bluuebunny/crossref_metadata_2025_split huggingface dataset:
TEACHING ABOUT MENTAL SUBNORMALITY TO THE MEDICAL STUDENT AND PHYSICIAN: A CONFERENCE REPORT
Authors: Knobloch Hilda 
Published: December 2021

MENTAL SUBNORMALITY is defined officially by the World Health Onganization as incomplete or insufficient general development of the mental capacities. It has two components: mental deficiency and mental retardation. Mental retardation is present when the social and educational performance is lower than that expected from a knowledge of intellectual abilities. Mental deficiency is diminution of the mental capacities themselves as a result of pathological processes. Individuals with organic disease of the brain may have additional impairment of intellectual functioning as the result of adverse environmental circumstances.
It seems clean that advances in medical care have resulted in increasing survival of infants with brain damage, and more attention is being paid to the problem of subnormal mental functioning as well as to other neuropsychiatric disabilities. The American Academy of Pediatrics has reflected this increased interest by organizing a Section on Child Development and appointing a group to study formation of a separate Committee on Mental Retardation. The forthcoming report of the President's Panel on Mental Retardation will undoubtedly include consideration of the role of the official pediatric organizations as well as that of the individual pediatrician.
In 1957 a conference on Teaching Mental Retardation in Medical Education was held. As its name implies, it was restricted to the problems of physician education. However, the relationship between physicians and other professionals concerned with providing services to the mentally subnormal was not considered. The report represents the consensus of members of the conference as to the most fruitful approach to engaging the interest of the physician, from the time he starts as a medical student, and mobilizing it in the most constructive fashion.
PRESIDENT'S MESSAGE
Authors: Webb Clarence H. 
Published: December 2021

THE ROLE of the pediatrician in the totality of medical practice in this country undergoes close scrutiny; panels and papers have dealt with it. Pediatric educators are vitally concerned that their teaching programs be tailored to future needs; official interest of the American Academy of Pediatrics has been expressed through its Committee on Medical Education and Subcommittee on Postgraduate Education. Now the Academy, jointly with the American Pediatric Society, the Society for Pediatric Research, the American Board of Pediatrics, and the Pediatric Section of the A.M.A., cosponsors a study of Pediatric Research, Education and Practice (PREP) under the direction of Dr. Alex Steigman.
I speak now for the practicing pediatrician. The experiences and philosophy acquired from a third-century devoted to pediatric practice, spanning the lifetime of the Academy, may be of value to those concerned with the future of the specialty. Not content to rely on an individual judgment, I have submitted the outline of my thought to 20 friends of my generation for their opinions of its validity, their experiences and ideas. Their responses, enthusiastic and often detailed, enhance and embellish my observations.
The composition of this group is important, since my thesis relies on their approval and added experiences. They practice in 17 states from New England and Florida to California and Hawaii; they live in cities and towns from the size of New York and Chicago to as small as 25,000 on 35,000 population. All are long-time members of the Academy; many, but not all, have held office or served on committees of this organization. All have been primarily involved in practice, but many have had part-time teaching experience in university or hospital; a few are known for clinical research and published articles.
Academy Recommendations and Public Health Regulations
Authors: BOGGS THOMAS R. 
Published: December 2021

Dr. Fred Harvie's expressed concern (Pediatrics, 27:838, 1961) over the possibility that a well-intentioned but perhaps naive city government might translate the American Academy of Pediatrics recommendations for nursery space requirements into law was not without foundation. The City of Philadelphia has moved so far in this direction that these recommendations will become law in a matter of weeks unless the city government chooses to change its mind. Unfortunately, the proposed law, in this instance, is to apply to existing, not new, facilities; consequently considerable pressure is being exerted to influence the city to refrain from passing the law.
There were 48,775 recorded live births in the City of Philadelphia in 1961; 32,502 were white and 16,723 were non-white.
Letters to the Editor
Authors: SILVERMAN WILLIAM A. 
Published: December 2021

