bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letters to the Editor
Authors: NADAS ALEXANDER S. 
Published: December 2021

It is a particular pleasure to have a former trainee comment on one's views. When reading Dr. Guntheroth's previous, and supporting, commentary in regard to the mumps-fibroelastosis controversy, I was beginning to worry lest middle age and creeping conformity are catching up with him. The present letter of disagreement, reassuringly, redresses the balance.
I do not wish to reopen the "numbers game." I would only like to draw Dr. Guntheroth's attention to a couple of facts he may have overlooked in the frenzy of his sabbatical year.
PSEUDOHYPOPARATHYROIDISM
Authors: PETERMAN M. G. , GARVEY J. L. 
Published: December 2021

THIS case is presented because the circumstances provided an unusual opportunity to review and study a rare condition. The child concerned had been diagnosed as having a case of hypothyroidism and epilepsy and the parents had been advised to place her in an institution. The child was referred to the authors in a further effort to obtain relief or advice.
CASE HISTORY
A 12 yr. old girl was examined because of "incessant talking in a silly, immature fashion; excessive greed for food and salt; lethargy, fatigue, over-affection and clumsiness, awkwardness, inability to skate or ride a bicycle."
A year before admission she began to scream in her sleep once or twice every night. Six months later she began to scream during the day. The attacks of screaming occurred suddenly without warning. She abruptly stopped what she was doing, stared ahead and screamed in a loud, hoarse voice for several seconds. Immediately afterward, she was embarrassed and tried to withdraw from the scene. Treatment elsewhere with adequate doses of phenobarbital, tridione, benzedrine, thyroid and pituitary extract had been ineffective.
Report of a previous examination at a university clinic was "moderately plump girl with a round face and lethargic appearance. There was narrowing of the right palpebral fissure and mild ataxia of the lower extremities. The physical examination was otherwise unimportant. The IQ was 80."
Examination later at a hospital-clinic was reported as "revealing obesity and cretinism in spite of a basal metabolic rate of minus 6 and minus 7."
Mother and father are intelligent and the 4 siblings are normal and well-adjusted. There is no history of convulsive disorders or mental disease.
PEDIATRICS IN SOUTH VIETNAM
Authors: Hallett George W. 
Published: December 2021

SOUTH VIETNAM is a country of 18 million people and approximately 1,000 native physicians, most of whom are in the military service. Civilian needs are met by 350 physicians, giving a doctor: population ratio of approximately 1:50,000. This figure is even more shocking in view of the inherent disease problems, augmented by wartime conditions. To help alleviate this shortage, a number of nations have sent paid medical or surgical units to assist the Vietnamese in their own provincial hospitals. England and Switzerland have sent small teams, and West Germany has sent a hospital ship. Iran, Japan, South Korea, the Philippines, New Zealand, and Australia have also participated. The United States has many Army and Air Force medical teams who assist in civilian care, and, through the United States Agency for International Development (U.S.A.I.D.), has financed a volunteer program which is administered by the American Medical Association. Transportation and living expenses are provided by the program. During the past 2 years, 24 to 32 United States volunteer physicians have been kept in the country at all times, serving in different provincial hospitals for 60-day periods.
The author was stationed at Long Xuyen Hospital, a 500-bed installation, serving the half million people of An Giang Province in the Mekong Delta. In addition to 10 Vietnamese physicians, this hospital has been staffed by an Australian surgical team during the past 2 years. These teams rotate every 90 days and usually consist of four or five doctors, four to five nurses, and laboratory and x-ray technicians.
Letters to the Editor
Authors: MARQUIS HENRIETTA L. 
Published: December 2021

