bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Diethylnicotinamide on the Concentration of Serum Bilirubin of Newborn Infants
Authors: SERENI F. , PERLETTI L. , MARINI A.
Published: December 2021

An investigation was performed to ascertain the influence of diethylnicotinamide on serum bilirubin levels of newborn infants with non-hemolytic jaundice. Twelve pairs of twins were examined.

Ninety-six hours after starting drug administration treated twins had significantly lower serum bilirubin levels than controls.
Salivary Immunoglobulins: Absence of γA in Saliva Following Exchange Transfusions in Neonatal Period
Authors: SELNER JOHN C. , MERRILL DEBORAH A. , CLAMAN HENRY N.
Published: December 2021

The possible transport of serum γA into saliva was studied in the newborn period. Five infants with erythroblastosis fetalis and undetectable γA in serum or saliva had two-volume exchange transfusions. Serum γA rose to "adult" levels after transfusion, but no detectable γA appeared in serial samples of saliva, as measured by electroimmunodiffusion (EID). The data support the thesis that salivary γA is not transported from the serum and tends to confirm the findings of Haworth and Dilling who previously described the absence of salivary γA following exchange transfusions in newborn infants.
Letters to the Editor
Authors: EISENBERG LEON
Published: December 2021

I seem not to have made my meaning plain. The pediatrician does not deny responsibility for patients with kidney disease because the molecular mechanisms for renal sodium transport are still in dispute; neither should he disdain developmental disorders because theorists quarrel. In both instances, the good physician undertakes to seek a working synthesis of available evidence even as he and his colleagues search for new knowledge. It was this that I had intended to stress.
Breathholding Spells
Authors: CATZEL PINCUS
Published: December 2021

Drs. Lombroso and Lerman are to be congratulated for the light that they have shed on breathholding spells and for so clearly distinguishing the cyanotic and the pallid forms.

Tucked away amidst their learned discussion of the pathophysiology of breathholding attacks is a curious one sentence statement:

"Anemia has been discussed as contributing to breathholding spells (Holowach and Thurston) and in our experience anemic breathholders show a remarkable improvement after treatment of their anemias."
Basic Concepts of Inborn Errors and Defects of Steroid Biosynthesis
Authors: CRIGLER JOHN F.
Published: December 2021

This short, paper-back volume summarizes the Proceedings of the Third Symposium of the Society for the Study of Inborn Errors of Metabolism which was held in Birmingham, England, in October 1965. As the title implies, a major portion of the symposium was devoted to the presentation of current views on the group of inborn errors that lead to defects in steroid hormone biosynthesis. The four papers on that general subject are largely in the nature of reviews of the clinical manifestations (Prof. D. V. Hubble) and biochemical abnormalities of cortisol (R. W. H. Edwards), androgens (O. M. Galal and B. T. Rudd), and aldosterone biosynthesis (H. K. A. Visser) in patients with congenital adrenal hyperplasia.
The Essentials of Paediatric Surgery
Authors: CARPENTER REGINALD
Published: December 2021

This little book on pediatric surgery has, because of its popularity, come to a second edition within 5 years. Once again the authors have directed the book primarily to the senior medical student but have also, because of the interest shown by colleagues, added material not of immediate interest to a student. In a few places the chapter headings and positions have been altered and this has resulted in increased clarity and better continuity.

The book begins with a chapter on the causes of congenital malformation, and this has been expanded and rewritten to bring it up to date.
TURNER'S PHENOTYPE IN THE MALE
Authors: Ferrier Pierre E. , Ferrier Simone A.
Published: December 2021

The clinical and laboratory findings in four males with the Turner's phenotype are reported. Three of the four patients had some evidence of testicular deficiency. Biopsy in one instance revealed abnormal spermatogenesis, thickening of the tubular basement membrane, interstitial fibrosis, and absence of Leydig cells. The dermatoglyphic findings in three of the four patients were in keeping with those previously reported in females with Turner's syndrome. No chromosome abnormality could be demonstrated, and extensive cytological investigations in one patient failed to produce evidence of sex chromosome mosaicism. Review of the literature suggests that only in a few cases is the Turner's phenotype in the male connected with a sex chromosome aberration. The majority of cases occur sporadically and only exceptionally can a genetic transmission be suspected.
Metabolic Reference Standards for the Newborn, and the Fatness of Big Babies
Authors: ACKERMAN BRUCE D.
Published: December 2021

In the May 1967 issue of Pediatrics, Sinclair, Scopes, and Silverman discuss metabolic reference standards for neonates. The authors conclude that the most suitable standard is body weight minus extracellular fluid (ECF), since, over a wide range of birth weights, there is a nearly constant value for oxygen consumption (Vo2 per (body weight—ECF). The authors found fat-free weight, as well as several other standards, much less satisfactory, since over the birth weight range studied the value found for Vo2 per fat-free weight varied markedly with body weight.
Prophylactic Use of Isoniazid
Authors: YERUSHALMY J.
Published: December 2021

