bluuebunny/crossref_metadata_2025_split huggingface dataset:
VARIABLES AFFECTING SPLITTING OF THE SECOND HEART SOUND IN NORMAL CHILDREN
Authors: Castle Robert F. , Hedden Carol A. , Davis N. Park 
Published: December 2021

Phonocardiograms were recorded in a population of normal children and adolescents (116 subjects) in order to evaluate variables which might affect splitting of the second heart sound. Tracings were recorded during normal respiration in supine and sitting positions.
Position was the major variable affecting splitting. Eighty-five percent of this population exhibited greater variation in splitting when sitting than while supine. In the remainder of the subjects, the splitting variation was greater in the supine position.
Heart rate, sex, age, height, and weight had little or no effect on the splitting pattern of the second sound; 15% of the subjects exhibited fixed splitting of the second sound in either, but not both, the supine and upright positions. This was defined as less than 10 msec variation in splitting during normal respiration. This observation indicates the necessity of assessing the second sound in both supine and upright positions before a judgment is made concerning the existence of an abnormal splitting pattern.
Hypertensive Encephalopathy and Desoxycorticosterone
Authors: Marks James F. , Fink Chester W. 
Published: December 2021

Doctor Monteleone reports a patient with congenital adrenal hyperplasia who had permanent severe neurologic sequellae following DOC-induced hypertensive encephalopathy. Since the preparation of our previous manuscript, we have seen three additional children who have suffered from mineralocorticoid-induced hypertension following the implantation of DOC pellets. Our experience would indicate that this complication of mineralocorticoid therapy is much more common than previously recognized.
The administration of some long-acting form of salt-retaining hormone is necessary in the infant with the salt-losing form of adrenal hyper plasia.
A SAD STORY READ BY CHILDREN IN A POPULAR READER OF THE 1860'S
Authors: C. T. E. 
Published: December 2021

Children's readers of a century ago contained lessons far different from those in our contemporary ones. A good example of this difference is the following story in a widely read reader published in 1867.
Please Get It Now, Brother
"Hand me some water, brother, won't you?" said a little sick girl.
"In a minute, Bettie," said Harry, and his little hands went on as busy as ever with the trap he was making. Bettie's fevered cheek was again pressed to the pillow, and Harry soon forgot her request.
"Please get it now, brother," and her voice was very feeble. But Harry heard it and ran for the water, and soon was holding the cup to his sister's lips.
"Not this, please, but some fresh and cold water from the well," and she turned her head languidly away.
"0, don't be so particular! This is fresh; and I am so busy, I can not go to the well now-won't this do?"
Bettie no longer refused, but quietly took the cup which Harry offered her. It was the last time she ever called upon her brother for an act of kindness.
The next day she stood beside the River of Life, and drank of its cool waters. Sickness and death had passed away, and little Bettie would thirst no more.
But Harry could not be comforted. Of all who wept over the little brown coffin, as it lay on the table before the pulpit, there were none who shed more bitter tears than the boy who could not forget that he had refused the last request of his sister.
THE CHILD WITH FREQUENT INFECTIONS: DIAGNOSTIC CONSIDERATIONS
Authors: Johnston Richard B. , Janeway Charles A. 
Published: December 2021

