bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECT OF SPLENECTOMY ON PORPHYRIA ERYTHROPOIETICA
Authors: Rosenthal Ira M. , Lipton Earle L. , Asrow Gertrude 
Published: December 2021

Studies performed on a case of porphyria erythropoietica revealed a compensated hemolytic process. Cell survival studies, performed by the Ashby technique, showed the presence of erythrocytes of short life span, demonstrating an intracorpuscular defect in this patient. Fluorescence was found in a large percentage of the normoblasts of bone marrow aspirations, giving evidence that the bone marrow is the source of the excess porphyrins in this case.
Splenectomy was performed in an attempt to reduce hemolysis, diminish erythropoiesis and porphyrin production, and thus secure palliation of the disease. The spleen and a liver biopsy were analyzed for porphyrins, and a considerable concentration of uroporphyrin and coproporphyrin was found in each organ. Following splenectomy there was a marked reduction in porphyrin excretion followed by a gradual rise approaching the preoperative levels. Some amelioration of the hydroa estivale was found in the first summer after splenectomy. The rising level of porphyrin excretion, however, suggests that the improvement will probably not be sustained. It is the opinion of the authors, however, that splenectomy should be considered in cases of porphyria erythropoietica in which increased hemolysis can be demonstrated, even if no anemia is present, because of possible variation in the response to the operation of individual patients.
HYPERNATREMIA IN INFANTS
Authors: Finberg Laurence , Harrison Harold E. 
Published: December 2021

It has been shown that hypernatremia may accompany dehydration in infants with diarrhea and with infections associated with interference with water intake. Suitable modification of the treatment dehydration for these patients has appeared to improve the results of their care.
Hypernatremic dehydration may be suspected from the history and clinical features and is readily diagnosed by laboratory procedures.
The occurrence of neurological manifestations, some of which may be irreversible, is a feature of outstanding importance. Despite loss of body water the usual changes in tissue turgor and the circulatory state associated with severe dehydration may not be present.
Because in this type of dehydration, a large intracellular water deficit exists, the repair solution should be relatively dilute with respect to sodium. The best results have been obtained by administering fluids which, if combined, would have a final sodium concentration of from 15 to 40 mEq./l.
Hypocalcemia has been a frequent complication and more study is needed to elucidate its pathogenesis. Awareness of its occurrence facilitates therapy.
As in other types of dehydration in infants, the potassium deficit may be impressive and should be corrected promptly after restoration of renal function.
The somewhat special treatment indicated for patients with hypernatremic dehydration makes recognition important. Recognition or suspicion from clinical signs and rapid laboratory diagnosis are essential for optimal management.
CLINICAL EVALUATION OF RESPIRATORY INSUFFICIENCY IN NEWBORN INFANTS
Authors: Miller Herbert C. , Conklin Eugene V. 
Published: December 2021

Detailed clinical observations were made on the respiratory behavior of 96 newborn infants, 69 of whom were prematurely born. It was found that the infants could be divided into 3 main groups depending on the trend taken by their respiratory rates during the first few hours following birth.
All of the severe respiratory insufficiency and all the deaths occurred in the group of infants whose respiratory rates were approximately normal during the first hour but subsequently increased to 60 or more per minute sometime during the next 2 days. Some of the latter infants died during this 48-hour period of initial respiratory distress; others appeared to recover and some of these died a few days later.
There was a greater tendency for infants whose birth weights were 1500 gm. or less to have an increase in their respiratory rates during the first day or two following birth than for infants who weighed more than 1500 gm. at birth.
The trend of the respiratory rate was helpful in planning oxygen therapy during the first 2 days. Satisfactory criteria for using oxygen therapy after the first 2 days were not developed from the data in this study.
Retraction of the chest wall on inspiration during the first 24 hours was minimal or absent in infants whose respiratory rates did not increase after the first hour.
OBSERVATIONS ON THE ENDOMETRIUM AND OVARY IN THE NEWBORN
Authors: Ober William B. , Bernstein Jay 
Published: December 2021

