bluuebunny/crossref_metadata_2025 huggingface dataset:
HORMONE-SECRETING TUMORS OF THE ADRENAL CORTEX IN CHILDREN
Authors: Hayles Alvin B. , Hahn Henry B. , Sprague Randall G. , Bahn Robert C. , Priestley James T.
Published: December 2021

In 12 children with hyperadrenocorticism caused by tumor of the adrenal cortex the most common clinical picture was that of a mixture of adrenogenital and Cushing's syndromes. All tumors were surgically removed; adrenal steroids were used in the preparation of 11 patients for operation. One patient died with extensive metastasis 5 months after operation, while 11 were alive and well 18 months to 29 years after operation. Data from the 12 cases in this series and from those in the literature suggest that the likelihood of metastasis may be correlated with the relation of tumor weight to body weight.
CHRONIC HEMODIALYSIS IN A PRE-ADOLESCENT
Authors: Hutchings R. H. , Hickman R. , Scribner B. H.
Published: December 2021

A 15½-year-old girl with chronic glomerulonephritis (creatinine clearance less than 1 ml/min has been treated with periodic hemodialysis for 18 months. The technique as applied to adults has proved to be technically feasible, although cannula maintenance is more difficult. The primary goal of the project, complete reversal of the patient's arrested growth and development, has to date not been realized, although suboptimal increase in growth rate has occurred. Long-range effects on psychosocial development are not yet known. Further modifications of the treatment in an attempt to achieve the foregoing goal are planned, but at this time this method of treatment of chronic renal disease in preadolescents cannot be considered ready for general application.
READING RETARDATION: II. PSYCHOEDUCATIONAL ASPECTS OF READING DISABILITIES
Authors: Klapper Zelda S.
Published: December 2021

THE Chinese alphabet is said to have been the invention of one Ts'ang Chien, dragon-faced and four-eyed, who patterned the Chinese characters after nature: the stars he saw above him, the marks on the back of the turtle running before him, and the footprints left by birds on the ground below him.

And it is said that Brahma searching for a way to write down his teachings, invented the Hindu letters by copying the patterns of the seams of the human skull.

The puzzling symbolism of the written word to the ancients, whose bewilderment is conveyed by these legends, remains to confound many of us. A writing system may represent objects on ideas directly, or may, as in our alphabet system, be a transformation of spoken language and represent both sounds and ideas. No matter how representational or abstract the written symbols are, learning from experience with the signs is basic to literacy: reading is an active process involving a learned reaction to symbols or symbols of symbols. Provided an opportunity for experience with two-dimensional representations, the mastery of reading skill should proceed as one's own writing system becomes increasingly familiar. When it does not, we are faced with a reading problem and have to look further.

There are many useful conceptual templates one might choose to use in examining the clinical and research findings related to reading disability; one also confronts an impressive array of terminological offerings. The present paper uses the term "dyslexia," and regards reading disability as a major disturbance in adaptive behavior, resulting from deficient mechanisms for processing sensory information.
Letters to the Editor
Authors: O'CONNELL EDWARD J. , FELDT ROBERT H. , STICKLER GUNNAR B.
Published: December 2021

Replying to Dr. I. Krieger's letter to the editor poses difficulties. In using this communication for submission of her own data for publication, she has not felt the need to provide the careful documentation that would allow critical analysis. For example, her statement that "small stature, small head size, and mental subnormality are frequently associated" is true on the basis of our experience but is not supported by her recorded data. No psychometric test results are noted in the text or in the illustrations accompayning her letter.
Hereditary Enamel Hypoplasia: Its Association with Characteristic Hair Structure
Authors: ROBINSON GEOFFREY C. , MILLER JAMES R. , WORTH H. M.
Published: December 2021

A pedigree of a family with hereditary hypoplasia of the enamel has been described, in which all affected members show characteristic curly hair. This combination has not previously been reported.
Pulmonary Vasoconstriction and the Pharmacology of Respiratory Distress
Authors: IVANHOE FRANCIS
Published: December 2021

Having previously advanced a hypothesis on the mechanism of pulmonary shutdown in hyaline membrane disease, I now can inform you that certain conclusions advanced earlier this year by the undersigned have now been tested in a clinical setting and have been found to hold true.

To be sure, noradrenaline turned out to be too problematical a drug to administer to these infants, and so a synthetic analog of it, ethyl adrianol, was given instead.
The Handling of Soya α-Galactosides by a Normal and a Galactosemic Child
Authors: SCHWARZ V.
Published: December 2021

The treatment of galactosemic children with soya preparations in place of milk relies on the complete inability of the body to hydrolyse α-galactosides or to absorb galactose liberated from them by the intestinal flora. From this stipulation it follows that the demonstration of galactose absorption in a small number of subjects would confirm the desirability of avoiding foods containing α-galactosides, while the proven inability of a few subjects to hydrolyse these compounds would not permit any generalizations.
Diphenylhydantoin Poisoning in an 18-month-old Infant
Authors: ESPERON LUIZ CARLOS
Published: December 2021

In view of the absence of reports of accidental poisoning with diphenylhydantoin in the Brazilian literature, and the unusual youth of the patient, this case is briefly presented:

An infant girl of 18 months has been effectively treated with 100 mg daily of Epelin liquid (Parke Davis, 1 ml = 25 mg diphenylhydantoin for epileptic seizures. The medicine was carelessly left where the child could reach it, and circumstances indicated that shortly after her noon meal she had opened the bottle and drunk at least 60 ml of its contents, equal to a dose of 1.5 gm of diphenylhydantoin.
More Pets, Parasites, and Pediatrics
Authors: DEUTCH MAX
Published: December 2021

Although salmonella infection does not usually produce serious illness, the onset in a child may sometimes be shock-like, and many types of severe salmonella infections have occurred in patients who were being treated with cortisone or antibiotics, in gastrectomized and other post-surgical patients, and in patients in hospital with a debilitating disease.

