bluuebunny/crossref_metadata_2025_split huggingface dataset:
NUTRITIONAL REQUIREMENTS IN EARLY LIFE
Authors: Holt L. Emmett 
Published: December 2021

IN ACCEPTING the Borden Award I must say how deeply I appreciate this honor. One's efforts in the realm of science tend to have a somewhat jaundiced look in retrospect, but when someone else thinks they have merit it is very heartening. I have chosen the nutritional requirements of children for my topic, if only to show how little we know about it and how important it is to know more.
Why is it important to study nutritional requirements today? Isn't it true that infant feeding is a dead subject? Can't we feed a child today in a hundred different ways and have it thrive? That is certainly true of the normal subject in our own country. Food shortage is no problem. The problem of digestibility has been solved by a variety of processing techniques. We can supply the necessary nutrients with a wide margin of safety. We have no difficulty in meeting caloric and protein requirements, and vitamin deficiencies are almost a thing of the past. Why should we worry all out nutrition? The answer is, however, not hard to find. We may have mastered the problem of nutrition in health, but we have scarcely touched the problem of nutrition in disease. In the autopsy room we still see plenty of infants and children who are emaciated as the result of disease. Their nutrition has failed. If it could have been maintained the result might have been different.
Disease poses special problems for the nutritionist. It may affect the organs of digestion, assimilation and utilization, and thus limit the quantity of nutrients available to the body. It may impose limitations on particular types of food and, finally, it may impose special nutritive requirements. We are all familiar with the increased caloric demands made by fever and there is evidence, too, of an increased nitrogen requirement at this time. We are familiar, too, with the demineralizing effects of acidosis and with an increasing number of situations in which potassium losses from the cells need to be replaced.
THE INCIDENCE OF THE NEPHROTIC SYNDROME IN CHILDREN
Authors: Rothenberg Michael B. , Heymann Walter 
Published: December 2021

The results of a 5-year survey of the incidence of the nephrotic syndrome in children, in Ohio are presented. For the Greater Cleveland Area, with a total population of 1,500,000, there were 0.8 new cases per year per 100,000 total population and 6.9 new cases per year per 100,000 children aged 0 to 9 years; using an average duration of this disease of 2 to 5 years, there were 1.5 to 3.8 active cases per year per 100,000 total population and 13.8 to 34.5 active cases per year per 100,000 children aged 0 to 9 years. For the state of Ohio, with a total population of 8,000,000, there were 0.5 new cases per year per 100,000 total population and 2.3 new cases per year per 100,000 children aged 0 to 9 years; again using an average duration of this disease of 2 to 5 years, there were 1.0 to 2.5 active cases per year per 100,000 total population and 4.6 to 11.4 active cases per year per 100,000 children aged 0 to 9 years.
A nationwide survey of the incidence of the nephrotic syndrome in children has been attempted, using death rates as an indicator of incidence. A possibly higher, or at least equal incidence of this disease in non-white than white children was found. A higher incidence of this disease in both the white and non-white populations of certain southern states as compared to the North was noted.
Neurology and Psychiatry in Childhood
Authors: MACQUEEN JOHN C. 
Published: December 2021

The book Neurology and Psychiatry in Childhood records the proceedings of annual meeting of the Association for Research in Nervous and Mental Diseases. Thirty-four similar publications record the previous annual meetings of the Association. The decision to discuss so broad a theme as the neurologic and psychiatric problems of childhood determined that the topics presented at the meeting would be of wide variety.
A major portion of the book is devoted to a presentation of current thought concerning a variety of common neurologic problems of childhood.
PARENTERAL ADMINISTRATION OF RESERPINE IN THE TREATMENT OF HYPERTENSION DUE TO ACUTE AND CHRONIC NEPHRITIS
Authors: Daeschner C. William , Moyer John H. , Bell William R. , Clark John L. 
Published: December 2021

