bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE BACTERIOLOGY OF THE URINE IN INFANTS AND CHILDREN WITH GASTROENTERITIS
Authors: Pryles Charles V. , Lüders Dieter 
Published: December 2021

A bacteriologic study of samples of urine from 41 patients (27 infants and 14 children) with acute gastroenteritis and with diarrhea as a symptom was carried out.
Clean-voided urine samples from 22 of the 27 infants (less than 2 years of age) with diarrhea contained fewer than 10,000 organisms per milliliter; in 2 cases in which the counts were between 9,000 and 10,000, catheter samples obtained simultaneously were sterile. Three of the five infants with more than 10,000 organisms/ml of cleanvoided urine had fewer than 140 organisms/ml in catheter samples obtained at the same time; the remaining two had more than 100,000 organisms/ml and were presumed to have infection of the urinary tract.
Of the 14 children (over 2 years of age), 13 had fewer than 1,000 organisms/ml of clean-voided urine. The remaining one had more than one-million organisms/ml from both a clean-voided and catheter sample and was presumed to have infection of the urinary tract. Of the 41 patients with diarrhea, 3 (7%) had a significant bacteriuria (i.e., more than 10,000 organisms/ml of urine in infants, and more than 1,000 organisms/ml of urine in children), and were considered to have an infection of the urinary tract. It is of interest that each of these three patients had specffic gastroenteritis; one had a gastroenteritis due to Shigella sonnei, and two had an infection due to pathogenic enteric strains of Escherichia coli (055 and 0111); all three were girls, 1 month, 12 months and 7 years of age. Thus, 3 of 16 patients (19%) with specific gastroenteritis had bacteriologic evidence of infection of the urinary tract. Urine cultures for the three girls revealed organisms other than those isolated from cultures of stools.
The significance of the finding that only those patients with specific gastroenteritis were found to have a true bacteriuria and then only in girls, and that urine cultures in those patients with a true bacteriuria revealed organisms other than those isolated from the stool specimens is not clear and deserves further study.
The relationship of acute gastroenteritis to the pathogenesis of renal infection is discussed briefly, and consideration is given to the possible role disturbance in acid-base equilibrium may play in the pathogenesis of renal infection.
SEVERE REACTIONS TO LONG-ACTING SULFONAMIDES
Authors: Rallison Marvin L. , O'Brien John , Good Robert A. 
Published: December 2021

Long-acting sulfonamides, represented by sulfamethoxypyridazine and sulfadimethoxine, appear to share toxic potential with other sulfonamide derivatives. Serious, often life-threatening, reactions have been reported in 35 patients receiving sulfamethoxypyridazine, with six deaths.
Erythema multiforme exudativum was observed in one child receiving sulfamethoxypyridazine and one receiving sulfadimethoxine. A disease resembling lupus erythematosus was observed in a girl treated for a long period with sulfamethoxypyridazine. Evidence of lupus disappeared when the drug was withdrawn.
The reversible nature of the observed case of lupus erythematosus supports the postulate that lupus is a disease resulting from an abnormal reactivity of a constitutionally abnormal reticuloendothelial system to the challenge of various environmental agents.
THE PHYSICAL DEVELOPMENT OF CHILDREN
Authors: Falkner Frank 
Published: December 2021

In the title of this essay the traditional partner of development—growth—is missing. We have been taught that growth refers to the multiplication of cells and size changes, while development concerns the maturation of such structures and their concomitant functions. Today we realize that the whole process—call it what you will—is extremely complex and a mass of processes interacting upon each other. Because, in addition, there is no dividing line between the two terms, it seems desirable to drop an unnecessary and rather false division and use but one of the two good words.
PART I. A GUIDE TO THE INTERPRETATION OF GROWTH-CHARTS AND DEVELOPMENT ASSESSMENTS
The pediatrician is confronted today with many aspects of development. Are babies who are fed two different regimens growing comparably? Is a patient receiving steroids being stunted? Or does an anabolic hormone hasten epiphysial closure to the extent that it causes premature arrest of growth? Before interest can be taken in such questions, and in the problems of identifying true disturbances in developmental patterns, the basic principles of human development, of present methods, and the resources available must be critically reviewed.
The pediatrician and his ancillary colleagues may well be overwhelmed by the quantity of data, charts and grids concerning growth that have appeared in the last 20 years. This is not surprising and not the fault of physicians. It is perhaps an irritating fact that development and its allied problems cannot be discussed without a basic, simple knowledge of biometiy. The reader can be assured that the knowledge he requires is not complicated and will stand him in good stead in many branches of his scientific art.
DISTURBANCES OF WATER AND ELECTROLYTES IN INFANTILE DIARRHEA
Authors: DARROW DANIEL C. , PRATT EDWARD L. , FLETT JAMES , GAMBLE ALICE H. , WIESE HILDA F. 
Published: December 2021

