bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiographic Findings in Early Onset Neonatal Group B Streptococcal Septicemia
Authors: Leonidas John C. , Hall Robert T. , Beatty Eugene C. , Fellows Richard A.
Published: December 2021

Chest roentgenograms obtained in the first two days of life from 67 infants with respiratory distress were reviewed to determine whether the radiographic features of group B streptococcal septicemia were diagnostic or distinctive. The retrospective review contained 24 infants with proven and 14 with suspected septicemia, as well as 29 patients with other causes of respiratory distress. The films were reviewed ill random order by two pediatric radiologists without their prior knowledge of clinical or laboratory data. Typical radiographic appearance of pneumonia was present in only ten of the 24 proven and two of the 14 suspected cases of group B streptococcal sepsis. The radiographic pattern of respiratory distress syndrome (RDS) was just as common among these patients. The most prominent associated radiographic feature of infants with proven septicemia was cardiomegaly which was significantly increased when compared with infants who had other causes of respiratory distress (P < .001). X-ray recognition of neonatal group B streptococcal septicemia is limited because of superimposition of roentgen patterns probably related to associated disorders.
Hypoventilation During Sleep in Children Who Have Lymphoid Airway Obstruction Treated by Nasopharyngeal Tube and T and A
Authors: Kravath Richard E. , Pollak Charles P. , Borowiecki Bernard
Published: December 2021

Three children with sleep apnea, alveolar hypoventilation, apparent mental retardation, and poor growth associated with chronically enlarged tonsils and adenoids were treated with the use of a nasopharyngeal tube followed by tonsillectomy and adenoidectomy. The effectiveness of this therapy was documented by polygraphic recording of sleep stages and respirations, and by correlation with serial arterial blood gases and pH.

The nasopharyngeal tube was well tolerated, easy to use, and effective in diagnosis and treatment. We suggest that its use be further evaluated in patients with obstructive apnea.
Noninvasive Evaluation of the Pediatric Airway: A Recent Advance
Authors: Slovis Thomas L.
Published: December 2021

Visualization of the pediatric airway is now possible by new noninvasive radiologic methodology-the magnification high kilovoltage (Mag-high KV) technique. Clinical examples of airway diseases are presented to show the ease and utility by which precise diagnoses can be made. The dynamic aspect of airway evaluation is discussed. The Mag-high KV technique is also valuable for the number of invasive procedures it prevents.
SCIENTIFIC RACE
Authors: Price D. J. deS.
Published: December 2021

. . . Papers which make the same citations have an increased likelihood of doing the same work. Thus, increasing the efficiency of the rate at which one can make priority claims automatically seems to produce a higher incidence of such claims or at least of the raw material for them. There is a feedback working to minimize part of the advantage gained by rapid publication.

I therefore arrive at the conclusion that a scientific race to get there first is tremendously wasteful, and that anything that lessens the reward for such achievement is good. Thus it is perhaps a good thing to deprive the authors of their chance to get their names on the paper. It might be made sufficient honor and reward that they are allowed to play with the team.
Children With Cystic Fibrosis: I. Psychological Test Findings of Patients, Siblings, and Parents
Authors: Gayton William F. , Friedman Stanford B. , Tavormina Joseph F. , Tucker Ford
Published: December 2021

Psychological evaluation of 43 families, each with a child with cystic fibrosis, is reported. Personality testing of the parents showed that 32% of the fathers and 22% of the mothers obtained scores in the range suggestive of emotional disturbance. The Family-Concept Q Sort assessment of family interaction indicated that the primary effect of having a child with cystic fibrosis was in terms of decreased family satisfaction and family adjustment. The results do not support previous estimates of an increased incidence of emotional disturbance in children with cystic fibrosis. Evidence for negative psychological impact of chronic illness on sibling development was also lacking. Future research would benefit from a focus on the strengths and resilience of children with cystic fibrosis and their families.
Kerion Caused by Trichophyton verrucosum
Authors: Stocker William W. , Richtsmeier Anthony J. , Rozycki Alan A. , Baughman Richard D.
Published: December 2021

A 12-year-old girl developed a severe inflammatory fungal infection of the scalp caused by Trichophyton verrucosm. The infection resulted in scarring alopecia. The natural history, differential diagnosis, pathogenesis, and treatment of this infection of the skin are reviewed.
Drs. Tiwary and Rosenbloom Reply
Authors: Tiwary Chandra M. , Rosenbloom Arlan L.
Published: December 2021

We thank Dr. O'Tuama and his colleagues for interest in our article on behavioral effects of TRH. Their failure to obtain a beneficial effect is not surprising.

We had initially noticed that the behavioral effect was not seen until several hours after the TRH injection and that it continued throughout the day.1 Therefore, we initiated objective behavioral observations about 2½ hours after the injection and continued them for five hours and repeated them the next day.
Language Development in 2-Year-Old Normal and Risk Infants
Authors: Zarin-Ackerman Judith , Lewis Michael , Driscoll John M.
Published: December 2021

A variety of language measures was obtained on two groups of 2-year-old infants matched for social class but differing in terms of birth conditions. One group, a high risk group, contained infants who suffered from RDS, birth asphyxia, hypercalcemia, and hyperglycemia while another group consisted of normal infants. The results of the language tests revealed that the high risk group showed poorer performance than the normal subjects. Other tests of perceptual-cognitive development revealed little difference between the groups. The data suggest that the assessment of early trauma needs to employ a variety of measures, especially those which are related to the unfolding skills appropriate for the particular age group studied.
SOME SAYINGS OF BRITISH NANNIES
Authors: C. T. E.
Published: December 2021

Perhaps the most remarkable and envied of all British institutions is the British nanny. Jonathan Gathome-Hardy in his delightful book on the history of the nanny lists many nanny sayings and practices. Among these are the following:

"Never go upstairs empty handed, never go downstairs empty handed."

