bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital Dyserythropoietic Anemia
Authors: Humphrey G. Bennett , Mojab Bahaod-Din , Mutz Ingomar
Published: December 2021

Reading the excellent article by Drs. Murphy and Oski, "Congenital Dyserythropoietic Anemia (CDA)",1 which further defines type II, produced a sense of deja vu. In the 1950s, nonspherocytic, hemolytic anemias (HNHA) were categorized as type I and II based on the in vitro autohemolysis test.2 This group of anemias has subsequently been demonstrated to be due to a series of enzymatic abnormalities in carbohydrate metabolism.3

In CDA, the morphological characteristics which define types I, II, and III probably reflect nuclear rather than cytoplasmic abnormalities.
Faith of Physicians
Authors: Frazier Claude A.
Published: December 2021

I am planning to edit a book with the tentative title of Notable Physicians And Their Faith, and am seeking contributors to this book. I believe that physicians can and would want to share their faith, for the benefit of other physicians and the public. Anyone interested in contributing to this book, please write to me at the following address:
Pediatric Clinical Gastroenterology, by Arnold Silverman, M.A., M.D., Claude C. Roy, M.D., F.R.C.P. (C), and Frank J. Cozzetto, M.D. St. Louis: The C. V. Mosby Company, 1971, 580 pp., $39.50
Authors: Shwachman Harry , Grand Richard J.
Published: December 2021

This excellent, useful and up-to-date, easyto- read text contains a great wealth of clinical information; it is the first and only book of its kind. Anyone interested in pediatrics or gastroenterology should find a place for it in his library. It does much to establish and recognize pediatric gastroenterology as a specialty.

The book is divided into three major sections. Part I considers common gastroenterologic symptoms and signs; Part II (the bulk of the book) considers common disease entities (25 chapters); and Part III is entitled "Laboratory Tests and Procedures and Nutritional Care."
Excerpt XII: Lion and the Mouse
Authors: Cone Thomas E.
Published: December 2021

The moral of the fable illustrated belowl will be recognized as the well-known rule of ethical conduct called the golden rule.

All of the fables published in this series have demonstrated that fables consist of two parts-the symbolic representation and the application or the instruction from it; the latter is the moral of the tale and indispensible to it.
Warren R. Sisson, M.D., President of the American Academy of Pediatrics, 1948-1949
Authors: Clifford Stewart
Published: December 2021

On November 22, 1972, Warren R. Sisson died in his 88th year. He had been in amazing mental and physical health until he was struck by a sudden attack of abdominal pain, on August 2, that was discovered to be caused by malignancy.

As an elder statesman of the Academy, Dr. Sisson's life deserves description in the pages of its journal. Born in Hamilton, New York, on April 13, 1885, he graduated from Colgate in 1906 and then spent two years teaching at Colgate Academy to earn enough money to start medical school.
The Pediatrician as Ombudsman for the Handicapped Child
Authors: Borgstedt Agneta D.
Published: December 2021

I wish to congratulate Dr. Constance U. Battle for her excellent discussion of the role of the pediatrician as ombudsman in the health care of the handicapped child. I have had the privilege of being associated with Dr. Battle during her pediatric training at the University of Rochester School of Medicine and Dentistry, Rochester, New York. She expresses well the opinions of many pediatricians of this community.

As a member of the Committee for the Handicapped, Academy of Pediatrics, Chapter I, I am involved in the development of a statement of philosophy and its implication for the provision of services to the handicapped child.
Letters to the Editor
Authors: Wegman Myron E.
Published: December 2021

Dr. Brewer has apparently confused the term perinatal mortality rate, usually defined as the number of fetal deaths during the first week before delivery plus the neonatal deaths during the first week after delivery, per 1,000 live births, with infant mortality, deaths of live born infants during the first year of life, per 1,000 live births.: Both rates have considerable importance and utility but they are quite different.

The National Center for Health Statistics has validated the general reliability of the 10% sample as reflecting very closely the final and correct data, which are usually not available until one or two years later.
Patient Care and Student Learning in the OPD
Authors: Orenstein David M. , Dietrich Allen J.
Published: December 2021

We read with interest the article by Duff et al.1 on ambulatory pediatric training, and especially the comments by Drs. Haggerty and Green.2,3

A program which would be easily adapted to many different medical school settings and which meets most of Dr. Haggerty's criteria for initial ambulatory experiences has been in operation at Case Western Reserve University for three years.

The Medical Student Apprenticeship Program was conceived of, organized, and run by students. It is an official elective course in the Department of Community Health for first-and second-year students, some 40 to 50 of whom are now enrolled.
Blood Diseases Of Infancy And Childhood, ed. 3, by Carl H. Smith, M.D. St. Louis: The C. V. Mosby Company, 1972, 874 pp., $29.75
Authors: Pearson Howard A.
Published: December 2021

The third edition of Dr. Carl Smith's classical textbook has been published posthumously. Dr. Smith had completed much of the updating before his death and his colleagues at Cornell completed the task.

