bluuebunny/crossref_metadata_2025_split huggingface dataset:
Night Breast-Feeding and Dental Caries
Authors: Abbey Louis M. 
Published: December 2021

It is of concern to some dentists and pediatricians lately that at-will nocturnal infant breast-feeding has been implicated as a cause of a dental caries pattern1,2 similar to "nursing bottle" caries.3
I submit that not a shred of valid scientific evidence exists supporting the contention that the practice of nighttime, at-will breast-feeding promotes dental caries in young children. Studies examining the incidence of dental caries in primitive cultures, where demand breast-feeding including at-will nighttime nursing is the norm4 and children are not usually weaned until 18 months to 3 years, continually report extremely low caries rates among the children.5-7
Ontogeny of the Local Immune System
Authors: Ogra Pearay L. 
Published: December 2021

The classic studies of Tomasi and his colleagues' in early 1960s demonstrated that the predominant class of immunoglobulin in various external fluids was of IgA class, although it is a relatively minor immunoglobulin in serum. These observations represent the foundations of the earlier concept of the secretory immune system. Subsequent studies conducted during the last decade have made it clear that in addition to IgA, other immunoglobulin (IgM, IgE, IgG), components of T-cell-mediated immunity and other nonimmunologic factors are also present in significant amounts in the external mucosal secretions.2,3 Thus, the current concept of the local (secretory) immune system includes the secretory IgA, other immunoglobulins and cell-mediated immune reactivity. The local immune system is referred to the complex mechanisms of specific immunity existing on the external mucosal surfaces and which appear to operate somewhat independent of the immune function in other systemic sites in man and most other mammalian species. The local immune system includes the bronchus associated lymphoid tissue (BALT), gut associated lymphoid tissue (GALT), and the immunocompetent cell or organized lymphoid follicles in the conjunctiva, salivary glands, and upper respiratory tract, genitourinary tract and mammary glands.4-6 A number of publications3,4 have extensively reviewed the development and function of the secretory immune system. In this report, an attempt will be made to provide an overview of the more recent developments in the mechanisms of local immunity.
SECRETORY IMMUNOGLOBULINS
Structure of Secretory IgA
The bulk of the IgA immunoglobulin in external secretions exist as a complex molecule which consist of three immunologically distinct components: (1) a dimer of two 7 S IgA molecules, (2) the J (joining) chain, and (3) the secretory component (SC).
Cellular (T Cell) Immunity in the Human Newborn
Authors: Stiehm E. Richard , Winter Harland S. , Bryson Yvonne J. 
Published: December 2021

The cellular immune system of the human newborn, like the rest of the immunologic apparatus, is anatomically intact, antigenically inexperienced, and functionally deficient. The latter is suggested by the newborns' enhanced susceptibility to infection, diminished delayed cutaneous hypersensitivity reactions, and selective abnormalities (when compared to adults) of measures of cellular immunity in vitro. These include impaired proliferative response to ubiquitous antigens, depressed lymphotoxin, migration inhibition factor, and immune interferon production, and diminished cytotoxic reactions including cell-mediated lympholysis. By contrast, other aspects of neonatal T cell function, such as to mitogens or allogeneic lymphocytes, natural interferon and leukocyte inhibition factor production, and number and percentage of E-rosette-forming cells are generally normal.
These decreased functional properties may provide an explanation for the newborns' susceptibility to infection and for the occasional occurrence of engraftment of foreign cells from either the mother or from prenatal or neonatal blood transfusion.
Rickets
Authors: Lovinger Robert D. 
Published: December 2021

