bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSYCHOMETRIC EVALUATION AND FACTORS AFFECTING THE PERFORMANCE OF CHILDREN WHO HAVE RECOVERED FROM TUBERCULOUS MENINGITIS
Authors: Nickerson Granville , MacDermot P. N. 
Published: December 2021

This particular group of children recovering from tuberculous meningitis have suffered a significant degree of intellectual impairment.
It appears that the factor having the most unfavorable influence in intellectual recovery is severe clinical illness as evidenced by convulsive seizures.
Loss of consciousness for some time during the early phase of tuberculous meningitis in itself does not appear to be a highly unfavorable sign. Nevertheless, when unconsciousness is associated with convulsive seizures the intellectual functioning of the patient, in most instances, can be expected to be seriously impaired.
An infant with tuberculous meningitis may be expected to have an unfavorable prognosis aside from any other factors. An older child, who has remained conscious throughout his illness and without convulsions, may be expected to have a relatively good prognosis.
Adverse social factors, prolonged hospitalization and isolation, and sensory-motor sequelae are considered to have influenced unfavorably the psychometric scoring of many of these children.
Repeat psychometric testing, after an interval, reveals that still further improvement in intellectual functioning may be expected in a number of these children who do not have serious sensory-motor impairment.
For the majority, however, repeat testing reveals that they have varied little from their previous performance; the normal children continuing to develop within their normal group whereas the retarded children have remained retarded.
It is noteworthy that observations on five adults treated at the Alexandra Hospital have been at some variance with the observations of Williams and Smith who found no measurable disturbance of intellect, personality or memory in 19 adult patients. Three of the five adults treated in this unit have obvious changes in personality in that they are unable to concentrate as formerly, are easily frustrated, childish and frequently quick-tempered. The remaining two patients appear to have no apparent intellectual or personality sequelae.
Although this is a study of a small number of children, it is hoped that other workers will undertake psychometric evaluation of children recovering from tuberculous meningitis and make their results known for comparison.
OCCULT BLOOD LOSS IN IRON DEFICIENCY ANEMIA OF INFANCY
Authors: Hoag M. Silvija , Wallerstein Ralph O. , Pollycove Myron 
Published: December 2021

Blood loss from the gastrointestinal tract was measured in 13 infants with iron deficiency anemia, using radioiron as a tracer. The radioiron was given intravenously; radioactivity in the erythrocytes and feces was measured for the following 3 to 4 weeks.
The percentage of total Fe administered that was recovered in the stools varied between 0.75 and 16.4%, with a mean of 5.75%. This represents loss of whole blood in the stools varying from 7 to 107 ml, with a mean of 41 ml during the observation period.
Occult blood loss from the gastrointestinal tract appears to be a significant factor in the development of iron deficiency in early childhood.
RESPIRATORY VOLUME-FLOW IN THE CRYING NEWBORN INFANT
Authors: Long Ernest Croft , Hull Wayland Elroy 
Published: December 2021

Maximum inspiratory and expiratory volume-flow have been recorded in 14 crying infants during the first 3 days of their lives, by a method that will follow rapid changes accurately. Average maximum inspiratory volume-flow of 161 ml/sec and average maximum expiratory volume-flow of 106 ml/sec were observed. The relation of volume-flow to noise production was also studied.
It is suggested that there is a certain maximal tracheal volume-flow measured by the maximum volume-flow recorded during the inspiration preceding a cry.
CARDIOAORTIC FISTULAS AND ANEURYSMS OF SINUS OF VALSALVA IN INFANCY
Authors: Heiner Douglas C. , Hara Masauki , White Harold J. 
Published: December 2021