Balances of water, nitrogen, chloride, sodium, potassium, phosphorus and calcium are reported in eight cases of diarrhea.
Average deficits/kg. in severe dehydration due to diarrhea are H2O, 125 gm.; Cl, 9.2 mM; Na, 9.5 mM; and K, 10.4 mM. These figures may be about 10% too high for H2O, Na and Cl because of overexpansion of extracellular fluids in some cases.
These findings, especially the approximately equal retentions of Na and Cl during recovery, indicate 1. that intracellular Na is slightly high during dehydration in many cases; 2. that NaCl without NaHCO3 should suffice to restore all deficits of Na and Cl; 3. that acidosis is explained chiefly by deficit of K which leads to transfer of extracellular Na into the cells during dehydration; 4. that fluids used to replace deficits of H2O and electrolyte in diarrhea should contain K as well as Na and Cl; 5. that administration of NaHCO3 without potassium salts so as to restore rapidly the concentration of serum HCO3 in acidosis is likely to aggravate the abnormality in cellular composition and may produce alkalosis and low concentration of K in serum.
Losses of H2O as sweat are frequently 50 ml./kg./day; the maximum measured was 100 ml./kg./day. Losses of H2O in stools are frequently 50 ml./kg./day; maximum measured was 85 ml./kg./day. Nitrogen losses are rapidly replaced when milk feedings are instituted even at low caloric intakes. In the development of dehydration, losses of water in sweat are quantitatively as important as losses in stools.
Relation of these findings to treatment of infantile diarrhea is discussed.
PANCREATIC ENZYMES: NORMAL OUTPUT AND COMPARISON OF DIFFERENT METHODS OF ASSAY
Authors: VÉGHELYI PETER V. 
Published: December 2021

Serial analyses of duodenal juices of 47 children were made by parallel estimations with different methods of amylase, trypsin and lipase assay for studying normal conditions and to establish a common denominator which would, independently from the method of estimation used and from the enzyme in question, indicate the normal or pathologic character of the findings. On the basis of more than 1,200 determinations it is proposed to take the lowest values recorded as 100% and to express any value below these figures as their fractions in per cent.
No differences of importance could be found between the enzyme values of different age groups and there were certainly no variations in the lipase levels.
No periodicity could be observed in the output of enzymes. Fluctuations occurred but these showed no periodicity and it could be proved that they were due to dilution of the pancreatic juice by bile. Fasting secretion continuously occurred in these healthy children and the amount of enzymes put out was constant in units of time.
A strict parallelism in the output of the three enzymes was observed in all the present cases. This holds true also following stimulation by pilocarpine and inhibition by atropine and whatever variation occurred happened simultaneously with each enzyme.
Six children were given unbalanced diets to determine whether the production of enzymes is adapted to the food given. The changes found during and after the diets could by no means be connected with the type of food eaten.
It is emphasized that all the above data were found in healthy and normal children and that the conditions described are thoroughly different in most pathologic conditions.
ESSENTIAL FATTY ACIDS IN PREMATURE INFANT FEEDING
Authors: Combes Mollie A. , Pratt Edward L. , Wiese Hilda F. 
Published: December 2021

