bluuebunny/crossref_metadata_2025 huggingface dataset:
HOW HENOCH TREATED CHILDREN WITH ENCOPRESIS
Authors: C. T. E.
Published: December 2021

Edward Heinrich Henoch (1820-1910) is usually remembered for his description of punpura but his contribution to pediatrics goes far beyond the form of purpura which bears his name. As the Director of the Department for Children's Diseases in the Royal Charité Hospital, Berlin from 1872 to 1893 he, more than anyone else, initiated the modern concept of pediatrics.1

From his superb textbook entitled, Lectures on Children's Diseases, the following description of how easily Henoch treated encopresis may surprise the contemporary physician faced with this vexing symptom:

In October 1879, a boy of 8 years was brought to the polyclinic who, for the last 2 years, had not been able to retain his faeces. . . . He dirtied his clothes several times a day, but never during the night time.
HOW TO RAISE A HUMAN BEING, by Lee Salk, Ph.D. and Rita Kramer, New York: Random House (201 East 50th Street, New York 10022), 1969, 205 pp., $5.95
Authors: Whipple Dorothy V.
Published: December 2021

Dr. Lee Salk, Director of the Division of Psychology, Department of Pediatrics, at the New York Hospital—Cornell Medical Center, and Mrs. Rita Kramer, a well-known editor and writer on child development for magazines and educational television, have done an excellent job of describing the needs of a human being for optimal development from birth (and even before birth) to maturity. They discuss how a child develops emotional stability, how he learns to accept limits, and develops warm relations with other people.
TERATOLOGY OF THE CENTRAL NERVOUS SYSTEM, by Harold Kalter. Chicago: The University of Chicago Press, 1968, 483 pp., $17.50
Authors: Gilles Floyd H.
Published: December 2021

Kalter's monograph is a compendium of congenital malformations of the central nervous system organized by agent or method (Part 1) or by animal (Part 2). As such it is a valuable source of teratological information to 1967. While largely a resume of literature, it includes a reserved presentation of the author's contribution to teratology. The bibliography of 94 pages seems well coordinated not only by the organization of individual chapters but by adequate author and subject indices.
INFANTS AND MOTHERS: DIFFERENCES IN DEVELOPMENT, by T. Berry Brazelton, M.D., with a foreword by Jerome S. Bruner. New York: Dell Publishing Company, 1969, 296 pp., $10.00
Authors: Finch Stuart M.
Published: December 2021

This is an excellent book not only because it deals as the title suggests in "differences in babies" but because it also deals with babies and their families in general. It is written by a pediatrician who obviously has had much experience with infants and their families. Perhaps the main point the author attempts to make throughout the book is that there are constitutional differences in infants and that families should learn to adjust to them.
ARTHROGRYPOSIS MULTIPLEX CONGENITA: TWENTY-THREE CASES IN AN ARAB KINDRED
Authors: Lebenthal Emanuel , Shochet Solly Barnard , Adam Avinoam , Seelenfreund Moshe , Fried Amnon , Najenson Theodore , Sandbank Uriel , Matoth Yehuda
Published: December 2021

An Arab kindred is described in which 17 males and six females had clinical manifestations of arthrogryposis multiplex congenita (AMC). The syndrome, which is present at birth, is expressed mainly by flexion and extension contractures of the knees and elbows, with muscle weakness around the involved joints. Six patients had associated congenital heart disease which caused death in five. One patient was mentally retarted.

Electromyographic studies failed to reveal any participation of the lower motor neurons. Histological and biochemical findings suggest a myogenicetiology.

The pedigree data, being characterized by a very high rate of consanguinity among the parents of the affected and the existence of 20 normal off-spring of three affected males, demonstrate the autosomal recessive mode of inheritance, which is in contrast to the dominant pattern observed in neurogenic AMC.
The Frequency of Asymptomatic Hypoglycemia in High Risk Newborn Infants
Authors: Guthrie Richard , Van leeuwen G. , Glenn Linda
Published: December 2021

Serial blood glucose determinations were performed on 109 high risk and 25 normal term infants. Eight of these risk infants (7.3%) had at least two glucose determinations of less than 20 mg/100 ml; 20 (18%) had at least one determination less than 20 mg/100 ml. Although no documented clinical significance of transient asymptomatic hypoglycemia is known to date, it occurs very frequently in high risk infants. Therefore, we advocate that the current practice of very early oral or intravascular feeding in risk infants be continued.
ADRENERGIC NEURONE AND RECEPTOR ACTIVITY IN THE IRIS OF THE NEONATE
Authors: Lind Norma , Shinebourne Elliot , Turner Paul , Cottom Denis
Published: December 2021

In premature and full-term infants, the response of the dilator pupillae muscle to directly and indirectly acting sympathetic amines was measured.

Phenylephrine always produced a mydriasis, whereas the response to tyramine and hydroxyamphetamine, which was positively correlated with age, tended to be absent in the least mature, smaller babies. The results indicate that, in this situation, the end organ has the capacity to respond to the sympathetic neurohumoral transmitter, but that the synthesis, storage, or release of neuronal noradrenaline may be deficient.
A 1-year Experience with Phototherapy for Jaundice of Prematurity
Authors: Giunta Frank
Published: December 2021

When premature babies were exposed from birth to environmental lighting of 90 footcandles and placed under "daylight" illumination of 500 footcandles, if the indirect bilirubin appproached or rose above 10 mg/100 ml., serum bilirubin was maintained at less than 12 mg/100 ml in all but 3.1%, compared with 27.5% in a control group treated from birth and for 6 days only under environmental (90 footcandles) lighting. The difference is statistically very highly significant; and this management of jaundice avoided exposing over 80% of our prematures unnecessarily to high-intensity illumination.
Malformations and Maternal Nutrition (Correction of an Error Published Elsewhere)
Authors: Owen George M.
Published: December 2021

The following erratum will be included in reports of the 60th Ross Conference on Research, "Problems of Nutrition in the Perinatal Period," which are distributed in the future.

