bluuebunny/crossref_metadata_2025_split huggingface dataset:
BRONCHOGRAPHY IN INFANTS AND CHILDREN
Authors: Waring William W. , Killelea Donald E. 
Published: December 2021

Bronchography in infants and young children requires a procedure different from that generally employed in adults. A safe and reliable technique has been reviewed which eliminates the need for fluoroscopic control of the madiopaque medium.
Under general anesthesia the contrast material is fractionally instilled through an endotracheal tube and guided sequentially by gravity to all segmental bronchi of the lung. The patient's color and respiration can be observed continuously throughout the procedure.
Conventional roentgenograms are taken, and the medium is then removed by gravity and suction. If desired, the contralateral lung may next be visualized by analogous maneuvers. Bronchography by this method requires a team of two operators, anesthesiologist, radiology technician, and probably a surgeon. The team can be effectively integrated by a pediatrician interested in chest disease who serves as one of the operators.
Fifty-eight bronchograms have been performed by this method in 52 children between the ages of 2 months and 13 years.
Criteria are outlined for determination of the adequacy of bronchograms. These criteria have been applied to this series on a segmental basis with totals tabulated for lobes and lungs. Bronchograms of adequate or better diagnostic quality were obtained in approximately 85% of the 53 bronchograms available for review. Failure to visualize a segment may be due to disease of that segment or to several technical factors. These latter include either extreme of anesthetic depth, failure to position the patient properly, excessively caudal placement of the endotracheal tube, delivery of medium into the endotracheal tube rather than just distal to it, and procedural delays due to any cause.
No deaths ascribable to the method have occurred. Complications in this series, however, have included cardiac arrest (one patient); bradycardia (one patient); and acute, transitory lobar atelectasis (three patients). These complications seem best related to airway obstruction by viscous contrast material.
POSSIBILITIES FOR A PREVENTIVE PSYCHIATRY
Authors: Eisenberg Leon 
Published: December 2021

WHEN A SPEAKER is invited to address a medical society, it may safely be assumed that its members (or at least the less jaundiced among them) anticipate enlightenment or entertainment or, mirabile dictu, both. How often these expectations are rewarded is quite another matter, upon which each of us will hold his own opinion. But it would seem to require some word of justification when a speaker arrives, as I do this evening, not to offer help but to seek it.
This is all the more unusual in view of the frequency with which psychiatrists are asked to advise pediatricians, and the relative rarity of the converse. A curious state of affairs, indeed, unless one were to assume that the psychiatrist knows all that the pediatrician does, plus something more—or that what the pediatrician knows is of no consequence for the psychiatrist. No one would seriously maintain the former statement, and the latter is no less patently absurd.
How this relationship between the two specialties has come to be is an interesting historical question, but not our present concern. However, its existence is to the detriment of both the psychiatrist and the pediatrician. It is with the hope that you will enter the lists in the struggle for the advancement of psychiatric knowledge that I propose to review what is known of preventive psychiatry. You will discern that a substantial part of it is pediatrics, has been contributed by pediatricians along with other specialists, and very much concerns pediatric practice.
Home Care of Mongoloid Children
Authors: HERSHER LEONARD 
Published: December 2021

A recent article in Pediatrics by Birch and Belmont has challenged the methodology, results and conclusions of an earlier article, by Centerwall and Centerwall, on home versus foster-home rearing of mongoloid infants.
The Centerwalls studied 64 mongoloid children one-half of whom had been placed in foster homes in the neonatal period, the other half having been reared in their own homes until at least 2½ years of age. All children were eventually institutionalized. At the time of admission to the institution, and approximately 4 years later, the home-reared group were found to be superior to the foster-placement group in intelligence, motor function, and social responsiveness. The investigators concluded that "the average baby with mongolism has a better chance of being a happy, easily cared for, somewhat productive person, if a reasonable adjustment can be made to having him remain in his own home during the first years of life (p. 685).
MISSION AND MANPOWER
Authors: STEIGMAN ALEX J. 
Published: December 2021

THE SPECIAL ARTICLE by Stewart and Pennell, "Pediatric Manpower in the United States and Its Implications," is interesting and timely. It will be viewed differently by various readers, by some as seen from their personal perch, by others in terms of the broad reaches past and present of pediatrics as a discipline.
The purposes of the Special Article are to highlight the manpower situation and to point out long-term trends and implications in the light of the growing responsibility of pediatrics. The authors say that one requires a "delineation of the role of the specialty of pediatrics in child health care," and "while this role may be shared by other types of physicians, the responsibility for the development, maintenance, and improvement of child health services was clearly assumed by pediatrics when, as a specialty, it adopted as its objectives the protection and promotion of the health of children."
COMMITTEE ON NUTRITION
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

