bluuebunny/crossref_metadata_2025_split huggingface dataset:
A CONTROLLED TRIAL OF MANAGEMENT OF RESPIRATORY DISTRESS SYNDROME IN A BODY-ENCLOSING RESPIRATOR I. EVALUATION OF SAFETY
Authors: Silverman William A. , Sinclair John C. , Gandy Gillian M. , Finster Mieczyslaw , Bauman William A. , Agate F. J. 
Published: December 2021

A sequential, controlled trial was conducted to compare the results of standard supportive care of RDS with those of management in a body-enclosing respirator. No important lowering of survival nor increased incidence of pulmonary or central nervous system complications occurred in the respirator-treated group.
Evaluation of the efficacy of respirator care for the respiratory distress syndrome should be carried out in a well organized neonatal intensive care unit staffed by specially trained personnel.
Clinical Management of Behaviour Disorders in Children
Authors: HUGHES JAMES G. 
Published: December 2021

The third edition of this textbook concerning behavior disorders of childhood maintains the tradition of excellence established by the two preceding editions.
It is logically and compactly arranged into 12 parts: growth and development, psychologic care, care of the physically ill and handicapped child, etiologic factors in behavior disorders of children, diagnosis and treatment of behavior disorders in children, problems related to intellectual functioning, developmental disorders, problems related to emotional development, problems of habit and training, organic disturbances with a large psychic component, antisocial behavior, and specific syndromes.
OCCURRENCE OF INNOCENT ADVENTITIOUS CARDIAC SOUNDS IN CHILDHOOD
Authors: FRIEDMAN SIDNEY , ROBIE WILLIAM A. , HARRIS T. N. 
Published: December 2021

A group of 500 children between the ages of 2 and 12 years was subjected to a special cardiac examination. Of these, 234 (46.8%) were found to have functional cardiac murmurs and 137 (27.4%) were found to have extra cardiac sounds.
There was a considerable degree of association between the occurrence of these two types of adventitious sounds. Neither, however, was found to be correlated with the degree of anemia present, the age, color, sex, state of nutrition, or the temperature of the subjects examined.
A strong association was found to exist between the quality of many functional cardiac murmurs and their point of maximal intensity over the precordium, those in the midprecordium being commonly of the vibratory type and those in the pulmonic region of the blowing variety.
The most valuable criteria for the differentiation of functional from organic heart murmurs in childhood are the acoustic quality and the point of maximal intensity of the murmur.
PLACENTAL TRANSFUSION: EARLY VERSUS LATE CLAMPING OF THE UMBILICAL CORD
Authors: Moss Arthur J. , Monset-Couchard Michelle 
Published: December 2021

IATROGENIC interruption of the placental circulation at birth has, in most cases become an automatic procedure with little or no regard for the physiologic alterations evoked or for their subsequent effect upon the fetus. The relative merits of "early" and "late" clamping of the umbilical cord have been the subject of controversy for many years. More recently it has been suggested that the time of cord clamping may be involved in the pathogenesis of idiopathic respiratory distress syndrome (IRDS). As of this writing, the controversy of "early" versus "late" clamping remains unsettled. Review of the pertinent literature indicates that this is due largely to failure to define uniformly "early" and "late," failure by many to consider the effects of onset of respiration, of gravity, of uterine contractions, and, in some instances, to conclusions not completely warranted by supporting data.
In view of the potential significance of the issue and the current confusion surrounding it, critical re-examination appears to be in order. A major purpose of this review is to call attention to the areas of investigation needing further documentation.
Effect on Blood Volume
The blood volume of newly born infants has been studied by a number of investigators. In Table I are listed six studies in which the time of cord clamping was taken into account. In a study of 35 infants, DeMarsh, Windle, and Alt found a significant increase in blood volume when cord clamping was delayed until after separation of the placenta. In a similar study by Whipple, Sisson, and Lund these results were not confirmed.
Letters to the Editor
Authors: VON HOFE FREDERICK H. 
Published: December 2021

In response to the letter written by Dr. R.A. Norton of Tacoma, Washington, addressed to Mr. W. J. Becker, and forwarded to the Editor of Pediatrics, I say AMEN!
Too many articles that appear in Pediatrics are of the type of lectures delivered which fully display the speakers' unusual knowledge of particular subjects but give the audience nothing to take home.
I should welcome more practical articles that may have application to the practice of pediatrics.
White and Nonwhite Mortality
Authors: CHUSID EMANUEL 
Published: December 2021

