bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Theory and Political Practice: Do We Need a ‘State-Nation’ Model as Well as a ‘Nation-State’ Model?
Authors: Stepan Alfred
Published: January 2008

Some polities have strong cultural diversity, some of which is territorially based and politically articulated by significant groups that, in the name of nationalism, and self-determination, advance claims forindependence.In this article such polities are defined as ‘politically robustly multinational’. If the goal is peace and democracy in one state in such a polity, this article advances theoretical and empirical arguments to show that ideal typical ‘nation-state’ making policies are less appropriate than policies associated with new ideal type I construct called ‘state-nation’. Countries discussed are Spain, Belgium, and Canada and the ‘matched pair’ of successful Tamil political integration via state nation policies in India, and failed Tamil political integration due to nation-state policies in Sri Lanka.
The “Vertical Response Time”: Barriers to Ambulance Response in an Urban Area
Authors: Silverman Robert A. , Galea Sandro , Blaney Shannon , Freese John , Prezant David J. , Park Richard , Pahk Raymond , Caron Djorge , Yoon Sonia , Epstein Jonathan , Richmond Neal J.
Published: January 2008

Background: Ambulance response time is typically reported as the time interval from call dispatch to arrival on‐scene. However, the often unmeasured “vertical response time” from arrival on‐scene to arrival at the patient's side may be substantial, particularly in urban areas with high‐rise buildings or other barriers to access.

Objectives: To measure the time interval from arrival on‐scene to the patient in a large metropolitan area and to identify barriers to emergency medical services arrival.

Methods: This was a prospective observational study of response times for high‐priority call types in the New York City 9‐1‐1 emergency medical services system. Research assistants riding with paramedics enrolled a convenience sample of calls between 2001 and 2003.

Results: A total of 449 paramedic calls were included, with a median time from call dispatch to arrival on‐scene of 5.2 minutes. The median on‐scene to patient arrival interval was 2.1 minutes, leading to an actual response interval (dispatch to patient) of 7.6 minutes. The median on‐scene to patient interval was 2.8 minutes for residential buildings, 2.7 minutes for office complexes, 1.3 minutes for private homes (less than four stories), and 0.5 minutes for outdoor calls. Overall, for all calls, the on‐scene to patient interval accounted for 28% of the actual response interval. When an on‐scene escort provided assistance in locating and reaching the patient, the on‐scene to patient interval decreased from 2.3 to 1.9 minutes. The total dispatch to patient arrival interval was less than 4 minutes in 8.7%, less than 6 minutes in 28.5%, and less than 8 minutes in 55.7% of calls.

Conclusions: The time from arrival on‐scene to the patient's side is an important component of overall response time in large urban areas, particularly in multistory buildings.
Funding Opportunities in Knowledge Translation: Review of the AHRQ's “Translating Research into Practice” Initiatives, Competing Funding Agencies, and Strategies for Success
Authors: Handrigan Michael , Slutsky Jean
Published: January 2008

The Agency for Healthcare Research and Quality actively funds and conducts research to improve health care for all Americans. This article is intended to provide a brief overview of Agency for Healthcare Research and Quality activities in knowledge translation and to accompany the presentation given on May 15, 2007, to the Academic Emergency Medicine Consensus Conference, “Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake.”
Toward Improved Implementation of Evidence‐based Clinical Algorithms: Clinical Practice Guidelines, Clinical Decision Rules, and Clinical Pathways
Authors: Gaddis Gary M. , Greenwald Peter , Huckson Sue
Published: January 2008

This is a summary of the consensus‐building workshop entitled “Guideline Implementation and Clinical Pathways,” convened May 15, 2007, at the Academic Emergency Medicine Consensus Conference, “Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake.” A new term, “evidence‐based clinical algorithms” is suggested to encompass evidence‐based information codified into clinical pathways, clinical practice guidelines, and clinical decision rules. Examples of poor knowledge translation (KT) relevant to the specialty of emergency medicine are identified, followed by brief descriptions of important research and concepts that inform the research recommendations. Four broad themes for research to improve the KT of evidence‐based clinical algorithms are suggested: organizational factors, cognitive factors, social factors, and motivational factors. In all cases, research regarding optimizing KT for the subthemes identified by Glasziou and Haynes, “getting the evidence straight,” and “getting the evidence used,” are interwoven into the thematic research recommendations. Consensus was reached that the majority of research efforts to evaluate means to improve KT need to be centered on the factors that show promise to enhance “getting the evidence used,” focused especially on organizational factors.
Knowledge Translation in International Emergency Medical Care
Authors: Arnold L. Kristian , Alomran Hisham , Anantharaman V. , Halpern Pinchas , Hauswald Mark , Malmquist Pia , Molyneux Elizabeth , Rajapakse Bishan , Ranney Megan , Razzak Junaid
Published: January 2008

More than 90% of the world population receives emergency medical care from different types of practitioners with little or no specific training in the field and with variable guidance and oversight. Emergency medical care is being recognized by actively practicing physicians around the world as an increasingly important domain in the overall health services package for a community. The know‐do gap is well recognized as a major impediment to high‐quality health care in much of the world. Knowledge translation principles for application in this highly varied young domain will require investigation of numerous aspects of the knowledge synthesis, exchange, and application domains in order to bring the greatest benefit of both explicit and tacit knowledge to increasing numbers of the world's population. This article reviews some of the issues particular to knowledge development and transfer in the international domain. The authors present a set of research proposals developed from a several‐month online discussion among practitioners and teachers of emergency medical care in 16 countries from around the globe and from all economic strata, aimed at improving the flow of knowledge from developers and repositories of knowledge to the front lines of clinical care.
Implementation of an Emergency Department–based Transient Ischemic Attack Clinical Pathway: A Pilot Study in Knowledge Translation
Authors: Brown Michael D. , Reeves Mathew J. , Glynn Ted , Majid Arshad , Kothari Rashmi U.
Published: January 2008

Objectives To assess the feasibility of implementing an emergency department (ED)—based transient ischemic attack (TIA) clinical pathway that uses computer‐based clinical support, and to evaluate measures of quality, safety, and efficiency.

