bluuebunny/crossref_metadata_2025 huggingface dataset:
Fikret Özçelik, Hadis Usûlünde Râvî Değerlendirme Metodu -İbn Ebî Hâtim Örneği-, İstanbul: Nida Yayıncılık 2020, 490 sayfa.
Authors: ASLAN Muhammet İkbal
Published: December 2021

Fikret Özçelik’in Hadis Usûlünde Râvî Değerlendirme Metodu -İbn Ebî Hâtim Örneği- adlı eseri İbn Ebî Hâtim er-Râzî ve Cerh ve Ta‘dîl’deki Metodu adlı doktora tezinin matbu hâlidir. Eser İbn Ebî Hâtim (ö. 327/938) gibi önemli bir ismi konu edinmesi açısından önemli ve heyecan vericidir. Zira ülkemizde cerh-ta‘dîl ilmine dair kaleme alınan eserler hâlâ istenilen düzeyde olmayıp hem genel olarak cerh-ta‘dîl ilminin yapısına dair eserlere hem de her bir münekkide dair detaylı araştırmalara duyulan ihtiyaç devam etmektedir. Bu yazıda önemli bir ricâl münekkidini inceleyen Özçelik’in mezkûr eserinin İbn Ebî Hâtim’in cerh-ta‘dîl metodunu ne oranda ve hangi düzeyde tespit edebildiği incelenecektir. Üç bölümden oluşan eserde uzunca bir Giriş bölümü yer alır. Yazar burada konunun önemi, takip edilen yöntem, literatür taraması gibi konulardan bahsedip cerh-ta‘dîl ilminin doğuşu, önemi ve bu ilmi ortaya çıkaran faktörleri inceler. Birinci Bölüm İbn Ebî Hâtim’in hayatı ve ilmî kişiliğine, İkinci Bölüm el-Cerh ve’t-ta‘dîl’de kullandığı tabirlere, Üçüncü Bölüm ise İbn Ebî Hâtim’in râvi değerlendirme metoduna dairdir.
Brett Wilson. Milliyetçilik Çağında Kur’an Tercümeleri: Türkiye’de Yazılı Kültür ve Modern İslâm (trc. Ceren Can Aydın). İstanbul: Alfa Yayınları, 2018, 326 sayfa.
Authors: KÜLÜNKOĞLU Gülnur
Published: December 2021

Kitabın yazarı Brett Wilson, İstanbul’a yaptığı araştırma gezilerinden birinde Mehmet Akif Ersoy’un yeni bulunan meali vesilesiyle düzenlenen bilimsel bir toplantıya katılır. Yazar, toplantının hem mealin bulunmasından dolayı keyifli hem de oldukça resmî atmosferini dikkate değer bulur. Türkiye, Akif’in mealini neredeyse her düzeyde sevinçle karşılamaktadır. Bu vesileyle Wilson, ilk Kur’an tercümelerinin ulema tarafından nasıl olumsuz bir tepkiyle karşılandığına değinir. Yazar burada Haşim Nahid, Kazım Kadri, Mehmet Akif Ersoy, Musa Carullah Bigiyef gibi reformcular tarafından benimsenen ve ulemanın tepkisini çeken bir tür olarak Kur’an tercümelerinin ortaya çıkışından yaklaşık 90 yıl sonra neredeyse bütün kesimler tarafından benimsenmesinin izlerini sürer. Bu bakımdan Türkiye’de tercümeler, tercüme olmaktan daha fazlasını ifade etmektedir ki bu kitap, “daha fazlası” olarak ifade edilen bu kısımla ilgilenmektedir.
Las lágrimas del sol
Authors: Pachas Víctor Hugo
Published: December 2021

El objetivo de este artículo es caracterizar la continuidad de la religiosidad andina en espacios de minería de oro de pequeña escala en Bolivia, Colombia, Ecuador y Perú. Los mineros y sus familias son caracterizados como población flotante y como crimen organizado, y los gobiernos no tienen una comprensión cultural sobre su devenir. Sin embargo, ellos tienen experiencias religiosas que se interrelacionan y yuxtaponen como parte de la cultura andina. Sostengo que el animismo andino, donde la pachamama es ámbito reproductivo de la vida y de la muerte, tiene su correlato en los espacios mineros con una veta de oro. La etnohistoria señala que una veta de oro era considerada como una huaca y, el minero, un peregrino que buscaba simbólicamente las lágrimas del sol. Quinientos años después de las fuentes etnohistóricas, la etnografía contemporánea sostiene la presencia de la Gringa (nombre atribuido a la veta de oro) como un espíritu que tiene fuerte incidencia sobre fenómenos naturales, riquezas, enamoramientos, bienaventuranzas y castigos para los mineros en su vida cotidiana, así como la evocación ritual a la minería como un peregrinaje al reunir las lágrimas del sol.
Pinturas rupestres de cazadores-recolectores en el nororiente peruano
Authors: Villar Quintana Anthony
Published: December 2021

