bluuebunny/crossref_metadata_2025_split huggingface dataset:
MYCOPLASMA INFECTIONS IN CHILDHOOD
Authors: Clyde Wallace A. , Denny Floyd W. 
Published: December 2021

Mycoplasmas compose a ubiquitous group of minute microorganisms which include saprophytes, commensals, and pathogens. Of the seven species which have been isolated from man, only Mycoplasma pneumoniae has clearly established pathogenicity. Research continues to seek other possible disease relationships, since there are various animal diseases caused by mycoplasmas which have counterparts among human illnesses of unknown cause.
M. pneumoniae can be associated with a wide spectrum of respiratory tract disease, including bullous myringitis, pharyngitis, tracheobronchitis, pneumonia, and subclinical infections. These illnesses are generally mild and occur most frequently between ages 5 and 19 years in slowly progressive epidemics. The clinical aspects of the disease are indistinguishable from virus-associated syndromes, and epidemiologic features are often more suggestive of the diagnosis. Techniques for M. pneumoniae cultivation and serodiagnosis are now adaptable for use in clinical laboratories. Non-specific diagnostic tests, especially cold hemagglutination, have distinctly limited usefulness in pediatrics.
M. pneumoniae is sensitive to the tetracycline drugs and erythromycin; administration of these antibiotics shortens the clinical course of disease but may not be effective for prophylaxis or elimination of the carrier state. For these reasons, vaccines could provide more effective control and are being developed; however, greater experience concerning the relative role of M. pneumoniae among other respiratory disease agents is required before the need for control measures in the general population can be assessed.
SWEATING IN CONGENITAL HEART DISEASE
Authors: Alter Blanche P. , Czapek Emily E. , Rowe Richard D. 
Published: December 2021

Sweating was found to be increased in children with congenital heart disease who had a propensity to congestive heart failure, e.g., children with endocardial fibroelastosis or large or moderate sized left-to-right shunts. This was suggested in a review of cardiac clinic records of 220 patients and was supported by the results of pilocarpine sweat tests which were performed on 34 cardiac patients. By history and by measurement of the amount of sweat produced, children with a history of or tendency toward heart failure could be predicted though patients did not need to be in failure when tested. Contrary to previous opinion, the left-to-right shunt was not in itself sufficient to cause the child to sweat. The shunt had to be large enough to be associated with failure at some time.
It is suggested that the pilocarpine sweat test might actually be useful as an aid in predicting a child's potential for heart failure. Several theories regarding the mechanism of sweating in these situations are discussed.
TREATMENT OF MALIGNANT SYMPATHETIC TUMORS IN CHILDREN: CLINICOPATHOLOGICAL CORRELATION
Authors: Perez Carlos A. , Vietti Teresa J. , Ackerman Lauren V. , Kulapongs Panja , Powers William E. 
Published: December 2021

The results of treatment in a series of 46 children with malignant sympathetic tumors are reported with an absolute cure rate of 47% at 2 years and 46% at 5 years. Thirty-two percent of the patients with distant metastasis have survived tumor free 2 years or longer.
Factors affecting the prognosis and the various methods of treatment are analyzed. Aggressive radiation therapy of these patients is advocated, depending on their clinical condition, even in the presence of distant metastasis. The primary role of irradiation in the sterilization of these malignant sympathetic tumors is postulated. Chemotherapy with cyclophosphamide and vincristine produced only transient regression of some of the tumors, with limited palliative results. The indication of chemotherapeutic agents is questioned in the treatment of patients with localized tumor because it is felt that this may impair the host resistance of the patient. Intensive chemotherapy may adversely affect survival, although admittedly all patients receiving this form of therapy had far advanced disease.
LIMB-GIRDLE MUSCULAR DYSTROPHY: CLINICAL MANIFESTATIONS AND DETECTION OF PRECLINICAL DISEASE
Authors: Jackson Charles E. , Strehler Don A. 
Published: December 2021

