bluuebunny/crossref_metadata_2025 huggingface dataset:
A Follow-up Study of Traumatized Children
Authors: Elmer Elizabeth
Published: December 2021

This study compared 17 abused children with 17 children who had been in accidents, matched for age, race, sex, and socioeconomic status, eight years after all had been studied as infants. Each traumatized group was also compared with a matched untraumatized group with no known history of abuse or infantile accident. The majority of all children were lower-class. Hypotheses were that the abused children would fall below the nonabused in health history and physical development, intellectual functioning, language, and self-concept; and that the abused children would score higher in impulsivity and aggression. Clinical assessments revealed few group differences. The surprising finding was the extent of various problems across the entire sample Seventy percent of the children had speech problems; over 50% showed some degree of disturbance; and 39% were achieving poorly in school. However, these disabilities were distributed randomly among abuse, accident, and comparison children. Most of the children appeared sad and fearful of personal attack by adults or other children. Many mothers' reports indicated that the families, whether abuse, accident, or comparison, experienced constant violence, both environmental and personal. It was concluded that the effects on child development of lower-class membership may be as powerful as abuse.
Lacunar Skull Deformity and Intelligence
Authors: Fishman Marvin A. , Palkes Helen S. , Shackelford Gary D. , McAlister William H.
Published: December 2021

Prognostic criteria to be utilized in the selection of neonates with myelomeningoceles for early treatment have been proposed by Lorber.1 Stein et al. suggested modification of the selection factors based on the presence or absence of lacunar skull deformity (LSD) which they thought to be a good predictor of subsequent intellectual development.2 However, disagreement exists regarding the value of LSD as a useful criterion in early selection for treatment because Lonton et al. found only minor differences in intelligence among groups of patients with varying degrees of the deformity.3 In this report, a population of children with myelomeningoceles was studied in an effort to reach definite conclusions regarding the association between LSD and intelligence.

See table in the PDF file
Treatment of Phenothiazine Overdosage With Physostigmine
Authors: Wang Stephen F. , Marlowe Christopher L.
Published: December 2021

Phenothiazines are among the most widely used drugs in medicine today.1 They are used principally for the treatment of psychiatric illnesses and as symptomatic medication for nausea and vomiting. Most articles in the pediatric literature have dealt with the extrapyramidal effects of phenothiazine toxicity which are successfully treated with antihistamines.2,3 In a review of phenothiazine toxicity in children these were the major side effects mentioned.4 Phenothiazines can also produce the dangerous hypersensitivity reactions of agranulocytosis, hepatitis, and dermatitis.1

Overdosage, usually due to accidental ingestion in small children, can cause changes at all levels of the central nervous system. CNS depression has been manifested after ingestion of 100 mg by children 5 years of age and younger5; a 1-year-old child became comatose and apneic after swallowing 200 mg of chlorpromazine,5 and a 3-year-old died after ingestion of 800 mg.6
Safety and effectiveness of over-the-counter drugs: The FDA's OTC drug review
Authors:   Food and Drug Administration
Published: December 2021

Nonprescription (Over-The-Counter Or Otc) Drugs Permit Patients To Treat A Wide Range Of Minor, Usually Self-Limiting, Problems And May Be Helpful Before Professional Medical Assistance Is Sought Or When It Is Not Immediately Available. While Their Misuse May At Times Create Or Compound Medical Problems, Most People Perceive Otc Drugs As Safe And Effective In Their Limited Role. In Fact, However, The Evidence Supporting Safety And Effectiveness Of Most Otc Products Has Never Been Subjected To Critical Review. The Principal Reason For This Is That Most Otc Products Are Made Of Ingredients Marketed Long Before The Modern Requirements Of The Food, Drug And Cosmetic Act Were Promulgated.
Computerized Axial Tomography in Neurologic Disorders of Children
Authors: Bachman David S. , Hodges Fred J. , Freeman John M.
Published: December 2021

Computerized axial tomography offers major advantages over air encephalography and angiography for studies of neurologic disorders in children. The low morbidity and the ease of the procedure permit the accurate diagnosis of intracranial pathology in situations where more invasive procedures would not be undertaken. The techniques of the procedure and its uses and limitations are emphasized in a number of neurologic problems of children.
Presentation of the C. Anderson Aldrich Award: Introductory Remarks
Authors: Friedman David B.
Published: December 2021

When the Aldrich Award was established in 1964 there was no doubt in anyone's mind as to who was most deserving of the first award. Dr. Milton J. E. Senn was and is a pioneer and a giant in the field of pediatrics and child development. His brilliant academic career at Cornell and Yale, his excellent studies, his scholarly publications, and, most of all, his inspiring teaching of countless numbers of young pediatricians have earned him the respect and esteem of all of us.

In a volume published in his honor in 1963, Drs. Solnit and Provence wrote, "He has built his career on the conviction that children and families are our most important resources and on his scientific fascination with the intricacies of child development."

An S.R.C.D. monograph by Dr. Senn on the child development movement in the United States is now in press and he is now preparing a second book for the Yale Press.