Because the Report of the 60th Conference was widely distributed before the error was called to my attention (see attached correspondence), I would greatly appreciate your publishing this letter in Pediatrics so that earlier recipients of the Report will be aware of this unfortunate error.
Clinical Pathology in Mental Retardation, by R. D. Eastham, B.A. (Cantab.), M.D. (Cantab.), F. C. Path., D.C.P., Dipl. Path. and J. Jancar, M.B., B.Ch., B.A.O., D.P.M. (N.U.I.). Baltimore: The Williams & Wilkins Company, 1968, 353 pp., $13.25
Authors: Crocker Allen C.
Published: December 2021

One may applaud the earnestness of the present authors in their conception of a "clinical pathology" for mental retardation syndromes as an aid to pediatric workers, but then one must admit with regrets that the work fails in all critical areas. Coursing over all major inborn metabolic errors, cytogenetic syndromes, and acquired detrimental occurrences to fetuses or infants, the book fails to settle on a creditable description of the central issues of any. Framed in a scientific format, the text nonetheless allows painful inaccuracies to be perpetrated in every section.
CONGENITAL RUBELLA: PATHOGENESIS OF MOTOR DEFICITS
Authors: Zausmer Elizabeth
Published: December 2021

Study of the motor behavior of 43 children, ages 3 to 4½ years, with major hearing loss and a history of maternal rubella revealed a relation between the character and degree of their motor deficits and the maternal gestational age at which the infection had occurred. It appears that infection during the first 4 gestational weeks results in the greatest multiple handicaps for rubella children, and that the most serious motor deficits are associated with this period of pregnancy. It was also found that locomotor activities that require the maintenance of upright posture and equilibrium are most frequently, though not seriously, affected if the rubella infection occurs between the fifth and the eighth week of gestation; the risk of motor deficits is considerably reduced if infection occurs after the eighth week of pregnancy. The result of the study supports the hypothesis that motor deficits in children with congenital rubella can be attributed to damage at specific stages of embryologic development, when the structures that will be involved in a particular motor activity are in their most crucial stage of organization and differentiation.
ELEVATED URINARY SECRETORY IgA IN CHILDREN WITH URINARY TRACT INFECTION
Authors: Uehling David T. , Steihm E. Richard
Published: December 2021

Urinary immunoglobulins, especially locally secreted IgA, are a measure of the immune response to urinary tract infection (UTI). Urinary immunoglobulins have been quantitated in normal children and children with glomerulonephritis, the nephrotic syndrome, and urinary tract infection. Children with urinary tract infection show a unique elevation of urinary secretory IgA. The highest levels of urinary secretory IgA were found in children with severe anatomic derangements. Secretory IgA was elevated after UTI in 36% of female children without an identifiable anatomic abnormality and 77% of those with an abnormality. Maturation of the local immune response of the urinary tract is evidenced by increasing urinary secretory IgA levels with age.
IODIDE GOITER IN THE NEWBORN
Authors: Senior Boris , Chernoff Harvey L.
Published: December 2021

A hyperthyroid mother, treated with potassium iodide, gave birth to a baby with an enormous goiter. The infant, although hypothyroid, had massive cardiomegaly and high output failure due to a shunt across the vessels of the goiter. Administration of thyroid caused shrinkage of the gland and concomitantly the heart became smaller. The infant then developed hyperthyroidism which persisted for several months.

The late stage of onset of hyperthyroidism in the infant, the inability to demonstrate LATS in mother or child, and the resemblance to other reported cases of iodide goiter in infancy together indicate that the hyperthyroidism may have been a consequence of the iodide goiter rather than a result of the transmission of LATS from the hyperthyroid mother.
ALDOSTERONE SECRETION RATES IN CHILDREN WITH NORMAL ADRENAL FUNCTION
Authors: Bryan George T.
Published: December 2021

Aldosterone secretion rate (ASR) was measured in 17 children during low, normal, and high dietary sodium intakes. Their ages varied from 3 months to 16 years; there were eight girls and nine boys. The average ASR with low, normal, and high sodium intakes were 236, 77, and 18 µg/ day respectively. The independent contribution of patient age, sex, sodium and potassium intake, and duration of fixed sodium intake was tested by least squares multiple regression analysis. The most important independent variable was sodium intake, although the sex and age of the patient were statistically significant variables. From this study it seems unlikely that precise control of all nutrients is necessary for evaluation of ASR if careful attention is paid to sodium intake.
A Dangerous Situation Encountered in the Administration of Oxygen to an Infant in a Baby Warmer
Authors: Indyk Leonard
Published: December 2021

One method of elevating the ambient oxygen of a small baby during the admission procedure is to place his head in an oxygenated hood. We describe here a situation recently encountered in which a premature infant who was being provided 68% oxygen environment, administered with the aid of a head hood in an infant warmer, and was effectively cut off from the source of radiant heat.

