bluuebunny/crossref_metadata_2025 huggingface dataset:
Iron Fortified Formulas (Continued)*
Authors: Haddock Samuel T. , Harvey Norman A.
Published: December 2021

I had the feeling of anger and discouragement after reading the Supplement to the Newsletter of the American Academy of Pediatrics for December 15, 1970, in which the committee chaired by Dr. Lloyd J. Filer, Jr., recommended formula with iron supplement for the first 12 months of life. After reading the comments of the group, one could only wonder if Dr. Filer had worked for a milk company sometime during his pediatric career.

A few weeks later, this fear was suddenly reinforced as the representatives of several milk companies brought forth copies of the Newsletter recommending milk the first 12 months of life.
Black Tongue Moniliasis (Continued)
Authors: Dolsky Richard L. , Wolf I. J.
Published: December 2021

Under the title of "Black Tongue Moniliasis,"1 a letter was published in the December 1970 issue of Pediatrics.

The author based his diagnosis in this 5-year-old Negro boy by culturing Candida albicans from the tongue. However, culture of this organism from the oral cavity is not sufficient to warrant a diagnosis of candidiasis. Cultures obtained from the oral cavities of a normal population have been positive for Candida in 20 to 50%.2 The laboratory criterion for establishing Canada as a pathogen rather than as a saprophyte in the oral cavity is the demonstration of the mycelial and yeast forms on a direct smear mounted in 10% potassium hydroxide and not by culture.3
Unhappy Coincidence Department (Neonatal Division)
Authors: Shaw Edward B.
Published: December 2021

I trust that it was entirely fortuituous that "Neonatal Rupture of the Spleen"1 immediately followed "Renal Palpation in the Newborn."2
EPIDEMIOLOGY OF DISEASE IN ISOLATED POPULATIONS
Authors: Marks Melvin I.
Published: December 2021

What is the practical significance of epidemiological surveys in foreign populations for the understanding and practice of pediatrics in North America? Researches in distant and often exotic parts of the world actually do serve many purposes beyond an exciting adventure for the investigators. For example, the importance of herd immunity, the communicability, and the potential morbidity of measles were well illustrated in 1846, when Panum described that subsequently famous epidemic of measles which swept through the Faroe Islands1 and again in 1953, during an epidemic in Southern Greenland.2 Contrast this to the mild clinical expression of measles in a highly immunized population in Rhode Island.3
PARAINFLUENZA VIRUS IMMUNOFLUORESCENCE
Authors: Marks Melvin I. , Nagahama Hitoshi , Eller Jerry J.
Published: December 2021

The direct immunofluorescent method has been applied to the study of parainfluenza virus localization in tissue culture cells and to the rapid diagnosis of parainfluenza type 3 respiratory infections of children. After extensive testing of the conjugates for effects of fixation and specificity, 75% of parainfluenza type 3 infections were diagnosed by the fluorescent method in 100 children studied. The limitations of the fluorescent diagnostic technique including the five false-negatives and six false-positives encountered in the present study are discussed.
Adoptive Homes for "Hard to Place" Children
Authors: Wessel Morris A.
Published: December 2021

The Academy Committee statement discussing the need for finding adoptive homes for "hard to place" children1 challenges all child care professionals to support actively the increasing number of public and voluntary agencies seeking to increase their services in the area of transracial adoptions and the placement of children with physical handicaps. Adoptions of this nature require careful evaluation. This necessitates increased funding for staffs of agencies moving in this direction.
Prevention of Lead Paint—or Prevention of Pica?
Authors: Lourie Reginald S. , Wehrle Paul F.
Published: December 2021

The otherwise excellent and timely statement on acute and chronic childhood lead poisoning of the Academy's Committee on Environmental Hazards and Subcommittee on Accidental Poisoning of the Committee on Accident Prevention1 has one serious omission. After calling attention to pica as a major factor in lead poisoning in young children, this fundamental cause for most cases of plumbism is disregarded. A basic part of the problem would appear to be how it attacks the reasons why the children eat the paint on the walls in the first place.
Letterer-Siwe's Disease (Acute Disseminated Histiocytosis X), Disseminated I-V Coagulation, and Hemolytic-Uremic Syndrome
Authors: Moe Peter Johan , Mauger David C.
Published: December 2021

Will you please permit a short comment on the article: "Letterer-Siwe's Disease (Acute Disseminated Histiocytosis X). A Case Complicated by Disseminated Intravascular Coagulation and Responding to Heparin Therapy" by Dr. Mauger?1

In this article David C. Mauger gives an interesting presentation of a 17-month-old female with Letterer-Siwe's disease with skin hemorrhage and thrombocytopenia in conjunction with disseminated intravascular coagulation. It is stated in the article that disseminated intravascular coagulation has not been described in Letterer-Siwe's disease.
Mood-Altering Drugs (Continued)
Authors: Turner E. J. , Arnold L. Eugene
Published: December 2021

I read with great interest the letter by Dr. Ralph Olsen on "Pediatric Practice: Whose Mood Are We Altering?" in Pediatrics (47: 961, 1971).

Like Dr. Olsen, I too get quite a number of calls about children who are not sitting still in school, who are disturbing other children, or are not behaving according to the norm which the teacher considers to be normal for that particular child.

