bluuebunny/crossref_metadata_2025 huggingface dataset:
Geological structure and prospects of oil-gas presence at the Pohar plot (Folded Carpathians)
Authors: Shlapinsky Volodymyr , Pavlyuk Myroslav , Lazaruk Yaroslav , Savchak Olesya , Ternavsky Myroslav
Published: December 2021

The Pohar plot is situated in the Skole district of the Lviv Region, 30 km south-west of Skole town, between Pohar and Kryve villages. Tectonically it is located in of junction of the Skybian (Slavske Skyba) and the Krosno covers. At the end of XIX beginning of XX centuries in the region of the village the oil-extracting enterprise was existent. There deposits of Oligocen and Eocene of the Rozluch belt of the Krosno cover and Oligocene of the scale of the Slavske skyba of the Skybian cover were exploited. During two ten-years of exploitation by exploring shafts and shallow boreholes more than 3 thousand ton of oil was extracted. Prospects of the Pohar plot should be connected with sand horizons of the Holovets suite of Oligocen (Klivsky sandstones) that are characterized by satisfactory reservoir properties. They are localized in the immersed part of the Hrosivsky scale of the Krosno cover separated by the Rozluch fault (tectonically screened deposit) from its forkball part, drilled in 1973–1974 1-Pohar borehole (well bottom 1935 m), due to deflection of its hole to the south-east, didn’t expose the Klivsky sandstones and didn’t solve its task. For complete exposition of the Klivsky sandstones of the Holovets suite of Oligocene of the Hrosivsky scale it is necessary to design vertically oriented 2-Pohar borehole of 2300 m in depth. About probable commercial oil-gas saturation of the horizon of the Klivsky sandstones testifies not only to the existence of the oil-extracting enterprise in the past, but the intensive surface oil shows in the stretched area that is controlled by the Rozluch fault. Moreover, taking the prospect of the zone of junction of the given covers in consideration, the seismic survey should be conducted at the Pohar area for the estimation of the geological structure of the deeper horizons and parametric borehole of 4000–5000 m in depth should be designed.
Prospects for oil and gas presence of Lower Sarmatian deposits in the north-western part of the Outer zone of the Carpathian foredeep (by hydrogeochemical and hydrodynamic indicators)
Authors: Medvid Halyna , Teleguz Olga , Harasymchuk Vasyl , Kost’ Maria , Kalmuk Solomiya
Published: December 2021

The hydrogeochemical parameters of the Lower Sarmatian aquifer of the north-western part of the Outer Zone of the Carpathian Foredeep have been studied. The waters of the chloride-calcium type (according to the classification of V. O. Sulin) are dominated. Other types of water are distributed locally. On the basis of the calculated genetic coefficients, the conclusion on sedimentogenic conditions of their forming during a geological history of the region is made. It is established that the general tendency for the deposits of the Outer Zone is increasing of TDS of water with depth and stratigraphy. The waters of the north-western part of the Outer Zone are characterized by reduced values of sulfate content and sulfation coefficient rSO42– • 100/rCl–, indicating the conditions of hydrogeological closed structures. The genetic index of formation water metamorphism (rNa+/rCl–) is mainly inversely dependent on TDS. Its values greater than one are inherent in waters of hydrocarbonate-sodium and sulfate-sodium types, which are not typical for the hydrocarbon deposits. The nature of fluctuations in the values of the chlorine-bromine coefficient is fully consistent with other hydrochemical parameters and the results of paleohydrodynamic reconstructions. A detailed analysis of the current hydrodynamic situation of Lower Sarmatian aquifer in combination with geochemical features and paleohydrodynamic reconstructions allowed to identify the perspective structures of the studying region. Our forecasts for the gas potential of the Krukenychy depression are consistent with the forecasts of researchers of Ivano-Frankivsk National Technical University of Oil and Gas. The results of their research are based on gravitational field anomalies.
Innovative technologies of the prospecting for mineral deposits based on data of fluid inclusions research
Authors: Naumko Ihor , Svoren Yosyp
Published: December 2021

The innovative approach to the development of prospective technologies (methods) was substantiated on crystallogenic and physicochemical principles of the knowledge of mineral forming environments (fluids) (thermobarogeochemistry – mineralofluidology – fluid inclusions) as a new branch of geological knowledge within the framework of the new scientific direction in the geology – «thermobarometry and geochemistry of gases of veinlet-impregnated mineralization in deposits of oil- and gas-bearing areas and metallogenic provinces» as a natural phenomenon of the Earth’s lithosphere. According to him, the creation of radically new technologies and realization of prospecting for mineral deposits (first of all hydrocarbons and gold) simultaneously with the elucidation of the problem of genesis and synthesis of hydrocarbons at the atomic-molecular level fixed by such defects in the mineral crystals as fluid inclusions. Developed technologies, namely: determination of genesis of hydrocarbon gases; determination of prospects of oil and gas presence of a local area; local forecast of enriched areas of gold ore fields; express determination of potassium ions in inclusions for identification of gold-enriched and barren veinlet formations, – belong to the branch of the exploration geology and geochemistry and are used to ascertain genetic guestions, to solve tasks of the mineralogical-geochemical prediction and prospecting for mineral deposits in the local structures of oil- and gas-bearing areas and metallogenic provinces. The comparison of fluid inclusions of veinlets and host rocks based on the sections of a number of wells has shown the considerable possibilities of the developed technologies and prospects of the usage of thermobarogeochemical-mineralofluidological indicators in the complex with the geochemical and geophysical (petrophysical) methods, data of geological survey, deep-seated drilling while predicting hydrocarbon deposits in the local structures of the sedimentary strata promising for oil and gas and making necessary amendments in the directions of the following geological-prospecting works.
Family-Rated Pediatric Health Status Is Associated With Unplanned Health Services Use
Authors: Steele Brian J. , Kemp Kyle , Fairie Paul , Santana Maria J.
Published: December 2021