"If you want your hair to curl you must eat fried bread behind the door."

"Save your breath to cool your porridge." (That is, don't talk so much.)

"Patience and perseverance brought the snail to Jerusalem."

"There are three sorts of sin: little sins, bigger ones, AND TAKING OFF YOUR SHOES WITHOUT UNDOING THE LACES."

"Better to wear out than to rust out."

"Everyone's got to eat a peck of dirt before they die." (child fussing over some sand, say, in the salad)

"Always pick blackberries above dog-lifting-leg height."
Antenatal Diagnosis of Diaphragmatic Hernia
Authors: Bell Martin J. , Ternberg Jessie L.
Published: December 2021

Hernia of the diaphragm with displacement of portions of the gastrointestinal tract may be diagnosed before birth using fetography. Swallowed amniotic fluid containing positive contrast material will allow visualization of the herniated bowel when roentgenograms are taken 6 to 24 hours after contrast injection. Prompt operative treatment after delivery of an infant with this disorder may minimize the development of hypoxemia and acidosis commonly noted in these infants. In addition, appropriate parental counseling may be started.

CASE REPORT

A 3,000-g white girl was delivered to a 36-year-old, gravida 10, para 1, abortus 8, class C diabetic mother who had essential hypertension.
I Agree With Kempe
Authors: Siegel Lawrence K.
Published: December 2021

I read with interest the letter by Dr. Arthur L. Klein (Pediatrics 57:577, April 1976) regarding Dr. Kempe's commentary (Pediatrics 56:693, November 1975) and his reply (Pediatrics 57:578, April 1976).

In our county, Waukesha, Wisconsin, there is an active public health department performing many of the tasks mentioned by Dr. Kempe. This group has been useful to me as a practicing pediatrician in helping to pinpoint families with disturbed mother-child relationships, in developmental screening, and in seeing that patients with special or chronic problems understand and follow complicated directions.
Do You Know What a "Martha" Is?
Authors: Glasser E. J.
Published: December 2021

The following brief statement about "Martha" and inguinal adenopathy in grammar school students is made to assist colleagues in mastering the vernacular of this group and also to acquaint them with this etiology of inguinal adenopathy.

I recently saw a young man with marked inguinal adenopathy and superficial erythema over his lower abdomen. The specific cause was not apparent and tuberculosis was ruled out. His complete blood cell count was essentially normal. There is no good history for local infection or cat scratch fever.
A Strong Opinion!
Authors: Montgomery John E.
Published: December 2021

I have read with great interest the conflict occurring for and against pediatric nurse associates (PNAs). Dr. Klein's letter (Pediatrics 57:577, April 1976) stated that well-baby examinations are a present economic necessity for the practicing pediatrician.

I am a 33-year-old practicing pediatrician and would agree totally with the Academy's and Dr. Kempe's views on PNAs. The pediatrician of today is wasting approximately 80% of his time in doing well-baby exams and annual physicals. We are overtrained for what we are now being forced to do by the Academy, society, and our pocketbooks.
Drs. Armstrong and Rein Reply
Authors: Armstrong John H. , Rein Michael F.
Published: December 2021

We agree with Dr. Cochran that precipitation of silver nitrate by the chloride ion in a saline rinse solution may occur, as first commented on by Barson.1 On page 891 of our article, we remark that rapid removal of the silver nitrate solution by the rinse may also render the prophylaxis less effective. We are unaware, however, of a controlled study indicating that the saline rinse increases the risk of gonococcal ophthalmia. That neither precipitation nor rapid removal of silver nitrate accounts for all 43 cases of gonococcal ophthalmia is supported by two facts.
What Do You Call a Baron's Child?
Authors: Silverman Joseph A.
Published: December 2021

The article by Sneed and Bell, entitled "The Dauphin of Munchausen: Factitious Passage of Renal Stones in a Child" (Pediatrics 58:127, July 1976), makes interesting reading, but the title is an example of incorrect heraldic terminology.

Baron Karl Friedrich Hieronymus von Munchausen (1720 to 1797) was a German soldier, adventurer, and nobleman, noted for exaggerated tales of his exploits.1 The title "Dauphin" was given to the eldest son of the king of France during the period 1349 to 1840.1
Decreasing Medical Trauma
Authors: Berry Frederic A.
Published: December 2021

I would like to add several thoughts to the excellent article "Dealing With Unnecessary Medical Trauma to Children" by Drs. Sibinga and Carey (Pediatrics 57:800, May 1976). They stressed the elimination of unnecessary procedures or techniques that are potentially traumatic to the infant and child. There is another concern that more pediatricians, surgeons, and anesthesiologists should turn their attention to, i.e., minimizing the trauma of necessary painful procedures. The fact that the physician cares enough to attempt to minimize trauma has direct and indirect benefits for the patient, the parents, and the entire medical community.
Misleading Information in a Committee Report?
Authors: Harris Robert H.
Published: December 2021