With the free availability of neurological consultation and brain tracings and with a population who seem to have acquired quite large but superficial medical knowledge, most of my parents do not seem to accept my statement that the child is neurologically intact.
Fetal Growth and Development, edited by Harry A. Waisman, M.D., Ph.D., and George R. Kerr, M.D. New York: McGraw-Hill, 1970, 320 pp., $17.50
Authors: Smith Clement A.
Published: December 2021

When William Windle published his Physiology of the Fetus, in 1940, he referred to Preyer's Specielle Physiologie des Embryo, published 65 years before that, as "long the only source of summarized knowledge concerning the activities of embryos and fetuses of many species." Dr. Windle then noted how "within the last decade of two" or some 40 years after Preyer, "interest has revived and a new school of developmental physiology has come into being . . . (though) . . . few biologists are aware of all that has been accomplished."
EVALUATIONS OF SAFETY PACKAGING FOR THE PROTECTION OF CHILDREN
Authors: Done Alan K. , Jung August L. , Wood M. Carol , Klauber Melville R.
Published: December 2021

The use of a crossover approach in which each of a group of packages is tested in each subject in randomized sequence has been found to give highly satisfactory evaluations of safety packagings, when data are analyzed properly, using limited numbers of children. The method is described as a model for the evaluation of safety packaging in the prevention of childhood poisoning. Its use showed the limited effectiveness of snap-type "safety caps," the significant retardant value of unit packaging, and the effectiveness of press-release types of closures in denying access of young children to the contents.
Decline in Serum Bilirubin Concentration Coincident with Clinical Onset of Kernicterus
Authors: Ackerman Bruce D. , Dyer Geraldine Y. , Taylor Paul M.
Published: December 2021

A decline in serum bilirubin level, coincident with the onset of clinical signs, occurred in 4 of 13 infants with kernicterus. Such a decline in bilirubin level carries a poor prognosis, but occurs too late to be clinically valuable as an indication for exchange transfusion.

Sources of patient material were: University of California, Irvine, College of Medicine, Pediatric department: Los Angeles County General Hospital, White Memorial Hospital, Los Angeles, Orange County Medical Center, Orange, California; and University of Pittsburgh, School of Medicine, Pediatric department: Magee-Womens Hospital, Pittsburgh, Pennsylvania.
Symptomatic Autism
Authors: L'Ecuyer Jerome L.
Published: December 2021

In "Symptomatic Autism in Childhood and Adolescence,"1 Dr. Easson describes the altered perceptions of the blind and the deaf child which might contribute to this kind of "autism." He unfortunately does not mention the probably larger group of susceptible children with this diagnosis of minimal cerebral dysfunction in which there is good sight, hearing, and autonomic function. This diagnosis may be accompanied by a normal on superior intelligence and yet because of an inability (presumably temporary) of the normal percept-concept forming cycle and/or accompanied by varied degrees of lack of sensori-neuromotor integration, he may much more often present with what Dr. Easson terms "symptomatic autism."
Confirmation of Henoch's Treatment of Encopresis
Authors: Lieberman Allan D. , Cone Thomas E.
Published: December 2021

The morning after reading Dr. T. E. Cone's article on Henoch's treatment of encopresis, (Pediatrics, 46:802, 1970), I saw a 10-year-old mildly retarded male child whose chief complaint was soiling. For the past 4 years the child had been having daily soilings following a period of several years of successful toilet training. Examination revealed an already soiled but otherwise healthy boy with normal anal sphincter and rectal examination. The child stated he just could not control himself.
The Psychiatric Disorders of Childhood, ed. 2, by Charles R. Shaw, M.D. and Alexander R. Lucas, M.D. New York: Appleton-Century-Crofts, Educational Division/Meredith Corporation, 1970, 499 pp., $12.00
Authors: Aug Robert G.
Published: December 2021

This is an excellent basic textboook of child psychiatry; written primarily for the child psychiatrist, it has much to offer the practicing pediatrician, primarily because it brings its rich array of information into a practical clinical framework. The book's strong point is its success at pulling together, into a unified framework, data from multiple different points of view. Its main weak point is its less-than-ideal updating from the First Edition (1966).

The book consists of five sections.
INTELLIGENCE AND BEHAVIORAL PATTERNS IN PATIENTS WITH COOLEY'S ANEMIA (HOMOZYGOUS BETA-THALASSEMIA); A STUDY BASED ON 138 CONSECUTIVE CASES
Authors: Logothetis John , Haritos-Fatouros Mary , Constantoulakis Mathios , Economidou Joanna , Augoustaki Olga , Loewenson Ruth B.
Published: December 2021

A study of 138 consecutive cases of Cooley's anemia (homozygons beta-thalassemia) was conducted in Greece for evaluation of their mental status. Intelligence Quotients were computed with the Wechsler Intelligence Scales (WISC and WAIS) and Porteus-maze test in 125 patients above the age of 5. The means and distributions of IQ scores revealed no significant deviation from the expected norms. Correlation with various clinical and laboratory parameters of the illness suggested relatively lower IQ scores in patients presenting more severe stigmata of the illness and in patients subjected to less vigorous transfusion programs. Abnormalities in character and behavior were noted in 96 of 138 cases. About half of the patients presented abnormal emotional responses most commonly in the direction of a depressed mood and floating anxiety.
Cornelia de Lange Syndrome: Evolution of the Phenotype
Authors: Passarge Eberhard , Mecke Sigrun , Altrogge Hans C.
Published: December 2021

A recent report described the difficulties inherent in diagnosing the Cornelia de Lange (CdL) syndrome at birth.1 The authors observed a child who at the age of 9 months was thought to have the Turner syndrome, but instead developed the well-known features of the CdL syndrome within the following year.