Recently I saw a 4-year-old asthmatic child who became severely dehydrated at the onset of an attack of gastroenteritis.
Diagnosis of Megacolon: The Rectal Examination
Authors: LOEFFLER JOHN G.
Published: December 2021

The following comments pertain to an article in Pediatrics, 36:572, 1965.

In their article, "Aganglionic and Functional Megacolon in Children—a Diagnostic Dilemma," Drs. Kottmeier and Clatworthy have done a commendable job in pointing out the pitfalls of diagnosing aganglionic megacolon in the newborn infant. I am afraid, however, that the authors have given the impression that reliance should be made on barium enema and rectal biopsy when distinguishing between aganglionic megacolon and functional constipation in the older child who presents with chronic constipation. In the article no mention was made about the value of a simple digital rectal examination.
OXYGEN CONSUMPTION IN NORMAL NEWBORN INFANTS DURING MODERATE HYPOXIA IN WARM AND COOL ENVIRONMENTS
Authors: Cross K. W. , Flynn D. M. , Hill June R.
Published: December 2021

The oxygen consumption of 20 normal newborn babies was measured using a closed-circuit apparatus with good time-resolution in which the environmental temperature could be closely controlled. In each baby the oxygen consumption while breathing air was compared with the value obtained a few minutes later while breathing 15% oxygen in nitrogen or vice versa. Five babies were examined in a warm environment while naked: some of these were included in the total of 18 babies who were examined in a cool environment, of these 6 were naked and 12 were clothed.

In a warm environment oxygen consumption values were the same whether air or 15% oxygen was breathed.

From 6 naked babies in a cool environment 10 measurements of oxygen consumption were obtained, breathing first air, then 15% oxygen. The mean value breathing air did not differ significantly from that obtained when 15% oxygen was breathed. In a further 12 babies who were in a cool environment but clothed 18 oxygen consumption measurements (air then 15% oxygen) were obtained; again there was no significant difference between the means.

Sixteen additional measurements of oxygen consumption were obtained while the babies were breathing air after 15% oxygen. The mean value was not significantly different from the mean value when breathing 15% oxygen or the mean value in the preceding period breathing air.

It was concluded that breathing 15% oxygen did not depress the oxygen consumption of babies either in a warm environment or a cool one; however, babies in a cool environment were subjected to only a mild degree of cold stimulus, and the metabolic response thus produced was fairly small.

This work failed to confirm earlier reports that 15% oxygen did depress oxygen consumption in newborn babies in a cool environment. Possible reasons for the discrepancy are discussed.
THE INFLUENCE OF ENVIRONMENTAL TEMPERATURE ON THYROID, ADRENAL, AND WATER METABOLISM IN THE NEWBORN HUMAN INFANT
Authors: Fisher D. A. , Oddie T. H. , Makoski E. J.
Published: December 2021

Measurements of fluid and caloric intake, urine output, urine osmolality, creatinine clearance, weight change, 48-hour PBI and thyroid radioiodine clearance, 4-hour hematocrit increment, and 12-hour urinary 17-OH-CS excretion have been conducted in newborn term infants exposed to relatively cold ambient temperature (23-29°C) and contrasted with values in infants incubated at ambient air temperatures of 31-40°C during the first 36-48 hours of life. Deep rectal and skin temperatures were consistently lower in the infants in the cooler environment.

Non-incubated infants showed significantly higher PB! values and higher thyroid radioiodine clearance at 48 hours than did the incubated infants, suggesting that the usual feedback suppression of TSH secretion is inoperative in the infants in the colder environment. These observations are in agreement with the hypothesis that the neonatal hyperthyroid state is the result of thermal receptor stimulation of TSH secretion by the relatively cold extrauterine environment.

The cooler non-incubated infants showed significantly greater urine volumes with significantly lower (urine) osmolality than did the incubated infants. Mean osmolal and creatinine clearance were similar in the two groups of infants. Although this cold induced water diuresis seems most likely due to a larger fluid intake in the non-incubated infants in response to a greater metabolic rate, the observation of similar non-renal water metabolism in cold and warm infants suggests the possibility of a primary "cold diuresis" similar to that observed during acute cold exposure in adults.

A significantly greater increment in hematocrit was observed during the first 4 hours in the colder infants. The mechanism of this response, presumably due to a displacement of plasma volume from the vascular compartment, remains to be defined.

Urinary methylene chloride extractable 17-OH-CS excretion was similar in the cold exposed and the incubated infants.
PARALYTIC POLIOMYELITIS IN A CHILD WITH HYPOGAMMAGLOBULINEMIA: PROBABLE IMPLICATION OF TYPE I VACCINE STRAIN
Authors: Chang Te-Wen , Weinstein Louis , MacMahon H. Edward
Published: December 2021

1. An instance of paralytic poliomyelitis developing 7 weeks after administration of live type I poliomyelitis virus vaccine in a child with hypogammaglobulinemia is described.

