bluuebunny/crossref_metadata_2025 huggingface dataset:
Letter to the Editor
Authors: Harrison Stanley L.
Published: December 2021

The Academy appreciated Dr. Aronson's comment on the maternal role of the working mother. As one who was involved in most of the discussion during the preparation of the Executive Board's statement, I can assure her it is not the intent of the Committee, Council or Board to perpetrate the myth that the good mother is one who obtains her sense of fulfillment primarily from the maternal role as she states in her letter. Instead, we were simply stating a fact that an increasing proportion of mothers are not at home to fulfill the maternal role in care and guidance and as a consequence the child needs this care outside the home.
Routine Screening of Women for Gonorrhea (Is "Offer" of Tests Enough?)
Authors: Katz Selig H.
Published: December 2021

In a letter published in the August 1973 issue, Dr. Hania W. Ris suggests routine screening of women for gonorrhea.

A recently enacted amendment to the Public Health Law of New York State requires all physicians, clinics or facilities providing gynecological, obstetrical, contraceptive, sterilization or termination-of-pregnancy services or treatment to offer to administer to every New York State resident coming for such services or treatment, appropriate tests for the detection of syphilis and gonorrhea.
Exercises in Diagnostic Radiology, No. 5, Pediatrics, by Richard M. Heller, M.D., and Lucy Frank Squire, M.D. Philadelphia/London/Toronto: W. B. Saunders, 1973, 162 pp., $5.95
Authors: Caffey John
Published: December 2021

This volume is a compact miscellany of many important, diagnostic problems in pediatric radiology. It is designed primarily to test the competence of medical students and pediatric and radiologic residents in the diagnostic evaluation of the radiographic changes, in cases in which the radiographic examination plays an essential role. Dr. Heller in the Preface points out that "this little volume presents some of the highlights" in the wide, deep, and complex field of pediatric radiology.
Pediatric Orthopedics, Vol. I and II, by Mihran O. Tachdjian, M.S., M.D. Philadelphia/London/Toronto: W. B. Saunders Company, 1972, 766 pp. (Vol. I), 1001 pp. (Vol. II), $65.00
Authors: Ferguson Albert B.
Published: December 2021

Pediatric Orthopedics is aimed primarily at the orthopedic surgeon with operative procedures shown in detail.

Mihran Tachdjian, the author, and W. B. Saunders, the publisher, have collaborated to produce a superbly illustrated and designed text. The illustrations, a combination of the contribution of the photographic and the medical illustrator, are great examples of the work of both fields. The two volumes are memorable achievements in the illustrative fields. The hand, orthotics, and prosthetics in children are omitted.
DIAGNOSIS OF GLYCOGEN STORAGE DISEASE TYPE I BY SERUM IMMUNODIFFUSION
Authors: Collipp P. J. , Chen S. Y. , Maddaiah V. T. , Thomas J. , Huijing F. J.
Published: December 2021

An antiserum was prepared by immunizing guinea pigs with a preparation of partially purified human liver microsomal glucose-6-phosphatase. Using double agar diffusion and immunoelectrophoresis this antiserum was found to react with an antigen in normal human serum, and also with serum from a child with glycogen storage disease, type III, i.e., debranching enzyme deficiency. No reaction occurred with serum or liver from patients with glycogen storage disease type I. While additional experience with this method is needed, this paper presents a potential method for establishing the diagnosis of type I glycogen storage disease without resort to liver biopsy.
DEXAMETHASONE IN THE MANAGEMENT OF KEROSENE PNEUMONIA
Authors: Wolfsdorf J. , Paed. Dip. , Kündig H.
Published: December 2021

The efficacy of steroids in the treatment of acute aspiration pneumonia, following intratracheal kerosene instillation in primates, was examined. Forty Chacma baboons were utilized in three groups: group I (normal animals), group II (animals receiving 0.3 ml/kg intratracheal kerosene alone, control group), and group III (animals receiving 0.3 ml/kg intratracheal kerosene plus pre- and posttreatment with 5 mg/kg IMI dexamethasone). The lungs from all animals were examined macroscopically and microscopically and their lung wet weight-dry weight and lung weight-body weight ratios determined. On all parameters utilized, the lungs from groups II and III were different from group I. No statistical difference, however, could be detected between values obtained from groups II and III. These data tend to support the contention that steroids, even when given early, and in large doses, in the course of kerosene pneumonitis, do not alter the acute inflammatory process that occurs.
Biochemical Basis for Nutritional Management of Preterm Infants
Authors: Räihä Niels C. R.
Published: December 2021

