bluuebunny/crossref_metadata_2025_split huggingface dataset:
ROCKY MOUNTAIN SPOTTED FEVER WITHOUT A RASH
Authors: WARTHEN ROBERT ORR , BURDICK WILLIAM FOSTER 
Published: December 2021

An unusually severe case of Rocky Mountain spotted fever that failed to develop a rash by the eighth day of fever in spite of the delay in beginning specific chloramphenicol therapy until that time is reported.
Due to the absence of a rash the diagnosis was of necessity only presumptive when chloramphenicol therapy was begun. It was not definitely established until later, when the agglutination and complement fixation tests became positive.
Chloramphenicol effected a recovery within 48 hours of its initiation.
This is the first reported case of severe tick fever to survive eight days of symptoms without specific therapy and yet fail to develop a rash.
DEGENERATIVE CHANGES IN YOUNG DIABETIC PATIENTS IN RELATIONSHIP TO LEVEL OF CONTROL
Authors: JACKSON ROBERT L. , HARDIN ROBERT C. , WALKER GLENN L. , HENDRICKS ATLEE B. , KELLY HELEN G. 
Published: December 2021

The level of control, as well as the duration of the disease is an important factor influencing degenerative changes and good control will delay and possibly prevent degenerative changes.
Our present knowledge makes it not only possible but practicable to maintain a high level of control of diabetes in children living in a well adjusted home.
Until more knowledge concerning the treatment of childhood diabetes is available, a high level of control appears to offer the best means of averting or delaying chronic degenerative changes.
Additional knowledge is needed to understand the pathologic physiology of various levels of noncontrol.
An optimistic rather than a pessimistic outlook is warranted.
NATURAL HISTORY AND PATHOGENESIS OF MILIARY AND MENINGEAL TUBERCULOSIS IN CHILDREN
Authors: PERRY THOMAS L. 
Published: December 2021

In preparation for a program of treatment of miliary and meningeal tuberculosis with streptomycin and other antituberculous drugs, 163 consecutive cases admitted to the Los Angeles Children's Hospital in the 15 years between 1933 and 1948 were analyzed.
Twenty-one infants and children had miliary tuberculosis, 58 had tuberculous meningitis and 84 had both diseases. Of 145 patients who received only symptomatic treatment, all died.
The usual frequency of these diseases in the spring was not observed in this series.
Anergy to tuberculin was uncommon; only 2% of the patients reacted negatively to 1.0 mg. O.T.
Forty-eight per cent of the cases occurred before the age of 2 years, and two thirds before the age of 4 years. There was pathologic evidence that tuberculous meningitis occurs commonly within a few months of the primary infection; 82% of the autopsied cases showed evidence of fresh primary tuberculosis.
Vague symptoms such as vomiting, fever and lethargy were most common in early tuberculous meningitis and rarely stimulated a prompt diagnosis. Headache was a frequent complaint in children over 4 years, but was uncommon in those under 4 years. The average duration of life of patients with tuberculous meningitis from onset of symptoms to death was 20 days; the duration of symptoms until a correct diagnosis was made averaged over 11 days.
Caseous tuberculous foci antedating the meningitis were demonstrated in the central nervous system in 27 out of 70 cases in which careful pathologic examination was made. Thirty-five per cent of the autopsied cases of tuberculous meningitis had no acute hematogenous dissemination elsewhere in the body.
Hydrocephalus was found in 25 out of 80 brains examined and tended to appear early in the course of the disease.
Possible precipitating factors were found in the histories of 15% of the 163 patients.
Suggestions are made as to possible means of preventing the development of miliary and meningeal tuberculosis in infants and children and the need for prompt diagnosis and treatment is stressed.
THE WORRIES OF A GRIEVOUSLY ILL ENGLISH FATHER AS WRITTEN TO HIS CHILDREN IN 1794
Authors: C. T. E. 
Published: December 2021

