bluuebunny/crossref_metadata_2025 huggingface dataset:
Take Off Your Shoes and Walk
Authors: HAGGERTY ROBERT J.
Published: December 2021

"Babies appear to have flat feet because of the thick layer of baby fat present in every infant's arch. . . ."

"Because of poor feet, countless of Americans have posture distortions, are usually fatigued and become prone to degenerative illnesses."

These two statements, taken from Dr. Wikler's book, suggest the dual aspects of this book—the eminently good, common-sense discussion on foot wear and normal development of feet and the extraordinary loose thinking about the relation of foot problems to general health.
PRESIDENT'S MESSAGE
Authors: Webb Clarence H.
Published: December 2021

TWO MAJOR facets of the pediatrician's role in practice have been presented in previous messages: as a child's specialist and as family medical advisor and counsellor. The bases of these observations, previously detailed, are the author's experiences in practice and the reported experiences of a panel of 20 of his peers from various parts of this country.

A third characteristic of the pediatrician, less frequently recognized but all-pervasive, is that of teacher. The image immediately evoked by this term is of university connection, of medical school faculty. Indeed, pediatricians are justifiably proud of the rapid rise in status of pediatric teaching from a part-time or subsidiary position in most faculties 40 years ago to the present full-time status co-equal with surgery, medicine, and obstetrics. We are further gratified by the increasingly large corps of expert pediatric teachers throughout the country. Despite the fears sometimes expressed that the sudden outpouring of funds for research—long overdue—may shift the medical school emphasis away from the primary function of instruction, the probabilities are that a balance will be struck between teaching and research. Effective pediatric instruction will be likely to continue in the medical school and residency setting.

My thought, however, is of the teaching which the practitioner of pediatrics does, which extends pediatric thought to a widening circle. The attitude of instruction is inherent in all physicians, recognized from the earliest days of medicine and reflected in the Oath of Hippocrates. The pediatrician has an extra missionary zeal because he deals with the young impressionable individual and the developing family, wherein he seeks to establish attitudes and practices which will benefit the child.
Letters to the Editor
Authors: SILVERMAN WILLIAM A.
Published: December 2021

I was saddened to read that Doctor Harvie thinks the Committee on Fetus and Newborn has contributed to creeping authoritarianism by making a specific recommendation after evaluating evidence concerning the relationship between "spacing out" and airborne infection in hospital nurseries. Moreover I think he has misinterpreted the Committee's recommendations if he believes that they have advised nurseries to place sole reliance on reducing population density in order to minimize the risk of nosocomial infections. As Doctor Harvie comments, different modes of spread may be involved in the various types of infection that can be acquired in a newborn nursery.
MALIGNANT PHEOCHROMOCYTOMA
Authors: Cone Thomas E. , Pearson Howard A.
Published: December 2021

A case of malignant pheochromocytoma during a 6-year period in a 12-year-old, obese, white girl represents the first recorded case to meet the most stringent criteria for a diagnosis of malignant pheochromocytoma, namely, that metastases occur at a site where aberrant endocrine tissue is not otherwise found, and that secretory function be proved by the presence of appropriate hormone in the metastases and their secretions. Studies of the clinical course of pheochromocytoma in children during the past decade and a half have shown that this tumor may be familial, may frequently be extraadrenal, may be recurrent, and may be malignant, as demonstrated by this case.
FACTORS AFFECTING FOOD INTAKE
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

Emotional and cultural factors are of exceptional importance in determining food intake. The deeply ingrained pattern of three meals daily may be the cultural factor most open to criticism.

In experimental animals, and probably in the human, established nutritional habits are particularly potent factors in determining food intake. Proper nutritional education in early childhood may establish patterns of food selection that will be helpful in avoiding specific deficiencies and gross excesses in later life.

Appetite may prove adequate for selection of a nutritionally acceptable diet under certain circumstances but selection of food on the basis of nutritional principles is more reliable and is to be recommended.

A knowledge of normal variations in food intake in relation to age, sex, environmental temperature, and caloric expenditure is beneficial in interpreting the feeding behavior of children. Complaints by parents that their children have "poor appetites," are commonly based on a misconception regarding normal patterns of food intake.

Vitamins, iron, and other specific nutrients act as appetite stimulants only in the presence of deficiency of the particular nutrient.
Mild-Moderate Forms of Protein-Calorie Malnutrition
Authors: FOMON SAMUEL J.
Published: December 2021

Kwashiorkor and marasmus have been the topics of a great many publications during the past several years. Incidence, clinical characteristics, differences in these characteristics from one locality to another, biochemical findings, metabolic alterations, treatment of acute and convalescent stages, and descriptions of various programs aimed at preventing severe protein-calorie malnutrition have been presented in detail. Publications specifically oriented toward the less severe but much more frequent forms of protein-calorie malnutrition have appeared comparatively rarely. There are, unfortunately, no simple biochemical on metabolic tests that aid greatly in establishing a diagnosis of mild protein-calorie malnutrition.
Reflex Testing Methods for Evaluating C. N. S. Development
Authors: BYERS R. K.
Published: December 2021

