bluuebunny/crossref_metadata_2025 huggingface dataset:
A REVIEW OF 164 CHILDREN WITH MECONIUM ILEUS SEEN AT THE CHILDREN'S HOSPITAL MEDICAL CENTER, BOSTON
Authors: Donnison A. B. , Shwachman H. , Gross R. E.
Published: December 2021

Meconium ileus is a complication of cystic fibrosis which still causes a high mortality rate in the first year of life. The condition is frequently complicated by meconium peritonitis, volvulus, and/or atresia, but these complications are not necessarily fatal. In the last ten years, the mortality rate for babies with meconium ileus has been about 40%. Thirty-five percent of children who survived the operation died from pneumonia in the first 6 months of life. Children who lived to 6 months had a prognosis similar to other children with cystic fibrosis who did not suffer from meconium ileus, and this will depend on the degree of pulmonary involvement. Some children with meconium ileus may have few pulmonary symptoms and, with good medical care reach adult life.

Close cooperation between the surgeon and pediatrician and the early application of an intensive prophylactic and therapeutic pulmonary program are essential if we are to improve the mortality and morbidity in this disease.
Advertising
Authors: THELANDER H. E.
Published: December 2021

It was gratifying to read the letter by Dr. Arthur Eidelman regarding "Advertising in the Journal." This has been a sore point with me for many years. The January journal is almost half advertising. Many of the pictures are unattractive if not disgusting. If one considers the taxpayer's money that goes into FDA in the first place to control drugs, the money that is spent by the poor patient to buy drugs, the time wasted by doctors to listen to salesmen, and the necessity for county medical societies and other organizations to put up protection against drugs, I think it is high time that the medical profession took a very definite stand on advertising of all drugs.
Atlas of Pediatric Surgery
Authors: SCHUSTER SAMUEL R.
Published: December 2021

Dr. White has gone a long way in fulfilling the need for a primarily illustrative text of the surgical techniques used in the management of many of the problems of childhood.

This is a very large volume encompassing 923 pages and includes almost every surgical specialty. The techniques which are illustrated are well accepted surgical procedures and are portrayed with clarity. There is, however, an occasional instance in which a contributing author has failed to stress sufficiently the features which are of primary importance in the child.
Ciba Foundation Symposium, Caries-Resistant Teeth
Authors: SWEENEY EDWARD A.
Published: December 2021

This volume contains the proceedings of a symposium held in June 1964 to discuss the concept of caries resistance. That the aim of the symposium was accomplished is attested to by the lively and very informative discussions of the leaders in dental research. Some of these newer concepts vary greatly from the traditional beliefs, such as Brudevold's findings that the mechanism of action of fluoride in caries protection is one of facilitative remineralization rather than of a decreased solubility of fluorapatite crystals.
PROBLEMS OF DIAGNOSIS AND TREATMENT: COMMUNICATION BETWEEN PEDIATRICIAN AND PSYCHIATRIST: RETROSPECT AND PROSPECT
Authors: Lourie Reginald S.
Published: December 2021

We Have Come a long way from the thirties when Brenneman was writing about "The Menace of Psychiatry"1 and Crothers described the confusion of " The Pediatrician in Search of Mental Hygiene."2 On the surface at least we seem to have come to the opposite pole. A pediatrician sits on the Child Psychiatry Committee of the American Board of Psychiatry and Neurology. Most teaching services in pediatrics have at least a consultant in child psychiatry, and many hospitals and medical have divisions and departments of child psychiatry closely allied to pediatrics. In the late fifties Dr. Janeway3 as a member of a panel with Anna Freud, said that whereas 25 years ago the presence of a professor of pediatrics on such a platform lent respectability to psychoanalysis, "it now lends respectability to the pediatrician."

When, however, one looks below the surface where child psychiatrists and pediatricians function together, mutual dissatisfaction is not infrequent. Probably the pediatricians have more complaints about the psychiatrists than the other way. A frank and critical look at these complaints reveals that they are consistently related to problems in orientation and in understanding each other. On analysis, their differences usually fall into the following relatively few patterns.

TYPES OF DISAGREEMENT AND COMMUNICATION DIFFICULTIES

A common complaint concerns the communication system, or better, the lack of communication between psychiatrist and pediatrician. Starting sometimes with the differences of professional language, this often goes on to involve the psychiatrist's confidently stated basic assumptions which the pediatrician may refuse to take for granted, or may flatly disbelieve.
Katharine Dodd
Authors: Luther Gertrude C.
Published: December 2021

Although I understand that Pediatrics usually limits memorial notices to founders and past presidents of the Academy, may I use your "Letter" section for a brief note about Doctor Katharine Dodd? Doctor Dodd was my teacher and good friend. I am sure this could be said by many of the hundreds of doctors practicing in this world who were influenced by her. Katie Dodd died of carcinoma on November 7, 1965. It is my feeling that this information should be noted on the pages of Pediatrics.
The Pediatrician and the Distribution of Pediatric Care
Authors: TOLL DAVID
Published: December 2021