The book is comparable in number of pages with the second edition, but the size of the type has been reduced so that the actual written text is increased about 25%. The smaller type is a little difficult to read. As in the earlier editions, many of the illustrations are of only passable quality; and two of the book's color plates, which show the twin to twin transfusion syndrome and hemorrhagic measles, are hardly of signal hematologic importance.
REVOLUTIONS AND CYCLICAL RHYTHMS IN PRENATAL LIFE: FETAL RESPIRATORY MOVEMENTS REDISCOVERED
Authors: Dawes G. S.
Published: December 2021

Donald Paterson, for whom this lecture is named, was one of those giants of paediatric medicine who gave the Hospital for Sick Children at Great Ormond Street its great reputation. In the 1920s Donald Paterson played a vital part in the foundation of the British Paediatric Association. By the 1950s he had returned to Canada, but was by no means retired. I well remember his warm welcome to the participants in the Ross Laboratories Symposium here in Vancouver in 1958. That meeting heralded the application of methods, developed in the experimental laboratory, to the analysis of disease in premature infancy. It was the beginning of the end of a long era in which the doctrine of noninterference and of noninvestigation had been preeminent. For many it was not an easy transition. But for Paterson the new technology, the catheters, the body plethysmographs and new-style incubators, and the whole postwar development of experimental medicine provided a fertile ground for analysis, critical appraisal, speculation, and above all, encouragement. This was the most important gift that anyone in his position could have made, and he was generous.

It is interesting to look back and consider why this doctrine of noninterference with newly born sick children was so widely held. Unnecessary handling was known to be unwise, from practical experience. But of equal importance was the general view that the infant was relatively incompetent, feeble, incapable of communication, and unable to regulate its bodily functions adequately. It lost heat rapidly, its temperature regulation was poor, its urine dilute, its breathing periodic, its blood pressure low, and its immunity passive.
SOME SIMPLE HOME REMEDIES WIDELY USED FOR SICK CHILDREN IN 1846
Authors: C. T. E.
Published: December 2021

Mrs. Lydia Maria Child (1802-1880), a prolific writer of books of advice for mothers and housewives during the first half of the 18th century, recommended the remedies below for the treatment of some of the most common childhood illnesses.1

Ear-ache. Cotton wool wet with sweet oil and paragoric, relieves the ear-ache very soon.

Croup. Equal parts of camphor spirits of wine, and hartshorn, well mixed, and rubbed upon the throat, is said to be good for the croup.

Sore throat. Loaf sugar and brandy relieves a sore throat; when very bad, it is good to inhale the steam of scalding hot vinegar through the tube of a tunnel (a straw). Also a stocking bound on warm from the foot.

Constipation. Boil castor-oil with an equal quantity of milk, sweeten it with a little sugar, stir it well, and, when cold, give it to children for drink. They will never suspect it is medicine; and will even love the taste of it.

Tooth-ache. A Poultice made of ginger or of common chickweed that grows about one's door in the country, has given great relief to the toothache, when applied frequently to the cheek.

Cuts and Wounds. Balm-of-Gilead buds bottled up in New England rum, make the best cure for fresh cuts and wounds. Every family should have a bottle of it. The buds should be gathered in a peculiar state; just when they are well swelled, ready to burst into leaves, and well covered with gum. They last but two or three days in this state.
A Device for Administration of Continuous Positive Airway Pressure by the Nasal Route
Authors: Kattwinkel John , Fleming David , Cha Chul C. , Fanaroff Avroy A. , Klaus Marshall H.
Published: December 2021

The application of continuous positive airway pressure (CPAP) throughout the respiratory cycle constitutes a major breakthrough in the treatment of severe respiratory distress syndrome (RDS) of infancy. All studies to date have demonstrated improved oxygenation and lessened requirements for exposure to high environmental oxygen concentration following institution of therapy; improved survival has been suggested.

Various methods of application have been proposed. Originally, Gregory et al.1 advocated the use of an endotracheal tube or sealed head chamber. Chernick and Vidyasagar,2 and more recently Fanaroff et al.3 have suggested the use of continuous negative external pressure (CNP) applied to the body below the neck.
Hazards of the "Busy Box"
Authors: Fugazzotto David J.
Published: December 2021

A great deal of attention has been drawn to the hazards of many infant's and children's toys. I would like to add one more to the list. It is a contraption called a "Busy Box."

In the past two years I have treated four children, all between 8 and 24 months of age, for corneal abrasions sustained from contact with this apparatus.

It consists of a 12 x 14 x 2 inch plastic plaque-like box.
Letters to the Editor
Authors: Wehrle Paul F.
Published: December 2021

Dr. Paul F. Wehrle forwarded this letter to the Editorial Office with the following comment:

The letter from Dr. Kochen was first directed to the Committee on Environmental Hazards as a part of its Alert Practitioner Program. Since mid-1972, the Committee has been operating a surveillance program through three hospital centers, supported by a contract from the N.I.E.H.S. to the Academy. Specifically, we have been looking for possible associations between environmental hazards and disease states.
Letters to the Editor
Authors: Harrison Stanley L.
Published: December 2021

We referred the question of adequate information for parents and pediatricians on deafness in children to Dr. Stanley Harrison, Director, Department of Committees, American Academy of Pediatrics. Dr. Harrison writes:

Dr. Austin's concerns about recognition and treatment of the deaf or hard of hearing infant are shared by the American Academy of Pediatrics. The manual, Standards of Child Health Care (AAP, second edition, 1972, Appendix F, p. 120), contains an updated chart titled "Speech, Language, and Hearing" which includes a checklist for parental observation similar to the chart prepared by the Foundation of Hearing Research, Inc., P.O. Box 452, Redwood City, California, submitted with his letter.
Female Purses and Female Purse Snatchers (or the Editor Edited)
Authors: Sobel Edna H.
Published: December 2021