2. The strain of virus isolated from pharyngeal washings and stool possessed the characteristics of "vaccine-like" strain. No other enteroviruses were detected.

3. Antibodies of diphtheria, the 3 serological types of poliomyelitis virus, and a number of other viruses could not be demonstrated despite apparent adequate "immunization" to some of these agents.

4. Histological studies revealed a marked activity in the reparative process in the spinal cord and a conspicuous absence of secondary lymph follicles throughout the body.

5. It is suggested that live vaccines be administered to patients with a significant degree of gamma-globulin deficiency with great caution. The possibility of the simultaneous administration of a properly selected dose of specific antibody or gamma-globulin deserves consideration in such instances.
A New Electrocardiographic Observation in Infants and Children with Hypothyroidism
Authors: ERTUGRUL ALI
Published: December 2021

Dome-shaped T waves and the absence of the ST segment combined with generalized low voltage of all complexes with bradycardia are specific signs of hypothyroidism. An electrocardiogram of a hypothyroid patient resembles the silhouette of a mosque. The dome-shaped T wave immediately after the QRS complex without a ST segment resembles a minaret with a dome. This finding has been present in 14 of 38 hypothyroid patients. In 12 patients the electrocardiographic changes were suggestive of hypothyroidism, but they were not diagnostic. The electrocardiograms of the remaining 12 patients had only non-specific changes.

When this change is present, it is diagnostic. However, absence of change is not necessarily indicative of the absence of hypothyroidism.

On rare occasions electrocardiographic findings in different types of myocarditis and electrolite disturbances may somewhat resemble these changes. However, these characteristic changes have not been found in any other disease except hypothyroidism in infants and children in our medical center.
Mental Deficiency
Authors: GERRARD J. W.
Published: December 2021

This is the second edition of a volume which has already proved its value. It is a product of the Fountain Hospital, being written by Dr. Hillard, the former superintendent, and Dr. Kirman, with the assistance of four colleagues, one of whom, Dr. Crome, is consultant neuropathologist to the hospital. The book is tailored to the British scene in its historical review and in the survey of facilities for the care of the retarded, but it can be read with profit and interest by all concerned with the retarded child.
Handburgh Der Kinderheilkunde, Vol. IV
Authors: EICHENWALD HEINZ F.
Published: December 2021

This book represents Volume IV of a massive German effort to discuss all of pediatrics in an encyclopedic fashion, and, if future volumes are as fine as the several already published this effort will represent a notable achievement as well as a landmark in the history of pediatrics.

The present volume contains within its 1,243 pages the general topics of metabolism, nutrition, and gastrointestinal function. Under the general editorship of Drs. Opitz and Schmidt, 59 authors have contributed discussions of consistently high caliber, great thoroughness and attention to detail.
ACID-BASE EQUILIBRIUM OF BLOOD IN NORMAL INFANTS
Authors: Albert Morris S. , Winters Robert W.
Published: December 2021

Acid-base equilibrium of arterialized capillary blood was determined on 139 normal infants between the ages of 3 months and 2 years. The mean and standard deviation of each component was as follows: pH 7.398 ± 0.027, base excess -3.2 ± 1.7 mEq/L, pCO2 33.8 ± 3.7 mm Hg, and plasma total CO2 content 21.1 ± 1.9 mM/L. When compared to normal adult values, all components except blood pH were reduced to a statistically significant extent. These data are proposed as definitive standards for normal acid-base equilibrium in infants of this age group.
THE EFFECT OF BODY TEMPERATURE ON THE LEVEL OF CARBOHYDRATE METABOLITES AND OXYGEN CONSUMPTION IN THE NEWBORN
Authors: Pribylová Hana , Znamenácek Karel
Published: December 2021

The effect of body temperature on the level of carbohydrate metabolites and oxygen consumption in the newborn was followed in 10 infants placed in incubators at 33°C immediately after birth, and in 30 infants kept at 23°C ambient temperature. Significant differences between the two groups were encountered in concentrations of blood glucose, lactate, and excess lactate. Oxygen consumption was higher in the group in cold environment, indicating a higher metabolic rate after birth.

Factors influencing oxygen consumption, blood levels of glucose, lactate and pyruvate, and their mutual relationships were discussed and the protective influence of high environmental temperatures in newborn infants immediately after birth was considered.
ALL HUMAN BEINGS START LIFE AS BABIES
Authors: Washburn Alfred H.
Published: December 2021

I AM MOST GRATEFUL to the Academy of Pediatrics for bestowing upon me the C. Anderson Aldrich Award. I am particularly happy to accept it because of my many years of warm friendship with Andy Aldrich. At the same time I accept it with real humility, knowing that it honors Dr. Aldrich whose wisdom and skills, and whose warmth of personality, made him one of the most admired and beloved pediatricians of his time.

I still believe that the Aldrich's Babies are Human Beings is one of the wisest books of our century about the nature of babies growing up in our twentieth century culture. I have chosen my title with some care to suggest the projection of Dr. Aldrich's thinking about babies being human beings. One might think of it as the reverse side of a coin whose obverse bears the words "Babies are Human Beings."