"Carcinogens in Drinking Water," by Dr. Robert W. Miller of the American Academy of Pediatrics Committee on Environmental Hazards (Pediatrics 57:462, April 1976), is an important effort to alert pediatricians to the potential hazards of carcinogens in drinking water. Unfortunately, the review and discussion under the subhead "Chemical Carcinogens" contain several erroneous and/or misleading statements. These are as follows:

1. Although Miller is correct that drinking water from the Mississippi River contains "chlorinated or brominated hydrocarbons," numerous other classes of organic compounds of toxicological importance have been identified, including aliphatic and aromatic hydrocarbons, phthalate esters, and nitrosamines.
Drs. Klimek and Quintiliani Reply
Authors: Klimek Joseph J. , Quintiliani Richard
Published: December 2021

Although we appreciate the comments of Dr. Walker pertaining to the difficulty in establishing a causal relationship between the CNS abnormalities and Mycoplasma infection in our patient, it seems, in our view, to be a very reasonable conclusion. Unlike most other reports of this association that provide serologic evidence for recent Mycoplasma infection only from studies of the serum, our patient demonstrated antibodies indicative of this diagnosis both in the CSF and in the blood.
Real Gravel
Authors: Rambar Alwin C.
Published: December 2021

The article on factitious passage of renal stones in a child (Pediatrics 58:127, July 1976) reminded me of a quotation from the Priens' study on the composition and structure of urinary stone.1 They said as follows: "Some very bizarre situations have been encountered in these patients [malingerers]. Sir William Osler, himself, provided medical history with a practical joke when he, on his death bed, slipped into the garden to fetch gravel which he placed in his urine specimen.
Dr. Tomlinson Replies
Authors: Tomlinson William A.
Published: December 2021

I appreciate the care with which Ms. Kornacki and Dr. Fazen have analyzed this article, and I appreciate their constraint in mentioning only some of its shortcomings. Ironically, some of the methodological deficiencies they mention are the very ones I found frequently in the review articles I mentioned. This perhaps helps explain why so few such articles have appeared in pediatric journals. Regarding point 3 of their second paragraph, we really do not know that the suburban questionnaires were answered exclusively by the mothers to whom they were mailed.
Are We Being Realistic?
Authors: Osler David C.
Published: December 2021

As the director of a community health program which has traditionally employed nurse practitioners, I would like to comment on the policy of the American Academy of Pediatrics regarding pediatric nurse associates (Pediatrics 57:467, April 1976). As stated, the policy places the nurse "under the supervision and direction of the pediatrician."

The pediatrician and the nurse associate have each had specific training, and should work interdependently. In fact, while residencies have tended to emphasize such areas as the treatment of the sick child, most training programs for nurse associates have spent large amounts of time in health maintenance and preventive education.
Gastrin Concentration in the Neonate
Authors: Euler Arthur R. , Ament Marvin E.
Published: December 2021

We read with interest the article "Gastrin Concentration in Plasma of the Neonate at Birth and After the First Feeding" by von Berger et al. (Pediatrics 58:264, August 1976). Similar findings of gastrin concentration in mothers and newborns were documented by our group also.1,2 The authors' comments concerning the source of the gastrin in the umbilical cord serum have stimulated the following thoughts and questions.

1. The documentation of no transport of gastrin labeled with iodine 125 across the rat placenta, although of interest, does not indicate that this could not occur in the human.
Racial Difference in Mean Pulse Rate of Children Aged 6 to 11 Years
Authors: Shekelle Richard B. , Liu Shuguey , Raynor William J. , Miller Robert A.
Published: December 2021

Schachter and colleagues observed that black newborns have a higher mean heart rate than white newborns during non-rapid eye movement sleep, and this observation reportedly has been repeated at other laboratories.1,2 In Schachter's experience, the racial difference has persisted through the sixth month of life.3 Since heart rate is correlated cross-sectionally with level of blood pressure in adults4 and adolescents,5 and since increased heart rate in young adults is associated prospectively with risk of hypertensive disease,6-8 a racial difference in heart rate of newborns might be related to the racial difference in risk of hypertension. For these reasons, we investigated differences in mean pulse rate between black and white children, using data collected by the National Health Examination Survey (NHES).
Who Pays for Advertising in Pediatrics?
Authors: Reader Guilty
Published: December 2021

I pay a relatively low rate to subscribe to Pediatrics because advertisers contribute a large portion of the cost of publishing this ad-filled journal. Although the same can be said of the subscription rates of my newspaper and other magazines, there is a sly difference. It is no secret that the cost of advertising in nonmedical publications is passed on to me in the form of higher prices when I purchase the advertised goods. But, I never buy anything advertised in Pediatrics; the drugs hawked in these pages are meant to be purchased by the parents of my patients.
Physician Involvement in Safety Programs Is Not Enough
Authors: Walsh Matthew J.
Published: December 2021

Automobile safety has become a serious concern to every pediatrician. Of all deaths of children aged 1 to 14 years, 20% are related to auto accidents.1 Several authors have stated that physician involvement in counseling of parents is an integral step in the use of safety seats by parents.2,3 Yet, physician involvement alone is not enough. I have demonstrated this during the past two years in my practice at White Sands Missile Range, New Mexico, where I am the sole pediatrician.
In Reply: You Have to Use Endoscopy
Authors: Kosloske Ann M.
Published: December 2021

Plastic foreign bodies in the trachea may be tricky, as Drs. Stool and Bluestone point out. We would not hesitate to use bronchoscopy on their patient either, since the history, physical examination, and roentgenograms all were equivo cal. Bronchoscopy was diagnostic as well as therapeutic. Postural drainage treatment is not appropriate without a diagnosis of foreign body aspiration.

