bluuebunny/crossref_metadata_2025 huggingface dataset:
GROUP DISCUSSIONS WITH MOTHERS IN THE CHILD HEALTH CONFERENCE
Authors: Bleiberg Nina , Forrest Susanne
Published: December 2021

The rationale and organization of two series of group discussions with mothers are described. The group of mothers from the better economic area was more successful in terms of attendance and continuity. A brief summary of five selected sessions of one group is given, in order to demonstrate the problems and the flow of the discussion. A brief summary of the courses of three cases from the other group is also reported.

It is believed that distinct benefits do accrue to parents from these group discussions with mothers. This type of experience is also considered valuable for the professional staff.

It is hoped that this report will stimulate interest in an experimental design for evaluation of the effects of group discussions so that further understanding of their value in mental hygiene might be gained.
COR PULMONALE ASSOCIATED WITH SYMPTOMS AND SIGNS OF ASTHMA IN CHILDREN
Authors: Griffin J. Trenholme , Kass Irving , Hoffman Murray S.
Published: December 2021

Symptoms and signs of bronchial asthma, associated with cor pulmonale, are rare clinical findings in infants and children. Three cases are presented which suggest a relationship between the two entities. Two of the three cases did not present any evidence of atopy.

Although studies of cardiopulmonary functions should be done in all children suffering from "bronchial asthma," it is essential that the cardiac status be evaluated whenever a patient with asthma is responding poorly to treatment or evidence of decreased pulmonary function is found.

It is hoped that this presentation will alert physicians to cor pulmonale as a complication of asthma.
EFFECTS OF EARLY AMBULATION ON THE COURSE OF NEPHRITIS IN CHILDREN
Authors: McCrory Wallace W. , Fleisher Daniel S. , Sohn William B.
Published: December 2021

The course of convalescence of acute nephritis in 35 children allowed early resumption of physical activity was followed for at least 2 years.

Thirty-four of the 35 children completely recovered from nephritis as judged by one or more normal Addis counts of the urinary sediment.

The early resumption of physical activity did not appear to have any adverse effect on the prognosis of nephritis in these children.

The value or necessity of continuing bed rest after symptoms and signs of the acute stage have subsided in typical cases is considered to be unsubstantiated.
THE ADMINISTRATION OF SODIUM GLUCURONATE TO JAUNDICED NEWBORN INFANTS
Authors: Dwyer J. Henry , McCue Carolyn M.
Published: December 2021

Sixteen cases of jaundice in the newborn period were treated with parenteral administration of sodium glucuronate. One case showed a decrease in concentration of indirect bilirubin in the serum, 2 cases showed a slight increase, and 13 cases showed no change during the entire observation period.

Experimental evidence and clinical experience suggest that parenteral administration of sodium glucuronate does not enhance the formation of bilirubin glucuronide in the newborn infant. In the authors' experience, it has been an inefficient and unreliable method of reducing the concentration of indirect bilirubin in serum. In our opinion exchange transfusion is still the only recognized therapeutic procedure for decreasing indirect bilirubin in serum in the newborn infant.
ADRENAL FUNCTION IN ALLERGY
Authors: Siegel Sheldon C. , Lovin Bailey J. , Ely Robert S. , Kelley Vincent C.
Published: December 2021

An evaluation of a schedule of intermittent prednisolone therapy in the treatment of 42 children with severe allergic disorders, who had failed to respond to ordinary allergic management, is presented. In 11 subjects the response was excellent; in 28, good; and in 3, poor. No serious complications were observed as a consequence of the method of treatment.

Appraisal of adrenal function, as measured by a standardized test of response to adrenocorticotropin, was undertaken before and after the institution of therapy in the majority of the subjects. The mean urinary excretion of 17-hydroxycorticosteroids in the test observed after the introduction of therapy was significantly less than that prior to treatment. This suggests that the regimen of therapy employed impairs the adrenals' response to exogenous ACTH. The unresponsiveness of the adrenals was at least partly dependent upon the dosage of hormone administered.

The effect of intermittent steroid therapy on the urinary excretion of adrenocortical steroids in 16 subjects is also reported. Some hypofunction of the adrenals, which is overcome only partially during the days hormones are withheld, is suggested by the data on 17-OHCS. There was no discernible effect on the urinary excretion of 17-KS.

The indications for use of steroid therapy in allergic children and the implications of the findings in this study are discussed. Although a schedule of intermittent steroid therapy was found to be useful as an adjunct in the treatment of intractable asthma and atopic dermatitis, it should not be used as a substitute for conventional methods of treating allergic patients. The criteria for selection of patients and the precautions required in the administration of continuous hormone therapy, should also be applied in the use of intermittent hormone therapy.
The Advantages of Surface Area of the Body as a Basis for Calculating Pediatric Dosages
Authors: TALBOT NATHAN B. , RICHIE ROBERT H.
Published: December 2021

The use of surface area of the body as a basis for calculating fluid dosages has been questioned in recent communications. This letter is being written to call attention to certain facts which the authors of these communications appear to have overlooked.