Las superficies de diversas formaciones rocosas en las cuencas de los ríos Marañón y Utcubamba fueron el soporte de distintas expresiones de arte rupestre a lo largo de distintos periodos. En este artículo, presentamos nuestras apreciaciones acerca de las pinturas rupestres atribuidas a grupos humanos de cazadores-recolectores que habitaron el área, para lo cual hacemos referencia a su estilo, antigüedad y composición artística (elementos y escenas representadas), tomando en cuenta los trabajos realizados al respecto por distintos investigadores.
Metabolic Bone Disease of Prematurity
Authors: Vachharajani Akshaya J. , Mathur Amit M. , Rao Rakesh
Published: December 2021

The incidence of metabolic bone disease (MBD) in preterm infants has been declining due to advances in nutritional care. Although the terms osteopenia and rickets have been used in the literature, MBD of prematurity is the preferred terminology for this condition. Despite the use of human milk fortifiers and commercial infant formulas specified for this population, MBD remains an important cause of morbidity in preterm infants. This review focuses on the physiology of intrauterine bone growth, the development of MBD in preterm infants, the various risk factors for MBD, pitfalls in diagnosis, prevention, and treatment of MBD. The use of speed of sound (SOS) ultrasonography and dual-energy X-ray absorptiometry (DXA) in the diagnosis, management, and prognosis also is discussed.
HYPOPLASTIC ANEMIA WITH MULTIPLE CONGENITAL DEFECTS (FANCONI SYNDROME)
Authors: KUNZ HANS W.
Published: December 2021

A case of Fanconi syndrome at an unusually young age presenting anemia, leukopenia, thrombocytopenia, microcephaly, hypogenitalism, skin pigmentation, and anomalies of thumbs, kidneys and heart is described. The patient's younger brother with multiple anomalies of the extremities, hydrocephalus, abnormal ears and genitalia died at the age of 17 months without pigmentation and hematologic symptoms, changes which usually do not occur before the age of 5 years.

The literature is reviewed and a follow-up on previously reported cases is given. It seems that in addition to a hypoplasia of the bone marrow an extracorpuscular hemolytic mechanism plays a role in the pathogenesis of the anemia. It is suggested that some manifestations may be due to impaired adrenocortical function.
PRECOCIOUS GROWTH OF SEXUAL HAIR WITHOUT OTHER SECONDARY SEXUAL DEVELOPMENT; "PREMATURE PUBARCHE," A CONSTITUTIONAL VARIATION OF ADOLESCENCE
Authors: SILVERMAN SAMUEL H. , MIGEON CLAUDE , ROSEMBERG EUGENIA , WILKINS LAWSON
Published: December 2021

GROWTH of sexual hair in a young child suggests the possibility that adrenal tumor or hyperplasia may be causing virilization or that true sexual precocity may be beginning. However, neither of these relatively serious conditions may exist. Approximately 10 years ago workers in the Endocrine Clinic of the Harriet Lane Home became aware of the fact that sexual hair may appear in early life long before there is any other secondary sexual development dependent upon either androgen or estrogen. Although this syndrome has been referred to briefly in textbooks as "precocious adrenarche" and "premature pubarche," no detailed studies of a series of cases have been recorded.

The present report is based on a study of 29 children who developed sexual hair before the age of 8 years. It was possible to follow a number of these patients long enough to demonstrate that the condition is a benign variation in the pattern of sexual development and is followed later by normal adolescence. It seems important to bring the findings to the attention of pediatricians who may not be familiar with the syndrome and to discuss its differential diagnosis and probable etiology.

Methods

Urinary 17-ketosteroids (17-KS) were determined by a modification of the method of Callow, Callow and Emmons previously described, urinary estrogens were measured as the "fluorogenic phenols" by the method of Jailer. Vaginal smears stained by the method of Shorr were interpreted as described elsewhere. The "bone age" was based on the average epiphysial development at all the joints.

Clinical and Laboratory Findings
PSYCHOGENIC MEGACOLON MANIFESTED BY FECAL SOILING
Authors: GARRARD STERLING D. , RICHMOND JULIUS B.
Published: December 2021

The results of surgical therapy in cases of aganglionic megacolon have tended to create the impression that all cases of megacolon can be benefited by surgery. The authors have described six patients in whom megacolon had a psychogenic origin; this group has been previously described as "functional" or "idiopathic," and its psychogenic origin has not been clearly recognized. Psychogenic megacolon may be diagnosed by the following clinical findings without the necessity of a detailed psychiatric history: admitting complaint of fecal soiling, onset in the second year of life or later, infrequent use of the toilet for defecation, defecation in the standing or supine position, inhibition of the stool, periodic voluminous stools, absence of episodes of intestinal obstruction, a feces-packed rectum, absence of a spastic segment of rectum or rectosigmoid using Neuhauser's fluoroscopic technic and a relatively benign course insofar as physical status is concerned.

A sharp clinical distinction is apparent when the following findings of the aganglionic group are considered: admitting complaint of constipation without fecal soiling, onset at birth or in the first few weeks of life, use of the toilet for defecation, defecation in the sitting position, pellet-like or ribbon-like stools, frequent episodes of intestinal obstruction, an empty rectum, and the presence of a spastic segment of rectum or rectosigmoid using Neuhauser's fluoroscopic technic.