In the past the practicing pediatrician has played virtually no part in the planning and development of governmental programs for health care of children. Until this year these programs were tangential to his work. They were limited either to certain well defined problems or to well defined population groups or both. Many men in practice chose to participate as their contribution to the welfare of disadvantaged children; however, the extent and manner of their participation was a matter which they themselves could determine individually. Now the situation has changed.
Terminal Sterilization of Formulas in the Home
Authors: BOWMAN HARRY D.
Published: December 2021

I was raised during the era of high infant mortality under 2 years of age, and I studied medicine under the enlightened era of sterilization of infant formulas. Over the years I have thus witnessed the tremendous obliteration of infant mortality due to gastroenteritis. When I began practice, we already had pasteurized milk and a water supply that was considered safe, yet I was taught that human error and mechanical failure could happen, and therefore mothers should be taught the "sterile field method" of preparation of formulas.
Letters to the Editor
Authors: SHWACHMAN HARRY , KHAW KON-TAIK
Published: December 2021

We are cognizant of the report of Schubert and Partin calling attention to the risks involved in performing small intestinal biopsies and were indeed surprised to read of the high incidence of perforations. Obviously our techniques differ.

We have had no perforations in our series, which covers 195 biopsies performed with the Crosby capsule (3 mm port) and over 350 biopsies using the Rubin tube. We do not fix an age or weight below which we dare not operate. Approximately 50% of our patients were under 2 years of age and weighed less than 25 lb.
Principal Infectious Diseases of Childhood
Authors: EICHENWALD HEINZ F.
Published: December 2021

When the reviewer began to peruse this volume, he was unable to put it down until he had completed reading it. The book is full of fascinating items of information, a few of which might be cited: "the common cold and minor respiratory illnesses are most likely caused by the group of bacteria found in upper and lower respiratory tract infections (usually the pneumonococcus, and streptococcus);" "(the etiology of primary atypical pneumonia) is obscure but it is believed that a specific respiratory virus will eventually be recovered;" "meningitis . . . is so serious a disease that one must recommend that most upper and lower respiratory infections be treated with sulfonamide and/or antibiotics;" "(sepsis neonatorum should be treated) with sulfadiazine or some other intravenous sulfonamide."
TREATMENT OF CONGENITAL MEGACOLON IN 50 INFANTS
Authors: Shim Walton K. T. , Swenson Orvar
Published: December 2021

Fifty infants less than 1 year old with Hirschsprung's disease were treated at Children's Memorial Hospital in the past 6 years.

Thirty-two of the 35 barium enema studies yielded "diagnostic" roentgenographic studies, and 3 were "negative" for Hirschsprung's disease. Fourteen of the 50 infants had a history of diarrhea. Enterocolitis in infants may be extremely rapid in onset and progression. It should be vigorously treated with rectal irrigations and intravenous fluids.

Nineteen patients (38%) had aganglionic segments extending above the rectosigmoid colon, and eight (16%) were aganglionic proximal to the splenic flexure. This includes three patients with aganglionosis of the entire colon and one that was aganglionic from the jejunum to anus.

Emphasis is placed on an aggressive combined attack by pediatrician, radiologist, pathologist, and surgeon to diagnose and prepare the sick infant as early as possible for colostomy or definitive abdominal-perineal pull-through operation. Twelve infants with an average weight of 12.5 lb were operated on primarily with no deaths or complications. It is our belief that definitive surgery can be done with greater ease in an infant than in older children, but careful selection and preparation of the patient and meticulous operative technique must be exercised. The important criteria for selection of infants for immediate resection are the absence of emaciation and enterocolitis, although the infant may be small.

Twenty-six infants had colostomy and resection with no deaths or complications.

Our raw mortality figures show 10 deaths in 50 patients (20%). There were 7 deaths in 47 surgical patients (15%).
America's Unhealthy Children: An Emerging Scandal
Authors: BATES TALCOTT
Published: December 2021

With a brief nod to the Teaching Medical Center and the middle and upper class, predominantly suburban, private pediatric practice, Tunley takes off on the deficits of American pediatrics. His list begins with antenatal care.

In the field of obstetrics we are an underdeveloped country; we rank sixth in infant mortality; the proportion of women receiving antenatal care is declining; our lowest infant mortality, even in essentially all white states, is above Europe's best.

Our free clinics are "alms" oriented, crowded, inconveniently located, bleak and uninviting, poorly staffed, with rude and thoughtless personnel; in other nations they are convenient, attractive and offer inducements—layettes in Finland, cash bonuses and compensation for loss of income during pregnancy in Sweden.
THE PROTECTIVE EFFECT OF POLYVALENT OIL-ADJUVANT INFLUENZA VACCINE IN CHILDREN
Authors: Quilligan J. J. , Baernstein H. D.
Published: December 2021

Polyvalent oil-adjuvant influenza vaccine has been shown to be practical and effective in children. Its use resulted in respectable levels of antibody after 2 and 3 years when two injections were given. A protection ratio of 3.1 was observed during natural challenge with A2 virus after 2½ years. The value of a program of surveillance for the presence of viral respiratory disease in a hospital population offers the opportunity to test vaccine efficacy under conditions of natural challenge.
TIME-MOTION STUDY OF PRACTICING PEDIATRICIANS
Authors: Bergman Abraham B. , Dassel Steven W. , Wedgwood Ralph J.
Published: December 2021

Four practicing pediatricians were followed by an observer with a stopwatch for a total of 18 days to gain a profile of how their working days were spent.

