bluuebunny/crossref_metadata_2025_split huggingface dataset:
STUDIES ON CONGENITAL HEMOLYTIC SYNDROMES
Authors: Erlandson Marion E. , Schulman Irving , Smith Carl H. 
Published: December 2021

Rates of destruction of erythrocytes and of effective production of erythrocytes and hemoglobin have been determined in eight patients with sickle cell anemia. The method employed was based upon survival of chromium-labeled erythrocytes in patients in whom a state of hemopoietic equilibrium was present.
Rates of destruction and production of erythrocytes tended to be greater than in patients with homozygous thalassemia and congenital spherocytosis.
Comparison of data from patients with the same three congenital hemolytic disorders has indicated that peripheral indexes such as concentration of hemoglobin and hematocrit do not accurately reflect the true comparative degrees of anemia in terms of total volume of erythrocytes. Plasma volume was markedly expanded in patients with sickle cell anemia and very little, if at all, in congenital spherocytosis. Intermediate values were found in patients with thalassemia.
Two patients with sickle cell anemia in whom the spleen was enlarged demonstrated splenic sequestration of erythrocytes. The role of the spleen in this disease has been discussed.
Hepatic sequestration of erythrocytes was demonstrated in all eight patients to a significantly greater degree than in patients with other congenital hemolytic disorders.
Results of studies of erythrocyte survival in one patient when well and when in crisis indicated that hyperhemolysis was not a significant feature of the painful crisis.
Contraction of plasma volume during a painful crisis of sickle cell anemia has been described.
Studies in patients with sickle cell-thalassemia and sickle cell-hemoglobin C disease demonstrated that the hemolytic defects were less severe than in the usual patient with sickle cell anemia.
THERAPEUTIC AGENTS FOR REDUCTION OF INTRACRANIAL PRESSURE
Authors: MATSON DONALD D. , ROBERTSON JAMES T. 
Published: December 2021

SHRINKAGE of brain volume may be highly desirable in a variety of disease states in order to decrease intracranial pressure and thereby prevent irreversible compression of the brain stem. Temporary reduction of cerebral swelling may also be beneficial in: 1) granting time for planning elective surgical intervention, 2) facilitating the technical problems of brain retraction, and 3) minimizing the dangers of post-operative edema.
Pressure of the cerebrospinal fluid varies inversely with the osmolarity of the serum providing blood pressure remains relatively constant. Numerous hypertonic solutions have been employed experimentally and clinically in an attempt to reduce cerebral swelling. These have included glucose sucrose, saline, magnesium sulphate and concentrated human plasma.
IDIOPATHIC SPONTANEOUS HYPOGLYCEMIA IN CHILDREN
Authors: Haworth J. C. , Coodin Fischel J. 
Published: December 2021

Seven cases of idiopathic spontaneous hypoglycemia in children are reported. A review is made of 51 case reports of this condition found in the literature.
The onset of symptoms occurred under the age of 6 months in 60% of the cases and of these, over half showed permanent neurologic sequelae. Of 23 cases first developing symptoms when over 6 months of age only 3 later showed permanent brain damage. Of the total 58 cases, 90% first developed symptoms when under 2 years of age.
Although an elevation of the blood sugar to normal levels is often seen during treatment with ACTH, some patients do not respond favorably to this treatment, nor to treatment with adrenocorticosteroids. Treatment by dietary means is of little value.
Of the 58 cases, 25 underwent partial pancreatectomy; 15 were cured and 10 were not. It is the authors' belief that partial pancreatectomy should be performed in those cases which do not respond to medical treatment within 1 to 2 years.
The pancreas was examined histologically in 29 cases and in 9 of these there was evidence of hypertrophy or hyperplasia of the islets of Langerhans.
No familial incidence was noted with the exception of two reported series.
Of the total 58 cases, 7 died; in 3, the death was a direct result of the hypoglycemia.
The etiology is discussed. Although few cases have been studied, high levels of circulating insulin-like activity in serum have been previously recorded in two patients. A normal value in one patient is recorded here. Cases may be classified as leucine-sensitive and leucine-insensitive according to the blood sugar response to this amino acid. The possibility exists that another cause may be an inability to raise the blood glucose by the release of adrenalin.
The "syndrome of idiopathic hypoglycemia of infants" as described by McQuarrie is believed by the authors not to be a single clinical entity.
CLINICAL TRIAL TO ASSESS THE EFFECTIVENESS OF GAMMA-GLOBULIN IN ACUTE INFECTIONS IN YOUNG CHILDREN
Authors: Finkel K. C. , Haworth J. C. 
Published: December 2021