Dr. Boggs' letter of reproof continues the dialogue begun in 1961 (Pediatrics, 27:838, 1961) on the Academy's recommendations for the design of newborn nurseries, and little would be gained by repeating these arguments. However it seems to me that he has raised two issues that call for an additional reply by the Committee on Fetus and Newborn.
The first question concerns the information at hand on which the space recommendation was made. As Dr. Irving Schulman noted in 1961, the recommendation of 30 square feet per infant was based upon experimental evideuce on the transmission of airborne infection from infant to infant which was presented to the Committee on Fetus and Newborn and its consultants.
SHOULD OUR CHILDREN PAY FOR THE CIGARETTE COMMERCIALS?
Authors: WISHIK SAMUEL M. 
Published: December 2021

The evidence that continues to pile up concerning the unfavorable health effects of cigarette smoking is most striking when a person has been a fairly heavy smoker over a long period of years. Obviously, this points to the seriousness of persons starting to smoke early in life.
An article on the tobacco industry in the January, 1963, issue of Fortune magazine documents the tremendous recent increase in cigarette smoking by young people. As one looks around to see 18 and 19 year old boys and girls smoking, one is impressed with the number of them who have already become heavy smokers. It is not a matter of an occasional cigarette.
The Well Child's Problem—Management in the First Six Years
Authors: ILLINGWORTH R. S. 
Published: December 2021

The author has set out to provide a compendium to guide the practicing physician in the management of children's everyday problems. The book discusses physical growth and development, the health supervision of the well infant, feeding and nutrition, and common behavior problems.
I have no doubt that the writer has provided a great deal of useful information which will prove to be of much value to the physician. His sections on toilet-training, sleep, and toys are particularly good.
Records for Hyperbilirubinemia
Authors: MILLER ALVIN A. , FUERTH JOHN H. 
Published: December 2021

The problem of jaundice is frequent in a large nursery service. In a hospital delivering 400 to 500 babies per month, our "exchange team" commonly sees 15 to 20 babies each month. Most of these are subjected to diagnostic hematologic and bilirubin studies; some require exchange transfusion. We have devised the forms reprinted herein to be used as part of the newborn infant's record.
The "Graphic Data Sheet—Newborn Jaundice" (Fig. 1) has been useful in the following way. 1. All laboratory work is recorded on this form. 2. An over-all numerical record of the rate of rise and the degree of bilirubinemia is immediately apparent. 3. The need to search through many laboratory slips to relate age to level of bilirubin is avoided. 4. After discharge this sheet is removed and kept for future evaluation of our experience with neonatal jaundice in regard to etiology, frequency, course, and management. 5. We have also used this record for newborn infants with mild clinical icterus, if any work-up is done, to give more accuracy to statistical studies.
The "Exchange Transfusion Record—Newborn Jaundice" (Fig. 2) is used for all exchange transfusions of newborn infants. All occurrences and medications during exchange are recorded. Changes in the infant's condition, venous pressure, pulse rate, calcium infusions, exchange volume, and duration for procedure are documented. Morbidity and mortality statistics on exchange transfusions may then be readily accumulated.
These records and their analyses have facilitated our management of hyperbilirubinemia from known hemolytic disease, as well as bilirubinemia of undiscovered origin (called B.U.O. in our nursery). Perhaps other pediatricians would find these forms an aid to their care and study of newborn infants with jaundice.
We have submitted these records to the Academy's Committee on Fetus and Newborn for consideration as part of the "Standards and Recommendations for Hospital Care of Newborn Infants."
Intestinal Biopsy, Ciba Foundation Study Group No. 14
Authors: CRAIG JOHN M. 
Published: December 2021

This is one of the group of Ciba Foundation's well-known Symposia. In contrast to the Conferences, which last 3 to 4 days and appear in book form, the Study Groups cover a more limited aspect of an area of new knowledge and are published in booklets with hard covers but with the usual attention to typographic and reproductive excellence given to their larger counterparts.
The 21 participants in this conference gave six individual papers at the one-day meeting in Madrid. These covered the important areas in this relatively new field dating from 1956 when the first intestinal biopsies were carried out by Crosby and Doniach.
PRIMATES, DRUGS AND FETAL SAFETY
Authors: LUCEY J. F. 
Published: December 2021