One is that body fluid requirements, like many other body functions, are not directly proportional to body weight. For this reason, Oliver et al. find it necessary to use five separate ml/lb-factors to calculate the fluid allowances of infants, children and adults. As can be seen in the table at the bottom of Figure 1, these diminish as individuals grow larger. Darrow likewise lists a series of eight factors to calculate body fluid requirements. Specifically he recommends that calories expended per kilogram be assumed to vary between 45 and 50 in the newborn, 60 and 80 in infants of 3 to 10 kg, 45 and 60 in children of 10 to 15 kg and so on down to a range of 25 to 30 in individuals weighing more than 60 kg.
The Magic Years
Authors: WORK HENRY H.
Published: December 2021

The fact that there continue to be books written to help parents with child rearing suggests both that our knowledge is improving and that it is not always possible for one writer to reach all audiences. The Magic Years is a new and fresh approach which will appeal to many mothers.

In general, this book tends to stress strongly the situations which arise in the earliest years of the child's life and the effect of these situations on a child's later development. The book places a healthy emphasis on the very real effect of mother-child relationships in these years. Fortunately, also, fathers are not neglected.
THE USE OF ACETAZOLEAMIDE IN THE THERAPY OF SALICYLATE POISONING
Authors: Feuerstein Richard C. , Finberg Laurence , Fleishman Evelyn
Published: December 2021

Data on a series of 45 patients with salicylate poisoning, managed on the pediatric service of the Baltimore City Hospital, are presented. A regimen consisting of acetazoleamide and fluids administered intravenously in 27 patients is outlined. Results of therapy are presented and compared to a group of 18 patients treated with parenteral fluids alone. This mode of therapy in the 27 patients so treated has proven to be an apparently safe and effective means of enhancing salicylate excretion. The importance of early initiation of therapy is stressed. The rationale for the use of acetazoleamide to facilitate the excretion of salicylate is discussed. Conflicting evidence from animal experiments suggests caution in the indiscriminate application of this type of therapy.
RADIATION HAZARDS IN DIAGNOSTIC RADIOLOGY
Authors: CAFFEY JOHN
Published: December 2021

THE MOST pressing current problem in pediatric radiology is the reduction of hazard to the patient from exposure to ionizing radiations. Pediatric radiologists must become deeply interested in the problems of better protection for their patients because fetuses, infants and children are the most vulnerable of all humans to injury by ionizing radiation, for several reasons. First, young patients are all potential parents. Second, they have the longest expectancy of survival which provides longer life spans for the development of leukemia and for additional, possibly excessive, irradiation. Third, their reticulum cells are more abundant and probably more labile, which makes them more prone to wild growth (leukemia). Fourth, in routine radiologic procedures relatively larger parts of their smaller bodies are usually exposed. Fifth, frightened youngsters often move during exposures and additional exposures must be made to get satisfactory films. Sixth, in small patients the gonads are nearer the central rays in all types of examinations, save when the gonads are exposed directly in adults. Seventh, currently the bones of younger children contain 3 to 4 times more radioactive strontium-90 per gram of calcium than the bones of adults.
A STUDY OF CHILDREN WITH MONGOLISM REARED IN THE HOME COMPARED TO THOSE REARED AWAY FROM THE HOME
Authors: Centerwall Siegried A. , Centerwall Willard R.
Published: December 2021

A comparison was made of the physical and mental development of children with mongolism who were put into foster placement very soon after birth (Group P) with similar children who were reared in their own homes until 2½years of age or older (Group H). All of these children at the time of study had been patients at a state hospital for several years. The two groups (consisting of 32 children each) were matched as to present age but were otherwise chosen in a random way from the hospital population.

The children of Group H showed significantly better nutrition and growth and walked at a much earlier age.

The average Intelligence Quotient of Group P at an average age of 7 years was 16 while that of Group H at the same age was 23. The Social Quotients at the same time were 24 for Group P and 32 for Group H. A statistical analysis of these differences show them to be highly significant. It might be said that the children in Group P function generally within the severely retarded range whereas those in Group H are within the moderately retarded or trainable range.
Determination of Specific Gravity of Urine
Authors: ROSENTHAL IRA M.
Published: December 2021

Goldman (Pediatrics, 24:814, 1959) pointed out that determination of the specific gravity of urine of pediatric patients by use of a urinometer was often difficult to perform because a minimum sample of 25 ml was required. It should also be noted that the ordinary urinometer is a relatively inaccurate instrument. Moreover, the test as ordinarily done does not take into consideration additional error resulting from variation in the temperature of the urine.

Goldman suggested that the determination of specific gravity of urine by means of the copper sulfate method was suitable for clinical use in pediatrics. The method suggested requires replacement of solutions every 2 weeks and some skill in performance of the test.
WATER-SOLUBLE RADIOPAQUE MEDIA IN ROENTGENOGRAPHIC EXAMINATION OF THE ALIMENTARY TRACT IN INFANTS AND CHILDREN
Authors: Jarvis J. Luther , Nadelhaft Jerome
Published: December 2021

Water-soluble iodinated compounds can be satisfactorily used as the radiopaque contrast agents in certain roentgenographic [see Table VI in Source PDF] examinations of the alimentary tract in infants and children. They are preferable to barium-water mixtures in tracheo-esophageal fistulas, hypertrophic pyloric stenosis, fistulous tracts which communicate with the alimentary tract, and in post-surgical examinations of the alimentary tract. The low viscosity of these substances permits their passage through tiny tracts or narrowed lumens which will not permit passage of thicker suspensions of barium.

