bluuebunny/crossref_metadata_2025_split huggingface dataset:
TREATMENT OF CONGENITAL MEGACOLON IN 50 INFANTS
Authors: Shim Walton K. T. , Swenson Orvar 
Published: December 2021

Fifty infants less than 1 year old with Hirschsprung's disease were treated at Children's Memorial Hospital in the past 6 years.
Thirty-two of the 35 barium enema studies yielded "diagnostic" roentgenographic studies, and 3 were "negative" for Hirschsprung's disease. Fourteen of the 50 infants had a history of diarrhea. Enterocolitis in infants may be extremely rapid in onset and progression. It should be vigorously treated with rectal irrigations and intravenous fluids.
Nineteen patients (38%) had aganglionic segments extending above the rectosigmoid colon, and eight (16%) were aganglionic proximal to the splenic flexure. This includes three patients with aganglionosis of the entire colon and one that was aganglionic from the jejunum to anus.
Emphasis is placed on an aggressive combined attack by pediatrician, radiologist, pathologist, and surgeon to diagnose and prepare the sick infant as early as possible for colostomy or definitive abdominal-perineal pull-through operation. Twelve infants with an average weight of 12.5 lb were operated on primarily with no deaths or complications. It is our belief that definitive surgery can be done with greater ease in an infant than in older children, but careful selection and preparation of the patient and meticulous operative technique must be exercised. The important criteria for selection of infants for immediate resection are the absence of emaciation and enterocolitis, although the infant may be small.
Twenty-six infants had colostomy and resection with no deaths or complications.
Our raw mortality figures show 10 deaths in 50 patients (20%). There were 7 deaths in 47 surgical patients (15%).
America's Unhealthy Children: An Emerging Scandal
Authors: BATES TALCOTT 
Published: December 2021

With a brief nod to the Teaching Medical Center and the middle and upper class, predominantly suburban, private pediatric practice, Tunley takes off on the deficits of American pediatrics. His list begins with antenatal care.
In the field of obstetrics we are an underdeveloped country; we rank sixth in infant mortality; the proportion of women receiving antenatal care is declining; our lowest infant mortality, even in essentially all white states, is above Europe's best.
Our free clinics are "alms" oriented, crowded, inconveniently located, bleak and uninviting, poorly staffed, with rude and thoughtless personnel; in other nations they are convenient, attractive and offer inducements—layettes in Finland, cash bonuses and compensation for loss of income during pregnancy in Sweden.
TIME-MOTION STUDY OF PRACTICING PEDIATRICIANS
Authors: Bergman Abraham B. , Dassel Steven W. , Wedgwood Ralph J. 
Published: December 2021

Four practicing pediatricians were followed by an observer with a stopwatch for a total of 18 days to gain a profile of how their working days were spent.
An average of 48% of the day was spent with patients, 12.5% on the phone, and 9% on paper work. Fifty per cent of patient time was spent with well children, and 22% on children with minor respiratory illness. Intellectual understimulation seemed to arise from spending the majority of time with children who did not require their special talents.
In view of the alarming decline in ratio of physicians to child population, pediatricians are urged to play a decisive role in formulating the alternative patterns of child health care that must inevitably develop in the United States.
THE NATURE OF A SMALL PEDIATRIC GROUP PRACTICE
Authors: Breese B. B. , Disney F. A. , Talpey W. 
Published: December 2021

The nature of a small suburban three-man group practice in Rochester, Monroe County, New York, has been analyzed largely from special records of patients seen on every fifteenth day over the 2-year period 1959 to 1960.
Data are presented on the growth of pediatric practice within the county, the distribution of pediatricians, the increase in groups, the number of patients seen, distribution of calls by year, month, day of week, and time of day, together with information on the age of patients, parents' age, their type and place of occupation, size of family, presence and absence of tonsils, diagnosis, treatment, charges to patient, and some additional figures on the economics of our particular practice.
1. The carrier rate for beta hemolytic streptococci among normal children in a private pediatric practice when direct inoculation of cultures onto sheep blood agar plates are used is extremely low (less than 4%).
2. Because of these low rates among "normal" children, positive cultures, particularly strongly positive ones, are generally of diagnostic importance.
3. The lower carrier rate found in our practice than that reported by other investigators is probably due to differences in our bacteriologic methods, the age of the children sampled, and our method of treating known streptococcal illness.
4. Significant streptococcal illness is an exceedingly common and important illness in our practice; it is found in approximately 1 child in 20 of all children, sick or well.
5. The frequency of streptococcal illness seems to have a definite relation to age and season of the year.
Cardiac Pacemakers
Authors: LYNFIELD JOSHUA 
Published: December 2021