The hood which was utilized was made of ⅛'' plexiglass, 8'' x 9'' x 5'' high and was provided with a cutout on one side which normally fitted loosely about the child's neck when in use.*
Pharmacological Approaches to Learning Impediments
Authors: Freeman Roger D.
Published: December 2021

Regarding "An Evaluation of the Pharmacologic Approaches to Learning Impediments," I found the Report of the Committee on Drugs (Pediatrics 46: 142) very disappointing:

(1) The title is rather presumptuous, since nothing new is being communicated beyond some rather trite statements that the methodology is difficult, long-term studies are necessary, but that drugs offer some promise.

(2) The language is excessively tortuous, and in places unclear. For example, what is a "behavior impediment"? What is the meaning of the word "effective" in the sentence "The administration of appropriate or effective antiepileptic agents... may result in some improvements"? There are many other examples of similar obscurities.
Neonatal Pneumopericardium
Authors: Markarian Marguerite , Ablow Ronald C.
Published: December 2021

We would like to add a case of pneumopericardium in the newborn to the seven reviewed by Matthieu, et al.1 This case is unusual in that it is only the second reported in which the pneumopericardium cleared spontaneously without aspiration.

V. J. was a premature, Negro, female infant born at 26 weeks' gestation to a 14-year-old Gravida I, Para 0 mother. Birth weight was 794 gm. Her 1-minute and 5-minute Apgar scores were 1, and spontaneous respirations did not begin until after 20 minutes of positive pressure oxygen therapy and administration of 5 mEq of sodium bicarbonate solution via the umbilical vein.
Corticosteroids in Croup: Is a Controlled Clinical Trial Needed?
Authors: Eden Alvin N.
Published: December 2021

I read with a great deal of interest the Committee on Drugs Report entitled, "Should Steroids be used in Treating Bronchiolitis?" I am in complete agreement with the report, namely, that steroids have no place in the treatment of bronchiolitis. The committee rightly points out the unique contribution a collaborative controlled study can make in problems of this type.

I have been particularly interested in the use of corticosteroids in the treatment of croup and have previously published two double blind studies on the subject.2,3
DRUGS AND BILIRUBIN
Authors: Thaler M. Michael , Schmid Rudi
Published: December 2021

Current concepts of the mechanisms of biotransformation and drug detoxification evolved largely as a result of studies of the last decade and a half.1 It was demonstrated that most of the enzyme systems responsible for the oxidative, reductive, hydrolytic, and conjugating reactions of drugs, toxins, and many endogenous substances are located in the endoplasmic reticulum of the liver cell, operationally defined as the microsomal fraction. Remmer2 and Conney and his collaborators3 were among the first to point out that many of the compounds metabolized by these pathways have the capacity of enhancing not only their own metabolic transformation, but also that of substances chemically or biologically unrelated to the stimulating agent.
THE ROLE OF THE CENTRAL NERVOUS SYSTEM IN PERINATAL RESPIRATION: STUDIES OF CHEMOREGULATORY MECHANISMS IN THE TERM LAMB
Authors: Herrington Robert T. , Harned Herbert S. , Ferreiro Jose I. , Griffin Clarence A.
Published: December 2021

Studies were performed to define the CNS acid-base status in the fetal lamb, as well as the contribution of CNS mechanisms in the initiation and control of breathing in the newly born lamb.

The average CSF pH in term fetal lambs was found to be similar to that in young lambs as well as man. When fetal CSF hydrogen ion concentration was noted to be increased, or when perfusion of the ventral lateral medulla with mock CSF high in hydrogen ion concentration was carried out, no respiratory activity was noted. This suggests that the central response to hydrogen ion concentration, which is responsible for control of respiration in the breathing animal, may not be operative in the fetal state. However, in the physiologic setting of these experiments, the onset of breathing was primarily a central function which was little affected by peripheral chemoreceptor or baroreceptor discharge, as animals with their carotid sinus and vagal nerves divided initiated respiration as consistently as controls. Once breathing has been initiated, the central response to hypercarbic breathing could be demonstrated in the absence of any possible peripheral chemoreceptor influence.
Ichthyosis and Methotrexate: A Word of Caution
Authors: Jetton Robert L. , Eby Charles S.
Published: December 2021

Methotrexate given orally once each week was used to treat two patients with epidermolytic hyperkeratosis (bullous congenital ichthyosiform erythroderma). Neither objective clinical nor histopathological improvement occurred. These results support the mounting evidence that this hyperplastic dermatosis does not respond to antifolate therapy. Failure to respond to Methotrexate is, perhaps, unexpected on the basis of epidermal biometric data and previous experience with the use of folic acid antagonists in psoriasis; however, it may indicate a different or more complex subcellular disease process.

An exact clinical and histological diagnosis and, where possible, epidermal kinetic data should be required before treating an ichthyosiform dermatosis with Methotrexate. Methotrexate may be indicated in the ichthyosiform dermatosis, severe erythrodermic psoriasis, which fails to respond to potentially less dangerous antipsoriatic measures.
Gastric Mucosal Diaphragm in a Child
Authors: Johnson George M.
Published: December 2021

The fifth pediatric case of an antral mucosal diaphragm of the stomach is reported. This lesion is to be distinguished from a pyloric mucosal membrane. Usually, there are signs and symptoms of epigastric pain relieved by emesis and/or belching. Antacids and ulcer diets are ineffective.