Stool and Bluestone correctly point out the hazard of migration of the foreign body, with the potential complication of glottic obstruction or spasm.

See image in the PDF file
Dr. Gross's Findings Supported
Authors: Millichap J. Gordon
Published: December 2021

In his article "Growth of Hyperkinetic Children Taking Methylphenidate, Dextroamphetamine, or Imipramine/Desipramine" (Pediatrics 58:423, September 1976). Dr. Gross concludes that there is no stunting of growth from the longterm use of CNS stimulant medications in the treatment of hyperkinetic or minimal brain dysfunction syndromes. Since this report contradicts the results of retrospective studies by Safer et al.,1,2 it seems important to draw attention to additional evidence obtained in my patients that supports the findings of Dr. Gross.
In Reply: Comparative Study: Ampicillin and Cephalexin in Otitis Media
Authors: Stechenberg Barbara W. , Anderson Donald , Chang Margan , Dunkle Lisa , Wong Michael , Van Reken David , Pickering Larry K. , Feigin Ralph D.
Published: December 2021

The dose of cephalexin recommended by the manufacturer when we initiated our comparative study of ampicillin and cephalexin in otitis media in 1973 was 25 to 50 mg/kg/day.1 Moreover, the study was initiated at a time when cephalexin was not an approved drug for the treatment of otitis media. It has only been in recent package inserts that otitis media has been listed as an indication for the use of cephalexin and that the dosage for otitis media has been changed.
HOSPITAL COSTS AS THEY WERE 40 YEARS AGO
Authors: C. T. E.
Published: December 2021

In this era of skyrocketing hospital costs and dwindling purchasing power of the dollar, the total cost of a ten-day maternity stay in 1934 may be read with disbelief as will the long puerperal hospital stay. The time-honored custom of keeping women in bed nine days or more following delivery was generally observed until the mid-1940s.

A hospital in Los Angeles charges $115 to $180 for a confinement case in a private room, $80 to $90 in a semiprivate room. The price includes all [italics mine] hospital services during a ten-days' stay: nursing, use of the delivery-room, anaesthetic, bandages, medicines, laboratory, and the feeding, nursing and clothing of the infant.
Ataxia and Hearing Loss Secondary to Perilymphatic Fistula
Authors: Healy Gerald B. , Friedman Jules M. , DiTroia Joseph
Published: December 2021

Ataxia is rarely attributed to lesions of the peripheral vestibular system. In 1973, the first case of ataxia and hearing loss secondary to a labyrinthine fistula was reported. Until now, this syndrome has not been reported in patients under the age of 10 years. A case is presented of a 5-year-old boy with symptoms of ataxia and hearing loss as well as vertigo and tinnitus after head trauma.

Three physical findings appear to be most characterisitic of patients with perilymphatic fistulas: a positive fistula response, positive positional testing with the involved ear down, and evidence of vestibular ataxia when testing station and gait.

The absolute diagnosis of perilymphatic fistula can only be established by exploration of the middle ear space. If a fistula is found, it may be sealed with soft tissue and, if this fails, actual stapedectomy may be required.
HLA Antigens in Kawasaki Disease
Authors: Kato Shunichi , Kimura Mikio , Tsuji Kimiyoshi , Kusakawa Sanji , Asai Toshio , Juji Takeo , Kawasaki Tomisaku
Published: December 2021

Two hundred five patients with Kawasaki disease and 500 normal controls were HLA-typed, using a standard microcytotoxicity test of tissue typing. HLA-BW22 was more common in patients with Kawasaki disease than in normal controls (25.4% instead of 11.8%, corrected P < .0005). Among subtypes of HLA-BW22 antigen, Kawasaki disease was associated with HLA-BW22J2, which was found specifically in Japanese and not in Caucasians. These facts may suggest that there is a gene controlling the susceptibility to Kawasaki disease and linked with a Japanese-specific HLA antigen.
Unmasking the Benefits of CDP
Authors: Hunt Carl E.
Published: December 2021

The conclusions reached by Belenky et al. (Pediatrics 58:800, December 1976) in their controlled study of continuous positive airway pressure (CPAP) and positive end-expiratory pressure (PEEP) compared to conventional respiratory management are both surprising and disconcerting. In the commentary by Wung et al. that appeared in the same issue (p. 783) the physiological benefits of continuous distending pressure (CDP) are well summarized and the conclusion is reached that, for reasons which were not clear, the controlled study failed to confirm the superiority of CDP over conventional respiratory management in respiratory distress syndrome (RDS).
The Season and Diabetes
Authors: Fleegler Francene , Rogers Kenneth D. , Drash Allan , Travis Luther B. , Rosenbloom Arlan L.
Published: December 2021

MacMillan and co-workers reported the ages and month of detection of all new insulin-dependent diabetic patients (N = 120) admitted to Children's Hospital, Louisville, Kentucky, from 1960 through 1975 (Pediatrics 59:113, January 1977). They reported possible differences in month of onset for children 6 years old or older and those under 6 years. A similar observation was made by Bloom et al. in the British diabetes register study for children under age 5 years.1