Today an increasing number of small prematurely born infants survive as a result of intensified perinatal care. Brain growth, which proceeds at a rapid rate at this critical period of development, may be irreversibly damaged by unfavorable factors such as nutritional deficiencies and alterations in the metabolic homeostasis. In the past, the long-term outlook of preterm infants has been fairly pessimistic, and since there exists much evidence that outcome may be related to postnatal care it becomes important to identify the most favorable ways to care for these surviving low birth-weight infants. In order to arrange optimal management we must understand the functional and metabolic deficiencies which form the basis for immaturity and the reasons why these infants have so many difficulties in adjusting to extrauterine existence. The possible consequences of the inability of the fetus and the premature infant to synthesize a certain important amino acid such as cystine and, on the other hand, the inability to metabolize another amino acid such as tyrosine have been discussed in relation to the nutritional management of the infants. A clinical nutritional study which takes into consideration these underlying metabolic deficiencies of premature infants has been presented. Another approach to the problem of functional immaturity in surviving premature infants would be to artificially accelerate the biochemical development. The "induction" of critical enzymatic activities presents potential possibilities. We have shown in the current presentation that the enzymes involved in phenylalanine and tyrosine metabolism in the liver can be induced in fetal human liver in organ culture by hormonal agents. These results demonstrate the competence of human fetal tissues to respond to external stimulation by increasing enzyme activity. Finally, it is suggested that additional basic information concerning the factors regulating enzymic differentiation is essential before these potentially useful but still somewhat unspecific methods can be clinically applied.
Glucose Intolerance in Infants of Very Low Birth Weight
Authors: Dweck Harry S. , Cassady George
Published: December 2021

Forty-three of fifty babies with birth weights 1,100 gm or less were hyperglycemic with serum glucose levels exceeding 125 mg/100 ml while receiving parenteral glucose. Serum glucose levels exceeded 300 mg/100 ml in 36 of these 50 babies. Hyperglycemia was most frequent in the 24 hours after birth and was also related to high rates of glucose infusion (> 0.4 gm/kg/hr from birth) as well as parenteral glucose administration in the absence of oral supplement. These data attest to the fragile nature of glucose metabolism in infants of very low birth weight.
Applying An Old Concept to A New Method of Streptococcal Surveillance
Authors: Zimmerman Robert A. , Horn Kenneth A. , Meyer W. Terrence , Klesius Phillip H.
Published: December 2021

Streptococcal surveillance programs in areas of high endemicity are difficult to maintain due to the high economic costs and excessive laboratory demands based on total number of cultures taken.

Through retrospective analysis of data accumulated from five different surveillance studies carried out by the Streptococcal Disease Section in Colorado, we have been able to devise a new approach to streptococcal surveillance programs.

By utilizing the concept of familial susceptibility and employing crude criteria to define susceptible and nonsusceptible families, we found that S families accounted for 53% to 96% of all group A acquisitions and demonstrated a fourfold to sixfold higher mean prevalence when compared to NS families. Guidelines for setting up a streptococcal surveillance program utilizing these principles are presented. This applied approach can reduce economic costs and laboratory work by 50% to 60% and still maintain effective surveillance of the high-risk segment of the population being studied.
Screening for Gonorrhea During Pregnancy
Authors: Scanlon John W.
Published: December 2021

The editorial by Dr. Shaw and the letter by Dr. Ris in the August 1973 issue discussing gonorrheal opthalmia neonatorum raise several salient points. Among these is that identification of infected mothers is a key to preventing neonatal infection. While arguments can be advanced about cost versus benefits in the routine, repeated screening of all pregnant women for gonorrhea, there is one way to identify mothers who are at demonstrably greater risk to contaminate their infants.
Letter to the Editor
Authors: Kattwinkel John , Fanaroff Avroy A. , Klaus Marshall H.
Published: December 2021

Initially, our procedure in instituting nasal CPAP was to start with a pressure of 6 cm H2O and increase gradually as blood gases dictated. Our concern was that in some infants, higher pressures might impede venous return thus compromising cardiac output. However, experience shows that if the technique is reserved for only patients with severe RDS (i.e., PaO2 < 60 mm Hg in FiO2 ≥ 70%) their lung compliance is low and transmission of pressure to the vascular space is probably negligible.
Letter to the Editor
Authors: Dolan Thomas F. , Meyers Alan
Published: December 2021

We agree that follow-up urine culture should be obtained after the diagnosis of a urinary tract infection is made. The frequency with which such cultures are obtained is, however, debatable. Our questionnaire did not include this aspect of management.

Since 59% of family practitioners and 45% of pediatricians diagnosed urinary tract infections without benefit of culture on a routine basis, it would seem likely that follow-up urine cultures are not performed with regularity.

We would join with Dr. Browning in urging careful follow-up and evaluation for children with documented urinary tract infections.
Letter to the Editor
Authors: Heisinger Dale H.
Published: December 2021

Since retrospective studies on the use of corticosteroids in acute laryngotracheobronchitis have demonstrated no significant improvements following their administration and the use of antibiotics in dealing with children with acute laryngotracheobronchitis is of questionable value, it was a relief to find an alternative treatment as presented by Adair on the use of racemic epinephrine in children with acute LTB and the quite impressive statistics that demonstrated no tracheotomies during his study for this illness. It gave those of us treating children with this condition the opportunity to use a relatively benign treatment program that would both benefit the patient immediately as well as, hopefully, obviating the necessity of tracheotomies.
Hemophilus Influenzae, edited by Sarah H. W. Sell, editor, and David T Karzon, associate editor. Nashville: Vanderbilt University Press, 1973, 325 pp., $15.00
Authors: Lepow Martha L.
Published: December 2021

This 300-page volume consists of the proceedings of a conference on the "Antigen-Antibody Systems, Epidemiology and Immunoprophylaxis" of Hemophilus influenzae held on April 24-25, 1972, at Vanderbilt University School of Medicine, sponsored by Vanderbilt University and the Department of Pediatrics of the School of Medicine.