Dr. Senn made me promise to make my remarks brief, and I'll keep my promise: members of the Child Development Section and friends, I give you Dr. Milton J. E. Senn who will present the 1975 Aldrich Award.
Abnormal in vitro Granulopoiesis in Phenotypically Normal Parents of Some Children With Congenital Neutropenia
Authors: Rich Kenneth , Falk Peter M. , Stiehm E. Richard , Feig Stephen , Golde David W. , Cline Martin J.
Published: December 2021

Bone marrow from hematologically normal parents of congenitally neutropenic children showed defective myeloid differentiation in vitro. In one family only the mother's marrow differentiated abnormally; in the second family both parents demonstrated abnormal myeloid differentiation. In vitro culture of bone marrow may be useful in establishing the mode of inheritance of some forms of familial neutropenia.
A Question Regarding Validity of Questionnaire for Follow-up
Authors: DeWitt Gerald W.
Published: December 2021

In their description of the rural perinatal evaluation and education program in Iowa, Hein et al.1 present a comparison of pre- and post-site-visit policies, practices, and procedures. This evaluation was based on two sets of data obtained by different means without evidence of the validity of this comparison.

The first group of data was determined by assessment of the existing situation at the local hospital by a visiting perinatal team, utilizing direct observation.

Approximately 90 days after the site visit and educational program, a questionnaire was sent to the hospital for self-assessment of changes in perinatal practice.
Gram-Negative Cerebrospinal Fluid Shunt-Associated Infections
Authors: Sells Clifford J. , Shurtleff David B. , Loeser John D.
Published: December 2021

Twenty hydrocephalic children with cerebrospinal fluid (CSF) shunts over an 11-year period were seen with Gram-negative central nervous system (CNS) infections. Seventeen infections were with single organisms and three were mixed. Sixteen of 20 (80%) of the infections occurred within five months of shunt surgery. Complete shunt removal or replacement in a new site plus systemic and intraventricular antibiotics resulted in a 100% (9/9) cure rate. Systemic and intraventricular antibiotics alone or in combination with incomplete shunt removal generally were unsuccessful.

Significant morbidity and mortality were associated with these infections. Of the 18 patiens with follow-up data, seven (39%) died with the infection four (22%) sustained definite CNS damaeg, three (17%) were retarded after infection but their preinfection status was unknown, and only four (22%) patients escaped without definite sequelae. Early recognition and appropriate therapy, hopefully, will improve the current bleak prognosis.
Head Circumference in Children With Short Stature Secondary to Primary Hypothyroidism
Authors: Burt Leslie , Kulin Howard E.
Published: December 2021

There is little available information on head growth in children with hypothyroidism, whereas head size in children with isolated growth hormone deficiency, another endocrine cause of short stature, generally is below the mean.1 In reviewing our clinical population of short, hypothyroid children, we found a tendency for relative macrocephaly in comparison to body size. The present study compares the results of head circumference and linear growth measurements in children with these two forms of endocrine disturbance.

METHODS AND CASE MATERIALS

The records of all children with hypothyroidism referred to the Endocrinology Clinical of the Milton S. Hershey Medical Center were reviewed.
CHILDREN IN ADULT JAILS
Authors: H. R. J.
Published: December 2021

The overwhelming majority of children we found in adult jails were not detained for violent crimes and could not be considered a threat to themselves or to the community. Only 11.7 percent were charged with serious offenses against persons. The rest—88.3 percent—were charged with property or minor offenses. What is most alarming is that 17.9 percent of jailed children we found had committed "status offenses," i.e., actions which would not be crimes if done by adults, such as running away or truancy. And an additional 4.3 percent of the jailed children had committed no offense at all.
Upper Urinary Tract Anomalies in Congenital Adrenal Hyperplasia
Authors: Kirkland Rebecca T. , Keenan Bruce S. , Clayton George W.
Published: December 2021

We previously reported a 7.5% incidence of congenital anomalies in 105 cases of congenital adrenal hyperplasia (CAH).1 Subsequently, we have examined the intravenous pyelograms (IVPs) of 23 patients for the presence of anomalies of the upper urinary tract. These pyelograms were performed for the following reasons: evaluation of recurrent urinary tract infections in eight patients, recurrent hematuria in one, evaluation of hypertension in one, evaluation of possible nephrosis in one, and initial diagnostic work-up in 12 patients.
MANUAL OF NEWBORN CARE AT GRADY MEMORIAL HOSPITAL. Edited by D. Feldman, et al. New York, Medcom Press, $13.95; 255 pp
Authors: Philip Alistair G. S.
Published: December 2021

This manual of newborn care was formulated by the faculty of Emory University, Atlanta, Georgia, and the introduction indicates the authors' concern with providing the proper perspective for students and house staff, for whom it is primarily intended. They state that "Given an intact central nervous system and an intact body through which to execute its development, the newborn infant has the greatest of all potential for achievement.... The newborns we care for today will be the keepers of our world in 35 years of so."
Are Infantile Periarteritis Nodosa With Coronary Artery Involvement and Fatal Mucocutaneous Lymph Node Syndrome the Same? Comparison of 20 Patients From North America With Patients From Hawaii and Japan
Authors: Landing Benjamin H. , Larson Eunice J.
Published: December 2021

We reviewed available clinical and pathologic autopsy material from 20 patients with infantile periarteritis nodosa with coronary artery involvement (IPN) from the continental United States, two Hawaiian patients with fatal mucocutaneous lymph node syndrome (MCLS; Kawasaki disease), and three patients with classical periarteritis nodosa (CPN). Comparison of the findings in patients with IPN and in patients with MCLS from Hawaii to material from patients with fatal MCLS from Japan showed no definite clinical reason to distinguish IPN from MCLS; neither gross nor microscopic features of the vascular lesions nor their pattern of distribution appears to warrant separation of IPN from fatal MCLS. CPN differs, both clinically and pathologically, from IPN/MCLS, and may well have a different etiology.
DEJA VU EXPLAINED
Authors: Granville J. Mortimer , Philip A. G. S.
Published: December 2021