The quotation below is an excellent example of the anxieties once faced by seriously ill parents in the days long before the existence of child welfare programs.
The thoughts of a hard usage which some poor, friendless children meet with from unthinking and unfeeling people, cannot but be matter of concern to every parent, under the prospect of leaving a family of dear infants in such a melancholy situation. They cannot but be under some concern for them, respecting things pertaining to their comfort in this life, in things that are only of a temporal nature; but still greater must be the concern of every pious and religious parent, respecting things of a spiritual nature! Where shall the dear children now find a friend who will watch over them in things that have reference to futurity? Since real religion, and the fear of God, is so very unfashionable, that people who are in real concern about it, are, with St. Paul, thought to be beside themselves. Who will be so singular as to take the pains to shew (sic) them their danger from sin, and their remedy a Saviour? Who will shew them the necessity of holiness, and carefully instruct them in all the branches of it? Who will direct them in the choice of their company with a parental tenderness and anxiety; kindly reminding them, as occasion requires, that "he that walketh with wise men shall be wise; but a companion of fools shall be destroyed." Who will diligently observe, and tenderly check in them the beginnings of bad habits, and considering that "the beginning of sin is as the letting out of water," which, if not early stopped, will soon prove unconquerable?
INEFFICACY OF FRESH FROZEN PLASMA THERAPY OF MUCOPOLYSACCHARIDOSIS II
Authors: Erickson Robert P. , Sandman Robert , Robertson William van B. , Epstein Charles J. 
Published: December 2021

Patients with Mucopolysaccharidosis II (Hunter's syndrome) were given short-term treatment with large infusions of fresh frozen plasma to evaluate recent claims of clinical and chemical improvement by such therapy. Clinical behavior, urine glycosaminoglycans, and skin, serum, and urine acid hydrolases were evaluated by single-blind techniques. There was no noticeable effect of fresh frozen plasma infusion on the performance of these patients. The total urinary excretion of glycosaminoglycans was not altered by the infusions and there was no change in the size of the glycosaminoglycan fragments.
The abnormal skin activity levels of β-galactosidase, β-glucuronidase, and N-acetylglucosaminidase were unaltered three days after fresh frozen plasma infusion and, similarly, the abnormal levels of these enzymes in the serum persisted without significant change during the ten days of evaluation.
ABO Hemolytic Disease, Complement, and Phagocytosis
Authors: Gordon B. D. 
Published: December 2021

The first reference for the letter "ABO Hemolytic Disease, Complement, and Phagocytosis" by Dr. B. D. Gordon (Pediatrics, 50:169, 1972) should read as follows:
1. Wang, M. Y. F. W., and Desforges, J. F.: Complement in ABO—hemolytic disease of the newborn. Pediatrics, 48:650, 1971.
SITE OF ACTION OF EXFOLIATIVE TOXIN IN THE STAPHYLOCOCCAL SCALDED-SKIN SYNDROME
Authors: Lillibridge Clinton B. , Melish Marian E. , Glasgow Lowell A. 
Published: December 2021

The purpose of this study was to demonstrate morphologic correlates of exposure of skin to exfoliative toxin derived from live phage group II staphylococci. Human infection with these staphylococci has been associated with scarlatiniform rash, generalized exfoliation, or bullous impetigo.
Histologically, the skin lesions in patients and animals injected with the exfoliative toxin appear indistinguishable. The characteristic change is an intraepidermal cleavage through the granular cell layer. Electron microscopically, this cleavage appears to result from disruption of otherwise normal attachment structures (desmosomes) through their intercellular contact area. This disruption may be related to disappearance of extracellular globules which are proposed possibly to contain proteolytic enzymes.
Letter to the Editor
Authors: DeHaven Kenneth E. 
Published: December 2021