Methods This was a prospective cohort study of adult patients presenting to a community ED with symptoms consistent with acute TIA. Adherence to the clinical pathway served as a test of feasibility. Compliance with guideline recommendations for antithrombotic therapy and vascular imaging were used as process measures of quality. The 90‐day risk of recurrent TIA, stroke, or death provided estimates of safety. Efficiency was assessed by measuring the rate of uneventful hospitalization, defined as a hospital admission that did not result in any major medical event or vascular intervention such as endarterectomy or stent placement.

Results Of the 75 subjects enrolled, physician adherence to the clinical pathway was 85.3%, and 35 patients (46.7%) were discharged home from the ED. Antithrombotic agents were prescribed to 68 (90.7%), and vascular imaging was performed in 70 (93.3%). The 90‐day risk of recurrent TIA was seven out of 75 (9.3%; 95% confidence interval [CI] = 4.6% to 18.0%), one patient experienced stroke (1.3%; 95% CI = 0.2% to 7.2%), and three patients died (4.0%; 95% CI = 1.4% to 11.1%). Uneventful hospitalization occurred in 38 of 40 patients (95.0%).

Conclusions Implementation of a clinical pathway for the evaluation and management of TIA using computer‐based clinical support is feasible in a community ED setting. This pilot study in knowledge translation provides a design framework for further studies to assess the safety and efficiency of a structured ED‐based TIA clinical pathway.
Vergleich zwischen dem Kapillarnetz des frühgeborenen und dem des reifen Kindes und Über die Bedeutung des unentwickelten Kapillarnetzes bei der Entstehung gewisser bei Frühgeburten vorkommender Eigenschaften.
Authors: MALI ATLE M. , RÄIHÄ. C.‐E.
Published: January 2008

1. Bei der Darstellung von Blutgefäss‐Injektionspräparaten wird die grössere Fragilität der Kapillaren von frühgeborenen im Vergleich zu denjenigen von reifen Kindern festgestellt.

2. Beim Färben des Kapillarbluts wird konstatiert, dass die Maschen im Kapillarnetz der Frühgeburt um so weiter und spärlicher sind, je kleiner dieselbe war, als sie zur Welt kam.

3. Es wird nachgewiesen, dass die grossen Maschen des Kapillarnetzes die Sauerstoffversorgung der Gewebe erschweren.

4. Auf den obigen Befund lassen sich folgende Umstände wenigstens zum Teil zurückführen:

a) der relativ niedrige Grundumsatz der Frühgeburt,

b) ihre Neigung zur Azidose,

c) ihre schlechte Wärmeregulation.

5. Als eine Ursache der in den nächsten Tagen nach der Geburt auftretenden asphyktischen Anfälle wird der von dem weitmaschigen Kapillarnetz abhängende Sauerstoffmangel hervorgehoben. Die Entstehung von später, im Alter von 1 bis 3 Monaten vorkommenden aspyktischen Anfällen wird ausserdem durch die Abnahme des Bluthämoglobins begünstigt.

6. Es wird angenommen, dass die Periodizität der Atmung bei Frühgeborenen primär von dem durch das weitmaschige Kapillarnetz hervorgerufenen Sauerstoffmangel in den Atmungs‐zentra abhängt.

7. Die durch das weitmaschige Kapillarnetz hervorgerufenen Übelstände können eventuell auf die Entstehung der bei Frühgeburten häufig vorkommenden geistigen Entwicklungs‐schwäche einwirken.

8. Als ein Faktor, der die Entstehung des Ikterus neonatorum begünstigt, gilt der von dem grossmaschigen Kapillarnetz abhängende, ungewöhnlich kleine Flächenraum der Leberkapillarwände sowie die eventuell vom Sauerstoffmangel der Leberzellen herrührende mangelhafte Leberfunktion.

9. Es wird konstatiert, dass unsere bisherige Kenntnis der hormonalen Eegulierung des fetalen Wachstums uns zu der Annahme berechtigt, dass die Vermehrung der Kapillaren bis zum sechsten Fetalmonat eine relativ langsamere ist, als der Massenzuwachs des zentralen Nervensystems und des epithelialen Gewebes, und dass die Entwicklung des Kapillarnetzes vom sechsten Fetalmonat ab den Vorsprung verkürzt, den das Zentralnervensystem und die epithelialen Gewebe bis dahin im Wachstum gewonnen haben.
Über den Lungenbau der Früngeburt und des ausgetragenen Kindes, vor allem mit Rüeksicht auf die Entwicklung der elastischen Fasern und der Kapillaren.
Authors: KLEMOLA ERKKI
Published: January 2008

1. Die beste Grundlage bei Beurteilung des Entwicklungssrades des elastischen Stützgerüstes der Lungen ist das Gewicht des Fötus. Sogar noch bei solchen Föten, deren Gewicht gegen 2 ½ kg beträgt, sind die elastischen Fasern in den Lungen sehr schlecht entwickelt, aber bei Föten im Gewicht von über 3 kg scheint der Entwicklungsgrad schon relativ gut, ja er kann bei übergewichtigen Föten sogar äusserst mächtig sein.

