bluuebunny/crossref_metadata_2025 huggingface dataset:
DIAGNOSIS AND TREATMENT: THE UNDESCENDED TESTICLE
Authors: Bongiovanni Alfred M.
Published: December 2021

THE QUESTION of the management of cryptonchidism remains vexing and controversial. Perhaps the major argument centers on the ideal age for treatment and the outcome to be anticipated. So much has been written from the single viewpoint of an individual clinical experience that the varying conclusions attest mainly to the disagreement among authorities. Indeed, it is not at present possible to arrive at a single plan of action which will provide ideal results in the majority of cases. With any plan the outcome will depend also to some extent upon surgical skill and practice.

It has long been regarded as injurious to the human testis to remain above the scrotum. Yet, in certain species the testes do not descend until well after birth and in some seasonal breeders the morphologic and functional states of the gonads vary from intra-abdominal to scrotal position without deleterious effects. In man the testes generally descend between the eighth to ninth fetal month. However, it is recognized that a variable number of newborn male infants—estimated between 1 and 10%, and higher in prematures—have undescended testes which, in more than half the cases, subsequently migrate to their normal position, usually within the first year of life. There is no reason to suspect damage to these organs when descent occurs in early life, and realization of this justifies dismissal of any consideration of treatment during early infancy. Thus, in certain infants with cryptonchidism, the testes will descend spontaneously. It has also been stated that spontaneous descent will occur in a smaller number of instances after the first year of life and even up to the time of puberty.
Letters to the Editor
Authors: ADAMSONS KARLIS
Published: December 2021

The aim of the exchange transfusion in utero is not to remove bilirubin, but to provide the fetus with a maximal quantity of donor erythrocytes, at the same time avoiding undue expansion of the intravascular compartment and excessive red cell concentration in the immediate posttransfusion period. The use of a vein rather than an artery offers advantages, however considerable technical difficulties exist in placing and maintaining a venous catheter in younger fetuses.
INTRAUTERINE GROWTH IN LENGTH AND HEAD CIRCUMFERENCE AS ESTIMATED FROM LIVE BIRTHS AT GESTATIONAL AGES FROM 26 TO 42 WEEKS
Authors: Lubchenco Lula O. , Hansman Charlotte , Boyd Edith
Published: December 2021

Charts of intrauterine growth in length, weight-length ratio and head circumference as estimated from liveborn measurements are presented. These, in conjunction with intrauterine weight charts, permit the identification of infants with unusual intrauterine growth patterns.
BIRTH WEIGHT, GESTATIONAL AGE, AND PREGNANCY OUTCOME, WITH SPECIAL REFERENCE TO HIGH BIRTH WEIGHT-LOW GESTATIONAL AGE INFANT
Authors: Battaglia Frederick C. , Frazier Todd M. , Hellegers Andre E.
Published: December 2021

The distribution of birth weights at various gestational ages are presented for all single births occurring in Baltimore City in 1959, 1960, and 1961. These data are presented as pregnancy distributions or percentile curves for comparison with data of several other studies. In general, the frequency distribution of birth weights at any given gestational age spans a wide weight range.

The neonatal, fetal, and perinatal mortality rates for various cell groups are presented. There is striking agreement between these data and those of a similar study from New York City. The clinical implications of these mortality rates and percentile curves are discussed.
FAMILIAL DYSAUTONOMIA DIFFERENTIATED FROM RELATED DISORDERS
Authors: Riley Conrad M. , Moore Richard H.
Published: December 2021

1. A tabulation of "essential" and helpful criteria for the diagnosis of familial dysautonomia is presented. The importance of accurate diagnosis is stressed.

2. Two cases where the diagnosis of familial dysautonomia was strongly suggested but was not justified are presented by way of contrast to the typical syndrome.

3. Current literature offering new observations of a pharmacological, physiological and anatomical nature is reviewed. Some of these appear to offer important new diagnostic criteria as well as bases for hypotheses for the pathogenesis of the disorder.

4. An attempt to synthesize the various findings is made. It is apparent that the basic functional defect has not yet been identified, though a humoral anomaly, very possibly enzymatic, still seems a reasonable interpretation of the underlying cause of the physiological abnormalities reported.
NEUROFIBROMATA SIMULATING A PENIS AND LABIOSCROTAL GONADS IN A GIRL WITH VON RECKLINGHAUSEN'S DISEASE
Authors: Kenny Frederic M. , Fetterman George H. , Preeyasombat Chawalit
Published: December 2021

A 15-year-old girl is described, who had ambiguous genitalia from birth. Enlargement of the clitoris, and labioscrotal masses were present; these were shown to be due to unusually situated neurofibromata. This is the first reported instance of neurofibromata masquerading as a phallus and testes. Prior to the correct histologic diagnosis of the neurofibromata, she underwent two exploratory laparotomies, and unilateral ovariectomy in an attempt to explain the etiology of her ambiguous genitalia.
INFLUENCE OF PENICILLINASE-PRODUCING STAPHYLOCOCCI ON THE ERADICATION OF GROUP A STREPTOCOCCI FROM THE UPPER RESPIRATORY TRACT BY PENICILLIN TREATMENT
Authors: Quie Paul G. , Pierce Howard C. , Wannamaker Lewis W.
Published: December 2021

Penicillinase-producing strains of S. aureus were isolated from the upper respiratory tract of 28% of a group of children presenting with signs or symptoms of respiratory illness and group A streptococci on cultures from the pharynx or anterior nares. Although group A streptococci were found in 10% of the children 14 to 30 days after penicillin treatment, no correlation was found between the presence of penicillinase-producing S. aureus initially or at follow-up and re-isolation of group A streptococci.