These contrast solutions are the opaque materials of choice in the radiologic investigation of megacolon. The iodinated compounds because they are true solutions, do not desiccate and form the impactions which are the main hazard in the use of barium-water suspensions in cases with obstruction of the alimentary tract.
L'hérédité moléculaire: Conditions Normales et Pathologiques
Authors: BLANC WILLIAM A.
Published: December 2021

This book presents a clear and well organized compilation of the modern theories of heredity and illustrates the basic concepts with excellent and up-to-date reviews on phenylketonuria, galactosemia, glycogen storage diseases, hepatolenticular degeneration, connective tissue diseases, neurofibromatosis, intestinal polyposes, Rh factors, coagulation defects and abnormal hemoglobins. This book does not duplicate any of the existing textbooks on the subject and covers a great variety of material in a compact form. The text is written in French and this will unfortunately be a factor limiting its spread and its usefulness for the American physician not yet familiar with the language of Claude Bernard, Pasteur and Camus.
PROCEEDINGS
Authors: Cramblett Henry G.
Published: December 2021

Croup is a syndrome in which there is inspiratory stridor, cough and hoarseness, due to varying degrees of laryngeal obstruction . A schematic representation of the pathogeneses of croup is presented in Figure 1. In an individual case, the clinical manifestations of croup may be entirely the result of spasm or edema or any combination of the two. Further, a foreign body or extrinsic mass which encroaches upon the laryngeal airway may be accompanied by varying degrees of spasm and edema. In addition to the larynx, the rhinopharynx and tracheobronchial tree may be simultaneously involved if the basic etiology is infectious.

CLASSIFICATION OF ETIOLOGY

For the purposes of this discussion, the etiology of the croup syndrome will be considered as being due to infectious, mechanical or allergic factors (Table I). Traditionally, most classifications of croup have included in addition another distinct category, i.e., "spasmodic" croup. Typically, this form of croup was described as developing suddenly at night, tending to be recurrent and usually associated with minor upper respiratory infection. This type of disease was said to be due to allergy or immaturity of the larynx and to occur in "the nervous type of child." No doubt a major portion of the laryngeal obstruction in this form of the disease is due to spasm with a lesser degree of actual subglottic edema. However, there is increasing evidence that the laryngeal spasm is apparently triggered by, and associated with, a preceding viral upper respiratory infection in a majority of cases. [SEE TABLE I IN SOURCE PAGE].
THE BODY COMPOSITION OF NEWBORN INFANTS OF DIABETIC MOTHERS
Authors: Osler Mogens , Pedersen Jorgen
Published: December 2021

Studies on the body composition of new born infants of diabetic mothers (diabetic infants) are reported. Birth weight and length, total body water, water compartments, body fat, osseous maturity, and urinary excretion of water, electrolytes and nitrogen were determined in newborn infants of diabetic mothers, and for comparison in normal full-term infants (normal infants) and new-born infants of the same gestational age as the first group, but born to nondiabetic mothers (control infants).

Infants of diabetic mothers must be characterized as infants whose maturity in terms of development of ossification centers, excretion of water, electrolytes and nitrogen, and other organ functions corresponds to their chronologic age, or even less. Besides they are grossly overweight on account of a surplus of fat, and to a lesser degree, of carbohydrate stores in tissues and organs.

The combination of premature organ functions, increased fat content and water release on account of breakdown of protein and carbohydrate stores after birth, may be major factors in the neonatal pulmonary syndrome exhibited by infants of diabetic mothers.

Discussing the influence of glucose plus insulin, growth hormone and adrenal cortical steroids upon the body composition, the authors conclude that the changes found in newborn infants of diabetic mothers may be due primarily to maternal hyperglycemia.
BEHAVIOR, DIET AND GLUCOSURIA OF DIABETIC CHILDREN IN A SUMMER CAMP
Authors: Weil William B. , Sussman Marvin B.
Published: December 2021

Observations were made on 13 pre-adolescent diabetic boys at a summer camp. Glucosuria, hypoglycemia, dietary intake with self-regulated and prescribed diets, emotional adjustment and measures of group structure were recorded and correlated to determine the relationship between psychologic-sociologic factors and metabolic changes in the diabetic state.

Average values for glucosuria for the entire group indicated that during the period of a prescribed diet, the per cent glucose in the urine was not statistically different during any of the three periods of the 24 hours. With the self-regulated diet there was a significantly greater per cent glucose in the urine during the day and evening periods than during the night period.

The type of diet the boys had received at home did not affect their performance during the two dietary programs.

There was less hypoglycemia and a higher per cent glucose in the urine during the day with the self-regulated diet than with the prescribed diet. These differences were significant, with a P value of less than .025. There was no difference in glucosuria during the night collection with the two dietary programs.

