bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Environmental Effects on Child Health Are Recognized
Authors: Miller Robert W. 
Published: December 2021

There is no doubt that the fetus and child have special susceptibility to the harmful effects of chemical pollutants.
EPIDEMIOLOGIC CASE REPORTS
Example 1
"Strange incidents occurred in villages along Minamata Bay in [the] Kyushu district in Japan, in which many cats went mad and died. These incidents were the prelude to [an] epidemic of a mysterious disease in human beings."1 In this way Japanese scientists began their account of the link between the ailment, now known as Minamata disease, and pollution of water with methylmercury.
Initially, a degenerative neurological disease was observed only in older children and adults. Apparently no one thought of possible fetal effects. In consequence, they went unnoticed for several years before it was realized that an epidemic of cerebral palsy had paralleled the illness in adults and older children. This was the first evidence that a chemical pollutant could harm the human fetus.
Methylmercury was identified as the cause of the epidemic by looking back into the histories of affected persons. The frequency and seriousness of the effect was greatest in the families of fishermen. It had been noted that fish in the Bay swam erratically. Fishermen sold their best catch and used the sickest looking fish as food for their families. Twenty-three children developed cerebral palsy after intrauterine exposure. Six percent of births during the interval were affected, as compared with 0.5% elsewhere in Japan. Although brain damage in the children was severe, only one of their mothers showed signs of the disease.
The methylmercury came from waste flushed into the Bay by a factory that made vinyl plastic.
Problems in Applying Teratologic Observations in Animals to Man
Authors: Warkany Josef 
Published: December 2021

In teratology you will have to deal with the question of the relation between animal experiments and legislative regulation. As one who has long been interested in human malformations and who has been in experimental teratology for 35 years, I will tell you about the application of animal experiments to human situations. Thirty-five years ago it was discovered that vitamin deficiencies were reliable teratogenic procedures, yet I have not seen any comparable effects in human beings. In 1959 we found that salicylates are excellent teratogens in rats. I still have not seen a child who was deformed by salicylates. With thalidomide, the situation is the other way around; its teratogenicity was first discovered in man and then one had to find susceptible animals. These experiences exemplify how cautious one must be in applying animal observations to man. I do not say that the animal studies were in vain. They gave us important concepts about general principles of teratogenesis, but one cannot simply apply observations in mice, rats, or monkeys to man. Yet, it is done all the time.
We have also learned from experimentation about the variability of response in different species, and even within species there are strain differences in susceptibility. Furthermore, we have learned that a combination of genetic and environmental factors play an important role in the production of congenital malformations, as has been well demonstrated in mice in which cleft palate was produced by cortisone in certain but not all strains. Those who have been in the field for a long time are most hesitant in applying animal results to man.
Environmental Exposures and Biologic Considerations of the Adolescent in Relation to Chemical Pollutants
Authors: Cohen Michael I. 
Published: December 2021

The somewhat dissimilar biologic processes occurring within the adolescent and his often unique environmental subculture place him at different and, at times, greater risk than his older or younger relalives. These potential differences and a current American census of approximately 35 to 40 million adolescents form the basis of the following discussion.
Essential to any thoughtful exploration of chemical pollutants and adolescence is a clear appreciation of the unique physiologic features1 of the teen-ager and his unusual societo-environmental subcultures. After initially viewing the adolescent as biologically in an active stage of physiologic growth, as well as being a fragile social phenomenon in the development of modern man in a rapidly changing milieu, one must next address the issue of the adolescent as a patient.2,3 Inherent in the latter concept are the features of health maintenance and disease specific to this group and the environment in which they exist. For the purposes of this discussion, only the areas of adolescent health or the adolescent environment which may predispose to attack by chemical pollutants will be pursued.
Definitions of the adolescent individual most often applied clinically deal with a chronological age coupled with the onset and termination of puberty (endocrine age); the onset of specific and obvious psychosexual behaviors and their resolution (psychological age); or the change in certain restricted anthropometric parameters (bone age, height age, weight age). Clinicians could just as easily include additional observations of dental age; legal age; intellectual age; vocational or educational age; a host of other anthropometric ages; alterations in body composition and body image; and, with the continued accumulation of more data, "ages" as defined by study of other biological processes and their maturation.
Some Pediatric Aphorisms From Hippocrates
Authors: C. T. E. 
Published: December 2021