Parenteral administration of reserpine has been evaluated for its antihypertensive effect in normal subjects, in patients with hypertension due to acute nephritis and in a limited number of patients with hypertension due to chronic nephritis.
The greatest reduction in blood pressure was obtained in the patients with severe hypertension (diastolic 130 mm of mercury or greater) due to acute nephritis while patients with mild hypertension (diastolic blood pressure less than 110 mm of mercury) showed a less marked response. This has led to the designation of reserpine administered parenterally as an antihypertensive rather than a hypotensive agent.
Reserpine appears to be safe and effective for use in the hypertension associated with acute nephritis when given parenterally in doses of 80 to 150 µg/kg of body weight. In certain patients the hypertension is resistant to parenteral administration of reserpine and the addition of hydralazine may be necessary for ideal control of blood pressure. In our experience only rare patients have required combined drug therapy.
Patients with chronic nephritis and hypertension show a decrease in blood pressure with reserpine either parenterally or orally. However, in some patients the addition of a ganglionic blocking agent may be necessary to achieve ideal control of the patient's hypertension.
Renal hemodynamic studies show a decrease in renal function associated with acute reduction in blood pressure. This decrease is not marked and within an hour is usually followed by a gradual return of renal function toward normal.
GALACTOSE TOLERANCE IN GLYCOGEN STORAGE DISEASE
Authors: Schwartz Robert , Ashmore James , Renold Albert E. 
Published: December 2021

Observations on a 3-month old infant with hypoglycemia and hepatomegaly from hepatorenal glycogen storage disease are reported.
The diagnosis was based on analysis of the liver as well as typical clinical and laboratory findings. The liver histologically showed accumulation of glycogen and fat and biochemically was found to be deficient in glucose-6-phosphatase.
An oral galactose tolerance test resulted in lactic acidosis with failure to detect any galactose or rise in concentration of glucose in the blood.
An intravenous galactose tolerance test on two occasions resulted in the normal disappearance of galactose; however the concentration of glucose remained unchanged or declined, and that of lactate rose.
The intravenous galactose test offers a further means for evaluating the glycolytic pathways in the liver in glycogen storage disease.
CLINICAL CONFERENCE
Authors: Dorfman Albert 
Published: December 2021

Dr. Dorfman: The patient to be presented is a 9-year-old white female who was first admitted to Bobs Roberts Hospital on October 7, 1954. During a large part of her illness she was on the service of Dr. Klara J. Prec.
Her past history, family history, birth history and early development are not pertinent to the present complaint. The present illness is related to a disease that had its onset with fever and sore throat at the age of 4 years. Despite therapy with unidentified antibiotics, only poor recovery occurred. It was recognized a week later that she had anemia and an elevated erythrocyte sedimentation rate.
The patient was hospitalized in another hospital with a diagnosis of acute rheumatic fever. At this time she was treated with antibiotics and acetylsalicylic acid and after 4 weeks was discharged to her home.
After 1 week at home, her parents felt she was not doing well and the patient was admitted to La Rabida Jackson Park Sanitarium at that time. At the time of this admission in 1951, the pulse rate was elevated and a grade 3 systolic murmur was heard over most of the precordium. The heart was markedly enlarged as measured by roentgenogram. A throat culture was positive for beta-hemolytic streptococcus.
During the following 4 months she remained at La Rabida. The streptococcal infection was eradicated. She was treated intermittently with salicylates and had a steady, progressive improvement, so that at the end of this time she was discharged with no evidence of active rheumatic fever, but evidence of mitral insufficiency was present.
Six Children
Authors: KORSCH BARBARA 
Published: December 2021

Six Children is a book by a school psychiatrist who, in spite of rather extensive experience, has retained a very limited understanding and a rigid outlook concerning the emotional and psychological problems of children. She divides the problems she has encountered into six categories exemplified by the Six Children in the title:
1. The quick-thinking child.
2. The slow-thinking child.
3. The child whose brain has been injured.
4. The child maladjusted emotionally.
5. The child of unusual cultural background.
6. The child of unusual training.
GENETICS AND HUMAN CONGENITAL MALFORMATIONS
Authors: Neel James V. 
Published: December 2021

