bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benign Red Pigmentation of Stool Resulting from Food Coloring in a New Breakfast Cereal (The Franken Berry Stool)
Authors: Payne John V. 
Published: December 2021

It has long been known that certain drugs and foods can cause alteration in the color of stools. These alterations in color may be of concern to parents and physicians unless recognized. The following case is presented as yet another example of a product which may alter stool color. The breakfast cereal under discussion has only been on the market a few weeks and physicians should be aware of its potential for producing reddish stools.
Case Report
A 12-year-old Negro boy presented to the outpatient department with the chief complaint of passing red stools for 2 days that were somewhat loose and unassociated with abdominal pain or other symptoms.
CHILDHOOD DIET AND CORONARY HEART DISEASE
Authors: Filler L. J. , Barness Lewis A. , Goldbloom Richard B. , Haworth James C. , Holliday Malcolm A. , Miller Robert W. , O'Brien Donough , Pearson Howard A. , Scriver Charles R. , Weil William B. , Whitten Charles F. , Cravioto Joaquin , Kline O. L. 
Published: December 2021

A subcommittee of the Inter-Society Commission for Heart Disease Resources recently recommended an immediate, nationwide change in dietary habits to reduce the risk of coronary heart disease in later life.1 Specifically, the Commission urges that people eat less than 300 mg of cholesterol each day, that the total calories from fat be less than 35% of the diet, and that the fat calories essentially be divided equally among saturated, monounsaturated, and polyunsaturated sources. (A commentary on these recommendations appears in this issue of Pediatrics.2)
The Committee on Nutrition, realizing that pediatricians will increasingly be asked about diets for children to reduce the risk of heart disease in later life, has evaluated the Commission's report for its application to pediatric practice. The Committee stresses that such dietary intervention is, at present, experimental and recommends against dietary changes for all children. Dietary intervention may be warranted in special circumstances, but not before 1 year of age. Reasons for these recommendations will be given in this report.
The evidence relating dietary cholesterol to coronary heart disease is summarized as follows:
1. Some inborn or acquired diseases with hypercholesterolemia are associated with premature atherosclerosis.
2. Serum cholesterol levels are higher than usual in persons with coronary heart disease.
3. Persons with high cholesterol levels in prospective studies developed coronary heart disease more often than those with normal levels.
4. The mortality rate from coronary heart disease in different countries varies in relation to the average blood cholesterol values (or dietary fat intake).
5. Experimentally induced hypercholesterolemia in animals is associated with atherosclerotic deposits.
Prevention of Unintentional Esophageal Intubation
Authors: Niccum W. L. 
Published: December 2021

I read with interest the experience of Stool, Johnson, and Rosenfeld in unintentionally introducing an endotracheal tube into the esophagus.1 I would like to relate that 15 years or so ago we had a similar type of problem with one of my young patients.
We have solved the problem of unintentional esophageal intubation in a different and it seems to me a more simple way. Each one of our Foregger endotracheal tubes has on its proximal end approximately 6 in. of #3 black silk looped through a perforation on the tube.
HEREDITARY ISOLATED SOMATOTROPIN DEFICIENCY: EFFECTS OF HUMAN GROWTH HORMONE ADMINISTRATION
Authors: Sheikholislam Bagher M. , Stempfel Robert S. 
Published: December 2021

The clinical and laboratory appraisal of a familial isolated growth hormone deficiency is reported. The lack of consanguinity and the absence of other short members in the family speak for the occurrence of a mutation in the father which he then transmitted as a dominant trait to four of his seven children. Growth hormone administration not only resulted in an increase in linear growth in those members of the family whose epiphyses were not closed, but also the rapid appearance of secondary sexual characteristics in the 18-year-old sexually infantile female and an increase of body hair and libido in both the father and the 21-year-old sexually mature, staturally retarded sister.
These observations strengthen the contention that the diagnosis of hypopituitarism cannot be excluded on the basis of eventual sexual development in individuals whose statural growth is retarded.
It is concluded that induction of sexual maturation during growth hormone therapy is not related to increased pituitary gonadotropin release. Growth hormone administration appeared to have no effect on thyroid function or on adrenal responsiveness to administered ACTH and metyrapone. An antiinsulinogenic effect of growth hormone was demonstrated during both oral and intravenous glucose tolerance tests.
FETAL GROWTH AND NEONATAL MORTALITY
Authors: Miller Herbert C. 
Published: December 2021