Publication of the interesting report of implantation of a cardiac pacemaker in a 4-month-old infant by Martin, et al. (Pediatrics, 37:323, 1966), raises the question of pacemaker selection for the infant with heart block. The Cordis Atriocor Synchronous type of pacemaker is probably best for this condition because it is possible to vary the ventricular rate according to the needs of the body at rest and during exercise over a fairly wide range.
The advantage of this pacer is that atrial activity is in control of pacemaker function over a physiological range of heart rates.
PNEUMOCYSTIS CARINII PNEUMONIA AND ALTERED HOST RESISTANCE: TREATMENT OF ONE PATIENT WITH PENTAMIDINE ISETHIONATE
Authors: Patterson Joseph H. , Lindsey I. L. , Edwards E. S. , Logan William D. 
Published: December 2021

Three infants with proved Pneumocystis carinii pneumonia and immunologic deficiency are reported. Pertinent aspects of the clinical history, physical findings, laboratory data, and x-ray examinations are discussed.
Review of the pediatric literature confirms the association of P. carinii pneumonia in infants with altered host resistance.
Emphasis is given to the value of open lung biopsy as a diagnostic tool.
The experience of treatment and re-treatment of one infant with pentamidine isethionate (4 mg/kg/day) and gamma-globulin is recorded.
The underlying disease state of immunologic deficiency or lymphoreticular disease may make the ultimate prognosis grave, even in view of clinical improvement or recovery from P. carinii pneumonia following treatment with pentamidine isethionate.
CONGENITAL ABSENCE OF THE PARATHYROID AND THYMUS GLANDS IN AN INFANT
Authors: Taitz Leonard S. , Zarate-Salvador Concepcion , Schwartz Eugene 
Published: December 2021

A female infant with congenital absence of the parathyroid and thymus glands is reported. In addition, the patient developed renal tubular acidosis which was associated with nephrocalcinosis. The relation of this complication to the presence of hypomagnesemia and the administration of parathyroid hormone calcium and vitamin D is discussed.
It is proposed that two forms of primary hypoparathyroidism are seen in the first year of life. One is a non-lethal sex-linked form. The other, to which the patient reported here belongs, has a high mortality which may be due to immunological disorders secondary to the absence of the thymus gland or multiple associated anomalies.
DIAGNOSIS AND TREATMENT: NASOTRACHEAL INTUBATION AS A SUBSTITUTE FOR TRACHEOSTOMY
Authors: Smith Robert M. 
Published: December 2021

THE OBVIOUS advantages of tracheostomy must always be weighed against the hazards and complications with which it may be associated. The initial performance of the operation may entail complete airway occlusion, hemorrhage, or cardiac arrest secondary to sudden reduction of carbon dioxide concentration. Maintenance of the tracheostomy may involve pneumothorax, pneumomediastinum, sepsis, and occlusion or dislocation of the tube, and final removal can be followed by such problems as tracheal collapse or stenosis.
To avoid some of these difficulties a new concept has been introduced whereby a smooth, sterile endotracheal tube is introduced through the nose and maintained in place for several days, or even weeks. Undoubtedly the method had been used in many individual situations throughout the world, but the idea was first tried on a large scale in Australia. In the Adelaide Children's Hospital and in The Royal Children's Hospital of Melbourne tracheostomy has been largely abandoned and only endotracheal intubation has been used for the past two years in children with laryngotracheitis, croup, and various other types of reversible respiratory inadequacy. In these hospitals tracheostomy is reserved for inindividual situations where secretions are especially heavy or in some patients with severe laryngotracheitis. Nasotracheal intubation has been adopted throughout many parts of the British empire and has recently been employed widely throughout the United States.
The indications for nasotracheal intubation are similar to those for tracheostomy. Children in whom airway obstruction results in retraction, stridor and, finally, increasing pulse rate constitute one group of patients who require such assistance.
Letters to the Editor
Authors: WRIGHT F. H. 
Published: December 2021