Rickets is a disease of growing children. Historically, its winter prevalence and its occurrence among children confined to sunless sweat shops and smog-ridden cities during the industrial revolution implicated insufficient exposure to sunlight in its etiology.1-3 Despite the discovery of the anti-rachitic action of cod-liver oil more than 200 years ago, rickets remained a serious health problem until the early part of the 20th century when the identification, isolation, and finally almost ubiquitous addition of vitamin D to our food supply soon rendered conventional rickets a disorder of mere academic interest. Recently, however, a slow increase in the incidence of rickets in children with a variety of medical problems including renal tubular disorders, illness requiring chronic hemodialysis, cystic fibrosis, and as a complication of anticonvulsant therapy has been noted. Thus, the reappearance of rickets in new, more subtle forms, necessitates increased physician awareness of its incidence and its pathogenesis.
CALCIUM AND PHOSPHORUS HOMEOSTASES
Fundamental to the pathophysiology of rickets are calcium and phosphorus homeostases.4 Calcium plays a central role in many body functions and is an important cofactor in muscle contraction, neural transmission, enzyme activity, blood clotting, and other cellular processes. Calcium exists in a number of body pools of varying exchangeability or availability for immediate use. The nonexchangeable calcium pool includes the bones, which contain approximately 99% of the body's calcium, and certain body proteins to which it is tightly complexed. The rapidly exchangeable pool is made up of either ionized or loosely complexed calcium, present both in the body fluids and within individual cells.
CHARLES DICKENS DESCRIBES HIS IMPRESSION OF THE CHILDREN AT THE PERKINS INSTITUTION FOR THE BLIND
Authors: C. T. E. 
Published: December 2021

In his American Notes, published in 1843, Dickens vividly described his six months' visit to the United States between January and June 1842. None of the public institutions that he visited made a more favorable impression on him than the Perkins Institution for the Blind, located in Boston.
He wrote:
I went to see this place [the Perkins Institution] one very fine winter morning: an Italian sky above, and the air so clear and bright on every side, that even my eyes, which are none of the best, could follow the minute lines and scraps of tracery in distant buildings. Like most other public institutions in America, of the same class, it stands a mile or two without the town, in a cheerful, healthy spot; and is an airy, spacious, handsome edifice.
The children were at their daily tasks in different rooms, except a few who were already dismissed, and were at play. Here, as in many institutions, no uniform is worn; and I was very glad of it, for two reasons. Firstly, because I am sure that nothing but senseless custom and want of thought would reconcile us to the liveries and badges we are so fond of at home. Secondly, because the absence of these things presents each child to the visitor in his or her own proper character, with its individuality unimpaired—not lost in a dull, ugly, monotonous repetition of the same unmeaning garb, which is really an important consideration.
The wisdom of encouraging a little harmless pride in personal appearance even among the blind, or the whimsical absurdity of considering charity and leather breeches inseparable companions, as we do, requires no comment.
Excellent Outcome of Bacteroides Meningitis in a Newborn Treated with Metronidazole
Authors: Law Barbara J. , Marks Melvin I. 
Published: December 2021

Hydrocephalus has developed in all three reported cases of Bacteroides fragilis meningitis in newborns.1-3 One author suggested this complication was related to the documented persistence of Bacteroides in the CSF despite chloramphenicol therapy.3 In two of the cases metronidazole was tried late in the course, followed by prompt clinical and bacteriologic resolution.1,3 We report a newborn with B fragilis meningitis in whom metronidazole was used early, with rapid sterilization of the CSF, clinical cure, and no sequelae after 12 months of follow-up.
CASE REPORT
A 2,020-gm white male infant was delivered vaginally at 32 weeks gestation to a healthy primigravida, 52 hours after premature rupture of membranes.
Noonan's Syndrome: A Historical Perspective
Authors: Cole Roger B. 
Published: December 2021

Pediatrics and fine art do not often cross paths, but such an example seems to have occurred with Noonan's (pseudo-Turner's) syndrome and a famous painting by Ivan Le Lorraine Albright.
In 1968 Noonan first described the syndrome that bears her name.1 These patients have characteristic facies: ptosis, antimongoloid palpebral slant, broad flat nose, webbed neck, as well as a high arched palate and malformed ears. They are usually of short stature and frequently have congenital heart disease, most often pulmonic stenosis secondary to a dysplastic valve with or without an associated shunt at the atrial level. Pectus excavatum, cubitus valgus, undescended testes, and impaired mental development are commonly found.
Questioning Diagnosis of Kawasaki Disease
Authors: Leggiadro Robert J. 
Published: December 2021