The clinical picture of limb-girdle muscular dystrophy is described as seen in 37 affected individuals from two large Amish kindreds. The disease is characterized by an autosomal recessive mode of inheritance with as many females as males being affected, and with affected individuals being the product generally of consanguineous matings. The age of onset was observed to be between 4 and 15 years of age (average 8½) with a quite variable age of confinement to a wheelchair (12 to 44 years ). The disease was compatible with a life span in one patient to 67 years of age. The involvement of proximal shoulder and pelvic girdle muscles was similar to that in the X-linked recessive, Duchenne type of muscular dystrophy; however, the zygomaticus muscles of the face are preserved and a normal upturned smile is noted in this type of muscular dystrophy rather than the flat transverse smile noted in the X-linked recessive type.
Muscle biopsy abnormalities in two individuals very early in the course of their disease suggest that biopsy would probably be useful in detection of preclinical disease in this type of muscular dystrophy. Gross abnomalities of serum enzymes in 12 younger siblings of affected individuals in these two families suggest that these enzyme determinations are useful in detecting preclinical, limb-girdle muscular dystrophy. When therapy for muscular dystrophy becomes available, the determination of preclinical disease by these techniques will become of greater clinical significance.
DEVIANT GENDER-ROLE BEHAVIOR IN CHILDREN: RELATION TO HOMOSEXUALITY
Authors: Bakwin Harry 
Published: December 2021

There is ample evidence to show that homosexuality, in a certain proportion of cases, has its roots in childhood. Follow-up observations in the literature, as well as those reported here, show a high risk of homosexuality in children with deviant gender-role behavior, that is, effeminate or sissy boys and tomboyish girls. Family backgrounds of those children show no consistent pattern.
A discussion of whether gender-role behavior is inborn or learned is included. The author inclines to the view that it is inborn.
Suggestions for management, which are designed to encourage gender appropriate behavior and to prevent homosexuality are offered.
Letters to the Editor
Authors: Lucey Jerold F. 
Published: December 2021

Dr. Bowman's letter citing his recent improved unpublished experience with intra-uterine transfusions demonstrates the value of having this procedure carried out by experts. Technical skill is obviously very important in those transfusions being carried out before the twenty-eighth week.
His experience with the treatment of hydrops fetalis is encouraging. Perhaps it is due to the fact that he is not just doing a "simple" fetal transfusion. He has been treating both mother and fetus (sometimes directly) with other medications.
EFFECT OF THE THERMAL ENVIRONMENT ON COLD RESISTANCE AND GROWTH OF SMALL INFANTS AFTER THE FIRST WEEK OF LIFE
Authors: Glass Leonard , Silverman William A. , Sinclair John C. 
Published: December 2021

Twelve matched pairs of small (1,001-2,000 gm birth weight) asymptomatic neonates, age 1 week, were placed in either of two frequently recommended thermal environments ("standard": abdominal skin controlled at 35.0°C to approximate the thermal state commonly realized in nurseries for premature infants; "warm": abdominal skin controlled at 36.5°C to approximate thermoneutral condition). Both groups were fed 120 calories/kg/day.
Before and after 2 weeks in the test environment, the infants were placed in a simulated room environment-28°C incubator wall—for 1 hour and the change in body temperatures was measured.
Cold resistance–the ability to prevent a fall of deep body temperature in the 28°C environment– was significantly greater among infants who had spent 2 weeks in the slightly cooler environment. The rate of increase in body weight and length was significantly faster in the warmer condition.
PREVENTION OF HYPERBILIRUBINEMIA OF PREMATURITY BY PHOTOTHERAPY
Authors: Lucey Jerold , Ferreiro Mario , Hewitt Jean 
Published: December 2021

The ideal treatment for hyperbilirubinemia of prematurity would be a safe and simple method for preventing its occurrence. In 1958 it was first demonstrated that serum bilirubin concentrations of newborn infants can be reduced by exposure to light. This treatment has not been widely used because of doubts as to its effectiveness and concern for the possible toxicity of the photochemical decomposition products of bilirubin. Recent experimental evidence indicates that these products are non-toxic. A controlled clinical trial has been carried out among 111 premature infants to test the effectiveness of artificial blue light in preventing hyperbilirubinemia of prematurity. Treated infants were placed in light from 12 to 144 hours of age and serial bilirubin determinations were carried out. The control (58 infants) and treated (53 infants) groups were comparable with respect to birth weight, gestational age, fluid intake, and weight loss. The results indicate a statistically significant difference between the groups.
By taking advantage of this alternate route of elimination of bilirubin in the newborn infant, it should be possible to greatly reduce the need for exchange transfusion for hyperbilirubinemia of prematurity.
SYSTEMIC LUPUS ERYTHEMATOSUS IN CHILDHOOD
Authors: Meislin Aaron G. , Rothfield Naomi 
Published: December 2021