A controlled clinical trial was conducted to test the effectiveness of gamma-globulin in the treatment of acute infections in children under the age of 2 years. A total of 102 children with acute infections were divided by random selection into three treatment groups: patients in the first group received gamma-globulin 0.2 ml/lb, in the second group 0.1 ml/lb, and the third group which received no gamma-globulin, served as controls.
The three groups were comparable with respect to age, sex, length of illness and diagnoses. The administration of gamma-globulin to the two treatment groups did not affect the recovery time as compared with the controls.
The presence of physiologic hypogamma-globulinemia in the early months of life was confirmed, and a steady increase in level of gamma-globulin was demonstrated with increasing age.
In this series there was a statistically higher incidence of severe infections in infants under 6 months of age. Patients with severe in infections recovered more slowly than those with mild infections. No correlation was found between recovery time the age of the patient or the initial level of gamma-globulin.
In those children 13 to 24 months of age there was a statistically significant correlation between initial level of gamma-globulin and the history of previous infection.
COMMITTEE ON NUTRITION
Authors:   COMMITTEE ON NUTRITION, American Academy of Pediatrics
Published: December 2021

IMPLANTATION and feeding of various synthetic and natural estrogenic hormones especially diethylstilbestrol, to achieve improved efficiency of feed and better quality of carcass is a common practice among producers of livestock and poultry in this country. Androgenic agents have been used only experimentally to date. The preparations dosages and techniques employed are regulated by the Food and Drug Administration. Despite their requirement that no detectable residue of estrogenic hormones be present in edible tissues of treated animals offered for sale, some individuals maintain that the use of these hormones should be banned entirely because they believe that controls are inadequate to insure proper usage, and that analytic methods are not sensitive enough to detect minute quantities of hormones, whose repeated ingestion even in trace amounts might prove harmful.
Fortunately, extensive data have been gathered on the physiologic effects of stilbestrol and other estrogenic agents, their therapeutic uses and toxicology. Also, the quantities of estrogenic residues in the tissues of treated animals have been determined.
Greatest concern has been expressed over effects of stilbestrol on reproductive function on growth, and its possible carcinogenic properties. There is no doubt that stilbestrol can suppress ovulation in women if given in adequate amounts during the proper period of the menstrual cycle; and a relatively large dose (25 mg) may produce temporary impotence, but not sterility, in the male. These effects do not persist, however, when the dosage is discontinued, as the drug is destroyed and excreted in 3 or 4 days.
Relatively little is known about the specific effects of stilbestrol on children since its therapeutic use has concentrated on adults.
CLINICAL CONFERENCE
Authors: White Harvey 
Published: December 2021

Thorough familiarity with normal variations and insignificant anatomic deviations is essential to the practice of clinical pediatrics. Through constant observation and experience differentiation from disease becomes possible. In radiology this same problem exists and is probably more significant, as roentgenograms record only the situation as of a particular moment-an inherent weakness of the method. In radiology many standard procedures are established so that results may be duplicated and progress of disease evaluated. Deviations from standard procedures often simulate disease. In addition to this pitfall, there are many anatomic variations to plague the radiologist at the time of interpretation.
The following are examples of roentgenograms which have simulated disease but upon investigation proved to be normal:
1. The gaseous pattern in the infant differs from the adult. Ordinarily, we are taught that gas in the small bowel suggests obstructive ileus. In the infant under 2 years of age, gas in the small bowel is normal. After this age or after the child begins to walk the gas in the small bowel disappears and its presence then assumes significance. Improved intra-abdominal circulation, better co-ordination of diaphragmatic movements is responsible for greater absorption of gas in the small bowel after this age (Fig. 1).
Large amounts of air in the stomach are not necessarily due to obstruction. A very hungry baby will swallow huge amounts of air to a point of distending the abdomen. We know this occurs and is without significance, as we use this phenomenon for diagnostic pyelography. In this procedure, the ravenously hungry child is given a bottle of formula after the intravenous or intramuscular injection of contrast material is administered.
ROLES OF HEREDITY AND ENVIRONMENT IN INTELLECTUAL DEVELOPMENT
Authors: McCandless Boyd R. 
Published: December 2021