Everyone must, at some time, have experienced that extraordinary sensation which has been held to constitute subjective evidence of a previous existence—the feeling that a particular locality has been visited, a scene witnessed, a sound heard, or an act performed, before; when, as a matter of fact, there could not possibly have been a previous experience in the life of the individual to account for the sense of repitition. In explanation of this sensation I submit that "passive ideation", or the reception of mental impressions, which are fixed as images in the mind, proceeds in utero, and that the original idea . . . is, in fact, a maternal idea reflected in upon the foetal brain, and there fixed.

. . . How is the maternal impression or idea passed on to the foetal mindorgan? I suggest, through the blood.
Phototherapy for Neonatal Jaundice in Erythrocyte Glucose-6-Phosphate Dehydrogenase-Deficient Infants
Authors: Tan K. L.
Published: December 2021

The effectiveness of phototherapy in the management of neonatal hyperbilirubinemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient infants was studied. "Prophylactic" phototherapy for six continuous days commencing from the first day of life was effective in preventing a significant rise in bilirubin levels in 12 G6PD-deficient infants in the first three days, during which period a rapid rise was observed in a control group of G6PD-deficient infants. The hemoglobin levels on the first and eighth postnatal days were comparable in both groups. "Therapeutic" phototherapy proved equally effective in reducing bilirubin levels in 24 infants with nonhemolytic hyperbilirubinemia and an equal number of infants with hyperbilirubinemia associated with G6PD deficiency.

Phototherapy was efficacious in the prevention or treatment of neonatal hyperbilirubinemia associated with G6PD deficiency; even if its use is prolonged it does not cause hemolysis in such infants.
Percutaneous Arterial Sampling Using Transillumination
Authors: Wall Patrick M. , Kuhns Lawrence R.
Published: December 2021

Percutaneous arterial sampling was performed using transillumination. A success rate of 96% was obtained when sampling the radial, ulnar, posterior tibial, and dorsalis pedis arteries. Although small hematomas were produced despite pressure, no serious complications of infection, thrombotic obstruction, or thermal injury occurred. We conclude that the use of transillumination for arterial sampling is a safe technique that permits rapid sampling of very superficial peripheral arteries, allows visual confirmation of the Allen test for estimation of collateral flow, and would perhaps aid in arterial cannulation.
Percutaneous Peripheral Arterial Cannulation in the Neonate
Authors: Barr Peter A. , Sumners James , Wirtschafter David , Porter Ronald C. , Cassady George
Published: December 2021

Although indwelling arterial catheterization in the neonate is usually accomplished through an umbilical artery, this site may be precluded under certain circumstances. An umbilical artery cannot be catheterized in an estimated 5% to 10% of infants.1 Need for an indwelling arterial catheter may arise at a postnatal age when catheterization of an umbilical artery is not possible. A complication may provoke premature removal of the catheter.1 In the past, such circumstances have led to operative insertion of a peripheral arterial cannula2,3 or intermittent needle-puncture of peripheral arteries.4 Recently, indwelling percutaneous radial arterial cannulae have been used in the neonate.5,6

This is a report of the results of two studies.
Changes in Tonsillectomy Rates Associated With Feedback and Review
Authors: Wennberg John E. , Blowers Lewis , Parker Robert , Gittelsohn Alan M.
Published: December 2021

Among 13 Vermont Hospital Service Areas, tonsillectomy rates decreased over a five-year period. In 1969, the rates in seven areas exceeded the estimated United States national rate; by 1973, the average rate for all areas had declined 46% and only one area remained above the U.S. rate. Much of the change occurred after feedback of data to the Vermont State Medical Society demonstrating 1969 variations. In 12 of the 13 areas, the relationship between feedback and change in clinical practices could not be documented; however, physicians in the area with the highest rate reviewed the indications for tonsillectomy and adopted a second opinion procedure for reviewing candidates for the surgery. The experience suggests that feedback of population-based data on incidence of procedures may be a valuable tool for the peer review process.
Otitis Media in Children Less Than 12 Weeks of Age
Authors: Tetzlaff Thomas R. , Ashworth Carolyn , Nelson John D.
Published: December 2021

Cases of otitis media in infants under 12 weeks of age were reviewed to delineate the frequency, clinical features, and etiologic agents involved. Tympanocentesis was performed in 42 infants, 0 to 5 weeks of age, and in 17, from 6 to 11 weeks of age. The most common symptoms were irritability/lethargy (69%), fever (52%), cough (36%), vomiting (21%), diarrhea (20%), tachypnea (20%), and anorexia (18%). Associated illnesses were present in 33 (54%) of the patients, the most common being pneumonia (9), bronchiolitis (7), meningitis (6), conjunctivitis (4), and omphalitis (4). No peripartum infections or severe perinatal problems were found. Common respiratory pathogens were the predominant etiologic organisms, but coliform organisms were identified in 18% of the infants under 6 weeks of age. Cultures were sterile or grew organisms of questionable pathogenicity ("nonpathogens") in 39% of specimens. Since the signs and symptoms of otitis media in children less than 12 weeks of age are nonspecific and frequently associated with other major illnesses, the physician caring for these infants needs to be more aware of this disease and the therapeutic problems it presents.
Retrolental Fibroplasia and Factors Influencing Oxygen Transport
Authors: Lechner David , Kalina Robert E. , Hodson W. Alan
Published: December 2021

