bluuebunny/crossref_metadata_2025 huggingface dataset:
Letters to the Editor
Authors: CORIELL LEWIS L.
Published: December 2021

The Red Book is a concise digest in outline form of the latest information on control, prevention, and treatment of infectious disease for quick reference. Material has always been presented in telegraphic style to save time for the reader and to facilitate revision with the hope that readers would refer to textbooks for supplementary information.

The decision to administer rabies vaccine should not become a routine prescription for each and every bite because rabies vaccination requires a long series of injections that are followed by severe erythema, fever, or arthralgia in 5-10% of cases.
Cortisone for Dermatitis Venenata
Authors: TOW ABRAHAM
Published: December 2021

Dermatitis Venenata, particularly poison ivy, is indigenous to Logan County, West Virginia. An opportunity to treat well over a hundred cases with oral corticosteroids during the past two years has served but to confirm an impression gained earlier.

Our hospital, a small 45-bed institution, located in Logan, the county seat, services an inordinate number of families receiving medical assistance under state and federal programs. The patients come mostly from the numerous coal camps in the area, some even more than a score of miles distant.
The Growth and Development of the Prematurely Born Infant
Authors: DANN MARGARET
Published: December 2021

This is a clear, well-organized account of a longitudinal study of several hundred prematurely born and full-term children, born in Edinburgh in 1952 and 1953. Starting with 595 children, 251 singletons weighing 5 lb 8 oz or less at birth, 119 full-term singletons as controls and 225 twins of all birth weights, Dr. Drillien was able to follow nearly 90 percent to school age. Besides the main survey group, she added a supplementary group of children of very low birth weight (3 lb or less) born between 1948 and 1960; in all, 110 children in this birth weight group were traced, and 72 followed to school age.
The Malnourished Newborn
Authors: PICK WALTER
Published: December 2021

The article "Growth and Development of Twins of Dissimilar Size at Birth" by S. G. Babson et al., in the March issue of Pediatrics (33:327) was thought provoking.

The authors point out that there is uncertainty among investigators as to the outcome of malnourished but not grossly malformed infants. Some investigators report that infants who weigh less than 5 lb but are not premature, are indistinguishable from normal babies by the time they are 4 to 6 months old.
CERVICAL ADENITIS IN CHILDREN DUE TO HUMAN AND UNCLASSIFIED MYCOBACTERIA
Authors: Black Bob G. , Chapman John S.
Published: December 2021

Thirty cases of mycobacterial lymphadenitis have been accumulated. By culture 7 have proven to be caused by Myco. tuberculosis, 13 by unclassified mycobacteria.

Clinical differentiation has been attempted with strong probability that accurate separation of lymphadenitis caused by human organisms from that caused by unclassified mycobacteria can be accomplished. Precisely, a negative history of contact with tuberculosis, large reactions to unclassified skin test antigen with concomitant weakly positive or negative tuberculin skin test, the absence of a tuberculin band on agar diffusion in the face of reaction to unclassified antigens, and the absence of active pulmonary parenchymal disease in the preschool age group (predominantly age 1-3 years) point toward an unclassified mycobacterial etiology. A positive history of contact with tuberculosis, large reaction to tuberculin with concomitant small or negative unclassified mycobacterial skin tests, the presence of a tuberculin band on agar diffusion, and the presence of active pulmonary parenchymal disease favors Myco. tuberculosis as the etiologic agent.

The treatment of both human and unclassified mycobacterial disease of lymph nodes has been attended with good results and relatively uncommon recurrence.
AMINO ACID EXCRETION OF NEWBORN INFANTS DURING THE FIRST TWENTY-FOUR HOURS OF LIFE
Authors: Armstrong Marvin D. , Yates Kerin N. , Connelly John P.
Published: December 2021

The amino acid excretion of 10 fasting newborn infants for the first 24 hours of life have been determined. These data provide an indication of the range which may be expected for amino acid excretion of newborns and provides a basis for further studies of alterations which occur during infancy.
IMPORTANCE OF STANDARDS OF CARE FOR PATIENTS WITH CARDIOVASCULAR PROBLEMS
Authors: Taussig Helen B.
Published: December 2021

AN IMPORTANT consideration in regard to standards of care for children with cardiovascular problems is that the pediatricians have the responsibility for organizing a good diagnostic and surgical team. A good anesthesiologist, a competent surgeon, good nursing care, and keen postoperative observation for early signs of complications are all essential to success. The pediatricians cannot regulate the surgeon, but the standards set can require that the surgeons have met their own standards before they have charge of the pediatric surgical program. The superb results of open-heart surgery as quoted by Dr. Kirklin from the Mayo Clinic are unfortunately not a universal experience and hence recommendations for surgery in a given area must be based on local operative results.

The responsibility for operation rests clearly with the pediatrician and the pediatric cardiologist. The family grants permission for operation but their consent is given on the basis of the advice they receive from the doctor. If operation is not indicated or the risk too high, ours is the responsibility to persuade child and parent not to have an operation. To do right by the child and the family the diagnosis should be accurate, the indications for surgery should be clear, and the family should fully understand the situation. Even if the odds are overwhelmingly in favor of a successful operation, for any one patient the odds are one to one between life and death.