This paper documents our experience with a young child over a period of 2 years. Initially, at the age of 8 and 11 months, she showed some features of the cri du chat syndrome, but by the age of 21 months she had developed the classical phenotype of having the CdL syndrome.

Clinical Data
BOOK OF ACCIDENTS
Authors: Cone Thomas E.
Published: December 2021

The illustration in the lesson below shows how easy it was in 1830 for children to be burned when playing near open fireplaces. This was particularly true for girls who wore long, cotton dresses and aprons. In the 1830's, the high flammability of cotton cloth, especially when worn in the loose flowing style depicted below, must have caused many serious childhood burns.1
Expiration Date on Biologicals: Report of Dr. Katz for the Infectious Disease Committee
Authors: Katz Samuel L.
Published: December 2021

Dr. Johnson's problem1 is both real and perplexing. I am afraid the solution is not as simple as requesting that the United States "adopt similar devices" because, to my knowledge, they do not exist. Those to which he refers, used in the testing of autoclave efficacy, depend on exposure to steam for their activation. The lability to heat and light of viral vaccines and other such biologic products is much more delicate and individually variable than that and, to my knowledge, no one has yet devised suitable indicator mechanisms.
Rehabilitation after Head Injury
Authors: Cohen Herbert J. , DeVivo Darryl C. , Dodge Philip R.
Published: December 2021

While the article by De Vivo and Dodge1 on the diagnosis and management of head injury was an excellent review of this problem, I would like to take issue with their statements concerning the physical rehabilitation of the traumatized child. Though responsible professionals in the field of pediatric rehabilitation share the authors' concern about the inadequate documentation of the results claimed by proponents of "elaborate and time-consuming programs of physiotherapy" applied to post-traumatic brain damaged patients, the authors' proposed approach utilizing only range of motion exercizes "to minimize contractures and maintain muscle tone and strength" is inadequate.
Successful Treatment of Multiple Pulmonary Infarctions in Childhood
Authors: Karlin Joel M. , Hilgartner Margaret
Published: December 2021

Pulmonary thromboembolic disease in childhood had previously been a postmortem diagnosis occurring in association with congenital heart disease, sickle cell anemia, infection, and foreign bodies. This paper is the first report of multiple sterile pulmonary infarctions in a child successfully treated with anticoagulation therapy.

Case Report

D. P., a 6-year-old Caucasian male, was admitted to the New York Hospital with fever and cough of 7 days duration unresponsive to oral antibiotic therapy. He had initially presented here at age 7 weeks in congestive heart failure with a large left-to-right shunt at the ventricular level demonstrated by cardiac catheterization and angiography.
Salmonella-Infected Subdural Hematoma
Authors: Lerner Phillip I. , Goldon Patrick F. , Jane John A.
Published: December 2021

A 13-year-old girl developed persistent and progressively severe headache 4 months after partial removal of a posterior fossa astrocytoma and subtotal gastrectomy for upper intestinal hemorrhage. Antibiotics and craniotomy were required to eliminate a subdural hematoma that had become infected, sometime in the interim, with Salmonella St. Paul.
Steam Vaporizers—Therapy or Tragedy?
Authors: Barich Donald P.
Published: December 2021

Recent experience working with a burn service, developed in a large metropolitan community where no other organized unit was available, has focused our attention on factors responsible for burns in children. In a 5-month period 23 children were admitted to the hospital for treatment. Two of these were unusual because of their relationship to the use of steam vaporizers. In that the subject of steam vaporizer burns has not been discussed specifically in the American literature, the present report was prepared to alert members of the medical community to this potentially avoidable tragedy.

Case Reports

Case 1: A. S. was a 7-month-old Caucasian boy who, 2 days prior to admission, was noted to have upper respiratory symptoms.
Diagnosis of Subacute Sclerosing Panencephalitis by a Simple Spinal Fluid Gel Precipitation Test for Measles
Authors: Dietzman Dale E. , Horta-Barbosa Luiz , Krebs Helen M. , Madden David L. , Fuccillo David A. , Sever John L.
Published: December 2021

A double-diffusion gel precipitation test is described which provides an easy, rapid, and reliable procedure for assistance in the diagnosis of subacute sclerosing penencephalitis by detecting measles antibody in concentrated cerebrospinal fluid. The test is based on the precipitation of rubeola antibodies with a high titered SSPE measles-virus antigen. The sensitivity of the test is comparable to the sensitivity of rubeola complement-fixation and hemagglutination-inhibition determinations on unconcentrated spiral fluid. The method could be available to hospitals or institutions if the antigen were prepared commercially or by a national center.
Little League Football for 8- to 12-year-Olds
Authors: Klein J. M.
Published: December 2021

Has the Academy any decision on participation of 8- to 12-year-olds in Little League Football? Kindly send me what information you may have.
Letter to the Editor
Authors: Chisolm J. Julian
Published: December 2021

Dr. Scanlon's point concerning the paucity of data on fetal exposure to lead is well taken. Aside from occasional case reports in the recent medical literature, what information we have in humans is based on epidemiologic data of the adverse effects of gross occupational exposure to lead on reproductive capacity among women employed in the pottery industry almost a century ago. Reviews by Lane and Lund may be consulted: Stillbirth and spontaneous abortion were clearly increased.
Letter to the Editor
Authors: Diamond E. F.
Published: December 2021