This little book, consisting mostly of illustrations of postural reflexes beginning with the most primitive and ending with some of the more complex cortical postural reflexes, is most useful from the point of view of assessing motor developmental levels. It sorts out reflexes from various levels of the central nervous system, spinal cord, brain stem, midbrain, and cortex; and points out that the automatisms of the first two groups are by themselves insufficient for any type of upright posture.
ETIOLOGY OF RESPIRATORY INFECTIONS
Authors: Wulff Herta , Kidd Patricia , Wenner Herbert A.
Published: December 2021

Sixty viruses were recovered from 58 of 114 infants and children ill of respiratory infections. Two outbreaks, one caused by RS and the other by influenza B viruses, occurred during the study period. RS and influenza B viruses totaled 55% of the virus yield. Other viruses recovered were parainfluenza types 1, 2 and 3 (14 strains), reovirus, type 1 (5 strains), adenovirus (5 strains), and mumps (1 strain). Two viruses were lost and remain unidentified.

Good correlation was obtained between viruses and development of specific antibody. A small fraction of infants had dual virus infections; heterotypic antibody responses were observed in 20% of the patients. These were considered to represent in part successive infections with specific viruses.

Fourteen of 18 RS viruses, 6 influenza, and all except one of the parainfluenza viruses (type 3) were associated with laryngotracheobronchitis, bronchiolitis, and pneumonia. None was associated with any single clinical category. RS was associated more often with pneumonia than bronchiolitis; influenza B was associated less often with these than with upper respiratory infection.

Analysis of virus-positive and virus-negative subgroups for bacterial "pathogens" and leukocytosis indicated that pneumonia of virus-negative infants was very likely bacterial in origin. Evidence was also obtained of concurrent bacterial infection in a fraction of patients yielding viruses.
ASSESSMENT OF THREE METHODS FOR MEASURING INTESTINAL FAT ABSORPTION IN INFANTS AND CHILDREN
Authors: Goldbloom Richard B. , Blake Roy M.
Published: December 2021

Intestinal fat absorption has been measured in 22 infants and children with various forms of steatorrhea or growth failure, using four different techniques. Vitamin A absorption, I131-triolein absorption, butterfat absorption (as measured by alteration in serum turbidity), and 4-day fecal fat balance. The last of these was used as the reference standard, expressed both as gm/ day and as percentage of intake excreted over the 4-day period.

The measurement of Vitamin A absorption was unreliable as an index of the intestinal handling of lipid. I131-triolein absorption correlated well with fecal fat output, expressed as gm/day. A close relationship both to fecal fat balance and to quantitative daily excretion was attained by results of the serum turbidity method for butterfat absorption. The simplicity and special advantages of this technique are described.
Bloody Diarrhea in the Newborn Infant of a Mother with Ulcerative Colitis
Authors: AVERY GORDON B. , HARKNESS MARY
Published: December 2021

A case is presented of self-limited bloody diarrhea suggesting ulcerative colitis in the immediate newborn period of an infant born to a mother with ulcerative colitis during pregnancy. The question is raised whether the transplacental passage of antibodies against the colon might be a possible mechanism for this association.
Emotional Problems of Adolescents
Authors: HEALD FELIX P.
Published: December 2021

This book discusses some of the common emotional problems of adolescents. There is no attempt or intent on the part of the authors to create a textbook for the serious professional student. Instead, the authors have taken some of the common problems encountered with this age group and which are familiar to those who come in frequent contact with adolescents such as parents, teachers, counselors or physicians. These behavioral crises are examined in a manner which enables the non-professional person to achieve some degree of understanding of the particular symptom or behavioral problem under discussion.
Possible Idosyncrasy to Belladonna, Phenobarbital, or Paregoric
Authors: COHEN GEORGE J.
Published: December 2021

With the thought that an unusual response to a common drug might be of interest, the following case is briefly reported.

A two-month-old girl with diarrhea for three days was given two teaspoons (as one dose) of Donnagel-PG; this dose contains the equivalent of 2 ml of paregoric, 0.0344 mg of hyoscyamine sulfate, 0.0063 mg of atropine sulfate, 0.0021 mg of hyoscine hydrobromide, and 5.4 mg of phenobarbital. Ten minutes later, because she became stiff and held her head to the left she was taken to the emergency room of a nearby hospital.
BILATERAL VAGOTOMY AND PULMONARY HYALINE MEMBRANE FORMATION
Authors: Milley Paul S. , Casarett Louis J.
Published: December 2021

Bilateral midcervical vagotomy in adult and newborn rabbits results in the formation of pulmonary hyaline membranes similar to those observed in newborn infants dying of the respiratory distress syndrome. There are, however, important differences in the histopathology of the two conditions. Twenty adult rabbits survived unilateral right-sided cervical vagotomy for 30 days, but the majority died with hyaline membranes soon after the remaining left vagus was cut. Survival times were generally longer in animals in which the right recurrent laryngeal nerve was intact. Bilateral recurrent laryngeal nerve section resulted in death and pulmonary edema, but no hyaline membrane formation. Ten rabbits survived section of distal vagal fibers. Subsequent recurrent nerve section in 5 of these resulted in hyaline membrane formation not seen in sacrificed controls. Vagotomy-induced hyaline membrane formation appears to depend on loss of both recurrent laryngeal and distal vagal fibers, the former being more important. While there may be no relationship between experimental vagotomy and the respiratory distress syndrome, these experiments raise the possibility of an upper airway disorder in the clinical disease.
A Handbook on Diseases of Children Including Dietetics and the Common Fevers
Authors: GERRARD J. W.
Published: December 2021