The weight gain, caloric intake, and serum levels of total fatty acids, dienoic, trienoic, and tetraenoic acids and cholesterol were measured in premature infants fed to satiety on three diets identical in all respects except for the amounts of partially hydrogenated coconut and corn oil. The calories from fat were kept at 18% of the total, but Diet A6 provided 0.01%, Diet B8 0.05%, and Diet C7 4.5% of the calories as linoleic acid. All infants appeared clinically well and gained regularly throughout the study.
Infants on the diet containing 4.5% of the calories as linoleic acid had a slightly better partial caloric efficiency ratio than that of the infants on the diet with 0.01% of the calories as linoleic acid. The serum lipid values in the infants fed the lower amounts of linoleic acid (lower amounts of corn oil) resembled those reported in experimental animals with recognizable essential fatty acid deficiency. The serum lipid values for the group receiving 4.5% of the calories as linoleic acid (also ingesting the largest amount of corn oil) approach those reported in infants fed human milk.
The significance of these observations to practical infant feeding is not clear until more is known concerning the inter-relationships of essential fatty acids and numerous other food substances in human nutrition.
AN EPIDEMIOLOGICAL INVESTIGATION OF A STREPTOCOCCAL AND RHEUMATIC FEVER EPIDEMIC IN DICKINSON, NORTH DAKOTA
Authors: Zimmerman Robert A. , Siegel Alan C. , Steele C. Patton 
Published: December 2021

Data have been presented relating 11 cases of acute rheumatic fever to a high prevalence rate of Group A streptococci in a population of school children in Dickinson, North Dakota. The majority of cases of rheumatic fever did not have a clear cut antecedent streptococcal infection which came to the attention of the examining physicians. Carrier rates for beta-hemolytic streptococci approached 50 to 60% on the initial survey, and rapidly diminished over a 6-week period. Approximately 60% of the Group A streptococci were typeable, and one-third of these were Group A, Type 5.
Convalescent antistreptolysin O titers obtained on a group of fifth grade school children, of two schools followed, clinically revealed significantly high titers above any described in previous civilian epidemiological studies but comparable to epidemic strains seen in the military. A virulent Group A, Type 5 streptococcus explosively spread through this community and undoubtedly was responsible for a high attack rate of rheumatic fever. Recommendation for civilian mass prophylaxis on the basis of the data obtained from this epidemic may be made for the first time.
Should All Newborn Infants Be Tested for Phenylketonuria?
Authors: NORDSTROM FRANK B. 
Published: December 2021

I have read the increasing spate of correspondence dealing with phenylketonuria.
It would seem that the writers have already assumed that universal testing of newborns is necessary and only ask how. I practice in a town of 20,000. In practical terms this means that I would probably test for this disease for a lifetime and discover one case. Would the vast expenditure of time and money be worth it? To carry the testing program further, why not test for mucoviscidosis with a routine sweat test?
Colic
Authors: HELLERSTEIN STANLEY 
Published: December 2021

This is written to call attention to urinary tract infections as one of the causes of the colic-syndrome in infants. Though many esoteric entities have been mentioned, neither the article by Clark et al. (Pediatrics, 31:65, 1963) nor others I've surveyed mention cystitis in the differential diagnosis of infantile colic.
During the past 18 months our two-man pediatric practice has encountered urinary tract infection as the cause of "colic" in three infants. In the first of these we had been aware of a very tense family situation from experience with the two older children.
Academy Recommendations and Public Health Regulations
Authors: HARVIE F. H. 
Published: December 2021

A recent communication (Pediatrics, 31:156, 1963) opens with a somewhat extended interpretation of comments from a previous letter of mine. If space permits, I should like to make some additional comments based principally on a few words from this same earlier letter: "Circumstances differ from one hospital to another."
The whole idea of wide spacing implies that a newborn infant presents considerable infectious risk to those in neighboring cribs. The degree of this risk will depend on the management of the maternity service as a whole and should be very small in any well-conducted unit.
HAS PSYCHOLOGIC MALNUTRITION TAKEN THE PLACE OF RICKETS AND SCURVY IN CONTEMPORARY PEDIATRIC PRACTICE?
Authors: Talbot Nathan B. 
Published: December 2021