The Interesting yet controversial article by Knobloch and Pasamanick in this issue of Pediatrics throws additional, and badly needed, scientific light on four hotly disputed issues of intellectual endowment and development.
1) Race: The Knobloch-Pasamanick data demonstrate that, during infancy (approximately the first year of life), there are no Negro-white differences in developmental quotients, if circumstances of pregnancy-history, birth-weight, and rate of physical development are evened-out statistically.
2) Socioeconomics and race: Differences, when found, are more reasonably accounted for by socioeconomic status than by race.
3) Reliability of tests in infancy: The paper presents data sharply at variance with those existing in the literature concerning tests available for infants.
HISTOLOGIC OBSERVATIONS IN ERYTHEMA TOXICUM NEONATORUM
Authors: Lüders Dieter 
Published: December 2021

The first histologic description of lesions of erythema toxicum neonatorum is given. It is shown that erythema toxicum neonatorum is related to the pilo-sebaceous follicle. The histologic picture is quite different from that of other rashes considered in the discussion of the clinical differential diagnosis.
The papule of erythema toxicum neonatorum shows an accumulation of leukocytes with a predominance of eosinophils within the layers of the hair follicle just below the dermal-epidermal junction of the skin. The pustule of erythema toxicum neonatorum is the result of an accumulation of these cells within the superficial epidermis encircling the hair. The papulo-pustular lesion shows also histologically a combination of both components. The microscopic changes associated with the macule and erythema are meager; only a few perivascular eosinophils are present in the dermis.
The cause of erythema toxicum neonatorum is unknown.
COMMITTEE ON CONTROL OF INFECTIOUS DISEASES
Authors:   Committee on Control of Infectious Diseases, Coriell Lewis L. , Dent John H. , Hodes Horace L. , Kempe C. Henry , McNaughton George A. , Top Franklin H. , Walcher Dwain N. , Ward Robert , Weller Thomas H. , Valdes Jose M. , Steigman Alex J. 
Published: December 2021

Immunization with formaldehyde-inactivated vaccine is recommended for all children and young adults. The course recommended earlier was two 1-ml intramuscular injections (1 month apart) followed by a third 1-ml injection (after an interval of approximately 7 months). This is probably adequate for older children and adults.
Preliminary evidence indicates that a considerable proportion of infants have a less than optimal or relatively short-lived antibody response when immunized in this fashion. Vaccination of infants should be started at about 1½ to 2 months of age. The Committee recommends that children under 5 years of age be given a series of three 1-mi injections (1 month apart) followed by a fourth injection (up to 8 months later) and then a fifth injection (at about 4 yearsof age).
In the present state of knowledge, additional injections seem advisable as indicated in Table I. A recall injection should be given before traveling abroad or before entering an epidemic area.
Preparations containing inactivated poliovirus vaccine combined with diphtheria and tetanus toxoids and pertussis bacilli are now available. Such quadruple preparations should be given according to the manufacturer's directions, in general adhering to the schedule presently used for DPT (see Table I). For reasons of safety and to avoid possible loss of antigenic potency, it is considered advisable for physicians not to improvise mixtures of combined diphtheria, pertussis, and tetanus antigens and poliomyelitis vaccine.
See table in the PDF file
There are few contraindications to poliomyelitis vaccination. It may be performed safely at any time of the year, even when poliomyelitis is prevalent.
THE EFFECT OF TONSILLECTOMY ON THE INCIDENCE OF STREPTOCOCCAL RESPIRATORY DISEASE AND ITS COMPLICATIONS
Authors: Chamovitz Robert , Rammelkamp Charles H. , Wannamaker Lewis W. , Denny Floyd W. 
Published: December 2021

