bluuebunny/crossref_metadata_2025_split huggingface dataset:
ERYTHROBLASTOSIS FETALIS
Authors: VAUGHAN VICTOR C. , ALLEN FRED H. , DIAMOND LOUIS K. 
Published: December 2021

1. Twelve years' experience with 539 cases of erythroblastosis fetalis has been reviewed.
2. It is not possible to show beyond the statistical limits of chance that any change in mortality of erythroblastosis fetalis in relation to therapy in live born infants has occurred in this time.
3. It is probable that the early induction of labor has caused an increased risk to live born babies during part of this period, when erythroblastosis fetalis has been complicated by immaturity, particularly before 38 weeks' gestation.
4. Caution is urged in assaying the value of any therapeutic measure, the use of which in erythroblastosis fetalis may result in a selected body of clinical material.
DOSAGE OF DRUGS IN INFANTS AND CHILDREN: I. ATROPINE
Authors: UNNA KLAUS R. , GLASER KURT , LIPTON EARL , PATTERSON PAUL R. 
Published: December 2021

The susceptibility of apparently healthy children of all age groups to atropine by oral and subcutaneous administration was studied in carefully controlled experiments on 129 children. The minimal effective dose (MED) of atropine was determined by its effect in suppressing sialorrhea elicited either mechanically by chewing gum and/or pharmacologically by subcutaneous injection of methacholine.
Variations in individual susceptibility to atropine are large in all age groups and independent of the route of administration (oral, hypodermic.)
The average MED/kg. body weight following oral administration is somewhat smaller in infants of 1 to 12 months and children from 12 to 36 months (0.16 and 0.14 mg./kg., respectively) than in older children in the age groups of 3 to 6 years and 6 to 12 years (0.22 and 0.20 mg./kg., respectively). Comparable results are obtained by hypodermic administration.
The ratio between the MED by mouth and the MED by hypodermic injection is approximately 3:1 in all age groups.
The determination of the susceptibility of children of various ages of atropine fails to adduce evidence supporting the assumption of an increased resistance to atropine or of a physiologic vagotonia in infants.
The relation of the MED of atropine in apparently healthy children to the doses recommended in pediatric therapy is discussed. The calculation of the dosage of atropine by body weight is recommended.
STUDIES ON THE GELATIN-LIQUEFYING PROPERTIES OF CERTAIN BACTERIA
Authors: JOHNSTONE DOUGLAS E. 
Published: December 2021

The gelatin film test for the demonstration of gelatin-liquefaction of bacterial cultures and stool suspensions is described. This test may aid in the identification of gelatin-liquefying bacteria, particularly members of the Pseudomonas and Proteus groups.
One hundred and seventy-nine strains of bacteria were tested. Positive results were obtained with Ps. aeruginosa, P. ammoniae and some strains of P. morgani. Negative results were obtained with 24 hour cultures of Staph. aureus hemolyticus and Esch. coli.
This test may be positive in dilutions of 24 hour broth cultures of gelatin-liquefying bacteria as high as 1:100,000 with an average of 1:200. The average number of such bacteria found necessary to give a positive gelatin film test is 960,000/2 drops of test solution (varying from 80,000 to 360 million). Bacteriologically sterile Seitz filtrates of gelatin-liquefying bacteria also gave positive gelatin film tests in high dilutions.
A mixture of gelatin-liquefying bacteria with saline suspensions of feces gave positive tests.
Stool cultures of four and duodenal cultures of three proved cases of cystic fibrosis of the pancreas revealed heavy growth of gelatin-liquefying bacteria. All these specimens gave positive gelatin film tests.
The presence of aureomycin in the stool (in concentrations of up to 1 mg./cc.) does not inactivate bacterial gelatinase.
The fact that bacteria present in the gastrointestinal tract may give a positive gelatin film liquefaction test makes mandatory the re-evalution of the positive feces "x-ray" tests for the diagnosis of cystic fibrosis of the pancreas. To avoid false positive gelatin film tests, the results of the test should be correlated with the presence or absence of gelatinliquefying bacteria.
AORTIC-PULMONARY COMMUNICATION DUE TO LOCALIZED CONGENITAL DEFECT OF THE AORTIC SEPTUM
Authors: GIBSON STANLEY , POTTS WILLIS J. , LANGEWISCH WILLIAM H. 
Published: December 2021

