bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observations on Immediate Reactions of Families to Sudden Infant Death
Authors: Smialek Zoë 
Published: December 2021

Many health professionals do not adequately support newly bereaved parents and may in fact ignore and abandon them at the time of bereavement. A possible reason for this lack of involvement may be the discomfort experienced by these individuals during such encounters and a misunderstanding of the normal grief reactions. From a two-year experience observing 351 families in whom an infant has died suddenly and unexpectedly, I have noted the most common immediate grief reactions. These reactions are discussed to increase the professional's awareness of the particular needs of these individuals.
These immediate reactions include shock, disbelief, and denial; negativism, hostility, and anger; self-reproach and guilt; demonstration of former unresolved grief; verbalization of previous fears of loss; and sometimes, even, relief. Families are entitled to assistance during this distressing time from a warm, caring professional who is able to allow free expression of grief however it is manifested and answer accurately the disturbing questions about the death of their infant.
Postneonatal Infant Mortality in Infants Admitted to a Neonatal Intensive Care Unit
Authors: Kulkarni Prakash , Hall Robert T. , Rhodes Philip G. , Sheehan Michael B. 
Published: December 2021

The postneonatal infant mortality (PNIM) of 2,205 infants admitted to a neonatal intensive care unit from January 1971 to December 1974 was 44 in 1,000 infants who survived to age 28 days. This rate is approximately ten times that of the general population. Congenital malformations (59%), infections (12%), sudden infant death syndrome (10%), and asphyxial brain damage (10%) were the most common causes of death.
One third (26) of the infants remained in the hospital whereas two thirds (52) had been dismissed prior to death. All who remained in the hospital plus 36 who had been dismissed died of severe illnesses that were incompatible with prolonged survival. The remaining PNIM was 10 in 1,000 neonatal survivors. This rate is still twice that of the general population. These deaths occurred in infants who were apparently well at the time of dismissal and subsequent examinations. Sudden infant death syndrome and infections constituted the largest portion of this mortality. Factors contributing to mortality in this group were poor socioeconomic status and low birth weight. Maternal age, race, marital status, and neonatal illnesses including apnea were not significantly related.
Factors that appear to be important in the birth of high-risk infants continued to be operative in the postneonatal period, and contribute to a high mortality in apparently normal infants dismissed from the neonatal intensive care unit.
WHICH WAY TO GO
Authors: Carroll Lewis , Gardner Martin 
Published: December 2021

‘"Would you tell me, please, which way I ought to go from here?" "That depends a good deal on where you want to get to," said the cat. "I don't much care where—" said Alice. "Then it doesn't matter which way you go," said the cat.’
John Kemeny places Alices question, and the cat's famous answer, at the head of his chapter on science and values in A Philosopher Looks at Science, 1959. . . . The cat's answer expresses very precisely the eternal cleavage between science and ethics. As Kemeny makes the clear, science cannot tell us where to go, but after this decision is made on other grounds, it can tell us the best way to get there.
Choledochal Cyst: Delayed Diagnosis in a Jaundiced Infant
Authors: Harris Vivian J. , Kahler John 
Published: December 2021

Obstructive jaundice in young infants represents a clinical situation whose diagnostic evaluation has changed dramatically over the past few years.1-3 Biliary atresia and some forms of neonatal hepatitis are the most common diseases to be differentiated. Emphasis has shifted in recent years toward early surgical exploration for the possibility of performing some form of portoenterostomy.
Among surgically correctible lesions, the choledochal cyst, although a rare cause of obstructive jaundice during the newborn period, should be considered and actively pursued since irreversible cirrhosis is a major sequela in untreated cases.4
We describe a patient who was considered to have biliary atresia but on whom a choledochal cyst was discovered at 5½ months of age.
Periorbital Cellulitis in Children
Authors: Barkin Roger M. , Todd James K. , Amer Jules 
Published: December 2021

