bluuebunny/crossref_metadata_2025_split huggingface dataset:
PIGEON BREEDER'S LUNG IN CHILDREN
Authors: Stiehm E. Richard , Reed Charles E. , Tooley William H. 
Published: December 2021

Diffuse interstitial pneumonitis associated with the prolonged exposure to pigeons is described in five boys ages 7 to 15. The clinical characteristics include a gradual onset of cough, shortness of breath, and weight loss; in three cases, acute onset of fever, chills, cough, and muscle aches occurred within 12 hours after heavy exposure. Physical findings consisted only of occasional rales and wheezes. The chest x-rays in four cases showed a diffuse interstitial pneumonitis. A lung biopsy in one case disclosed interstitial inflammation, round cell infiltration, and giant cell formation. The patients improved when the birds were removed. One severely ill boy was treated successfully with steroids.
Pulmonary function studies disclosed diminished vital capacity, absent or minimal airway obstruction, and a variable defect in diffusing capacity. Their sera contained normal or elevated complement levels, increased γG and γA globulin, and precipitating antibody to extracts of pigeon feathers, droppings, and plasma. Levels of precipitating antibody, measured by a new radial diffusion technique, tended to correlate with the severity of the disease and the degree of exposure to pigeons. Antibody levels fell progressively when pigeons were removed from the environment.
Except that the specific antigens differ, pigeons breeder's lung, Farmer's lung, bagassosis, maple bark stripper's disease and other similar syndromes are identical. They all differ sharply from allergic bronchial asthma in the symptoms and the mechanisms of the hypersensitivity. The histopathology of the biopsy, the elevated serum complement, and the absence of disease in some exposed individuals who have precipitins favor the interpretation that the pathogenesis of this illness is a delayed hypersensitivity to the inhaled antigens; but participation of an Arthus-type reaction cannot be excluded.
COMMITTEE ON FETUS AND NEWBORN
Authors: SILVERMAN WILLIAM A. , LECEY JEROLD F. , BEARD ALICE , BROWN AUDREY K. , CORNBLATH MARVIN , GROSSMAN MOSES , LITTLE JOSEPH A. , LUBCHENCO LULA O. , METCOFF JACK , SCHAFFER ALEXANDER J. , SPECTOR SAMUEL , GRUENWALD PETER , MURTAGH JUAN 
Published: December 2021

A WORKSHOP MEETING of the Committee on Fetus and Newborn and Consultants was held in Chicago on October 22, 1966, to consider standard terms for the classification of newborn infants with respect to duration of gestation, birth weight, and intra-uterine growth.
INTRODUCTION
Liveborn infants have usually been classified according to weight at birth because of the close association between ponderal size and the risk of death in the first hours and days of life. This simple classification has been useful in developing uniform national and international vital statistics and the data have been used to plan public health programs aimed at reducing the incidence and the high mortality of neonates who are small at birth. However, the classification based on weight alone and the international definition of prematurity (≤2,500 gm), which equated birth size and fetal age, have had the effect of obscuring medically important differences between likesize infants of dissimilar gestational ages. In view of the evidence indicating that many of the neonates included within the limits of the international definition are not born prematurely (&lt;37 weeks), the Expert Committee on Maternal and Child Health of the World Health Organization recommended that the concept of "prematurity" in the definition should give way to that of "low birth weight." Although the primary axis of classification (birth weight) remained unchanged, the new recommendation emphasized the need to use terms which make a clear distinction between size at birth and duration of gestation.
In the past few years careful appraisal of newborn infants has revealed a growing number of associations between specific disorders in the neonatal period (e.g., antenatal infections, hypoglycemia, chromosomal abnormalities, respiratory distress syndrome) and either gestational age or aberrant intra-uterine growth.
Letters to the Editor
Authors: HAMMOND KEITH 
Published: December 2021

