bluuebunny/crossref_metadata_2025 huggingface dataset:
ACUTE DIARRHEA IN INFANCY
Authors: ARIZTÍA ANÍBAL , GARCÉS CARLOS
Published: December 2021

An analysis of acute diarrheas in infancy is made, based on the clinical study of two groups of patients: the first is made up of 1,505 infants who had 3,391 diarrheal episodes in a period of six years; and the second, of 199 infants who had a dysentery-like diarrhea in a period of one year's observation.

Out of the 3,391 diarrheal episodes 3,020 showed an infection of parenteral origin, 210 enteral, and 161 no demonstrable infection.

We consider every acute diarrhea in infancy as having an infectious origin either parenteral or caused by specifically enteric exogenous germs as well as the nonspecific intestinal flora.

In the great majority of our diarrhea cases (2,060 or 60.7%) there was a coexisting metabolic impairment and this was almost general in the enteral infection group, having a mortality rate of 17%.

The isolation of a specific enteric germ (salmonella, shigella) was only possible in approximately 30% in both groups, the first one with 210 cases of enteral infection, and the other of 199 children with dysentery-like diarrhea.

The highest incidence of diarrhea in this country is in spring and summer seasons. Most of the affected children were previously undernourished.

Postmortem examinations in fatal cases failed to show a relationship between the severity of intestinal lesions and the type and origin of the infection. Neither could we demonstrate a definite parallelism between cause and character of the diarrhea, although specific enteric infections had certain predominance of inflammatory stools (salmonella, shigella).

From a diagnostic, therapeutic and prophylactic standpoint, we have indicated the importance of two main elements in any given case of diarrhea: its metabolic impairment and the infectious etiologic factor. We think neither element alone justifies the denomination and classification of acute diarrhea in infancy.

The preservation of a good nutritional state and the sanitary control of food, water. sewage, etc., as well as the elimination of carriers, seem to be of the foremost prophylactic importance.

In the individual case treatment should correct the metabolic impairment and infection.
Re: Anaerobic Metabolism in the Newborn Infant. I. On the Resistance of the Fetus and Newborn to Oxygen Lack, James L. Wilson, M.D., et al, PEDIATRICS 1:581, 1948
Authors: RAPOPORT SAMUEL
Published: December 2021

In their recent article Drs. Wilson et al have undertaken a reinvestigation of the problem of the acid-base balance of the premature infant. The authors conclude from a review of the literature and their own findings that a "paradox" exists. On the one hand, the effect of oxygen on the respiration would indicate a condition of inadequate pulmonary respiration, while, on the other, the data on plasma CO2 and pH, "interpreted in the usual way," would point to overventilation. They reject as improbable the thought that a difference might exist between oxygen and CO2 in their rate of diffusion through the alveolar membrane. Instead, they propose that an incomplete metabolism might lead to a lower production of CO2.

The purpose of this letter is to direct attention to studies by M. Krogh and A. Krogh (J. Physiol. 49:271; 52:391) in which a great difference in the diffusibility of the two gases through biologic membranes was demonstrated, with the CO2 diffusing at a 20-30 fold rate compared with oxygen.
A CONTROLLED CLINICAL TRIAL OF THE EFFECTS OF WATER VAPOR MIST ON RESPIRATORY DISTRESS AMONG INFANTS OF DIABETIC MOTHERS
Authors: Hsia David Yi-Yung , Peterson Herbert G. , Gellis Sydney S.
Published: December 2021

A controlled clinical trial of the effects of water vapor mist on respiratory distress has been undertaken in a group of 100 newborn infants of diabetic mothers.

Half of the group was placed in an incubator in which the atmosphere was supersaturated with water vapor mist (over 100% humidity). The other half was placed in a similar incubator with 50 to 70% humidity. The infants in the two groups were comparable with respect to sex, weight, severity of maternal diabetes, etc.

The two groups were compared with regard to mortality, clinical evidence of respiratory distress, respiratory rates, and roentgenographic evidence of pulmonary hyaline membranes. No striking difference could be found in the course and outcome of the infants in the two groups.
Cerebral Palsy–Advances in Understanding and Care
Authors: DENHOFF ERIC
Published: December 2021

Cerebral Palsy, Advances in Understanding and Care, is the most recent of the newer texts which present cerebral palsy as a comprehensive problem involving the handicapped child, his family, and the community. The text is a remarkable collection of all that has been published on the subject during the past 15 years. The material has been culled, refined, and co-ordinated so that a wide variety of professional persons will find useful material, regardless of whether they are new to the field or expert in it.
Helping Babies Breathe Global Development Alliance and the Power of Partnerships
Authors: Keenan William J. , Niermeyer Susan , af Ugglas Anna , Carlo Waldemar A. , Clark Robert , Gardner Matthew Ross , Kak Lily P. , Laerdal Tore , Little George A. , Patterson Janna , Schoen Eileen , Silkoset Unni , Visick Michael K. , Wall Stephen , Wright Linda L.
Published: December 2021