Inflammation of periorbital tissues is common in pediatric patients, but little information regarding guidelines for treatment is available. The patient with periorbital cellulitis has erythema and swelling of the soft tissues of the eye. The condition is distinguished from more severe orbital involvement by the absence of ophthalmoplegia, proptosis, or impaired vision (Table I).1 This review was initiated to develop bacteriologic data for the treatment of periorbital cellulitis.
PATIENT POPULATION
Patients hospitalized at the Children's Hospital of Denver between December 1972 and June 1976 with the diagnosis of orbital or periorbital cellulitis were reviewed. Patients with periorbital cellulitis (lid swelling and erythema without ophthalmoplegia, proptosis, or impaired vision) were analyzed; clinical, bacteriologic, and roentgenographic data were obtained. A positive blood or cellulitis aspirate culture was required to prove a bacteriologic cause. Roentgenograms were interpreted by two pediatric radiologists.
FINDINGS
Seventy-one cases of periorbital cellulitis without orbital involvement were identified during the study period. Children ranged in age from 10 days to 18 years; 41 (58%) were 4 years of age or younger. The right periorbital tissues were involved in 39 patients (55%) and the left in 28 (39%); bilateral involvement was noted in four.
A temperature greater than 37.8 C (100 F) was documented on the day of admission in 52 (73%) children; 34 (48%) had temperatures greater than 38.3 C (101 F). Although not a presenting complaint, 19 (27%) exhibited mild conjunctival hyperemia without purulent discharge. Clinical sinusitis manifested by a history of drainage, pain, or local tenderness was noted in ten (14%) patients.
BENEVOLENCE
Authors: Glasser I. 
Published: December 2021

. . .Although it is normal for parents to love their children, it is not normal for society to love the socially helpless. Who loves the aged, the mentally ill, or the troubled children of the poor? Who loves welfare recipients or the residents of public housing? Abstractly, perhaps, society adopts a superficially charitable attitude toward these groups. But if one looks at what society does, and not at what it says, there is little love reflected. The record of public charity is an unloving record of punishment, degradation, humiliation, intrusion, and incarceration. If parents treated their children the way society treats the helpless, they would be cited for neglect and child abuse. The power of "lovability," which normally saves the child from disaster, has no precise social analogue.
The varieties of social dependence, described in Dickens' novels and intrinsic to the modern American welfare state, have therefore resulted in profound violations of individual liberty. These violations were not explicitly anticipated by those who wrote our Constitution and its Bill of Rights. Dependence upon the institutions of caring establishes-for millions of people-a condition of fragility against encroachments of power, and benevolence is the mask that hides it. It is not that benevolence is itself mischievous or cynically to he regarded with mistrust. It is not benevolence we should abandon, but rather the naive faith that benevolence can mitigate the mischievousness of power so feared by those who wrote our Bill of Rights. We have traditionally been seduced into supposing that because they represented charity, service professionals could speak for the best interests of their clients.
Breast-Feeding
Authors:   A Commentary in Celebration of the International Year of the Child, 1979
Published: December 2021

1. Full-term newborn infants should be breastfed, except if there are specific contraindications or when breast-feeding is unsuccessful.
2. Education about breast-feeding should be provided in schools for all children, and better education about breast-feeding and infant nutrition should be provided in the curriculum of physicians and nurses. Information about breast-feeding should also be presented in public communications media.
3. Prenatal instruction should include both theoretical and practical information about breast-feeding.
4. Attitudes and practices in prenatal clinics and in maternity wards should encourage a climate which favors breast-feeding. The staff should include nurses and other personnel who are not only favorably disposed toward breast-feeding but also knowledgeable and skilled in the art.
5. Consultation between maternity services and agencies committed to breast-feeding should be strengthened.
6. Studies should be conducted on the feasibility of breast-feeding infants at day nurseries adjacent to places of work subsequent to an appropriate leave of absence following the birth of an infant.
Impact of the Apnea Monitor on Family Life
Authors: Black Lois , Hersher Leonard , Steinschneider Alfred 
Published: December 2021