Handbooks are popular with the student, if only because they help him to coven the subject of his study relatively quickly; they are of little value to the intern, to the practitioner, or to the embryonic pediatrician, for these all need books with more substance to them. This little handbook is eminently readable, and on this account may be popular with the student; it cannot, however, be recommended, for its pages still pulsate with anachronisms that were once popular with a past generation of teachers.
The Changing face of Childhood
Authors: CONE THOMAS E.
Published: December 2021

Every so often one unexpectedly comes across a book which is so charmingly written and illustrated that one wishes everyone else could enjoy it too. This beautifully illustrated and skillfully narrated volume is just such a book.

The author has deftly selected over 150 illustrations ranging from prehistoric paintings to those of the present which show children at play, in school, at prayer, in the streets and at home; the pictures tell so much about the activities, the games they played, the toys and pets they loved, the food they ate, the books they read, the clothes they wore, and how they were taught.
FIRST WHITE HOUSE CONFERENCE ON HEALTH
Authors: BATES TALCOTT
Published: December 2021

ON November third and fourth of 1965 some 850 persons gathered in Washington, D.C., for the first White House Conference on Health. Here are some impressions which might interest and concern pediatricians.

Pediatricians and other practitioners from all parts of the country attended, with medical educators, representatives of the broadest possible array of medical personnel, and lay persons. Representation of governmental agencies ranged from the Mayor of Unalakleet, Alaska, population 574, to the Secretary of State.

To observe the dialogue between medicine and government, perhaps 100 or more persons from governmental agencies attended as observers. Pediatrics was well represented, although it was not always easy to spot pediatricians—they attended among many roles as medical school deans, family planners, and public servants at all levels, from "Bill" Stewart, the Surgeon General, and Harry Towsley, retiring Academy president, on down. A versatile lot.
A DOUBLE BLIND STUDY ON THE EFFECTS OF CORTICOSTEROIDS IN THE TREATMENT OF BRONCHIOLITIS
Authors: Dabbous Ibrahim A. , Tkachyk John S. , Stamm Stanley J.
Published: December 2021

Under the conditions of the study outlined above, 22 patients with bronchiolitis treated with corticosteroids did not show any statistically significant difference from an equal number of patients treated with a placebo. This included hospital course, 2-week or 4-week follow-up, as judged by clinical, radiological, and biochemical means. There was no evidence that the patients on steroids had a less favorable course or outcome. There were no complications or deaths in the entire study. The use of uniform criteriae for diagnosis and follow-up of these patients is discussed. A bronchiolitis scoring system is suggested.
Increased Fontanelle Tension as Early Sign of Cardiac Failure
Authors: SILVER WALTER , GOLDENBERG LEON
Published: December 2021

We have recently noted that an increase in tension of the anterior fontanelle has preceded the usual signs and symptoms of cardiac failure in infancy.

After reviewing the standard pediatric and cardiology textbooks and pertinent literature, we have found that this physical finding is not listed as a sign of heart failure in infancy.

CASE 1: A newborn with dextrocardia (without situs inversus) had shown cyanosis, when oxygen was not administered, and tachypnea since birth.
UNPROVEN METHODS OF TREATMENT
Authors: MASLAND RICHARD L.
Published: December 2021

NOT INFREQUENTLY, within the field of medicine, we encounter situations where a form of therapy which many knowledgeable scientists consider valueless, is reported to give dramatically beneficial results, and is observed to achieve wide public acclaim. Certainly, it is well recognized that especially when one is dealing with conditions termed "hopeless" the victims and their relatives will seize upon any form of therapy whose proponents claim beneficial results.

Recently, there have been recommended various unconventional treatments for children and adults suffering from congenital or acquired brain dysfunction. The wide and reportedly uncritical acceptance of such treatments has been a cause of some concern, and it is therefore important to be aware of certain special factors which may operate in this particular area of medicine.
CEREBRAL LIPIDS IN PHENYLKETONURIA
Authors: Menkes John H.
Published: December 2021

The lipid fraction of cerebral grey and white matter from three phenylketonuric patients was examined chemically. Total lipid and phospholipid content fell within the range of normal. Cholesterol was slightly decreased in two of the three cases. Lipid hexose was low in all three specimens of white matter, and the concentration of pure cerebroside was at or beyond the lower limit of normal in the three patients.

