bluuebunny/crossref_metadata_2025_split huggingface dataset:
HEREDITARY OROTIC ACIDURIA
Authors: Rogers Lon E. , Warford Lloyd R. , Patterson Richard B. , Porter F. Stanley 
Published: December 2021

A new case of hereditary orotic aciduria is reported. Clinical manifestations included growth retardation, orotic acid crystalluria, and a megaloblastic anemia. Uridine therapy produced a prompt hematologic response and a rapid acceleration of growth. Orotic acid excretion on treatment ranged from 0.96 gm to 3.89 gm orotic acid per gram creatinine, and no decrease in excretion was observed when the uridine dosage was increased from 0.75 to 2.0 gm per day. Studies of the patient's erythrocytes revealed a virtual absence of the activity of orotidylic pyrophosphorylase and orotidylic decarboxylase. Previously undescribed studies of liver revealed the enzymatic deficiency in this tissue as well.
Four generations of the patient's family were evaluated with erythrocyte enzyme assays and with a urinary screening test developed during the course of these studies. A subject apparently unrelated to the propositus was unexpectedly found to be a carrier of the disorder. Investigation of his family revealed other heterozygous individuals. With the pedigrees of these families, an autosomal, recessive mode of inheritance was demonstrated.
THE CHILD DEVELOPMENT TRAVELING CLINIC PROJECT IN SOUTHERN CALIFORNIA
Authors: Koch Richard , Baerwald Ann , McDonald Joan , Fishler Karol , Boyle David 
Published: December 2021

This report is the result of a demonstration project illustrating how to develop diagnostic services to young retarded children. The techniques and methods utilized in this project are described.
The practicality of a multidisciplinary approach to the problem of mental retardation using the local district public health nurse as the case coordinator is demonstrated. The project suggests that this model of cooperation between a specialized pediatric center and a local health department could be utilized to serve other groups of handicapped children. Furthermore, it appeared that the participation of local professionals in the decision-making process concerning a course of action for the retarded child committed them to greater effort to implement and facilitate such care. In each county served, the clinic appeared to mobilize pediatric and other professional interest in the problems faced by parents of retarded children.
Urine of Abnormal Color
Authors: Fleisher Daniel S. 
Published: December 2021

In the March issue of Pediatrics, Dr. Thomas E. Cone, Jr., presents an excellent summary of some syndromes, diseases, and conditions associated with abnormal coloration of the urinary diaper. I should like to suggest an additional consideration for the clinician faced with a urine of abnormal color. Perhaps the best way to do this is to briefly cite a ne cent experience which led me to this suggestion.
A 10-year-old boy was referred to me recently by a urologist with a statement that the boy passed orange-pink urine.
The Self-Curing Poison
Authors: Nussbaum Arnold H. 
Published: December 2021

I have read with interest every suggestion made to prevent accidental poisoning in children. I also incorporate into my practice every practical idea that is advanced by our colleagues and drug firms. It appears, however, that, in spite of our best efforts, some children manage to obtain pills and other medications and do harm to themselves.
Recently I made a suggestion to one of the detail men of a drug firm but he could not do much about it.
Sporotrichosis in Childhood
Authors: Carpenter Carlton L. , Jolly Henry W. 
Published: December 2021

Sporotrichosis, a world-wide disease caused by Sporotrichium schenckii, occurs as a subacute or chronic infection, usually of the skin and subcutaneous tissues, but may on rare occasions undergo extracutaneous dissemination. Sex and race may be less important than age in its genesis. Children are rarely attacked. The organism occurs as a saprophyte on various plants and has been isolated from the soil.
Direct person-to-person transmission probably does not occur, although infection has followed the handling of bandages from clinical lesions,1 and from animals.2
The majority of the cases of sporotrichosis are of the localized lymphangitic type. There is usually a history of minor trauma (i.e., scratch, prick, or insect bite) followed within 1 to 4 weeks by the appearance of a small, painless papule or pustule.
In Reply: Follow-up of Infectious Lymphocytosis Cases
Authors: Putnam Samuel M. , Moore Gordon T. , Mitchell Donald W. 
Published: December 2021