X-ray findings are distinctive and should allow the pediatrician to make a preoperative diagnosis of this unusual anomaly. This should help the surgeon in his search for the membranous septum in the stomach and in his decision regarding the proper surgical procedure.
Are Radiant Heaters Safe in the Delivery Room?
Authors: Robertson Alex F. , Oliver T. K.
Published: December 2021

Infants needing resuscitation in the delivery room frequently become chilled. For resuscitation the infant must be covered and on a flat surface. Heated surfaces are available with circulating-water mattresses and resuscitation tables. These only heat the dependent area of the infant and are usually insufficient to prevent heat loss. The combination of such a unit with an overhead radiant heater or the overhead radiant heater alone is adequate. However, the overhead radiant heater must allow free access to the infant, which is not the case with all radiant heaters now being marketed.
COMPLETE RECOVERY, AS REPORTED IN 1849, OF A 16-YEAR-OLD BOY FROM A FULL-THICKNESS BURN OF MORE THAN HALF HIS BODY SURFACE
Authors: C. T. E.
Published: December 2021

The case report cited below, published in 1849, of the recovery of a 16-year-old-boy from an extensive, full-thickness burn of his body adds further support to one of the oldest adages of medicine–namely faith in the vis mediatrix naturae, or as Hippocrates expressed it: "Nature is the healer of disease."

The most extensive burn ending in complete recovery that I have read of, is described by Mr. Grantham. A youth sixteen years of age, was burnt to the following extent by the explosion of some fireworks. From the upper and fore part of the neck, extending laterally down the left arm to the insertion of the deltoid; occupying both axillae; passing backwards to within three inches of the spines of the vertebrae; over the chest, body, and genitals, to the verge of the anus; extending along the upper part of the right thigh, and down the left thigh to the knee; destroying the cuticle, rete mucosum, and corium. The whole measured above six hundred superficial inches; and averaged a quarter of an inch in depth. The subcutaneous structure was completely lost, so that the arteries and veins were seen, as if neatly dissected, lying on the surface of the muscles and the fascia. The treatment consisted in freely giving opium, in well supporting the strength, in properly protecting the wound, and in the external and internal use of antiseptics. Three months after the accident, the patient had a sphacelated wound over the sacrum; four months after this, an attack of bronchitis; and two years subsequently– when he had improved so as to be able to walk a short distance–a severe attack of erysipelas.
Who Has Been Sleeping?
Authors: Golden Archie S.
Published: December 2021

"Who has been sleeping" are the terminating words of the second commentary,1 which jocularly discusses several articles aimed at the clinician in the January 1971 Pediatrics. I contend that the pediatric profession has been sleeping, and within that august body, one might pick out Pediatrics as being the most profound somnambulator of all, since it is organized pediatrics' chief educational tool.

For years my pediatric colleagues have complained, but in a weak voice, about the content of Pediatrics; stating that the majority of the articles had little to do with the practical aspects of clinical child care.
Estimation of True Number of Congenital Malformations (Continued)
Authors: Hay Sylvia , Mackeprang Muriel , Khalili Abbass
Published: December 2021

As users of birth certificates in studying the epidemiology of congenital malformations, we are as concerned as Dr. Khalili and his colleagues1 in problems of underascertainment. We read with great interest their attempts to estimate the true incidence by the use of vital records. However, in spite of their conclusions, we remain dubious as to the efficacy of their method.

The authors present three hypotheses: that the death rate among infants reported on birth certificates as malformed at birth is (1) equal to, (2) greater than, or (3) less than the death rate for all malformed infants.
THE NEONATAL RESPONSE TO GASTROGRAFIN ENEMA
Authors: Rowe Marc I. , Furst Alex J. , Altman Donald H. , Poole Catherine A.
Published: December 2021

A new nonoperative treatment for uncomplicated meconium ileus has recently been described. Obstruction is relieved by high gastrografin enema. In View of the high surgical mortality for meconiuun ileus, this procedure appears to be a valuable contribution. Gastrografin has an osmolality of 1900 mOsm/L and when introduced into the gastrointestinal tract has been reported to decrease plasma volume. This may be dangerous to the sick infant. The purpose of this study is to identify the alterations that occur with gastrografin and to suggest preventive measures. Twenty newborn puppies received either a high gastrografin or barium enema. Castrografin produced an increase in hematocrit, a rising serum osmolality, and a fall in pulse rate and cardiac output. It is suggested that the physician, before he embarks on the non-operative treatment of meconium ileus, should be aware of the dangers and correct pre-existing dehydration, increase the intravenous fluid intake during the enema, and have a means of monitoring water balance. Four patients managed in this fashion, showed no changes in their clinical condition or serial serum osmolality measurements.
GROWTH HORMONE LEVELS IN NORMOGLYCEMIC AND HYPOGLYCEMIC INFANTS BORN SMALL FOR GESTATIONAL AGE
Authors: Humbert James R. , Gotlin Ronald W.
Published: December 2021