Most of the 40 participants, all from the United States, are actively engaged in research in the biology, immunology or epidemiology of this complex group of microorganisms, with special emphasis on H. influenzae type b.
Dr. Turtle's Babies, by William John Turtle, M.D., with the assistance of Lydia Pope Turtle. Philadelphia/London/Toronto: W. B. Saunders Co., 1973, 318 pp., $4.95
Authors: Pittelli Alexandra W.
Published: December 2021

Dr. Turtle was a retired pediatrician when he wrote this book; he wrote it from the vantage point of years of experience in dealing with young patients and their concerned mothers, polished by several years' experience in leading prenatal discussion groups. This is a gentle book written for parents to be—perhaps too gentle and repetitive for some of today's more sophisticated young mothers.

"Preventive medicine" in child rearing is the purpose of the book in introducing to prospective parents some of the concerns, self-questioning and even panic which they will soon fall heir to, so that in the calm before the storm they may be able to set reasonable goals and a philosophy of child rearing, and to consider objectively a baby's needs in nutrition, love and handling, discipline and accident prevention.
What Shall We Tell the Kids?, by Bennett Olshaker, M.D. New York: Dell Publishing Company, 1973, 286 pp., $1.50
Authors: Schell Norman B.
Published: December 2021

"What kids want to hear from their parents" is the first statement on the cover of this new paperback. It might more appropriately read, "What kids should hear from their parents."

This is a well-written pocket manual in Spockian style. The language may appeal to the junior high school-educated parent readers, but, by the same token, breeziness may appear as an oversimplistic approach to child rearing to the senior high school or college-educated parent readers.
Parathyroid Function in Uremic Children With and Without Osteodystrophy
Authors: Roof Betty S. , Piel Carolyn F. , Rames Linda , Potter Donald , Gordan Gilbert S.
Published: December 2021

Circulating radioimmunoassayable parathyroid hormone (iPTH) was not present in 30% (117) of 389 normal children tested at ages from cord blood to 17 years. In the other 70% (272), mean iPTH was found to be 25 ± 0.7µl eq/ml (± SEM; range, 0-53 ± 2 SD) . The iPTH levels were elevated in 59% of 24 uremic children without radiologic evidence of osteodystrophy in 94% uremic children with osteodystrophy. Infusion of calcium (10 mg/kg over three hours or 15 mg/kg over four hours) in the children without osteodystrophy reduced the iPTH by nearly 50%; suppression was sustained for 9 to 20 hours. In uremic children with osteodystrophy, similar infusions failed to elevate the serum calcium concentration to the same degree and there was less suppression of iPTH which was not sustained as long. Mean increment in serum calcium observed was 2.1 mg/100 ml with 10 mg/kg/3 hr and 3.4 for 15 mg/kg/4 hr in children without osteodystrophy, and 1.24 and 1.4 mg/100 ml in those with osteodystrophy for similar infusions. In both groups, calcium infusions lowered the concentration of serum magnesium and elevated the serum phosphate concentration. Tubular reabsorption of phosphate did not change consistently despite fall in serum iPTH levels. There was no correlation between suppressibility of parathyroid function and serum creatinine level. In five children with osteodystrophy in whom calcium infusions did not suppress iPTH levels, normal iPTH levels were achieved rapidly after successful renal transplantation. These data indicate that the secondary hyperparathyroidism of uremic children is suppressible and not autonomous.
Letter to the Editor
Authors: White Priscilla
Published: December 2021

I am in favor of Doctor Feeman's proposal for early detection of diabetes in the childhood population. Among other reasons, the rate of diabetes in the childhood population is unknown. Formerly in a house-to-house canvas the rate was believed to be one child in 2,400. A recent study of school children in Detroit showed that one child in 600 had been diagnosed as having diabetes. These statistics contain some errors as a few of these children were diagnosed as individuals with diabetes but were not requiring insulin therapy.
Letter to the Editor
Authors: Yankauer Alfred
Published: December 2021

Dr. Chamberlin is justifiably concerned about how to evaluate preventive health care. He points out the need to measure input content and goals (as well as time) and to measure outcome or goal achievements in broader functional terms than the narrow conventional but objective medical parameters. Although these are tough issues they must certainly be faced. However, by addressing himself to minimal numbers of scheduled visits to a medical setting rather than to how to attain broad child-rearing objectives, I think Dr. Chamberlin has inadvertently fallen into a trap.
The Child With Leukemia, by Carl Pochedly, M.D. Springfield, Illinois: Charles C Thomas, 1973, 297 pp., $11.75
Authors: Jaffe Norman
Published: December 2021