2. Solche Kinder, deren Geburtsgewicht unter 2.5 kg beträgt, oder »Frühgeburten» befinden sich während ihrer ersten Lebenszeit—1—2 Wochen, oder mehr, je nach dem Gewicht der Frühgeburt, — hinsichtlich der Struktur des elastischen Stützgerüstes ihrer Lungen im Vergleich zu ausgetragenen Kindern noch in einer ganz besonderen Stellung. Sie geraten in die Lage, mit Lungen atmen zu müssen, die ein relativ schlecht entwickeltes elastisches Gewebe enthalten, ein Umstand, der manche von den für Frühgeburten charakteristischen Atmungsstörungen verursachen dürfte.

Die Frühgeburten holen jedoch den »Vorsprung» der ausgetragenen Kinder in 1—2 Monaten oder schon früher vollständig ein. Somit ist die Entwicklung der elastischen Fasern der Lungen bei Frühgeburten nicht verzögert, well sie dem »wirklichen Alter» (vom Befruchtungsaugenblick ab gerechnet) voraus ist. An dieser raschen Entwicklung kann nur die Atmungstätigkeit schuld sein.

3. Das Kapillarnetz der Lungen ist desto dichter, um einen je schwereren Fötus es sich handelt.
Acute Rheumatic Infection in Children.
Authors: FRIEDLæNDER AXEL
Published: January 2008

A material is presented comprising 446 children treated during the period 1914–43 in Kronprinsessan Lovisa's Children's Hospital in Stockholm for acute rheumatic infection. (Polyarthritis rheum.: 248 cases, Chorea rheum.: 198 cases.)

Ekg and Fkg were systematically performed on 83 children during 1933–43. Age, year division, family disposition, mortality and recurrence percentage are investigated. Certain characteristic symptoms in the initial stage (abdominal pain, tonsillitis, free interval and monarticular appearance) are described.—

The results of tonsillectomy are discussed

The frequency, diagnostic and prognostic value of erythema annulare, multiform erythema, rheumatic nodules and rheum. erythema nodosum are mentioned. Concerning the involvement of the heart, attention is drawn to the »primary» carditis, and the importance of Fkg for the early diagnosis of endocarditis is stressed (particularly phonocardiographic registration of gallop rhythm, systolic and diastolic murmurs are emphasized). The value of Fkg in the differential diagnosis between cong. heart disease, rheumatic carditis and »physiological» murmurs are discussed.—

Some details as to rheumatic anaemia and the sedimentation rate during the course of ac. e. rheum, inf. are demonstrated.
Three years Prophylaxis against Rickets in Prematures, with D, Massive Dose
Authors: KLACKENBERG G.
Published: January 2008

100 prematurely born infants, who had been treated with a massive dose of vitamin D for prophylactic purposes, were subjected to a control examination, in order to ascertain how far they were free from marked rachitic symptoms. This control showed that the protective effect of the administration of 500 000 international units of vitamin D2 per os was distinctly efficacious. During the three immediately following months the infants, with merely two exceptions, had not received any further supply of vitamin D. In 19 cases slight rachitic residues were clinically observed. Only 4 of them had been treated lege artis after the period, during which the massive dose is effective. Among the said cases, a strikingly large number consisted of twins and of infants who had received their massive dose later than one month after birth. This forces us to the conclusion that the massive dose should be administered at a very early stage, preferably during the first 14 days of life. No definite indications that the massive dose treatment had entailed any toxic lesions could be detected.
Functional Development During Infancy
Authors: Wallgren Arvid
Published: January 2008

The normal variation in the mental and postural development of the child has been studied in a number of healthy children from the child health center of the Gothenburg Children's Hospital. Statistically calculated, there is a great difference in the normal variations of different functions. Early achievements such as prehension and sitting without support show very slight variations. More advanced functions, e.g. walking capacity and excretory control, are much more individually variable. A simple diagram of functional development during infancy intended for general use in the Swedish children's welfare centers is presented.

Etude a été faite des variations normales du développement mental et des attitudes de l'enfant chez un certain nombre d'enfants bien portants observés à la consultation de 1'enfant à 1'Hôpital pédiatrique de Gothembourg. L'expression statistique des faits a montré une grande différence dans les variations normales des différentes fonctions. Les premiers stades du développement psychomoteur, tels que la préhension et la station assise sans soutien ne montrent que de légères variations. Les fonctions plus avancées, telles que la faculté de marcher et le contrôle de l'excrétion varient d'me façon très individuelle. Un diagramme simple du développement fonctionnel durant la première enfance, établi à l'intention d'un usage courant dans les dispensaires d'enfants suédois, nous est présenté.

Bei einer Anzahl der Kinder der Mütterberatungsstelle des Gotenburgischen Kinderkrankenhauses wurden die Variationen in der normalen geistigen Entwicklung untersucht. Die Statistik zeigte grosse Schwankungen. Je einfacher die Funktionen sind, wie Greifen und Sitzen, desto kleiner sind die Schwankungen, aber um so grösser bei den komplizierteren Funktionen wie z. B. Gehrersuche und selbständige Regulierung der Exkretionsvorgänge. Ein einfaches Diagramm der funktionellen Entwicklung während der Säuglingszeit zum Allgemeingebrauch in der schwedischen Kinderfürsorge ist beigefügt.