A report of an infant with a previously undescribed congenital malformation of the heart consisting of an aneurysm of the left sinus of Valsalva with rupture into the left atrium and associated atrial septal defects is presented. This cardiac anomaly, along with others in the literature, supplies evidence that sizable congenital aneurysms may arise from any of the three sinuses of Valsalva and may communicate directly with any of the four cardiac chambers, the pulmonary artery or the pericardial sac. Other contiguous intrathoracic structures should also be considered potential sites of ruptures. Such a consideration may prevent some instances of congenital aneurysms from being missed simply because they have not been reported. Embryologic factors are briefly discussed as is the possibility that the patient may represent a variant of Marfan's syndrome. Surgical implications are also mentioned.
The patient reported presents a clinical syndrome that should be recognizable during life if the possibility of an aortic to left atrial shunt is kept in mind. The findings included evidence of heart disease soon after birth, a loud continuous murmur and thrill present maximally in the left axilla, bounding peripheral pulses and a wide pulse pressure. Roentgenograms showed marked cardiomegaly involving all cardiac chambers, a bulge in the cardiac silhouette to the left of the main pulmonary artery, and marked pulmonary vascular engorgement. There was electrocariodgraphic evidence of atrial and combined right and left ventricular hypertrophy. Cardiac catheterization revealed a peculiar pressure gradient between the left and right atria in spite of an atrial septal defect with a left-to-right shunt. Venous angiocardiograms and retrograde aortograms were not diagnostic, although a more adequate aortographic dye injection would have demonstrated the defect. Retrograde arterial catheterization should also permit an accurate diagnosis.
THE INCIDENCE OF MENTAL AND PHYSICAL HANDICAPS IN SCHOOL-AGE CHILDREN OF VERY LOW BIRTH WEIGHT
Authors: Drillien Cecil Mary 
Published: December 2021

Fifty children of a total of 97 whose weight at birth was 3 lb (1,360 gm) or less, born in two Edinburgh hospitals between 1948 and 1960, have now passed their fifth birthday, the statutory age for school entrance. One case was not available for examination Recent data regarding type of schooling or other disposal, educational attainment behavior observed in school, and physical defect affecting education are presented for the 49 children examined. The findings are as follows:
One-half of the total were ineducable in normal school, for reason of physical or mental handicap or both, one-quarter were dull children requiring special educational treatment within the normal school, and one-quarter were considered low average, average or superior in ability.
Twenty-six children (53%) had one or more physical defects; 9 of these attended schools for the physically handicapped.
Thirty-eight children (78%) were reported as having problems of behavior.
Of 30 children with siblings for comparison, 2 were considered to be superior in ability, 6 approximately equal to at least one sibling and 22 obviously slower than all their siblings.
In five of seven pairs of twins, the larger twin scored higher on intelligence tests than the smaller.
A highly significant increase of severe handicap was found in children born between 1953 and 1954, as compared with those born in 1948 to 1950, and it is suggested that this is due to an increasing number of damaged children surviving, associated with an improved survival rate. There is a significantly higher proportion of males among those later born children, but there is no evidence of sex differential with regard to mental grade. A significantly higher incidence of handicap is found in children from the poorest homes. Twins show a lower average mental grade, but this is not statistically significant.
In the period 1953 to 1954, 29% of mothers gave a history of relative infertility; all children born to these mothers were severely handicapped. Ten per cent of mothers in the period 1948 to 1952 gave a like history; all their children were considered average in mental ability.
CONGENITAL LARYNGEAL STRIDOR
Authors: Schwartz Abraham B. 
Published: December 2021

The hypothesis is proposed that congenital laryngeal stridor results from excessive rehearsal of the laryngeal closing reflex during the aquatic environment of fetal life.
An unusual frequency of allergic manifestations in stridorous infants who have been followed to maturity, or in their families suggests a relationship between allergy and congenital laryngeal stridor.
PRESIDENT'S MESSAGE
Authors: Wheatley George M. 
Published: December 2021

