bluuebunny/crossref_metadata_2025_split huggingface dataset:
PEDIATRICS AND MENTAL RETARDATION—A CONTINUING CHALLENGE
Authors: Gordon Harry H. 
Published: December 2021

It is high privilege to participate in a ceremony in which the American Academy of Pediatrics honors the memory of one of its founders and most illustrious Fellows. The C. Anderson Aldrich Award for 1973 is presented to Dr. Gunnar Dybwad, Professor of Human Development at the Florence Heller Graduate School of Advanced Studies in Social Welfare, Brandeis University. The Award is made for Dr. Dybwad's contributions to the development of children, particularly those with mental retardation. Inherent in his choice as awardee by the Section on Child Development of the Academy is recognition of mental retardation as a disability in development, one that is subject to change with time, either amelioration or deterioration, depending in a major way on the child's social surroundings. It is to these latter that Dr. Gunnar Dybwad has particularly addressed himself.
For the benefit of younger members and guests of the Academy, a few biographical notes seem in order about Dr. Aldrich who died 25 years ago. Born in Plymouth, Massachusetts, in 1888, Dr. Aldrich received his early education in Boston and New York; his college and medical school degrees at Northwestern University. After general practice in Winnetka, Illinois, for five years, he limited his practice to pediatrics. While in practice, he worked at the Children's Memorial Hospital of Chicago rising to a full Professorship at Northwestern University, and succeeding Dr. Joseph Brenneman in 1941 as Chief of Staff at the Children's Memorial Hospital. In 1944 he moved to Rochester, Minnesota, and founded the Rochester Child Health Institute, interested in research on the development of normal infants and children and in a program of delivery of child care to an entire community.
Hyperglycemia and Sickness
Authors: Klein Michael , Kopelman Arthur , Lawrence Ruth 
Published: December 2021

Dweck and Cassady1 have done an excellent job of bringing to our attention the frequent occurrence of hyperglycemia in very small premature infants. They implicate as the major cause of this phenomenon glucose infusion rates of &gt;0.4 gm/kg/hr. Based on the association between the highest glucose and osmolality values in their series and intraventricular hemorrhage, they imply causality. The authors suggest further that oral glucose feeding confers a protective effect against hyperglycemia.
The premature infants in the authors group 3, those with serum glucose levels of 300 mg/100 ml, have the lowest birth weights.
Diagnosis of Gonorrhea and the 1974 Red Book
Authors: Ris Hania W. 
Published: December 2021

At Last The Long-Awaited Seventh Edition Of The Red Book,1 The Bible Of The Pediatrician, Has Appeared. The Section On Gonorrhea Was Updated. I Fear, However, That The Paragraph On Diagnostic Tests (Pp. 60-61) May Be Misinterpreted As Meaning That The Gram-Stained Smear Has A High Degree Of Reliability In Diagnosis Of Exudates, As There Is Great Emphasis On The Smear Rather Than The Culture.
It Is Well Established That Grain-Stained Cervical And Vaginal Smears In The Female Are Unreliable For Diagnosis Of Gonorrhea.
Another Method for Changing U. A. Catheters
Authors: Chopra Devinder R. , Flanagan James , Obak Joshua , Sinnhuber John , Kieffer James , Seay Alan 
Published: December 2021

In regard to the article by Michael Heymann in the Januany issue1 we have the following comments:
We have had the opportunity of changing arterial catheters in our intensive care unit over the last 1½ years in well over two dozen cases and we did this by the following procedure:
The change is done by two persons—one withdrawing the catheter and the other ready with the new catheter to be inverted. Usually the umbilical cord and artery will be molded around the catheter.
Complication of Ritual Circumcision in Israel
Authors: Frand M. , Berant N. , Brand N. , Rotem Y. 
Published: December 2021

We have recently had the opportunity to see 3 cases of a very unusual complication of circumcision. Performers of ritual circumcision in Israel wrap the circumcised penis with a firm, circular bandage for hemostasis.
The three newborn infants we saw were brought to the emergency room about a day after the procedure because of restlessness, refusal to eat and occasional vomiting. One of the mothers noticed blue discoloration of her child's legs.
On examination, cyanosis of both lower extremities and a huge bladder were found in all three infants.
BENJAMIN FRANKLIN'S ACCOUNT OF INOCULATION (VARIOLATION) IN BOSTON
Authors: C. T. E. 
Published: December 2021

