bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relation of Prenatal Phenylalanine Exposure to Infant and Childhood Cognitive Outcomes: Results From the International Maternal PKU Collaborative Study
Authors: Widaman Keith F. , Azen Colleen 
Published: December 2021

Objective. The primary aims of this study were to model the form of the relation between prenatal exposure to phenylalanine (Phe) and measures of offspring intellectual development and to estimate the developmental relations of maternal demographic, pregnancy-related, and perinatal variables on offspring intelligence during infancy and childhood.
Methods. The participants were the 413 children and their mothers from the International Maternal PKU Collaborative Study.
Results. Results supported a nonlinear relation between prenatal Phe exposure and offspring cognitive outcomes, with damage to the developing fetus if average Phe levels are above approximately 360 μmol/L. Moreover, prenatal Phe exposure had a strong effect on offspring outcomes at 1 year of age and was the only one of the background, pregnancy-related, or perinatal variables to influence directly offspring outcomes at 2, 4, and 7 years of age.
Conclusion. The present study was able to document the importance of prenatal exposure to Phe for predicting offspring cognitive outcomes in the presence of other predictors of these outcomes.
Parent Report of Reading to Young Children
Authors: Kuo Alice A. , Franke Todd M. , Regalado Michael , Halfon Neal 
Published: December 2021

Objective. The purpose of this study was to investigate the predictors and frequency of book-sharing activities in a nationally representative sample of families with young children and to examine the extent to which parents report that pediatric health care providers are addressing early literacy activities.Methods. This study analyzed data from the 2000 National Survey of Early Childhood Health (NSECH), a telephone survey of 2068 parents of children aged 4 to 35 months. Parents were queried about the frequency of reading with their child, whether their pediatric provider discussed reading in the past year, and, if not, whether a discussion of the importance of reading to their child would have been helpful. Descriptive statistics, bivariate analyses, and multivariate logistic regression to identify predictors of daily reading among parents of young children nationally were used.Results. Approximately 52% of young children are reportedly read to every day by a parent. Significant predictors of daily reading include older child’s age (19–35 months; odds ratio [OR]: 1.77; 95% confidence interval [CI]: 1.18–2.65, as compared with 4–9 months), maternal education greater than high school (OR: 2.00; 95% CI: 1.24–3.22), greater number of children’s books in the home (OR: 1.01; 95% CI: 1.00–1.01), and discussion of reading by the pediatric provider (OR: 1.66; 95% CI: 1.23–2.24). Lower odds of daily reading are found for maternal full-time working status (OR: 0.68; 95% CI: 0.49–0.95), black race/ethnicity (OR: 0.61; 95% CI: 0.41–0.91), Hispanic race/ethnicity (OR: 0.56; 95% CI: 0.37–0.86), Spanish language–dominant parents (OR: 0.37; 95% CI: 0.22–0.62), and &gt;1 child in the household (2 children OR: 0.68, 95% CI: 0.48–0.97; 3 children OR: 0.53, 95% CI: 0.35–0.82). Approximately 37% of parents of young children stated that their child’s pediatric provider had not discussed reading with them. Nearly half (47%) of these parents indicated that they would have found such a discussion helpful.Conclusions. Family context and daily reading routines are important for a child’s early literacy development. This national study identifies how family characteristics and routines are associated with the family’s literacy orientation. The analysis also indicates that a large percentage of parents with young children who do not read daily believe that it would be helpful to discuss the importance of reading with their child’s pediatric provider.
Insurance Status and Vaccination Coverage Among US Preschool Children
Authors: Santoli Jeanne M. , Huet Natalie J. , Smith Philip J. , Barker Lawrence E. , Rodewald Lance E. , Inkelas Moira , Olson Lynn M. , Halfon Neal 
Published: December 2021

