bluuebunny/crossref_metadata_2025_split huggingface dataset:
RICKETS, DEFICIENCY OF "ALKALINE" PHOSPHATASE ACTIVITY AND PREMATURE LOSS OF TEETH IN CHILDHOOD
Authors: SOBEL EDNA H. , CLARK LELAND C. , FOX R. PHYLLIS , ROBINOW MEINHARD 
Published: December 2021

A child, studied between the ages of 1½ and 3½ years, presented an abnormally low plasma alkaline phosphatase activity (0.8-1.64 Bessey-Lowry u.), a deformed skeleton and the loss of most of her deciduous teeth. The serum Ca was normal; the serum inorganic phosphate remained at the normal relatively high levels of infancy as the child grew older Roentgenograms demonstrated deficient mineralization of the skeleton and teeth. Biopsies of the liver and the costochondral junction displayed a deficiency of tissue alkaline phosphatase activity. The architecture of the rib was consistent with rickets. There was no evidence for the presence of an inhibitor of alkaline phosphatase, such as beryllium, or for an excessive excretion of the enzyme. Treatment with purified growth hormone, ascorbic acid and thiamin chloride had no effect, while vitamin D 500 thousand u. caused little change in the enzyme activity in a 10 day period. The father had low plasma alkaline phosphatase activity and a number of similar patients are mentioned, for whom there was also evidence that the deficiency in alkaline phosphatase activity may be genetically determined.
While the precise role of alkaline phosphatase activity in the metabolism of bone is not clear, the findings in this patient suggest that growing bone may require the presence of alkaline phosphatase for normal calcification, and that the skeletal disorder, which could not be distinguished from rickets, may be related to a disturbance in the local factor.
EOSINOPHILIA-HEPATOMEGALY SYNDROME OF INFANTS AND YOUNG CHILDREN
Authors: MILBURN CONN L. , ERNST KENNETH F. 
Published: December 2021

Attention is directed to the existence of a recently recognized syndrome in infants and young children with the prominent features of chronic eosinophilia, hepatomegaly, liver biopsy findings of eosinophilic infiltrative and granulomatous lesions, a benign course, and occasionally symptoms and signs of transient pneumonitis.
An analysis of 15 reported cases with the syndrome is presented, including the report of a case due to an unidentified nematode larva, but probably Toxocara canis, invading the liver.
Signs and symptoms, pathology, pathogenesis, etiology, course and prognosis, and treatment are discussed.
Evidence is preponderantly in favor of the etiology in all cases being nematode larvae invasions of the liver and other viscera.
These cases cause conjecture as to whether other diseases of chronic eosinophilia, such as Löffler's syndrome, tropical eosinophilia, familial eosinophilia and pseudoleukemic cosinophilia, may not also be due to visceral nematode larvae migrations. Further investigation is warranted in these diseases.
STAPHYLOCOCCAL PNEUMONIA AND EMPYEMA
Authors: KANOF ABRAM , EPSTEIN BERNARD , KRAMER BENJAMIN , MAUSS IRVING 
Published: December 2021

Forty-one cases of staphylococcal pneumonia, treated with sulfonamides, sulfonamides plus penicillin, and with aureomycin plus penicillin are described. Since characteristic bacteriologic findings are now uncommon, diagnosis of this condition depends on the presence of a typical clinical and roentgenologic picture, herein described.
The mortality rate with sulfonamide treatment alone was 50%. The mortality rate in cases treated with sulfonamides and penicillin was 25%. With the introduction of aureomycin none of the 12 consecutive cases in this series died.
Empyema treated with sulfonamides and penicillin often cleared with repeated aspiration alone or aspiration followed by instillation of penicillin into the pleural cavity. Cases of empyema treated with aureomycin plus penicillin seldom required paracentesis.
Resolving Pediatric Preventive Care Gaps Through Hospital Inreach
Authors: Morehous John F. , White Cynthia , Brinkman William B. , DeBlasio Dominick J. , Reyner Allison , Kleiman Julie , Iyer Srikant B. 
Published: December 2021

OBJECTIVES
Panel management processes have been used to help improve population-level care and outreach to patients outside the health care system. Opportunities to resolve gaps in preventive care are often missed when patients present outside of primary care settings but still within the larger health care system. We hypothesized that we could design a process of “inreach” capable of resolving care gaps traditionally addressed solely in primary care settings. Our aim was to identify and resolve gaps in vaccinations and screening for lead exposure for children within our primary care registry aged 2 to 66 months who were admitted to the hospital. We sought to increase care gaps closed from 12% to 50%.

