bluuebunny/crossref_metadata_2025_split huggingface dataset:
FOR THE WELFARE OF CHILDREN
Authors: Beaven Paul W. 
Published: December 2021

THIS is the Preface to a newly published volume containing the annual addresses (1921-1955) of the first 25 presidents of the American Academy of Pediatrics. These addresses, unlike those of other medical societies, are not scientific in content. Nor were they composed to make history. They were essentially personal observations on current problems considered important by each president as he concluded his span of office. Moreover, they reflect many impressions and aspirations. So when these addresses are assembled in one volume, they become, in a sense, both a history of the Academy and of our specialty during these 25 years.
These presidential addresses have an underlying theme: the dedication of the pediatrician to child welfare. They underscore the important fact that the Academy was not formed for the benefit of its members. Rather, it was dedicated to a program which would give children a better future, not only in physical but also in mental and social health. This altruism is evident in almost every essay. We should never forget this aim, for therein lies the reason for our being.
Naturally, nearly all of the presidents are but names to most of our members. Reprinting their addresses can remind all of us of the initial and enduring purpose of the American Academy of Pediatrics. What we read in these addresses, as would obviously be the case, differs with each author. There are long addresses and there are short ones. Some of them are pessimistic and some are optimistic. A few are mainly factual, while others are truly literary.
In order to introduce each of the presidents, their photographs are reproduced. A short appreciation of each president follows, written by one or more contemporary personalities. Remarks on each essay follow, giving in some instances the background of its composition and delivery. The address is then reprinted.
Each address shows in its own way how the Academy has succeeded or failed to achieve its original aims:
PRIVATE RESIDENTIAL INSTITUTIONS FOR THE CARE OF MENTALLY HANDICAPPED CHILDREN
Authors: MUNNS GEORGE F. , BRAHDY M. BERNARD , BYERS RANDOLPH K. , DENHOFF ERIC , JONES MARGARET H. , KOBES HERBERT R. , PERLSTEIN MEYER A. , TAUSSIG HELEN B. , YANNET HERMAN 
Published: December 2021

THE CHOICE of a private institution which can offer effective training and education to a mentally handicapped child has always been a difficult problem for the average physician. Very little information has been available concerning most of these institutions. We hope that the present study together with follow-up studies by the state committees will be of future assistance in this respect.
Special local committees under the direction of the state chairmen, were appointed to carry on the study at state levels. An "outline" or questionnaire was prepared by our committee which was designed to elicit pertinent information. A "guide" was also prepared which offered information to the local committees concerning desirable methods and practices to be looked for in institutions under scrutiny.
The 5-page outline or questionnaire was designed to reveal many details concerning these institutions, such as location, source of income, type of construction, fees, recreational facilities, type of patients accepted, segregation problems, etc., but most of all, information was sought concerning the training, experience and education of the attending staff. Information was particularly sought regarding the availability of research and consultation facilities and whether an intelligent and effective program of therapy, instruction, training and education was being conducted.
Questionnaires and information were received from 33 states and 82 institutions representing a total population of more than 117,000,000.
We shall report here only information of practical interest to the average physician. The "outlines" from which the information was compiled have been returned to the states which submitted them to be used for future reference by the state committees.
Eleven states reported that they have no private residential institutions for the care of mentally retarded children. In this group there are, no doubt, an unknown number of small custodial or boarding homes which are probably to be found in all states.
SERUM GAMMA GLOBULIN LEVELS IN NORMAL INFANTS
Authors: T. O. Orlandini , Sass-Kortsak A. , Ebbs J. H. 
Published: December 2021

Changes of serum gamma globulin levels with age are described in a group of 140 normal infants from birth to 2 years of age.
The mean cord blood level of gamma globulin is significantly higher than the level in the mother's blood. This relation is, however, by no means constant in the individual pairs, as one-third of the 28 pairs showed the opposite relationship.
The gamma globulin level drops soon after birth, reaching about one-third of the birth value at 1 month of age. After very little change between 1 and 3 months, the levels start to rise and adult values are closely approximated by 2 years of age.
Breast-fed newborns show as rapid a decrease in gamma globulin levels as do artificially fed newborns. Colostrum does not, therefore, seem to contribute significantly to the serum gamma globulin levels in humans.
The above described changes in serum gamma globulin levels with age appear to be different in direction, timing, and extent, from changes observed in the other serum protein fractions.
The decrease of serum gamma globulin in the first month of life has the characteristics of a simple exponential decay. Comparison of this decay curve with that of passively acquired antibodies, and consideration of available data on gamma globulin turnover rates, warrant the hypothesis that there is practically no gamma globulin formation in the first month of life.
THE TREATMENT OF SALMONELLOSIS WITH MASSIVE DOSES OF PENICILLIN COMPARED WITH OTHER METHODS OF THERAPY
Authors: Rabe Edward F. 
Published: December 2021