In reply to Dr. Tuttle's letter, I can only state that I missed Dr. Caffey's references and should obviously have searched further.
Regarding Dr. Aase's letter, since reporting and describing the dimples in Pediatrics I have encountered them in a child with achondroplasia. Perhaps they have been described in this association also—I do not know—but it is interesting that Dr. Aase's patients also have musculoskeletal abnormalities. However, I also recently saw them in a young infant who seemed otherwise normal and in whom the history revealed nothing apparently significant. I have not noticed the limitation of joint motion.
THE PEDIATRICIAN AND THE PUBLIC
Authors: MORGAN HUGH J. 
Published: December 2021

IT IS a pleasure and a great honor to come to the Old North State from a daughter state, Tennessee, to speak to you on the occasion of the 150th anniversary of the foundation of your Medical Society.
The conventional address for such an occasion would be a historical one. Certainly, old records of this Society provide extraordinarily rich and attractive material for the historian. Your current program of medical education, medical research and medical administration in relation to the improvement and extension of medical care, both preventive and curative, is a source of pride and stimulation for all of the southern states. North Carolina is leading the way in the South.
But I do not plan to review in detail the past or current accomplishments of the profession in North Carolina. This has just been done for us in a scholarly and inspiring address by Dr. Hubert A. Royster. Suffice it to say that the membership of your Society has exhibited a capacity, unusual in organized medicine, for self examination and self evaluation and has been alert to change. Your membership has been judged courageous and progressive, and the country in general and the South in particular has become accustomed to look to North Carolina for guidance and example. Perhaps some of you hardly recognize yourselves as I talk! Maybe there are a few of you like the thieving, prowling, lying and intemperate colored man on judgment day who read, as he arose from his grave at the sound of the trump, the inscription on a tombstone—provided by the faithful, generous wife who survived him—"Here lies an honest man, a faithful husband, a truthful citizen and a temperate, devoted churchman." "Scuze me, Lord," said our friend, "I done come up outer the wrong grave!"
PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK
Authors: HILBERT HORTENSE 
Published: December 2021

THE effort to coordinate nursing organizations in the United States and make them more effective in the tremendous task of meeting the nation's constantly increasing demand for nursing care, which has become known among nurses as "the structure study," is currently being given fresh impetus as nurses all over the country hold workshops to consider two new plans prepared by their Committee on the Structure of National Nursing Organizations.
The study of the structure of organized nursing began more than a decade ago when the board of directors of the American Nurses' Association, in response to a recommendation of a state nurses' association, voted that a special committee be appointed to consider the possibility of consolidating the American Nurses' Association, the National League of Nursing Education, and the National Organization for Public Health Nursing.
Next definite action occurred in January 1944, when the boards of directors of those three organizations voted to undertake a joint survey of their "organization structure, administration, functions and facilities to determine whether a more effective means can be found to promote and carry forward the strongest possible program for professional nursing and nurses." A committee representative of all three organizations was formed, and in late 1944 and early 1945 representatives were named to the committee by three other organizations, the National Association of Colored Graduate Nurses, the American Association of Industrial Nurses, and the Association of Collegiate Schools of Nursing.
NEW CONCEPTS OF THE ETIOLOGY, DIAGNOSIS AND TREATMENT OF CONGENITAL MEGACOLON (HIRSCHSPRUNG'S DISEASE)
Authors: SWENSON ORVAR , NEUHAUSER EDWARD B. D. , PICKETT LAWRENCE K. 
Published: December 2021

Hirschsprung's disease, or congenital megacolon, is due to a functionally abnormal segment of bowel in the sigmoid or rectosigmoid. This can be demonstrated effectively by appropriate roentgenologic studies with barium as a contrast medium. The bowel above this abnormally functioning segment shows changes commonly found above an area of obstruction; the bowel is dilated and hypertrophied.
Removal of the functionally abnormal bowel (rectum or rectosigmoid) has relieved the patients' symptoms. A new operative technique is utilized in performing this resection. The fact is stressed that these children will have to be followed for a period of several years before any claims of a permanent cure can be made.
BRONCHIECTASIS IN CHILDHOOD
Authors: FIELD C. ELAINE 
Published: December 2021