In a letter written on February 16, 1759 to an English friend, Benjamin Franklin described the practice of inoculation for smallpox in Boston as follows:
Inoculation was first practiced in Boston by Dr. Boylston in 1721 . It was not used before in any part of America, and not in Philadelphia till 1730. Some years since an enquiry was made in Philadelphia of the several Surgeons and Physicians who had practised Inoculation, what numbers had been by each inoculated, and what was the success. The result of this enquiry was that upwards of 800 (I forget the exact number) had been inoculated at different times, and that only four of them had died. If this account was true, as I believe it was, the reason of greater success there than had been found in Boston, when the general loss by Inoculation used to be estimated at about one in 100, may probably be from this circumstance, that in Boston they always keep the distemper out as long as they can, so that when it comes, it finds a greater number of adult subjects than in Philadelphia, where since 1730 it has gone through the town once in four or five years, so that the greatest numbers of subjects for inoculation must be under that age.
Notwithstanding the now uncontroverted success of Inoculation, it does not seem to make that progress among the common people in America, which was at first expected, Scruples of conscience weigh with many, concerning the lawfulness of the practice, and if one parent or near relation is against it, the other does not choose to inoculate a child without free consent of all parties, lest in case of a disastrous event, perpetual blame should follow.
INTRODUCTION: Screening in Child Health Care
Authors: North A. Frederick 
Published: December 2021

The eight papers in this symposium have been brought together to help practicing pediatricians evaluate the place of screening, and of particular screening procedures, in their own practices and in programs of child health care in which they participate.
Advancing technology is making available an increasing number of tests and observations which might be employed in the early detection of health problems. The Federal government has mandated an Early and Periodic Screening Diagnosis and Treatment (EPSDT) program for all Medicaid eligible children, and California has mandated health screening for school attendance. With this kind of pressure to "screen," how should the pediatrician react? We hope that this symposium will help him decide. The first two papers discuss definitions and criteria, the following five illustrate the application of these criteria in specific areas of current interest and controversy, and the final paper attempts to summarize the current status of screening and to predict some future directions for screening in the health care of children.
Selection of Diseases and Tests in Pediatric Screening
Authors: Frankenburg William K. 
Published: December 2021

The availability of a suitable screening test does not justify screening for a disease unless the disease is important, relatively prevalent, and amenable to early treatment. Screening for a disease which has the necessary characteristics cannot be justified unless there is an acceptable, reliable and valid test which can be carried out at reasonable cost.
Screening which is carried out without knowledge and consideration of these criteria is likely to be wasteful of scarce medical resources and may actually do more harm than good.
In Reply: Galactokinase Deficiency in Twins
Authors: Frasier S. Douglas , Olambiwonnu N. O. , Ng Won G. , Donnell George N. 
Published: December 2021

We appreciate the opportunity to respond to the comments made by J.A. Monteleone et al. concerning our paper, "Galactokinase deficiency in twins: Clinical and biochemical studies."
It is apparent that Monteleone and his colleagues have not read our paper carefully, since we do not use the term "galactose-free" diet. Rather the term "lactose-free" formula or diet is employed with full recognition that Nutramigen is known to contain a small residual amount of lactose.
The experience in this laboratory with galactokinase deficiency has been only with the two patients described in our paper.
Skin Care of Newborns
Authors: James L. Stanley , Graven Stanley N. , Kay Jacob L. , Korones Sheldon B. , Meyer H. Belton , Muirhead Donald M. , Oliver Thomas K. , Shinefield Henry , Spear Robert L. , Sutherland James M. , Swyer Paul R. , Hasselmeyer Eileen , Knox Eric , Talner Norman S. 
Published: December 2021