One of the most arresting and dramatic statements concerning the importance of thinking in terms of all human beings having started as babies is the following quotation from Erik Erikson's interesting book entitled Childhood and Society:

One may scan work after work on history, society, and morality and find little reference to the fact that all people start as children and all peoples begin in their nurseries. It is human to have a long childhood; it is civilized to have an even longer childhood. Long childhood makes a technical and mental virtuoso out of man, but it also leaves a life-long residue of emotional immaturity in him.
Letters to the Editor
Authors: BROWN AUDREY K.
Published: December 2021

We are indebted to Dr. J. D. Harley and to Dr. Helen Robin for calling to our attention their report of hemolysis and jaundice in a G-6-PD deficient infant, and particularly for reminding us that administration of drugs to the lactating mother is, in effect, administering the drug to the breast-fed infant.

Our reports differ only in that sulphamethoxypyridazine (Kynex) was administered to the mothers of our infants before delivery. The long-acting drug presumably persisted in the infant long enough to incite hemolysis. The infant described by Harley and Robin received the same agent through breast milk.
Gastric Acidity in the First Day of Life
Authors: Avery Gordon B. , Randolph Judson G. , Weaver Thomas
Published: December 2021

Elevated pH in the gastric contents of babies immediately after birth suggests the presence of alkaline amniotic fluid in the stomach of the fetus. After the stomach had been lavaged, a strongly acid secretion was immediately noted, implying that the secretory ability of the gastric mucosa is unimpaired immediately after birth. Therefore, no delay in the onset of oral feedings based on poor gastric functioning seems warranted.

Infants born by Cesarean section and not subjected to abdominal compression by the birth process had an even more alkaline gastric residuum at birth, suggesting the presence of excessive amniotic fluid in the stomach of these babies. The recommendation that babies' stomachs be emptied immediately after Cesarean section seems justified to avoid an increased hazard from vomiting and aspiration. This has proved an innocuous and beneficial procedure in our hands.
Letter to the Editor
Authors: Graven Stanley N.
Published: December 2021

The reference to the method for measurement of pH and pCO2 pertained to data showing the effect of activity in an infant with respiratory distress. Since it was an isolated case, it was omitted from the revised manuscript. The reference in the materials and methods section should have been deleted. There were not a sufficient number of pH and pCO2 determinations performed on the group of infants reported to differentiate the. relative effects of muscular activity and altered ventilation.
A Practical Suggestion for Poison Control in the Pediatric Age Group
Authors: JONES J. ALBRIGHT
Published: December 2021

I am among the numerous pediatricians who have undergone unpleasant and frustrating experiences with little patients who ingested an overdose of some drug, usually aspirin. During the past several years, I have experimented with many types of plastic containers and bottle tops that small children could not remove, but I have been unsuccessful in developing a foolproof container that is economically feasible to manufacture.

Last summer while manipulating the numbers on the combination lock to my bathhouse locker, it suddenly occurred to me that the use of a combination lock on a small metal box was the answer I have been seeking to the problem of safeguarding medicines in the home.
Cardiac Evaluation in Normal Infants
Authors: MESEL EMMANUEL
Published: December 2021

Spurred by advances in cardiovascular surgery in the last decade, great strides have been made in the clinical understanding of children with congenital heart disease. One of the problems that continues to vex both pediatrician and cardiologist alike is the frequent difficulty in interpreting the cardiovascular examination in the infant under 1 year of age. In writing this book, it is Doctor Ziegler's purpose to "promote a better understanding of the normal cardiovascular system of infants and, through such understanding, provide some practical clinical guidelines toward its differential determination."
ANTIBIOTIC CONCENTRATIONS IN MIDDLE EAR EFFUSIONS
Authors: Silverstein Herbert , Bernstein Joel M. , Lerner Phillip I.
Published: December 2021

Penicillin G and oxytetracycline were present in measurable concentrations in effusions taken from the middle ear of patients with acute suppurative otitis media, following an intramuscular injection of either drug from 1 to 3 hours earlier.

Fluid taken from the middle ear space of patients with secretory otitis media given similar injections contained quantities of oxytetracycline too low to measure accurately, while penicillin activity was readily measurable and comparable to levels found in patients with acute suppurative otitis media.

When the antibiotic concentrations present in these effusions were considered in terms of the accepted in vitro inhibitory concentrations of the common middle ear pathogens, penicillin appeared to be the drug better suited for the management of most acute middle ear bacterial infections. Oxytetracycline, on the basis of its in vitro antibacterial activity and the concentrations achieved in the middle ear fluid, does not appear to be the drug of choice if the pathogen is Strep. pyogenes, D. pneumoniae, or Staph. aureus. A limited number of observations suggests that penicillin, though not the ideal drug, has more promise than oxytetracycline in the management of middle ear infections due to H. influenzae.

Preliminary observations suggest that penicillin given by mouth results in concentrations in middle ear effusions adequate to suppress a large proportion of the pathogenic gram-positive cocci that cause middle ear infection. An extensive study of this problem is needed.