Background. Insurance status has been shown to have an impact on children’s use of preventive and acute health services. The objective of this study was to determine the relationship between insurance status and vaccination coverage among US preschool children aged 19 to 35 months.Methods. We linked data from 2 national telephone surveys, the National Immunization Survey and the National Survey of Early Childhood Health, conducted during the first half of 2000. Children were considered up to date (UTD) when they had received at least 4 diphtheria-tetanus-acellular pertussis/diphtheria-tetanus-pertussis vaccines, 3 poliovirus vaccines, 1 MMR vaccine, 3 Haemophilus influenza vaccines, and 3 hepatitis B vaccines at the time the interview was conducted.Results. Among the 735 children in our study sample, 72% were UTD. The vast majority (94%) reported some type of health insurance at the time of the survey. Children with private insurance were more likely to be UTD (80%) than those with public insurance (56%) or no insurance (64%). In a multivariate analysis that controlled for child’s race/ethnicity; household income; maternal age/marital status/educational level; location of usual care; and Special Supplemental Nutrition Program for Women, Infants, and Children participation, insurance was no longer an independent predictor of vaccination.Conclusions. The disparity in vaccination coverage among publicly, privately, and uninsured children is dramatic, underscoring its importance as a marker for underimmunization, despite the multivariate findings. The Vaccines for Children Program, a partnership between public health and vaccination providers who serve uninsured children and those enrolled in Medicaid, is well suited to target and improve vaccination coverage among these vulnerable children.
MYASTHENIA GRAVIS IN EARLY CHILDHOOD
Authors: MACRAE DONALD 
Published: December 2021

Four cases of myasthenia gravis in early childhood are reported. One case is congenital, and exhibited no fetal movement, suggesting that the myasthenia had an intrauterine onset. The relationship of the myasthenia to the coexisting maternal hyperthyroidism—the first case reported—is considered in view of an apparent relationship in adults. That other "toxic" states may play a part is possible.
One of the cases had a sister and possibly other siblings affected with myasthenia gravis. From the published accounts it appears that a familial incidence of myasthenia is considerably higher in childhood. It is, however, concluded that this does not represent a genetic factor—rather that unknown environmental factors are operative.
Two cases showed severe exacerbations during intercurrent infections—one being in complete remission between infections. The manner in which an infection results in an exacerbation is not clear.
The myasthenic-like state affecting the children of myasthenic mothers is discussed in relation to myasthenia. It is concluded from the evidence at present available that the defect in myoneural transmission in myasthenia gravis is the effect of a circulating substance whose nature, source and mode of action, remains obscure; but appears to be continuously or intermittently secreted.
While myasthenia gravis is a rare disorder, it is becoming increasingly apparent that the incidence in early childhood is considerably higher than previously suspected. Some of the reasons causing difficulty in diagnosis are discussed.
THE PEDIATRICIAN AND THE PUBLIC
Authors: GRIEVE CHARLES B. , GILL JAMES M. 
Published: December 2021

THE FIRST communication in this issue is by two general practitioners who have written their views of the British National Health Service as a companion article to the one by Professor John Craig which appeared last month. Dr. Charles B. Grieve, a medical practitioner in Aberdeen, is present Chairman of the Local Medical Committee of Aberdeen and also Vice-Chairman of the Executive Council of Aberdeen. Dr. James M. Gill is a country practitioner in Inverurie, a town in the county of Aberdeenshire; he is Vice-Chairman of the Executive Council of the Counties of Aberdeen and Kincardine. Dr. Craig writes that: "They are both liberal-minded men who have thought a lot about the service and have been taking an active part in its planning."
The second communication is a description of private practice in Britain by Dr. Philip Evans, Professor of the Department of Child Health at Guy's Hospital, London. Dr. Evans has translated British medical fees into American dollars but, as noted last month, there is such a difference in the cost of living between the two countries that 2.8 dollars to the pound does not give an accurate picture. On a cost of living basis, the exchange rate is probably nearer 4 than 2.8 dollars to the pound.
THERE must be few doctors with experience of general practice among the poor, the working and lower middle classes in the years before the introduction of the National Health Service who would not agree that the medical care of this group was grossly inadequate.
STUDIES IN SICKLE CELL ANEMIA
Authors: SCOTT ROLAND B. , FREEMAN LELABELLE C. , FERGUSON ANGELLA D. 
Published: December 2021

