bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatal "Iron Heart" in an Adolescent: Biochemical and Ultrastructural Aspects of the Heart
Authors: Sanyal Shyamal K. , Johnson Warren , Jayalakshmamma B. , Green Alexander A. 
Published: December 2021

Histochemical and ultrastructural aspects of the heart were investigated in an adolescent with fatal congestive heart failure resulting from exogenous hemochromatosis. Extensive iron deposits were found in all four chambers, papillary muscles, and the conduction system. These deposits were most prominent over the outer third of the left ventricular myocardium, with no significant difference between deposits in the middle and inner thirds. Quantitative analysis of iron from different chambers and all zones of the left ventricular myocardium confirmed the aforementioned pattern of iron distribution. Iron deposits in sinoauricular and atrioventricular nodes were similar to those in the right atrial myocardium. Degenerative changes and fibrosis were minimal.
Ultrastructural studies showed that intracytoplasmic iron deposition followed a perinuclear, paranuclear, or diffuse pattern. In addition, some iron was consistently present in the nucleus and mitochondria. It is postulated that the presence of iron in the mitochondria may adversely affect the cellular enzyme system; this could provide a biochemical basis for myocardial dysfunction in patients with acquired iron-storage disease.
IF AT FIRST YOU DON'T SUCCEED, QUIT
Authors: Cahn Steven M. 
Published: December 2021

American higher education stands on the brink of chaos. Never have so many spent so long learning so little.
The present crisis stems from the increasingly widespread acceptance among faculty and administrators of the fatal educational principle that a student should not be required to do any academic work that displeases him. If a student prefers not to study science or history or literature, he is allowed to attain his degree without studying any science, history, or literature.
If he prefers not to take examinations, he either makes special arrangementswith his instructor or else chooses his courses from among the evergrowing number that involve no examinations. If he prefers that his work not be graded, he arranges in most or all of his courses to receive an undifferentiated pass or fail. If he is concerned about obtaining high grades, he selects his teachers from among the many who have yielded to student pressure and now indiscriminately award A's to virtually everyone. As the dean of Yale's Morse College recently remarked of her students, "They get a B and they bawl. It takes a man or woman of real integrity to give a B."
Throughout the country the attempt is being made to provide students with what is advertised as a liberal education without requiring of them the necessary self-discipline and hard work. Students have been led to believe they can achieve without effort, that all they need do in order to obtain a good education is skip blithely down the merry road to learning.
WILLIAM BUTLER YEATS WRITES ABOUT HIS BACKWARDNESS IN LEARNING TO READ
Authors: C. T. E. 
Published: December 2021

That Yeats (1865-1939), the greatest poet to write in English in our time, had difficulty in learning to read may offer hope to parents and teachers faced with children for whom reading is not acquired with ease.
Writing in 1915, this is how Yeats described his slowness in learning how to read:
Because I had found it hard to attend to anything less interesting than my thoughts, I was difficult to teach. Several of my uncles and aunts had tried to teach me to read, and because they could not, and because I was much older than children who read easily, had come to think, as I have learnt since, that I had not all my faculties. But for an accident they might have thought it for a long time. My father was staying in the house and never went to church, and that gave me the courage to refuse to set out one Sunday morning. My father said if I would not go to church he would teach me to read. I think now that he wanted to make me go for my grandmother's sake and could think of no other way. He was an angry and impatient teacher and flung the readingbook at my head, and next Sunday I decided to go to church. My father had, however, got interested in teaching me, and only shifted the lesson to a weekday till he had conquered my wandering mind.
Acquired Aganglionic Megacolon in a Premature Infant: Report of a Case
Authors: Touloukian Robert J. , Duncan Raymond 
Published: December 2021