Birth weight and calculated fetal age traditionally have served to predict risk of dying in the newborn period. Birth weight describes new-born infants inadequately, and calculated or estimated fetal age is uncertain. In the present study, well-defined fetal growth patterns observed in newborn infants replaced birth weight; crown-heel length was substituted for fetal age as a measure of fetal maturity.
Four high-risk groups and two low-risk groups of infants were identified. High-risk groups included infants with extremely high or low ponderal indices, infants disproportionately grown, and normally grown infants with body lengths of 45 cm or $$Word$$. Low-risk groups included normally grown infant; with body lengths over 45 cm and infants whose only fetal growth pattern was their short body lengths for their fetal ages.
RESPIRATORY DISEASE IN GROUP DAY CARE
Authors: Loda Frank A. , Glezen W Paul , Clyde Wallace A. 
Published: December 2021

The frequency of occurrence and etiology of respiratory disease during a 40-month period in a day care center is reported. The day care center had a maximum enrollment of 39 children ranging in age from 1 month to 5 years. Sick children were not excluded from the center. During the period of the study there was not an excessive amount of respiratory illness in the children in day care when compared with the reported illness occurrence in children receiving home care. In the total group there were 8.4 respiratory illnesses per child-year with the highest rate in infants under 1 year of age.
The agents responsible for the respiratory disease in the day care center were similar to those reported as significant in the community, and the patterns of virus isolation were similar to those in the community in age incidence, seasonal occurrence, and illness association. Respiratory syncytial virus and parainfluenza virus type 3 were the agents most often implicated in lower respiratory disease. Adenovirus types 2 and 5 frequently caused febrile upper respiratory illness in infants. The study suggests group day care is safe medically for infants and that exclusion of sick children is unnecessary in a day care program with adequate space and staffing.
FLUORIDE AS A NUTRIEN
Authors: Filer L. J. , Barness Lewis A. , Goldbloom Richard B. , Holliday Malcolm A. , Miller Robert W. , O'Brien Donough , Pearson Howard A. , Scriver Charles R. , Weil William B. , Whitten Charles F. , Cravioto Joaquin , Kline O. L. 
Published: December 2021

The association of mottled enamel and dental fluorosis with community drinking water was detected before 1920 and was specifically related to the fluoride content of the water when Churchill, in 1931,1 was able to measure trace amounts of fluoride in drinking water. Also, in areas with communal water supplies naturally contaming increased amounts of fluoride, the occurrence of dental caries was lower than that seen in the general population.2 These observations and subsequent studies3 led to the practice of adding fluoride to communal waters, with a consequent significant reduclion in the incidence of dental caries. Nearly 90 million persons in 7,500 communities4 use water supplies containing an amount of fluoride effective in reducing the dental caries rate.
Fluoride is present in the customary diet and in most potable water sources in amounts that vary from 0.1 to 0.5 parts per million (ppm).5 The average dietary intake of fluoride is approximately 0.5 mg daily from these two sources. In the temperate zone, fluoridated community water supplies are increased in fluoride content to a level of 1.0 ppm, thus providing, on the average, a total fluoride ingestion of 1.5 mg per day. A lesser level of fluoridation may be sufficient in warmer climates conducive to a higher water consumption. Fluoride is regarded as an essential nutrient6 and it is now well known to be effective in the maintenance of a tooth enamel that is more resistant to decay.
Fluoride is a normal component of tooth enamel and bone. Studies in vivo and in vitro demonstrate that the calcified tissues of both enamel and bone are made up of a combination of hydroxy- and fluor-apatites of varying composition, depending on the abundance of fluoride at the site of formation.
Letter to the Editor
Authors: Provenzano R. William 
Published: December 2021