Non-aeration of alveoli is a feature common to the childhood illnesses predisposing to bronchiectasis and is regarded as the important factor in the aetiology of the disease, infection playing a subsidiary part.
Pulmonary collapse is therefore regarded as a prebronchiectatic state and in order to assess its importance two groups of cases have been studied: (1) 272 cases of pulmonary collapse; (2) 99 cases in which the diagnosis of bronchiectasis was doubtful at first examination.
Pulmonary collapse was seen most frequently in the right middle lobe and left lower lobe. It was usually persistent in the left upper lobe but frequently the right lower lobe reexpanded.
The duration of cough, according to the history, was commonly of three months' duration ion or less in cases of pulmonary collapse that reexpanded, in contrast to the long history of two years or more in the majority of cases that developed bronchiectasis.
Of the 272 cases of pulmonary collapse, only 157 reexpanded without permanent bronchiectatic changes. It was not uncommon, however, to find temporary bronchial dilatation in this group, the bronchi returning to normal calibre when the collapse reexpanded—a condition described as reversible bronchiectasis.
The treatment recommended for pulmonary collapse includes steam inhalations, postural drainage, and breathing exercises. Unless foreign body is suspected, immediate bronchoscopy is no longer considered necessary. No significant difference in the incidence of reexpansion of the lung was found between the cases treated with bronchoscopy and those treated without.
Ninety-nine cases were classified as doubtful bronchiectasis when first seen. Of these, 47.5% suffered from asthma, a disease frequently difficult to differentiate from bornchiectasis. Forty of the 99 cases have now developed true irreversible bronchiectasis after a period of three or more years. It was necessary to observe cases showing doubtful bronchial dilatation over a period of years, the bronchograms being repeated at intervals in order to determine the permanently diseased parts.
PULMONARY TUBERCULOSIS IN CHILDREN TREATED WITH STREPTOMYCIN
Authors: MCENERY EUGENE T. , SWEANY HENRY C. , TURNER GEORGE C. 
Published: December 2021

The use of streptomycin in the treatment of primary progressive tuberculosis has uniformly lessened and in most cases obliterated the toxic manifestations of the disease, and has reversed the general downward clinical course of the disease in a series of 21 cases. The physical findings improved and decreased roentgenologic changes followed the clinical and physical improvement. Conversion of sputum from positive to negative findings was completed in four to five months in 89% of primary progressive lesions.
The group of three cases with the adult type of pulmonary tuberculosis was too small to be statistically significant, but from observations of these children it is believed that the results were similar to cases of chronic pulmonary tuberculosis in adults treated with streptomycin in this and other institutions. Two of these cases were only temporarily improved. One of these died and the other is now in a terminal stage. The third child is awaiting surgery.
Streptomycin therapy should not be considered a cure-all; its use is still in the experimental stage and a larger number of cases will have to be observed over a longer period of time.
MECHANISM OF EMERGENCE OF RESISTANCE TO STREPTOMYCIN OF H. PERTUSSIS AND H. PARAPERTUSSIS DURING TREATMENT WITH THIS ANTIBIOTIC
Authors: ALEXANDER HATTIE E. , REDMAN WINIFRED 
Published: December 2021

In large populations of H. pertussis and H. parapertussis which have never been exposed to streptomycin, it is possible to demonstrate the presence of cells resistant to streptomycin 1000 mcg./cc.
These highly resistant cells exhibit the following traits which are characteristic of mutants: 1. Irregular occurrence in different independent cultures of same population size and strain and therefore independence of the action of streptomycin. 2. Transmission of the resistant trait unchanged in degree through many subcultures in the absence of streptomycin and, therefore, inheritance of the trait. 3. A rate of occurrence consistent with mutation frequency; the mutation rate of cells resistant to 1000 mcg./cc. does not differ significantly between these two species.
FAMILIAL ALDOSTERONE DEFICIENCY: ENZYME DEFECT, DIAGNOSIS, AND CLINICAL COURSE
Authors: David R. , Golan S. , Drucker W. 
Published: December 2021