METHODS
We formed a multidisciplinary team composed of primary care and hospital medicine physicians, nursing leadership, and quality improvement experts within the Division of General and Community Pediatrics. The team identified a smart aim, mapped the process, predicted failure modes, and developed a key driver diagram. We identified, tested, and implemented multiple interventions related to role assignment, identification of admitted patients with care gaps, and communication with the inpatient teams.

RESULTS
After increasing the reliability of our process to identify and contact the hospital medicine team caring for patients who needed action to 88%, we observed an increase in the preventive care gaps closed from 12% to 41%.

CONCLUSIONS
A process to help improve preventive care for children can be successfully implemented by using quality improvement methodologies outside of the traditional domains of primary care.
CHRONIC ILLNESS IN CHILDHOOD: PART I. EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS
Authors: Pless Ivan Barry , Douglas James W. B. 
Published: December 2021

In 1946 a random sample (N = 5,362) of all children born in England, Wales, and Scotland during 1 week in March were selected for a longitudinal study of health and development. Educational, clinical, and psychological information were obtained from this national cohort at repeated intervals. At age 15, all children who had experienced a chronic physical disorder were identified. Their clinical profiles were defined and the social, psychological, and educational data on this group (N = 528) were compared with the remaining physically healthy children (N = 4,196).
A total prevalence rate of 111 chronically ill children per thousand under age 16 was found. This figure is of the same order as those reported for other studies of a similar kind. Most of the children (58%) suffered from a condition which primarily affected motor activities; 20% involved vision, speech or hearing, and 20% affected appearance.
Most disorders were mildly disabling and over 60% were still present at age 15. The composition of this population was compared with that of the remaining healthy children with respect to sex, social class, family size, and parents' health. These comparisons provide a background for subsequent reports describing the psychological, educational, and social consequences of chronic illness during childhood.
UTILIZATION OF SERVICES AT A NEIGHBORHOOD HEALTH CENTER
Authors: Salber Eva J. , Feldman Jacob J. , Rosenberg Lynn A. , Williams Shirley 
Published: December 2021

Services received during 1968 by 1,989 children of 521 families registered over a 5-month period at a neighborhood health center have been examined. Eighty-seven percent received at least one professional service. Seventy percent of the children were seen by a pediatrician; most children received services from at least two types of personnel, the commonest combination being pediatrician and dentist.
Once families were registered, variables such as race, Aid to Families with Dependent Children status, residence, family size, and education of mother had only a minor effect on utilization of services at the health center. The child's age markedly influenced utilization rates, a greater proportion of preschool children than adolescents coming for attention and attending more often.
Visits to physicians and dentists were higher than national norms for corresponding ethnic and socioeconomic groups. We conclude that the response of residents to the health center has been favorable and that the easy accessibility, reachingout philosophy, and genuine concern of the staff has had its effect. Although many of our patients use a combination of resources to obtain medical care, the Martha Eliot Center appears to have become the primary unit for child care in a large section of the population served.
STUDIES OF THE SCHOOL AGE CHILD WITH MENINGOMYELOCELE: I. PHYSICAL AND INTELLECTUAL DEVELOPMENT
Authors: Scherzer Alfred L. , Gardner G. Gail 
Published: December 2021

Fourteen meningomyelocele survivors in the beginning school years underwent physical and neurological examinations; 13 had re-evaluation of renal, orthopedic, and neurosurgical status. General physical status was satisfactory. Six showed eye abnormalities; nine had hydrocephalus to some degree; eight required an ileal conduit; 11 are fully ambulatory. Use of a Degree of Impairment rating system indicated eight with mild to moderate and six with severe physical involvement. This rating scale may be of benefit in studying future management of older children with this defect.
All children received psychological evaluation. Eight showed intelligence in the low to high average range. Three are mildly and three moderately retarded. The median I.Q. was 88. Social quotients paralleled I.Q. scores. I.Q. and S.Q. were not related to hydrocephalus, but correlated well with social class.
Six patients are in regular school programs while eight attend special classes for physically and /or mentally handicapped.
It is concluded that appropriate intervention can enable many children with meningomyelocele to develop satisfactorily and to have the intellectual capacity to master major cognitive and social tasks.
Psychosocial Study of Childhood Poisoning: A 5-Year Follow-up
Authors: Margolis James A. 
Published: December 2021