Dr. Pochedly is to be congratulated on his efforts to present to the "pediatrician, general practitioner as well as the clinical hematologist" a monograph devoted exclusively to childhood leukemia. The text is arranged in logical sequence commencing with types of acute leukemia in childhood (chapter I) and congenital leukemia (chapter II). Chapters III through VII deal with the signs and symptoms, complications and metabolic and immunologic abnormalities. Diseases which simulate leukemia are discussed in chapter VIII, while the remaining four chapters are devoted to treatment and to chronic granulocytic leukemia of childhood.
Golden's Diagnostic Radiology, Section 15, Laurence L. Robbins, M.D., editor: Pediatric Radiology, ed. 2, by Lawrence A. Davis, M.D., and Loretta T. Shearer, M.D. Baltimore: The Williams & Wilkins Company, 1973, 293 pp., $27.50
Authors: Wilkinson Robert H.
Published: December 2021

This book is an extremely ambitious undertaking covering a wide range of abnormalities in a relatively short space. The authors start and finish with some practical guidelines for the radiographic examination of the pediatric patient based on many years of experience in a good pediatric hospital.

The organization of the diseases presented is logical with many references supplied. Some of the entities are discussed in detail while others, properly, are only mentioned with appropriate references suggested. The scope of the diseases presented is very wide; perhaps deletion of some of the rare conditions would have provided space for more discussion of common problems.
Laryngotracheoesophageal Cleft: Report of a Case Successfully Treated and Review of the Literature
Authors: Burroughs Nathan , Leape Lucian L.
Published: December 2021

Laryngotracheoesophageal cleft is a rare but potentially curable anomaly. It should be considered in the differential diagnosis of neonatal respiratory distress aggravated by feeding. Diagnosis is difficult, and repeat endoscopic procedures may be necessary. Immediate surgical repair is indicated. Incorporation of part of the esophageal wall into the repair may enhance success. Tracheostomy has been required in all survivors. Because a cleft may be associated with esophageal atresia and/or tracheoesophageal fistula, its presence should be suspected in patients with these conditions who have persistent symptoms after successful repair.
INTRODUCTION: The Treatment of Paroxysmal Disorders
Authors: Menkes John H.
Published: December 2021

As the accompanying series of papers indicates, the treatment of paroxysmal disorders in childhood is still an art, laid down on a thin groundwork of scientific information.

While there is unanimous agreement that all patients with recurrent seizures should be treated as soon as the diagnosis is established, there is considerable controversy regarding the optimum method of dealing with certain patients.

1. Febrile convulsions. There is considerable controversy as to whether a child who has experienced his first febrile convulsion should receive continuous prophylactic anticonvulsant therapy. Controlled prospective studies have indicated that the mcidence of recurrent febrile convulsions is not significantly less in patients who have been placed on daily doses of phenobarbital or diphenylhydantoin than those on intermittent anticonvulsants administered only at the time of a febrile episode, or on no therapy at all. It is possible that the failure of phenobarbital prophylaxis is due to inadequate blood levels, and serum barbiturate levels of 1.5 mg/100 ml or higher may be required to prevent further febrile convulsions.

2. The child with an isolated major motor convulsion. I believe that treatment of this type of patient is optional, and to a large measure dependent on social factors. While phenobarbital, the drug of choice in this instance, has few side effects, it must be stressed that sudden withdrawal of the drug by the parents, unconvinced of its necessity, may precipitate status epilepticus.

3. Breath-holding spells. Most authorities agree that antiepileptic drugs are of no value in preventing recurrence of attacks.
Unusual Presentations of Epilepsies
Authors: Walsh Gregory O.
Published: December 2021

Seizures are either focal (partial) or generalized in onset (Table I).1 The manifestation of the seizure is related to the area of the brain involved in the initial electrical seizure discharge. If the initial seizure discharge is related to the motor strip then one might see a Jacksonian type of seizure with first clonic movements of the thumb and fingers, then a march up the hand, arm, face and leg on the contralateral side of the body. If the initial seizure discharge is related to the temporal lobe then one might see impairment of consciousness and automatic movements (automatisms). The "aura" is actually the start of the electrical seizure discharge which is confined to one area of brain. The type of "aura" that a patient has is related to the area of brain involved in the seizure discharge. For example, the olfactory aura of an unusual smell may be related to a mesial temporal lobe or mesial frontal lobe discharge. The aura of an unusual taste is related to a discharge in the insular cortex. If the electrical seizure discharge spreads out to involve other areas of brain or the whole brain then the patient has a secondarily generalized major motor seizure. The important point is to recognize that the seizure was a partial onset seizure becoming secondarily generalized and therefore due to a focal etiology rather than a primary generalized seizure disorder, which affects a particular area of brain which is may be precipitated in response to some stimuli which effects a particular area of brain which is extraordinarily sensitive because of an epileptic lesion in that area.

