bluuebunny/crossref_metadata_2025 huggingface dataset:
THE INCIDENCE OF CYTOMEGALOVIRUS, HERPES SIMPLEX, RUBELLA, AND TOXOPLASMA ANTIBODIES IN MICROCEPHALIC, MENTALLY RETARDED, AND NORMOCEPHALIC CHILDREN
Authors: Baron John , Youngblood Leona , Siewers Christiane M. F. , Medearis Donald N.
Published: December 2021

The cause of most microcephaly is unknown. Hanshaw's observation that 44% of microcephalics had cytomegalovirus (CMV) complement fixing (CF) antibody (Ab) suggested that inapparent congenital CMV (and other) infections might be a significant cause. Accordingly, sera from non-institutionalized microcephalic, mentally retarded normocephalic, and normal children were tested for cytomegalovirus and herpes simplex virus (HSV) complement fixing, rubella hemagglutination inhibition (HI), and toxoplasma dye test antibodies in an effort to determine whether there was a significant association between infection with these agents and microcephaly or mental retardation.

Eight of 62 (13%) microcephalic children who were from 5 months to 5 years of age had titers of CMV CF Ab equal to or greater than 1:10. Four of 26 (15%) mentally retarded normocephalic children were seropositive to CMV, and two of 44 (5%) normal normocephalic children were seropositive. These differences are not statistically significant. In the age range 5 months to 5 years, 9 of 62 (15%) microcephalic, 9 of 26 (15%) normocephalic mentally retarded, and 4 of 44 (9%) normal normocephalic children were seropositive to HSV CF Ab. In the group 5 months to 5 years old tested for rubella HI Ab, 11 or 61 (18%) microcephalic, 2 of 25 (8%) normocephalic mentally retarded, and 6 of 38 (16%) normal normocephalic children were found to be seropositive. Three of 61 (5%) microcephalic, 2 of 26 (8%) mentally retarded normocephalic, and 3 of 42 (7%) normal normocephalic children from 5 months to 5 years had Ab to toxoplasma. There was no statistically significant association of evidence of infection with these three organisms and microcephaly. The authors speculate that inapparent congenital CMV infection can cause microcephaly and mental retardation without microcephaly, but that this infection causes only a small proportion of these conditions.
THE BURIAL CLUBS: OR HOW TO TURN SICK CHILDREN TO ACCOUNT
Authors: C. T. E.
Published: December 2021

The pernicious practice of killing infants to collect the insurance on their lives is vividly described in an editorial in The Dublin Medical Press of December 4, 1844.1 The editorials published in this Journal were especially noted for their fervor to correct evil medical practices and also for their biting political satire, usually directed against England. The juxtaposition of the former and latter will be apparent in the editorial excerpts below:

In the last [London] Medical Gazette, we have again attention drawn to the horrible, the atrocious practice of destroying children for the purpose of obtaining money insured on their lives, or rather on their deaths. Our readers will scarcely believe us when we say it, but it seems there can be now no more doubt on the subject than there is that people were strangled by BURKE and HARE for the sake of their bodies to be sold for dissection. The plan is, to subscribe in the child's name to what is called a "burial club," a kind of "little go" insurance office, where for a penny a week a sum varying from £2 to £10is allowed on the child's death, and the same child may be entered into many clubs; so that the insurer or parent may receive as much as £5, £10, or £15 on the death of the insured infant, while the expense of interment is only about £3.A sum, as the writer says, "larger than the insurer in most cases ever previously possessd . . .
OSTEO-CHONDRO-MUSCULAR DYSTROPHY
Authors: Huttenlocher Peter R. , Landwirth Julius , Hanson Virgil , Gallagher Brian B. , Bensch Klaus
Published: December 2021

Three cases of a disorder of bone and of skeletal muscle are reported. Clinical manifestations of this disease begin in infancy with slowly progressive bony deformities, including coxa vara or valga, pectus carinatum, vertebral flattening, dwarfism, and basilar invagination. In addition, there is a mild dystrophic process in muscle, with muscular hypertrophy followed by atrophy, and with prominent myotonia. The descriptive label of osteo-chondro-muscular dystrophy is suggested, since this covers both the skeletal and the neuromuscular aspects of the disease. Present evidence favors a recessive mode of inheritance. Muscle biopsy studies, including electronmicroscopy and determination of muscle electrolytes, suggest a disorder of muscle membranes, with inability to maintain normal gradients of sodium and potassium. An abnormally low potassium concentration in muscle was noted already in a 6-month-old infant with this disease, at a time when dystrophic changes were minimal. Procaine amide therapy was effective in improving muscle function in the two children in whom it was tried.
The Pediatrician and the Parent of the Deaf Child
Authors: Luterman David M. , Chasin Judith
Published: December 2021

In most instances, the pediatrician is the first professional person the parent of a young child consults when a hearing loss is suspected. The extent to which he is able to counsel the family about the child's handicap will, to a large degree, determine the eventual education and social success of the child. Since most pediatricians will encounter only a few congenitally deaf children during their years in practice, they may well be unfamiliar with the recent advances in diagnosis and education of the young deaf child and the sources of referral for these children. Therefore, the following parent survey was undertaken to see how well the pediatrician responded to the needs of the parents of confirmed deaf children, and in which areas he appeared to be lacking the kind of formation that the parent wished to have.
The Clapper-Dapper
Authors: Macfarlane David W. , Hanks Susan B.
Published: December 2021

One of the problems frequently encountered with ambulatory spastic cerebral palsied children is their tendency to toe walk, due to tightness of the plantar flexors of the ankle. They often develop equinus deformities and, if asymmetrically affected, will bear as little weight as possible on the more involved leg.