Hippocrates, generaly regarded as the "Father of Medicine," was probably born in 480 B.C. on the Island of Cos. Some of his aphorisms of interest to pediatricians are these:
Old persons endure fasting most easily; next, adults; young persons not nearly so well; and most especially infants, of them such as are of a particularly lively spirit.
A humid regimen is bifitting in all febrile diseases, and particularly in children, and others accustomed to live on such a diet.
Epilepsy in young persons is most frequently removed by changes of air, of country, and of modes of life.
With regard to the seasons, in spring and in the commencement of summer, children and those next to them in age are most comfortable, and enjoy best health; in summer and during a certain portion of autumn, old people; during the remainder of the autumn and in winter, those of the intermediate ages.
In the different ages the following complaints occur: to little and newborn children, aphthae, vomiting, coughs, sleeplessness, frights, inflammation of the navel, watery discharges from the ears.
At the approach of dentition, pruritus of the gums, fevers, convulsions, diarrhea, especially when cutting canine teeth, and in those who are particularly fat, and have constipated bowels.
To persons somewhat older, affections of the tonsils, incurvation of the spine at the vertebra next the occiput, asthma, calculus, round worms, ascarides, acrochordon, satyriasmus, struma, and other tubercles (phymata), but especially the aforesaid.
If in a person affected with fever, without any swelling in the fauces, be seized with a sense of suffocation suddenly, it is a mortal symptom.
George Bernard Shaw on the Institution of the Family
Authors: C. T. E. 
Published: December 2021

Shaw tells us that "no man is bad enough to tell the truth about himself during his life time, involving, as it must, the truth about his family and his friends and colleagues." One wonders how near the truth Shaw was when he wrote as follows about his family.
The institution of the family, which is the centre of reverence for carefully brought-up children, was just the opposite for me. In a large family there are always a few skeletons in the cupboard; and in my father's clan there were many uncles and aunts and cousins, consequently many cupboards, consequently some skeletons. Our own particular skeleton was my father's drunkenness. It was combined with a harmlessness and humaneness which made him the least formidable of men; so that it was impossible for him to impress his children in the manner that makes awe and dread almost an instinct with some children. It is much to his credit that he was incapable of deliberately practising any such impressiveness, drunk or sober; but unfortunately the drunkeness was so humiliating that It would have been unendurable if we had not taken refuge in laughter. It had to be either a family tragedy or a family joke; and it was on the whole a healthy instinct that decided us to get what ribald fun was possible out of it, which, however, was very little Indeed. If Noah had made a habit of drinking, his sons would soon have worn out the pious solicitude which they display on the occasion of his single lapse from sobriety.
Noncompliance Contributing to Apparent Drug Failure in Status Epilepticus
Authors: Wilson John T. 
Published: December 2021