This letter was referred to the Academy's Joint Committee on Physical Fitness, Recreation, and Sports Medicine, whose Chairman answered it as follows:

Football is a collision sport which involves the risk of injury. The degree of risk is usually related to the conditions under which practice and play are conducted and the quality of supervision affecting the participants. Unless a school or community can provide exemplary supervision-medical and educational-it should not undertake a program of collision sports at the preadolescent level.
Prognosis with X-Chromosomal Abnormalities: Neoplastic Disease
Authors: Bartuska Doris , Vardaro Linda
Published: December 2021

The report of Eller, et al. on the prognosis in newborn infants with X-chromosomal abnormalities prompts this note.

Because of our interest in cytogenetic factors in carcinogenesis, a routine buccal smear for sex chromatin is performed on all our patients with amenorrhea or irregular vaginal bleeding.

Recently a 26-year-old woman with dysmenorrhea and irregular periods was seen. She had a mass arising from the cervix which was subsequently diagnosed as an unusual exophytic type of squamous cell carcinoma.
Letter to the Editor
Authors: Robinson Arthur
Published: December 2021

The comments of Drs. Bartuska and Vardaro are of great interest and importance. We hope, of course, to follow our patients long enough to make observations on the occurrence of neoplasia in them.

If, as we suspect, virus infection and x-ray exposure are factors in the production of non-disjunction, they might represent the link with some predisposition to neoplasia.

Recent suggestions that exposure of female fetuses to stilbestrol may predispose them some 20 years later to genital carcinoma make even more pressing our plans to study sex hormone metabolism in newborn infants with a 47,XXX karyotype.
A Physical Exam—Flow Record
Authors: Weinberger Howard L. , Schneiderman Herbert , Jensen Robert
Published: December 2021

We should like to present a form developed in a University Hospital Well Child Clinic for use by medical students and house officers. This form was designed to: (a) specify a minimal data base; (b) allow easy recording of normal data; (c) allow easy scanning for abnormal findings; (d) recognize and highlight changes in physical examination which are appropriate at different ages; and (e) allow for relative efficiency in retrieval of information for the supervisor or instructor.
Letter to the Editor
Authors: Graef John W.
Published: December 2021

I have real reservations about "checklists." Not only do they save time in mechanical tasks such as writing; I'm also afraid they may produce the undesirable effect of reducing time spent in thinking. Nonetheless, it's probably useful to present such forms to stimulate thought about modes of communication in general.
The Allergic Child, by Kjell Aas, M.D. Springfield, Illinois: Charles C Thomas, 1971, 287 pp., $11.75
Authors: Mueller Harry Louis
Published: December 2021

Whether read from cover to cover or in occasional chapters as the preface suggests, it is obvious that the author has had extensive clinical experience with allergic children, which he employs to advantage with well chosen cases to illustrate his points. The book is well organized, has clear type face, and is written or translated into a readable style that is, for the most part, readily understandable, but occasionally "the fog index" rises to a level that is well above the expected capabilities of most parents.
REMARKABLE APPEARANCE OF THE WORDS "NAPOLEON EMPEREUR" IN THE EYES OF A CHILD
Authors: C. T. E.
Published: December 2021

The first volume of the Boston Medical and Surgical Journal (1828) contained the following notation, abstracted from an English medical journal.

Remarkable Appearance in the Eyes of a Child

One of the leading wonders of the day in the French capital, to which the seekers of the extraordinary have been lately attracted, has been an infant of three years of age, who was said to have the words NAPOLEON EMPEREUR very clearly marked in her eyes. Unwilling to allow this lusus to escape us, we took advantage of an opportunity afforded by the kindness of Mr. Guthrie of judging for ourselves. We confess we were before a little skeptical upon this subject. The fact is simply this: The child has light blue eyes, the irides being very strongly striated with irregular white lines which have been thought to constitute the above ominous words. In our opinion, it would require a very poetical vision, and a great deal of imagination to discover them. Some of the lines certainly resemble letters; we endeavored in vain to make out any distinct words. It is true we had no magnifying glass at hand which the mother assured us was necessary to make the letters clearly perceptible.

The French police have taken alarm and deemed it prudent to deprive the friends of various certificates which they had obtained from different persons, asserting that they could with facility decipher the much dreaded name. We remember that some years ago, the name of Napoleon was said to have been detected upon a hen egg, in good round German text.
INFANCY CELIAC DISEASE WITHOUT DIARRHEA
Authors: McNicholl Brian , Egan-Mitchell Bridget
Published: December 2021

Three infants presented at about 1 year of age with failure to thrive, anorexia, vomiting, varying degrees of constipation, but no diarrhea. They were found to have severe mucosal atrophy characteristic of celiac disease. Each infant had fecal retention on admission, none had steatorrhea, and they all thrived well on gluten-free, milk-containing diets. Other investigations, including sugar tolerance tests, mucosal lactase, and dipeptidases were confirmatory.