The Helping Babies Breathe Global Development Alliance (GDA) was a public–private partnership created simultaneously with the launch of the educational program Helping Babies Breathe to accelerate dissemination and implementation of neonatal resuscitation in low- and middle-income countries with the goal of reducing the global burden of neonatal mortality and morbidity related to birth asphyxia. Representatives from 6 organizations in the GDA highlight the recognized needs that motivated their participation and how they built on one another’s strengths in resuscitation science and education, advocacy, frontline implementation, health system strengthening, and implementation research to achieve common goals. Contributions of time, talent, and financial resources from the community, government, and private corporations and foundations powered an initiative that transformed the landscape for neonatal resuscitation in low- and middle-income countries. The organizations describe the power of partnerships, the challenges they faced, and how each organization was shaped by the collaboration. Although great progress was achieved, lessons learned through the GDA and additional efforts must still be applied to the remaining challenges of prevention, widespread implementation, improvement in the quality of care, and sustainable integration of neonatal resuscitation and essential newborn care into the fabric of health care systems.
FOOD ALLERGY
Authors: Kessler Walter R.
Published: December 2021

A VARIETY of disorders and symptom complexes have been ascribed to allergy—often to hypersensitivity to foods. In the majority of instances, however, it has not been possible to produce objective evidence for the existence of an antigen-antibody reaction and such a mechanism has been assumed rather than demonstrated. Instances of true food allergy occur. Their frequency however is difficult to determine with any degree of accuracy. Dr. Pratt (Pediatrics, 26:642, 1958) has properly called attention to the inadequate evidence on which practitioners as well as laymen frequently ascribe signs and symptoms to allergy to foods.

Even when the diagnosis is based on good clinical observation, it may not be possible to demonstrate an immunologic mechanism.
STUDIES IN CYSTIC FIBROSIS OF THE PANCREAS: PROTEIN PATTERN IN MECONIUM ILEUS
Authors: Green Morris N. , Clarke John T. , Shwachman Harry
Published: December 2021

Aqueous extracts of meconium obtained from normal children and from patients with meconium ileus were examined by means of chemical precipitation, paper electrophoresis and precipitin tests.

All the extracts from patients with meconium ileus were found to contain protein which was readily precipitated by trichloracetic acid. In 59 extracts of meconium from normal infants no protein could be demonstrated by the use of trichloracetic acid.

In the abnormal extracts, the major constituent was found to be identical with serum albumin, both by paper, electrophoretic-migration studies at two pH levels and by precipitin tests with anti-albumin horse serum. Other protein components were found on electrophoresis that were similar, but not necessarily identical with, the alpha-, beta-, and gamma-globulins of human serum.

The extracts from normal meconium gave only a very faint reaction for protein. The electrophoretic pattern did not in any way resemble that obtained with the abnormal extract.

Precipitin tests showed that the albumin content of the normal extract was about 1-2% of that of the abnormal extract.

After electrophoretic separation of the components of extracts of meconium from patients with meconium ileus, the stainable carbohydrate was found to be greater in the "alpha" region than in the corresponding area for normal serum.

The possible role of plasma proteins in the formation of abnormal meconium in meconium ileus is discussed.
The Placement of Adoptive Children
Authors: KARELITZ SAMUEL
Published: December 2021

The publisher describes the author as having written this book for "the medical and legal professions, clergy, social workers, adoptive parents, and all other persons who participate in the creation and nurturance of adoptive homes"; and indicates that it "provides definite answers for questions of central interest to both adoptive parents and child placement workers. . . . That it offers useful illumination for numerous perplexing issues and indicates the nature of much of the research which is required for substantial advances in this most intricate area of social work practice."
FAMILIAL THALASSEMIA AND ERYTHREMIC MYELOSIS
Authors: Olshin Irving , Sawitsky Arthur
Published: December 2021

A patient with familial thalassemia who developed a myeloproliferative disorder with bidirectional involvement has been studied. It is suggested that because of the inherited red cell defect predominant expression was in the erythroid system.

Some of the hazards attendant upon prolonged adrenal-steroid and antibiotic therapy and splenectomy are discussed.
A NURSERY SCHOOL FOR CHILDREN WITH CEREBRAL PALSY
Authors: Koch Fremont P.
Published: December 2021

Obviously 13 cases is too small a number on which to base firm conclusions, particularly when we consider the different types of cerebral palsy, variations in degree, mental abilities, emotional status, economic background, social status and type of follow-up program. A few tentative conclusions could be made, realizing the above mentioned limitations:

Intelligence is a major factor in determining the physical progress that can be anticipated in a child with cerebral palsy.

Intelligence can be determined quite accurately in a child with cerebral palsy as young as 18 months of age.

A cerebral palsy nursery school should have facilities for emotional guidance of children and parents. Lacking this, some children may fail to make the expected physical progress.

Because consistent follow-up therapy and programming is very important, a skilled social service department can be very helpful.

In general, parents and staff members felt that this cerebral palsy nursery school was very worthwhile when considered in retrospect 5 years later.
A CLINICAL PERSPECTIVE IN THE DIAGNOSIS OF CONGENITAL HEART DISEASE
Authors: Joos Howard A.
Published: December 2021

The pediatric clinician enjoys a responsible position in the evaluation and management of cardiac problems in early life.