There was no suggestion from these studies that antibiotic therapy aimed at penicillin-resistant staphylococci would be of any greater value than intramuscular benzathine penicillin G for the treatment of patients with group A streptococci in the upper respiratory tract.
PRESENCE OF PLASMA CELLS AND γ1M-GLOBULIN SYNTHESIS IN A PATIENT WITH THYMIC ALYMPHOPLASIA
Authors: Fireman Philip , Johnson Horton A. , Gitlin David
Published: December 2021

A child is described who had thymic alymphoplasia with increased serum concentrations of γ1M-globulins and a deficiency of γ1A- and 7S γ2-globulins; the child was subject to severe infections from 2 weeks of age and succumbed to pneumonia at 11 months of age. Even though the tissues of this patient at necropsy revealed a remarkable paucity of lymphocytes, there were relatively normal numbers of lymphocytes in his peripheral circulation and his bone marrow. Plasma cells were readily demonstrated in the spleen and lymph nodes. The studies suggest that the development of plasma cells and γ1M-globulin synthesis may occur independently of the development of the thymus and the small lymphocytes in man.
SMALLPOX VACCINATION: WHEN AND WHOM TO VACCINATE
Authors: Coriell Lewis L.
Published: December 2021

THERE has been a recent increase in inquiries concerning the present practice of smallpox vaccination in the United States. This can be traced in part to the excellent studies of Dr. Henry Kempe who has made many contributions to knowledge of smallpox and vaccination and has called attention to the question—Is the risk of smallpox in the United States today sufficient to warrant the risk of the complications of smallpox vaccination? It is pertinent to examine the salient facts.

THE BACKGROUND

Before the days of widespread vaccination, smallpox was epidemic in most parts of the world, with a morbidity rate of 25% and a case fatality rate of 20 to 80%, averaging 50% for variola major. Successful vaccination was introduced over 160 years ago, but the disease still persists. In the past 12 years, reported cases in the world have fallen from 500,000 to 100,000; but it is certain that many cases are not reported. Smallpox is gone from North America, Europe, Russia, and Oceania but may be reintroduced by air travelers from endemic areas much more easily than in the past when intercontinental travel time was usually longer than the incubation period of smallpox. For example, smallpox was introduced into 18 countries by travelers in the year 1956. In 1962 there were 24 deaths among 60 cases stemming from imported cases in the United Kingdom. In Europe in 1963 five cases were imported and caused a total of 140 secondary cases with 11 deaths in Sweden, Poland, Germany, Hungary, and Switzerland.
Mental Retardation: A Family Study
Authors: KOCH RICHARD
Published: December 2021

This is a monumental study of the relatives of 289 persons who lived at Faribault Minnesota State Colony for the Retarded during the years 1911 to 1918. Information about 82,217 persons is analyzed in this volume—each retardate averaged 25 years of residential care within the institution. The original study was developed in 1910 and was reopened in 1949 by the present investigators.

I find it difficult to assess the value of this book for pediatricians. It is undoubtedly a very meaningful report for geneticists, but I would not recommend its purchase by the practicing pediatrician.
CHEMORECEPTOR REFLEXES IN THE NEWBORN INFANT: EFFECT OF COOLING ON THE RESPONSE TO HYPOXIA
Authors: Ceruti Eliana
Published: December 2021

1. The effect of brief exposures to warm and cool environments on the newborn infant's response to hypoxia was studied in 14 healthy full-term infants.

2. In all infants studied in a cool environment minute ventilation was significantly higher while breathing 21% O2.

3. During the first week of life, hypoxia (12% O2) induced a transient hyperventilation in babies studied in a warm environment. This response was not seen when the infants were in a cool environment.

The ventilatory response was the same even when the PACOACO2 was maintained constant and elevated.

A decrease in ventilation and return to control levels after 21% O2 was reinstituted, occurred at both thermal environments.

4. PACOACO2 decreased during hypoxia, at both ambient temperatures.

5. Heart rate increased significantly during hypoxia and was not affected by the environmental temperature or age.

6. The ventilatory response to 3% CO2 inhalation was unaffected by temperature or age.

7. After the first week of life, a sustained hyperventilation during hypoxia occurred at both ambient temperatures.
PLASMA FREE FATTY ACID AND BLOOD SUGAR LEVELS IN NEWBORN INFANTS AND THEIR MOTHERS
Authors: Keele Doman K. , Kay Jacob L.
Published: December 2021

Simultaneous plasma free fatty acid (FFA) and blood sugar levels were determined for fasting newborn infants during the first 24 hours of life, for their cord bloods, and for their mothers at delivery. The following observations were made. In control infants the mean FFA level rose about three times the cord level after birth and was accompanied by a 25% drop in the mean blood sugar level. Thereafter, the mean blood sugar level remained relatively constant, but the mean FFA level varied from 2½ to 3 times the cord level. There was no significant correlation between the length of maternal fasting prior to delivery and the infant FFA level; there was, however a significant negative correlation between the length of maternal fasting prior to delivery and the infant blood sugar level at 24 hours of age. High FFA levels occurred in the infants of obese mothers and low levels were observed in infants with delayed respirations, in infants of preeclamptic mothers, and in infants of diabetic mothers.
A SALMONELLA NEWPORT OUTBREAK IN A PREMATURE NURSERY WITH A ONE-YEAR FOLLOW-UP
Authors: Abroms I. F. , Cochran W. D. , Holmes L. B. , Marsh E. B. , Moore J. W.
Published: December 2021

