bluuebunny/crossref_metadata_2025_split huggingface dataset:
"WHEN SHOULD ONE LIGATE THE UMBILICAL CORD?"
Authors: S. C. A. 
Published: December 2021

THE WORDS ABOVE, freely translated from the French, repeat the title of an article published in 1875 and referred to in this month's Review Article. Ninety-two years and at least 90 published papers later, the question is still unanswered today. It is worthwhile to ask: Why?
The appearance of this useful Review Article and of the investigation by Oh, Wallgren, Hanson, and Lind in the same issue suggested that Professor Lind himself be asked for a Commentary containing his own recommendation on when to ligate. Despite much evidence of his interest in placental transfusion, he was politely (as always) unwilling to commit himself in the hoped-for Commentary, or even in a personal letter.
FACTORS PERTAINING TO PROLONGED PREGNANCY AND ITS OUTCOME
Authors: Zwerdling Michael A. 
Published: December 2021

Pregnancies extending more than 3 weeks beyond the expected date of confinement were studied among 9,719 single, white births from the Child Health and Development Studies in Oakland, California, and 358,702 births representing all white, singleton pregnancies in New York City terminating from 1957 through 1959.
The incidence of prolonged pregnancy was 7.3% in the Child Health and Development Studies and 5.4% in New York City. Younger women, primigravidas, and women of high parity showed an increased incidence.
Fetal and neonatal mortality rates were approximately doubled in prolonged pregnancy in both Oakland and New York City. This relationship held for both primiparas and multiparas, for antepartum and intrapartum fetal deaths, and for all major causes of fetal and neonatal mortality.
Post-term infants weighing less than 2,500 gm (5½lb) had a neonatal mortality rate seven times the rate for prolonged pregnancies as a whole. There was no increase in neonatal mortality among post-term infants weighing more than 4,100 gm (9 lb) compared with prolonged pregnancy infants between 2,500 and 4,100 gm (5½ to 9 lb).
There was a slightly increased incidence of congenital anomalies in the prolonged gestation group. Neonatal mortality in infants with severe congenital anomalies was substantially higher in prolonged pregnancy.
The excess mortality experience of prolonged pregnancy children continued for at least the first 2 years of life. Hospitalization and clinic visit data also implied a poorer health status in these children over the first 3 years of life.
Data on growth and intelligence revealed no difference between children with prolonged and normal gestation in a small group examined at age 5.
There were no gross placental findings to support the hypothesis of placental senility as a cause of pathology in prolonged pregnancies.
A tendency was noted for prolonged pregnancy to recur in successive gestations.
POSTNATAL BONE GROWTH OF INFANTS WITH FETAL GROWTH RETARDATION
Authors: Wilson Miriam G. , Meyers Harvey I. , Peters Allen H. 
Published: December 2021

Infants with fetal growth retardation, diagnosed by a birth weight less than the 10th percentile for gestational age, had shorter fibulas and retarded development of epiphyses at the knee, measured from radiographs, when compared to infants with normal weight for gestational age. The neonatal fibula growth rates of the infants with fetal retardation and normal infants were similar, indicating that most infants with fetal growth retardation grow postnatally at a normal rate. Of the 30 infants with fetal growth retardation, 3 showed profound failure of neonatal fibular growth. These infants had severe physiological disturbances in postnatal life resulting from congenital anomalies. In one of these infants, the failure of neonatal growth was evident 3 to 4 weeks before any other signs of her illness appeared.
It appears, therefore, that a small proportion—10% in this study—of infants with fetal growth retardation have significant congenital malformations that interfere with postnatal growth. The majority of infants who are small at birth for gestational age grow adequately at a normal rate during their neonatal life.
INTELLIGENCE OF THE UNIDENTIFIED PHENYLKETONURIC CHILD
Authors: Brown Eleanor S. , Waisman Harry A. 
Published: December 2021