This survey of 1100 Negro children in various age categories was undertaken to determine the effect of age upon the appearance of the sickling phenomenon from infancy throughout childhood. The general incidence of sickling in 1100 Negro children including sickle cell anemia and sickle cell trait was 7.4%. The data on the incidence of the asymptomatic sickling trait and of sickle cell anemia are summarized by age and sex in Tables I and II.
We encountered 22 cases of sickle anemia, seven of which were previously undiagnosed and unknown. Sixteen cases of sickle cell anemia in males and six in females were encountered in the total test group, comprising 651 males and 449 females.
This investigation disclosed 60 subjects bearing the asymptomatic sickling trait. There were 40 and 20 instances of asymptomatic sickling observed in 635 males and 443 females, respectively. When the sexes were divided into two age categories (1 month through 4 years and 5 years through 16 years), there was an actual decrease in the incidence of sickling in the girls and an increase in the sickling phenomenon in the boys. We have no explanation for this finding. The overall incidence of the sickling trait for both sexes in all age groups represents no significant deviation from a 1:1 ratio.
The data available from this study failed to disclose a definite progressive increase in the incidence of sickling in the age groups studied. Quantitatively the general transition from the low incidence of sickling in the newborn (3.4%) to the higher occurrence in older children (7.5%) apparently takes place during the first year of life. Additional studies of both a qualitative and quantitative nature and involving a detailed age breakdown during the first year of life would probably elucidate this period of transition.
THE CONCENTRATION OF DIFFERENT AMINO ACIDS IN THE BLOOD PLASMA IN CHILDREN SUFFERING FROM RICKETS AND SCURVY
Authors: HUISMAN T. H. J. 
Published: December 2021

Using the chromatographic analysis with Dowex 50 according to Stein and Moore the ninhydrin positive substances of plasma filtrates were determined before and sometimes after hydrolysis.
Plasma filtrates of two normal adults, four normal children of different ages, two children with scurvy and three patients with some form of rickets were analyzed in whole or in part. It was shown, that most of the common amino-acids are present in notable amounts, while hydroxy-proline is lacking. Many unknown substances are also present, some of them seem to be inherent to age.
Aspartic and glutamic acids are present in large amounts as asparagine and glutamine, while after hydrolysis only alanine, valine, leucine, phenyl-alanine, histidine and perhaps threonine and serine have been increased in concentration.
The chromatographic studies of the plasma of children with scurvy and with rickets showed no significant differences as compared with controls.
CORTICOTROPIN AND STEROID HORMONE THERAPY OF ALLERGIC STATES IN CHILDREN
Authors: Levin Samuel J. 
Published: December 2021

This paper summarizes our experience with the practical use of ACTH and the steroid hormones in several hundred allergic children. The indications, contraindications and rationale of their use is discussed. It is particularly emphasized that the improvement induced in many allergic conditions is temporary and of short duration, unless the causative factors are removed. Hormone therapy should be regarded as a valuable supplement to, rather than a substitute for, conventional methods of symptomatic and immunological management.
Undesirable physiologic effects were not observed with short-term therapy of 5 to 7 days duration. In this series of approximately 200 patients in which these agents were used, long-term therapy was resorted to in 3 intractable cases and eventually discontinued in 2.
Caution is urged in the use of these hormones, especially for long-time treatment of allergic diseases since their deleterious effects on the growing child is still not completely known.
Allergic reactions to the gelatin vehicle in which ACTH is suspended, were encountered in 2 children. One child was apparently allergic to hydrocortisone used in nasal sprays.
STUDIES ON A NEUTRALIZING ANTIBODY AGAINST CANINE DISTEMPER VIRUS FOUND IN MAN
Authors: Karzon David T. 
Published: December 2021

A reproducible test is described for the measurement of serum neutralizing capacity against a strain of CDV adapted to the chick embryo.
A heat-stable neutralizing substance against CDV was demonstrated in human serum and in high titer in the gamma globulin fraction.
The neutralizing substance is transmitted via the placenta quantitatively from the mother to the newborn infant. It is lost by the sixth month and reappears in the population between the second and tenth years of life. It reaches an incidence of almost 100 per cent in adults.
The evidence so far available indicates that the neutralizing substance has the properties of a true antibody, formed in response to an as yet unidentified infection with an agent identical to or bearing an antigenic structure in common with CDV.
IDIOPATHIC HYPOPARATHYROIDISM WITH BONY DEMINERALIZATION AND CARDIAC DECOMPENSATION
Authors: Schulman Jerome L. , Ratner Harold 
Published: December 2021