Sumario

Se ha efectuado el estudio de las variaciones normales en el desarrollo mental y postural del niño en buenas condiciones de salud, en una serie de niños del centro de Salud del hospital de Infantes de Göteborg. Los calculos estadisticos dan una gran diferencia en las variaciones normales de las distintas funcionea. Las adquisiciones precoces como la prehensión, y el mantenerse sentado, muestran muy pequefias variaciones. En cambio las funciones que son adquiridas mas tardíamente como ser la marcha y el control de los esfienteres, son mas variables individualmente. A continuación se propone un diagrama sobre el desarrollo funcional del niño para uso general de los centros de salud del niño en Suecia.
β‐Hemolytic Streptococci in the Disease Groups Eczema Infantum‐Prurigo
Authors: HELVE ANJA , OKER‐BLOM NILS , PÄTIÄLÄ RISTO
Published: January 2008

A great number of hemolytic streptococci were found in the wards in which eczematous children were nursed in the Children's Clinic. Nose, throat and skin swabs obtained from such children of varying ages yielded numerous streptococci. The AST of these children was usually low and so were the sugar tolerance values at the manifest stage of the disease.

On a trouvé dans les chambres de la Clinique d'enfants où des enfants eczémateux ont été traités un grand nombre de streptocoques hémolytiques. Le nez, la gorge et les particules de peau obtenues de ces enfants, d'âges différents, renfermaient une grande quantité de streptocoques. L'AST de ces enfants était généralement bas ainsi que les valeurs de tolérance de sucre au stade manifeste de la maladie.

In der Abteilung für ekzematöse Kinder der Kinderklinik wurden hämolytische Streptokokken in grosser Menge gefunden. Abstriche von Nase, Eachen und Haut solcher Kinder verschiedenen Alters ergaben zahlreiche Streptokokken. Der AST dieser Kinder war allgemein niedrig und ebenso die Werte der Zuckertoleranz im manifesten Stadium der Krankheit.

En las habitaciones de la Clínica de Niños, donde los niños eczemosos han sido tratados, se ha encontrado un gran número de estreptococos hemolíticos. La nariz, la garganta y las particulas de la piel obtenidas de estos niños, de edades diferentes, contenían una gran cantidad de estreptococos. El AST de estos niños era generalmente bajo, así como los valores de toleraneia de azúcar, al estadio manifiesto de la enfermedad.
Acute Quinidine Poisoning in a 3 Year Old Child (With special reference to the electrocardiographs changes)
Authors: WARFVINGE L. E.
Published: January 2008

A study of the electrocardiographic changes presented by a 3 year old boy after having taken at least 1.6 gram of quinidine sulfate. Characteristic increase of P and QRS time and impairment of AV conduction and intraventricular conduction. Control after 18 hours demonstrated a normal ecg.
Medical Child Care in Sweden: Short Review of its Development, Importance and Immediate Objectives
Authors: STRÖM JUSTUS
Published: January 2008

During the last 25 years one of the main developments within the field of pediatrics has been the appreciation and increasing application of social aspects of childhood problems. Sweden has been fortunate enough to have had farsighted pediatricians guiding this development. Of these Wallgren has been one of the leading men.
Discussion on Electroencephalographic Observations in Subacute Progressive Encephalitis: A Report of Two Cases
Authors: D'AVIGNON M. , HUSBY J. , WIDÉN L.
Published: January 2008

Two cases of subacute progressive encephalitis are described. One patient died 11 months after the onset of the illness. The other is still alive after 33 months of illness. Both inoculation experiments on animals and attempts to cnltnre the virus gave negative results. I n Ciase 1, study of the brain showed sparse inflanimatory changes, chiefly in the central ganglia, sparse ganglion cell degeneration, diffuse demyelination in the fibres of the optic radiation, and intranuclear inclusion bodies in the cortex of the occipital lobe and the nuclei of the pons. Both cases exhibited the typical EEG changes. The specificity of these EEG changes is discussed.
A Characteristic Physiognomy, Resembling that Encountered in (Hushing's Syndrome, Observed in Newborn Infants of Diabetic Mothers
Authors: ÅKERRÉN Y.
Published: January 2008

The author describes a characteristic habitus in newborn infants of diabetic mothers.1 The physiognomy is particularly striking and merits the designation tomato face, thus resembling that encountered in Cushing's syndrome. A tabulation of data from the literature, particularly Hultquist's investigations, shows that changes in the anterior lobe of the hypophysis and in the suprarenal glands, resembling those observed in Cushing's syndrome, occur in foetuses of experimental animals with diabetes and in infants of diabetic mothers. The observation is thus evidence of the conception that endocrine disturbances are of decisive significance for the development of those special features which characterize newborn infants of diabetic mothers.
Lack of Proteins in Child Nutrition
Authors: FRONTALI G.
Published: January 2008

The author presents a concise picture of the research conducted by himself and his co‐workers in the last 9 years about the lack of complete proteins in early childhood.

In the complex symptoniatology of the disease, which has resemblances in different (tropical and sub‐tropical) parts of the world and which is designated by different names such as “starchy food dystrophy” and “kwashiorkor”, the author has separated, through a nicthod of clinical analysis, the additional avitaminotic manifestations which can be eliminated by addition of the respective vitamins, thus delimiting a central syndrome, which disappears only after administration of animal proteins.

Research into proteinaemia, albumin/globulin ratio, ionogram, extracellular fluid, tryptic, amylo‐ and lipolytic power in the duodenal fluid complete the picture of the lack of proteins (“hypoproteinosis”) as it is shown by Italian children.