Despite inadequacies in information concerning the minimum prophylactic requirement of vitamin D for all age groups beyond infancy, there is no doubt that a total intake of 400 I.U. per day is adequate to prevent vitamin D deficiency in substantially all normal children from birth through adolescence.
Evidence derived from the study of idiopathic hypercalcemia suggests that certain infants excessively sensitive to the toxic action of vitamin D may, on rare occasions, be adversely affected by daily intakes of 3,000 to 4,000 I.U. and sometimes considerably less. Because of the prevalent practice of food fortification in the United States and Canada, there is now a definite possibility that the individual, even the young infant, may ingest considerably more than the recommended vitamin D allowance, and intakes of 2,000 to 3,500 I.U. per day are possible, particularly beyond infancy. Although there has been no specific evidence that intakes of this order produce deleterious effects beyond infancy, it is pointed out that the long-term consequences of this new nutritional situation on older children or adults are entirely unknown.
In view of these considerations the Committee on Nutrition recommends that efforts be taken to ensure a total vitamin D intake of 400 I.U. per day by all infants and children. At the same time, an attempt should be made to restrict the intake from all sources to an amount not greatly in excess of this figure.
The value of carefully planned enrichment of commercial milk supplies with vitamin D has been clearly demonstrated. However, the present practice of enriching foods other than milk and infant formula products is not justified, and discontinuation of this practice is to be recommended. Under the present circumstances, cognizance should be taken of the amount of vitamin D acquired by the individual from food sources before prescribing a vitamin D supplement.
In keeping with present concepts regarding vitamin D requirement, commercial vitamin D supplements should be adjusted to contain not more than 400 I.U. per dose.
THE HISTIDINE REQUIREMENT OF THE INFANT
Authors: Snyderman Selma E. , Boyer Audrey , Roitman Ellen , Holt L. Emmett , Prose Philip H. 
Published: December 2021

Histidine appears to be an essential amino acid for the young infant. Its omission from the diets of young infants gives rise to a depression of weight gain and of nitrogen retention. It also resulted in a dermatitis clinically and pathologically similar to infantile eczema, except for the absence of pruritus and atrophic changes in the sebaceous glands.
Under the conditions of this study, the histidine requirement was less than 35 mg/kg/day in all six infants tested with this intake. Five infants were given a trial of 22 mg/kg/day; in three this figure was satisfactory, but in the remaining two there was some evidence of inadequacy. An intake of 16.6 mg/kg/day appeared to be adequate for one infant.
BLOOD PRESSURE AND VASOMOTOR REFLEXES IN THE NEWBORN INFANT
Authors: Moss Arthur J. , Duffie Edward R. , Emmanouilides George 
Published: December 2021

The aortic pressure was measured via an umbilical artery in 74 normal full-term and 26 premature infants. The ages ranged from 1 to 77 hours and the weights from 1.2 to 4.5 kg. The pressure was lower in the premature than in the full-term group and there was a positive correlation with age in both groups and with weight in the premature group.
Vasomotor reactivity was appraised by use of the cold pressor test and postural tilting. The results indicate that the vasomotor regulatory mechanisms are present and functional at birth in premature as well as in full-term infants.
Unusual Responses to Smallpox Vaccinations in Two Children
Authors: HYATT HERMAN W. 
Published: December 2021

Since it appears that no case of lymphatic transfer of smallpox vaccine to new areas with resultant primary takes or of excessive hair growth around the periphery of a recently healed smallpox scar has been described in the medical literature, it seems important to report one infant with the former, and another with the latter, condition.
Case 1
F.S., a 3-week-old white male infant, received a smallpox vaccination on the right deltoid area, June 3, 1956 at Kern County Health Department, Bakersfield, California.
On June 15, an enlarged lymph node (about 1.5 cm in diameter) appeared in the right axilla. Although somewhat tender on June 15 and 16, the swollen node was barely palpable on June 17.
On June 16, an elevated erythematous "ridge" extended from the right deltoid vaccination site to the elbow. On June 17, the erythematous area had extended to the dorsum of the hand, about 1 cm below the wrist. Immediately below the termination of the "ridge" a small yellow vesicle had formed, after which the entire erythematous area disappeared. Subsequently, an elevated erythematous area extended from the vesicle to the end of the distal phalanx of the third right finger. On June 19, a yellow vesicle formed on the indicated finger immediately below the termination of the erythematous area. Shortly after the formation of the second vesicle, the erythematous "ridge" spontaneously disappeared.
The vesicles underwent desiccation, umbilication, and scab formation. The scabs thereafter separated, leaving the typical pitted smallpox scar. (Except for the tiny needle pricks related to the original inoculation, there was no change in the deltoid vaccination site.)
MILK ALLERGY
Authors: Goldman A. S. , Anderson D. W. , Sellers W. A. , Saperstein S. , Kniker W. T. , Halpern S. R. 
Published: December 2021