The case to be described illustrates apparent drug failure because of noncompliance in the drug delivery system, and the sequelae of this mishap. In connection with investigation of this case further occurrences of noncompliance were found. This incident also brings into focus the importance of plasma drug level determinations for effective application of therapy.
CASE REPORT
A 7-year-old, 26-kg, black girl was admitted with a 16-month history of nonprogressive neurologic disease accompanied by clinical and EEG evidence of petit mal and grand mal epilepsy which responded to diphenylhydantoin (DPH), phenobarbital or ethosuximide (Zarontin) treatment. Generalized convulsions had been infrequent for four months, but, before the present admission, a marked increase in grand mal seizures was noted. On the day of admission (day 1), recurrent generalized seizure activity progressed to status epilepticus within six hours. Intravenous diazepam (Valium [0.18/mg/kg]) controlled the seizures. Primidone (Mysoline), 250 mg tid, and ethosuximide, 500 mg tid were prescribed as maintenance anticonvulsants in an attempt to allay further progression to status epilepticus.
For the next several days her seizures could be controlled only with paraldehyde (0.36 mg/kg intravenously), although administration of other drugs was continued. Assays of drug plasma levels did not become available until day 6. They disclosed that plasma levels of diazepam and demethyldiazepam were high (289 and 50 ng/ml, respectively) one hour after dosing with 0.18 mg/kg. This indicated that diazepam was not effective for continuous control of seizures, but this information was not acted upon immediately. The most striking finding was that primidone was not detected in plasma, although the prescibed dosage was 250 mg tid.
Indian Health Service—By One Who Provides It
Authors: Sondheimer Henry M. 
Published: December 2021

As one of the "young, highly idealistic physicians, just out of internship or residency . . ." and currently in the Indian Health Service, I read the Commentaries of Drs. Mortimer and Kemberling with great interest. Although it is unfair to extrapolate from my experiences at one hospital to the entire Indian Health Service, I believe a practicing pediatrician in the field may comment.
Dr. Mortimer may be surprised to hear that sick newborn infants at our hospital are cared for not by aides but by physicians in close contact with the Arizona Newborn Transit System in Phoenix (250 miles away), and that seriously ill newborns are transferred to one of the two neonatal intensive care units in Phoenix under the auspices of this system.
Committee on Drugs Attacked
Authors: Oettinger Leon 
Published: December 2021

I note Doctor Livingston's comments on the use of amphetamines in epilepsy and the Committee's reply. I would like to support Doctor Livingston's endorsement of the use of amphetamines in epilepsy.
He and his colleagues wrote an article in the fifties on their use in petit mal. Laufer and Denhoff also indicated an increase in the convulsive threshold using a metrazol activation in hyperkinetic children.
Although the Committee may not be aware of the literature concerning this, many of us who have had extensive clinical experience with epilepsy feel that the amphetamines are of value.
Calcium and Fat Absorption From Infant Formulas With Different Fat Blends
Authors: Barnes Lewis A. , Morrow Grant , Silverio John , Finnegan Loretta P. , Heitman Sandra E. 
Published: December 2021

Three formulas with different fat blends were fed to 29 infants from the fourth to the tenth days of life. Absorption and retention of fat, calcium, and phosphorus were measured by a metabolic balance technique. The following observations were made:
1. Absorption of oleate and linoleate was best with the formula that had a linoleate:oleate ratio similar to that of human milk. Absorption of palmitate was similar with all three formulas. Stearate absorption was low in the formula with the lowest stearate content.
2. Calcium absorption was 36 mg/kg/day or 38% of intake with the formula which had a linoleate:stearate ratio similar to that of human milk; this was significantly greater than with the other two formulas which both had much higher linoleate:oleate ratios.
3. Phosphorus absorption was approximately 90% of intake with all three formulas, equivalent to 47 to 79 mg/kg/day. Retention varied from 27 to 53 mg/kg/day.
Dr. Nathan's Assumptions Attacked
Authors: Katcher Ayrum L. 
Published: December 2021

David G. Nathan's commentary (Pediatrics, 52:768, 1973) on problems of delivery of health care suggests that the rational application of scientific methods which have been so successful in the biomedical research area to the problems of the delivery of health services to our population, will produce comparable achievements in this new arena.
Nathan may well be correct in his faith in the research process. However, he also seems to believe that persons engaged in research possess talent ("the cream") which is equipotential in all areas.
Viewpoint From the Division of Community Child Health
Authors: Bass Joel , Johnson Dorothea , Kirby Jacqueline , Lamb George A. , Levy Janice C. , McCarthy Paul L. , Robins Carol , Ross Cynthia 
Published: December 2021