The diagnosis of congenital heart disease is facilitated by an understanding of the functional meaning of cyanosis, the physical work of the heart and its chambers, and the significance of the pulmonary vascular bed. Medical history and physical findings may be interpreted to suggest the presence or absense of a shunt, its predominant direction and gross magnitude, and its effect on volume flow and pressure in the pulmonary circulation. Similarly, many obstructive lesions and anomalous vascular arrangements may be identified, localized and their severity grossly evaluated from historic and physical observations.

A malformation is significant to the extent that circulatory function is disturbed. The resulting stresses are manifest as clinical abnormality. Clinical evaluation incorporating appreciation of abnormal function leads logically to differential identification of anatomic alternatives.

Innocent murmurs, commonly a cause of needless parental anxiety and iatrogenic cardiac disability, may be confidently identified in large majority by their own physical characteristics.

Electrocardiographic and roentgenographic study are essential for complete evaluation. Complex and severe cases may require the skill of a consultant and the assistance of definitive investigative procedures, particularly if the differential diagnosis includes an operable malformation. Indications for cardiac catheterization and angiographic study may vary, but indiscriminate use at any age is discouraged. Even when such methods are necessary, searching clinical appraisal is required in order to define the most profitable direction and optimum time for study. For simpler problems, such procedures may be unnecessary and even misleading as well as significantly hazardous and expensive.

Diagnosis is often most difficult and most critical in early infancy, partly because of characteristics of circulatory function peculiar to this period, partly because of the larger number of bizarre, complex and lethal malformations encountered.
The Normal Child: Some Problems of the First Five Years and Their Treatment
Authors: HARPER PAUL A.
Published: December 2021

The first edition of this readable and valuable volume, published in 1953, described the problems, other than diseases, which arise in the normal child in his first 3 years; this revision extends the age period to 5 years. It has the same chapter headings except that the sections on accidents and play have now been given chapter status and a new chapter has been added on the sick child and the child in hospital.

Section 1, Feeding Problems, devotes about two-thirds of its 80 pages to breast feeding and is well done; the treatment of artificial feeding and related problems is outlined much more briefly.
Letters to the Editor
Authors: FINBERG LAURENCE
Published: December 2021

The Principle issue of the discussion in the editorial to which Dr. Holt refers centered upon factors which tend to produce hypernatremia during the course of diarrheal disease. It has been our repeated experience that attempts to feed milk mixtures to infants who have diarrhea has been a contributory factor to the development of hypernatremia. Apparently we all agree that high-solute feedings, such as skim milk or unmodified whole milk, are unadvisable in such circumstances.
A Nasal Aspirator for Home Use
Authors: CHASTAIN PHILIP J.
Published: December 2021

A nasal aspirator is now available based upon the Venturi principle of water pressure suction. By means of simple adaptors this apparatus may be easily attached to kitchen water faucets in more than than 90% of homes. It has a long plastic hose and plastic, bulb-type nasal tip designed to fit securely in the ostia of the nose. The nasal tip has a safety vent on time side so that pressure can be controlled easily by the finger.[See figure in source pdf.]

This aspirator is inexpensive.
PATENT DUCTUS ARTERIOSUS
Authors: Rudolph Abraham M. , Mayer Florence E. , Nadas Alexander S. , Gross Robert E.
Published: December 2021

Twenty-three infants less than 1 year of age with symptoms due to patent ductus arteriosus have been studied clinically and by cardiac catheterization. In view of the absence of a characteristic clinical picture in this age group, it is suggested that the diagnosis be considered in any infant with clinical evidence of a large left-to-right shunt.

Cardiac catheterization has proved to be a useful and reliable method for establishing the diagnosis and providing detailed hemodynamic observations.

The problem of arterial oxygen unsaturation, present in over one-half the patients, is discussed in its relation to pulmonary disease and right-to-left shunting of blood.

A large atrial left-to-right shunt may occur through a dilated foramen ovale in infants with patent ductus arteriosus. The significance of this is considered.

Pulmonary arterial hypertension of mild to severe degree was present in the majority of patients but pulmonary vascular resistance was elevated in only five infants.

The absence of a continuous murmur in infants with patent ductus arteriosus is discussed in relation to time pressure gradient between the aorta and pulmonary artery.

Surgical treatment of infants with severe symptoms due to patent ductus arteriosus has produced gratifying results.
POLYNEURITIS IN CHILDREN
Authors: Low Niels L. , Schneider Julia , Carter Sidney
Published: December 2021

Polyneuritis in children is becoming more common. The clinical picture is variable; it may be manifested by motor and sensory findings, or by a combination of peripheral and cranial nerve signs and symptoms. The etiology is usually obscure. The pathologic picture varies with the severity of the disease and differs according to the stage at which the patient dies, but all fatal cases show the same main characteristic changes. Clinical records of 30 cases, 17 boys and 13 girls from 17 months to 16 years of age, are reviewed. The clinical manifestations, course and treatment are described.
THERAPY OF SALICYLATE POISONING
Authors: WINTERS ROBERT W.
Published: December 2021

SALICYLATE intoxication presents as complex a metabolic disturbance as the pediatrician is likely to be called upon to treat. This disorder is frequently accompanied by a) one of several disturbances of acid-base equilibrium, b) depletion of body potassium, c) fever, d) disturbed mental state and coma, e) bleeding due to hypoprothrombinemia, thrombocytopenia or to other causes, and f) variable degrees of dehydration. In very severe cases, acute pulmonary edema, respiratory depression or acute renal failure may occur.