Traditional modes of therapy used to counteract deformities have included passive stretching, braces, and surgery

Recently, we examined a child with moderately severe spastic quadriplegia for whom braces had been prescribed and surgery planned for heel-cord lengthening. This child resisted bracing with such vigor that his parents discontinued therapy.

[See pdf for the Figure]
Increased Reduction of Nitroblue Tetrazolium by Neutrophils of Newborn Infants
Authors: Humbert James R. , Kurtz Michael L. , Hathaway William E.
Published: December 2021

The spontaneous reduction of nitroblue tetrazolium (NBT) was found to be significantly elevated in phagocytes of normal newborn in fants in the absence of infection. This was evident using both a simple histochemical test and a more elalborate quantitative test for NBT reduction. During phagocytosis of latex particles, the expected rise in NBT reduction was significantly greater in neonatal phagocytes than in phagocytes of control subjects. The increased NBT reducing activity of neonatal neutrophils makes it impossible to use the NBT histochemical test for tile detection of bacterial infection in that age group. However, NBT-reduction tests can be used with profit in the neonatal period to diagnose chronic granulomatous disease when a positive family history warrants such an investigation.

[See pdf for the Figure]
HOPES FOR TOMORROW VERSUS REALITIES OF TODAY: THERAPY AND PROGNOSIS IN ACUTE LYMPHOCYTIC LEUKEMIA OF CHILDHOOD
Authors: Holland James F.
Published: December 2021

The inability of Drs. Stein, Ablin, Kushner and Zoger, in their Letter to the Editor1, to "see what good can come of exaggerating the effectiveness of current therapy" for childhood leukemia is not surprising. They imply that others have such distorted vision that they see castles where only hovels stand. The implication of Dr. Stein and his colleagues, were it true, would be damning. I believe that faulty logic, poor data, sketchy analysis, and embellished accounts in the popular press over which the interviewed exercises no editorial control led these correspondents to improper conclusions.

In the design of clinical investigations to explore potentially improved therapeutic approaches to acute lymphocytic leukemia, the Acute Leukemia Group B has structured from two to five regimens into concurrent comparisons on a multi-institutional level.
NEONATAL SEPARATION: THE MATERNAL SIDE OF INTERACTIONAL DEPRIVATION
Authors: Barnett Clicord R. , Leiderman P. Herbert , Grobstein Rose , Klaus Marshall
Published: December 2021

Studies of maternal behavior in nonhuman mammals have suggested that the degree of interaction permitted between mother and infant in the postpartum period will influence later maternal attachment and infant development. The hypotheses raised by these studies can be explored with human mothers and infants through manipulation of care procedures of mothers and newborns in the immediate postpartum period.

A pilot study was conducted to determine the feasibility of changing premature care procedures in order to study the effects of interactional deprivation in the neonatal period on maternal attitudes and behavior. Forty-one mothers were permitted to enter the nursery and touch or handle their premature infants in incubators as early as the second day after birth. The feasibility of admitting mothers to the premature nursery without increasing the risk or occurrence of infection, or disrupting the organization of the care of the infants, was demonstrated.

We are now conducting a long-term study based on this pilot model to delineate the differences in commitment, feelings of competence, and behavior in the two differentially treated groups of mothers and to relate their behavior to the motor and mental development of the infants.
CALCIUM-FATTY ACID ABSORPTION IN TERM INFANTS FED HUMAN MILK AND PREPARED FORMULAS SIMULATING HUMAN MILK
Authors: Hanna Fikri M. , Navarrete Delia A. , Hsu Fay Ann
Published: December 2021

In full-term infants 4 to 10 days of age fed human milk or formulas of higher fat and calcium content, the absorption and retention of nitrogen and phosphorus are equal. Higher fecal excretion of fat and calcium were observed. There is a correlation between calcium and palmitic and stearic acid in the stools. This correlation is found at both low and high levels of fecal calcium. It is not clear whether the reduced calcium absorption or the reduced fat absorption is the primary event.
A DAY HOSPITAL FOR CHILDREN WITH RHEUMATIC FEVER
Authors: Spagnuolo M. , Gavrin J. , Ryan J.
Published: December 2021

One hundred consecutive children with acute rheumatic fever attended a Day Hospital in the latter part of their illness. Near-normal physical activities were tolerated well by all children except three who had chronic rheumatic activity. Six other patients had clinical rebounds and three of them had to be re-hospitalized. Most patients were discharged shortly after discontinuation of therapy. The incidence of residual heart disease did not differ from that of children who had been hospitalized for the full duration of their illness in the years immediately preceding the opening of the Day Hospital.
Letter To The Editor
Authors: Eaves Linda C. , Klonoff Harry , Dunn Henry G.
Published: December 2021

We showed Professor Illingworth's letter to Dr. Eaves and her colleagues. They comment as follows:

We are glad to reply to Professor Illingworth's interesting comments on our paper "Developmental and Psychological Test Scores in Children of Low Birth Weight."

