bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE PEDIATRICIAN AND THE PUBLIC
Authors: Dean R. F. A. 
Published: December 2021

IN THE proper study of human nutrition, it is impossible to keep a limited objective, because the problems that at first sight appeared to be academic are quickly seen to be problems in ecology. The difficulty of selection of the most profitable lines of enquiry increases greatly, and the present account of the Infantile Malnutrition Group will probably be found to illustrate that difficulty only too well. As always happens in practice, the selection made was dominated to a large extent by familiarity with certain techniques, and other investigators with different techniques at their command would undoubtedly have chosen differently. The account also attempts to indicate the necessary scope of an enquiry into the effects of undernutrition on the development of the African child, and into the measures required to eradicate the undernutrition.
I. THE ORIGINS OF THE GROUP
1. Mulago Hospital Kampala
Early in 1951, the author and one assistant, a biochemist, arrived in Uganda. Their aim was to find to what extent some earlier work on the use of plant proteins, carried out in Germany shortly after the recent war, might be applicable to East Africa. It was at once obvious that nowhere in Uganda would it be possible to find an orphanage, or similar institution, where a collection of young children might be closely observed under controlled conditions.
TREATMENT OF TUBERCULOSIS IN CHILDREN
Authors: Jones Edna M. , Howard W. Leonard 
Published: December 2021

The history of antimicrobial therapy (AMT) of tuberculosis in children at the Wm. H. Maybury Sanatorium is reviewed; its superiority over previous treatment is emphasized by the change in mortality. The importance of treating early cases of primary tuberculosis is shown by comparing the results of 2 similar groups of cases, one treated with and the other without antimicrobial therapy. Although the AMT cases showed markedly better progress as shown by roentgenographic clearing and conversion of gastric and pharyngeal cultures, the occurrence of temporary worsenings could not be prevented. The freshness of the disease seemed to be the most important factor in the development of worsening. In the AMT group they cleared more promptly and left less residuals than in the controls. Worsening was more likely to occur in the persistently positive culture cases among the controls but not among the AMT cases.
The various regimens of antimicrobial therapy are discussed; isoniazid is considered to be a necessary part of each AMT combination for the first year. The need for early diagnosis is emphasized and the values of early treatment are discussed. One of the weakest links in the antimicrobial therapy of tuberculosis in children would seem to be the delay in its use until the organisms have created large areas of caseous necrotic tissue in which to barricade themselves. If we knew the tuberculin reaction of all children and could start treatment at the time of conversion and continue for 9 to 12 months we should be able to eliminate generalized tuberculosis and prevent the possibility of endogenous reinfection later in life.
THE USE OF GAMMA GLOBULIN IN THE TREATMENT OF MEASLES ENCEPHALITIS
Authors: Allen John E. , Frank Donald J. 
Published: December 2021

A clinical review of 25 recent cases of measles encephalitis demonstrates the continued importance of measles in the field of contagious diseases.
A comparison of a group of patients with measles encephalitis treated with supportive therapy only, with a group treated with massive doses of gamma globulin, is presented. The over-all results of this study do not demonstrate any effect on the rate of sequelae or of complete recovery rate in those patients receiving massive doses of gamma globulin. While a possible decrease of mortality was demonstrated in those patients treated with gamma globulin, statistical analysis does not support this conclusion. This information is compared to that from a similar study by Odessky et al.
It is concluded that gamma globulin in massive doses is not indicated in the treatment of measles encephalitis.
The extreme importance of modifying all cases of measles in all age groups whenever possible is emphasized as a most potent tool for the prevention of measles encephalitis, as well as other post-measles complications.
SPECIAL ARTICLE
Authors: Payne Wilfrid W. 
Published: December 2021

