bluuebunny/crossref_metadata_2025 huggingface dataset:
THE PRESIDENT COMMENTS
Authors: BAKWIN HARRY
Published: December 2021

DURING the past year a committee on juvenile delinquency has been formed in the Academy under the chairmanship of Dr. Preston McLendon of Washington, D.C. Though the problem is not as urgent as some would have us believe, it is, nevertheless, of sufficient gravity and magnitude to merit serious study. The pediatrician is in the best position for this purpose since the springs of criminal behavior in the adolescent reach back into early childhood.

Juvenile delinquency, at one time regarded as a product of the slums of our large cities, has now spread to rural areas as well, and affects rich and poor alike. It is indeed anomalous that as the general economic situation has risen, as slums are eliminated and housing is improved, as playgrounds have been extended, we have, if anything, more, rather than less, delinquency than we used to have. Nor has the rising interest in psychiatry during the past 3 decades helped to deter the juvenile criminal. An effort to prevent delinquency in a "predelinquent" group of boys with psychiatric treatment failed.

Studies on the origin of youthful criminal behavior emphasize that the etiology is multiple. A certain constellation of personality traits, probably in good part inborn; broken homes; cultural factors in the home; a weakening of the deterring forces in the home, the church, the community, and the state—these are among the principal factors.

As for methods of handling the juvenile delinquent, there are even less data than about causes. There has been for many years a general reaction against the severe penal methods of the past.
CAUSATION OF JUVENILE DELINQUENCY
Authors: Johnson Adelaide M.
Published: December 2021

It is highly dangerous in science to talk about a cause, and our wish has been to emphasize only outstanding factors which we have observed operating in the etiology of the individual delinquent or psychopath, where the behavior is unconsciously initiated and fostered by the parents. In addition, I have described the conscious permissiveness by families and circumscribed cultural forces operating in limited areas to produce the sociologic group delinquencies. That there is overlapping, on occasion, of these two large categories seems undeniable.
Adoption of Handicapped Children
Authors: BEAVEN PAUL W.
Published: December 2021

I am writing this as a "Letter to the Editor" because the subject is a highly controversial one, and I hope by presenting it in this manner to arouse a response which will reflect the opinion of pediatricians.

I submit that adoption agencies should be urged as a part of their program to attempt to find adoptive homes for mildly or moderately retarded children. I realize the difficulty in finding prospective parents for such children.
EDUCATION
Authors: Wyatt Tyree C. , Alsever William D.
Published: December 2021

THIS is a report of the plan for teaching basic pediatric pathology in connection with ward teaching during clinical clerkships, which has been in use for several years in the Pediatric Department of the State University of New York at Syracuse. Its success as one of the most practical ways of drawing the preclinical basic sciences closer to actual patient care may be of interest to teachers, either in pathology or on the wards, who feel that there is still too wide a gap between the preclinical years and the clinical teaching years. This problem has been one of long recognition and concern, varying in degree and intensity in different settings dependent in a large measure on the background in basic science training and experience of the clinical teachers.
Staphylococcal Infections
Authors: SHAFFER THOMAS E.
Published: December 2021

In the recent epidemic of staphylococcal infections in the newborn nurseries at Ohio State University Hospital, a single strain of Micrococcus pyogenes, phage type 42B-47C-44A-52, was found to be responsible for all lesions. A report of this epidemic is to be published in Pediatrics (Schaffer, T. E., Baldwin, J. N., Rheins, M.S., and Sylvester, R. L., Jr.: Staphylococcal infections in newborn infants: I. A study of an epidemic among infants and nursing mothers).

Since that time we have had opportunities to study organisms responsible for similar epidemics among newborns and nursing mothers in Portsmouth and Lancaster, Ohio; Lepeer, Michigan; Seattle, Washington; Hartford, Wisconsin; and Philadelphia, Pennsylvania, and have found that in every instance phage type 42B-47C-44A-52 was responsible.
IDIOPATHIC HYPOPARATHYROIDISM AND BILATERAL CONGENITAL GLAUCOMA IN THE NEONATAL PERIOD
Authors: Rhyne J. L. , Carriker Frederick R.
Published: December 2021

A case of idiopathic hypoparathyroidism and congenital bilateral glaucoma in the neonatal period is reported. No previous reports of these two conditions occurring concomitantly have been found.

No proven case of idiopathic hypoparathyroidism diagnosed during the neonatal period has been previously reported.

It is postulated that the hypoparathyroidism and the glaucoma were both congenital in origin. Their relationship to each other is unknown.
THE NATIONAL COUNCIL ON INFANT AND CHILD CARE, INC
Authors: BARBA PHILIP S
Published: December 2021

THE RECENTLY announced formation of the National Council on Infant and Child Care, Inc. will be welcomed with interest and enthusiasm not only by pediatricians but by all physicians. It is a cooperative effort of representative business concerns, other organizations and members of our profession. Its purpose is to combat the dangerous and increasing tendency toward ambiguous, misleading and sometimes actually false statements made in the advertising of products offered for use in various fields of medicine and child care. Another aim is to serve in an advisory capacity to authors, editors and producers of presentations on medical subjects for the reading and listening public.
STAPHYLOCOCCAL INFECTIONS IN NEWBORN INFANTS
Authors: Shaffer Thomas E. , Baldwin Jack N. , Rheins Melvin S. , Sylvester Robert F.
Published: December 2021

An outbreak of staphylococcal infections of infants and nursing mothers and the resultant epidemiologic investigation are described.