Hirschsprung's disease is presumably caused by intrauterine environmental or genetic factors which prevent the migration and formation of the intramural ganglion cell (IMG) in the distal colon. While the IMG is known to be particularly sensitive to anoxemia and other postnatal environmental factors, its selective loss following such stress has not been substantiated in an unoperated patient. The following report of a stressed premature newborn with the clinical and radiographic features of Hirschsprung's disease clearly documents the histologic disappearance of the IMG from the distal colon.
CASE REPORT
D.J. (#88-65-29), a 1,525-gm male infant, was born to a healthy 22-year-old abortus 0, gravida 1, para 0 mother following an uncomplicated 30-week gestation, ending in a spontaneous uncomplicated delivery.
Anterior Fontanelle Herniation
Authors: Gibson Noah F. , Ball Marshall M. , Kelsey Doris S. , Morrison Lemuel 
Published: December 2021

Herniation of brain tissue through the anterior fontanelle is an extremely rare occurrence. Recently we treated a patient with anterior fontanelle brain herniation, most probably acquired secondary to meningitis.
CASE REPORT
A 2-week-old black male infant in previous good health was admitted to an outlying hospital with a one-day history of fever and irritability. Lumbar puncture revealed 238 WBC/cu mm with 90% neutrophils and a protein of 269 mg/ 100 ml. The infant was begun on parenteral therapy with methecillin, ampicillin, and kanamycin but was changed to penicillin G and kanamycin the following day when the cerebrospinal fluid culture grew β-hemolytic Streptococcus, non-group A or D. During the first two days of therapy, the infant had intermittent seizures and the anterior fontanelle began to bulge.
Decreased Bactericidal Activity of Leukocytes of Stressed Newborn Infants
Authors: Wright William C. , Ank Bonnie J. , Herbert Jennifer , Stiehm E. Richard 
Published: December 2021

Previous studies have established that leukocyte phagocytosis and intracellular killing are normal in term and low-birthweight newborns who are well. To determine the effect of stress or illness on newborn leukocyte function, the phagocytic and bactericidal activity of leukocytes from 40 sick newborns was compared with that of leukocytes from 12 newborns and 23 normal adults. To eliminate abnormal phagocytosis resulting from serum opsonic defects in newborn sera, pooled adult sera were used in all assays.
Twenty-five of the 40 stressed newborns (63%) had decreased in vitro activity against either Staphylococcus aureus 502A or Escherichia coli, or both, compared with decreased activity in two of 12 well infants (17%) and in four of 23 adult controls (17%). The mean bactericidal activity (percentage of organisms killed after two hours) of leukocytes from stressed newborns against S. aureus (83% ± 2 [SEM]) and E. coli (87% ± 4 [SEM]) was significantly less than in the combined well infant and adult control group (94% ± 1 for S. aureus and 97% ± .5 for E. coli). Although the more severely ill infants had an increased incidence of impaired antibacterial activity, the degree of impairment was not related to the severity of illness. No consistent relationship of decreased activity to birthweight, gestational age, age when studied, or specific diagnosis was seen. The leukocyte abnormality in stressed infants against S. aureus was principally a killing defect, while against E. coil both phagocytosis and killing were abnormal.
This study indicates that a wide variety of neonatal disorders may affect one or more of the steps required for normal bacterial killing. The lability of leukocytic antibacterial function under stress is an additional mechanism for the newborn's increased susceptibility to infection.
Parrot's Pseudoparalysis, Revisited
Authors: Rothner A. David , Klein Norma 
Published: December 2021

Just over 100 years ago, Parrot described several children in whom pain in one or more extremities secondary to syphilitic involvement of bone resulted in lack of movement of those extremities. He called this pseudoparalysis. In recent years, the incidence of congenital syphilis has risen dramatically. Most physicians presently in training and many already in practice have had no personal experience with the signs and symptoms of this disorder. A recent case of congenital syphilis presenting with what appeared to be a right hemiparesis is illustrated in the following report.
CASE REPORT
A 2½-month-old black girl was evaluated for decreased movement of her right arm and right leg of three days' duration.
Questions Diagnosis of Single Ventricle
Authors: Shakibi Jami G. 
Published: December 2021