A BRIEF SURVEY of the vast subject of "Genetics and Human Congenital Malformations" can scarcely be expected to be systematic. Accordingly, discussion of the subject will be limited to a series of more or less unrelated observations concerning genetics and the study of human teratology. The first portion of this discussion will be devoted to three general points concerning which there seems to be room for misunderstanding between the genetically and nongenetically oriented student of teratology. The latter portion of the discussion will be concerned with drawing attention to some general genetic approaches which may be profitable in specific areas. In approaching the material in this fashion, familiarity with the current status of work on human teratology is assumed. It is further assumed that the principal reason for this Conference on Teratology is to consider useful lines of attack on outstanding problems in this area.
It is important at the outset to establish the fact that, from the genetic point of view, human malformations are a very "mixed bag" indeed. At the one extreme there are malformations which have a clear-cut and relatively simple genetic basis. Many of the skeletal malformations, such as the relatively benign brachydactyly or polydactyly, or the more serious ectrodactyly (split hand) or acheiropodia, fall into this category. At the other extreme there are a few malformations, such as tracheo-esophageal fistula1 which thus far have not been demonstrated to show a noteworthy tendency to concentrate in particular families. The majority of congenital malformations fall into neither of these extremes, showing clearly statistical tendencies to occur in certain families, but in these tendencies not following any simple pattern.
PEDIATRICS AND ECONOMICS
Authors: SISSON WARREN R. 
Published: December 2021

WHETHER we like it or not, we must admit that we are living and working in a period of basic changes in the economic aspects of the practice of medicine. There was a day when the physician could make his visits on a completely individual basis and charge as much for his services as he considered appropriate. His bills were entirely between himself and his patients.
But today an increasing number of physicians are finding themselves participants in one or another of the many medical care plans which are spreading rapidly throughout the country. A great variety of plans are being developed by public welfare agencies, health departments, non-profit organizations, medical societies, unions, cooperatives and other groups. Under the provisions of these plans the physician must abide by certain regulations directly affecting his practice and the fees he is entitled to collect.
The growth of the Blue Shield plans for voluntary medical care insurance has been phenomenal and is now so rapid that it is impossible to state accurately from day to day the number of their subscribers. A recent estimate indicates that there are 48 plans with more than 7,000,000 subscribers. In fact Blue Shield seems to be on the way to catching up with Blue Cross, which now has some 30,000,000 subscribers.
Other plans are testing different methods of providing service. One of the most notable of these is the Maryland Medical Care Program, which was established by legislation in 1945 providing that the State Department of Health should administer a program of medical services for indigent and medically indigent persons. Under the provisions of this plan county health officers have assumed administrative responsibility for this program of medical services; physicians are paid directly by the State Treasurer in accordance with a fixed fee schedule.
Panel Discussion
Authors: CLIFFORD STEWART H. , BAIN KATHERINE , HERBOLSHEIMER HENRIETTA , TISDALL FREDERICK F. , ALDRICH C. ANDERSON , WEGMAN MYRON E. 
Published: December 2021

Well established principles for the care of premature infants include constant and competent nursing care, maintenance of satisfactory environment, prevention of infection and provision of proper nutrition.
Implementation of these principles is based on specific standards for care, which cover physical facilities, equipment, qualifications and duties of personnel.
There is need for community-wide integrated programs which will insure care that meets these standards, for every premature infant. Programs should include establishment of specialized centers to provide care meeting all standards, and facilities to train personnel both in and outside these centers; decentralized training and guidence in areas other than the centers; complete case-finding and provision for transportation; adequate follow-up; services of public health nurses and social workers. Cooperation, central planning and acceptance of responsibility by health departments, medical schools, private physicians and community agencies are all essential to success.
THE TREATMENT OF TETANUS
Authors: HARRIS RUTH C. , MCDERMOTT THOMAS F. , MONTREUIL FERNAND L. 
Published: December 2021