High IgA levels were found in each infant and low IgM in one. Although occurrence of celiac disease without diarrhea or steatorrhea is recognized in older children and adults, it must also be considered as a cause of failure to thrive in infants without these symptoms, particularly when other causes cannot be found.
RETINOPATHY AND PAPILLEDEMA IN CYANOTIC CONGENITAL HEART DISEASE
Authors: Petersen Robert A. , Rosenthal Amnon
Published: December 2021

A retinopathy consisting of dilated, tortuous retinal blood vessels and, in some patients, papilledema may occur in cyanotic congenital heart disease (CHD). Of 83 patients with cyanotic CHD examined ophthalmologically, 52 exhibited some degree of the retinopathy, and 12 had papilledema. The severity of the fundus changes was closely related to the patient's arterial oxygen saturation and hematocrit and bore no relationship to arterial Pco2, pH, central venous pressure, type of cardiac malformation, or the patient's age.
THE EFFECT OF COMPETITIVE PITCHING ON THE SHOULDERS AND ELBOWS OF PREADOLESCENT BASEBALL PLAYERS
Authors: Torg Joseph S. , M.D. Howard Pollack , Sweterlitsch Paul
Published: December 2021

With the advent of Little League Baseball there has developed an awareness of the adverse effect that excessive pitching can have on the growth areas about the shoulder and elbow of the preadolescents. The terms "Little Leaguer's Shoulder" and "Little Leaguer's Elbow" describe distinct clinical entities. In addition to reviewing these problems, an attempt has been made to identify their cause. Specifically, clinical and radiological observations made on a group of 49 preadolescent pitchers who participated in a low-competition, recreational baseball program are reported. Although the data are not conclusive, we believe our observations indicate that the preadolescent should avoid pitching in an intensely competitive situation.
GOLEMICS
Authors: Levin S.
Published: December 2021

In the legend of the golem we find the prototype of the newly born and about-to-be-born baby. Like the perinatal infant, the golem was a robot, an automaton, functioning in a decerebrate fashion. In much recent work involving the neurology of infancy, and in particular the phenomenon of imprinting, it seems that neonatal and early infantile experiences can influence subsesequent behavior for a lifetime. The behavior and experiences of infancy and their consequences might be considered a separate field of study called Gobemics.
Absent IgA Associated with Normal Chromosomes
Authors: Choi Yu Chien , Dallarie Louis , Eisen A. H.
Published: December 2021

The Norwegian population register and the closely-knit Norwegian medical community have been utilized in the past to conduct several detailed evaluations of specific disease entities. Dr. Tobias Gedde-Dahl, Jr. has utilized these same facilities to produce this extensive review of epidermolysis bullosa. The volume contains a wealth of data and a complete bibliography concerning the several entities which have as their common attributes cutaneous bulla formation and evidence of genetic transmission.

The book is written in a thesis-type format with extensive documentation and much detail.
Letter to the Editor
Authors: Marks Herman B.
Published: December 2021

I accept your invitation to comment on the letter of Dr. Ralph Olsen on "Pediatric Practice: "Whose Mood Are We Altering?" in Pediatrics1 and the responses of Dr. Turner2 and Dr. Arnold3 in Pediatrics.

Certainly, in any large group of school children, one can find a significant number of children, mostly boys, who are extremely active and who have all the associated findings of the "hyperkinetic syndrome" or the "minimal cerebral dysfunction syndrome"-the short attention span, the poor capacity to concentrate, the poorly controlled impulsivity, and so forth.
Letter to the Editor
Authors: Martin Gilbert
Published: December 2021

Pediatricians who evaluate and treat so-called "hyperactive children" may have found recent letters to the editor concerning the employment of "mood-altering drugs quite interesting." (Pediatrics, 47:961, 1971 ; 48:496, 1971) . Although in many cases a diagnosis of hyperactive child is based on historical information and soft neurologic findings, ancillary studies can often negate the need for long term medical therapy. Employing refined psychological testing may point to individual strengths and weaknesses which when approached properly can increase the self-confidence of the child and improve intellectual and behavioral problems dramatically.
Letter to the Editor
Authors: Nathenson Gerald
Published: December 2021

We agree with Dr. Rosen that bilirubin binding should be studied in newborn infants receiving parenteral diazepain. Our laboratory will be looking into this, shortly.

Nevertheless, we can reassure Dr. Rosen that the hazard of bilirubin encephalopathy in infants undergoing narcotic withdrawal, treated with diazepam, is very remote. We say this because recent work from our laboratory on bilirubin metabolism in these infants has shown a striking lack of jaundice in this group, related to induction of bilirubin glucuronyl transferase by narcotic drugs.
Foetal and Neonatal Immunology (North-Holland Research Monographs Frontiers of Biology, volume 20), by J. B. Solomon. Amsterdam/London: North-Holland Publishing Company, 1971, 381 pp., $23.00
Authors: Johnston Richard B.
Published: December 2021

Dr. Solomon is an embryologist who is active in basic immunology research. In this book, he has undertaken a study of the comparative embryology of the immune system. His main thesis is that the ability to recognize and reject foreign material develops in much the same manner and at similar physiological times in all vertebrate species. Moving up the phylogenetic scale, immunity mediated by a lymphoid system is first encountered in the hagfish. Likewise, the appearance of small lymphoyctes marks the beginning of immune development in the individual fetus.
The Basic Neurology of Speech, by Michael L. E. Espir, M.A., M.B., M.R.C.P. and F. Clifford Rose, M.B., M.R.C.P., D.C.H. Philadelphia: F. A. Davis Company, 1970, 134 pp., $7.00
Authors: Olmsted Richard W.
Published: December 2021