We agree with the conclusions of Dr. Oleinick and Dr. Glass. Their letter points out the problems of using a small group of patients to study questions related to an illness of low incidence, such as leukemia.
We were careful to state the limitations of our study and said that we hoped that this report would stimulate others to study this question in greater detail. As Drs. Oleinick and Glass state, more patients will need to be studied before any association of lymphocytosis and malignancy can be statistically ruled out.
Rheumatic Nodules Wanted
Authors: Wedum Bernice G. 
Published: December 2021

In the course of tissue culture studies on the pathogenesis of rheumatic fever, we are in need of rheumatic nodules which have recently formed in the course of rheumatic carditis. These structures have become rare due to the recent decrease in the prevalence and severity of acute rheumatic fever and the widespread use of steroids.
The nodule should be situated on the extremities, be readily accessible to biopsy, and, preferably, be just in the process of forming, although nodules of any age would be welcome.
ANNUAL SUMMARY OF VITAL STATISTICS—1967
Authors: Wegman Myron E. 
Published: December 2021

0nmany occasions previously this annual article has included serious criticism of the record of the United States as to infant mortality. It is satisfying, therefore, to report that 1967 marked a second year of a downward trend and that early tentative reports for 1968 are encouraging that the trend has continued. Nevertheless, as will be seen later, there is still a long way to go, and there are too many unacceptably high rates in particular population groups.
Each year at this time a report is presented of the national situation in respect of the most significant vital rates, that is live births and infant deaths.
Paediatric Anaesthesia, by Harold T. Davenport, M.B., R.F.A.R.C.S. Philadelphia: Lea and Febiger, 1968, 181 pp., $650
Authors: Smith Robert M. 
Published: December 2021

In the field of pediatric anesthesia, a coliection of references is gradually being constructed; the small volume by Dr. Davenport is a welcome and valuable addition because it is a concise personalized view by an intelligent and experienced clinician. This book is designed to fit both the pocket and pocketbook and in its relatively small size lie both its advantages and its shortcomings.
The British background of tile author is obvious in phrase, brevity, and content.
SOME ASPECTS OF THE CURRENT DRUG SCENE
Authors: Louria Donald B. 
Published: December 2021

Since antiquity man, both civilized and primitive, has utilized a confused collection of drugs for a variety of purposes, including escapism, pleasure, divination, magic, prophesy, warfare, rituals, and orgies. It is clear that no one drug has a single, entirely predictable effect; rather, the effects are largely dependent on the expectations and underlying personality pattern of the user and on the setting in which the drug is taken. This is well illustrated by the following three quotations.
1. They (the Otomac Indians) have another dreadful way of getting drunk through the nose, using malignant powders called yupa which drive them completely out of their minds so that, beside themselves, they seize any weapon to hand and if the women were not clever enough to stop them and tie them up, they would wreak cruel havoc every day. The Saliva Indians and other tribes also take yupa; but as they are gentle, harmless and cowardly people they do not become infuriated like the Otomacs who . . . get fighting mad with yupa, wound themselves and full of blood and fury go out to fight like raging tigers.1
2. After they had eaten (the mushrooms) and drunk they foregathered on the plain and danced and sang for joy all through the night and day, this on the first day. The following day they all wept a great deal and they said that they cleaned and washed their faces and eyes with their tears (an effect of hallucinogenic mushrooms on Chichimec Indians of Latin America).
UNIFORMITY OF VENTILATION IN THE NEWBORN INFANT: DIRECT ASSESSMENT OF THE ARTERIAL-ALVEOLAR N2 DIFFERENCE
Authors: Nourse C. H. , Nelson N. M. 
Published: December 2021

The arterial-alveolar pressure difference for nitrogen (aADN2) was directly measured during the first 4 hours after birth in nine clinically normal infants. Transient gross elevations of the aADN2 were seen in most babies, indicating early maldistribution of ventilation.
However, by 4 hours of age, the aADN2 had subsided to 6 ± 22 mm Hg, a value characteristic of normal older infants and children. These findings are in conflict with previous indirect assessments of aADN2 by analyses of urinary nitrogen pressure. It is concluded that normal infants achieve excellent uniformity of pulmonary distribution of gas and blood soon after birth.
EARLY INTRAVENOUS FEEDING OF THE LOW BIRTH WEIGHT NEONATE
Authors: Mamunes Peter , Baden Melvin , Bass James W. , Nelson James 
Published: December 2021