OBJECTIVE

Self-rated health is a common self-reported health measure associated with morbidity, mortality, and health care use. The objective was to investigate the association of family-rated health status (FRH) in pediatric care with administrative indicators, patient and respondent features, and unplanned health services use.

PATIENTS AND METHODS

Data were taken from Child-Hospital Consumer Assessment of Healthcare Providers and Systems surveys collected between 2015 and 2019 in Alberta, Canada and linked with administrative health records. Three analyses were performed: correlation to assess association between administrative indicators of health status and FRH, logistic regression to assess respondent and patient characteristics associated with FRH, and automated logistic regression to assess the association between FRH and unplanned health services use within 90 days of discharge.

RESULTS

A total of 6236 linked surveys were analyzed. FRH had small but significant associations with administrative indicators. Models of FRH had better fit with patient and respondent features. Respondent relationship to child, child age, previous hospitalizations, and number of comorbidities were significantly associated with ratings of FRH. Automated models of unplanned services use included FRH as a feature, and poor ratings of health were associated with increased odds of emergency department visits (adjusted odds ratio: 2.15, 95% confidence interval: 1.62–2.85) and readmission (adjusted odds ratio: 2.48, 95% confidence interval: 1.62–2.85).

CONCLUSION

FRH is a simple, single-item global rating of health for pediatric populations that provides accessible and useful information about pediatric health care needs. The results of this article serve as a reminder that family members are valuable sources of information that can improve care and potentially prevent unplanned health services use.
Association Between Corticosteroids and Outcomes in Children Hospitalized With Orbital Cellulitis
Authors: Gill Peter J. , Mahant Sanjay , Hall Matt , Parkin Patricia C. , Shah Samir S. , Wolter Nikolaus E. , Mestre Marcos , Markham Jessica L.
Published: December 2021

OBJECTIVES

To examine the association between systemic corticosteroid use and outcomes for children hospitalized with orbital cellulitis at US children’s hospitals.

METHODS

We conducted a multicenter observational study using administrative data from the Pediatric Health Information System database from 2007 to 2019. Children between the ages of 2 months and 18 years with International Classification of Diseases, Ninth Revision, Clinical Modification or 10th Revision, Clinical Modification discharge diagnostic codes of orbital cellulitis were included. The primary exposure was receipt of systemic corticosteroids on the day of hospital admission. The primary outcome was hospital length of stay, and secondary outcomes included surgical intervention, ICU admissions, revisits, and health care costs. We used generalized logit model with inverse probability weighting logistic regression to adjust for demographic factors and assess for differences in clinical outcomes reported.

RESULTS

Of the 5832 patients hospitalized with orbital cellulitis, 330 (5.7%) were in the corticosteroid group and 5502 (94.3%) were in the noncorticosteroid group. Patients in the corticosteroid group were older, had more severe illness, and received broad spectrum antibiotics. In adjusted analyses, corticosteroid exposure was not associated with differences in length of hospital stay, need for surgical intervention, ICU admissions, emergency department revisits, 30-day hospital readmissions, or hospital costs. Restricting the analysis to only those patients who received broad spectrum antibiotics did not change the findings.

CONCLUSIONS

Early use of systemic corticosteroids in hospitalized children with orbital cellulitis is not associated with improved clinical outcomes. Use of corticosteroids in hospitalized children with orbital cellulitis should be discouraged outside of clinical trials.
ROUND TABLE DISCUSSION ON ANTIBIOTICS
Authors: Platou Ralph V. , Nelson Waldo E. , Alexander Hattie E. , Platou Erling S. , Wegman Myron E. , Greenbaum J. Victor
Published: December 2021

Because the participants have covered their assignments so well, a complete summary is not necessary, though it seems fair to hazard a few tentative conclusions based on our discussions.

(1) No more than the broadest kind of generalizations for dosage schedules of penicillin or streptomycin are permissible at present. To serve the best interests of patients, therapy directed against any infectious agent must be individualized. Specific means for such individualization are available, and deserve wider application.

(2) Probably all pathogenic micro-organisms have a number of similar mechanisms for combatting the injurious effects of antibiotic agents; some of these mechanisms have been discussed, others undoubtedly remain to be elucidated. The greatest single limiting factor for effective use of streptomycin is emergence of resistance. Some resistant organisms are probably present in any bacterial population; it is important that these be eradicated by adequate therapy at the earliest possible moment.

(3) Toxic effects of penicillin are relatively minor in contrast to those of streptomycin; the danger of streptomycin therapy should be very carefully weighed against the patient's need before this agent is used.