A small additional group of cases has been described by others in which megacolon is due to anatomic obstruction; these cases can usually be diagnosed by digital examination of the rectum.

The authors have classified the symptom of megacolon into three groups and have given them the following generic designations: psychogenic, neurogenic and anatomic. Only the neurogenic and anatomic groups are benefited by surgery.
Less Aggressive Treatment of Neonatal Jaundice and Reports of Kernicterus: Lessons About Practice Guidelines
Authors: Newman Thomas B. , Maisels M. Jeffrey
Published: December 2021

The publication of guidelines calling for less aggressive treatment of jaundice in newborns has been followed by a reappearance of case reports of kernicterus. These case reports illustrate important issues for writers and consumers of practice guidelines. One issue is the particular salience of identified patients with bad outcomes, and their potentially disproportionate influence on decision-makers. A second issue is whether, when good evidence of treatment benefit is lacking, policymakers should recommend what has traditionally been done, recommend less treatment, or not make recommendations at all. Finally, the cases raise the question of whether treatment guidelines should be more conservative than their authors actually believe is necessary, to take into account the likelihood that they will not be closely followed.

We believe that case reports can serve as an important early warning system, but policymakers should be aware of their potentially disproportionate influence. In the long run, patients and clinicians will be best served by guidelines that summarize and acknowledge the limitations of existing evidence, that allow a wide range of treatment options when evidence is weak, and that recommend what the guideline authors actually believe should be done. In the short run a period of readjustment may be required, however, as clinicians become accustomed to guidelines written to be followed, rather than bent.neonatal jaundice, bilirubin, kernicterus, practice guidelines.
Inadequate Therapy for Asthma Among Children in the United States
Authors: Halterman Jill S. , Aligne C. Andrew , Auinger Peggy , McBride John T. , Szilagyi Peter G.
Published: December 2021

Objective.

Childhood asthma morbidity and mortality are increasing despite improvements in asthma therapy. We hypothesized that a substantial number of children with moderate to severe asthma are not taking the maintenance medications recommended by national guidelines. The objective of this study was to describe medication use among US children with asthma and determine risk factors for inadequate therapy.

Methods.

The National Health and Nutrition Examination Survey (NHANES) III 1988–1994 provided cross-sectional, parent-reported data for children 2 months to 16 years of age. Analysis focused on children with moderate to severe asthma (defined as having any hospitalization for wheezing, ≥2 acute visits for wheezing, or ≥3 episodes of wheezing over the past year). We defined these children as adequately treated if they had taken a maintenance medication (inhaled corticosteroid, cromolyn, or theophylline) during the past month. Demographic variables were analyzed for independent associations with inadequacy of therapy. The statistical analysis used SUDAAN software to account for the complex sampling design.

Results.

A total of 1025 children (9.4%) had physician-diagnosed asthma. Of those with moderate to severe asthma (n = 524), only 26% had taken a maintenance medication during the past month. Even among children with 2 or more hospitalizations over the previous year, only 32% had taken maintenance medications. In a logistic regression analysis, factors significantly associated with inadequate therapy included: age ≤5 years, Medicaid insurance, and Spanish language. Children surveyed after 1991, when national guidelines for asthma management became available, were no more likely to have taken maintenance medications than children surveyed before 1991.

Conclusion.

Most children with moderate to severe asthma in this nationally representative sample, including those with multiple hospitalizations, did not receive adequate asthma therapy. These children may incur avoidable morbidity. Young children, poor children, and children from Spanish-speaking families appear to be at particularly high risk for inadequate therapy.
Reducing After-Hours Referrals by an After-Hours Call Center With Second-Level Physician Triage
Authors: Kempe Allison , Dempsey Catherine , Hegarty Teresa , Frei Nicole , Chandramouli Vijayalaxani , Poole Steven R.
Published: December 2021

Objectives.

One-third of practices signing-out to The Children's Hospital Call Center in Denver, Colorado, choose to do second-level physician (SLP) triage for calls judged by the Center to require after-hours referral (AHR). We examined: 1) the effect of SLP triage on the rate of AHRs and 2) reasons for physicians' decisions.

Design.

From January 1998 to August 1998 all calls from patients using a 5-member suburban pediatric practice judged by the Call Center to require AHR were referred to the practice's on-call physician who did SLP triage and completed a questionnaire.

Results.

There were 955 eligible calls, 22% (N = 216) of which were initially given an urgent disposition by Call Center nurses. Physician questionnaires were completed for 97% (N = 209). Of patients initially triaged for AHR, 49% (N = 103) were subsequently given an AHR, 17% (N = 35) a next day office referral, and 34% (N = 71) home care and advice. Reasons for not urgently referring included the following: 1) medical problem didn't require urgent evaluation (95%,N = 99); 2) change in the patient's condition; (40% N = 43); 3) prior knowledge of family's ability to evaluate and care for the patient (40%,N = 43); and 4) knowledge of the patient's medical history (18%, N = 19). After SLP triage the overall urgent referral rate was 11%.

Conclusions.