The recent concern related to bathing newborns with hexachlorophene has led to a redefinition of appropriate skin care for newly born infants in hospital nurseries. Skin manipulations are performed (1) for prevention of infection and (2) for aesthetic and cleansing purposes.
The skin is a protective organ and any break in its integrity affords an opportunity for initiation of infection. In addition, it is clear that protection against invading pathogenic organisms is afforded by skin secretions or contents and the normal skin biota.
Therefore, skin care should involve cleansing with a non-toxic, non-abrasive neutral material.
Consideration of skin care of the newborn is further complicated by the fact that the infant does not have protective skin flora at birth, has at least one and possibly two open surgical wounds, the umbilicus and circumcision site, and is exposed to fomites and personnel that harbor a variety of infectious agents.
Risks and benefits of each skin-care technique in the newly born must be weighed. Is the agent used absorbed and toxic directly or indirectly? What is the effect of the technique on the skin itself? Does the agent predispose to a biota change that is detrimental to the infant?
The currently available data suggest that perhaps the best method for managing infant skin is to minimize manipulation. The recommended technique is referred to as dry skin care. "Dry technique" is recommended for the following reasons: (1) it subjects the infant to less heat loss by exposure; (2) it diminishes skin trauma; (3) it requires less time, and (4) it does not expose the infant to agents with known or unknown side effects.
Sacral Agenesis
Authors: Lebowitz Robert L. 
Published: December 2021

It is important to recognize the patient with sacral agenesis and associated neurogenic bladder dysfunction before irremediable damage to the urinary tract occurs, as stressed by Thompson, Kirk, and Dale.1 It is also true that this entity is often occult. Thus, any clue to the diagnosis, or statistical association with another clinical problem, is of great help in identifying patients with this malformation, aptly termed "the syndrome of caudal regression" by Duhamel.
Thompson, Kirk, and Dale failed to point out the striking incidence of sacral agenesis in infants of diabetic mothers, first noted in this journal by Rusnak and Driscoll.
PEDIATRIC BILL OF RIGHTS
Authors: Andreasen Susan 
Published: December 2021

Recently, while attending a course concerned with Humanities in Medicine I had the pleasure of meeting the 10-year-old daughter of one of the participants. The young lady was party to several of our informal discussions on informed consent and children. She was pleased to hear that a Pediatric Bill of Rights existed but she was most displeased when she read the contents. For the Bill of Rights proposed by the National Association of Childrens Hospitals and Related Institutions1 supports the right of minors to obtain medical care without parental consent if a conflict exists. Susan, objected to this being called the "Pediatric" Bill of Rights for it had little to do with what children would propose. Consequently, she composed a true Pediatric Bill of Rights as follows:
1. Any person regardless of age has the right to refuse pedeatric care.
2. Any person regardless of age has the right to pick there own pedeatrision, if there a girl they can pick a girl, if if there a boy they can pick a boy.
3. Any person regardless of age has the right to not take there medicen if they dont want to.
4. Any person regardless of age has the right not to wear those paperthings at the doctors office.
5. Any person regardless of age has the right not to get weighed at the doctors office.
Increased Lead Burden and the Energy Crisis
Authors: deCastro F. J. , Lazzara J. , Rolfe U. T. , Engeler E. 
Published: December 2021

The present report describes a child with increased lead burden due to inhalation of fumes from lead-base-painted wood burned in an old faulty furnace.
A 5-year-old boy was referred while asymptomatic with a blood lead level of 67µg/100 ml (atomic absorption). He had no history of pica or abnormal behavior. Physical examination revealed a small, alert, thin white boy whose physical and neurological examination were normal Hemoglobin and urinalysis were normal. Radiographs of the abdomen, left knee, and right elbow were normal.
The Absorption of Iron as Supplements in Infant Cereal and Infant Formulas
Authors: Rios Ernesto , Hunter Robert E. , Cook James D. , Smith Nathan J. , Finch Clement A. 
Published: December 2021

The absorption of iron was measured from isotopically tagged salts used in supplementing infant cereals and as the iron supplement in cow's milk and soy-based formulas.
Iron as sodium iron pryophosphate and ferric orthophosphate were poorly absorbed from infant cereal (mean, &lt; 1.0%) and thus are not dependable sources of iron to meet the nutritional needs of infants. Reduced iron of very small particle size and ferrous sulfate when added to cereal was absorbed to a greater extent (mean, 4.0% and 2.7% respectively). For technical reasons, these two forms of iron had not been added to commercial cereal products because of discoloration, distribution problems of the iron in the product, and shortened shelf life. Therefore, at the present time, iron supplementation of infant cereals with sodium iron pyrophosphate, ferric orthophosphate, and reduced iron of large particle size does not provide a predictable and available source of iron to meet the needs of infants.
Supplemental iron as ferrous sulfate in milk- and soy-based formulas gave a mean absorption of 3.4% to 5.4%. The iron supplements in these formulas can essentially meet the needs for dietary iron of healthy infants.
Lettrt To The Editor
Authors: Alvord Ellsworth C. , Shuman Robert M. , Leech Richard W. 
Published: December 2021

