bluuebunny/crossref_metadata_2025_split huggingface dataset:
Behavioral and Developmental Effects of Preventing Iron-Deficiency Anemia in Healthy Full-Term Infants
Authors: Lozoff Betsy , De Andraca Isidora , Castillo Marcela , Smith Julia B. , Walter Tomas , Pino Paulina 
Published: December 2021

Objective. To determine the behavioral and developmental effects of preventing iron-deficiency anemia in infancy.
Methods. Healthy full-term Chilean infants who were free of iron-deficiency anemia at 6 months were assigned to high- or low-iron groups or to high- or no-added-iron groups. Behavioral/developmental outcomes at 12 months of age included overall mental and motor test scores and specific measures of motor functioning, cognitive processing, and behavior. There were no differences between high- and low-iron groups in the prevalence of iron-deficiency anemia or behavioral/developmental outcome, and they were combined to form an iron-supplemented group (n = 1123) for comparison with the no-added-iron group (n = 534).
Results. At 12 months, iron-deficiency anemia was present in 3.1% and 22.6% of the supplemented and unsupplemented groups, respectively. The groups differed in specific behavioral/developmental outcomes but not on global test scores. Infants who did not receive supplemental iron processed information slower. They were less likely to show positive affect, interact socially, or check their caregivers’ reactions. A smaller proportion of them resisted giving up toys and test materials, and more could not be soothed by words or objects when upset. They crawled somewhat later and were more likely to be tremulous.
Conclusions. The results suggest that unsupplemented infants responded less positively to the physical and social environment. The observed differences seem to be congruent with current understanding of the effects of iron deficiency on the developing brain. The study shows that healthy full-term infants may receive developmental and behavioral benefits from iron supplementation in the first year of life.
CHRONIC FAMILIAL NONSPHEROCYTIC HEMOLYTIC ANEMIA
Authors: LIPTON EARLE L. , GROSSMAN HERBERT J. , RICHMOND JULIUS B. 
Published: December 2021

The authors have presented the problems in the diagnosis of an obscure anemia in two sisters which was apparently present at birth. The mechanism could not be established during the initial period of observation. Re-investigation revealed a nonspherocytic, familial, probably hereditary and possibly sex-linked hemolytic anemia.
These cases do not fit into any known specific category and are compared with other nonspherocytic hemolytic anemias recorded in the literature. It is suggested that other cases considered to be hypoplastic or aregenerative anemias be re-investigated to exclude the possibility of a hemolytic component.
RENAL RESPONSE OF PREMATURE INFANTS TO ADMINISTRATION OF BICARBONATE AND POTASSIUM
Authors: TUDVAD FOLKE , MCNAMARA HELEN , BARNETT HENRY L. 
Published: December 2021

THE OBSERVATIONS to be described were undertaken in an attempt to answer the following questions: 1. Does renal immaturity play a role in the "physiologic" acidosis of the premature infant? 2. Can this acidosis be corrected by the administration of bicarbonate? 3. Is the premature infant able to excrete potassium as readily as the adult? The answers to these questions possess both physiologic and clinical interest.
The acidosis of the premature infant has been attributed to increased production of organic acids. However, immaturity of renal functions involving hydrogen ion excretion could be responsible for failure of the infant to correct the acidosis completely. In addition, a decreased maximum rate of tubular reabsorption of bicarbonate due to decreased hydrogen ion excretion would in itself result in a continuous drain on bicarbonate stores.
In regard to the second question, it is generally agreed that correction of the "physiologic" acidosis of the premature infant is not indicated. However, further knowledge may reveal circumstances where it is desirable to increase serum bicarbonate. If so, it would be of clinical importance to known whether the serum bicarbonate concentration of the premature infant can be raised to normal adult values by the administration of bicarbonate. If the maximum rate of tubular reabsorption of bicarbonate is decreased, bicarbonate administration would result not in increased serum bicarbonate concentrations but only in increased rate of excretion.
The third question has very clear clinical application. Safe treatment of potassium deficiency by the administration of potassium is dependent in large part upon the ability of the kidney to excrete potassium rapidly.
DIAGNOSIS AND PROGNOSIS OF HYPSARHYTHMIA AND INFANTILE SPASMS
Authors: GIBBS E. L. , FLEMING MARILYN M. , GIBBS FREDERIC A. 
Published: December 2021