I read with interest the paper by Tingelstad et al. which appeared in the July 1974 issue of Pediatrics. However, as far as the diagnosis of congenital heart disease is concerned, I am in the dark. After cardiac evaluation a diagnosis of mitral atresia, a single ventricle and corrected transposition was made.
A single ventricle by definition means the presence of only one ventricle receiving two atrioventricular valves. Mitral and tricuspid atresia are thus excluded.2, 4
The Use of Xanthines in Treating Apnea of Prematurity
Authors: Morens David M. 
Published: December 2021

The inclusion in the May 1975 issue of Pediatrics of two articles and a related commentary on the use of xanthines in the treatment of apnea of prematurity bring to mind some potential hazards of this sort of therapy to which none of the authors addressed themselves.
Xanthines are notorious gastrointestinal irritants. Presumably, many of the infant candidates for xanthine administration will also be at risk for the development of necrotizing enterocolitis. Prematurity, intestinal bacteria, enteral alimentation, and direct or indirect injury to the mucosa are frequently mentioned risk factors.
Dr. Shapiro Replies
Authors: Shapiro Donald L. 
Published: December 2021

We appreciate the concerns expressed by Dr. Morens. Because of insufficient knowledge of the toxicity of theophylline in prematures, we are still restricting its use to severely apneic infants who fail to respond to all other therapies, including CPAP, and would otherwise require respirator ventilation.
We have continued to use the drug orally pending further studies on its pharmacokinetics in premature infants and have not noted serious gastrointestinal or electrolyte disturbance in our patients.
McAtee and Silver Reply
Authors: McAtee Patricia A. , Silver Henry K. 
Published: December 2021

We appreciate the commentary of Dr. Austin regarding our article.
The nurse practitioner role was created because the needs of children for primary health care were not being adequately met through the existing health care delivery system.
Pediatricians who practice with nurse practitioners have found that the pediatrician and the nurse can provide more primary health services to children and can give more personalized care than they previously were able to do. Acceptance by patients and their parents has been excellent; more than one half of the parents indicated that joint care was better than that received from the same pediatrician alone.
The Asthmatic Child and His Participation in Sports and Physical Education
Authors: Kugel Robert B. , Barbero Giulio J. , Bartram John Bowman , Bost Roger B. , Dickinson David G. , Garrard Sterling D. , McMahon Jean L. , Scott Roland B. , Shard Austin R. , Weil William B. , Green William T. , Kennedy Charles , Koch Richars , Browder J. Albert , Gallagher James J. , Halpern Daniel 
Published: December 2021

Bronchial asthma is a chronic pulmonary disorder, frequently allergic in nature, and characterized by paroxysms of dyspnea, wheezing, tightness in the chest, and bronchospasm. Asthmatic attacks may be minor and short in duration with little discomfort, or they may be very severe and of long duration, producing the characteristic picture of intractability. During symptomatic periods, it is usually possible to demonstrate changes in certain aspects of pulmonary function. With mild symptoms or between the episodes of severe asthma, the individual may be at little or no disadvantage in any or all activities. However, when the symptoms of pulmonary distress become severe or prolonged, this may lead to interruption of the child's daily routine, including school attendance. Occasionally, such children may become home or hospital bound for long periods of time.
Between the two extremes of no symptoms and severe asthma, there is a spectrum of respiratory or pulmonary disability—the nature and severity of which requires that each child receive individual consideration and evaluation in the matter of his daily activity. The outlooks for the control of asthma in children has been improving during the past several decades. However, with the increase in population, there is an increasing number of children who require medical management for this disorder. It is a leading medical cause for school absenteeism and probably contributes to inefficient school work because of chronic fatigue, irritability, decreased attention span, and secondary emotional disorders.
There is general agreement among physicians that most children with bronchial asthma should attend regular school since, when under proper control and with no residual pulmonary defect the child needs no special facilities.
DEATH RITUAL
Authors: Aries Philippe 
Published: December 2021