Each year I scrutinize a little more thoroughly Myron Wegman's vital statistic summaries. I regard these as kind of report card of the state of health of our patients. One might estimate how effective we are by how the numbers look.
The white-nonwhite mortality differential which Dr. Wegman has noted has been painfully elaborated by Dr. Helen C. Chase. Her compilation of death registration figures shows that, in 1963, infant mortality rate for whites was 22.3, and for nonwhites was 41.7.
Letters to the Editor
Authors: MENXES JOHN H. 
Published: December 2021

Dr. Dancis's letter underlines the complexities encountered in studying the various metabolic alterations resulting from a derangement of the internal environment as seen in phenylketonuria.
It is a clinical fact that phenylketonuric individuals have diluted hair and iris pigmentation and that this defect is reversible by restriction in phenylalanine intake or supplementation of a normal diet by tyrosine.
The inhibition by phenylalanine of tyrosinase derived from embryonic skin (Saunders, et al.), mushrooms (Dancis and Balis), or mammalian melanoma (Miyamoto and Fitzpatrick) suggests but one of several possible sites at which melanin formation may be inhibited in the phenylketonuric patient.
STUDY OF ADRENAL FUNCTION IN CHILDREN WITH MENINGITIS
Authors: Migeon Claude J. , Kenny Frederic M. , Hung Wellington , Voorhess Mary L. 
Published: December 2021

CORTICOSTEROIDS were introduced into the therapeutic armamentarium in 1949, and initially there was considerable enthusiasm regarding their possible uses in infectious diseases. One authority in a review in 1957 commented as follows: "I am prepared to state that the use of ACTH or adrenocorticosteroids on a short term basis in carefully selected patients with severe infections, often with debilitating and painful complications, not only will frequently contribute to the recovery of patients, but also will at times prevent permanent and disabling sequelae. In preparation for this review over 1,000 reports in the literature have been surveyed, and the more pertinent references have been included." However, initial enthusiasm has abated, and there are now few, if any, situations in which it is universally agreed that steroid treatment of an infectious disease is beneficial.
Experience in this field has been acquired largely through the comparison of steroid treated with non-treated controls.
In order to help clarify the still debatable issue of whether steroid treatment might be beneficial in cases of fulminating meningococcemia, we have selected another approach. We have attempted to study adrenal function in steroid-untreated patients, and we have compared the data with those obtained in other types of bacterial meningitis and in aseptic meningoencephalitis.
METHODS
Patients Studied
Unselected patients (Tables I-IV) admitted for meningitis were studied at The Children's Hospitals of The District of Columbia and of Pittsburgh, and The Children's Medical and Surgical Center of Baltimore. House officers at those centers notified the authors at the time of, or shortly after, the patients' admission. Most patients were started on the study immediately after admission, but some of them were included after varying time lapses.
THE FIRST REPORT OF THE VALUE OF FISH LIVER OIL AS A CURE FOR RICKETS
Authors: C. T. E. 
Published: December 2021

In spite of the enormous literature concerning the history and use of fish liver oil in the prevention and treatment of rickets, the following interesting report published in 1779 seems to have escaped the notice of all who have delved into this subject:
The following account of a method by which the inhabitants of the western isles of Scotland, excite a fever and cure the rickets, has lately been communicated to Dr. Duncan, by an ingenious gentleman, in whose veracity and accuracy our readers may put great dependence.
"We are indebted to the most uncultivated part of mankind for many useful discoveries, especially in medicine; and however inexplicable they may be by our theories, yet even the most unpromising of them deserve attention and trial, more especially when they may prove useful in saving the lives of many of our fellow-creatures.
"The medicine made use of in the western islands for the cure of rickets, is an oil extracted from the liver of the skate fish. The method of application is as follows. First, the wrists and ancles [sic] are rubbed with the oil in the evening; this immediately raises a fever of several hours duration; when the fever from the first rubbing subsides, the same parts are rubbed again the night following, and repeatedly, as long as the rubbing of these parts continues to excite the fever: after no fever can be excited by rubbing the wrists and ancles [sic] alone, they are rubbed again along with the knees and elbows. This increased unction [sic] brings on the fever again; and is practiced as before, till it no longer has that effect. Then the vertebrae and sides are rubbed along with the former parts, and this unction, [sic] which again brings on the fever, is repeated as the former. When no fever can be longer excited by this unction, [sic] a flannel shirt, dipped in the oil, is put upon the body of the patient; this brings on a more violent and sensible fever than any of the former unction, [sic] and is continued till the cure is completed, which commonly it is in a short time."
THE FUNCTION OF THE PEDIATRIC JOURNAL
Authors: C. T. E. 
Published: December 2021