BESSMAN has raised a number of questions regarding treatment of patients with phenylketonuria (PKU), some of which can be answered by data presently available. The most important of these concerns the expected outcome for an untreated phenylketonuric child. If it is possible, as Bessman suggests, that PKU is often very benign and that we have identified only the atypical severe cases, then the apparent results of treatment may be due simply to observing the more usual course of the disease. Therefore, it is important to study a high-risk group of children who have not previously been tested for PKU. This group consists of those siblings who were already born at the time that the proband was diagnosed. Since routine testing for PKU has only been done recently, these children presumably have not been tested previously.
The number of PKU siblings expected in this group of previously untested brothers and sisters is partially dependent upon the frequency and degree of mental retardation in the disease as suggested by the following possibilities:
1. If mental retardation is incidental in PKU, then one fourth of these siblings would be expected to have PKU as determined by blood and urine tests, and their mental abilities, which might be normal, would be considered typical of untreated phenylketonuric individuals. This would also indicate that most families with PKU members have not been found during the past 10 years, when most cases were ascertained because of mental retardation.
2.If PKU causes severe retardation and urine and blood tests are done on all retarded children, then the first affected child would be identified as the proband in each family; all siblings born before the proband would be non-PKU, and all children with true PKU would be clearly identified.
COMMITTEE ON NUTRITION
Authors: LOWE CHARLES U. , COURSIN DAVID BAIRD , HEALD FELIX P. , HOLLIDAY MALCOLM A. , O'BRIEN DONOUGH , OWEN GEORGE M. , PEARSON HOWARD A. , SCRIVER CHARLES R. , FILER L. J. , KLINE O. L. 
Published: December 2021

THIRTEEN YEARS AGO a dietary approach to the therapy of phenylketonuria was proposed, and data on the usefulness as well as the very real limitations of this program have accumulated in the intervening years. At the present time studies on the application of special diets for use in this disease, as well as for many other hereditary metabolic diseases, are in progress. As wider use is made of procedures for detection of hereditary metabolic disease in the newborn, an increasingly larger number of patients who may benefit from appropriate nutritional therapy will be identified very early in life. For example, calculations based on the current birth rate and apparent incidence of phenylketonuria indicate that as many as 4,000 infants with this disorder in the United States alone could require dietary therapy in the next decade. There is, therefore, a need to evaluate the principles governing nutritional management of hereditary metabolic disease in order to develop optimal treatment facilities for use in conjunction with new detection methods. It seems anomalous that comparatively little has been done either to establish good treatment practices in hereditary metabolic disease or to mobilize scientific resources to ensure an optimistic out-come for therapeutic endeavors, while so much emphasis has been placed on detection.
Dietary treatment of hereditary metabolic disease is simple in theory; however, practical application may be unexpectedly difficult, or even hazardous, if not carefully supervised. It should be determined whether: (1) the untreated disease is in fact harmful, (2) the treatment is useful in preventing or reversing the unfavorable progression of the disease, (3) the therapy may be harmful by interfering with growth or development, and (4) the program may be harmful to others to whom it is inadvertently or inappropriately given.
MORTALITY FROM CONGENITAL CARDIOVASCULAR DISEASE IN OREGON
Authors: Menashe Victor D. , Osterud Harold T. , Griswold Herbert E. 
Published: December 2021

Over one half of the deaths from all congenital malformations were due to congenital cardiovascular disease. There were 496 individuals who died of congenital cardiovascular disease in Oregon during 1957 thru 1961, and three fourths of the deaths occurred in infants under 1 year of age.
More males were affected by congenital cardiovascular disease than females, but, when congenital cardiovascular disease was present, the length of survival, as measured by life span, did not differ by sex.
One out of every four infants dying of congenital cardiovascular disease was of low birth weight; of these, 60% were over 37 weeks' gestation. However, there was no difference in the life span of low birth weight and normal birth weight infants who died with congenital cardiovascular disease. This would imply that the significant factor of death in these infants was the cardiac malformation rather than the low birth weight. One out of every three infants who died with congenital cardiovascular disease had malformations of other systems.
Fewer deaths than expected were identified among first born. Fetal deaths were noted more frequently in the population of mothers of children with congenital heart disease than in the overall population. The parental age in this group was significantly higher than in the general population and death rates of infants with congenital cardiovascular disease increased with advancing parental age. Thirty-two percent of the infants who died with congenital cardiovascular disease had single lesions.
Early diagnosis and treatment is to be stressed if mortality is to be reduced.
Jell-O-Water—An Adjunct in the Treatment of Infantile Dehydration
Authors: QUILLIAN WARREN W. 
Published: December 2021