The list of syndromes associated with diminished resistance to infection has grown bewilderingly long and complex in recent years. The busy pediatrician finds little consolation in the fact that knowledge gained from study of these specific defects has led to a more comprehensive understanding of normal immune mechanisms. Yet, this new insight has permitted a logical grouping of syndromes which can provide the physician with order and confidence in his diagnostic endeavors. One possible classification of immune deficiencies is offered here, primarily as a basis for some suggestions as to what should make a pediatrician suspect an immune defect and how he can test his suspicions. The reader is encouraged to substantiate the framework presented here with more detailed reviews.1-5
Mechanisms of resistance to infection may be separated into four major systems: physico-anatomical barriers, phagocytosis, humoral factors, and cellular immunity.
PHYSICO-ANATOMICAL BARRIERS
Defects of this "system" are often confined to one anatomical area or, at least, predispose to infections of a localized site. Cystic fibrosis, urethral stenosis, foreign bodies, eczema, skull fracture, and, occasionally, asthma are examples. Sickle cell disease, indwelling intravenous catheters, and prolonged broad-spectrum antibiotic therapy may induce generalized or localized infection. Diagnostic techniques applicable to this group are well known to pediatricians.
PHAGOCYTOSIS
The body clears bacterial invaders largely through the process of phagocytosis. Resistance to infection by fungi and viruses, on the other hand, depends primarily upon the integrity of the small lymphocyte, through a mechanism which is not yet understood. Thus, a patient with an abnormality of phagocytosis has little difficulty with fungal or viral infections if his lymphocytes are normal, but he is threatened by bacteria, especially those not easily killed by other defense mechanisms.
Cat Scratch Disease: The Larger View
Authors: Carithers Hugh A. , Carithers Cornelia M. , Edwards Ray O. 
Published: December 2021

We are indebted to Margilethi for neawakening an interest in a common pediatric problem by reporting 115 persons with cat scratch disease, the first sizable series analyzed in many years.
The conclusion reported in our more recent analysis of 154 cases of cat scratch disease seen in a private pediatric practice is in agreement with that of Margileth in many particulars. However, his series, seen in a hospital setting for the most pant, again contains a high proponlion of relatively severe cases that give a distorted picture of the disease, as have other series reported through the years.
Oral Hypoglycemic Agents
Authors: Tibbs Robert C. 
Published: December 2021

I noted with interest the article by Drs. Adam and Schwartz, "Should Oral Hypoglycemic Agents Be Used in Pediatric and Pregnant Patients?" (Pediatrics, 42:819, 1968). In regard to juvenile diabetics, his conclusions were an echo of what usually appears in the ped iatric literature, namely, these drugs have no place in the management of any pediatric onset diabetic.
There are no clearly documented reasons for using them in pediatric practice. At best, the oral agents used in this young age group act as symptomatic medicines which require careful supervision and under such conditions, may involve only a small risk.
PULMONARY COMPLICATIONS OF CONGENITAL HEART DISEASE
Authors: R. A. M. 
Published: December 2021

Respiratory distress is a very frequent symptom in infants with acyanotic congenital heart disease. Some of the specific physiological and pathological mechanisms involved in this association have been presented in Pediatrics.1 That communication stressed the frequency with which cardiac failure associated with large left-to-right shunts presents with respiratory distress, often misinterpreted as being due to pulmonary disease.
It has, however, also been long recognized that there is a high incidence of pulmonary infection in infants with large left-to-right shunt lesions. The cause of these frequent infections in such patients is not yet evident, but a possible explanation now seems to be suggested from recent observations at autopsy.
JACOB ABBOTT (1803-1879), AUTHOR OF THE MOST FAMOUS BOOK ON CHILD REARING OF THE 1870'S, DISCUSSES CORPORAL PUNISHMENT OF CHILDREN
Authors: C. T. E. 
Published: December 2021

Jacob Abbott wrote the most widely read book about child nurture in the decade just after the Civil War. His two principal themes were: the absolute need for parental authority over the child "without violence or anger," and "right development of the child's character . . . in harmony with the structure and characteristics of the juvenile mind." If the child did not bow to parental authority, Abbott advised parents of the need for corporal punishment:
The parental authority must, therefore, be established-by gentle means, if possible-but it must by all means be established, and be firmly maintained. If you cannot govern your child without corporal punishment, it is better to resort to it than not to govern him at all. Taking a wide view of the field, I think there may be several cases in which a resort to the infliction of physical pain as the only available means of establishing authority may be the only alternative. . . . Complete, absolute, unquestioned authority can often be obtained most forcefully by this form of punishment . . . manoeuvre and artifice and reason and affection (are) a sandy foundation for establishing parental authority that came from God and nature.1
As harsh as this advice may seem today, Abbott was convinced that his suggestions about "gentler" controls offered proof and strengthened belief in the child's rationality or tractability.
Letter to the Editor
Authors: Elbualy M. S. 
Published: December 2021