Four patients who had findings suggestive of a patent ductus arteriosus were explored. In none was a patent ductus found.
Evidence is offered in support of an aortic-pulmonary communication due to a localized defect in the aortic septum as accounting for the clinical symptoms and signs.
Round Table Discussion
Authors: SMITH CLEMENT A. , HEATON CLAUDE , HARSHBERGER JANE Y. , SPOCK BENJAMIN , NATHANSON IRA T. , BAIN KATHERINE , KIMBALL E. R. 
Published: December 2021

Chairman Smith: In their approach to breast feeding, as to religion, pediatricians might be classified in 3 groups. There are the firm believers, with serene faith that all women ought to nurse their babies because "breast feeding is best feeding." At the other extreme, certain agnostics hold that it makes no important difference whether a baby is breast fed or given a formula. Much the most numerous are the third group, who would be glad to have a faith to stand up for if the rational basis of such a faith were revealed to them. These conscientious physicians, anxious to give sound scientific advice, find themselves falling back among traditions and impressions, in the absence of modern factual knowledge. Much new data concerns only premature infants, for whom it is quite possible that Nature did not design human milk. Obviously we need facts. Are the antibodies in human milk significant? Does it protect against neonatal diarrhea? Does suckling cause uterine involution? What constitutes optimum growth in infancy? Does it result with artificial feeding?
Without the answers to these and other questions the subject escapes into psychologic and emotional fields since it cannot be properly tackled in physiologic territory. Indeed whether a mother will nurse her baby is now usually decided psychologically rather than physiologically. If 72% of New Hampshire babies leave the maternity hospital on bottle feeding only, compared to 10% of those in South Carolina, the psychology of South Carolina women, and of their doctors, must differ from that of those in New Hampshire.
THE PEDIATRICIAN AND THE PUBLIC
Authors: GOLDMANN FRANZ 
Published: December 2021

1. Payment for the services of physicians conducting diagnostic clinics is made most frequently by allowing flat rates, either per unit of time or per clinic session, somewhat less frequently by using the part-time salary system, and only rarely on the basis of the fee-for-service system.
2. Payment for specialist consultations outside of clinics is based on the fee-for-service system and the part-time salary system in this order of frequency.
3. Payment for treatment by physicians, both specialists and general physicians, is made most frequently on the basis of the fee-for-service system and less frequently on the basis of the part-time salary system.
4. In at least eight states, the part-time salaries paid to the physicians cover a varying combination of the following types of professional service: diagnostic clinic sessions, consultations outside of clinics, and treatment, including preoperative and postoperative care as well as operative procedures.
5. Dentists, including orthodontists, are compensated on the basis of the fee-for-service system in the great majority of all states.
6. Pediatricians receive fees most frequently and flat rates or part-time salaries less frequently. Orthopedic surgeons are paid on the basis of the flat rate system, the fee-for-service system, or the part-time salary system in this order of frequency.
7. Reimbursement of travel expenses incurred in connection with both service at diagnostic field clinics and consultations outside of clinics is a widely accepted principle.
8. There is little, if any, information on such questions as the reasons for the choice of certain methods of payment, the basis for the determination of specific rates of compensation, the number of diagnostic clinic sessions actually held per month or year, the average number of hours, excluding travel time, actually spent on one clinic session, the amount of work and time actually contributed by the physicians receiving part-time salaries, or the type and amount of service rendered by physicians compensated on the basis of the fee-for-service system. In the absence of such information no conclusions can be drawn on the relative merits of the various payment methods employed and especially on the adequacy of the compensation received by the participating physicians and dentists, the effect on the quality of service, and the administrative implications.
BLOOD CARBONIC ANHYDRASE ACTIVITY IN NEWBORN INFANTS AND THEIR MOTHERS
Authors: ALTSCHULE MARK D. , SMITH CLEMENT A. 
Published: December 2021