Forty-two of 52 families that were participants in a retrospective study of childhood poisoning 5 years ago were included in this follow-up study. During the interim, none of the subjects or their siblings poisoned themselves and there was no shift from poisoning to other types of childhood accidents. Socioeconomic factors and school performance do not differentiate the groups. However, the poisoned children, especially the repeaters, have more behavior problems during latency than the control children and are characterized as hyperactive, "aggressive-impulsive," and "passive-anxious." The present study indicates that childhood poisoning is not only related to maladaptation in the child and family at the time of the poisoning, but predicts later problems in the child that are focused on difficulties in interpersonal relationships rather than exposing him to increased accident susceptibility. A parent-child relationship in the form of a "power struggle," misdirected anger, and developmental characteristics of oral explorative behavior, mimicry, and negativism predispose toddlers to ingest poisons.
Preventitive implications concentrate on the parent-child relationship rather than environmental risk. This approach includes education regarding developmental characteristics of the toddler, parent guidance to prevent power struggles and other inadequate methods of dealing with the child and ongoing intervention to help the child find more appropriate ways of handling aggression. These seem necessary both to reduce further poisonings and as primary prevention of serious characterologic problems later in the child's development.
Intraspinal Neurilemoma in Association with the Rubinstein-Taybi Syndrome
Authors: Russell N. A. , Hoffman H. J. , Bain H. W. 
Published: December 2021

A case of intraspinal neurilemoma associated with typical Rubinstein-Taybi syndrome is presented. Although many patients with this syndrome have pyramidal tract signs, this is the first reported case of associated intraspinal tumour.
Possibly more patients with this syndrome will present with central nervous system tumours of the type associated with Von Recklinghausen's disease. Indeed the Rubinstein-Taybi syndrome possibly should be grouped with Von Recklinghausen's disease as one of the phakomatoses.
On Testing to Predict the Need for Eructation
Authors: Penchina Claude M. 
Published: December 2021

Curiously enough, neither eructation, nor burping, nor belching, nor bubbling can be found in the indexes of the popular textbooks by Nelson1 and Holt,2 though air-swallowing in relation to colic, regurgitation, and vomiting is, of course, described. Furthermore, neither of these texts nor the popular book by Spock,3 describes any operational means (other than observation of pain and discomfort) to determine the existence of a trapped air bubble.
We have found a simple audio test to determine the presence of a large trapped air bubble in an infant's stomach before it becomes painful.
Bronchography Outmoded? A Radiologist Comments
Authors: Gyepes Michael T. 
Published: December 2021

Dr. Mary Ellen Avery's very timely commentary, "Bronchography: Outmoded Procedure?" (Pediatrics, 46:333) deserves a few comments by a pediatric radiologist.
One of the problems with pediatric bronchography in the United States is that there is insufficient experience with the appropriate performance of this procedure and therefore there are only very small series available. Most of the large series are in the European literature and the perusal of that literature clearly indicates that this can be an excellent procedure and it can also be done safely.1-3
EXPERIMENTAL SALICYLATE POISONING: OBSERVATIONS ON THE EFFECTS OF ALTERING BLOOD pH ON TISSUE AND PLASMA SALICYLATE CONCENTRATIONS
Authors: Hill John B. 
Published: December 2021

Sprague-Dawley rats were infused with sodium salicylate followed by saline, bicarbonate, or carbon dioxide inhalation. Bicarbonate raised the blood pH and lowered the muscle, brain and liver salicylate concentrations compared with the saline controls. Carbon dioxide inhalation produced the opposite effect.
Acetazolamide lowered the blood pH, raised the tissue salicylate levels, and increased the toxicity of sodium salicylate. If the systemic acidosis produced by acetazolamide was prevented with bicarbonate, the rise in tissue salicylate was also prevented.
MINIMAL CEREBRAL DYSFUNCTION IN CHILDREN WITH CHRONIC THROMBOCYTOPENIA
Authors: Matoth Yehuda , Zaizov Rina , Frankel Jacob J. 
Published: December 2021