IT IS a great honour to be asked to give a lecture dedicated to Kenneth Black-fan. His work and reputation are known to all who have the good fortune to work in children's hospitals. Much of the work on which this paper is based stems from that which he and Dr. Gamble pioneered some 3 decades ago.
In recent years considerable advances have been made in our knowledge of the function of the renal tubules, and this in turn has enabled the student of human pathology to understand to some degree the previously inexplicable vagaries of some diseases now assumed to be due to renal tubular dysfunction.
A very full classification of these tubular defects has been made by Fanconi and I am greatly in his debt for it. However, I propose to rearrange this classification to some extent and to suggest a framework into which renal tubular defects can be fitted.
Briefly, tubular functions can be separated into 3 groups (Fig. 1).
I. Reabsorption in Bulk
Water
Sodium
Chloride
Bicarbonate
This group represents the main constituents of the glomerular filtrate and is often considered to be reabsorbed by the proximal tubule, but it is quite likely that the distal tubule also takes part.
II. Specific Reabsorption
Glucose
Phosphate
Individual amino acids
Calcium
Uric acid
Potassium (?), etc.
These substances are reabsorbed specifically, and this is assumed to occur in the proximal tubule.
III. Maintenance of Biophysical Body Constants
Regulation of pH [SEE THE FIG 1 IN SOURCE PDF]
Regulation of size of extracellular fluid space
Regulation of plasma osmotic pressure
ON FINGER-SUCKING
Authors: SENN MILTON J. E. 
Published: December 2021

ONE OF the perennial problems of child care for parents and professional folk alike is that of finger-sucking. Over the years as even now, parents have worried about this practice and brought it to the attention of their physicians who, like dentists, have had strong feelings on the subject.
American pediatric literature from the Eighteenth Century down to the present time has frequently discussed finger-sucking as to its normality, prevention and cure. As with most issues, there have been advocates as well as opponents of the idea that this behavioral trait was beneficial to the well-being of an infant.
GOITERS IN CHILDHOOD
Authors: Crawford John D. 
Published: December 2021

CHILDREN with various types of goiter presently constitute approximately 16 per cent of the new admissions for primary endocrine disease seen in the Adolescent Endocrine Clinic at the Massachusetts General Hospital. Hence, it is evident that these conditions are by no means uncommon. In all fairness to the non-endocrinologist, however, the frequency of occurrence should be put in a second frame of reference. Such perspective is gained by noting that only about 1 per cent of the total new admissions to this hospital are comprised of patients with primary endocrine disorders.
Thyrotoxic goiter and 5 other types will be given consideration; the latter include neonatal goiter, the goiters of adolescence and lymphocytic infiltration, the goiter of defective thyroxin synthesis and, finally, thyroid carcinoma. Iodine deficiency goiter has become so rare in this country as a result of prophylaxis as to deserve no more than mention. In the past 5 years we have encountered only 1 case, that in a boy of 8 years, a recent immigrant from the Italian Alps.
NEONATAL GOITER
Goiters in newborn infants are not seen frequently but every pediatrician who deals with neonates should be in a position to recognize the syndrome, understand its causation and prognosis and to advise therapy. These goiters are seen most frequently in infants born of mothers receiving iodides for hay fever or asthma or of mothers being treated for thyrotoxicosis with one of the thyroid synthesis blocking agents. In the first instance, iodide or an iodide metabolite appears to cross the placenta and block the fetal TSH secretion.
ARTHROGRYPOSIS
Authors: Kanof Abram , Aronson Stanley M. , Volk Bruno W. 
Published: December 2021

Three typical cases of arthrogryposis are presented.
Neurological examination points to involvement of the central nervous system in this illness.
Repeated muscle biopsies in all 3 patients and a complete post-mortem examination in 1, suggest that this may be an infantile form of neuromuscular atrophy rather than a primary disease of either the joints or the muscles.
Neither the use of steroid therapy nor prostigmine produced lasting benefits, although ACTH did seem to produce a definite, though slight, effect in freeing motion in the smaller, peripheral joints.
One patient may have benefited from application of rehabilitation techniques.
TRANSFUSIONS IN PEDIATRIC PRACTICE: INDICATIONS AND LIMITATIONS
Authors: Smith Carl H. 
Published: December 2021

