bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overview: The Effects of Chemical Pollutants on the Fetus and Child
Authors: Robbins Frederick C. 
Published: December 2021

What I have to say in my summary will be very personal. It concerns information that has filtered through those remaining neurones, and perhaps reflects certain prejudices which result from a good many years of association with a rather comparable field, the prevention of infectious diseases and the development and introduction of vaccines. This work has many problems similar to those pertaining to chemical pollutants. Throughout this Conference we have emphasized repeatedly the peculiar susceptibility of the fetus and young child to environmental chemical pollutants. It has been pointed out that, in addition to the periods of special vulnerability (particularly evident in early fetal life), the infant and child are more subject to certain environmental risks at different stages of development (e.g., the high incidence of poisonings in toddlers). Our special concern for the fetus and the young child is not based on these considerations alone. Clearly, any adverse happening to an individual early in life, particularly if it affects intellectual achievement, provides a great burden on the social system; and, the longer the period this person must be supported by society, the greater the burden and the greater the cost-not just in money but in many other ways. Death from the socioeconomic point of view is relatively unimportant, compared to a chronic disability.
Behavioral psychologists have taught us about imprinting, which is particularly evident in some animals but has not been demonstrated in children. Dr. Holland's comments about the effect of air pollution in the first year of life, and its sequelae in later life are of great importance, and certainly need to be subjected to further study.
Familial Congenital Duodenal Atresia
Authors: Der Kaloustian Vazken M. , Slim Michel S. , Mishalany Henry G. 
Published: December 2021

More evidence for the genetic etiology of a form of duodenal atresia has been coming our way since the publication of our report in Pediatrics,1 followed by a Letter to the Editor.2
The original paper and the follow-up letter reported three patients with congenital duodenal atresia in two families closely related. All four parents were first cousins of each other and an autosomal recessive type of inheritance was suggested. The source of the proposed gene for both families was traced to a single individual.
EPSDT (Early and Periodic Screening, Diagnosis and Treatment Programs)
Authors: Dixon Morris S. 
Published: December 2021

EPSDT is the means the federal government has selected to force the states to seek out poor children who are out of the mainstream of medical care and to offer them preventive services. The use of periodic screening exams (as defined in the Program Regulations Guide) is an untried method of providing health care and may be unsuccessful, but fortunately the states have been given much freedom in program design and future modification.
Major obstacles at present are the absence of specific goals at the state level, and a lack of commitment by state governments and administrators to provide adequate funds and direction for a successful program. Inadequate health resources in inner cities and rural areas, the lack of outreach workers, and a low priority for health care on the part of the consumer all add to the problem.
If EPSDT is successfnl in screening out children with problems and then providing diagnosis and treatment for them, it will be a major achievement. If it takes the next step and places children in a continuing primary care facility, it will be a significant advance in achieving the Academy's goal-the attainment by all children of their full potential for physical, emotional, and social health.
Searching the cause for seizures
Authors: Menkes John H. 
Published: December 2021

As in other neurological disorders, the diagnostic process in a child with epileptic seizures attempts to answer two questions: (1) the ascertainment of the type of seizure that the child has experienced, and its focus, if any; and (2) the cause for the attacks.
The paper by Yalaz and Treves,1 published in the current issue of Pediatrics, raises the point as to how extensively one should search for an answer to these questions. A thorough history, taken not only from the parent, but also from the child who may prove to be a surprisingly reliable informant, is undoubtedly the single most important prerequisite for diagnosing the seizure type.
Fond memories of Virginia Apgar
Authors: James L. Stanley 
Published: December 2021

Virginia Apgar died in her sleep on August 7, 1974, but the example of her life, her enthusiastic spirit, her optimism, her generosity, and her fearlessness are still very much alive. She was 65 years old. In her lifetime she had at least five careers: anesthesiology, public health, genetics, aviation, and research. In addition, there were her many hobbies. And she excelled in all.
She was one of the most remarkable people I have ever known. With her, life was exciting; her youthful enthusiasm and energy were boundless. She was warm and compassionate, and at the same time had a great sense of humor, sometimes earthy.
WISDOM OF A NOBEL PRIZE WINNER
Authors: Timbergen N. 
Published: December 2021