Chronic cases of idiopathic thrombocytopenic purpura (ITP) follow a relatively benign course in the majority of cases. A conservative attitude is, therefore, generally adopted in dealing with these cases.
A disproportionately high incidence of the syndrome of minimal cerebral dysfunction (MCD) has been observed in a series of 20 patients with chronic ITP closely followed over a period of years. Six patients had serious behavior problems and learning difficulties. Psychological testing revealed a visuomotor deficiency and an impaired capacity for abstraction. The clinical and psychological picture was consistent with the diagnosis of MCD. This diagnosis was supported by EEG findings, which showed abnormalities in all six patients. Psychological indicators of MCD and EEG abnormalities were prominent in the group of 20 patients as a whole.
These findings could be accounted for by multiple minute capillary bleeding. Considerations of prognosis in chronic ITP should be modified in view of this evidence for an organic brain lesion.
Hyperlipidemia in the Hemolytic-Uremic Syndrome
Authors: Kaplan B. S. , Gale Diana , Ipp Tania 
Published: December 2021

Campbell and Carré1 recorded the occurrence of hypertriglyceridemia in association with fatal hemolytic-uremic syndrome in a set of monozygotic twins and suggested that the hypertriglyceridemia was present as an inherited disease.
The purpose of this paper is to describe the finding of elevated triglyceride, cholesterol and phospholipid levels in six children with hemolytic-uremic syndrome.
Materials and Methods
Serum triglyceride, cholesterol, and phospholipid levels were measured in six out of seven consecutive patients with hemolyticuremic syndome admitted to the Transvaal Memorial Hospital for Children, Johannesburg. The criteria for diagnosis were hemolytic anemia with fragmentation of the red cells, a platelet count below 140,000 per cmm, and evidence of renal involvement.
Traumatic Amputation of the Glans Penis: A Follow-up Note
Authors: Mason James C. 
Published: December 2021

This is a follow-up note in the case of amputation of the glans penis reported by Vincent and Rothenberg in the August, 1969 issue of Pediatrics.1
Recently, David, now aged 12, was admitted to the University Hospital, Seattle, Washington for removal of a bladder stone "the size of a hen's egg." As noted in the case reports, the boy, then 8, had accidentally amputated the glans penis when involved in a sadistic game proposed by an older boy.
Handbuch Der Algemeinen Pathologie: Prolegomena Einer Allgemeinen Pathologie, Erster Band, edited by H.-W. Altmann F. Büchner, H. Cottier, G. Holle, E. Letterer, W. Masshoff, H. Meessen, R. Roulet, G. Seifert, G. Seifert, and A. Studer. Berlin/Heidelberg/New York: Springer-verlag, 1969, 311 pp., no price given
Authors: Vawter Gordon W. 
Published: December 2021

This prologue or introduction to a current German handbook of general pathology follows the previously published volumes of the series by as long as 15 years, but clearly includes material of current concern. The title of the series is usually interpreted as "General Pathology" but may be translated equally well here as the universal study of disease. This theme transcends the concept of general anatomic pathology as evidenced by the several contributors to the current volume who are not anatomic pathologists, but internists, anthropologists and so on.
The six articles composing the "prologema" range from 24 to 63 pages length in variably modern or simplified German, dealing in turn with:
ELEVATED SERUM IgA GLOBULIN IN ANAPHYLACTOID PURPURA
Authors: Trygstad Carl W. , Stiehm E. Richard 
Published: December 2021

Serial determinations of serum levels of IgA, IgD, IgG, and IgM globulin were performed on 27 children with anaphylactoid purpura and two children with acute poststreptococcal glomerulonephritis. Ten of 20 children with anaphylactoid purpura seen within 3 months of the onset of the skin rash had significant elevations of their serum IgA globulin. The other immunoglobulin levels were normal in the remaining children and those with acute poststreptococcal glomerulonephritis.
The selective elevation of serum IgA globulin may be related to the pathogenesis of anaphylactoid purpura.
THE CRITICALLY ILL CHILD: CARE OF THE INFANT IN CARDIAC FAILURE
Authors: Goldring David , Hernandez Antonio , Hartmann Alexis F. 
Published: December 2021