Data on 42 children with systemic lupus erythematosus have been analyzed and compared with data from 200 adults with the disease. Among the children, the age of onset ranged from 3 to 15 years of age, with a peak for girls during adolescence. The age of onset among male patients, both adult and children, was constant for all decades and there was no cluster at any particular age.
The disease in children was similar to that in adults except for a higher incidence of hepatosplenomegaly and lymphadenopathy among the children. Renal disease occurred with similar frequency in the two groups. It was generally unusual for additional system involvement to occur following diagnosis, although some patients who had no renal disease at the time of diagnosis did develop renal disease subsequently. Combined antimalarial and moderately high dose steroid therapy was employed. Renal involvement at the time of diagnosis reduced survival among both the adults and the children. The prognosis in childhood was decidedly worse than in adults. Models of survival were developed based upon crude mortality rates. Similar survival models may serve to study prognosis of other diseases and other management of lupus.
METABOLIC ASPECTS OF DEEP SURGICAL HYPOTHERMIA IN INFANCY
Authors: Baum David , Dillard David H. , Mohri Hitoshi , Crawford Edward W. 
Published: December 2021

Aspects of carbohydrate and lipid metabolism were examined in 10 infants whose core temperatures were lowered by external cooling to 15 to 20°C during cardiovascular surgery.
Modest hyperglycemia, found with ether anesthesia, persisted in three patients not given glucose, but it was markedly increased in others given glucose infusions. Despite continued glucose infusion, plasma glucose returned toward prehypothermic levels with rewarming, provided epinephrine was not administered. When epinephrine was given, the return was slowed. These observations suggest diminished glucose utilization during hypothermia and arouse speculation concerning a related insulin abnormality.
In general, plasma lactate and glycerol levels increased during hypothermia, reaching a peak after circulatory arrest and with rewarming. Plasma free fatty acid concentrations changed little until rewarming when they usually became depressed. Death occurred in all five infants in whom plasma glycerol and lactate levels were rising at the procedure's end, while plasma glycerol and lactate concentrations were falling on completion of the operation in patients who did well. These findings and the known importance of the liver in lactate and glycerol metabolism suggest that the course of plasma lactate and glycerol levels may prove useful as a reflection of hepatic dysfunction in patients undergoing hypothermic surgery.
CHRONIC MUCOCUTANEOUS CANDIDIASIS—ASSOCIATED IMMUNOLOGIC ABNORMALITIES
Authors: Landau Joseph W. 
Published: December 2021

Candidiasis (moniliasis, candidosis) includes a group of fungous diseases varying in severity from commonly encountered local superficial involvement of the oral mucosa to fulminating systemic infections rapidly terminating in death.1 The etiologic agent is Candida albicans or occasionally another species of candida. These fungi are frequently found as saprophytes in the oral cavity, gastrointestinal tract, and vaginal area. Some local or systemic impairment of host defense mechanisms usually appears to be an essential predisposing factor for the development of candidiasis.
The term chronic mucocutaneous candidiasis refers to a heterogeneous group of fungous diseases characterized by persistent or recurrent candida infection of mucous membranes, nails, and skin.1-3 Involvement of internal organs seldom, if ever, occurs.
SLEEP PATTERNS IN PRE-ADOLESCENT CHILDREN: AN EEG-EOG STUDY
Authors: Ross John J. , Agnew Harman W. , Williams Robert L. , Webb Wilse B. 
Published: December 2021