Signing out to a Call Center decreased physicians' after-hours calls by 77% and SLP triage halved the number of urgent after-hours referrals.
Self-Reported Physician Practices for Children With Asthma: Are National Guidelines Followed?
Authors: Finkelstein Jonathan A. , Lozano Paula , Shulruff Reeva , Inui Thomas S. , Soumerai Stephen B. , Ng Mitzi , Weiss Kevin B.
Published: December 2021

Objective.

To determine self-reported adherence to national asthma guidelines for children by primary care physicians in managed care; and, to analyze sources of variation in these practices by physician specialty and managed care practice type.

Design.

A survey of 671 primary care physicians (pediatricians and family physicians) practicing in 3 geographically diverse managed care organizations (MCO). Domains of interest included asthma diagnosis, pharmacotherapy, patient education and follow-up, and indications for specialty referral. Item formats included self-reports of usual practice and responses to case vignettes.

Results.

A total of 429 (64%) physicians returned surveys, 22 of whom did not meet criteria for inclusion in the analysis. Most respondents had both heard of (91%) and read (72%) the National Asthma Education and Prevention Program (NAEPP) guidelines. For diagnosis, 75% reported routine use of office peak flow measurement, but only 21% used spirometry routinely. Family physicians were more likely than pediatricians to use spirometry in diagnosis (odds ratio [OR] = 5.9), and less likely to recommend daily peak flow measurement (OR = .3). The median reported frequency of providing written care plans was only 50%. Though inhaled corticosteroids were deemed very safe or safe by 93%, almost half had specific concerns regarding at least 1 side effect, most commonly growth delay. Primary care physicians' criteria for referral to an asthma specialist differed from those of the NAEPP panel in choosing to manage more severe patients without asthma specialist input. Family physicians were more likely than pediatricians to refer a child after a single hospitalization, 2 to 3 emergency department visits, after 2 exacerbations, or if the child was <3 years old and required daily medications. Responses to vignettes showed generally appropriate initial use of antiinflammatory agents, but reluctance to increase the dose in response to continued symptoms, and less frequent follow-up than recommended by the NAEPP.

Conclusion.

Most physicians for children report having read and adopted NAEPP guideline recommendations for asthma treatment, including generally appropriate use of medications. Opportunities for improvement exist in specific areas such as the use of written care plans, optimizing antiinflammatory dosing, and providing routine follow-up. Although physicians show evidence of awareness of national guidelines and knowledge consistent with much of their content, additional work is required to promote the use of self-management tools in practice.
Health Care Needs of Children in the Foster Care System
Authors: Simms Mark D. , Dubowitz Howard , Szilagyi Moira A.
Published: December 2021

Nearly 750 000 children are currently in foster care in the United States. Recent trends in foster care include reliance on extended family members to care for children in kinship care placements, increased efforts to reduce the length of placement, acceleration of termination of parental rights proceedings, and emphasis on adoption. It is not clear what impact welfare reform may have on the number of children who may require foster care placement. Although most children enter foster care with medical, mental health, or developmental problems, many do not receive adequate or appropriate care while in placement. Psychological and emotional problems, in particular, may worsen rather than improve. Multiple barriers to adequate health care for this population exist. Health care practitioners can help to improve the health and well-being of children in foster care by performing timely and thorough admission evaluations, providing continuity of care, and playing an active advocacy role. Potential areas for health services research include study of the impact of different models of health care delivery, the role of a medical home in providing continuity of care, the perception of the foster care experience by the child, children's adjustment to foster care, and foster parent education on health outcomes.
Evaluation and Development of Potentially Better Practices for Improving Family-Centered Care in Neonatal Intensive Care Units
Authors: Saunders Roger P. , Abraham Marie R. , Crosby Mary Jo , Thomas Karen , Edwards William H.
Published: December 2021

Objective. Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant’s physical needs. Parents’ participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care.

Methods. Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted.

Results. Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000).

Conclusions. Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.
Trends in Environmentally Related Childhood Illnesses
Authors: Woodruff Tracey J. , Axelrad Daniel A. , Kyle Amy D. , Nweke Onyemaechi , Miller Gregory G. , Hurley Bradford J.
Published: December 2021

Tracking incidence or prevalence of diseases and using that information to target interventions is a well-established strategy for improving public health. The need to track environmentally mediated chronic diseases is increasingly recognized. Trends in childhood illnesses are 1 element of a framework for children’s environmental health indicators, which also includes trends in contaminants in the environment and in concentrations of contaminants in bodies of children and their mothers. This article presents data on 3 groups of important childhood diseases or disorders that seem to be caused or exacerbated, at least in part, by exposure to environmental agents and for which nationally representative data are available. They are asthma, childhood cancers, and neurodevelopmental disorders. Data were used from the National Health Interview Survey for asthma and neurodevelopmental disorders; the Surveillance, Epidemiology, and End Results Program for childhood cancer incidence; and the National Vital Statistics System for childhood cancer mortality. The prevalence of children with asthma doubled between 1980 and 1995, from 3.6% in 1980 to 7.5% in 1995. The annual incidence of childhood cancer increased from 1975 until approximately 1990 and seems to have become fairly stable since. Childhood cancer mortality has declined substantially during the past 25 years. Incidence of certain types of cancers has increased since 1974, including acute lymphoblastic leukemia, central nervous system tumors, and non-Hodgkin’s lymphoma. Approximately 6.7% of children aged 5 to 17 were reported to have attention-deficit/hyperactivity disorder in 1997–2000, and approximately 6 of every 1000 children were reported to have received a diagnosis of mental retardation during the same period.
EXSTROPHY OF THE CLOACA
Authors: SWAN HENRY , CHRISTENSEN SCOTT P.
Published: December 2021

Three newborn premature infants were seen with an unusual and extensive congenital abnormality involving bowel, urogenital tract, bony pelvis and anterior abdominal wall.