Dr. McCarl has raised 19 objections to our findings of a vacuolar encephalopathy related to hexachlorophene exposure. We reject each of them.
Dr. McCarl begins by challenging the degree to which our sample was representative of the whole pediatric population. He notes that 70% of the second of our three samples in Table I had to be omitted because the brainstem had been discarded in the five years between the autopsy and our study. He ignores the fact that the first sample had the same prevalence of the vacuolar encephalopathy (11% and 9%, as reported on page 692) and no cases were omitted because the specimens were being brought directly to our neuropathology lab two weeks post-mortem and saved thereafter.
Fucosidosis Type 2
Authors: Kousseff Boris G. , Beratis Nicholas G. , Strauss Lotte , Brill Paula W. , Rosenfield Richard E. , Kaplan Beatrice , Hirschorn Kurt 
Published: December 2021

Two siblings, 9 and 4½ years old, had α-L-fucosidase deficiency, angiokeratoma, progressive psychomotor retardation, neurologic signs, coarse facial features, and dysostosis multiplex. It appears that genetic heterogeneity is present in fucosidosis; there are at least two types. In type 1, patients have no vascular lesions, but have rapid psychomotor regression, severe and rapidly progressing neurologic signs, elevated sodium and chloride excretion in the sweat, and fatal outcome before the sixth year. In type 2, patients have angiokeratoma, milder psychomotor retardation and neurologic signs, longer survival, and normal salinity in the sweat.
Quantitative studies on erythrocytes and in saliva disclosed severely increased expressions of Lea and Leb. Biopsies of skin and gingiva showed alterations as seen in angiokeratoma. There was also evidence of lysosomal storage in vascular endothelium, eccrine sweat gland epithelium, and fibroblasts of the skin.
The Hematology of Bacterial Infections in Premature Infants
Authors: Zipursky A. , Palko J. , Milner R. , Akenzua G. I. 
Published: December 2021

A series of premature infants was studied for the presence of bacterial infection. On the basis of clinical evidence and bacteriological studies, they were divided into three groups in which sepsis was considered to be proven, possible, or unlikely. Band neutrophil counts were elevated most frequently in the "sepsis-proven" group and the elevation occurred usually within 24 hours of onset of signs of disease. Qualitative changes in neutrophils (Döhle bodies, toxic granulation, and vacuolization) were more frequent in the sepsis-proven group and, together with the band count, provided valuable techniques for the diagnosis of bacterial infections.
Thrombocytopenia occurred frequently in the sepsis-proven group and seemed to result from increased utilization or destruction of platelets rather than failure of production. In such cases, evidence of intravascular coagulation was minimal and it was concluded that thrombocytopenia had resulted from a direct effect of the bacteria or its products on platelets and/or endothelium.
A Question on Throat Cultures
Authors: Abello Victor B. 
Published: December 2021

The article by Drs. Katz and Clancy1 on the home throat culture was well received here because of the importance of throat culture and its interpretation.
As a resident, I notice only those patients with positive β-hemolytic Streptococcus sensitive to bacitracin. The authors' statement that treatment should include a subsequent visit to the physician only if the culture is streptococcal-positive seems to bear out this thinking.
Although the majority of sore throat cultures will not yield Streptococcus because they are mostly viral,2 proper clinical screening will increase the yield.3
Why Not Use Topical Penicillin?
Authors: Lerman Stephen J. 
Published: December 2021