IT WAS WELL KNOWN to teratologists at least, prior to the thalidomide disaster, that congenital anomalies could be produced in animals by a wide variety of therapeutically useful substances (thyroxine, vitamin A, caffein, salicylates, cortisone, insulin, penicillin, and streptomycin). Very little public attention was paid to these data. The teratologists remained quiet and well aware of the many pitfalls involved in interpreting such studies.
When the thalidomide disaster struck there was an understandable stampede back to the study of the teratogenic effects of drugs in animals. We now find ourselves in an apparently bottomless pit confronted with studies indicating that in some animals, at some time, under certain conditions, any drug with pharmacologic action is capable of causing anomalies.
ACCEPTANCE OF PRESIDENCY
Authors: Douglass Frank H. 
Published: December 2021

THIRTY-THREE men have held this office before me—thirty-three of the greatest names in Pediatrics. With such a heritage I feel very grateful and humble.
It has been my good fortune to have known most of these men personally, and to the following three, I am particularly indebted: Dr. J. B. Bilderback, who was my teacher; Dr. Henry Dietrich, under whom I had my residency; and Dr. Jay I. Durand who was the first to interest me in our Academy and who was always an inspiration to me.
The founders and officers of the Academy who have served before me have set the purpose of the voyage of the Good Ship American Academy of Pediatrics; the Executive Board of the Academy continually reviews our problems and charts our course; the Execcutive Director and Central Office staff arrange the cargo, but you—the stock holders—must work the cargo if our voyage is to be successful. I will try to the best of my ability to run a happy and efficient ship— and hold her steady as she goes.
TREATMENT OF A CASE OF NONTUMOROUS CUSHING'S SYNDROME WITH o,p'DDD
Authors: Bar-Hay J. , Benderly A. , Rumney G. 
Published: December 2021

A case of a nontumorous Cushing's syndrome in a 10-year-old girl is presented. The diagnosis was based on the clinical picture, the high levels of urinary steroids and plasma 17-OH corticosteroids, the results of ACTH stimulation tests, and finally by the histology of the left adrenal.
Therapy with o,p'DDD had a dramatic effect on the patient's condition. The typical signs of Cushing's syndrome disappeared, and the girl is developing normally. The urinary steroids and the plasma 17-OH corticosteroids returned to normal levels. The ACTH stimulation tests gave results indicative of a normally functioning adrenal gland.
THE CORRECTION OF PROLONGED BLEEDING TIMES IN TWO BROTHERS BY PLATELET TRANSFUSIONS DESPITE NORMAL IN VITRO PLATELET TESTS
Authors: White James G. , Yunis Edmond , Colliander Marian , Krivit William 
Published: December 2021

1. Two children with congenital disorders have been presented.
2. Laboratory evaluation of their problem revealed only prolonged bleeding times and positive cuff tests.
3. The transfusion of normal platelets, but not plasma, corrected their abnormal bleeding times.
4. The use of blood product transfusion as a means of establishing diagnosis was useful in our patients and is recommended in the study of all difficult bleeding problems.
New Information Available on Hazards of Fallout: Useful Work of a New Jersey Academy Committee
Authors: CHARLES SEYMOUR 
Published: December 2021

Our Committee, for the past two years, has concerned itself with the potential hazard of fallout to the health of the infant, child, and fetus. In May, 1963, we initiated a survey of the countermeasure programs within the individual states. Countermeasures are possible methods of controlling exposure to fallout which might be used by government or private health facilities.
Our studies form the basis for testimony to a Sub-Committee on Atomic Energy of the Congress.
The Allergic Child
Authors: BURGIN LEO B. 
Published: December 2021

As is frequently the case, texts produced by multiple authors may vary considerably in degree of excellence. In this opus, while there are variations, one would classify the chapters as excellent in most instances, good in a few. This same multiple authorship leads to some duplication of material which adds to the length of the book. Since this book is aimed at the practicing physician shortening of the text would be welcome.
In general the various aspects of pediatric allergy are presented in a clear and precise manner. Controversy is avoided and for the most part middle of the road methods are recommended.
CONGESTIVE HEART FAILURE AND RHEUMATIC ACTIVITY IN YOUNG PATIENTS WITH RHEUMATIC HEART DISEASE
Authors: Spagnuolo Mario , Feinstein Alvan R. 
Published: December 2021