Accepted methods of routine prophylaxis of skin infection in the newborn nursery are re-evaluated.

Control of the epidemic was quickly achieved through the routine prophylactic administration of erythromycin to all infants in the nursery.

No erythromycin-resistant strains of coagulase-positive staphylococci emerged as the result of this method of epidemic control.

There were no untoward reactions to the antibiotic among 463 infants who received erythromycin prophylaxis.
ABNORMALITIES OF THE GENITOURINARY TRACT DISCOVERED BY PALPATION OF THE ABDOMEN OF THE NEWBORN
Authors: Sherwood David W. , Smith Richard C. , Lemmon Robert H. , Vrabel Irene
Published: December 2021

Twenty-four cases of congenital anomalies and pathologic states of the genitourinary tract, discovered by palpation of the abdomen in newborn infants have been presented together with a review of the literature and description of the methods employed in their detection.

The authors are of the opinion that deep palpation of the abdomen in newborns will reveal abnormalities, mostly of the genitourinary tract but also of the gastrointestinal tract, which are now being overlooked. It is also our belief that these pathologic conditions are most easily detected shortly after birth and that early detection is of great importance to the welfare of the patient.
ALLERGIC COLIC IN INFANTS IN THE GENERAL PRACTICE OF PEDIATRICS
Authors: Martin Frederick J.
Published: December 2021

Gastrointestinal allergy has been said to be a rare cause of colic in infancy. We had been impressed by the family history of allergy elicited in many cases. Frequent occurrence in colicky babies of stools containing mucus, eosinophils, and sometimes blood, was also noted. The Nance method of staining stool mucus for eosinophils was used. A point was made of inquiring concerning hay fever, allergic asthma, perennial allergic rhinitis, atopic dermatitis, frequent and severe sinusitis and migraine headache, in the mother, father, siblings, grandfathers, uncles, aunts and first cousins. This has been done in the case of all newborns.

The following data were accumulated from newborns whom we treated throughout the course of their complaint.

We found 367 colicky infants among 611 who came from allergic families, an incidence of 60.1 per cent; among 296 infants from non-allergic families, 74 had colic, an incidence of 25 per cent. Where the father and mother both suffered from major manifestations of allergy, out of 55 infants, 43 had colic, an incidence of 78.2 per cent.

A total of 814 infants had 308 colicky babies among them, an incidence of 36.1 pen cent in our practice. These data were gathered because we could find none in the literature answering the basic question of the incidence of colic in private pediatric practice. A broad cross-section of social classes and nationalities found in a metropolitan area were included. The over-all incidence of 36.1 per cent was a surprise to us. The incidence of 60.1 per cent of colic found in allergic families was impressive.
STUDIES ON KETOSTEROIDS IN URINE OF NORMAL CHILDREN USING ALUMINA CHROMATOGRAPHIC FRACTIONATION
Authors: Masuda Minoru , Holmes Thomas H.
Published: December 2021

Patterns of urinary excretion of ketosteroids in eight normal children, four males and four females, ranging in age from 3 to 5 years, were determined by alumina chromatography. The method has also been applied to urines of five normal adults.

The patterns of excretion in these boys and girls were alike.

Comparison of patterns of excretion of children with those of normal adults reveals important differences. There is a relatively lower excretion of androsterone and etiocholanolone. The 11-oxy l7-ketosteroid excretion is percentage-wise the same in children as in adults. There is a relative increase in other unidentified ketosteroid metabolites.
Family, Socialization and Interaction Process
Authors: KUHN MANFORD H.
Published: December 2021

This book is altogether unlike any other sociological treatise on the family. There are two generally recognized types of books on marriage and the family. One, theoretical in nature, deals with the family as a social institution. The other deals with the problems of courtship, marriage and parenthood—more or less as a manual for youths in contemporary society. The book at hand does not structure the family as a social institution, but neither is it in any sense a popular, practical manual for the guidance of youth in pursuit of marital bliss!
CONGENITAL MALFORMATIONS AND PEDIATRICS
Authors: Warkany Josef
Published: December 2021

Congenital malformations are of interest to the pediatrician because they contribute greatly to children's mortality and morbidity.

When pediatrics emerged as a new medical specialty around the turn of the century it was dominated by interest in nutritional and infectious diseases, which were in those days the most urgent problems confronting our predecessors. The two generations of pediatricians who worked before ours were incredibly successful; they reduced the mortality and morbidity of infants and children to an extent considered impossible by the founders of the specialty. Although much credit must be given to improved sanitation, to improved social and economic conditions and to other sciences, pediatrics can claim a share in the success, because it recognized the problems, directed the reforms and applied and devised medical treatment. However, children are still subject to illness or death and our hospitals are overcrowded. It is generally recognized that a shift has taken place in the spectrum of the causes of death and disease.1-4 The fetal and neonatal mortality rates have not fallen so rapidly as have those of older age groups.1,5 While some of the causes of early death yield to medical measures, others persist and assume increased relative importance. Congenital malformations are among the persistent offenders. They show a relative increase in neonatal life and throughout early childhood (Figs. 1 and 2).