First, we cannot agree that "several of the Griffiths1 tests have no bearing on intelligence." Motor skills are included in the concept and measurement of intelligence, and Dr. Ruth Griffiths has found that correlations among the various Scales in her tests show well-knit results which she attributes to a strong common factor or ‘g’ (general intelligence).
Dyslexia (Continued)
Authors: Faigel Harris C.
Published: December 2021

Snyder and Mortimer ask a number of questions about dyslexia which are difficult to answer. In the first place, dyslexia is not a single well defined entity, but includes a spectrum of severity of symptoms which control the age at which the condition becomes manifest, the degree of disability, the severity of the emotional trauma, and the prognosis.

I know a physician and a lawyer who have dyslexia. A number of my patients are currently in college or have recently graduated despite dyslexia. And four dyslexic fathers are college graduates in executive positions, one of them in the publishing business.
GLUCOSE TOLERANCE, INSULIN AND GROWTH HORMONE IN INFANTS OF GESTATIONAL DIABETIC MOTHERS
Authors: Cole Harold S. , Bilder Joan H. , Camerini-Davalos Rafael A. , Grimaldi Richard D.
Published: December 2021

Twelve control and nine gestational diabetic mothers (GDM) and their infants were studied at birth. All GDM were obese. The criteria for selection of control mothers were a negative family history for diabetes, a normal oral glucose tolerance test, and the presence of obesity. The mean birth weights of the infants were not significantly different. All infants received a 3-hour oral glucose tolerance test (OGTT), completed within the first 24 hours of life. Glucose, serum immunoreactive insulin and growth hormone levels were determined.

The mean glucose values obtained at the time of delivery revealed no significant differences between the GDM and the control mothers or between the infants of gestational diabetic mothers (IGDM) and the normal control infants.

At birth, the mean seruni insulin levels of the GDM and the IGDM were both significantly higher than were their control GDM and IGDM.

The OGTT was performed between 0 and 21 hours after birth and after a 4-hour fast. The mean fasting blood glucose level of the IGDM was significantly lower than that of the control infants, p≤.02. However, during the OGTT, the normal control infants showed a disposal of glucose similar to the IGDM. No evidence of hyperinsulinemia was observed in either the control infants or the infants of gestational diabetic mothers.

The mean growth hormone values for the infants at the time of delivery revealed no significant differences between the two study groups. During the OGTT, the IGDM had significantly higher mean growth hormone values at both 60 and 120 minutes.
TRIVALENT ORAL POLIOVIRUS VACCINE: A COMPARISON OF TWO INFANT IMMUNIZATION SCHEDULES
Authors: Hardy George E. , Hopkins Cyrus C. , Linnemann Calvin C. , Hatch Milford H. , Chambers J. Carroll , Witte John J.
Published: December 2021

The Public Health Service Advisory Committee on Immunization Practices (ACIP) and the Committee on Infectious Diseases of the American Academy of Pediatrics have not reached complete agreement in their currently recommended schedules for primary infant immunization with trivalent oral poliovirus vaccine (OPV).

To determine which if either of these is the more efficacious, 200 infants were immunized with trivalent OPV. Approximately 50% of these infants completed the 3 dose primary series recommended by the ACIP; remaining infants completed the 4 dose series recommended by the Academy. Microneutralization titers to all three poliovirus types were determined at appropriate time intervals.

At the completion of the study, a satisfactory percentage of individuals in both groups exhibited microneutralization titers of 1:10 or greater to all three poliovirus types. During the course of study, minor differences were noted between the two groups in the percentage of individuals with titers against poliovirus types 1 and 3.
Gangrene of an Extremity in the Newborn
Authors: Gilbert Enid F. , Hogan Gwendolyn R. , Stevenson Mable M. , Suzuki Hiroshi
Published: December 2021

A second-born twin with intra-utenine gangrene of the right lower limb secondary to a dissecting intramural hematoma of the femoral artery is reported. Although trauma seems most likely, the exact mechanism of intramural hemorrhage with compression and obliteration of the lumen of the vessel remains unknown.
Nursery Environmental Controls
Authors: Lee Henry F.
Published: December 2021

I was pleased to read Dr. Gezon's last paragraph1 in "Should Nursery Environmental Control Measures Be Re-examined?" There, he points out the danger of generalizing about nursery techniques as applied under one set of circumstances.

I am all for hexachlorophene. I am all for hand-washing, as I, too, believe that the hands of personnel and especially of physicians are the greatest single transfer mechanism in nursery pyodermia.

However, there may be something much bigger. I am impressed-both as an erstwhile marine biologist and as a physician-with great naturally occurring ecologic swings of population densities involving whole groups of organisms.
THE EFFECTS OF IMMERSION AND TEMPERATURE ON RESPIRATION IN NEWBORN LAMBS
Authors: Harned Herbert S. , Herrington Robert T. , Ferreiro Jose I.
Published: December 2021

The effects of immersion on respiration of term lambs during the perinatal period were studied under various conditions. After consistent breathing had developed in the newborn animal, immersion of the entire animal, immersion of its head, or introduction of fluid retrogradely into the trachea produced very marked respiratory depression as determined by a pneumotachometer attached to a trachial airway. Less marked, but still significant, respiratory depression was noted in animals subjected to snout immersion and to immersion with the head kept above the water bath. In this latter group, warm water depressed breathing more than cool water. The inhibitory effect of immersion on the initiation of breathing was shown by lack of survival of intubated lambs delivered into a water bath.
MEDICAL CARE OF URBAN INFANTS: THE COMMON COMPLAINTS
Authors: Mindlin Rowland L.
Published: December 2021