The Commentary of Doctors Davis and Wedgwood on TB, PPT and INH presents up-to-date descriptions of some of the newer concepts of tuberculosis. Most of their conclusions concerning the implications of these new ideas to tuberculosis control are interesting and valid. I must, however, take issue with their statement that isoniazid has been shown to be safe and their implied recommendation of its use as a prophylactic measure against tuberculosis. May I call your attention to two investigations which are strongly suggestive that the prolonged use of isoniazid may lead to increased mortality.
Reducing the Poison Toll
Authors: COLEMAN ALLAN B.
Published: December 2021

This communication is prompted by an article entitled "You Can Reduce the Poison Toll," published in Pediatrician's Management for February 1967. The author details some educational aids related to prevention of accidental poisoning available for use in physicians' offices, all of which are undoubtedly beneficial. But, he draws the incorrect conclusion that use of such educational efforts is likely to decrease the case load of accidentally poisoned children materially.

I regret that an apposite view must be advanced.
PEDIATRICS AT A CROSSROAD
Authors: SMITH RICHARD T.
Published: December 2021

THE THEME to be expressed here is that pediatrics in the medical school, the hospital and in practice today shows signs of great vigor as might be expected of a specialty entering an adolescent phase of differentiation. One hears all about a serious dialogue of change which inevitably precedes progress; this is indicative of vitality, not, as some would have it, dissatisfaction and unrest with a moribund anomaly in medicine. At the same time, close examination reveals a quality gap in many phases of our specialty. The new goals to which we aspire may become unattainable through educational and academic impotence unless we seek to repair existing deficiencies and follow roads of progress with a strong commitment to sustaining the highest quality.
SOME HORRIBLE WARNINGS OUR COLONIAL CHILDREN READ ABOUT IN BOOKS
Authors: C. T. E.
Published: December 2021

In Colonial America children read that they were born not to live but to die. This was largely due to the influence of the puritanical clergymen such as Cotton Mather, who dominated the intellectual activity of New England. Good examples of the horrible warnings children read about are the following:

If by Undutifulness to your Parents you incur the Curse of God, it won't be long before you go down into obscure Darkness, even, into Utter Darkness: God has Reserv'd for you the Blackness of Darkness for ever.

Though I am Young, yet I may Die

And hasten to Eternity:

There is a dreadful fiery Hell,

Where the wicked ones must always dwell.

The Lord Delights in them that speak

The Words of truth; but ev'ry liar

Must have his portion in the lake (of hell)

That burns with brimstone and with fire.
Psychogenic, Recurrent, Abdominal Pain
Authors: PARTINGTON M. W.
Published: December 2021

Congratulations to Dr. Morris Green on an excellent review (Pediatrics, 40:84, 1967) of a common disorder so badly dealt with in our textbooks. I would like to take issue on one point, namely the use of the term psychogenic.

It seems to me that we have no good evidence that this type of recurrent abdominal pain is psychogenic if by this we mean "of mental origin or causation" similar to, for example, an hysterical paralysis.
Letters to the Editor
Authors: GREEN MORRIS
Published: December 2021

Dr. Partington is entirely correct in emphasizing how little is known about the pathogenesis of pain for which there is no identifiable organic lesion. Our use of the adjective "psychogenic" derives from the reasoning of Engel in his important paper on the pain-prone patient and is intended to categorize the occurrence of pain in the absence of a recognizable peripheral lesion, such as duodenal ulcer. The use of a more specific adjective awaits more sophisticated studies of these children.
Abdominal Pain in Girls at Puberty
Authors: WESSEL MORRIS A.
Published: December 2021

Morris Green's article "Diagnosis and Treatment: Psychogenic, Recurrent, Abdominal Pain" in the July 1967 issue of Pediatrics calls attention to a presenting complaint well-known to pediatric practitioners. Girls in the early months of puberty often come to their physicians with a complaint of recurrent abdominal pain of a somewhat cyclical nature. Physical findings are variable, although there is often some tenderness in one of the lower abdominal quadrants.

The general heightened sensitivity to any bodily discomfort which accompanies the pubertal increase in hormone level causes pubescent girls to be quite aware of and frightned by this pain.
Letters to the Editor
Authors: NEFF JOHN M.
Published: December 2021

In reply to Dr. Thalheim's letter, I can only say that our denominator data is not sufficiently accurate for us to look at the incidence of the various dermal complications by even 4-month periods for those under the age of 1. This is obviously an important question, but its answer will have to wait until more specific immunization surveys can be developed. Despite this, however, it is difficult for me to see why it is necessary to vaccinate children under 1 year of age.
Error in Hematocrit Determinations Due To Too High Concentration of Anticoagulant
Authors: CULLUM CAROL , LEPOW MARTHA L.
Published: December 2021

Speciously low hematocrit levels were found in 1,500 children studied in Project Head Start because an inadequate volume of blood was placed in commercially prepared tubes containing 9 mg Na2 EDTA intended to anticoagulate 7 ml of blood. This error may be made by those drawing blood from small children and may be an often unsuspected source of inaccuracy in hematocrit determinations.
DANGERS TO INFANTS CAUSED BY CHANGES IN OSMOLAL CONCENTRATION
Authors: Finberg Laurence
Published: December 2021

THE presence of acidemia in conditions of ventilatory insufficiency, such as asphyxia neonatorum, circulatory insufficiency, and in prematurely born infants with respiratory distress, has been well documented. Rudolph and his associates have reasoned that when pulmonary blood flow is reduced, physiologic compensation for the acidemia is impaired and a vicious circle leading to uncontrolled metabolic acidemia and possible death may result. Attempts to interrupt this process have been presented by Usher for respiratory distress syndrome and by Rudolph and Danilowicz in congenital heart disease.