It is of interest to compare the trends of mortality from diseases which were in the center of pediatric attention with those from the neglected congenital malformations. In Figure 3 are plotted the percentage contribution of deaths under 1 year of age from enteritis against deaths from congenital malformations, as reported by the U.S. Vital Statistics between 1910 and 1952.6
THE PHILOSOPHY OF THE ASSOCIATION FOR THE AID OF CRIPPLED CHILDREN IN RELATION TO GRANTS FOR MEDICAL RESEARCH
Authors: Mayo Leonard W.
Published: December 2021

The board of the Association for the Aid of Crippled Children asked me to convey its greetings to the participants in this conference and the hope that it would prove to be a valuable one. The Association is happy to have had a part in making the conference possible and it is an additional pleasure to have joined with the Human Embryology and Development Study Section of the National Institutes of Health in furnishing the auspices for it.

On the assumption that not everyone is acquainted with the present program of the Association and why it is interested particularly in teratology and related research, a brief description of the current program will be given.

The Association was founded in 1900. Its first service was the teaching of crippled children. As new developments dictated, it moved later into a program of financial, material and medical aid to handicapped children and their families and later to nursing and physical therapy and the teaching of public health nurses in orthopedic nursing.

In 1900, a horse-drawn carriage trundled through a small East Side New York neighborhood bringing crippled children to the first special class in the city conducted by the Association. In 1953, a huge Stratoliner flew the Association's director halfway around the world to help plan for the rehabilitation of Korean children. This switch from horsepower to air power is more than symbolic. It represents the changes in program brought about through the years. The Association had a part in shifting the focus of interest in handicapped children from the handicap itself to the whole child and his total needs and this in turn led to a new emphasis on prevention.
ACKNOWLEDGMENTS
Authors: May Charles D.
Published: December 2021

The Conference on Teratology at which the papers in this Supplement were presented was subsidized by the Association for the Aid of Crippled Children and a grant from Human Embryology and Development Study Section, Division of Research Grants, National Institutes of Health, United States Public Health Service.

The Conference was organized by Dr. Josef Warkany, Professor of Pediatrics, College of Medicine, University of Cincinnati. Dr. Warkany serves as Guest Editor for this Supplement to Pediatrics at the invitation of the Editorial Board. Publication of this Supplement was made possible through provision of the necessary funds by the Association for the Aid of Crippled Children.

Dr. Walter Landauer presented a paper entitled "Problems of Avian Teratology with Special Reference to Genetics." This paper is not included in this Supplement as the material will be published under the title "Phenocopies and Genotype, with Special Reference to Sporadically-occurring Developmental Variants" in The American Naturalist (91: March-April, 1957).
PREMATURE AND NEWBORN INFANTS
Authors: Day Richard L. , Silverman William A.
Published: December 2021

Participating in the seminar's first session were Dr. William R. Richardson, Kings County Hospital, Brooklyn, New York, who served as moderator, Dr. Thomas Santulli, Children's Surgeon at Columbia-Presbyterian Hospital, New York City, Dr. Marel H. Harmel, Anesthesiologist at Kings County Hospital, and Dr. Lawrence K. Pickett, Chief of Surgery at the State University of New York Medical Center in Syracuse. All speakers emphasized the importance of closely co-operative effort by pediatricians, surgeons, radiologists, anesthesiologists and nursing personnel to facilitate early recognition, diagnosis and effective treatment of neonatal complications requiring surgery.

Diagnosis

Early recognition of surgical problems usually depends upon the observations of well-trained nurses. Any history of obstetric complications especially breech presentation, a maternal history of hydramnios, any signs of respiratory distress, difficulty in swallowing at the time of the first feeding, emesis of bile-stained fluid, abdominal distention, or failure of the appearance of the first stool within 24 hours after birth should alert all observers to the possibility of complications which will require surgery.

As soon as respiratory or gastrointestinal complications are suspected, Dr. Pickett requests radiologic consultation. A roentgenogram of the chest, taken at this time, will delineate not only the infant's pulmonary status, but also the gas pattern of the intestinal tract. When the clinical picture suggests gastrointestinal obstruction, Dr. Pickett and his colleagues employ a No. 8 to 10 French soft rubber catheter, specially prepared by punching several holes in its terminal 1 cm portion. This tube is inserted under fluoroscopic control and passed cautiously to avoid traumatic puncture of any obstructing tissue which may be encountered When esophageal atresia is recognized the proximal esophageal pouch is carefully aspirated to remove pooled saliva.
REHABILITATION OF NEUROMUSCULAR DISTURBANCES
Authors: Denhoff Eric , Jones Margaret H.
Published: December 2021

The report of the Baruch Committee on Medicine, April, 1944, has stated the problem as follows: "There is a gap between the customary endpoint of medical attention and the real necessities of many patients. In general, physicians have filled this gap in a lackadaisical and spotty manner. Rehabilitation fills this gap and provides maximal improvement for the patient."

