bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of intravenously administered lipid in neonates
Authors: Heird William C. , Driscoll John M. 
Published: December 2021

In this month's Pediatrics another method for feeding small infants is described. Although the method per se (i.e., intravenous supplementation of tolerated oral feedings) has been used frequently over the past few years, the present application is the first by which intrauterine growth rates with respect to weight, height, and head circumference have been achieved. The unique feature of the current application of the method is inclusion of an intravenously administered fat preparation as part of the nutrient infusate. The impressive growth rates were achieved without the use of central venous catheters with their attendant complications and without the use of indwelling intragastric or intraintestinal tubes.
Several aspects of this interesting paper require comment. First, despite the fact that achievement of intrauterine growth rates postnatally has been the goal of neonatologists for a number of years, such a growth rate has never been shown to be beneficial. In fact, it can be argued that infants who are gaining weight, regardless of how slowly, are receiving adequate nutrients to meet on-going metabolic requirements and are not undergoing a net breakdown of endogenous nutrient stores. Furthermore, a number of changes in body composition (e.g., loss of body water) occur postnatally and these changes make a continued intrauterine growth rate almost impossible out major changes in metabolism and/or metabolic requirements. Moreover, most of the weight increase during the last trimester is fat which, perhaps beneficial before birth, may actually be detrimental when deposited postnatally.
The appropriateness of a continued intrauterme growth rate is particularly pertinent when it is achieved with an agent that has not been evaluated thoroughly in very small infants (i.e., an intravenous soybean oil [Intralipid]).
Basic and Clinical Aspects of the Alpha1-Antitrypsin
Authors: Talamo Richard C. 
Published: December 2021

A deficiency of the major serum α1-globulin, the α1-antitrypsin, was first described in five patients by Laurell and Eriksson in Sweden in 1963. It soon became obvious that severe α1-antitrypsin deficiency was familial, and highly associated with chronic lung disease, having its onset in the third or fourth decade of life. Since the early descriptions of this common deficiency state, it has become clearly associated with familial emphysema in some families, familial infantile cirrhosis in others, and occasionally with a combination of childhood lung and liver disease in siblings. For the pediatrician, severe α1-antitrypsin deficiency now enters into the differential diagnosis of both chronic pulmonary disease in childhood and obstructive jaundice in the newborn period. In addition, low levels of α1-anrirtysin in serum are characteristic of respiratory distress syndrome, and elevations of this protein may be found in a variety of clinical situations.
The α1-antitrypsin probably functions as a major control protein against the tissue-damaging effects of both endogenous and exogenous enzymes. This review will cover several basic and clinical features of this protein with respect to its importance in pediatrics.
CHEMISTRY AND METABOLISM
A 50,000 molecular weight glycoprotein, the α1-antitrypsin is synthesized in the parenchymal cells of the liver and is secreted into serum as the major α1-globulin, comprising approximately 4% of the total serum protein level (normal concentrations are approximately 2.2 mg/ml). Alpha1-antitrypsin is present in many body fluids, having been found in microgram per milliliter quantities in nasal secretions, tears, saliva, pulmonary secrelions, duodenal fluid, cerebrospinal fluid, cobstrum, and mother's milk.
FREE WILL, ETHICS, AND HEALTH CARE
Authors: H. R. J. 
Published: December 2021

In a recent volume1 Arrow takes the libertarian view that individuals can and should make a free choice of whether and when they want to get medical care, when given all the information.
Pellegrino comments on the limitations of this libertarian view: (1) We are not isolated individuals but social beings whose actions effect others as well as ourselves. (2) Society has now said that it will care for people when sick. But if they are sick because of what they willfully did then should society not provide care? For children it is difficult to argue that they should be punished for their parents' failings. (3) The sick person's ability to deal with "all" the facts is limited, especially so for children. Pellegrino advocates an ethical view of the right to medical care as well as a legal one. " . . . law is the coarse adjustment that guards against the grosser violations of human rights; ethics is the fine adjustment that sets a higher ideal than law can guarantee." It would seem that children should have the right to medical care.
Presentation of the C. Anderson Aldrich Award to Anna Freud
Authors: Solnit Albert J. 
Published: December 2021