In 100 low birth weight neonates, the effect of early intravenous feeding on several biochemical and clinical parameters was evaluated by comparing this regimen to one with oral feedings after a 24-hour fast.
Blood glucose determinations obtained on 11 occasions during their first 5 days of life revealed a statistically significant higher mean value for the intravenous group through the first 60 hours of life. An unexpectedly high percentage (21%) of infants from both of the groups had glucose values below 30 mg/100 ml within 1 to 2 hours after their birth.
Fasted infants under 1,500 gm had significantly lower glucose levels than the entire fasted group through most of the first 33½ days of life. Only fasted infants (10%) developed consecutive glucose values below 30 mg/100 ml, all were males, and four-fifths were below the 20th percentile for weight for their gestational age.
Sudden cessation of the intravenous infusion was at times associated with a precipitous drop in the blood glucose, especially in the infants under 1,500 gm. Rate of weight loss or subsequent gain, mean maximum bilirubin levels, incidence of respiratory distress syndrome, and mortality were not altered by the intravenous fluid, but a slight hemodilution did occur.
CRITERIA FOR GUIDANCE IN THE DIAGNOSIS OF TUBERCULOSIS
Authors: Stegen Guillermo , Jones Kenneth , Kaplan Patricio 
Published: December 2021

In countries with a high incidence of tuberculosis and where BCG vaccination at birth is a routine procedure, the diagnosis of tuberculosis in infants and young children may be exceedingly difficult.
A point system is proposed in order to evaluate all the available data when tuberculosis is suspected. This approach offers the advantages of a uniform criterion for diagnosis and treatment and a useful guide for completing diagnostic procedures. This point system carried out on each individual case gives four possible answers: (1) tuberculosis unlikely; (2) tuberculosis possible, requires further investigation; (3) tuberculosis probable, may justify therapy; (4) tuberculosis appears unquestionable.
It is a great help in clarifying a dubious diagnosis of tuberculosis based on vague x-ray shadows and positive tuberculin tests of doubtful interpretation in the absence of positive sputum or gastric washings. This point system has the limitations of all rigid point systems of evaluation. However, if priority is given to clinical experience, it is an additional tool in a difficult diagnosis.
Handbuch der Kinderheilkunde, Vol. IX: Paediatrische Grenzgebiete, Augen, Ohren, Zahne, Haut, edited by H. Opitz and F. Schmid. Berlin-Heidelberg-New York: Springer-Verlag, 1968, 968 pp., $96.25 (by subscription $77.00)
Authors: Eichenwald Heinz F. 
Published: December 2021

This book represents Volume IX of the monumental Handbuch der Kinderheilkunde; only Volume I (Growth and Development) and VIII (Neurology-Psychiatry; Tumors) still remain to be published.
Volume IX is devoted to those areas which the editors consider to be "Grenzgebiete" (literally, "border areas") of pediatrics, a term perhaps not quite appropriate since the contents deal with ophthalmology, otolaryngology, dermatology, and dentistry. Actually, this volume consists of four concise textbooks covering different areas of vital interest to pediatricians.
INFLUENCE OF THE INFANT'S FOOD ON HIS CHARACTER ACCORDING TO DR. JOSEPH SIMMS WRITING IN 1891
Authors: C. T. E. 
Published: December 2021

Until almost the beginning of this century, a commonly and widely accepted belief was that an infant imbibes with the breast milk the character of the nurse. Even as late as the 1890's there were physicians who vigorously supported this hypothesis. None was more convinced of this erroneous concept than Dr. Joseph Simms, who in 1891 wrote:
The child that sucks the milk of the mother who bore it will naturally take on the mother's moral characteristics; while the orphan, compelled to take in the milk of an animal, will reveal in its character some of those idiosyncracies peculiar to that animal. This is not a visionary statement; it is founded on fact, and can be testified to by those who have paid any attention to the subject. An illustration of what we mean was found in 1870 in the family of Captain P. M. Choutea, of Kansas City, Mo. In the captain's family there was a little girl, five years of age, who had been deprived of a mother's milk and nursed on the milk of a goat, and when she grew up and was able to run about, she gave unmistakable evidence of the truth of that law for which we contend. She had a strong and very unusual desire for climbing. She would mount rocks, fences, and go to the tops of houses, and, in fact, jump about in every respect like the animal whose milk she had sucked. Nor when in her climbing moods did she manifest any tokens of fear; and these peculiarities became apparent in her climbing moods did she had sucked.
Kinderheilkunde, edited by Professor G.-A. von Harnack. Berlin/Heidelberg/New York: Springer-Verlag, 1968, 451 pp., $9.50
Authors: Cone Thomas E. 
Published: December 2021

