoking are likely to be harmful, even lethal, to the children under his care, then he has a real responsibilityto make these facts known in the most persuasive manner at his disposal. The cumulative effect of anticigarette edu-cation in thousands of doctors’ office, in the patient’s home, and in the school is bound to bring about eventually achange in public attitude towards smoking.” Indeed he was right. Pediatricians and parents successfully eradicatedtelevision shows glorifying smoking, advertising for cigarettes, and even Joe Camel. Now smoking rates in childrenare at their lowest in years, and deaths from cigarette-induced lung cancer are slowing.2

Like it or not, as pediatricians we are still a persuasive, critical mass for social justice and public health.We should domore than pass out advice and antibiotics. In the next 50 years, we should hope that The Journal chronicles declines inchildhood obesity, gun violence toward children, and child trafficking. Are we convinced yet that these problems areharmful, even lethal, to the children under our care?

Paul Graham Fisher, MDDepartments of Neurology, Pediatrics, and Human Biology

Stanford UniversityLucile Packard Children’s Hospital

Palo Alto, Californiahttp://dx.doi.org/10.1016/j.jpeds.2013.04.064

References

1. Tobacco smoking and cancer of the lung: statement by the Medical Research Council. BMJ 1957;1:1523-4.

2. Current tobacco use among middle and high school students—United States, 2011. MMWR Morb Mortal Wkly Rep 2012;61:581-5.

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