The hospital records of 58 premature infants in whom proliferative retrolental fibroplasia (RLF) developed were matched with the records of 58 infants without RLF for birth weight, gestational age, and duration of oxygen therapy. The two groups were compared for factors likely to influence tissue delivery of oxygen by blood. No significant difference was found in incidence of blood transfusions or exchange transfusions, use of phototherapy, or occurrence of acidosis.
Prolonged Sleep Apnea and Respiratory Instability: A Discriminative Study
Authors: Steinschneider Alfred
Published: December 2021

This report is based on a study of 53 infants, 28 of whom had clinically observed prolonged apnea (≥ 20 seconds) during sleep whereas the remaining did not. In addition to the clinical observations, each infant was studied in a sleep laboratory during a complete nap, and a continuous recording was made of respiratory activity and rapid eye movements. Measurements were made of all apneic pauses (≥ 2 seconds) observed in the laboratory and the two groups of infants were compared in terms of the frequency and average duration of apneic pauses, the longest apneic pause, the amount of periodic apnea, and the relative amount of apnea. The infants with prolonged sleep apnea had, during a single nap, more frequent and longer apneic pauses and more periodic apnea. This supports the hypothesis that respiratory instability during sleep and prolonged apnea have a common etiology. By employing a multiple linear regression model and including all laboratory apnea measures in a single analysis, a composite laboratory score was developed to differentiate members of the two groups. It would thus appear that the study of infants during a single nap could assist in the identification of infants at risk for prolonged sleep apnea and provide an indirect method for determining the influence of a number of variables on the occurrence of prolonged sleep apnea.
Posterior Urethral Valves in Identical Twins
Authors: Kroovand R. Lawrence , Weinberg Neal , Emami Abbas
Published: December 2021

Similar congenital anomalies in siblings are common.1-3 Enuresis,4 vesicoureteral reflux,5 and ureteroceles6 have been reported in identical twins, but posterior urethral valves have not been confirmed in proven monozygotic twins.

CASE REPORT

Twin boys, weighing 2,380 and 2,637 g, were born by repeat cesarean section to an 18-year-old, gravida 2, para 1 woman. The placenta was monochorionic and diamniotic. Immediately after birth, twin A developed grunting respiration and mild substernal retraction; a firm 6 x 5 cm suprapubic mass was palpated. Suprapubic aspiration produced clear urine, and catheterization decreased the size of the mass. A voiding cystourethrogram and an intravenous pyelogram were diagnostic of posterior urethral valves.
25-Hydroxyvitamin D Levels and Rickets
Authors: Giangiacomo Joseph , Gleason Wallace A.
Published: December 2021

The article by Arnaud et al. (Pediatrics 57:221, February 1976) compared the serum concentration of 25-hydroxyvitamin D to the changes in long bones as assessed by x-ray films, concluding that the serum concentration of 25-hydroxyvitamin D correlated with the stage of clinical disease in patients with nutritional rickets.

The rachitic patients were divided into three groups, with three patients having mild changes, five moderate, and only one severe. The control group contained nine children with a mean serum 25-hydroxyvitamin D level of 36 ng/ml, significantly different from the five moderately rachitic patients whose mean 25-hydroxyvitamin D level was 12 ng/ml.
Letter to the Editor
Authors: Lathrop Fred
Published: December 2021

Dr. North's article suggests the ramblings of an idealistic professor, avoiding or out of touch with the realities of our post-Watergate moral culture.

He lists no criterion "inability of parents to cope," which is a common cause for hospitalization in my community. If I try to sneak such a patient into the hospital under one of Dr. North's criteria, rather than labeling the patient honestly, I face several problems: (1) I feel that I am dishonest and sneaky, and not open and honest as is required by the post-Watergate morality; (2) the hospital will have inaccurate data on which to base analyses of causes for admission; (3) if I use the criterion "intensive observations required" I must order unnecessary and expensive observations to justify the admission; (4) if I use the criterion "removal from a dangerous home situation" then I must report the case to the child abuse prosecutor.
Bladder Hemorrhage Following Transcutaneous Bladder Aspiration
Authors: Carlson K. P. , Pullon D. H. H.
Published: December 2021

Suprapubic bladder aspiration is a very useful technique for diagnosing urinary tract infections in children. It is a simple and generally safe procedure.1,2 Few instances of complications following the procedure have been reported.

Case Report. A 4-month-old girl was admitted to the Waikato Hospital with vomiting and diarrhea of five days' duration. This was diagnosed as gastroenteritis from which she made a rapid and uneventful recovery. Shortly after admission, as part of the clinical workup of the case, a bladder aspiration was attempted twice by the house physician with a sharp 22-gauge 4-cm needle.
Inhalant Danger
Authors: Bajoghil Mehdi
Published: December 2021

In the article "Generic Prescribing" (Pediatrics 57:275, February 1976), the factors and reasons for prescribing drugs by brand name rather than generic name are stated. I might add another factor and that is the pressure of the gas content or vacuum of the bottle of a similar drug from different companies which may vary and in some may cause the spread of the powder after opening the bottle cap and provoking immediate reaction in susceptible individuals.1
Mucocutaneous Lymph Node Syndrome or Infantile Polyarteritis Nodosa?
Authors: Becker Anton E.
Published: December 2021

An experience with a girl 16 months of age who died of a ruptured coronary aneurysm prompted me to write this letter in the hope that it may contribute to clarification of, what I think, is a confusing terminology.