The term exstrophy of the cloaca is suggested as a simple term for a complex situation.

The embryologic development of this anomaly is discussed. Any satisfactory explanation must explain interposition of cecum between a bipartate bladder. It is possible that current theories regarding the development of the cloaca must be revised in the light of these observations.

A plan for the surgical correction of this anomaly is presented.
TOOLS AND METHODS OF DIAGNOSIS AND NEW TRENDS IN THE TREATMENT OF ENDOCRINE DISORDERS
Authors: WILKINS LAWSON
Published: December 2021

I FEEL very proud but most humble on receiving the honor of the Borden Award. My humility arises from the fact that whatever has been accomplished has been due to the painstaking and hard work of a series of faithful collaborators over a period of 18 years. Drs. Walter Fleischmann, Roger Lewis, Lytt Gardner, Claude Migeon, Alfred Bongiovanni and Walter Eberlein have carried out the laboratory studies, while Drs. Robert Klein, John F. Crigler, Jr., Samuel Silverman, George Clayton, Judson Van Wyk and Melvin Grumbach have directed clinical investigations. Visiting Fellows such as Salvador de Majo, Eugenia Rosemberg and José Cara have contributed materially. I gratefully share the honor with all these colleagues. The check, I shall keep myself.

I shall seize the singular opportunity of the occasion to discuss the newer tools and methods which have made possible the advances of clinical endocrinology, and to point out new therapeutic approaches rather than to give a factual presentation of our own work.

In 1935 when Dr. Park asked me to organize a pediatric endocrine clinic, I hesitated because I felt that at least some clinical endocrinologists were perhaps somewhat overenthusiastic and uncritical, and seemed inclined to let their imaginations run wild. During the previous century great clinical masters had given to the main endocrine disorders classical descriptions which will never be surpassed. One may mention Graves' and Basedow's descriptions of thyrotoxicosis in 1834 and 1840, Addison's of adrenal insufficiency (1854), Gull's of adult myxedema (1873), Osler's of sporadic cretinism (1893), Pierre Marie's of acromegaly (1886) and Froehlich's of the hypothalamic syndrome (1901). It was obvious that less complete forms of these and other endocrine disorders must exist.
TRENDS
Authors: KENDALL NORMAN , ROSE ELIZABETH KIRK
Published: December 2021

THE continued high neonatal mortality rate, especially of premature infants, is still considered excessive and presents a challenge to the medical profession. Further detailed analysis of the causes and contributory factors of neonatal deaths is necessary prior to further reduction of the neonatal mortality rate. The following presents an outline of the organization and procedures employed in the study of neonatal mortality. It is based on the approach used by the Philadelphia Neonatal Study Committee.

Background

The separate study of neonatal deaths was an outgrowth of an initial attempt some 20 years ago to determine the facts and preventable factors in maternal deaths. Both studies were inaugurated by a group of broad-minded physicians through the Philadelphia County Medical Society and were based on the premise that such studies offered an educational program for the physicians.

Organizationion

The Neonatal Study Committee consists of a representative from each hospital, preferably a member of the department of pediatrics. This representative reviews the final neonatal mortality data from his hospital, brings cases before meetings of the hospital staff for discussion, completes the special study form data, including autopsy findings and staff opinion on each case and forwards it to the Committee for further evaluation.
FURTHER OBSERVATIONS ON FAMILIAL DYSAUTONOMIA
Authors: RILEY CONRAD M. , FREEDMAN ALFRED M. , LANGFORD WILLIAM S.
Published: December 2021

Studies of familial dysautonomia by a team made up of a pediatrician, a neurologist, speech therapists, psychiatrists, psychologists and a psychiatric social worker have been presented in summary form.

1. Facts supporting the theory that this is a condition of genetic origin are enumerated. They are compatible with its being transmitted by an autosomal recessive gene.

2. Evidence of disturbance of statural growth, with frequent significant dwarfing, is presented.

3. Postural hypotension as a regular part of the syndrome is demonstrated.

4. Data showing the variable neurological abnormalities are included.

5. The frequency of disturbance of speech, but not of language organization, is reported.

6. Psychological testing suggests a deterioration with advancing years in dealing with concrete tests, but no significant disturbance in abstract thinking.

7. At the psychosocial level, inadequate adjustment to daily life is seen in all patients. This difficulty is reflected in varying degree by emotional disturbance in the parents. A schematic concept of the dynamics is offered.