An average of 48% of the day was spent with patients, 12.5% on the phone, and 9% on paper work. Fifty per cent of patient time was spent with well children, and 22% on children with minor respiratory illness. Intellectual understimulation seemed to arise from spending the majority of time with children who did not require their special talents.

In view of the alarming decline in ratio of physicians to child population, pediatricians are urged to play a decisive role in formulating the alternative patterns of child health care that must inevitably develop in the United States.
THE NATURE OF A SMALL PEDIATRIC GROUP PRACTICE
Authors: Breese B. B. , Disney F. A. , Talpey W.
Published: December 2021

The nature of a small suburban three-man group practice in Rochester, Monroe County, New York, has been analyzed largely from special records of patients seen on every fifteenth day over the 2-year period 1959 to 1960.

Data are presented on the growth of pediatric practice within the county, the distribution of pediatricians, the increase in groups, the number of patients seen, distribution of calls by year, month, day of week, and time of day, together with information on the age of patients, parents' age, their type and place of occupation, size of family, presence and absence of tonsils, diagnosis, treatment, charges to patient, and some additional figures on the economics of our particular practice.

1. The carrier rate for beta hemolytic streptococci among normal children in a private pediatric practice when direct inoculation of cultures onto sheep blood agar plates are used is extremely low (less than 4%).

2. Because of these low rates among "normal" children, positive cultures, particularly strongly positive ones, are generally of diagnostic importance.

3. The lower carrier rate found in our practice than that reported by other investigators is probably due to differences in our bacteriologic methods, the age of the children sampled, and our method of treating known streptococcal illness.

4. Significant streptococcal illness is an exceedingly common and important illness in our practice; it is found in approximately 1 child in 20 of all children, sick or well.

5. The frequency of streptococcal illness seems to have a definite relation to age and season of the year.
Milk Induced Colitis in an Infant
Authors: GRYBOSKI JOYCE D. , BURKLE FREDERICK , HILLMAN RICHARD
Published: December 2021

An infant is reported who developed acute colitis on three occasions after the ingestion of milk. It is suggested that milk-induced colitis in this infant is a disease which is distinct from ulcerative colitis but one which must be added to the spectrum of causes operative in the development of colitis in infants and young children.
A Proposal for Providing for the Future of Abnormal Infants
Authors: NICKMAN STEVEN L.
Published: December 2021

The burden of the family which must care for a child with a severe congenital defect is always hard to bear; most physicians are aware of more than one home which was broken as a result of such stress. Frequently the families which are thus disrupted were unstable from the beginning, and the birth of a child with meningomyelocele or phocomelia is merely a precipitant cause of desertion by the father or psychic breakdown in the mother.
Cardiac Pacemakers
Authors: LYNFIELD JOSHUA
Published: December 2021

Publication of the interesting report of implantation of a cardiac pacemaker in a 4-month-old infant by Martin, et al. (Pediatrics, 37:323, 1966), raises the question of pacemaker selection for the infant with heart block. The Cordis Atriocor Synchronous type of pacemaker is probably best for this condition because it is possible to vary the ventricular rate according to the needs of the body at rest and during exercise over a fairly wide range.

The advantage of this pacer is that atrial activity is in control of pacemaker function over a physiological range of heart rates.
Thrombocytopenia in Rocky Mountain Spotted Fever
Authors: RILEY HARRIS D.
Published: December 2021

I would like to comment on the case of Rocky Mountain spotted fever with multiple coagulation disturbances reported by Atkins, et al. in Pediatrics, 36:327, 1965, and the letter concerning this case from Doctor Stryker in Pediatrics, 37:386, 1966. In our experience the association of thrombocytopenia with Rocky Mountain spotted fever (RMSF) is not uncommon. We have accumulated 19 cases of this infection associated with thromboctyopenia. After the preliminary report of this association appeared from this clinic, personal communication from other clinics in this and other regions brought to light the occurrence of other cases.
PNEUMOCYSTIS CARINII PNEUMONIA AND ALTERED HOST RESISTANCE: TREATMENT OF ONE PATIENT WITH PENTAMIDINE ISETHIONATE
Authors: Patterson Joseph H. , Lindsey I. L. , Edwards E. S. , Logan William D.
Published: December 2021

Three infants with proved Pneumocystis carinii pneumonia and immunologic deficiency are reported. Pertinent aspects of the clinical history, physical findings, laboratory data, and x-ray examinations are discussed.

Review of the pediatric literature confirms the association of P. carinii pneumonia in infants with altered host resistance.

Emphasis is given to the value of open lung biopsy as a diagnostic tool.

The experience of treatment and re-treatment of one infant with pentamidine isethionate (4 mg/kg/day) and gamma-globulin is recorded.

The underlying disease state of immunologic deficiency or lymphoreticular disease may make the ultimate prognosis grave, even in view of clinical improvement or recovery from P. carinii pneumonia following treatment with pentamidine isethionate.
CONGENITAL ABSENCE OF THE PARATHYROID AND THYMUS GLANDS IN AN INFANT
Authors: Taitz Leonard S. , Zarate-Salvador Concepcion , Schwartz Eugene
Published: December 2021

A female infant with congenital absence of the parathyroid and thymus glands is reported. In addition, the patient developed renal tubular acidosis which was associated with nephrocalcinosis. The relation of this complication to the presence of hypomagnesemia and the administration of parathyroid hormone calcium and vitamin D is discussed.