I read with interest the article by Dr. R. G. Scherz, et al. (Pediatrics, 43:84, 1969). It is long overdue that child resistant containers (CRC) are made for all drugs and not merely for "baby aspirin." The suggestion that CRC be used for household products is worthy of note.
The statement that the reduction in childhood poisoning was, "due directly to the use of CRC to dispense perscription tablets and capsules" is challenged, because the reduction may have been due to the use of CRC indirectly-inn that the patients may have been more careful since the containers will have reminded them of accidental poisoning.
NATURAL HISTORY OF "APPARENTLY HEALED" ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS IN CHILDREN
Authors: Treser Gerhard , Ehrenreich Theodore , Ores Richard , Sagel Inge , Wasserman Edward , Lange Kurt 
Published: December 2021

Twenty-three children with apparent cure of an acute poststreptococcal glomerulonephritis were followed at monthly intervals for periods up to 10 years. They were considered clinically healed if asymptomatic and if the following were normal: blood pressure, urea clearance, and three consecutive Addis counts. Sequential kidney biopsies were performed and studied by light and electromicroscopy and immunohistology.
Renal biopsies performed between 1 and 3 years after the onset of the acute disease revealed normal glomerular morphology and no evidence of immune reaction only in four patients. The remaining 19 patients had segmental mesangial lesions and varying degrees of immunofluorescence with antihuman gamma-globulin and antihuman complement. Subsequent biopsies on these patients showed further resolution of the glomerular lesions in 16 cases. The remaining three patients had evidence of continuing immune reaction and morphologic progression of glomerular lesions.
No correlation could be found between the duration of symptoms and abnormal laboratory findings at the onset of the disease and the extent or reversibility of the glomerular lesions. In seven patients minimal transient urinary abnormalities reappared after initial clearing. This occurrence need not necessarily carry an ominous prognosis, but it must be interpreted in the light of morphologic and immunologic changes.
Continued presence or diminution of immune activity was the most reliable indicator of the evolution of glomerular damage as evidenced by subsequent biopsies.
Availability, Effectiveness, and Economy of Better Child Health Services
Authors: Holtz Albert I. 
Published: December 2021

I would like to add an observation to Dr. Butler's stimulating article, "Availability, Effectiveness and Economy of Child Health Services," Pediatrics, 43:284, 1969.
My practice involves, in part, consultations in a lower socioeconomic area of suburban Los Angeles. By working with general practitioners and local hospitals, I have been able to offer pediatric knowledge to a community of approximately 100,000. The general practitioners, surgeons, and obstetricians refer patients for consultation on an inpatient and outpatient basis.
Family Life and Sex Education
Authors: Faigel Harris C. 
Published: December 2021

It appears to me that one of the implications of the Academy's statement on family life and sex education (Pediatrics, 42: 535, 1968) is that such programs are a form of immunization against the social health problems of today's society. If this is truly the feeling of the committees jointly represented, I would like to point out that there is no valid proof of this statement.
In my experience, many practicing physicians, be they family physicians or pediatricians, are totally unprepared and are psychologically unable to effectively serve as the supportive link and catalyst for the instruction of parents and schools the Academy recommends.
Purpura Fulminans Associated with Neisseria catarrhalis Septicemia and Meningitis
Authors: Feigin Ralph D. , Joaquin Venusto San , Middelkamp J. Neal 
Published: December 2021

Purpura fulminans in association with N. catarrhalis septicemia and meningitis was found in a 6-month-old male infant. The small number of cases in the literature of meningitis due to saprophytic neisseria may understate the incidence of infection with this ordinarily nonpathogenic organism and has served to mask the apparent predilection of N. catarrhalis producing meningitis and septicemia for the young child.
The association of purpura fulminans with N. catarrhalis septicemia merely serves to emphasize that this life-threatening complication may accompany almost any infectious disease of childhood.
PARATHYROIDS AND CERVICAL THYMUS IN SUDDEN UNEXPECTED DEATH IN INFANCY
Authors: Ellis H. A. , Knight B. 
Published: December 2021