The objective of oral fluid therapy for the treatment of mild infantile gastroenteritis is the provision of adequate replacement of caloric, water, and electrolyte deficits without increasing stool losses. Solutions used to accomplish this should be accepted readily by the infant and be balanced to avoid accentuation of hypotonic or hypertonic conditions.
Jell-O-Water (85 gm package of Jell-O per liter of water) is an inexpensive and palatable mixture. The original package costs 10c. During the past few years we have found this solution useful in the oral treatment of mild dehydration during infancy.
Hazards of Glass Food Jars
Authors: GROSSMAN PERRY 
Published: December 2021

I would like to call attention to a potential hazard to young infants which has received little or no publicity to my knowledge. I refer to the possibility of the glass in a standard baby food jar cracking underneath the label. This may go unnoticed until the child has consumed a substantial portion of the jar's contents.
We recently cared for a 1-year-old child who was involved in such a mishap. This child sustained lacerations of the pharynx with a retropharyngeal abscess.
DUTY OF CHILDREN TO PARENTS
Authors: C. T. E. 
Published: December 2021

A little more than a century ago New England children between 10 and 13 years of age read and memorized passages in their readers which were frequently pious admonitions from the sermons and writings of the leading contemporary ministers, none of whom was more respected than William Ellery Channing (1780-1842). Yet children today, if their reading skills are up to it, will usually roll on the floor with disbelief and laughter when they read statements such as these taken from Channing's essay on the Duty of Children to Parents.
What greater monster can there be than an unthankful child, whose heart is never warmed by the daily expressions of parental solicitude; who, instead of requiting his best friend by his affectionate conduct, is sullen and passionate, and thinks his parents will do nothing for him, because they will not do all he desires?
Consider how much better they (parents) can decide for you than you can for themselves. You know but little of the world in which you live. You hastily catch at every thing which promises you pleasure; and unless the authority of a parent should restrain you, you would rush into ruin, without a thought or fear. In pursuing your own inclinations your health would be destroyed, your minds would run to waste, you would grow up slothful, selfish, a trouble to others, and burdensome to yourselves.
COMMITTEE ON FETUS AND NEWBORN
Authors: LUCEY JEROLD F. , BROWN AUDREY K. , BEARD ALICE GAMBLE , CORNBLATH MARVIN , GROSSMAN MOSES , LUBCHENCO LULA O. , METCOFF JACK , SCHAFFER ALEXANDER J. , SCHWARTZ ROBERT , GRUENWALD PETER , MURTAGH JUAN J. 
Published: December 2021

THE physical design of and routine practices in neonatal units (especially nurseries for high-risk infants) are presently influenced almost entirely by considerations related to the risk of spreading infection in the nursery by fomites and personnel. The role of nursery design and specific routines in preventing epidemics is considered so important that the details are encoded in many local, state, and federal health laws or regulations. These are enforced by periodic inspections and conformity is made a prerequisite for official approval, allocation of funds, etc. Although there is little reason to doubt that these policies have had the effect of reducing the incidence of nursery epidemics, there is growing concern that official rigidity in these matters may interfere with optimal care of the very ill infant, as well as with research designed to improve care and find solutions to the overall problems of neonatal mortality and morbidity.
Infections are an important and frequent cause of disease in the newborn. They are, however, clearly outdistanced by major non-infectious disorders that account for the majority of deaths and brain damage in the neonatal period (respiratory distress, asphyxia, acidosis, hypoglycemia, and hyperbilirubinemia). Some of the precautionary techniques used to reduce the risk of infections have the practical disadvantages of making it difficult (1) to approach the neonatal patient and (2) to apply modern diagnostic maneuvers and therapeutic aids in order to improve the neonatal patient's chances for intact survival. As a result the nursery-based infants in this country are, in general, quite well protected from the risks of nosocomial infections; but, they receive less than ideal management for cardiorespiratory disorders, a major cause of neonatal mortality.
It is obvious that new solutions are required to solve the problem of hospital care of the sick neonate. Unfortunately, both the search for new approaches to neonatal care and the application of some newly established knowledge are now being impaired by rigid rules and construction codes which do not permit innovation. Although these rules cannot be completely abandoned until safe alternatives have been demonstrated, the Committee believes that public health administrators and hospital committees must permit cautious, responsible exploration and evaluation of new approaches to the multiple problems involved.
ACCEPTANCE OF THE PRESIDENCY OF THE AMERICAN ACADEMY OF PEDIATRICS
Authors: Logan George B. 
Published: December 2021