Post-mortem examination of endometria of 169 newborn infants reveals that 68 per cent are in an indifferent or proliferative phase, 27 per cent show secretory activity, and 5 per cent show progestational changes including decidual transformation of the stroma and changes analogous to those seen in adult menstruation.
Examination of the ovaries in 115 of these cases shows gonadotropic changes in 38 per cent. Examination of the 42 adequately sectioned ovaries from this group plus 31 from cases in which the endometrium was not available shows gonadotropic activity in 90 per cent. The observation of atretic follicles indicates that cellular response to gonadotropic stimuli is present and occasionally completed in utero.
It is concluded that the endometrial and ovarian changes are unrelated and that each is secondary to a different endocrine stimulus.
Evidence is adduced to indicate that progesterone is capable of traversing the "Arthus' phenomenon" thereby producing a were infective hyperplasia of the spleen, placental membrane and producing the decidual transformation of the endometrial stroma.
ACUTE POLIOMYELITIS IN INFANTS UNDER ONE YEAR OF AGE: EPIDEMIOLOGICAL AND CLINICAL FEATURES
Authors: Abramson Harold , Greenberg Morris 
Published: December 2021

In order to compare the epidemiological and clinical features of poliomyelitis in infants under 1 year with those in children and adults, a study was made of all cases of poliomyelitis that occurred in New York City in 1949 and 1950. This revealed the following characteristics of the disease among infants in the first year of life:
Clinically recognizable poliomyelitis was of infrequent occurrence among infants under 1 year of age. It was even more infrequent among infants in the first 6 months of life. This is in marked contrast to the findings in the 1950 epidemic in Israel, where one-third of all cases occurred in the first year of life, and one-tenth in infants in the first half year of life. Male infants exhibited a greater susceptibility to the disease than females. Fatalities in this age group were high, particularly among infants under 3 months, with some predominance of deaths in males.
Under 1 year of age, non-paralytic poliomyelitis was unusual, especially in the first 6 months of life. Paralytic forms of the disorder were dominant, spinal involvement being more common than bulbar. Case fatality occurred chiefly in bulbar forms of the disease, as in older children and adults. The fatality rate was higher than in older children and higher than in all ages combined.
The onset of poliomyelitis among infants under 1 year of age was variable. It was acute, with fever, or fever with nuchal spasm, or the triad of fever, nuchal spasm and spasm of back muscles. Temperature at onset of illness averaged 98.3°F.(36.8°C.), with a low of 97.6°F.(36.3°C.), and a high of 102°F.(38.8°C.). Temperatures recorded subsequently during the day of onset of illness were from 99.9°F. (37.7°C.) to 105°F.(40.5°C.), the mean being 102.8°F. (39.3°C.). The interval between onset of illness and first detection of paralysis averaged 5.5 days, with a spread from the day of onset to 25 days later. Paralysis of a single limb occurred more frequently than of 2 or more limbs, and the ratio of arm to leg paralysis was about 1 to 3.
Initial spinal punctures in infants under 1 year were made on an average of 3.4 days after onset of illness in non-paralytic cases, and 5.7 days in paralytic cases. The spinal fluid was usually clear, with a mean count of 91 lymphocytes/mm. . The average sugar content was 55 mg./and protein 72 mg./100 ml. of fluid.
EDUCATION
Authors: White Park Jerauld 
Published: December 2021

ALL OF US who are concerned with training pediatricians for the practice of pediatrics must agree that the time has come to say with Browning's Rabbi,
"Something is wrong: there needeth a change.
But what? Or where? At the last or first?"
The answer is: at both first and last. I write with whatever authority may have been conferred by 35 years in the private practice of pediatrics, plus a fair amount of part-time clinical teaching. As I retire from private practice (but not yet from clinic and ward work) I lay down my telephone and say, "For this relief much thanks." Thirty-five years of night-and-day pediatrics, with the endless raucous obbligato of the telephone, have led inevitably to reflections upon certain obvious trends in pediatric education as well as in pediatric practice, reflections based upon happy association with young pediatricians in and out of hospital training.
PROGRESSIVE VACCINIA ASSOCIATED WITH AGAMMAGLOBULINEMIA AND DEFECTS IN IMMUNE MECHANISM
Authors: Kozinn Philip J. , Sigel M. Michael , Gorrie Rachel 
Published: December 2021