We read with interest Dr. Nathan's comments on primary medical care (Pediatrics, 52:768, 1973), but feel compelled to add another viewpoint.
One of the striking changes occurring today in teaching hospitals and medical schools is an increased awareness of and interest in primary care. Some institutions, including our own, have created residencies and fellowships in ambulatory pediatrics as a response to house staff interests and also in response to the needs of the surrounding community.
Dr. Nathan's Reply to His Critics
Authors: Nathan David G. 
Published: December 2021

Though the tone of some of the responses to my commentary is a bit more strident than I would hope to hear in a discussion among colleagues, I must admit that some of the criticisms are well taken.
There are one or two points that require closer examination. First, it is not fair to blame the overgrowth of specialty and research medicine on the department chairmen of the 50s. The facts are that organized medicine made certain that no funds would be available to develop new primary care programs aside from traditional residency training programs.
School Problems and Their Causes
Authors: Wender Esther H. 
Published: December 2021

In most respects Dr. Marcel Kinsbourne's discussion of school problems was excellent1, but he makes some statements which I feel should be reviewed critically.
His opening statement that "the great bulk of illiteracy in this country derives from socioeconomic adversity and cultural alienation that presents a primarily political rather than a medical challenge" (emphasis mine), though often made, confuses correlation and causation. Although illiteracy can be correlated with low socioeconomic class, that does not necessarily mean that a poor socioeconomic status causes illiteracy (cf the arguments regarding intelligence and social class).
Letter to the Editor
Authors: Mutti Margaret , Sterling Harold M. 
Published: December 2021

Marcel Kinsbourne's paper (Pediatrics, 52:697, 1973) is timely and practical. Unfortunately, however, the volume of children with school problems approaches the unmanageable, and we need reliable and effective ways of screening which will enable us to give appropriate professional attention to the "problems".
In 1969 we began to develop an instrument that would select school children having distinct neurologic handicaps from a large group experiencing learning problems. Our brief screening can be administered in approximately 20 minutes by medical or nonmedical professional qualified personnel.
An Account of the Successful Outcome of a Compound Skull Fracture in a Six-year-old Boy-Reported in 1763
Authors: C. T. E. 
Published: December 2021

The case history below attests to the vis mediatrix naturae because the patient survived a serious head injury without any of the supportive therapeutic aids which would be considered routine today.
Thomas Walker, a child about six years of age, living at Caton, being asleep near the fire, a stone about half a hundred-weight fell from the top of the chimney upon the side of his head, and fractured his skull in a most terrible manner. The poor lad lay as dead for several hours; but his parents being persuaded to carry him to Dr. Brachen of Lancaster, they immediately followed the advice. The doctor made a proper incision, in order to clear the skull from the pericranium, and discover the fracture; when he found the parietal bone fractured in twenty pieces (some as large as a shilling piece) with their sharp points sticking down in the brain, the dura and the pia being both destroyed, and a considerable effusion of blood from the vessels of the brain.
The bones were removed with great care and dexterity, for as their points went so far into the brain, the nicety consisted in removing them so that the instrument might not pass too far into the substance of the brain, and consequently destroy the patient. In time the boy recovered beyond expectations, and is now entirely well, though it is three months since he received the hurt. Therefore, the said Dr. Brachan inserts this for the information of those who are bigoted to an opinion, that if the brain was wounded till the lobe or particular part of the brain was rotted or consumed away, the case would be desperate.
Hydrocarbon Pneumonitis
Authors: Eade Norman R. , Taussig Lynn M. , Marks Melvin I. 
Published: December 2021