See table in the PDF file
Nylidrin (Arlidin) Poisoning
Authors: Coté Charles J.
Published: December 2021

A 14-year-old female ingested 60 to 120 mg of nylidrin and 1 to 2 gm of chlorothiazide. She later developed chest pain, headache, flushing and shortness of breath. The initial heart rate was 156 and the blood pressure 125/0 mm Hg. The remainder of her physical examination was normal. Over six hours the diastolic pressure and heart rate returned to normal. The signs and symptoms were consistent with toxic effects of beta-receptor stimulation causing decreased peripheral vascular resistance, fall in end-diastolic blood pressure, and poor coronary perfusion.
Is Randomization Always Random?
Authors: Barnett Harry L. , Edelmann Chester M.
Published: December 2021

We applaud the objectives of Rhodes and Hall in conducting a controlled study of the value of continuous positive airway pressure delivered by face mask in infants with idiopathic respiratory distress. We also agree heartily with the thesis that the true value of a procedure which returns measurably altered physiological functions toward normal must ultimately be assessed by observing its effect on the clinical course of the patients being treated. In many instances, as in this one, the decision to undertake the necessary controlled clinical trial (termed "daring" by Chernick in his comment on the question being asked here) and the subsequent tasks of designing, conducting, and interpreting the results of the investigation are exceedingly difficult.
Rates and Calcium Concentrations of Sweat in Relation to Cystic Fibrosis
Authors: Gibson Lewis E.
Published: December 2021

The authors of the recent article which failed to show a significant difference between sweat calcium concentrations of CF patients and control subjects, suggest that the findings refute our hyperpermeability hypothesis. They found sweat Ca of 0.32 to 1.67 mEq/liter in 26 control subjects and 0.42 to 2.03 mEq/liter in 16 CF patients. With these tremendous ranges many more subjects would be required to prove or disprove a difference.

A difference undetectable in a moderate number of subjects is probably not of pathophysiologic significance if the Ca really varies unpredictably.
What Kind of Drug Education Do We Need—And for Whom?
Authors: Nader Philip R.
Published: December 2021

Congratulations on publishing the "Outcomes of Drug Education" by Drs. Tennant, Weaver and Lewis. It may be of interest to report other case studies to further question the "efficacy" of so-called drug education even at elementary level. In one study elementary children's attitudes as measured by a semantic differential were uniformly negative toward drugs and were not affected by a drug education course which consisted mostly of descriptions of the various drugs, their dangers and the legal implications.
Letter to the Editor
Authors: Tennant Forest S.
Published: December 2021

The experience of Dr. Nader certainly parallels that of my colleagues and myself. I concur in the recommendation that education on drugs, smoking, VD, and sex per se be replaced with an ongoing health education and human ecology approach. I believe that our drug education evaluations provide ample evidence that should guide us in this direction. Recent evidence indicates that the major efforts to mold positive health (including mental health) behavior should be directed to elementary-age school children.
Letter to the Editor
Authors:   Committee on Drugs
Published: December 2021

Appropriate study of drugs for new conditions, particularly neuropsychiatric conditions, requires appropriate controls. An appropriate control in a condition with as much psychiatric component as stuttering should be done in a double-blind fashion, or at least a single-blind fashion. The interesting observation of Dr. Healy of the effectiveness of Haldol in stuttering thus should require confirmation in a controlled fashion before large numbers of children are given this drug for what, in many cases, is primarily a benign disorder.
Letter to the Editor
Authors: Frazier Robert G.
Published: December 2021

The Academy regrets the lack of sufficient commonality of understanding of the pediatric nurse practitioner concept and of shared reponsibility for the certification program announced by the ANA to enable continued support by the AAP. The AAP is working closely with the newly formed National Association of Pediatric Nurse Associates and Practitioners to develop a jointly sponsored certification program more generally applicable to the concerns of pediatricians and the needs of graduates from PNA training programs.
Developmental Nephrology, by Wallace W. McCrory, M.D. Cambridge, Massachusetts: Harvard University Press, 1972, 216 pp., $12.00
Authors: Blau Edward B.
Published: December 2021

Doctor McCrory states his book was written for "those students, biologists, and physicians interested in the kidney, but too involved with their special trees to notice some of the changes in the forest in which they toil." Doctor McCrory has written a book that is both timely and useful, since it provides both theoretical material and clinical data relevant to the care and investigation of the newly-born. My criticisms of the book are minor ones: I did not find the extensive plates showing the microdissection of the developing kidney particularly useful.
Practical Pediatric Electrocardiography, by Arthur J. Moss, M.D., and George Emmanouilides, M.D. Philadelphia: J. B. Lippincoit Company, 1973, 148 pp., $17.00
Authors: Talner Norman S.
Published: December 2021

The authors present a review of electrocardiography as applied to the infant and child with cardiac disease. The technical aspects of the electrocardiogram are presented in a reasonable fashion. The electrocardiographic tracings are of good quality throughout the text. For the normal infant and for infants and children with cardiac disease, representative recordings are included. For each diagnosis, i.e., right ventricular hypertrophy, a rather long list of entities which may produce this condition is included.
Gender Differences: Their Ontogeny and Significance, edited by Christopher Ounsted and David C. Taylor. Baltimore: The Williams & Wilkins Company, 1972, 273 pp., $17.00
Authors: Reinisch June , Sutton-Smith Brian
Published: December 2021

The promise implied in the title of this collection of papers is not completely fulfilled in its contents. Although some of the contributions are theoretically innovative and contain recent information, others are lacking either in new data or in report of current research and theoretical opinion. The 11 papers cover, with varying degrees of competence and completeness, a variety of subjects dealing with sex differences from chromosome anomalies, sex ratios in growth and disease, and genetic transmission of disease to sex differences in spacial, linguistic, perceptual-motor, and behavioral development.
A Silent Tragedy: Child Abuse in the Community, by Peter and Judith DeCourcy. New York: Alfred Publishing Company, Inc., 1973, 231 pp., $6.95
Authors: Fontana Vincent J.
Published: December 2021

Peter and Judith DeCourcy have written a splendid book on child abuse. It certainly should be read by every professional and nonprofessional, and every citizen with a conscience.