It was with great interest and pleasure that I read the article written by Naeye, et al.,1 the Commentary by Reynolds and the Letter to the Editor by Tow3 describing the successful use of steroids in hyaline membrane disease.
The use of adreno-cortical extract in pediatrics, its beneficial effects in adrenal hypoplasia of the newborn,4 on the respiratory system of the newborn,5 and its possible use in atelectasis6 (a term previously used to describe the respiratory distress syndrome and now termed hyaline membrane disease), was reported in 1950, 1951, and 1952.
Contamination of Umbilical Vessel Catheters: Encouraging Information
Authors: Powers William F. , Tooley William H. 
Published: December 2021

In his recent editorial, Dr. Cook1 mentions bacterial contamination as one of the complications of umbilical artery catheterization, and refers to a report by Krauss, et al.2 who grew bacteria from 6 of 11 (55%) umbilical artery catheters. Balagtas, et al.3 have also published similar findings with umbilical vein catheters, 52% of which had bacterial colonization on removal. These reports stress the significant risk of generalized infection with umbilical vessel catheters.
On the other hand, Casalino and Lipsitz4 report a 5% incidence of bacterial contamination.
Letter to the Editor
Authors: Pachioli Renato 
Published: December 2021

It is quite clear that Doctor Spitzer, who is certainly very able to perform scientific research, has forgotten that we are essentially physicians, whose main concern is for the treatment of our patients. For this reason we preferred to change schemes of treatment repeatedly in order to fit them to the clinical condition of each patient and the evolution of the illness, rather than allow too rigid therapeutic regimens.
Our results (mainly obtained on patients in different phases of illness and already subjected to previous therapeutic treatments) are not quite suitable to a statistical evaluation, but have the worth of having been made on a large number of cases, through personal and continuous observations, for a period of 17 years.
Concepts of Disease: A Textbook of Human Pathology, edited by Joel C. Brunson, M.D. and Edward A. Gall, M.D. New York/London/Toronto: The Macmillan Company, 1971, 1134 pp., $23.95
Authors: Vawter Gordon W. 
Published: December 2021

This is a lusty 7½ pound newborn book with most organ systems more than adequately mature to assure a long and fruitful life. The two senior obstetricians enlisted the aid and advice of 36 other especially knowledgeable specialists to assure successful delivery.
Concepts of Disease is a textbook of pathology with a novel design, emphasizing pathology as process, and incorporates much of the newer information derived from cell biology, and from the recent developments in ultrastructural and immunofluorescent techniques.
THE END OF ROUTINE SMALLPOX VACCINATION IN THE UNITED STATES
Authors: Kempe C. Henry 
Published: December 2021

1971 was the year in which the Surgeon General of the United States Public Health Service, the Redbook Committee of the American Academy of Pediatrics, and the Territorial Health Officers agreed that the time had come to discontinue routine primary smallpox vaccination for American children. As a result of this it may also be expected that school vaccination laws presently in effect in some 28 states will soon be repealed or will not be enforced with vigor.
The American pediatrician views these developments with mixed feelings, since there have been extensive and often spirited debates regarding the timing for discontinuation of routine smallpox vaccination.
MULTINODULAR HEMANGIOMATOSIS OF THE LIVER IN INFANCY
Authors: McLean Robert H. , Moller James H. , Warwick Warren J. , Satran Leon , Lucas Russell V. 
Published: December 2021

Multinodular hemangiomatosis of the liver (MHL) is characterized pathologically by multiple hemangiomas, primarily in the liver but also in other organs. The hepatic hemangiomas act as small arteriovenous fistulae and their combined effect may result in a massive peripheral arteriovenous shunt and high output congestive cardiac failure.
Patients with MHL may be recognized clinically by the classical triad of congestive cardiac failure, hepatomegaly, and cutaneous hemangiomas.
All but 2 of 31 cases of MHL herein reviewed had the onset of symptoms prior to 6 months of age.
High output cardiac failure were severe and resulted in a 70% mortality. Hepatomegaly was massive and out of proportion to the degree of cardiac failure.
Therapy includes intensive treatment of congestive cardiac failure and judicious transfusion in anemic patients. Irradiation of the liver and corticosteroids have been utilized in attempts to speed evolution of the hepatic arteriovenous fistulae. The data are not sufficient to establish the efficacy of either of these treatment modalities.
LEFT ATRIAL MYXOMA IN A CHILD
Authors: Steinke William E. , Perry Lowell W. , Gold Harvey R. , McClenathan James E. , Scott Lewis P. 
Published: December 2021