Gastroenteritis due to S. newport occurred in 11 premature infants. Meningitis due to this organism developed in a twelfth infant after an incubation period of 1 month. Oral ampicillin (following parenteral penicillin G and kanamycin) was clinically effective as specific therapy in all 11 cases of gastroenteritis, but there was a recurrence of the organism in the stools of 9 of 11 infants during or after ampicillin therapy. No toxicity with ampicillin was found.

At 2 months after the start of the disease 6 of 11 infants had positive stool cultures. Of the 10 followed for 1 year, 4 had positive cultures at 8 months and 1 at 12 months.
Reproductive Rates in Families of Children with Idiopathic Mental Retardation
Authors: BACOLA ELENI
Published: December 2021

Analysis was made of pregnancy records in families of 28 normal and 28 mentally retarded children. The pregnancy records of mothers, maternal aunts, and grandmothers of the retarded population were compared to the records of the normal population.

There were no significant differences in the mean reproductive rates between the retarded and control groups.
DROWNING AND THE TREATMENT OF NON-FATAL SUBMERSION
Authors: Imburg Jerome , Hartney Thomas C.
Published: December 2021

Animal studies have shown that fluid enters the body via the lungs in sea-water and fresh-water drowning. In fresh-water drowning in dogs, there is marked and rapid hemodilution with death due to ventricular fibrillation in about 4 minutes. In sea-water drowning in dogs, there is hemoconcentration; the blood water is lost into the sea water in the lungs with bradycardia and death due to asystole in 6 to 8 minutes.

Studies of human drowning victims show similar, but less striking, changes in hemodynamics. In human non-fatal submersion the problems are usually those produced by impaired pulmonary function and central nervous system damage due to hypoxia. Hemodilution and ventricular fibrillation have not been documented in human nonfatal submersion.

Therapeutic measures may be divided into those of an immediate urgent nature to be employed at the accident scene: expired air resuscitation, which should be started on reaching the unconscious victim in the water, and external cardiac massage, when indicated.

Later measures to be instituted in the hospital include: cardiac resuscitation, intermittent positive-pressure breathing, hypothermia, tracheostomy and tracheal tiolet, oxygen therapy, antibiotics, steroids, and intravenous fluids to correct defects in blood elements (hemoglobin, electrolytes, pH). Later, pulmonary function should be studied for impairment due to alveolar damage and fibrosis. Permanent neurologic sequellae may develop.
Letters to the Editor
Authors: GREEN D. M.
Published: December 2021

This letter is in answer to yours relative to our product, Congespirin.

By law, recommendations as to the indications for use of a drug, its dosage, and the precautions to be observed, are the primary responsibility of the manufacturer. It is the function of the Food and Drug Administration to determine that the drug is safe and effective under these conditions.

The indications, dosage, and cautions for Congespirin were reviewed extensively with the Food and Drug Administration prior to marketing.
Diets for Sick Children
Authors: GERRARD J. W.
Published: December 2021

It is axiomatic that many pediatric diseases require dietary treatment, sometimes as the sole form of therapy, for example, in celiac disease and phenylketonuria, and sometimes as an adjunct, as in nephrosis and diabetes.

Diets for Sick Children gives very practical and careful guidance in the preparation of diets for all such children. The proprietary foods referred to in the text are those commonly available on the English market; its usefulness is, therefore, limited on this side of the Atlantic, but it should prove a useful addition to any pediatric dietetic department, and is recommended on this account.
Early Observations of Measles Enanthem
Authors: WARING JOSEPH IOOR
Published: December 2021

The peculiar spots seen on the buccal mucosa which are accepted as diagnostic of measles in the pre-eruptive stage were brought into general recognition by Dr. Henry Koplik of New York, who published a full description of them in 1896. Koplik wrote then that William Osler in 1892 had spoken of "a distinct punctiform rash" in the mouth and that before that time Eduard Heinrich Henoch in 1882 had also noted the spots as punctate or stellate red lesions on the palate. Koplik noted too that French writers had lately described a bluish center in the buccal lesions.

Earlier pediatric texts had little to say of the enanthem. Condie's book of 1868 made no mention of an enanthem.
Diseases of the Newborn
Authors: AVERY GORDON B.
Published: December 2021

To the extent that a single book can crystallize a field and create a new subspecialty, Schaffer's Diseases of the Newborn has done just that. The time was ripe with the rapid accumulation of knowledge concerning newborns and with individuals here and there beginning to devote their chief attention to neonates. There were in existence excellent handbooks on premature care, at least one fine book on the physiology of newborns, and another on the pathology of newborns.
Child Health in the Tropics
Authors: CONE THOMAS E.
Published: December 2021

This is a book I have come to know well because we have used it for about a year as a text for several classes of young Peace Corps volunteers in training to serve as health educators in developing countries. The book wears well and the more I use it the more I realize how excellent it really is. Some of us have a tendency to denigrate a text which is pocketsized and published to be used essentially as a practical how-to-do-it handbook.
The Foetus and the New-born: Recent Rresearch
Authors: SMITH CLEMENT A.
Published: December 2021

Is the British Medical Bulletin widely enough known in the United States? Most research laboratories and academic centers know it well. But every physician, anywhere, who hopes to keep up with current and clinically applicable developments in science should know about this three-times-yearly publication, as he should also know the brief and authoritative monthly Physiology and Pharmacology for Phyricians.