The effectiveness of transfusion of whole blood or any of its components depends in large measure on a clear understanding of the anticipated role in supplying a specific deficiency or correcting a pathologic state while realizing the limitations and hazards.
A prerequisite in infants and children is a knowledge of the normal changes occuring at various developmental periods so as to appraise the abnormality more accurately and to determine the need and extent of reparation.
The pathogenesis of various bleeding disorders has been more precisely characterized so that treatment can be prescribed with greater selectivity.
Except during active hemorrhage, holding blood requirements to a minimum frequently serves the patient to greater advantage than maintaining normal hemoglobin levels by frequent and maximal administrations of blood. This restriction is especially pertinent in the refractory anemias—the aplastic-hypoplastic and chronic hemolytic groups. Here multiple transfusions result not alone in hemosiderosis but in a potential suppressive effect on erythropoiesis and hemoglobin synthesis. The retarding effect of transfusion must also be considered in the management of the convalescent anemic phase of erythroblastosis and in the anemia of prematurity.
It should be emphasized that the hemoglobin concentration at which transfusion is indicated for patients who require single on multiple administrations of blood cannot be arbitrarily fixed but varies with the attendant clinical signs and symptoms and the promise of relief by this form of treatment.
Letters to the Editor
Authors: KOZINN P. J. 
Published: December 2021

Dr. Slotkowski's comments on the lack of unanimity in terminology for the newly recognized complication of cowpox vaccination summarizes many important factors.
However, the cases with prolonged vaccinia represent more than an unfortunate and interesting complication of a minor office procedure. They are a "window" through which some of the fragments of the immune mechanism can be seen. At least 5 different types of defects have been recognized and not all are present in every case.
PLASMA PROTEIN PATTERNS IN PREMATURE INFANTS OF VARYING WEIGHTS ON THE FIRST DAY OF LIFE
Authors: Saito M. , Gittleman I. F. , Pincus J. B. , Sobel A. E. 
Published: December 2021

Plasma protein patterns were studied by paper electrophoresis on the first day of life in 59 premature infants. These babies were divided into 3 groups according to weight. A fourth group was used as a control.
The total proteins, albumin, globulins, alpha 1, alpha 2, beta and gamma fractions were determined. This study also included the estimation of fibrinogen levels in the plasma of these prematures.
The concentrations of total proteins, albumin and globulin varied directly with the weight of the infants. Alpha 1, alpha 2 and beta globulins did not vary with the weight of the infants. Gamma globulin varied directly with the weights of the infants, the lowest mean gamma globulin level being observed in the lowest weight group. The mean fibrinogen content, however, was highest in the lowest weight group.
IDIOPATHIC ACQUIRED HEMOLYTIC ANEMIA IN YOUNG CHILDREN
Authors: O'Connor Walter J. , Vakiener Jane M. , Watson R. Janet 
Published: December 2021

Two cases of idiopathic acquired hemolytic anemia have been presented. Following splenectomy and the administration of hormones intermittently for 4 months one has had a complete remission lasting 5 years. This patient had spherocytosis and increased osmotic fragility. The second child, apparently identical except for normal erythrocyte fragility and absence of spherocytosis, has been asymptomatic for 12 months after similar therapy, although the Coombs test remains positive.
The course during hormonal therapy in these patients and in others already reported in the literature suggests with the reservations discussed, that the treatment is of some value.
ROENTGENOGRAPHIC MANIFESTATIONS OF CONGENITAL MEGACOLON (HIRSCHSPRUNG'S DISEASE) IN EARLY INFANCY
Authors: Berman Carroll Z. 
Published: December 2021