It is my privilege and pleasure to introduce Anna Freud to you and to read her paper for this most important occasion. Dr. Freud deeply regrets that she is unable to be with you and asked that I represent her at this meeting. May I say how appropriate and fitting it is to honor children throughout the world by conferring the C. Anderson Aldrich Award for 1974 on Dr. Anna Freud. Historically it is impressive that in 1968 and in 1971 this distinguished award was conferred on two of Anna Freud's former students and colleagues. I refer to Dr. Edith B. Jackson and Professor Erik Erikson.
Anna Freud, who started her professional activities as a teacher of young children, became the founder of child psychoanalysis. Throughout her career she has always had an affinity for working together with pediatricians, teachers, nurses, and all who are concerned with children. To this day she meets at least once a month with a group of distinguished English pediatric colleagues who have been her collaborators for more than 20 years. They share much in their curiosity about and compassion for children. They are devoted to helping children overcome illness and the handicaps of life. These include the burdens, threats, and losses associated with poverty, war, physical illness, genetic handicaps, and the destruction of the child's body and mind that result from adult abuse and deprivation.
In introducing Anna Freud, it is appropriate to call attention to her clinic, the Hampstead Child Therapy Center, and to her gallant colleagues with whom she works so closely on a daily basis.
Vietnamese Children
Authors: Carlin Jean E. 
Published: December 2021

I am very much concerned about Vietnam and the Vietnamese people, especially because I was there in 1969 and again in 1971 with the Volunteer Physicians for Vietnam. During that time I learned to know and respect many of the Vietnamese including physicians, medical students, and orphans.
Because of my experiences and friendships, I feel I must communicate with the general public and with my country's physicians who will be caring for the imported orphans from Vietnam.
More Criticism of Circumcision
Authors: Carpenter Gary G. , Hervada Arturo R. 
Published: December 2021

As natural optimists, we thought medical indications for the tribal, antediluvian custom of routine circumcision of the newborn had been finally terminated by the brief, crisp, and concise statement on circumcision made by the Committee on the Fetus and the Newborn of the American Academy of Pediatrics: "There are no valid medical indications for circumcision in the neonatal period."1
We hoped that foreskin clipping had been arrested as the last surgical procedure done to man without anesthesia or sedation, but we found the paper, "Why Circumcision?" by Burger and Guthrie,2 with unnecessary pessimism again resharpening the brutalized merry-go-round.
Lettrt To The Editor
Authors: Burger Robert 
Published: December 2021

We knew that our article would incite and excite some of our colleagues, and it does us good to see the response.
As urologists, we do not usually get called upon to do neonatal circumcisions but instead see the "problem prepuce." We see the paraphimosis, the carcinomatous penis, the verruccous penis, and the infectious processes that start under the prepuce and can eventually destroy penile and scrotal architecture. For this reason, the urologist's view is different from that of the pediatrician or obstetrician and we consider neonatal circumcision to be medical prophylaxis.
The Trisomy 9p Syndrome
Authors: Centerwall Willard R. , Beatty-DeSana Jeanne W. 
Published: December 2021

Since the first description of trisomy 9p in 1970, there has been a rapidly increasing recognition and reporting of new cases. The physical and mental features of retarded growth and development, down-turned corners of the mouth, mildly globular nose, slightly wide-set and deepset eyes with anti-Mongoloid slant, and unusual dermatoglyphics are distinctive enough to establish trisomy 9p as a clinical chromosomal entity-one which may prove to be the fourth most common autosomal syndrome (after trisomies 21, 13,and 18).
This paper includes a review and tabulation of features seen in the 20 reported cases and photographs of the faces of ten of these children. A new case included in this survey demonstrates the practical application of four types of chromosome banding identification (C, G, Q, and R). The confirmation of the chromosomal aberration in this syndrome is dependent on the use of one or more of these special laboratory techniques.
Most of the clinical characteristics distinctive of the trisomy 9p syndrome are seen also in other trisomies involving more or less of the number 9 chromosome. From these observations it is determined that the crucial determinants of the classical features of this syndrome lie within the distal half of the number 9 short arm.
Familial Partial Trisomy of the Long Arm of Chromosome 10 (q24-26)
Authors: Moreno-Fuenmayor Humberto , Zackai Elaine H. , Mellman William J. , Aronson Margaret 
Published: December 2021