Small children, particularly those aged 1 to 5, often drink liquid hydrocarbons when these substances are left accessible to them by careless adults. The hydrocanbons most commonly ingested include petroleum solvents, dry cleaning fluids and spot removers, kerosene, lighten fluids, gasoline, and "mineral seal oil" which is found in many liquid polishes and waxes. For statistical purposes many surveys also include ingestions of turpentine, oil paints, stains and a variety of hydrocarbon-based preservatives. In 1972, petroleum products accounted for 4.6% (4,571 of 105,018 poisonings reported) of accidental ingestions in the United States among children under 5 years of age.1 This figure has remained virtually unchanged since 1969. In a hospital based study published by Deeths and Bneeden2 in 1971, ingestion of hydrocarbons was reported to be the second most common cause of admission to hospital for accidental poisoning in each of the years from 1962 to 1968. In the United States from 1951 through 1958, 763 people died following accidental ingestion of petroleum distillate and children under 5 years of age accounted for about 90% (680 of 760) of these deaths.3 However, statistics reveal a decreased mortality rate, with only nine hydrocarbon fatalities reported in 1972 for this same age group.1
Although a wide variety of hydrocarbons are involved in the accidental poisonings reported, most related publications have dealt with kerosene intoxication. The incidence rate and the mortality rate from kenosene ingestion is decreasing, although it continues to be a major problem in the United States. For children less than 5 years of age in 1972, there were 579 reported cases of kerosene ingestion of which two were fatal.1
ADVICE FROM AN OLD DOCTOR TO A YOUNG DOCTOR ON "KEEPING UP"
Authors: Hailey A. 
Published: December 2021

"You're young, you're full of spice and vinegar—that's good. You know your stuff too. You're up-todate—you know things that I never did and never will now. Take my advice and try to keep it that way. It'll be tough to do; make no mistake about it." He waved toward the desk he had just vacated. "You'll sit in that chair and the phone will ring, and it'll be the administrator—talking about budgets. Next mmute one of the lab staff will want to quit; and you'll have to smooth that out. And the doctors will come in, and they'll want this bit of information and that." The old man smiled thinly. "Then you'll get the salesman—the man with the unbreakable test tube and the burner that never goes out. And when you're through seeing him there'll be another and another and another. Until at the end of a day you'll wonder what happened to it and what you've accomplished, what you've achieved."
"That's the way the next day can go, and the next, and the one after that. Until you find a year has slipped by, and another, and another. And while you're doing all this you'll send other people on courses to hear about the new things in medicine—because you can't take time out to go yourself. And you'll quit investigation and research; and because you work so hard, you'll be tired at night, and you won't feel like reading textbooks. And then suddenly, one day, you'll find everything you knew is out of date.
Immunization Action Month, October 1974
Authors: Katz Samuel L. 
Published: December 2021

The Executive Board of the American Academy of Pediatrics, in a recent session, unanimously approved a resolution supporting Immunization Action Month, October 1974, in order to stimulate a more widespread immunization of American children against poliomyelitis, diphtheria, rubella, mumps, pertussis and tetanus. It is completely appropriate, therefore, that the Academy take an active role in a nationwide effort to make October 1974 a month for emphasis and promotion of childhood immunization. Joining with the Academy in this effort are the American Medical Association, American Academy of Family Physicians, National Medical Association, American Osteopathic Association, American Nurses Association, American League of Nursing, five major service organizations and five manufacturers of biologics.
The entire campaign is initiated and coordinated by the Center for Disease Control. The aims of this national effort are twofold: (1) "to motivate parents to check the immunization status of their children with their family doctor"; and (2) "to create receptivity on the part of the physician to these parental inquiries and encourage him and his office nurse to conduct an ongoing office audit of the immunization record of every child he sees." A third goal should be to make every effort to reach those indigent and other disadvantaged groups who do not receive consistent health care.
Why is such a campaign necessary? The striking reductions in the numbers of reported cases of diphtheria, tetanus, pentussis, poliomyelitis, and measles attest to the remarkable efficacy of the vaccines in the prevention of these diseases. Disquieting information has arisen from two sources: (1) the surveillance reports of infectious diseases; and (2) the surveys of the immunization levels of preschoolers and those children at the time of school entry.1