Ninety distinct episodes of congestive failure have been analyzed in 40 children and adolescents with rheumatic heart disease. The cause or precipitating factor of each episode was sought by careful clinical evaluation. Without regard to laboratory tests, the episodes were classified as "active" when associated with other major features of the Jones diagnostic criteria for rheumatic fever, and as "inactive" when such features were absent, with the congestive failure presumably due to mechanical or pharmaceutical causes, pulmonary infarctions, or nonstreptococcal infections.
Associated values for the erythrocyte sedimentation rate and CRP were remarkably consistent in both the "active" and "inactive" groups. These tests were often specific enough to be useful in deciding the cause and treatment of the episodes. The ESR was at its highest and was almost always elevated in untreated "active" patients; it usually remained within normal limits in those "inactive" episodes not associated with pulmonary infarctions or nonstreptococcal infections. The CRP results followed the same pattern.
It is currently believed that every episode of congestive failure in young patients with rheumatic heart disease is due to "rheumatic activity" and that the low values frequently found for ESR are due exclusively to the failure itself. The present results contradict these concepts. Congestive failure can often occur in this age group without rheumatic activity; it does not significantly lower an ESR elevated by inflammation. Low ESR values in patients not receiving anti-rheumatic therapy suggest that the congestive failure is due to causes other than rheumatic activity.
Physiology and Morphology of Bronchiolitis
Authors: ROBBINS J. J. 
Published: December 2021

I was very much interested in Dr. Ingeborg Krieger's excellent study of pressure-flow-volume relationships in acute infantile bronchiolitis, published in Pediatrics, 33:45, 1964.
I am wondering if Dr. Krieger is acquainted with the recently published studies by Engel of the anatomy of the bronchiolar tree in infancy and childhood which might well provide an explanation for the seemingly paradoxical lack of rise in outflow resistance and prolongation of expiratory phase as is characteristic of other obstructive lung disease as bronchial asthma.
Hyaline Membranes and Pulmonary Blood Pressure
Authors: BROWN R. J. K. 
Published: December 2021

The aetiology of the syndrome of respiratory distress in the premature infant remains unsolved. As I know to my cost, theories based upon mere speculation rarely prove correct. However, when new facts are discovered it is inevitable that we should try to fit them into the clinical picture.
In the December issue you have published a most exciting article (32:1094, 1963) which provides an important clue to the pathogenesis of the syndrome. One feels it should provide the complete answer, but this finding, like so many others, is capable of different interpretations because of the complexity of the respiratory and haemodynamic factors involved.
STROKE VOLUME AND RELATED HEMODYNAMIC DATA IN NORMAL CHILDREN
Authors: Sproul Ann , Simpson Ellen 
Published: December 2021

1. Catheterization data on 21 children between the ages of 6 and 16 years with no demonstrable hemodynamic abnormality were analyzed in order to establish normal values for blood flow in children.
2. The findings are: (a) Body surface area is a reliable standard of size for predicting cardiac output, stroke volume, and oxygen pulse. (b) Stroke volume is less variable than cardiac output or oxygen pulse since it is less affected at rest by minor variance from the basal state. (c) Cardiac index of 4.1 1/min/ m2 is valid within the surface area range of 0.7 to 1.2 m2. (d) Stroke index of 42 ml/beat/ m2 is valid within a surface area range of 0.7 to 1.5 m2.
3. Oxygen pulse is proposed as a sensitive index of the variance from basal state and as a useful flow measure for outpatient cardiac function studies.
4. A nomogram is presented for predicting cardiac output, stroke volume, and oxygen pulse from surface area.
THE NATURAL HISTORY OF CERTAIN CONGENITAL CARDIOVASCULAR MALFORMATIONS
Authors: Nadas Alexander S. 
Published: December 2021