Two fourth cousins with a strikingly similar pattern of malformation and who have an unbalanced translocation (46, XY, —17, +t (17p; lOq) are described. From an analysis of the phenotypes of these patients and others reported with lOq trisomy, we propose that the trisomy 1Oq 24-26 syndrome includes: growth and mental retardation, a characteristic facies (microcephaly, flat face with spacious forehead, small nose, depressed nasal bridge, arched wide-spaced eyebrows, blepharophimosis, microphthamia, low-set ears, bow-shaped mouth with prominent upper lip, micrognathia), palate anomalies (high-arched cleft or agenesis), congenital heart disease, and anomalies of the hands and feet.
Anomalies common to the cousins, but not described in other patients with trisomy 1Oq, are believed to be expressions of a partial monosomy of 17p.
Cerebellar Hypoplasia in an Infant With Congenital Cytomegalovirus Infection
Authors: Ceballos Ricardo , Ch'ien Lawrence T. , Whitley Richard J. , Brans Y. W. 
Published: December 2021

Cerebellar hypoplasia is a prominent feature of fetal brain pathology as produced in experimental animal models with various congenital viral infections.1-3
We have recently studied an infant with classical congenital cytomegalovirus (CMV) syndrome. The pathologic changes noted in the brain of micropolygyria, periventricular calcifications, and chronic inflammation have long been regarded as the hallmarks of chronic CMV infection of the fetal brain.4,5 However, the presence of striking cerebellar hypoplasia, reminiscent of some viral infections of the central nervous system described in the experimental animal models, has prompted this short communication.
CASE REPORT
B.B.P. was born to a 22-year-old mother, gravida 2 para 1, after an uncomplicated pregnancy.
Compliance of Chronic Asthmatics With Oral Administration of Theophylline as Measured by Serum and Salivary Levels
Authors: Eney R. Donald , Goldstein Eugene O. 
Published: December 2021

A group of ambulatory asthmatic children was studied with serum and salivary theophylline levels following a prescribed dose of a hydroalcoholic solution of theophylline to determine compliance. The gas chromatographic procedure used was both selective and sensitive for theophylline without the necessity of withholding coffee, tea, chocolate, or cocoa. In the first group of patients, only 11% achieved therapeutic levels, 65% had less than therapeutic levels, and 23% had no measurable drug in saliva. With more directive and supervised drug administration in a second group of patients, 42% achieved therapeutic levels, 51% were below therapeutic levels, and only 6% had no measurable drug.
Monitoring patients with salivary theophylline levels proved an effective way of improving compliance and also alerted physicians to noncompliance as a possible explanation of "treatment failure." Salivary specimens are readily obtained and noninvasive so that the technique is readily adaptable for use in the office of clinic setting.
Commentson Breast-Feeding and Immunity
Authors: Du Busc James V. 
Published: December 2021

Dr. Gerrard's recent review, "Breast-Feeding: Second Thoughts"1 concluded that breast-feeding offered a measure of immunological protection during the first six months of extrauterine life. Before this conclusion is accepted, further examination of the surveys cited in the article is warranted.
Gerrard states that Grulee et al.'s 1934 survey2 is "the most convincing evidence on the subject." The author's review fails to mention the design or controls employed in Grulee et al.'s "study." In fact, Grulee et al. merely compiled statistics on all those infants (20,061 from 1924 to 1929) who had been observed periodically during the first nine months of life, not including those who died.
Comment on Comments About Reading
Authors: Cavanaugh James J. A. 
Published: December 2021