The approach of the use of infusions of alkali to correct the "metabolic component" of an acidemia that has an underlying basis in failure of ventilation has achieved widespread acceptance. The purpose of this paper is to call attention to an important possible risk of such therapy—hyperosmolality.

In particular, the recent interest in instant repair of neonatal acidemia and the now common practice in patients of all ages of rapid repair of acidemia by NaHCO3 infusions in the management of patients undergoing cardiac surgery and of those being resuscitated have rekindled interest in the limits of tolerance for the infusion of hyperosmolal solutions.

The current use of concentrated contrast materials for angiography, the intravenous use of 50% glucose solutions for neonates, and the increased use of concentrated mannitol and other hyperosmolal solutions for treatment of shock and cerebral edema constitute other clinical situations calling for a review of the underlying physiologic changes attending such therapy and emphasizing when and where serious danger exists in inducing changes in body fluid osmolality.
Experience in Project Head Start: A Method of Acquainting Pediatric House Staff with Primary Health Screening and Community Resources
Authors: CRUMRINE ROBERT S. , CHARNEY EVAN
Published: December 2021

Most communities call upon their pediatric practitioners to serve as school doctors and team physicians and to advise and participate in other community health programs. Yet, most house staff training programs provide little training or experience relating the pediatrician to his role in the community. Because Project Head Start provides health services to preschool children in a setting that demands careful integration of these services with an educational and social services program, and with other health and social resources of the community, it offers an excellent opportunity for a pediatric house officer to approach his role in the community with the same critical thought and supervision that he applies in approaching the care of a hospitalized child with an unusual syndrome.
Cancer Chemotherapy
Authors: HALL THOMAS E.
Published: December 2021

In the two decades since the effective chemical treatment of cancer began to emerge there have been few books published which review what can be accomplished by chemotherapy. Dr. Greenwald's book will be of particular value to the practitioner interested in cancer chemotherapy because the approach, though clinically oriented, is thorough and is based on sound pharmacologic principles.

The plan of the book is first to discuss the pharmacologic properties of the currently available chemotherapeutic agents, then modes of action of the several classes of drugs:
DOES THE CUTTING OF TEETH IN INFANCY CAUSE FEVER?
Authors: C. T. E.
Published: December 2021

Sir George Frederic Still (1868-1941) was England's foremost pediatrician during the first quarter of this century. His textbook, Common Disorders and Diseases of Children, is probably the most meticulously written pediatric textbook in the English language. In it Still writes about his personal observations resulting from years of intimate, clinical contact with thousands of infants and children. Contrary to what we are told today, Still wrote as follows about dentition as a cause of fever:

I have already expressed my opinion that the worry of dentition is sometimes the sole cause of fever in infants: I know only too well that this is dangerous doctrine, for it is likely to be abused; but nonetheless it is, I think, a fact as well proved by experience as most scientific observations in clinical medicine, that in some infants the temperature will rise to 102° or 103° when a tooth is nearing eruption and will fall to normal within a few hours after the tooth is cut, and this without any other ascertainable cause for the fever. Lancing the gums is out of fashion nowadays, and probably deservedly so, for no doubt far more mischief and pain was produced by indiscriminate gum-lancing than was caused by the dentition which it was supposed to assist, but although I have never personally had the courage of my conviction to proceed to gum-lancing, I strongly suspect that there are cases in which the fever could be stopped speedily by judicious lancing of the gum when the tooth is at the point of eruption, and unless most of the writers of half a century ago were extremely bad observers, their experience proves that this is so.
DISSEMINATED PATHERGIC GRANULOMATOSIS IN A 4-MONTH-OLD INFANT: A CASE REPORT
Authors: Collins Joseph O. , Rosenberg Harold A. , Warren Philip
Published: December 2021

A 4-month-old infant in whom sudden death terminated a clinical picture which included conjunctivitis but was dominated by high fever, leukocytosis, and clinical signs and x-ray evidence of pneumonitis is reported along with autopsy findings. The pathologic findings were dominated by a productive, exudative, and thrombotic occlusive vasculitis involving principally the coronary arteries and their branches with a lesser degree of vasculitis and granulomatous inflammation of lungs and spleen. The clinical picture may have given a clue to the underlying pathology. Fienberg's term, "pathergic granulomatosis," may be appropriately applied to cases of this type until more is known of the etiology.
NEGATIVE EFFECTS OF VITAMIN K PREPARATIONS ON GLUCURONYL TRANSFERASE ACTIVITY
Authors: Jones Barbara
Published: December 2021

In vitro studies using a mouse liver microsome system failed to demonstrate that menadiol sodium diphosphate, menadione sodium bisulfite, or phytonadione enhanced or inhibited the quantity of ortho-aminophenol glucuronide produced.