The use of an apnea monitor in the home to limit the duration of prolonged apneic spells and thus, possibly, to prevent sudden infant death syndrome (SIDS) has raised a number of questions about the effect of such devices on the infant, family, and parent-child interaction. Through interviews and questionnaires, descriptive data were obtained from 31 families who recently or currently had an infant on a monitor. The infants treated were either those who had one or more severe cyanotic episodes, siblings of infants with SIDS or severely cyanotic infants, or normal newborn infants in a research study. On the basis of laboratory sleep studies, all were believed to be prone to prolonged apneic spells.
Most families believed that using the apnea monitor had a significant but temporary impact on their personal and social lives. Many patterns of daily living and child-care routines were altered to accommodate monitor use. Technical limitations of the machine severely aggravated parents' problems. Despite these observations, most parents believed the monitor was an anxiety reducer and, in retrospect, well worth the trouble. Generally it was not seen as a deterrent to normal parent-child relations.
These generalizations are explored in detail and are presented as a stimulus to further investigation and improved management.
Some Kind of a Social Doctor: Martha May Eliot, 1891-1978
Authors: Schmidt William M. 
Published: December 2021

Martha May Eliot was one of the most influential pediatricians to hold positions of public authority in the United States during a long and distinguished career. Her name is linked with that of Edwards A. Park in the history of the control of rickets. With Grace Abbott and Katharine Lenroot she brought provisions for children into the Social Security Act, a big step beyond the original plan.
within the councils of the American Pediatric Society, she encouraged proposals leading to the landmark study Child Health and Pediatric Education (1949) conducted by the Academy of Pediatrics.
For more than 50 years Martha May Eliot took a leading part in the development of health services for mothers and children. She was concerned for children of all countries of the world and worked for them in the great international organizations: the League of Nations, the United Nations Relief and Rehabilitation Administration (UNRRA), the United Nations Children's Fund (UNICEF), and the world Health Organization. In the United States, her own country, she used her Vision and vigor in the US Children's Bureau, at Yale Medical School, Harvard School of Public Health, and the Massachusetts Committee for Children and Youth, as well as in many other governmental and nongovernmental agencies and committees.
Her entire career was a fulfillment of a decision and comniitment made early in her life. At Radcliffe she had a great interest in the classics, and her deep appreciation of her cultural heritage enriched her work and her life. While still a Radcliffe student, she determined to study medicine.
Kawasaki Disease: Effect of Treatment on Coronary Artery Involvement
Authors: Kato Hirohisa , Koike Sigeyuki , Yokoyama Takashi 
Published: December 2021

Ninety-two patients with Kawasaki disease were treated with five different types of drug therapy: a steroid preparation (prednisolone), aspirin, an antibiotic, a combination of steroid plus aspirin, and a combination of steroid plus warfarin. One to two months after the onset of the disease, coronary angiography demonstrated coronary aneurysms in 20% of cases treated with an antibiotic alone, 64.7% of cases in the steroid-treated group, and 11% of those in the aspirin-treated group.
These findings suggest that the steroid might act adversely to cause a progression of coronary lesions of the disease. The aspirin-treated group did not have a significantly lower incidence of coronary lesions compared with the group treated with an antibiotic alone. But in view of the fact that the direct cause of sudden death of the disease is thrombotic occlusion of a coronary artery, aspirin might act as the effective means for prevention of sudden death due to Kawasaki disease.
Delayed Elevation of Serum Phenylalanine Level in a Breast-Fed Child
Authors: Binder John , Johnson Charles F. , Saboe Beverly , Krug-Wispe Susan 
Published: December 2021