Random samples of infants born in an interracial slum and a middle-class neighborhood were followed during the first year of life by monthly home interviews conducted by trained lay interviewers. Mothers were asked about infants' health and medical care. Caucasian infants had an average of 6.9 conditions per year; 4.0 conditions per infant were seen by a physician. Corresponding data for Negro infants are: 6.9 conditions, 4.1 seen; for Spanish infants: 8.0 conditions, 4.4 seen. Repeated interviewing tends to minimize these rates. Colds, rashes, teething, and gastrointestinal disturbances accounted for half of the health troubles. Most of the common conditions seen by physicians were similar in the three ethnic groups. Auxilliary health workers, properly trained, could share in the delivery of medical care to infants in a variety of settings.
AN OBJECTIVE COMPARISON OF THE PEDIATRIC INTERVIEWING SKILLS OF FRESHMAN AND SENIOR MEDICAL STUDENTS
Authors: Helfer Ray E.
Published: December 2021

The use of videotapes to observe senior medical students as they interviewed mothers of children has demonstrated a deficit in their ability to communicate with these parents. Seniors often fail to obtain the vital information pertaining to the child as an individual within a family unit. This study was performed to test the hypotheses that freshmen would obtain (1) more interpersonal and (2) less factual information from mothers of ill children than would seniors. Randomly selected freshmen and seniors videotaped interviews of three simulators who were programmed to portray mothers of a child with a serious organic illness with related psychosocial problems. The use of the programmed "mother" permitted each student to obtain a standardized interviewing experience. The students were given identical information about these children and informed that the mothers were simulators. Objective measurements were made by five trained observers who rated each videotape using a modified interaction analysis technique and an objective checklist of facts obtained. An interrater reliability coefficient for each group of ratings was high, rarely falling below 0.80.

The results clearly demonstrated that freshmen obtained significantly more interpersonal information (i.e., the affect of the illness upon the child and his family) and asked fewer leading questions than did seniors (p < 0.01). Seniors obtained more factual information (p < 0.001). The ramifications of these data are far reaching. It would appear that, as medical students move through their training, a certain degree of their innate ability communicate with mothers of ill children seems to have been altered by their desire to obtain factual information. This alteration may well limit their effectiveness as the child's physician.
Exchange Transfusion versus Assisted Ventilation for Drug Induced Respiratory Depression
Authors: Werthmann Milton W.
Published: December 2021

It seems indicated to join the Hall-Asnes, Lamb controversy to alert others who "read and accepted" the reply of Doctors Asnes and Lamb to Dr. Hall (Pediatrics, 44: 619, 1969). While Dr. Hall (Pediatrics, 43: 1056, 1969) might have cited more current references in defense of his position that exchange transfusion is not benign, he did write "since infants experience a 1 to 5% mortality with exchange transfusions. . . ." Doctors Asnes and Lamb misread this as "the statement that infants experience a 1 to 15% mortality with exchange transfusion. . . ."
Thursday's Child Has Far to Go: Four Handicapped Children. Their Struggles For Acceptance, by Kathleen Lukens and Carol Panter. Englewood Cliffs, New Jersey: Prentice-Hall Incorporated, 1969, 248 pp., $5.95
Authors: Harrel John A.
Published: December 2021

A physician's wife (Mrs. Panter) aided by the wife of a clinical psychologist (Mrs. Lukens, who is also the mother of a handicapped child) are the authors of this book. The authors vividly tell of the struggles of four handicapped children, and, as stated on the book's dust cover, how these children were accepted by an unperceptive world.

The first chapter, "Song of David," by Mrs. Lukens, describes an aphasic child and his utter frustration in not being able to communicate with those around him.
CIRCADIAN PERIODICITY OF BLOOD AMINO ACIDS IN THE NEONATE
Authors: Feigin Ralph D. , Haymond Morey W.
Published: December 2021

Blood amino acids were obtained every 4 hours for 24 hours from 46 full-term infants who were between 1 hour and 120 hours of age when first sampled. Blood was also obtained at 0400 and 1200 hours on the same day from 10 additional infants, aged 48 to 72 hours at the time of study, for more detailed analysis of individual blood amino acids. Periodicity of total blood amino acids was demonstrated as early as the first day of life in some infants. This blood amino acid rhythmicity was similar but not identical to that previously observed in adults and older children. Concentrations of blood amino acids were minimal at 0400 hours and peaked between 1200 and 2000 hours. Periodicity of individual blood amino acids was similar to that for total blood amino acids but much less consistent. The presence of periodicity for plasma tyrosine was demonstrable even in two patients with neonatal tyrosinemia.