Other antibiotics should be studied to find an agent that both enters the middle ear in concentrations equal to or in excess of those needed to inhibit H. influenzae in vitro and possesses the activity of penicillin against the common gram-positive pathogens responsible for middle ear infections.
Unsafe at any Speed
Authors: DIAMOND EUGENE F.
Published: December 2021

This book and the attendant publicity given its author during the hearings on auto safety by the Ribicoff Committee have been among the prime movers in the enactment of sweeping legislation by the Congress and drastic changes in the automotive industry's policy toward safety design. The author is an attorney who was an advisor to the Senate Sub-committee investigating automobile hazards. One may question his competence in discussing some of the technical aspects of automotive design, although his documentation is impressive.
Foreign Body of the Palate A Case Report
Authors: SITARZ ANNELIESE L.
Published: December 2021

A 13-month-old Negro girl, suspected of having a tumor of the palate, was found to have half of a pistachio nut wedged between the ridges of a high arched palate. The foreign body was detected during a physical examination and was removed in the clinic.
THE PEDIATRICIAN'S INTEREST IN THE POPULATION PROBLEM
Authors: WISHIK SAMUEL M.
Published: December 2021

THE very term "population explosion" conjures up visions of swarms of people like teeming ants covering every square inch of land and perhaps ocean. In some parts of the world this picture has already been realized, whether we are thinking of the slums of Chicago or Calcutta, where people reside, or the canyons of lower Manhattan, where they work, or the sampans of Hong Kong, where families live their entire lives on the water. If a person in 1900 could have foreseen the present metropolitan complexes with their density, geographic scope, transportation snarl, and pollution, the picture would have been described as an intolerable one which called for immediate, imaginative, courageous, and radical preventive measures.
THE PREVALENCE OF INTRADERMAL SENSITIVITY TO VARIOUS MYCOBACTERIAL ANTIGENS IN A GROUP OF HEALTHY CHILDREN IN SOUTHEASTERN UNITED STATES
Authors: Cramblett Henry G. , Siewers C. M. F. , Edmond Elizabeth W. , Crews Jeanette
Published: December 2021

Two hundred seventy-four healthy white school-age children residing in a children's home in northwestern North Carolina were tested intradermally with 5 tuberculin units of PPD-Watson (Group II), PPD-Battey (Group III), PPD-S (Mycobacterium tuberculosis), and PPD-Phlei (Group IV). Ninety per cent of the children had at least one positive reaction (2 mm or more of mean induration) at one or more of five readings (24 hr, 48 hr, 72 hr, 96 hr, and 168 hr). The most frequent reactions were to PPD-Watson. In 22 children, positive responses to PPD-S were probably cross-reactions as a result of infection with one or more atypical mycobacteria.
TOTAL BODY WATER AND SOLIDS IN SIX- TO SEVEN-YEAR-OLD CHILDREN: DIFFERENCES BETWEEN THE SEXES
Authors: Novak Ladislav P.
Published: December 2021

Total body water of the boys in this study was higher by 1.63 1 and by 3.75% than total water, expressed either in absolute or relative values, of the girls. These mean differences between the sexes were significant. The absolute quantity of body solids was higher in the girls by 0.44 kg. This difference was statistically insignificant. However, body solids expressed as a percentage of body weight were found to be higher by 3.75% in the girls, a difference which was statistically significant.

The relative estimate of fatness by five skinfold measurements revealed all the skinfolds to be smaller in the boys. In particular, the upper arm and the thigh skinfolds were smaller in the boys to a statistically significant extent.

The relative estimate of muscle mass made from the three calculated diameters showed that the boys had slightly greater musculature on their limbs. However, none of these differences proved to be statistically significant.
Drug Distribution by Mail; Prescription by TV
Authors: COHEN JOSEPH S.
Published: December 2021

The communication of Dr. Joel J. Alpert which appears in the April issue of Pediatrics (37:700, 1966) bears notice by all physicians. The danger of freely sending medications via unsolicited mail to both the layman and the doctor is very likely to be quite underestimated. Even one life is too high a price to pay!

My principal objection beyond the danger of poisoning is the usurping of prescribing medicines from the physician to the mailman and the TV set.
Salmonella Antigen and Antibody in the Immune Mechanism
Authors: MINDEN PERCY , ROTHBERG RICHARD M.
Published: December 2021

Doctors Gotoff and Cochran should be commended for their efforts to study the immune response of premature infants to Salmonella newport (Pediatrics, 37:610, 1966). This is another example of the practical application of a clinical pediatric problem to examine the development of the human immune mechanism.

The authors state, however, that "the type of antibody produced in all of the infected infants was γM globulin. No γG globlin was detected as late as 56 and 59 days after the onset of symptoms."
SOME FACTORS AFFECTING McCAMAN-ROBINS TEST RESULTS IN SCREENING NEWBORNS FOR PKU
Authors: Kleinman David S. , Twiss SuzAnne , Day Robert W.
Published: December 2021

An investigation of some of the factors affecting McCaman-Robins Test Results in a PKU screening program is reported here. It appears that the age of a normal newborn when tested (at time of discharge from hospital) and type of feeding, i.e., breast vs. average formula feeding, have rather small effects on test results and that the factor which has the largest effect on test results is the age of the specimen. This effect can be controlled by continuously holding the specimen frozen until tested.
Group B Streptococcal Infection in Infancy: A Case Report and Review
Authors: MAHER ERNEY , IRWIN ROBERT C.
Published: December 2021

A case of meningitis and septicemia due to hemolytic streptococcus group B in a 42-day-old, low birthweight infant has been presented. The increasing evidence of danger to the newborn from this organism has been discussed. The fulminant progression of the meningitic infection from initial symptoms to death leaves little hope for successful treatment. The practice of eradicating asymptomatic streptococcal B organisms from birth canals of pregnant women is proposed as a possible measure for reducing neonatal morbidity and mortality.
Failure to Isolate Streptococci from Children under the Age of 3 Years with Exudative Tonsillitis
Authors: ALPERT JOEL J. , PICKERING M. RUTH , WARREN ROBERT J.
Published: December 2021

Forty-seven children less than 3 years of age with exudative tonsillitis were studied and only seven (14.6%) were found to have streptococci. Attempts to explain the etiology of this syndrome by virological study were unsuccessful, although 22% of 27 patients studied did have evidence of virus infection.