Heart failure may be defined simply as the inability of the heart to pump blood commensurate with the body needs. Although it is possible for the right or left ventricle to fail separately, it is much more common for infants to present with failure of both chambers. When a ventricle fails, the end-diastolic pressure in that chamber rises and the pressure in the atrium, central, and peripheral veins is increased. There is a decrease in blood flow to the kidney which is thought to be responsible for the renal retention of sodium and water which, in turn, increases blood volume. Thus, the elevations in pressures, the disturbances in blood flow, and abnormal distribution of water and electrolytes are homeostatic and compensatory mechanisms which help preserve cardiac output while they are recognized as the signs and symptoms of heart failure.
Infants under 1 year of age account for 90% of pediatric patients who develop congestive heart failure. The majority of these have congenital malformations, which are increasingly amenable to corrective surgery. The physician must, therefore, be able to make the diagnosis of heart failure with confidence and institute immediate therapy. The patient, ideally, should be transferred to a medical center with a well-equipped and well-staffed intensive care unit where therapy can be administered under 24-hour monitoring. Such an approach should steadily improve the salvage rate of infants in congestive heart failure.
Treatment of Cyanide Poisoning (Continued)
Authors: Mofenson Howard C. , Greensher Joseph , Horowitz Ray , Berlin Cheston M. 
Published: December 2021

Dr. Berlin's schedule of treating cyanide poisoning by sodium nitrite and sodium thiosulfate should be in every emergency room and poison control center.1 It should also be included in Lilly's Cyanide Antidote Kit which contains these materials. (I have written the Eli Lilly Company concerning this.)
Since cyanide is a spectacular poison and evokes such a frightening response and vigorous treatment, it is important to emphasize that ferrocyanide and ferricyanide as found in Turndall's Blue and Prussian Blue are of low toxicity (potential single adult fatal dose 50 gm).
BODY IMAGE CHANGES IN TEEN-AGE DIABETICS
Authors: Kaufman Richard V. , Hersher Betsy 
Published: December 2021

Fantasies of five diabetic teen-agers about their illness were collected in a study of the relationship between body illness and body image. All of the subjects revealed underlying distortions of their knowledge of the disease process bated on primitive notions about physical causality. The imagery employed was strongly visual and illness was seen as the result of external deprivation, or of various internal abnormalities and deficiencies, such as absence of part of the pancreas, blockage within the pancreas, or dilatation of the stomach. The influence of previous instruction and education by the medical staff was found to be superficial and in all cases the children's intellectual knowledge was incorporated into their own private thought systems.
The patients drew what the illness meant to them rather than what they knew about the pathophysiological processes, and in this way demonstrated the link between physical illness and body image. The patients described feeling seriously damaged by the diabetes, and were able to graphically symbolize their conceptions of this damage. Knowledge that the child's illness significantly alters a part of the self contributes to greater precision and effectiveness in communication.
Cytomegalovirus Complement-Fixation Antibody Responses in Eskimo Families
Authors: Sinha Shyamal K. , Paul5 Frank P. 
Published: December 2021

At the International Conference on Cytomegalovirus (CMV) Infections held at St. Gall, Switzerland in April, 1970, investigators from various countries reported the epidemiologic aspects of CMV infection and indicated its occurrence in many parts of the world.1
In the following data on CMV complement-fixation antibody responses in 44 Eskimo families located ill Wainwright Village, Alaska, 154 blood samples were collected during July, 1968. The complement-fixation (CF) test micromethod2 was adopted using the CF antigen (strain AD 169) prepared by Microbiological Associates, Bethesda, Maryland.
A SYSTEM FOR COMPUTERIZED AUTOMATED BLOOD GAS ANALYSIS
Authors: Veasy L. George , Clark Justin S. , Jung A. Larry , Jenkins Jarrell L. 
Published: December 2021

An automated system for on line, real time computerized determination of arterial blood pressure of oxygen and carbon dioxide, and pH has been developed at the Primary Children's Hospital. The determinations are made from a 0.3 ml sample of blood withdrawn automatically under computer control from an indwelling arterial catheter. The results are displayed nearly immediately in alpha-numeric terms on a memory scope at the cribside.
Laboratory evaluation and a limited clinical experience with six patients indicate the system to be a safe method for accurate and close monitoring of critically ill infants and is particularly applicable to use in the respiratory distress syndrome. The system is known as CABAS, a term coined from Computerized Automated Blood Analysis System.