Well adjusted boys had less of an increase in glucosuria when they went from a prescribed diet to a self-regulated one than did the poorly adjusted boys. The differences in glucosuria were partially correlated with the differences in caloric consumption, the poor adjustors having a greater increase in calories consumed than the good adjustors. These changes did not reach the .05 level of significance.

Eating as a preferred activity increased in prominence during the course of the study.

Group structure did not become well defined with these boys because of the lack of a cabin-oriented program in the camp, so no correlation could be made between group position and change in glucosuria.
PSYCHOMETRIC EVALUATION AND FACTORS AFFECTING THE PERFORMANCE OF CHILDREN WHO HAVE RECOVERED FROM TUBERCULOUS MENINGITIS
Authors: Nickerson Granville , MacDermot P. N.
Published: December 2021

This particular group of children recovering from tuberculous meningitis have suffered a significant degree of intellectual impairment.

It appears that the factor having the most unfavorable influence in intellectual recovery is severe clinical illness as evidenced by convulsive seizures.

Loss of consciousness for some time during the early phase of tuberculous meningitis in itself does not appear to be a highly unfavorable sign. Nevertheless, when unconsciousness is associated with convulsive seizures the intellectual functioning of the patient, in most instances, can be expected to be seriously impaired.

An infant with tuberculous meningitis may be expected to have an unfavorable prognosis aside from any other factors. An older child, who has remained conscious throughout his illness and without convulsions, may be expected to have a relatively good prognosis.

Adverse social factors, prolonged hospitalization and isolation, and sensory-motor sequelae are considered to have influenced unfavorably the psychometric scoring of many of these children.

Repeat psychometric testing, after an interval, reveals that still further improvement in intellectual functioning may be expected in a number of these children who do not have serious sensory-motor impairment.

For the majority, however, repeat testing reveals that they have varied little from their previous performance; the normal children continuing to develop within their normal group whereas the retarded children have remained retarded.

It is noteworthy that observations on five adults treated at the Alexandra Hospital have been at some variance with the observations of Williams and Smith who found no measurable disturbance of intellect, personality or memory in 19 adult patients. Three of the five adults treated in this unit have obvious changes in personality in that they are unable to concentrate as formerly, are easily frustrated, childish and frequently quick-tempered. The remaining two patients appear to have no apparent intellectual or personality sequelae.

Although this is a study of a small number of children, it is hoped that other workers will undertake psychometric evaluation of children recovering from tuberculous meningitis and make their results known for comparison.
OCCULT BLOOD LOSS IN IRON DEFICIENCY ANEMIA OF INFANCY
Authors: Hoag M. Silvija , Wallerstein Ralph O. , Pollycove Myron
Published: December 2021

Blood loss from the gastrointestinal tract was measured in 13 infants with iron deficiency anemia, using radioiron as a tracer. The radioiron was given intravenously; radioactivity in the erythrocytes and feces was measured for the following 3 to 4 weeks.

The percentage of total Fe administered that was recovered in the stools varied between 0.75 and 16.4%, with a mean of 5.75%. This represents loss of whole blood in the stools varying from 7 to 107 ml, with a mean of 41 ml during the observation period.

Occult blood loss from the gastrointestinal tract appears to be a significant factor in the development of iron deficiency in early childhood.
FRIEDREICH'S ATAXIA WITH HEART DISEASE IN CHILDREN
Authors: Thilenius Otto G. , Grossman Burton J.
Published: December 2021

Two children with Friedreich's ataxia are reported in whom cardiac manifestations preceded neurologic symptoms. Both cases were initially diagnosed as rheumatic fever and were treated as such with 3 and 12 months of bed rest respectively. The differential diagnosis of Friedreich's ataxia with heart disease and rheumatic heart disease and the possible etiology of the disease are discussed.
EFFEMINACY IN PREPUBERTAL BOYS
Authors: Green Richard , Money John
Published: December 2021

Eleven prepubertal boys, who at the time of their referral were assuming many of the behavioral characteristics of girls, were studied. One case has been followed 5 years, four for 2 years, and six were seen this past year for the first time. A brief summary of case findings is presented along with theoretic considerations and a program for case management during childhood.
FACTORS IN THE GENESIS OF BILE STASIS IN INFANCY
Authors: Nakai Hisayo , Landing Benjamin H.
Published: December 2021

Forty-two of 340 infants dying before 3 months of age had bile stasis in the liver. Statistical comparison of these infants with 81 jaundiced infants and 217 with neither jaundice nor bile stasis demonstrated that bile stasis was associated with hepatitis, galactosemia, erythroblastosis fetalis, prematurity, esophageal atresia with tracheoesophageal fistula, duodenal atresia and lower small intestinal obstruction. High proportions of the infants with bile stasis also had one or more of: infection with gram-negative organisms, significant internal hemorrhage and dehydration. Infants with congenital heart disease were statistically unlikely to have either jaundice or bile stasis, and the transposition complex was associated with a lower incidence of jaundice than was the hypoplastic left heart complex. The data indicate that biochemical dysfunction of liver cells is a cause of bile stasis, as is duct obstruction, and suggest that disturbance of hepatic blood flow is also a causative factor. Statistically, bile stasis in the liver is associated with elevation of conjugated bilirubin in serum, and the causative factors listed are thus relevant to the genesis of the inspissated bile syndrome in infancy. The spectrum of causes of bile stasis in older children differs strikingly from that seen in young infants.
RESPIRATORY VOLUME-FLOW IN THE CRYING NEWBORN INFANT
Authors: Long Ernest Croft , Hull Wayland Elroy
Published: December 2021