"What is the upshot of these remarks?"
First of all they stress the importance for medical science of open minded observation—of "watching and wondering." This basic scientific method is still too often looked down upon by those blinded by the glamor of apparatus, by the prestige of tests, and by the temptation to turn to drugs . . ."
Medical science and practice meet with a growing sense of unease and lack of confidence from the side of the general public. The causes are complex, but at least in one respect the situation could be improved: a little more open mindedness, a little more collaboration with other biologic sciences and a little more attention to the body as a whole and the unity of body and mind could substantially enrich the field of medical research.
Smallpox Vaccination Reactions, Prophylaxis, and Therapy of Complications
Authors: Goldstein Joel A. , Neff John M. , Lane J. Michael , Koplan Jeffrey P. 
Published: December 2021

Smallpox vaccination in the United States is a routine public health measure which has been under intensive review during the last decade. The most frequently occurring adverse reactions to vaccination are benign and require little or no systemic therapy. These reactions include accidental infection, erythematous and urticarial rash, and generalized vaccinia. Chickenpox occurring concurrently with vaccination presents no problem unless vaccinia has widely superinfected the chickenpox lesions. There is no risk to the pregnant woman who is vaccinated, but there is a slight risk that the fetus will develop fetal vaccinia. The vaccinia does not cause congenital malformations. Vaccinia hyperimmune globulin (VIG) in prophylactic dosage may be given to a pregnant woman who is traveling to a smallpox infected or endemic area in order to prevent fetal vaccinia.
Vaccinia necrosum and eczema vaccinatum require vigorous systemic therapy with VIG, and often thiosemicarbazone. Post-vaccinial encephalitis, while frequently serious, has not been shown to be ameliorated by VIG therapy, although there are data which suggest VIG has some value in prophylaxis for encephalitis. Prophylaxis, prompt recognition, and proper therapy may reduce the fatality rates of these complications.
Revaccination of patients who have suffered a complication is a frequent clinical problem. Revaccination of an individual who has had post-vaccinial encephalitis or vaccinia necrosum is contraindicated unless the risk of contracting smallpox outweighs the risk of the above two diseases. Revaccination of children who have had eczema vaccinatum is not contraindicated. Revaccination of children with a history of accidental infection or erythematous or urticarial rash presents no known or theoretically increased risk.
THOMAS RAYNALDE ON GOGGLE EYES (1552)
Authors: C. T. E. 
Published: December 2021

Thomas Raynalde (fl. 1540-1551), an English physician, is best known as the translator of Eucharius Roesslin's Rosegarten which is known in English as the Byrth of Mankynde. This, the first English printed book on midwifery, recommends that goggle eyes be treated as follows:
If the child have goggle eyes, or that it look a squint, then first set the cradle in such a place, that the light may come directly and right in the child's face, neither in the one side, neither in the other, neither above the head, lest it turn the sight after the light. Also mark, on which side the eyes do goggle, and let the light come unto it on the contrary side, so that by this means the goggling of the eyes may be returned to the right place. And farther, it shall be good to hang clothes of divers and fresh colours on the contrary side, and specially of the colour of light green or yellow, for the child shall have pleasure to behold these strange colours, and in returning the eyesight towards such things, it shall be occasion to rectify the sight again.1
Dr. Pierce Replies
Authors: Pierce Alexander W. 
Published: December 2021

Dr. Manoguerra is correct in noting discordance between the two articles included in the symposium on poisoning in childhood.
It is generally accepted that the combined use of syrup of ipecac and activated charcoal requires deferring the administration of the activated charcoal until emesis has been induced. Since activated charcoal should be administered within 30 minutes of ingestion to achieve significant inhibition of drug absorption and since syrup of ipecac frequently requires 30 minutes to induce emesis, combined use of the two therapeutic modalities has been precluded.
The lost art of consultation—a plea for the return of striped trousers
Authors: Goldbloom Richard B. 
Published: December 2021