The lack of certain amino acids and their therapeutic effect as well as the possibility of combining different vegetable proteins together in order to obtain complete mixtures of amino acids at low cost for the social prophylaxis of “hypoproteinosis” are discussed.

From the therapeutic point of view the author presents his experience about urgent treatment and realimentation, about plasma transfusion and administration of animal protein hydrolysates, as well as of preparations of soluble caseinate.
Mental and Physical Disturbances in Children Recovered from Infantile Interstitial Plasma Cell Pneumonia
Authors: HALLMAN NIILO , YLPPÖ ARVO
Published: January 2008

The development has been observed of the first years of life of 47 interstitial plasma cell pneumonia infants born in 1948‐52. A reply was received to the questionnaire sent out in 42 of the cases and a follow‐up examination was made at the hospital in 31. Two of the children died.

In quite a number of cases the development of the child has been slow even compared with other children of the same birth—weight class. At the time of the investigation 9 of the children were distinctly backward and 5 slightly backward. It proved possible to examine the former group clinically. The growth of the children has been slow. The bone age is almost regularly behind that of children of the same age, but the correlation with height approximates the normal.

For 25 cases of the material the plasma calcium was determined during the acute phase of int. pneum. and had clearly risen in 20. Of the distinctly backward children the majority belong to the group with the highest calcium values. However,. some of the children with equally high plasma calcium values developed fully satisfactorily. In four children who are all distinctly backward both the plasma calcium and residual nitrogen continue to be high. The bone age in these children is exceedingly low though corresponding approximately to the growth in height.

In three of the children osteosclerotic changes can be established in the bones. All four children squint. They are all around 3 years of age and have begun to progress, especially recently.
Fortschritte in der Behandlung der tuberkulösen Meningitis
Authors: KLEINSCHMIDT H. , SANTELMANN TH.
Published: January 2008

Eine Übersicht über die Behandlung der tuberkulosen Meningitis mit Tuberculostaticis zeigt, dass ini Laufe weniger Jahre wesentliche Fortschritte erzielt worden sind. Zur vergleichenden Beurteilung der Ergebnisse ist die Kenntnis des Lebensalters und des Behandlungsbeginnes von Bedeuhng. Eswerden 4 Behandlungsformen unterschieden: 1. Streptomycin allein, 3. in Verbindung niit anderen tuberculostatischen Mitteln, 3. intralumbale Behandlung mit Streptomycin, Solvoteben und PAS aus der Mischspritze, 4. Streptomycin mit INH. Die letzte Behandlungsform ist als aussichtsreichste zu bezeiehnen; sie ist zugleich die einfaehste und schonendste, weil sie eine Abkiirzung der intralunibalen Behandlung erlaubt. Sie sollte moglichst fruhzeitig in zentralen Behandlungsst iitten durchgefiihrt werden. Expositions‐prophylaxe und BCG‐Impfung bleiben trotz der bisher erzielten therapeutischen Erfolge dringlich.
Cystic Fibrosis of the Pancreas in Patients Over Ten Years of Age
Authors: MCINTOSH RUSTIN
Published: January 2008

A study of 27 patients with cystic fibrosis of the pancreas who lived to be more than 10 years of age presents a wide range of clinicd states. Four of these children on whom observations were made after they had reached the age of 10 years have died at various ages up to nearly 20 years, all with the picture of progressive purulent bronchopneumonia. One of the fatal cases, coming to autopsy after a life span of 13½ years, showed cardiac changes consistent with cor pulmonale.

Among the 23 living patients all have cough and clubbing of the fingers as continuing evidence of broncho‐pulmonary infection. The healthiest show no other signs of impaired respiratory function, either by roentgenogram or following a work tolerance test; likewise, some of these healthier patients have attained a body weight and height which do not differ significantly from mean values for the appropriate age and sex. For the group as a whole, however, a trend toward significant retardation of growth in height and of gain in weight is evident, the degree of retardation being roughly correlated with the severity of the pulmonary infection. Pubertal changes may be delayed. A number of the most seriously involved patients are in effect respiratory invalids, having a markedly reduced exercise tolerance. Regardless of the severity of their somatic functional status, however, almost all of them sustain a cheerful outlook for the future and build ambitious plans in the manner of all normal children.

Although their nutritional state depends primarily on the severity and activity of their broncho‐pulmonary infection, as a group these children respond fairly uniformly to changes in diet. Almost without exception they prefer to avoid fat foods, having learned that ingestion of appreciable quantities of fat is followed by abdominal pain or by a change for the worse in the number and character of their stools. Many, having taken pancreatin for several years, now appear to do equally well without it.

It would appear that adequate compensation for lost pancreatic digestive function in cystic fibrosis is quite readily attainable, but that the bronchopulmonary infection, once entrenched, is difficult to eradicate. Perhaps the best hope for the future lies in early recognition of the pancreatic lesion and in the institution of an effective prophylaxis of the infection.
Care of the Premature Infant: A Résumé of a Study on Social Organization and Function of Nursing Services in a Premature Infant Center
Authors: PLATOU R. V. , ROHRER JOHN H. , ALLEN ELAINE
Published: January 2008

This inventory or evaluation of social organization, attitudes and relationships of personnel and current work distribution has been, and we hope will be, helpful in our continuing efforts to iniprove our programs of caring for premature infants and of training others in this work. Most of the faults brought to light by this study are probably not unique in our unit, and practically all of them are correctible.