Cardiac operations should be undertaken only to correct or alleviate an abnormality of the heart. Indeed, the pediatrician must be certain that the child's complaints are related to the cardiac condition. The tendency is a natural one to assume that two unknowns go together.
WHY AND HOW ARE CHILDREN FAT?
Authors: WALLACE WILLIAM M.
Published: December 2021

IN SONG AND STORY, obesity has always had an association with the positive and happy values of life. The fat person was the image of the one to be trusted. He was kind, happy, jolly, and successful. If he were lazy, it was a good sort of laziness. If he were the butt of a joke, the jokester was the eventual loser. In the female, two standard deviations above mean weight was a sign of beauty. Today all this, for not easily discernible reasons, is changed. The pediatrician who would begin the study of obesity today could well start with a study of Piggy in the "Lord of the Flies." Either by intent or intuition, Golding has made him physically inept, myopic, frightened, and carried to an early and violent death, his wisdom and foresight unheeded.
ANTICOAGULASE IN SERA OF CHILDREN WITH STAPHYLOCOCCAL INFECTIONS
Authors: Velarde-Frias Ramon , Shaffer Morris F.
Published: December 2021

A small series of children undergoing intensive chemotherapy for staphylococcal disease were followed with respect to serum anticoagulase levels. The majority showed no appreciable neutralizing antibody versus any of a battery of 15 coagulases prepared from "standard" strains of staphylococci representing several phage groups. Three individuals exhibited relatively high (and in one instance a significantly rising) titer versus coagulase derived from the etiologic organism or from strains of closely related phage types. These antibodies were possibly the result of a prolonged initial episode of exposure to a single strain of staphylococci.
Letters to the Editor
Authors: BOGGS T. R.
Published: December 2021

Dr. Erlandson's criticism is a valid one and I am grateful for it. The term"lower risk" would be better than "low risk."
THALLITOXICOSIS: REPORT OF THREE CASES IN MASSACHUSETTS
Authors: Smith David H. , Doherty Richard A.
Published: December 2021

The cases of three Massachusetts children with thallium intoxication are reported. Ptosis, ataxia, tremors, paresthesias, and a state simulating a "toxic" encephalopathy were the outstanding signs and symptoms of these patients. The characteristic alopecia did not become evident in the two survivors until two to three weeks following the onset of symptoms. The diagnosis could not be confirmed by previously described screening tests for thallium but was substantiated by specific quantitative analysis of urine (and tissues). While the condition of both survivors improved following the institution of dithizon therapy, the urinary excretion of thallium was unaffected by any of the therapeutic agents employed.

A brief review of the pharmacology of thallium salts, the pathological consequences, clinical manifestations, and therapy of thallitoxicosis is presented. The availability, attractiveness, and potential toxicity of thallium-containing retail products is emphasized and a plea made for their interdiction.
FATE OF DEFINED ANTIGENS IN THE NEWBORN CHIMPANZEE
Authors: Eitzman Donald V.
Published: December 2021

Seven newborn chimpanzees injected at the time of birth with BSA and HoGG cleared the injected antigens at an exponential rate without evident antibody production following initial injection. When challenged with the same antigens, 4 of 7 injected with BSA and 4 of the 6 injected with HoGG were immune. Tolerance of BSA was seen in 3 of 7 chimpanzees and tolerance of HoGG in 2 of 6 chimpanzees.

The initial response to BSA and HoGG of both the adult and newborn chimpanzees is an exponential decay of the antigen without a rapid phase of degradation. Re-injection of the antigens in an immune animal results in a rapid clearance and antibody production.

These data suggest that newborn primates may react immunologically to foreign proteins either by antibody production or by immunological tolerance—the inhibition of antibody production to subsequent exposures to the same antigen. The dosage, maturity, and other factors which determine which outcome will follow a given exposure are not revealed by these studies. Therefore, it must be assumed that newborn primates, including humans, may be sensitized by foreign proteins administered parenterally or orally.
DIAGNOSIS AND TREATMENT: USE OF STEROIDS IN ASTHMA IN CHILDREN
Authors: Vaughan Victor C.
Published: December 2021

ALTHOUGH cortisone and its derivatives have been widely and increasingly used in the management of allergic conditions during the past fifteen years, no final judgment has been reached as to their place in management of asthma, either in adults or in children. The seriousness of unresolved questions is well exemplified in the discussion by Alexander, Samter, Arbesman, and others as to whether mortality in asthma has fallen or risen since corticosteroid drugs became available. Without taking sides we can acknowledge that because these agents are both effective and hazardous, their use poses a dilemma.