In their communication entitled "Purse" Poisons1 Drs. Shulman and Reddy make a good point, but in language that detracts from the value of their comments. For one thing, adult human beings, especially when their social functions are being referred to, are most appropriately called men or women. It sounds condescending to speak of adult women as ladies, in the context of the communication, and even more so to call them females. Moreover, the language is so imprecise that one not familiar with colloquial English might have to guess at the meaning.
Neonatal Dermatology (Vol. IX in the series Major Problems in Clinical Pediatrics), by Lawrence M. Solomon, M.D., and Nancy B. Esterly, M.D. Philadelphia/London/Toronto: W. B. Saunders, 1973, 214 pp., $16.50
Authors: Griesemer Robert D.
Published: December 2021

This is probably the first monograph in English about cutaneous disease in the newborn, a field in which there are only a handful of observers with adequate experience. Textbooks of dermatology and of pediatrics have only brief, unsatisfactory sections about this neglected field. Drs. Solomon and Esterly have had excellent training in both dermatology and pediatrics and have presented their special interest and knowledge in a very useful volume. It should be in the library of every pediatrician and dermatologist.
EVALUATION OF SCREENING TESTS FOR URINARY MUCOPOLYSACCHARIDES
Authors: Rezvani Iraj , Collipp P. J. , DiGeorge Angelo M.
Published: December 2021

A recently developed spot test, "MPS paper," has been added to other screening tests for urinary mucopolysaccharides. The effectiveness of this test has been compared to that of the cetytrimethylammonium bromide and the acid albumin gross turbidity tests in normal children and in patients with mucopolysaccharidoses. Although all these tests are effective in the detection of excessive mucopolysaccharides in urine, their excessive sensitivity yields many weak false-positives. We found "MPS paper" test to yield 34% false-positive tests, compared to 42% for cetytrimethylammonium bromide and 8% for the acid albumin gross turbidity test.

We have concluded that the acid albumin gross turbidity is the most reliable screening test for detection of mucopolysaccharide disorders. "MPS paper" spot test has the advantage of being simple and practical, but weak positive results should be interpreted with great caution; it has the added disadvantage of being the most costly of the screening tests at the present time.
OBSERVATIONS ON THE RELATIONSHIP BETWEEN DURATION OF RUPTURE OF THE MEMBRANES AND THE DEVELOPMENT OF IDIOPATHIC RESPIRATORY DISTRESS SYNDROME
Authors: Yoon Jing Ja , Harper Rita G.
Published: December 2021

Retrospective analysis of 211 premature infants between 1,001 and 2,165 gm at birth revealed a decreased incidence of idiopathic respiratory distress syndrome in infants with rupture of the membranes more than 24 hours prior to delivery. Infants with factors which are known to predispose to idiopathic respiratory distress syndrome (maternal hemorrhage, maternal diabetes, fetal asphyxia, twin B, history of a sibling with idiopathic respiratory distress syndrome and cesarean section) were then eliminated. One hundred and twenty infants remained. Infants with rupture of the membranes more than 24 hours prior to delivery had a significantly lower incidence of idiopathic respiratory distress syndrome when compared with infants with rupture of the membranes less than 12 hours prior to delivery (P<0.05).

From this study it appears that rupture of the membranes for more than 24 hours prior to delivery protects against the development of idiopathic respiratory distress syndrome.
PULMONARY FUNCTION STUDIES DURING THE FIRST YEAR OF LIFE IN INFANTS RECOVERING FROM THE RESPIRATORY DISTRESS SYNDROME
Authors: Bryan M. H. , Hardie M. J. , Reilly B. J. , Swyer P. R.
Published: December 2021

Serial measurements of pulmonary function during the first year of life were obtained in 38 premature infants following recovery from respiratory distress syndrome (RDS). Twenty-seven similar weight normal prematures were studied as controls. Serial measurements were made of functional residual capacity, dynamic compliance, and arterial blood gases.

All infants following the acute phase of RDS showed decreases in functional residual capacity and/or dynamic compliance, arterial PO2 and mild to severe carbon dioxide retention. Nine nonventilated infants returned to normal by age 2 to 4 months. Eight of 11 infants ventilated for RDS with subsequent development of bronchopulmonary dysplasia died by age 5 months. The 3 survivors had increased FRC, markedly decreased dynamic compliance, relative hypoxia, and carbon dioxide retention throughout the first year. Eighteen ventilated infants with clinical recovery showed considerable individual variations, but the mean group arterial PO2 was lower than normal from 6 to 12 months of age. Abnormalities in chest radiographs were common in infants after ventilation and readmission to hospital for respiratory problems during the first year of life occurred in 8 of 21 surviving infants initially ventilated for RDS.
Gonococcal Tonsillitis-Pharyngitis in a 5-Year-Old Girl
Authors: Abbott Stephen L.
Published: December 2021

A case is presented of gonococcal tonsillitis-pharyngitis in a 5-year-old girl with a brief review of the clinical spectrum of gonococcal oropharyngeal infection. The importance is stressed of recognizing this entity as a potential manifestation of child molestation.
Patient Response Toward a Change in the System of Health Care Delivery
Authors: Motil Kathleen J. , Siar W. John
Published: December 2021