THIS change of blue to purple ribbon on my badge is a great honor. I thank you for selecting me to serve the Academy in this way. However, acceptance of the presidency at this time gives me some feelings of trepidation, despite your support and the support of a strong Executive Board and Central Office staff.
American medicine is undergoing revolutionary changes: scientifically and educationally as well as in its methods of delivery. Pediatrics as a major division of medicine is not exempt from these changes. Government is playing an ever-increasing role in medical activities. Whether we agree with these changes or not is beside the point. The fact is, they are with us. But these changes are not unique to the United States. They seem to be part of worldwide scientific and social alterations.
This year, you as Academy members must become accustomed not only to the usual yearly change of a president but also to a change of executive directorship. Dr. Christopherson's years in this office have been years of tremendous accomplishment. We are all confident that Dr. Frazier's will be the same.
Those of us to whom the mantles of responsibility are being given are grateful for the firm foundation that has been built by our predecessors in office. We shall, to the best of our ability, face present and future problems with equanimity, dispatch, good sense, and the best possible judgment.
As we undertake these tasks we shall always keep before us the section of our Constitution which states: "the object of the Academy shall be to foster and stimulate interest in Pediatrics and correlate all aspects of the work for the welfare of children which properly come within the scope of Pediatrics."
COMMITTEE ON NUTRITION
Authors: LOWE CHARLES U. , COURSIN DAVID BAIRD , HEALD FELIX P. , HOLLIDAY MALCOLM A. , O'BRIEN DONOUGH , OWEN GEORGE M. , PEARSON HOWARD A. , SCRIVER CHARLES R. , FILER L. J. , KLINE O. L. 
Published: December 2021

FOR MORE than 40 years it has been known that vitamin D is essential for maintenance of normal calcium metabolism in man. Efforts over this period have been directed toward establishing an adequate intake of vitamin D throughout the population. National advisory committees in many countries have formulated recommended allowances for the various age groups, public health education programs have stressed the need for the vitamin and the value of sunshine, and the vitamin has been made available to the population at large through provision of inexpensive vitamin supplements and, more recently, the enrichment of milk and a number of commonly used foodstuffs. In consequence, vitamin D deficiency rickets, once a common pediatric problem, is now relatively rare in the United States and other parts of the world.
On the other hand, it has also long been known that vitamin D is potentially dangerous in very high dosage. It had been thought originally that the margin of safety between the requirement of vitamin D and its toxic dosage was very great. However, reports from Great Britain and Switzerland in 1952 drew attention to a group of infants with unexplained hypercalcemia. Additional cases of infantile hypercalcemia began to appear throughout the British Isles, and patients with mild or severe manifestations have been reported in the United States, Canada, and elsewhere. On the basis of circumstantial evidence, vitamin D was implicated in the pathogenesis of the disease, and, as a result, there has been a growing question about the safety of vitamin D intakes which appreciably exceeded the 400 I.U. daily allowance currently recommended for prevention of vitamin D deficiency during growth, pregnancy, and lactation.
THE LUNG, TRACHEAL FLUID, AND LIPID METABOLISM OF THE FETUS
Authors: Scarpelli Emile M. 
Published: December 2021