It is proposed that two forms of primary hypoparathyroidism are seen in the first year of life. One is a non-lethal sex-linked form. The other, to which the patient reported here belongs, has a high mortality which may be due to immunological disorders secondary to the absence of the thymus gland or multiple associated anomalies.
HEMATOLOGIC CHANGES IN THE D1 TRISOMY SYNDROME
Authors: Walzer Stanley , Gerald Park S. , Breau Germaine , O'Neill Daniel , Diamond Louis K.
Published: December 2021

A propositus was presented manifesting the clinical picture of the D1 syndrome and demonstrating the chromosomal findings of a D/D translocation "trisomy." The increased level of Hb F usually seen in patients with this syndrome was serially demonstrated in the propositus over the first 9 months of life. In addition, the Hb A2 concentration was found to be significantly decreased during the same period. The hypothesis of maturational retardation was invoked to explain the hemoglobin changes and possibly the leucocytic changes in the usual D1 syndrome patient.
Letters to the Editor
Authors: KATZ SAMUEL L.
Published: December 2021

Thank you for providing us an opportunity to read and comment upon the letter submitted by Drs. Fulginiti, Sieber, and John. That these readers of your journal have appreciated the discordance of the data reported in the two papers cited (by Shone, et al. and Gersony et al.) reaffirms my high opinion of the Editor of Pediatrics who chose deliberately to place these articles in juxtaposition to stimulate his subscribers to ponder upon the ambiguity of this inconstant observation in patients with endocardial fibroelastosis.
Interacting Systems in Development
Authors: SISSMAN NORMAN J.
Published: December 2021

Embryology is today one of the most neglected of all medical fields. Only a handful of medical schools offer more than an introductory course on the subject, and most physicians' knowledge of embryological principles and mechanisms is rudimentary or, at best, limited to circumscribed areas of special interest. This is particularly unfortunate for pediatricians whose practices include such a significant percentage of congenital defects, which are really instances of normal embryologic processes gone awry.
Commentary
Authors: ODELL GERARD B.
Published: December 2021

Doctor Diamond's commentary on his recently published observations in experimental kernicterus has reaffirmed previous concepts of its pathogenesis and emphasized the importance of albumin on the distribution of bilirubin in the body. Albumin forms an anion protein complex with bilirubin and thereby reduces its aqueous phase concentration and ultrafiltration into the CNS. It is this latter, diffusible bilirubin, which gains access to intracellular fluid rather than the protein-bound bilirubin. The recent observations of Cowger, et al. have demonstrated the exquisite sensitivity of intact cells to bilirubin at concentrations as low as 0.5 mg/100 ml of extracellular fluid when no albumin is present in the cell media.
Commentary
Authors: LUCEY JEROLD F.
Published: December 2021

The foregoing article and comments create a dilemma for pediatricians. The experimental evidence cited is quite convincing that increased amounts of serum albumin decrease the neurotoxic effects of bilirubin. If physicians are convinced of its usefulness, they will want to use this additional treatment for hyperbilirubinemia when it is indicated. Unfortunately, well established therapeutic guidelines do not exist. Serum albumin does not need to be administered to all infants requiring exchange transfusions. Some tentative answers to the questions of which infants should be treated and the amount of serum albumin to be used have been suggested by Dr. Odell in his comments.
THROMBOCYTOSIS, CENTRAL NERVOUS SYSTEM DISEASE, AND MYOCARDIAL INFARCTION PATTERN IN INFANCY
Authors: Sanyal Shyamal K. , Yules Richard B. , Eidelman Arthur I. , Talner Norman S.
Published: December 2021

Two infants with thrombocytosis and significant neurological symptoms are presented. The electrocardiographic and vectorcardiographic findings in both suggested apical myocardial infarction. The isoenzyme studies done in one infant, however, did not support this diagnosis. This observation raises the possibility that the electrocardiographic and vectorcardiographic abnormalities may be due to associated central nervous system disease rather than due to a compromised coronary blood flow.
DIAGNOSIS AND TREATMENT: NASOTRACHEAL INTUBATION AS A SUBSTITUTE FOR TRACHEOSTOMY
Authors: Smith Robert M.
Published: December 2021

THE OBVIOUS advantages of tracheostomy must always be weighed against the hazards and complications with which it may be associated. The initial performance of the operation may entail complete airway occlusion, hemorrhage, or cardiac arrest secondary to sudden reduction of carbon dioxide concentration. Maintenance of the tracheostomy may involve pneumothorax, pneumomediastinum, sepsis, and occlusion or dislocation of the tube, and final removal can be followed by such problems as tracheal collapse or stenosis.