TODAY the calls on your time and skills are probably greater than they have ever been before. As a physician you are throughout your career a teacher as well. The very word "doctor" means "teacher" and no other professional person is better equipped than you to give families 1) an understanding of the child's illnesses, 2) health supervision and guidance, 3) family life counseling and 4) preventive medical care and advice about accident prevention.
This comes to mind with special pertinence at this time because the 1961 National Health Forum sponsored by the National Health Council, of which the Academy is a member, is on the subject of "Health and Communication". It is being held at the Waldorf-Astoria Hotel in New York, March 13 through 16, 1961. Here members of the health professions will discuss and exchange ideas on effective communication with the public and with particular professional groups. The President, the President-elect, and the Executive Director are the Academy's delegates to the National Health Council. As this is being written, one can only speculate on the outcome of such a conference. But it is safe to conclude that no individual is more influential as a health communicator than the physician, and our own specialty has a foremost position in health education.
It is timely to consider this whole matter of the physician as health educator. Actually this is at the core of the much talked about "physician-patient relationship," and every pediatrician knows that good communication is essential in his relations with parents and little patients. It is also worth thinking about this aspect of medical skill because your role as a teacher and a preventer of illness probably takes more of your time than even you realize. As far back as 1947, at the time of the Academy's study of child health services, pediatricians on the average were devoting about half of their time to health supervision.
ACUTE INFANTILE GAUCHER'S DISEASE
Authors: Stein Marvin , Gardner Lytt I. 
Published: December 2021

The present clinical conference takes up the case of a 5½-month-old boy who was admitted to the hospital because of irritability and failure to gain weight. His irritability progressed to definite neurologic signs, and marked enlargement of the spleen developed, together with some hepatomegaly. Bone marrow aspiration revealed abnormal cells, showing an eccentric nucleus and wavy, fibrillar cytoplasm, with an appearance consistent with Gaucher cells. A progressively downhill course ensued, characterized by opisthotonus and respiratory difficulties, and the child died at age 7 months.
A discussion of numerous aspects of Gaucher's disease is presented, including biochemical and genetic considerations. The problems encountered in genetic counseling of parents who have children with this disease are brought out. Since Gaucher's disease as a syndrome exhibits a heterogenous pattern of inheritance, the dangers inherent in giving parents oversimplified genetic data are emphasized. If the parents ebect to have no further children of their own and instead wish to adopt children, certain implications which this course of action may raise are discussed.
An experiment is described wherein spleen tissue obtained from two patients with Gaucher's disease was analyzed for cerebroside content. Most of the cerebroside found in both spleens was the abnormal glucose form, whereas in normal human tissue the galactose cerebroside predominates. Studies are being made in this laboratory of the incorporation of carbon-14 labelled glucose and galactose using microsomal fractions of spleens from patients with Gaucher's disease. On the basis of preliminary data, it is postulated that the site of the biochemical error in most patients with the disease is at the conversion of the glucocerebroside to the galactocerebroside. It is believed that a defect in a UDP-galactose-4-epimerase-like mechanism at this site would cause the accumulation of the "abnormal" glucose cerebroside. Figure 5 indicates graphically the location of this suggested metabolic block.
The Healthy Child: His Physical, Psychological, and Social Development
Authors: STINE OSCAR C. 
Published: December 2021

This book is a timely addition to the pediatrician's library. The education, practice and philosophy of the specialty of pediatrics are expanding in understanding of and services for the healthy child. The authors, representing five medical specialties and four nonmedical disciplines, offer contributions to the pediatrician for this progress.
The relationship between episodes of illness and the health and development of the child is discussed by Dr. Isabelle Valadian. Examples for illustration are taken from children in the Harvard Longitudinal Study of Child Health and Development.
Two chapters will serve as reviews of pediatric information for most pediatricians. The first is a summary of the natural development of immunities and the artificial induction of immunities. The second is a clinical description of physiological conditions in the newborn that are consistent with health. Their clarity and simplicity will serve usefully in teaching.
BILATERAL NEPHROBLASTOMA (WILMS' TUMOR)
Authors: Martin Lester W. , Kloecker Richard J. 
Published: December 2021

Three cases of bilateral nephroblastoma (Wilms' tumor) are reported. In all three instances, the tumor was thought to be unilateral prior to surgery. (In one instance, involvement of the opposite kidney was discovered at necropsy.) It is probable that bilateral involvement is somewhat more frequent than has been generally recognized in the past; it probably occurs in approximately 5 to 10% of the cases.
Bilateral nephroblastoma does not necessarily carry a fatal prognosis, and it may be cured in a certain percentage of cases by radical surgery. The treatment of choice of bilateral nephroblastoma is surgical removal of both tumors, leaving behind at least half of one kidney.
Because in many instances the bilateral involvement is not diagnosed preoperatively, it is recommended that exploration for nephroblastoma always include detailed exploration (including visual inspection) of all surfaces of the opposite kidney, through a generous transperitoneal approach.
IDIOPATHIC (HEREDITARY) HYPERLIPEMIA AND HYPERCHOLESTEREMIA IN CHILDREN
Authors: Rausen Aaron R. , Adlersberg David 
Published: December 2021