The thoracic wall provides the major retraction force for the liquid filled fetal lung. This could assist the movement of air into the lung at birth.
The tone of the respiratory muscles in utero may set intrapulmonary pressure levels and facilitate movement of tracheal fluid out of the lungs.
Surface rather than elastic forces probably are most important in determining the static work of breathing in the newborn.
The lung is a source of tracheal fluid, and possibly amniotic fluid, phospholipids.
Albumin may be an important stabilizer of tracheal fluid phospholipids.
The lung synthesizes tracheal fluid phospholipids rapidly. Phosphatidyl ethanolamine is probably an important precursor of lecithin and this conversion may take place within tracheal fluid itself.
These studies confirm our previous findings that the first fraction obtained from the Sephadex separation of lung extracts contains the lung surfactant system and that lung surfactant is not lipoprotein.
There is little transfer of lipids from the fetus to the ewe.
Phospholipids probably are synthesized by brown adipose tissue in the fetus; lipids do not cross the fetal blood brain barrier.
The implications of these studies to pathogenesis of the respiratory distress syndrome was discussed.
HEAD CIRCUMFERENCE FROM BIRTH TO EIGHTEEN YEARS
Authors: Nellhaus Gerhard 
Published: December 2021

Head circumference graphs for boys and girls from birth to 18 years of age, calculated from reports in the world literature published since 1948, are presented.
No significant racial, national, or geographic differences in head circumferences were found.
A single "normal" head circumference, that is one which lies within two standard deviations above and below the mean for age and sex, may prove misleading, since it gives no clue as to rate of head growth. Serial head circumference measurements should, therefore, be a routine part of the physical examination of infants and children. When such measurements are plotted on the composite graphs, abnormal growth patterns are readily discernible. Rapid upward deviation may signify correctable conditions, such as hydrocephalus, subdural hematomas or effusions. Marked slowing or arrest of head growth offers a poor prognosis for mental development. But even a single measurement outside the range of normal should lead to further evaluation of the child.
RELATION OF MEDICINE TO THE PROBLEM OF RADIOACTIVE FALLOUT
Authors: Farr Lee E. 
Published: December 2021

I have one additional item for the conference—a recommendation Dr. Joseph Sternberg wishes to bring before you to determine whether the conference participants are in agreement.
Throughout this conference many participants stressed the pediatric importance of radioactive isotope contamination before or during pregnancy. It is evident that studies of the effects of ionizing radiation upon the child must be begun even before the time of conception.
Therefore, this conference places upon the record the recognition of the great desirability and need of establishing closer and more effective liaison between appropriate public health officials, health physicists, radiobiologists, nuclear medicine physicians, obstetricians, and pediatricians that the problems faced by the conference may be more effectively and rapidly solved, and the members of this conference request this record be brought before appropriate organizations of each group for such further implementation as they may determine.
Is it the sense of this conference that this action be taken?
Let the record show that it is so ordered.
Dr. Seeds: I think we would be remiss if we became so engrossed in science as to forget the courtesy that the American Academy of Pediatrics has extended to all of us. I assert the privilege of giving them our thanks.
Dr. Farr: Thank you Dr. Seeds. There being no further items for discussion, the meeting stands adjourned.
MODEL FOR THE INVESTIGATION OF INTRACTABLE HYPOGLYCEMIA: INSULIN-GLUCOSE INTERRELATIONSHIPS DURING STEADY STATE INFUSIONS
Authors: Adam Peter A. J. , King Katherine , Schwartz Robert 
Published: December 2021

The relationship between blood glucose and Plasma insulin concentrations in hypoglycemic infants was contrasted to that observed in normal subjects while maintaining blood sugar levels in a physiological range. Glucose was infused continuously by peripheral vein at four constant rates in sequence to the following groups of subjects: (1) nine normal adults, (2) four normal infants, (3) five children who had diabetes, and (4) four infants who had intractable hypoglycemia.
There was a direct relationship between blood glucose and plasma insulin concentrations in both normal groups. Although the relationship between blood glucose and plasma insulin concentrations was similar, normal infants disposed of the exogenous glucose load more rapidly than normal adults. Hypoglycemic infants had one of two responses: (1) moderate hyperinsulinemia at low blood glucose concentrations, or (2) low insulin concentrations at all blood glucose levels, a response similar to that observed in the diabetic children.