We referred these questions to Dr. Kenneth E. DeHaven, Orthopedist of the Cleveland Clinic, Cleveland, Ohio, and to Mr. Creighton J. Hale, Vice President, Little League Baseball, Williamsport, Pennsylvania. Excerpts from their answers follow:
The risks of serious or permanent injury to the elbow are the same as for pitchers of any age, namely, medial tension overload, lateral joint compression syndromes, and extensor overload. In addition, the preadolescent pitcher runs the risk of medial epicondylar epiphysitis.
Behavior Modification by Drugs: The Need for Definitions
Authors: Johnsen Stanley D. 
Published: December 2021

Dr. Conners is to be credited with the initiation of a study into the clinical evaluation of the beneficial effects of various stimulant drugs used in the treatment of minimal brain dysfunction. Of particular value appears to be the comparison of the psychometric tests done before and after treatment. One, however, has to question critically the value of many of the statements that were made in evaluating a patient's response to drugs.
The author does not precisely define various terminology used in the study.
Brain Hypoxia (Clinics in Developmental Medicine No. 39/40), edited by J. B. Brierley and B. S. Meldrum. London: Spastics International Medical Publications, 1971, 320 pp., $20.00
Authors: Koenigsberger M. Richard 
Published: December 2021

This group of papers presented at the Carshalton Symposium on brain hypoxia is remarkable in being quite different from its sister volumes in the splendid British series of Clinics in Developmental Medicine. The papers are grouped under sections concerned with cerebral blood flow, electromicroscopy, biochemical approach to brain hypoxia, post-hypoxic brain swelling, atmospheric decompression, hypoglycemia, and epilepsy.
The result is a mixed bag; most of the papers do not deal directly with the effects of permnatal hypoxia, the subject of greatest interest to the pediatrician, neurologist, and pediatric neurologistxsx.
On alcohol burners and paper clips
Authors: Nelson Nicholas M. 
Published: December 2021

Those readers who tend to be titillated into reading articles whose titles include such eye-catching phrases as "a simple method" may well, at first, be disappointed in the contribution of Lister et al. elsewhere in this issue of Pediatrics. Surely, one feels appendices which assault our senses with such polysymbolic multiple equations as these must relate to a method more accurately described as formidable and, at best, academic-certainly not practical!
Now, a paper clip is, indeed, simple in concept and design-its functional application is self-evident. Yet, the engineer's calculations and mechanical drawings of the machinery which enabled production of such a basic instrument of civilized living are, no doubt, a good deal more complicated than Listers' illustrations and appendices.
Dr. Jean Astruc on the Vicious Conformation of the Froenum Linguae, or Bridle of the Tongue (1746)
Authors: C. T. E. 
Published: December 2021

In 1746 an English edition of lectures on diseases of children given by Jean Astruc (1684-1766) was published anonymously in London. Astruc, Regius Professor of Medicine at Paris, as well as Chief Physician to the King of France, had this to say about the management of the "tongue-tied" infant.
The tongue is naturally connected with the fund of the mouth by the help principally of the muscles, called Geniohyoidei, which are inserted on the fore part, under the point of the tongue, where we meet a duplicature of the skin which covers the mouth, forming the froenum linguae. This is sometimes so advanced under the tongue, that the point of this organ cannot be folded or turned back to perform it's necessary functions. Hence this is a disorder of vicious conformations. The midwives prudently anticipate the physicians or surgeon's advice in this case; for immediately after the child is born, whilst the ligament is still very soft and tender, they break its superfluous connection with the tongue by their nail; which if it be not timely done, or if the bridle is too rigid and hard to yield to this method, the nurse soon feels the inconveniency thereof, by the infant's manner of sucking; or it becomes manifest at last when he begins to speak, at which time as the bridle is harder, the operation or incision should be performed by the help of the knife, or, which will do better, by the scissars (sic), putting the patient in a proper and commodius (sic) situation.
Prediction of Hospitalization During Infancy: Scoring the Risk of Admission
Authors: Winter S. T. , Lilos Pearl 
Published: December 2021