To avoid some of these difficulties a new concept has been introduced whereby a smooth, sterile endotracheal tube is introduced through the nose and maintained in place for several days, or even weeks. Undoubtedly the method had been used in many individual situations throughout the world, but the idea was first tried on a large scale in Australia. In the Adelaide Children's Hospital and in The Royal Children's Hospital of Melbourne tracheostomy has been largely abandoned and only endotracheal intubation has been used for the past two years in children with laryngotracheitis, croup, and various other types of reversible respiratory inadequacy. In these hospitals tracheostomy is reserved for inindividual situations where secretions are especially heavy or in some patients with severe laryngotracheitis. Nasotracheal intubation has been adopted throughout many parts of the British empire and has recently been employed widely throughout the United States.

The indications for nasotracheal intubation are similar to those for tracheostomy. Children in whom airway obstruction results in retraction, stridor and, finally, increasing pulse rate constitute one group of patients who require such assistance.
Letters to the Editor
Authors: WRIGHT F. H.
Published: December 2021

As Dr. Van Leeuwen suggests, the points made in his letter were considered in some detail before and during the Institute on Residency Training held by the American Board of Pediatrics last September in Atlanta. A summary of these deliberations appears as the October supplement to Pediatrics. The following rejoinder to Dr. Van Leeuwen's letter is a personal rather than an official interpretation of the "sense of the meeting."

The impending shortage of pediatricians in this country is recognized.
Your Child and You, a Pediatrician Talks to Young Mothers
Authors: CONE THOMAS E.
Published: December 2021

Has the tidal wave of books, pamphlets, tracts, magazine articles, and newspaper columns written in an effort to answer the questions which new mothers and even those with growing families so often ask finally reached a point where a halt should be declared on such publications? The authors of these two books, both of whom are seasoned and experienced middle-aged pediatricians in active private practice, feel the answer is no. Both authors give cogent reasons for their adding another book to the many already available to provide mothers with counsel and emotional support in helping them to rear their children in these complex times.
INFANT MORTALITY RATES FOR THE TOWN OF SALEM, MASSACHUSETTS, IN 1782 AND 1783
Authors: C. T. E.
Published: December 2021

The infant mortality rate for a single New England town for the years 1782 and 1783 cannot be used as a true index of this statistic for the 13 states which made up the United States during the 1780's. As we lack data concerning infant mortality for the country as a whole during this period, information about the mortality of infants in the town of Salem, Massachusetts, where all births were recorded, should be of interest to pediatricians.

Doctor Edward A. Holyoke of Salem in a letter to Mr. Caleb Garnett, the Recording Secretary of the American Academy of Arts and Sciences, gave these figures for the town of Salem:

In 1782 there were 311 live-born infants and of these 36 died before they reached their first birthday, for an infant mortality rate of 115.

In 1783 of 374 live-born infants, 38 died during their first year of life, for an infant mortality of 102.

When one recalls that the rate for 1915 in the United States was 100, the infants, at least in Salem, did not fare too badly.
Pediatric Therapy (1966-1967)
Authors: PASCOE DELMER J.
Published: December 2021

The second edition of Pediatric Therapy accurately reflects many of the important changes which have occurred in the treatment of children since the first edition appeared just 2 years ago. Doctor Shirkey has not only written about one-fifth of the material in the book himself but has also asked 72 other highly qualified contributors to bring to the reader the best current therapy for most of the commonly encountered clinical problems in pediatrics. Doctor Shirkey well supports his statement in the preface of the book that "pediatric therapy is not a twig of the tree of general therapy.
Cardiomegaly due to Chronic Hypocalcemia
Authors: ANTEBI L. , BOUCHARD R. , GUEDENEY J. , PERLES C. , WEILL J.
Published: December 2021

The occurrence of cardiomegaly as a consequence of chronic hypocalcemia is extremely rare. We have recently studied a 9-year-old child in whom cardiomegaly, coexistent with hypocalcemia, was demonstrated; there were no signs of cardiac insufficiency. Normalization of cardiac size accompanied restoration of normocalcemia.

CASE HISTORY

The patient was referred at the age of 8 years, 7 months because of mental retardation and convulsive seizures. The neonatal period was normal, but febrile convulsions began at 6 months of age. Convulsive episodes became more frequent and severe after 1 year of age, and developmental retardation was evident. He had daily seizures by 8 years, 7 months, was constantly agitated, and did not talk; his weight was 24 kg and his height was 122 cm.
Letters to the Editor
Authors: TOWNLEY REGINALD
Published: December 2021

I regret that my comments on dietary management of sucrose intolerance may have lacked sufficient detail. Apart from sucrose itself all cakes, candy, soft drinks, chocolate, ice-cream, fruit preserves, jellies, syrups, and sweetened condensed milks are likely to contain large amounts of sucrose and should be avoided or restricted. Enquiries should be made of the manufacturer where doubt exists about the sucrose content of commercial products.