A fatal vaccination reaction is reported in an infant 3 months of age, characterized by the continuous enlargement of time original vaccination and progressive development of new lesions. Virologic and histologic logic examinations indicated that the lesions were caused by vaccinia virus. Clinical and laboratory findings suggested that the disease was associated with agammaglobulinemia and defects in the immune mechanism. Differential features of this disease, generalized vaccinia and variola are presented in the discussion.
The infant's blood appeared to lack γ-globulin. Nevertheless, the serum yielded positive results in the hemagglutination inhibition and neutralization tests, though not in the complement fixation test. Some of the reactive substances in the serum, especially the neutralizing substances, were probably antibodies passively acquired.
Pathologically, the disease was characterized by lymphopenia, absence of healing and lack of inflammatory response.
The infant was treated unsuccessfully with γ-globulin and plasma from recently vaccinated donors. Successful treatment of this condition has recently been reported by the use of antivaccinal γ-globulin.
THE EPIDEMIOLOGICAL EVALUATION OF A NON-CELLULAR PERTUSSIS ANTIGEN
Authors: Felton Harriet M. , Verwey Willard F. 
Published: December 2021

A brief discussion of the background and current status of pertussis immunization has indicated the need for a more satisfactory immunizing agent.
The clinical evaluation of a new non-cellular pertussis antigen is described.
Statistical analysis of data from 197 children completely immunized with the non-cellular antigen, 207 completely immunized with whole organism vaccine and 238 non-immunized control children suggest the following conclusions:
The epidemiological data relating to the non-cellular antigen indicates its ability to produce a satisfactory level of immunity to pertussis.
The significantly higher agglutinin titers and better protection in humans suggest that there is a better response to time non-cellular antigen than to the control vaccine even though mouse protective activities were approximately equal.
The non-cellular pertussis antigen caused a febrile reaction of shorter duration than the control vaccine and other less quantitative measures of toxicity indicated that the non-cellular antigen was less toxic than the control vaccine.
The frequency of pertussis cases in both immunized groups was significantly lower than in the non-immunized control group.
The groups employed in the study were significantly uniform and thus permitted a valid comparison of the results among the various groups.
OBSTRUCTIVE JAUNDICE COMPLICATING HEMOLYTIC DISEASE OF THE NEWBORN
Authors: Stempfel Robert , Broman Birger , Escardó Florencio E. , Zetterström Rolf 
Published: December 2021

In a consecutive series of 83 Rh-isoimmunized infants, 7 had significantly elevated levels (greater than 1.0 mg./100 ml.) of direct bilirubin in the cord blood and developed obvious biliary obstruction. In no instance was a low concentration of direct bilirubin in the cord blood associated with the development of this condition. Serially determined electrophoretic separations of the serum proteins in 6 of the 7 patients revealed patterns not unlike those seen in the normal infant.
In exchange transfusions calculated to remove 85 per cent of the infant's blood, the total bilirubin concentration of the serum was reduced 30 to 50 per cent in infants with and in those without biliary obstruction. However, for the purpose of maintaining the total bilirubin concentration below "critical" levels, it was found that exchange therapy is less efficient, from a temporal standpoint, in infants whose hemolytic disease is complicated by biliary obstruction.
The cause of intrahepatic biliary obstruction is discussed and the prognostic value of the concentration of direct bilirubin in the cord blood of erythroblastotic infants is stressed.
THE USE OF INDIRECT ARTERIAL PULSE TRACINGS IN THE DIAGNOSIS OF CONGENITAL HEART DISEASE
Authors: Donoso Ephraim , Sapin Samuel O. , Kuhn Leslie A. , Grishman Arthur 
Published: December 2021