In vivo studies in young rats with these vitamin K analogues also failed to show an effect on glucuronide conjugation.

Based on this data, it is concluded that the hyperbilirubinemia seen in prematures after large doses of water-soluble vitamin K analogues is probably not due to an inhibitory effect of glucuronyl transferase. The evidence suggesting that it may be due in part to hemolysis is briefly reviewed.
PEDIATRIC SCREENING EXAMINATIONS IN PRIVATE PRACTICE
Authors: Austin Glenn , Foster William , Richards John C.
Published: December 2021

A pediatric assistant performs health screening examinations in a private pediatric practice without the presence of the doctor. Only patients between the ages of 6 to 12 years who have no apparent significant problems and who have had a complete physical and history by a pediatrician the year previously are accepted for the screening, which includes a system review, height, weight, visual and hearing testing, hemoglobin, urinalysis, and immunizations. The pediatric assistant, chosen for her ability to communicate with mothers, is of special value in listening to minor complaints. The chart is reviewed by the child's pediatrician and problems are discussed with the assistant. Physician follow-up is accomplished if deemed helpful. This is accepted by patients, allows continuity of personal comprehensive medical care in the pediatric office at a reduced cost, and allows the physician more time for patient care while increasing efficient use of paramedical personnel. Possible misuse of screening examinations, with resulting impersonal and fragmented medical care, is discussed.
DIAGNOSIS AND TREATMENT: CURRENT INDICATIONS AND RESULTS OF FETAL TRANSFUSIONS
Authors: Lucey Jerold F.
Published: December 2021

The best candidate for a fetal transfusion is from 28 to 32 weeks of estimated gestational age, has a high Zone II or low Zone III ΔO.D. 450 (rising or not decreasing on successive amniocenteses), and does not have hydrops fetalis. If carried out by an experienced team, this procedure has a low risk for the mother, about a 5% mortality for the fetus, and appears to decrease the perinatal mortality rate from erythroblastosis fetalis by about 50%.

The future usefulness of fetal transfusions, however, appears quite limited since the introduction of hyperimmune Rh gamma-globulin.13 They may one day be of only historic interest. But, they have demonstrated that fetal diagnosis and treatment are not beyond reason. This may well be a major contribution to pediatrics.
Historical-Ethical Note on Historical Note
Authors: Fried Ralph I.
Published: December 2021

The October 1967 issue of Pediatrics contains a note sent in by Dr. Thomas E. Cone, Jr., in which he quotes from an essay by William Ellery Channing on the "Duty of Children to Parents." I read this with pleasure and enjoyment.

On October 23, 1967, the Washington Post carried a story about a group of students in New England who burned their draft cards to protest the Selective Service Act and to demonstrate their rebellion against the authority of the Federal Government.
Synopsis of Pediatrics, ed. 2, by James G. Hughes, M.D. Saint Louis: The C. V. Mosby Company, 1967, 1099 pp., $10.85
Authors: Cone Thomas E.
Published: December 2021

The appearance of new editions of both these synopses of pediatrics must mean that they fill a need in the education of the medical student and practitioner. Perhaps, as textbooks become larger and more expensive and as time for leisurely reading for most of us becomes increasingly hard to find, books such as these which attempt to assemble in a tidy fashion the relevant facts the pediatrician needs to know will continue to be read by an ever-widening number of readers.
"PRECLINICAL" AND "CLINICAL" EVIDENCE
Authors: Silverman William A.
Published: December 2021

Most of the pages in Pediatrics are reserved for original descriptions of a wide variety of phenomena which interest those concerned with the health of children. Advanced technics of biologic investigation are used increasingly to study these natural events in minute detail and at various levels (often subcellular) of organization. As a result, readers are now presented with much basic ("preclinical") evidence which provides the foundation for improved understanding of many outstanding problems in clinical pediatrics. Since there has been some discussion about the apportionment of space in Pediatrics between "preclinical" and "clinical" reports, it is appropriate to comment on some aspects of this particularly artificial dichotomy.
Arterial-alveolar CO2 Tension Gradient in Hyaline Membrane Disease
Authors: Harrison V. C.
Published: December 2021

Chu, et al.1 recently indicated the presence of a significant a–A gradient for PCO2 in infants with hyaline membrane disease. In their study, alveolar CO2 tension was determined by means of a CO2 analyzer. The method makes use of the fact that end tidal gas forms a plateau on the expiratory CO2 curve and that this plateau can be assumed to be representative of alveolar CO2.

In hyaline membrane disease, however, it is not possible to obtain such plateaus and Strang2 has demonstrated that a series of spiked peaks only are produced during expiration.
ALVEOLAR-ARTERIAL O2 AND CO2 DIFFERENCES AND THEIR RELATION TO LUNG VOLUME IN THE NEWBORN
Authors: Thibeault D. W. , Poblete E. , Auld P. A. M.
Published: December 2021

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient.