The Basic Neurology of Speech is an interesting book for physicians with a particular interest in speech disorders. It is well written, concise, and makes a complicated subject understandable to the relatively uninitiated. The authors cover not only the neuroanatomy of speech but also the disorders of speech which occur at all ages of life. The disorders primarily of adult life are better handled than are those which are unique to childhood perhaps, reflecting the adult orientation of the authors. This book would be of interest to some pediatricians, but not to all.
IN UTERO DETECTION OF FAMILIAL METABOLIC DISORDERS
Authors: Nadler Henry L.
Published: December 2021

Diagnostic amniocentesis for the prenatal detection of genetic disorders has been shown to be useful to the physician in monitoring high risk pregnancies.1 The paper by Schneck, et al.2 in this issue of Pediatrics demonstrates not only the effective use of this technique for clinical management of the high-risk patient but documents its potential value for the study of the early stages of human metabolic disease.

The presence of biochemical and structural alterations in cells and organs of fetuses affected with inborn errors of metabolism appears to be a common finding. Early gestational manifestations arising from the basic genetic defect have been found in Tay-Sachs disease,2-4 Niemann-Pick disease,5 Gaucher's disease,6 Pompe's disease,7 and Krabbe's disease.8
THE MEDICAL EVALUATION OF CHILDREN WITH READING PROBLEMS (DYSLEXIA)
Authors: Kenny Thomas J. , Clemmens Raymond L. , Cicci Regina , Lentz George A. , Nair Prasanna , Hudson Barbara W.
Published: December 2021

Data are presented on 92 children, ages 6 years through 12 years, referred to a diagnostic and evaluation clinic because of reading problems. All the children had IQ's of 80 or above. Results of the medical evaluation, which consisted of the history, neurological examination and electroencephalogram, failed to reveal any statistical relationship to suggest a diagnostic pattern. That the majority of the children had no more than one positive finding indicates the limited effectiveness of the medical evaluation.

See table in the PDF file

Treatment recommendations emanating from the evaluation were primarily educational, emphasizing that reading problems are pedagogic problems with the medical evaluation playing a minimal part in their diagnosis or treatment.
Mumps—A Cause of Hydrocephalus?
Authors: Bray Patrick F.
Published: December 2021

The patient reported here developed hydrocephalus insidiously secondary to aqueductal stenosis after having had mumps 20 months previously. Ours is the second example of this clinical coincidence of events. The experimental production of aqueductal stenosis in suckling hamsters infected with mumps virus by Johnson and Johnson alerted us to this possible interrelationship. Whether mumps virus is truly causal in this neurologic syndrome will depend upon serologic studies in other patients with aqueductal stenosis and the incidence of this specific type of obstructive hydrocephalus in patients who have been effectively immunized against mumps.
Letter to the Editor
Authors: Solomons Clive C.
Published: December 2021

In his letter to the Editor, Dr. Graham has requested information concerning, (i) the properties of arginine, (ii) the adequacy of controls for the inhalation and fat absorbtion studies. In answer to these questions the following can be stated: (i) the properties of arginine discussed in the paper have been documented by Clarke, E. R. and Martell, A. G., J. Inorg. Nucl. Chem., 23:911-926, 1970, and Hardel M., and Hoppe Seyl. Z.: Physiol. Chem., 346:224-228, 1966.
Utilization of Allied Health Workers: Does It Solve the Basic Problem?
Authors: Crook William G.
Published: December 2021

American physicians seem unable to meet the health care demands of all American children. As one solution, Dr. Martin Baren1 would have nonphysicians deal with some of the sick children, while pediatricians supervise development, give guidance, handle school problems, and so on.

My associates and I suggested (in an exhibit at the Academy's meeting in April, 19712) that with appropriate space, supporting personnel, systems, and management, a pediatrician can double his productivity and improve the quality of care he gives.
Procaineamide in Treatment of Ventricular Tachycardia
Authors: Fareau Gerard
Published: December 2021

I would like to call your attention to some errors in the article by Doctors Gelband, Steeg, and Bigger.1

1. In Figure 1, the electrocardiogram shows a rate of 300 per minute rather than 150. The length of the QRS complex varies between 0.04 seconds and 0.08 seconds. This clearly is not representative of ventricular tachycardia.

2. For the sake of clarity the third sentence in the caption of Figure 1 should read, "The second complex in Lead V5 is a fusion beat and shows partial atrial capture of the ventricles."
Osteomyelitis: Clinical Features, Therapeutic Considerations, and Unusual Aspects, by Francis A. Waldvogel, M.D., Gerald Medoff, M.D. and Morton N. Swartz, M.D. Springfield: Charles C Thomas, 1971, 110 pp., $8.25
Authors: Ferguson Albert B.
Published: December 2021

This book of 110 pages (including index) is clearly written. It supports standard treatment but does not shed new light on the clinical understanding of osteomyelitis. The sample of cases from the Massachusetts General Hospital files is the source of the statistical data. It is particularly weak in the infants and children's cases and reflects the danger of making clinical observations from material of this type which is often secondary in its exposure to the treating physician rather than primary.
Insect Allergy: Allergic and Toxic Reactions to Insects and Other Arthropods, by Claude Albee Frazier, M.D. St. Louis: Warren H. Green, Inc., 1969, 493 pp., $24.00
Authors: Mueller Harry Louis
Published: December 2021

The Author has assembled a great deal of detailed information about some of the anthropoda and their involvement in human pathology. The book is organized into 10 chapters, five of which cover those orders of the class insecta known to produce allergic reactions by bites or stings; but much of the subject matter concerns other types of insect pathology in man as well.