The early attention to total appraisal, attempted prognostication, intelligent therapeutic emphasis, and the development of desirable traits for eventual vocational placement, are of major importance. A continuing interest in these same objectives in a given patient, must be maintained.

It is apparent that the pediatrician must assume a more important role in rehabilitation in view of his early contact with most of these children, if the most effective rehabilitation program is to be instituted appropriately for attainment of the best possible results in later life.
NEONATAL ANEMIA DUE TO FETAL HEMORRHAGE INTO THE MATERNAL CIRCULATION
Authors: Gunson H. H.
Published: December 2021

A case of anemia caused by loss of fetal blood into the maternal circulation is reported. The diagnosis was established by detection of fetal erythrocytes in the maternal circulation by differential agglutination. Ashby counts on the mother's blood, showed that the fetal cells persisted in the maternal circulation for approximately 80 days, following which the mother developed Rh antibodies. Fetal hemorrhage from the placenta probably not infrequently causes anemia in the newborn period. In many cases, however, conclusive proof of such a diagnosis is not made.
COEXISTENCE OF TUBERCULOUS AND CRYPTOCOCCAL MENINGITIS
Authors: Nanda Satya P. , Kass Irving , Cohn Maurice , Dressler Sidney H.
Published: December 2021

A case is reported in which tuberculous meningitis and cryptococcal meningitis are thought to coexist. This has not been reported previously in the literature. Apparent remission of the cryptococcal meningitis followed therapy with ethyl vanillate. A review of the literature, including the treatment of cryptococcosis is presented.
SHOCK IN THE NEWBORN CAUSED BY TRANSPLACENTAL HEMORRHAGE FROM FETUS TO MOTHER
Authors: Shiller Jack G.
Published: December 2021

1. A case of shock in the immediate postnatal period is presented. Its origin is believed to be in transplacental hemorrhage from fetus to mother just prior to delivery.

2. Evidence for proof of this hypothesis consists of:

a. The clinical condition of the infant.

b. An elevated concentration of bilirubin in the serum in the mother immediately post partum, with subsequent disappearance.

c. An elevated concentration of fetal hemoglobin in the mother's peripheral blood immediately post partum with subsequent disappearance.

d. A rising anti-A titer in the mother over a 3-month period post partum with subsequent fall.

e. Microscopic sections of the placenta showing nucleated erythrocytes in the maternal vascular spaces.

3. It is concluded that transplacental hemorrhage may explain shock or severe anemia in a newborn infant who does not show obvious bleeding or laboratory evidence of hemolytic disease.

4. Simple transfusion is the treatment of choice.
PHYSIOLOGIC HYPERBILIRUBINEMIA AND HEMOLYSIS OF ERYTHROCYTES BY HYDROGEN PEROXIDE SOLUTION IN THE NEWBORN: INVESTIGATION OF A POSSIBLE RELATIONSHIP
Authors: Richards Jo-Anne E. , Goldbloom Richard B. , Denton Ronald L.
Published: December 2021

Forty-three full-term infants have been studied with respect to hemolysis of erythrocytes in solutions of hydrogen peroxide and concentrations of bilirubin in the serum.

Mean values for concentration of bilirubin in the serum and percentage of hemolysis followed similar patterns in the first few days of life. However, statistical analysis of the data in individual cases showed no significant correlation between the degree of hemolysis in solutions of hydrogen peroxide and the concentrations of bilirubin in the serum.

Administration of vitamin E prevented an increase in hemolysis of erythrocytes in solutions of hydrogen peroxide but failed to produce any significant change in concentrations of bilirubin as compared with the control group.

The evidence suggests that the relative deficiency of vitamin E which exists in most newborn infants does not play a part in the causation or maintenance of physiologic hyperbilirubinemia.

The clinical significance of increased hemolysis of the erythrocytes of the newborn infant in solutions of hydrogen peroxide remains a mystery. Possible approaches to the clarification of this problem are suggested.
EDUCATION
Authors: Boder Elena
Published: December 2021

An integrated program for training medical students in the diagnosis and treatment of handicapped children is presented. Jointly sponsored by a medical school and a public school system on the basis of mutual advantage, it utilizes the invaluable teaching material provided by a School for Physically Handicapped Children.

The chief educational advantage of the program lies in providing means for medical students to see handicapped children not merely as patients in a hospital or clinic but as children engaged in the normal co-operative and competitive activities of an educational setting. This unique feature is in accord with the current trend in medical education toward providing opportunities to observe children in normal social situations.