The molecular composition of cerebrosides and sulfatides was examined in all three cases. The structure of cerebrosides was normal in two cases. In one brain, the quantity of kerasin was decreased and its major component was an iso-C24 branchedchain fatty acid of unknown structure. An analogous reduction of kerasin sulfate was observed in all three brains. It has been postulated that a relative deficiency of non-hydroxy fatty acids in the glycolipid fraction, particularly in sulfatides, may represent one of the consistent defects in the chemical structure of phenylketonuric white matter.
STUDIES ON HYALINE MEMBRANE DISEASE
Authors: Weintraub David H. , Ambrus Clara M. , Ambrus Julian L.
Published: December 2021

In a group of 60 infants treated on a double-blind basis with placebo- or urokinase- activated human plasmin, clinical and laboratory data were analyzed in order to evaluate their diagnostic and prognostic value. Blood samples for laboratory studies were obtained at the time of final diagnosis and initiation of treatment, 4 hours later, and at additional time intervals if necessary.

Respiratory rate and its changes during the first 4 hours appeared to be of little diagnostic or prognostic value.

Chest x-rays alone did not appear to be useful in establishing diagnosis during the first 4 hours of life. In older infants, however, high diagnostic accuracy was obtained. Positive findings were generally dependable, but false negatives occurred in half of the cases. Improvement during serial x-ray examinations was a good prognostic sign but negative findings turning to positive ones were followed by survival in only one of two cases.

Initial pH and pCO2 values varied widely. Changes in these parameters appeared to be of prognostic value in the placebo-treated infants but not in the urokinase-activated plasmin-treated group. In the latter, improvement in pH and pCO2, apparently due to increased respiratory gas exchange, was not sufficient to result in survival of the patient in the presence of additional pathology (e.g., pulmonary or intracranial hemorrhage, pneumonia). Generally, pH appeared to be a more sensitive predictive parameter than pCO2.

Potassium levels and their changes during the first 4 hours were of no diagnostic or prognostic significance.
THE EFFECTS OF MILK SOLUTE ON URINARY CAST EXCRETION IN PREMATURE INFANTS
Authors: McCann Michael L. , Schwartz Robert
Published: December 2021

Low-birth-weight premature infants who were fed a high solute formula excreted large numbers of coarse, granular casts in a dilute urine. Urine cultures were sterile. Cast formation appeared to be related to the degree of prematurity, the duration of feeding and the total solute intake. Substitution of a lower solute intake resulted in the cessation of cast excretion and resolution of the clinical and chemical derangement.
Youth and the Hazards of Affluence
Authors: CONE MARY C.
Published: December 2021

To this reviewer Youth and the Hazards of Affluence is an excellent attempt to explain the difficulties, anxieties, and the frequently disturbing emotional manifestations of youth. Dr. Blaine apparently wishes to include in his reading public adults as teachers, parents, and administrators, as well as the young person himself. The genuine concern that illuminates this book would not be wasted on the average self-conscious, narcissistic youth. Dr. Blaine has gone well beyond the average adult in trying to understand and help the young person.
Tryptic and Chymotryptic Activity of Stools of Newborn Infants
Authors: MULLINGER MARGARET , PALASI MILAGROS
Published: December 2021

Pancreatic exocrine functional capacity may be measured directly by collection and evaluation of duodenal aspirate. Pancreatic drainage is time consuming, uncomfortable for the patient, and presents difficulties in obtaining all of the duodenal secretion separated from gastric juice over specified time periods. It is particularly difficult in neonates because of their size. The development of specific substrates for trypsin and chymotrypsin has made possible the accurate measurement of these enzymes in the stools. [SEE TABLE I IN SOURCE PDF].

As part of a long term study of pancreatic activity in children with cystic fibrosis, a study of fresh spot stool specimens obtained from healthy newborn infants was undertaken, with a view to establishing normal values as a tool in the early diagnosis of cystic fibrosis.
The Importance of an Evaluation Laboratory to a Pediatric Department and the Pediatric Community
Authors: THELANDER H. E.
Published: December 2021

For the past 14 years a center for evaluating, counseling, and proper placement of children with handicaps has been conducted at Children's Hospital in San Francisco. This type of facility is as essential to the modern pediatric department as is the clinical laboratory. It can be organized in very much the same manner as the clinical laboratory. There should be a pediatrician in charge who is responsible for coordinating the paramedical services. The essential non-medical personnel are:
V. ADDENDUM—STATEMENT OF POLICY BY THE AMERICAN BOARD OF PEDIATRICS
Authors: DAY RICHARD L.
Published: December 2021

FOLLOWING the deliberations of the Institute and the formal presentation to the Academy of Pediatrics of the report of the PREP Committee, the American Board of Pediatrics has considered at some length the several recommendations made and has formulated new policies to govern the admission of candidates to its examinations. Pending the revision of its booklet of standards, the Board has sent the letter displayed below to all directors of pediatric training programs. Recommendations of the Institute pertaining to changes in the type of examinations and to the evaluation of programs are still under study.

To directors of pediatric training programs:

The American Board of Pediatrics has made the following changes in the training requirements for admission to examination. These changes are designed to provide a greater flexibility in the manner through which the requirements may be fulfilled.

The core of pediatric training is a period of two years spent in intensive, closely supervised work with both sick and well children in a hospital setting. Thereafter, the Board feels that pediatric training may properly take different paths.

A total of three years of hospital work is required, one of which must be an approved internship. However, the Board strongly recommends that if the internship is other than a straight pediatric internship, a full three years of training in pediatrics be secured.