Death in the hospital is no longer the occasion of ritual ceremony, over which the dying person presides amidst his assembled relatives and friends. Death is a technical phenomenon obtained by a cessation determined in a more or less avowed way by a decision of the doctor and the hospital team. Indeed, in the majority of cases the dying person has already lost consciousness. Death has been dissected, cut to bits by a series of little steps, which finally makes it impossible to know which step was the real death, the one in which consciousness was lost, or the one in which breathing stopped. All these little silent deaths have replaced and erased the great dramatic act of death, and no one any longer has the strength or patience to wait over a period of weeks for a moment which has lost a part of its meaning.
From the end of the eighteenth century [there has been] a sentimental landslide . . . causing the initiative to pass from the dying man himself to his family . . . Today the initiative has passed from the family, as much an outside person, to the hospital team. They are the masters of death—of the moment as well as the circumstances of death.
Nasopharyngitis and Prolonged Sleep Apnea
Authors: Steinschneider Alfred 
Published: December 2021

The effect of nasopharyngitis on the simultaneous occurrence of prolonged sleep apnea (≥20 seconds in duration) was studied in 26 infants managed at home on an apnea monitor. During the observation period, these infants had a total of 69 illnesses which appeared to represent an upper respiratory tract inflammatory process. In general, the daily frequency of prolonged apneic episodes was significantly greater during nasopharyngitis when compared to comparable time intervals immediately prior to and following the illness. In addition, there was a decrease in the frequency of apneic episodes with increasing postnatal age until the episodes finally ceased to occur during the illnessreleted intervals. Apneic episodes ceased to occur at an earher age for the before- and after-illness intervals than for the time interval during which there were clinical symptoms. Thus, it would appear that infants go through an agerelated phase wherein prolonged apnea occurs during nasopharyngitis but not when free of illness.
The implications of these results for the management of infants having prolonged sleep apnea are discussed. In view of the hypothesis that prolonged sleep apnea is part of the physiological process resulting in the sudden infant death syndrome, these results also provide for the prediction that infants who suddenly die in association with nasopharynqitis would do so, in general, at a later age than those who succumb when free of an upper respiratory tract inflammatory tory process.
Adverse Reactions to Iodide Therapy of Asthma and Other Pulmonary Diseases
Authors: Yaffe Sumner J. , Bierman C. Warren , Cann Howard M. , Cohen Sanford N. , Freeman John , Segal Sydney , Soyka Lester F. , Weiss Charles F. , Ballin John C. , Done Allan K. , Del Prato Pierre S. , Farchione Louis , Kretchmer Norman , Oakley Godfrey , Sawchuk Steven , Scott C. P. , Simopoulos Artemis P. , Chudzik Gregory 
Published: December 2021

Neonatal deaths from tracheal obstruction caused by congenital goiters have been reported from such widely scattered locales as Buffalo, New York, New York City, Philadelphia, Washington, D.C., Seattle, Tokyo, Japan, and Glasgow, Scotland. The mothers of these infants had asthma and were receiving conventional doses of iodides, either as potassium iodide or as mixtures of bronchodilators and iodides. Because of these deaths, the Committee on Drugs of the American Academy of Pediatrics has reviewed the use of iodides in the therapy of asthma and other chronic pulmonary diseases.
Five current textbooks advocate the use of iodides in chronic asthma.1-5 "Iodide compounds have a stimulating effect on bronchial secretions and represent expectorants of major importance in treating asthma and particularly status asthmaticus."2 The AMA Drug Evaluations6 recommends the use of iodides only for short-term medication. Current Pediatric Therapy7 emphasizes careful patient selection because only an occasional patient may benefit.
Dosage recommendations usually are 300 mg of potassium iodide every two hours in adults1 and 60 mg per year of age four times daily in children.4 These dosage recommendations are many times greater than the 65 mg of organic iodine (T4 and T3) which the average human thyroid gland delivers to the circulation per day, or the estimated daily adult iodide requirement of 200 mg of iodide.8 As a matter of fact, these recommended dosages for iodides represent 10 to 30 times the total body content of iodide!
Many preparations–some of which are available on an over-the-counter (nonprescription) basis–contain iodides, including antiasthmatic preparations, expectorants, and preparations whose trade names may not suggest the presence of iodides.
When Does Hydranencephaly Develop?
Authors: Bachman David S. 
Published: December 2021