I would like to comment on a letter of Dr. R. A. Norton, published in the March 1967 issue of Pediatrics, wherein he states that he finds Pediatrics almost useless to a man in private practice.
My training is such that I am not "board eligible," but I have been active in pediatrics since 1940. I know there are many physicians in the same situation. I practice in a state that suffers from insufficient pediatric manpower, and I am associated with a hospital that has one of the few approved pediatric resident training programs in our state. Successful clinical practice is based on the thorough knowledge of the basic sciences.
Minimal Brain Damage
Authors: SCHWALB EUGENE 
Published: December 2021

I would like to make several observations on "Minimal Brain Damage: 25 Year Follow-up" published in the March issue of Pediatrics, (39:393, 1967).
The 18 patients studied by Menkes, et al. ranged from 4.7 to 15.6 years old. We find that brain dysfunction in a 5 year old is not the same in a 15 year old. Hyperactivity, for instance, is common in the former and psychological stresses engendered by school, home, failure, and frustration take dominance in the latter.
Early Diagnosis of Shigellosis
Authors: NANCE FRANCIS D. 
Published: December 2021

I have read with interest Doctor Suchada Poh's communication in your January 1967 issue entitled "Shigellosis: Clue to Early Diagnosis." An even more specific clue to the diagnosis is available, but frequently not used. I refer to microscopic examination of stained smears of the mucoid portion of stools in these patients.
Willmore and Shearman, in 1919, as a result of investigations during an epidemic of shigellosis among British troops on the Island of Malta, first reported the diagnostic specificity of the cell picture in this disease.
Removal of Ear Wax
Authors: KEITEIR W. E. 
Published: December 2021

Since publication of my Letter to the Editor (Pediatrics, 39:313, 1967) I have had numerous inquiries about the technique of using the Water Pik. If I may be allowed the space I would like to add the following description of how to use the Water Pik for this purpose.
The fine pulsating jet stream of the Water Pik is perfect for loosening impacted wax from the ear canal. I hold the nozzle about 1 cm from the external orifice of the canal and direct the stream into the canal. Immediately a great outflow of fine debris drains into a small emesis basin held under the ear, against the neck.
Cutaneous Nerves in Dysautonomia
Authors: BROWN J. COLIN , BRUNT PETER W. , JOHNS RICHARD J. 
Published: December 2021

We were interested to read the communication in your December 1966 issue from Drs. Winkelmann, Bourlond, and Smith (Pediatrics, 38:1060) in which they described normal nerve endings in a patient with familial dysautonomia. They stated that nerve conduction studies would be interesting but had not so far been done in dysautonomia.
During the last 18 months we have had the opportunity to study 13 children with this syndrome performing nerve conduction studies in 10 and, in two instances, skin biopsies.
HYPOPROTEINEMIA IN INTESTINAL LYMPHANGIECTASIA
Authors: Herskovic T. , Winawer S. J. , Goldsmith R. , Klein R. , Zamcheck N. 
Published: December 2021

A 15-year-old boy with congenital lymphedema, ascites, hypoproteinemia, and a jejunal biopsy diagnostic of intestinal lymphangiectasia was studied. I131 albumin survival was evaluated by differential counting of the radioactivity in the lymphedematous and in the normal arm.
When a diet containing 150 gm of fat was fed daily, the I131 albumin half-life was 3.7 days in the normal arm and 22 days in the lymphedematous arm. Substitution of 75 gm MCT for 75 gm dietary fat increased the half-life in the normal arm to 5.1 days. Reduction of dietary fat to 25 gm per day further increased the half-life to 6.5 days in the normal arm. The I131 albumin half-life in the lymphedematous arm was not significantly affected by these dietary changes.
Although approximately 50% of the injected dose of labeled albumin had disappeared from the normal arm within 4 days, fecal and urinary losses accounted for only 15% of the injected dose. The high level of radioactivity remaining in the lymphedematous arm suggested significant "trapping" of the radioactive albumin. Albumin, cleared more slowly from the lymphedema because of inadequate lymphatic drainage, becomes unavailable to the metabolic pool. The observed rapid albumin half-life in intestinal lymphangiectasia is, thus, partly due to this "trapping" in addition to the known enteric losses of plasma proteins.
HIPPOCRATES DESCRIBES MUMPS FOLLOWED BY ORCHITIS
Authors: C. T. E. 
Published: December 2021