It is anticipated that as more medical schools and resident training centers recognize the feasibility of teaching programs that utilize community facilities for handicapped children, new programs will develop in many areas. Reports on these programs as they develop can be valuable in stimulating further interest in integrating independent facilities and personnel into medical education.
INDICATIONS FOR TREATMENT OF ASYMPTOMATIC TUBERCULOSIS IN CHILDREN
Authors: Yeager Robert L.
Published: December 2021

FROM 1915 until 1930, medical literature was filled with discussions concerning the necessity of the treatment of patients whose roentgenograms showed open cavities but who in other respects were relatively asymptomatic. In many instances such patients were offered little or no treatment. From 1925 to 1945 authors questioned the necessity of the treatment of minimal, but otherwise asymptomatic tuberculosis. Now all agree that such cases should be treated.

In the early days after the discovery of streptomycin, antimicrobials were reserved for those patients who showed progressive pulmonary tuberculosis while under other forms of treatment. It was common to save chemotherapy until it was needed. Today, in any tuberculosis hospital, approximately 100% of the patients admitted, and proven to have tuberculosis, will be treated with chemotherapy.

It is a well-established fact that a primary infection confers a certain degree of resistance to reinfection. The good effects of the primary infection have been so fully studied both in experimental animals and in humans, particularly in regard to the program of vaccination, that the deleterious effects have been frequently overlooked.

A person who is a recent tuberculin converter undoubtedly has living tubercle bacilli in his body. No one has yet proven what happens to these bacilli either in the experimental animal or in the human. For years it was assumed, but without positive proof, that they slowly or rapidly died. It is now realized that while they may not multiply, they may remain dormant but living in the lymph node component of the primary complex.
CUTANEOUS CANDIDIASIS IN EARLY INFANCY AND CHILDHOOD
Authors: Kozinn Philip J. , Taschdjian Claire L. , Dragutsky David , Minsky Arnold
Published: December 2021

The presence of Candida albicans in the stools of newborn infants, detected by routine laboratory tests, was overwhelmingly indicative of subsequent oral and/or cutaneous candidiasis.

Cutaneous candidiasis in newborn infants may occur independently of oral lesions, and in such cases C. albicans may be present in the stools only.

Cutaneous candidiasis may appear during the first week of life. It should be suspected in all infants suffering from oral thrush or from unmanageable diaper dermatoses. The diagnosis should be confirmed by laboratory examination of scrapings from the lesions and stool specimens.

One hundred per cent of the newborn infants and 88% of the older children who suffered from candidal diaper rashes harbored C. albicans in the intestine.

Since infected stools are obviously a focus for such cutaneous lesions, local therapy should be supplemented with medication designed to eliminate C. albicans from the digestive tract.

Candida albicans was not isolated from the mouth, skin, or stools of 15 newborn infants with "red buttocks" and of 17 patients with ammoniacal, contact or seborrheic dermatitis.

Scrapings and cultures from healthy skin, and from the site of cured candidal lesions were negative for C. albicans.

On the basis of these findings and reports in the literature, it is concluded that C. albicans occurs on the skin only in pathologic conditions attributable to the organism.
INDICATIONS FOR EXCRETORY UROGRAPHY IN CHILDREN
Authors: Askin John , Reichelderfer Thomas , Salik Julian , Merritt Jules
Published: December 2021

The indications for excretory urography derived from the results of 797 examinations in 656 subjects are presented. Twenty-eight per cent of all urograms performed were abnormal (191 patients).

The most important indications for performing this procedure were, in order of frequency, pyuria, recurrent abdominal pain, hematuria and abdominal masses.

The results of the study emphasize the importance of urographic examination in both male and female children after the first attack of pyuria, and in children with repeated attacks of unexplained abdominal pain.
Principles and Technics of Rehabilitation Nursing
Authors: JONES MARGARET H.
Published: December 2021

The authors' stated aim is to produce a practical guidebook on rehabilitation for nurses. The majority of the material presented deals with adults who were "normal" prior to a specific illness or accident. Emphasis is given to the importance of consideration of the person as a whole, his social and emotional needs as well as those of his illness, be it acute or chronic, beginning at the time of hospitalization. The multidisciplined approach with the doctor as the co-ordinator but integrating psychologists, social workers, therapists, teachers, nurses and others, is discussed and illustrated by case examples. This approach is deemed necessary to help many individuals regain a place in society after acute or chronic illness.
PROGRESSIVE HEREDITARY DIAPHYSEAL DYSPLASIA
Authors: Stegman Kenneth F. , Peterson J. C.
Published: December 2021

A patient with hereditary progressive diaphyseal dysplasia with severe physical manifestations and bony changes is reported in detail.

The diagnosis made at 18 months is the earliest reported. The progression of the physical and roentgenographic changes over a period of 3½ years are noted. In this patient, necrosis and atrophy of muscle were demonstrated in a biopsy. A thorough roentgenographic survey failed to reveal any changes in other members of the family.
PNEUMOCYSTIS CARINII PNEUMONIA
Authors: Eberling Ernest W. , Cohen Frank
Published: December 2021

A native-born American infant presented clinical and pathologic features characteristic of pneumonia due to Pneumocystis carinii. Apparently at the present writing this is the second such case to be reported from the United States. Though the clinical picture was distinctive enough to suspect the etiology during life, confirmation awaited pathologic studies. This is the third known case to show a low concentration of gamma globulin as a possible contributory factor. Much remains to be learned about this distressing but apparently quite distinctive pulmonary disease, which may be more common than is now generally appreciated.
THE RELATION OF SERUM CONCENTRATIONS OF BILIRUBIN TO RESPIRATORY FUNCTION OF PREMATURE INFANTS
Authors: Miller C. Arden , Reed Henry R.
Published: December 2021

This study showed that in infants weighing less than 1750 gm at birth the concentration of bilirubin in the serum rose higher and reached a peak a little later than in premature infants weighing more than 1750 gm.