The child was admitted to the Department of Pediatrics with a nine-day history of a mild upper respiratory tract infection, vomiting, skin rash, and fever, which did not respond to antibiotics. During hospitalization she further developed diarrhea, a swollen left knee, and enlargement of cervical lymph nodes.
Sturge-Weber Syndrome Without Port-Wine Nevus
Authors: Gorman Richard J. , Snead O. Carter
Published: December 2021

In their article on birthmarks in the neonate (Pediatrics 58:218, August 1976), Jacobs and Walton state that the Sturge-Weber syndrome only occurs when the port-wine stains involve the distribution of the first branch of the trigeminal nerve.

This point would appear to be misleading, as there is substantial evidence that the Sturge-Weber syndrome can occur in the absence of a facial nevus. Lund1 reported on seven patients without a facial nevus, Peterman et al.2 noted five, Tonnis and Friedmann3 reported four, and Poser and Traveras4 reported on an additional two cases.
Is It of Any Practical Value To Identify "Accident-Prone" Children?
Authors: Dershewitz Robert
Published: December 2021

The article by Padilla et al. concerning predicting accident frequency in children (Pediatrics 58:223, August 1976) is certainly timely, yet several comments should be made.

Padilla et al. are trying to formulate a predictive model for the identification of the "accident-prone" child, presumably for screening purposes. It is clear that the vast majority of accidents do not occur to the "accident repeater," a term which may be defined as a person who has three or more accidents that come to medical attention per year.
Health Education Literature
Authors: Kornacki Mary Jane , Fazen Louis E.
Published: December 2021

The article "Parents’ Knowledge of Respiratory Disease: A Comparison of Inner-City and Suburban Parents," by William Tomlinson (Pediatrics 56:1009, December 1975) deserves comment. We are supportive of the concepts of health education; however, the study lacks the rigorous approach of most studies published in Pediatrics. If education is to be accepted as a viable means of improving health, high standards of quality must be applied to research in this field.

The methodological deficiencies lead us to question the validity of the findings.
How About Using a Sign
Authors: Knoop David E.
Published: December 2021

Concerning the three articles and commentary regarding automotive safety (Pediatrics 58:307, 316, 320, 323, September 1976), I will take this opportunity to remind my colleagues that a sign is available (ABC Manufacturing, Raleigh, MS 39153) that can be posted in the parking lot of physicians and that may be useful in reinforcing the in-office education given by the physician. It reads "Fasten Children's Seat Belts." It is baked enamel on steel, 30 x 45 cm (12 x 18 inches), suitable for outdoor use.
You Have to Use Endoscopy
Authors: Stool Sylvan E. , Bluestone Charles D.
Published: December 2021

A few days following receipt of the issue containing the article by Law and Kosloske (Pediatrics 58:362, September 1976), we admitted a 1-year-old child with a history of coughing after "putting a piece of paper" in his mouth. Radiographic findings were not remarkable and physical examination revealed an occasional coarse rhonchus bilaterally. The question arose should we use bronchoscopy in this infant or attempt removal according to this nonoperative method.

In our opinion, there was no hesitancy to recommend bronchoscopy.
Croup: IPPB and/or Racemic Epinephrine Therapy
Authors: Bass James W.
Published: December 2021

In 1975 Taussig and associates1 evaluated the use of intermittent positive-pressure breathing (IPPB) with racemic epinephrine in the treatment of croup. Apparently their untreated control group received neither racemic epinephrine nor IPPB although all patients received mist tent therapy with 30% to 40% oxygen. A statistically significant benefit was observed in the treated group. A previous controlled study evaluating the effectiveness of aerosol racemic epinephrine alone, without IPPB, failed to show a significant difference between treated patients and placebo (aerosolized saline)-treated controls.2
THE TREATMENT OF WHOOPING COUGH AS GIVEN IN DR. NATHANIEL AMES' ALMANACK OF 1761
Authors: C. T. E.
Published: December 2021

Dr. Nathaniel Ames (1708-1764) of Dedham, Massachusetts, made his almanacks [sic] a sort of annual cyclopedia of information on a variety of subjects, including medicine. The 1761 edition contained this "recipe to cure the whooping cough" which he claimed "has been tried with success."1

Take dried Colt's Foot, a good Handful, cut them small, and boil them in a Pint of Spring Water, till half the water is boiled away, then take it off the Fire; when almost cold, strain it through a Cloth, squeezing the Herbs as dry as you can; throw the Herb away, and dissolve in the Liquor Half an Ounce of brown Sugar Candy, finely powdered; when dissolv'd, add to them one spoonful & an Half of the Tincture of Liquorice—of which give a Child five Years old one Spoonful three or four Times a Day. Grown Persons may take four Spoonfuls at a Time, and as often. It will cure in two or three Days.