The roentgenographic findings in the first month of life were reviewed in a series of 23 infants with histologically proven [See FIG. 9. in source pdf] Hirschsprung's disease. The plain roentgenograms of 18 of the babies showed significant large bowel distention and 12 had prominent colonic fluid levels. In 15 of 19 of the patients which had been subjected to barium enema, the roentgenograms are diagnostic of congenital megacolon. In 5 of 7 of the infants contrast enemas in the first week of life demonstrated the characteristic deformity.
The conclusions which appear justified from this investigation are:
Congenital megacolon (Hirschsprung's disease) may be strongly suspected in the newborn period in a large majority of cases from the appearance of plain roentgenograms of the abdomen made in recumbent and erect projections.
In some instances, roentgenograms in the inverted position supply additional or substantiating evidence of the disease.
In lesions starting in the proximal half of the colon, the abdominal distention involves mainly small bowel, and the differentiation from low jejunal or ileal obstruction is usually not possible from the plain roentgenograms. Here examination by barium enema may be expected to establish the diagnosis.
When the segment of achalasia begins above the ileocecal valve, the plain roentgenograms again indicate small bowel obstruction, but here barium enema does not demonstrate a significant contour or caliber abnormality of the colon. In this type of case, follow-up roentgenograms 24 and 48 hours after the enema will often show considerable retention of the barium thus suggesting the diagnosis which must be confirmed by biopsy.
When the proximal end of the involved segment of colon is low in the rectum, the lesion may be very difficult to demonstrate by barium enema.
The age factor alone, i.e., the performance of the examination very early in infancy, does not of itself preclude demonstration of the lesion of Hirschsprung's disease by barium enema.
A SIMPLE TECHNIQUE FOR THE DIAGNOSIS OF NONLIPID HISTIOCYTOSIS
Authors: Moore Tom D. 
Published: December 2021

Summaries of two cases of nonlipid histiocytosis (Letterer-Siwe disease) proved by biopsies of lymph node and skin are presented.
A technique is described whereby the diagnosis of this disease may be aided by a touch preparation of the skin lesions.
The successful use of this technique in the two cases described supports its validity.
CELONTIN® (PM-396) IN THE TREATMENT OF EPILEPSY
Authors: Livingston Samuel , Pauli Lydia 
Published: December 2021

One hundred thirty-six patients with epilepsy, mostly children, were treated with Celontin® for periods ranging from 6 to 15 months. The maximum dosage of one or more other anticonvulsant agents administered for periods of 1 year or more had previously proved inffective in controlling seizures in 85 of these patients.
Celontin® was effective in controlling minor motor and psychomotor seizures in this group of patients.
The frequency of spells was reduced in some of the patients with petit mal epilepsy. Patients with major motor seizures were not significantly benefited by this drug.
Side effects were experienced by 18 of the 136 patients treated. Drowsiness was the most frequently occurring side effect. There were no irreversible toxic disturbances.
SOME CONCEPTS OF PLASMA PROTEIN METABOLISM, A.D. 1956
Authors: Gitlin David 
Published: December 2021

[In presenting the First E. Mead Johnson Award for 1956 to Dr. Gitlin, Dr. Bakwin, President of the Academy, made the following remarks:
["Dr. David Gitlin was born in New York, in 1921. He received the M.D. degree from New York University College of Medicine in 1947. Prior to this he was honored by being the Naumberg Scholar to the University of Puerto Rico in 1940-41, and was awarded the Borden Undergraduate Research Award in Medicine in 1947.
["Dr. Gitlin had his internship at Morrisiana City Hospital; from there he went to Harvard as a Research Fellow in Pediatrics and later served as a Fellow in Medicine; an intern on the Medical Service, an Instructor in Pediatrics, Assistant Physician, and an Associate in Pediatrics, all at the Children's Medical Center and Harvard Medical School.
["Dr. Gitlin is certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics. During his short career Dr. Gitlin has been an energetic, tenacious, imaginative worker. He has accomplished much in investigation and has published over 30 papers.
["To quote his Chief, Dr. Charles Janeway, `Dr. Gitlin's researches represent a coherent, progressing series of studies in which, by the use of chemical, immunochemical, and histochemical methods, with good physiologic reasoning, he is gradually elucidating some basic problems of the physiology of human plasma and structural proteins and the derangements in disease.' It is for these works that the Academy's Committee on Awards has selected Dr. Gitlin as the recipient of the First E. Mead Johnson Award for 1956. Dr. Gitlin will honor us by giving a résumé of what he considers to be his important works."]
EARLY RECOGNITION OF RHEUMATOID DISEASE WITH COMMENTS ON TREATMENT
Authors: Gauchat Robert D. , May Charles D. 
Published: December 2021