Common fruits and vegetables which contain significant amounts of sucrose include sugar beets, sweet potatoes, bananas, dates, and pineapples.
THYROID CARCINOMA AND X-IRRADIATION
Authors: SILVERMAN FREDERIC N.
Published: December 2021

IN 1948, when I first had the pleasure to assist Dr. John Caffey in a seminar on pediatric x-ray diagnosis at an annual meeting of the American Academy of Pediatrics in Atlantic City, I asked Dr. Caffey to devote some time to a discussion of the normal thymus gland in relation to the outmoded custom of administering x-irradiation whenever this structure was found "enlarged" in radiographs of the chest. This custom had its origin in a report by Dr. Alfred Friedlander and subsequently was accepted with great enthusiasm by physicians eager to provide effective treatment at a time when specific therapeutic agents were practically unknown.
A DEVELOPMENTAL SCREENING INVENTORY FOR INFANTS
Authors: Knobloch Hilda , Pasamanick Benjamin , Sherard Earl S.
Published: December 2021

PREDICTIVE diagnosis of development is possible because behavior matures in an orderly fashion, but it is not a simple matter. Unlike most other diagnostic problems in medicine, disturbances in neuropsychologic functioning involve integration on many different levels, from the biologic to the sociocultural. Analysis of something as complex as behavior thus is not without difficulties, and extensive training in making, and interpreting, observations is necessary for accurate diagnosis.

The number of children in whom abnormal development is suspected is enormous, the need for service great and the supply of specialists limited. Under these circumstances an adequate screening procedure which will detect infants in need of referral for a complete diagnostic evaluation is of great value. A number of devices and lists of behavior have been offered; when they have been tested at all it has not been for their correlation with an examination that has predictive ability. They have consisted for the most part of a few behavior patterns at widely separated ages and most have fallen into disuse because of their apparently unsatisfactory nature.

CRITERIA FOR AN ADEQUATE SCREENING DEVICE

In evaluating development one is concerned with both present and future functioning, and the complete examination from which the screening inventory is derived must be an adequate predictor of later abnormality. First, then, it must have validity. Since this predictive value can be determined only by longitudinal studies, such data must derive from follow-up correlations between complete infant examinations and those at later ages. Further, for prediction as well as for present management, intellectual defect and motor disability must be distinguished.
A STUDY OF THE EFFECT OF THE MOTHER'S PRESENCE DURING ANESTHESIA INDUCTION
Authors: Schulman Jerome L. , Foley Jeanne M. , Vernon David T. A. , Allan David
Published: December 2021

The effect of the mother's presence during anesthesia induction was studied in a controlled fashion with 32 children between the ages of 2 and 6 years. Mood during induction and changes in behavior following hospitalization were investigated. The analyses of mood provided support for the hypothesis that upset during induction is mitigated by the mother's presence. The techniques of the anesthesiologists also appeared to be quite important. The effects of other variables were also investigated. The mothers who were present were thoroughly cooperative and were uniformly enthusiastic about the experience. Even those who were relatively anxious did not appear to increase the distress of their children.
SUDDEN AND UNEXPECTED DEATH IN INFANCY: A REVIEW OF THE WORLD LITERATURE 1954-1966
Authors: Valdes-Dapena Marie A.
Published: December 2021

It is apparent that we are still woefully ignorant with respect to the subject of sudden and unexpected deaths in infants. Only by continual investigation of large series of cases, employing uniform criteria to define such deaths and using the investigative procedures outlined above as well as others which will undoubtedly suggest themselves, can we hope to understand and possibly prevent the deaths of some 15,000 to 25,000 infants in the United States each year. These lives, to say nothing of those in other countries throughout the world might provide some of the leadership which is necessary to maintain and advance the human race in the years to come.
PRESIDENT'S ADDRESS
Authors: Hughes James G.
Published: December 2021

AT THE CONCLUSION of his term of office, it is traditional for each President of the Academy to address the membership on some topic of importance. In the 20 years I have regularly attended these meetings, I have listened to many distinguished predecessors make impressive presentations. The most common theme has been a review of the Academy's progress during the particular president's term of office, joined to a prediction of things to come—problems posed, challenges to meet, goals to set.

I think it is worthwhile to pause in this manner—to take stock of ourselves, inventory assets, admit liabilities, strike a balance, and forge ahead.

In former years the annual address was the principal means by which the president conveyed his thoughts to the membership. Therefore, the presentations were often lengthy, though highly interesting.

Nowadays, the membership is virtually flooded with information concerning Academy activities. The Newsletter appears twice a month, covering a wide range of subject material. Chapter and Section letters are distributed periodically. The President, District Chairmen, and Central Office pediatric personnel meet often with the members, usually at District or State Chapter meetings. We also have the reports of the Executive Director, Secretary, Secretary for Chapters, Secretary for Committees, Director of Information, Committee Chairmen, and an increasing number of excellent Academy manuals. In brief, our communications network is highly developed.

Therefore, it would be redundant of me to review in detail the events of the past year in the life of the Academy. Besides, I have already discussed them on more than one occasion in issues of the Newsletter.
History of the American Pediatric Society 1887-1965
Authors: STOKES JOSEPH
Published: December 2021

There would appear to be few more difficult assignments in historical review than that of covering the multitude of items in the field of medical science—and what was mostly not science—with which the American Pediatric Society was concerned during its growth and development.

When one remembers that, at the time of its birth in 1888, such procreators as its first president, Abraham Jacobi (who also became President of the American Medical Association), William Osler, Job Lewis Smith, Luther Emmett Holt, William Pepper, Victor C. Vaughan, and Henry Dwight Chapin were just beginning to accept the revolution of Louis Pasteur and Lister, one can well imagine the authors' problem of unfolding, in adequate sequence, the rapidly developing panorama of pediatric medicine.
CLINICAL PHARMACOLOGY OF ANTIMICROBIALS IN PREMATURE INFANTS: II. AMPICILLIN, METHICILLIN, OXACILLIN, NEOMYCIN, AND COLISTIN
Authors: Axline Stanton G. , Yaffe Sumner J. , Simon Harold J.
Published: December 2021

The absorption, apparent volumes of distribution, serum concentrations, serum half-lives, and urinary excretion of ampicillin, methicillin, oxacillin, neomycin, and colistin were studied in premature infants by means of a micro-diffusion technique.