The name coltsfoot was given in England to describe the heart-shaped leaf of this plant. It is a cough remedy of long standing. More than 19 centuries ago, Pliny wrote, "Its root is placed on live coals of cypress wood and the fumes of it are inhaled through a funnel for chronic cough." The generic name Tussilago is derived from the Latin word for cough, tussis.2
Steady State Serum Digoxin Concentration in Relation to Digitalis Toxicity in Neonates and Infants
Authors: Halkin H. , Radomsky M. , Blieden L. , Frand M. , Millman P. , Boichis H.
Published: December 2021

Steady state serum digoxin concentrations were determined in 34 neonates and infants receiving standard maintenance doses of the drug.

Digitalis intoxication, diagnosed by ECG criteria, occurred in four of 13 patients with a serum concentration above 2 ng/ml and not in any of 21 subjects with a serum digoxin concentration below this level.

This association was found to be significant. It seems that the concept of increased tolerance to digoxin hitherto ascribed to infants is not tenable and that the monitoring of serum digoxin concentration is essential to treatment in this age group.
THE TEN COMMANDMENTS OF PHOTOTHERAPY
Authors: Pramanik Arun K.
Published: December 2021

Thou shalt

1. Not use phototherapy prior to determination of etiology.1,2

2. Not use phototherapy in infants with direct hyperbilirubinemia (conjugated direct bilirubin level > 2 mg/100 ml).1,3

3. Not judge jaundice clinically in infants treated with phototherapy, but measure serum bilirubin level every 4 to 12 hours as indicated.1,2

4. Monitor temperature of infants placed under phototherapy initially every hour for the first four hours and thereafter every four to six hours.2,3

5. Weigh low-birth-weight infants receiving phototherapy twice daily. Increase their fluid intake above requirements by 2% to 10% depending on postnatal age, cardiac status, and whether the infant is under a radiant warmer or an adequately humidified incubator.1,3

6. Protect eyes with adequately designed patches. Turn off light and remove eye patches when parents are visiting.2,3

7. Monitor hematocrit value, particularly in hemolytic diseases.1,2

8. Watch for rebound of bilirubin level following discontinuation of phototherapy. Delay discharge by about 6 to 12 hours till rebound can definitely be ruled out.2

9. Change the lamps after 20% decrease of original irradiance output. Consult with the manufacturer of the individual lamps used, or energy output in the blue spectrum (425 to 475 mm) every 200 hours of use.1,2

10. Check all phototherapy units for proper electrical grounding.
Reevaluation of Levodopa-Propranolol as a Test of Growth Hormone Reserve in Children
Authors: Collu Robert , Brun Gérard , Milsant Françoise , Leboeuf Gilles , Letarte Jacques , Ducharme Jacques-Raymond
Published: December 2021

The growth hormone (GH) reserve of 15 short children was evaluated with the levodopa-propranolol test (DPT) and the sequential arginine-insulin test (AIT). Four patients failed to respond to both tests and were classified as hyposomatotropic. In the other 11 children, the mean GH peak response to the DPT was significantly higher than that to the AIT, mainly because five subjects who had a normal response to the DPT failed to respond to the AIT. These children had a generally poor yearly growth increment prior to testing associated in three with an obvious emotional problem, and were found at follow-up to have resumed a normal growth pattern.

These data confirm the effectiveness of the DPT as a test of GH reserve. Although hypoglycemia can occur occasionally during the test, this procedure is safer and easier to perform than the widely used AIT. Finally, the DPT seems to detect a category of children who have a temporary growth failure and nonresponse to the usual GH tests but who are not hyposomatotropic and consequently do not require human GH.
Complex Acid-Base Disorders in Subacute Necrotizing Encephalomyelopathy (Leigh's Syndrome)
Authors: Hirschman Gladys H. , Chan James C. M.
Published: December 2021

This report describes a case of subacute necrotizing encephalomyelopathy (Leigh's syndrome) in a 7-month-old boy. The clinical data suggest an association with a disorder of renal tubular acidification, characterized by both (proximal) type II and (distal) type I renal tubular acidosis (hybrid type). Concomitantly, the initial uncompensated metabolic acidosis evolved into a mixed metabolic acidosis and respiratory alkalosis-features of this syndrome not previously reported.
Adenovirus Meningoencephalitis
Authors: Kelsey Doris Sanders
Published: December 2021

Central nervous system manifestations in association with adenovirus infections have rarely been documented. In this report, four children, ages 4, 5, 6, and 10 years, with adenoviral meningoencephalitis are described. Adenoviruses were recovered from CSF specimens in all four patients.
Simultaneous Determination of α-Fetoprotein and Immunoglobulin Levels From a Microhematocrit Capillary Tube
Authors: Kohlschütter Alfried
Published: December 2021

The α-fetoprotein (AFP) concentration in serum is an indicator of gestational age in preterm infants.1 IgM and IgA concentrations are helpful in the diagnosis of perinatal infections.2,3 Determination of all three protein levels can conveniently be made from one single microhematocrit capillary tube. The small blood volumes involved and the simplicity of the procedure make it a tool for routine use in newborn nurseries. The technique described can also be used for the determination of many other compounds.

MATERIALS

Heparinized microhematocrit capillary tubes (Propper Manufacturing Co., Inc., Long Island, N. Y.) are 75 mm long and have an internal diameter of 1.1 to 1.2 mm.
Use of pneumococcal vaccine in children
Authors: Klein Jerome O. , Mortimer Edward A.
Published: December 2021

A 14-type pneumococcal polysaccharide vaccine has been licensed for use in the United States (Pneumovax, Merck & Co., Inc.). Although there are more than 80 immunologically distinct capsular types of pneumococci, the strains incorporated into the vaccine have been responsible for approximately 80% of the cases of serious pneumococcal disease in the United States in recent years. The vaccine should be of value for selected children at risk for severe or life-threatening disease due to the pneumococcus.

