bluuebunny/crossref_metadata_2025_split huggingface dataset:
PERNICIOUS ANEMIA IN AN EIGHT YEAR OLD GIRL
Authors: ROSENZWEIG LEONARD , BRUTON OGDEN C. 
Published: December 2021

A progress report on an 8 year old female diagnosed as "nutritional anemia" at 4 months of age is presented.
The patient's good response, both clinically and hematologically, to folic acid and vitamin B12 during relapse has been observed.
She now appears to fulfill all criteria for the diagnosis of pernicious anemia and because of its rare occurrence in childhood she is reported as an additional case of that disease.
ERYTHROBLASTOSIS FETALIS
Authors: ALLEN FRED H. , DIAMOND LOUIS K. , VAUGHAN VICTOR C. 
Published: December 2021

The prognosis of erythroblastosis fetalis has been studied in relation to maternal history, maternal titer of Rh antibody, and length of fetal gestation.
The outlook for recovery of the first Rh-positive infant born to a mother after sensitization to the Rh factor occurs is good. About 30% of such infants have no clinical disease. Few are stillborn.
Subsequent affected babies have a less favorable prognosis. Stillbirths become common (about 40%) and are related to the fact that the maternal titer is likely to be high throughout a large part of pregnancy. The authors have not seen a general tendency to increasing severity of erythroblastosis after the second affected baby.
The prognosis of erythroblastosis fetalis in live born infants is more closely related to maternal titer than to family history of affected infants, with high titers carrying increased risk of kernicterus.
Immaturity in a live born baby with erythroblastosis fetalis carries an increased risk of unfavorable outcome, particularly with respect to kernicterus.
POLIOMYELITIS
Authors: THELANDER HULDA E. , SEHRING MAXINE , SHAW EDWARD B. 
Published: December 2021

There is presented an analysis of the cases of poliomyelitis admitted to Children's Hospital, San Francisco, during a six year period in an effort to correlate this material with certain deductions regarding course, nature and the factors which affect the outcome.
This series does not constitute a completely valid cross section of northern California epidemics because the admissions were modified by age, economic status, by a somewhat higher proportion of females, and by the fact that, in general, more severe cases were referred to this hospital from outlying districts.
In addition to the physical traumatic factors which are generally admitted to be important in precipitating paralytic poliomyelitis, some evidence is introduced that systemic infections of unrelated etiology may provide a traumatic factor of comparable significance.
In the biphasic febrile course of poliomyelitis the initial period of fever is rarely a matter of hospital observation and proof is usually completely lacking that this initial fever is certainly due to poliomyelitis virus. This preliminary rise in temperature may very well be due to other infectious agents which serve to precipitate the onset of poliomyelitis.
There is much to indicate the considerable ubiquity of poliomyelitis virus among a population during an epidemic. In the absence of great exposure dosage, entrance of the virus into the body may frequently produce inapparent and completely latent infection which may be converted into active disease only by a variety of factors, including unrelated infections, which increase momentarily the susceptibility of the central nervous system of the host.
The value of pooled irradiated human plasma in therapy is admittedly not very great but seems to have a certain value. Statistical demonstration in support of this is almost impossible because of the fact that a weakly effective agent is applied in the treatment of an infection which has an extremely variable outcome.
This measure of treatment may displace the spectrum of outcome favorably without there being a great contrast in the statistical comparison of paralytic or nonparalytic outcome.
Nonparalytic poliomyelitis is generally believed to be of frequent occurrence. Unquestionably this is more frequent with the inclusion of patients in which the diagnosis is based on minimal and unconvincing evidence. If the diagnosis is restricted to those cases with very definite clinical and laboratory findings, only a small proportion will completely escape paralysis though this paralysis may be minimal, may be detected only by careful and repeated examination, and may disappear entirely before the end of the two week period of hospitalization.
ERYTHROBLASTOSIS FETALIS
Authors: VAUGHAN VICTOR C. , ALLEN FRED H. , DIAMOND LOUIS K. 
Published: December 2021