Maximum inspiratory and expiratory volume-flow have been recorded in 14 crying infants during the first 3 days of their lives, by a method that will follow rapid changes accurately. Average maximum inspiratory volume-flow of 161 ml/sec and average maximum expiratory volume-flow of 106 ml/sec were observed. The relation of volume-flow to noise production was also studied.

It is suggested that there is a certain maximal tracheal volume-flow measured by the maximum volume-flow recorded during the inspiration preceding a cry.
CARDIOAORTIC FISTULAS AND ANEURYSMS OF SINUS OF VALSALVA IN INFANCY
Authors: Heiner Douglas C. , Hara Masauki , White Harold J.
Published: December 2021

A report of an infant with a previously undescribed congenital malformation of the heart consisting of an aneurysm of the left sinus of Valsalva with rupture into the left atrium and associated atrial septal defects is presented. This cardiac anomaly, along with others in the literature, supplies evidence that sizable congenital aneurysms may arise from any of the three sinuses of Valsalva and may communicate directly with any of the four cardiac chambers, the pulmonary artery or the pericardial sac. Other contiguous intrathoracic structures should also be considered potential sites of ruptures. Such a consideration may prevent some instances of congenital aneurysms from being missed simply because they have not been reported. Embryologic factors are briefly discussed as is the possibility that the patient may represent a variant of Marfan's syndrome. Surgical implications are also mentioned.

The patient reported presents a clinical syndrome that should be recognizable during life if the possibility of an aortic to left atrial shunt is kept in mind. The findings included evidence of heart disease soon after birth, a loud continuous murmur and thrill present maximally in the left axilla, bounding peripheral pulses and a wide pulse pressure. Roentgenograms showed marked cardiomegaly involving all cardiac chambers, a bulge in the cardiac silhouette to the left of the main pulmonary artery, and marked pulmonary vascular engorgement. There was electrocariodgraphic evidence of atrial and combined right and left ventricular hypertrophy. Cardiac catheterization revealed a peculiar pressure gradient between the left and right atria in spite of an atrial septal defect with a left-to-right shunt. Venous angiocardiograms and retrograde aortograms were not diagnostic, although a more adequate aortographic dye injection would have demonstrated the defect. Retrograde arterial catheterization should also permit an accurate diagnosis.
THE INCIDENCE OF MENTAL AND PHYSICAL HANDICAPS IN SCHOOL-AGE CHILDREN OF VERY LOW BIRTH WEIGHT
Authors: Drillien Cecil Mary
Published: December 2021

Fifty children of a total of 97 whose weight at birth was 3 lb (1,360 gm) or less, born in two Edinburgh hospitals between 1948 and 1960, have now passed their fifth birthday, the statutory age for school entrance. One case was not available for examination Recent data regarding type of schooling or other disposal, educational attainment behavior observed in school, and physical defect affecting education are presented for the 49 children examined. The findings are as follows:

One-half of the total were ineducable in normal school, for reason of physical or mental handicap or both, one-quarter were dull children requiring special educational treatment within the normal school, and one-quarter were considered low average, average or superior in ability.

Twenty-six children (53%) had one or more physical defects; 9 of these attended schools for the physically handicapped.

Thirty-eight children (78%) were reported as having problems of behavior.

Of 30 children with siblings for comparison, 2 were considered to be superior in ability, 6 approximately equal to at least one sibling and 22 obviously slower than all their siblings.

In five of seven pairs of twins, the larger twin scored higher on intelligence tests than the smaller.

A highly significant increase of severe handicap was found in children born between 1953 and 1954, as compared with those born in 1948 to 1950, and it is suggested that this is due to an increasing number of damaged children surviving, associated with an improved survival rate. There is a significantly higher proportion of males among those later born children, but there is no evidence of sex differential with regard to mental grade. A significantly higher incidence of handicap is found in children from the poorest homes. Twins show a lower average mental grade, but this is not statistically significant.

In the period 1953 to 1954, 29% of mothers gave a history of relative infertility; all children born to these mothers were severely handicapped. Ten per cent of mothers in the period 1948 to 1952 gave a like history; all their children were considered average in mental ability.
CONGENITAL LARYNGEAL STRIDOR
Authors: Schwartz Abraham B.
Published: December 2021

The hypothesis is proposed that congenital laryngeal stridor results from excessive rehearsal of the laryngeal closing reflex during the aquatic environment of fetal life.