The recent article by Silver1 that provoked Dr. Snyder's reflections2 on the importance of reading skills in our school children cited some of the many sides of this phenomenon of learning disability in youngsters of school age. Dr. Snyder's persuasions that the troubled reader should explore alternative modes of communication have been advanced previously3 and demand response.
The printed word may not be the best form of communication but in a literate society it is the best we have.
Use of Limulus Lysate for Detecting Gram-Negative Neonatal Meningitis
Authors: Dyson Donald , Cassady George 
Published: December 2021

The Limulus, lysate test was evaluated as a method for rapid detection of neonatal gram-negative bacterial meningitis. A total of 208 CSF samples were collected from 145 newborn infants suspected of having meningitis. Initial samples from all six babies with culture-proven gram-negative bacterial meningitis had positive Limulus tests within 30 minutes of incubation. Samples from 14 infants with gram-negative organisms isolated only in blood and/or urine, as well as from four neonates with gram-positive organisms in CSF cultures and from 13 with gram-positive organisms in blood cultures all yielded negative Limulus tests.
Thus, of 37 newborn infants with bacteria demonstrated in systemic cultures, only those six with gram-negative organisms in CSF had positive CSF Limulus tests. The CSF Limulus test was shown to be a rapid, reliable, and specific test for the detection of neonatal gram-negative bacterial meningitis.
Measurement of Human Chorionic Gonadotropin (HCG) Concentrations in Paired Maternal and Cord Sera Using an Assay Specific for the Beta Subunit of HCG
Authors: Penny Robert , Olambiwonnu N. Olatunji , Frasier S. Douglas 
Published: December 2021

Human chorionic gonadotropin (HCG) concentrations were determined in paired maternal and cord sera using an essay specific for the beta subunit of HCG. The sera of 46 mothers and 46 infants, 24 female and 22 male, were studied. Results were compared to those obtained using a radioimmunoassay for luteinizing-hormone (LH) which cross-reacted with HCG.
With either assay system, mean maternal HCG concentrations were lower when the sex of the fetus was male than when the sex of the fetus was female. Mean cord HCG concentrations of male (0.09 ± 0.02 IU/ml) and female (0.09 ± 0.04 IU/ml) infants were not different as determined by the beta HCG assay. In contrast, the mean cord serum concentration of HCG was significantly greater (P &lt; .005) in male infants (0.29 ± 0.05 IU/ml) than in female infants (0.23 ± 0.09 IU/ml) as determined by the cross-reacting assay. HCG concentrations were lower in both maternal and cord sera when assayed in the specific HCG system than when assayed in the cross-reacting system. There was a significant correlation (r = &lt; .9; P.005) between the results obtained with the two assays in both maternal and cord blood. Regardless of the assay system employed, the cord serum concentration of HCG was markedly less than the corresponding maternal serum concentration. There was no correlation between maternal and cord serum HCG concentrations with either assay.
These data are in agreement with the results of previous studies employing less specific methodology which indicated that maternal serum HCG concentrations were less when the fetus was male than when it was female. They are also consistent with a placental barrier effect with regard to HCG transfer to the fetus. The difference in results obtained in cord blood with the two assay systems suggests that the newborn male infant secretes more LH and/or alpha LH subunits than the newborn female infant.
Was the Patient Nonatopic?
Authors: Hamburger Robert N. 
Published: December 2021

In the article "Diazepam-Associated Asthma"1 the authors present evidence that the patient was at least capable of an IgE-mediated allergic response to diazepam. The authors then go on to state, "The serum IgE concentration was 200 IU/ml. On the basis of a nonallergic family history, personal history, negative skin tests, and a normal IgE level we concluded that E. B. was a nonatopic individual."
Our data2-3 as well as that from other laboratories4-6 would suggest that, in the absence of helminthiasis, a normal serum IgE concentration for a nonatopic 9-year-old boy would be 60 IU/ml.
The Drs. Bergner Reply
Authors: Bergner Arthur , Bergner Renee K. 
Published: December 2021