Studies were made of the carotid arterial pulse curves, recorded by indirect means utilizing a crystal microphone system, of 21 normal patients and 38 patients fulfilling the clinical criteria of congenital aortic or subaortic stenosis, 6 of whom had coexisting coarctation of the aorta.
There were definite and constant abnormalties in the pulse curves of the carotid artery in the group with aortic or subaortic stenosis. These were characterized by the presence of an initial sharp anacrotic notch placed low on the ascending limb of the Pulse curve; a series of systolic vibrations on the ascending limb, the graphic representation of a palpable thrill in the carotid vessels of these patients; plateau formation near the peak of the curve; a slow rise of the ascending limb of the curve to reach a later peak than normally seen; and, in some cases, an increased duration of systole as measured from the beginning of the carotid upstroke to the dicrotic notch of the carotid.
Although the patients studied would appear to fulfill the clinical criteria for diagnosis of congenital subaortic stenosis as opposed to congenital aortic valvular stenosis, it is emphasized that the differential diagnosis of these 2 conditions may not be possible during the life of the patient.
It is stressed that congenital aortic or subaortic stenosis may be considerably more frequent than can be judged by previously reported necropsy statistics and that, in addition, there may be a frequent association of these conditions with coarctation of the aorta.
PNEUMOCYSTIS CARINII—ETIOLOGIC AGENT OF INTERSTITIAL PLASMA CELL PNEUMONIA OF PREMATURE AND YOUNG INFANTS
Authors: Gajdusek D. Carleton 
Published: December 2021

Pneumocystis carinii, a parasite found almost a half century ago in the lungs of small mammals and of man in Brazil and, subsequently, in the lungs of man and of wild and laboratory rodents in Europe, has been identified with increasing frequency in the lungs of patients dying from interstitial plasma cell pneumonia of premature and young infants. The microorganism is found with considerable regularity in such patients, and has, in addition, been found in material obtained by lung puncture during life. Although its morphologic characteristics and life cycle have been well worked out, its taxonomic position remains a matter of conjecture. It has been tentatively classed as a protozoan of the Class Haplosporidia, but many authors believe it to be a fungus. The organism is not often encountered in the lungs in serial, unselected necropsies, but it has been found occasionally in lungs of older children and adults debilitated by chronic infections or malignant neoplasm and rather more frequently in association with cytomegalic inclusions in the lungs and salivary glands of infants and adults. However, it has been regularly identified in lungs of interstitial plasma cell pneumonia patients with only rare exceptions. Recently infection with what appears to be this microorganism has been transmitted to infant mice and kittens.
The wide geographic distribution of natural infection with this agent in wild and domestic mammals of many species, the fact that it was first discovered in man and animals in South America, its frequent identification in the lungs of infants afflicted with this unique pneumonia of infancy, a disease which has now been reported in the United States, and the recent identification of Pneumocystis carinii in a diseased human lung from Canada, make it essential that American pediatricians be aware of this parasite as a potential human pathogen. Only further study will establish clearly what role this organism plays in the pathogenesis of human disease and settle the controversy as to whether it is fungal or protozoan.
INFANTILE HEMANGIOENDOTHELIOMA OF THE LIVER
Authors: Crocker Diane W. , Cleland Robert S. 
Published: December 2021

Three cases of infantile hemangioendothelioma of the liver are reported, one with spontaneous regression. In two cases there was cardiac hypertrophy, dilatation and failure, presumably due to arteriovenous shunting within the tumor.
Clinical and pathologic aspects are discussed.
The similarity of this tumor to the infantile hemangioma of the skin is cited and a similarity of natural evolution suggested.
Therapeutic and prognostic implications of such a natural course are discussed.
REPEATED PSYCHOMETRIC EVALUATIONS OF PRESCHOOL CHILDREN WITH CEREBRAL PALSY
Authors: Kogan Kate L. 
Published: December 2021

Test scores for 31 children with cerebral palsy who had had two or more psychometric examinations within a 3-year period were reviewed.
The average shift from one examination to another was 6.5 I.Q. points.
It was likely that the changes in test scores due to retesting were largely attributable to the probable errors of the test scores, and that the intelligence quotient may be no less consistent for handicapped children than for an unselected population.
COMMITTEE ON NUTRITION
Authors:   COMMITTEE ON NUTRITION, American Academy of Pediatrics
Published: December 2021