In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants.
STUDIES OF POLYMORPHONUCLEAR LEUKOCYTES FROM PATIENTS WITH CHRONIC GRANULOMATOUS DISEASE OF CHILDHOOD: BACTERICIDAL CAPACITY FOR STREPTOCOCCI
Authors: Kaplan Edward L. , Laxdal Throstur , Quie Paul G.
Published: December 2021

Polymorphonuclear leukocytes (PMNs) from children with chronic granulomatous disease of childhood have been shown to readily phagocytize staphylococci and certain gram-negative bacteria, but they demonstrate an impaired intracellular bactericidal capacity for these organisms. The in vitro phagocytic and bactericidal capacities of PMNs from three patients with this disease for four species of streptococci (Streptococcus faecalis, Streptococcus viridans, microaerophlic streptococci, and Streptococcus pyogenes) were tested by the modified method of Maaloe.

The PMNs obtained from the patients phagocytized and killed the four species of streptococci in a normal manner while still showing the defect for Staph. aureus and S. marcescens. Morphologic examination of coverslip preparations of PMNs revealed minimal post-phagocytic degranulation and vacuole formation when either staphylococci and serratia or the streptococcal species were tested. This suggests that different intracellular mechanisms may be responsible for the streptococcal killing.

These observations are in accord with the clinical courses of these patients, who rarely have serious streptococcal infections in contrast to the frequent and life-threatening infections caused by staphylococci and some gram-negative bacteria.
RHEUMATIC FEVER UNDER 3 YEARS OF AGE
Authors: Rosenthal Amnon , Czoniczer Gabor , Massell Benedict F.
Published: December 2021

Ten definite cases of rheumatic fever occurring under 3 years of age are reported. These represent 0.5% of all initial attacks of rheumatic fever in children 16 years old or less admitted to our hospital between 1939 and 1966. Thus, rheumatic fever in the first few years of life is rare but not nonexistent. Our youngest patient was 19 months old. The predominant manifestations of the disease in the first few years of life were carditis and congestive heart failure, and all but one of the patients had significant mitral regurgitation. Polyarthritis was also a common feature. Elevated antistreptolysin-O titers were demonstrated in all cases in which the test was performed. Therefore, evidence of a preceding streptococcal infection is important in considering this diagnosis, even in children under 3 years of age. The differentiation of rheumatic fever from congenital heart disease, viral myocarditis, and rheumatoid arthritis is dicussed. In our experience, the prognosis for the infant with rheumatic carditis has improved since the introduction of penicillin and corticosteroids.
Citrullinemia
Authors: Kekomäki Martti
Published: December 2021

In their exceptionally interesting article, "Citrullinemia with defective urea production,"1 the authors discuss the metabolism of arginine in their citrullinemic patient:

When given for a sustained period, arginine increased the production of urea stoichiometrically but equi-molar amounts of ornithine, citrulline, argininosuccinic acid, and arginine were not recovered from the urine. . . . Nitrogen balances in addition to protein and arginine loading studies suggest alternate pathways for the degradation of arginine.

According to our investigations2, considerable activity of ornithine-ketoacid aminotransferase (EC 2.6.1.13) can be demonstrated in human liver tissue.
Letters to the Editor
Authors: Morrow Grant , Barness Lewis A.
Published: December 2021

We would like to thank Doctor Kekomäki for his letter letter concerning our patient with citrullinemia.

Doctor Kekomäki's investigations are certainly quite interesting and may explain why we were unable to pick up equi-molar amounts of the urea cycle amino acids. Semi-quantitative analysis of the urine for α-keto acids revealed a moderate increase in α-keto glutarate and pyruvate following the arginine load but no unusual α-keto acid was noted. The urine was not tested for Δ-pyrroline-5-carboxylic acid.
Ontogeny of Immunity, edited by R. T. Smith, M.D., R. A. Good, M.D., and P. A. Miescher, M.D. Gainesville, Florida: University of Florida Press, 1967, 208 pp. $15.00
Authors: Rosen Fred S.
Published: December 2021

It has been stated that the adaptability of higher organisms to environmental changes and stress is most vividly manifested by the organization of mind, the detoxifying versatility of liver, and the responsiveness of immune mechanisms. Thus, the evolutionary and developmental aspects of any of these systems are of broad biological interest, beyond the realm of the molecular biologists and their now incisive comprehension of E. coli. In two successive volumes the editors have assembled a distinguished collection of presentations in the balmy isolation of Sanibel Island, Florida.
Letters to the Editor
Authors: Marshall Donald G.
Published: December 2021

I would like to express my appreciation to Dr. Schmitt for his thoughtful reading and critical comments of my paper representing the views of this surgeon on recurrent abdominal pain. While it may indeed be true, as Apley has stated, that the onset of recurrent pains may be in the preschool years in 40% of patients, the fact remains that in my experience patients in this age group rarely come to the surgeon's attention because of those recurrent pains of ill understood nature that so frequently plague older children.
More on Poisoning
Authors: Wolf I. J.
Published: December 2021

The FDA should not permit drug companies to manufacture any pills in candy form for children. When children are given flavored aspirin, vitamins, or chewable antibiotic tablets, they are taught that pills are candy and may chew up a whole bottle of their medication and get poisoned. They may also chew up their parents' pills because they have been taught that pills are candy, and get poisoned.

In Pediatrics, January 1968, there is another case report of poisoning in a 3½ year-old boy "who found his aunt's ‘blue sugar pills’ irresistible," and developed chlorpropamide poisoning.
Letters to the Editor
Authors: Smith Richard T.
Published: December 2021

Extensive discussion of the issues raised by my respected colleague, Alex Steigman, would serve no useful purpose. My presentation was meant to point out certain soft areas in pediatrics today which demand our attention as educators. That the style and synthesis included personal value judgments on quality, derived from cumulative impressions, was not even thinly disguised and no apologies are extended.

Two major points appear to be based upon interpretations which I did not intend to convey.
Choanal Abnormalities
Authors: Marcus Milton
Published: December 2021

In reference to "Screening for Hidden Congenital Anomalies" (Pediatrics 41:147, 1968), Dr. Van Leeuwen found some cases of choanal stenosis and unilateral atresia and comments that there is little in the literature on the subject. Eight years ago I studied 500 neonates in an attempt to determine the frequency of choanal stenosis. I had a much higher incidence because I arbitrarily used a No. 8 catheter as the determining factor in the event that it could not be passed..
Pediatric Nursing, by Helen C. Latham, R.N., M.S., and Robert V. Heckel, Ph.D. St. Louis: The C. V. Mosby Company, 1967, 516 pp., $7.85
Authors: Pounds Lois A.
Published: December 2021

The authors of this nursing textbook write in a clear, concise style presenting their material well. The student will find this an easy book to use, either as a general text on pediatric nunsing, or for reference purposes. Large topic headings on the two-columned pages are somewhat distracting but make locating an area for rereading simpler. Ample illustrations are used to demonstrate points in the text, and examples of charting methods for clinical observations should prove helpful to readers.
Infant Mortality Problems in Norway, by Julie E. Backer, Ph.D., and Øystein Aagenaes, M.D. Washington, D.C.: Government Printing Office (PHS Publication Number 1000, Series 3, No. 8 of National Center for Health Statistics), 1967, 40 pp., $0.30
Authors: Backer Julie E. , Aagenaes Øystein
Published: December 2021

One of a group of studies designed to delineate the perinatal and infant mortality problem in the United States, this new report from the National Center for Health Statistics presents an analysis of the problem in Norway.

The study focuses on the sizable decreases in late neonatal and postneonatal mortality rates and the considerably smaller decrease in the perinatal rate. Changes in several parameters of infant loss and their influences on the infant and perinatal mortality trends are discussed, including such risk factors as legitimacy status, maternal age and parity, seasonal, and urban-rural differences.
PLASMA RENIN ACTIVITY IN CONGENITAL VIRILIZING ADRENAL HYPERPLASIA
Authors: Imai Masashi , Igarashi Yoshio , Sokabe Hirofumi
Published: December 2021

Peripheral plasma renin activity was markedly elevated in two cases of the salt-losing form of congenital virilizing adrenal hyperplasia. The renin activity was reduced after treatment with deoxycorticosterone and sodium chloride. In the hypertensive form of the plasma renin activity was suppressed.
MARTIN LUTHER'S ATTITUDE TOWARD THE MENTALLY RETARDED
Authors: C. T. E.
Published: December 2021

Kanner, more than anyone else, has called our attention to the gradual but slow and halting emergence of compassion and concern on the part of churchmen, philosophers, philanthropists, physicians, and politicians toward the mentally retarded.

It may come as a surprise to learn that it was during the "enlightenment" and "reform" of the sixteenth and seventeeth centuries that the treatment of mental defectives was at its worst. It was during this period that many of them became victims of the prevailing demonism. Martin Luther referred to the feeble-minded as godless and reported this occurrence in one of his Table Talks:1

Eight years ago, there was one in Dessau whom I, Martinus Luther, saw and grappled with. He was twelve years old, had the use of his eyes and all his senses, so that one might think he was a normal child. But he did nothing but gorge himself as much as four peasants or threshers. He ate, defecated, and drooled and, if anyone tackled him, he screamed. If things didn't go well, he wept. So I said to the Prince of Anhalt: "If I were the Prince, I should take the child to the Moldau River which flows near Dessau and drown him." But the Prince of Anhalt and the Prince of Saxony, who happened to be present, refused to follow my advice. Thereupon I said; "Well, then the Christians shall order the Lord's Prayer to be said in church and pray that the dear Lord take the Devil away." This was done daily in Dessau and the changeling died in the following year.
PRE-EXCITATION SYNDROME ASSOCIATED WITH SUBVALVULAR AORTIC STENOSIS IN CHILDREN
Authors: Hastreiter A. R. , Rodriguez-Coronel A. , Paul M. H.
Published: December 2021

The Wolff-Parkinson-White syndrome has been recently reported in cases of idiopathic hypertrophic subaortic stenosis. Its occurrence in the discrete fibrous type of subaortic stenosis is not well-known. Four of the five children presently reported have this combination, with or without associated muscular stenosis, and the fifth has isolated idiopathic hypertrophic subaortic stenosis.
Influenza Vaccine
Authors: Marder Gerard
Published: December 2021

I would like to take exception to recommendations of the Committee on Control of Infectious Diseases in regard to influenza vaccine usage, published in the Academy's Newsletter, October 15, 1967.