WHILE MEDICAL HISTORIANS cannot provide us with accurate statistics concerning the incidence of rickets and scurvy in centuries past, they leave little room for doubt about the high prevalence of these disorders prior to the advent of modern scientific medicine. Thus, Castiglione has written that in the sixteenth century scurvy raged throughout northern Europe, in Scandinavia, on the shores of the Baltic, and in the interior of Germany. It is interesting to note, however, that Jacques Cartier, whose sailors had been ravaged by scurvy, learned in 1536 from the Indians that the malady could be cured by juices of the almeda tree. This was 200 years before James Lind demonstrated the curative effects of lemon juice in his treatise on scurvy published in 1753 and almost 400 years before ascorbic acid, which was isolated by Szent-Gyorgi in 1928, was recognized to be vitamin C by Waugh and King in 1932.
Rickets, likewise, was occurring in a large portion of children prior to the discovery of the existence of vitamin D by Hess, Steinbock, and Windaus in 1918, of its therapeutic value by Mellanby in 1919, of the equivalent role of sunlight by Hess in 1921, and of the chemical composition of the vitamins by Windaus in 1922. But 200 years earlier Friedrick Hoffman had the answer to the control of this disease almost in hand. He attached much importance to climatic conditions as a factor in rickets, noting that if anything is specially powerful in producing this affliction, it is a surrounding atmosphere of cold foggy air. He cited as striking evidence of this the famous emporium of England, London, which he found to be specially apt to produce and foster this disease.
Unsuspected Bacterial Interference with Antibiotic Therapy
Authors: CANBY JOHN P. 
Published: December 2021

The problem of the recurrent streptococcal pharyngitis after apparently adequate antibiotic (especially penicillin) therapy has been a thorny problem which often plagues those in clinical medicine. Dr. Simon and Sakai are certainly to be congratulated for the very interesting paper on "Staphylococcal Antagonism to Penicillin Therapy Streptococcal Infection" (Pediatrics, 31:463, 1963). Perhaps this will help to solve this problem in clinical medicine.
I wish to point out that this may not be an isolated instance of staphylococcal interference with antibiotic therapy for what should be nonresistant organisms.
VINCRISTINE (LEUROCRISTINE) SULFATE IN THE TREATMENT OF CHILDREN WITH METASTATIC WILMS' TUMOR
Authors:   Writing Committee
Published: December 2021

Metastatic Wilms' tumor was temporarily controlled by vincristine (leurocristine) sulfate in 9 of 13 children. The responses to the drug were prompt, becoming apparent within 3 weeks in 75% of the patients. The duration of the responses was relatively short, however, being less than 2 months in half the group. No cross-resistance in antitumor effect with previously administered chemotherapy or radiotherapy was observed.
The vincristine was administered in "priming" doses for 5 days, and thereafter in weekly maintenance doses. Although some of the patients had two or more toxic manifestations, i.e., alopecia, nausea, vomiting, increased irritability, pain in the abdomen and in the jaws, disturbances of gait, and hematuria, only two patients required a temporary alteration of the dosage regimen. No deleterious effects upon the body weight or blood count of any of the patients were detected.
The potential usefulness of vincristine sulfate as a palliative treatment for patients with Wilms' tumor is discussed.
MECHANICS OF RESPIRATION IN BRONCHIOLITIS
Authors: Krieger Ingeborg 
Published: December 2021

Data on the pressure-flow-volume relationships in bronchiolitis were obtained by recording simultaneously tidal volumes and esophageal pressures per unit of time in 24 infants with bronchiolitis. All infants had acute pulmonary hyperinflation. The values for dynamic compliance were markedly decreased. The decrease is presumably caused by unequal ventilation at high respiratory frequencies and by the increased retractive force active in a previously normal lung at a high level of inflation. The mean tidal volume/m2 was lower and the mean minute volume/m2 higher than normal. Expiratory flow was rapid and expiration shorter than inspiration in most cases. The mean expiratory resistance was lower than the mean inspiratory resistance and below normal when compared with the values of 24 normal infants. The mean combined resistance was in the normal range.
Judging from known anatomical changes in bronchiolitis, an elevated combined resistance had been expected. The finding of low values for resistance can be explained by Otis' theory of the "equality of time constants," i.e., when flow is rapid in a system of unequally obstructed airways, the measured resistance will approximate that in the larger airways. It thus appears that the measurement of resistance in the common pathway does in certain conditions not represent the true resistance in the peripherie, particularly not the resistance of the more severely affected branches.
It is suggested that the finding of a short expiratory phase is caused by the increased elastic recoil, which distends the airways at high lung volumes and consequently facilitates flow in those bronchioles which are only minimally involved by the disease process. Flow in the more severely obstructed bronchioles will decrease when a given pressure is greater than that necessary for maximal flow. It appears that the measured flow in the present cases with bronchiolitic pulmonary hyperinflation is not representative of over-all effective flow as indicated by the findings of paradoxically low values for resistance.
GROUP A STREPTOCOCCAL INFECTIONS IN A CHILDREN'S HOME
Authors: Moffet Hugh L. , Cramblett Henry G. , Black Joyce P. 
Published: December 2021