Having grown up in a medical household, I remember vividly my late father's reminiscences about the accepted protocol for medical consultation during his early years as a practicing pediatrician in Montreal more than half a century ago. In those days, whenever a second opinion was requested by the patient's family or physician, the family physician made a personal approach to the consultant, preliminary discussion of the problem was held, and a time was established when physician and consultant would convene at the bedside, whether at the home or in hospital.
The details of the consultation rite were formal and unvarying.
Another Idea Regarding SIDS
Authors: Shaw Edward B. 
Published: December 2021

The large number of pediatricians and investigators who have a great interest in the sudden infant death syndrome (SIDS) should read the recent paper by Kadlub and Kadlub. They propose a theory that adds a new concept to the many theories which have been proposed, many of which have been already discarded. They state "this is a disease which does not make sense" and "the very first symptom of this condition is death." True.
They believe that the infant who swallows large amounts of air along with his food, who has not been allowed to belch, and who lies flat in his crib, perhaps right after feeding, may expel an enormous amount of air in his sleep from the position in which he sleeps and with which his epiglottis, nasopharynx, and nasal passage are inadequate to deal.
The Effect of Cromolyn Sodium on Exercise-Induced Bronchospasm Using a Free Running System
Authors: Shapiro Gall G. , Pierson William E. , Blerman C. Warren 
Published: December 2021

This study was designed to assess the effectiveness of comolyn sodium in modifying exercise-induced bronchospasm (EIB). Twenty children and adolescents with EIB were given either cromolyn or placebo in a prerandomized double-blind fashion. They then performed a free running maneuver. Pulmonary function tests were obtained before and after this exercise. Patients returned one week later to repeat the same procedure. This time subjects took placebo if they had previously taken cromolyn and vice versa.
Significant beneficial effects of cromolyn were noted in forced vital capacity and forced expiratory volume in one second measurements but not in forced expiratory flow between 25% and 75% of the flow-volume curve) (FEF 25%-75%). This suggests that larger airway disease is preferentially helped by cromolyn when subjects are stressed maximally as with a free running system. Subjects who received placebo on study day 1 and cromolyn on study day 2 showed the most striking benefit from cromolyn. This may be related to the better baseline status of subjects on day 2 as well as to familiarity with the procedure and medication.
Summary
Authors: Blerman C. Warren , Pierson William E. 
Published: December 2021

Asthma is the most frequent chronic respiratory illness of childhood. It is the number one cause of school absenteeism and forces afflicted youngsters to miss a total of 9 million school days annually. Athma and other respiratory allergies such as hay fever and perennial allergic rhinitis account for nearly one third of all chronic conditions in children Under 17 years of age.
Among many of these young people, bronchosmasm induced by exercise is a physical handicap which is frequently overlooked by the child's parents, physician, teachers and often by the child himself. This condition may have lasting physical and psychological effects, for the individual with exercise bronchospasm may avoid sports and other physical activities. This can result in poor physical condition and poor self-image, which is reinforced by ridicule from peers, teachers, and physical education instructors.
Exercise-induced asthma (EIA) or exercise-induced bronchospasm (EIB) as it has been variously termed has been mentioned from time to time in medical writings since the third century A.D. Only during the past decade, however, has it been studied in a systematic fashion as to incidence, physiological changes, and pharmacological therapy. Few of these studies, however, are readily available to pediatricians.
This symposium has been organized to compile existing knowledge concerning exercise and asthma for physicians caring for allergic children and adolescents as a guide to early recognition since effective therapy is available for EIB. Thus, the physician's goal should be pharmacologic prevention rather than physical restriction, so that the child can participate in normal activities with his peers with the resulting physical and emotional benefits.
DR. TOBIAS SMOLLETT ON THE EVILS OF URBANIZATION (1771)
Authors: C. T. E. 
Published: December 2021