Both of these books, one English the other German, will satisfy the needs of the reader who wants something more than a synopsis yet less than a detailed textbook of pediatrics. Each accomplishes this goal, but in a different way.
Dr. Jolly wrote his book entirely by himself, drawing on his long and varied clinical expenience in both England and West Africa. This in itself is a tremendous accomplishment because there are few pediatricians left in any country whose professional experience is broad enough for them to be able to write single-handedly a text of pediatrics in the classical tradition.
PLACENTAL TRANSFER OF GROUP A TYPE-SPECIFIC STREPTOCOCCAL ANTIBODY
Authors: Zimmerman R. A. , Hill Harry R. 
Published: December 2021

Group A streptococcal infections and their nonsuppurative complications are rare in infancy in spite of the fact that there is ample opportunity for streptococcal acquisitions. In an attempt to define the long-recognized contribution of trans-placental antibody to this epidemiological phenomena, the present study of 107 maternalcord paired sera was undertaken. Seventy-eight percent of the maternal specimens contained antibody to at least one of the four M-types common in the area, and 62% had antibody to two or more of the serotypes.
The high prevalence of type-specific antibody (TSA) in maternal sera, along with the fact that both TSA and bactericidal activity cross the placental barrier and persist in the newborn infant, suggest that passively acquired immunity might be partially responsible for the low incidence of streptococcal acquisitions which occurs during the newborn period.
Other investigators have reported higher levels of antistreptococcal antibodies in cord sera than in the corresponding maternal specimen. Five cord specimens in the present study were found to have higher TSA titers as well as higher antistreptolysin and/or antihyaluronidase levels than found in the maternal sera. Cord macroglobulins were elevated in each case; however, treatment with 2 mercaptoethanol did not significantly decrease the type-specific titers in these sera. The reason for the higher levels of antistreptococcal antibodies in cord sera warrants further investigation.
Mist Therapy Reconsidered Twice More
Authors: Matthews LeRoy W. , Doershuk Carl F. 
Published: December 2021

Drs. Wolfsdorf, Swift, and Avery1 have carried out an interesting study of the delivery and distribution of aerosolized water in the respiratory tract of adult humans. We do not doubt the validity of their data with the experimental design utilized. It is unfortunate that their design does not reproduce either the usual clinical setup for direct inhalation from a nebulizer or for inhalation from a mist tent.
The usual mist tent is not air-tight. The fact that diffusion of air into and of oxygen out of such a tent occurs very rapidly is apparent to anyone who has attempted to raise the oxygen concentration above 50% by adding oxygen.
Down's Syndrome and Cystic Fibrosis
Authors: Vetrella M. , Barthelmai W. , Matsuda H. 
Published: December 2021

The association of Down syndrome with cystic fibrosis (CF) is a very interesting problem. Recently Dr. Milunsky reported three cases; one was confitmed by karyograni as trisomy 21.
We have studied a newborn with trisomy 21 and cystic fibrosis who showed an unusual hematologic picture with hypoplastic thrombocytopenia at the same time. Diagnosis was confirmed by: sweat-test (81 mEq Na I, 141 mEq Cl/1), absence of pancreatic enzymes in duodenal juice, delayed meconium passage, pneumonia, and intestinal problems. The infant died at 49 days of age with severe diarrhea, anemia, leukopenia (WBC 3500/mm, with 520 neutrophiles) and a platelet count of 2000/mm.
DO INFANTS CRY IN THE WOMB?
Authors: C. T. E. 
Published: December 2021