The therapeutic effects of steroids have not been easily separated from their undesired side effects, particularly in prolonged use. Table I lists the better-known effects of chronic administration. The likelihood of each effect varies with the drug used, the effects on fluid and electrolyte economy having been particularly well separated in some agents from the anti-inflammatory effects. It has not been possible, however, to attain adequate anti-inflammatory effects without some stimulation of protein catabolic processes or without some evidence of increased susceptibility to infection or to adrenal suppression. The subtle nature of symptoms of infection in patients receiving steroid therapy may lead to disastrous delays in diagnosis, and have given rise to the legendary patient receiving steroid therapy who "walks to his place on the autopsy table." Certain side effects are more or less specific features of certain agents, such as the marked stimulation of appetite, the weight gain, and the euphoria associated with dexamethasone, or the anorexia, depression, and toxic myopathy associated with triamcinolone. Sometimes a distressing side effect may be avoided by change in agent; highly soluble prednisolone phosphate appears, for example, less likely than prednisolone to stimulate peptic ulceration.
Letters to the Editor
Authors: NAEYE RICHARD L.
Published: December 2021

Dr. Cornblath presents insufficient data in his letter to draw any sound conclusions about the effect or lack of effect of parabiosis on carbohydrate metabolism. I emphasized that the smaller members of parabiotic pairs are malnourished. It is on this latter point that speculations were based, for as Dr. Cornblath has shown, it is in malnourished neonates that hypoglycemia is apt to appear. We have found that specific organ abnormalities which may contribute to hypoglycemia in small twins are also found in malnourished single-born infants and in infants who have experienced alimentary malnutrition after birth.
APPEARANCE AND LOCALIZATION OF A NERVE GROWTH-PROMOTING PROTEIN DURING DEVELOPMENT
Authors: Winick Myron , Greenberg Robert E.
Published: December 2021

A nerve growth-promoting protein (NGF) has been identified in a number of vertebrate species, including the human fetus. This protein can be localized to the axial regions or the sympathetic chain directly, and wherever found is immunologically similar to NGF from mouse salivary gland. During development NGF appears concomitant with morphologic differentiation of the sympathetic chain and always in association with it. These studies further implicate the participation of the nerve growth-promoting protein in the regulation of growth of sympathetic ganglia.
UNILATERAL PSEUDOEMPHYSEMA—A CASE REPORT
Authors: Wiseman Daniel H.
Published: December 2021

This paper describes unilateral pseudoemphysema and reports the case of a 19-month-old boy in whom this condition became apparent during the resolution of a severe and prolonged bronchopneumonia. The findings in this case are similar to those found in the literature, but, in contrast to previous reports, these findings were observed as they became clinically apparent. This is a rare condition consisting of poor ventilation of one lung which is radiolucent on x-ray but normal or small in size. There is no obstruction to its major bronchi, but diffuse obstruction of the minor bronchi is seen on the bronchogram and this has been confirmed in the few pathologic studies available. The pulmonary artery as seen on the angiogram is uniformly smaller than its fellow but appears normal in the pathologic specimens. The involved lung is a functionless sac that contains enough air to remain inflated but contributes little or nothing to oxygen uptake.
ENDOBRONCHIAL PRESSURE AS AN AID TO TRACHEO-BRONCHIAL ASPIRATION
Authors: Segal Sydney
Published: December 2021

The provision of endobronchial pressure at the tip of an aspiration catheter, as described above, results in a more effective removal of obstructive mucus.
DIAGNOSIS AND TREATMENT: MANAGEMENT OF ACUTE VIRAL BRONCHIOLITIS IN INFANCY
Authors: Wright F. Howell , Beem Marc O.
Published: December 2021

ACUTE bronchiolitis (capillary bronchitis, obstructive emphysema) is one of the common afflictions of the lower respiratory passages of infants. Although infection has long been accepted as the primary inciting factor, investigators (with the exception of Sell who believes H. influenzae to be responsible) have not found bacterial pathogens in consistent association with the syndrome. By exclusion, it has been assumed that most cases are precipitated by a viral infection. During the past decade this view has been substantiated by the application of new techniques to the study of respiratory viruses. Surveys of winter and spring epidemics of bronchiolitis in several urban centers have demonstrated a very significant portion of the cases to be associated with respiratory virus infection, most commonly the respiratory syncytial virus (RS), but in a minor number of instances influenza B or the parainfluenza agents. To date, no rapid laboratory proof of viral etiology is available, nor have any of the antiviral substances been found to be effective in treatment. Consequently, the welfare of the individual infant depends upon his physician's acumen in arriving at a correct clinical diagnosis and in utilizing nonspecific measures to combat the disturbances of his respiratory physiology.

DIAGNOSIS

The first requisite of proper management is an accurate diagnosis. Table I lists other causes of infantile dyspnea which may cause confusion. Exclusion of these entities depends upon a careful history and physical examination, a chest roentgenogram, and a few well-chosen laboratory tests. The most frequent differential problem is the distinction among viral bronchiolitis, asthmatic bronchitis, and bacterial infection of the lower respiratory passages.
SOME EFFECTS OF ALTERED ENVIRONMENTS
Authors: Avery Mary Ellen
Published: December 2021

The aerospace medical literature contains a surprising number of investigations which interest the pediatrician. The investigators of space problems, in their concern over altered environments, ask about the effects of immersion in fluid on the distribution of the circulation, and the function of the fluid-filled lung. They ask about the role of nitrogen in the gaseous environment if man and animal can live in pure oxygen at reduced pressure without significant toxicity for thirty days or longer. Consideration of the adaptation to altered day-night cycles is of concern to the aerospace investigators; yet such an adaptation has been demonstrated by the human species from the time the first infant was born. The problems are not new. The space age has perhaps given us a new perspective on old problems, and since these views are of outer space, it is hoped their value may be in proportion to the perspective from which they are perceived.
Magnesium Sulfate Enemas for the Respiratory Distress Syndrome
Authors: VAN GELDER DAVID W.
Published: December 2021