Phenylketonuria (PKU) is an autosomal recessive disorder that causes mental retardation if not treated. Treatment consists of a low phenylalanine diet. If the diet is instituted prior to 3 to 4 weeks of age, the child can be expected to develop within the normal range.1 Early detection of PKU is therefore necessary to institute dietary therapy before harmful effects begin. In Iowa, state public policy specifies that a blood test for phenylalanine must be done on an infant prior to discharge from the hospital and again at 4 weeks of age.2
To diagnose PKU, the National Collaborative Study of Children Treated for Phenylketonuria requires that two serum phenylalanine levels of greater than 20 mg/dl be obtained.
Digitalis Toxicity and Serum Levels
Authors: Berman William 
Published: December 2021

The article by Halkin et al (Pediatrics 61: 184, February 1978) alerts pediatricians to the prevalence of toxicity to dligoxin in infants and children. However, I am concerned that casual reading of the article will lead some to conclude that tolerance to digoxin does not vary with age and that a serum level of digoxin of 2 ng/ml is a "magic number." Neither of these conclusions is substantiated by the data in the manuscript.
The findings of the series are clouded somewhat by the broad criteria used for diagnosing toxicity, the time at which serum specimens were obtained (eight hours after the preceding maintenance dose), and the lack of information about drug clearance as it relates to drug dose and the serum levels achieved.
IMPOSITION vs GROWTH OF KNOWLEDGE
Authors: Perkinson H. 
Published: December 2021

The trouble with the transmission conception of the educational process, which has reigned since Aristotle, is not simply that it is wrong, but that it results in an authoritarian construction of education.
Construing education as a process of transmission converts it into imposition. The teacher's task is to impose knowledge, or learning on the students. The knowledge transmitted is the acquired (justified? proven?) wisdom of society. Teachers who try to transmit usually employ many different tactics and strategems to pull this off in a benign way. They try to "motivate" students to want to learn what they are supposed to learn. They try to match the materials to be learned to the learner—to his "needs," "interests," "abilities," "aptitude," and "capabilities." But the process is still one of imposition.
The argument against imposition is that it prevents growth. Here is the argument....
In all cases the student learns through trial and error elimination. So when teachers and schools try to impose learning, they are simply coercing students to adopt their criteria for identifying errors. They are saying, in effect, "All knowledge that is contrary to this knowledge we present to you is false." This prevents growth.
Here is another argument. Suppose teachers completely succeeded in imposing knowledge on the young and completely succeeded in "proving" that this knowledge was true. It is patently clear that for those students so taught (indoctrinated?) that the advancement of that knowledge would cease. Because, you see, these students would "know" the truth. So we are led to conclude that the growth of knowledge has occurred and will continue to occur only because teachers failed to impose knowledge on the young.
Placental Transfer of Theophylline: Two Case Reports
Authors: Arwood Larry L. , Dasta Joseph F. , Friedman Chad 
Published: December 2021

The placental transfer of xanthine compounds such as caffeine and theophylline has only recently been recognized. By measuring serum theophylline concentrations in two mothers and their neonates at delivery, we have attempted to determine the extent and significance of placental theophylline transfer to the fetus. At delivery, the two maternal serum theophylline concentrations were 13 µg/ml and 11 µg/ml, and cord serum contained 12 µg/ ml and 11 µg/ml of theophylline, respectively. In our first case, the neonatal theophylline concentration at delivery was not reported, but a concentration of 13 µg/ml was obtained six hours after delivery. In the second case, the neonatal serum contained 14 µg/ml of theophylline at delivery, 3 µg/ml higher than the cord or maternal serum concentration. It is possible that the fetus behaves as a pharmacokinetically "deep" compartment with slower drug elimination relative to maternal excretion.
Serial serum theophylline concentrations in the neonates were determined at 6, 18, 30, and 40 hours after delivery. For the first 18 hours of life, both neonates' serum contained theophylline within or very close to the therapeutic range (10 to 20 µg/ml) in adults and children. Both neonates reported on in this article had minor clinical symptoms that may have been related to the theophylline present in their serum. Neonates of mothers receiving theophylline products should be monitored for the pharmacologic actions of theophylline.
New Thoughts on Pertussis
Authors: Katz Samuel L. , Wilfert Catherine M. 
Published: December 2021