The diagnosis of Kawasaki disease should be made only if certain diagnostic criteria, including the exclusion of other known disease processes,1 are met. Slovis et al (Pediatrics 65:789, 1980) present four cases in their article regarding the use of sonography in the diagnosis and management of hydrops of the gallbladder occurring in Kawasaki disease. I do not believe the data reported for the first patient satisfactorily exclude the diagnosis of acute rheumatic fever.
The physical signs of a pericardial rub, large pericardial effusion, and gallop rhythm satisfy the requirements for the major manifestation of carditis in the modified Jones criteria scheme.
Letters to the Editor
Authors: Weitzman Michael , Lamb George A. 
Published: December 2021

We would like to commend Fallot et al1 on their recent article attempting to demonstrate yet another advantage of breast-feeding, " ... that exclusively breast-feeding during the first three months of life significantly reduces the incidence of infections that ultimately require hospitalization of infants."1 Unfortunately, the data presented do not really add substantial support to the notion that breast-feeding reduces the incidence of hospitalization for infection.
What the authors have accomplished, (if their method of identifying exclusively breast-fed infants by chart audit of hospital clinic, inpatient, and private physician medical records is reliable and valid in this regard) is to demonstrate that breast-feeding and lower rates of hospitalization for infection in the first three months of life are statistically associated.
Letters to the Editor
Authors: Cromer M. , Collard S. B. 
Published: December 2021

Fallot et al1 report fewer hospitalizations among breast-fed infants.
Since breast-feeding has been correlated with socioeconomic status,2 we believe caution should be exercised in interpreting this finding. Previously documented factors may be involved, eg, parental cigarette smoking,3 crowding,4 bottle propping,5 or numerous other variables as suggested in Sauls' thorough analysis.6
Close examination of Fallot's Table 1 fails to support the implication that breast-feeding had any beneficial effects among the "clinic" patients. Application of the X2 test to this group of patients shows no significant effect to be associated with breast-feeding (P &gt; .5).
Blood Pressure Study
Authors: Gillum Richard F. 
Published: December 2021

de Swiet and colleagues (Pediatrics 65:1028, 1980) are to be congratulated on their excellent study of systolic blood pressure in infants which supplies much needed data. I would like to make two important points, however, regarding this valuable study.
1. The authors have excluded for technical reasons approximately one third of the readings at age 6 months, and something over 5% at 1 year, thus opening the possibility of substantial bias in the reported data, particularly at the 6-month point.
Annual Summary of Vital Statistics—1979: With Some 1930 Comparisons
Authors: Wegman Myron E. 
Published: December 2021

It seems fitting that in June 1980, concurrent with the celebration of the 50th anniversary of the American Academy of Pediatrics, the provisional infant mortality rate for the preceding 12-month period should have reached 12.8, the lowest point in US history.3 For calendar 1979, as shown in Table 1, the rate was 13.0, 6% below the rate for 1978. As to the other major vital indices, births and birth rate were up, as had been predicted, and so were both marriages and divorces. Total deaths were fewer and the crude death rate was down.
ACCURACY OF HISTORICAL DATA
Since the 50th anniversary calls for some historical references it is important to note some of the shortcomings in US data for 1930, the year of the Academy's founding, and for prior years.
Competitive Athletics for Children of Elementary School Age
Authors: Schaffer Thomas E. , Coryllos Elizabeth , Dyment Paul G. , Flynn Thomas G. , Luckstead Eugene F. , Smith Nathan J. , Strong William B. , Van Rooy Clemens W. , Baker Frederick W. , Burkett Lucille , Levison Henry , Malacrea Richard 
Published: December 2021

