bluuebunny/crossref_metadata_2025_split huggingface dataset:
KINKY HAIR SYNDROME: RESPONSE TO COPPER THERAPY
Authors: Bucknall William E. , Haslam Robert H. A. , Holtzman Neil A. 
Published: December 2021

A 3-month-old male with kinky hair syndrome was given copper salts and purified ceruloplasmin, and the clinical and chemical responses measured. Initial plasma copper concentration was l5µ/100 ml and ceruloplasmin was undetectable. A seven-day course of oral cupric sulfate did not raise plasma copper or ceruloplasmin concentrations. After intravenous administration of cupric acetate on two occasions ceruloplasmin was detectable by chemical and immunological assays. Intravenous administration of purified human ceruloplasmin raised plasma ceruloplasmin levels acutely to normal. The in vivo half-life of this ceruloplasmin was within the range observed in infants with nutritional copper deficiency.
These results support the contention of Danks et al. (Lancet, 1:1100, 1972) that intestinal copper absorption is defective in this syndrome. They further demonstrate that ceruloplasmin synthesis and decay appear normal when copper is available. The patient's clinical condition showed no change after copper and ceruloplasmin administration, suggesting that the neurological damage was irreversible. The possibility remains that earlier administration of copper or ceruloplasmin might be effective.
SCHOOL PROBLEMS
Authors: Kinsbourne Marcel 
Published: December 2021

School problems result from factors of three types: environmental, emotional, and developmental. The great bulk of illiteracy in this country derives from socioeconomic adversity and cultural alienation that presents a primarily political rather than a medical challenge. But some children, even when offered adequate schooling under tolerable conditions, fail to achieve at a level to be expected from normally intelligent children at that age. Such children often also appear to be emotionally disturbed, and it may be difficult to decide what is the primary cause of the school failure. There are some cases in which the emotional disorder was clearly antecedent. These I will not discuss. I will talk about children who underachieve for no obvious reason.
Learning disorder is very much a matter of unexpected school failure, of the child doing less well than his parents or teachers expected. Before he does anything else, the clinician needs to satisfy himself that the child is really underachieving. There are two parts to this investigation: achievement tests and intelligence tests. It is not necessarily true that the child is doing badly because the teacher says so nor because the parents say so. You cannot know whether the child in fact is falling well short of national norms without a reading achievement test such as the California, Metropolitan, or Wide Range. An advantage of these tests is that they do not only give information about the child's ability in reading and writing, which for some reason are almost the only subjects ever complained of (and on which I will, therefore, concentrate), but they also measure his ability in arithmetic.
Letters to the Editor
Authors: Holliday Malcolm A. 
Published: December 2021

The Chairman of the A.A.P. Committee on Nutrition answers as follows:
The Committee on Nutrition is preparing a broad statement on the use of milk, which will, when completed, provide you information on the questions raised. The Committee has stated its position relating diet to atherosclerosis in a memorandum (Pediatrics, 49:305, 1972) . The AMA Council on Food and Nutrition recently published a similar statement (JAMA, 222:18, January, 1973; December 25, 1972). Specifically, we believe that skim milk as well as whole milk are suitable depending upon whether weight reduction is desired or not.
Letters to the Editor
Authors: Mahon Jean L. 
Published: December 2021

For the Committee on the Handicapped, the Chairman commented as follows:
Dr. Mock emphasizes an important aspect which was alluded to in the original statement in the recommendation that if a hearing loss was suspected, the child should be referred for a thorough diagnostic evaluation following which a plan would be developed to meet the child's physical, psychological, and social needs. The audiogram is only a small part of the overall assessment. For a detailed description of hard of hearing vs. deaf, refer to: Educational Audiology Hard of Hearing, Frederick S. Berg, Ph.D., United States Office of Education, Bureau of Education for the Handicapped, May 1973.
HEALTH SERVICES IN THE HOME
Authors: Williams Cicely D. 
Published: December 2021

1. The hospital is the power source for patient care, for teaching, for supervision and research. But if it loses sight of the home situation and of other agencies, the treatment and the teaching become inadequate, the research unrealistic; it is spinning its wheels and failing to maintain any progress.
2. Maternal and child health in advanced countries has adopted a pattern of "preventive but little or no curative" care. It is only when there is a properly integrated service that care of the sick, teaching and research will be effective. Service must be comprehensive in content and extent. This type of integrated service is the most suitable for developing areas.
3. There has been an artificial separation between preventive and curative medicine. Public health services provide preventive medicine in its major operations and with the mass approach. But personal or individual medicine must be both preventive and curative. In treating a minor disorder we are preventing a major catastrophe. It would be preferable if the division came not between curative and preventive, but between individual and mass medicine. Then hospitals, health centers, and homes could provide rational settings for continuity of care.
4. Continuity of care is essential. The public health nurse, health visitor, community nurse, midwife, district nurse, and their aides are the most essential workers. Their numbers should be increased and their training improved. The first diagnosis is made by the mother when she decides to take the child to the doctor, the hospital, or the clinic. The second diagnosis is made by the nurse when she decides to refer the child to the doctor. Without continuity in this chain of diagnosis, the whole system is inefficient.
5. Training of personnel needs to be revised with these objects in view.
GALEN ON THE HYGIENE OF THE NEWBORN
Authors: C. T. E. 
Published: December 2021

Claudius Galenus is one of the most remarkable figures in medical history. Born at Pergamos in Asia Minor, A.D. 131, he travelled extensively, studied medicine at Alexandria, and in 162 settled in Rome, where in 169 he became the personal physician to the Emperor Marcus Aurelius. In his text entitled Hygiene (De Sanitate Tuenda) he described the care of the newborn infant as follows:
The newborn infant, in his entire constitution, should first be powdered moderately and wrapped in swaddling-clothes, in order that his skin may be made thicker and firmer than the parts within. For during pregnancy everything was equally soft, since nothing of a harder nature touched it from without, and no cold air came in contact with it, whereby the skin would be contracted and thickened, and would become tougher and denser than it was before and than the other parts of the body. But when the baby is born, it is necessarily going to come in contact with cold and heat and with many bodies harder than itself. Therefore it is appropriate that his natural covering should be best prepared by us for exposure.
For infants who are in accordance with nature, a simple salt dusting-power is sufficient; for those whom it is necessary to sprinkle with dried leaves of myrrh, or something else of this sort, are obviously abnormal. But at present it is our purpose to discuss those of the best constitution. These, then, as has been said, having been wrapped in swaddling-clothes, should receive milk for nourishment, and baths of pure water; for they require a completely moist regime, since they have a moister constitution than those of other ages. . . .
DR. GEORGE ARMSTRONG WRITES ABOUT THE DISINTEREST OF PHYSICIANS IN THE CARE OF SICK CHILDREN
Authors: C. T. E. 
Published: December 2021

Dr. George Armstrong (1719-1789), one of the first of the English physicians to devote his time entirely to the care of children, and the originator of the first dispensary for sick children in the English speaking world, had this to say about the lack of concern of physicians of his day in the care of children:
If we take a survey of the different provinces of medicine, we shall readily discover, that one which happens to be of the greatest consequence to society, as the population of every country in a great measure depends upon it, I mean that which regards the diseases of infants, has hitherto lain uncultivated. I do not pretend to account for this strange neglect, nor is it to my purpose: but certain it is, that though the human species can only be preserved by taking proper care of the infant race, which is much more helpless than the young of other animals; and though a much greater number of our species in proportion to the whole, than of any that we know, dies very young; yet the care of infants, even with regard to medicine, has commonly been left to old women, nurses, and midwives, so that it has long been a common saying in this country, that the best doctor for a child, is an old woman. . . .
I know there are some of the physical tribe who are not fond of practicing among infants; and I have heard an eminent physician say, that he never wished to be called in to a young child; because he was really at a loss to know what to order for it.
Crystal Formation: A New Complication of Total Parenteral Nutrition
Authors: Pomerance Herbert H. , Rader Richard E. 
Published: December 2021

Since 1971, the Newborn Intensive Care Unit (NICU) of the Charleston Area Medical Center has developed considerable experience with Total Parenteral Nutrition (TPN). A new technical complication of this procedure has been encountered and is reported herewith. It is not the purpose of this communication to repeat the background of TPN,1 or to detail the case histories involved.
Initially, like others, we used a mixture containing a casein hydrolysate (5% Amigen and 5% Dextrose Injection*), additional glucose, and minerals including calcium gluconate. In May 1972 we changed our formula to include a fibrin hydrolysate (Aminosol 5% in D5W†). At the same time, we added phosphate ion by changing from potassium chloride to potassium acid phosphate (Table I) .
ACETAMINOPHEN: POTENTIAL PEDIATRIC HAZARD
Authors: W. C. F. 
Published: December 2021

Acetaminophen, long popular in Europe, has received increasing use in the United States as an analgesic and antipyretic, in both adult and pediatric practice. This increased use has come about partly because of concern over side effects of aspirin, especially its interference with blood-clotting mechanisms. Pediatric use of acetaminophen has been facilitated because it can be formulated into a stable suspension, easy to administer to children.
Acetaminophen is available in many forms and formulations, alone and in combination, in both prescription and over-the-counter products. The table at the end of this section, admittedly incomplete, lists some 200 brand names of products containing this compound which are marketed in the United States.
The extensive availability of acetaminophen increases the probability of accidental ingestion of toxic quantities by infants and children. Although package inserts characterize this drug as having exceptional safety in recommended doses, ingestion of moderately large quantities can cause kidney and liver damage resulting sometimes in death. Adverse side effects have been reported from lesser quantities. It is, therefore, important to alert practitioners to the potential toxicity, symptomatology and procedures for handling overdose. A highly significant aspect in such incidents is that early signs of poisoning may be minimal, even in cases where death ultimately occurs. Unaware of this, a physician might delay intensive therapy.
Poisoning by acetaminophen and its treatment have been extensively studied in the United Kingdom where consumption of this drug has progressively risen over the past decade and has been accompanied by an increasing number of poisonings.
THE ATHLETE AND MEDICATION
Authors: Yaffe Sumner J. , Bierman C. Warren , Cann Howard M. , Gold Arnold P. , Kenny Frederic M. , Riley Harris D. , Schafer Irwin , Soyka Lester F. , Stern Leo , Weiss Charles F. , Chudzik Gregory , Shirkey Harry C. , Ballin John C. , Done Alan K. , Farchione Louis , Scott C. P. , Lockhart Jean D. , Sawchuk Steven , Simopoulos Artemis P. 
Published: December 2021

The Committee on Drugs unites with the Joint Committee on Physical Fitness, Recreation, and Sports Medicine in condemning the use of drugs to improve athletic performance. However, the Committee on Drugs would like to clearly distinguish between the promiscuous use of drugs and their pharmacologic use to control a specific disease state enabling the adolescent to participate in sports, for example, the use of insulin for diabetes, anticonvulsants for epilepsy, digitalis for heart disease, or bronchodilators for asthma.
Children and adolescents with handicaps should be given the same advantages as other children, including participation in athletic activities. Athletes with medical conditions controlled by drugs should not be placed in the same category as youths taking drugs for other purposes, and there should be minimal, if any, restrictions imposed on them. One recent example of the type of restrictions which should not be imposed is the athlete with exercise-induced bronchoconstriction who was disqualified in the 1972 Olympics in Munich because he used a bronchodilator prescribed by his physician. Exercise-induced bronchospasm is a common handicap of allergic youth, and may occur in between 60% and 80% of individuals with allergic respiratory distress.1 Such bronchoconstriction can be modified by the administration of theopylline,2 theophylline ephedrine combinations,3 or cromolyn sodium.4,5 The Committee on Children with Handicaps also recommends that children with asthma participate in sports and physical education and that every effort be made to minimize restrictions.6
At the annual meeting of the American Academy of Allergy in Washington, D.C., February 14, 1973, the following resolution was approved unanimously: "Participants in competitive athletics with asthma and other allergic conditions should not be disqualified because of the use, with medical supervision, of therapeutic doses of ephedrine before and during athletic competition."7
Radiographic Diagnosis of Sinusitis
Authors: Thompson Robert S. 
Published: December 2021

The article by Kogutt and Swischuk(Pediatrics, 52:121, 1973), purporting to show the utility of sinus x-rays in the diagnosis of sinusitis in infants and children does no such thing. Rather, I believe it demonstrates that uncontrolled trials often give misleading results.
This conclusion is demonstrated by perusal of the work of Maresh and Washburn1 who did serial sinus films on 100 normal children from birth to adolescence. These authors showed that radiographic changes often considered to be diagnostic of sinus disease are found in nearly 60% of normal children in the birth to 1-year age group, 33% of those aged 5 to 6 years, and 14% of those 11 to 12 years old.
Policy of the Academy on Day Care: Some Doubts I. From Indiana
Authors: Sweeney Robert M. 
Published: December 2021

The policy statement on day care released in Pediatrics has been discussed at length by the Executive Committee of the Indiana Chapter of the American Academy of Pediatrics.
It is understood that it is necessary on the part of the American Academy of Pediatrics to make such a policy statement regarding daycare centers. One does, however, become somewhat concerned regarding the general tone and philosophy of the statement. It is felt that it mainly glosses over the fact that, for most children, child care and guidance are best given in the homes by the families.
Educational Pediatrics
Authors: Nader Philip R. , Dodge Warren F. 
Published: December 2021

In our view the establishment of a subspecialty of "educational pediatrics" holds a dangerous possibility for further compartmentalization of the delivery of useful health and education services in schools. One of the historic difficulties has been the lack of a link between primary care givers and health programs within schools. Subspecialization may widen this gap.
Many practicing pediatricians have areas of special interest such as adolescent medicine, growth problems, diabetes or neonatology, without devoting full time to this single area of practice.
FOLLICLE STIMULATING HORMONE (FSH) AND LUTEINIZING HORMONE-HUMAN CHORIONIC GONADOTROPIN (LH-HCG) CONCENTRATIONS IN PAIRED MATERNAL AND CORD SERA
Authors: Penny Robert , Olambiwonnu N. Olatunji , Frasier S. Douglas 
Published: December 2021

FSH and LH-HCG concentrations were determined by radio-immunoassay in paired maternal and cord sera. The sera of 50 mothers and 51 infants, 25 female and 26 male (one set of twins), were assayed.
Mean (± SD) FSH concentration of mothers (3.4 ± 0.9 mIU/ml) giving birth to female infants was not different, p&gt;0.1, from that of mothers (3.7 ± 0.7 mIU/ml) giving birth to male infants. In contrast, mean (± SD) LH-HCG concentration of mothers (15.99 ± 3.1 IU/ml) giving birth to female infants was significantly, p&lt;0.005, greater than that of mothers (11.37 ± 5.0 IU/ml) giving birth to male infants.
Cord serum FSH mean (± SD) concentration was significantly, p&lt;0.005, greater in female infants (3.7 ± 0.5 mIU/ml) than male infants (2.4 ± 0.8 mIU/ml). However, mean (± SD) LH-HCG concentrations in female infants (0.122 ± 0.015 IU/ml) was significantly, p&lt;0.005, less than that of male infants (0.156 ± 0.040 IU/ml).
Poor correlation, on an individual basis and on a statistical basis, between maternal and cord serum FSH and LH-HCG concentrations was observed.
The data of this investigation are consistent with fetal pituitary gonadotropin secretion, confirm previous observations that women bearing a female fetus have higher LH-HCG concentrations than those bearing a male fetus, and suggest a sex difference in cord serum gonadotropin concentrations.
Lethal Forms of Chondrodysplastic Dwarfism
Authors: Curran John P. , Sigmon Becky A. , Opitz John M. 
Published: December 2021

Thanatophoric dwarfism and achondrogenesis are lethal forms of skeletal dysplasia with clinical, radiographic, and genetic features distinct from classic achondroplasia. Both of these forms of lethal chondrodystrophy continue to be mistaken for achondroplasia, with serious genetic implications, since present evidence suggests that at least achondrogenesis is the result of autosomal recessive inheritance.
This report presents the clinical, radiographic, and autopsy findings in three short-limbed infants who died soon after birth. Early death is due to respiratory insufficiency secondary to severe pulmonary hypoplasia and, in one case, dysplasia of the tracheal rings. The incidence of lethal chondrodystrophies is about one in 19,000 live births. It is suggested that the differential diagnosis between thanatophoric dwarfism and achondrogenesis can be established unequivocally on radiographic grounds, as can the differentiation of these two lethal skeletal dysplasias from classic achondroplasia. It is important for proper genetic counseling that these distinctions be made.
The Detection of Fetal Asphyxia in Labor
Authors: Beard R. W. 
Published: December 2021

In recent years the search for a means of improving the physical and mental health of children has inevitably led to a more critical assessment of the influence of intrauterine environment, particularly with regard to intrapartum asphyxia.
In this paper the current state of knowledge concerning the methodology and clinical results from utilizing the two most widely used techniques for monitoring the fetus in labor-continuous fetal heart monitoring and fetal blood sampling will be discussed.
Racemic Epinephrine in Croup (continued)
Authors: Adair John C. , Ring Wallace H. , Jordan William S. , Elwyn Richard A. 
Published: December 2021

We believe the article by Gardner et al., "The Evaluation of Racemic Epinephrine in the Treatment of Infectious Croup," in the July 1973 issue of Pediatrics deserves comment.
In our paper, "Ten-Year Experience with IPPB in the Treatment of Acute Laryngotracheobronchitis," referred to by Gardner et al., we described a method which, in our hands, totally eliminated the necessity for tracheostomy in infectious croup, with no mortality. To date we have found it necessary to perform tracheostomies on two patients with croup, both of whom were subsequently found to have congenital tracheal stenosis necessitating long-term tracheotomies; otherwise the effectiveness of our regimen in the treatment of infectious croup remains unchanged (100%), now over a 13-year period.
Foetal and Neonatal Physiology (Proceedings of the Sir Joseph Barcroft Centenary Symposium). New York: Cambridge University Press, 1973, 641 pp., $32.50
Authors: Smith Clement A. 
Published: December 2021

A collection of 66 contributions to seven different areas of fetal and neonatal physiology can hardly be reviewed. Perhaps it may not even be described. How, then, can it be used?
Not many clinicians may be expected to dip into these pages but those who consider themselves neonatologists certainly should, while those learning to think seriously as perinatologists must do so. One hopes all those who dip, and even a few who merely skim, will at least learn something about Joseph Barcroft, whatever else they find here.
Blood Sampling From Scalp Arteries
Authors: Allué Xavier 
Published: December 2021

I would like to offer a comment to Schlueter et al. regarding their report on blood sampling from scalp in the January 1973 issue of Pediatrics.
One should not be discouraged by the occasionally sluggish blood flow from a scalp artery. Letting it flow through the butterfly infusion set without applying pressure to the syringe, we have been able invariably to fill, at least, the infusion set system. We then replace the cap, withdraw and bend the needle, and send the butterfly set to the laboratory.
Cooling as First Aid for Burns
Authors: Kravitz Harvey 
Published: December 2021

I would like to refer Doctors Epstein and Crawford to my paper, "First-Aid Therpay for Burns-Cool It," which appeared in Clinical Pediatrics in 1970.
We have anticipated their suggestions regarding dissemination of this vital piece of information. As a member of the National Accident Prevention Committee of the American Academy of Pediatrics, my colleagues and I have put this information into the first aid chart published by the American Academy of Pediatrics also. Through the kind courtesy of Mead-Johnson and Company, hundreds of thousands of posters on the use of cold water for burns have been distributed across the country and are found in hospital outpatient and neighborhood clinics.
Negative Urine Sugars in Galactosemia
Authors: Harris Ruth C. 
Published: December 2021

Drs. Wadlington, and Riley apparently have not had the unfortunate experience in their dependence on negative urine sugars in suspected galactosemia as we have had.
Eleven years ago a physician's 2-month-old baby failed to thrive, had vomiting and diarrhea. Among other tests a careful examination of three urine specimens following milk feeds showed protein, amino acids and no reducing substance. Unfortunately, this was a time when no enzyme studies were available nor was a galactose tolerance performed.