Infants whose respiratory rates increased significantly after the first hour and who were therefore classified as Group III, had concentrations of bilirubin in the serum which were significantly higher than those of other infants in the study. This difference did not appear to be accounted for on the basis of differences in birth weight alone.

Twenty per cent of the infants in Group III developed concentrations of bilirubin in the serum in excess of 14.0 mg/100 ml. No infant in groups I and II developed concentrations of bilirubin greater than 14.0 mg/100 ml. These studies indicate that classification of premature infants according to the trend of the respiratory rate has predictive value for identifying those infants who may develop hyperbilirubinemia not associated with proved blood group isoimmunization.

Explanation for the association between the trend of the respiratory rate and the concentration of bilirubin in the serum is not clearly evident.
Liver, Biliary Tract and Pancrfas
Authors: CLIFTON JAMES A.
Published: December 2021

This volume is the latest addition to the Ciba Collection of Medical Illustrations by Frank H. Netter, M.D. Volume III of this series is to be devoted to the digestive system and will be published in three parts. The publishers state that due to current interest in diseases of the liver this monograph is being published first, though it is part III of the digestive system volume. Doctor Ernst Oppenheimer is the general editor of this series and in the preparation of this particular volume he has been ably assisted by a panel of outstanding authorities.
Letters to the Editor
Authors: TRIEGER NORMAN
Published: December 2021

My suggestion of incorporating sodium fluoride into pediatric vitamin preparations, as a reliable and practical method, in areas where there is no communal water fluoridation was offered as a suitable "vehicle for fluoride administration."

I appreciate the significance of Dr. Doty's remarks on proper dosage, particularly as related to patient age, and wish to point out that the dosage I originally used, 0.5 mg of sodium fluoride, was intended for infants. I have since increased this dose— based on the schedule suggested by the National Research Council.
Microtechniques of Clinical Chemistry for the Routine Laboratory
Authors: KAPLAN SOLOMON A.
Published: December 2021

The need of the pediatrician to have available microtechniques of chemical analysis of constituents of the blood has become a pressing one over the past 10 years. As the value of reliably-performed determinations came to be appreciated, it was realized that, especially in the case of the care of small children, methods had to be devised which would make it possible to gain a considerable amount of information from the analysis of 1 ml of blood or less.
The Good Housekeeping Book of Baby and Child Care
Authors: ROSS RALPH A.
Published: December 2021

The association of an author so well known and an agency so long connected with practical advice to American mothers, has produced a highly readable book on the care of children, from early pregnancy in the mother through adolescence. It is impressive in format and contains many line-drawing illustrations by Saul Lambert and a number of handsome photographs by Tana Hoban. The latter have only slight illustrative value.

Doctor Halt's chapters on basic nutrition and description of disease entities known generally to the lay public are simply, concisely and enjoyably written.
Roentgen Diagnosis of Abdominal Tumors in Childhood
Authors: CAFFEY JOHN
Published: December 2021

This small book is a compendium which describes in detail the radiographic changes produced by tumors in the abdomens of infants and children. The authors, all from the University of Minnesota, emphasize the value to the surgeon, before laparotomy, of accurate identification of the size and position of these tumors by relatively simple radiographic methods free of the hazards of repeated manual palpation of tumors, in the case of malignancies.

The first part of the book is concerned with the embryologic and anatomic aspects of abdominal masses, and the radiographic methods which are most helpful in their study.
NEPHRECTOMY IN JUVENILE HYPERTENSION ASSOCIATED WITH RENAL DISEASE
Authors: Welch Herbert C. , Harris Lloyd E. , DeWeerd James H.
Published: December 2021

Fifteen children who had hypertension apparently associated with renal ischemia underwent nephrectomy. Of 11 who presumably had unilateral renal disease, 9 were observed for at least 1 year with 8 maintaining normal blood pressure and 1 still being hypertensive.

Four children were believed to have bilateral renal disease but with greater impairment of function of one kidney than the other. Removal of the more severely affected kidney in these children did not result in reduction of the blood pressure. Three of the four were dead in from 2 months to 6 years after nephrectomy and in the fourth hypertension persisted after 2½ years.

The presence of hypertension in a child demands thorough investigation as to the etiology since the hypertension may be of the secondary type and therefore often curable.
ANTIBIOTICS AND IATROGENIC DISEASE
Authors: Roy T. E.
Published: December 2021

THE ASSOCIATION of the term "iatrogenic disease" with the clinical use of antibiotics poses many problems.

Physicians generally are familiar with most of the untoward reactions that may follow the use of antibiotics, and many excellent reviews of the subject are to be found in the literature.