The typical all-night sleep pattern of the pre-adolescent male was determined by analyzing the simultaneous EEG-EOG tracings of 18 healthy schoolboys (range 8 to 11 years). The sleep patterns of these boys resembled that of older subjects by the occurrence of a more or less orderly sequence of sleep stages which spontaneously shifted from one stage to another. Stability of the pattern for a given boy was observed in the consistent amount of time spent in each sleep stage and in the number of sleep stage changes night after night.
When compared with the adult sleep patterns, pre-adolescent total sleep time was 2½ hours longer with unequal distribution of the added time to each of the sleep stages. Sleep stages in children are longer in duration than in adults, and the sleep patterns are as stable as that of the adult.
RULES OF EVIDENCE APPLIED TO TREATMENTS OF NEONATAL HYPOXEMIA AND ACIDOSIS
Authors: Prod'hom L. S. 
Published: December 2021

BIOCHEMICAL MONITORING of the low birth weight infant during the first 24 hours of life frequently reveals abnormalities of acid-base balance and hypoxemia; these anomalies are very striking in infants with clinical signs of respiratory distress. The clinician is then faced with two problems: the first in diagnosis, the second in treatment.
In the past few years certain regimes for respiratory distress have been recommended with varying degrees of fact and forcefulness. These include the careful maintenance of thermal balance to keep oxygen consumption at a minimum, correction of acidosis by NaHCO3 or THAM in rapid or slow infusion, adequate oxygenation sometimes requiring an inspired O2 concentration above 40%, assisted ventilation (either through a tracheal tube or by a negative pressure tank), and, finally, administration of agents acting on vasomotor tone.
Non-immunologic Hydrops Fetalis Associated with a Large Hemangioendothelioma
Authors: Daniel Sara Jo , Cassady George 
Published: December 2021

Non-immunologic hydrops fetalis has been reported in association with such conditions as maternal diabetes mellitus, fetal infection, multiple fetal malformations (particularly cardiac), congenital nephrosis, homozygous alpha-thalassemia, prenatal closure of the foramen ovale, sublethal umbilical or chorionic vein thrombosis, and parabiotic syndrome.1-3 To our knowledge, the following case represents the first reported instance of fetal and placental hydrops associated with a tumor which acts as a fetal arteriovenous malformation.
A female infant was delivered to a 38-yearold Japanese woman at a calculated gestational age of 32 weeks. One previous pregnancy with the same Caucasian father had resulted in a living, normal child.
THE PRESIDENT'S MESSAGE: ACADEMY STUDY OF THE DELIVERY OF HEALTH CARE TO CHILDREN
Authors: Logan George B. 
Published: December 2021

The delivery of health care has become one of the most talked about subjects in medical circles in recent years. Governmental agencies, labor groups, insurance companies, and consumer groups also have become concerned about it. The Brookings Institution began a short series of public policy conferences for physicians in the fall of 1967, their first venture into the field of health. The delivery of care has been discussed from many standpoints in all of them.
Within the Academy we have become increasingly aware of the shortcomings of our present "system" of medical practice as it relates to children. It is not that the system is altogether bad. It seems that primarily there are too few pediatricians and family physicians and the ones available are not well distributed. Certain aspects of the investigation of the problems of practice have been and are being studied by the Council on Pediatric Practice, which has been in existence since 1964. The urgency and necessity of doing even more was pointed out in the Spring of 1967 by the report of an ad hoc committee of the Executive Board, the chairman of which was Dr. John MacQueen. This then led to the appointment of an ad hoc committee of the Academy to study means of approaching this complex problem. This committee recommended a detailed investigation which would require the services of a chairman who was experienced and who could devote at least one half of his time to it. Dr. Carl Fischer of Philadelphia was selected for this position.
Letters to the Editor
Authors: Mortimer Edward A. 
Published: December 2021

Dr. Mortimer answers Dr. Greenblatt as follows:
You are probably aware that the Public Health Service Advisory Committee On Immunization Practices has recommended that influenza vaccine be given intradermally under only one circumstance, as a booster dose to older individuals who have previously experienced undue reactions to influenza vaccine.
You are correct in saying that there is not a satisfactory study of intradermal influenza vaccination in childhood. This is in part because such a study is extremely difficult to set up.
PENICILLIN RESISTANT ALPHA STREPTOCOCCI IN PHARYNX OF PATIENTS GIVEN ORAL PENICILLIN
Authors: Sprunt Katherine , Redman Winifred , Leidy Grace 
Published: December 2021