The examination may be taken five years after graduation from medical school. In addition to the three years of internship and residency, two years are assigned to the practice of pediatrics or its equivalent.
SMALL-FOR-DATES NEONATES
Authors: North A. Frederick
Published: December 2021

Records of 762 infants weighing less than 2,500 gm at birth and born after 37 to 44 weeks' gestation—small-for-dates neonates—were compared with records of infants with similar birth weight born after 28 to 32 weeks' gestation—pre-term infants—and with records of infants weighing 3,000 to 3,500 gm born after 37 to 44 weeks' gestation—"average" infants. Records were compared with regard to maternal and gestational features, perinatal survival, and neonatal complications. The group of small-for-dates neonates differed markedly from the pre-term infants in 15 of the 35 variables examined and from the "average" infants in 31 of the 35 variables examined.

Small-for-dates infants showed a higher incidence of maternal toxemia and hypertension, a greater incidence of primiparous mothers, a lower incidence of gestational bleeding, a lower incidence of low-birth-weight siblings, fewer neonatal complications and deaths, and a lower incidence of hemolytic disease and pulmonary disease in the newborn period than did weight-matched pre-term controls.

Gestational age, though subject to error in measurement, is as important a predictor of neonatal clinical status and outcome as is birth weight. Future studies of the antecedent conditions, neonatal course, and longterm outcome of low-birth-weight infants must consider both birth weight and gestational age.
HUMAN PLACENTAL LIPID METABOLISM
Authors: Robertson Alex. , Sprecher Howard
Published: December 2021

The arterial circulation of human placentas was perfused to remove fetal erythrocytes. This perfused tissue as well as amnion and chorion laeve were homogenized and incubated with C14 oleic acid and lysolecithin to demonstrate the activity of acyl GPC acyltransferase. This enzymatic activity was present in all three tissues. These results allow the speculation that placental enzymatic activity may influence maternal and fetal lipid patterns.
HEPATOSPLENOMEGALY AND HEART DISEASE IN THE CONGENITAL RUBELLA SYNDROME
Authors: Jeresaty Robert M. , Russell William
Published: December 2021

Hepatomegaly, observed in 8 infants with congenital heart disease and the rubella syndrome, failed to respond to digitalization and/or division of a patent ductus arteriosus in five of the eight infants. Hepatomegaly was accompanied by splenomegaly in seven infants and by purpura in two. Such manifestations may be erroneously diagnosed as evidences of heart failure. It should, therefore, be noted that the hepatomegaly of the rubella syndrome (unlike that from circulatory failure) is present at birth and non-progressive, is unresponsive to digitalis, diuretics, and curative surgery, and is usually accompanied by splenomegaly and often by purpura.

The possibility of infection of the fetus by prepartum maternal rubella and of postnatal cardiovascular damage by the rubella virus were suggested by two infants studied.
THE INCIDENCE OF CIGARETTE SMOKING BY BOYS IN ENGLAND MORE THAN 60 YEARS AGO
Authors: C. T. E.
Published: December 2021

In the first volume of The British journal of Children's Diseases published in 1904 the following editorial comments were made about cigarette smoking by boys:

CIGARETTE SMOKING BY BOYS—This subject has continued to be a topic in some of the daily papers. According to one of them, a schoolmaster who has a class of seventy-one boys between the ages of eight and thirteen asked those who smoked to stand on the forms. Sixty-seven stood up, and the four who remained seated "were looked at with suspicion." This seems to us rather a large percentage, and if the four who remained seated were justly "looked at with suspicion," we can hardly help thinking that some who stood on the forms feared ironical jeers from their schoolmates if they classed themselves with the "behind-the-times" non-smokers more than they did a lecture from the schoolmaster if they associated themselves with the smokers. There can be little doubt that it is not the pleasure of smoking, but the idea that it is grand or manly that leads the majority of boys who smoke to indulge in the practice. Even with many adults it is not the flavour of the tobacco or any soothing effect upon the mind that is the explanation of their use of the pipe or the cigarette. It is one means of affording relief to a nervous craving a man may have when he is idle for something to do, if it is only for something to handle with his. fingers. A cigarette to a man is what knitting-pins. are to many women.

Save for the quaint comment about knitting-pins taking the place of a cigarette for women, could not this same editorial be written today? Once again plus ça change, plus c'est la même chose!
The Pediatrician's Ophthalmology, a collaborative effort of several authors
Authors: ROBB RICHARD M.
Published: December 2021

This book, the product of the combined effort of 25 contributors, is written primarily for the pediatrician and the general practitioner. It should not be judged by how well it covers new and sophisticated aspects of ophthalomology, but by its success in presenting sound discussions of ophthalmic problems seen in pediatric practice. The editors rightly point out that a school eye examination should no longer be considered an adequate means of uncovering structural or functional abnormalities in the eyes of children.
NATIONAL NUTRITIONAL SURVEY OF PRESCHOOL CHILDREN
Authors: LOWE CHARLES U.
Published: December 2021

IN THE past year, several commentaries in Pediatrics have directed the attention of readers to problems confronting the medical community in general and the pediatrician in particular. The first step toward dealing with one of these problems, malnutrition in certain segments of the American population, has been taken. The Children's Bureau has announced the funding of a nutrition survey of the preschool children of the United States.