Competitive sports sponsored by schools or other community agencies are now so universally played by boys and girls 13 years old and younger that there is a compelling need for positive and realistic guidelines to govern participation.
Young children are not miniature adults; they are boys and girls in the process of maturing into adults. They seek and can profit from suitable play opportunities, but the benefits do not come without prudent planning. High quality supervision and a broad range of physical education activities, including sports adapted to the needs and capacities of growing children, are required for a full realization of benefits.
A sound physical education program includes a variety of competitive and recreational sports to guarantee that all children in the school system or community have a fair share of available funds, facilities, instruction, and leadership. A varied sports program provides a meaningful experience for all children, not just the physically gifted, the well developed, or the precocious.
Sports have important effects on stamina and physiologic functioning, and some have lifelong value as recreational activities. These positive aspects should be emphasized in athletic programs by encouraging sports that are appropriate for children of elementary school age. These sports include bowling, golf, skating, swimming, tennis, and running.
There is no physical reason to separate preadolescent children by sex in sports, physical education, and recreational activities. However, girls should not participate against pubertal and postpubescent boys in heavy collision sports because of the risk of serious injury due to their lesser muscle mass per unit of body weight.
Biochemical Aspects of Urea Cycle Disorders
Authors: Snodgrass P. J. 
Published: December 2021

In this paper I will review the biochemistry of the urea cycle of mammalian liver and point out the important clinical implications of this biochemistry. Second, I will consider some problems that arise in the use of human liver enzyme assays for evaluating deficiencies of urea cycle enzymes. Finally, I will comment on our own research concerning enzyme induction of the urea cycle of mammalian liver.
In Fig 1 the urea cycle is reviewed. Within the mitochondrion of the liver cell, ammonium cation combines with bicarbonate anion and 2 moles of adenosine 5'-triphosphate (ATP) in the presence of an activator, N-acetylglutamate, to form carbamylphosphate. Enzyme 1, which carries out this reaction is carbamylphosphate synthetase I (CPS1). There is also another enzyme, CPS2, in the cytoplasm of liver cells about which more will be said later. Once carbamylphosphate is formed, the carbamyl group is transferred to the δ-amino group of ornithine to form citrulline. The enzyme in this reaction, enzyme 2, is ornithine transcarbamylase (OTC). Citrulline escapes, by a process other than active transport, into the cytoplasm where it is conjugated with aspartate to form argininosuccinate; this is accomplished by enzyme 3, argininosuccinate synthetase (AS). Argininosuccinate, a double amino acid, is then cleaved to yield fumarate, and the nitrogen of aspartate moves to arginine. The enzyme in this reaction, enzyme 4, is argininosuccinate lyase (AL); its trivial name is argininosuccinase. Finally, arginine undergoes cleavage of its ureido group by enzyme 5, arginase, to form urea and regenerate ornithine. Ornithine is then taken up into the mitochondria by an active transport process to combine again with carbamylphosphate.
Clinical Aspects of Disorders of the Urea Cycle
Authors: Snyderman Selma E. 
Published: December 2021

SYMPTOMS
All of the defects of the urea cycle may result in the accumulation of ammonia. This is manifested clinically by episodes of vomiting, lethargy, seizures, coma, and ultimately in death if the hyperammonemia is not controlled. In older children these symptoms may be preceded by a period of irritability and hyperactivity. It has usually been considered that the severity of the hyperammonemia depends on the site of the block; the nearer it is to ammonia, the greater the accumulation. There are, however, exceptions, as hyperammonemia leading to neonatal death has been observed in arginino-succinate lyase deficiency,39,40 the fourth step in the cycle. Death due to hyperammonemia has been observed in all the defects except arginase deficiency.41-43 There are variations in the severity of the clinical course of all of these syndromes; the exact reason for this has not been ascertained, although it is quite possible that this is related to the degree of residual enzyme activity. Thus, carbamylphosphate synthetase deficiency has been associated both with death in the newborn period or survival without specific treatment but with physical and mental retardation for a number of years.42-44
The clinical features of ornithine transcarbamylase deficiency have been the most completely described.45,46 As this anomaly is inherited as a sexlinked dominant, males are most severely affected, and neonatal death has been almost universal.13 Males who have survived without the most vigorous treatment have had a variant of the disease,47,48 the enzyme having different kinetic properties. Females who have various degrees of residual enzyme activity usually do not manifest symptoms until sometime after the neonatal period, often in response to some stress.
Pneumocystis
Authors: Meuwissen Hilaire J. 
Published: December 2021