The nature of the acid-base disturbances is considered in this issue of Pediatrics. The typical disturbance in children is a mixed state involving primary respiratory stimulation, manifested by hyperventilation, and a primary metabolic disturbance, manifested by ketosis. The sequential nature of these two disturbances has been stressed in the past but without adequate documentation. However, it is clear that many patients do present with both disturbances occurring simultaneously.
Infant-Mother Relations in Ancient Greece
Authors: VOLLMER HEBMANN
Published: December 2021

The Fifth Century in Greece, specifically the Pericleic Period in Athens, is regarded as the Golden Age in the history of Western culture. Pericles, a magnanimous statesman with a passion for beauty and sublimity, inspired ingenious forces in others and attracted great men to Athens. Architecture, drama, philosophy, science and medicine flourished and the spirit of Athens profoundly influenced the world.

One would like to know how children fared in so great an epoch: their importance within the society; the principles of education; or the concept of an ideal mother-child relationship which we regard as so basic for human development.
LUNG VOLUMES OF NORMAL AND ASTHMATIC CHILDREN
Authors: Andrewes John F. , Simmons Daniel H.
Published: December 2021

Measurements of the various lung volumes were carried out with 27 normal children, 21 asthmatic children and 4 with allergic rhinitis. The asthmatic children had increases in functional residual capacity and residual volume.

There was a significant increase in the time required for intrapulmonary mixing of gas in the asthmatic subjects.

A biphasic character to the "wash-out" curves in both normal and asthmatic subjects was shown.

It was considered, though not proved, that the increases in lung volume were due to the presence of bronchial obstruction.
CONTROL OF PERSISTENT VOMITING IN INFANTS AND CHILDREN
Authors: Gibson John P.
Published: December 2021

An infant or a child with persistent vomiting is thirsty, crying, and the vomiting excites him. Intramuscular administration of secobarbital sodium quiets the patient, including the vomiting center; it also quiets his family. One injection usually is enough. For a few hours after the sedative has been given, the upset alimentary tract is granted complete rest. Neither nourishment nor medication is introduced at either end of it. At the close of the few hours, most patients can retain small quantities of swallowed fluid. Thus, oral rehydration begins. The method is safe, simple, effective and usually can be applied at home.

In a review of a series of 110 cases of persistent vomiting in infants and children, results were considered satisfactory if, after one intramuscular injection of secobarbital sodium, the patient vomited no more than three times and ceased to vomit on the day of the injection. In 99 cases (90%) these conditions were met; actually, after the sedative had been given, only 1 patient vomited as many as three times; 5 vomited only twice; 23, only once, and 70 not at all.
IDIOPATHIC HYPERCALCEMIA OF INFANCY
Authors: O'BRIEN DONOUGH
Published: December 2021

SINCE the first descriptions in 1952, idiopathic hypercalcemia of infancy has come to be a well-recognized and not uncommon entity in Europe, especially in the United Kingdom—a contrast to the sparse and more recent observations from North America.

The clinical features of the disease first appear between the second and eighth months of age and are commonly described as developing into mild and severe forms. In the benign type, where full recovery can usually be expected after a few weeks of treatment, the early signs are not specific: an insidious onset of vomiting, loss of appetite, constipation and irritability. The infant becomes listless and hypotonic and plainly fails to thrive; the appearances indeed are indistinguishable from those of hyperchloremic renal acidosis which is an occasionally associated complication. Bands of increased density are sometimes seen in roentgenograms at the metaphyseal margins of the long bones and metacarpals.
CAROTID ARTERY OCCLUSION IN CHILDHOOD
Authors: Stevens Harold
Published: December 2021

The inclusive term "infantile hemiplegia" usually implies cerebral venous thrombosis. However, arterial occlusion may cause hemiplegia in childhood and infancy. The internal carotid artery may be the site of the occlusion. Three such eases are reported, two of which were "spontaneous"; one carotid artery thrombosis was associated with endocardial fibroelastosis.

The clinical manifestations and course were identical with those of carotid artery occlusion in adults. Diagnosis can be suspected from the history of "stuttering" pattern of recurrent, stereotyped, focal neurologic involvement, appearing hours to months before the hemiplegia appears. Other diagnostic points are enumerated.

The cause of spontaneous nontraumatic carotid artery occlusion in childhood remains a mystery. Only few instances have been reported. Disseminated vascular degeneration may involve the carotid artery in some instances, or an isolated atheromatous plaque may be responsible. Investigation for underlying disease, including hematologic, metabolic or infectious disease, and for congenital malformations should be pursued.

With the segregation of occlusion of the carotid artery from venous thrombosis in "infantile hemiplegia" the possibility of specific therapy is discussed.
A FINGER-TIP, MICRO HETEROPHILE AGGLUTINATION TECHNIC
Authors: Heemstra John G. , Stanage Willis F.
Published: December 2021

A finger-tip micro heterophile agglutination technic is described. Figures showing the comparison between the finger-tip technic and the regular heterophile technic are given. The finger-tip micro heterophile titer compares favorably with the regular technic and is suitable for use with pediatric patients and other individuals from whom it is difficult to obtain venous blood.
Leukämie im Kindesalter. Bettrage zur Morphologie, Klinik Pathophysiologie und Therapie
Authors: SMITH CARL H.
Published: December 2021

Based on an experience of 191 cases of leukemia in the past 13 years, the authors have prepared a well-organized book dealing with the essential features of leukemia in childhood. As would be expected the bulk of cases are the acute leukemias which they term acute leukocytic, undifferentiated or paraleukoblastosis; a small number are acute promyelocytic, chronic myelocytic and rare types. In common with the experience from other clinics the incidence of leukemia rose from 0.159% in 1946 to 0.546% in 1956.

The authors have written a readable and timely text dealing concisely with the following subjects: pathologic anatomy and hematology, clinical aspects, individual organ changes, leukemia and infection, differential diagnosis, the newer knowledge relating to etiology and therapy, metabolic aspects, prognosis and psychologic aspects in management. In each chapter current information has been assembled, this being especially noticeable in discussion of etiology and therapy.
A Physician Looks at Psychiatry
Authors: BAKWIN HARRY
Published: December 2021

From time to time the physician finds it necessary to consult a colleague about his own health or that of his family. When the author's twin sons were in their second year of life it became evident that they were not developing in normal fashion. They were greatly retarded in speech and social orientation yet much of their behavior showed evidence of superior intelligence. At the time, 1947, early infantile autism had only recently been described by Kanner and was not widely recognized.

When Dr. May and his wife consulted psychiatrists, hopefully anticipating kindly understanding and wise insight, they were met, instead, by aloofness and distrust. They were the culprits who had produced the psychologic aberrations in their children; they were irresponsible persons who, through deceit, rejection and an insincere emotional veneer, had injured them.
Advances in Pediatrics, Vol. X
Authors: MAY CHARLES D.
Published: December 2021

The editor of this series, Dr. S. Z. Levine, is to be congratulated on his perceptive selection of topics which are in need of review at this time, and for his wise choice of authors to take on these assignments. Such a group of reviews as are contained in this volume are essential for anyone who strives to maintain a broad grasp of the subject matter of pediatrics. The same well-balanced assortment of material which has characterized this series of reviews is maintained in the present volume. It is fortunate that there is so little duplication in the subjects treated in the several books now available each year containing reviews of topics in pediatrics.
CLINICAL CONFERENCE
Authors: Sedlis Emilia , Prose Philip
Published: December 2021

Dr. Sedlis: A brief review of the clinical features of a group of patients with eczema will be followed by a report of special studies of the pathology of the skin. Eczema is a frequent, important skin disease in early life. It has been a puzzling problem for the physician and an exasperating one for parents and patients alike.

We began our study of eczema about 1 year ago. During this year, we have accumulated and organized the study material, and we have tried to learn about the clinical picture of eczema and to evaluate certain concepts of its etiology, pathogenesis and therapy.

Our study is far from complete, and I will therefore try to avoid drawing definite conclusions from the data presented.

Our material to date consists of a clinic population of 169 patients, 91 males and 78 females, who made a total of 646 clinic visits. Fifty-four of these patients required hospitalization in the University Hospital. Thirty of the hospitalized patients were males, 24 were females. I do not know whether the prevalence of boys in our census is significant.

The distribution of the patients by race is:

Puerto Ricans, 102;

Negro, 40;

White, 25;

Others, 2.

The distribution by age shows that the majority of patients were under 1 year of age on their first visit to the clinic:

91 patients were 1 year or less;

36 patients were between 1 and 2 years, making a total of 127 patients under 2 years;

42 patients were over 2 years, the oldest child being 6½ years.
The Year Book of Pediatrics
Authors: MAY CHARLES D.
Published: December 2021

This is a handy and well-selected collection of abstracts from the world's literature on pediatrics during the years 1957 and 1958. The abundance of editorial comments and the comments of others solicited by the editor make this collection of abstracts a special delight to those who would like to know what other people think about some of the papers they may have read. This publication is now too well established to require extensive review of each new volume in the series.
Certain Language Skills in Children: Their Development and Interrelationships
Authors: DARLEY FREDERIC L.
Published: December 2021

Every specialist in child behavior—every practitioner of the pediatric approach—will find in this detailed descriptive report the most comprehensive body of normative language data pertaining to children yet published. It is a valuable contribution to all whose work requires a grasp of the complexities of physical, intellectual, and social growth of children, including growth in language production and comprehension.

Dr. Templin and her co-workers studied 480 children—white, urban, monolingual singletons of normal intelligence presenting no gross evidence of hearing impairment. Sixty children 30 boys and 30 girls), constituting a representative group socio-economically, were selected from the public schools, kindergartens, and nursery schools of Minneapolis and St. Paul at each of eight age levels 3, 3½, 4, 4½, 5, 6, 7, and 8 years).
Rehabilitation of the Cardiovascular Patient
Authors: LURIE PAUL R.
Published: December 2021