With the emphasis being placed on comprehensive health care, outpatient clinics in major city hospitals have found it necessary to reevaluate their methods of health care delivery. An increasing number of patients who fail to schedule or keep medical appointments appear for crisis care, resulting in a higher cost of hospital operation due to unnecessary utilization of emergency rooms and the wasting of time of clerical and professional personnel, as well as poor quality of health care due to

See the Table in PDF File

sporadic clinic attendance. When comparing behavior patterns and attitudes of clinic patients under different methods of health care delivery, patient preferences become apparent.
Child Health Associates and Pediatric Nurse Practitioners: Their Competence
Authors: Stone Frederic M.
Published: December 2021

As a recent trainee in pediatrics at the University of Colorado, it was with considerable interest that I read the article by Drs. Silver and Ott and the commentaries that followed.1-4 During my training, I had the opportunity to observe and participate in the education, training, and evaluation of both child health associates and pediatric nurse practitioners. As one interested in the problems of health care delivery, I have followed the development of these programs (CHA and PNP) with special interest and in relationship to my own experience as a recent pediatric house officer.
Letters to the Editor
Authors: Silver Henry K. , Ott John E.
Published: December 2021

Dr. Stone raises a number of pertinent items in his letter. However, it should be pointed out that he had contact only with first- and second-year child health associates who had completed approximately half or less of their training. As do all medical practitioner students, child health associates first need to acquire a data base which can then be used in developing diagnostic and interpretive clinical skills. Clinical experience in the practice of medicine is often required before the student can separate normal from abnormal, and the esoteric from the commonplace.
Letters to the Editor
Authors: Bierman C. Warren
Published: December 2021

Dr. Bergner is quite correct in pointing out that skin testing with a freshly prepared penicillin solution will select out only about 30% of patients who are anaphylacticly sensitive to penicillin.1 On the other hand, the use of a sterile solution of benzylpenicillin diluted with alkaline buffered saline (pH 7.6) and permitted to stand at room temperature for at least two weeks appreciably increases the number of patients so detected.2 We would agree that the availability of a penicilloyl polylysine (PPL) testing solution and a stabilized minor determinent mixture (MDM) would greatly enhance the armamentarium of the clinician to detect anaphylactic sensitivity to penicillin.3
Transracial Adoption
Authors: Shearer William T. , Shearer Mary I.
Published: December 2021

The recent statement by the Committee on Adoption and Dependent Care1 is to be lauded for most of its content.

The conference mentioned held in St. Louis, April 1972, the Third North American Conference on Adoptable Children, was not named as a conference on interracial adoption as were its predecessors because parents' groups supporting these conventions wished to promote the adoption of all available children regardless of reason for nonadoption.

The final statement phrase that ". . . the child will surely be sacrificed to the popular movement of his day" falsely implies that the practice of interracial adoption is a widespread, new phenomenon that will be harmful to the involved children.
Letters to the Editor
Authors: Feiertag Richard B.
Published: December 2021

It was not the intent of our committee to impede the practice of transracial adoption. However, we feel that this a very sensitive area of social practice and one in which hazards do exist.

We recognize that there are humanitarian and psychological overtones in every adoption, but welfare of the individual child must receive the highest priority. Other considerations are of secondary importance.

A previous statement, "Adoption of Black Children,"1 described the efforts that are being made to promote the placement of black children, both within their own race and transracially.
Nutrition and Development, edited by Myron Winick. New York: John Wiley & Sons, 1972, 245 pp., $17.50
Authors: Dobbing John
Published: December 2021

This collection of six essays on developmental nutrition will probably be of considerable interest to nutritionists, but it is my impression that pediatricians will derive less benefit from them. In his preface Dr. Winick claims that the book "synthesizes existing knowledge" in the field. My impression is that it reports and brings together a good deal, but synthesizes little. Indeed my main criticism is the absence of any discernible theme emerging from a great deal of experimentally derived fact.
HEMATOCRIT: MATURITY RELATIONSHIP IN ADOLESCENCE
Authors: Daniel W. A.
Published: December 2021

The time of onset of adolescence, the velocity of change, and the age at which somatic maturity occurs varies with each individual. Chronologic age, per se, provides little information as to growth and development. The sequential changes in secondary sex characteristics can be divided into five stages and then one of these assigned as a "maturity rating" to any patient. Hematocrit determinations were performed on 1,007 girls and 1,000 boys, aged 11 to 20 years. All patients were from low-income families and each boy or girl was examined and classified according to maturity rating, sex, and color. In boys, correlation of hematocrit determinations and sex maturity ratings showed an increase in the hematocrit percentage with an increase of maturity rating. Boys have a smooth, progressive rise in hematocrit levels as they mature and this increase is apparently associated with the production of testosterone and the development of greater muscle mass. Hematocrit values increase in relation to chronologic age, only when sexual maturation is taking place, thus evaluation of anemia based only on age may be incorrect. Hematocrit determinations related to sex maturity ratings provide a logical criterion for the diagnosis of anemia and of therapeutic response in its treatment.
Sex Difference in Hepatitis-Associated (Australia) Antigen Carrier State One Year After Hepatitis Outbreak
Authors: Curtis Jerry L. , Samper Luis , Rodriquez Luis A. , Garrett Martha G.
Published: December 2021