Marked demineralization of the entire skeleton occurred in a 12-year-old girl with chronic idiopathic hypoparathyroidism. It is postulated that the demineralization was directly related to the unusual severity of the hypocalcemia.
The patient also manifested cardiac decompensation. There was no evidence of organic heart disease and the cardiac status improved coincident with the rise in serum calcium. It is postulated that the cardiac decompensation was the result of hypocalcemia.
THALLOTOXICOSIS
Authors: Grossman Herman 
Published: December 2021

A review of the history, pharmacology, manifestations and treatment of thallium poisoning is presented.
A case of thallium poisoning is reported in an 8-year-old boy who presented with peripheral neuritis and alopecia. Thallium intoxication was proven by finding thallium in the urine, 1.8 mg./1., 2 weeks after the onset of symptoms.
The pediatric cases in the American literature since 1935 are summarized. There are 18 reported cases, including the present case. Ten of these eighteen children died. Sixteen patients had nervous symptoms, 11 had alopecia. Eight children gave a history of ingestion of rodenticide and in 5 the source of thallium was not known.
THE APPARENT ABSENCE OF SIGNIFICANT PRIMARY VASOSPASM IN ACUTE SPINAL POLIOMYELITIS
Authors: Trott Arthur W. , Hellstrom Mary D. , Green William T. 
Published: December 2021

Measurement of skin temperatures under controlled conditions can be used as an index of the state of the cutaneous circulation.
During the first 40 days after the onset of poliomyelitis, there is no measurable alteration, based upon mean temperature values, in the cutaneous or deep circulation which can be attributed to the effects of the disease alone.
What little change in circulation was found in the group of patients with poliomyelitis seemed to be similar to that produced by bed rest alone in a group of non-poliomyelitic patients.
TREATMENT OF ATELECTASIS BY THORACIC TRACTION
Authors: Townsend Edward H. , Squire Lucy 
Published: December 2021

A case of amyotonia congenita presenting recurrent atelectasis of the right lung has been successfully treated by thoracic traction.
This is the first time that atelectasis and its treatment have been visualized with ciné-fluorography.
It is suggested that application to treatment of neonatal, postoperative and other forms of atelectasis in childhood might be studied similarly.
THE PATHOGENESIS AND TREATMENT OF VIRILIZING ADRENAL HYPERPLASIA
Authors: Grumbach Melvin M. , Wilkins Lawson 
Published: December 2021

SINCE the discovery by wilkins et al., in 1950, that in virilizing adrenal hyperplasia the clinical effects and the increased excretion of androgenic steroids can be suppressed by cortisone treatment, our knowledge of the primary metabolic disturbance underlying this disease has been advanced significantly through the work of a number of investigators. Considerable evidence has been obtained to support the observation of Bartter et al., in 1950, that in this disorder the ability of the adrenal cortex to synthesize gluconeogenetic hormone, or compound F, is impaired. This results in the increased secretion of ACTH in an attempt to provide sufficient compound F for homeostasis and secondarily leads to hyperplasia of the adrenal glands and the production of excessive quantities of adrenal androgen. In contrast to the normal, generally low levels of 17-hydroxycorticoids are found in plasma, and usually no significant rise occurs after the administration of ACTH. An excessive amount of endogenous ACTH is present in the blood which can be decreased readily by the administration of cortisone.
Important advances in clarification of the series of transformations by which the adrenal cortex synthesizes compound F or hydrocortisone from precursors have been made by Hechter and his associates and [SEE FIG 1 IN SOURCE PDF] others. Jailer suggested that in virilizing adrenal hyperplasia there is a metabolic block in this synthetic pathway between 17-hydroxyprogesterone and hydrocortisone (Fig. 1). The observation by Bongiovanni of an excessive quantity of pregnanetriol, a metabolite of 17-hydroxyprogesterone, in the urine of patients with this disease contributed substantial evidence to the support of such and hypotheses.
THE ROLE OF TRACE ELEMENTS IN HEMOPOIESIS AND IN THE THERAPY OF ANEMIA
Authors: Bush James A. 
Published: December 2021