Recently both lay (Time Magazine, October 30, 1964) and medical (Medical Tribune, November 11, 1964) news media have reported the use of saturated solutions of magnesium sulfate enemas as therapy for infants with the respiratory distress syndrome. In the past two weeks I am personally aware of three infants in our community where the possibility of use of such treatment has been mentioned by either parents and/or physicians. I imagine that our experience has been duplicated by many pediatricians in other areas.
ANTI-BOVINE SERUM ALBUMIN AND ANTI-ALPHA LACTALBUMIN IN THE SERUM OF CHILDREN AND ADULTS
Authors: Rothberg Richard M. , Farr Richard S.
Published: December 2021

1. Because precipitin, hemagglutination, and complement-fixation tests measure secondary manifestations of antigen-antibody interactions and are sometimes negative even after a primary antigen-antibody reaction has occurred in vitro, the incidence and amount of anti-bovine serum albumin (BSA) was evaluated in the sera from 900 children and adults by means of precipitating I131-labeled BSA-antibody complexes with 50% saturated ammonium sulfate. A similar study using I131-labeled alpha lactalbumin (ALA) was performed on 718 of this same group of sera.

2. Antibody to BSA was detected more frequently among children (75%) than among young adults 16 to 40 years of age (25%), or among older age groups (8%).

3. The incidence of detectable antibody to ALA had the same age distribution, but only half the frequency as anti-BSA.

4. In contrast to the near absence of antibody in the cord serum as measured by hemagglutination titers using red cells coated with milk proteins, most of the antibody detected in maternal sera in the present study was able to cross the placental barrier and was present in the cord sera.

5. The incidence of both anti-BSA or anti-ALA was the same in males and females.

6. If a given sera bound both IBSA and IALA, the anti-BSA activity was usually, but not always, greater than the anti-ALA activity.

7. No shared antigenicity was detected between IBSA and ovalbumin, insulin, protamine, diptheria, and tetanus toxoid, pertussis vaccine, poliomyelitis vaccine, and influenza vaccine. The apparent inhibiting effects of unlabeled bovine gamma-globulin and ALA on IBSA binding were probably due to trace amounts of BSA in these protein preparations.

8. BSA, ovalbumin, and bovine gamma-globulin had no detectable shared anti-genicity with IALA.

9. Positive skin tests to milk or BSA did not correlate with the anti-BSA levels measured in the serum.

10. The incidence of persons with anti-BSA and anti-ALA was comparable among the "patient" and "well" populations. Ten of the 31 sera with the greatest capacity to bind IBSA were from the "well" population, the remaining 21 sera were from children with a variety of disease states.
WOLMAN'S DISEASE: THREE NEW PATIENTS WITH A RECENTLY DESCRIBED LIPIDOSIS
Authors: Crocker Allen C. , Vawter Gordon F. , Neuhauser Edward B. D. , Rosowsky Andre
Published: December 2021

Three patients are presented, the first ones of American origin, with a newly identified constitutional lipidosis previously described by Wolman from Israel. The clinical picture as seen to date shows poor weight gain, vomiting and diarrhea, increasing hepatosplenomegaly with abdominal protuberance, and death in nutritional failure by 2-4 months of age. One of the patients in this report had a similarly involved sibling; present data suggest recessive genetic transmission. Foam cells are found in the bone marrow, and vacuolated lymphocytes in the peripheral blood, each entirely similar to those seen in Niemann-Pick disease. Serum lipids are normal, and signs of adrenocortical insufficiency are moderate. An apparently pathognomic radiologic sign is the presence of greatly enlarged adrenal glands, easily visible by virtue of diffuse punctate calcific deposits, with normal shape of the gland preserved.

Pathologic studies show disseminated foam cells, laden with cholesterol and neutral fat, most notable in the liver, spleen, lymph nodes, marrow, thymus, and small intestinal mucosa. In addition, neutral fat deposits are found in connective tissue cells, vascular endothelium, bile ducts, hepatic parenchymal cells, and adrenal cortical cells. The adrenal enlargement is produced by increase in the adrenal cortex, with secondary, possibly ischemic, necrosis and calcification. Direct analysis of unfixed tissue has shown that the cholesterol level of the liver is increased 15-20-fold, and of the spleen 4-5 times normal, with apparent major increase in triglycerides as well. Nervous system changes are milder. The accumulated sterol has been demonstrated to be genuine cholesterol in the tissues studied so that the mechanism of the disease does not appear to rest with disturbed biosynthesis of cholesterol.
REPETITIVE POISONING IN CHILDREN: A PSYCHOSOCIAL STUDY
Authors: Sobel Raymond , Margolis James A.
Published: December 2021

The families of 20 poison repeaters, 19 single ingestors, and 13 controls were studied. Social class, religious affiliation, income, geographic setting, and family size do not seem to be correlated with repeated episodes of poisoning in children.

The present study indicates that repetitive poisoning in children is not related to accident proneness, pica, environmental hazard, or lack of parental supervision. Ingestion of poisons seems to be the result of purposeful behavior on the pant of the child. Correlated with this behavior, especially in the case of the poison repeater, are: hyperactivity, negativism and other behavioral problems of the child, limited parent-child relationship, marital tension, and a tense and distant family atmosphere.