These facts being appreciated, the true work of the pediatric journal is rendered clear. It is the medium of communication between the observer and the practitioner. By observer is not meant simply the laboratory worker and the pathologist, but it includes the physician of the hospital and dispensary. It is not limited even to these, for we should not fail to appreciate the invaluable experiences gained by the general physician. To him we allot ample space in these pages and urge more frequent publication of the knowledge which he gains in his daily contact with disease. On the whole, however, it must be admitted that the most important and substantial advances in knowledge result from the researches of special workers. The wisely conducted medical journal, will be, therefore, in large degree, the medium of communication between such special workers and that great body of men who do the practical work of the profession.
As the department of pediatrics cannot be restricted to a few consultants in large cities or teachers in medical colleges, so the pediatric journal cannot be limited in its scope. While its best contributors are drawn largely from the ranks of the true specialists, the man to whom it should prove of the greatest actual value is the general practitioner, to whom the diseases of children are of such vital importance. The true aim of such a journal should be the education of the profession at large in the important department which it represents. It should constantly strive to place the knowledge which is being continually accumulated by skilled observers, in such forms as to be most available for practical use. It has been the aim of the Archives throughout its whole history to attain this end, and no departure will be made from this policy.
DIAGNOSIS AND TREATMENT: THE COMPLICATIONS OF STEROID TREATMENT
Authors: Eberlein Walter R. , Bongiovanni Alfred M. , Rodriguez Carmen Saenz 
Published: December 2021

WHEN administered in pharmacologic amount, the adrenal glucocorticoids act in an almost magic way to suppress the overt manifestations of a large variety of inflammatory diseases, for which there is no known cause or cure. It is for this nonspecific purpose, rather than for replacement therapy of adrenocortical insufficiency states, that the steroids are so widely used. The extent of their use may be judged from the fact that total manufacturer sales of these products currently exceed $100 million annually.
To date, the pharmaceutical houses have synthesized over 1,500 corticosteroid analogues, only a few of which have proved in practice to be superior to cortisol and cortisone as anti-inflammatory agents. The analogues have been created in an attempt to avoid some of the undesirable effects which result from the pharmacologic use of cortisol or cortisone. Table I lists the major metabolic changes produced by the natural steroids and the clinical picture which develops when they are given or secreted in excess. It should be emphasized that the newer steroids avoid only one of these "complications," the action of cortisol given in large doses to cause sodium retention and potassium loss, thus producing edema, hypertension, hypokalemia, and metabolic alkalosis. The avoidance of edema and hypertension has certainly proved desirable in the treatment of nephrosis or rheumatic carditis, conditions for which cortisone is now rarely prescribed. And yet, if given in large enough amount, the analogues, such as prednisone, will produce profound muscular weakness, presumably via this same mechanism.
The possible complications listed in Table I ought to warn the physician not to use these steroids to treat trivial ailments.
Letters to the Editor
Authors: LOMBROSO CESARE T. , LERMAN PINCHAS 
Published: December 2021

We gratefully acknowledge the kind remarks addressed to our paper by Drs. Kidd and Prichard, as well as their suggestions regarding the pathophysiology of breathholding spells (BHS).
We were cognizant of the differing views on the subject and indeed an effort to reconcile some of these was one of our aims. As we tried to point out, there seem to be at least two main mechanisms by which a "seizure" can be precipitated in "breathholders," namely through "ischemic anoxia" or through "anoxic anoxia."
CEREBRAL GIGANTISM IN CHILDHOOD
Authors: Milunsky Aubrey , Cowie Valerie A. , Donoghue Elaine C. 
Published: December 2021

Two cases of cerebral gigantism in childhood are reported, and 14 earlier cases are reviewed. The major manifestations of this non-progressive neurological disorder included gigantism, macrocrania, dolichocephaly, mental retardation, characteristic facies, high arched palate, and ataxia or clumsiness.
Pneumoencephalography in 10 out of 11 cases revealed a dilated ventricular system. Normal fasting plasma growth hormone levels were found in our patients, but both showed evidence of impaired function of the hypothalamic-pituitary axis in that these levels failed to rise following marked hypoglycemia. Abnormal dermatoglyphic patterns are reported and their value as an aid to diagnosis is mooted.
Both the cause and the nature of the neurological lesion remain obscure. The evidence favors a pathogenic mechanism operative in utero.
Some Disenchantment with a Disputatious View
Authors: GERSH MARVIN J. 
Published: December 2021