An unusual frequency of allergic manifestations in stridorous infants who have been followed to maturity, or in their families suggests a relationship between allergy and congenital laryngeal stridor.
PRESIDENT'S MESSAGE
Authors: Wheatley George M.
Published: December 2021

TODAY the calls on your time and skills are probably greater than they have ever been before. As a physician you are throughout your career a teacher as well. The very word "doctor" means "teacher" and no other professional person is better equipped than you to give families 1) an understanding of the child's illnesses, 2) health supervision and guidance, 3) family life counseling and 4) preventive medical care and advice about accident prevention.

This comes to mind with special pertinence at this time because the 1961 National Health Forum sponsored by the National Health Council, of which the Academy is a member, is on the subject of "Health and Communication". It is being held at the Waldorf-Astoria Hotel in New York, March 13 through 16, 1961. Here members of the health professions will discuss and exchange ideas on effective communication with the public and with particular professional groups. The President, the President-elect, and the Executive Director are the Academy's delegates to the National Health Council. As this is being written, one can only speculate on the outcome of such a conference. But it is safe to conclude that no individual is more influential as a health communicator than the physician, and our own specialty has a foremost position in health education.

It is timely to consider this whole matter of the physician as health educator. Actually this is at the core of the much talked about "physician-patient relationship," and every pediatrician knows that good communication is essential in his relations with parents and little patients. It is also worth thinking about this aspect of medical skill because your role as a teacher and a preventer of illness probably takes more of your time than even you realize. As far back as 1947, at the time of the Academy's study of child health services, pediatricians on the average were devoting about half of their time to health supervision.
ACUTE INFANTILE GAUCHER'S DISEASE
Authors: Stein Marvin , Gardner Lytt I.
Published: December 2021

The present clinical conference takes up the case of a 5½-month-old boy who was admitted to the hospital because of irritability and failure to gain weight. His irritability progressed to definite neurologic signs, and marked enlargement of the spleen developed, together with some hepatomegaly. Bone marrow aspiration revealed abnormal cells, showing an eccentric nucleus and wavy, fibrillar cytoplasm, with an appearance consistent with Gaucher cells. A progressively downhill course ensued, characterized by opisthotonus and respiratory difficulties, and the child died at age 7 months.

A discussion of numerous aspects of Gaucher's disease is presented, including biochemical and genetic considerations. The problems encountered in genetic counseling of parents who have children with this disease are brought out. Since Gaucher's disease as a syndrome exhibits a heterogenous pattern of inheritance, the dangers inherent in giving parents oversimplified genetic data are emphasized. If the parents ebect to have no further children of their own and instead wish to adopt children, certain implications which this course of action may raise are discussed.

An experiment is described wherein spleen tissue obtained from two patients with Gaucher's disease was analyzed for cerebroside content. Most of the cerebroside found in both spleens was the abnormal glucose form, whereas in normal human tissue the galactose cerebroside predominates. Studies are being made in this laboratory of the incorporation of carbon-14 labelled glucose and galactose using microsomal fractions of spleens from patients with Gaucher's disease. On the basis of preliminary data, it is postulated that the site of the biochemical error in most patients with the disease is at the conversion of the glucocerebroside to the galactocerebroside. It is believed that a defect in a UDP-galactose-4-epimerase-like mechanism at this site would cause the accumulation of the "abnormal" glucose cerebroside. Figure 5 indicates graphically the location of this suggested metabolic block.
Simplified Procedures for Calculating Drug Dosage from Body Weight in Infancy and Childhood
Authors: GLAZKO ANTHONY J.
Published: December 2021

The primary purpose of this communication is to describe some rather simple procedures for calculating pediatric doses when they are proportional to a fixed power of body weight. It is generally recognized that dose requirements per unit of body weight are usually higher for children than for adults. Consequently the total dose is not directly prportional to the body weight, but appears to be more nearly proportional to the body surface area. This requires preliminary estimation of the body surface area with the assistance of various charts and tables, following which the dose can be calculated by simple proportion when the adult dose is known.
BACTERIAL ENDOCARDITIS IN AN INFANT PRESENTING AS ACUTE CARDIAC TAMPONADE
Authors: Schneider George W. , Patterson Peter H. , Parmley Loren F.
Published: December 2021

An unusual case of an infant with bacterial endocarditis, caused by alpha hemolytic streptococcus involving a congenital pulmonary stenosis is presented. The initial clinical feature of cardiac tamponade due to rupture of a mycotic aneurysm of the sinus arteriae pulmonalis is unique. The rarity of bacterial endocarditis in infancy is noted, and the necessity of being alert to its possible occurrence is stressed.
The Healthy Child: His Physical, Psychological, and Social Development
Authors: STINE OSCAR C.
Published: December 2021

This book is a timely addition to the pediatrician's library. The education, practice and philosophy of the specialty of pediatrics are expanding in understanding of and services for the healthy child. The authors, representing five medical specialties and four nonmedical disciplines, offer contributions to the pediatrician for this progress.

The relationship between episodes of illness and the health and development of the child is discussed by Dr. Isabelle Valadian. Examples for illustration are taken from children in the Harvard Longitudinal Study of Child Health and Development.