The high quality of the Bulletin is apparent in the names of the Editors for the January, 1966, issue, together with that of R. A. McCance, who contributed its Introduction.
CORTISOL PRODUCTION RATE
Authors: Kenny Frederic M. , Preeyasombat Chawalit , Spaulding John S. , Migeon Claude J.
Published: December 2021

Treatment of pregnant mothers with pharmacologic doses of prednisone and triamcinolone did not suppress the CPR of their offspring. Babies of diabetic mothers and infants with autosomal trisomy had normal CPR's. Two infants with anencephaly had a CPR in the lower range of normal.
Galactose-1-Phosphate Uridyl Transferase Levels in the Newborn
Authors: KABACY GEORGE , HODGMAN JOAN E. , DONNELL GEORGE N. , SPEARS ROBERT L.
Published: December 2021

The activity of galactose-1-phosphate uridyl transferase was determined in red cells from mothers and their newborn infants. The newborn infants' enzyme activity in the cord blood and for 48 hours thereafter was the same as that of their mothers at delivery; both were significantly lower than normal controls.

By 1n6 months postpartum the enzyme activity of both mothers and infants had increased as compared to their values at delivery, but they were still below the control values.
The Editing of Advertising
Authors: STEEG CARL N.
Published: December 2021

The very important and provocative letter by Dr. Eidelman in the January 1966 issue of Pediatrics prompts this further communication on the same subject.

As I scan the advertisements, Warner-Chilcott's persistent omission of the ingredients in Tedral becomes disquieting.

Admittedly to many of us Tedral has become a "household word," but surely this is no excuse for the absence of a notation concerning its makeup.

One hopes that Warner-Chilcott is not establishing a trend in pharmaceutical advertising and attempting to lull the reader into regarding the drug purely by its commercial name rather than by its generic chemistry.
PKU and State Legislation—Good and Bad
Authors: ROBINAULT ISABEL P.
Published: December 2021

It is time to be at least equally concerned with the quality of state legislation for children as with its quantity. Although 29 states passed legislation related to phenylketonuria (PKU) by November 1965, there are serious drawbacks to the structure of some of the laws. For example, most of the 29 states require that newborn infants be tested for the presence of metabolic abnormalities which may be expected to result in subsequent mental deficiency (PKU Test).
NEONATAL MENINGITIS
Authors: Berman Peter H. , Banker Betty Q.
Published: December 2021

The case histories of 29 infants in whom purulent meningitis developed during the first month of life were reviewed. There was a high incidence of maternal perinatal infections, and identical organisms were frequently isolated from both the mother and offspring. Gram-negative intestinal organisms were the most frequent etiologic agents. Because signs suggesting meningeal and nervous system involvement developed only late in the course of the illness, the diagnosis was frequently not made until the spinal fluid was examined. The course of the illness was usually fulminant; death occurred within 4 days from the onset of symptoms in the majority of infants. Of the five infants who recovered from the meningitis, four died from neurologic complications within a few months.

Postmortem examinations were performed on 25 infants. Although the inflammatory reaction was essentially limited to the spinal fluid pathways and their contents, a wide-spread, at times devastating, non-infectious encephalopathy occurred in every case.

Our observations emphasize the paucity and subtlety of the clinical manifestations of meningitis in the neonate and the remarkably high mortality that seems to be little influenced by standard methods of therapy. The pathological features of a meningitis in the newborn are similar to those in the more mature individuals, except for the sparsity of lymphocytes in the subacute stage of the meningeal reaction, the prominence of bacteria in the meningeal exudate long after appropriate antibiotics have been employed, and the high frequency of sequelae in the survivors. The sparsity and delay in appearance of lymphocytes and plasma cells in the inflammatory response may be an important factor in the inadequate defense of the newborn to this infection.
THE ENERGY METABOLISM IN INFANTS WITH GROWTH FAILURE DUE TO MATERNAL DEPRIVATION, UNDERNUTRITION, OR CAUSES UNKNOWN
Authors: Krieger Ingeborg
Published: December 2021

The energy metabolism of 37 infants with growth failure and malnutrition was investigated, by use of the insensible loss of weight (IL) as the index of metabolic rate. The IL was measured 4 to 6 (standard IL) and 12 hours (basal IL) after a regular meal, while asleep. Twenty infants were tested repeatedly throughout the recovery period. Control values for the IL, obtained in 27 normal infants, agreed well with established norms for IL and for basal metabolic rate, calculated from oxygen consumption.