Necessarily greater dependence on aids—nonprofessional persons trained on the job—has evolved as a reasonable, practical, and effectiae solution to current and increasing shortages of professional nursing staff. Closer integration of care and training programs will almost certainly require expansion of learning experiences and responsibilities for aids, with more and more of the time and talents of a carefully selected but relatively small staff of professional nurses devoted to supervision and training efforts. Experienced nonprofessional care personnel deserve and should have increased formal recognition as an important step toward further success in both care and training programs. Also important are a number of changes aimed a t integrating more closely these two major objectives and a t correcting as best we can those causes for conflicts, anxieties, and frustrations revealed by this study.

Whatever successes we have enjoyed in our care prograni have been achieved despite serious and continuing shortages of personnel in all categories. A consequently huge care‐burden of itself has quite apparently and logically forced experienced nurses and aids to impress on d l newer workers very forcibly and quite effectively the concept of “deuotion to care duty” as the most important value guiding all activities in this Unit. This concept in turn seems to deniand further opportunity for informally supervised crib—side learning experiences even under the pressures of a caseload such as ours, if we are to attain greater successes.

From these facts and generalizations, several hypotheses seem justified and are probably widely applicable:

(1) When joint goals of care and training exist in a hospital unit, niajor emphasis will probably always be given to the former.

(2) The ability to assume responsibility for performance of any procedure will vary directly with understanding, skill, and experience in that procedure.

(3) Real or perceived ambiguities in responsibilities or authorities will interface with accomplishment of goals.

(4) Exposure and correction of psychologic or social bases for conflict within any programs can do much to further the successes of such programs.

(5) Finally, standards and recommendations will probably always require major modification on the basis of purely local considerations.
Granulocytopenie nach Mononucleosis infectiosa bei einem 4jährigen Jungen
Authors: SALMI TOIVO , PELTONEN TUOMAS
Published: January 2008

Bericht iiber einen Fall von Mononucleosis infectiosa, als dessen Folge eine chronische Granulocytopenie bestehen blieb (Beobaehtungszeit 1 ½ Jahre). Pat. dadurch anfallig gegen verschiedene Infektionen. Blutübertragungen ohne Einfluss auf die Granulocytopenie. Dagegen vorübergehende Besserung durch Tonsillektomie, ACTH und Cortison. Auch die bakteriellen Infektionen haben die Granulocyten vorubergehend vermehrt, Röteln haben sie im Endergebnis vermindert. Zu Anfang der Krankheit etwas niedrige Thrombocytenwerte. Blutungs‐ und Blutgerinnungsstatus stets normal geblieben. Ständig leichte, normochromische Anämie.
The Organization and Functions of a Clinic for Juvenile Diabetes
Authors: LARSSON YNGVE
Published: January 2008

In view of the poor long‐term results of juvenile diabetes mellitus, a more intensive metabolic control is considered the therapeutic alternative which should be given serious long‐term trial. The consequences of this opinion as regards the organization of the diabetes clinic are described. The need of the subspecialities represented in the pediatric university clinic is emphasized. The role of the dietitian and principles of dietary treatment are outlined. Teaching of the patients is regarded as one of the main therapeutic tools, and methods used are described. Patients with juvenile diabetes should remain under pediatric supervision until they have reached full maturity.
On the Interaction between Protein and Glucose in Human Blood
Authors: RÄIHÄ NIELS C. R. , SOMERSALO O. , NORDSTRÖM C.‐G. , RÄIHÄ C.‐E.
Published: January 2008

An interchange between albumin‐bound hexose and free glucose in human plasma has been demonstrated. If there is a protein‐bound hexose in the red cells, it may interfere with the distribution of glucose between the cells and plasma.
Studies on Special Disturbances within the Reading and Writing Function in Children (“Dyslexia”“Word‐Blindness”): II. Contribution to the Question of Origin
Authors: SÖDERLING BERTIL
Published: January 2008

A pupil, otherwise capable of learning, who is unable to learn to read and/or spell during the first three years of school is dyslectic and accordingly handicapped. He should be treated as a dyslectic. If this pupil is given special instruction as early as possible, which is highly desirable for reasons stated above, this instruction should not presuppose a 100% recovery. That would bring about an excess demand noticeable in the attitude towards the pupil–patient. If, in the highest classes or higher schools the child is still disturbed by special reading or writing difficulties we must reckon with a definite handicap.

As scientific prognostic study we should with regard to the improved or “healed” case try to determine what happens spontaneously through coordinational maturity and what can be ascribed to the special pedagogic help. Until we know something about this we are unable to estimate the effectiveness of the special reading and writing tuition.
Extracardiac Congenital Malformations in Children with Congenital Heart Diseases
Authors: BOESEN I. , MELCHIOR J. C. , TERSLEV E. , VENDEL S.
Published: January 2008

The incidence of congenital extracardiac malformations in a series of 615 children with congenital heart diseases is found to be 11.4%, and in a series of autopsies of 1145 children with congenital heart diseases to be 13.4 %, in both materials excluding the diagnosis of mongolism as a malformation per se.