Two chapters will serve as reviews of pediatric information for most pediatricians. The first is a summary of the natural development of immunities and the artificial induction of immunities. The second is a clinical description of physiological conditions in the newborn that are consistent with health. Their clarity and simplicity will serve usefully in teaching.
BILATERAL NEPHROBLASTOMA (WILMS' TUMOR)
Authors: Martin Lester W. , Kloecker Richard J.
Published: December 2021

Three cases of bilateral nephroblastoma (Wilms' tumor) are reported. In all three instances, the tumor was thought to be unilateral prior to surgery. (In one instance, involvement of the opposite kidney was discovered at necropsy.) It is probable that bilateral involvement is somewhat more frequent than has been generally recognized in the past; it probably occurs in approximately 5 to 10% of the cases.

Bilateral nephroblastoma does not necessarily carry a fatal prognosis, and it may be cured in a certain percentage of cases by radical surgery. The treatment of choice of bilateral nephroblastoma is surgical removal of both tumors, leaving behind at least half of one kidney.

Because in many instances the bilateral involvement is not diagnosed preoperatively, it is recommended that exploration for nephroblastoma always include detailed exploration (including visual inspection) of all surfaces of the opposite kidney, through a generous transperitoneal approach.
Stuttering and What You Can Do about It
Authors: BROWN SPENCER F.
Published: December 2021

Like every other publisher the university press wishes the widest possible distribution of its imprints. The University of Minnesota Press announces on the jacket of this book that it is "for parents worried about their children's stuttering, for teachers, doctors, friends and relatives of those who stutter, and for stutterers themselves." This reviewer feels, however, that the book was actually written for a narrower audience, and that the "you" of the title refers to those on whom its impact will be greatest—the stutterer and his parents.
IDIOPATHIC (HEREDITARY) HYPERLIPEMIA AND HYPERCHOLESTEREMIA IN CHILDREN
Authors: Rausen Aaron R. , Adlersberg David
Published: December 2021

Except for fatty serum and variable degrees of hepatosplenomegaly, children with idiopathic hyperlipemia may remain asymptomatic for many years. Abdominal crises and xanthomata are not necessary concomitants of the disorder in children. The finding of mild hyperlipemia in the mother of siblings with marked hyperlipemia emphasizes the hereditary nature of this disorder.

The clinical findings in a child with idiopathic hypercholesteremia and xanthomatosis have been presented. The presence of hypercholesteremia and the absence of overt coronary artery disease in many members of this child's family emphasizes the poorly undestood interrelationships between heredity and environment in the pathogenesis of atherosclerosis.

Treatment of hyperlipemia with a low-fat diet tends to correct the abnormal lipid pattern in serum. Coincidental regression of hepatosplenomegaly may also occur. Therapy with nicotinic acid resulted in temporary improvement in the chemical abnormality in one child with idiopathic hyperlipemia. As opposed to experiences with adult hypercholesteremics, high doses of nicotinic acid did not decrease the cholesterol level of a child with idiopathic hypercholesteremia.
MATERNAL-FETAL TRANSFUSION AS A CAUSE OF PLETHORA IN THE NEONATAL PERIOD
Authors: Michael Alfred F. , Mauer Alvin M.
Published: December 2021

Three infants with marked neonatal plethora have been described. Evidence was presented to implicate a maternal-fetal transfusion as the cause for the plethora in these infants.
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Authors: REISMAN MARTIN
Published: December 2021

There has recently appeared in Pediatrics (and other medical journals) a colorful advertisement for a "new" comprehensive liquid hematinic (Zentron, Lilly). There are aspects of this advertisement that are both disturbing and depressing.

Firstly, that another vitamin-iron, "shot gun," tonic should appear on the market is distressing in itself. The mixture contains ferrous sulfate in routine dosage, the B-complex vitamins including vitamin B12, and vitamin C all in a 2% alcohol vehicle. The advertisement claims that this medication 1) "corrects iron deficiency" which is undoubtedly true—but then again so would any less expensive U.S.P. iron preparation; 2) "restores healthy appetite"—which is at best wishful thinking.
A Modification of Exchange Transfusion Technique Using a Five-way Stopcock
Authors: DE LAMERENS SERGIO
Published: December 2021

Exchange transfusion is the only recognized treatment for hyperbilirubinemia caused by hemolytic disease and other forms of hyperbilirubinemia of the newborn. The purpose of this paper is to introduce a modification of this technique, which in our hands has proved to be of significant value in this procedure. This new technique has been repeatedly used with excellent results in performing exchange transfusions in full-term and premature infants.

The modification consists of the use of a five-way stopcock instead of the two three-way stopcocks as in the conventional procedure.
Candida Albicans
Authors: KOZINN PHILIP J. , TASCHDJIAN CLAIRE L.
Published: December 2021

In view of the increasingly authoritative nature of the Report of the Committee on the Control of Infectious Diseases, issued by the American Academy of Pediatrics, we would like to call attention to certain ambiguities in the 1961 report, notably in connection with the etiology and therapy of candidiasis.

On page 55 (Candidiasis: Etiology and Epidemiology: Source) it is stated that "yeastlike fungi are frequently found in . . . the skin of normal individuals." This statement implies that Candida albicans is one of the saprophytic yeastlike fungi. Careful investigative work by various authors (Benham and Hopkins: Arch. Derm. Syph., 28:532, 1933; Winter, W. D.: Yearbook of Pediatrics, 1954/55, Yr. Bk. Pub., 1955, p. 355; Marwin, R. M. J.: J. invest.
Gamma-globulin in Prevention of Hepatitis
Authors: GELLIS SYDNEY S. , MCCOMB JAMES A.
Published: December 2021

The 1961 edition of the "Redbook" of the American Academy of Pediatrics distinguishes between dosages for the adult and the child for the first time in its recommendations for the prevention of infectious hepatitis. This amounts to 2½ times more for adults than for children per pound of body weight. These recommendations resemble those of Krugman et al. (J.A.M.A., 174:823, 1960) and do not take into account 10 years of satisfactory experience and published reports by many workers using the 0.01 cc/lb of body weight dosage first advocated by Stokes et al. 10 years ago. In the Krugman trials this dosage did not show the satisfactory results of previous published reports. The lot of globulin used by him at this dosage was not tested at any other dosage level. When he employed a higher dosage in his next trial, the gamma-globulin used was from a different commercial source.
EXPERIMENTAL KEROSENE POISONING IN RATS
Authors: Ashkenazi Asaria E. , Berman Shimon E.
Published: December 2021

The gastrointestinal absorption of kerosene has been investigated by the use of radioactive hendecane 1-C14 given under circumstances where no possibility of aspiration existed. The major concentration of kerosene was found in the liver 8 to 24 hours after administration. As a result the liver was increased in weight, had an increased fat content, and exhibited excessive mitosis. Severe lung pathology was encountered following the administration of larger amounts of kerosene. In rats paraffin oil was shown to decrease absorption and the toxic effects of kerosene ingestion, as well as to reduce the mortality when large amounts were administered. This constitutes a valid basis for further evaluation of the use of paraffin oil in the treatment of accidental kerosene poisoning in childhood.
IDIOPATHIC PULMONARY ALVEOLAR MICROLITHIASIS
Authors: Clark Robert B. , Johnson F. Craig
Published: December 2021

An asymptomatic case of idiopathic pulmonary alveolar microlithiasis in a child is described, with an 8-year follow-up. A review of the world literature indicates that this is an uncommon, often familial, disease, occurring in males and females equally. It is characterized by extensive alveolar calculi and can easily be suspected from the appearance of a roentgenogram of the lungs. When the disease is discovered the symptoms are usually absent to minimal, in contrast to the apparently severe involvement of the lung. Probably the majority of the patients develop the disease during childhood. The usual course is slow progression, terminating in cardiopulmonary failure during middle age. The etiology remains obscure, and there is no known treatment.
Spectrophotometric Measurement of Bilirubin in Serum with Special Reference to the Corrections for Hemolysis
Authors: REINHOLD JOHN G.
Published: December 2021

In a recent Commentary on the reliability of bilirubin determinations in sera of newborn infants, Mather has correctly pointed out that the use of the diazo method has serious shortcomings, mainly because of the significant error introduced by hemolysis of even slight degree. Fortunately, spectrophotometric measurement of concentrations of bilirubin in serum is not only more accurate but simpler, and in the sera of newborn has the required specificity for bilirubin because of the low concentrations of lipochrome pigments during the early weeks of life.
Staff of the Therapeutic Nursery School
Authors: MENDELSOHN ROBERT S.
Published: December 2021

I was surprsied to find that Bleck and Headley (Treatment and Parent Counseling for the Preschool Child with Cerebral Palsy. Pediatrics, 27:1026, 1961) do not include a pediatrician in the school staff. The only medical person mentioned is an orthopedic surgeon, who directs the physical and occupational therapists.

It hardly seems necessary to repeat that the pediatrician, as a result of his orientation and training, is excellently qualified to supervise and co-ordinate the many medical (neurology, orthopedics, special senses, physical medicine, psychiatrists, etc.) and paramedical disciplines concerned with cerebral palsy.
OCCURRENCE OF CONGENITAL ADRENAL HYPERPLASIA IN HALF SISTERS
Authors: Robinson Geoffrey C. , Miller James R. , McIntosh Hamish W.
Published: December 2021

The occurrence of female pseudohermaphroditism due to congenital adrenal hyperplasia in half sisters is described. It is concluded that the disease is transmitted by autosomal recessive genes. The mother, herself a heterozygote, was unfortunate in that her two husbands each were heterozygous for the mutant gene in question.
A NEW SPECIFIC ANTIDOTE FOR ORGANIC PHOSPHATE ESTER POISONING
Authors: Read William T. , Combes Mollie A.
Published: December 2021

As the organic phosphate esters become more widely used, particularly in the home, intoxication from accidental ingestion will no doubt increase. For this reason a discussion of the toxic effects and treatment is presented. The signs, symptoms and treatment are summarized in the Tables.