Salmonellosis can be treated with intramuscular crystalline penicillin in large doses. Although the results are not consistently good, the clinical course and bacteriologic "cures" in 7 cases compared favorably with the results in 19 cases treated with chloramphenicol and other drugs.
Serum penicillin levels varying from 4.2 to 48.0 units/ml. occur in time sera of patients receiving 150,000 units (0.090 gm.)/ kg./24 hr. of crystalline penicillin intramuscularly divided into 6 doses.
The problem of dependable elimination of the carrier state in patients with salmonellosis by chemotherapeutic means remains unsolved. The value of penicillin in combination with an easily administered dosage form of probenecid deserves further investigation.
SPECIAL ARTICLE
Authors: Harris T. N. , Harris Susanna 
Published: December 2021

STUDIES on the site of formation of antibodies have been in progress in this laboratory for some time. The investigations to be reviewed here are those conducted in recent years using the technic of cell transfer. These studies followed an earlier series in which the experimental approach involved the injection of particulate antigenic material into the tissues of rabbits and the examination of tissues and fluids of the lymphatic system for antibodies to the antigen injected.
It had been observed that when antigens were injected into the hind foot pads of rabbits, homologous antibodies could be found in whole tissue extracts of the draining lymph nodes at titers which might, in the early days of the antibody response, exceed the concentration of the antibody found in the blood serum at the same time. These findings were in agreement with those of McMaster et al. In the case of pooled mouse lymph nodes regional to sites of injection of antigens. It was also shown in this earlier series of studies that antibody could be found in lymph obtained from the efferent lymphatic vessel of lymph nodes draining sites of injection of antigens and, furthermore, within the lymph in higher concentration in extracts of the cells of the lymph than in the lymph plasma.
In this work antibodies were being measured in extracts of lymphatic tissue. The experimental situation was complicated by the fact that the lymphatic system is one which is spread throughout the body and of which each unit (spleen, lymph nodes) consists of 2 major portions each of which, in turn, contains several species of cells.
Letters to the Editor
Authors: MCLEAN C. C. 
Published: December 2021

I am writing in regard to the penicillin contents in the Salk poliomyelitis vaccine. Polymyxin has been proven and accepted as a suitable substitute. If the penicillin content is removed the benefits obtained from the use of the vaccine will not be affected.
The individuals who have so much to do with the direction of the process of the production of the Salk vaccine have:
1. Due to the fact that so few children reacted to the vaccine at the time given, concluded that there was little or no danger of sensitization from the penicillin content.
Letters to the Editor
Authors: SILVERMAN WILLIAM A. 
Published: December 2021

Those concerned with the care of premature infants should be alerted to a possible noxious effect of sulfisoxazole (Gantrisin®) when this drug is administered to very small infants in the first few days of life.
The relative effectiveness of 2 prophylactic antibiotic regimens on newborn infants whose birthweight was less than 2,000 gm. was the subject of a controlled trial which has just been completed in the premature nursery of Babies Hospital. Ninety-seven infants received oxytetracycline (Terramycin®) 5 mg./kg./12 hr. for the first 5 days of life.
THERAPEUTIC EFFECTS OF ACTH AND CORTISONE IN RHEUMATIC FEVER: CARDIOLOGIC OBSERVATIONS IN A CONTROLLED SERIES OF 100 CASES
Authors: Harris T. N. , Friedman Sidney , Needleman Herbert L. , Saltzman Herbert A. 
Published: December 2021

The therapeutic effects of ACTH and cortisone have been studied in a series of 100 patients with acute rheumatic fever, with special emphasis on cardiologic observations. This series involved cyclical alternation among hormone-treated patients and control patients. The latter received symptomatic and supportive therapy, but not salicylates in large doses.
Observations on such patients during the period of hospitalization (did not indicate any significant difference between hormone-treated and control subjects in terms of the appearance or disappearance of cardiac murmurs, the degree of transmission of apical systolic murmurs, incidence and duration of pericarditis, or other cardiologic phenomena recorded.
Rates of occurrence of "rebound" phenomena and of complications of the hormone therapy have also been reported.
COARCTATION OF THE AORTA WITH CONGESTIVE HEART FAILURE IN INFANCY—MEDICAL TREATMENT
Authors: Lang Henry T. , Nadas Alexander S. 
Published: December 2021