It is difficult to accept the fact that in our society today, inhuman cruelty to children appears to be rapidly increasing and that the perpetrators of these crimes are for the most part not strangers, but parents themselves. In this book, the DeCourcy's accurately describe cases of child abuse and the problems encountered when dealing with such cases.
Eschatological Thoughts of the Just 16-year-old Emily Dickinson
Authors: C. T. E.
Published: December 2021

Other poets of comparable stature have made the theme of death central in much of their writing. Emily Dickinson (1830-1886) did so in hers to an unusual degree. In one way or another she has drawn it into the texture of some five or six hundred poems.

One persistent thought that binds together her many poems is that death snaps the line of commuication with those she has known and loved, and creates the uncertainty in the minds of all mortals whether that communication can ever be re-established.1

The letter below, written to a friend when Emily was just a month past her sixteenth birthday is both a good example of her literary style and her views about death.
The Ductus Arteriosus, by Donald E. Cassels, M.D. Springfield, Illinois: Charles C Thomas, 1973, 345 pp., $17.75
Authors: Liebman Jerome
Published: December 2021

Dr. Cassels should be congratulated on attempting a monograph on this subject. This reviewer's first reaction before opening the cover of the attractively packaged book was to say—why? But on reading the table of contents and getting into such content, the "why" was answered—positively.

There are 25 chapters, varying from history, embryology, histology, anatomy, etc. to hemodynamics, theories of patency, pulmonary hypertension, and the effects of patency of the ductus arteriosus on growth. Each chapter is well illustrated, with specific anatomical drawings, usually of excellent quality.
Letter to the Editor
Authors: Smith Arnold L.
Published: December 2021

Dr. Lindenbaum raises a point whose answer all would agree upon, namely when pneumococci or meningococci have been identified as the etiologic agent of bacterial meningitis, penicillin G is the simplest, cheapest, specific antimicrobial therapy. However, it is worth noting that in a controlled study of bacterial meningitis due to these agents ampicillin was an equivalent, albeit more expensive, alternate.
Psychosocial Aspects of Terminal Care, edited by B. Schoenberg, A. C. Carr, D. Peretz, and A. H. Kutscher. New York: Columbia University Press, 1972
Authors: Galdston Richard
Published: December 2021

Thanatology, the study of death and dying, is a medical specialty of recent establishment. Over the past two or three decades, there has been a marked increased interest in this topic and in the number of articles and books devoted to its discussion. It has been said that this development is due to a lifting of earlier taboos against public discussion and that the medical profession had been remiss in its failure to provide a more open, forthright airing of its experience with death.
Childhood in the Early Colonial Period
Authors: Bloch Harry
Published: December 2021

A great deal has been written about the life, struggles, and accomplishments of pioneer men and women who crossed the ocean to build a new world in the wilderness; but infant and child life during early colonial days is largely hidden in obscurity. Little has been recorded.1

It is known that few children under the age of 7 survived in the crowded immigrant ships: falling into the sea, accidents, hunger, thirst, and sickness took its sad toll. Nevertheless, there were many young2-5: a third of the founders of Plymouth were children; Puritan youth were evident in the great migration to the Massachusetts Bay Colony; several cargoes of poor children and orphans from Dutch almshouses were "bound out" to the burghers of New Netherlands; children were frequently dispatched from England as indentured servants and apprentices; the London Company sent 100 children to Virginia in 1619, and 1,500, kidnapped from Ireland and England, in 1627; African slave children were shipped to the colonies after 1620; and the colonial mother6 bore many children, buried many, and often followed them to the grave at an early age. Fecundity,5 characteristic of early colonists, served to people a continent (the population was 2.5 million in 1776), and provided needed child labor. Over 50% of Plymouth colony consisted of children.7

Colonial children were viewed as miniature adults; and boys and girls were dressed alike until the age of 7.1,7,8 The infant1,7 wore a long linen smock; was covered with a woolen blanket; and a wooden or wicker cradle, hooded to protect from cold draughts, much like those in which Indian babies slept, was its bed.
VINYL CHLORIDE
Authors: Miller Robert W.
Published: December 2021

A 1½-day international symposium was held in New York primarily on liver disease from heavy industrial exposure to vinyl chloride. Worldwide, 19 workers are known to have developed hepatic angiosarcoma: 13 in the United States, two in West Germany, two in Sweden, and one each in Great Britain and Norway. The interval between first vinyl chloride exposure and diagnosis was 11 to 30 years. Duration of exposure was the same-11 to 30 years.