8. Drug treatment of the acute crisis is discussed and a plan for daily management of such cases is projected.

9. Avenues for further investigation are briefly mentioned.
NEUROBLASTOMA (NEUROBLASTOMA SYMPATHETICUM)
Authors: Uhlmann Erich M. , von Essen Carl
Published: December 2021

It has been shown that neuroblastoma can be controlled by irradiation even after extensive spread. It must be agreed that in some instances it is highly unlikely that cancerocidal doses could have reached all the tumor cells. With the knowledge that this tumor may occasionally spontaneously regress or mature into a benign ganglioneuroma, it may be postulated that irradiation can promote or accelerate the process of maturation. To our knowledge there have been no follow-up histological studies in cured individuals. This would be of great value if biopsy of the liver or other previously involved organs could be made perfectly safe. The report of patients showing arrest and regression of disease after chemotherapy should also stimulate further interest in tile biological behavior of this unusual tumor.

Unquestionably, radiation does arrest and control this disease by direct cancerocidal action. However, the favorable results in a few instances of disseminated neoplasm render further clinical investigations highly important in solving the riddle of its biological behavior.
CONGENITAL NONHEMOLYTIC JAUNDICE WITH DISEASE OF THE CENTRAL NERVOUS SYSTEM
Authors: Rosenthal Ira M. , Zimmerman Hyman J. , Hardy Noreen
Published: December 2021

The case of a child with persistent severe jaundice, beginning in the neonatal period, and progressive neurologic symptoms, with onset at the age of 3 years is reported. This patient is considered to be another example of the disease described originally by Crigler and Najjar. The severe jaundice is the result of reduced capacity of the liver to excrete bilirubin, although the pathophysiologic mechanism is obscure. The neurologic syndrome is believed to be the result of bilirubin encephalopathy. If this be the case, the course of this patient indicates that development of bilirubin encephalopathy is not necessarily confined to infancy. It can apparently occur in young children, and probably in older children and adults, if the concentrations of indirect-reacting bilirubin in the serum are sufficiently high for a prolonged period.
COMPARISON OF TERATOGENIC CHEMICALS IN THE RAT AND CHICK EMBRYOS
Authors: Murphy M. Lois , Dagg C. P. , Karnofsky David A.
Published: December 2021

THE CHICK EMBRYO is used widely in studying drugs for teratogenic activity. Chemicals, which have been injected at the same period of incubation of the chick embryo, may produce separate and characteristic patterns of developmental abnormalities. The effects of many drugs, such as insulin, azaserine, sulfanilamide, 4-aminopteroyl glutamic acid, 8-azaguanine, physostigmine, thallium, lead, boric acid and cortisone, have been reviewed.

The chick embryo in the egg is an isolated and independent system, whereas mammalian embryos are usually intimately involved with the maternal host which may detoxify, excrete or otherwise protect the fetus against noxious chemicals. It was, therefore, of interest to determine the effects of drugs, teratogenic in the chick embryo, on the mammalian fetus. The rat was selected because of its availability and because there is considerable information on rat embryology and teratology. Because some drugs, apparently inactive in the chick embryo, have produced consistent developmental abnormalities in the rat fetus, the pregnant rat also has been used for the initial study of selected compounds.

The objectives of these studies were: 1) to determine and compare the teratogenic action of drugs on the chick and rat embryos; 2) to determine the consistency and specificity of action of each drug; 3) to determine the relation between the time during gestation when a drug is introduced and the occurrence of specific abnormalities; 4) to determine the relationship of the dose of a drug toxic to the mother, the dose toxic to the embryo, and the dose producing consistent developmental defects, and 5) to detect compounds which protect the embryo from the teratogenic action of a chemical.
NEUROLOGIC SYMPTOMS ASSOCIATED WITH CAT SCRATCH DISEASE
Authors: Paxson Edwin M. , McKay R. James
Published: December 2021

Two cases of cat scratch disease with associated encephalopathy involving patients in the pediatric age group have been reported. They fulfill the criteria for such a diagnosis, namely: (1) history of cat scratch or of contact with a cat; (2) regional adenopathy; (3) positive skin test with cat scratch antigen; (4) histologic picture of biopsied lymph nodes consistent with cat scratch disease plus a sterile culture obtained from the same node; (5) otherwise unexplained encephalopathic symptoms developing within 6 weeks of the appearance of adenopathy. Review of the literature and this report of two cases suggests that this disease may be sudden and severe in onset but is self-limited with benign sequelae and in most cases without residual effect.

In all cases of encephalitis with associated unexplained lymphadenopathy the diagnosis of cat scratch disease should be entertained as an etiologic factor.
MILK ALLERGY
Authors: Bachman Kay D. , Dees Susan C.
Published: December 2021

In a series of 172 infants under 2 years of age who were referred for allergy studies during 1954-1956, 109 were found to be allergic.

Thirty-three of the one hundred nine allergic infants were sensitive to cow's milk, with an incidence of 30%.

The diagnosis of cow's milk allergy was based upon the same criteria applied to a series of well babies. Namely, repeated production of one or more allergic symptoms on exposure to cow's milk, improvement on withdrawal, and with no other apparent cause for improvement, confirmed by positive skin test, and without other cause for symptoms.

The allergic symptoms due to milk were eczema, gastrointestinal abnormalities and less frequently asthma or rhinitis.