One cannot divorce the undesirable effects of antibiotics from the beneficial ones and, in this light, therapy becomes a calculated risk. If the probable discomforts or dangers outweigh the probable advantages, the cure may be worse than the disease, and one is then dealing with true iatrogenic disease.

Probabilities of this kind cannot be assessed easily with antibiotics because reactions vary so much with type of drug, dose, course, method of giving and in different patients. Certain reports may be biased one way or the other because of personal prejudices or unusual series. Some ill effects are undoubtedly related to unwise, improper or careless use of the drug; others are not. So true incidences are not accurately known. Reactions where antibiotics are being used needlessly for trivial infections or for unnecessary prophybaxis are particularly deplorable while risks are justified when dealing with severe infections known to respond. Evaluation is difficult with infections of borderline severity and those prone to exceptionally severe secondary bacterial complications.

Reactions may be mild or severe; none is negligible. Oxytetracycline, for example, is considered to be relatively harmless. Still, Jackson and his colleagues reported that 58% of patients with pneumonia showed untoward effects attributable to this antibiotic. Most reactions were mild, but the antibiotic was believed to have contributed in large measure to the fatal outcome in five of the seven patients who died in the 91 cases.
THE EFFECT OF POSITION ON THE RESPIRATORY RATE OF PREMATURE AND MATURE NEWBORN INFANTS
Authors: Kravitz Harvey , Elegant Lawrence , Block Bernard , Babakitis Mary , Lundeen Evelyn
Published: December 2021

Values for respiratory rates in the supine and prone positions in 96 premature and 49 full-term infants have been presented. Premature infants have a significant increase in respiratory rate in the prone position compared to the supine position. This difference decreases with increasing weight and age. Mature infants show a slight increase in respiratory rate in the prone compared to the supine position.

The position of the premature infant has a definite effect on the physiology of respiration. Further studies must be done to establish whether the supine or prone position is superior. Irregularity of rate and amplitude of respirations are noted in the supine position, while respirations of regular rate and amplitude are frequently found in the prone position. The amplitude of respiration was greater in the supine position than in the prone position.
A COMPARISON OF THE FIBRINOLYTIC ENZYME SYSTEM IN MATERNAL AND UMBILICAL-CORD BLOOD
Authors: Phillips Louise Lang , Skrodelis Valija
Published: December 2021

Studies of the fibrinolytic enzyme system in the plasma of mothers and the newborn infants are reported and the results compared.

All mothers had elevated levels of fibrinogen in the plasma at the time of delivery. The levels of fibrinogen in the newborn infants fell into a low normal range. Premature infants tended to have slightly lower levels of fibrinogen than term infants, with certain exceptions which are discussed. A direct correlation of values for fibrinogen with the birth weight could not be established. No correlation was observed between fibrinogen levels in mothers and infants, indicating that significant placental transfer of fibrinogen does not occur under normal conditions and that fibrinogen is manufactured by the fetus itself.

All mothers had higher levels of free and total profibrinolysin in the plasma than did the infants. The differences were found to be highly significant. The levels of free profibrinolysin in premature infants did not vary as much from those of the term babies, as was the case with total profibrinolysin. The levels of total profibrinolysin show a definite trend upward with increasing birth weight.

Inhibitors of the fibrinolytic enzyme system were also significantly higher in mothers than in infants. Premature infants had significantly lower levels than term infants although considerable overlapping in the range was noted.

Evidence was obtained that small amounts of an active proteolytic enzyme are present in the euglobulin fraction of the mother at delivery even after the course of a normal labor. No hemorrhagic manifestations were observed, presumably because of the high levels of inhibitor in maternal blood. In contrast, lysis of clots was observed more frequently in samples of cord blood, possibly due to lower levels of inhibitor.

Placental transfer of various decomposition products of protein apparently exists as indicated by measurements of trichloracetic acid-soluble products in samples of plasma.

A possible relation between the low proteolytic activity of the plasma of premature infants and the high incidence of fatality from hyaline membrane disease in these infants is proposed and discussed.
Hormones in Blood, Ciba foundation Colloquia on Endocrinology, Volume XI
Authors: KELLEY VINCENT C.
Published: December 2021

This book is the report of a Ciba Foundation Symposium held February 18-22, 1957. The list of participants includes the names of 35 of the world's leading investigators in endocrine research. Among these are scientists from North and South America and Europe, all of whom have made major contributions in developing and applying methodology for the detection and quantitation of hormones in blood.

In the 410 pages of this volume there are included verbatim the papers which were presented formally at the Conference as well as detailed reports of the free and spontaneous discussion which followed each presentation.
THALLIUM POISONING
Authors: Chamberlain Philip H. , Stavinoha William B. , Davis Helen , Kniker William T. , Panos Theodore C.
Published: December 2021

Fourteen children with thallium poisoning are described.

Alopecia and neurologic symptoms dominate the clinical picture. In the absence of alopecia, the diagnosis depends upon a high degree of suspicion in regard to any child presenting bizarre neurologic complaints with acute onset.