Children with exudate in this age group do not usually require antimicrobial therapy unless there is proof by culture of the presence of streptococci or unless there is other clinical indication such as otitis media. The presence of exudate is, in fact, a strong indication that the streptococcus is not the etiologic agent.
Toxicity of Hexachlorophene
Authors: KLUMPP THEODORE G.
Published: December 2021

We have read with great interest the Letter To The Editor on the toxicity of hexachlorophene (pHisoHex) taken internally by Dr. Don A. Stotzer and the comments by Dr. Allan B. Coleman, Chairman of the Subcommittee on Accidental Poisoning (Pediatrics, 37:1030, 1966).

As the manufacturers of pHisoHex, we are naturally deeply concerned about accidental poisoning with any of our products. As indicated by our statement relative to toxicity and overdosage (symptoms and treatment) in our own publication to which Dr. Stotzer referred ("Information on Symptoms and Treatment of Overdosage of Selected Winthrop Products," 1965), we are fully aware of the potential toxic effects of hexachlorophene on humans, especially on children, if large amounts of pHisoHex are swallowed accidentally.
Sterilization of Formulas in the Home
Authors: RUBELL EARL B.
Published: December 2021

In the July issue (Pediatrics, 38:147, 1966) Dr. Harry D. Bowman raised some interesting questions in regard to terminal sterilization of formulas in the home. There was also a very good answer by Dr. Charles U. Lowe of the Committee on Nutrition. Dr. Bowman stated that he would be interested in knowing how pediatricians in other parts of the country feel about sterilization. Position of my partner (Dr. Mitchell L. Frank) and me after 20 years of practice of pediatrics on the part of one of us and 15 years of the other.
Exchange Transfusions: Blood Volume, Increment Volume, Efficiency
Authors: PHIBBS RODERIC H. , SPROUL ANN
Published: December 2021

We wish to call attention to an apparently common misconception about the efficiency of exchange transfusions.

The mechanics of the procedure are: a substance (bilirubin and/or antibody-coated red cells) is washed out of a compartment (the baby's blood volume) by the removal of a fraction of that compartment and its replacement by an equal volume of diluent (donor blood). This flushing process is repeated many times, usually until the total volume replaced is 2 to 3 times the volume of the compartment itself.
Hematologic Problems in the Newborn (Volume IV in the Series Major Problems in Clinical Pediatrics)
Authors: PEARSON HOWARD A.
Published: December 2021

The title of this small, excellent book markedly understates its content and scope. The authors' stated purpose is to describe the hematologic processes—both normal and abnormal abnormal—of the first month of life. Fortunately, they do not restrict themselves to this limited period of time. Rather, they succinctly review broad areas of pediatric hematology and its biochemical and physiological bases. Unique aspects of the hematology of early life are thus placed into balanced perspective.

Although more than half of the text is devoted to the red cell, the white cell, platelet, and coagulation disorders are also well represented.
Letters to the Editor
Authors: ELEY R. C. , SHERWOOD D. W. , DIAMOND L. K.
Published: December 2021

The sad news of the recent death of our friend and former associate, Richard W. B. Ellis, reminds us of the year he spent with us as a resident pediatrician at the Children's Hospital Medical Center, Boston, a fact not mentioned in his obituary in The Lancet. We who knew him best here always felt the experience was most rewarding for us and in our all too rare meetings with Dick, here and abroad, he often mentioned how much he had valued his medical training in this country. From the first weeks of his sojourn with us in 1929, it was readily apparent he was an unusual individual.
Letters to the Editor
Authors: WAHRMAN JACOB , BERANT MOSHE
Published: December 2021

Thank you for calling our attention to Doctor Wong's interesting patient.

One out of the 11 symptoms mentioned by Doctor Wong, namely the lobulated tongue, is very characteristic of the oral-facial-digital syndrome (OFD), and some of the other symptoms are also frequently found in association with OFD. However, a median cleft in the lower lip, two small median (?) clefts in the upper lip producing a small median process, normal hands and absence of toes in one foot are not favorable for accepting a diagnosis of OFD.
Letters to the Editor
Authors: LOW MERRITT B.
Published: December 2021

The Committee on Accident Prevention discussed the letter from Dr. Friend at the last meeting and agrees entirely with Dr. Friend. It will take some time to get this hook changed, and in the meantime we recommend some kind of "taping" of the hooks when the swing seat is off. This matter has also been channelled through to Mr. Philip Dykstra, Home Department of the National Safety Council—an organization with a coercive effect in this area, too.
Cantharidin Poisoning from Ingestion of a "Blister Beetle"
Authors: WERTELECKI WLADIMIR , VIETTI TERESA J. , KULAPONGS PANJA
Published: December 2021