Tobias Smollett (1721-1771), usually remembered as a brilliant novelist, was also a surgeon in the Royal Navy. He published a number of satirical novels on English social life. In one of these, The Expedition of Humphrey Clinker (1771), Smollett described how urbanization was changing London as follows:
But notwithstanding the improvements, the capital is become an overgrown monster; which, like a dropsical head, will in time leave the body and extremities without nourishment and support. The absurdity will appear in its full force, when we consider, that one sixth part of the natives of this whole extensive kingdom, is crowded within the bills of mortality. What wonder that our villages are depopulated and our farms in want of day-labourers? The abolition of small farms is but one cause in the decrease of population. Indeed, the incredible increases in horses and black cattle to answer the purposes of luxury, requires a prodigious quantity of hay and grass, which are raised and managed without much labour; but a number of hands will always be wanted for the different branches of agriculture, whether the farms be large or small. The tide of luxury has swept all the inhabitants from the open country. The poor squire, as well as the rich peer, must have his house in town, and make a figure with an extraordinary number of domestics. The plough-boys, cow-herds and lower-hinds are debauched and seduced by the appearance and discourse of those coxcombs in livery, when they make their summer excursions. They desert their dirt and drudgery, and swarm up to London in hopes of getting into service, where they can live luxuriously and wear fine clothes, without being obliged to work; for idleness is natural to man.
Primary Peritonitis Due to Group G Streptococcus: A Case Report
Authors: Khan Abdul J. , Evans Hugh E. , Macabuhay Marylu R. , Lee Yu-En , Werner Robert 
Published: December 2021

Beta-hemolytic Streptococcus group G, a rare human pathogen, has long been implicated in human disease as causing pharyngitis, puerperal sepsis, empyema, and even septicemia. We are reporting a rare, life-threatening, acute illness, primary peritonitis, due to this organism, whose etiological source probably was a family dog.
Case Report
R.K., a 2-year-old girl, was admitted with the complaints of anorexia, vomiting of three days' duration, and severe abdominal distension of one day's duration. The symptoms started following a burn injury over the face and lips three days prior to admission. Past history was noncontributory.
Physical examination revealed an ill child of average size, fully conscious.
THE TERRIBLE INFLUENCE READING NOVELS WOULD HAVE ON YOUNG GIRLS-AN 1815 VIEW
Authors: C. T. E. 
Published: December 2021

For more than three centuries the almanac served as the newspaper, the radio, the television, and almost the only source of information and news for millions of Americans. An example of the morality found in a widely read almanac of 1815 follows:
The indiscriminate reading of Novels and Romances is to young females of the most dangerous tendency . . . it agitates their fancy to delirium of pleasure never to be realized . . . and opens to their view the Elysium fields which exist only in the imagination . . . fields which will involve them in wretchedness and inconsolable sorrow. Such reading coverts them into a bundle of acutely feeling nerves and makes them "ready to expire of a rose in aromatic pain" . . . The most profligate villain, bent on the infernal purpose of seducing a woman, could not wish a symptom more favorable to his purpose than a strong imagination inflamed with the rhapsodies of artful and corrupting novels.1
Generic Prescribing
Authors: Yaffe Sumner J. , Bierman C. Warren , Cann Howard M. , Cohen Sanford N. , Freeman John , Kagan Benjamin M. , Kauffman Ralph , Pruitt Albert , Segal Sydney , Soyka Lester , Weiss Charles F. , Chudzik Gregory , Ballin John C. , Del Prato Pierre S. , Done Alan K. , Farchione Louis , Oakley Godfrey , Sawchuk Steven , Scott C. P. , Simopoulos Artemis P. 
Published: December 2021