The clinical syndrome of kernicterus in erythroblastosis fetalis is reviewed.
Data are presented which indicate that there is a tendency for the familial occurrence of kernicterus in siblings. Kernicterus is shown to be directly related to the intensity of maternal sensitization, and to the degree of immaturity of the infant. It is more common in male infants than in female.
Evidence is presented that the occurrence of kernicterus in a baby with erythroblastosis fetalis cannot be accurately predicted on the basis of degree of clinical illness at birth, nor on the basis of laboratory examination of the baby's blood at birth.
The possible relationship of kernicterus to hyperbilirubinemia and to other predisposing factors in erythroblastosis fetalis is discussed.
STUDY OF ADOLESCENT CHILDREN INOCULATED WITH BCG IN EARLY INFANCY
Authors: LEVINE MILTON I. 
Published: December 2021

This study consists of a follow-up of 1165 adolescent children of whom 601 had been vaccinated with BCG during infancy. The remainder, 564, had been followed from infancy as controls.
Approximately 550 of these cases received roentgenographic examinations which were compared with RGs taken during the first 5 years of life.
As was to have been expected, roentgenographic evidence of healed lesions of primary pulmonary tuberculosis was found much more frequently in the control group than those in the group vaccinated by BCG.
Of the 298 vaccinated cases which received RGs there were three with evidence of a healed pulmonary primary complex. There were also two cases with re-infection tuberculosis of the lungs. Of the 286 controls, there were 27 showing evidence of healed pulmonary primary complex. There were no cases of re-infection tuberculosis in the control group.
A study of the three vaccinated cases which developed evidence of a healed primary pulmonary complex suggests that in two of the cases the BCG vaccine was weak or inadequate while in the third case the child has been exposed and was probably vaccinated in the pre-allergic phase of a human tuberculosis infection. Of the two vaccinated cases that developed signs of a re-infection tuberculosis in adolescence, it is evident in the first case that the allergy following a weak BCG inoculation subsided and the child received a subsequent exposure to open tuberculosis, later with the development of the re-infection tuberculosis. The second case with re-infection tuberculosis showed evidence of having lost the tuberculin allergy approximately three years after inoculation.
As yet no evidence is forthcoming on the ability of BCG vaccine given in infancy to diminish the tuberculosis mortality rate among adolescents and young adults. There were no tuberculosis deaths in either group.
It is evident that the BCG inoculation has the ability to prevent a pulmonary primary tuberculosis, at least during the period of postvaccination tuberculin allergy.
There is no evidence to indicate that BCG given in infancy is capable of preventing reinfection tuberculosis in adolescence. It is yet to be demonstrated that if the post-BCG tuberculin allergy is maintained the re-infection type of tuberculosis will be avoided.
It would appear from this study that there is great difficulty in determining the efficacy of BCG unless some method of maintaining the potency be devised and a standard accurate means of inoculation be used.
It is suggested by this study that the BCG tuberculin sensitivity be maintained by revaccination whenever the skin reaction becomes negative.
STUDIES ON PREMATURITY
Authors: STEINER MORRIS , POMERANCE WILLIAM 
Published: December 2021

The fatality rate of 791 liveborn premature infants delivered at the Jewish Hospital of Brooklyn during the five year period from 1941 to 1945 was investigated. The data were analyzed to determine the significance of fetal maturity and of magnitude of birth weight as factors influencing survival.
It was found that for a given weight group, the fatality rate varied inversely with the length of the gestation period. In other words, the outlook for the infant improved in proportion to the degree of its maturity. This was especially striking in the case of infants weighing less than 1500 gm., a result which served to emphasize the importance of length of gestation period as well as birth weight in predicting the chance of survival.
Premature infants born of multiple births had a lower over-all fatality rate than those born of single births. This was directly attributable to the greater maturity of babies born of multiple births.
VITAMIN E LEVELS IN TERM AND PREMATURE NEWBORN INFANTS
Authors: MOYER WINFIELD T. 
Published: December 2021