There is much repetition in the text and surprisingly, repetition of illustrations also. As an example of the latter, "infected chigger bites on the ankle" found on pages 225 and 451.
Childhood Behavior and Mental Health, by Michael Shepard, M.A., D.M., F.R.C.P., D.P.M., Bram Oppenheim, B.A., Ph.D. and Sheila Mitchell, B.Sc. (Econ.), Ph.D. New York: Grune & Stratton, Inc., 1971, 240 pp., $9.75
Authors: Friedman Stanford B.
Published: December 2021

The data contained in this provocative and challenging book raise fundamental questions of interest to any professional involved in mental health services for children. The book focuses upon a health survey of more than 6,000 school children, representing a cross-section of children within a single county in England. The sample was selected by picking out every tenth card from the school medical record cards in a manner that included children from 5 to 15 years of age.
HEXACHLOROPHENE
Authors: James L. Stanley
Published: December 2021

Yet another chemical widely used by the population has been discovered to be potentially dangerous. Hexachlorophene was first synthesized in 1939 and found to have both bactericidal and fungicidal properties, but its toxicity has only been appreciated in the last few years. Probably the most alarming aspects are that the chemical is not only neurotoxic but is also readily absorbed from the skin.

Although muscle twitching and coma were observed 3 years ago in burn patients treated with hexachlorophene, these observations were not actually responsible for the recent toxicity studies which have focused attention on this subject and raised many important questions.
INDICES OF THE CHILD'S EARLIEST ATTACHMENT TO HIS MOTHER, APPLICABLE IN ROUTINE PEDIATRIC EXAMINATION
Authors: Parens Henri
Published: December 2021

Knowledge about the psychological aspects of early child development is now a regular component of basic clinical knowledge for pediatricians. In the past 25 years this newer knowledge has become documented, refined, and translated into every-day pediatric competence. The practicing pediatrician and his academic colleagues will be as deficient without this understanding as applied in clinical care as if they were deficient in up-to-date knowledge about immunizations, adequate nutrition, or the recognition and care for the common infections and infectious diseases of childhood. Children do not grow out of developmental deviations any more than they grow out of the need for adequate nutrition. This note is a reminder, not only of all the competent care pediatricians provide, but of the risk they take for their patients when they are ambiguous or less than rigorous about the earliest signs of maternal deprivation or other causes of developmental deviation in the first year of life.

Five years after a first adoption, a middle class couple privately adopted Fay at the age of 1 month. Within weeks, the natural mother sued for the return of her child, and the case remained in litigation from within the second month of Fay's life to 16 months of age, when the court legalized the adoption.

Mrs. G., the adopting mother, cared for her child's physical and physiological needs well. However, during this entire 15 months, because she feared she might lose Fay at any point, Mrs. G. took particular pains to limit the amount of emotional contact she, her husband, and their adopted son had with Fay.
Letter to the Editor
Authors: Levison Henry , Aspin Norman
Published: December 2021

Many physicians do not accept the hypothesis put forward in Dr. Chadwick's letter but rather they still accept the statement by the Committee on Therapy regarding the treatment of cystic fibrosis. This document states, "the aim of nebulization therapy in cystic fibrosis is to deposit particles of water or water-containing medication in the bronchial tree at the site of the disease process" and further goes on to state "nebulization or aerosol therapy must not be confused with humidification."
Letter to the Editor
Authors: Wilfert Catherine M. , Katz Samuel L.
Published: December 2021

Thank you for the opportunity to reply to Dr. Marder's letter concerning the therapy of H. influenzae meningitis. The Red Book recommendations to which he refers were written in 1968 (published 1970) and list chloramphenicol or ampicillin as satisfactory.

The use of ampicillin in the therapy of childhood meningitis has become the initial treatment of choice for several reasons. First, this drug offers the advantage of a single effective antibiotic to initiate therapy before the cause of the meningitis has been definitely identified.
How Much does Improved Medical Service Affect Infant Mortality?
Authors: Gilbert Arnold
Published: December 2021

The meaning of the article by Dr. Chabot in Pediatrics, June 1971 concerning improved infant mortality between 1964 and 1968 in Denver puzzled me. I wonder whether there is any relation between the improved community health programs described and the happy results presented. Surely, many factors other than medical care affect infant mortality. For example, I wonder whether the author would suggest that the startling (to me) rise in infant mortality noted in Table II for Boston, Buffalo, Phoenix, Pittsburgh and Seattle, resulted from poorer delivery of medical care.
Trial of Therapy and Prospective Study of Nephroblastoma
Authors: Voûte P. A. , Lemerle J.
Published: December 2021

The International Society of Pediatric Oncology (ISPO) is planning a clinical therapeutic trial on nephroblastoma in Europe. Large agreement exists on the treatment of these tumors; the principal modalities are surgery, radiation therapy, and chemotherapy. However, there are some unanswered questions as to the value of different forms of administration of radiation and chemotherapy, which we feel could best be elucidated by a prospective study in the form of a clinical trial.