A cohort of 5,243 live newborn infants in Haifa was followed to determine hospital admissions during the first two years of life. Parameters of the family and the neonate, routinely available at birth, were collected and studied in order to select those which would identify co-host infants with an increased risk of hospitalization during infancy. A total of 767 cohort children (14.6%) were admitted to hospital.
Multivariate analysis showed that many group factors are interrelated and therefore inconsistent. Six single independent factors predisposing to hospital admission could be defined (in order of decreasing significance): increasing birth order, male sex, poor education (up to four years of schooling), birth weight less than 2,250 gm, Jewish mothers born in Asia or Africa, and maternal age up to 24 years.
Numerical risk coefficients allocated to each of the above six single (multivariate) factors enabled the calculation of a predicted risk coefficient scoring the risk of admission to hospital. The use of a score predicted 43.3% of the total initial hospitalizations affecting 23.3% of the total cohort.
The allocation of health resources might be improved by the use of such a method of scoring to select families in need of special services.
Factors Influencing Length at Birth and Height at Five Years
Authors: Wingerd John , Schoen Edgar J. 
Published: December 2021

The net effects of various factors on length at birth and height at 5 years were determined in 3,707 single-born white California children. First-born children were significantly short at birth, but taller than average at 5 years. Children born to women with early menarche and children of older parents were average in birth length but taller than average at 5 years. Length and weight at birth showed significant correlations with height at 5 years. The child small at birth was most likely to catch up with his peers at age 5 if short gestation caused small birth size. Children of smoking mothers were short at birth and at 5 years.
Socioeconomic factors (income, education, and occupation) appeared to be of little importance as determinants of growth.
Of the total variation in height at age 5 years which is explained by the factors considered, parental height alone accounted for 88.6%; all other factors for 11.4%.
Pneumococcal Meningitis in Mother and Neonate
Authors: Tempest Bruce 
Published: December 2021

Recent reports have stressed several features of meningitis in the newborn period: high mortality rates despite antibiotic therapy, the absence of symptoms and signs of meningeal irritation and the frequency with which enteric bacilli are the causative agent. The observation that obstetrical complications increase the incidence of neonatal meningitis and that the majority of these infants develop their disease before the sixth day of life suggest that the infection is acquired during parturition.
The following case is of interest because of the unusual occurrence in both mother and infant of meningitis due to pneumococci, an organism which is an infrequent cause of meningitis in the neonatal period.
To Tap or Not to Tap in Convulsion (Free Will vs Damnation)
Authors: Lewak Norman 
Published: December 2021

Should all children with first febrile convulsions routinely receive lumbar punctures? This issue was raised by Dr. Kafa in a Letter to the Editor (October 1973) issue of Pediatrics. Dr. Menkes defended having such a rule by replying that "(clinical intuition) is not reserved for those physicians who have not yet acquired the ‘feel’ for a seriously ill child."
Dr. Menkes hopes that by making a rule (all children having their first febrile seizure must have a lumbar puncture), better medicine will be practiced.
Glaucoma in Infants and Children, by Marvin L. Kwitko, B.A., M.D., F.A.A.O., F.A.C.S., F.I.C.S., F.R.C.S.(C). New York: Appleton-Century-Crofts, 1973, 651 pp., $28.50
Authors: Walton David S. 
Published: December 2021

Less than 25 years ago the treatment of infantile glaucoma was considered hopeless. In the 1940s the goniotomy operation was established as a successful method of treatment for many patients. Since then the early recognition of congenital and infantile glaucoma to allow early treatment has become a pediatric diagnostic responsibility of great practical significance.
This book is the second textbook devoted to the pediatric glaucomas to be published within the last three years, and awareness of its arrival should at the least serve to remind pediatricians of the occurrence of these unusual disorders.
Pediatric Aspects: From the Embryo Through Adolescence: Special Susceptibility and Exposure
Authors: Lowe Charles U. 
Published: December 2021