No definite correlation has been found between a specific congenital heart disease and extracardiac malformations, yet atrial septal defects seem to be found more often than expected combined with harelip and cleft palate and ventricular septal defects with malformations of bones and joints and of lungs.
Medical Treatment of Habitual Vomiting
Authors: RAFSTEDT STURE
Published: January 2008

Fourteen cases of habitual vomiting have been treated with alimemazin, given as a syrup, containing 0.5 mg/ml. In 12 cases good results were obtained, the patients having a good weight gain and no or only a few vomitings a day. Even if the disease in most cases is harmless and the vomitings often cease spontaneously after a few months duration, usually when the child is about one year old, the favourable effect of alimemazin is of great value not only for the small patients themselves but certainly also for their mothers in handling their babies during the distressing and tiresome period of habitual vomiting. No side‐effects of alimemazin were reported.
Membranous Stomatitis in Sweden 1956–1961
Authors: SELANDER PER
Published: January 2008

Membranous stomatitis was first known in Sweden in April 1957. Since then 191 cases have been reported, but the actual number of cases is certainly considerably greater. The disease culminated in 1959 with 78 cases. In Malmo alone during the years 1957–1961 94 cases are known. The disease has been reported least frequently during the winter months. It affects both sexes equally often. Possibly it affects premature infants somewhat more often than full‐term ones. Of the affected children 75 % are in the first 3 weeks of life. The youngest was 2 days, the oldest 2 years.
Some Reflections on Juvenile Diabetes and Its Treatment
Authors: SÖDERLING BERTIL
Published: January 2008

Current research on juvenile diabetes mellitus may better indicate the very early origin of angiopathy, formerly considered to be “late complication”. Electron microscopic studies seem to reveal typical alterations of cell membranes even in cases, which are prediabetic. It may be considered that these “membranoses” and diabetes are separate signs of the same basic disease, which no treatment has yet been able to reach or even cause. Thus, the author recommends a more realistic approach to current clinical treatment, which should be concentrated on making the patients present handicap as small as possible. In this regard, satisfactory well‐being, which includes several criteria, is often more important than laboratory figures. Some less well‐known sources of errors are discussed. The difficulty in keeping teenagers under good control is mentioned. Concerning the presence of inactive insulin, the author points out that unexplained insulin hypersensitivity is seen in many early cases of diabetes.
26. Premature Infants Treated with Human Albumin
Authors: CYVIN K. B.
Published: January 2008

Total serum protein content was determined in the cord blood of 79 premature infants. There was a tendecy for the serum protein values to rise with the birth weight and gestational age. Boys had, on average, lower serum protein values than girls. 31 infants with serum protein content less than 5 g/100 ml were treated with albumin solution, 2 g per kg of body weight intravenously, on the first day of life. 27 infants, serving as controls, were not treated with albumin. The two groups showed the same frequency of “respiratory distress”. One infant died in connection with the administration of albumin.
Diphtheria Antitoxin Levels and the Schick Reaction in Mothers and their Newborns
Authors: PAPADATOS C. , PAPAEVANGELOU G. , KOUKOU A.
Published: January 2008

One hundred and sixty one mothers and their newborns were tested for their Schick state. In 18 cases diphtheria antitoxin levels were determined in maternal and cord blood.

A Schick positive reaction was found in 3.1 % of mothers. All newborns were Schick negative.

A good correlation was noted between maternal and cord blood antitoxin levels, as well as between the Schick state and the antitoxin titer in the mother. The discrepancy between antitoxin titer and the Schick reaction in the newborn is discussed.
A FAMILIAL 3/18 RECIPROCAL TRANSLOCATION RESULTING IN CHROMOSOME DUPLICATION‐DEFICIENCY (3?+– 18q ‐)
Authors: AARSKOG DAGFINN
Published: January 2008

Following 3 abortions a mother with 3/18 reciprocal translocation gave birth to 2 sons with multiple congenital abnormalities. Chromosome analysis in one of them revealed trisomy for a segment of one arm of chromosome No. 3 and a deletion involving the long arm of No. 18. The clinical features resembled closely those reported in deletion of the long arm of chromosome No. 18. At the age of 12 months he had normal serum levels of IgM, IgG and IgA. Both parents and the child had blood group O. Serum from the child revealed an absence of anti‐A isoagglutinins, and anti‐B isoagglutinins could only be detected with special technique, wheras both parents had relatively high titres of both isoagglutinins. The gene loci of MNS, Rh, Duffy, Gm, Hp, and phosphoglucomutase can be excluded from the deleted part of chromosome No. 18.
HUMAN GROWTH HORMONE AND HYPOPITUITARY GROWTH RETARDATION
Authors: TRYGSTAD O.
Published: January 2008

Human growth hormone (HGH) has somatotropic, luteotropic and adipotropic/diabetogenic activities. It is a potent antigen, and serum concentrations can be determined immunologically. However, we do not know whether the somatotropic core or another part of the molecule is active antigenically.

The secretion of HGH is influenced by humoral agents as well as by psychical and physical stress. HGH stimulation tests are negative in several states beside hypopituitarism.

The diagnosis of hypopituitary nanism can be difficult, especially in isolated growth hormone deficiency, which is not uncommon. Clinical and laboratory characteristics in the diagnosis of pituitary nanism are discussed. It is emphasized that growth retardation usually starts in infancy, and that hereditary types are rather frequent. The most important criteria in the diagnosis are: negative HGH stimulation tests, increased nitrogen retention and urinary hydroxyproline excretion during a metabolic study with HGH, and the catch‐up growth at a therapeutical trial with HGH.