A syndrome of growth retardation, salt wasting, hypoaldosteronism, and elevated urinary Porter-Silber reacting steroids is described in two infant siblings. Their excessive urinary excretion of 18-hydroxytetrahydro compound A (18-OH-THA), the major metabolite of 18-hydroxycorticosterone, suggested an enzyme defect in the dehydrogenation of 18-hydroxycorticosterone to aldosterone. A simple method is outlined for the detection of this syndrome based upon the finding of a distinctive pattern of urinary steroid response to suppressive doses of various hormones. Advantage was taken of the fact that 18-OH-THA is a Porter-Silber positive steroid. Thus, total urinary Porter-Silber chromogens, and specifically 18-OH-THA, (1) were increased by sodium deprivation, (2) were not suppressed by dexamethasone, but (3) were promptly suppressed to normal levels following the administration of salt and deoxycorticosterone acetate. A quantitative method for the determination of urinary 18-OH-THA based upon the Porter-Silber reaction is also outlined.
The subtle clinical manifestations of this disorder are emphasized. Growth retardation was the predominant feature in our patients. The abnormality in serum electrolytes was transient in one, although the biochemical defect persisted. Response to salt and mineralocorticoid therapy in both cases was manifested by prompt clinical improvement, especially in growth rate.
NEUROLOGIC MATURATION AND AUDITORY EVOKED RESPONSES IN LOW BIRTH WEIGHT INFANTS
Authors: Graziani Leonard J. , Weitzman Elliot D. , Velasco Mutya S. A. 
Published: December 2021

The maturation of the nervous system of two groups of infants of low birth weight was estimated by the results of a standardized clinical neurologic examination and by evaluation of the electroencephalographic responses to auditory stimuli (clicks). Algebraically summed responses to clicks were recorded simultaneously from 10 scalp electrodes, using a standard electroencephalograph, tape recorder, and a computer of average transients. The results obtained by the two methods were compared with the age postconception, estimated from the maternal history. One group consisted of infants whose birth weights were below the 10th percentile for their gestational age (37.1 ± 2.0 weeks); the other group consisted of infants whose birth weights were similar to the first group but were between the 25th and 75th percentile for their gestational age (31.0 ± 2.3 weeks).
In the small-for-age infants, the electroencephalographic responses and the neurologic reflexes were more mature than in the infants of similar birth weights who were not small for age. The results of both examination methods correlated well with the estimated postconception age but less well with birth weight, postnatal age, or somatic growth.
PULMONARY ALVEOLAR PROTEINOSIS IN THREE INFANTS
Authors: Wilkinson Robert H. , Blanc William A. , Hagstrom Jack W. C. 
Published: December 2021

Chronic lung disease in children may present a perplexing diagnostic problem. While open lung biopsy usually will provide a diagnosis without excessive morbidity, we believe that pulmonary alveolar proteinosis can be diagnosed radiographically, and we wish to point out the early age at which this disease can occur.
The clinical course of three infants is described together with the necropsy findings. Two 3-month-old and one 23-month-old infants are reported. The radiographic appearance of diffuse alveolar consolidation and the progressive respiratory involvement should alert physicians to the true nature of this disease. Recovery is reported in adults, but results of treatment in infants is disappointing.
PERINATAL MORTALITY—THE WOODS AND THE TREES
Authors: Smith Clement A. 
Published: December 2021

"Practicing Physicians, not uncommonly, are suspicious of statistical reports and rates and one often hears pejorative comments about any statistics and all statisticians." So wrote Dr. Wegman in his latest "Annual Summary of Vital Statistics,"1 and most readers will only need to look within themselves to see what he was writing about. Yet, suspicious as we may be we can seldom resist looking at statistics about our own particular pediatric problems and even occasionally making some tabulations of our own data.
This is certainly true of one who has spent more Friday noon hours than he cares to think about in a weekly conference on the fetal and neonatal deaths of a large maternity hospital.
DIAGNOSIS AND TREATMENT: TONSILS AND ADENOIDS—A PROBLEM REVISITED
Authors: Haggerty Robert J. 
Published: December 2021