We recorded age and month of diagnosis of new cases of juvenile-onset diabetes in Pittsburgh (N = 673), Gainesville, Florida (N = 127), and Texas (N = 741).
When to Obtain Roentgenograms in Suspected Child Abuse
Authors: Mindlin Rowland L. , Palmer William M.
Published: December 2021

The Committee on Infant and Preschool Child and its Subcommittee on Child Abuse have received a number of requests for recommendations on the roentgenograms that should be taken routinely on a child suspected of being physically abused. We have consulted, among others, Frederic N. Silverman, M.D., a pediatric radiologist and a co-author with C. Henry Kempe, M.D., of the landmark article1 in which the term "battered child syndrome" was coined. We would like to bring Dr. Silverman's clear and reasoned response to the attention of all pediatricians, indeed to all physicians encountering children who may have been abused.
Statistics Misused?
Authors: Woodruff Calvin W.
Published: December 2021

In the July 1977 issue (Pediatrics 60:124, 1977) an excellent plea for appropriate use of statistics in descriptive studies is accompanied by a glaring example of their misuse (Pediatrics 60:60, 1977). Analysis of the serum gastrin levels reported assumes a normal distribution of values, which is obviously not the case on inspection of either the raw data or the reported SEM, which is larger than the mean (22.5 ± 23.9 after an eight-hour fast). Using the data in Figure 2 and repeating the calculations, it becomes obvious that the values reported as SEM are, in fact, SDs.
THE EARLIEST RECORDED AUTOPSY IN AMERICA PERFORMED IN 1662 ON THE 8-YEAR-OLD ELIZABETH KELLEY
Authors: C. T. E.
Published: December 2021

The parents of Elizabeth Kelley of Hartford, Connecticut, attributed her death to witchcraft practiced on her by Goody Ayres, one of their neighbors.

Elizabeth was suddenly taken with a violent attack of coughing and choking during the evening of March 24, 1662. In her delirium she cried out: "Father, father help me, help me Goodwife [Goody] Ayres is upon me, she chokes me, she kneels on my belly, she will break my bowels, she pinches me, she will make me black and blue." Elizabeth died the next day. Following the superstition of those times, both her parents and the townspeople thought that her death was due to some preternatural cause, such as bewitchment. The General Court of Connecticut accordingly ordered a postmortem examination on Elizabeth to determine the cause of her death.

Mr. Bryan Rossiter, the prosector, described his findings in the following protocol1:

All these 6 particulars underwritten I judge preternatural: Upon the opening of John Kelley's child at the grave I observed,

1. The whole body, the musculous parts, nerves and joints were all pliable, without any stiffness or contraction, the gullet only excepted. Experience of dead bodies renders such symptoms unusual.

2. From the costal ribs to the bottom of the belly in the whole latitude of the womb, both the scarf skin and the whole skin with the enveloping or covering flesh had a deep blue tincture, when the inward part thereof was fresh, and the bowels under it in true order, without any discoverable peccancy to cause such an effect or symptom.
Antecedents of Child Abuse and Neglect in Premature Infants: A Prospective Study in a Newborn Intensive Care Unit
Authors: Hunter Rosemary S. , Kilstrom Nancy , Kraybill Ernest N. , Loda Frank
Published: December 2021

Families of premature and ill newborns admitted to a regional newborn intensive care unit were studied prospectively to assess the incidence of reported child abuse and neglect. Of the 255 infants discharged to their parents, ten were subseqtiently reported as victims of maltreatment during the first year of life. The high incidence of maltreatment (3.9%) in these Prelnatttre and ill newborns supports the findings of retrospective studies that there is an increased risk of maltreatment in these special infants. Thirteen family psychosocial characteristics, assessed by admission interview, showed significant association with later maltreatment. These family characteristics included social isolation, a family history of child abuse and neglect, serious marital problems, inadequate child care arrangements, apathetic and dependent personality styles, and inadequate child spacing. Maltreated infants were less mature at birth and had more congenital defects than their nursery mates. There was also less family-infant contact during the prolonged nursery hospitalization in families in which maltreatment eventually occurred.
COMING UP WITH A BETTER IDEOGRAPH
Authors:   Student
Published: December 2021

All it took was a piece of string, a few pieces of plastic, the British equivalent of an Erector set and a cardboard tube that has been used to package linoleum. With these odds and ends, two linguists at Cambridge University in England have come up with a wondrous invention: a device that enables a computer to "understand" and "write" Chinese characters.

The feat, accomplished by Richard Sloss and Peter Nancarrow, is remarkable because written Chinese employs an unwieldy 4,500 characters. . . .