Scratch tests were frequently positive to foods. Thirty-seven infants reacted with positive skin tests to milk, of whom 33 had clinical allergy to milk. Infants from 9 to 12 months of age had the highest number of nonspecific skin reactions.
MANAGEMENT OF THE PATIENT WITH CLEFT LIP AND CLEFT PALATE
Authors: MacCollum Donald W. , Richardson Sylvia Onesti
Published: December 2021

Although some aspects of the management of a child with a cleft lip or cleft palate or both are controversial, it is generally agreed that the best possible care of these youngsters involves the co-operation of a multi-professional group including at least a surgeon, dentist, speech therapist, pediatrician, orthodontist, and the parents as well. It is not necessary for the group to be centralized in location, although this is helpful to the patient. However, each member of a group must be aware of the potentialities and procedures of the other members and should have a knowledge of the terminology and basic principles of the other disciplines represented. As his duties of total care are ever present and continuous, the pediatrician is in a strategic position to help the parents to understand and to implement the consecutive phases of therapy in the home.

The rationale and a general description of one type of cleft lip—cleft palate program as it is carried out at the Children's Medical Center in Boston is presented. During the last 15 years, 2,635 operations for closure of the lip and palate have been performed in the Plastic Surgery Unit. The authors' policy is to repair a cleft lip at 6 to 8 weeks of age and to repair the palate within the first 2 years of life, preferably at about 14 months of age.

Included is a summary of a study made at this Center to evaluate the long-range results of early palatal closure and over-all care of a group of 164 children operated upon between the years of 1942 and 1952.

The conclusions of this study corroborate the authors' previous clinical impression that the results of early palatal closure have been so satisfactory that continuation of the policy seems warranted.

Supportive care is described in some detail because of the authors' wish to emphasize its importance and to provide for the pediatrician a practical guide which long experience has proven to be successful.
GESELL TESTS ON AFRICAN CHILDREN
Authors: Geber Marcelle , Dean R. F. A.
Published: December 2021

The results of a series of Gesell tests on African infants and children are presented.

The most remarkable finding was the precocity of the younger infants. The motor development was greatly in advance of that of European infants of the same age, but was not an isolated phenomenon; it was paralleled by advanced adaptivity, language and personal-social behaviour.

The precocity was usually lost in the third year, but was retained by some children who had the advantages of a kinderganten.

The results of the Gesell tests were confirmed by a study of newborn African infants, whose state of development was also precocious by European standards.

The findings are discussed in relation to some details of the African environment, and especially to some local customs which may affect early development. Emphasis is placed on the potential value of finding means by which the early precocity could be maintained.
THE HOME CARE OF SEVERELY RETARDED CHILDREN
Authors: Holt K. S.
Published: December 2021

A study is reported of the practical and emotional problems found in 201 families with mentally retarded children in Sheffield, England.

The families were selected for study solely because they had a retarded child, so that the observations might give a true measure of the incidence of the various disturbances.

The main practical problems were nursing care in 14 families (7%), constant supervision in 63 families (31%), and frequent attention at night in 31 families (15%). These problems caused the exhaustion of the mother in 19% of the families and of the father in 5%. The siblings suffered from attacks by the mentally retarded child in 12% of the families, and through helping in 5%. The parents' activities were limited: in 41% of families they were never able to go out together and in 17% they never had a holiday. The retarded child was the cause of extra expense in 59 families (29%).

The emotional problems observed were disappointment, guilt, shame and a sense of inadequacy. These reactions led to quarrelling between the parents in 6% of the families. The parents had separated in 5% of the families but usually there were other causes behind these separations. In 10% of the families the siblings showed resentment, and in 5% they were ashamed of the retarded child. The emotional factors led to social isolation in 63% of the families.

The place of home care for retarded children is discussed. It is suggested that this can be helped by careful counselling and guidance for the parents, by attention to the needs for practical help, and by reducing the still prevalent stigma against mental defect.
A STUDY OF PICA IN RELATION TO LEAD POISONING
Authors: Greenberg Morris , Jacobziner Harold , McLaughlin Mary C. , Fuerst Harold T. , Pellitteri Ottavio
Published: December 2021

During 1956 and 1957 all children under the care of the child health stations of the Department of Health in New York City, who manifested pica, were examined for symptoms and signs of lead poisoning. A blood specimen was taken and tested for lead content; if the concentration of lead was 0.06 mg/100 ml or higher, the child was referred to a doctor for diagnosis and treatment. Among 194 children with pica, there were 28 cases and 20 probable cases of lead poisoning. The follow-up of children with pica is a good case-finding method for lead poisoning.
THE DEVELOPMENT OF ENZYME SYSTEMS DURING EARLY INFANCY
Authors: Driscoll Shirley G. , Hsia David Yi-Yung
Published: December 2021

PEDIATRIC literature and clinical experience contain abundant indications of physiologic immaturity in newborn infants, especially in those born prior to term. Functional immaturity of brain, liver, kidney, immune response and blood coagulation are among the well-recognized peculiarities of the newborn period. Exaggerations of these usually mild, transitory phenomena may contribute to grave disorders and possibly prove to be lethal. In addition to apparent derangements of particular systems or organs, there are occasional infants, notably the delicate offspring of diabetic mothers, whose general response and appearance suggest immaturity disproportionate to size and gestational age. In this group, general metabolic disturbances are suspected which await biochemical localization and characterization. Conventional post-mortem examinations may be discouragingly unrevealing in these babies. For example, one of the most commonly encountered problems is that of infants dying following unexplained respiratory distress. Pathologically, only so-called "hyaline membranes" with atelectasis have been found. This pattern can be noted in at least half of all infants of diabetic mothers and prematures and occasionally in a full-term baby, and constitutes one of the most baffling problems in clinical pediatrics today.