Anyone who is sure of the indications for removing tonsils and adenoids is surely naive and anyone who attempts to write about it impolitic, for little in medicine elicits more strong or divergent opinions. Living in Rochester, New York, where Dr. Albert Kaiser carried out his courageous community studies1 over 40 years ago may give me some license to write about the problem but should also keep one humble for even here, its hometown, the study is little known.
In the early 1920's Kaiser was able to organize a community-wide program which accomplished the incredible job of removing tonsils and adenoids from 10,000 of the then 50,000 children in Rochester in a 5-month period. The major follow-up data2 were on 5,000 of these children who had the operation and were able to be followed for 10 years after operation. Comparison was made between a subsample of 2,200 of these and a like number who had been recommended for tonsillectomy and adenoidectomy but never had had the operation. While there are many defects in this study compared to the ideal controlled trial, it would comfort Dr. Kaiser to know that no other study since has been able to do much better, since clinical trials to determine the effectiveness of an operation can rarely be controlled in the sense of random assignment of patients and practically never double blind (this would require sham operations).
It is worth reading Kaiser's works again for, though widely touted as a condemnation of the procedure, they are in fact no such thing.
TREATMENT OF HEAT RASH IN INFANTS IN 1746 ACCORDING TO DR. JEAN ASTRUC
Authors: C. T. E. 
Published: December 2021

Jean Astruc (1684-1766) is best known for his book on venereal diseases, De Morbis Veneris (Paris 1736); it may surprise some that he was also interested in pediatrics. The English edition of his lectures on children's diseases published in 1756 contains many suggestions for the treatment of illnesses of infancy and childhood. The following is a good example of early 18th century pediatric practice.
Let the patient be lightly covered and his cloths frequently changed; let him also be kept in a cool place, and lye in clean linen in the afternoon, or during the heat; thus the tumours will vanish at last by the change of the season: but if they be too obstinate, order a decoction of mash-mallows and milk. If they degenerate into a sort of impetigo, order Galen's Cerat, which is made of wax and the oil of sweet-almonds, boiled to a proper consistence. You may add a little vinegar, of frog-spawn water, or boil these with wax, and anoint the tumours therewith; the patient must abstain from all salt and spiced meats, wine, etc., and let him take for his ordinary drink, pullet broth, or mineral waters; he may also drink of barley-water, or water mixed with lemon-juice, and use moderate exercise.1
Letter to the Editor
Authors: Meislin Aaron G. , Rothfield Naomi 
Published: December 2021

So long as the diagnosis of SLE is based on an overall view of the entire clinical picture with assistance from various laboratory tests such as LE cells, antinuclear antibodies, and skin and renal biopsies, there will be problems in arriving at a definitive diagnosis and the inevitable "semantic arguments" will continue to arise. We welcome Drs. Stickler and Burke's letter, which provides the opportunity to further clarify our concept of SLE.
Criteria for diagnosis of SLE were set forth in our second paragraph of the section entitled Discussion, in as precise a manner as we feel the disease permits at the present state of knowledge.
PROPOSALS FOR CHILD HEALTH CARE
Authors: Yankauer Alfred 
Published: December 2021

In contrast to the prevailing tenor of less than a decade ago, few voices can be heard today reassuring the public or the professional that the American "health care system" is itself in good health. Having dealt with the aged through Medicare, the national spotlight now focuses on children who form the other major segment of our "poverty population." Analyses and complaints, proposals and programs flow forth at an accelerating pace.
Two types of programs are discussed in the current issues of Pediatrics-one as a proposal presented to the American Academy of Pediatrics last fall, and the other as a report of work in progress.