Since plasma amino acids vary normally as a function of time, "normal values" must be standardized for time of day.
COMPARISON OF SURVIVAL CURVES, 1956 VERSUS 1962, IN CHILDREN WITH WILMS' TUMOR AND NEUROBLASTOMA
Authors: Sutow W. W. , Gehan E. A. , Heyn R. M. , Kung F. H. , Miller R. W. , Murphy M. L. , Traggis D. G.
Published: December 2021

Through a nationwide questionnaire survey, data regarding diagnosis, treatment, and clinical course were obtained on 60 cases of Wilms' tumor in 1956, on 108 cases of Wilms' tumor in 1962, on 84 cases of neuroblastoma in 1956, and on 142 cases of neuroblastoma in 1962. Survival curves for patients with Wilms' tumor showed a significant improvement in 1962 compared with 1956. This change occurred in children of all ages without metastases at the time of first examination and in children 2 years of age and older with metastases at first examination. The improvement in survival curves among children with Wilms' tumor is attributed to the addition of actinomycin-D, vincristine, and cyclophosphamide to the treatment regimens in 1962. Although the intensity of chemotherapy increased from 1956 to 1962, the survival curves for children with neuroblastoma showed no statistically significant differences between the two time periods. With either tumor without metastases, children under 2 years had better survival curves than those over 2 years.
PERSISTENCE OF IMMUNITY FOUR YEARS FOLLOWING JERYL LYNN STRAIN LIVE MUMPS VIRUS VACCINE
Authors: Weibel Robert E. , Buynak Eugene B. , Stokes Joseph , Hilleman Maurice R.
Published: December 2021

Neutralizing antibody following Jeryl Lynn strain live mumps virus vaccine persisted for at least 4 years following vaccination, without substantial decline in titer. The pattern for mumps antibody persistence after vaccine paralleled that following natural mumps infection. No instances of mumps occurred among 18 vaccinated children in families who were exposed to infection by contact with natural mumps cases which occurred in siblings 32 to 44 months after the vaccine had been given. Similarly, no instances of mumps occurred among 25 children in classrooms who were exposed to natural mumps during the fourth school year following vaccination. The available data indicate that the protection afforded by the mumps virus vaccine will be lasting.
ANTIMICROBIAL SUSCEPTIBILITY OF HEMOPHILUS INFLUENZAE
Authors: McLinn Samuel E. , Nelson John D. , Haltalin Kenneth C.
Published: December 2021

Seventy strains of Hemophilus influenzae (49 capsulated and 21 noncapsulated) were tested for in vitro susceptibility to eight antibiotics and two sulfa drugs. Inoculum size has a marked influence on the apparent susceptibility to penicillin, ampicillin, sulfadiazine, and sulfisoxazole. If the Harper and Cawston effect is not taken into account in sulfa testing, hemophilus will appear falsely resistant. Plate dilution testing with a large inoculum results in apparent resistance of hemophilus to ampicillin, whereas all strains are highly susceptible to ampicillin by tube dilution testing.

With optimal methodology, Hemophilus influenzae appears susceptible to levels of ampicillin, tetracycline, chloramphenicol, erythromycin, sulfadiazine, and sulfisoxazole which can be achieved with usual therapeutic doses. Lincomycin is not effective, and most strains are resistant to cephalexin, a cephalosporanic acid derivative for oral administration. Levels of 10 to 20 µg per milliliter kanamycin are required for inhibition.

Testing conditions have a marked influence on the apparent susceptibility or resistance of Hemophilus influenzae to antimicrobial drugs. Because routine laboratories do not employ the necessary conditions for obtaining meaningful susceptibility testing of this fastidious organism, the physician should not be misled by possibly erroneous antibiotic sensitivity reports.
Haemophilus Parainfluenzae Meningitis in a 4-Year-Old Boy
Authors: Barnshaw James A. , Phillips Carol F.
Published: December 2021

Type b Haemophilus influenzae is the most common cause of bacterial meningitis in children and infants between 6 months and 5 years of age. In contrast, H. parainfluenzae is a rare cause of meningitis in infants, children, and adults. The organism has been associated with subacute bacterial endocarditis with brain abscess1 but a review of the literature reveals only one case report of H. parainfluenzae meningitis, which occurred in a 2-day-old infant.2 This report reviews a case of H. parainfluenzae meningitis in a 4-year-old boy.

Case Review

On June 14, 1969, D. C., a 4-year-old Caucasian boy, was admitted to the Mary Fletcher Unit of the Medical Center Hospital of Vermont with suspected meningitis.
Asymptomatic Urinary Tract Infection in Premature Infants
Authors: Hoffpauir Calvin W. , Guidry D. J.
Published: December 2021

Current evidence suggests that urinary tract infections (UTI) in infants often go unrecognized, that they receive inadequate treatment, and that the patient is seldom kept under observation for a sufficiently long period of time1. Detection of UTI is especially difficult in neonates where clinical symptoms may be entirely lacking, and in such cases diagnosis must depend on examination of the urine2-4. This is well illustrated by the two cases presented here where several bouts of pyuria and of bacteriuria were detected in asymptomatic premature infants. Both belonged to groups of randomly selected, premature infants whose urine was collected at regular intervals for either routine urinalysis and bacterial colony counts (Case 1) or for Addis sediment counts (Case 2).
Hearing Loss after Maternal Rubella: Need for Accurate Diagnosis of Maternal Infection
Authors: Reynolds David W.
Published: December 2021

Borton and Stark, in their recent paper,1 designed a study to describe hearing loss secondary to maternal rubella. Having been intimately involved in the surveillance of maternal rubella for the past 18 months, I must seriously question the validity of their case finding procedure. Unless the two Illinois state agencies are remarkable exceptions, the case records examined by the authors have dubious value as documents of clinical merit. This type of data often becomes increasing nebulous with each successive transcription.
Letter To The Editor
Authors: Trey Charles
Published: December 2021