Experiences in HGH‐treatment of 20 children with idiopathic hypopituitary nanism are given. They all responded well, and the mean growth velocity increased from 2.8 cm yearly before to 9.7 cm the first year on treatment. Two patients with organic hypopituitarism did not respond to HGH treatment. The principles for hormonal replacement therapy in pituitary nanism are discussed.
THE VENOUS PLASMA FREE AMINO ACID LEVELS OF MOTHER AND CHILD DURING DELIVERY. III.
Authors: LINDBLAD B. S. , RAHIMTOOLA RAZIA J. , SAID MAHMOODA , HAQUE QAMAR , KHAN NAFEES
Published: January 2008

The plasma aminograms of mother's and cord vein plasma during delivery were studied in selected cases from a lower socio‐economi‐cal group in West Pakistan with a high incidence of intrauterine growth retardation of the foetus.

There was a highly significant increase in the levels of the non‐essential amino acids glycine and ornithine in the mother's plasma and of glycine and proline in cord plasma. The plasma glycine/valine quotient was significantly increased in maternal as well as in cord plasma.

It is suggested that the plasma glycine/valine quotient may serve as an index of subclinical protein undernutrition (low intake of dietary nitrogen) of mother and foetus and thus become a tool in the investigation of the immediate and late effects of this condition during pregnancy in human populations. The maternal quotient is not changed by short gestation or hypertensive disorder during pregnancy.
Development of an Immunochromatographic Strip for Rapid Detection of H9 Subtype Avian Influenza Viruses
Authors: Peng Fuhu , Wang Zheng , Zhang Shuhui , Wu Renwei , Hu Sishun , Li Zili , Wang Xiliang , Bi Dingren
Published: January 2008

An immunochromatographic strip was developed for the detection of the H9 subtype of avian influenza viruses (H9AIVs) in poultry, using two monoclonal antibodies (MAb), 4C4 for H9AIV hemagglutinin (HA) and 4D4 for nucleoprotein. The 4C4 MAb was labeled with colloidal gold as the detection reagent, and the 4D4 MAb was blotted on the test line while a goat anti-mouse antibody was used on the control line of the nitrocellulose membrane. In comparison with the HA and HA inhibition (HI) tests, the strip was specific for the detection of H9AIV, with a sensitivity at 0.25 HA units within 10 min. Storage of the strips at room temperature for 6 months or at 4°C for 12 months did not change their sensitivity and specificity. Evaluation of the strip with experimental tracheal and cloacal swab samples collected from H9N2-infected chickens revealed that the strip detected the H9N2 viruses on day 3 postinoculation, earlier than the appearance of clinical symptoms. Application of the strip for the analysis of 157 tracheal or cloacal samples from potentially infected chickens on five poultry farms showed that four farms had chickens that were infected with H9AIV. Further characterization of 10 positive and 30 negative randomly selected samples showed that no single sample was false positive or negative, as determined by the standard virus isolation and HI assays. Therefore, the immunochromatographic strip for the detection of H9AIVs has high specificity, sensitivity, and stability. This finding, together with the advantages of rapid detection and easy operation and without the requirement for special skills and equipment, makes the strip suitable for onsite detection and the differentiation of H9AIVs from other viruses in poultry.
Humoral Immune Responses of Tuberculosis Patients in Brazil Indicate Recognition of
Mycobacterium tuberculosis
MPT-51 and GlcB
Authors: Melo Cardoso Almeida Cristina , Vasconcelos Arioldo C. , Kipnis André , Andrade Ana Lúcia , Junqueira-Kipnis Ana Paula
Published: January 2008

The humoral responses to recombinant MPT-51 and GlcB was determined by using an enzyme-linked immunosorbent assay. Levels of immunoglobulin M (IgM) against MPT-51 and IgG against GlcB were higher among tuberculosis (TB) patients than among control individuals. When the MPT-51 and GlcB assays were combined, 90.8% specificity and 75.5% sensitivity were observed. MPT-51 and GlcB were recognized in the humoral responses of Brazilian TB patients.
Impact of Human Immunodeficiency Virus Infection in Pregnant Women on Variant-Specific Immunity to Malaria
Authors: Dembo Edson G. , Mwapasa Victor , Montgomery Jacqui , Craig Alister G. , Porter Kimberly A. , Meshnick Steven R. , Molyneux Malcolm E. , Rogerson Stephen J.
Published: January 2008

Human immunodeficiency virus (HIV) increases susceptibility to
Plasmodium falciparum
infection, and this has most clearly been demonstrated in pregnant women. Variant surface antigens on the surfaces of erythrocytes infected with
P. falciparum
are major targets of protective immunity. We studied the impact of HIV infection on pregnant women's humoral immunity to variant surface antigens expressed by placental and pediatric isolates of
P. falciparum
. By flow cytometry, sera from HIV-infected women more frequently lacked antibodies to these antigens than sera from HIV-uninfected women. This difference was similar in magnitude for pediatric isolates (unadjusted odds ratio [OR] = 6.36; 95% confidence interval [CI] = 1.14, 35.32;
P
< 0.05) and placental isolates (unadjusted OR = 6.47; 95% CI = 0.75, 55.64;
P
< 0.10). We divided women into high and low responders on the basis of their antibody levels. After adjustment for CD4 count, maternal age, and gravidity, we found that HIV-infected women more frequently had low responses to both pediatric isolates (OR = 5.34; 95% CI = 1.23, 23.16;
P
= 0.025) and placental isolates (OR = 4.14; 95% CI = 1.71, 10.02;
P
= 0.002). The relative quantity of antibodies to both pediatric isolates (
P
= 0.035) and placental isolates (
P
= 0.005) was lower in HIV-infected women than in HIV-uninfected women. HIV infection has a broad impact on variant-specific immunity, which may explain the susceptibility of infected individuals to clinical malaria episodes.