In the course of electroencephalographic studies on patients with epilepsy an abnormal pattern has been found that is peculiar to infants and young children. It occurs in patients with brief quivering spells, myoclonic jerks or spasms.1 This pattern (chart 1) has been called hypsarhythmia (mountainous arhythmia) and the clinical state with which it is associated is referred to as infantile spasms.
The present report is based on 237 cases with hypsarhythmia and infantile spasms. For the most part this group is made up of patients who were referred for electroencephalographic study by private physicians in the Chicago area; a few came from the Department of Pediatrics at the University of Illinois School of Medicine; 60% were males and 40% were females. On referral they bore such diagnostic labels as "colic," "petit mal epilepsy," "myoclonia," "spasms nutans" and "spasmophilia."
TRACHEOTOMY IN INFANCY
Authors: BIGLER JOHN A. , HOLINGER PAUL H. , JOHNSTON KENNETH C , SCHILLER FILMORE 
Published: December 2021

The incidence of tracheotomy in infants under one year of age is increasing due to a broadening of indications, greater acceptance of tracheotomy as an adjunct to other therapy and a lower mortality through improvements in surgical technic and in the postoperative care of tracheotomized infants.
Tracheotomy for inflammatory lesions is decreasing, but the incidence of tracheotomy for congenital and miscellaneous lesions is increasing.
Of 62 infants under one year of age who required tracheotomy, congenital lesions were considered the cause of the respiratory obstruction in 32 cases (15 males and 17 females) and acquired lesions in 30 (21 males and 9 females). In 8 of the 30 infants in the "acquired" group congenital anomalies were indirectly responsible for the tracheotomy, since it was necessitated following extensive surgical procedures performed in an attempt to correct gross anomalies of organs other than those of the respiratory system.
There were 17 deaths in the series of 62 cases. Eight occurred in the miscellaneous group, principally those operated on for gross anomalies of other organs, 3 in the group of 17 congenital laryngeal anomalies, 4 in the group of 18 inflammatory lesions and 2 in the group of 8 neoplasms.
Tracheotomy is generally looked upon as an emergency life-saving procedure. However, in most cases it can be a planned, careful operation, preceded by the establishment of an airway to avoid cerebral and surgical trauma. The post-tracheotomy period is the critical period during infancy.
TOTAL BODY CHLORIDE OF CHILDREN IN POTASSIUM DEFICIENCY AND UNDER CIRCUMSTANCES OF POOR NUTRITION
Authors: CHEEK DONALD B. 
Published: December 2021

(1) The distribution of bromide has been used to measure total body chloride in children of poor nutritional status and in circumstances of potassium deficiency.
(2) In malnutrition there is an increase of extracellular water and of tissue chloride, per unit weight.
(3) One patient with fibrocystic disease revealed a deficit of body chloride during heat stress.
(4) Children with chronic gastro enteritis and potassium deficiency receiving only glucose and saline tend to develop chloride and water retention in the extracellular compartment. It is not known whether potassium deficiency per se is causally related to this finding.
(5) Deficits of extracellular sodium and of chloride have been revealed in four cases of hypotonic dehydration with cell potassium deficiency. Presumptive evidence only of potassium loss was presented in one case of pyloric stenosis, but conclusive proof was offered in the investigation of a child with acrodynia.
A FATAL CASE OF POLIOMYELITIS IN A NEWBORN INFANT DELIVERED BY CESAREAN SECTION FOLLOWING MATERNAL DEATH DUE TO POLIOMYELITIS
Authors: SWARTS CHARLES L. , KERCHER ERVIN F. 
Published: December 2021