Since the presentation and publication of our report numerous verbal reports have been received of persons with apparent hypersensitivity to pancreatin powder. The condition is evidently not rare and should be suspected in patients with cystic fibrosis as well as relatives exposed to these enzymes.
Dr. Abernathy's letter raises the issue of the value and limitations of scratch and intradermal testing as an aid for identifying a causative allergen.
Our reluctance to rely on a skin test in the diagnosis of pancreatin hypersensitivity in our patient was not limited to concern about anaphylaxis.
The Management of Cerebral Edema in Pediatric Practice
Authors: Batzdorf Ulrich 
Published: December 2021

Cerebral edema is one of the most dreaded complications associated with many central nervous system (CNS) disorders. The condition adds significantly to the morbidity from such diverse conditions as neonatal hypoxia and hypernatremia, water intoxication, meningitis, encephalitis, birth trauma, lead poisoning, and radiation therapy of the brain, as well as brain tumors and abscesses. Cerebral edema increases the volume of the intracranial contents and, thus, may precipitate the intracranial translocation syndromes of uncal and tonsillar herniation which often result in death. Indeed, the mass effect due to edema of the CNS tissue (brain, cord) is often more harmful than is that of the underlying blood clot, tumor, or other pathologic process (Fig. 1). Diffuse and widespread cerebral edema can produce massive increases in intracranial pressure. The successful treatment of cerebral edema, therefore, remains a matter of paramount importance and may have a critical effect upon the patient's prognosis. Two types of therapeutic measures must be considered: (1) those that diminish the volume of intracranial contents in a nonspecific manner, and (2) those that reduce cerebral edema per se. An understanding of their correct use is essential.1,2
Prevention of cerebral edema is, of course, preferable to treating it. In infants and children undergoing neurosurgical operations, preoperative prophylactic measures can be instituted to reduce the magnitude of postoperative cerebral edema. In most situations, however, therapy cannot be initiated before the edema-producing insult occurs. Nevertheless, steps to minimize the development of cerebral edema often may be taken, and these will be discussed.
Cerebral edema has been defined as the abnormal accumulation of fluid in cerebral tissue.
A Pediatric Screening Examination for Psychosocial Problems
Authors: Metz J. Richard , Allen Constance M. , Barr George , Shinefield Henry 
Published: December 2021

In an effort to avert the cumulative effects of unresolved emotional problems on children's social and school adjustment, a psychosocial phase was added to a pediatric multiphasic examination. Based upon a cumulative stress concept, the screening procedures included child behavior and family stress questionnaires for parents, and abbreviated standard psychological tests for children, administered by specially trained aides. Computerized results were reported to the child's pediatrician. Follow-up by mental health counselors attached to the pediatric clinic was provided for patients identified as being at high risk of serious psychosocial problems.
Evidence of validity of the screen, factors affecting the scores, and effectiveness of clinical follow-up of high-risk patients are discussed. Valid semicomputerized screening of school-age children for serious psychosocial problems can be carried out routinely and at relatively low cost by paraprofessional personnel in a pediatric setting. Impediments to effective use of the screening results on the part of both health care provider and patient are discussed.
Dr. Hoekelman Replies
Authors: Hoekelman Robert A. 
Published: December 2021

The issues raised by Dr. Stein and Dr. Weinberger are quite important and, in fact, prompted the determination of correlation coefficients for the actual number of well-baby visits made and the maternal competence, satisfaction, and compliance scores between and within settings by provider groups and, overall, between settings. These were all less than .25 as reported in the text of the article.
It must be remembered that the visit figures presented in Table XIV to which both writers refer are means for the entire sample.
Concern About Theophylline
Authors: Brady Raymond E. 
Published: December 2021

The introduction of a new therapeutic modality, in this case the use of theophylline in the treatment of "apnea of prematurity," needs careful evaluation before its acceptance as a routine therapeutic measure. The studies by Shannon et al.1 and Uauy et al.,2 and Lucey's commentary3 attest to the success of theophylline. However, I feel a few comments are needed.
Therapeutic effects of theophylline (besides bronchodilatation) include diuresis and natriuresis4; lowering of peripheral resistance, right atrial pressure, and mean pulmonary artery pressure; and an increase in cardiac output.5