"I don't think we could have done it if we'd had a lot of money," Mr. Nancarrow said. Without money to buy fancy equipment, he said, "you have to solve the problem with your brain."
Feline Rhinotracheitis-Calici-Panleukopenia Vaccine
Authors: Turner Edward J.
Published: December 2021

Recently, a vaccine called FVR C-P has come into popular use as a means of protecting cats against certain viral infections. This vaccine is prepared and distributed by Pitman-Moore. The interesting thing about the use of this vaccine, which perturbs me, is that it seems to be transmitted to humans. I saw two children in my office, one of whom had generalized swelling of the face that was followed, a week later, by a herpetic type of dermatitis on the nape of the neck.
Prevalence of Hepatitis B in a High-Risk Setting: A Serologic Study of Patients and Staff in a Pediatric Oncology Unit
Authors: Tabor Edward , Gerety Robert J. , Mott Martin , Wilbur Jordan
Published: December 2021

The prevalence of serologic markers for hepatitis B virus (HBV) among 188 patients and 158 employees in a pediatric oncology unit was evaluated. Evidence of past or present HBV infection was detected in 33 patients (18%) and in 25 employees (16%). The prevalence was higher among patients receiving chemotherapy (19%) than among those not receiving chemotherapy (7%). The prevalence of HBV serologic markers, while much higher than generally found among healthy children in the United States, was low compared to previously reported prevalences in such settings, and may reflect the use in recent years of blood and blood products screened by "third generation" methods (radioimmunoassay and reversed passive hemagglutination) for hepatitis B surface antigen and the use of all volunteer blood donors. This prevalence suggests that perhaps there is less urgent need for the use of hepatitis B immune globulin and hepatitis B vaccine (when it becomes available) in oncology units than had been anticipated from earlier data in oncology units.
Acute Pericarditis Associated With Hepatitis B Infection
Authors: Adler Robert , Takahashi Masato , Wright Harry T.
Published: December 2021

Patients infected with hepatitis B have demonstrated a wide spectrum of clinical manifestations other than hepatitis. Immune complex formation has been proposed as a possible mechanism for such varied disease presentations.

The present report describes a case in which acute pericarditis is associated with hepatitis B surface antigen-positive disease. Speculations are made relating the pericardial changes to the formation of immune complexes following hepatitis B virus infection.
Growth of Children With Down's Syndrome: Birth to Age 3 Years
Authors: Cronk C. E.
Published: December 2021

The article "Growth of Children With Down's Syndrome: Birth to Age 3 Years," by Cronk (Pediatrics 61:564, April 1978), was supported in part by Maternal and Child Health Study Project 928 and by grant HD 5341-03 from the National Institute of Child Health and Human Development.
SUPERSTITIONS OF A LYING-IN ROOM A CENTURY AGO
Authors: C. T. E.
Published: December 2021

Most of the following list of English superstitions about pregnancy and birth were brought to this country and were commonly believed by American parents of a century ago.

1. If a pregnant woman suffer from acid dyspepsia [heartburn] the child will be born with a good crop of hair. 2. If the gravid uterus project much in front, it is a boy; if "all round," a girl. Another version is that, if a woman carry a boy on one side, and on the next pregnancy on the opposite side, it will be a girl. 3. A child born with a caul will be lucky and will not be drowned. 4. It is unlucky to have kittens in the house with young children, because they are supposed to suck the breath of the children and so kill them. Does the milk about the infant's mouth occasionally attract the kitten? 5. In tying the cord of a newly born infant, the length of cord left attached to the umbilicus must be considered with reference to sex: if a boy, it must not be too short, or his penis will be in proportion. 6. When the cord is detached from the umbilicus, it must not be allowed to fall to the ground, or the infant will be a "pee-a-bed." 7. It is unlucky to weigh new-born child; they will probably die, or will not thrive. 8. It is customary to burn the placenta, and the process gives indication of a woman's fertility. The nurse counts the number of "snaps" or "crackles," which equal the number of children the woman will bear.
Child advocacy in the nuclear age
Authors: Berger Lawrence R.
Published: December 2021

In 1943, amidst the nation's mobilization for the Second World War, there appeared an article by Dr. William Schmidt of the Children's Bureau on the susceptibility of young people to the hazards of radioactive materials.1 Reviewing the literature, and invoking generally accepted pediatric principles, Dr. Schmidt concluded that young people possess special vulnerability to the hazards of radiation, and that this warranted their exclusion from employment in the gas mantle and radium dial industries.

Now, more than 30 years later, there again exists an urgent need to review the topic of radiation and children. With the spread of nuclear weapons technology to many countries, the spectre of nuclear test fallout (not to mention nuclear warfare!) is once again upon us.
Practicality of Screening Urinalyses in Asymptomatic Children in a Primary Care Setting
Authors: Gutgesell Margaret
Published: December 2021

The value of screening for proteinuria in the pediatric age group is a subject of current debate. Previous studies have1,2 reported proteinuria prevalence rates of 5.4% to 14.8% when random urine samples were tested. Since the test for proteinuria is simple and inexpensive, Bailey et al.3 recommended that indicator strip testing for proteinuria be done by the primary physician in preschool, preadolescent, and adolescent children. The Committee on Standards of Child Health Care4 suggests at least dipstick urinalyses as part of a regular health maintenance program. Haggerty5 recommends using only the dipstick tests for protein and glucose since these tests are simple and adequate. However, Bailey et al.3 and North6 do not recommend glucose screening since there is a low probability of finding new cases of diabetes mellitus. Dodge et al.7 are reluctant to recommend widespread screening in schoolchildren for proteinuria and hematuria because the significance of these two conditions is unknown in asymptomatic children. For those found to have proteinuria and/or hematuria, West8 proposes a systematic evaluation including determination of certain serum chemical values, radiographic studies, and even renal biopsy. To study the practicality of such a screening test in a primary care setting, we have reviewed 2,309 random dipstick urinalyses collected over a 26-month period.