Nine infants with uncomplicated coarctation of the aorta in congestive heart failure are presented.
The symptomatology was dominated by feeding problems, failure to thrive, dyspnea, and cyanosis.
On physical examination, in addition to signs referable to the coarctation, signs of both left and right-sided congestive heart failure were noted.
The roentgenographic survey revealed marked generalized cardiomegaly and pulmonary congestion.
Electrocardiograms in the infants less than 6 months of age showed left, right, or combined ventricular hypertrophy, whereas those more than 6 months of age all showed left ventricular hypertrophy.
Medical treatment, consisting of digitalis, oxygen, mercurial diuretics, diet low in sodium, and antibiotics, was successful in all instances. Digitalization was maintained throughout infancy. Operative intervention can be safely postponed until late childhood unless medical management is not successful.
A review of the pertinent literature is presented.
INFANTILE SPASTIC HEMIPLEGIA V. ORAL LANGUAGE AND MOTOR DEVELOPMENT
Authors: Hood Philip N. , Perlstein Meyer A. 
Published: December 2021

A study of the onset of walking and oral language in the present series of patients with spastic hemiplegia has led to the following conclusions.
The group composed of all patients with congenital hemiplegia plus those who acquired spastic hemiplegia before the onset of walking and talking showed a delay from normals of 9 months in walking and talking words and a delay of 6 months from normals in using sentences.
When only the patients with congenital hemiplegia are considered, the delay is again 9 months for walking and first words an 7 months for the use of sentences.
The patients with acquired hemiplegia walked and talked earlier than those congenitally involved; the delay for walking being 5 months, for first words, 8 months, and 4 months for sentences. The differences between the "congenital" and "acquired" groups, though not statistically significant, suggest that those patients with some normal period of development predating the onset of spastic hemiplegia, acquire their motor and language skills earlier.
Although patients with left hemiplegia walked and talked from 2 to 3 months earlier than those with right hemiplegia, the differences were not statistically significant.
The presence of seizures delayed walking 6 months, talking of words nearly 9 months and sentence usage less than 1 month.
Mental deficiency likewise delayed motor and language development.
Mental deficiency was a much more potent factor in delaying walking than was the presence of seizures.
The physical defect of hemiplegia per se does not retard the rate of motor and speech development more than 4 to 5 months.
SPECIAL ARTICLE
Authors: Sapin Samuel O. , Donoso Ephraim , Braunwald Eugene , Grishman Arthur 
Published: December 2021

Vectorcardiography is a method of graphically registering the total electrical activity of the heart and presents this in 3 dimensions.
The technique of obtaining vectorcardiograms and the determination of the electrocardiogram from the vector loop are discussed in a simplified manner.
The characteristics of normal and abnormal vectorcardiograms in infants, children and adults are presented.
Electrocardiograms in different conditions, e.g. conduction delay, right ventricular hypertrophy and normal variants may be indistinguishable, particularly in infancy. However, the vectorcardiogram clearly differentiates these entities.
The diagnostic accuracy of the electrocardiogram and vectorcardiogram was compared in a series of patients with unilateral ventricular hypertrophy due to congenital heart disease. The vectorcardiogram was superior to the electrocardiogram in diagnosing unilateral right ventricular hypertrophy as well as left ventricular hypertrophy. However, both the electrocardiogram and the vectorcardiogram are of greater value in detecting right than left ventricular hypertrophy.
The absence of right ventricular hypertrophy in the vectorcardiogram militates strongly against the existence of predominant right ventricular hypertrophy.
Axis deviation in the standard leads as a result of the vectorcardiographic studies is considered to be of little diagnostic importance.
The chief contribution of the vectorcardiogram in congenital heart disease is in the determination of the type of predominant ventricular hypertrophy and this renders it a most valuable addition to the diagnostic tools available in this field.
ACUTE HEMATOGENOUS OSTEOMYELITIS
Authors: Green Morris , Nyhan William L. , Fousek Mildred D. 
Published: December 2021

The clinical records of 99 infants and children admitted to the Grace-New Haven Community Hospital with acute hematogenous osteomyelitis are reviewed.
The presenting symptomatology and physical findings are discussed. Detection of localized tenderness is the most significant early clinical sign. This was not, however, a common finding at the time of admission.
The diagnoses entertained in these patients at the time of admission are reviewed and the differential diagnosis is discussed.
The distribution of the bony lesions was similar to that noted by other authors. However, attention is called to the frequent involvement of the bony pelvis.
A specific bacteriologic diagnosis was made in 87 per cent of the patients. In 63 per cent staphylococcus was the etiologic agent. Beta-hemolytic streptococcus was considered the etiologic agent in 18 per cent. Staphylococcus was the most frequent offender in all age groups. In infants less than 2 years of age osteomyelitis was streptococcal in 27 per cent.
The average interval from the onset of symptoms to the development of positive roentgenographic signs was 10 days. The range was 3 to 17 days.
In treatment of patients suspected of having osteomyelitis, vigorous antibiotic therapy should be continued until at least 3 weeks have elapsed since the onset of symptoms. If at the end of that period roentgenograms remain normal and clinical signs and symptoms have been absent for at least 1 week, it would seem safe to discontinue treatment.
A detailed program for medical therapy is Presented and the indications for surgery are considered. Emphasis is placed on vigorous search for the infecting organism. The necessity for intensive treatment given over an extended period of time is stressed.
CONGENITAL INTRAHEPATIC BILIARY ATRESIA
Authors: Sass-Kortsak Andrew , Bowden Drummond H. , Brown Roderick J. K. 
Published: December 2021