The cases of two patients with tetanus have been presented in detail. One patient was severely ill and the other moderately so. Both were treated with large doses of antitoxin, curare, penicillin and sulfadiazine, tracheotomy and sedation. In the first case, sodium pentothal was used for continuous sedation for 15 days, supplemented with paraldehyde, chloral hydrate and sodium phenobarbital. In the second case sodium pentothal was needed only during the first three days of illness. Both patients recovered.
Sodium pentothal was chosen because of its prompt action when given by vein, minimal toxicity to the liver, and noncumulative effect. Some degree of tolerance was noted and other sedatives were added to supplement its effect.
D-tubocurarine chloride (Squibb) in wax and peanut oil (1 cc. = 30 mg. or 175 units) was given intramuscularly daily to aid in diminishing peripheral irritability and to supplement the sedative effect. A clear-cut evaluation of its beneficial effect is impossible because of the small series of cases and the number of other agents hitherto untried in this disease.
Tracheotomy was used in these patients, prophylactically to prevent fatal laryngospasm, and therapeutically to provide an adequate airway and exit for accumulated thick gelatinous secretions. Few reports of its use in this disease have appeared in the literature. It was felt that it greatly benefitted these patients. Adequate, regular aspiration of the tracheotomy tubes was found to be mandatory while the patients were severely ill and while deep sedation was required. It was found that positive pressure oxygen could be administered through the tracheotomy tube for respiratory arrest while under curare and pentothal sedation. A simple apparatus for this purpose is presented.
POLIOMYELITIS IN FAMILIES ATTACKED BY THE DISEASE
Authors: WENNER HERBERT A. , TANNER WILLIAM A. 
Published: December 2021

A study has been made concerning the presence, and persistence of neutralizing antibodies to poliomyelitis virus in six individuals. Five individuals had poliomyelitis; the remaining subject was a familial contact.
Neutralizing antibodies do appear in the serums of patients convalescent from poliomyelitis. In this study neutralizing antibodies, as a rule, appeared during the first ten days of illness. There is the suggestion that these antibodies appear rapidly, quickly reach their highest level, and that there is little if any fall in titer during the ensuing year.
The neutralizing antibody titer may not reach a high level in a considerable number of patients.
Round Table Discussion
Authors: BLATTNER RUSSELL J. 
Published: December 2021

Chairman Blattner: During recent years, there has been increasing interest shown in diseases caused by filterable viruses, and significant work has been accomplished in this comparatively new and absorbing field of endeavor. With the advent of chemotherapeutic agents and antibiotics, the presence and action of these infectious agents has become more apparent. Viral diseases, therefore, have assumed increasing importance in medical literature in general and in pediatric literature in particular.
By way of review, it is well to bear in mind that viruses are filter-passing agents, obligate intracellular parasites, capable of reproducing themselves and of producing disease in plants and animals, including man. While these agents cannot be seen except by the most elaborate methods, their presence can be detected by their injurious effects.
The pathologic picture produced by viral agents is rather characteristic and can be recognized readily by experienced observers acquainted with tissue response. In some instances, inclusion bodies are produced which may be intranuclear or intracytoplasmic, and represent cytologic changes which are considered typical of the pathologic response to viral invasion. When inclusion bodies are present they may serve as sign posts for the recognition of the type of infectious agent.
The nature of a filterable virus is as yet unknown. Viruses may be a form of life similar to bacteria, but infinitely smaller in size. It is conceivable that viruses are enzymes capable of reproducing themselves and capable of producing cellular response. They may be non-living, crystallizable substances, such as the Stanley tobacco-mosaic virus; or a form of life, the definite nature of which is as yet unrecognized. Dr. Thomas M. Rivers has stated : "Viruses are a heterogeneous collection of diverse agents which happen to induce a state of broad similarity." He points out that the reaction of the tissues in general, and of the cells in particular, determines the nature of the pathologic process about as much as the infectious agent itself.
THE ABSORPTION OF OILY AND AQUEOUS PREPARATIONS OF ESTER AND ALCOHOL VITAMIN A BY NORMAL CHILDREN AND CHILDREN WITH VARIOUS DISEASES
Authors: MCCOORD AUGUSTA B. , KATSAMPES CHRIS P. , LAVENDER C. FRED , MARTIN FREDERICK J. , ULSTROM ROBERT A. , TULLY ROBERT H. , KEENAN ALICE J. 
Published: December 2021