METHODS

Indicator strip testing (Labstix) was performed on random urine samples of all eligible patients on their first visit for whatever reason to the pediatric clinic of West End Health Center, Houston.

The center is one of a network of seven neighborhood clinics of the Harris County Hospital District and serves a low to moderate socioeconomic group.
Committee on Radiology Water-Soluble Contrast Material
Authors:   Committee on Radiology
Published: December 2021

Contrast agents available in North America for excretory urography are combinations of sodium and/or meglumine salts of diatrizoate and iothalamate in 50% to 60% solutions (Conray-60, Hypaque Meglumine 60%, Reno-M-60, Renografin-60, and Hypaque Sodium 50%). There is no substantive reason for choosing between these various iodinated contrast agents: packaging, pricing, and quality control are the determinants for their selection.

Because of their high osmolarity, the intravenous injection of Renografin-60 (1,400 mOsm/ liter) and Hypaque Sodium 50% (1,170 mOsm/ liter) may result in profound changes in the hemostatic mechanisms of small infants. Blood samples of infants obtained at regular intervals after an injection of 5 ml/kg of Renografin-60 disclosed changes in serum osmolarity, serum sodium levels, and hematocrit values. The mean increase in serum osmolarity three minutes after injection was 15 mOsm/liter, or a 5.3% increase. Hematocrit values decreased by a mean of 7.4%, and the serum sodium concentrations fell by a mean of 4.6 mEq/liter. These values gradually returned to normal in one to four hours.1

Acute expansion of blood volume after the intravenous administration of contrast agents might precipitate heart failure in infants with tenuously compensated congenital heart disease, and the ensuing diuresis may intensify a mild state of dehydration. The magnitude of increase in the intravascular volume may be diminished by slow injections of the contrast material (90 seconds or more) and by injecting a smaller volume (3 ml/kg). Repeat injections should not be administered at less than 30-minute intervals.

Occasionally after intravenous contrast materials are injected, Tamm-Horsfall protein will precipitate in the renal tubules, and renal failure may result.
Meconium Aspiration and Tolazoline
Authors: Duc Gabriel
Published: December 2021

In days gone by, therapists had a limited number of medications (principally, harmless decoctions) to choose from. Under these circumstances, untested proclamations concerning treatment with these medications were of little practical consequence to patients. In the modern era of powerful pharmacologic agents, the situation is different. Unevaluated proposals for therapy (such as antibacterial prophylaxis using sulfisoxazole or chloramphenicol, or oxygen for newborn infants) have had tragic results. Therefore, it is disturbing to find an example of untested advice in a highly respected and widely circulated textbook of pediatrics.
IS DR. PATRICK BLAIR'S DESCRIPTION OF PYLORIC STENOSIS IN 1717 THE EARLIEST ON RECORD?
Authors: C. T. E.
Published: December 2021

The first description of pyloric stenosis in infants has been attributed successively to earlier and earlier writers. Hezekiah Beardsley of Connecticut described such a case in 1788.1 George Armstrong recorded the case of an infant similarly affected in 1777.2 However, the credit for drawing attention to the earliest description on record belongs to the late Ernest Caulfield of Connecticut, who pointed out that in 1717 Patrick Blair (1665-1728) reported to the Royal Society a clinical history and autopsy report of a 5-month-old boy who had pyloric stenosis. Blair's description follows:

The Child was five months old and was so emaciated that he appear'd rather to have decreased than to have encreased [sic] in Bulk from the time of his Birth, the whole Body not weighing above five Pounds. The Skin and Muscles of the Abdomen were very thin, but the Peritoneum was preternaturally thick. The Ventriculus was more like to an Intestine than to a Stomach, its length being five inches and its breadth but one inch. The Coats of it were thick and fleshy, and the cavity very inconsiderable. The Pylorus and almost half the Duodenum were cartilaginous and something inclined to an ossification, so that no nourishment could have passed into the Intestines tho' the Stomach had been capable of Containing it, which makes it no wonder that the Body was so emaciated....

Upon enquiring after the Symptoms this Child had been affected with, his Mother told me he seem'd to be healthy till he was about a Month old, when he was seized with a violent Vomiting and a Stoppage of Urine and Stool. Some time after both these became more regular, but the Vomiting still continued. He seem'd to have a great Appetite, taking what Suck, Drink, or other Food was offer'd him with a kind of eagerness but he immediately threw it all up again.... There could be nothing more emaciated than this Child was.
INFANTICIDE
Authors: Harris Martin
Published: December 2021

According to a demographic survey of over 600 primitive populations carried out by William T. Divale of the American Museum of Natural History, there is an extraordinary consistent imbalance of boys over girls in the junior and infant age ranks (up to about 15 years old). [Divale says] that many primitive groups follow a practice of overt female infanticide. Female children are suffocated or simply left unattended in the bush. But more often infanticide is covert, and people usually deny that they practice it....

Warfare inverts the relative value of the contribution made by males and females to a group's prospects for survival. By placing a premium upon maximizing the number of combat-ready adult males, warfare obliges primitive societies to limit their nurturance of females. It is this, and not combat per se, that makes warfare an effective means of controlling population growth....

Lacking any safe and effective means of contraception or abortion, primitive peoples must focus their institutionalized means of population control on individuals who are already alive. Children are the logical victims of these efforts—the younger the better—since number one, they can't resist; number two, there is less of a social and material investment in them; and number three, the emotional ties to infants are easier to cut than those between adults.