(4) Means for increasing and prolonging effective levels of antibiotic agents in body fluids at present have limited practical value, but may be of value in specific situations.

(5) Clinically, "the trend" in the treatment of most infections with antibiotic agents is to increase the individual and total dosage, increase the interval between doses, reduce the number of doses and the total duration of therapy. By the very mechanism of their action, these agents should never be used to "taper off" an effective clinical response. They are rarely justified for minor infections or for an all too common indication, "just in case."
A Difference in Mortality Rate and Incidence of Kernicterus Among Premature Infants Allotted to Two Prophylactic Antibacterial Regimens, by William A. Silverman, et al,Pediatrics, 1956;18:614–624
Authors: Sinclair John C.
Published: December 2021

Background. Low birth-weight (LBW) infants have a high incidence of serious infections. These are difficult to diagnose early. Thus, prophylactic treatment with antibiotics appears to be rational, but the best choice of antibiotics is uncertain.

Objective. In newborn LBW infants, to compare the effects on death rate and principal findings at necropsy of two prophylactic antibacterial regimens, oxytetracycline (OT) versus penicillin/sulfisoxazole (P/S).

Methods. Consecutively admitted LBW infants (N = 193) were randomly assigned, within three birth-weight strata, to receive either subcutaneous 0T or a combination of P/S. The primary outcomes were death before 120 hours, death before 28 days, and principal diagnoses at necropsy.

Results. Infants allocated to P/S had a large and statistically significant increase in death rate, determined up to 120 hours (OT, 20.6%; P/S, 48.4%; absolute risk increase, 27.8%) and up to 28 days (0T, 27.8%; P/S, 63.2%; absolute risk increase, 35.3%). This increase in deaths was not attributable to death from infection; the incidence of positive postmortem blood culture results was lower in the P/S group, and there was no significant difference between groups in the incidence of pneumonia or other infections at necropsy. However, in the P/S group, there was a large, unexpected, and statistically significant increase in the finding of kernicterus at necropsy among necropsied deaths occurring up to 120 hours (0T, 6.3%; P/S 36.4%; absolute risk increase 30.1%) and up to 28 days (0T, 4.5%; P/S, 43.2%; absolute risk increase, 38.7%).

Conclusions. Infants who received P/S died at a significantly higher rate and had a higher rate of kernicterus at necropsy than those who received OT. The mechanism of the differences observed in rates of mortality and death with kernicterus is unknown.
DEFICIENCY OF IgM
Authors: Faulk W. P. , Kiyasu W. S. , Cooper M. D. , Fudenberg H. H.
Published: December 2021

An 8½-month-old infant with absent IgM had recurrent Pseudomonas infections. IgG and IgA, but no IgM-containing plasma cells, were identified in the spleen by immunofluorescence. The spleen and lymph nodes lacked germinal centers, but Peyer's patches and the appendix were normal. The absence of IgM was perhaps genetically determined because the father's serum IgM was also low. This may have predisposed to the Pseudomonas infection, since antibodies to Pseudomonas are predominantly IgM.
USE OF MASSIVE DOSES OF PROCAINEAMIDE IN THE TREATMENT OF VENTRICULAR TACHYCARDIA IN INFANCY
Authors: Gelband Henry , Steeg Carl N. , Bigger J. Thomas
Published: December 2021

An 18-month-old infant presented with ventricular tachycardia. The arrhythmia was controlled only with procaineamide in a dose of 3,600 mg/day. A plasma procaineamide level was 9 µg/ml which is within the therapeutic range previously described for adults. Poor absorption, increased tolerance of the agent, and a large volume of distribution relative to body weight may account for the high dosage required. No etiology for the arrhythmia was found and the child made an uneventful recovery. The pharmacological effects of procaineamide on cardiac electrophysiology are discussed.
ERYTHROMYCIN CONCENTRATIONS IN MIDDLE EAR EXUDATES
Authors: Bass James W. , Steele Russell W. , Wiebe Robert A. , Dierdorff Edwin P.
Published: December 2021

Children with acute otitis media were treated with oral esters of erythromycin in doses of 12.5 mg/kg at 6-hour intervals for 24 hours (50 mg/kg/day). Two hours after the last dose serum and middle ear exudates obtained by needle aspiration were assayed for erythromycin levels. Gram stained smears and cultures of the middle ear exudates were obtained and correlated with the levels of erythromycin found in the exudates. Concentrations of the drug were found in middle ear exudates sufficient to be effective against essentially all strains of D. pneumoniae and Lancefield Group A beta hemolytic streptococci. These results may explain why erythromycin is highly effective in the treatment of acute otitis media due to these organisms. Penetration of erythromycin into middle ear exudates may not be sufficient in some cases to eradicate all strains of H. inflenzae and therefore otitis media due to this organism may not respond as readily to therapy with this agent.
THE MEASUREMENT OF FLUID DEPOSITION IN HUMANS FOLLOWING MIST TENT THERAPY
Authors: Bau Samuel K. , Aspin Norman , Wood Donald E. , Levison Henry
Published: December 2021

Mist tent therapy is used in the treatment of cystic fibrosis to deposit fluid droplets in the terminal airways of the lung. It is assumed that water deposited in the peripheral airways thins the secretions and facilitates their clearance from the lung.

The distribution of inhaled mist was assessed by labelling aerosol from an ultrasonic nebulizer with technetium 99m and measuring the distribution of radioactivity in a subject who breathed the aerosol in the mist tent. Subjects breathed from the tent for 1 hour after which the total uptake of fluid was measured by a scintillation probe and its distribution with a rectilinear scanner. Three different ultrasonic nebulizers were used. In some studies 10% propylene glycol in water was used as the nebulizing fluid.

In six healthy adults and eight patients with cystic fibrosis, less than 5% of the activity nebulized and distributed in the tent entered the body. Of this, 90% of the inhaled radioactivity initially lodged in the nasopharynx and rapidly appeared in the stomach. Very little activity was detected over the lungs. These results indicate that very little aerosol fluid from a mist tent is directly deposited in the terminal airways of the lung.
PROGRESS REPORT
Authors: Riley Harris D. , Alsever William D. , Calcagno Philip L. , Cunningham George , Kemberling Sidney R. , Staub Henry , Tower John C. , Bridge Allyn G. , Montgomery Theodore A. , Moore William M. , Post David B. , Rogers Kenneth D.
Published: December 2021

The purpose of this statement is to provide a progress report concerning the activities and accomplishments of the Committee on Indian Health. The Committee was established in late 1964 with the following objectives defined by the Executive Board:

1. To encourage experienced pediatricians to consider careers within the Indian Health Service.

2. To conduct or sponsor studies of special pediatric problems in Indian and Alaskan natives.

3. To provide leadership in the review and development of methods and procedures to improve the provision of pediatric services to the Indian and Alaskan native population.

4. To stimulate continuing individual and organizational interest in the Indian Health Program by pediatricians, particularly those in practice in areas with a large Indian population.

5. To establish a continuing liaison and professional relationship between the Academy and pediatricians assigned to the Indian Health Program.

COMMITTEE ACTIVITIES

Meetings

Since its inception, the Committee has held formal meetings in Phoenix, Anchorage, Billings, Chicago, Washington, Albuquerque, Tucson, and Oklahoma City. Members of the Committee are physicians who are informed and interested in Indian health and who reside near Indian or Alaskan native populations. The Committee has seen the problems of American Indians and Alaskan natives firsthand during field trips to reservations and other locations with concentrations of Indian populations.

Shortly after its establishment, the Committee saw the need to maintain continuing liaison with other committees and agencies. Therefore, a consultant from the National Institute of Child Health and Human Development was named to the Committee, and a liaison representative from the Committee on School Health of the Academy was added as a consultant.
Pseudomonas Osteomyelitis: Puncture Wounds of the Feet
Authors: Hagler Donald J.
Published: December 2021

The recent report1 of pseudomonas osteomyelitis following puncture wound of the foot raises the question of why this rarely reported,

See Images in the PDF File

but clinically recognized phenomenon occurs.* I would like to report an additional case which demonstrates similar evidence for the etiology.

S.S., an 8-year-old Caucasian male, presented at this hospital with a several–day history of swelling and tenderness of the site of a nail puncture wound in the plantar aspect of the foot, approximately in the second metacarpal phalangeal area (Fig. 1).
CLINICAL AND IMMUNOLOGICAL RESPONSE OF INFANTS AND CHILDREN TO ADMINISTRATION OF LOW- TEMPERATURE ADAPTED RESPIRATORY SYNCYTIAL VIRUS
Authors: Kim Hyun Wha , Arrobio Julita O. , Pyles Gloria , Brandt Carl D. , Camargo Ena , Chanock Robert M. , Parrott Robert H.
Published: December 2021

Thirty-nine infants and children 6 months to 13 years of age received live 26°C grown respiratory syncytical (RS) virus (strain A2) by the oropharyngeal and nasopharyngeal route. RS virus was recovered from 22 individuals and 17 of these showed a significant rise in CF and/or plaque reduction serum antibody. Twelve of those from whom virus was recovered and an additional three from whom virus was not recovered showed a threefold or greater rise of RS nasal neutralizing activity. Thus 26 of the total showed some evidence of having been infected with the ES strain. The rate of infection was significantly greater in infants and children under 2 years of age than in older children. Infection in individuals older than 8 months of age was asymptomatic. Three infants infected with the vaccine strain had relatively minor respiratory tract illness.

The findings from this study indicate that the low-temperature adapted virus retains a low level of virulence which is expressed only in individuals undergoing primary infection. Nonetheless, these studies have shown that it is possible to induce local and systemic immune responses to RS virus by means other than fully virulent natural infection.
NORMAL PRESSURE HYDROCEPHALUS: COMPLICATION OF POSTERIOR FOSSA SURGERY IN CHILDREN
Authors: Stein Bennett M. , Fraser Richard A. R. , Tenner Michael S.
Published: December 2021

The occurrence of symptomatic normal pressure hydrocephalus in children as a complication of posterior fossa surgery is recorded here.

Diagnosis of this exceedingly treatable condition is essential since its syndrome can be confused with brain stem or cortical injury attributed to surgery.

All cases responded to shunting with marked improvement.
THE PEDIATRICIAN AND ATHEROSCLEROSIS
Authors: Mitchell Shiela , Blount S. Gilbert , Blumenthal Sidney , Jesse Mary Jane , Weidman William H.
Published: December 2021

The incidence of premature disability and death from complications of atherosclerosis in the adult American is so high that pediatricians must accept the responsibility of finding the threatened child and, insofar as possible, reducing the future risk.

The Council of Rheumatic Fever and Congenital Heart Diseases of the American Heart Association formed a Committee which, during the past 2½ years, has met with a number of different experts in the field. These presentations have been supplemented by a selected review of the literature, and a workshop made up of experts in several related fields selected from the United States and a number of foreign countries to complement the above presentations.
STATEMENT ON MARIJUANA
Authors: Hazard Sprague W. , Allen V. Robert , Eisner Victor , Garell Dale C. , Hammar S. L. , Shaffer Thomas E. , Shen Jerome T. Y. , Tanner Natalia M. , Welty John Allen
Published: December 2021

In October 1970, the Academy identified itself with those who favored Separating marijuana from the group of drugs subject to stringent narcotic laws. It recommended that individuals who were found to be in possession of the drug for personal use, or were present where the drug was being used, should be charged with a misdemeanor rather than a felony.1 Subsequently, the Committee on Drugs in a statement on drug abuse legislation noted its concern with marijuana.2

This position is based on the fact that marijuana is clearly not a narcotic and does not appear to have a potential for physical dependence. It should not be construed, however, as favoring the legalization of marijuana. A decision in this regard must await the development of further research on the properties of the drug.

The potency of marijuana has not been standardized and may vary widely. Furthermore, anecdotal accounts exist of the adulteration of marijuana with other chemical agents to produce a more profound effect. It has therefore been difficult to determine with precision the effects of marijuana as it is commonly used. The limited research findings that are currently available would not appear to indicate any significant harmful physical effects from the smoking by humans of moderate amounts of plain marijuana.

The recent report from the Department of Health, Education and Welfare3 states that "although the state of intoxication is frequently vivid as described by the (marijuana) user, an observer may see little change from a normal state. Mild states of intoxication often go completely undetected. Physiological changes are notably minimal."
KERNICTERUS IN SMALL SICK PREMATURE INFANTS RECEIVING PHOTOTHERAPY
Authors: Keenan William J. , Perlstein Paul H. , Light Irwin J. , Sutherland James M.
Published: December 2021

Four patients are described who developed kernicterus. All infants were immature and with each patient there were multiple factors that may have favored the development of kernicterus. Serum bilirubin in all patients fell after phototherapy began, but phototherapy as used in these infants failed to prevent the occurrence of kernicterus.
MASSACHUSETTS METABOLIC DISORDERS SCREENING PROGRAM. I. TECHNICS AND RESULTS OF URINE SCREENING
Authors: Levy Harvey L. , Madigan Phyllis M. , Shih Vivian E.
Published: December 2021

Screening of filter paper urine specimens for metabolic and transport disorders has been conducted in Massachusetts for the past few years. Disorders not identifiable by blood screening are detectable by this program. Specimens are obtained routinely by the parents on 3- to 4-week-old infants and mailed to a central laboratory. Testing is performed on discs punched directly from each specimen utilizing several methods of paper chromatography.

Cystinuria, histidinemia, Hartnup disease, and iminoglycinuria (Group I) is each approximately as frequent as is phenylketonuria (PKU) in Massachusetts (1:14,219). Other disorders identified, including the hyperglycinemias, argininosuccinic aciduria, hyperlysinemia, hyperornithinemia, and the Fanconi syndrome (Group II) each has a frequency that seems to be no greater than 1:200,000 of the population.

Transient abnormalities, such as tyrosinuria-tyrosyluria, generalized hyperaminoaciduria, iminoglycinuria, cystine-lysinuria, and others have been noted. Also diaper creme or fecal contamination of specimens as well as the ingestion of formulas supplemented with DL-methionine, of ampicillin, or of n-acetylcysteine may result in unusual amino acid patterns.

A program such as this requires multiple testing procedures, access to proper evaluative and investigative facilities, and cooperation among the various participating groups. The total expense of this program is about $80,000 per year or approximately $1.00 per infant tested.
SERUM PARATHYROID HORMONE LEVELS IN ACQUIRED VITAMIN D DEFICIENCY OF INFANCY
Authors: Arnaud Claude , Glorieux Francis , Scriver Charles R.
Published: December 2021

The later stages of the vitamin D deficiency syndrome during infancy are associated with impaired renal tubular reabsorption of amino acids, phosphate, and other metabolites. Secondary hyperparathyroidism has been implicated as the cause of the renal abnormality. Serum immunoreactive parathyroid hormone levels are elevated in infants with vitamin D deficiency (60 to 238 µl Eq/ml; normal < 40 µl q/ml). The highest levels were found in the more advanced stages of vitamin D deficiency.
KIDNEY FUNCTION IN YOUNG INFANTS
Authors: BARNETT HENRY L.
Published: December 2021

IT IS with gratitude that I accept this second E. Mead Johnson Award, being fully aware of the honor it brings to all of us who have shared in the work. The progress of the work has been stimulated by the encouragement and guidance given previously by Dr. Alexis F. Hartmann in St. Louis and, more recently, by Dr. Samuel Z. Levine in New York. I also wish to thank the doctors, nurses, technicians, secretaries and laboratory helpers who have actively participated and especially Miss Helen McNamara who makes the editorial "we" a reality. The nature of our studies required substantial financial support and we wish to express appreciation to the U. S. Public Health Service and the New York Heart Association for supplementing the excellent facilities for research at the New York Hospital-Cornell Medical Center.

It is the purpose of this paper to consider the development and present status of our knowledge of kidney function in young infants and to indicate some of its application to clinical problems. This knowledge is understandably incomplete because it is only during the last 10 years that the precise technics of kidney physiologists have been applied to the study of kidney function in young infants. The primary role of the kidneys in regulating the composition and volume of body fluids had been established earlier by an important series of observations, utilizing the technics of water and electrolyte balances. In many of these earlier observations there were already indications of an underdeveloped kidney function in young infants.
TREATMENT OF MALARIA IN CHILDREN WITH CHLOROQUINE
Authors: NELSON THOMAS L. , CONLIN GERALD J.
Published: December 2021

Forty-nine children with 54 episodes of malaria were treated with chloroquine with four known relapses and one suspected treatment failure.

A dosage scale for children is offered (Table I).

Only minor toxic effects of chloroquine were observed.

Chloroquine did not prevent the presence of the gametocytes of Plasmodium falciparum in peripheral blood.

Nine cases severely ill with malaria responded well to this treatment.
AUREOMYCIN IN THE TREATMENT OF EXPERIMENTAL AND CLINICAL INFECTIONS WITH H. INFLUENZAE, TYPE B
Authors: CHANDLER CAROLINE A. , HODES HORACE L.
Published: December 2021

Aureomycin, in doses of 20 mg./kg. body weight, was as effective in the treatment of mice infected with H. influenzae, type B, as streptomycin and dihydrostreptomycin, and more effective than polymyxin or Q-19.

Two infants with H. influenzae, type B, meningitis were treated successfully with aureomycin and sulfadiazine. Spinal fluid cultures became negative and marked clinical improvement occurred within 48 hours. Both patients went on to complete recovery. Three children were treated with aureomycin alone. Although their response to treatment was not so rapid as that of the infants treated with aureomycin and sulfadiazine, rccovery was assured within four to seven days and subsequently there were no evidences of residual damage. No serious toxic reactions to aureomycin were apparent.

A sixth patient, desperately ill on admission, succumbed within 36 hours in spite of adequate treatment with combined aureomycin and sulfadiazine.
MEASLES ENCEPHALITIS
Authors: SPRAGINS MELCHIJAH , SHINNERS BURTON M. , ROCHESTER BETSEY
Published: December 2021

The acute symptoms of onset of 31 cases of rubella complicated by encephalitis are presented. The correlation of the incidence of severe residua with the slow recovery from acute symptoms is pointed out.

The residual symptoms developing in 12 patients followed over a period of two years are described. It is emphasized that disturbances of personality, concentration and memory are most frequent in occurrence. The electroencephalographic changes occurring in these patients are described and a correlation between the clinical severity of residua and electroencephalographic changes is presented.

The need for close follow-up of the convalescing postencephalitic patient is stressed so that developing behavior difficulties may be recognized and intelligently managed. The value of the EEG in the evaluation of the difficulties of the postencephalitic patient is discussed.

Selected case reports are presented demonstrating the electroencephalographic changes and the associated clinical manifestations.
CHRONIC ACIDOSIS OF RENAL ORIGIN IN INFANCY
Authors: KELSEY WESTON M. , REINHART JOHN B. , FISHEL JOHN
Published: December 2021

Two infants are described, both of whom had unexplained signs of anorexia, vomiting, dehydration, fever and acidosis. Both probably had defects in reabsorption of bicarbonate in the renal tubules without other evidence of anatomic renal disease.

The symptoms of both infants were relieved by the administration of alkaline salts. One patient, after a year of therapy, recovered and has developed normally without further treatment. The other still requires alkaline salts to prevent the development of acidosis.
RELATIONSHIP OF ABILITY TO BREAST FEED AND MATERNAL ATTITUDES TOWARD BREAST FEEDING
Authors: NEWTON NILES RUMELY , NEWTON MICHAEL
Published: December 2021

Ninety-one mothers were interviewed shortly after delivery to ascertain their attitudes toward breast feeding. Independent judges divided the attitudes into three categories on the basis of written records of the interview.

Of the mothers who expressed positive attitudes toward breast feeding, 74% had enough milk by the fifth day after delivery to make formula supplementation unnecessary. Only 35% of those who expressed doubtful and 26% of those who expressed negative attitudes toward breast feeding had enough milk to make formula supplementation unnecessary by the fifth day.

Mothers with positive attitudes gave a larger average amount of milk on the fourth day, reported slightly more signs of let-down, and used nipple shields less frequently than the mothers with negative attitudes. Mothers with positive attitudes reported that their babies had less difficulty sucking and less frequently refused the breast, but more frequently refused the bottle than those mothers with negative attitudes.

The course of lactation in the mothers with doubtful attitudes although upon the whole more like that of the negative group did follow in some ways that of the positive group.

The incidence of crying at the breast and biting or chewing the nipple was the same in all three attitude categories.

The implications of this study on the management of breast feeding are discussed.
677 CONGENITALLY MALFORMED INFANTS AND ASSOCIATED GESTATIONAL CHARACTERISTICS
Authors: STEVENSON STUART SHELTON , WORCESTER JANE , RICE ROBERT GERALD
Published: December 2021

CONGENITAL malformations are defects which are present at birth. Lay persons have long ascribed them to a multitude of natural and supernatural prenatal influences and the medical profession, hampered by the difficulties of observing human fetal development within the uterus, has long ascribed them to defective inheritance and adopted a fatalistic attitude toward them. Studies in human teratology until recently have been confined largely to descriptions of frequencies and morphologies. Congenital malformations, as an unhappy result, have remained unchanged in incidence while fetal and infant morbidity and mortality due to many other causes have declined.

In 1940, Warkany announced the production of skeletal deformities in rats whose mothers had been reared on a deficient diet. Gregg's report was published the next year and teratology, as an etiologic science, was conceived with this proof that human congenital malformations can result from environmental insult. It is not necessary to summarize here the voluminous literature which has been published since these two papers, and the reader is referred for bibliography to two excellent recent reviews by Gruenwald and Warkany.

Wesselhoeft has named rubella the modern Flibbertigibbet, after Shakespeare's fiend who "squints the eye and makes the hare-lip." He writes, in an article which summarizes the literature on this disease, "The Flibbertigibbet of today responsible for at least some congenital defects seems to be the virus of rubella, which stalks unseen by day as well as by night in the house, the school room and crowded places and which until recently was quite unsuspected and unfeared." Numerous other diseases have been indicted, but only rubella seems to have been convicted.
SPECIAL REVIEWS
Authors: FABER HAROLD K.
Published: December 2021

Application of experimental results to human problems in poliomyelitis is valid and helpful, especially when the modes of inoculation infection are similar.

The disease is spread largely by contact, probably much more often from pharyngeal than from fecal sources.

The concept that infection is introduced into and spreads by way of nerve fibers, with multiplication in the nerve cells, appears to explain adequately the various phenomena of the disease, without resort to hypothetic extraneural infection.

The usual site of entry is the upper respiratory and alimentary tract, notably the pharynx, rather than the intestine.

The usual primary site of infection is probably the peripheral ganglia supplying the upper respiratory and alimentary tracts and the usual primary focus of infection in the central nervous system is probably the lower brainstem, to which many of the earliest and most characteristic clinical manifestations can be traced, particularly to the reticular formation. This nonparalytic form of bulbar poliomyelitis is to be distinguished from the paralytic form.

The so-called constitutional symptoms of poliomyelitis are as readily referable to neural infection as to extraneural and presumably are due to the former.

In diphasic ("dromedary") cases, the onset of the first phase is essentially of a neurologic, not of a nonspecific or "systemic" character. The diphasic case is regarded as a simple example of remission and relapse.

Contributory factors are of two kinds: (1) those that serve to introduce virus into the body; (2) those that increase the severity of already established infection. Avoidance or minimization of these factors is of preventive value.
Radiographic Atlas of Skeletal Development of the Hand and Wrist
Authors: MARESH M. , WASHBURN A. H.
Published: December 2021

The Brush Foundation studies on human growth and development, begun in 1931 and terminated in 1942, have been intensively reviewed and studied by Dr. Greulich and Miss Pyle in the formulation of this Radiographic Atlas of Skeletal Development of the Hand and Wrist. Serial radiographs of from 2 to 20 hand-films made at successive examinations of each of 1000 boys and girls made up the radiographic material. Standards were selected that were judged to be the most representative of the central tendency or anatomic mode of each chronologic age group from birth through 18 years.
Sensitivity of a Nitrite Indicator Strip Method in Detecting Bacteriuria in Preschool Girls
Authors: Kunin Calvin M. , DeGroot Jane E.
Published: December 2021

The nitrite indicator strip is an inexpensive and convenient method for detecting bacteriuria. Because it can be performed in the home by a parent without special equipment, it has proven to be particularly convenient for testing preschool children.1

A previous study2 showed that the nitrite indicator strip test performed on three consecutive first-morning voided urine specimens detected 85% of culture-confirmed bacteriuric adult women. This report indicates that the nitrite dipstrip test has a similar sensitivity in detecting bacteriuria in preschool girls.

MATERIALS AND METHODS

Twenty-one of the 26 bacteriuric girls detected in the previously reported screening program were tested at three-month intervals for periods of three months to two years, using nitrite indicator strips (Microstix-Nitrite, Ames Laboratory, Elkhart, Indiana), and urine cultures were preformed, using dip-slides (Uricult, Orion Laboratories, Helsinki).
One Pediatric Burn Unit's Experience With Sleepwear-Related Injuries
Authors: McLoughlin Elizabeth , Clarke Nicola , Stahl Kent , Crawford John D.
Published: December 2021

Review of the records of 678 children with acute injuries referred during an eight-year period to this burn unit indicated that flame burns from a single ignition source (50%) outranked scalds (27%) or house fires (12%) as causes of injury. There was no temporal trend in the rank pattern. The majority of these single-source flame injuries were severe and involved ignition of the child's clothing. From 1969 through 1973, sleepwear was the clothing involved in 32% of the instances. Since that time and coincident with promulgation of strict federal and state standards for flammability of children's night clothing, a dramatic decline in the number of children referred with injuries of this type has taken place. It is probable that the single factor most important to the decline, in our experience with these injuries, is lower fabric flammability but, because our data may not be representative, corroboration is needed before one can exclude factors such as altered garment design, fire safety-related practices at home, or changing patterns of hospital referral.
Injuries Resulting When Small Children Fall Out of Bed
Authors: HELFER RAY E. , SLOVIS THOMAS L. , BLACK MARY
Published: December 2021

Children frequently fall out of bed but seldom incur serious injury. When such a fall raises parental concern, the pediatrician is consulted; even in this group, the child is rarely found to have a severe injury. There is a clinical impression that skull radiographs, when taken in these situations,are of extremely low yield and are not necessary as a routine.