The first ingestion may be the result of the child's negativism, imitation of the parent's pill-taking, or confusion with food and is rarely the result of chance alone. Subsequent ingestions seem to be inappropriate methods the child uses to gain more relatedness with his parents or to express anger or negativism.

The physician's role in poison prevention should be to help parents of preschool children establish a cautious but confident attitude toward childhood poisoning and to realize that childhood poisoning may indicate family psychopathology which may require treatment.
THE ETIOLOGICAL ROLE OF MYCOPLASMA PNEUMONIAE IN OTITIS MEDIA IN CHILDREN
Authors: Soběslavský O. , Syrůček L. , Brůčková M. , Abrahamovič M.
Published: December 2021

The paper brings a report on the isolation and identification of Mycoplasma pneumoniae as possible etiological agent of otitis media in three naturally infected children. The disease was a complication of a mild respiratory tract illness. All patients recovered in the course of one week.

M. pneumoniae isolation was successful both in enriched liquid and on solid PPLO media from throat swabs of two patients and from the ear swab of one after paracentesis of the eardrum. The strains isolated grew on solid media forming typical colonies and producing hemolysin. Their final identification was accomplished by means of the immunofluorescence as well as by the complement-fixation test.

In the paired sera of two of these patients a significant rise of complement-fixing antibody against both the M. pneumoniae standard strain (strain F.H.) and the strains isolated was established. On the other hand there were no antibody rises against influenza viruses, adenoviruses, parainfluenza virus type 1, and RS virus, nor a significant rise of antistreptolysin O.
DISTRIBUTION OF CYTOCHROME C AND MYOGLOBIN IN RATS WITH DIETARY IRON DEFICIENCY
Authors: Dallman Peter R. , Schwartz Herbert C.
Published: December 2021

A decrease in cytochrome c and myoglobin concentrations was observed in young rats made anemic on a low-iron diet. The degree of depletion of hemeprotein varied according to tissue. In the iron-deficient rat, myoglobin and cytochrome c were most depleted in skeletal muscle which contains the major portion of these proteins. Cytochrome c expressed as percentage of corresponding control mean concentrations was 44% in skeletal muscle, 61% in intestinal mucosa, 69% in kidney, 79% in diaphragm, 89% in heart, and 97% in brain. Myoglobin in the iron-deficient rats was 44% of the corresponding control concentration in skeletal muscle, 63% in diaphragmatic muscle, and 80% in heart muscle.

The variations in degree of hemeprotein depletion in response to iron deprivation appeared to be related to organ function, growth rate, and cell turnover. Cardiac and diaphragmatic muscle, whose function is essential to survival, resisted the loss of myoglobin and cytochrome c to a greater extent than did skeletal muscle. Severe depletion of hemeprotein was observed in tissues with a rapid rate of growth such as skeletal muscle or a rapid cell turnover as in the case of intestinal mucosa. Brain, which grows minimally during the period of iron deprivation, was unchanged in its cytochrome c content.

A significant impairment of oxidative metabolism in the iron deficient rat was suggested by a reduction in the rate of respiration of muscle homogenates.
Driveway Accidents
Authors: KRAVITZ HARVEY
Published: December 2021

The writer of this letter has already called attention in print to the dangers of car driveway accidents (Kravitz, H. and Korach, A., Illinois Medical Journal, December, 1964). Since pediatricians are by the nature of their work especially likely to use driveways where children are playing, or to have influence over parents who do so, I would like to call attention of readers of Pediatrics to this special (and preventable) danger. Recommendations for its prevention include:
Vitamin D Intake and the Hypercalcemic Syndrome
Authors:   COMMITTEE ON NUTRITION, American Academy of Pediatrics
Published: December 2021

The Committee on Nutrition of the American Academy of Pediatrics in 1963 published a memorandum entitled. "The Prophylactic Requirement and the Toxicity of Vitamin D," (Pediatrics, 31:512, 1963). The Committee believed at that time that there was circumstantial evidence relating vitamin D intake to the pathogenesis of the mild form of infantile hypercalcemia, and probably also of the severe form, which, in addition to hypercalcemia, manifests typical facies, supravalvular aortic stenosis, and a mental defect.
Magnesium Sulfate for Respiratory Distress
Authors: NICHOLS M. M.
Published: December 2021

Dr. Silverman's succinct comments on new treatments (Pediatrics, 35:369) are well-bornout by the following case report.