School-age children living in a children's home had pharyngeal cultures made on 485 consecutive infirmary admissions during a period of 14 months by inoculating the throat swab on the surface of a sheep blood agar plate. ASO titers were determined for the acute and convalescent phases of 95% of the 321 untreated illnesses associated with negative cultures. A rise in ASO titer occurred in 3.6% of these illnesses.
ASO titers were also determined on pairs of sera for 51 of 53 untreated febrile illnesses associated with negative streptococcal cultures in 1962 and a rise in ASO titer occurred for only one of these illnesses (2%).
This simple method for pharyngeal cultures is adequate and accurate as a laboratory aid to the practicing physician for the diagnosis of streptococcal pharyngitis in normal children. Bacitracin sensitivity showed an excellent correlation with Group A streptococci. Studies of duplicate swabs indicated that overnight storage of a dry swab at room or refrigerator temperature was associated with the recovery of more than 10 colonies of hemolytic streptococci from 80% to 88% of the swabs whose duplicates had more than 50 colonies.
SERUM ANTIBODIES IN STAPHYLOCOCCAL DISEASE
Authors: Quie Paul G. , Wannamaker Lewis W. 
Published: December 2021

Serum antibody titers to the staphylococcal Muller factor and alpha-hemolysin were determined in population groups of various ages and in maternal-cord serum pairs. There was evidence for placental transmission of antibodies and after 2 years of age most persons demonstrated antibody to both of these staphylococcal extracellular products.
Antibody titers in patients with staphylococcal lesions were usually in the upper range of those found in the normal population of similar age, but no striking or consistent elevation of titers was observed in association with or following staphylococcal disease. Exceptions, due in part perhaps to age, were found in patients with staphylococcal pneumonia whose sera often contained no measurable antibody and in certain patients with recurrent skin infection whose sera contained alpha-hemolysin antibodies but failed to demonstrate Muller factor antibodies. The general similarity of antibody titers in patients with staphylococcal lesions to those in normal persons suggests that the antibody response to staphylococcal Muller factor and to alpha-hemolysin is little different after a staphylococcal lesion than after nasal or cutaneous colonization. These findings emphasize that, in addition to antibodies to toxins, presently ill-defined cellular bactericidal mechanisms are necessary for complete defense against staphylococcal disease.
A Case of Spider Bite with Severe Hemolytic Reaction
Authors: MINTON SHERMAN A. , OLSON CHARLOTTE 
Published: December 2021

A 7-year-old boy developed a severe hemolytic reaction following a bite by a spider. A hemorrhagic and necrotic lesion developed at the bite. Although the arachnid responsible was not available for identification, the syndrome is typical of bites by spiders of the genus Loxosceles and quite different from that associated with bites or stings of other arthropods of this geographic region. A specimen of Loxosceles reclusa was later collected in the patient's house.
The mechanism of hemolysis and indeed the entire mode of action of Loxosceles venom is very little understood. Regarding a case they observed, Weiner and associates conclude, "It seems likely that the hemolytic system did not require participation of the patient's tissues in the production of antibodies." The Coombs test was negative in their patient but was positive in one case as reported by Nance. It was not done in the case reported here. Atkins et al. could not reproduce the massive hemolysis syndrome with Loxosceles venom in rabbits and guinea pigs, although intestinal and muscle hemorrhages were seen. The local necrotic lesions are readily produced in experimental animals. While reactions similar to the one reported here occur in only a small percentage of Loxoscles bites, they represent a potentially fatal complication. Therapy in this case was symptomatic and supportive except for administration of ACTH and prednisone before admission. These agents had no discernible effect on the course of the envenomation.