Patients who have received oral penicillin may carry in the oropharynx alpha hemolytic streptococci, of which varying proportions are resistant to one or more units of penicillin per milliliter. Since the use of oral penicillin is increasing and penicillin is the drug of choice for prevention of endocarditis before oral or pharyngeal trauma, semiquantitative methods have been used to document (1) the frequency of α-streptococci resistant to 1 or more units of penicillin per milliliter in patients receiving prophylactic penicillin orally and intramuscularly, (2) the frequency and rate with which significant numbers of α-streptococci appear after exposure to oral penicillin, (3) the proportion and degree of resistance of α-streptococci which emerge resistant, and (4) the rate at which the numbers of resistant organisms are reduced to a presumably insignificant level when penicillin is withdrawn. The results show that there is a statistically significant increase (P &lt;.001) in the proportion of α-streptococci resistant to at least 1 U per milliliter of penicillin in the pharynx of patients receiving their prophylactic penicillin in oral form (75%) in comparison with those on intramuscular penicillin prophylaxis (15%). Similarly, 17 of 22 patients on oral penicillin therapy developed flora containing resistant streptococci. Six such patients carried α-streptococcal populations, 7 to 50% of which were resistant to 1 but not 5 U. Eleven carried streptococci, 1 to 100% of which were resistant to 5 or more units per milliliter. Of 12 patients followed closely, 8 developed resistant streptococci within the first week of therapy, one after 2 days.
Resistant streptococci decreased rapidly when therapy was discontinued. Eleven of 12 patients showed less than 20% of their streptococcal population resistant to 1 unit at 15 days and less than 10% at 30 days. Low levels (&lt; 10%) persisted in six patients followed for intervals longer than 30 days and up to 144 days.
SMALLPOX VACCINATION: BEFORE OR AFTER ONE YEAR OF AGE?
Authors: Neff John M. , Lane J. Michael 
Published: December 2021

Data have been reported recently indicating that complications following smallpox vaccination occur more frequently in children less than 1 year old than in any other age group. A review of illnesses attributed to smallpox vaccination in England and Wales from 1951 to 1960 demonstrated that dermal complications, particularly generalized vaccinia, occurred two to three times as frequently in children vaccinated before the first birthday as in any other childhood age group.1,2 A review of smallpox vaccination complications in the United States in 1963 yielded similar results.3,4 As a result, the American Academy of Pediatrics Committee on the Control of Infectious Diseases and the Public Health Service Advisory Committee on Immunization Practices have recommended that primary smallpox vaccination be deferred until after the first birthday.5,6 Despite this, many physicians have expressed reluctance to adopt this recommendation as was most evident by the general comments made at the recent panel on immunization at the meetings of the American Academy of Pediatrics in October 1967 and by letter to members of the Smallpox Eradication Program at the National Communicable Disease Center. The purpose of this paper is to review briefly the arguments for and against routine smallpox vaccination in children under 1 year of age.
The principal objections to deferring vaccination until after the first birthday are as follows:
1. If vaccination is not routinely practiced during the first several well-baby clinic visits, many children, particularly those from clinics in the large cities. might not return for subsequent clinic visits and therefore might not have the benefit of a smallpox vaccination.
Pitfalls in Interpretation of Oral Glucose Tolerance Tests in the Newborn
Authors: Pildes Rosita S. , Hart Robert J. , Warrner Richard , Cornblath Marvin 
Published: December 2021

In the course of study of metabolic responses to oral glucose in eleven newborn infants of gestational diabetic mothers (IGDM), three infants had significantly higher blood glucose and plasma insulin values than those of the other eight. The only difference between the two groups was that, in the former, blood was obtained from an umbilical vein catheter and, in the latter, from a peripheral vein. In order to determine if the differences observed in insulin and glucose values were due to sampling sites, standard oral glucose tolerance tests were done with simultaneous sampling from both sources.
Material and Methods
Two-hour oral glucose tolerance tests (2 gm per kilogram) were done in five IGDM.