A fatal case of poliomyelitis in a newborn is reported. The case is important as the infant was delivered by cesarean section within a few minutes after maternal death due to acute poliomyelitis. The same immunological strain of poliomyelitis virus was isolated from both infant and mother.
While positive proof is not offered, this case plus a review of the literature offers strong evidence that transplacental transfer of the poliomyelitis virus can occur.
EDUCATION
Authors: SOLNIT ALBERT J. , SENN MILTON J. E. 
Published: December 2021

1. The out-patient clinic is the most valuable place for the physician to learn how comprehensive pediatrics can be mastered in his every-day office and home-visit practice. It is also the logical place to teach the relationship of community resources to pediatric practice.
2. Comprehensive medical care of the child is defined as the prevention and treatment of physical disease, and the supervision of healthy growth and development, physical and psychological. Through his comprehension of physical, psychological and social forces that influence the child, the pediatrician enables the child and his family to take an active role in solving their health problem.
3. The interview should serve as a basic instrument of diagnosis and treatment. It should be flexible, and enable the patient to express fears, anticipations and questions about his symptoms. It should be practical in length of time and sequence, depending on the patient's symptoms and his reactions to being examined by the doctor.
4. The attitudes necessary for the practice of pediatrics are best acquired by the student through the demonstrations of his teachers and through his professional identification with them.
5. When pediatric teaching is focussed on the patient as a person, a student learns that:
a) Every patient is an interesting person. It can be as satisfying and important to care for a six-week-old infant who is well or a child who is going to camp, as one who suffers from a rare disease.
b) There is no such thing as a non-contributory family history. It is necessary to know the meaning that complaints or questions have for the mother and the child. This can only be obtained through the physician's expressed interest in both, and in his patient attitude and willingness to listen to what both have to tell him.
c) The physician is faced with a patient (child) who is extremely dependent on parents or parental figures. The parents and child form a unit. It is the pediatrician's goal to help improve the health of the child by understanding the child's position in the unit. He should utilize the assets of this unit for the child and parents.
d) His interest in and acceptance of the patient results in more effective diagnosis and treatment. This attitude develops gradually when adequate supervision is available.
SURGICAL JAUNDICE IN INFANCY
Authors: Kiesewetter William B. , Koop C. Everett , Farquahr John D. 
Published: December 2021

Forty cases of surgical jaundice in the newborn and infancy period have been reviewed from which the following conclusions seem justified:
1. The predominant cause is atresia of the biliary ducts, either extrahepatic or intrahepatic.
2. The only liver function test of use in differentiating hepato-cellular jaundice from obstructive jaundice is the total bilirubin which declines or is irregular in the former and rises steadily and uninterruptedly in obstruction.
3. Liver biopsy is of value in confirming operative findings and giving some measure of prognosis based on the amount of hepatic damage.
4. The end results are discouraging, with 10 per cent operability and 68 per cent overall mortality in the whole series of those operated.
5. After medical causes have been eliminated, exploratory laparotomy should be carried out.
CLINICAL ASPECTS OF CEREBRAL ANGIOGRAPHY IN CHILDREN
Authors: Poser Charles M. , Taveras Juan M. 
Published: December 2021

A series of 90 children subjected to cerebral angiography is reviewed. One hundred thirty-one cerebral angiograms were performed of which 117 were by the percutaneous method. All but 2 were done under general anesthesia. Cerebral angiography was of definite diagnostic value in 43.5 per cent of the patients.
No fatalities were encountered in this series. Morbidity and complications were present in 35 per cent of the procedures but all were mild and transient. Complications believed to be due specifically to angiography were present in 20 per cent. It is felt that the morbidity and complications are affected in some way by general anesthesia and premedication. Morbidity in cerebral angiography in children is lower than in pneumoencephalography performed under the same conditions in a comparable group of children.
Cerebral angiography is a useful and relatively harmless procedure in children when the proper precautions are taken and the indications are definite. The percutaneous technique is suitable for children of all ages.
A NOTE ON SPEECH RETARDATION IN MENTAL DEFICIENCY
Authors: Brown Spencer F. 
Published: December 2021