Each ml.of erythrocytes of newborn infants exhibits carbonic anhydrase activity which, on the average, is approximately 40% of that found in the erythrocytes of adult subjects. The deficiency appears to vary with the maturity of the organism, either in or ex utero. It is not as great as that described by earlier workers who used methods of less validity. Moreover, the relative polycythemia of the newborn infant counteracts this deficiency, and accordingly the blood of these infants may exhibit carbonic anhydrase activity within or a little below the normal adult range. Transfusion into infants of adult blood increases the carbonic anhydrase activity.
Mothers in whom blood hemoglobin levels are low show similar degrees of lowering of blood carbonic anhydrase activity.
The functional significance of the changes found in the newborn infant is not known.
TOTAL BLOOD EOSINOPHIL COUNTS IN THE NEWBORN PERIOD
Authors: MEDOFF HAROLD S. , BARBERO GIULIO J. 
Published: December 2021

A total of 262 eosinophil counts were done on a series of 57 infants. The mean level was 267 at birth and 483 at 1 month of age.
The eosinophil count rose significantly in the first week of life in 75% of 44 infants. Eighty-two per cent of 28 infants showed a significant rise in eosinophils from 5 to 30 days of age.
The marrow of newborn infants was relatively rich in myelocytic and rubrocytic elements and low in lymphocytes. At 30 days of age the marrow showed a significant and reciprocal change in the relative proportions of these elements.
The infant's eosinophil pattern in the first week after birth was variable and erratic. It differed quantitatively and qualitatively from that of his mother.
STUDIES OF ACID BASE EQUILIBRIUM IN PREMATURE INFANTS
Authors: REARDON HELEN S. , GRAHAM BRUCE D. , WILSON JAMES L. , BAUMANN MARY L. , TSAO MAKEPEACE U. , MURAYAMA MAKIO 
Published: December 2021

A study of the acid base balance of arterial blood in 92 premature infants, aged 1 to 65 days and 1.1 kg. to 2.3 kg. in weight, has been presented. The temporal artery blood was analyzed for pH, plasma CO2 content, chloride, total protein, total base. Alveolar carbon dioxide tension (pCO2) and "R" were calculated. Acid base analyses on the femoral artery blood of 16 adolescent well boys were used as controls. The study reveals the following salient facts:
There is a wide variation in the blood chemical findings between normal, well premature infants. In addition, repeat determinations upon the same infants revealed a more labile blood chemical picture than is found in older infants or adults.
No premature infant had all fractions of the acid base balance within the adult normal range.
The mean values for pH, CO2 content and protein were reduced in premature infants, while the mean values for total base, chloride, phosphate and "R" were elevated as compared to the values for the adult controls. The mean value for carbon dioxide tension was normal.
Sixty-seven per cent of the premature infants had the chemical findings of an uncompensated metabolic acidosis; 13% had a normal pH and CO2 content; 10% had a respiratory acidosis, 7% had a respiratory alkalosis and 3% were unclassified.
There was no statistical correlation of acid base values to birth weight or age or weight at the time of chemical sampling.
There was no difference of acid base values in infants who had been transfused by blood or plasma and those infants who had never been given blood or plasma transfusions.
By clinical examination alone, the nature of the acid base variations could not be anticipated in what we generally consider as well premature infants. There was no correlation between the variations of the acid base disturbance and the prognosis for life in these babies.
The fact that most premature infants have an increased hydrogen ion concentration and an unstable acid base balance may be additional reasons why premature babies so easily develop severe acidosis when any stress occurs, whether it is improper feeding, infection, etc.
The cause of the acidosis in premature infants has not been established. The theory that premature infants have a partial anaerobic metabolism with a decreased production of carbon dioxide is tenable but not established.
GASTRIC ULCER OF THE PYLORUS SIMULATING. HYPERTROPHIC PYLORIC STENOSIS
Authors: COLE ARTHUR R. C. 
Published: December 2021