The success of initial pertussis immunization programs resulted not only in a sharp decrease in the incidence of the disease but also in a diminution of interest in and research on the organism, and complacency with regard to the vaccine itself.
Concern and apprehension about both the efficacy and the safety of pertussis vaccine have recently stimulated a renewed investigative interest in the biology of Bordetella pertussis. This occurs at a time. when cases of pertussis reported in the United States are at an all-time low (less than 2,000 in 1978 contrasted with more than 150,000 in 1950). This infrequency of clinical whooping cough contributes to our desire for a more critical examination of the rare serious complications attributed to the immunizing procedure.
Acute Hydrocephalus and Death Following V-P Shunt Disconnection
Authors: Neuren Alan , Ellison Patricia H. 
Published: December 2021

Acute hydrocephalus was described following sudden complete obstruction of cerebrospinal fluid (CSF) pathways.1 This is one of the many complications that have been reported with ventriculoperitoneal shunts.2 Rarely are these acutely lifethreatening. We report a case of acute hydrocephalus after sudden disconnection of a ventriculopertoneal shunt with subsequent death of the child.
See Images in the PDF file
CASE REPORT
A 5-month-old male infant developed bacterial meningitis in February 1976. Two months later, a ventriculoperitoneal shunt was inserted for treatment of progressive communicating hydrocephalus. On a follow-up examination in October 1976, he was reported to be mildly delayed without other neurologic handicap.
Nasopharyngeal Carriage of Antibiotic-Resistant Haemophilus influenzae in Healthy Children
Authors: Lerman Stephen J. , Kucera Jon C. , Brunken Jan M. 
Published: December 2021

We selected 16 schools representing a broad socioeconomic cross-section of metropolitan Omaha and obtained nasopharyngeal cultures for Haemophilus influenzae from 1,084 healthy 4- to 7-year-old children. We found that 34.2% of the children carried nontypable strains and 2.0% carried type b strains. Carriage rates were not influenced by recent illness, family size, or number of people sharing a bedroom.
The prevalence of ampicillin-resistant H influenzae in the sample population was 0.9% for nontypable strains and 0.4% for type b strains; it was not significantly different in the group of children who had recently used β-lactam antibiotics. One child carried a nontypable strain which was resistant to both chloramphenicol and tetracycline, the first chloramphenicol-resistant H influenzae detected in Omaha.
A survey of healthy children may be a useful method for projecting a community's risk of disease caused by ampicillin-resistant H influenzae. Among the nasopharyngeal isolates from healthy children, 2.7% of nontypable strains and 18.2% of type b strains were resistant to ampicillin (P &lt; .01). During the same five-month period in Omaha, clinical failure in the treatment of otitis media with ampicillin was uncommon and four (20.0%) of 20 cases of H influenzae type b bacteremia and meningitis were caused by ampicillin-resistant organisms.
Bilirubin: Worked Out Years Ago?
Authors: Levine Rodney L. 
Published: December 2021

1. The free bilirubin theory proposes that unbound bilirubin binds to and enters cells. The theory is simple, reasonable, and attractive.
2. To date, there is no evidence to support the free bilirubin theory over other possible mechanisms.
3. The measurement of free bilirubin is now technically possible for mixtures of purified bilirubin and albumin. Measurement in serum is promising, but proven methods still elude current capabilities.
4. At present, there is no justification for the use of free bilirubin tests in the management of jaundice. This evaluation holds for related tests, regardless of aliases: reserve binding capacity, bilirubin binding capacity, albumin saturation, loosely bound bilirubin, gel bound bilirubin, and binding affinity.
5. For smaller prematures, the concentration of total bilirubin at which the risk of kernicterus exceeds the risk of treatment is unknown. There is no scientific basis to guide the clinician in deciding when to institute treatment of jaundice in these babies.
6. Hyperbilirubinemia can lead to kernicterus. Whether it causes other, milder forms of neurologic and developmental damage is unknown. At present, there is no basis for treating jaundice with the hope of preventing such damage.