Pneumococcal vaccines have been used since the turn of the century. In 1914, Sir Almroth Wright* and colleagues reported favorable results of a whole cell vaccine administered to gold miners in South Africa.1
Antibiotics and Upper Respiratory Tract Infections
Authors: Traisman Howard S.
Published: December 2021

I wish to commend Dr. Alvaro Navia-Monedero on his letter regarding the use of antibiotics in upper respiratory tract infections (Pediatrics 59:141, January 1977). Dr. Martin Hardy and I did a similar study in the 1950s1 and arrived at the same conclusion that antibiotics are of no value in the treatment of the uncomplicated upper respiratory tract infection. It is unfortunate that we see the use of antibiotics by our colleagues for this same benign condition.
Leprosy in a Child
Authors: Harris Ruth C.
Published: December 2021

Recently, a 10-year-old child who had been in this country for 19 months after the "baby-lift" in Vietnam was discovered to have a granulomatous lesion on her right index finger. Biopsy and histologic examination failed to reveal the exact diagnosis except that it was a "granulomatous process." Recurrence of a similar lesion on the palm of the hand and referral of the patient to a large medical center identified the process as mild tuberculoid leprosy.
Requests Information on Fatal Stings
Authors: Frazier Claude A.
Published: December 2021

I am convinced that lives now needlessly lost due to severe systemic reactions to insect stings could be saved. How? By a greater awareness of the possibility of such fatal reactions plus knowledge of the existence of an insect sting kit. The kit is an emergency first aid measure to prevent anaphylaxis. Because of my convictions, I am presently collecting and correlating data on the incidence of such fatalities.

I am especially interested in time lapse between sting and death, although information concerning the following would be helpful:
Blood Pressure in Children and Its Interpretation
Authors: Berenson G. S. , Voors A. W. , Webber L. S. , Frerichs R. R.
Published: December 2021

The "Report of the National Heart, Lung, and Blood Institute's Task Force on Blood Pressure Control in Children" (Pediatrics suppl, May 1977) is a serious and long-needed attempt at establishing guidelines for practitioners in monitoring blood pressure levels in children and diagnosing early primary hypertension. Further, and importantly, it includes a consideration of prevention of future hypertensive disease, encouraging greater research and clinical interest in blood pressure in the pediatric age group. Specifically it encourages the physician examining children to include observations of blood pressure as a routine part of a physical examination.
Interpretation of Data Questioned
Authors: Weinberger Miles
Published: December 2021

Analysis of data from the study of Blumberg et al. (Pediatrics 60:14, July 1977) is subject to alternative interpretations. Fortunately, when the same data (without mention

See image in the PDF file

Relationship of pulmonary function over time during administration of ephedrine (solid line) or placebo (dotted line). FEV1 = forced expiratory volume at one second; PFR = peak expiratory flow rate. of the terbutaline) were published in The Journal of the American Medical Association,1 the actual pulmonary function measurements of the patients were expressed in a standardized manner as percent of predicted.
Reduction of Sleep Apnea and Bradycardia in Preterm Infants on Oscillating Water Beds: A Controlled Polygraphic Study
Authors: Korner Anneliese F. , Guilleminault Christian , Van den Hoed Johanna , Baldwin Roger B.
Published: December 2021

The sleep and respiratory patterns of eight apneic preterm infants were polygraphically recorded for 24 hours. This polygraphic study was designed to test and extend our previous finding that gently oscillating water beds reduce apnea in premature infants. The infants who ranged in gestational age from 27 to 32 weeks and in birth weight from 1,077 to 1,650 gm served as their own controls, off and on the water bed. The 24-hour recordings were divided into four time blocks with the infant being placed on the water bed during alternate six-hour periods. Apnea was significantly reduced while the infants were on the oscillating water beds, with the longest apneic periods and those associated with severe bradycardia being reduced the most. Reduction of apnea was most consistent during indeterminate sleep and most pronounced during quiet sleep. Short respiratory pauses and periodic breathing were not significantly reduced. Reductions of central, obstructive, and mixed apneas were approximately equal.
Medium-Chain Triglyceride Feeding in Premature Infants: Effects on Calcium and Magnesium Absorption
Authors: Tantibhedhyangkul Phienvit , Hashim Sami A.
Published: December 2021

The effect of medium-chain triglycerides (MCT) On the absorption of calcium and magnesium in premature infants was studied in 34 infants with birth weights lower than 2,000 gm. The infants were divided into three groups and fed three formulas similar in nutrient content except for the type of fat, as follows: group 1 (control): corn oil, oleo, and coconut oil (39:41:20); group 2: MCT, corn oil, and coconut oil (40:40:20); group 3: MCT and corn oil (80:20). The infants fed MCT-containing formulas absorbed significantly more calcium than the control group. Magnesium absorption was significantly increased in the 80% MCT group.
Glucose Disposal in Low-Birth-Weight Infants During Steady-State Hyperglycemia: Effects of Exogenous Insulin Administration
Authors: Pollak Arnold , Cowett Richard M. , Schwartz Robert , Oh William
Published: December 2021