A study was made of the absorption of aqueous and oily preparations of ester and alcohol vitamin A by normal subjects and by patients with various diseases. The oily preparations used were the Abbott product (containing 210,000 I. U. ester vitamin A/gm.) and the Borden product (210,000 I. U. alcohol vitamin A/gm). The aqueous preparations used were: "Vifort Special" (60,000 I. U. alcohol vitamin A/gm.); Vi-Syneral Vitamin Drops (7,000 I. U. alcohol vitamin A/gm.); "Zymadrops Special" (10,500 I. U. ester vitamin A/gm.).
When seven normal children ingested 14,000 I. U. vitamin A/kg. of body weight in the form of aqueous "Vifort Special" or the oily Borden or Abbott products, the maximum concentration of vitamin A in serum was found three to four hours after the ingestion of "Vifort Special" and four to five hours after the oily products. In most cases "Vifort Special" produced somewhat higher concentrations. The vitamin A in the serum tended to remain elevated longer after the oily products. We did not find the striking difference in the absorption of the oily and aqueous preparations of vitamin A in favor of the aqueous reported by other investigators. This seemed to be due to the fact that we used relatively concentrated oily vitamin A products containing 210,000 I. U./gm., while they used oleum percomorphum containing 60,000 I. U./gm.
Four hours after ingestion of 7,000 I. U. vitamin A/kg. body weight in the form of the oily Abbott ester product the mean I. U. vitamin A/100 ml. serum for 35 normal newborn infants, 13 older children and 12 adults was, respectively: 502, 1,569 and 1,300. After ingestion of the oily Borden alcohol product, the corresponding values were, respectively: 688, 817 and 1,273. The absorption of vitamin A by the newborn infants was very variable while the older subjects absorbed both products well.
After oral administration, 13 children with cystic fibrosis of the pancreas absorbed only small amounts of the Abbott ester product but absorbed the Borden alcohol product well, while seven children with celiac disease showed poor absorption of both products. Therefore a comparison of the absorption of concentrated oily preparations of ester and alcohol vitamin A is an aid in the differential diagnosis of these two diseases.
Since patients with cystic fibrosis of the pancreas, anemia, diarrhea, giardiasis, severe malnutrition and some acute conditions absorb alcohol vitamin A in oil much better than the ester in oil, it is suggested that the alcohol form of vitamin A in oil or in an aqueous dispersion or emulsified ester vitamin A would be effective sources of vitamin A in the proper nutrition of these patients.
Patients with celiac disease, intestinal ulcers and certain other diseases absorbed both oily and aqueous products poorly. Other patients showed excellent absorption of the various aqueous and oily products.
PRIMARY PULMONARY HYPERTENSION
Authors: Rosenberg Harvey S. , McNamara Dan G. 
Published: December 2021

A case is reported of a 4-month-old infant in which the outstanding clinical features were failure to gain weight, cough, and progressive dyspnea. There was marked accentuation of the second pulmonic sound and no significant murmur. The electrocardiogram was interpreted as showing right ventricular hypertrophy and roentgenographically, there was unusual clarity of peripheral lung fields and prominence of hilar vessels. Cardiac catheterization demonstrated pulmonary hypertension and revealed no left to right intracardiac shunt. Anatomically, there was right ventricular hypertrophy and prominence of the medial layer of the small pulmonary arteries.
This vascular change is indistinguishable from that seen in the normal newborn and certain varieties of secondary pulmonary hypertension. Although the clinical diagnosis can be suspected, the definitive anomaly can be determined only at post-mortem examination.
CHÉDIAK-HIGASHI SYNDROME
Authors: Donohue W. L. , Bain H. W. 
Published: December 2021

An additional fatal case of Chédiak-Higashi's syndrome, occurring in the firstborn of a Canadian family, is reported.
The parents were not related and the mother has subsequently given birth to a normal healthy child.
The clinical features of the Canadian case were in all essential features similar to those reported by Chédiak and Higashi. The hematologic abnormalities were identical.
In addition to findings referable to the blood dyscrasia, the post-mortem examination disclosed a peculiar type of "encephalomyelitis," probably secondary to a chronic degenerative process.