A brief review of the natural history of peptic ulcer in infancy and childhood is given. The symptomatology, differential diagnosis and diagnostic procedures are presented. The diagnosis of peptic ulcer should be considered more often in infancy and childhood and the proper diagnostic procedures instituted.
A case of gastric ulcer simulating hypertrophic pyloric stenosis is presented. A summary of 31 cases with peptic ulcers found at autopsy at the Babies Hospital from January 1, 1924 to January 1, 1950 is given.
From a summary of coexistent disease found in the autopsy cases at the Babies Hospital and reports from the recent literature, it would appear that diseases of the central nervous, gastrointestinal and respiratory systems are commonly present in cases which have shown peptic ulcer at autopsy.
Round Table Discussion
Authors: REILLY WILLIAM A. , WILKINS LAWSON H. , DEAMER WILLIAM C. , MOTEL WILLIAM G. , DIETRICH HARRY F. 
Published: December 2021

Chairman Reilly: The first topic that I want to discuss with you is thyroid extract, its indications and usage. This sounds like a hackneyed subject but still there is a great deal of misusage and misinformation about thyroid.
The first thing about thyroid that might be of use to you is its preventive usage. In pregnancy it is probably advisable in the endemic areas where goiter and iodine deficiency occur to give some iodine. I am going to be very dogmatic and didactic and hope that our fellow participants will disagree, if they care to. A good many physicians feel, and I agree, that the pregnant woman should be given a little thyroid substance if it is properly indicated.
Now for the therapeutic use of thyroid. First, the indications are as follows: It is unnecessary to state to you gentlemen that you do not have to use thyroid extract for thyrotoxicosis. I have seen that happen very recently in a child with a great thyroid overactivity and carditis; some one administered a tremendous amount of thyroid inducing further decompensation of the heart. The prime indication for thyroid therapy is real hypothyroidism. Other conditions that still might be indications for thyroid are nephrosis, eczema, ichthyosis, obesity and perhaps prematurity. I am going to be very dogmatic about mongolism. Thyroid extract in mongolism has no use unless the mongol has hypothyroidism. I want to decry the use of thyroid in mongolism, although I have no better therapy. However, I do give it a trial, if for no other reason than to demonstrate to the parents that thyroid will not benefit their child.
Drs. Ehrlich and Tait Reply
Authors: Ehrlich Mary A. , Tait Charles A. 
Published: December 2021

We are pleased to respond to Dr. Gluckman's thoughtful comments regarding our article, which is concerned with applying the objective methods of acoustic impedance measurements to pediatric clinical populations.
Dr. Gluckman specifically asks if acoustic impedance measurements are practical for evaluating the "struggling, toxic infant with acute otitis media, or the infant who is frightened and struggling and has serous otitis media." Impedance measurements are objective because no behavioral responses are required of the patient.
Surgical Correction in Infancy To Reduce Mortality in Transposition of the Great Arteries
Authors: Kawabori Isamu , Guntheroth Warren G. , Morgan Beverly C. , Mohri Hitoshi , Dillard David H. 
Published: December 2021

The mortality for infants with transposition of the great arteries (TGA) prior to the introduction of medical and surgical septostomy was over 80% by 6 months of age. The mortality has fallen recently, due to balloon atrial septostomy (BAS), but still exceeds 25% by 6 months of age in major centers. The cumulative mortality rises to 40% by 1 year of age with or without additional surgical atrial septectomy.
In our center, 12 patients with an average age of 3 months were operated on for interatrial baffle correction of their TGA under surface-induced deep hypothermia. BAS had been done preliminarily in those patients without an adequate atrial communication. Ten of these 12 patients (83%) survived. These patients have been followed up from one month to eight years with an average follow-up of over four years. Surgical correction during infancy offers a better survival rate for infants with TGA than does medical management, with or without palliative surgery.
On Tympanostomy Tubes: Rationale, Results, Reservations, and Recommendations
Authors: Paradise Jack L. 
Published: December 2021