WITHIN the past 10 years, increasing attention has been focused on children with chronic deforming arthritis. With few exceptions, such children have claimed interest of those concerned primarily with rheumatoid arthritis in adults, orthopedic surgeons and workers in the field of physical medicine, to whom these patients have presumably been referred for care by pediatricians and general practitioners. Lack of general pediatric interest in this disease is suggested by the small number of pertinent papers in the pediatric literature. Furthermore, the relative lack of importance of these children in the general thinking of students of arthritis is suggested by the fact that a current statistical study of the incidence and prevalence of rheumatoid arthritis in a large American metropolitan area has been arbitrarily limited to patients 15 years of age or older.
Is rheumatoid arthritis sufficiently common within the pediatric group to deserve pediatric attention? Although there have been only a few statistical studies, the available evidence suggests that the incidence of new cases in the general population, under 15 years of age, is roughly the same for rheumatoid arthritis, diabetes mellitus and nephrosis, approximately 3 new cases per 100,000 persons under 15 years of age each year. In round numbers, 1200 new cases of rheumatoid arthritis, of diabetes and of nephrosis occur annually within the childhood population of this country. Parallel comparison of the amounts of attention paid to these three groups of patients by pediatricians would belabor the point. These juvenile victims of rheumatoid arthritis certainly deserve increasing pediatric attention, and we suggest that they also present many stimulating challenges.
PRODUCTION OF CONGENITAL ANOMALIES IN MAMMALS BY MATERNAL DIETARY DEFICIENCIES
Authors: Nelson Marjorie M. 
Published: December 2021

Multiple or single congenital anomalies may be produced experimentally by certain maternal dietary deficiencies. The similarity of the anomalies resulting from all acute dietary deficiencies and other acute teratogenic procedures is striking. When the dietary deficiency is controlled by the use of anti-metabolites, it can easily be demonstrated that the teratogenic effects vary with the time of instituting the deficiency and with its duration or severity. It can also be demonstrated that the period of sensitivity to the teratogenic dietary deficiencies is usually limited to the critical period of differentiation and organogenesis, as it is in irradiation. However, fetal vitamin deficiencies similar to those observed in the adult can probably be produced by the deficiency later in pregnancy. The severe fetal damage is in marked contrast to the relatively slight effects on the maternal organism. Presumably, although this point has not been proven, the effect of the deficiency is directly on the fetus and indicates that certain vitamins play a highly significant role in embryonic differentiation and organogenesis. We already have considerable knowledge concerning the biochemical reactions with which the B vitamins are concerned in adult tissues. It is possible that, by use of these specific vitamin deficiencies as tools, we may succeed in identifying certain key reactions in embryonic differentiation and organogenesis and thus advance our knowledge of chemical embryology.
The teratogenic dietary deficiencies can provide abundant material for the pathologist to study the early stages of specific anomalies. For the physiologist, studies of anomalous conditions before and after birth are possible for some organs and systems. Studies of the interrelations of nutritional and genetic factors should lead to increasing knowledge concerning individual susceptibility to such teratogenic conditions and the application of these findings to man. The briefness of the period necessary to affect fetal development and the irreversibility of fetal damage by dietary supplementation later in pregnancy must be emphasized.