The effects of exogenous insulin administration on glucose disposal during steady-state hyperglycemia were evaluated in eight well, low-birth-weight (LBW) infants (mean birth weight 1,090 gm; mean gestation 29 weeks) at age 5 to 14 days. The study was performed on two consecutive days. On the first day, at midpoint during a four-hour constant glucose infusion (14 mg/kg/min), a placebo was given. The following day, insulin (10 mU/kg/min) replaced the placebo. Serum insulin level increased significantly during steady-state hyperglycemia on both days. In contrast to placebo, the administration of exogenous insulin resulted in normoglycemia. It is speculated that the hyperglycemia during glucose infusion in well LBW infants is the result of persistent endogenous hepatic glucose production and/or decreased peripheral glucose utilization, both of which could be due to ineffective mediation of insulin on the liver or other insulin-sensitive peripheral tissues. The prompt reduction in serum glucose level which occurs as a result of the administration of exogenous insulin further suggests that in LBW infants a higher insulin level is necessary to achieve the appropriate control of glucose homeostasis. During this study, no osmotic diuresis was observed since the quantity of urinary glucose did not constitute an osmolar load.
Lymphoblastic Conversion in Chronic Myelogenous Leukemia
Authors: Crist William M. , Ragab Abdelsalam H. , Ducos Rafael
Published: December 2021

A child presented with "acute leukemia" in which the blast cells resembled lymphoblasts and had negative cytochemical staining (PAS, Sudan black, and myeloperoxidase). Remission was induced and typical adult-type chronic myelogenous leukemia (CML) followed. Cytogenetic studies initially and during remission and subsequent "acute leukemia" relapses revealed the presence of the Philadelphia chromosome abnormality.

Terminal transferase assay performed on peripheral blood blast cells was markedly elevated and soft agar culture growth parameters were typical of acute lymphohlastic leukemia. T and B cell marker studies revealed no markers. This case report with supportive laboratory studies suggests that a cell line with lymphoid characteristics may predominate during acute leukemic transformation. This type of subclassification of leukemia may be of importance in therapeutic planning.
Growth of Children With Down's Syndrome: Birth to Age 3 Years
Authors: Cronk C. E.
Published: December 2021

A sample of 90 children with Down's syndrome were measured for recumbent length and weight from birth to age 36 months at the Children's Hospital Medical Center in Boston. At birth, means for both length and weight were reduced by about 0.5 SDs from the control group means. By 36 months, mean recumbent length was greater than 2 SDs below that for the control group, while the mean for weight was reduced by about 1.5 SDs from the control group mean. Growth velocity for both length and weight was most deficient within the first two years of life. About 30% of the sample demonstrated excess weight for length relations by 36 months. Children with moderate or severe heart disease were significantly smaller than those without or with mild cardiac problems at all times after birth. Measurements of a subsample of children at 4, 5, and 6 years of age suggested that growth velocity after 3 years of age may be within the range of normal. Assessment of growth of the child with Down's syndrome may be carried out with reference to charts plotting tenth to 90th percentiles based on these data.
Unilateral Gluteal Hypoplasia and Brachysyndactyly: Lower Extremity Counterpart of the Poland Anomaly
Authors: Riccardi Vincent M.
Published: December 2021

The Poland anomaly is characterized by unilateral upper extremity brachysyndactyly, ipsilateral aplasia/hypoplasia of the sternal head of the pectoralis major, and/or hypoplasia of the nipple or mammary gland. A case is presented here of a child with a comparable combination of findings in a lower extremity. Because her abnormalities are so similar to those seen in the Poland anomaly they may be instructive as to the developmental origin of the Poland anomaly.

CASE REPORT

A 21-month-old girl was referred for evaluation of a small left lower extremity.
Prevention and Therapy of Serous Otitis Media by Oral Decongestant: A Double-Blind Study in Pediatric Practice
Authors: Olson Ardis L. , Klein Suzanne W. , Charney Evan , MacWhinney James B. , McInerny Thomas K. , Miller Robert L. , Nazarian Lawrence F. , Cunningham David
Published: December 2021

We studied the efficacy of (1) preventing the development of serous otitis media (SOM) by using an oral decongestant in children with acute otitis media and (2) treating SOM with an oral decongestant. In a randomized double-blind study, 190 children were treated for acute otitis media with antibiotics and either pseudoephedrine hydrochloride (Sudafed) or placebo. They were evaluated two weeks later by tympanometry and (independently) by clinical evaluation and pneumotoscopy. There were no significant differences between the two groups, except that males developed SOM significantly more often than did females. Use of decongestant and placebo was continued in 78 patients with SOM for up to four more weeks. Again, there were no significant differences between the treatment groups except that patients with an allergic history did significantly worse using a decongestant. Overall there was no benefit from pseudoephedrine in either the prevention or treatment of SOM.
Child-Resistant Locks in Poison Control
Authors: Godwin Richard H.
Published: December 2021

Three child-resistant locks were incorporated into a medicine cabinet, an under-the-sink cabinet, and a vanity box. Three hundred 3- to 5-year-old children were tested against these locks. Only two were able to open the receptacles, whereas all 50 of a group of adults and teenagers similarly tested were able to open all of the containers.

The use of adequately protected medicine chests and under-the-sink cabinets is urged as a further step toward the complete prevention of poisoning in children.