It has recently been claimed that there is a reduction in the number of parathyroid glands and abnormal fusion of parathyroid and thymic tissues in the sudden unexpected death (SUD) syndrome in infancy. In the present study, the parathyroid glands and thymus were dissected under the stereomicroscope at autopsy in 55 infants, including 31 with features of SUD. The identity of the glands was confirmed histologically.
Parathyroid glands were identified in comparable numbers and sites in infants dying with the SUD syndrome or from some ascertainable cause. Cervical thymic tissue was commonly found in infants, whatever the cause of death, and fusion of parathyroid and thymic tissues was not confined to the SUD syndrome.
The study provides no evidence to support the claim that there is a deficiency of parathyroid glands in the SUD syndrome or that fusion of thymic and parathyroid tissues normally does not occur.
CARE OF THE CRITICALLY ILL CHILD: ENDOTOXIN SHOCK
Authors: Hodes Horace L. 
Published: December 2021

F OR practical purposes we may consider that endotoxins of gram-negative bacteria are the cause of endotoxic shock. In general, endotoxins are produced by bacteria which form smooth colonies. However, it should be mentioned that small quantities of endotoxin have been found in colonially rough, gram-negative rods and in some gram-positive bacteria.
Endotoxins are found in the outer layers of the bacterial cell wall. They are so closely associated with other constituents of this structure that their isolation requires strong chemical treatment.1 Endotoxins are macromolecules which readily form complexes with each other and with other macromolecules. The two major constituents of endotoxins are lipids and polysacchanides. Endotoxins also contain a small percentage of peptides, so we may consider that endotoxins are lipid-polysaccharide-peptide macromolecules. All endotoxins contain phosphorus also. The polysaccharide moiety is composed of a number of different carbohydrates, such as glucose, galactose and mannose, as well as pentoses, heptoses, and hexosamines.2 Also present are di-deoxy hexoses, which are found only in endotoxins.
The lipid moiety contains even-numbered saturated and unsaturated fatty acids. The chemical constituents of endotoxins are arranged in three major zones in the macromolecule: the polysaccharide, the lipid-rich, and the amino acid-rich moieties. The backbone of the molecule is polysaccharide, to which are attached amino acids. The fatty acids are also attached to the carbohydrate backbone; these are ester bound to OH groups or amide bound to NH2 groups of the carbohydrate, probably through such compounds as glucosamine.2 The endotoxin molecule is unique in its fatty acid-carbohydrate linkages, which have not been found in any other natural substance.3 Phosphoric acid is found in both the lipid and carbohydrate moieties.
Practical Management of the Allergic Child, by Vincent J. Fontana, M.D. New York: Appleton-Century-Crofts (Division of Meredith Publishing Company, 440 Park Avenue So., New York, New York 10016), 1969, 371 pp., $15.00
Authors: Holt L. Emmett 
Published: December 2021

There are many texts on allergy; a number of them deal with allergy in childhood. Why this one? What are the features that characterize Dr. Fontana's recent book?
The clinical manifestations of allergy in childhood are described in various chapters together with appropriate treatment. The book is well written, obviously the work of a master with an intimate first-hand knowledge of the subject. Particularly useful are the discussions of differential diagnosis included with each entity. Therapy to avoid as well as therapy to adopt is stressed.
CONGENITAL HYPOPARATHYROIDISM SIMULATING EPILEPSY, WITH OTHER SYMPTOMS AND DENTAL SIGNS OF INTRA-UTERINE HYPOCALCEMIA
Authors: Moshkowitz Abraham , Abrahamov Abraham , Pisanti Sara 
Published: December 2021

A 10-year-old girl presented with bilateral cataracts, nail deformities, and dental changes associated with hypocalcemia. Past history revealed the occurrence of several episodes of epileptic seizures, which were treated unsuccessfully with anti-epileptic drugs. Clinical signs and laboratory tests confirmed the diagnosis of idiopathic hypoparathyroidism, and the patient was treated successfully with viatmin D2 and oral calcium.
The improvement in the patient's condition, as indicated by the rise of serum calcium level, was further demonstrated by improvement in the electrocardiographic and electroencephalographic examinations, which prior to treatment showed disturbed patterns of the type observed in severe hypocalcemia and convulsive disorders.
The interesting observation of episodes of intrauterine hypocalcemia, probably due to hypoparathyroidism in utero, is made on noting the effects on dentition. The problem of intrauterine suppression of the fetal parathyroid glands is discussed.
Letter to the Editor
Authors: Levin S. 
Published: December 2021