It was suggested at the First White House Conference on Health that American medicine, while the best in the world, is poorly distributed. Many of the poor in our cities and in a number of rural districts get medical care which is inadequate in both quantity and in quality.
GROUP B, COXSACKIE VIRUS INFECTION IN INFANTS WITH ACUTE LOWER RESPIRATORY DISEASE
Authors: Eckert Herbert L. , Portnoy Bernard , Salvatore Margaret A. , Ressler Ronald
Published: December 2021

The clinical, clinical laboratory, and viral aspects of 12 infants with acute, lower respiratory disease associated with group B, Coxsackie virus infection and/or isolation have been described. The prevalence of group B, Coxsackie virus infection was significantly greater among infants with lower respiratory disease than in infants without disease. Although a definite etiologic association could not be made because of the presence of concomitant infections with other viral agents, it was concluded that the group B, Coxsackie viruses might ultimately be added to the list of agents responsible for lower respiratory disease in infancy.
ALDOSTERONE SECRETION RATES IN NORMAL SUBJECTS FROM INFANCY TO ADULTHOOD
Authors: Weldon Virginia V. , Kowarski Avinoam , Migeon Claude J.
Published: December 2021

Aldosterone secretion rates (ASR) were determined in 46 normal infants and children and in 15 normal adults. The values obtained in all subjects over 1 week of age had an overall mean of 81 µg/24 hours with a range of 25 to 162 µg/24 hours. In the group of subjects whose surface area was less than 0.8 M2, there was a significant correlation between ASR and body surface area. However, the ASH's of the adults were not statistically different from the olden infants and children, reflecting the great overlapping of values in the various age groups. The ASR's of the seven infants were significantly lower than those of the other subjects (mean = 23 µg/24 hours). The response to low sodium intake in 12 infants and young children was similar to that observed in adults. When the values for the excretion of the 3-oxoconjugate were compared to the secretion rates, a significant correlation was obtained but certain individual subjects deviated markedly from the average. The importance of determining the ASR rather than depending on excretion of a metabolic product to evaluate adrenal function is discussed.
Letters to the Editor
Authors: SILVERMAN WILLIAM A.
Published: December 2021

I wrote "...rights of parents ... are in no way abrogated when they place reliance in the judgement of the `physician-friend' to make all medical decisions...." Mr. Hershey apparently (and, if so, mistakenly) took this to mean suspension of the normal dialogue between personal physician and parents. He must surely understand that in making every day medical decisions, physicians are fully aware of the need for full discussions with parents when any unusual procedure is contemplated for a child.
BCG VACCINATION IN SWEDEN
Authors: LUNDQUIST JOHN
Published: December 2021

It may without exaggeration be said that BCG vaccination is popular among the Swedish population and there has been registered no reaction against it, similar to that resistance which occasionally is asserted against smallpox vaccination.
ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY (BLAND-WHITE-GARLAND SYNDROME)
Authors: GASUL BENJAMIN M. , LOEFFLER ERNST
Published: December 2021

The anomalous origin of the left coronary artery from the pulmonary artery is a definite pathologic and clinical entity. A review of the literature reveals 22 reported cases. Four additional cases are presented. Additional considerations explaining observations ions in this syndrome and a suggestion for the possible treatment of this malformation are presented.
TRENDS
Authors: TENNEY H. KENT
Published: December 2021

AS OF present date the states listed below have published reports of the study of child health services. Most of the other states are known to have reports in various stages of preparation.[SEE THE TABLE IN SOURCE PDF]

It is timely to note some of the steps being taken to activate the recommendations of these state reports. The following communication from Dr. Tenney, State Chairman for Wisconsin, is one example of significant progress being made at the state level:

DEAR DR. HUBBARD:

As a first step in activating the findings and recommendations of the Wisconsin Study of Child Health Services, the committee decided to inaugurate the plan of "roving residents." The theory and scope of the project is well set forth in a letter which Mr. Roy T. Ragatz, assistant secretary of the State Medical Society, sent to the officers of the county societies selected as trial areas. He states:

"The Committee on Maternal and Child Health of the State Medical Society, in cooperation with the State Board of Health and the Pediatric Departments of our two medical schools, has been working on a program which we feel will be of great service to your members if properly introduced and adequately supervised.

"It has been proposed that a carefully selected number of pediatric residents be made available to selected county medical societies for a short period of time this spring to work with individual members who have special pediatric problems they wish discussed. The plan is to supply this service only upon the invitation of the county medical society and it is to be set up in such a way that there will be no conflict with private practice or the normal channels of consultation.
Pediatric and Adolescent Gynecology
Authors: STURGIS SOMERS H.
Published: December 2021

Pediatrics and gynecology have developed as separate disciplines, each requiring its own specialized training for Board qualification. There is no uniformly recognized age limit to pediatric care; relatively few pediatricians feel properly trained to handle menstrual disorders in adolescents. Gynecologic disturbances in young girls are managed, for the most part, by the mother's obstetrician and he, also, may have little experience in developmental sexual abnormalities.
Letters to the Editor
Authors: HOLDAWAY DAVID , GARDNER PHILLIP S.
Published: December 2021

We appreciate Dr. Horowitz's helpful criticisms of our paper and we agree that the differential diagnosis of wheezing in the young child can be difficult. That a disease corresponding to our descriptive definition exists, is increasingly called acute bronchiolitis, predominantly affects children under 2, and in at least two out of three children is related to virus (mainly respiratory syncytial virus) infection, is in our view, beyond question.