The initial standard and basal IL of the infants with growth failure fell between the regression lines on height of normal controls representing ±3 SE., but were above normal when related to body weight. The basal IL remained essentially within this range throughout the recovery period. By contrast, the standard IL rose upon realimentation with a high caloric diet sufficient to cause weight gain and declined during periods of weight loss or no weight gain. This rise, representing postprandial heat production in excess of basal (EHP), was greater than normal (up to 96%) for a period following realimentation. Peak values for EHP showed a near linear correlation with the average daily protein intake. This correlation appeared to be induced by the supply of sufficient calories, since the EHP was in a low range on admission and upon recovery regardless of the average daily protein intake. EHP did not correlate with the protein content of the meal given prior to measurement of the standard IL; therefore, factors other than those generally implicated in the specific dynamic action of food seem to be operative.
HEPARIN THERAPY OF PURPURA FULMINANS
Authors: Allen Donald M.
Published: December 2021

A patient with a rapidly progressing intravascular thrombosis with gangrene (purpura fulminans) was successfully treated by heparinization alone without complication and despite the finding of incoagulable blood and hemorrhagic gangrenous lesions Further cautious trials of heparin in this and allied disorders are indicated.
Chronic Myelogenous Leukemia in an Infant: Serial Cytogenetic and Fetal Hemoglobin Studies
Authors: BLOOM GERALD E. , GERALD PARK S. , DIAMOND LOUIS K.
Published: December 2021

An 8-month-old child is described who showed typical features of the adult type of chronic myelogenous leukemia including the Philadelphia chromosome. As far as known, this is the youngest patient reported with this disease. Serial fetal hemoglobin levels and cytogenetic studies are presented and discussed in terms of their possible relationship to the origin of the two types of chronic myelogenous leukemia found in childhood.
Your Child Is a Person: A Psychological Approach to Parenthood Without Guilt
Authors: BULLARD DEXTER M.
Published: December 2021

This well written, small volume about the care, behavior, and development of children is addressed to parents, teachers, and pediatricians. It is a non-technical account of child-rearing practices derived from one of the outstanding longitudinal studies of child development conducted in the United States during the past 20 years.

I found the book pleasing in many ways. Foremost, and a central theme of this work, is the authors' demonstration of the role temperament plays in children's development.
NUTRITION, GROWTH AND NEUROINTEGRATIVE DEVELOPMENT: AN EXPERIMENTAL AND ECOLOGIC STUDY
Authors: Cravioto Joaquin , DeLicardie Elsa R. , Birch Herbert G.
Published: December 2021

IN THIS MONOGRAPH we report the results of an experimental and ecologic study concerned with estimating some of the effects which malnutrition in early childhood may have upon neurointegrative functioning. In particular, we have been concerned with the association between malnutrition early in childhood and intersensory organization in children during the school years. A study of these relationships has derived from a concern with the possibility that inadequate food intake, particularly as represented by protein-calorie malnutrition, affects not only stature and weight, but also the capacity to learn. If this is indeed the case, then the significance of the observable and dramatic consequences of malnutrition for physical stature may be but one visible sign of functionally, perhaps, far more important non-visible handicapping.

Findings on the effects which malnutrition has on the central nervous system suggest strongly that protein deficiency may result in structural lesions of the nervous system. Animals experimentally deprived are persistently delayed in achieving simple developmental landmarks, appear to be less adequate in environmental responsiveness and slower in learning as well as poorer in the retention of that which has been learned than normal controls. Considering the animal experiments and the findings in humans as a unit, one is led to be concerned with what in an ecologic sense could be called a "spiral" effect. A low level of adaptive capacity, ignorance, social custom, infection, or environmental paucity of foodstuffs appear to result in malnutrition which may produce a large pool of individuals who come to function in suboptimal ways.
LONG-TERM FOLLOW-UP OF STAPHYLOCOCCAL PNEUMONIA
Authors: Wise Melvin B. , Beaudry Pierre H. , Bates David V.
Published: December 2021

Fifteen patients who had recovered from severe staphylococcal pneumonia in infancy and early childhood were studied 5 to 16 years after the original disease. From the interim history, there was no suggestion of subsequent increased incidence or severity of respiratory disease. Physical examination and chest x-rays were all within normal limits. There was no evidence of disturbance of pulmonary function, as measured by vital capacity, functional residual capacity, residual volume, total lung capacity, forced expiratory volume, maximum mid-expiratory flow rate and mixing efficiency. Thus, all information obtained from these 15 patients indicates their complete recovery.
THE EFFECT OF ATMOSPHERIC IONS ON THE RESPIRATORY SYSTEM OF INFANTS
Authors: Palti Yoram , Nour Elchanan De , Abrahamov Abraham
Published: December 2021

Forty-one experiments with positive and negative atmospheric ions were performed on 19 children, of whom 13 were suffering from asthmatic (spastic) bronchitis. The results of these experiments indicate that the atmospheric ions have the following effects.

Negative ions

1. Shorter duration of the spastic attack as compared with duration of the attack in children receiving the conventional therapeutic treatment.

2. Reduction of tachypnea in cases of spastic bronchitis and bronchopneumonia.

3. Termination of spastic attacks induced by positive ionization.

4. The effect of negative ions on respiratory spasticity usually becomes obvious about 8 hours after the beginning of the ionization.