Recent investigations have raised the possibility that growth hormone (GH) influences intra-uterine weight and length. Moreover, the hypoglycemic tendency of small for gestational age (FSGA) infants and their small size could result from GH deficiency. To verify these hypotheses, a prospective study of daily serum GH and glucose levels was conducted in 46 newborn infants, including 18 FSCA infants, 18-full-term, appropriate for gestational age (FAGA), and 10 premature (PR) infants. Two FSGA babies became hypoglycemic. Both manifested normal GH competence as evidenced by normal daily GH levels, adequate GH response to arginine provocation, and satisfactory growth for over 2 years. Eleven of 12 FSGA babies followed from 14 to 26 months showed no evidence of impaired linear growth. The FSGA babies had GH values similar in magnitude and pattern to those of FAGA and PR infants. During the second half of the first postnatal day, a significant rise in serum GH occurred in all infants regardless of their size or gestational age; this rise may be the result of the stimulating effect of early milk feedings. GH deficiency does not appear to contribute to either the small size or hypoglycemic tendency of FSGA newborn infants.
PURE FAMILIAL HYPERPROLINEMIA: ISOLATED INBORN ERROR OF AMINOACID METABOLISM WITHOUT OTHER ANOMALIES IN A SICILIAN FAMILY
Authors: Mollica Florindo , Pavone Lorenzo , Antener Ilse
Published: December 2021

Type I hyperprolinemia was detected in several members of a Sicilian family, in which no clinical or biological signs of nephropathy and of other hereditary anomalies were present. A family with similar findings has been reported in 1970 by Fontaine, et al. These two families indicate that hyperprolinemia is probably an inborn error of aminoacid metabolism without clinical implications, which can be inherited as "pure familial hyperprolinemia," independently of other hereditary disorders, by an autosomal and probably recessive gene.

A wide range of serum proline levels (from about 5 to about 25 mg/100 ml) was found in the affected members. It is suggested that even the 0heterozygotes may show some degree of hyperprolinemia.
FUNCTIONAL HYPOSPLENIA IN CYANOTIC CONGENITAL HEART DISEASE
Authors: Pearson Howard A. , Schiebler Gerold L. , Spencer Richard P.
Published: December 2021

Hematologic abnormalities suggesting decreased splenic function (Howell-Jolly and Heinz bodies ) were found in the blood of two infants with cyanotic congenital heart disease. Since both of these infants were shown to possess anatomically normal spleens, "functional hyposplenia" is considered to be the basis for the abnormal hematologic findings.

The congenital asplenia syndrome is usually associated with severe, complex, and uncorrectable forms of cardiac malformation. This has discouraged diagnostic and therapeutic measures in children in whom the diagnosis has been made. Since similar blood changes may occur in children with anatomically normal spleens, this bad prognosis may not always be valid. Functional hyposplenia might, on occasion, contribute to the morbidity and mortality of infants with cyanotic congenital heart disease.
Continuous Positive Transpulmonary Pressure in Hyaline Membrane Disease: A Simple Device
Authors: Vidyasagar D. , Chernick V.
Published: December 2021

A simple modification of the Isolette incubator -respirator such that a constant negative (subatmospheric) pressure (CNP) may be applied to the body chamber is described. A constant subatmospheric pressure around the thorax (constant positive transpulmonary pressure) has been used in the treatment of five newborn infants with severe hyaline membrane disease with favourable results. Arterial Po2 increased significantly while the alveolar-arterial Po2 difference decreased. There was no significant influence on arterial Pco2. This approach appears to be a useful adjunct to the treatment of hyaline membrane disease since it increases arterial Po2, allows more rapid reduction of inspired o2 concentrations to levels not toxic to the lung, and may obviate the need for endotracheal intubation and artificial respiration.
An Automatic Oxygen Control System for Infants
Authors: Berran Anthony V. , Taylor William F. , Ackerman Bruce D. , Sperling Donald R. , Strauss José
Published: December 2021

A new automatic system for the monitoring and controlling of ambient oxygen in incubators was evaluated with newborn infants requiring oxygen therapy. Ambient oxygen was controlled to within ±1% of the preselected level. High and low incubator oxygen flow had no effect on the skin, rectal, and ambient temperature, and there was no accumulation of carbon dioxide. With the infant's tissue oxygen monitored, this system permits controlled "step down acclimatization" from high to normal environmental oxygen concentrations, thereby minimizing the untoward effects of hypoxemia and hyperoxemia often seen with current manual methods of oxygen regulation.
Floxuridine Treatment of Congenital Cytomegalic Inclusion Disease
Authors: Feigin Ralph D. , Shackelford Penelope G. , Devivo Darryl C. , Haymond Morey W.
Published: December 2021

A patient with culturally confirmed congenital cytomegalic inclusion disease was treated at 12 days of age with Floxuridine (FUDR). FUDR was intravenously administered in a dose of 0.5 mg/kg/day as a single continuous 12-hour infusion each day for 5 consecutive days. Positive cultures for cytomegalovirus were obtained from urine and saliva throughout the course of therapy as well as from cerebrospinal fluid and a hip joint effusion at the conclusion of therapy. No therapeutic effect of FUDR was demonstrable clinically and no toxic drug effects were noted.
Iron-Fortified Formulas, Cost Analysis (Continued)
Authors: Fisher Stanley E. , Allen Alexander C. , Filer L. J.
Published: December 2021