The diagnosis of milk allergy was confirmed in 89 children by oral challenge with milk and/or purified milk proteins. Most of these patients were diagnosed as allergic during the first 2 years of life. The symptoms of milk allergy usually began during the first few months of life. Eighteen of the total patients experienced spontaneous remission of milk hypersensitivity. Multiple symptoms were produced by oral milk challenge in 77% of the patients. Vomiting, diarrhea, abdominal pain, asthma, rhinitis, and atopic dermatitis were frequently presenting and challenge symptoms. Several patients had central nervous system symptoms, urticaria, or anaphylactic reactions following milk challenge. Seventy-eight per cent of the presenting symptoms were reproduced by oral milk challenges. Challenge feedings produced symptoms not found in the history in 18% of the patients. No consistent patterns of symptom combinations were found.
The onset time of oral challenge reactions was usually within the first 12 to 24 hours. Some reactions occurred within a few minutes while others required 2 days or more before they were discernible. The duration of challenge reactions was usually between 12 to 24 hours. Allergic symptoms appeared much sooner after oral challenge in the patients who required less milk to elicit an allergic reaction.
Forty-five patients were challenged with amounts of the purified milk proteins, casein, alpha-lactalbumin, beta-lactoglobulin, and bovine serum albumin, present in the challenge doses of 100 ml skim milk. Every patient had an allergic reaction to one or more milk proteins. The frequencies of reactions were casein, 57%; BSA, 51%; beta-lactoglobulin, 66%; and alpha-lactalbumin, 54%. The reactions from oral challenge to skim milk or purified milk protein in a given patient were very similar. No correlation was found between the symptoms produced and the specific protein which produced these reactions.
By oral challenge tests few patients (13%) were allergic solely to the heat labile protein, BSA. Only two of these patients could be actually managed on a processed milk in which BSA was inactive by laboratory tests.
PRESIDENT'S MESSAGE
Authors: Webb Clarence H. 
Published: December 2021

QUESTIONS are asked, sometimes hesitantly, sometimes stridently: Shall the American Academy of Pediatrics continue its traditional role in the framework of American medicine? Or should it alter the purposes expressed by the founders, to which it has held consistently through the years? Should it become partisan on behalf of the pediatrician's welfare, a political-action organization, active also in medical economics?
Those who have concern for the ultimate future of pediatrics and the path which the Academy travels must take a thoughtful, searching look at these questions and arrive at a concert of opinion.
Why do these questions arise?
They represent one expression of growing pains in our specialty. All surveys and reports indicate that pediatrics is flourishing, one of the fastest growing of the specialties. Increasing numbers of American and foreign graduates are in pediatric residency training and apply to the American Board of Pediatrics for certification. Many foreign trainees remain in the Americas and seek citizenship. The present body of pediatricians, in practice, teaching, and research, has neither the post-training experience nor the cohesiveness of purpose of the Academy founders and members during its formative years; many lack the reassurance of established solidity.
Paralleling this development, the Academy grows in size, significance, and comprehensiveness of program. Now 8,000 in membership, it is the largest pediatric organization in the world. Its voice on behalf of children becomes increasingly persuasive; its programs of training, of research into special problems, of committee activities in many spheres of child health and welfare, its reports and publications, have an expanding influence.
The Disgruntled Pediatrician Syndrome
Authors: VANDERSALL THORNTON A. 
Published: December 2021

One year ago, after 3 years of practice, I left Pediatrics and began a 3-year fellowship in Psychiatry. In the belief that my thoughts about leaving have more than purely personal validity, I am submitting them here.
I began with the stark realization that I did not like practice. Having reveled in hospital Pediatrics, I was surprised. I first complained that the work of practice was not essential (compared to "sick child" care in hospitals). Any mother who picks up the phone to call a pediatrician can point out the error in that argument.
ADENOVIRUS COMPLEMENT-FIXING ANTIBODY TITERS FROM BIRTH THROUGH THE FIRST YEAR OF LIFE
Authors: Nemir Rosa Lee , O'Hare Donna , Goldstein Stanley , Hilton Charles B. 
Published: December 2021

Complement fixing antibody titers to the adenoviruses were determined in 251 newborn infants, using cord blood. Approximately 95% of these were found to have CF titers of 1:16 or over, the majority (75%) were 1:32 or more. Material from the pharyngeal and rectal swabs of these infants on tissue culture studies (542) on HeLa and amnion cells showed no cytopathic effect in oven 96% of these infants.
A longitudinal study of 114 of these infants was made at 3 months intervals; 67 have been observed for one year. At 3 months, only 12% still showed CF antibody titers, and these were chiefly at a low level, 1:16. At the subsequent 3-month interval observations, a gradual rise in CF antibodies were found. At one year of age, approximately 37% had titers of 1:32 on over.
The findings of this report support the statement that CF antibodies to adenovirus pass the placental barrier. There is a gradual increase in the percentage of infants with positive CF antibodies after 3 months.
ORGANIC ACIDS IN FETAL BLOOD AND AMNIOTIC FLUID
Authors: Räiha Niels C. R. 
Published: December 2021