Since his World War II experience, Dr. Rusk has achieved fame as the promoter of rehabilitation in general, but with emphasis upon severe neural and orthopedic handicaps. Dr. White has achieved his share of the lay spotlight by his role in the cardiovascular ailments of a president. These men have joined with their associates to produce this small book at a time of high popular interest in the subject. The book brings into sharp focus the differences in the functions and accomplishments of the two authorities and others sharing their interests in the present era. The sections showing Dr. Rusk's hand are those regarding cerebral vascular disease. There is little of direct benefit to pediatricians as it pertains almost entirely to the older adult with strokes. In this chapter one is able to see the actual check lists used in initial evaluation and progress recording during the rehabilitation of patients at the New York University Rehabilitation Center.
Small Patients: The Autobiography of a Children's Doctor
Authors: MAY CHARLES D.
Published: December 2021

The title of this autobiography, referring as it does to the author's patients, places the emphasis appropriately, for Dr. Goldbloom's candid account of his life shows him to have been unburdened by conceit. This is the more remarkable because he is a facile, versatile and talented person. The unique potentialities of an autobiography are magnificently realized by a forthright, remarkably objective revelation of the dreams and purposes which determined his career.

A balanced consideration of the forces which mold human behavior makes one hesitate to ascribe a preponderant role to either hereditary or environmental influences. If one happens to place great reliance on the popular version of an ideal parent-infant relationship, he may be discomfited to find that in spite of inauspicious beginnings Alton Goldbloom managed to succeed pretty well by material standards and seems to have enjoyed a large measure of happiness.
THE IXTH INTERNATIONAL CONGRESS OF PAEDIATRICS—SUCCESSFUL AND SIGNIFICANT
Authors: MAY CHARLES D.
Published: December 2021

THE Canadians deserve unstinted praise for careful organization and superb conduct of an inspiring survey of the present status and future trends in scientific and social pediatrics. The mechanical aspects of arranging an International Congress were so expertly handled that nothing interfered with the enjoyment of a truly professional program and the invaluable fraternization between pediatricians from many countries. Appreciation of the achievement of the various persons and committees who made the success of the IXth International Congress of Paediatrics so outstanding was abundantly expressed from all sides during the sessions and can only be echoed publicly here.

All concerned with planning the Congress referred to Dr. J. Harry Ebbs of the Hospital for Sick Children in Toronto as the guiding force in development of the superior, well-balanced scientific program.
THE USE OF EXTRACORPOREAL HEMODIALYSIS IN THE TREATMENT OF SALICYLATE INTOXICATION IN A 2-YEAR-OLD CHILD
Authors: Spritz Norton , Fahey Thomas J. , Thompson David D. , Rubin Albert L.
Published: December 2021

The procedure employed in the dialysis of a 13 kg boy with salicylate intoxication is described. Clinical and chemical data are presented which demonstrate the effectiveness and safety of this procedure.

The arguments in favor of dialysis rather than exchange transfusion in the treatment of salicylate intoxication are discussed and the indications for the use of hemodialysis are enumerated.
A FIELD FOR CULTIVATION BY THOSE INTERESTED IN THE "NEW PEDIATRICS"
Authors: Talbot Nathan B.
Published: December 2021

THE acute, severe illnesses that used to occupy the pediatrician now are often prevented by the use of proper food, antibiotics and other prophylactic measures. As a by-product of this and other advances in the science of diagnosis and therapy, many children with enduring types of congenital and acquired physical and metabolic difficulties, who used to die early, are now surviving for many years. In dealing with patients who are faced with this type of problem one finds that some, like Helen Keller, are able to live successfully within the narrow bounds remaining to them, while others by comparison appear unable to deal effectively even with relatively minor impediments. This has great significance to us, as the physicians responsible for the care of patients, because we are able to govern their activities only to a limited extent.

Most of the time the patient must be the person chiefly responsible for his self-care.
CLINICAL CONFERENCE
Authors: Riker William , Bigler John A.
Published: December 2021

Dr. William Riker: We have had a number of interesting experiences with tumors in childhood since the tumor board was started at the Children's Memorial Hospital. One of the things that has impressed us has been the unpredictability of tumors in childhood.

One of the most difficult and most unpleasant tasks we have to face as pediatricians and surgeons is to have to give a prognosis to the parents of a child who has a malignant tumor. It is very difficult to do, and it is debatable as to whether it is worse to give an excellent prognosis in the case of a favorable tumor and have the child expire from the malignancy, or to give a hopeless outlook to the parents of a child who has a usually fatal disease, only to have the child survive.

I would like to present several case histories of children in which the prognostication was very difficult.

Neuroblastoma. K.S. was a 5-weeks-old female infant when admitted to Children's Memorial Hospital May 12, 1955. Immediately prior to admission it was noticed that the abdomen was getting large and she began to regurgitate.