The eardrums of millions of infants and children throughout the world contain foreign bodies, surgically implanted as prostheses. Myringotomy combined with placement of an indwelling tympanostomy tube (or grommet) has gained widespread acceptance among otolaryngologists as the treatment of choice for persistent middle ear effusion1 and for certain related otologic conditions. But otolaryngologists by no means stand alone: many if not most of the operations currently performed were initially recommended by pediatricians.
It is difficult to determine how many such operations are currently performed on pediatric patients in this country, since most operations take place in outpatient settings and therefore escape systematic reportage. A reasonable estimate, however, would be 1 million procedures per year or, because most of them are bilateral, two million tubes inserted.
Among the conditions for which the operation is performed, undoubtedly the most common is chronic secretory otitis media. Here there are three interrelated objectives: to remove the effusion, to relieve any associated hearing loss, and to institute and maintain middle ear ventilation. Less commonly the operation may be undertaken for one of various other reasons: to try to reduce the frequency of episodes of acute otitis media2,3; to relieve persistent underaeration of the middle ear when associated with conductive hearing loss or other symptoms2; or to prevent the development of adhesive otitis media or cholesteatoma when atelectasis or, especially, retraction pockets of the eardrum are present.2,4-6
The idea of using an indwelling tube to artificially ventilate the middle ear dates from 1868, when the great Viennese otologist, Politzer, introduced a ventilating eyelet made of hard rubber.7
STATISTICS
Authors: Prescott R. J. ,   Student
Published: December 2021

. . .Perhaps the medical profession should take a close look at its attitude towards statistics. The medical statisticians are thin on the ground, and it would be unrealistic to expect all papers with some statistical content to be refereed by them, even if this was thought desirable. Another way to tackle the problem is through undergraduate and postgraduate medical education. Since most medical students will not become research-workers, it is debatable whether the computational complexities of a test form a relevant part of their medical education. However, all doctors should keep up to date with developments reported in the journals, and to do so adequately they must learn to judge published work critically. It is this aspect of statistics which appears to be in most need of emphasis in undergraduate medical education.
For the aspiring researcher, the most important statistical skills to be learnt at postgraduate level are the design of experiments, surveys, and clinical trials. Without them the techniques of statistical analysis, which also need to be learnt at this time, may have poor material to work on.
Unless moves of this sort occur the present situation is likely to continue. Many research-workers will spend much of their time on work which is doomed in advance to be of no medical or scientific merit; valuable research facilities will be inefficiently used; the literature will continue to produce articles where the conclusions do not follow from the data. Worst of all, such articles will continue to be believed.
CARRIER PIGEONS AND THE COUNTRY PRACTITIONER (1900)
Authors: C. T. E. 
Published: December 2021

Seventy-five years ago telephone service was not yet available in many parts of the United States. The editorial below offered a practical solution for the physician who practiced in areas where phone service was not available. The solution will surprise many of our younger physicians.
The perfection and cheapness of the long distance telephone and its consequent instillation in many country neighborhoods have done much to lessen the anxiety, if not the labor, of the country doctor. As the greater part of our country, however, is as yet unprovided with telephone service, a practical suggestion in regard to the use of carrier-pigeons which we find in the recent number of the Gazette des Hòpitaux may prove of value to some of our readers. The writer, after having trained a number of pigeons, leaves one or two at the house of the patient to be dispatched with a message should an emergency arise, or to state the morning and evening condition in a critical case. This means of communication gives the patient a sense of security and often serves to lessen the labors of the physician. So well satisfied is the doctor with this that he has established a station in each of the villages in his neighborhood so that he may be promptly summoned for new cases. He finds that he can leave two pigeons, always of the same sex, in a post for about a week. The longer the birds have been absent, the more quickly do they return.
Legal change for child health: Report on a conference
Authors: Seidel Henry M. 
Published: December 2021

"Physically and politically powerless, children have always gotten the short end of the stick. In earlier times, the surplus, especially females, were legally and deliberately killed; in the Middle Ages and until recently children were chattels; in Dickensian England they starved in workhouses or were exploited as beggars a la Oliver Twist...."
Louise Raggio, Conference Participant
The building Frank Lloyd Wright called Wingspread served as the setting for a discussion concerning the relationship of the health of the young to their legal needs and the role of the pediatrician in these regards. Men and women from medicine, the law, and social work shared their points of view, seeking a firm definition of advocacy for children, attempting to highlight some manageable priorities among the legal needs so that pediatricians might move to a partnership with others in the community which might facilitate access to a better life for all children and youth.