In the first book of the Epidemics Hippocrates gave this excellent description of mumps complicated by orchitis:
Swellings appeared about the ears, in many on either side, and in the greatest number on both sides, being unaccompanied by fever so as to confine the patient to bed; in all cases they disappeared without giving trouble, neither did any of them come to suppuration, as is common in swellings from other causes. They were of a lax, large, diffused character, without inflammation or pain, and they went away without any critical sign. They seized children, adults, and mostly those who were engaged in the exercises of the palestra and gymnasium, but seldom attacked women. Many had dry coughs without expectoration, and accompanied with hoarseness of voice. In some instances earlier, and in others later, inflammations with pain seized sometimes one of the testicles, and sometimes both; some of these were accompanied with fever and some not; the greater part of these were attended with much suffering. In other respects they were free of disease, so as not to require medical assistance.
Influence of Diethylnicotinamide on the Concentration of Serum Bilirubin of Newborn Infants
Authors: SERENI F. , PERLETTI L. , MARINI A. 
Published: December 2021

An investigation was performed to ascertain the influence of diethylnicotinamide on serum bilirubin levels of newborn infants with non-hemolytic jaundice. Twelve pairs of twins were examined.
Ninety-six hours after starting drug administration treated twins had significantly lower serum bilirubin levels than controls.
Breathholding Spells
Authors: CATZEL PINCUS 
Published: December 2021

Drs. Lombroso and Lerman are to be congratulated for the light that they have shed on breathholding spells and for so clearly distinguishing the cyanotic and the pallid forms.
Tucked away amidst their learned discussion of the pathophysiology of breathholding attacks is a curious one sentence statement:
"Anemia has been discussed as contributing to breathholding spells (Holowach and Thurston) and in our experience anemic breathholders show a remarkable improvement after treatment of their anemias."
The Essentials of Paediatric Surgery
Authors: CARPENTER REGINALD 
Published: December 2021

This little book on pediatric surgery has, because of its popularity, come to a second edition within 5 years. Once again the authors have directed the book primarily to the senior medical student but have also, because of the interest shown by colleagues, added material not of immediate interest to a student. In a few places the chapter headings and positions have been altered and this has resulted in increased clarity and better continuity.
The book begins with a chapter on the causes of congenital malformation, and this has been expanded and rewritten to bring it up to date.
Reducing the Poison Toll
Authors: COLEMAN ALLAN B. 
Published: December 2021

This communication is prompted by an article entitled "You Can Reduce the Poison Toll," published in Pediatrician's Management for February 1967. The author details some educational aids related to prevention of accidental poisoning available for use in physicians' offices, all of which are undoubtedly beneficial. But, he draws the incorrect conclusion that use of such educational efforts is likely to decrease the case load of accidentally poisoned children materially.
I regret that an apposite view must be advanced.
SOME HORRIBLE WARNINGS OUR COLONIAL CHILDREN READ ABOUT IN BOOKS
Authors: C. T. E. 
Published: December 2021

In Colonial America children read that they were born not to live but to die. This was largely due to the influence of the puritanical clergymen such as Cotton Mather, who dominated the intellectual activity of New England. Good examples of the horrible warnings children read about are the following:
If by Undutifulness to your Parents you incur the Curse of God, it won't be long before you go down into obscure Darkness, even, into Utter Darkness: God has Reserv'd for you the Blackness of Darkness for ever.
Though I am Young, yet I may Die
And hasten to Eternity:
There is a dreadful fiery Hell,
Where the wicked ones must always dwell.
The Lord Delights in them that speak
The Words of truth; but ev'ry liar
Must have his portion in the lake (of hell)
That burns with brimstone and with fire.
Psychogenic, Recurrent, Abdominal Pain
Authors: PARTINGTON M. W. 
Published: December 2021