She was critically ill and poorly nourished. The abdomen was markedly distended with prominent veins over the upper abdomen. The liver was smooth and firm and generally enlarged; the right and left lobes extended to the brim of the pelvis. The spleen was not palpable. There was respiratory embarrassment due to the marked abdominal distention pushing up the diaphragm (Fig. 1, A).
Undesirability of Definitive Surgical Repair of Cleft Lip in Infancy
Authors: FOMON SAMUEL , BELL JULIUS W. , LUBART JOSEPH , SCHATTNER ALFRED , SYRACUSE VICTOR R.
Published: December 2021

Pediatricians and surgeons generally recommend repair of cleft lip as soon as the infant's condition permits. In his recently published textbook of pediatric surgery, Swenson states: "Early repair is now universally advocated, with some difference as to actual age selected for operation. Repair 10-14 days after birth when feeding schedule has been established and a search for obscure anomalies has been completed is preferred." MacCollum et al. suggest that the lip be repaired "when the baby is 2.7 kg (6 lb) in weight or over, exhibits a steady gain in weight, is in good health and is 4 to 6 weeks of age." Thoroughgood and Fischer have recommended repair of unilateral cleft lip at the age of 12 hours.
Letters to the Editor
Authors: MACCOLLUM DONALD W.
Published: December 2021

Dr. Fomon's letter in regard to postponing repair of the cleft lip until at least 1 year of age brings up a controversial subject that has been frequently weighed by all surgeons who repair these deformities. It is a well recognized fact that a certain amount of molding of the structural foundations of the face always occurs when the soft tissues which have been approximated maintain a steady pressure on separated alveolar ridges. In most instances this is beneficial rather than harmful and results in bringing the alveolar processes into proper alignment. In the patient with a very wide cleft, the tension caused by the closure of the soft tissue and musculature of the lip may be so great that the alveolar processes eventually overlap.
Orthodontics
Authors: BATES GEORGE
Published: December 2021

The excellent article on Orthodontics by Dr. Cohen (Pediatrics, 23:956, 1959) prompts me to respond to his request for communication. It has seemed to me that the expense of orthodontic care has placed it in the class of a luxury that many families can hardly afford. I wonder if methods of treatment can he developed which are simpler or adaptable to the average family budget.
COARCTATION OF THE AORTA IN INFANTS
Authors: Glass Irving H. , Mustard William T. , Keith John D.
Published: December 2021

A review of 108 cases of coarctation of the aorta diagnosed under 1 year of age, and admitted to The Hospital for Sick Children, Toronto, over a 12-year period, is presented. Preductal coarctation accounted for 90% of the fatalities under 1 year. Patency of the ductus arteriosus occurned in 98% of cases in the first 6 months of life.

Forty-nine per cent of cases of coarctation of the aorta under 1 year of age have major cardiac anomalies other than patent ductus: ventricular septal defect, 33%; transposition of great vessels, 10%; and atrial septal defect, 6%. Problems in diagnosis occurred when blood pressure readings were equivocal. Operative mortality for coarctation of the aorta in the first year of life was 41%, while after 1 month of age it was only 29%. Mortality in patients not operated on during the first year of life was 50%, while for those less than 1 month of age with symptoms and signs of decompensation and not operated on, the mortality was 87%.

In dealing with coarctation of the aorta in the first year of life the following are recommended: 1) When blood pressure readings in the arms and legs are equivocal, the readings should be repeated frequently until the diagnosis is clarified; 2) aortogram should be performed on patients difficult to diagnose; 3) babies presenting with symptoms in the first month of life should be operated on promptly unless they show a dramatic response in a 12-hour trial of treatment with digitalis; 4) babies after 1 month of age who respond to digitalis may be kept on this medication until adequate adjustment in circulatory hemodynamics has taken place and surgery can be performed at the optimum age.
MANAGEMENT OF OFFICE PRACTICE—A PHILOSOPHY
Authors: Thompson Hugh C. , Seagle Joseph B.
Published: December 2021

The Young pediatrician starting in practice has a dream of an office steadily full of happy satisfied mothers and their children, whom he guides from birth to maturity and whose illnesses he treats. He also has, or dreams of, a wife with whom he spends his leisure hours and children of his own, whom he guides, teaches and enjoys. In addition, he dreams of a personal life of reading, study, research, church activities, civic clubs and duties, golf, fishing and so on. Whether he has the time and money for these three facets of his life depends basically on how he manages his office, for it is here that the pediatrician spends most of his working hours and earns most of his income.
EXTREME HYPERIMMUNOGLOBULINEMIA E AND UNDUE SUSCEPTIBILITY TO INFECTION
Authors: Buckley Rebecca H. , Wray Betty B. , Belmaker Elaine Z.
Published: December 2021

The clinical and immunologic features of two adolescent boys who had recurrent pyogenic infections are judged to constitute a new syndrome. Its characteristics include: recurrent cutaneous, pulmonary, and joint abscesses; growth retardation; coarse facies; chronic dermatitis; exquisite immediate hypersensitivity associated with exceptionally high serum concentrations of IgE and eosinophilia; and depressed in vivo cellular immunity and antibody formation. These patients lacked evidence of respiratory allergy or parasitism. Atopic dermatitis was not present in one boy and the physical characteristics of the other boy's dermatitis were not typical for that entity. Concentrations of immumnoglobulins G, A, M, D and the various IgG subtypes were normal, as were natural antibody titers to red cell antigens. Nevertheless, depressed anamnestic antibody responses were noted to diphtheria and tetanus antigens and neither patient demonstrated responses to primary immunization with KLH, typhoid, and DNCB antigens. Complement and polymorphonuclear functions were normal.

In vitro lymphocyte studies done demonstrated normal DNA synthesis in phytohemagglutinin and staphylococcal antigen-stimulated cultures and MIF production by some antigen-stimulated cultures from each. The explanation for the undue susceptibility to infection, increased IgE production, subnormal antibody formation, and impaired in vivo cell-mediated immunity in these patients remains conjectural.
Buffered L-Arginine as Treatment for Cystic Fibrosis: State of the Evidence
Authors: Graham George G.
Published: December 2021

Solomons, et al. (Pediatrics, 47:384) describe some provocative results with buffered L-arginine in the treatment of cystic fibrosis. In their first paragraph they ascribe, without reference, some fascinating pharmacologic actions to this amino acid. Perhaps they are the result of the most unusual structure, with a supercharged nitrogen, of the arginine they used, so different from the one to which we are accustomed.

In the pulmonary function studies one is disturbed by the fact that both the patients and the individuals administering the aerosol, and presumably promoting the deep breaths, were well aware of the fact that they were using the agent with expected therapeutic effects.
Belsky's→(?Henoch's?)→Filatov's→Koplik's Spots
Authors: Lipman Richard P.
Published: December 2021

The answer to the question, "Did Henoch describe Koplik's spots before Koplik?"1 is an emphatic "no." There are at least three distinct enanthems of measles: the punctate and stellate red palatine patches described by Henoch; Koplik's minute blue-white buccal and labial lesions with surrounding erythema; and the blue-gray or white Herrman spots on the tonsils. Only Koplik spots are pathognomonic.

Although the various enanthems are reviewed in Weinstein's excellent clinical text for general practitioners,2 it is a pity that some of our standard pediatric textbooks devote too little attention to clinical description.
Edema of the Pulmonary Interstitium in Infants and Children
Authors: Moylan Fergus M. B. , O'Connell Kathleen C. , Todres I. David , Shannon Daniel C.
Published: December 2021

Ten infants and children with respiratory failure, receiving standard maintenance water requirements, were treated on 13 occasions with intravenously given furosemide (1 to 2 mg/kg) because of continued impairment of oxygenation despite conventional therapy. Pulmonary auscultation and radiographs were normal or typical of the primary diagnosis. After a five-fold increase in urine output the mean Po2 rose from 61 mm Hg at a mean FiO2 of 0.7 to 140 mm Hg at an FiO2, of 0.65. The Pco2 decreased from 46 to 38 mm Hg. Interstitial pulmonary edema in these patients can be related to both their lung disease and impaired water tolerance during ventilatory therapy.
Comment on Outpatient Intravenous Therapy
Authors: David Simeon
Published: December 2021

There has been a recent trend to treating more and more pediatric patients with chronic diseases on an ambulatory basis. This is true of both hemophilia1,2 and cystic fibrosis. In a recent report Drs. Rucker and Harrison3 presented data on 62 patients who received a total of 127 outpatient intravenous antibiotic courses for bronchopulmonary infections. Despite their success in keeping slightly more than two thirds of their patients out of the hospital, I think that they might be more successful in the future if the following points are considered.
Lettrt To The Editor
Authors: Gold Arnold P.
Published: December 2021

Dr. Schwartz's comments are appreciated. It is certainly true that the diphenylhydantoin dosage of 10 mg/kg appears to be excessive with the usual therapeutic dose being 5 to 8 mg/kg of body weight. However, this dosage was not infrequently necessary to obtain seizure control and the blood level in this most difficult group of children with psychomotor seizures often did not exceed the desired therapeutic range of 10 to 20µg/100 ml. It is recommended that initially the lower dosage be used and if seizure control is not attained that the higher dosage be evaluated.
Lettrt To The Editor
Authors: Glueck Charles J.
Published: December 2021

We have carefully reviewed the informative letter from Dr. Garry concerning the measurement of vitamin A and a non-vitamin A component, phytofluene. As indicated by Dr. Garry, our average vitamin A levels agreed with those published by Kahan1 and by Hansen and Warwick.2 As noted by Garry et al.3 and by Thompson et al.,4 unless corrected for by chromatography or calculated formula, phytofluene in plasma variable affects the "total" levels read as vitamin A (the sum of vitamin A and the non-vitamin A, phytofluene).
Saldino-Noonan Short RibPolydactyly Dwarfism Syndrome
Authors: Lowry R. B. , Wignall N.
Published: December 2021

There have been an increasing number of reports on lethal forms of dwarfism. Spranger and others have delineated two forms of short rib—polydactyly (SRP) dwarfism, known as the Majewski and the Saldino-Noonan types. Despite the fact that we know very little about basic biochemical mechanisms in the majority of the chondrodystrophic conditions, descriptive morphology is still important as it frequently leads to recognition of further cases and ultimately to information on the etiology. We wish to draw attention to this entity by reporting a further case.

CASH REPORT

This male infant was the second child of healthy, wirelated, normal parents whose ages were 35 (father) and 32.
Drs. Pierson and Bierman Reply
Authors: Pierson William E. , Bierman C. Warren
Published: December 2021

The letters of Drs. Sloan and Goldstein deserve the following comments to clarify various points raised by their correspondence.

In regard to Dr. Sloan's specific comments:

(1) A child or adolescent who fails to respond to three injections of epinephrine (15 ml) is defined as being in status asthmaticus and is admitted to the hospital (intensive care unit). The outpatient use of intravenous fluids and medications is risky due to obvious lack of proper monitoring of intensive clinical evaluation and arterial blood gases.