The article by Nishida and Risemberg1 is a well-conceived and useful study, but I would like to criticize one point in the discussion.
The authors state that "sensitization of infants" is one of the disadvantages of topical penicillin for prophylaxis of gonorrhea ophthalmia neonatorum. Anthoratative sources have previously sounded the same caveat.2,3 All of the reports of hypersensitivity reactions following ocular use of penicillin ointment or drops, however, deal with adults4-7; "sensitization of infants" with topical penicillin has never been reported.
Pediatric Nuclear Medicine
Authors: Grossman Herman , Felman Alvin , Kirkpatrick John , Shopfner Charles E. , Swischuk Leonard E. , Taber Paddy , Conway James J. 
Published: December 2021

The subspecialty of pediatric nuclear medicine has rapidly developed since the last discussion1 of the indications for and value of radionuclide imaging in children. New imaging techniques, equipment, and radiopharmaceuticals have stimulated this rapid growth. Bone imaging with the 99mTc phosphate compounds has been applied to evaluate benign as well as malignant processes. Tumor detection and staging have been accomplished with various 99mTc radiopharmaceuticals. Vesicoureteral reflux is more effectively detected with direct radionuclide cystography. A major role in the detection and evaluation of cardiac abnormalities and shunts has been achieved with nuclear techniques.
Recognition of this remarkable growth and development is found in the publication of several books on pediatric nuclear medicine, the presentation of pediatric nuclear in medicine seminars, and formal sessions at the Society of Nuclear Medicine annual meeting.2-6 This brief discussion will hopefully keep the pediatrician aware of the expanding role that radionuclide techniques have in the management of pediatric patients.
Treatment of Tall Girls With Estrogen
Authors: Crawford John D. 
Published: December 2021

The practice of giving estrogen to normal girls destined to become taller than they wish goes back to the 1940s. The train of thought leading up to the first trials includes two basic observations. First, it was noted that children in whom persistent precocity syndromes develop early in life become short adults and have premature epiphyseal closure. Second, and conversely, in the absence of the gonadal steroids, the epiphyses remain open indefinitely and growth continues beyond the usual age of cessation. While the majority of these cases are complicated by the presence of pituitary disease and the fact that because of their lack of growth hormone the patients are small, the early clinicians bolstered their faith in the converse by their admiration of the enormous size reputed to be attained by the harem eunuchs.
These observations prompted two conclusions. First, gonadal steroids were not only responsible for closing the epiphyses but also for "turning off" secretion of growth hormone. Thus, in the early 1930s, it was reasoned that while children would be well endowed, adults must lack any circulating pituitary growth hormone, save in the rare instance of acromegaly. These were the concepts that led to the treatment of that disorder first with gonadal extracts,1,2 then, when pure steroids became available, with androgens and estrogens.3 The effect of testosterone was disappointing; the beneficial influence of estrogen, however, was so impressive as to be taken as proof of the earlier drawn conclusion that it is the gonadal steroids that normally turn off growth hormone secretion at adolescence.
WAS MATTHEW ARNOLD'S CROOKED LEG CAUSED BY RICKETS?
Authors: C. T. E. 
Published: December 2021

Matthew Arnold (1822-1888), poet and critic, the second child (of nine) and oldest son of Thomas and Mary Arnold, had a crooked leg and spent two years of his childhood in heavy iron braces—the family nicknamed him "Crabby" for his shuffling gait.
Park Homan1 in his recently published biography of Matthew Arnold describes the treatment Arnold received for his crooked leg as follows:
Instructing his infants in oarsmanship, the father now took them out on the Trent in the Frolic.... Within a day or two of this time, she [Mrs. Arnold] noticed that something was wrong with Matthew's leg.... But within ten days of leaving the River Trent, the Arnolds consulted Mr. Tothill, back at home, and then a London specialist—with the result that a frightening iron apparatus arrived ... to be fitted to his limbs. His father was not deeply worried: ‘We have had some anxiety about Matt,’ Thomas Arnold wrote to a friend ... ‘from the Effects of a bad habit of crawling before he could walk, and which was greatly bent one of his Legs, so that he has obliged to wear Irons, and must continue to do so for some time.’
At two or three, most children become excitedly aware of themselves in relation to other people, but Matthew found that thick leg-straps and leg-braces of the heaviest iron made him peculiar and decidedly ugly. He found it difficult to move about and reacted very audibly. ‘I also remember,’ he writes at 13, ‘wearing irons and being obstinate and being taken up to London about my crooked legs.’