Congratulations to Dr. Morris Green on an excellent review (Pediatrics, 40:84, 1967) of a common disorder so badly dealt with in our textbooks. I would like to take issue on one point, namely the use of the term psychogenic.
It seems to me that we have no good evidence that this type of recurrent abdominal pain is psychogenic if by this we mean "of mental origin or causation" similar to, for example, an hysterical paralysis.
Abdominal Pain in Girls at Puberty
Authors: WESSEL MORRIS A. 
Published: December 2021

Morris Green's article "Diagnosis and Treatment: Psychogenic, Recurrent, Abdominal Pain" in the July 1967 issue of Pediatrics calls attention to a presenting complaint well-known to pediatric practitioners. Girls in the early months of puberty often come to their physicians with a complaint of recurrent abdominal pain of a somewhat cyclical nature. Physical findings are variable, although there is often some tenderness in one of the lower abdominal quadrants.
The general heightened sensitivity to any bodily discomfort which accompanies the pubertal increase in hormone level causes pubescent girls to be quite aware of and frightned by this pain.
DANGERS TO INFANTS CAUSED BY CHANGES IN OSMOLAL CONCENTRATION
Authors: Finberg Laurence 
Published: December 2021

THE presence of acidemia in conditions of ventilatory insufficiency, such as asphyxia neonatorum, circulatory insufficiency, and in prematurely born infants with respiratory distress, has been well documented. Rudolph and his associates have reasoned that when pulmonary blood flow is reduced, physiologic compensation for the acidemia is impaired and a vicious circle leading to uncontrolled metabolic acidemia and possible death may result. Attempts to interrupt this process have been presented by Usher for respiratory distress syndrome and by Rudolph and Danilowicz in congenital heart disease.
The approach of the use of infusions of alkali to correct the "metabolic component" of an acidemia that has an underlying basis in failure of ventilation has achieved widespread acceptance. The purpose of this paper is to call attention to an important possible risk of such therapy—hyperosmolality.
In particular, the recent interest in instant repair of neonatal acidemia and the now common practice in patients of all ages of rapid repair of acidemia by NaHCO3 infusions in the management of patients undergoing cardiac surgery and of those being resuscitated have rekindled interest in the limits of tolerance for the infusion of hyperosmolal solutions.
The current use of concentrated contrast materials for angiography, the intravenous use of 50% glucose solutions for neonates, and the increased use of concentrated mannitol and other hyperosmolal solutions for treatment of shock and cerebral edema constitute other clinical situations calling for a review of the underlying physiologic changes attending such therapy and emphasizing when and where serious danger exists in inducing changes in body fluid osmolality.
Cancer Chemotherapy
Authors: HALL THOMAS E. 
Published: December 2021

In the two decades since the effective chemical treatment of cancer began to emerge there have been few books published which review what can be accomplished by chemotherapy. Dr. Greenwald's book will be of particular value to the practitioner interested in cancer chemotherapy because the approach, though clinically oriented, is thorough and is based on sound pharmacologic principles.
The plan of the book is first to discuss the pharmacologic properties of the currently available chemotherapeutic agents, then modes of action of the several classes of drugs:
DOES THE CUTTING OF TEETH IN INFANCY CAUSE FEVER?
Authors: C. T. E. 
Published: December 2021