Occasionally a child who is reported to have fallen out of bed presents with a skull fracture, cerebral edema, retinal hemorrhage, subdural hematoma,and/or epidural hemorrhage. These severe injuries are discrepant with the history; it is often this discrepancy
It Is Not an Abuse
Authors: FLOOD WILLIAM L.
Published: December 2021

To the Editor:

I wish to take exception to Dr. Gorlick's letter, which appeared in the November 1975 issue (Pediatrics 56:839, November 1975). In that letter Dr. Gorlick criticized pediatricians for resorting to a type of“child abuse” by giving shots to children in lieu of oral medications. He inferred that this might be done both to bolster one's personal income as well as in ignorance of children's suffering and fear of doctors. From personal
Collaborative Study of Children Treated for Phenylketonuria: Study Design
Authors: Williamson Malcolm , Dobson James C. , Koch Richard
Published: December 2021

Studies that have attempted to test the effectiveness of treatment in phenylketonuria (PKU) have been handicapped by small samples due to rarity of the disorder and inadequate control of other sources of error. The present study was designed to overcome these limitations by treating a large number of children with PKU under controlled conditions from near birth to 6 years of age. Nineteen medical centers in 13 states have participated in the study, which is currently in progress. This article is one of a series of final reports. It describes the study design and sampling procedures employed to answer questions of interest for which results will be reported in subsequent articles. The study serves as a model for future collaborative investigations of a similar nature.
Traumatic Aortic Insufficiency in Children: Case Report and Review of the Literature
Authors: Rowland Thomas W.
Published: December 2021

Aortic valve regurgitation and saccular aneurysm of the ascending aorta developed in a 5-year-old boy following severe compressive injury to the chest. While rare, traumatic aortic valve disruption may lead to serious cardiac dysfunction. Recognition of acute aortic insufficiency and other forms of cardiac damage requires special attention in patients with nonpenetrating chest injury.
THE PAN AMERICAN HEALTH ORGANIZATION: HEALTH CARE MEANS MORE THAN DOCTORS
Authors:   Student
Published: December 2021

Today, the governments of the Americas, together with organizations like the Pan American Health Organization, are working to extend health care to rural groups, as well as to the urban poor. The task is a difficult one, but health workers are now employing what they call a "multisectoral approach" to improve health services for such underserved people. It means that all sectors-education, agriculture, industry-are directed towards the common task of improving health conditions.

This multisectoral approach was devised after many years of experience of attempting-and very often failing-to solve health problems by the health sector alone. For example, much money and energy went towards increasing the numbers of doctors and hospital beds; the idea was to model health services after the examples of wealthy developed nations. However, as explained by Dr. Fortunato Vargas-Tentori, PAHO's coordinator for health care extension, other factors were found to influence the level of health of the population. They include poor living conditions, unsafe water, malnutrition, and unproductive agriculture. In the face of such conditions, doctors-even if they were available-could do little of lasting good.
Effect of Various Phototherapy Regimens on Bilirubin Decrement
Authors: Rubaltelli F. F. , Zanardo V. , Granati B.
Published: December 2021

Continuous phototherapy in full-term newborns was found to be more effective than intermittent illumination. Treatment efficacy was also related to age and the initial bilirubin level of the infants. In fact, the reported data indicate an increased therapeutic effect in newborns affected with nonhemolytic hyperbilirubinemia who had an initial bilirubin level greater than 15 mg/dl as compared to neonates with an initial bilirubin level less than 15 mg/dl. The light treatment was also more effective in infants older than 3 days, possibly because of an increased ligandin and conjugating capacity. Shielding the hepatic area during illumination significantly decreased the efficiency of this treatment, suggesting that the liver could also be a phototherapeutic action site.
Vesicoureteral Reflux in the Primate: III. Effect of Urinary Tract Infection on Maturation of the Ureterovesical Junction
Authors: Roberts James A. , Riopelle Arthur J.
Published: December 2021

Recurrent bladder infections in the monkey appeared to cause a delay in maturation of the ureterovesical junction. This was not significant since it did not ultimately prevent maturation. Bacteriuria was prolonged when reflux was present.
Congenital Hypoplastic Anemia Terminating in Acute Promyelocytic Leukemia
Authors: Krishnan Eledath U. , Wegner Kurt , Garg Sudershan K.
Published: December 2021

Acute promyelocytic leukemia developed in a patient with congenital hypoplastic anemia (CHA). The patient had Turner's phenotype, but no chromosomal abnormality. The literature on CHA is briefly reviewed, and the relationship between leukemia and cytotoxic therapy is considered.