A population of military men with acute streptococcal respiratory infections (diagnosis established by clinical, bacteriologic and serologic studies) was investigated. Evidence is presented indicating that individuals who have had a tonsillectomy are neither more nor less susceptible to acute streptococcal infections of the respiratory tract. Once individuals acquire a streptococcal infection, the clinical course of the acute illness is not modified appreciably by the presence or absence of the tonsils. However, if antibiotic therapy is withheld, suppurative complications occur less frequently in those patients who have had their tonsils removed.
Tonsillectomy did not alter significantly the attack rate of acute rheumatic fever as a sequel of streptococcal infections, nor did it reduce significantly the development of valvular heart disease in patients with acute rheumatic fever. Moreover, it appears that streptococcal infections are less readily recognized in tonsillectomized patients and, therefore, are more likely to escape treatment appropriate for the prevention of rheumatic fever.
IRON DEFICIENCY IN THE PREMATURE INFANT
Authors: James John A. , Combes Mollie 
Published: December 2021

Iron-dextran was given intramuscularly to 84 small prematurely born babies during their stay in the nursery; 97 similar babies were not so treated and served as controls.
By 8 to 10 weeks of age, values for hemoglobin in the babies who received iron-dextran were significantly higher than in the controls and remained high throughout the first year. Virtually all of the control babies became anemic and hemoglobin levels below 5 gm/100 ml were observed in four infants.
There was no difference in the rate of growth or in the incidence of common infections in the two groups.
It is concluded that intramuscular injections of iron given prophylactically in the nursery will effectively prevent iron-deficiency anemia in premature infants and that this practice has definite clinical applicability. (See Addendum.)
Prevention of iron deficiency anemia does not reduce the high incidence of common infections experienced by prematurely born infants.
Combinations of Antibiotics
Authors: Jawetz Ernest 
Published: December 2021

I read with interest the paper by Haggerty and Ziai (Pediatrics, 25:742, 1960). I fully agree with the authors' recommendation that acute bacterial meningitis of infants be treated with multiple drugs directed at the most likely etiologic agents until a specific single organism has been identified. However, the authors' repeated references to some of my past publications force me to call attention to some possibly misleading statements in their paper.
After the initial demonstration of "antibiotic antagonism" in vitro and in experimental animals, we pointed out repeatedly (Arch. Int. Med., 90:301, 1952; Pharmacol.
CEREBRAL ARTERIOVENOUS FISTULA ASSOCIATED WITH CONGESTIVE HEART FAILURE IN THE NEWBORN
Authors: Glatt Benjamin S. , Rowe Richard D. 
Published: December 2021

Two infants with congestive failure in the newborn period were found to have congenital arteriovenous fistulae at post-mortem examination. One case died at 5 months of age with advanced neurologic disease; the other died at 3 days in severe congestive heart failure. In neither case were there developmental cardiac anomalies.
A brief review of the literature on congenital cerebral arteriovenous aneurysms and a discussion of their circulatory effect is presented.
It is suggested that the neonatal heart works near its maximum capacity and congestive failure may be readily precipitated.
Extracardiac conditions responsible for congestive failure are enumerated.
STATUS EPILEPTICUS IN PETIT MAL
Authors: Merlis Sidney 
Published: December 2021

Occurrence of petit mal status epilepticus in a 12-year-old girl is reported, and the literature to date is reviewed.
The necessity of the electroencephalogram for the accurate diagnosis of this condition is stressed.
The aggravating effect of diphenylhydantoin sodium in cases of petit mal is again suggested.
The use of carbromal in the case herein reported appeared to be helpful in the control of the petit mal seizures.
A HAZARD OF EXCHANGE TRANSFUSION IN NEWBORN INFANTS—NEGATIVE PRESSURE IN THE UMBILICAL VEIN
Authors: Mintz A. A. , Vallbona C. 
Published: December 2021