5. When the negative ionization is stopped, a moderate rebound of spasticity and tachypnea was noticed in several cases.

Positive ions

1. Induce spastic attacks in normal infants.

2. Cancel the therapeutic effects of negative ions on patients with spastic bronchitis.

3. Cause tachypnea in infants.

4. On the average, the effects of these ions on respiratory spasticity becomes evident about 10 hours after the beginning of ionization.
ERYTHROCYTE C-14 CORTISOL UPTAKE IN THE NEWBORN
Authors: Marks James F. , Freeman Betty J. , Richardson John M.
Published: December 2021

The RBC C-14 cortisol uptake was measured in a group of normal adults, mothers at term, cord blood, and two to three day old infants. The variations observed with the technique are consistent with the observations of an elevated cortisol-binding globulin capacity in mothers at term. The results obtained are consistent as well with data suggesting a depression in cortisolbinding globulin capacity in the neonate.
INFLUENCE OF ACIDEMIA ON LEFT VENTRICULAR FUNCTION IN THE NEWBORN LAMB
Authors: Talner Norman S. , Gardner Thomas H. , Downing S. Evans
Published: December 2021

The performance of the left ventricle in 20 newborn lambs was examined in a preparation which allowed precise control of aortic pressure, cardiac output, heart rate, and temperature.

Reduction of arterial pH from a normal range (7.35 to 7.5) to severe acidemia (6.8 to 7.0) by hydrochloric or lactic acid infusion resulted in no significant impairment of left ventricular function.

Prolonged acidemia (over 2 hours) failed to produce a reduction in left ventricular stroke volume or mean ejection rate for a given left ventricular end-diastolic pressure.

Responsiveness of the left ventricle of the lamb to catecholamine stimulation was not diminished over the pH range 7.5 to 6.8.

Under conditions of these investigations the apparent resistance of the myocardium of the newborn lamb, as well as the adult cat, to wide variations in pH may reflect a buffering capacity of cardiac muscle which would allow minimal change in intracellular pH, even though extracellular pH may indicate the presence of severe metabolic acidosis.
THE DIENCEPHALIC SYNDROME OF EARLY INFANCY DUE TO SILENT BRAIN TUMOR: WITH SPECIAL REFERENCE TO TREATMENT
Authors: Bain Harry W. , Darte John M. M. , Keith William S. , Kruyff Evert
Published: December 2021

Three patients with typical "diencephalic syndrome" have been described. The clinical observation of an emaciated and pale, but remarkably bright, cheerful, and active infant with a normal or increased appetite and food intake should suggest the diagnosis. Physical findings are conspicuous by their absence, although mild nystagmus, tremor, or ataxia may occasionally be present. An elevated total eosinophil count and an elevated cerebrospinal fluid protein are important, though not invariable, features. Metopirone test coupled with ACTH-adrenal stimulation test indicate markedly reduced pituitary reserve. Diagnosis is confirmed by pneumoencephalography and biopsy.

It is likely that with increasing knowledge, the clinical spectrum of this syndrome will be broadened, and one might expect to find, on occasions, anorexia rather than increased appetite, lassitude rather than hyperactivity, irritability rather than euphoria, obesity rather than emaciation, and different combinations of all of these features.

The results of therapy with beam-directed cobalt irradiation are encouraging.
Ethics and Placebos
Authors: BAILIT IRVING WILLIAM
Published: December 2021

The following resolution was adopted by the New England Society of Allergy, primarily through the efforts of Dr. Lewis Webb Hill.

The Placebo in Clinical Investigation

The double blind study when carried out with honesty and with consideration for patients is surely a legitimate and valuable procedure in clinical research. If employed in ways other than this, it does not come within the best traditions of the generally accepted doctor-patient relationship.

The patient's understanding of the placebo is the gist of the whole matter.
ANTIBODY RESPONSES OF YOUNG INFANTS TO NATURALLY OCCURRING VIRAL INFECTIONS
Authors: Moffet Hugh L. , Cramblett Henry G.
Published: December 2021

A fourfold rise in neutralizing antibodies was demonstrated for 45% of infants 1 through 6 months of age compared to 63% of older children or adults from whom an adenovirus or an enterovirus was recovered. This difference appeared to be related to severity of illness rather than to age, as there was no significant difference between young infants and older patients when only clinically severe illnesses were analyzed. The isolation of virus from more than one specimen increased the probability of a significant response in either age group.

Infants with minor symptoms had a low frequency of significant fourfold antibody responses after virus isolation, but this was not significantly different from older children with minor symptoms. Failure to develop an increase in antibody titer could not be related to the presence of maternal antibodies.
TAKAYASU'S DISEASE (PRIMARY AORTITIS): REPORT ON TWO CASES IN CHILDREN
Authors: Zerpa Fabio , Hirschhaut Eduardo , Ferrer Alberto , Capriles Miguel A. , Dubois Eloy
Published: December 2021

Pulseless disease is described in a child of 10 and one of 12 years old. A renal disease of unknown origin with hypoplasia of the right kidney and arterial hypertension was also found in one. The other had an anomaly of the left coronary artery and heart failure resistant to therapy. Few cases of pulseless disease in children have been reported.
Electrocardiograph in Hypothyroidism and in Hypercalcemia
Authors: ROMANO C. , GEMME G. , RAFFAELLI E.
Published: December 2021

Dr. A. Ertugrul has recently drawn attention in this journal to a new electrocardiographic observation in infants and children with hypothyroidism. This new electrocardiographic feature, emphasized by Dr. Ertugrul is the disappearance of the S-T segment and the dome-shape of the T waves. Accordingly, the relationship of these observed changes with the serum calcium level must be investigated; actually in hypercalcemia the electrocardiogram commonly reveals the absence of the S-T segment, dome-shaped T waves with shortening of the Q-T interval.
THE MENTALLY RETARDED ADOLESCENT
Authors: Hammar S. L. , Barnard K. E.
Published: December 2021

The cases of 44 adolescents referred to the University of Washington Adolescent Clinic for evaluation of actual or suspected mental retardation were reviewed. The concerns presented by the parents regarding their teenager's behavior often differed from the problems identified by the professional staff and the school personnel. This difference was particularly significant with respect to problems relating to dependency and immaturity. While parents were usually more anxious about sexual behavior and aggressiveness, professional workers frequently viewed immaturity, lack of self-help skills, and unfulfilled training potential as the major problems needing attention. This discrepancy often made parent-professional communication and planning difficult.