It seems that there are certain clinical and laboratory findings which may suggest the diagnosis of intrahepatic biliary atresia. This diagnosis should be considered when all incompletely obstructive, chronic, fluctuating jaundice is present in an infant who is otherwise healthy. Pronounced elevation of serum lipids, especially the neutral fat fraction, and dissociated changes in tests relative to biliary obstruction, should be regarded as further suggestive evidence. These features may be encountered as early as 2 to 3 months of age, as demonstrated in the present case.
There is not enough evidence at the present time to suggest that the above features, or a combination of them are specific for intrahepatic biliary atresia. Likewise, there is not enough evidence that the absence of these features excludes the diagnosis. The findings in the present case, and those in the previous reports on this condition, would rather serve to stress the importance of detailed investigation of infants suffering from an obstructive jaundice and the need for follow-up studies with tests repeated at regular intervals.
A tentative diagnosis of intrahepatic biliary atresia is probably justified when the above criteria are fulfilled, but a definitive diagnosis is dependent on examination of a representative biopsy specimen.
IDIOPATHIC HYPOPARATHYROIDISM
Authors: Harrison Harold E. 
Published: December 2021

IDIOPATHIC hypoparathyroidism is one of the rarer abnormalities of endocrine function in childhood. For that reason it may be missed on occasion because it is not considered among the diagnostic possibilities. There have been 6 cases of idiopathic hypoparathyroidism seen at the Harriet Lane during the past 10 years and the youngest child of this series was 17 months when admitted. This child's symptoms may have begun in the neonatal period and this may be true of other children with hypoparathyroidism. An apparently authenticated case of congenital hypoparathyroidism has been reported by Rhyne and also by Calcagno and Rubin. The etiology of this disease is completely obscure. There is ordinarily no story of multiple cases in families, except for a group of cases in which there has been a strange combination of moniliasis, hypoparathyroidism and in some instances adrenal insufficiency. The possibility that severe moniliasis may produce toxic injury to parathyroid and adrenal glands has been suggested, as has been the converse notion that the spread of monilia infections is facilitated by the biochemical disturbances of hypoparathyroidism. Among the 6 cases in our series only 1 has shown obvious moniliasis and this has not been of the extraordinarily severe degree reported in the literature.
Some type of seizure either focal or generalized is the usual manifestation which brings the child to the physician. The seizures may persist for several years without becoming more severe and may be treated as epilepsy. One of the patients in this series was admitted at the age of 15 years.
ACTIVE IMMUNIZATION WITH INFLUENZA VIRUS A AND B IN INFANTS AND CHILDREN
Authors: Glazier Manuel M. , Benenson A. S. , Wheeler Ralph E. 
Published: December 2021

With the aim of finding a method of influenza virus A and B vaccination with maximal antibody response and minimal untoward reaction, a wide range of dosage and other variations in method were tested among 614 unselected children, of which 110 were studied serologically.
Systemic reactions occurred in 22.8 per cent of the children following 1 or more injections and were severe in 9.2 per cent. Reactions were not related to family or individual history of allergy, sex or bodytype structure. Reactions did occur more often and more severely in the very young when the same dosage of vaccine per kg. of body weight was given. Moreover, at different ages systemic reactions were more frequent and more severe when larger doses of vaccine per kg. of body weight were given.
No differences in serologic response were found in children who had systemic reactions to the vaccine and those who had none.
Serologic response was good even among those children who received the minimum amounts of vaccine per kg. of body weight.
The results suggest that primary vaccination is fairly effective with a single small injection of 0.1 ml. vaccine, intradermally, or 0.2 ml. vaccine, subcutaneously. An even higher and more rapid response in antibody titer is probable when 2 small (0.1 ml.) injections of vaccine are given a week apart. There is no higher rise in blood titer of antibody when the primary vaccination is accomplished by a larger dose (0.6 ml. or 0.7 ml.) following a smaller initial dose.
A booster dose, whether in a small amount (0.1 ml.) or a larger amount (1.0 ml.) and given 3 to 7 months after the primary vaccination, resulted in a similar favorable rise in titer among the groups which had been given various amounts for primary vaccination.
The elevated titer in vaccinated children persisted above the preimmunization levels for 12 to 18 months.