Except for fatty serum and variable degrees of hepatosplenomegaly, children with idiopathic hyperlipemia may remain asymptomatic for many years. Abdominal crises and xanthomata are not necessary concomitants of the disorder in children. The finding of mild hyperlipemia in the mother of siblings with marked hyperlipemia emphasizes the hereditary nature of this disorder.
The clinical findings in a child with idiopathic hypercholesteremia and xanthomatosis have been presented. The presence of hypercholesteremia and the absence of overt coronary artery disease in many members of this child's family emphasizes the poorly undestood interrelationships between heredity and environment in the pathogenesis of atherosclerosis.
Treatment of hyperlipemia with a low-fat diet tends to correct the abnormal lipid pattern in serum. Coincidental regression of hepatosplenomegaly may also occur. Therapy with nicotinic acid resulted in temporary improvement in the chemical abnormality in one child with idiopathic hyperlipemia. As opposed to experiences with adult hypercholesteremics, high doses of nicotinic acid did not decrease the cholesterol level of a child with idiopathic hypercholesteremia.
Advertisement in PEDIATRICS
Authors: REISMAN MARTIN 
Published: December 2021

There has recently appeared in Pediatrics (and other medical journals) a colorful advertisement for a "new" comprehensive liquid hematinic (Zentron, Lilly). There are aspects of this advertisement that are both disturbing and depressing.
Firstly, that another vitamin-iron, "shot gun," tonic should appear on the market is distressing in itself. The mixture contains ferrous sulfate in routine dosage, the B-complex vitamins including vitamin B12, and vitamin C all in a 2% alcohol vehicle. The advertisement claims that this medication 1) "corrects iron deficiency" which is undoubtedly true—but then again so would any less expensive U.S.P. iron preparation; 2) "restores healthy appetite"—which is at best wishful thinking.
A Modification of Exchange Transfusion Technique Using a Five-way Stopcock
Authors: DE LAMERENS SERGIO 
Published: December 2021

Exchange transfusion is the only recognized treatment for hyperbilirubinemia caused by hemolytic disease and other forms of hyperbilirubinemia of the newborn. The purpose of this paper is to introduce a modification of this technique, which in our hands has proved to be of significant value in this procedure. This new technique has been repeatedly used with excellent results in performing exchange transfusions in full-term and premature infants.
The modification consists of the use of a five-way stopcock instead of the two three-way stopcocks as in the conventional procedure.
Candida Albicans
Authors: KOZINN PHILIP J. , TASCHDJIAN CLAIRE L. 
Published: December 2021

In view of the increasingly authoritative nature of the Report of the Committee on the Control of Infectious Diseases, issued by the American Academy of Pediatrics, we would like to call attention to certain ambiguities in the 1961 report, notably in connection with the etiology and therapy of candidiasis.
On page 55 (Candidiasis: Etiology and Epidemiology: Source) it is stated that "yeastlike fungi are frequently found in . . . the skin of normal individuals." This statement implies that Candida albicans is one of the saprophytic yeastlike fungi. Careful investigative work by various authors (Benham and Hopkins: Arch. Derm. Syph., 28:532, 1933; Winter, W. D.: Yearbook of Pediatrics, 1954/55, Yr. Bk. Pub., 1955, p. 355; Marwin, R. M. J.: J. invest.
Staff of the Therapeutic Nursery School
Authors: MENDELSOHN ROBERT S. 
Published: December 2021