THE DIAGNOSIS of retarded speech development in a preschool child is often a difficult problem, and many cases can be adequately evaluated only after extensive neurological, psychological, otological, and other examinations. Frequently the history will yield sufficient information to enable one to assign the cause of the retarded speech with a high degree of accuracy, although every presumptive diagnosis should be confirmed by appropriate examinations.
In the study of a large number of children with delayed speech, a curious item has frequently appeared in the histories. It was often discovered that the child began to use single words at approximately the average age normal age, namely about 12 months. These words are usually few—3 to 6 or 8. They are not used often but occur at variable intervals over a period of a few weeks to 6 or more months. Then these words disappear the child is not heard to use them again, and other words do not take their place. It must be pointed out that this is not a cessation of speech after a normal beginning. The words which the child uses do not emerge from a large amount of babbling. They come suddenly and unpredictably. Yet they are phonetic combinations which are used consistently—if sparingly—to refer to the same person or object.
In all instances in which such a history has been found, it has been the author's experience that the child in question is significantly mentally retarded. Conversely, such a pattern has not been found in any child of normal intelligence whose speech retardation is on another basis.
PATHOGENESIS OF SUBDURAL COLLECTIONS OF FLUID
Authors: Gitlin David 
Published: December 2021

Eighteen patients with subdural accumulations of fluid were selected for study; of these, 11 had had acute bacterial meningitis, 1 had had subdural air secondary to pneumoencephalography, 5 had developed fluid secondary to trauma and 1 did not fit any of these categories.
The albumin: γ-globulin ratios and albumin : total protein ratios in the subdural fluids were considerably higher than these ratios in the corresponding serum samples.
These findings suggest that, although the forces involved are complex, the basic mechanism of fluid accumulation in the subdural space was similar in all these patients, namely, an effusion through irritated or damaged capillary walls.
PUBLIC HEALTH, NURSING, MEDICAL SOCIAL WORK
Authors: Laidlaw Elizabeth H. 
Published: December 2021

THE PROBLEM that we have solved in the Tucson Schools in the last 3 years by means of the Revolving Health Fund of our Health Council, is one which, though definitely characteristic of Tucson, may also exist in other cities in the United States; consequently, we offer our solution in the hope that there may be other communities with the same types of problems who might benefit from our experiences. The problem is that of the financing of medical care for indigent children whose families cannot afford to pay a private doctor, yet whose income possibilities or resident and citizenship qualifications, do not entitle them to welfare aid or state and county medical care. In larger cities there are usually clinics available to such medical indigents at a low fee, and social workers to determine eligibility for this service.
But, in Tucson (and possibly in some other cities which have grown up rapidly under similar circumstances) the situation is somewhat unusual in certain respects, and it is because of these peculiar characteristics that we have had to evolve a plan tailored to meet our individual problem.
In solving this problem our Health Council has found it necessary to function not only as a coordinating and planning agency in the conventional sense, but also as an operating agency.
ADRENAL CORTICAL HORMONES AND INFECTION
Authors: Robinson Harry J. 
Published: December 2021

Animal studies show that cortisone, hydrocortisone or the steroid prednisolone may lower the resistance of a variety of animal species to many infectious agents.
The mechanisms by which large doses of these hormones alter host resistance to infection appear to be related to a decrease in the movement and phagocytic activity of polymorphonuclear leukocytes, suppression of antibody formation, and an alteration in the function of the reticulo-endothelial system.
Antibiotics, in larger doses than usually employed, will control infectious diseases in cortisone- and hydrocortisone-treated animals and patients.
Despite the results of animal studies, the reported incidence of intercurrent infections in humans treated with adrenal cortical hormones appears to be relatively low. Complicating infections may be kept at a minimum if careful histories and physical examinations are employed to detect patients with latent infection on arrested tuberculosis.
Patients treated with adrenal cortical hormones should be followed carefully for signs of infection. If the latter is suspected, cortisone therapy should be gradually reduced, and vigorous antimicrobial treatment instituted as soon as diagnostic measures, including specimens for bacteriologic identification, are taken.
The use of adrenal cortical hormones in the treatment of active infection is still under investigation and requires further study before final conclusions can be reached. However, the results to date are encouraging in Waterhouse-Friderichsen syndrome, tuberculous meningitis, and various other life-threatening and unusually severe infections. Hence the cautious and discriminate use of these hormones in certain severe infections would appear to be a helpful adjuvant to other therapy.
Should the Patient Know the Truth
Authors: SHIRLEY HALE F. 
Published: December 2021