The acid-base balance and the concentrations of lactate, pyruvate, citrate, alphaketoglutarate and total acetone bodies have been studied in human amniotic fluid and in cord blood. Lactate and citrate concentrations are elevated in amniotic fluid, the other acids being present in a concentration similar to that in blood.
Lactate accounts for only a part of the total metabolic acidosis in cord blood. The concentration of the other organic acids studied does not explain this difference.
The lactate and pyruvate concentrations are significantly correlated with the degree of metabolic acidosis in cord blood expressed as negative base excess, the other acids showing no correlation with the degree of acidosis and asphyxia.
An Atlas of Congenital Heart Disease
Authors: SISSMAN NORMAN J. 
Published: December 2021

Despite the vast experience accumulated during the past decade with all aspects of the lives and deaths of patients with congenital heart disease, there is still room for the clarification and direction that careful, informed, imaginative analysis of the results of pathological examination of postmortem material can give to the clinical management of these patients. Dr. Sherman has made a notable contribution in this area with the present volume.
The atlas was compiled from 503 specimens collected in the Museum of Congenital Heart Disease at the Children's Hospital in Pittsburgh since 1954.
A COMMUNITY EPIDEMIC OF ENTEROPATHOGENIC ESCHERICHIA COLI O126:B16:NM GASTROENTERITIS ASSOCIATED WITH ASYMPTOMATIC RESPIRATORY INFECTION
Authors: Boris Marvin , Thomason Berenice M. , Hines Virginia D. , Montague Tom S. , Sellers Thomas F. 
Published: December 2021

A 15-month surveillance was conducted at a metropolitan hospital for detection of enteropathogenic Escherichia coli (EEC). Of the 383 admissions, 151 cases of gastroenteritis (39.6%) were due to EEC as determined by the fluorescent antibody (FA) method. During the late summer of 1962, the O126:B16:NM strain was unusually prevalent, having been detected in 39 of the 82 cases (47.5%) of EEC enteritis. Epidemiologically, the outbreak was localized in three geographically distinct areas. Age and race specific rates for infants hospitalized with O126:B16:NM enteritis from these areas were 73.2, 54.5, and 118.2 per 1,000 population.
Age and race specific attack per 1,000 population for all gastroenteritis in the clinic population and hospitalized patients were 177.2 and 30.3, respectively, with 31.7% due to EEC. In the nonwhite population, 0-3 months of age, 13% of the infants were hospitalized for gastroenteritis of which 53% was caused by EEC.
In three selected hospital populations, 6 of 270 surveyed infants were asymptomatically infected with EEC, an incidence of 2.2%.
In a community investigation, 50% of index households had one or more asymptomatic pharyngeal carriers of strain O126:B16:NM, while next-door neighbor households and distant community control households had pharyngeal carrier rates of 33 and 0% respectively. Intestinal carriage rates in these three groups were 18%, 3%, and 0%, respectively. Follow-up studies in pharyngeally infected neighbor households in which no members were intestinal carriers of EEC revealed on subsequent examinations six previously uninfected individuals became infected in four of five households examined. This implies a respiratory transmission of EEC.
MENTAL RETARDATION AND THE MATERNAL AND CHILD HEALTH AMENDMENTS OF 1963
Authors: LESSER ARTHUR J. 
Published: December 2021

IT IS A little over a year since a Panel appointed by the President published its report entitled "A Proposed Program for National Action to Combat Mental Retardation." In preparation for the report, members of the Panel discussed mental retardation in its broadest aspects with thousands of people in this country and abroad. Over 90 recommendations for action were made including recommendations for federal legislation.
The enactment in October, 1963, of Public Law 88-156, "The Maternal and Child Health and Mental Retardation Planning Amendments of 1963" will make it possible for the Children's Bureau to carry out some of the major recommendations of the President's Panel.
WHY ARE TWINS DISSIMILAR?
Authors: DRISCOLL SHIRLEY G. 
Published: December 2021

TWINNING has captured the imaginations of artist, story-teller, and scientist throughout recorded history. Many studies of the intrapair likenesses and differences of twins have been directed toward elucidation of the interplay between nature and nurture. Yet the dissimilarities which occur within twin pairs may not be recognized and the mechanisms which underlie these differences often are not understood. Indeed, clinical observation of discordance between cotwins seems to evoke surprise, especially when such dissimilarities are evident at birth and in monozygous twins. In terms of the health and survival of the twins, these phenomena may be of critical importance.
How do these differences arise? Dissimilarities between dizygous twins are to be expected, reflecting the individual genetic heritage of two siblings, as they evolve contemporaneously.