Although we agree fully with the principle of iron supplement, preferably added to the milk, issue must be taken with Dr. Filer's cost analysis (in Table I of the paper).1 There seems to be an error in addition: the total cost for evaporated milk plus iron and vitamin ACD drops should be $0.23 to $0.27, not $0.23 to $0.31. This means a savings over concentrated proprietary formulas of $0.06 per day, or about $22 per year.
Down's Syndrome (Mongolism), Annals of the New York Academy of Sciences, vol. 171, article 2, edited by Virginia Apgar, M.D. New York: The National Foundation–March of Dimes, 1970, pp. 303–688, $24.50
Authors: Zellweger Hans
Published: December 2021

This volume of the New York Academy of Sciences contains the transactions of a conference on mongolism held by the New York Academy of Sciences and the National Foundation– March of Dimes on November 24-26, 1969, in New York. Over 40 articles written by some of the world's most knowledgeable experts summarize and review in part well established facts, while other investigators discuss newer developments such as somatic cell culture technics (T. T. Puck) and hybridization of mammalian cells (B. R. Migeon).
SYSTEMIC BONE DISEASE DEVELOPING IN SMALL PREMATURE INFANTS
Authors: Griscom N. T. , Craig J. N. , Neuhauser E. B. D.
Published: December 2021

Three very small premature infants developed systemic bone disease, discovered in their third month of life. Roentgenograms showed epiphyseal separations, extensive subperiosteal new bone, metaphyseal cupping, rib fractures, porosis, and enlarged costochondral junctions. The babies were hypoproteinemic and anemic. One was severely neutropenic, the others moderately so. In two infants, the abnormalities slowly disappeared. The most severely affected infant died of an apparently unrelated congenital malformation. Examination of the bones post-mortem confirmed porosis, fractures, epiphyseal shippages, and periosteal new bone. There was failure of normal enchondral bone growth, which was much more severely affected than intramembranous bone formation.

We believe the cause of this illness to be metabolic and probably nutritional. It is unlike any of the better known deficiency syndromes. There are similarities to the syndrome reported in copper deficiency depletion. Whatever the cause, the illness may be fairly common among small premature infants.
A SEX DIFFERENCE IN THE CARRIER STATE OF AUSTRALIA (HEPATITIS-ASSOCIATED) ANTIGEN
Authors: Goodman Morris , Wainright Robert L. , Weir Homer F. , Gall John C.
Published: December 2021

A survey of 1,077 mentally retarded residents of Plymouth State Home and Training School for the distribution of Australia (hepatitis-associated) antigen and precipitins to this antigen revealed that karyotypically normal females show a much lower prevalence of the antigen than do the males, whereas among young G-trisomic patients the females as well as males show a high prevalence of the antigen. Early age of institutionalization increases the risk of becoming an Australia antigen carrier, but less so in karyotypically normal females than in other groups.
PEDIATRIC ALLERGY: SOME IMPRESSIONS GAINED OVER A 37-YEAR PERIOD
Authors: Deamer William C.
Published: December 2021

The most effective treatment of allergy is discovery and removal of the allergen. Injection therapy, while useful in some forms of inhalant allergy such as hay fever, is a less effective measure.

Respiratory tract allergy is frequently mistaken for respiratory tract infection. A history of repeated episodes of bronchitis or pneumonia should suggest the possibility of asthma. Similarly, a history of repeated "colds" should suggest allergic rhinitis.

Increased sneezing and itching and rubbing of the nose are frequent minor symptoms of allergic rhinitis. Coughing at night and coughing on exertion are common minor symptoms of asthma. Since allergic rhinitis and asthma often occur together and share the same etiology, all four of these minor symptoms may serve as a guide in identifying and treating asthma.

Positive skin tests for allergy may be found in as much as 50% of "normal" individuals, many of whom may have no recognized clinical allergy. Positive skin tests therefore do not constitute evidence of clinical symptoms.

Nonspecific trigger factors such as nervous tension, respiratory tract infections, fatigue, climate, exercise, and smoke or strong odors may precipitate an attack of asthma. Frequently overlooked are the more important specific factors such as pollens, house dust, animal danders, and foods.

An important variable factor in asthma is the state of the patient's sympathetic-parasympathetic nervous system balance. At times this may act to augment synergistically the action of the chemical mediators of the allergic reaction, thus involving non-immunological as well as immunological factors.

Food allergy or intolerance is a frequently unrecognized cause of asthma and allergic rhinitis. It is also a frequent cause of the tension-fatigue syndrome–a common but little known entity.
Fecal Excretion of Rose Bengal I131 in the Diagnosis of Obstructive Jaundice in Infancy with Special Reference to Biliary Atresia
Authors: Maksoud João Gilberto , Thom Anneliese Fischer , Kieffer Julio , Carvalho Pinto Virgilio A.
Published: December 2021

Despite the poor prognosis of biliary atresia, there are a small number of cases in which early surgery will be of real benefit. Every effort must therefore be made to arrive at the correct diagnosis as quickly as possible so as not to delay surgical intervention.

In our experience, FERB I131 has been the most reliable diagnostic test; we are convinced that this test must be done in every case in which the differential diagnosis of neonatal or infantile jaundice is not clear.
Diabetic Ketosis and Coma (Continued)
Authors: Martin Gilbert , Schwartz Robert
Published: December 2021

I read the article on diabetic ketoacidosis by Robert Schwartz in the May issue of Pediatrics1 and felt that it certainly offered a concise, organized approach to therapy. There are, however, several points which deserve comment.