A 9-year-old female presented with mitral regurgitation, heart failure, fever, abnormal serum proteins, elevated sedimentation rate, and elevated antihyaluronidase titer. At first thought to have rheumatic fever, she initially responded favorably to medical therapy which included corticosteroids. Evidence of progressive disease led to cardiac catheterization and angiography which demonstrated a left atrial myxoma which was successfully excised.
Review of the literature reveals that 23 children with left atrial myxomas have been reported. These may present with embolic, obstructive, or constitutional symptoms. Most children have clinical evidence of mitral regurgitation. Associated heart failure, anemia, elevated sedimentation rate, elevated antihyaluronidase titer and initial favorable response to medical therapy often lead to the incorrect diagnosis of acute or chronic rheumatic heart disease.
In these patients, increased endogenous hyaluronic acid excretion from tumor cells may lead to increased hyaluronidase and antihyaluronidase activity, abnormal serum proteins and elevated sedimentation rate.
The Incidence of Associated Anomalies in 105 Patients with Congenital Adrenal Hyperplasia
Authors: Kirkland Rebecca T. , Kirkland John L. , Librik Leon , Clayton George W. 
Published: December 2021

A survey of 105 patients with defective adrenal steroid 21-hydroxylation, the most common defect in congenital adrenal hyperplasia, has been carried out to determine the presence of additional congenital or developmental anomalies. The following is a report of this survey.
The diagnosis of congenital adrenal hyperplasia was suspected in infants who presented with ambiguous genitalia or with defect in electrolyte metabolism manifested by failure to thrive, vomiting and dehydration with hyponatremia and hyperkalemia. Measurement of elevated levels of urinary 17-ketosteroids, 11-keto pregnantriol and pregnantriol confirmed the diagnosis. Seventy-two (68.6%) of the 105 patients surveyed demonstrated defects in electrolyte metabolism and 39 of these were males.
Fluid Deposition in Airways after Mist Tent Therapy
Authors: Chadwick David L. 
Published: December 2021

In the October issue of Pediatrics, S. K. Bau, et al. record observations that neatly demonstrate the failure of mist tents to deposit fluid in the lungs of their occupants. They conclude, "If in fact mist tents are of therapeutic value in the treatment of cystic fibrosis the benefits must accrue for reasons other than the deposition of fluid in the lung, thinning the mucous secretions and promoting their removal from the airways."
The hypothesis implicit in the use of mist tents is not that they deposit water in the lung.
Aminophylline in Status Asthmaticus: Some Questions
Authors: Caplinger Kelsy J. 
Published: December 2021

The report of a double blind trial of aminophylline in status asthmaticus by Pierson, et al. seems indeed to have shown that significant improvement in ventilatory function resulted without serious side effects.
Aminophylline toxicity is a very real and potentially serious complication of the treatment of status asthmaticus. There is a wide variation in the recommended children's dose of aminophylline. Since this study showed apparent good improvement in ventilatory function (when used with other accepted medications in appropriate doses) and serious side effects were avoided, it would be of interest to know the dose of aminophylline required in these patients.
Letter to the Editor
Authors: Pierson William E. 
Published: December 2021

This study was carried out because of the dichotomy between theoretical effectiveness and reported toxicity of aminophylline in children. The authors employed aminophylline dosages which are noted in the appendix: 7 mg/kg was administered as a priming dosage, placed into the intravenous tubing and administered over a 10-minute period, and followed by 9 mg per kilogram per 24 hours administered with intravenous fluids.
(To Dr. Martin)
Since this study of the effectiveness of aminophylline in status asthmaticus was based on objective data obtained by pulmonary function tests which required patient cooperation, we included only children over age 5 years.
H. Influenzae Meningitis: Is Ampicillin Proper Treatment?
Authors: Marder Gerard 
Published: December 2021