During the last several years there has been continued pressure from consumers, legislators, and health administrators to mandate generic prescribing. It has been proposed that requiring physicians to prescribe by generic rather than brand name and allowing pharmacists to substitute generically equivalent drug products would save consumers millions of dollars. These assumptions and the following events have stimulated the American Academy of Pediatrics to bring this issue to the attention of its membership.
(1) The report of the Office of Technology Assessment, Drug Bioequivalence Study Panel, entitled "Drug Bioequivalence," concluded that current standards and regulatory practices do not ensure bioequivalence for drug products, although most of the analytical methodology and experimental procedures for the conduct of bioavailability studies in man are available.1 Additional work may be required to develop the means of applying them to certain drugs and to special situations of drug use.
(2) The Drug Research Board of the National Academy of Sciences (October 25, 1974) recommended that the physician "should be required to delegate to the pharmacist, or explicitly to retain to himself, selection of the particular drug product to be dispensed."2
(3) The Maximum Allowable Cost Proposal published in the Federal Register (November 15, 1974)3 would establish a system to fix a "maximum allowable cost" for reimbursement for drugs dispensed under health financing and service programs of the Department of Health, Education, and Welfare which have multiple sources and are deemed bioequivalent. Other provisions of this proposal call for a fixed dispensing fee and supplying comparative price information to physicians and pharmacists.
Central Hypoventilation During Quiet Sleep in Two Infants
Authors: Shannon Daniel C. , Marsland David W. , Gould Jeffrey B. , Callahan Barry , Todres I. David , Dennis Jane 
Published: December 2021

Expired ventilation (VE), tidal volume (VT), frequency (f), and alveolar PCO2 (PACO2) were examined in six normal infants at 41 to 52 weeks post-conceptional age and in two infants who were apneic at birth. Their response to breathing 5% carbon dioxide in air and to 100% oxygen in quiet sleep were compared to those in rapid eye movement (REM) sleep.
VE in normal infants was 259 ml/kg/min in REM and 200.2 ml/kg/min in quiet sleep with the difference being due to decreased carbon dioxide production and to decreased dead space. VE increased 34.4 ml/kg/min/mm Hg of PCO2 elevation with 5% carbon dioxide breathing during REM and was not significantly different during quiet sleep. During oxygen breathing VE fell by 32.7% at 30 seconds before increasing again.
In the affected infants, VE and PACO2 during REM at 1 and 4 months were normal. At 1 month, during quiet sleep, each infant became apneic and PACO2 rose 9 and 8 mm Hg/min respectively. At this time mechanical ventilation was begun. At 4 months, during quiet sleep, VE was 0.064 and 0.063 ml/kg/min at PACO2 of 66 mm Hg in each infant. The change was due entirely to a decrease in VT to 2.3 and 2.5 ml/kg. At this time 5% carbon dioxide breathing given during normal ventilation in REM produced an abrupt fall in VT to 2.0 and 2.2 ml/kg with no change in frequency.
Oxygen breathing during REM at one month had no effect but at 4 months produced apnea requiring mechanical ventilation after one minute.
The findings suggest that the ventilatory response to carbon dioxide is (1) important in initiation of extrauterine ventilation and (2) in sustaining ventilation particularly in quiet sleep. It is not necessary in sustaining ventilation awake or in REM sleep and it represents a balance between the stimulatory and depressant effects of carbon dioxide on the central nervous system.
Insulin Responses During Catch-up Growth of Infants Who Were Small for Gestational Age
Authors: Colle Eleanor , Schiff David , Andrew Gail , Bauer Charles B. , Fitzhardinge Pamela 
Published: December 2021

Growth characteristics of 15 full-term infants, selected because of weights more than 2 SD below the mean for gestational age, are described. The response to an intravenous injection of glucose was utilized to measure the insulin response of the infants at 6 months.
Infants small for gestational age grow at a faster rate than appropriate-for-age infants during the first six months of life. There was a positive correlation between the growth velocity of the period and insulin release and a negative correlation between growth velocity and birth length. There was no correlation between these variables and increases in weight during the same period.
Growth velocity during catch-up growth is related to the degree of preceding retardation but insulin may play a permissive role.