In reply to the interesting case report of Dr. Deitcher, I am not aware of the use of azathioprine in patients in fulminant hepatic failure who have had previously normal liver functions and have developed this condition acutely. It has been used in patients with chronic active hepatitis. The patient in fulminant hepatic failure is subject to many complications and the addition of this immunosuppressive agent may mask some of these. This is the reason I would be unwilling to advocate its use at this time.
Pediatric Hematology, by Alvin M. Mauer, M.D. New York: McGraw-Hill Book Company, The Blakiston Division (330 West 42nd Street, New York, N.Y. 10036), 1969, 486 pp., $23.00
Authors: Pearson Howard A.
Published: December 2021

The volume presents an authoritative review of the blood diseases of infants and children by an active pediatric hematologist. The style and content reflect the author's accomplishments as teacher, researcher, and clinician.

In his introduction Dr. Mauer points out that a medical textbook may serve individuals of many levels of sophistication ranging from neophyte to specialist. The author has attempted to meet their different requirements in an interesting way. For the student and practitioner he presents concise and clinically useful descriptions of the diseases which constitute the practice of pediatric hematology.
The Allergy Cookbook, by Carol G. Emerling and Eugene O. Jonckers. New York: Doubleday and Company, Inc., 1969, 244 pp., $5.95
Authors: Dillon Agnes E.
Published: December 2021

A cookbook is an unusual item to be reviewed in a medical journal. However, any book which has value to the medical profession in improving the health or well-being of the ill or suffering should be brought to their attention. The Allergy Cookbook is such a book. It is the first cookbook for allergic individuals I have seen.

Certain foods which cause allergic reactions—such as strawberries—can be eliminated from the diet easily. Many other foods which can produce allergic reactions are used in a large percentage of the foods we eat; frequently, we do not even know they are there.
EPITHELIAL HEPATOBLASTOMA ASSOCIATED WITH CONGENITAL HEMIHYPERTROPHY AND CYSTATHIONINURIA: PRESENTATION OF A CASE
Authors: Geiser C. F. , Baez A. , Schindler A. M. , Shih V. E.
Published: December 2021

A 13-month-old boy with hepatoblastoma and hemihypertrophy is presented; this is the fifth known case with this association. Histological study showed that hemihypertrophy was related to cellular hyperplasia but not to hypertrophy of individual cells. Karyotypes of leukocytes and of skin fibroblasts from both sides of the body were normal. The association of hemihypertrophy and hepatoblastoma stresses the dysontogenetic origin of this neoplasm and signals the possibility of this tumor in children with asymmetry. Our patient showed cystathioninuria, which was related to the high content of cystathionine in his tumor. The presence of cystathioninuria in 7 of 10 patients with hepatoblastoma so far examined, shows the usefulness of urinary amino acid screening in the diagnosis of this rare childhood neoplasm.
NEONATAL SUPPURATIVE PAROTITIS
Authors: Leake Donald , Leake Rosemary
Published: December 2021

Ten patients with neonatal suppurative parotitis were seen at Children's Hospital Medical Center in the past 20 years. This makes nearly 100 cases in the world literature since 1878. The Center patients, 6 males and 4 females, ranged in age from birth to 23 days at the onset of symptoms. The diagnosis was made on the basis of parotid gland swelling and suppuration from Stensen's duct. Cultures of pus draining from Stenson's duct yielded Staphylococcus aureus from 6 patients, all of whom survived, E. coli from two patients, one of whom survived, and Pseudomonas aeruginosa and Neisseria catarrhalis from one patient each, both of whom died. All patients were treated with antibiotics except one who received only radiation. Four patients seen in the period 1948 to 1958 received low dose radiation varying from 75 to 300 R on each side. Two patients with fluctuance in the parotid had incision and drainage. Prognosis in the infant without other pathology is good. In the congenitally abnormal patient, the prognosis is poor.
CUSHING'S SYNDROME IN INFANCY
Authors: Gilbert Michel G. , Cleveland William W.
Published: December 2021

Cushing's syndrome in infancy is usually due to adrenal tumor which is often malignant. Three cases are described in which the disorder was due to adenoma and surgical cure was achieved. The clinical picture is strongly suggestive if not diagnostic. Its hallmark is generalized obesity with typical facies; also present are hypertension and signs of virilization. Striae were not found in our patients. Increased excretion of both 17-hydroxysteroids and 17-ketosteroids is characteristic; this excretion was not suppressed by dexamethasone in two of these patients in whom it was tested. Intravenous pyelogram was distinctly abnormal in all cases and indicated the presence and location of the tumor. The diagnosis can be made efficiently and surgical treatment can be promptly instituted with reasonable expectation of cure. Careful attention must be paid to preoperative and postoperative administration of adrenal steroids.
Abscess in Newborn Infants Caused by Mycoplasma
Authors: Sacker Ira , Walker Mildred , Brunell Philip A.
Published: December 2021

M. hominis was isolated from pus which was drained from a skin abscess of an infant at 7 and again at 27 days of age. The same organism was isolated from the vagina of the infant's mother. These findings provide additional evidence indicating that M. hominis, a normal inhabitant of the female genital tract, may not only colonize infants during passage through the birth canal but may also produce clinical illness in the newborn infant.
Letter To The Editor
Authors: Eichenwald Heinz F.
Published: December 2021