The difficulty lies in the interpretation of the word asthma.
The Pediatric Emergency Bed Service of Brooklyn
Authors:   UNIVERSITY COMMITTEE FOR CHILD CARE IN BROOKLYN
Published: December 2021

A computer-based system for equitable distribution of pediatric inpatients among nine major hospitals in Brooklyn is described. In the first year of operation it has efficiently resolved the problem of overcrowding of city hospitals and underutilization of voluntary hospitals.
Transcultural Psychiatry (CIBA Foundation Symposium)
Authors: WOLFF PETER H.
Published: December 2021

It is hard enough for psychiatrists to agree on the diagnosis of a single case when they share the same language and cultural values with their patient, and share the same range of clinical data and theoretical assumptions with their colleagues. If, however, psychiatrists step out of their clinical roles to collaborate with anthropologists, who have a different intellectual tradition, in order to investigate the patterns of mental illness among groups of people in foreign cultures, consensus on the incidence, distribution, etiology, and disposition of mental aberrations becomes incomparably harder.
Inborn Disorders of Sphingolipid Metabolism, edited by S. M. Aronson, and B. W. Volk. Oxford: Pergamon Press, 1967, 513 pp., $20.00
Authors: Crocker Allen C.
Published: December 2021

Brooklyn was where the action was (October 25 and 26, 1965), and now the substance of this redoubtable happening has appeared in book form. For the third time (previously in 1958 and 1961), Doctors Bruno Volk and Stanley Aronson have provided intelligent leadership for an "International Symposium on the Cerebral Sphingolipidoses," sponsored by the Jewish Chronic Disease Hospital and the Downstate Medical Center. Because of publishing difficulties, and through no fault of the editors, the appearance of the printed record in book form required 19 months, but this has not proven to be a serious handicap considering the present value of the publication.
Letters to the Editor
Authors: Sinclair John C.
Published: December 2021

Professor Burmeister, in dealing with problems of relative growth, uses equations of the form Y = a Xh, as proposed by Huxley. Values for the exponent b, in equations of this form, indicate the rate of accretion of the part (organ, chemical constituent, body compartment, metabolic function) in relation to the whole. Values for b of less than one indicate a relatively lesser rate of accretion of the part

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e.g., our exponent for extracellular fluid, b = 0.80 (Table II of Burmeister's reference 5); values of greater than one indicate a relatively greater rate of accretion of the part–e.g., Burmeister's exponents for total body potassium, 1.09, and for cell mass, 1.11, and ours for resting oxygen consumption, 1.22, and for fat, 2.18 (Table II of Burmeister's reference 5).
Management of Emotional Disorders in Pediatric Practice, by Jerome L. Schulman, M.D. Chicago: Year Book Medical Publishers, Inc., 1967, 307 pp., $9.50
Authors: Meeks John E.
Published: December 2021

It is difficult to write a useful book for practicing pediatricians on the management of emotional disorders. After all, the average pediatrician sees an unbelievable spectrum of children with unsatisfactory patterns of personality maturation. He often is forced to rush into family situations where angelic child psychiatrists would fear to tread–even after being armed with a cautious and complete evaluation. He often does this, as Dr. Schulman points out, without an inner conviction of his competence even to assess the Problem.
GLYCOLYSIS: STUDIES RELEVANT TO FETAL AND NEONATAL PEDIATRICS
Authors: Villee Claude A.
Published: December 2021

The problem of whether fetal tissues differ either qualitatively or quantitatively in their metabolic properties from adult tissues, and in particular whether they are able to obtain energy more efficiently under hypoxic conditions, has been investigated and discussed in a host of papers and symposia. The question of whether the mammalian fetus normally develops under hypoxic conditions has also been discussed extensively. Many observations relating to these questions have been made using rat or rabbit fetuses and sheep or goat fetuses. In these animals, observations can be made over the entire span of fetal life, but the characteristics of the placentas of these mammals differ in many respects from those of the human placenta and the pattern of development of enzymes in these fetuses is significantly different from the comparable pattern in human tissues.
Letters to the Editor
Authors: Patel B. M.
Published: December 2021

The diagnosis of drug eruption frequently poses a challenge. It becomes all the more difficult when there is an epidemic illness with a considerable number of patients having a similar exanthem, as Dr. Wolf reports. Even though four of his patients (who were all girls) received ampicillin, I doubt if these could be drug rashes since those without drugs also had similar rash. .Also, during this time, there were 56 other cases reported with a similar rash.
LETTER To THE EDITOR
Authors: Pryles Charles V.
Published: December 2021

I have just read the article by Drs. Young, Haddow, and Klein (Pediatrics, 41:516, 1968) which purportedly attests to the "failure of ampicillin to eradicate Hemophilus influenzae infection."