It is a very special responsibility to open a conference with a title and mission as specific and important as this one. I would like to congratulate both the Academy and the Committee on Environmental Hazards for assuming the responsibility of bringing together professionals from a variety of disciplines to discuss an issue which is clearly of great and increasing importance to the children of our country.
My presentation will emphasize several themes. Perhaps the most important, other than the need to protect infants and children, is the need for research. And it is a need for research which targets on specific vulnerable populations in our nation. I perceive that those with responsibility at the Federal and even the state level attempt to look at the environment as it impacts upon the population of our nation as if it were a homogenized whole. Those of us who deal with infants, children, and adolescents know that, in fact, this is far from the truth. So, my first theme will be research with respect to specific groups of children.
The second theme is the need for professionalism and a broad attack on the issues. I think the need for professionalism becomes less important as disciplines become well established; as yet, environmental studies hardly constitute a discipline. It is thus exceptionally important that we recruit into studies on environmental issues those with broad and competent professional backgrounds.
Our knowledge of age-related responses to a variety of chemical agents comes largely through study of drugs.
Environmental Aspects: Problems and Priorities
Authors: Kotin Paul 
Published: December 2021

Man is increasingly creating most of his environment. In the process he has created significant hazards to his health. Some of the adverse effects are longstanding but related to rapid technologic change. There has been an accumulation of contaminants and waste products. Not only is population increasing, but there is also mounting per capita consumption. People continue to concentrate in urban centers. All these changes have greatly magnified the threats and complicated the problems of keeping adverse effects down to acceptable limits.
This Conference is specifically addressed to threats arising from chemical pollutants, with special emphasis on the susceptibility of the fetus and child. It would be misleading, however, to believe that discussions can be limited to these important segments of the population, inasmuch as adverse effects of chemical pollutants following exposure in utero and childhood may not become manifest until late in adult life.
Man's continued drive for material progress has produced many by-products and wastes, some of which are disadvantageous or clearly threatening to his health. A series of crises has resulted at a rapid rate from unforeseen consequences of environmental changes. Solution of these crises has been restricted by the traditional regard for the environment as a series of isolated compartments rather than as a highly integrated continuum of strongly interdependent factors. Multiple factors act singly or in combination, sequentially or simultaneously, in their threats to human health. Such threats occur, furthermore, through exposure to low concentrations of environmental agents over long periods of time and call for action on the basis of sound presumptive evidence well before overt disease is established.
Special Susceptibility of the Host to Chemical Agents: Endocrinologic Considerations
Authors: Gardner Lytt I. 
Published: December 2021

THYROID
The thyroid offers a diagnostic advantage over other endocrine glands in that its enlargement can be detected clinically (that is also true of the testis which, however, enjoys somewhat less visibility). It is no doubt because of this visibility of the thyroid that observations on its enlargement in association with environmental events go back for centuries. In addition to endemic iodine deficiency (the classical explanation for endemic goiter and endemic cretinism), there may be additional factors acting as chemical pollutants implicated in thyroid disturbances. The 1972 Kroc Foundation Conference on Endemic Cretinism established that endemic goiter and endemic cretinism are worldwide diseases affecting thousands of persons in such remote geographical areas as the Andes, the Brazilian state of Goiaz, the Himalayas, the mountains of New Guinea, and two separate areas in the Congo.1 The syndrome varies from locale to locale, presumably due to interacting environmental factors.
A study which might be taken as a model is that of DeLange and Ermans in Idjwi Island in the Congo.2 They found that the presence of excessive dietary intake of thiocyanate as a chemical pollutant interacted with dietary iodine lack to produce an unusual and severe form of endemic goiter and endemic cretinism. They found no goiter in their most severe cases of cretinism; the fetal thyroid had been totally destroyed in utero with early brain damage. Figure 1 depicts the two forms of cretinism found on Idjwi Island. This is a classic example of how a dietary lack (iodine) may set the stage for special susceptibility of the host to a chemical pollutant (thiocyanate).