As Dr. Van Leeuwen suggests, the points made in his letter were considered in some detail before and during the Institute on Residency Training held by the American Board of Pediatrics last September in Atlanta. A summary of these deliberations appears as the October supplement to Pediatrics. The following rejoinder to Dr. Van Leeuwen's letter is a personal rather than an official interpretation of the "sense of the meeting."
The impending shortage of pediatricians in this country is recognized.
INFANT MORTALITY RATES FOR THE TOWN OF SALEM, MASSACHUSETTS, IN 1782 AND 1783
Authors: C. T. E. 
Published: December 2021

The infant mortality rate for a single New England town for the years 1782 and 1783 cannot be used as a true index of this statistic for the 13 states which made up the United States during the 1780's. As we lack data concerning infant mortality for the country as a whole during this period, information about the mortality of infants in the town of Salem, Massachusetts, where all births were recorded, should be of interest to pediatricians.
Doctor Edward A. Holyoke of Salem in a letter to Mr. Caleb Garnett, the Recording Secretary of the American Academy of Arts and Sciences, gave these figures for the town of Salem:
In 1782 there were 311 live-born infants and of these 36 died before they reached their first birthday, for an infant mortality rate of 115.
In 1783 of 374 live-born infants, 38 died during their first year of life, for an infant mortality of 102.
When one recalls that the rate for 1915 in the United States was 100, the infants, at least in Salem, did not fare too badly.
Cardiomegaly due to Chronic Hypocalcemia
Authors: ANTEBI L. , BOUCHARD R. , GUEDENEY J. , PERLES C. , WEILL J. 
Published: December 2021

The occurrence of cardiomegaly as a consequence of chronic hypocalcemia is extremely rare. We have recently studied a 9-year-old child in whom cardiomegaly, coexistent with hypocalcemia, was demonstrated; there were no signs of cardiac insufficiency. Normalization of cardiac size accompanied restoration of normocalcemia.
CASE HISTORY
The patient was referred at the age of 8 years, 7 months because of mental retardation and convulsive seizures. The neonatal period was normal, but febrile convulsions began at 6 months of age. Convulsive episodes became more frequent and severe after 1 year of age, and developmental retardation was evident. He had daily seizures by 8 years, 7 months, was constantly agitated, and did not talk; his weight was 24 kg and his height was 122 cm.
Letters to the Editor
Authors: TOWNLEY REGINALD 
Published: December 2021

I regret that my comments on dietary management of sucrose intolerance may have lacked sufficient detail. Apart from sucrose itself all cakes, candy, soft drinks, chocolate, ice-cream, fruit preserves, jellies, syrups, and sweetened condensed milks are likely to contain large amounts of sucrose and should be avoided or restricted. Enquiries should be made of the manufacturer where doubt exists about the sucrose content of commercial products.
Common fruits and vegetables which contain significant amounts of sucrose include sugar beets, sweet potatoes, bananas, dates, and pineapples.
A DEVELOPMENTAL SCREENING INVENTORY FOR INFANTS
Authors: Knobloch Hilda , Pasamanick Benjamin , Sherard Earl S. 
Published: December 2021

PREDICTIVE diagnosis of development is possible because behavior matures in an orderly fashion, but it is not a simple matter. Unlike most other diagnostic problems in medicine, disturbances in neuropsychologic functioning involve integration on many different levels, from the biologic to the sociocultural. Analysis of something as complex as behavior thus is not without difficulties, and extensive training in making, and interpreting, observations is necessary for accurate diagnosis.
The number of children in whom abnormal development is suspected is enormous, the need for service great and the supply of specialists limited. Under these circumstances an adequate screening procedure which will detect infants in need of referral for a complete diagnostic evaluation is of great value. A number of devices and lists of behavior have been offered; when they have been tested at all it has not been for their correlation with an examination that has predictive ability. They have consisted for the most part of a few behavior patterns at widely separated ages and most have fallen into disuse because of their apparently unsatisfactory nature.
CRITERIA FOR AN ADEQUATE SCREENING DEVICE
In evaluating development one is concerned with both present and future functioning, and the complete examination from which the screening inventory is derived must be an adequate predictor of later abnormality. First, then, it must have validity. Since this predictive value can be determined only by longitudinal studies, such data must derive from follow-up correlations between complete infant examinations and those at later ages. Further, for prediction as well as for present management, intellectual defect and motor disability must be distinguished.
PRESIDENT'S ADDRESS
Authors: Hughes James G. 
Published: December 2021