Sir George Frederic Still (1868-1941) was England's foremost pediatrician during the first quarter of this century. His textbook, Common Disorders and Diseases of Children, is probably the most meticulously written pediatric textbook in the English language. In it Still writes about his personal observations resulting from years of intimate, clinical contact with thousands of infants and children. Contrary to what we are told today, Still wrote as follows about dentition as a cause of fever:
I have already expressed my opinion that the worry of dentition is sometimes the sole cause of fever in infants: I know only too well that this is dangerous doctrine, for it is likely to be abused; but nonetheless it is, I think, a fact as well proved by experience as most scientific observations in clinical medicine, that in some infants the temperature will rise to 102° or 103° when a tooth is nearing eruption and will fall to normal within a few hours after the tooth is cut, and this without any other ascertainable cause for the fever. Lancing the gums is out of fashion nowadays, and probably deservedly so, for no doubt far more mischief and pain was produced by indiscriminate gum-lancing than was caused by the dentition which it was supposed to assist, but although I have never personally had the courage of my conviction to proceed to gum-lancing, I strongly suspect that there are cases in which the fever could be stopped speedily by judicious lancing of the gum when the tooth is at the point of eruption, and unless most of the writers of half a century ago were extremely bad observers, their experience proves that this is so.
NEGATIVE EFFECTS OF VITAMIN K PREPARATIONS ON GLUCURONYL TRANSFERASE ACTIVITY
Authors: Jones Barbara 
Published: December 2021

In vitro studies using a mouse liver microsome system failed to demonstrate that menadiol sodium diphosphate, menadione sodium bisulfite, or phytonadione enhanced or inhibited the quantity of ortho-aminophenol glucuronide produced.
In vivo studies in young rats with these vitamin K analogues also failed to show an effect on glucuronide conjugation.
Based on this data, it is concluded that the hyperbilirubinemia seen in prematures after large doses of water-soluble vitamin K analogues is probably not due to an inhibitory effect of glucuronyl transferase. The evidence suggesting that it may be due in part to hemolysis is briefly reviewed.
DIAGNOSIS AND TREATMENT: CURRENT INDICATIONS AND RESULTS OF FETAL TRANSFUSIONS
Authors: Lucey Jerold F. 
Published: December 2021

The best candidate for a fetal transfusion is from 28 to 32 weeks of estimated gestational age, has a high Zone II or low Zone III ΔO.D. 450 (rising or not decreasing on successive amniocenteses), and does not have hydrops fetalis. If carried out by an experienced team, this procedure has a low risk for the mother, about a 5% mortality for the fetus, and appears to decrease the perinatal mortality rate from erythroblastosis fetalis by about 50%.
The future usefulness of fetal transfusions, however, appears quite limited since the introduction of hyperimmune Rh gamma-globulin.13 They may one day be of only historic interest. But, they have demonstrated that fetal diagnosis and treatment are not beyond reason. This may well be a major contribution to pediatrics.
Historical-Ethical Note on Historical Note
Authors: Fried Ralph I. 
Published: December 2021

The October 1967 issue of Pediatrics contains a note sent in by Dr. Thomas E. Cone, Jr., in which he quotes from an essay by William Ellery Channing on the "Duty of Children to Parents." I read this with pleasure and enjoyment.
On October 23, 1967, the Washington Post carried a story about a group of students in New England who burned their draft cards to protest the Selective Service Act and to demonstrate their rebellion against the authority of the Federal Government.
Arterial-alveolar CO2 Tension Gradient in Hyaline Membrane Disease
Authors: Harrison V. C. 
Published: December 2021

Chu, et al.1 recently indicated the presence of a significant a–A gradient for PCO2 in infants with hyaline membrane disease. In their study, alveolar CO2 tension was determined by means of a CO2 analyzer. The method makes use of the fact that end tidal gas forms a plateau on the expiratory CO2 curve and that this plateau can be assumed to be representative of alveolar CO2.
In hyaline membrane disease, however, it is not possible to obtain such plateaus and Strang2 has demonstrated that a series of spiked peaks only are produced during expiration.
ALVEOLAR-ARTERIAL O2 AND CO2 DIFFERENCES AND THEIR RELATION TO LUNG VOLUME IN THE NEWBORN
Authors: Thibeault D. W. , Poblete E. , Auld P. A. M. 
Published: December 2021

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient.
In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants.