bluuebunny/crossref_metadata_2025_split huggingface dataset:
Round Table Discussion
Authors: MCARTHUR JANET W. , JOY FREDERICK B. , GLASSCOCK ERNEST L. 
Published: December 2021

Chairman McArthur: The first consideration of this discussion is: "Who shall take care of the menstrual problems of the adolescent girl?" Shall it be the gynecologist, the internist, or the pediatrician? My own feeling is that the pediatrician is probably the best qualified of all these specialists to handle adolescent problems. In the first place, he has usually known both the parent and the child for many years, and has gained a rapport of inestimable value in allaying the embarrassment of the patient and the anxiety of the parent. In the second place, the pediatrician has the developmental point of view. It is essential to treat adolescent menstrual disorders with patience and restraint—attitudes which come naturally to a specialist thoroughly accustomed to the vagaries of an evolving organism.
If we examine the following list, which enumerates the various sexual characteristics in the order in which they appear, we see the relevance of the developmental point of view to problems of sexual maturation. It becomes evident that adolescence is a process—not an event. Because the first menstrual period is such a dramatic occurrence one is apt to think that it is synonymous with sexual maturity, the ability to reproduce one's kind. Actually, this is not the case, as we know from several lines of evidence. Thus, anthropologists studying the inhabitants of the Trobiand Islands have found pregnancy to be rare in young girls until one to 2 years have elapsed following the first menstrual period. In these islands, it is customary for sexual congress to take place freely from childhood on.
Symposium
Authors: BYERS RANDOLPH K. , GIBBS FREDERIC A. , ALEXANDER HATTIE E. , CROTHERS BRONSON , MATSON DONALD D. 
Published: December 2021

In our discussion this morning we will deal with certain neurologic conditions of childhood. Such conditions differ from those in adults in that they affect a more or less rapidly developing complex organ. You need only be reminded of the rapid increase in brain weight and of the functional maturation attending and continuing after this weight gain to realize this fact. Our various developmental and intellectual examinations are attempts at measuring the latter.
The results of disease processes may show themselves by disturbing in various ways tissues already functionally active, as for instance by suppressing respiration in the newborn, or they may injure tissue not yet mature in which case they tend to distort or suppress development. As Dr. Crothers has long maintained, recovery from acute cerebral insults in infancy and childhood differs from recovery in adult life. In the latter, approximate return to the status quo ante is a satisfactory result. If, however, a 3 year old regains his attributes as a 3 year old and then fails to continue to develop he will be feebleminded at 6. Neurologic recovery in childhood therefore requires the resumption of orderly development, and can often not be determined for a period of years after an insult.
This is not the place to attempt an etiologic catalogue of cerebral disease in childhood. Suffice it to remind you that prenatal, natal and postnatal periods of life each has its own special developmental hazards. Because these affect the developing nervous system they tend in many instances to produce rather widespread changes resulting in the functional disabilities which we label mental retardation, cerebral palsy and epilepsy.
A HITHERTO UNRECOGNIZED BIOCHEMICAL DIFFERENCE BETWEEN HUMAN MILK AND COW'S MILK
Authors: GYÖRGY PAUL 
Published: December 2021

A specific mutant of L. bifidus (var. Penn) isolated from the feces of a breast-fed infant has shown no growth in the usual medium satisfactory for most strains of L. bifidus. It required for its propagation the addition of a specific "growth factor" present in human milk. Cow's milk had only 1/30 to 1/100 of the activity of human milk. The average relative activity was highest for the human colostrum, closely followed by rat colostrum, then by human milk, rat milk and cow's colostrum (taken on the first day). All the other milks tested, in particular the milk from ruminants such as sheep and goats in addition to cow's milk, have shown only very low activity. Sow's and mare's milk are slightly more active, guinea pig milk is inactive. This microbiologic growth factor is different from all known vitamins and growth factors. Very slight activity was exhibited by liver compounds, and practically none by yeast or meat. Meconium is highly active. Human semen, uterine (cervical) mucus, gastric juice (even in a case of pernicious anemia), saliva, amniotic fluid, and tears are also very active. The growth factor occurs in low and higher molecular form in human milk. In meconium it is present in undialyzable form. Purified blood group substance A and B are highly active. From human milk levorotatory active products were obtained containing N-acetyl glucosamine, fucose and galactose, but no amino acids. N-acetyl glucosamine and N-acetyl galactosamine were only slightly active.
L. bifiidus var. Penn contains a specific enzyme which inactivates the microbiologic growth factor required by the same strain. The enzymatic inactivation of meconium or purified blood group substance as growth factor is accompanied by the reduction of its serologic titer as specific blood group and by the liberation of dialyzable reducing substances, chiefly acetyl-glucosamine.
Round Table Discussion
Authors: KANNER LEO , McKAY ROBERT J. , MOODY E. EARL 
Published: December 2021

Chairman Kanner: Probably everybody in this audience has heard the old quip about the difference between a general practitioner and a specialist. The former, according to the jesters. knows a little about many things; as time goes on, he knows less and less about more and more, until he reaches a point when he knows nothing about everything. The specialist, in reverse, is said to know much about a circumscribed area of medicine; eventually, he knows more and more about less and less, until in the end he knows everything about nothing.
The pediatrician is the only medical man to whom this jocularly exaggerated pseudo-definition cannot possibly apply. His specialty is based not on a specific organ system or methodology but on an age group with all of its structural, functional, environmental, prophylactic and therapeutic concerns. He has thus the unique distinction of being a specialist and a general practitioner at the same time. His field is limited only to the extent that he courteously dismisses his patients when they reach the threshold of adulthood; it is broad enough to encompass every conceivable aspect of his patients' lives during infancy, childhood and adolescence.
The resulting multiplicity of interests, which is truly remarkable, has its rewards and its complications. The pediatrician has been widely accepted as a key figure to whom people turn with their puzzlements about their children's physical health, developmental pace, and mode of behavior. If a poll were taken as to whom the man-in-the-street regards as the logical adviser of parents, the overwhelming majority would undoubtedly name the pediatrician.
STIFF SKIN SYNDROME
Authors: Esterly Nancy B. , McKusick Victor A. 
Published: December 2021

Four patients are described with localized areas of stony-hard skin, mild hirsutism, and limitation of joint mobility. In three of these individuals the disorder was congenital and, in the fourth, it was first noticed in early childhood. No other abnormalities have been observed on repeated physical examination. Biopsies of affected skin show abnormal amounts of hyaluronidase-digestible acid mucopolysaccharide in the dermis. Fibroblast cultures from one individual demonstrated marked increase in intracellular metachromatic material. None of the patients had increased excretion of mucopolysaccharide in the urine.
The occurrence of this disorder in a mother and two children suggests an autosomal dominant mode of inheritance. It is postulated that these patients manifest a connective tissue disorder possibly resulting from an abnormality of mucopolysaccharide metabolism.
NITROGEN DIOXIDE AND LOWER RESPIRATORY ILLNESS
Authors: Pearlman Martin E. , Finklea John F. , Creason John P. , Shy Carl M. , Young Marion M. , Horton Robert J. M. 
Published: December 2021

Significantly increased bronchitis morbidity was reported among elementary school children exposed for 2 and 3 years and infant cohorts exposed for 3 years to elevated levels of nitrogen dioxide in the ambient air. Both the relative proportion of children affected and the frequency of attacks in these cases were higher in the polluted areas. Morbidity associated with croup, pneumonia, and hospitalizations did not significantly differ among the three exposure areas studied– high, intermediate, and low. Retrospective questionnaire responses were validated by physician and hospital records. Question sensitivity exceeded 67% and specificity 70% for each clinical diagnosis.
Lower respiratory tract infection appeared to be a sensitive host response indicator of air pollution. Increased bronchitis in childhood may augur increased morbidity and mortality in adulthood.
HUMAN MILK BANKING PRACTICES
Authors: Silverman William A. 
Published: December 2021

On June 13, 1970, an informal meeting was held in San Francisco sponsored by the Mothers' Milk Bank to review current methods for collection, decontamination, and storage of human milk, in the light of evidence which has accumulated in the past few years. A number of problems were identified and several recommendations were made.
Chemical contamination of human milk was discussed at length and it was concluded that adulteration by ingested drugs is preventable by thorough screening of the donor's history and the advisement that all drugs (including unusual amounts of alcohol, aspirin, and coffee) be avoided by the donor.
Environmental contaminants, especially chlorinated hydrocarbons, are now ubiquitous and it is unrealistic to expect that all traces of these compounds will disappear (or can be removed easily) from human milk. It appears unlikely that avoidance of human milk significantly reduces the total amount of DDT in the body beyond early infancy, since human milk is not the primary source of this material; it is transmitted to the fetus across the placenta and is soon available to the child in other ingested foods (especially meat). No physiologic effects attributable to DDT have been described in infants fed human milk (e.g., amounts are considerably lower than needed for hepatic microsomal enzyme induction) and "tolerances" have not been established; nonetheless it is cheering to find that sporadic reports of measurements of DDT in human milk since 1951 give no evidence that there has been an increase in recent years (Table I).1-5 It was concluded that it is not necessary to monitor DDT concentration in the milk of individual donors (especially since day to day variations are quite small); however it was recommended that measurements be made of pooled samples at regular intervals to detect long-term trends.
BOOK OF ACCIDENTS
Authors: Cone Thomas E. 
Published: December 2021

The consequences to children involved in worrying dogs were dreaded even more in the 1820's than today. Rabies prophylaxis and pediatric surgery were still unknown.
Medical and lay writers of the early 1800's often warned parents about the perils of dog bites. These writers tended to juxtapose the adjectival "wicked" whenever they wrote "boy," as though the two were inseparable.1
Poverty, Illness, and the Negro Child: A Dissenting Voice
Authors: Eschenburg C. G. 
Published: December 2021

Ordinarily, I am not an avid "Letters to the Editor" correspondent, but the article, "Poverty, Illness, and the Negro Child" (Pediatrics, 46:305) by Dr. Seham was the final straw.
How long must we be constantly bombarded by the press–including "scientific" journals–with such sociologic clap-trap? Are there so many guilt-ridden people who have to join the bandwagon that no other voices are heard?
Surely, physicians should realize that biologic organisms will group in a variable bellshaped curve. Why must we join the sociologists, politicians, and communists in trying to "flatten out" normal variability; producing (which is impossible) a nation of mediocre nebbishes.
Letters to the Editor
Authors: Fischer Carl C. 
Published: December 2021

We asked Dr. Carl Fischer, as the most appropriate representative of the Academy, to comment. He did so, as follows:
On reading Doctor Schulman's letter of October 13, 1970, I note that his concerns are the same as those felt by the Executive Board when it directed the Council on Pediatric Practice to make a 2-year study of the status of the delivery of health care to children and prepare a report with the best possible recommendations for the future.
Pica—Symptom, Vestigial Instinct, or What?
Authors: Palmeri R. 
Published: December 2021

Dr. H. H. Neumann's paper on "Pica–Symptom or Vestigial Instinct?" (Pediatrics, 46:441) raised two separate questions. I subscribe to the first question and hypothesis: (1) Chewing on hard material may be a deterrent against cavities. This discovery alone may turn out to be the answer to one of the oldest health problems and a great contribution to preventive medicine.
On the second question I strongly disagree with Dr. Neumann: (2) Can pica be explained solely and/or primarily on the basis of vestigial instinct? I believe that Dr. Neumann does not distinguish deviant behavior such as pica (not necessarily a chewing activity but rather the ingestion of a variety of always unedible materials) from the healthy habit of "chewing" on hard material (with or without ingestion but I suspect more without than with).
Neonatal Addiction to Methadone
Authors: Annunziato David 
Published: December 2021

In a recent effort to alert the members of our chapter to the increasing incidence of infants born manifesting withdrawal symptoms due to their mother's heroin addiction, we became aware of another area of concern. Members of our committee have seen infants with methadone withdrawal symptoms.
After reviewing the few published articles and after some direct communication with those in the field, the impression was that no symptoms occurred in the infants of mothers on methadone.
GUIDELINES ON SHORT-TERM CONTINUING EDUCATION PROGRAMS FOR PEDIATRIC NURSE ASSOCIATES
Authors: Burnett Robert D. , Frank Donald J. , Goldstein Paul S. , Haverty John Rhodes , Silver Henry K. , Skinner Alfred L. , Teate H. Luten , Connelly John P. , Connelly John P. , Burnett Robert D. , Frank Donald J. , Harrison Stanley L. , Hoekelman Robert A. , Chaney Patricia , Popiel Elda S. , Duiker Wesley J. , Burroughs Arlene K. , Dunkley Pearl H. , Church Gertrude , Di Maggio Gellestrina , Furnas E. Jane , Shannon Iris R. , Spector Audrey F. , Sorensen Gladys , Wittmann M. Elaine 
Published: December 2021

I. INTRODUCTION
The American Nurses' Association and American Academy of Pediatrics recognize collaborative efforts are essential to increase the quality, availability, and accessibility of child health care in the U.S.A. In order to meet the health care needs of children, it is essential that the skills inherent in the nursing and medical professions be utilized more efficiently in the delivery of child health care.
Innovative methods are needed to utilize these professional skills more fully. One such innovative approach is the development of the Pediatric Nurse Associate* program. This program will enable nurses, both in practice and reentering practice, to update and expand their knowledge and skills. It is essential that physicians become more aware of the skills and abilities of the nursing profession and that such skills be expanded in the area of ambulatory child health to enable both the nurse and the physician to devote their efforts in the delivery of child health care to the areas of their respective professional expertise.
The expansion of the nurse's responsibilities would encompass some of the areas that have traditionally been performed by physicians. Proficiency and competence in performing these new technical skills associated with the expanded responsibility should be viewed as increasing the sources from which the nurse gathers data for making nursing assessment as a basis for diagnoses and action and thus contributing directly to comprehensive nursing. Nurses must therefore be prepared to accept responsibility and accountability for the performance of these acts and must have the opportunity to be engaged in independent as well as cooperative decision making.
AUTOMATED BLOOD ANALYSIS: SUCCESS OR EXCESS?
Authors: Cook Charles D. 
Published: December 2021

As the abnormalities and complications of prematurity and especially the idiopathic respiratory distress syndrome have become better understood, it has become appropriate to treat any potentially viable infant much more aggressively than 20 or even 10 years ago. Once it was believed that an incubator served, among other things, as a barrier to protect a premature infant from the meddling and disturbing manipulations of physicians; now we have warming devices without walls so that the infants are more accessible and the physical barriers are minimized.
Much of the increased knowledge about normal and abnormal neonatal adjustments has been based on physiologic and/or biochemical investigations and these, in turn, have been possible because of the development of microtechniques, especially those for the determination of serum electrolytes, blood gases, and pH.
LIVER SCANS IN CHRONIC GRANULOMATOUS DISEASE OF CHILDHOOD
Authors: Samuels L. D. 
Published: December 2021

The biochemical defect of oxidase deficiency present in chronic granulomnatous disease of childhood is manifest clinically by recurrent infections, especially focal abscesses. In the liver these may be bacterial abscesses or characteriastic miliary, sterile granulomas. Either of these can be well-visualized and usefully followed with radioisotope liver scans.
Follow-up scans of the liver have shown that chronic changes of the disease may severely distort the gross liver morphology. Cases are presented of two surviving teen-age cousins and two young sisters, subsequently deceased, whose third sibling has just presented with the disease.
NEONATAL NECROTIZING ENTEROCOLITIS—OLD PIT-FALL OR NEW PROBLEM?
Authors: Fetterman George H. 
Published: December 2021