INFORMATION on the "natural history" of congenital cardiac malformations is difficult to obtain and may have very little meaning for the statistician. One is aware that the facts obtained may yield a profile only of those patients with heart malformations who have signs and symptoms significant enough to bring them to a cardiac center. The others, either not sick enough to come to a center, or too sick and even dying before they can be brought to the specialist, or living too far from the medical center, therefore, will not be included in any survey. The only way the entire congenital heart disease population may be caught in the net of the investigator is by following up carefully a large group of newborns.
Though information gathered may not be statistically significant it is none the less important as a frame of reference in making recommendations to patients and their families. Also it is of necessary historical import that we document the course of patients with malformations as yet unaltered by the hand of the surgeons. The effect of surgery on patients with certain malformations is far reaching and changes the course of their natural history. Another reason why we should try to find out what happens without operation to certain patients is that there will be a tremendous advance in cardiovascular surgical techniques for many lesions yet in the future. Nobody questions the fact that cardiac surgery, in many, if not most, areas will be better tomorrow than it is today.
The notable exceptions to improvement of surgical techniques include repair of patent ductus arteriosus, coarctation of the aorta, secundum atrial septal defect, and pulmonic stenosis.
CURRENT CONCEPTS IN PEDIATRIC CARDIOVASCULAR SURGERY
Authors: Kirklin John W. 
Published: December 2021

AMONG the many interesting congenital cardiac malformations amenable to surgery today, four will be discussed, namely, coarctation of the aorta, ventricular septal defect, Tetralogy of Fallot, and transposition of the great vessels. Recommendations for surgical therapy are based on the experience at the Mayo Clinic.
Coarctation of the aorta continues to be most satisfactorily treated by operation and the hospital mortality risk is extremely low. In general, the optimal age for surgery is about 10 to 12 years. Unusually severe systemic hypertension or cardiac enlargement constitute an indication for somewhat earlier surgery. When infants with isolated coarctation of the aorta show severe cardiac failure, and this certainly occurs although uncommonly, operation should be advised at that age. The risk even then is very low, but few cases may require reoperation at age 12 because of failure of adequate growth of the anastomosis.
The indications for repair of ventricular septal defect must take into account the estimated size of the lesion and its hemodynamic effects. Patients with small ventricular septal defects who have normalsized hearts and normal electrocardiograms, that is, those without clinical evidence of significant hemodynamic derangement, are not advised by us to undergo repair of the defect at present. Patients with ventricular septal defect and mild or moderate pulmonary artery hypertension (that is, patients whose pulmonary artery pressure is less than 75% of systemic artery pressure) can be operated upon at essentially no hospital risk. Operation is clearly advisable in all of these patients. Patients with ventricular septal defect who have severe pulmonary artery hypertension associated with a large pulmonary blood flow (and thus with only mild elevation of pulmonary vascular resistance) can be operated upon with a low hospital mortality rate, in the neighborhood of 5%.
COMMITTEE ON ENVIRONMENTAL HAZARDS
Authors:   Committee On Environmental Hazards
Published: December 2021

IN A REGENT REPORT on water resources, it is estimated that at the present rate of increasing population growth and industrial use by the end of this century it will be necessary to withdraw from streams and ground sources one billion acre-feet or approximately 75% of stream flow. This represents a threefold increase over the proportion now used, and reflects population increase, greater urbanization with associated increases in water consumption, and increased industrial usage proportional to present trends. That this presents serious problems for the future is readily appreciated when one considers the enormous load of waste, both human and industrial, that these streams are presently carrying. Of the over 500,000 organic chemicals known and described, many are finding their way into streams and thus into our water supplies. Only a small fraction of those presently in water would be acceptable to the Food and Drug Administration as proper additives for food and beverages for human consumption. Although waterborne outbreaks of acute communicable disease traced to established municipal water supplies are rare at the present time, the possibly harmful effects of various chemical additives are much more difficult to determine and trace. This problem is likely to become considerably more severe, since it seems likely that the present rate of industrial development will continue and our water usage is expected to reach one thousand billion gallons of water per day within this century.
This Committee was provided an opportunity recently to review the present status of water pollution in this country with the staff of the Robert A. Taft Sanitary Engineering Center.