In contrast, the increasing availability of biochemical methods of study are providing a rapidly growing fund of information concerning the normal fetus and newborn. From studies on the chemical embryology of other species and from limited similar work with human material, characteristic patterns of chemical differentiation are emerging. Extension of such observations may be expected to permit the establishment of new metabolic parameters by which to assess the developing fetus and infant.
A COMPARISON OF THE TERATOGENIC EFFECTS OF FIVE POLYFUNCTIONAL ALKYLATING AGENTS ON THE RAT FETUS
Authors: Murphy M. Lois
Published: December 2021

Five alkylating agents and x-rays, administered to pregnant rats on the twelfth day of gestation and which were killed on the twenty-first day, produced malformations in the fetuses.

The dosages producing four measured effects on the pregnant rats and their fetuses for each of the five alkylating agents and x-rays were found to resemble each other more than in a comparison of six antimetabolites in a previous study.

There is a similarity of the malformations produced by these agents, but some distinct differences in gross soft-tissue and skeletal abnormalities are described.
PEDIATRIC UROLOGY
Authors: Michie Alexander J.
Published: December 2021

THE MAJORITY of the concern in pediatric urology is centered around infections and anomalies, the former occupying the greater portion of the practicing pediatrician's problem in this field. Therefore, discussion was aimed mainly at pyelonephritis, with queries on other facets of genito-urinary pathology being mentioned.

A review of the literature reveals that pyelonephritis is the commonest cause of death in uremia. While it kills twice as many patients as glomerulonephritis, it occupies only about a third of the literature given to these two problems. The statistics of a number of widely accepted authorities reveals that of all the patients admitted to hospitals, 1% have a urinary tract infection and 5% of all patients treated by pediatric services have a urinary tract infection. Pyelonephritis is more common in the female than in the male in the ratio of 9:1. In the female it is more common in the years from 0-12 and from 25-70 years of age. Very few males have pyelonephritis except those with congenital anomalies, and in the older age group those with gonorrheal obstructions and prostatic enlargement. The manifestations of congenital obstructions to urine flow usually present themselves in the ages from 0-6 years.

CAUSES OF PYELONEPHRITIS

Natural Causes

The Short Rrethra of the Female: In females under 8 or 9 years of age, the urethra is about 1 cm long and some females have such a short urethra that it is essentially only a urethral sphincter. In 10 females less than 10 years of age, all 10 had dye in their bladders, after they sat down and stood up 20 times in 6 inches of dyed water. What is not understood is why more females do not get infection, if this is the answer to more frequent infections in females than in males.

Overdistention of the Bladder: Marked overdistention of the bladder causes vesicoureteral reflux. This condition is more common in adolescents who do not have enough social experience, i.e. those who would not feel free to excuse themselves from company in order to urinate.

Involuntary Residual Urine: In the male patient who has severe paraphimosis and dysuria, an increase in residual urine is often found. Also following circumcision, the skin of the glans penis often exfoliates, leading to urethral meatal ulceration causing dysuria which is followed by a residual urine.
PEDIATRICS AND SOCIETY
Authors: Elmer Elizabeth
Published: December 2021

These observations from social work practice in a children's hospital have their counterpart in the practice of many wise physicians. Such a physician intuitively senses the importance of the mother' feelings about rearing her infant, and he treats the mother and child as a single unit. While intuition is of great value, systematic attention to the role of the mother is sorely needed, as the mother is the primary external factor affecting the infant's welfare.
DISCIPLINE
Authors: Kenward John F.
Published: December 2021

For the present and future happiness of the child, and certainly for the well-being of those about him, the child must learn some obedience. The majority of parents know this, but from time to time may be discouraged and doubtful about their program of discipline. The pediatrician can do a great deal to help. In usual pediatric practice he can do, and does, much to preserve and create optimal conditions for discipline. With parents who are doubtful and unsure, he can counsel, guide and support them in establishing and carrying out a consistent program. When difficulties arise, he often can detect the cause and either correct it, or refer the family for more intensive treatment. Since discipline is primarily a family duty and privilege, he should not dictate policy or program, but he can help the parents see the need for obedience and how to achieve it.

Learning obedience does not mean that subjugation to an authority is a final end in itself. On the contrary, it is a means to an end. Good discipline, by helping the child to learn obedience, protects the child from dangers within and without, relieves him of the burden of making decisions for which he is not ready, and allows him to develop independence of thought and action within a secure framework. Good discipline does not have as its primary purpose the comfort of adults, although this is a secondary gain. It does not intend to make conformity a way of lifeand "adjustment" mandatory.