In late 1969 an outbreak of hepatitis occurred in the mental retardation unit of a large mental institution. Six percent of the residents (45 of 780) were clinically diagnosed as having hepatitis during this period. Hepatitis-associated antigen (Australia antigen) studies made one year later on this same population and examined for relationship to diagnostic category, age at admission, length of residence, sex, race, ward, serum enzyme levels, immunoglobulin levels, and prior history of hepatitis showed positive correlation for sex (males, 49 of 51 positives), diagnosis (Down's syndrome patients were carriers at twice the rate of the rest of the population), and serum enzyme levels (SGOT significantly elevated in carriers as compared to other patients). No correlation was found with prior history of hepatitis or any other variable considered.
HEALTH STANDARDS FOR JUVENILE COURT RESIDENTIAL FACILITIES
Authors: Hazard Sprague W. , Allen V. Robert , Eisner Victor , Garell Dale C. , Hofmann Adele D. , James W. Scott , Shen Jerome T. Y. , Welty John A. , Wolfish Martin G. , Shaffer Thomas E. , Gallagher J. Roswell , Tanner Natalia M.
Published: December 2021

Young people who find themselves in juvenile court facilities constitute a group who traditionally have displayed a high incidence of health problems. Many have had inadequate care in the past, and enter with preexisting medical and dental conditions. Whether or not they are in good physical health, they often are handicapped in the area of mental health. The conditions which necessitate removing them from their homes and placing them in institutions may aggravate, or even cause, physical and mental health problems.

When society undertakes to remove children and youth from their homes and place them in institutions away from the care of their parents, it assumes certain obligations. Among these obligations is care of their physical and mental health.

Health programs in juvenile court facilities must be broad and comprehensive and must go beyond the mere provision of medical care. The extent of the health care which should be offered to an individual will depend on the length of time he is in the institution. But, every institution which confines juveniles should have a health program designed to protect and promote the physical and mental well-being of residents, to discover those in need of short-term or long-term medical and dental treatment, and to contribute to their rehabilitation by appropriate diagnosis and treatment and provision of continuity of care following release.

The standards given here are designed to attain these goals.

ADMINISTRATIVE STRUCTURE OF THE HEALTH PROGRAM

Health Council

1. Each institution should have a multidisciplinary health council to set the policies of the health program.

2. The council may be organized within the institution or by the authority which operates the institution.
To Tap and How To Tap
Authors: Zisman A. S.
Published: December 2021

I have read the several articles in the March 1973 issue of Pediatrics concerning lumbar puncture.1-3

I think it would have been appropriate to review some of the technical features of lumbar puncture to which reference was made, but which were not fully delineated. I would have liked the following questions answered: (1) Are all children of all ages given a local anesthetic before the introduction of the spinal needle? (2) To what degree is the "doubling up and tight positioning of the child" required for ease of entry, versus the control of a child struggling because of pain?
Letters to the Editor
Authors: Byers Randolph K.
Published: December 2021

To Dr. Zisman:

Dr. R. K. Byers, after noting that your questions "are ones to which there are probably no generally accepted answers" answered them as follows:

Answer to Question 1: This depends on the habits of the operating physician. Personally, I use a good deal of local anesthetic, probably in 90% of the cases in which puncture is done for I think it is easier to do a lumbar puncture if the subject is unaware of the time that the needle is being stuck in his back.
Intrauterine Diagnosis for Sickle-Cell Disease
Authors: Carr John M.
Published: December 2021

In Pediatrics, Volume 51, No. 4, April 1973, there is a commentary by Fost and Kaback entitled, "Why Do Sickle Cell Screening in Children?"1 On page 742 there appears this statement, "Genetic counseling might assist parents in family planning and the possibility of intrauterine diagnosis of sickle-cell disease would offer a more meaningful opportunity for parents at risk to bear healthy children." This statement seems vague and confusing in an otherwise reasonably straightforward article. If the authors are suggesting that such women either be aborted or counseled concerning the possibilities of this, why not come out and say so?
Letters to the Editor
Authors: Fost Norman
Published: December 2021

Thank you for forwarding Dr. Carr's letter. We would not suggest that anyone undergo abortion or be counseled concerning abortion without knowing the specifics of the individual case. We only wished to point out that the possibility of intrauterine diagnosis and selective abortion would offer a positive alternative to those couples who presently refrain from having any children because they find unacceptable or unsatisfactory the choices of adoption, artificial insemination, and "gambling."

Intrauterine diagnosis would, of course, offer no new alternative to those who find abortion unacceptable.
The Physician's Assistant–Today and Tomorrow, by Alfred M. Sadler, Jr., M.D., Blair L. Sadler, J.D., and Ann A. Bliss, R.N., M.S.W. New Haven, Connecticut: Yale University Press, 1972, 189 pp., $11.75
Authors: Yankauer Alfred
Published: December 2021

The field encompassed by the term "physician extenders," a better description of the contents of this book than "physician's assistant," is rapidly changing. Thus, any view of the field at one point in time is apt to be limited and even misleading. This little paperback paints the picture as it was in 1971. Its coverage of historical background and its extensive bibliography are useful. However, some of the peer group statements which it reproduces or quotes have been superseded, others soon will be.
ASSESSMENT OF THE ROLE OF STAPHYLOCOCCUS EPIDERMIDIS AS A CAUSE OF OTITIS MEDIA
Authors: Feigin Ralph D. , Shackelford Penelope G. , Campbell Joel , Lyles Thomas O. , Schechter Miriam , Lins Robert D.
Published: December 2021

One hundred thirty children with clinical evidence of otitis media were studied. Cultures were obtained from the external auditory canal (prior and subsequent to cleansing), the middle ear (by needle aspiration), the nasopharynx, and throat. Gram stained smears of purulent material obtained from the middle ear were prepared. Isolates of Staphylcoccus epidermidis from the middle ear of patients with otitis media, S. epidermidis isolates from skin, S. epidermidis isolates from blood, and S. aureus isolates from blood were evaluated with regard to lysostaphin sensitivity, lysozyme production, DNAse production, oxygen consumption, growth rate and sensitivity to antibiotics and compared with each other. In ten patients S. epidermidis grew in pure culture on solid media and in nine of these individuals a gram stained smear showed gram-positive cocci within polymorphonuclear leukocytes. Each of these patients had a febrile illness and a bulging red tympanic membrane. Seven of the ten isolates were resistant to penicillin. With regard to most of the metabolic characteristics measured, isolates of S. epidermidis from the middle ear were similar to both pathogenic and nonpathogenic S. epidermidis recovered from other sources. Staphylococcus epidermidis may be the etiologic agent responsible for purulent otitis media in a small number of patients.
In Reply: How "Regular" (and What?) Is the "Regular Source of Medical Care?"
Authors: Starfield Barbara
Published: December 2021

Drs. Mindlin and Lobach have raised interesting points in their letter. In our paper we described respondents' perceptions, corroborated by some independently obtained data about the ease of consulting the physician identified as the one from whom care is said to be usually sought. It was our aim to show how these perceptions of regular source of care vary with type of physician. The study dealt with children of all ages and socio-economic class in an entire metropolitan area.
In Reply: Common Clinical Cardiological Problems: The Absence of Arbitrary Answers
Authors: Noonan Jacqueline A.
Published: December 2021

The comments above by Drs. Silver and Joos pertain to some important and quite complicated clinical situations. They pose questions which do not lend themselves to simple arbitrary recommendations by the Academy. All involve a good deal of basic understanding of the pathophysiology of congestive heart failure and congenital heart disease in general. I doubt a simple arbitrary recommendation of any of the listed problems could be given which would cover every clinical situation.

Active participation by trained pediatric cardiologist in both the training of medical students and house staff is, of course, a good and usual way for "future" pediatricians to learn how to manage "common pediatric cardiologic problems."
A New Syndrome? Or Galactosemia?
Authors: Harris Ruth C.
Published: December 2021

The interesting paper by W. B. Wadlington and Harris E. Riley1 discusses clearly the hepatic problems encountered in the newborn period, particularly metabolic disorders such as galactosemia, fructose intolerance and amino acid disorders. Also pertinent is the statement "abnormal accumulation of fat in its parenchymal cells is one of the most common responses of the liver to injury."

It is quite possible that this infant had galactosemia with liver damage, presenting early with steatosis, poor hepatic cell function producing high indirect (and some direct) bilirubinemia and poor albumin production.
The State of Nutrition in the Arab Middle East, by Vinavak N. Patwardhan, Ph.D., and William J. Darby, M.D., Ph.D. Nashville, Tennessee: Vanderbilt University Press, 1972, 308 pp., $15
Authors: Sadre Mahin
Published: December 2021

Drs. Patwardhan and Darby have awarded the medical world with a fine and richly detailed review of the state of nutrition in the Arab Middle East. Their book is based on published and/or unpublished research findings and data on nutrition surveys in those countries chosen for their subject.

The geographical location of study is a veritable storehouse for in-depth studies in nutrition; however, the authors repeatedly deplore the insufficiency and limitation of available data due perhaps to political and certainly to cultural factors.
Paediatrische Radiologie: Stützgewebe-Zentralnervensystem-Syndrome, Vol. I, by Franz Schmid. Berlin/Heidelberg/New York: Springer-Verlag, 1972, 504 pp., $78.70
Authors: Neuhauser Edward B. D.
Published: December 2021

Only the first volume of this projected two-volume textbook of pediatric radiology is available for review. Included in the first volume is a discussion of bones and soft tissues, the central nervous system, and 100 pages of syndromes in brief tabulated form.

This is a handsome book written in German with 451 excellent illustrations. Few of the 16 contributing authors are well known in this country and it would seem that few are full-time pediatric radiologists.
Vectorcardiography in Congenital Heart Disease: A Method for Estimating Severity, by R. Curtis Ellison, M.D., and Norma J. Restieaux, M.B., Ch.B., F.R.A.C.P., M.R.C.P. (London) with a forward by Alexander S. Nadas, M.D. Philadelphia/London/Toronto: W. B. Saunders Company, 1972, 209 pp., $13.50
Authors: Neill Catherine A.
Published: December 2021

This beautifully produced book not only shows excellent examples of specific congenital lesions and discusses them in an erudite manner, but also refers to the literature in a comprehensive way. It, therefore, will become a necessary reference book for anyone working in the field of the noninvasive assessment of severity of congenital cardiac lesions.

As might be expected from the special interests of the Boston group, the chapter on aortic stenosis is outstanding and provides excellent examples and a good review of the problem.
URETHRAL PROLAPSE IN YOUNG GIRLS
Authors: Klaus Hanna , Stein Robert T.
Published: December 2021

Five new cases of circular urethral prolapse in young girls occurred. All had vaginal bleeding. The proposed etiologies, differential diagnoses, management, and treatment are presented.

Prolapse of the urethra should be considered in the differential diagnosis of girls with minimal bleeding per vaginam.
An Alternative Model Act Providing for Consent of Minors for Health Services
Authors: Daniel William A. , Rigc C. Andrew
Published: December 2021

The "Model Act Providing for Consent of Minors for Health Services" proposed by the Committee on Youth of the American Academy of Pediatrics and published in Pediatrics in February 1973 (Vol. 51, No. 2, pp. 293-296), has been considered at length by the members of the Committee on Legislation Concerning Adolescents' Medical Care of the Society for Adolescent Medicine. We consider that the proposed AAP Model Act is unwieldly: it is too long and in places ambiguous.
A MODEL BILL FOR MINORS' CONSENT TO HEALTH SERVICES
Authors: Rigg C. Andrew , Bright George M. , McKusick Marjorie J. , Ris Hania , Werner Stanley C. , Wessel Morris A. , Hirsch Richard A. , Pilpel Harriet F.
Published: December 2021

I. Declaration of policy and statement of intent:

As a general rule of policy, parents should participate in all health care decisions relating to their minor children whenever feasible. At the same time, no legal barrier should exist to prevent minors from receiving needed health care. This article responds to the needs of certain categories of minors to be able to receive health services on their own consent in order to protect their health and the health of others.
Letters to the Editor
Authors: Hazard Sprague W.
Published: December 2021

This communication greatly exceeds the limit of 300 words we try to impose on correspondents. In view of the interest of the subject, and to encourage discussion in these columns by members of the A.A.P. Committee on Youth and others, that restriction has been lifted.

For the Committee on Youth, Dr. Hazard comments as follows:

One of the goals in developing "A Model Act Providing for Consent of Minors for Health Services" was to stimulate the health and legal communities into action regarding the unique and often very difficult situation in which the young person finds him or herself when they have a health problem.
Letters to the Editor
Authors: Klein Michael , Roghmann Klaus , Woodward Kenneth , Charney Evan
Published: December 2021

Dr. Klein and his co-authors comment as follows:

Dr. Gordon T. Moore has raised extremely pertinent questions in relation to our article on "The Impact of the Rochester Neighborhood Health Center on Hospitalization of Children."

Regarding his first point, we do acknowledge that the possible selection of low risk patients by the Health Center was not explored in the present study. Other local studies1 do not support his notion, however, and the registration process of the Health Center if anything tends to recruit and pursue high risk patients.
Pediatric Otolaryngolocy, Vol. II, ed. 2 of the Respiratory Tract in Children, edited by Charles F. Ferguson, M.D., F.A.C.S., and Edwin L. Kendig, Jr., M.D., Sc.D. (Hon.). Philadelphia/London/Toronto: W. B. Saunders, 1972, pp. 819-1369, $25.00
Authors: Stool Sylvan
Published: December 2021

This book is the second volume of a two-volume set, the first devoted to the lower respiratory tract and this to pediatric otolaryngology. The volume is designed to have a broad appeal rather than be a definitive text on pediatric otolaryngology.

Each section of the book, which is divided anatomically, begins with an appropriate and concise description of the embryology and anatomy of the region. Most of the sections have a description of the methods of examination which is of value to the pediatrician who may not be familiar with special methods and for the otolaryngologist who may not see many children.
Hodgkin's Disease, by Henry S. Kaplan. Cambridge: Harvard University Press, 1972, 452 pp., $16.50
Authors: Strum Stephen B.
Published: December 2021

Dr. Kaplan's Hodgkin's Disease is a classic in medical literature. It is the definitive work on Hodgkin's disease published to date, and probably for years to come. The text is comprehensive; no significant aspect of the disease is excluded from discussion. In addition, Dr. Kaplan's vast personal expericnes with this disease are shared with the reader in matters of academic and practical nature. The book is a product of a lifetime of work by the world's leading expert on Hodgkin's disease-no higher recommendation of its worth could be made.
SOME PENNSYLVANIA GERMAN FOLK REMEDIES TO EASE TEETHING PAINS
Authors: C. T. E.
Published: December 2021

The following folk remedies to ease the child's pain during teething were once widely used by Pennsylvania German families:

"Rub the child's gums with rabbit brain before the child is six months old; rub the child's hard palate during dentition with your thumb; grease the child's gums with fat from the pan in which meat was fried. Rub the gums with the rattles of a rattlesnake; pass a small fish through the mouth of a child to ease pain; suspend a rabbit's tooth about the child's neck; pass the comb of a decapitated cock through the mouth of the child before the cock is fully dead."
Factors In Child Neglect– Working Indian Mothers
Authors: Browder J. Albert
Published: December 2021

Oakland and Kane's1 failure to find a correlation between employment of Indian mothers and child neglect should help clarify misconceptions of professionals dealing with Navajo Indians. Undoubtedly, perpetuation of such misconceptions is closely related to Indian health problems subsequently defined by Mortimer2 and Kemberling.3 It should be appreciated that since Indian tribes vary widely in their life style, statements applying to Navajos are not necessarily uniformly applicable to all Indians.

Misconceptions such as "out-of-home employment leads to abuse and neglect" help explain why progress has been slow in dealing effectively with this major social problem.
Pollution, Emotions, Mental Health
Authors: Frazier Claude A.
Published: December 2021

I would appreciate hearing from anyone regarding the effects of pollution on emotions and mental health; i.e., letters, case reports, reprints, books, and so forth. Please send the information to the following address:
Letters to the Editor
Authors: Froehlich Luz A.
Published: December 2021

Dr. Froehlich comments as follows:

There are several reasons for the apparent higher mortality rate in our population compared to those cited.

1. As was indicated in the footnote of Table I, our mortality rate includes not only perinatal deaths but also infant deaths.

2. Our population consists of 46% blacks, 46% whites, and 8% Puerto Ricans and other races.1 The general United States population consists of about 10% to 11% blacks.

3. Except for one institution (University of Buffalo) our study population consists of clinic patients.1
Female Sex Anomalies, by Cary M. Dougherty, M.D., and Rowena Spencer, M.D. New York/Evanston/San Francisco/London: Harper & Row, Publishers, 1972, 273 pp., $12.75
Authors: Simpson Joe Leigh
Published: December 2021

The diagnosis and management of abnormal sexual development is confusing for many clinicians, although recent genetic and endocrine advances have helped clarify these disorders. Several books on abnormal sexual development have appeared, including Female Sex Anomalies, by Cary M. Dougherty and Rowena Spencer, respectively, an obstetrician-gynecologist at the Louisiana State University School of Medicine and a pediatric surgeon at Tulane University School of Medicine. Drs. John C. Weed and A. H. Sellmann also contribute.
We Mainline Dreams: The Odyssey House Story, by Judianne Densen-Gerber, J.D., M.D. New York: Doubleday & Company, Inc., 1973, 421 pp., $9.95
Authors: Faigel Harris C.
Published: December 2021

This is a highly personal, autobiographical book which has been written in the first person by a "ghost" and realistically describes some of the difficulties in starting a program for the rehabilitation of young drug abusers. Often absorbing, sometimes moving and dramatic, and sometimes overblown and repetitious, this book documents Densen-Gerber's own growth and maturation as a participant as well as her experience in founding Odyssey House.

Densen-Gerber and former residents of Odyssey House describe their life and work together in a series of autobiographical sketches interwoven through the book.
Behavior Disorders in Children, ed. 4, by Harry Bakwin, M.D., and Ruth Morris Bakwin, M.D. Philadelphia/London/ Toronto: W. B. Saunders, 1972, 714 pp., $17.50
Authors: Cohen Donald Jay , Berger Lawrence R.
Published: December 2021

The authors of this book never state for whom their text is intended; as reviewers representing a range of involvement with child psychiatry and pediatrics, we can recommend it to no particular group. Among the book's very genuine assets are its breadth of scope, clinical orientation, extensive references, and eminently readable format. Unfortunately, the volume's inaccuracies, simplifications, and distortions make it an unreliable reference for pediatricians.

No theoretical framework of child development and its disturbances is presented.
Sickle Cell Disease: Diagnosis, Management, Education and Research, Co-Chairmen and Editors–Harold Abramson, M.D., John F. Bertles, M.D., and Doris L. Wethers, M.D. St. Louis: The C. V. Mosby Company, 1973, 352 pp., $29.50
Authors: Nathan David G.
Published: December 2021

This is a very well-edited compilation of papers presented at a conference held two years ago under the auspices of the National Foundation–March of Dimes and the Foundation for Research and Education in Sickle Cell Disease. It is an expensive book (8 cents per page), but it represents a sound investment for those interested in the fascinating and important field of hemoglobin structure and function. There are many excellent presentations. The clinical chapters by Heller, Pearson, and Diggs, the ultrastructural studies of White and Bertles, and the electrophoretic techniques so clearly outlined by Rose Schneider are very useful.
Pediatric Cardiology, by Mary Allen Engle, Guest Editor (Cardiovascular Clinics Series, Vol. 4, No. 3). Philadelphia: F. A. Davis Company, 1972, 366 pp., $12.00
Authors: Steeg Carl N.
Published: December 2021

This volume seeks to present the current "state of the art in pediatric cardiology." It is an immensely readable work which has a distinguished roster of contributors who have broadly covered both newer clinical and investigative aspects of heart disease in children, as well as reviewing ever current topics such as the cyanotic newborn, congestive failure, innocent murmurs, electrocardiography, and radiography of patients with congenital heart disease, to mention a few.

Other chapters deal with such subjects as neuropharmacologic studies of the perinatal myocardium, embryology and morphology of the normal and abnormal heart, pediatric aspects of atherosclerosis, surgical treatment of tetralogy of Fallot, and the pharmacology of cardio-active agents.
Letter to the Editor
Authors: Harrison Stanley L.
Published: December 2021

I am sure that the Executive Board, the central office staff, the Council on Child Health, and the Committee on Infant and Preschool Child-all of whom were involved in the preparation of the Policy Statement on Day Care—welcome the publication of the letter reflecting the concerns of the Indiana Chapter. I can assure Dr. Sweeney and the others on his Executive Committee that these concerns were well aired in discussion by the Board, the Council, and the Committee during the preparation of this statement.