Basically, the Committee recommended limiting usage to chronically ill children. I have followed this recommendation in our practice over the years; but, after experiencing several flu epidemics, I feel that the recommendation should be revised.

Admittedly, most previously healthy children handle the infection well and the illness usually is no more (or less) than other respiratory ills of winter, and they are well in a few days.
LETTER TO THE EDITOR
Authors: Gellis Sydney S.
Published: December 2021

To the best of my knowledge no one has ever tried to passively immunize an Rh-negative mother with Rh antisera given immediately after birth.

It would probably work and is a good suggestion. To prove its efficacy would be a bit of work. I discussed your letter With Dr. Fred Allen of the Boston Blood Grouping Lab., who agreed with me that no one has tried to do this. He and I both will be very glad to offer advice or help should you wish to try it out.
OXYGEN CONSUMPTION AND GLYCOLYSIS IN FETAL, NEONATAL, AND INFANT MUSCLE OF THE RHESUS MONKEY
Authors: Beatty Clarissa H. , Basinger Glaydis M. , Bocek Rose Mary
Published: December 2021

Muscle fiber groups from fetal, neonatal, infant, and adult rhesus monkeys (Macaca mulatta) were incubated in glycylglycine and bicarbonate buffered media plus glucose-C14. Results obtained with these two media were similar. The metabolic data were calculated with noncollagenous nitrogen as a reference base. Under aerobic conditions the QO2 and CO2 productions were higher at 89 to 90 days fetal age, similar at 120 to 129 days, and lower at 150 to 160 days than those of adult muscle. Glucose uptake was higher at 89 to 90 days and 120 to 129 days fetal age than that of the adult series. Variations in the above parameters demonstrate that results on fetal metabolism must be reported for specific gestational periods. Lactate and lactate-C14 productions were higher in all three fetal series, and pyruvate and pyruvate-C14 productions were higher in the earlier fetal series than in those of the adult. The sum of C14 activities appearing in lactate, pyruvate, and CO2 was higher in rapidly growing muscle than in adult muscle. These data suggest that aerobic glycolysis is more active in fetal and neonatal than in adult muscle. Birth did not cause a significant change in any metabolic parameter. The relative increases, under hypoxic conditions, in glucose uptake and lactate and lactate-C14 productions in fetal compared with the increases in adult muscle suggest that the glycolytic pathway of fetal muscle does not respond more effectively to hypoxia.
PERMISSION TO CONDUCT THE FIRST STUDY OF THE HEIGHTS AND WEIGHTS OF CHILDREN IN THE UNITED STATES
Authors: C. T. E.
Published: December 2021

The beginning of all growth studies in this country occurred less than a century ago when the Boston School Committee approved the following order permitting Henry Pickering Bowditch, Professor of Physiology at the Harvard Medical School, to measure and weigh children in the Boston public schools. This document is one of the great, and I believe little known, landmarks in modern pediatrics.1

In School Committee, March 9, 1875

Ordered, That permission be given to Prof. Henry P. Bowditch, of Harvard University, to ascertain the height and weight of the pupils attending the public school, through such an arrangement as the respective chairman and the headmaster, or masters, may deem most convenient.
BIRTH WEIGHT OF NEWBORN INFANTS ACCORDING TO DR. JAMES KENNEDY IN 1825
Authors: C. T. E.
Published: December 2021

Erroneously high values for the birth weight of newborn infants were given by many eminent physicians as late as the middle of the last century.1

Writing in 1825, Dr. James Kennedy of Glasgow states:

Some new-born children have been known to be sixteell:–almost all the individuals of two large families were more than fifteen;–my own experience has furnished me with examples of two infants who were nineteen, one who was twenty, and another who had two teeth and was twenty-two pounds, at the time of their passing from the foetal state.–Such facts are curious:–they may afterwards come to be useful illustrations of the natural history of man.2
Amniotic Fluid Concentrations of Uric Acid
Authors: Marks J. F. , Baum J. , Kay J. L. , Taylor W. , Curry L.
Published: December 2021

At the present time the familial hyperuricemia syndrome (Lesch-Nyhan) leading to mental deficiency,1 is an untreatable disease. Since it was originally felt that the mental deficiency might be related to the hyperuricemia, early diagnosis would be imperative. We have recently found such a case at birth with a uric acid level of 19 mg/100 ml at 1 day of age.2 An attempt to diagnose this condition as early as possible has led us to a study of uric acid levels and their significance in fluid obtained by amniocentesis done in the third trimester of pregnancy.
Letters to the Editor
Authors: Nickman Steven L. , Weiner Leonard B.
Published: December 2021

We thank Drs. Moore and Edelmann for their detailed comments.