First, it is mentioned, "Initial therapy should avoid glucose administration, especially if marked hypoglycemia is present." This may be correct if levels are in the 600 mg per 100 ml range, but is of questionable value at lower levels.
WHAT IS THE RISK OF AN UMBILICAL ARTERY CATHETER?
Authors: Tooley William H.
Published: December 2021

In this issue of Pediatrics, Neal et al. report a 95% incidence of thrombosis with catheterization of an umbilical artery. Like the authors, I was surprised at this high rate of thrombus formation. It is, however, consistent with the experience of those who have studied the problem of deposition of thrombotic material on indwelling peripheral arterial catheters in children and adult patients. To some extent, the formation of a thrombus is dependent upon the composition of the catheter. Polyethylene, polyvinyl (from which the Argyle catheter is made), and polyurethane have rather rough surfaces and are quite thrombogenic. Nachmani et al. observed fibrin adhering to polyurethane catheters within 15 minutes of placement in an artery.
PEDIATRIC PERCEPTION: THOMAS MORGAN ROTCH (1849-1914), AMERICA'S FIRST FULL PROFESSOR OF PEDIATRICS: HIS CONTRIBUTION TO THE EMERGENCE OF PEDIATRICS AS A SPECIALTY
Authors: Bloch Harry
Published: December 2021

One hundred and twenty-eight years after John Morgan became America's first professor of medicine at the newly founded Medical School of the College of Philadelphia in 1765, America's first full professor of pediatrics was appointed in 1893 to the Medical School of Harvard with full faculty status. This was an act of great significance for the growth of pediatrics in the United States. It constituted an important step to the introduction and establishment of a scientific approach in pediatrics; increased tempo in the care and welfare of children; and opened the door wider for pediatricians seeking faculty appointments.

The acceptance of pediatrics had been a far greater task in America than in any European country, with the exception of England, due to "obstruction by reactionary powers such as antivivisectionists, antivaccinationists, and enemies of autopsies." Pediatrics was plodding along with painful, laborious steps until this belated recognition that illness in infants and children not only differed from that in adults and required special study, but there was urgent need to develop scientific knowledge of children's diseases. Children born in the 18th century had a good chance of dying of gastroenteritis; and if they recovered or escaped the affliction, they were still exposed to measles, scarlet fever, smallpox, diphtheria, dysentery, tuberculosis, malaria, typhoid, and yellow fever. The death rate was high, and only a very high birth rate could allow the country to grow. Those who survived these hazards lived to an old age with few brothers, sisters, and relatives. Therapy was the same for children as for adults-bleeding, purging, home remedies, prayer, fasting, diet, exotic and foul concoctions, sweating, and quackery.
Natural Variations in Environmental Illumination in a Newborn Nursery
Authors: MacLeod Patrick , Stern Leo
Published: December 2021

Measurements of the natural variation in environmental lighting depending on the amount of sunlight, visibility, the time of day, and the location of the infant within the nursery have shown a wide variation in intensity of illumination received by any infant ranging from 15 to 2,500 footcandles depending on the interplay of these factors. Both the physical structure of the nursery and the amount of sunlight available are major variables in determining the ultimate amount of light to which an infant is exposed. Both of these factors need to be taken into consideration in the architectural design of nurseries and the assignation of optimal illumination standards.
Condyloma Acuminata in Childhood
Authors: Patel Rashmi , Groff Diller B.
Published: December 2021

A case of massive condylomata acuminata in an 18-month old, the youngest patient diagnosed with this lesion, is presented. This is the only case reported in an infant whose mother was known to have condyloma acuminata during pregnancy and delivery. The surgical and medical aspects of the management are discussed and the benign nature of this lesion is emphasized.
MALTREATMENT OF CHILDREN THE BATTERED CHILD SYNDROME
Authors: Forsyth William B. , Allen John E. , Brinkley Joseph W. , Chenoweth Alice D. , Hunter Gertrude , Miller Roland E. , North A. Frederick , Schloesser Patricia T. , Siegel Earl , Wagner Marsden G. , Bates Talcott , Peters Ann DeHuff , Helfer Ray E. , Marks Herman B. , Mindlin Rowland L.
Published: December 2021

In February 1966, the Committee on Infant and Preschool Child published a statement concerning the status of the problem of the battered child. The present Committee has reevaluated the statement in light of increased knowledge and experience over the past 6 years. The 1966 statement concerned itself primarily with two issues: (1) a historical review and definition of the battered child syndrome, and (2) discussion and recommendations concerning identification and protection of the abused child.

While a great deal of study and activity has taken place with regard to the problem of the battered child and there have been some positive results (e.g., every state in the union now has some form of reporting mechanism of the suspected or proven case of child abuse), the consensus of the Committee and its consultants is that the total problem has become magnified and is uncontrolled by present methods of management.

The Committee reaffirms and supports the following recommendations of the 1966 report:

1. Physicians should continue to be required to report suspected instances of child abuse immediately to the agency legally charged with the responsibility of investigating child abuse, preferably the county or state department of welfare or health or its local representatives, or to the nearest law enforcement agency.