An increasing amount of attention must be devoted to the retarded adolescent, if his maximum potential is to be realized and if he is to become a productive member of the community. The retardate needs appropriate sex education, guidance regarding his behavior, and assistance with his educational placement and vocational training. The problems presented by most retarded adolescents are too complex for families to handle without professional assistance. Therefore, the physician must be willing to assume a continuing responsibility in planning for the retarded individual.
THE RELATIONSHIP OF AMNIOTIC FLUID VISCOSITY TO RESPIRATORY DISTRESS IN LAMBS
Authors: Moss Arthur J. , Rettori Ovidio , Simmons Norman S.
Published: December 2021

The viscosity of amniotic fluid was measured in 52 ewes and the results correlated with the postnatal course of the lambs delivered by cesarean section. Viscosity was not related to length of gestation or to the immediate prepartum condition of the ewe, but a definite relationship was found between amniotic fluid viscosity (AFV) and the postnatal course of the fetus. Of 22 lambs considered viable, 9 failed to survive. In 10 of the 13 survivors, AFV was less than 1.6; whereas in the nonsurvivors, AFV varied between 1.6 and 4.4. All of the nonsurvivors experienced respiratory difficulty associated with copious amounts of extremely viscous secretions in the mouth and oropharynx.

The substance responsible for the high AFV was a mucoprotein and was detectable in all samples with a viscosity of 1.24 or more but in none with a viscosity below 1.24. The data suggest the possibility that fetal distress may induce qualitative or quantitative alterations of fetal mucous secretions in utero which subsequently could impede lung expansion at birth.
Blood Diseases in Infancy and Childhood
Authors: PEARSON HOWARD A
Published: December 2021

The second edition of Carl Smith's Blood Diseases in Infancy and Childhood is the most complete, authoritative, and useful of the available texts of pediatric hematology. It is written by one of the authentic founders of the subspecialty who has remained critical and up to date during the great expansion of knowledge during recent years. The length of the second edition exceeds that of the first by more than 200 pages. Several chapters have been completely rewritten and in almost every area new information has been included; this is reflected by an approximate doubling of the number of references cited.
The Child's Right to Die at Home
Authors: DAVOLI ENRICO , EVERS JOSEPH C.
Published: December 2021

If circumstances permit, we believe that the terminally ill and incurable child should be given the right to die at home. The child's disease, the physical and emotional strength of the parents, the number of children in the family, and the economic situation of the family must certainly be considered. There are some parents who could not face the problem at home and we do not feel that they should be forced to do so.

Quite recently we had the sad experience of treating a 4½-year-old boy with neuroblastoma.
Pneumocystis Carinii Pneumonia; Pentamidine Therapy
Authors: PATTERSON JOSEPH H.
Published: December 2021

Since acceptance of our report on "Pneumocystis Carinii Pneumonia and Altered Host Resistance: Treatment of One Patient With Pentamidine Isethionate" (Pediatrics, 38:388, 1966), the child has expired and additional information has become available from the postmortem examination.

In February 1966, Patient 3 (K.C.) was readmitted to Egleston Hospital because of refractory diarrhea.

A third course of pentamidine isethionate was instituted 1 week after admission and continued for 14 days. Extensive studies for an infectious agent or metabolic basis were not revealing.
Pediatricians and Day-Care
Authors: WHITE PARK J.
Published: December 2021

When the Editor waxes out-going and invites comment, I take it that he wants specifics from us ordinary, wayfaring pediatricians.

Day-care obviously involves two groups, one small, the other large: (1) those who can pay (2) those who can't.

Day-Care for the Better-Off

With current trends, this classification is automatically both financial and geographic. The better-off are mainly suburbanites. They have fled the Inner Cities. Children in this group require day-care because some mothers must, or think they must, (a) express themselves by getting part or full-time jobs; (b) get such jobs to help pay for luxuries-become necessities, like big cars, houses, etc.; (c) seek regular activity (in occupations for which they may well have been trained) outside the home because they feel—understandably—that regular escape from child-attrition will enable them to perform the most difficult of all tasks, that of motherhood, more expertly and cheerfully.
Letters to the Editor
Authors: JONES J. ALBRIGHT
Published: December 2021

I wish to make a brief comment on the letters from Drs. Nathan and Crook.

A "child-proof container cap" is a most welcome invention and could prevent many cases of poisoning in children. But I am quite certain it will be a long time before enough force can be brought to bear on container manufacturers to adopt such a cap.