According to a New York Times report on June 1, 1974, a review of cases of hepatic angiosarcomas in the New York and Connecticut Tumor Registries yielded two of special interest. One was a 62-year-old woman who for nearly 30 years lived four blocks (about 0.3 km) from a factory where polyvinyl chloride (PVC) was made. The other was a worker who for 30 years used PVC resin to make insulation for electrical wire. A causal relation in these cases cannot be established. They do suggest, however, the possibility (perhaps remote) that carcinogenic exposures may occur from living in the neighborhood of a vinyl chloride factory or from certain polyvinyl plastics that contain the vinyl chloride monomer.
PARACELSUS ON WHAT THE PHYSICIAN SHOULD KNOW
Authors: C. T. E.
Published: December 2021

Paracelsus (1493?-1541) was one of the most remarkable figures in medicine. He firmly opposed the humoral theory of disease championed by Galen. He was first to write on miners' diseases, to establish the relationship between cretinism and endemic goiter and to note the geographic differences in disease.

Osler said that Paracelsus was "the Luther of medicine, for when authority was paramount he stood for independent study." Paracelsus believed the physician should know the following things:

The physician should know what is useful and what is harmful to unfeeling creatures to sea monsters and fish: what is pleasing and what is hateful to animals bereft of reason; what is healthy for them and what is unhealthy. This is what we must learn about Nature. What else? The powers of magic formulas, their origin and source, their nature: who is Melusina; who the Siren is; what is permutation, transplantation and transmutation; how to grasp them and how to understand them perfectly; what surpasses nature, species, life; the nature of the visible and of the invisible, of sweet and bitter; what has a good taste; what death is; what is used by the fisherman, the leather-worker, the tanner, the dyer, the blacksmith, the wood carver; what goes into the kitchen, in the cellar, in the garden; what concerns weather, the hunter's art and the miner's trade; the life of the vagabond and the homelover, the needs of the countryside and the causes of peace; the interests of the layman and the cleric; the occupations and the nature of different states, their origin; the nature of God and of Satan, poison and antidote, feminine nature and masculine nature; the difference between women and maidens, between yellow and buff; what is white, black, scarlet and grey; the reason for multiplicity of colours, for short and for long, for success and for failure; and how to obtain all these results.1
Diagnosis of Multiple Inhalant Allergies in Children by Radioimmunoassay
Authors: Hoffman Donald R. , Haddad Zack H.
Published: December 2021

A series of 302 patients reporting immediate hypersensitivity symptoms to inhalant allergens was evaluated by both puncture skin testing and the radioallergosorbent test (RAST) using 13 common inhalant allergens. Agreement between the two tests varied from 71% to 93% for the various allergens and averaged 82%. The best correlation, 93%, was obtained with mixed grass pollen allergens. If a purified allergen, rye group I, was used the correlation rose to 97.5%. The correlation was 88% for the mold Alternaria, and the negative-sera did not become positive when tested over a wide range of dilutions. Fifty-eight percent of the patients with house dust allergy reacted to house dust mite (Dermatophagoides farinae). Correlations of 71% to 93% were obtained with ten weed and tree pollens. The only patients in whom positive RASTs were found with negative skin tests to the same antigen had either severe atopic dermatitis or decreased skin response to exogenous histamine. Sera from a group of 20 patients with positive allergy history but negative skin tests also had negative RAST. The radioallergosorbent test appears to add little information to that obtained by a comprehensive allergy history and puncture skin tests in the great majority of children with inhalant allergy. The only exceptions were children with severe atopic dermatitis, suppressed skin reactivity or dermatographism.
The Pediatrician in Community Dental Health
Authors: Leske Gary S. , Leske M. Cristina Vera
Published: December 2021

Dental disease in children is one of the most common health problems encountered.1-3 Fifty percent of children have one or more carious teeth by the age of 2 years. Gingivitis occurs in a major portion of the child population and may lead to periodontal disease, the leading cause of tooth loss in adults. Cleft palate, with or without cleft lip, occurs once in every 700 births. Half of the school-age population has some form of malocclusion. So prevalent are these problems and so great is the backlog of dental neglect, that treatment of these defects is beyond the capabilities of the limited dental manpower we have in this country. In addition, treatment is time-consuming and expensive and the costs of dental services are constantly rising. It is obvious from these facts that dental disease cannot be controlled by treatment alone. It is only by preventing the occurrence of new disease, beginning with the child, that the problem of dental disease can be brought into a manageable form.

Pediatricians are in a unique position to have a significant impact on the dental health of their patients and communities. Since the pediatrician gives care to the child from birth, he can detect any existing abnormality early in life and promptly refer or treat the problem. Control of dental disease can best be accomplished if preventive measures are started shortly after birth. It is interesting to note that few children are seen by the dentist at the recommended age of 2½ to 3 years.
JACOB A. RIIS ON CHILDREN LIVING IN TENEMENTS (1892)
Authors: C. T. E.
Published: December 2021

Jacob A. Riis (1849-1914), a Danish-American journalist and social reformer, shocked the American conscience in his book How the Other Half Lives (1890), by his exposé of the horrors of New York City slums and the abuses of lower-class urban life. The following quotation from his book, The Children of the Poor (1892) unfortunately is still applicable today-82 years later!