Case Report

Baby girl X (UH No. 4033-P) was a 1,255 gm white female, approximately 28-week gestation, born to gray. II, 25-year-old mother whose first baby weighed 2 kg and died of hyaline membrane disease. Pregnancy was uneventful except that spontaneous labor occurred at 28 weeks with ruptured membranes and delivery under N2O and O2. Vistaril, 50 mg, intramuscularly, had been given 45 minutes before delivery.
RUBELLA: FREQUENCY OF ANTIBODY AMONG CHILDREN AND ADULTS
Authors: Sever John L. , Schiff Gilbert M. , Bell Joseph A. , Kapikian Albert Z. , Huebner Robert J. , Traub Renee G.
Published: December 2021

Serum specimens from 268 individuals who were in the general population of Montgomery County, Maryland, in 1957 were tested for antibody to rubella and rubeola. The frequency of antibody to rubella increased from approximately 35% among children 1-10 years of age to 85% in the age groups 16-25 years and older. This indicates that approximately 15% of the adults sampled were susceptible to infection with rubella. The major acquisition of rubella antibody occurred among schoolage children and was several years later than that of rubeola antibody. In all age groups the frequency of rubella antibody was consistently less than that for rubeola.
RED CELL METABOLISM IN THE PREMATURE INFANT
Authors: Oski Frank A. , Naiman J. Lawrence
Published: December 2021

The erythrocytes of premature infants, term infants, and adults were studied with respect to ATP levels, ATP stability, glucose consumption, glutathione stability, and the tendency to develop morphologic abnormalities during short periods of incubation. The erythrocytes of both the premature and term infants had higher ATP levels and glucose consumption, greater ATP and glutathione instability, and more marked morphologic abnormalities than the adult red cells. The erythrocytes of the premature infants showed the greatest degrees of abnormality. It is suggested that the premature infant at birth possesses a metabolic profile in his erythrocytes which results in ATP instability.
Suprapubic Aspiration of Urine in Premature and Term Infants
Authors: NELSON JOHN D. , PETERS PAUL C.
Published: December 2021

The purpose of this brief communication is to familiarize pediatricians with the advantages and ease of suprapubic needle aspiration of the urinary bladder in small infants when urine specimens for culture are needed.

The technique has been used successfully in adults. Pryles et al. reported on percutaneous suprapubic aspiration of the bladder in 42 children, including 6 babies 3 to 6 months of age; however, use of this procedure in the neonatal period has not been previously reported.

Contaminated urine specimens from neonatal infants are commonly encountered. We have studied 62 randomly selected, uncircumcised premature male infants. Using meticulous care in cleansing and handling of the specimens by the technique of Pryles et al.
Mothers' Opinions
Authors: FILER L. J. , MARTINEZ G. A.
Published: December 2021

The recent publication of Deisher, et al. quantitating mothers' opinions of pediatric care accorded their children has stimulated us to offer comparable observations elicited by mail questionnaires from mothers with infants 6 months of age or less. Surveys of mother opinion were obtained in 1958, 1962, and 1964. Each survey consisted of a nationally distributed sample of over 2,000 mothers using the technique described by Filer and Martinez. The characteristics of the sample reported by Filer and Martinez closely approximate those for the general population of mothers.
Control of Communicable Diseases in Man
Authors: KATZ SAMUEL L.
Published: December 2021

That a volume achieves its tenth edition and its fiftieth anniversary may be accepted as highly suggestive evidence of its value and popularity. A brief, or more leisurely, reading of the 1965 version of this handbook quickly convinces one of the great service rendered its readers by the editors. Dr. John E. Gordon, Emeritus Professor of Preventive Medicine and Epidemiology at the Harvard School of Public Health, and his Committee on Communicable Disease Control of the American Public Health Association present succinctly and lucidly the pertinent and current material in more than one hundred fifty infectious diseases, in a paperback pocket-size book.
STUDIES OF NON-HEMOLYTIC HYPERBILIRUBINEMIA IN PREMATURE INFANTS
Authors: Wishingrad Lester , Cornblath Marvin , Takakuwa Toshio , Rozenfeld Irving M. , Elegant Lawrence D. , Kaufman Avner , Lassers Elizabeth , Klein Reuben I.
Published: December 2021

1. A prospective clinical study of nonhemolytic hyperbilirubinemia in premature infants included 187 infants, of whom 100 had hyperbilirubinemia above 18 mg/100 ml and 87 had bilirubin levels never in excess of 15 mg/100 ml. In a random fashion, the infants with hyperbilirubinemia were divided evenly and either received replacement transfusions or did not.

2. Of the 50 infants in the exchange transfusion group, bilirubin levels were adequately controlled in 48 infants. There was no mortality associated with the exchange transfusion procedure. After 1 year, there does not appear to be any definite evidence of kernicterus in this group.

3. In the no-exchange group, 10 of the 50 infants had levels of bilirubin over 24 mg/ 100 ml for more than 48 hours. Of these, 1 developed fatal kernicterus. Eight of the other 9 infants, whose bilirubin values exceeded 24 mg/100 ml, and 32 of the original 40, whose bilirubin levels were over 18 but below 24 mg/100 ml, were examined neurologically after 1 year. No evidence of kernicterus was found.

4. Seventy-five of the 87 control infants were also examined neurologically after 1 year and none had evidence of kernicterus.

5. The evidence to date suggests that exchange transfusions in the management of non-hemolytic hyperbilirubinemia of the premature not associated with clinical factors which may enhance the development of kernicterus such as asphyxia, hypoproteinemia, sepsis, etc., need not be performed for unconjugated bilirubin values under 24 mg/100 ml. We believe that infants who will develop bilirubin levels in excess of 24 mg/100 ml may be anticipated if their plasma values exceed 20 mg/100 ml between 73 to 96 hours of age or 22 mg/100 ml between 96 and 120 hours.

6. The validity of these conclusions is dependent upon the long-term follow-up of these infants.
COMPARISON BETWEEN SNAKEBITES IN CHILDREN AND ADULTS
Authors: Parrish Henry M. , Goldner John C. , Silberg Stanley L.
Published: December 2021

This study is based on the hospital records of 1,538 people bitten by poisonous snakes during 1958 and 1959 in 10 selected states having high snakebite rates. Of these, 792 were less than 20 years of age and 746 were 20 or more years of age.

Snakebite rates were highest among children 5-19 years of age. Males had higher rates than females and whites had higher rates than non-whites. Children were not found to have excessively high case-fatality rates.

Ninety-five percent of the snakebites happened from April through October. Ninety-seven percent of the bites were inflicted on the extremities: 34% on the upper extremities and 63% on the lower extremities.

For 1,078 cases where antivenin was administered there were three deaths—a case-fatality rate of 0.28%. These patients received insufficient doses of antivenin. In 460 cases where there was no antivenin given there were 12 deaths—a case-fatality rate of 2.61%. These differences were statistically significant. The actual doses of antivenin which produced these results are listed.
Oculoglandular Tularemia: Transmission from Rabbit, through Dog and Tick to Man
Authors: HUGHES WALTER T.
Published: December 2021

A case of oculoglandular tularemia is reported. Three days after the patient's dog caught a rabbit, a tick was removed from the animal and in so doing blood from the tick was injected into the boy's eye. Conjunctival inflammation was apparent 1 day later and fever occurred 4 days after inoculation. The patient was not in contact with the rabbit. Signs and symptoms rapidly abated with streptomycin therapy.
HOSPITALS AND THE COMMUNITY
Authors: WEGMAN MYRON E.
Published: December 2021

WHEN and when not to hospitalize, what services and facilities should be expected from a hospital, what patterns of staffing should exist for medical and ancillary care, what standards should be demanded, and what reasonable costs may be expected, are questions daily of greater concern to practitioners caring for children. But the character and cost of hospitalization are not the only factors which influence the wise physician in deciding whether to care for a child at home or in hospital. Obviously, there can be little question about the imperative need for hospitalization in conditions requiring use of major equipment or highly skilled nursing care, such as major surgery or complex metabolic disorders.
THE PULMONARY SYNDROME OF WILSON AND MIKITY
Authors: Swyer Paul R. , Delivoria-Papadopoulos Maria , Levison Henry , Reilly Bernard J. , Balis John U.
Published: December 2021

Eight examples of the Wilson-Mikity Syndrome are reported, 2 of whom died at 127 and 145 days of age respectively. The radiology of the condition is relatively specific and gives strong grounds for suspicion of the diagnosis when taken in the clinical context. Gross, histological, and electron microscopic examinations reveal areas of normality, emphysema, and immaturity. The electron microscope additionally shows areas where the alveolar wall thickening is due to the presence of smooth muscle, reticulin, and collagen.

The most likely etiology is a disorder in postnatal alveolar development related to premature birth and functional use of an immature lung.

There are changes in lung mechanics with decreased compliance and increased non-elastic resistance to airflow mainly in expiration. The mechanical work of breathing is increased. There is a respiratory acidosis in spite of an increased minute volume. Arterial oxygen desaturation is common, increased by crying and only partially relieved by oxygen. Large R → L shunts have been demonstrated which are probably intrapulmonary.
SELECTED SOCIAL, EDUCATIONAL, AND MEDICAL CHARACTERISTICS OF PRIMIPAROUS 12–16-YEAR-OLD GIRLS (NEWBURGH, NEW YORK)
Authors: Keeve J. Philip
Published: December 2021

The fertility rate of a school-age population-at-risk in a community of moderate size (Newburgh, New York, and environs) based on hospital records for the period 1959-1963 appears to be stable at approximately 10% of 12-16-year-old girls. A detailed review of academic and medical records confirms the sociomedical and educational profile previously documented by others, and shows no unique conformation characteristic of the community nor did an individual predictive profile emerge which might make this population especially identifiable for screening or prevention programs. It is hoped that community attitudes toward social and economic poverty can be altered enough to cease punitive measures such as withholding education and public assistance from these girls. These approaches appear to be an organized escape-into-ignorance behavioral pattern whereby the community prohibits hospital-based family-planning clinics or any teaching resembling sex education in the schools, fearing that these activities may be interpreted as sanctioning and encouraging illegitimacy. Surely the time has come to re-evaluate our public education and health practices toward a problem inexorably linked to population growth and increasing public-health education. More knowledge is needed regarding dating and supervision of teen-agers. This study does indicate that the potentially pregnant school-age girl tends not to participate in organized extracurricular activities, so that community efforts to supply "family-life" education through girls' clubs, neighborhood and church groups, Y.W.C.A., and similar organizations will fail to attract the very population it is designed to reach. The school must prepare to accept this role realistically since informal educational experience does not meet the needs of these girls.
Hemolytic Disease of the Newborn Due to Anti-Kidd (Jkb): Case Report and Review of the Literature
Authors: ZODIN VITA , ANDERSON ROBERT E.
Published: December 2021

This report concerns the fifth recorded case of HDN due to anti-Jkb. Correlation of the present data with that of previous studies suggests that HDN resulting from Jkb incompatibility generally, although apparently not inevitably, follows a benign clinical course. A summary of some of the serologic characteristics of anti-Jkb is also included.
The Effect of Repeated Mumps Skin Tests on Skin Sensitivity to Mumps Antigen
Authors: ARONSON SUSAN S. , LEPOW MARTHA L.
Published: December 2021

The mumps skin test, developed by Enders et al., in 1945, has been especially useful in identifying individuals who are immune to mumps either as a result of clinical illness caused by the mumps virus or a subclinical infection. A positive skin test can be demonstrated in 98% of persons who have a rise in complement-fixing antibody titer to mumps virus, and skin hypersensitivity may develop from 1 week to 3 months after infection. Although repeated skin tests with mumps antigen are not commonly performed, occasionally it is necessary to repeat a skin test within a few months or a year after a previous one.
PHYSICAL GROWTH IN MENTAL DEFECTIVES
Authors: Mosier H. David , Grossman Herbert J. , Dingman Harvey F.
Published: December 2021

A cross-sectional survey of ten physical measures was carried out on 2,472 institutionalized mentally defective patients. This report gives the results in the Caucasian segment numbering 2,027. The means and standard deviations for each measure are shown by sex, age, I.Q. level, and diagnostic category. Body weight, crown-heel height, symphysis-heel height, biacromial diameter, and bicristal diameter had smaller dimensions than normal in both sexes and the degree of impairment related to the degree of I.Q. deficit. No differences among diagnostic categories in degrees of stunting were noted with the exception of Mongolism in which stunting was greater than in the other categories. Shortening of the lower extremities accounted for this difference. In contrast, the measurements of the width of the shoulder and pelvic girdles and length of the spine showed in mongolism no differences from the remaining diagnostic categories.

The literature on growth effects of experimental brain lesions was reviewed. These reports indicate that various known physiologic mechanisms may be involved especially after certain hypothalamic and amygdaloid lesions. Further work is needed to elucidate the effect of brain lesions on the growth-hormone mechanism.

On the basis of the experiments with brain lesions and observations in the human, it is concluded that the way in which brain injury produces stunted growth in the human is unclear. Further work will be needed on genetic, nutritional, neurophysiological, and endocrine aspects of physical growth before this mechanism can be defined.
PROGRESS IN CYSTIC FIBROSIS
Authors: MCINTOSH RUSTIN
Published: December 2021

OUR concept of a particular disease has a capacity for growth and development comparable to that of an animate creature. In some instances the clinical picture of a specific illness was known to the ancients and has undergone little amplification in thousands of years. Tetanus, of which Hippocrates provided a clear and still valid description, is such an example. In other instances new entities, first described only recently, may take on fresh aspects quite rapidly as experience extends their dimensions and clarifies their characteristics. Of the many examples which come to mind none is more instructive and, in a sense, more humbling than cystic fibrosis of the pancreas, fibrocystic disease, or mucoviscidosis–whichever term you wish to use.
A COMPARISON OF SR90 COMPONENT OF HUMAN AND COWS' MILK
Authors: Straub Conrad P. , Murthy Gopala K.
Published: December 2021

INFORMATION on the concentrations of specific radionuclides in human milk as well as in cows' milk is needed to understand potential exposure to radiation of infants consuming these milks. Considerable data are available on radionuclide concentrations in cows' milk, but similar data for human milk are meager. To obtain data on radionuclide concentrations in human milk, samples of human milk were obtained from Denver, Colorado (July 9, 1959, through February, 1961), and Chicago, Illinois (December 21, 1959, through August, 1961). The Denver samples represented pooled human milk collected postpartum, while those from Chicago represented human milk from individual donors contributing to a milk bank. For comparison, samples of cows' milk corresponding to that consumed by the donors participating in the Chicago program were collected (November, 1960, through August, 1961). In turn, these samples were compared with samples collected monthly from the rawmilk network serving a portion of the Chicago milkshed.

Samples were analyzed for calcium, potassium, strontium-90, and cesium-137, and the results are summarized in Tables I and II. As shown in Table I, the concentrations of strontium-90 and calcium in human milk samples from Denver and Chicago are similar, the mean geometric values being 0.62 and 0.56 picocurie of strontium-90 per liter (pc/1), and 0.24 and 0.25 gm of calcium per liter (gm/1), respectively. A comparison of the strontium-90 and the calcium concentrations of cows' milk with those of human milk from Chicago indicates that the concentration of strontium-90 in human milk is smaller by an order of magnitude, and that of calcium by a factor of approximately 5.
THE EFFECTS OF POSTNATAL CIRCULATORY ADJUSTMENTS IN CONGENITAL HEART DISEASE
Authors: Rudolph Abraham M.
Published: December 2021

The hemodynamic and clinical features of congenital heart disease are dynamic. They are closely related to the normal maturational changes in the small pulmonary blood vessels, which, in turn, are influenced by the presence of certain congenital anomalies.

The role of left atrial and pulmonary venous hypertension, possibly with associated hypoxia, in maintaining an elevated pulmonary vascular resistance, has been considered; and the relationship between cardiac failure, left atrial pressure elevation, and pulmonary hypertension, discussed.

Evidence has been presented demonstrating the importance of normal sympathetic nervous system activity and of catecholamine release, in the adaptation of the circulation to a large volume overload associated with left-to-right shunt.