The authors should add to their Table II, which lists "Factors Responsible for Failure to Eradicate Organisms Following Treatment of Acute Bacterial Meningitis," the omitted factor of inadequate duration of treatment. The lingering fever through the eleventh day of therapy is admitted by the authors, in a gross understatement, as possibly being a "reflection of continuing infection and an indication for continuing treatment longer than the 14 day course." Indeed!
NORMAL DISTRIBUTIONS OF AMINO ACIDS IN BODY FLUIDS
Authors: Scriver Charles R.
Published: December 2021

Great significance is often attached to the detection of an abnormal accumulation of an amino acid in the body fluids of a patient, for this can be the manifestation of an amino-acidopathv. Screening programs designed to discover latent hereditary metabolic disease are frequently dependent on their ability to discriminate a single sample showing an abnormal concentration of a metabolite from the many thousands of normal samples. It is tacitly assumed in such circumstances that we know what is "normal."

To achieve an understanding of the normal distribution of amino acids in physiological fluids of man has required much time and great effort. An earlier Commentary1 described this well.
MEDICAL AND SURGICAL MANAGEMENT OF ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY
Authors: Nora James J. , McNamara Dan G. , Hallman Grady L. , Sommerville Robert J. , Cooley Denton A.
Published: December 2021

A definitive program for the medical and surgical management of anomalous left coronary artery arising from the pulmonary artery is proposed based on experience with 10 infants and children with this diagnosis seen at Texas Children's Hospital. The 10 patients have been evaluated by history, physical examination, electrocardiography, vectorcardiography, cardiac catheterization, and selective angiocardiography. Although the mortality is reported to be 80% in patients with evidence of infarction, symptoms in infancy, and absence of a systolic-diastolic murmur, a more encouraging mortality of only 20% was found in this study. Medical management of the congestive heart failure is the only treatment so far offered to three patients. Three early patients have had ligation of the left coronary artery; two of these patients died postoperatively. Four recent patients have had definitive surgical correction of the anomaly by separation of the coronary artery from the pulmonary artery and anastomosis to the aorta. All of these patients have survived, and three have postoperative angiographic demonstration of a functioning two-coronary artery system. Because definitive surgical therapy is now possible, the authors feel that medical management until an age suitable for graft anastomosis of the anomalous vessel to the aorta is the treatment of choice with the lowest mortality in infancy and childhood and the most satisfactory long-term outlook.
A HYMN FOR A DYING CHILD AS MEMORIZED BY MANY NEW ENGLAND CHILDREN A CENTURY AND A HALF AGO
Authors: C. T. E.
Published: December 2021

One of the most widely read children's books in the early days of our Republic was Ann and Jane Taylor's Hymns for Infants Minds. By our standards the hymns seem grim and inappropriate for young minds, but in an earlier age when death of children was the rule rather than the exception, children were constantly forced to read, mark, learn, and inwardly digest morbid accounts of dying children. Almost every child living in New England a century and a half ago knew this hymn by heart and would have recited it aloud if death was imminent.
EARLY CORRECTION OF HYPOXEMIA AND ACIDEMIA IN INFANTS OF LOW BIRTH WEIGHT: A CONTROLLED TRIAL OF OXYGEN BREATHING, RAPID ALKALI INFUSION, AND ASSISTED VENTILATION
Authors: Sinclair John C. , Engel Knud , Silverman William A.
Published: December 2021

Twenty low-birth-weight infants showing hypoxemia and acidemia during the first hours of life were treated with contrasting policies of environmental oxygen exposure, correction of blood pH with sodium bicarbonate, and ventilatory assistance. Results were evaluated by clinical, physiologic, and radiologic observations, mortality during the first 7 days of life, and neurologic follow-up of survivors (study in progress). The course of the arterial oxygenation defect was assessed by serial measurements of arterial oxygen tension (pa02) during 100% oxygen breathing. On admission, the lower the pH, the greater was the calculated percent right-to-left shunt. In comparison to pa02 while breathing 50% oxygen, pa02 during administration of 100% oxygen rose more than could be accounted for by a change in calculated alveolar oxygen tension, i.e., calculated right-to-left shunt fell. This effect was not demonstrably modified by randomly manipulated concurrent correction of pH by rapid infusion of bicarbonate or by assisted ventilation. Within the limits of the study, the acute effect of hypoxemia and of oxygen breathing were more apparent than those of acidemia or its correction. However, no significant differences in early mortality could be related to variations in treatment.
One More Hazard: Plastic-backed Pads
Authors: Low Merritt B.
Published: December 2021

A report from Georgia mentions a case of suffocation in a 4-month-old infant, allegedly caused by one of the commonly used plastic-backed pads–in this case a "lochial" pad given to the mother on discharge from the hospital maternity floor, similar to the disposable diaper which has become so popular in the last few years.

Although recovery occurred in this particular case, the implications of this one case are ominous, and the Committee wishes to call this hazard to the attention of all physicians caring for infants.