The tenement and the saloon, with the street that does not always divide them, form the environment that is to make or unmake the child. The influence of each of the three is bad. Together they have power to overcome the strongest resistance. But the child born under their evil spell has none such to offer. The testimony of all to whom has fallen the task of undoing as much of the harm done by them as may be, from the priest of the parish school to the chaplain of the penitentiary, agrees upon this point, that even the tough, with all his desperation, is weak rather than vicious. He promises well, he even means well; he is as downright sincere in his repentance as he was in his wrongdoing; but it doesn't prevent him from doing the very same evil deed over again the minute he is rid of restraint. He would rather be a saint than a sinner; but somehow he doesn't keep in the rôole of saint, while the police help perpetuate the memory of his wickedness. After all, he is not so very different from the rest of us.
The Fetoplacental Circulation During Parturition: Evidence From Residual Placental Blood Volume
Authors: Klebe Joachim G. , Ingomar Carl Johan
Published: December 2021

The volume of blood left in the fetal part of the placenta after early clamping of the umbilical cord (residual placental blood) was measured in 24 deliveries, and found to be larger among infants born by the vaginal route compared to those born by cesarean section. The result is interpreted as an evidence of a temporary depositing of blood in the placenta during the second stage of labor. As early clamping of the umbilical cord, therefore, among cases of vaginal deliveries, amounts to a blood-letting of about 30 ml of the newborn infant's own blood, it is considered not to be a physiological procedure. The investigation has also demonstrated that the residual placental blood, among cases of vaginally delivered and early clamped infants, fails to represent the intrauterine distribution of the fetoplacental blood volume. Finally, the investigation shows that the placental transfusion, which takes place in late clamped infants, partly originates from previously deposited fetal blood, partly from placental blood.

See table in the PDF file.

See image in the PDF file.

See image in the PDF file.
ACETAMINOPHEN POISONING—A CRITICAL COMMENT
Authors: Matthew Henry
Published: December 2021

Editor, Pharmacology for the Pediatrician:

In the December 1973 issue of Pediatrics there appeared an article attempting to summarize the British experience of acetaminophen overdosage.1 This drug has caused considerable concern in Britam, largely because, having been advocated as a substitute for salicylate,2 little thought was given when advising such change that it is more dangerous in overdose than aspirin.3 More than 30 informative papers have appeared in the British literature since 1966 on acetaminophen overdose. However, little toxicity has been reported from the United States where I understand it is usually regarded as a benign ingestion. This attitude would suggest that the diagnosis of acetaminophen overdose is being missed in patients with jaundice or severe hepatic damage of apparently unknown etiology. However, Dr. Barry Rumack, of the University of Colorado Medical Center, has pointed out to me that 68 overdosings were encountered there during the past year, with three deaths, two of adolescents.

The paper by Goulding in the December issue requires critical comment regarding some of the factual information, certain omissions, and the views expressed. His statements regarding numbers of children involved in acetaminophen and aspirin poisoning in the United Kingdom are maccurate and misleading. In the first place, his reference 3 contains no mention of admissions of children to hospital for acetaminophen overdose. Under his reference 4 he states that admissions to hospital in England and Wales for accidental aspirim overdose in children under 5 years during 1970 was "about 6,000." Consultation of the reference shows that the total number in the age group mentioned admitted for all analgesic overdose was but 626!
Letter to the Editor
Authors: Fidone George S.
Published: December 2021

I feel compelled to take serious issue with Dr. Kinsbourne's endorsement of continuous medication for the hyperkinetic child. If this practice should as a result gain wider acceptance I feel we may expect to see even more chronically intoxicated children than we do now. Having dealt with hundreds of hyperkinetic children over the past several years at this center, we are increasingly convinced that the interrupted or holiday regimen is safer and more effective. Respite from such therapy permits physiologic recovery, tends to nullify the growth retardant effect and permits the maintenance of a more normal general health status.
Letter to the Editor
Authors: Kinsbourne Marcel
Published: December 2021

Dr. Wender adapts the disease approach to school problems. The trouble with this is that one might omit first to ask whether the child is hungry, sad or poorly taught. It makes little sense to speak of specific learning disability (SLD) with deprived children. Our very tests for SLD are meaningless for them. As to whether SLD children constitute a segment of the normal distribution of abilities, we don't know, and, for predictive purposes it does not matter.
Misconceptions Regarding Grasshopper Allergy
Authors: Bergner Renée K.
Published: December 2021

The case report, "Grasshopper Allergy,"1 was of interest. However, it suggested several misleading conclusions

1. That "testing proved a definite sensitivity to grasshopper extract."1 It should be pointed out that positive immediate skin tests may perhaps present some evidence for the existence of IgE antibodies in the skin—only. Testing did not prove a cause and effect relationship between the presence of such antibodies and the patient's symptoms of hives and angioedema.2 The hives and angioedema may have been mediated by other innumerable, inhalant antigens commonly found on football fields, or by mechanisms other than antigen-IgE hypersensitivity.3