Koffier, et al.1 report a case of hydranencephaly following polycythemia in a newborn infant. In their report, the authors speculate that the elevated hematocrit level in the newborn period may have led to cerebral infarction and liquifaction, with the baby then presenting 54 days later with hydranencephaly.
There are a couple of problems with this speculation based on the information presented in the case report: (1) It is well recognized that a hydranencephalic baby can have a normal neurologic examination, as well as a normal head circumference and, thus, may be completely missed in the newborn nursery.
Bacteremia in Children: An Outpatient Clinical Review
Authors: McCarthy Paul L. , Grundy Gordon W. , Spiesel Sydney Z. , Dolan Thomas F. 
Published: December 2021

In a 20-month period, 1,783 children seen in the pediatric outpatient department had blood cultures performed and 117 (6.5%) of these children had bacteremia. Two thirds of the isolates were Diplococcus pneumoniae and Hemophilus influenzae b. Ninety-three percent of children with H. influenzae b bacteremia and 20% of children with pneumococcal bacteremia had soft tissue involvement at the initial visit. Most children with positive blood cultures (102) were previously well and beyond the newborn period and many (46) had seemingly trivial illnesses initially: upper respiratory tract infection, fever of unknown origin, otitis media, and diarrhea. In the absence of soft tissue infection, the latter three diagnoses correlated best with bloodstream invasion.
Nineteen children had persistent bacteremia and five developed soft tissue complications not noted initially.
Two factors, age between 7 and 24 months and temperature between 39.4 and 40.6 C, showed increased specificity for bacteremia but were sensitive only for pneumococcal disease. A temperature of ≥ 40.5 C showed more specificity for bacteremia than lesser fevers. A white blood cell count &gt; 20,000/cu mm was poorly sensitive, and pulmonary infiltrates were neither specific nor sensitive for positive blood cultures.
Five bacteremic children had aseptic lymphocytosis in the cerebrospinal fluid.
Two days of intravenous antibiotic therapy and eight days of oral therapy were adequate for pneumococcal bacteremia without soft tissue involvement. This therapy may not be ideal, however, since other routes and duration of therapy were not evaluated.
Current Trends in Pediatric Urology
Authors: Woodard John R. , Belman A. Barry , Miller Harry C. 
Published: December 2021

With 29 papers presented before the Urology Section (Washington, D. C., October 18 to 23, 1975), the annual meeting of the American Academy of Pediatrics is rapidly becoming the major forum for pediatric urology in this country. The content of this year's papers highlights much of what is current in this growing subspecialty. The topics discussed largely fell into three major categories, i.e., genitourinary anomalies, problems relating to or resulting from obstructive uropathy, and genitourinary neoplasms.
ANOMALIES OF THE GENITOURINARY TRACT
Hypospadias and cryptorchidism are two of the most common genital anomalies. Following his excellent movie on embryology of the male external genitalia, C. J. Devine presented a series of 200 consecutive patients with hypospadias surveyed for associated anomalies. Over one fourth of these patients had other birth defects, some multiple. Hernia, hydrocele, and cryptorchism were commonly associated anomalies. Of particular importance, he found that 16 of 160 (10%) of the patients so examined had abnormal excretory urograms (IVP). Over one half of the pyelographic abnormalities were surgical lesions such as hydronephrosis and vesicoureteral reflux. On the basis of this extensive experience Dr. Devine recommended that all patients with hypospadias undergo excretory urography.
In managing the child with no palpable testes, S. D. Levitt and his associates pointed out that bilateral cryptorchism is much more common than anorchia but that surgical exploration, unless extensive, has not proven completely reliable in making the differentiation. They proposed a test whereby the presence of a functioning testis might be determined prior to exploratory surgery, thereby possibly avoiding the need for such surgery.
Dr. Holliday Replies
Authors: Holliday Malcolm A. 
Published: December 2021

The only valid grounds for concern about fluoride intake in early infancy is the low fluoride content of human milk, which is cited in my letter and presented as clearly as possible.
Obviously, a number of infants have been fed water with fluoride and no discernible harm has resulted. The evidence favoring the fluoride intake after six months is compelling and a reference has been cited.
I hope this information is helpful.