Although inappropriate ADH release had occurred to us as a contributing factor, we had difficulty in explaining just why it would have arisen in these cases, and therefore did not mention it. But since, as Drs. Moore and Edelmann point out, inappropriate ADH is not well understood anyhow, perhaps we should not have been so reticent.

A hypothetical possibility is the existence in these children of a latent defect in renal function which became apparent only under conditions of stress, namely water-loading.
Letters to the Editor
Authors: Garces L. Y. , Drash A. , Kenny F. M.
Published: December 2021

Thank you for the opportunity to reply to the letter from Dr. Milman regarding our recent paper on islet cell adenoma of the pancreas occurring in the neonatal period (Pediatrics 41:789, 1968). Dr. Milman suggests that our literature search was limited to reports occurring since 1960. Her apparent criticism applies equally to the paper by Cornblath and associates in the March issue of Pediatrics (41:646, 1968).

In actual fact, both Dr. Cornblath and our group made a very extensive literature review. The paper of Dr. Harry Sherman referred to by Dr. Milman is well known to us.1
Review of Modern Management of the Rh Problem, by John T. Queenan, M.D. New York: Harper and Row (Hoeber Medical Division), 1967, 318 pp., $12.50
Authors: Cone Thomas E.
Published: December 2021

Pity the busy practicing obstetrician who tries to keep up with the latest on the management of the "Rh problem" in his practice. Whereas once, there were only two Rh types, Rh positive and Rh negative, now there are more than two dozen, of which at least six can cause problems, though most rather rarely. And, there is a 20% danger of fetal death which may now be foretold by pigment changes in the amniotic fluid. So amniocentesis is an important prognostic measure.
Little Wide-Awake: An Anthology of Victorian Children's Books and Periodicals, selected by Leonard de Vries. Cleveland and New York: The World Publishing Company, 1967, 240 pp., $8.95
Authors: Cone Thomas E.
Published: December 2021

Almost 40 years ago, Dr. A. S. W. Rosenbach, one of America's greatest bibliophiles, and himself an avid collector of children's books, wrote: "Children's books have such a many-sided appeal that they are strangely satisfying to the collector. Not only do they have as much scholarly and bibliographic interest as books in other fields, but more than any class of literature they reflect the minds of the generation that produced them. Hence no better guide to the history and development of any country can be found than its juvenile literatune."
THE EFFECT OF ADRENERGIC STIMULATION UPON SWEATING IN NORMAL CHILDREN AND CYSTIC FIBROSIS PATIENTS
Authors: Gibson Lewis E.
Published: December 2021

An abnormality of the autonomic nervous system has frequently been postulated as having a role in the pathogenesis of cystic fibrosis. The author investigated the effects of adrenergic stimulation upon sweating in cystic fibrosis patients and in control subjects. It was found that the iontophoresis of isoproterenol, prior to the iontophoresis of pilocarpine, produces, in all subjects, more sweat than that produced by the iontophoresis of pilocarpine alone. In the cystic fibrosis patients, but not in the control subjects, the iontophoresis of isoproterenol led to a small (8.9%) but significant drop in the chloride concentration of the sweat. Sweating produced by the intracutaneous injection of isoproterenol, but not that produced by intracutaneous norepinephrine, could be blocked by the iontophoresis of atropine. This occurred in both cystic fibrosis patients and control subjects. These experimental results can be explained by hypothesizing that excessive water reabsorption occurs in the sweat duct of cystic fibrosis patients and that isoproterenol inhibits ductal water reabsorption in both the cystic fibrosis patients and the unaffected controls.
Choanal Atresia and/or Cardiac Disease
Authors: Stool Sylvan E. , Kemper Bennett I.
Published: December 2021

There are few catastrophies in the neonatal period which present so dramatically and uniquely, yet are remedied so quickly and simply, as congenital atresia of the posterior choanae. The lesion, once thought to be rare, is being detected more frequently and probably accounts for 0.5% per thousand major congenital anomalies. Unfortunately, even with early accurate diagnosis, many of these infants do not survive associated organic defets.1-4

Over 50% of the patients with bilateral choanal atresia studied at the Children's Hospital of Philadelphia between January 1960 and January 1967 had associated life-threatening congenital anomalies, especially cardiac disorders. One might speculate that maldevelopment in both organ systems occurs during the sixth to eighth week of fetal development, although no chromosomal aberration, chemical agent, or physical agent has been correlated.
Transient Infantile Hypermethioninemia
Authors: Goodman Stephen I. , O'Brien Donough
Published: December 2021

An infant with severe, transient hypermethioninemia is reported. Although probably very rare, it should be noted that elevation of serum methionine may not necessarily reflect the presence of homocystinuria, hereditary tyrosinemia, or severe liver disease.
Still More on Poisoning
Authors: Cohen Merton E.
Published: December 2021

Hurrah for Dr. Wolf!1 For many years I have complained about the completely unnecessary hazards in the use of "candy" flavored medications for children. The official statistics oil poisoning from this type of product cannot be refuted. And, with all due respect to Dr. Coleman, I do not agree that safer packaging is the answer. An intelligent preschool child can learn to open a "safety cap" almost as well as his mother, and, if the technique is made too complicated, the average mother will also have difficulty in opening the package.