In the Ladies Dictionary,1 printed in London in 1694, one finds the following answer to the question above:
Infants crying in the Wombs of their Mothers, have occasioned various discourses among the Learned, as to its Signification, but in this they differ; however, it is a thing very unusual, and therefore strange; Sorrow indeed is incident to mankind, and we begin it with Weeping before we know what it means but that is very rare, till we come to breath in the open Air; now whether such untimely Cryings may signify something extraordinary in the Course of Life; or that Provident Nature would have them Practice in the dark Cell of Generation, what they shall afterwards seldom want so long as they enjoy the Light, viz; Sorrow and Affliction we undertake not to determine; but such Relations of those little Prisoners that have been heard to cry in those close Apartments [sic] take as we find them in credible Histories. In Holland, a Woman had a Child cryed [sic] and bemoaned it self [sic] in her Womb with little intermission for the space of fifteen days. In Leyden, a gentlewoman being in Bed with her husband on a suddain [sic] hearing the Child cry in her Womb was greatly terrified, so that in two days after she fell in labour, though she expected to go a great while longer. In Rathstadt, a town in the Norwick Alps, a Child was heard to cry in his mothers [sic] Womb fourteen days before it was born.
TREATMENT OF THE CRITICALLY ILL CHILD: HEMORRHAGIC SHOCK
Authors: Replogle Robert L. 
Published: December 2021

Shock in the child is nearly always caused by blood (or fluid) loss, burns, or infection. The goal of the physician is to recognize which of these are causing shock in his patient, and to treat both the underlying disorder and the shock as quickly as possible. This review will touch only on the clinical management of the patient in hemorrhagic shock.
The pathophysiology of hemorrhagic shock is characterized by a decrease in cardiac output resulting in inadequate tissue perfusion, tissue hypoxia, and acidosis; and, it is caused by an inadequate circulating blood volume.
The patient often arrives in the emergency room with multiple injuries, being hypotensive, tachycardic, tachypneic, and obtunded. First priority is given to establishing an adequate airway, stopping massive hemorrhage (application of manual pressure or tourniquets) , and splinting unstable fractures. Since many resuscitative measures should be undertaken simultaneously, even the most experienced physician should call for assistance as soon as he recognizes the seriousness of a patient's condition. The nurse should start a chart on the patient, recording at frequent intervals vital signs, pupil size and reaction, and fluids and medications given. As quickly as possible, one or more routes for the rapid infusion of fluid should be established. In the child this is best accomplished by cutdown of the greater saphenous vein at the ankle and insertion of a large bore catheter.1 (Efforts at introducing a needle or catheter percutaneously into a collapsed peripheral vein will usually waste valuable time.)
Letters to the Editor (As a Mixed Bag)
Authors: Fields John P. 
Published: December 2021

Thank you for your kind words about "several" original articles in the March issue of Pediatrics. Thank you also for evidence that the Letters pages are-as we hope they will be-controversial.
May I briefly consider your specific comments in order?
Dr. Bumbalo's letter was sent to the author of the original article for comment on September 23, 1968. The inquiry was repeated December 10, 1968. Having received no answer to either letter, we decided upon publication of that from Dr. Bumbalo without further delay, in the hope that a response would result.
Dangers from Talcum Powder
Authors: Moss Malcolm H. 
Published: December 2021

Most pediatricians are aware of the adverse effects of talcum powder aspiration which may result in acute or chronic lung disease. At least three fatalities have been reported following the aspiration of talcum powder by infants. Verbal communication with the New York Poison Control Center reveals that approximately 50 cases of talcum powder aspiration are reported to that center annually.
Despite the potential dangers of talc aspiration, little has been done to publicize these dangers to the general public.
BISEXUALITY GONE AWRY—THE CHILD IS FATHER TO THE MAN
Authors: Solnit Albert J. 
Published: December 2021

Pediatrics has persisted in retaining its interest in all children and in not limiting its concern to certain kinds of children or to one set of influential factors in the development of children. Although his biological training is crucial, the pediatrician, as a generalist, has a critical interest in psychological aspects of child development and in the social-economic conditions that have a bearing on child and family life.
Deisher, Eisner, and Sulzbacher's article, "The Young Male Prostitute" (page 936 in this issue), demonstrates the pediatrician's scientific and humanitarian concern about a group of homosexual boys. This study, an excellent model of exploratory social science research, touches upon an extreme outcome of childhood psychopathology, lesser degrees of which are more frequently seen in the pediatrician's office.