I was surprsied to find that Bleck and Headley (Treatment and Parent Counseling for the Preschool Child with Cerebral Palsy. Pediatrics, 27:1026, 1961) do not include a pediatrician in the school staff. The only medical person mentioned is an orthopedic surgeon, who directs the physical and occupational therapists.
It hardly seems necessary to repeat that the pediatrician, as a result of his orientation and training, is excellently qualified to supervise and co-ordinate the many medical (neurology, orthopedics, special senses, physical medicine, psychiatrists, etc.) and paramedical disciplines concerned with cerebral palsy.
STUDIES OF ENZYMES IN SERUM IN MUSCULAR DYSTROPHY
Authors: Pearson Carl M. , Chowdhury Sudhir R. , Fowler William M. , Jones Margaret H. , Griffith Wendell H. 
Published: December 2021

Progressive muscular dystrophy is one of the relatively few chronic diseases in which an increase of various enzymes in serum is of diagnostic value. In the presence of muscular weakness high levels indicate a primary myopathic process. It has previously been shown that elevated values for enzymes in serum are most pronounced in childhood dystrophy, are highest early in the disease, and taper toward normal several years later.
This study involves a clinical and biochemical analysis of several families in which dystrophy is known to exist. An elevation of the enzymes studied (two transaminases, aldolase, two dehydrogenases) was found in several young boys who were at the time clinically asymptomatic. In one family the youngest of these children was 4½ months of age. Three of his brothers developed clinical dystrophy at about 3 years of age. In another family clinical follow-up for 3 years after the finding of elevated levels of enzymes in serum has shown the development of early muscular weakness in two male cousins of a known dystrophic person. Muscle biopsy in the preclinical stage has shown dystrophic changes in each of five cases.
The diagnostic and prognostic significance of enzyme levels in serum in families of dystrophic persons is impressive. It appears that in some forms of dystrophy the time of onset of the disease is very early in life, or even in the prenatal period. The enzyme studies have provided the first objective evidence that this may be the case.
BONE, MUSCLE AND FAT MEASUREMENTS
Authors: Maresh Marion M. 
Published: December 2021

The widths of the bone, muscle and fat shadows were measured at specific locations on 14 seriatim roentgenograms of the extremities of 25 boys and 25 girls between the ages of 2 months and 6 years. Mean values for each of these measurements were presented and demonstrate the changes with age that have been presented by other workers. Interesting individual differences were found in the relative widths of the same tissue measured at different locations as well as changes in relative level of bone, muscle and fat widths with increasing age.
Coefficients of correlation between these measurements and weight were all reasonably good, but the height:muscle widths and height:fat widths were considerably lower than the height:bone widths correla tions for both sexes. The bone:fat and muscle:fat correlations were low (-0.1 to 0.2) for both sexes, but a surprising difference which has not been reported by previous workers was found in the bone: muscle correlations for boys (over 0.5 after 1 year of age) and for girls (0.1 to 0.2).
For these 50 children, assessments of skeletal age at the chronologic age of 5 years were also available. The correlations with height and weight at this age were 0.32 and 0.38 for the boys and 0.47 and 0.52 for the girls.
A superficial examination of the nutritional data of these children and of their records of basal metabolism for this 6-year period has not revealed any obvious relationships between either of these sets of data and the bone, muscle and fat measurements in this study.
Accepting these measurements as less consistent than those made from roentgenograms taken for soft tissue delineation, and also accepting that these measurements are but one dimension of the tissue mass in the total body, they do seem to be a useful supplement to the clinical and anthropometric data in the study of the body composition of the child.
AN EPIDEMIC OF INFECTIOUS LYMPHOCYTOSIS WITH DIARRHEA
Authors: PETERMAN M. G. , KASTER J. D. , GECHT ELI A. , LEMBERT G. L. 
Published: December 2021

An epidemic of infectious lymphocytosis which occurred in the Milwaukee County Home for Dependent Children and Milwaukee County Hospital Pediatric Service has been reported. There was a total of 28 cases. Two of these cases occurred in children who were hospitalized for other reasons, and were from the population at large.
The most prominent presenting symptom was diarrhea, which was noted in 16 cases.
The leukocyte counts ranged from 18.9 thousand to 147 thousand/cmm. and the lymphocytes ranged from 64 to 94%.
The total apparent time for the epidemic was from November 1947 to March 1948.