A trial has been going on in the United States for 2 years.
LONG-TERM EFFECTS OF NEONATAL JAUNDICE ON BRAIN FUNCTION IN CHILDREN OF LOW BIRTH WEIGHT
Authors: Crichton John U. , Dunn Henry G. , McBurney Annetta Karaa , Robertson Ann-Marie , Tredger Enid
Published: December 2021

The remote effects of neonatal jaundice were studied prospectively in three matched groups of 30 children of low birth weight with varying maximal neonatal levels of serum bilirubin. After 4 to 11 years, mean IQ scores were slightly lower in the most severely jaundiced group than in the others, and this group had a significant excess of mentally retarded children. (IQ < 70), mostly boys. However, the differences between the mean IQ scores of the three matched groups were not significant, particularly when cases with hemolytic disease of the newborn were excluded. Analysis of the discrepancy between verbal and performance scores and of various special test scores also failed to demonstrate significant differences. electroencephalographic abnormalities were slightly more frequent according to neonatal levels of serum bilirubin, but differences were not significant. Within the most severely jaundiced group, 13 infants without hemolytic disease who received an exchange transfusion, on the average regained their birth weight significantly sooner than 14 similar infants who did not have a transfusion; the ultimate mean IQ of the former group was also considerably higher than that of the latter, but the difference was not significant. Large scale studies are considered necessary to elucidate these sequelae.
GLUCOSE METABOLISM, PLASMA INSULIN, AND GROWTH HORMONE SECRETION IN NEWBORN INFANTS WITH ERYTHROBLASTOSIS FETALIS COMPARED WITH NORMAL NEWBORNS AND THOSE BORN TO DIABETIC MOTHERS
Authors: Falorni Adriano , Fracassini Francesco , Massi-Benedetti Ferdinando , Amici Augusto
Published: December 2021

Twenty-two erythroblastotic infants (IEF), 22 normal infants, and 12 infants of diabetic mothers (IDM) were studied during their first day of life. Blood glucose, plasma insulin, and growth hormone were measured in the first 90 minutes after I-V glucose injection (1 gm/kg).

Mean fasting blood glucose of normal infants was significantly higher than that of IDMs. In four IEF, blood glucose levels lower than 20 mg/100 ml were observed. No significant difference of glucose tolerance (Kt) was found among the three groups of babies.

The mean fasting plasma insulin level in IDMs was significantly higher than in control infants and in IEF.

In the IEF a significant correlation was found (A) between hemoglobin (Hb) and Kt values, (B) between Hb and fasting plasma insulin. (C) between fasting blood glucose and fasting plasma insulin, and (D) between Kt and the sum of plasma insulin levels 3, 5, and 10 minutes after I-V glucose.

All normal babies and sixteen IEF showed a double course of insulin response. IDM showed a nearly monophasic pattern, but with a secondary minor peak between 30 and 60 minutes in some. In six (four with hypoglycemia) of the IEF group a single peak response of plasma insulin was found, together with mean Kt and fasting plasma insulin values higher than those of control infants. Fasting mean HGH concentration in plasma showed no significant difference among the groups of infants. During intravenous glucose tolerance tests mean values in IDM significantly higher than in normal infants and in IEF were found at 90 minutes.
Acute Leukemia in Children: Time Spent in Hospitalization
Authors: Fernbach Donald J. , Henrich William L. , Starling Kenneth A.
Published: December 2021

Since 1958 the Hematology and Oncology Section of the Department of Pediatrics, Baylor College of Medicine, has participated in the studies of the Southwest Cancer Chemotherapy Study Group. From the beginning it was intended that this section would maintain an emphasis on ambulatory care for children with neoplastic diseases and would develop a close liaison with the practicing physician. The general purpose was to supplement the care given by the local physician rather than to assume total management of the patient. The key to the success of any such program, where virtually all patients are referred and are registered on research protocols, is to maintain close communication with the family physician at all times.
Allergy and Urinary Infections: Is There an Association?
Authors: Horesh Arthur J.
Published: December 2021

I have now been treating pediatric patients for allergy problems for 44 years and have always been interested in the association of allergy with urinary infections. Therefore the letters of Dr. Gerrard1 and his co-workers from the University of Saskatchewan and of Dr. Anne Harrison2 from Rochester, New York have interested me. In 1955 I presented a paper before the allergy section of the Academy of Pediatrics entitled Allergic Pyelitis,3 reporting two patients with recurrent urinary infections with pyuria, one cured completely with allergic management–the other's genito-urinary infection recurred, but only in ragweed season.
Faith and Religion in Healing
Authors: Frazier Claude A.
Published: December 2021

I am editing a book on the role of faith or religion in healing from a physician's standpoint. Any physician interested in contributing to this book, please write to the following address: Claude A. Frazier, M.D., 4-C Doctor's Park, Asheville, North Carolina 28801.
In Reply: Belsky's→(?Henoch's?)→Filatov's→Koplik's Spots
Authors: Corn Thomas E.
Published: December 2021

The following quotation from a recent Russian textbook of pediatrics will interest Dr. Lipman:

N. Filatov was one of the first to describe, in 1885, the prerash (prodromal stage) symptom of measles—small, red, squamative spots in the mucous membrane of the mouth; somewhat earlier this symptom was reported by a country doctor, Belsky. In the Soviet Union this symptom is known as the Filatov or Belsky-Filatov sign. The same sign was described somewhat later by an American doctor, Koplik.