The authors of "Pneumocystis carinii Pneumonitis in Young Immunocompetent Infants" (Pediatrics 66:56, 1980) are to be congratulated on the development of a rapid test for demonstrating circulating antigens of Pneumocystis carinii and its application to the problem of pneumonia in young infants.
However, their statement "The findings of this prospective study clearly indicate, however, that P carinii is also etiologically linked to pneumonitis in young immunocompetent hosts without underlying illnesses" is open to challenge.
The study infants were between 2 and 12 weeks of age.
Letters to the Editor
Authors: Stagno Sergio , Pifer Linda L. , Hughes Walter , Brasfield Dana M. , Tiller Ralph E. 
Published: December 2021

Because of the prospective nature of our studies we have had the opportunity to examine a total of 19 patients with pneumonitis associated with Pneumocystis carinii antigenemia. In order to respond to Dr Meuwissen's comments we elected to analyze the data from the total group rather than from the original nine.
Two previous studies clearly show that at least 75% of presumably healthy children and adult blood donors have antibody to P carinii. This infers that infection occurred early in life.
Complete Blood Cell Counts and Infection
Authors: Karniski Walt 
Published: December 2021

I remember reading Todd's article1 as a medical student and feeling that he had simplified medical practice considerably, by "proving" that a complete blood cell count (CBC) could accurately distinguish between any child with bacteremia and a child with a viral illness. The article by Baron and Fink2 brought that memory to mind again, and therefore necessitates words of caution.
When considering the efficacy of a test, it is helpful to consider a two-by-two table as follows, in which the Baron and Fink data are presented:
PRESIDENT OF YALE ASSAILS AS ‘EXCESSIVE’ US REGULATIONS ON RESEARCH
Authors: L. J. F. 
Published: December 2021

A. Bartlett Giamatti, the president of Yale University has deplored the "mounting wave of regulation" and "requirements for massive amounts of paperwork" that he said Federal agencies heaped upon researchers supported by Government grants. Echoing a strong note of discontent voiced by many active in university-based scientific research, Mr Giamatti said "excessive or unthinking regulation" had damaged the relationship between government and universities. "There is a powerful resentment on all sides, and distrust," he told 500 people at the opening dinner of the annual Association of Yale Alumni assembly. "A radical skepticism bordering on open contempt for our centers of learning surfaces again."
Researchers at universities across the country have been protesting strongly against a government regulation, put into effect three months ago, that requires them to complete detailed "personnel activity reports" before they are reimbursed for "indirect costs"–overhead expenses–incurred during their work. Of $68 million Yale received in federal funds last year, Mr Giamatti said, $21 mfflion was for "indirect costs."
Under the new rule, researchers at Stanford University say they will have to complete 80,000 reports instead of the present 3,000, at a cost of between $250,000 and $300,000, Mr. Giamatti told the assembly, quoting from an article in Science magazine.
Critics also point to a 1968 Bureau of the Budget report evaluating time and effort reports when the original A-21 regulation, written in 1958, was revised in 1967 to include these reports. "Time or effort reports now required of faculty members are meaningless and a waste of time," the 1968 report says.
BCG VACCINE
Authors: BEAVEN PAUL W. 
Published: December 2021

It is evident that the time has arrived when pediatricians in this country should have expert advice on the use of BCG in the control of tuberculosis in children. Other parts of the world are now confronted with an increase in this disease. They are establishing programs to resist this infection, and their respect for the value of BCG is attested to by the fact that its use forms a major part of such programs. Physicians returning to America from these countries are advising us to accept this additional technic in our attempt to eradicate tuberculosis.
This symposium is the result of many requests from our members. In order to obtain divergent viewpoints, four speakers have been chosen whose opinions each of us respects but who have come to different conclusions.
Dr. J. A. Myers is the first speaker. He has spent his professional life in combatting tuberculosis in children and young adults. Following him, Dr. Sol Roy Rosenthal will speak. He is Director of the Tice Laboratories affiliated with the University of Illinois. This institution is one of the main distributors of BCG in this country. The next speaker is Dr. Milton Levine, Chief Consultant on BCG vaccination to the New York State Health Department. The concluding paper on the symposium will be given by Dr. Robert Anderson, Chief Medical Director, Division of Tuberculosis, of the U. S. Public Health Service.