AT THE CONCLUSION of his term of office, it is traditional for each President of the Academy to address the membership on some topic of importance. In the 20 years I have regularly attended these meetings, I have listened to many distinguished predecessors make impressive presentations. The most common theme has been a review of the Academy's progress during the particular president's term of office, joined to a prediction of things to come—problems posed, challenges to meet, goals to set.
I think it is worthwhile to pause in this manner—to take stock of ourselves, inventory assets, admit liabilities, strike a balance, and forge ahead.
In former years the annual address was the principal means by which the president conveyed his thoughts to the membership. Therefore, the presentations were often lengthy, though highly interesting.
Nowadays, the membership is virtually flooded with information concerning Academy activities. The Newsletter appears twice a month, covering a wide range of subject material. Chapter and Section letters are distributed periodically. The President, District Chairmen, and Central Office pediatric personnel meet often with the members, usually at District or State Chapter meetings. We also have the reports of the Executive Director, Secretary, Secretary for Chapters, Secretary for Committees, Director of Information, Committee Chairmen, and an increasing number of excellent Academy manuals. In brief, our communications network is highly developed.
Therefore, it would be redundant of me to review in detail the events of the past year in the life of the Academy. Besides, I have already discussed them on more than one occasion in issues of the Newsletter.
History of the American Pediatric Society 1887-1965
Authors: STOKES JOSEPH 
Published: December 2021

There would appear to be few more difficult assignments in historical review than that of covering the multitude of items in the field of medical science—and what was mostly not science—with which the American Pediatric Society was concerned during its growth and development.
When one remembers that, at the time of its birth in 1888, such procreators as its first president, Abraham Jacobi (who also became President of the American Medical Association), William Osler, Job Lewis Smith, Luther Emmett Holt, William Pepper, Victor C. Vaughan, and Henry Dwight Chapin were just beginning to accept the revolution of Louis Pasteur and Lister, one can well imagine the authors' problem of unfolding, in adequate sequence, the rapidly developing panorama of pediatric medicine.
CLINICAL PHARMACOLOGY OF ANTIMICROBIALS IN PREMATURE INFANTS: II. AMPICILLIN, METHICILLIN, OXACILLIN, NEOMYCIN, AND COLISTIN
Authors: Axline Stanton G. , Yaffe Sumner J. , Simon Harold J. 
Published: December 2021

The absorption, apparent volumes of distribution, serum concentrations, serum half-lives, and urinary excretion of ampicillin, methicillin, oxacillin, neomycin, and colistin were studied in premature infants by means of a micro-diffusion technique.
Marked changes in serum half-lives and urinary excretion of the penicillins occurred during the first month of life. The serum half-lives of ampicillin and methicillin declined from 4.0 and 2.4 hours to 1.6 and 1.2 hours, respectively, as postnatal age increased from 1 week to 1 month. The serum half-life of oxacillin declined from 1.6 hours in 1 to 2-week-old infants to 1.2 hours in those 3 weeks of age. Concomitantly, urinary excretion rate of the penicillins increased approximately twofold as the age of infants increased from 1 week to 1 month, suggesting that immature renal function was partially responsible for the elevated serum half-lives of the penicillins in the younger premature infants.
The serum half-life of neomycin was 6.5 hours in premature infants less than 2 weeks of age. It declined progressively to 3.3 hours in 3-week-old infants. The age-related changes in serum half-life were independent of birth weight.
In contrast to the findings with the penicillins and neomycin, the serum half-life of colistin was not prolonged in premature infants, nor did it change with postnatal age. The mean serum half-life of colistin in premature infants was 2.4 hours.
A method for using these data to calculate ampicillin, methicillin, oxacillin, neomycin, and colistin dosages appropriate for premature infants has been presented.
BACTERIAL AND VIRAL COPROANTIBODIES IN BREAST-FED INFANTS
Authors: Kenny Jean F. , Boesman Mary I. , Michaels Richard H. 
Published: December 2021