Dr. Franciosi raises a point which deserves emphasis: antimicrobial therapy is not a static process; the widespread use of an antibiotic will often result in emergence of resistant bacteria necessitating continuous review of recommendations for therapy. The emergence of resistance of gram-negative enterobacteria to kanamycin, including not only E. coli but also klebsiella-aerobacter, has been reported to us from a number of areas in the United States and is recorded in scattered reports in the literature.
Letter To The Editor
Authors: Schaller Jane
Published: December 2021

Dr. Schaller commented as follows:

Concerning our grievous misspelling of the word "pruritus," I can only reply that we erred and hereby promise to do better forever after. Aside from the two letters received by the editor, this matter was solely brought to our attention by Dr. Rustin McIntosh of Tyringham, Massachusetts. May spelling buttons be awarded forthwith to these astute orthographers!1

We are well aware that Drs. Calabro's and Marchesano's article on rash was published in 1968, not 1958 (it was originally correctly cited) and that they mentioned in passing that "eruptions were nonpruritic except in one child."
LONG-TERM FOLLOW-UP OF CYTOMEGALIC INCLUSION DISEASE OF INFANCY
Authors: Berenberg William , Nankervis George
Published: December 2021

Twelve children with cytomegalic inclusion disease (CID) of infancy were reevaluated at ages ranging from 3 to 12 years. Nine manifested significant mental and/or motor retardation while three did not have significant neuromuscular residual deficit. In general those infants with CID who demonstrated microcephaly, chorioretinitis, and intracranial calcification continued to exhibit these changes on follow-up while those free of these phenomena in infancy did not subsequently develop such changes. No significant abnormalities were encountered in studies of hematologic, renal, or hepatic function. Late mortality did not occur except as a consequence of severe neurologic disability. Fifteen children born of mothers who had had a previous child afflicted with CID were normal. The mothers remained well, although they had nine miscarriages after the birth of the affected infant, while none had occurred previously.
Population Control Begins at Home
Authors: Pinto Peter S.
Published: December 2021

It is commendable and it is right that so many fine pediatricians in the temples of learning and outside of them are concerning themselves in your pages with more efficient delivery of health care to greater numbers of children in the various strata of society; but like specialists of all kinds they see the world in terms of their specialty. A broad perspective on the problems of mankind and Americans should prompt any intelligent physician to an inevitable conclusion, and that is: there are just too many people, and medicine and public health which have caused the population explosion will never solve the problems of health care for that burgeoning population with more, more, and more of the same.
Genetics and Counseling in Medical Practice, by Leonard E. Reisman, M.D. and Adam P. Matheny, Jr., Ph.D. St. Louis: The C. V. Mosby Company, 1969, 215 pp., $12.75
Authors: Porter Ian H.
Published: December 2021

We have sorely missed good books on genetic counseling to supplant Sheldon C. Reed's Counseling in Medical Genetics (1963). Now they are appearing one after another: Genetic Counseling, by Walter Fuhrmann and Freidrich Vogel (1969), the long awaited book, Genetic Prognosis and Counseling edited by Arno G. Motulsky, and the book under review.

The quickening interest in medical genetics has led to an increase in the need for accurate genetic counseling by the clinician, the patient, and in the formation of public health policy.
THE TREATMENT OF RICKETS, AS SUGGESTED BY BOERHAAVE AND GLISSON AND INTERPRETED BY DR. JOHN THEOBALD OF LONDON IN 1764
Authors: C. T. E.
Published: December 2021

In 1764 the Duke of Cumberland asked Dr. John Theobald of London to compile a medical guide for the young wife to manage her children from the time of their birth to the age of 7 years. In about 49 pages, Dr. Theobald wrote a book containing "everything necessary to be known relative to the nursing of children, from the time of their birth to the age of seven years; together with a plain and full account of every disorder, to which infants are subject, and a collection of efficacious remedies, suited to every disease."

This little book might well have been the "Spock" of its period. A good example of how Theobald presented the latest information about common pediatric diseases to young mothers—over 200 years ago—is this chapter on rickets.

This distemper most frequently affects children from nine months old, to two years and a half. The child at the beginning is seized with an aversion to motion, or exercise of any kind; the joints grow feeble and weak, and the flesh soft and flaccid; the head is over large, and the child's capacity exceeds its years. The belly is hard and very prominent; the bones of the arms and legs, grow crooked and are knotty at the joints; a cough comes on and difficulty of breathing; the pulse is low and languid, and an hectic fever carries off the child. Take of the beet manna a drachm and an half, of dried raisins an handful, common ale a pint; infuse them together for twelve hours, and then strain them; let the child drink a draught of this frequently. . .
Spontaneous Thyrotoxicosis in Infancy: Report of a Case
Authors: Levitsky Lynne L. , Trias Estrellita , Grossman Milton S.
Published: December 2021

A 7-month-old child with severe thyrotoxicosis of several month's duration is presented whose initial symptoms were gastrointestinal disturbances and poor weight gain. She is the sixth reported case of spontaneous hyperthyroidism in infancy and the first to be diagnosed chemically. She is also the first infant with spontaneous thyrotoxicosis to be treated with propyolthiouracil.
SHOULD STEROIDS BE USED IN TREATING BRONCHIOLITIS?
Authors: Yaffe Sumner J. , Weiss Charles F. , Cann Howard M. , Gold Arnold P. , Kenny Frederic M. , Riley Harris D. , Schafer Irwin , Stern Leo , Shirkey Harry C.
Published: December 2021

Since their introduction into clinical use, corticosteroids have been employed as therapeutic agents in virtually every known disease state, ranging from minor dermatologic disorders to major and serious diseases. These agents have undoubtedly altered the clinical picture and prognosis of certain diseases. However, the use of corticosteroids is always potentially associated with a variety of untoward effects, some of which may be life threatening, i.e., decreased resistance to infection, growth retardation, neurological reactions, hypertension, peptic ulcerations, and many others.1 The time honored principle—first do no harm—should always be the guideline of therapy, especially when a definite indication for a particular therapeutic agent has not been established.