The physiologic importance of copper and cobalt in erythropoiesis is well established. Their importance as a supplement to natural diets for human subjects has not been demonstrated. Although some patients with the nephrotic syndrome or sprue may be partially depleted of copper, further studies will have to be done to determine whether the addition of copper to the diet is of any clinical benefit. With the possible exception of these 2 conditions, there is no evidence that therapy with copper has any value.
Cobalt, when administered in pharmacologic quantities, may under certain circumstances be a potent erythropoietic stimulant. However, toxic side effects may be associated with its administration and it remains to be determined whether on not the benefits outweigh the possible disadvantages. In iron deficiency anemia there is no indication for cobalt therapy. This anemia responds quite satisfactorily to iron alone.
Molybdenum deficiency has not been observed in man. Its role in hemopoiesis is unknown. Evidence for the usefulness of molybdenum-iron preparations in the treatment of anemias is not impressive.
Letters to the Editor
Authors: SLOTKOWSKI EUGENE L. 
Published: December 2021

New cases of complications of smallpox vaccinations are being reported in the pediatric literature.
The report of Bigler and Slotkowski in 1951 of prolonged vaccinia was the first in recent American medical literature. Since that time, oven a dozen cases have been reported. If untreated, these cases end fatally. With the development of hyperimmune vaccine gamma globulin, there is hope that the patients may recover.
Even though the recognition of this condition is relatively recent, there appears to be a lack of unanimity as far as terminology is concerned.
DOSAGE OF DRUGS IN INFANTS AND CHILDREN: III. NEOSTIGMINE
Authors: Patterson Paul R. , Lipton Earle L. , Unna Klaus R. , Glaser Kurt 
Published: December 2021

The susceptibility of healthy children to neostigmine by hypodermic injection was studied in controlled experiments on 45 children ranging in age from 1 month to 12 years. Minimum effective doses (MED) of neostigmine were determined by their effect in stimulating salivary and sweat glands, and in increasing gastrointestinal motility.
The MED of neostigmine for stimulation of salivation is in all age groups smaller (by 6 to 38 per cent) than the MED increasing gastrointestinal motility. The average MED either for glandular (.025 to .036 mg./kg.) or gastrointestinal (.036 to .045 mg./kg.) activity fails to show significant differences among the various age groups when expressed in terms of body weight. Exceptions were found exclusively in children weighing more than 30 kg. The findings do not support the view that a physiologic vagotonia is present in infants.
EDUCATION
Authors: Yankauer Alfred , Tschida Ethel , Engle Mary Allen , Phaneuf Madeleine 
Published: December 2021

The organization and content, of institutes for physicians and nurses in the care of premature infants at the New York Hospital-Cornell Medical Center, 1949-1954, are described. Participants and observers were drawn from 24 states and the Territory of Hawaii, and 11 foreign countries.
Several indications of the need and value of this type of graduate training have been discussed, based on 5 years of experience with the program.
Responses to a detailed questionnaire seeking the opinion of those who attended the institutes from 1949 through 1953 has been analyzed. Responses were received from 72 per cent of the group. They indicated that the institute had met existing needs in large part and that the experience was worthwhile. Concrete evidence of improvements in hospital and in public health practice was reported and was considered related to attendance at the institute.
In view of the favorable nature of this critical evaluation and a continuing demand for this type of training experience, the institutes will continue to be offered.
TAUSSIG-BING COMPLEX ASSOCIATED WITH ANOMALOUS RIGHT SUBCLAVIAN ARTERY ARISING PROXIMAL TO COARCTATION OF THE AORTA
Authors: Alcott Donald L. , Sanfilippo Philip , Edwards Jesse E. 
Published: December 2021

A case of the Taussig-Bing complex with necropsy findings is reported. Of additional interest was the unusual occurrence of associated malformations of the aortic-arch system, including coarctation of the aorta and anomalous origin of the right subclavian artery proximal to the coarctation. A narrow patent ductus arteriosus was present and probably represented a temporary phase in the process of normal anatomic closure. A single coronary artery that divided into the two main coronary arteries shortly after its origin also was present.
Origin of the anomalous right subclavian artery proximal to a zone of aortic coarctation is an extremely rare arrangement among malformations of the aortic-arch system.