No pediatrician with responsibility for the care of newborn infants, premature or full term, can fail to be interested in the syndrome of neonatal necrotizing enterocolitis. The recent outpouring of reports concerning the disease attests not only to the growing recognition of the problem but also the immediacy of the challenge which it presents. The challenge is twofold, demanding clinical diagnosis of the disease at an early stage as well as study directed toward the elucidation of its etiology and pathogenesis.
The most quoted articles from the European literature are Genersich's1 original case report in 1891, the series of 62 cases described by Willi2 in 1944, and the series reported by Rossier, et al.3 in 1959.
A BIZARRE METHOD TO TREAT INTUSSUSCEPTION
Authors: C. T. E. 
Published: December 2021

In the mid-nineteenth century, intussusception was an almost universally fatal disease, save for the occasional child who responded to inflation of the bowel or to enemas.1 Of all the nonoperative forms of treatment (the first successful operation for intussusception in a child was performed by Hutchinson2 in 1871), none is more outlandish than this published in 1857:
Intussusception
In which one portion of the bowel falls down into another, like as when a stocking is turned half way inside out, effectually prevents any passage from the bowels, and death is inevitable, unless relief is given. Our intimation previously, that a pint of molasses drank while quite warm, had been known to give immediate relief, has caused a suggestion from W. H. Stanton, of Knoxville, that his father's sheep were invariably cured of a similar ailment, by being taken by the hind legs and swung around several times. As ludicrous as this "operation" might seem in its application to a human being, we would not hesitate to try it, in case other things failed. To us there is a kind of grandeur in all that is true and practical.
The most violent case of hysterics may be instantly arrested, if a great indignity is offered to the patient, such as slapping in the face with your slipper; and yet that is a better remedy than a plug of the intolerable Asafoetida.3
EXTERNAL MONITORING AND PLASMA DISAPPEARANCE FOR THE DETERMINATION OF RENAL FUNCTION: COMPARISON OF EFFECTIVE RENAL PLASMA FLOW AND GLOMERULAR FILTRATION RATE
Authors: Cohen Melvin L. , Patel Jivan K. , Baxter David L. 
Published: December 2021

In 40 patients effective renal plasma flow (ERPF) was measured by analyzing mathematically the plasma disappearance curve and the precordial external monitor disappearance curve of Na hippuran I131 simultaneously after a single injection of 30 µCu. The monitor curve is variably more shallow than the actual plasma curve. A mathematical interpolation is described using two plasma samples to correct the external monitor curve to approximate the entire plasma curve. ERPF determined by using the corrected monitor curve correlates well (r = .998) with the ERPF determined from the actual plasma curve and gives a small scatter (S.E. of estimate 11.1). The terminal exponential slope of plasma disappearance of Na hippuran I131 is apparent before 30 minutes and ERPF can then be obtained in a 40-minute study.
Glomerular filtration rates (GFR) were performed in 34 patients using 10 µsCu of Na iothalamate I125, comparing values derived by blood and urine sampling with those derived by plasma disappearance.
The latter method gave consistently falsely high values. The terminal exponential slope of the plasma disappearance curve for this isotope was not apparent before 80 or 90 minutes. Determination of GFR by plasma disappearance alone using Na iothalamate I125 is invalid in studies lasting up to 100 minutes after a single injection.
A COMPARISON OF AMPICILLIN AND CHLORAMPHENICOL THERAPY IN HEMOPHILUS INFLUENZAE MENINGITIS
Authors: Schulkind Martin L. , Altemeier William A. , Ayoub Elia M. 
Published: December 2021

A comparison was made of the clinical courses of 37 patients treated for H. influenzae meningitis with either ampicillin or chloramphenicol. The only significant difference noted in the courses of the two groups of patients was a prolonged duration of fever in the ampicillin-treated patients. The prolonged febrile course was not accompanied by any evidence that the antibiotic had failed to eradicate the infection. Neither could the fever be explained on the basis of subdural effusion, intercurrent infections, phlebitis, or drug fever.
In all other respects, the H. influenzae meningitis patients treated with either ampicillin or chloramphenicol had similar responses to therapy. The mortality rate and the incidence of neurological sequelae were the same for both groups of patients.
These findings indicate that a prolonged febrile course may be expected during the effective treatment of H. influenzae meningitis with ampicillin. This persistent fever is, in itself, no indication for the replacement of ampicillin therapy as long as other criteria show evidence of a favorable response to therapy.