The development of the replacement transfusion for the prevention of brain damage associated with elevated levels of bilirubin in the blood has prompted numerous papers related to this procedure. The present report deals with a frequently observed phenomenon occurring during exchange transfusion, which seldom attracts attention until a disastrous episode takes place. This was our experience, and it therefore seemed desirable to re-evaluate the pathophysiology associated with pressure changes in the umbilical vein of the neonate.
This report will present a case of marked negative pressure in the umbilical vein of a neonate exhibiting inspiratory stridor of partial airway obstruction, and also the physiologic data from some animal experi ments to demonstrate this phenomenon.
CASE REPORT
Infant B was the second-born, male twin of a 24-year-old, Rh-negative, gravida 4, para 3 mother. At term the maternal Rh antibody titer was 1:32. The membranes ruptured spontaneously 48 hours prior to delivery. Labor was induced with oxytocin (Pitocin) administered intravenously. Twin Infant A was delivered spontaneously, unassisted; it was then found that twin B presented as a "transverse lie." This second twin was delivered in 15 minutes by version and extraction. Respiration was initiated after endotracheal aspiration and was normal for 1 hour, after which an inspiratory stridor was noted associated with moderate cyanosis. The stridor and cyanosis improved with oxygen-mist therapy. The baby weighed 2,930 gm and the blood was Rh-positive and Coombs' positive, as was the blood of his twin. Bilirubin in the serum at birth was 3 mg/100 ml; hemoglobin, 14.5 gm/100 ml.
CALCIFICATION OF CARTILAGE IN THE TRACHEA AND LARYNX IN INFANCY ASSOCIATED WITH CONGENITAL STRIDOR
Authors: Goldbloom Richard B. , Dunbar J. Scott 
Published: December 2021

A 4½-month-old boy with calcification of the tracheal, hyoid and cricoid cartilages is reported. These changes were associated with laryngeal and tracheal narrowing and congenital stridor. No significant metabolic disturbance was demonstrated.
Follow-up examinations of this patient up to the age of [unknown] years revealed progressive diminution of the stridor and a moderate reduction in the intensity of the cartilage calcification. The tracheal lumen returned to normal caliber.
The patient's mother, at 37 years of age, showed laryngeal and tracheal calcification. We do not yet know if this is significant, but the possibility that the condition may be genetically determined must be considered.
The etiology of this syndrome remains obscure. To our knowledge this is the third such case to be reported in the medical literature. It is suggested that an intrinsic congenital anomaly of the cartilage matrix in the affected areas may result in increased susceptibility to premature calcium deposition.
REGROWTH AND OVERGROWTH OF THE THYMUS AFTER ATROPHY INDUCED BY THE ORAL ADMINISTRATION OF ADRENOCORTICOSTEROIDS TO HUMAN INFANTS
Authors: Caffey John , Silbey Robert 
Published: December 2021

The oral administration of adrenocorti-costeroids provokes rapid atrophy of the thymus which is followed consistently, after stoppage of the steroid, by rapid regrowth of the thymus and, in some cases, over-growth.
Steroid-induced shrinkage of the thymus makes possible visualization of the true cardiac image which is often masked by the overlapping lobes of a large thymus. Such shrinkage may prevent the spurious diagnosis of cardiomegaly, and the use of more elaborate and hazardous methods such as opaque angiocardiography and cardiac catheterization.
Steroid shrinkage of the thymus is indicated only in patients who have cardiac signs and symptoms combined with enlarged deformed mediastinums in which the true cardiac image cannot be seen radiographically.
Steroid shrinkage is not indicated in patients who have cardiac signs and symptoms combined with small mediastinums, or in patients who have large mediastinums without cardiac signs and symptoms.
Steroid shrinkage should not be tried when there are other factors which suggest greater than the probable benefits to be derived from their use.
Massive rapid regrowth of the thymus following steroid-inducing atrophy was not associated with clinical signs or symptoms in any of our cases.
Growing Up in Newcastle upon Tyne: A Continuing Study of Health and Illness in Young Children within their Families, F. J. W. Miller, et al. New York, The Oxford University Press for the Nuffield Foundation, 1960, 369 pp., $5.75
Authors: Deisher Robert W. 
Published: December 2021

In order to appreciate this book one should be familiar with the volume on the same subject "A Thousand Families in Newcastle on Tyne." That told of all the children born in Newcastle in May and June of 1947 who were intimately observed by Sir James Spence and his collaborators. During the first year of these children's lives a complete record was kept of their illnesses and other significant observations.
This volume continues the intimate follow-up of the 847 children age 1 to 5 and their families.