2. The responsible agency must have ample personnel and resources to take action immediately on receipt of the report.

3. Reported cases should be evaluated promptly, and appropriate service should be provided for the child and family.

4. The child should be protected by the agency by continued hospitalization, supervision at home, or removal from home through family or juvenile court action.
Psychiatric Disorders of Children with Congenital Rubella, by Stella Chess, M.D., Sam J. Korn, Ph.D., and Paulina B. Fernandez, Ph.D. New York: Brunner/ Mazel, Inc., 1971, 178 pp., $7.50
Authors: Aug Robert G.
Published: December 2021

From the standpoint of source of data, this book is simply the report of a follow-up study of children with congenital rubella. However, because of the authors' sound and thorough approach, it is the most comprehensive and useful publication available on the psychiatric aspects of this tragic disease. This book can provide the clinician with many helpful ideas for the understanding and management of the learning, behavioral, and emotional problems of these children, their parents, and their siblings.
Mentally Retarded Children: What Parents and Others Should Know, by Harriet E. Blodgett, Minneapolis: University of Minnesota Press, 1971, 165 pp., $5.95
Authors: Cushna Bruce
Published: December 2021

When a worker has toiled long and devotedly with a field, due credit should be given professional contributions. Dr. Blodgett's years of experience with families of retarded children are reflected in some very sound advice to parents of retarded children: "Parents and educators alike must create and maintain at home and at school an atmosphere of appreciation for effort and progress on the part of the child [p. 43] . . . it is most important to define success in relation to each child's own ability and what can realistically be expected of him [p. 43].
COMPARISON OF PLACENTAS FROM TWO SOCIOECONOMIC GROUPS. II. BIOCHEMICAL CHARACTERISTICS
Authors: Laga Emil M. , Driscoll Shirley G. , Munro Hamish N.
Published: December 2021

By comparison with placentas from an urban North American (Boston) population, those from an urban Central American (Guatemala City) series were significantly deficient in trophoblastic and fibroblastic mass. The total amounts of DNA, RNA, protein and alkaline phosphatase also tended to be reduced in these placentas, but only in the case of DNA did the difference approach significance. In vitro protein synthetic capacity per unit of RNA was not different in the two groups, although this proportion of ribosomes recovered as polysomes was lower in the Guatemalan series. On analyzing the data according to length of gestation, weight of child and weight of placenta, the only unequivocal relationship was that between the weight of the child and placental composition. There was a positive correlation between the weight of the child and the total amount of DNA, RNA, and protein in the placentas of each group. The placentas of low birth weight children in Guatemala tended to have relatively more small cells (less RNA and protein per cell) than in Boston. The placentas of children of large size in Guatemala showed smaller increase in cell number (less DNA) but cells appeared to be larger (more RNA and protein per cell). Protein synthetic capacity increased with increasing weight of the child at birth, and was of similar intensity in both series.
QUANTITATIVE ASPECTS OF OXYGEN TOXICITY IN THE NEWBORN: INHIBITION OF LUNG DNA SYNTHESIS IN THE MOUSE
Authors: Northway William H. , Petriceks Rita , Shahinian Lee
Published: December 2021

The incorporation of 3H-thymidine into lung DNA in newborn mice was inhibited by increasing exposure to 96-100% oxygen. Twenty-four hours following the onset of this inhibition both total DNA per lung and lung weight decreased in the oxygen-exposed animals relative to the air-exposed control animals.

These data indicate that 96-100% oxygen retards lung growth in the newborn mouse by inhibiting DNA synthesis and cell replication. These results are consistent with observations on cultured cells of nonpulmonary origin. Such growth inhibition may occur at oxygen concentrations below 96 -100%.
INSENSIBLE WATER LOSS IN LOW BIRTH WEIGHT INFANTS
Authors: Fanaroff Avroy A. , Wald Michael , Gruber Howard S. , Klaus Marshall H.
Published: December 2021

Insensible water loss (IWL) was determined from measurements of insensible weight loss during the first 7 weeks of life on 30 immature and nine small-for-gestational age, low birth weight infants. Under standard conditions (single-walled incubator, infant nude, gavage feeding), 10 infants with birth weights less than 1,250 gm, gestational age < 230 days (32 weeks) and postnatal age <10 days lost >2.5 gm/kg/hr (equivalent to 60-120 ml/kg/day), considerably higher than previously reported. Studies following the insertion of a plastic heat shield revealed a 25% reduction in IWL.

The heat shield facilitates achievement of neutral thermal environment and reduced water losses in low birth weight infants. IWL measurements in infants with birth weights >1,500 gm and those small-for-gestational age were similar to previously reported studies. Because of the known limited ability of small immature infants to increase metabolic rate, these extremely high losses are believed to represent disproportionately larger water losses from skin. Skin factors predisposing to large water loss in immature infants include thinner epidermis, increased water content, and increased permeability.
A STUDY OF ERYTHEMA INFECTIOSUM: RECOVERY OF RUBELLA VIRUS AND ECHOVIRUS-12
Authors: Balfour Henry H. , May Donald B. , Rotte Thomas C. , Phelps W. Richard , Schiff Gilbert M.
Published: December 2021

A virologic study was conducted on specimens from 102 patients with erythema infectiosum (fifth disease). A laboratory diagnosis of acute rubella was made in 10 children (9.8%) and evidence of echovirus-12 infection was found in four others (3.8%). Clinically, these 14 children were indistinguishable from the 88 virus-negative patients. The data are consistent with two interpretations: (1) 14 of 102 (14%) erythema infectiosum patients in the present investigation had dual infections or (2) a strain of rubella or echovirus-12 may produce an exanthem resembling erythema infectiosum in some individuals. Preliminary challenge experiments with a rubella virus isolated from one of the study patients suggested that this agent produced an illness in adult volunteers similar to erythema infectiosum.