Stools of newborn breast-fed infants may contain significant amounts of hemagglutinating antibody to enteropathogenic E. coli and neutralizing antibody to polioviruses. Stool titers averaged only fourfold lower than maternal milk titers for antibacterial and less than twofold lower for antiviral activity. Similar ratios of stool:milk activity were also found for paired specimens obtained during the second and third postpartum months.
The stool antibodies were stable at 56°C and exhibited definite specificity. Bacterial hemagglutinins in feces were more sensitive to mercaptoethanol than the poliovirus neutralizing activity. Stools from breast-fed infants contained gamma-1 globulins similar to those in milk, including IgA and small amounts of IgM.
Meconium from bottle-fed infants with high serum antibody titers to polioviruses contained traces of homotypic neutralizing antibody. Antiviral and antibacterial activity were not detected in transitional and later stools from artificially fed infants, nor were human immune globulins.
Milk bacterial hemagglutinating antibodies were more resistant to acid and to pepsin than those in serum. Furthermore, acid had a less deleterious effect on virus neutralizing activity in milk than it had on that in serum, and it also had less effect on the milk antiviral than on the milk antibacterial antibodies.
THE CHILD IN MEDIEVAL SOCIETY
Authors: C. T. E. 
Published: December 2021

As Philippe Aries has dramatically called to our attention, childhood as a phenomenon unto itself is an invention of modern times. He writes:
In medieval society the idea of childhood did not exist; this is not to suggest that children were neglected, forsaken, or despised. The idea of childhood is not to be confused with affection for children: it corresponds to an awareness of the particular nature of childhood, that particular nature which distinguishes the child from the adult, even the young adult. In medieval society this awareness was lacking. That is why, as soon as the child could live without the constant solicitude of his mother, his nanny, or his cradle-rocker, he belonged to adult society. . . . Language did not give the word "child" the restricted meaning we give it today: people said "child" much as we say "lad" in every day speech. The absence of definition extended to every sort of social activity: games, crafts, arms.
BREATHHOLDING SPELLS (CYANOTIC AND PALLID INFANTILE SYNCOPE)
Authors: Lombroso Cesare T. , Lerman Pinchas 
Published: December 2021

A study of the incidence, evolution, and pathophysiology of so-called "breathholding spells" has been carried out prospectively, retrospectively, and physiologically in three groups of patients.
The term of infantile syncope is proposed for these attacks initiated by a noxious stimulus and in which both consciousness and posture are lost.
Convulsive components may occur if cerebral anoxia is marked. The degree of breathholding varies considerably among attacks, but is prominent in a majority.
From the clinical point of view, breathholders could be assigned to a cyanotic group, a pallid group, or an indeterminate group.
Such spells occurred in 4.6% of 4,980 individuals, and those affected tended to have a positive family history of such attacks.
The onset of such attacks varied from the neonatum to the middle of the fourth year, the commonest ages being between 6 and 18 months.
Precipitating factors consisted of mild injuries, frustration, or fright, and the factor of surprise seemed important.
From the retrospective point of view the attacks ceased spontaneously at or before school age.
Epilepsy and mental deficiency were unrelated to breathholding attacks.
Syncopal attacks in adulthood were a frequent sequel of breathholding attacks in infancy.
Differentiation into two physiologically diverse groups of cases could be made by monitoring the results of the oculocardiac reflex with simultaneous electrocardiogram and electroencephalogram.
Among cyanotic breathholders the response to ocular compression tended to be the usual one of bradycardia or brief asystole.
Among the pallid group, cardiac asystole was more prolonged and electroencephalographic abnormality paralleled it.
The prognosis for either type was excellent.
Differentiation from epilepsy was important, since treatment for epilepsy was usually unrewarding and often pushed to toxic levels.
In the pallid group with many attacks the use of atropine has been helpful, but treatment in most instances was unnecessary.