A 10-month-old girl swallowed a beetle of the Meloidae family and developed classical signs of cantharidin toxicity manifested by vomiting, urinary frequency, dysuria, hematuria, proteinuria, glycosuria, elevated blood urea nitrogen, and elevated white blood cell counts. A brief review of the pertinent literature and toxicology is given.
Serum Amylase Activity in the Newborn
Authors: SEARCY RONALD L. , BERK J. EDWARD , HAYASHI SHINICHIRO , ACKERMAN BRUCE D.
Published: December 2021

The presence of measurable quantities of amylase in the serum of newborn infants or in serum derived from cord blood may be demonstrated through the use of a sensitive saccharogenic procedure that permits analysis of small quantities of serum. Serum amylase levels are highly variable during the early part of the neonatal period, but they usually tend to be close to or below the lower limits of normal established for adults. The origins of the serum amylase in the newborn infant remain to be elucidated.
Letters to the Editor
Authors: SEWELL EDWARD M.
Published: December 2021

Dr. Arnhold expresses a need that we have all felt. As our knowledge of atypical mycobacteria grows, the question of the specificity of the tuberculin reaction frequently comes up. At these times testing with separate antigens for the various mycobacteria may be helpful.

In the American Academy of Pediatrics the need for a commercial source for these antigens was discussed by the Executive Committee of the Section on Diseases of the Chest in October 1965.
Mothers of Retarded Children: How They Feel: Where They Find Help
Authors: BURWASH IDA
Published: December 2021

This book comes when there is great activity in the field of mental retardation and when a study such as this is immediately pertinent. As the sample for his study, Dr. Ehlers selected 24 mothers from the files of the Cambridge Service for Retarded Children, a public health clinic in Cambridge, Massachusetts. The author not only explored the mothers' feelings and attitudes about their child's retardation and how and why they sought help, but he examined the functions of the clinic and its eight workers.
CARE OF THE CHILD WITH A LONG-TERM, LIFE-THREATENING ILLNESS: SOME PRINCIPLES OF MANAGEMENT
Authors: Green Morris
Published: December 2021

THE PHYSICIAN needs to care for the child who has a long-term, life-threatening disease, such as ulcerative colitis, nephrosis or rheumatic fever, with the same competence and sureness as he applies to managing the disease. Such illnesses are psychologically as well as physically hazardous. Because of the variability of physician, patient, family, and disease, principles of care cannot be described nor applied in a simple fashion but rather with attention to individual differences.

DISCUSSION OF THE DIAGNOSIS

Discussion of the diagnosis must be straightforward and honest, reflecting the exact state of affairs without over-or understatement. Although truthfulness is an important principle, the doctor tempers it in order to express it to the parents and child at a time and in a manner that is helpful and understandable rather than overwhelming. Some tolerate it better if they are given the information all at one time while others benefit more from a gradual presentation. The parents may need to have the diagnosis, as well as the treatment, explained many times before they are able to understand and accept the painful reality. Where practical, the use of a consultant to confirm the diagnosis, treatment, and prognosis can be a significant aid to the family's acceptance.

COMPETENCE

Nothing allays unwarranted anxiety as effectively as competent, conscientious care. As Engel has emphasized, this is "the first and major requirement of the correct psychotherapeutic approach." The family's fundamental need to believe that they are entrusting their child to the best doctor available leads them both to over-value his skills and, perhaps not incongruously, to question his experience: "Have you seen other children like this?" "How many children like me have you taken care of?"
Water Depletion Associated with Improperly Constituted Powdered Milk Formulas
Authors: SKINNER ALFRED L.
Published: December 2021

During the last few years several patients have been admitted to the Children's Hospital with water depletion (hypernatremia, hyperosmolarity) associated with improperly prepared powdered milk formulas. The history in these instances indicates that the mother prepared a powdered milk formula (Similac, Enfamil) in a dilution of "one to one" rather than in the recommended dilution of "one to two." There has been some variation in the actual measurement in that some others have diluted the prepared powder one packed level measure (1 tbsp ) to 1 oz of water; some have used 1 oz of formula product to 1 oz of water; others have used one measure of powder to one measure of water.
THAM in Status Asthmaticus
Authors: NOTTINGHAM R. J.
Published: December 2021

José Strauss, et al. recently cited two cases of status asthmaticus treated successfully with THAM. I wish to point out that during status the primary problem is one of adequate alveolar aeration. Respiratory acidosis can almost immediately be corrected if aeration is returned to normal.

Each of the two patients studied was given steroids, bronchodilators, intravenous fluids, and THAM. Both were out of serious trouble approximately 12 hours later.
Children of Sick Parents: An Environmental and Psychiatric Study
Authors: FRIEDMAN STANFORD B.
Published: December 2021

In the introduction of this monograph the author states: "Before establishing a concept of `a sick child ergo a sick parent' it is necessary to know something of the association between illness in parents and psychiatric disorders in their children. The present monograph is concerned with this basic problem." The author's approach is to review the psychiatric and medical histories of 922 children seen in the Mandsley Hospital clinics and wards in 1955 and 1959.
Glans Necrosis as a Complication of Circumcision
Authors: ROSEFSKY JONATHAN BENENSOHN
Published: December 2021

An 8 lb, 7 oz full-term, breech-delivery baby was born after a 36-hour labor. With a technique first described by Kariher and Smith in 1956, circumcision was performed at about 12 hours of age, utilizing a plastic flange-like ring which fitted over the glans and under the excess skin of the prepuce; a ligature was tied tightly over the excess skin which lay on the plastic ring. At age 24 hours, the baby was observed to have a moderately edematous scrotum, one-plus pitting leg edema, and a black, necrotic-appearing glans (Fig.1).