Most physicians in practice are frequently confronted with the question of what to tell a patient who has a serious or fatal disease. Should the patient be told the truth? What, when, and how should he be told? What should his family be told? What are the therapeutic, ethical, religious, materialistic, and legal factors to be considered in coming to a decision?
This little book is an outgrowth of a discussion of such problems at a meeting of the New York Academy of Medicine.
FURTHER OBSERVATIONS ON ELECTROLYTE CHANGE IN TUBERCULOUS MENINGITIS
Authors: Cheek Donald B. 
Published: December 2021

The investigation of the disturbance of the electrolytes of the serum in 8 patients with tuberculous meningitis again demonstrates the frequent presence of metabolic alkalosis, hypochloremia and hyponatremia, a normal total content of chloride in the body and hypotonic expansion of the extracellular fluid (chloride space). Total content of water is normal or decreased in some instances (on the basis of total weight) so that the expansion of the chloride space can be considered as being occasionally, if not frequently, at the expense of water from the cells. The instances in which total content of water is increased could be explained on a malnutrition basis. The findings of metabolic alkalosis and hypotonic expansion of the chloride space are not the rule in purulent meningitis.
The penetration by bromide of the blood-spinal fluid barrier has been investigated in 7 cases of tuberculous meningitis and in 5 cases of purulent meningitis. In the former instance, bromide, penetrated the spinal fluid almost completely within 8 hours of injection, giving a [See equation in source pdf] ratio of about one. In purulent meningitis the degree of penetration was also increased in some instances, and it is not possible to differentiate tuberculous meningitis from purulent meningitis by the above method.
While the initial cause of the coexisting metabolic alkalosis remains obscure, it is pointed out that requirements for potassium should be more than fulfilled, and loads of sodium should not exceed maintenance requirements in the presence of this persistent metabolic alkalosis.
Congenital Heart Disease, Report of the Fourteenth M & R Pediatric Research Conference
Authors: LURIE PAUL R. 
Published: December 2021

This brochure, which is already in the possession of most of the readers of this review, should not be ignored. To the pediatrician it is one of the most clinically useful of this Conference Report series. To those with special interest in pediatric cardiology it supplies information unobtainable elsewhere.
The delay of over a year between conference and publication which was necessitated by a painstaking editorial job has resulted in some loss of glamor. For example, human cross circulation in intracardiac surgery, new and sensational at the time of the conference, is already discarded by its proponents, in favor of the pump-oxygenator.
WEIGHT GAINS IN THE FIRST FOUR WEEKS OF INFANCY: A COMPARISON OF THREE DIETS
Authors: Gross Ruth T. , Moses Lincoln E. 
Published: December 2021

Four hundred seven healthy, full-term infants were divided into three groups and fed, respectively, a formula of evaporated milk and water with 5% carbohydrate; human milk; and a special modified evaporated milk designed to simulate human milk. No other foods were added to the diet. A comparison of the three groups was made, based on weight gains from birth to the end of the first 4 weeks. The conclusions refer only to weight gains; no attempt was made to determine the superiority of any particular diet.
The data show no significant differences in the 4-week weight gains among the three groups of infants, although sensitive statistical methods could be validly applied to the problem. These methods are explained.
The authors wish to emphasize the many variables which must be taken into account in a study of this sort; the necessity for careful selection of valid statistical methods; the importance of critical clinical judgement in the evaluation of the results.