"At the evidence of two witnesses . . . shall the matter be established." (Deuteronomy 19:15).
Concerning worms as a cause of urinary infections, I certainly do agree that pinworms carry B. Coli with them into the bladder, but I did not want to bring up this subject because my purpose was rather to draw attention to the syndrome of night cries in little girls. I have since observed a 10-year-old girl whose crepuscular crisis was caused by 2 pinworms on her hymen.
A STUDY OF STORAGE, CHILD BEHAVIORAL TRAITS, AND MOTHER'S KNOWLEDGE OF TOXICOLOGY IN 52 POISONED FAMILIES AND 52 COMPARISON FAMILIES
Authors: Baltimore Charles , Meyer Roger J. 
Published: December 2021

Like the paper that immediately precedes it, the following paper casts serious doubts on widely used countermeasures against poisoning—the safe storage of toxic products and the education of parents as to the toxicity of products commonly used in the home. The significant variable in childhood poisonings, according to these investigators, is the characteristic behavior of the child. Like many other studies of the same general type, however, the present one raises two questions, one having to do with the methodology, the other with the implications of the findings.
In retrospective studies which rely on recollections or other subjective reports by an interested party, one must always suspect that the event being studied (in this case a poisoning incident) may very well have distorted the subjective report. Is the mother of a child who has recently been hospitalized for poisoning more likely to report that her child "is always getting into everything" than the mother who has not experienced the same sort of event? The use of a control group, no matter how carefully selected, offers no protection against such distortion. The only satisfactory solution is to rely on objective records made before the event (and these are usually difficult to obtain) or to make the study a longitudinal one (which is especially difficult in accident research because accidents occur infrequently).
Any study that relates accidental injury to the personal characteristics of the victim raises more questions than it answers with respect to the development of effective countermeasures. Should efforts be directed toward changing the child's behavior pattern—by working with the child or with his mother or both? Or, once the child's behavior pattern is identified, should efforts be made to protect his environment by educating the parent about toxicity or by safeguarding toxic products, or both? At present these questions remain unanswered.
THE INJURY CONTROL PROGRAM OF THE U.S. PUBLIC HEALTH SERVICE
Authors: Marland Richard E. , Burg Frederic David 
Published: December 2021

Today the center for action and support of accident prevention activities within the Federal Government is the Injury Control Program. Therefore, it is appropriate to discuss the Government's role in solving this health problem.
The present stage of development in injury control allows us to define, comprehend, and control some injury types as if they were disease entities. If the appropriate funds were made available, the estimated 16 billion dollars per year lost to the economy from accidents, the 50 million injuries caused by accidents, the 100,000 plus deaths resulting from accidents, and the 20 million plus hospital bed days used up by accident victims could all be reduced by about 30%.
Figure 1 shows the benefit-cost potential to be found in the control of accidental injuries and is derived from study of cost-effectiveness of previous injury control programs. The present situation (point A) has been relatively static over the past few years-that is, a reasonably low return is being made from our investment. With a 20 to 30% increase in resources, the curve reaches a steeper slope where you will get the greatest benefits per dollars spent.
Fundamentally, injury control needs a high Federal priority to receive adequate resources to make progress in overcoming this health problem. The basic criteria used to ascertain a prioritY rating in preventive health programs are: (1) mortality rate (including age-specific rates), (2) morbidity rate (including age-specific rates), (3) financial impact on national economy, (4) utilization of space in our nation's hospitals by those involved in caring for those incapacitated or requiring care, (6) the control measures available for attacking the problem-or the case with which they can be attained, (7) available resources, both personnel and monetary, to attack and solve the problem, and (8) public reception to the idea of controlling the problem.