Marked changes in serum half-lives and urinary excretion of the penicillins occurred during the first month of life. The serum half-lives of ampicillin and methicillin declined from 4.0 and 2.4 hours to 1.6 and 1.2 hours, respectively, as postnatal age increased from 1 week to 1 month. The serum half-life of oxacillin declined from 1.6 hours in 1 to 2-week-old infants to 1.2 hours in those 3 weeks of age. Concomitantly, urinary excretion rate of the penicillins increased approximately twofold as the age of infants increased from 1 week to 1 month, suggesting that immature renal function was partially responsible for the elevated serum half-lives of the penicillins in the younger premature infants.

The serum half-life of neomycin was 6.5 hours in premature infants less than 2 weeks of age. It declined progressively to 3.3 hours in 3-week-old infants. The age-related changes in serum half-life were independent of birth weight.

In contrast to the findings with the penicillins and neomycin, the serum half-life of colistin was not prolonged in premature infants, nor did it change with postnatal age. The mean serum half-life of colistin in premature infants was 2.4 hours.

A method for using these data to calculate ampicillin, methicillin, oxacillin, neomycin, and colistin dosages appropriate for premature infants has been presented.
MIST TENT THERAPY OF THE OBSTRUCTIVE PULMONARY LESION OF CYSTIC FIBROSIS
Authors: Matthews LeRoy W. , Doershuk Carl F. , Spector Samuel
Published: December 2021

The physical and physiological principles involved in the effective utilization of nebulization inhalation therapy are discussed. Objective data are presented supporting the use of mist tent therapy in the treatment of the chronic obstructive pulmonary lesion of cystic fibrosis. After three control periods the addition of mist tent therapy to an otherwise comprehensive treatment program resulted over the next 2 months in significant decreases in functional residual capacity, residual volume and ratio of residual volume to total lung capacity, and increase in maximum breathing capacity. These changes in the direction of improvement were maintained with continued use of the mist tent over the next year. A similar study involving elimination of mist tent therapy for 1 month and reinstituting it in the home treatment program revealed significant changes in pulmonary function in increased airway obstruction and overinflation during the period of elimination. These changes were reversed when mist tent therapy was reinstituted.
BACTERIAL AND VIRAL COPROANTIBODIES IN BREAST-FED INFANTS
Authors: Kenny Jean F. , Boesman Mary I. , Michaels Richard H.
Published: December 2021

Stools of newborn breast-fed infants may contain significant amounts of hemagglutinating antibody to enteropathogenic E. coli and neutralizing antibody to polioviruses. Stool titers averaged only fourfold lower than maternal milk titers for antibacterial and less than twofold lower for antiviral activity. Similar ratios of stool:milk activity were also found for paired specimens obtained during the second and third postpartum months.

The stool antibodies were stable at 56°C and exhibited definite specificity. Bacterial hemagglutinins in feces were more sensitive to mercaptoethanol than the poliovirus neutralizing activity. Stools from breast-fed infants contained gamma-1 globulins similar to those in milk, including IgA and small amounts of IgM.

Meconium from bottle-fed infants with high serum antibody titers to polioviruses contained traces of homotypic neutralizing antibody. Antiviral and antibacterial activity were not detected in transitional and later stools from artificially fed infants, nor were human immune globulins.

Milk bacterial hemagglutinating antibodies were more resistant to acid and to pepsin than those in serum. Furthermore, acid had a less deleterious effect on virus neutralizing activity in milk than it had on that in serum, and it also had less effect on the milk antiviral than on the milk antibacterial antibodies.
Antigens for Testing for Infections with Atypical Mycobacteria
Authors: ARNHOLD RAINER G.
Published: December 2021

The plea by Cramblett, et al. (Pediatrics, 38:381, 1966) for assistance in obtaining mycobacterial antigens deserves strong support. From their and other data it appears that infection with atypical mycobacteria is not a rare phenomenon. At present, those of us in practice have no way of diagnosing most of these patients. Young children with a positive tuberculin test (PPD-S) are, therefore, usually treated prophylactically with isoniazid, even in the absence of other findings. If antigens for the atypical mycobacteria were available, specific diagnoses could be made.
THE CHILD IN MEDIEVAL SOCIETY
Authors: C. T. E.
Published: December 2021

As Philippe Aries has dramatically called to our attention, childhood as a phenomenon unto itself is an invention of modern times. He writes:

In medieval society the idea of childhood did not exist; this is not to suggest that children were neglected, forsaken, or despised. The idea of childhood is not to be confused with affection for children: it corresponds to an awareness of the particular nature of childhood, that particular nature which distinguishes the child from the adult, even the young adult. In medieval society this awareness was lacking. That is why, as soon as the child could live without the constant solicitude of his mother, his nanny, or his cradle-rocker, he belonged to adult society. . . . Language did not give the word "child" the restricted meaning we give it today: people said "child" much as we say "lad" in every day speech. The absence of definition extended to every sort of social activity: games, crafts, arms.
ABDOMINAL INJURY RELATED TO THE TRAUMA OF BIRTH
Authors: Eraklis Angelo J.
Published: December 2021