I am somewhat disappointed with the Pediatric Establishment for what I consider a lapse in the scientific method in the case of the assessment of proper therapy for H. influenzae meningitis. Every practicing pediatrician sees cases of H. influenzae meningitis each year. It is a serious disease and accurate information as to what is best treatment is important.
As recently as the 16th edition of the Red Book the Committee on Infectious Diseases recommended chloramphenicol as the Number 1 treatment for H. influenzac meningitis.
THE SMALL-FOR-DATE INFANT I. LATER GROWTH PATTERNS
Authors: Fitzhardinge P. M. , Steven E. M. 
Published: December 2021

In a prospective study, 96 of a possible 131 full term small-for-date (SFD) infants have been followed for a minimum of 4 years. Serial measurements for weight, height, and head circumference have been compared with the Stuart growth percentiles. By 4 years of age the mean weight and height were between the 10th and 25th percentiles with 35% below the 3rd and only 8% above the 50th percentiles. Increase in head circumference paralleled linear growth. Bone age showed a high positive correlation with height age.
Siblings of normal birth weight tended to be larger than the study children with 3% below the 3rd and 45% above the 50th percentiles. Heights of parents were normal, mothers were slightly underweight.
There was no difference in the 6-year height or weight between the most severely intra-uterine retarded babies and their less affected counterparts.
The growth pattern of the SFD children was similar to the normal child with the greatest velocity of growth occurring in the first 6 months. Those children whose 4-year height exceeded the 3rd percentile showed an accelerated velocity of growth in the first 6 months.
SYMPOSIUM: BEHAVIOR MODIFICATION BY DRUGS
Authors: Conners C. Keith 
Published: December 2021

A number of myths have grown up regarding the behavioral effects and use of stimulant medications with children. The first is that there is a type of child uniquely responsive to stimulant compounds, namely, the hyperkinetic child. The second is that the hyperkinetic child is any child who is sufficiently overactive to be considered a menace by adults. The third is that the stimulant medications act primarily to reduce motor activity in a paradoxical "sedative" fashion; and finally, that the drugs do not influence cognitive and perceptual functioning in these children. I believe that these myths are due partly to the historical accident of the manner in which they were first studied, partly to the imprecision in diagnosis and terminology of classification of patients, and partly to the paucity of systematic data on sufficiently large samples under sufficiently varied experimental conditions. I would like to present the results of studies which bear on these issues, and try to draw some general conclusions regarding the present state of knowledge with regard to the use of the various psychostimulants. In this paper I will deal with dextroamphetamine, methylphenidate, and magnesium pemoline.
I. METHYLPHENIDATE AND DEXTROAMPHETAMINE
The children for this study were referred from schools, pediatricians, and social agencies for either academic or behavioral difficulties, or both. The subjects retained for the drug study comprised about ⅔ of the original referral sample. They were selected to fit the description of the child with "minimal brain dysfunction" as defined by the National Institute of Neurological Diseases and Stroke (NINDS) Task Force I report.
SUCCESSFUL USE OF ELECTRIC SHOCK IN A LIFELESS CHILD AS REPORTED IN 1774
Authors: C. T. E. 
Published: December 2021

The report given below, published in 1774, is the first, to my knowledge, about the use of electrotherapy for children.
ELECTRICITY RESTORED VITALITY
One part of our benevolent design is to manifest the possibility of recovery in the various instances of sudden death, where the vital powers are suspended, without any essential injury to the frame. This extraordinary relation of resuscitation also manifests the admirable powers of the electrical shock; which we would earnestly recommend in all cases of suspended animation.
Sophia Greenhill, on Thursday last, fell out of a one-pair-of-stairs window, and was taken up by a man to all appearance dead. The SURGEONS at the Middlesex Hoapital, and an APOTHECARY, declared that nothing could be done for the child.—Mr. Squires, tried the effects of electricity.—Twenty minutes elapsed before he could apply the shock, which he gave to various parts of the body in vain;—but upon transmitting a few shocks through the THORAX, he perceived a small pulsation; in a few minutes the child began to breathe with great difficulty, and after some time she vomited.—A kind of stupor, occasioned by the depression of the cranium, remained for several days, but, by the proper means, being used, her health was restored.1