In recent years corticosteroids have been employed in the treatment of bronchiolitis on the hypothesis that their anti-inflammatory action would decrease swelling, inflammation, and the consequent respiratory obstruction. The opinions of different investigators on the efficacy of corticosteroids in this disorder have varied greatly; some have regarded their use as ineffective and others as lifesaving. It is the purpose of this report to review the findings from various studies and to outline the current status the use of corticosteroids in this common disorder of infants and children.

Bronchiolitis is a common, acute respiratory syndrome characterized by infection of the bronchioles and respiratory distress of varying degrees due to obstructive emphysema. It is common in the first year of life and is rare in the child over 2 years of age. It frequently occurs in outbreaks. The great majority of cases are due to viruses, especially the respiratory syncitial, influenza B, and parainfluenza viruses, but it may be due to bacteria and other respiratory pathogens.
Intra-Uterine Transfusion, Continued
Authors: Bowman J. M.
Published: December 2021

The paper, "Intra-uterine Transfusion: Fetal Outcome and Complications,"1 deserves comment.

The authors carried out 110 transfusions of 73 fetuses using a CO2 method to confirm placement of the catheter tip (or needle) in the peritoneal cavity of the fetus. On two occasions they injected blood into fetal bowel, on another into fetal bladder, and on a fourth into subcutaneous tissue. Such accidents imply that the CO2 method of confirmation of the catheter tip in the peritoneal cavity is not sufficiently accurate.
Is Typing of H. Influenzae Unnecessary?
Authors: Strauss Ronald G.
Published: December 2021

In volume 44 of Pediatrics several articles reporting information from the authors' experience ence or from the literature about infectious diseases have failed to classify Hemophilus in fluenzae organisms by groups1-4. It is probably safe to assume pathogenicity of such organisms regardless of their group if they are recovered in pure culture from an inflammatory exudate. Isn't it true, however, that most Hemophilus infections are due to group b Hemophilus influenzae; that pathogenicity is difficult to assign with certainty to other types of Hemophilus organisms; and that many healthy individuals harbor Hemophilus influenzae in their upper respiratory passages?5
Letter To The Editor
Authors: Jaffe Norman
Published: December 2021

Dr. Ng is probably correct that there is insufficient evidence of reported cases of contact dermatitis or other untoward effects associated with the preparation of these chemotherapeutic agents. However, nitrogen mustard is wellknown to cause a vesicant effect. Although I am unaware of other clinical reports of contact dermatitis associated with these drugs, I would not be surprised to learn that it did occur. With regard to systemic toxicity, this would be expected to be extremely small.
THE CONCEPT OF FAILURE TO THRIVE
Authors: Smith Clement A. , Berenberg William
Published: December 2021

One cannot overhear a pediatric hospital resident say that last night he "admitted two failures to thrive" (or was it "two failure to thrives"?) without momentary doubt whether description is clearly distinguished from diagnosis. A similar uneasiness may arise during the occasional grand rounds or postgraduate courses held under that title. If the concept of failure to thrive evokes a challenge to the student and house officer to proceed with a logical and orderly sorting out of the differential diagnoses, all is probably well. But if, as one sometimes suspects, failure to thrive is comfortably assumed to be a diagnosis in itself, or imply only one cause, or one group of causes, pediatric thinking may be blurred rather than clarified.
PEDIATRIC PERCEPTIONS
Authors: Wedgwood Ralph J.
Published: December 2021

The training of graduates from foreign medical schools presents a special problem in medical education. Their presence in training programs can be regarded from two totally disparate points of view. The first view, probably most generally held, is that foreign medical graduates are less well prepared for internship and residency than their American counterparts. The difficulties imposed by language barriers, by differences in education, social customs, and values are a reality. From this perspective the foreign medical graduate is not as "desirable" a house officer as the graduate of an American medical school; programs with a large proportion of foreign medical graduates are considered less competitive, or strong, than those with fewer.

Hospitals, however, need house officers to provide patient care services. Since the end of World War II there have been far more positions available than applicants. Hospitals compete strongly for these physicians, often, it must be admitted, to utilize their services for patient care rather than to provide them with an educational opportunity. The national picture over the past 20 years (Fig. 1) shows this steady trend. In 1968-1969, about one third of all house officers in the United States were foreign graduates; nearly 20% of available house officer positions were unfilled.

Thus, a different but equally valid viewpoint, increasingly voiced but not frequently recognized, is that the foreign medical graduate is a vital component of our health manpower resources. The United States is heavily dependent upon the immigration of physicians to provide the health services needed by the expanding population.