Evidence has been presented to show that:
1. The average vitamin E level in plasma or serum at birth is .23 mg./100 cc. with wide variations in both term and premature infants regardless of birth weight.
2. The average level of vitamin E in cord blood is equal to the average level of the infant's blood taken within the first 24 hours, although in any one case they may vary as much as 50% to 75%.
3. The vitamin E level in term infants appears to be higher after five days, averaging .36 mg./100 cc.
4. The vitamin E level in premature infants does not increase for two months. Between three and six months of age it increased to an average of .50 mg./100 cc.
Mucosal Enterokinase Activity in Pancreatic Insufficiency and Celiac Disease
Authors: Morin Claude L. , van Caillie Micheline , Roy Claude C. , Lasalle Roger 
Published: December 2021

Enterokinase (enteropeptidase, E.C. 3,4,4,8) converts trypsinogen into active trypsin and is a key enzyme in the digestion of dietary proteins. Its absence results in gross protein malabsorption.1
In the present study, jejunal biopsy specimens were obtained from children with cystic fibrosis (CF), celiac disease (CD), or congenital exocrine pancreatic hypoplasia (CEPH) and from control subjects. Sections were examined histologically and homogenates were used for measurement of enterokinase and sucrase activities.
This work was undertaken because enterokinase is considered a brush border enzyme,2,3 the release of which into the intestinal lumen is influenced by pancreatic enzymes,4,5 and also because we have recently shown a small bowel mucosal dysfunction in patients with CF.6
Dr. Gold Replies
Authors: Gold Arnold P. 
Published: December 2021

I certainly concur with the corrections noted by Drs. Soyka, Curless, and Walson. The original letter unfortunately gave the levels with percent signs, i.e., µg/ml%, and this was subsequently published as micrograms per 100 ml. Unfortunately, this error was not corrected prior to publication.
As correctly stated by Drs. Soyka, Curless, and Walson, the level should be micrograms per milliliter or milligrams per liter.
I must compliment those who picked up this error so rapidly; I have also received numerous personal communications regarding the problem.
THE MODERN CHILD AS VIEWED IN 1898
Authors: C. T. E. 
Published: December 2021

The editorial1 below, written in 1898, might well have been written today, although we would have to add the influence of television on the modern child of 1977.
To the student of sociology, one of the most notable features of the past few decades is the growing attention bestowed upon children. The thought now devoted to them would amaze our ancestors of three generations ago. Child-study has become one of great importance. Thousands of men and women are being trained in scores of normal schools for the one purpose of instructing young, for the work of a teacher is now believed to be one demanding extensive and peculiar education. Volumes are written annually for children and of children, while journals and magazines of the same character have increased a hundred-fold. The children are apparently considered a far more important factor in every household than they were fifty years ago. It is at least a fact that they receive more attention and are brought into much greater prominence. The average child of to-day has a score of toys where his grandfather had one. Many children are overburdened with them, and are less happy than they would be with a smaller number. The most contented and quiet children that the physician sees in his rounds are certainly not those with the most playthings.
We are far from criticising the general tendency to bestow more attention upon children and more thought upon their education and training, but it cannot be denied that the matter in many families is carried to a very injudicious extreme.
WHAT WILL BE THE END OF THE AMERICAN REPUBLIC IF AMERICAN WOMEN REFUSE TO BECOME MOTHERS?-AS VIEWED IN 1912
Authors: C. T. E. 
Published: December 2021

The editorial1 below appeared in the April 1912 issue of Pediatrics (N.Y.). Both the florid style in which it is written and the sentiments it expresses will seem antediluvian to most modern readers.
The majority of American women of today look upon maternity as undignified and a menace to a wife's liberty. They consider it an unwelcome invocation of duty and responsibility. So strong is this unhealthy sentiment prevalent in the rural districts, as well as in the Metropolitan centers that the gynecologist is eagerly sought and urged to do an operation which makes maternity impossible. If conception has occurred then these women seek a physician, devoid of moral obligation, and urge him to perform an operation which will rid her of the responsibility of motherhood.
The individual women is autocrat of her own decisions, but when she takes the vows of the marriage law, however broad or simple its words, there goes with this vow an injunction of motherhood. The woman who unites herself in marriage to a man and then refuses to be mother of his children unless there are moral, physical or hereditary laws-which cannot in justice to the unborn be propogated in the human race, has obtained a husband, a man to pay her bills, and to support and protect her through the subterfuge and methods of a common cheat. The man and woman unwilling to be father and mother to children are both unworthy of a place in Society and should not marry. Let their taints, whether of blood, or body or morals die with their own soul's death.
MEDICAL FALLIBILITY
Authors: Gorovitz  , MacIntyre  ,   Student
Published: December 2021