The ligature and the plastic ring were removed, without bleeding, following which the glans gradually became quite swollen and slightly moist over the following 12 hours.
Streptococcal M Protein Antibodies Acquired at Birth
Authors: QUINN ROBERT W. , LOWRY P. NYE
Published: December 2021

The results indicate that type-specific M protein antibodies were present in cord blood of seven of nine infants for the same serologic types and in similar titers to those in the mother's serum. These type-specific antibodies disappeared from the serum by the fifth postnatal month in those infants it was possible to follow.
WHO HAS THE LAST WORD?
Authors: Zuelzer Wolf W.
Published: December 2021

IN ADDRESSING the Pediatric Pathology Club on the occasion of its first anniversary I am equally gratified by the size of the membership as by the quality of the scientific program. Less than a generation ago the pediatric pathologists of this country were easily numbered on the fingers of one hand. The phenomenal growth rate reflected in this meeting shows that the need for workers in this field, men and women trained in developmental pathology and responsive to the special problems of the pediatrician, has come to be recognized. Whether this "Club" is the beginning of the formal organization of a subspecialty or the nucleus of a working community of interests is a question that will be decided by practical considerations and had best be left to the younger men whose task it is to set the goals for the future. Scientifically, pediatric pathology has come of age.

Having spent nearly 30 years in the laboratories and on the wards of children's hospitals, I shall invoke the privilege of the old-timer and give you some rambling disconnected thoughts on the role of the pediatric pathologist in the scheme of things that have troubled me from time to time, drawing on past experience rather than attempting to make predictions. This is, of course, in the best classical tradition of pathology. Ours is the task of describing end results, our preferred tense is the past perfect, our mode is the indicative, or rather, the un-conditional, our punctuation mark par excellence is the period.
THE SWEDISH BCG EXPEDITION IN GERMANY
Authors: NATHHORST HERBERT
Published: December 2021

IN SIMILARITY with conditions in other war-harassed countries, there was a great increase of tuberculosis in Germany during and immediately after World War II. Lydtin reports that the mortality in 1946 showed an increase of between 50 and 100% as compared with the prewar mortality rates. Children in the first three years of life and young people in ages ranging from 15 to 25 years especially fell victim to the disease. Owing to the lack of hospital accommodations and material for roentgenographic examinations, the Germans after the war had no possibility of treating or of isolating and supervising all these tuberculous cases. If to this there is added the appallingly overcrowded living-quarters of the bomb-damaged German towns and the inherent risk of contagion, one understands the apprehension of the German medical profession that the tuberculosis mortality rate, which since 1946 had seemed to be on the decrease, would again rise. It was therefore with deep appreciation that the Occupation Forces and the German authorities received an offer of assistance for BCG vaccination from the Danish and the Swedish Red Cross. After the war, there had been organized on the initiative of the Danish Red Cross and UNICEF a cooperation, for the purpose of fighting tuberculosis, between the Red Cross Associations of the Scandinavian countries, Denmark, Norway and Sweden, the only countries in which there is a long-standing and extensive experience with BCG vaccination. Physicians, nurses, vaccine and other materials for vaccination were accordingly sent to Germany. In 1947 the Danish Red Cross commenced BCG vaccinations in the American zone and in Schleswig-Holstein and in June 1948 the Swedish Red Cross commenced its task in the British zone.
MENINGITIS IN PREMATURE INFANTS
Authors: KAGAN B. M. , HESS J. H. , MIRMAN B. , LUNDEEN EVELYN
Published: December 2021

A review of the literature on the subject of meningitis in premature infants revealed 45 cases. In 10 of these cases from which bacterial agents were cultured, six showed a gram negative bacillus.

Twelve additional cases are added in this study and Esch. coli was cultured from the spinal fluid of nine (with another organism in three of the nine cases).

The symptoms and signs of meningitis in premature infants are discussed.

No reports have been found in the literature of recovery from meningitis in premature infants weighing less than 2,500 gm. The course and treatment of a premature infant who weighed less than 1,000 gm. and who recovered from an Esch. coli meningitis is described in detail.
RELATION OF PLASMA PROTEINS TO BIRTH WEIGHT, MULTIPLE BIRTHS AND EDEMA IN THE NEWBORN
Authors: DESMOND MURDINA M. , SWEET LEWIS K.
Published: December 2021

The concentration of total protein, albumin and globulin in the plasma increase with increasing birth weight in premature infants. These values are relatively stable and independent of birth weight in mature newborn infants. Infants born as twins have lower plasma protein values than do singly born infants of corresponding birth weight. The plasma protein values of twins may vary widely one from the other. This finding supports the theory that plasma proteins in the infant are produced and regulated independently of the mother. Infants born with edema may have essentially normal plasma protein values.