As Dr. Crook points out, if home builders and cabinet makers would install proper locks of the combination type, drugs, etc. could be kept out of little hands.
Medicine in America, Historical Essays
Authors: CONE THOMAS E.
Published: December 2021

This book offers the reader an enormous amount of information about the history of medicine in America and at the same time is a delight to read. One would expect nothing else from Professor Shryock who is, in my opinion, our foremost medical historian. No one has been more successful than he in showing that the history of the medical profession represents a significant phase of our social and cultural evolution. Excellent work has been done in this area previously by Doctor Packard in his well received History of Medicine in the United States and by Doctor Sigerist in his superb study Amerika und die Medizin.
CREATINE PHOSPHOKINASE ACTIVITY IN SERUM OF NEWBORN INFANTS AS AN INDICATOR OF FETAL TRAUMA DURING BIRTH
Authors: Rudolph Nathan , Gross Ruth T.
Published: December 2021

Serial studies have demonstrated a frequent rise in the activity of the enzyme creatine kinase in the serum of newborn infants following delivery. The rise in activity is independent of the maternal enzyme level.

Considerable elevations in serum creatine kinase activity, noted especially at 24 hours of age, have been found in a number of infants delivered as breech presentations, following secondary uterine inertia with oxytocin stimulation, and following emergency Cesarean section after a trial of labor. Muscle damage sustained by the infant during the birth process is suggested as a likely cause for the increase in neonatal serum enzyme activity.
STREPTOCOCCAL ANTIBODY TITERS IN SYDENHAM'S CHOREA
Authors: Ayoub Elia M. , Wannamaker Lewis W.
Published: December 2021

Antistreptolysin O (ASO), anti-desoxyribonuclease B (anti-DNAse B), and anti-nicotinamide adenine dinucleotidase (anti-NADase) titers were determined on patients with Sydenham's chorea and a matched group of controls. For each of the antibodies studied, elevated titers were found in a significant percentage of patients with chorea as compared with control individuals. This finding was also true of patients with "pure chorea" on whom antibody titers were performed within 6 months of the onset of choreic symptoms. Ten of 30 such patients failed to show an elevated ASO titer. Four of these were found to have markedly elevated anti-DNAse B titers. Elevation of two or more antibody tests, which is highly suggestive of recent streptococcal infection, was found in the majority (63%) of patients with pure chorea seen within 6 months as compared with the control group (10%). The practical and potential usefulness of multiple streptococcal antibody tests in patients with pure Sydenham's chorea is discussed.
SEPTIC ARTHRITIS IN INFANTS AND CHILDREN: A REVIEW OF 117 CASES
Authors: Nelson John D. , Koontz Wayne C.
Published: December 2021

A review of 117 cases of septic arthritis in infants and children revealed that the concept of staphylococci and streptococci as the major etiologic organisms should be modified to stress the frequency of Hemophilus influenzae in the 6-month to 2-year age bracket and to emphasize the variety of bacteria that must be anticipated in individual cases.

Suggestions are made for increasing the frequency of bacteriologic diagnoses and for initiating the antibiotic therapy of patients with septic arthritis based upon age groups and observations of bacterial stains of joint fluid.
Maladies Osseuses Constitutionnelles
Authors: NEUHAUSER EDWARD B. D.
Published: December 2021

This monograph on constitutional diseases of bone is based on a series of lectures given under the auspices of the College of Medicine of the Hospitals of Paris at the Hôpital Bretonneau. This monograph of approximately 100 pages of text and numerous excellent illustrations is written in French, but at the end of each chapter there is a brief résumé in English.

The first chapter is a short but excellent summary on the structure and physiology of bone.
THE UNMET NEEDS OF CHILDREN
Authors: STEWART WILLIAM H.
Published: December 2021

IT IS a real pleasure for me to be discussing pediatrics with pediatricians. More than any other group, you share my educational background and my earliest dedication as a physician. And, although my period of actual pediatric practice was rather brief, I feel that I share with you a basic orientation and a store of common experiences.

Reading through some of the recent periodical literature in our field, I have been impressed with a growing sense of professional restlessness. One article used the phrase "unhappy pediatrician syndrome"—partly but not entirely in jest.

I confess that I am not altogether unhappy with this kind of unhappiness.
THE PERPETUATION OF HEMOPHILIA BY MUTATION
Authors: Strauss Herbert S.
Published: December 2021

Sporadic cases of hemophilia, constituting approximately one third of all patients with hemophilia A and one fifth of patients with hemophilia B, have been ascribed to mutations or ignorance of the family history. Previous descriptions have not noted a preponderance of severe cases in the sporadic group. In our families sporadic occurrence was strikingly associated with severe disease. In 94 families with hemophilia A a single case per kinship occurred in 36 of 60 families with severe disease, and in only 2 of 34 families with non-severe disease. Similarly, 4 sporadic cases, all of them severe, occurred among 17 families with hemophilia B.

The distribution of Factor VIII levels in mothers and maternal grandmothers of sporadic cases of severe hemophilia A was compared to that in groups of confirmed female carriers and normal women. From this comparison it was concluded that in the majority of these families the hemophilic gene arose by recent mutation. On the basis of the frequency of hemophilia in the newborn population and the frequency of de novo cases the mutation rates for hemophilia A and B were estimated as slightly less than 4.2X10-5 and 0.46X10-5, respectively. Results were comparable to figures obtained on the basis of the reduced reproductive fitness of affected males. Due to a lower reproductive fitness in severe disease, a greater mutation rate is expected to balance the loss of genes for hemophilia. This is reflected in the preponderance of severe over non-severe disease among the de novo cases.

The results of this study underscore the importance of both personal and family history in the detection of the disease.