At present, the typical patient is systematically encouraged to believe that his physician will not make a mistake, even though what the physician does may not achieve the desired medical objectives, and even though it cannot be denied that some physicians do make mistakes. The encouragement of this inflated belief in the competence of the physician is of course reinforced by the practice of not keeping systematic and accessible records of medical error. Yet everyone knows that this is a false confidence . . . the current high incidence of iatrogenic illness constitutes a medical problem of enormous proportions, well recognized within government agencies and segments of the medical profession, but only dimly suspected by the public at large. There is still a relatively high probability of a patient suffering from medical error.
What patients and the public have to learn is to recognize, accept, and respond reasonably to the necessary fallibility of the individual physician. The physician-patient relationship has to be redefined as one in which necessarily mistakes will be made, sometimes culpably, sometimes because of the state of development of the particular medical sciences at issue, and sometimes, inevitably, because of the inherent limitations in the predictive powers of an enterprise that is concerned essentially with the flourishing of particulars, of individuals. The patient and the public therefore must also understand that medical science is committed to the patient's prospering and flourishing, and that the treatment of the patient is itself a part of that science and not a mere application of it.
Effects of Imipramine on Enuretic Frequency and Sleep Stages
Authors: Kales Anthony , Kales Joyce D. , Jacobson Allan , Humphrey Frederick J. , Soldatos Constantin R. 
Published: December 2021

Four children with a history of primary enuresis were evaluated in both the sleep laboratory and at home in a 68 consecutive-night protocol with successive conditions of 10 placebo-baseline nights, 27 drug (imipramine) nights, and 31 placebo-withdrawal nights. On the placebo conditions, two thirds of the enuretic events occurred during the first third of the night. Enuretic events occurred out of each sleep stage in approximate proportion to the time spent in that sleep stage for each third of the night. Thus, primary enuresis was found to be chiefly related to time of night and not any specific sleep stage such as stage 3 or 4 (slow wave) sleep.
Administration of imipramine in a manner simulating clinical use of the drug resulted in a marked decrease in overall enuretic frequency. The reduction of enuretic frequency was not related to the effects of imipramine on sleep stages. There was a reduction of enuretic events in the first two thirds of the night with an increase in enuretic events in the last third of the night. Also, with long-term drug administration, there was a significant increase in wakefulness in the last third of the night. These findings suggest that early in the night when sleep is deepest, imipramine decreases bladder excitability and/or increases the child's bladder capacity. This allows the child to continue to sleep without micturition and, later in the night when sleep is lighter, to be more aware of the stimuli from the bladder. Immediately following withdrawal of imipramine, enuretic frequency approximated baseline levels.
Administration of imipramine resulted in a moderate degree of rapid eye movement (REM) suppression. With long-term administration, there was a dimunition of the REM suppressant effect. Initial withdrawal of imipramine produced a marked REM rebound.
Classes of pediatric care
Authors: ROSS MAURICE 
Published: December 2021

Dr. Robert A. Hoekelman's commentary entitled “Primary Care: We Need All the Help We Can Get!” (Pediatrics 59:315, March 1977)raises some very important questions about the practice of pediatrics as a medical specialty.
Whether we like it or not, we must admit that there are different classes of pediatric care even in the health supervision of apparently well children. We are all familiar with well-child care as practiced by the qualified pediatrician. If we were to deny that the pediatrician who devotes his career to the care and study of children and adolescents cannot do this work better than
Comment on Intracranial Bleeding in Infants
Authors: SAMUELS DAVID , GRASSY RICHARD , ZACHMAN RICHARD D. 
Published: December 2021

To the Editor:
We read with interest the article by Deonna et al. entitled “Neonatal Intracranial Hemorrhage in Premature Infants,” reporting on 11 cases(Pediatrics 56:1056, December 1975). We have recently summarized the data on six similar infants in the neonatal intensive care unit at Madison, Wisconsin,and feel it is important to supplement the article of Deonna et al.
For better comparison with results of other newborn units, it would have been helpful if
Shouldn't SIDS Be Recognized?
Authors: BORGENICHT LOUIS 
Published: December 2021