Anyone who finds my reasoning depraved or "uncivilized" should read about eighteenth-century England. Gin-soaked mothers by the tens of thousands regularly dropped their babies into the Thames or wrapped them in the clothing of smallpox victims, left them in trash barrels, rolled over on top of them during drunken stupors, and otherwise contrived to shorten their babies' lives by direct or indirect means.
Learning-Disabled Boys as Adolescents: Cognitive Factors and Achievement
Authors: Ackerman Peggy T. , Dykman Roscoe A. , Peters John E.
Published: December 2021

Ninety-three boys, classified in grade school as either learning-disabled (LD) or normal achievers (controls), were followed-up at age 14. The 62 LD returnees remained, as a group, seriously retarded on the Gray Oral Reading Test and on the spelling and arithmetic subtests of the Wide Range Achievement Test (WRAT), but were just over a year behind (age norms) on the WRAT reading test. Controls averaged 10th-grade level on both reading tests and at grade level on the WRAT spelling and arithmetic tests. LD returnees wrote significantly slower than controls, their own names as well as a word and short sentence. Students who had poorest outcomes at follow-up were those who had the most severe early reading problems and who had depressed scores on the Information, Arithmetic, Digit Span, and Coding subtests of the WISC. This cluster continued to separate LD students and controls at age 14. Achievement-level outcomes were not related to earlier classification by activity level and neurological maturity on to intervention efforts.
FAMILY MORE IMPORTANT THAN HOUSING IN CHILDREN'S COGNITIVE DEVELOPMENT
Authors: H. R. J.
Published: December 2021

In Warsaw, Poland, a city destroyed at the end of World War II, housing and schools were rebuilt and assigned without regard to social class. In 1974, 96% of the children born eleven years earlier, were tested for cognitive ability and correlations made between parental occupation and education and with the school and distance of the home from the city. Results showed that parental occupation and education were much more strongly correlated with cognitive development than type of school or district in which the family lived. The authors conclude that equalization of living conditions and schooling over a generation have "failed to override forces that determine the social class distribution of mental performance among children."
Pyloroduodenal Atresia (Diaphragm Type): An Autosomal Recessive Disease
Authors: Mishalany Henry C. , Idriss Ziad H. , Der Kaloustian Vazken M.
Published: December 2021

In 1970,1 1971,2 and 19743 we described two families, each with two siblings who had atresia of the first portion of the duodenum. The four patients were first cousins to each other. We suggested a genetic etiology with an autosomal recessive mode of inheritance, which has been accepted.4 The source of the proposed gene for both families was traced to a single individual.

Recently, a third family, linked to the previous two with strong consanguineous ties, had a pair of twins affected with the same anomaly. The purpose of this article is to bring the weight of new evidence afforded by this third family to further substantiate the genetic etiology of this condition.
Letter To The Editor
Authors: Mcmillan Julia A. , Oski Frank A.
Published: December 2021

We wish to thank Dr. Brock for his comments. He is correct that the calcium and phosphate contents of the simulated human milk were not identical to that of human milk but were as similar as is commercially possible. Of perhaps greater importance, however, is the fact that the calcium/phosphate ratio of 1.75:1.00 is also similar to that of human milk—2.4:1.0. Monson and Cook1 have recently reported that the addition of phosphate alone to a test meal did not interfere with the absorption of non-heme iron.
Letter To The Editor
Authors: McMillan Julia A. , Oski Frank A.
Published: December 2021

We appreciate the opportunity to respond to Dr. Homan's concern about possible contradictory statements by the Committee on Nutrition and those made in the conclusion of our study.

It is important to focus on the statement made by the Committee on Nutrition that reads, "The needs of breast-fed infants for supplemental iron require more investigation." This statement was then followed by a recommendation that was unsupported by facts. The recommendation should be viewed in that context.
Hypercholesterolemia and Hyper-α-Lipoproteinemia in Schoolchildren
Authors: Glueck Charles J. , Kelly Kathe , Mellies Margot J. , Gartside Peter S. , Steiner Paula M.
Published: December 2021

Elevated levels of high-density lipoprotein cholesterol (C-HDL) can explain apparent hypercholesterolemia in some children, and high C-HDL levels may aggregate in families. In this study, 17 kindreds were identified by virtue of hypercholesterolemic proband children whose hypercholesterolemia was accounted for by elevated C-HDL levels. Family lipid and lipoprotein sampling revealed three-generation vertical appearance of elevated C-HDL level in two kindreds, and two-generation vertical appearance in eight additional kindreds. Since C-HDL level is inversely associated with coronary heart disease in adults, it is important to quantitate C-HDL and low-density lipoprotein cholesterol (C-LDL) in hypercholesterolemic children and to identify those with putatively reduced risk (elevated C-HDL level) or increased risk (elevated C-LDL level).
Interaction of Maternal and Neonatal Obesity
Authors: Udall John N. , Harrison Gail G. , Vaucher Yvonne , Walson Philip D. , Morrow Grant
Published: December 2021

There were two errors in the article "Interaction of Maternal and Neonatal Obesity" by Udall et al. (Pediatrics 62: 17, July 1978). On page 17, in the 17th line of the abstract, the word "pregnant" should be "prepregnant." In Table I on page 19, maternal height is given in inches, not centimeters.