The best means of confirming a diagnosis of thallotoxicosis is by finding thallium in the urine.

Dithizon appeared to be beneficial treatment in five of six severely ill patients. Further cautious trials of this drug are indicated.

On the basis of the few patients studied, it appears that increased urinary excretion of thallium is not correlated with urine volume, clinical improvement or the use of dithizon.
Neomycin: Its Nature and Practical Application
Authors: ADAMS JOHN M.
Published: December 2021

This book on neomycin is an excellent compilation f information on an antibiotic that has gained a permanent place among the useful therapeutic agents of today. Edited by Dr. Waksman and his associates, comprising a total of 35 contributors, no aspect of the story of neomycin is untouched from its brief history of less than ten years since its discovery in 1949 to its everyday use in clinical medicine at the present time.

Neomycin has found a permanent place in the therapy of man and animals, and because it is not readily absorbed from the gastrointestinal tract it has become an ideal intestinal antiseptic agent as well as being highly useful in the treatment of many infectious diseases.
Letters to the Editor
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

An excellent review by Dr. Howe (Effect of vitamin B12 on growth-retarded children: Am. J. Clin. Nutrition, 6:818, 1958) was not available to the Committee on Nutrition during the preparation of their Report. His comments are appreciated. The Committee is fully sympathetic with the point of view expressed in Dr. Howe's letter and with the conclusion in his review article: "More detailed, carefully controlled clinical experiments are clearly indicated to give an unequivocal answer to the question of the prevalence and importance of vitamin B12 deficiency in children in this country.
Anomalies of Infants and Children
Authors: WARKANY JOSEF
Published: December 2021

This book was written, according to the foreword, primarily for students and general practitioners. It is designed as a quick reference to aid in discussions with parents and to facilitate an understanding of the anatomic anomalies discussed, of the resulting functional disturbances and their treatment.

The authors are plastic surgeons and the subject matter is chosen essentially from their point of view. They deal with a variety of congenital anomalies but also with disorders resulting from postnatal injuries. Such etiologically heterogeneous subjects as deformities of the skull and brain, facial clefts, hemangiomas, fractures and dislocations of the facial bones and dental caries are discussed.
Association of Outpatient Directors
Authors: OLMSTED RICHARD W.
Published: December 2021

In this issue of Pediatrics appears an article by Doctor Barbara Korsch entitled "Pediatric Outpatient Departments."

In her article, Doctor Korsch states that "a group of pediatricians with special interest in outpatient work have met together over a series of years to discuss problems of common interest." It seems appropriate at this time to acquaint others with the history, present status and future plans of this group.

Since 1953, this group has met at the time of the combined meetings of the American Pediatric Society and the Society for Pediatric Research to discuss "problems of common interest." Anyone interested in outpatient department matters has been invited to participate. In 1956 and 1958, formal agenda were arranged for presentation of specific topics but with these exceptions the meetings have consisted of informal discussions. Until the present no attempt has been made to establish a definitive organization.
BODY SURFACE AS A BASIS FOR DOSAGE
Authors: FORBES GILBERT B.
Published: December 2021

MODERN therapeutic technology, with its array of drugs, sera and infusates, has demanded that the pediatrician devise some means whereby these materials can be given in proper dosage to subjects of widely varying size. At the same time modern clinical investigation has indicated the extent to which the human young differ metabolically and physiologically from adults. The practitioner has seen for himself that the dosage of many therapeutic agents is far from a simple linear function of body weight. The result has been the formulation of a number of dosage schemes, the most recent of which is the surface-area rule. In this scheme, dosage is expressed as grams or milliliters of a given material per square meter surface area rather than per unit body weight.

Body surface is calculated from weight and height according to the conventional DuBois nomogram, or from weight alone. The use of this rule automatically provides the infant with a larger per kilogram dose than the older child. This is because surface area increases less rapidly than weight as the body grows.
Modern Trends in Pediatrics
Authors: MAY CHARLES D.
Published: December 2021

The editors of this volume occupy senior positions in departments of pediatrics in England. They have been fortunate in securing a distinguished list of contributors from England, the United States and Russia. The scope of the 21 contributions which make up this Second Series of Modern Trends is comparable to that familiar to readers of Advances in Pediatrics published in the United States. Modern Trends attempts to cover the recent advances in the entire field of pediatrics, as broadly conceived, in contrast to the fewer selected contributions in each volume of Advances in Pediatrics.
The Mentally Retarded Child at Home
Authors: KUGEL ROBERT B.
Published: December 2021

Mrs. Dittman skillfully utilizes her wide experience as a specialist in child development to bring together in this small booklet information which doubtless will be of inestimable value to parents as they attempt to cope with the varied and complex problems of day-to-day-living which their mentally retarded children present. It is written in a style suited for a wide variety of people and stands as an excellent companion-piece with other Children's Bureau publications pertaining to child care. Nowhere in the booklet is there any maudlin sentimentality or crass indifference, so often seen material written about handicapped children. Quite the contrary, the style is one of sympathetic understanding where every effort has been made to present the problem of home care in an honest, forthright manner.