To the Editor:
Dr. Wegman's article “Annual Summary of Vital Statistics-1974”(Pediatrics 56:960, December 1975) provides some valuable and interesting information.
There is, however, some disconcerting information in Table III,“Infant Mortality Rates by Age and Selective Causes for the United States, 1964 and 1974.” There is no specific listing for the major cause of infant mortality between 1 and 12 months of age: sudden infant death syndrome (SIDS). As Dr. Wegman suggests, “To be
Comment on Parent Education
Authors: KASH IRWIN J. 
Published: December 2021

To the Editor:
I congratulate Dr. Tomlinson on having educated his private patients so well, but I feel that his conclusions are unfairly biased against the inner-city patient (Pediatrics 56:1009, December 1975). If he would have chosen his private patient group from the practices of randomly selected physicians in his geographic area, the patients might not have been so accurately informed. It has been my experience that numerous physicians misguide patients with myths about tonsils,
Diet and Growth in Congenital Heart Disease
Authors: STEIER MOSHE , LOPEZ RAFAEL , COOPERMAN JACK M. 
Published: December 2021

To the Editor:
We read with considerable interest the article by Strangway and her colleagues (Pediatrics 57:75, January 1976). The authors concluded that “nutrient intake is not an important factor limiting the growth of children with congenital heart disease.” Children and infants with growth failure associated with congenital heart disease are not a homogeneous population. We feel that the foregoing conclusion does not apply to the child with more severe heart disease. The studies on
Challenges “Fact” Cited in Committee Report
Authors: AINBENDER EUGENE , BROWN EDWIN G. , SWEET AVRON Y. 
Published: December 2021

To the Editor:
The report of the American Academy of Pediatrics Committee on Nutrition that appeared in the February 1976 issue (Pediatrics 57:278, 1976)contains a statement that is not factual and may be misleading. The Committee states, “There is some clinical evidence suggesting that [the immune globulins of colostrum and early breast milk] provide protection from necrotizing enterocolitis.” They base that statement on a publication of Santulli et al.1 who presented no clinical findings
Nothing New Under the Sun
Authors: HURD ARTHUR H. 
Published: December 2021

To the Editor:
The interesting report by Dr. Lee et al. (Pediatrics 57:259,February 1976) truly confirms the adage that there is “nothing new under the sun.” It is of interest that the earliest of their ten references to congenital neuropathy with absence of pain sensation was the article of D. Denny Brown written in 1951.
I am enclosing a copy of Dr. H. L. Heyl's intern's summary of two admissions to the Infant's Hospital
Distribution of HLA-B27 in Patients With Juvenile Rheumatoid Arthritis
Authors: MITSUI HIROSHI , JUJI TAKEO , SONOZAKI HIDEKICHI , WATANABE NOBUO 
Published: December 2021

To the Editor:
Lately there has been extensive searching for an association between histocompatibility antigen (HLA) and specific disease. Rachelefsky et al. demonstrated that HLA-B27 was found in 42% of all juvenile rheumatoid arthritis patients examined.1 Gibson et al. showed the frequency of this1 phenotype was 16%.2 These reports stimulated us to examine whether a similar relationship could be demonstrated in Japanese patients.
Twenty-four HLA antigens were examined in 181 normal Japanese controls and in
Intractable Diarrhea and the Colon
Authors: MICHEL MARIO VILLA , MARTUSCELLI ALFONSO 
Published: December 2021

To the Editor:
Dr. Lebenthal et al. (Pediatrics 56:585, October 1975) establish enterokinase deficiency and reduced intraluminal trypsin as a contributing factor to intractable diarrhea. The concomitant decrease in disaccharidase activity in the presence of blood in the stools, however, strongly suggests pathology in the colon.
Such has been our experience in over 30 children who had prolonged diarrhea which consistently showed mucus and blood in the stools.1Rectosigmoidoscopic examination revealed small bleeding ulcers, petechiae,