The following contribution was prepared at the request of the Committee on Nutrition as a step towards filling a long-felt need, namely, statement of the essential principles governing scientific appraisal of nutritional substances through clinical trials with humans. It is necessary to ascertain the validity of methods which may be employed for this purpose before attempting to devise practicable plans for clinical testing of products. Only on this basis can the results of clinical trials be properly evaluated. Pediatricians and manufacturers of nutritional products have both been handicapped in selection of truly beneficial products because of lack of suitable criteria for judging the effect of substances on nutrition in the period of rapid growth and development in infancy and childhood.
The critique which follows is not to be construed as a recommendation that any one of the methods mentioned is a superior approach in the conduct of clinical trials of substances, nor does it constitute a simple plan for specific clinical trials. Instead, it is emphasized that "uncritical use" of any technique is valueless. If one of these methods is to be employed (especially indirect measurements, such as short-term balance studies), to secure information on the effects of a substance on growth and nutrition, the considerations outlined must be respected.
Definition of ideal or optimal nutrition is not attempted in this communication. That would present even greater difficulties of an almost philosophic nature. The methods discussed are concerned with comparison of the state of nutrition achieved in test- and control-groups by substances under appraisal, through the use of various available indices.
THE CONDUCT OF CLINICAL TRIALS OF SUBSTANCES PROPOSED FOR THE NUTRITION OF INFANTS AND CHILDREN
Authors: Lowe Charles U. , Pessin Vivian 
Published: December 2021

ANIMAL experiments may offer evidence of the value of a substance for human nutrition, but only well-conducted clinical trials can result in a verdict. Unless substances are tested on human subjects, judgment should be withheld. Though the design of experiments varies, certain general principles pertain to all experimentation; in addition, special considerations apply in the field of nutrition. The outline which follows presents some of these principles and considerations and should be useful to those conducting clinical trials.
A statement of specific objectives should be prepared as the first step. In order to estimate the necessary sample size, estimates of expected results must be obtained, or deduced, either from the literature or from a pilot experiment. All possible sources of bias, such as age, sex, race, etc. should be listed in advance and considered in planning the study. Decisions must also be made concerning the following: 1) population for which the results will be relevant; 2) controls; 3)criteria for judging results; 4) sample size and duration of study; 5) form of reporting results. Whenever possible the people who give treatments and make measurements should be unable to distinguish between the study and the control subjects.
I. POPULATION
The type of population for which the conclusion is intended will determine the choice of subjects. For example the value of a foodstuff for all infants should be studied in subjects from a heterogeneous population. Alternatively, a dietary supplement for treating deficiency must be assayed in deficient subjects. Such a supplement would probably produce no signficant changes in normal subjects but even if it did the results would not necessarily apply to treatment of deficiency.
TRENDS IN MAMMALIAN TERATOLOGY
Authors: Gluecksohn-Waelsch Salome 
Published: December 2021

It Might be worth while to begin a discussion of this topic with some historical considerations, because it may help to elucidate and to evaluate modern trends of mammalian teratology. It is probably true for all disciplines of science, but particularly so in the case of mammalian teratology, that the influence of the cultural environment of the time plays a decisive role in determining the attitude towards a particular science and its trends. It is obvious that teratologic phenomena are among those events of nature which fascinate and stimulate the imagination, not only of the scientist directly concerned with the problem, but also of the layman who happens to come across monstrosities of one or the other kind.
Everybody knows of the role monsters played in Greek mythology. Descriptions of congenital abnormalities may be found in pre-Aristotelian times but it was Aristotle who made a first attempt at causal analysis, and thus introduced the scientific approach to problems of teratology. It is interesting to consider the argument with which he refuted the possible existence of monsters-which were thought to be part man, part animal: Aristotle was correct in denying the existence of such chimaerae but he was not correct in the choice of his argument which stated that different organisms could not develop together because of different gestation times. Modern trends of thought would lead us to argue against the existence of this type of monstrosity in terms of genetic differences.
The generally static and dogmatic trend of the Middle Ages is reflected in the absence of any causal considerations of teratology during that time.