A review of four infants with severe trauma to abdominal organs incident to delivery is presented. The protean manifestations of these injuries are noteworthy. A small but significant improvement in the neonatal mortality will reward the early diagnosis of these frequently remediable lesions.
BREATHHOLDING SPELLS (CYANOTIC AND PALLID INFANTILE SYNCOPE)
Authors: Lombroso Cesare T. , Lerman Pinchas
Published: December 2021

A study of the incidence, evolution, and pathophysiology of so-called "breathholding spells" has been carried out prospectively, retrospectively, and physiologically in three groups of patients.

The term of infantile syncope is proposed for these attacks initiated by a noxious stimulus and in which both consciousness and posture are lost.

Convulsive components may occur if cerebral anoxia is marked. The degree of breathholding varies considerably among attacks, but is prominent in a majority.

From the clinical point of view, breathholders could be assigned to a cyanotic group, a pallid group, or an indeterminate group.

Such spells occurred in 4.6% of 4,980 individuals, and those affected tended to have a positive family history of such attacks.

The onset of such attacks varied from the neonatum to the middle of the fourth year, the commonest ages being between 6 and 18 months.

Precipitating factors consisted of mild injuries, frustration, or fright, and the factor of surprise seemed important.

From the retrospective point of view the attacks ceased spontaneously at or before school age.

Epilepsy and mental deficiency were unrelated to breathholding attacks.

Syncopal attacks in adulthood were a frequent sequel of breathholding attacks in infancy.

Differentiation into two physiologically diverse groups of cases could be made by monitoring the results of the oculocardiac reflex with simultaneous electrocardiogram and electroencephalogram.

Among cyanotic breathholders the response to ocular compression tended to be the usual one of bradycardia or brief asystole.

Among the pallid group, cardiac asystole was more prolonged and electroencephalographic abnormality paralleled it.

The prognosis for either type was excellent.

Differentiation from epilepsy was important, since treatment for epilepsy was usually unrewarding and often pushed to toxic levels.

In the pallid group with many attacks the use of atropine has been helpful, but treatment in most instances was unnecessary.
HYPOGLYCEMIA AND RH ERYTHROBLASTOSIS FETALIS
Authors: Hazeltine Frederick G.
Published: December 2021

Severe Rh-erythroblastosis fetalis was associated with hypoglycemia in two newborn infants; one died at age 26 hours. Possible etiologic factors include transient functional hyperinsulinism and rebound hypoglycemia following exchange transfusions of ACD-preserved blood.
A CONTROLLED TRIAL OF MANAGEMENT OF RESPIRATORY DISTRESS SYNDROME IN A BODY-ENCLOSING RESPIRATOR I. EVALUATION OF SAFETY
Authors: Silverman William A. , Sinclair John C. , Gandy Gillian M. , Finster Mieczyslaw , Bauman William A. , Agate F. J.
Published: December 2021

A sequential, controlled trial was conducted to compare the results of standard supportive care of RDS with those of management in a body-enclosing respirator. No important lowering of survival nor increased incidence of pulmonary or central nervous system complications occurred in the respirator-treated group.

Evaluation of the efficacy of respirator care for the respiratory distress syndrome should be carried out in a well organized neonatal intensive care unit staffed by specially trained personnel.
RESPONSE OF MEDULLOBLASTOMA TO VINCRISTINE SULFATE: A CASE REPORT
Authors: Lampkin Beatrice C. , Mauer Alvin M. , McBride Bert H.
Published: December 2021

A 5½-year-old, Caucasian girl with metastatic medulloblastoma to the spinal cord was treated with vincristine sulfate. After four weekly injections of vincristine there was symptomatic improvement. Presently, 10 months after instituting vincristine therapy the patient attends school regularly and is doing well in school. This girl is the second patient with a recurrent medulloblastoma to respond to the administration of vincristine sulfate.
Maternal Care and Mental Health
Authors: WOLFF PETER H.
Published: December 2021

When Bowlby first published his comprehensive report to the World Health Organization on maternal deprivation, his conclusions and recommendations stimulated useful research and provoked critical discussion. The republication of this report 15 years later, together with six articles by others evaluating the monograph's implications, gives us a welcome opportunity to reconsider the findings from a historical perspective, and to acquaint a new generation of physicians with the problems of homeless children, which are still very much with us.
Clinical Management of Behaviour Disorders in Children
Authors: HUGHES JAMES G.
Published: December 2021

The third edition of this textbook concerning behavior disorders of childhood maintains the tradition of excellence established by the two preceding editions.

It is logically and compactly arranged into 12 parts: growth and development, psychologic care, care of the physically ill and handicapped child, etiologic factors in behavior disorders of children, diagnosis and treatment of behavior disorders in children, problems related to intellectual functioning, developmental disorders, problems related to emotional development, problems of habit and training, organic disturbances with a large psychic component, antisocial behavior, and specific syndromes.