Dr. Leon Eisenberg, commenting on Dr. Julius Richmond's provocative Aldrich Award Address in the May 1967 issue of Pediatrics, offers us a double exhortation.
The first part of his comment, it seems to me, is addressed to his own colleagues in child psychiatry. He chides them for their ignorance of pediatrics, a point of view with which I have no quarrel.
The second part of his comment is addressed to the pediatric community, of which I am a member.
Programs of the Cancer Control Program—U. S. Public Health Service
Authors: Schulte Charles J. A. 
Published: December 2021

ON JANUARY 1, 1967, the Cancer Control Program will become part of the National Center for Chronic Disease Control within the Public Health Service's new Bureau of Disease Prevention and Environmental Control. Our primary mission is to stimulate and encourage the application of currently available techniques of cancer prevention, cancer detection, and cancer control to the community at the grass roots level. If this will be the case after the reorganization remains to be seen. Figure 1 shows the new organization of the Public Health Service.
By way of illustration, I think it would be well to briefly outline a few of our activities. An area of heavy emphasis has been the use of the Papanicolaou smears for cervical cancer control. These programs have been responsible for developing certified cytotechnology training schools, supporting and training large numbers of cytotechnicians. In addition, we are supporting some 90 hospital-based cervical cancer screening projects across the country. A program to encourage the general practitioner to screen his private patients in the office is jointly sponsored by the American Academy of General Practice and the Cancer Control Program.
The very grave problem in the United States of smoking and carcinoma of the lung is the major responsibility of tile National Clearinghouse for Smoking and Health, a part of the Division of Chronic Diseases which developed out of the Cancer Control Program.
We are engaged in a number of developmental projects, such as the flexible fiber optic proctosigmoidoscope. We hope to be able to produce a proctosigmoidoscope that will reach the splenic flexure.
Upper and Lower Gastrointestinal Tract Bleeding Induced by Whole Cow's Milk in an Atopic Infant
Authors: KRAVIS LILLIAN P. , DONSKY GORDON , LECKS HAROLD I. 
Published: December 2021

The case of a 5-month-old infant who developed hematemesis as well as lower intestinal tract bleeding following a second exposure to homogenized cow's milk is presented as an example of unusually severe cow's milk allergy. Serum precipitins, hemagglutinins, and PCA antibodies were all present at the time of the acute reaction, but only skin-sensitizing antibodies could be demonstrated when the infant was asymptomatic and not ingesting milk.
Hypocalcemia, an elevated serum alkaline phosphatase level, and a marked microcytic, hypochromic anemia were associated with milder manifestations of milk intolerance in this same patient 2 months earlier. This unusual triad of laboratory findings can be interpreted as resulting from early damage to the intestinal mucosa by a local milk-antigen-antibody interaction.
GRANULOMATOUS CYSTITIS OF CHILDREN, BILHARZIA LIKE, OCCURRING IN BRITISH COLUMBIA
Authors: Johnson H. W. , Elliott G. B. , lsraels S. , Balfour J. 
Published: December 2021

Two cases of focal granulomatous cystitis are reported in children from British Columbia. The urologic lesions in both showed a distribution and clinical course which were bilharzial like. In one, after many therapeutic failures, use of an anti-bilharzial drug produced prompt healing. This was also noted in two instances reported by other investigators. [See FIG. 10. in Source PDF]
Zones intervening between the focal granulomata of foreign-body type showed eosinophilic cystitis. The links between this syndrome and eosinophilic gastroenteritis are reviewed. One case of eosinophilic cystitis, also in a child, is described. By exclusion all three cases we studied are thought to be parasitic in origin. The distribution reported to date appears to be in sea coast areas of North America, as in "clam digger's itch" another schistosomal disease.
HIGH URINARY DIVERSION WITH AN ILEAL CONDUIT IN CHILDREN
Authors: Holland James M. , King Lowell R. , Schirmer Horst K. A. , Scott William Wallace 
Published: December 2021

High ileal diversion has been performed on 26 children with destroyed ureteral function in the authors' experience. Fifteen were azotemic when diverted. Renal function has improved or stabilized in 21 of the 23 patients (91%) who survived operation followed for as long as 8 years. Pyelographic appearance has improved or stabilized in 34 of 39 kidneys (87%) in these children.
Ten patients were diverted more than 5 years ago. Renal function has improved or stabilized in all seven who are now alive.
High ileal diversion has thus proved to be safe and reliable. Although azotemic children also can be salvaged, the authors advocate earlier high diversion of kidneys drained by badly dilated and poorly functioning ureters.
Letters to the Editor
Authors: MOSS ARTHUR J. , MONSET-COUCHARD MICHELLE 
Published: December 2021

Many of the issues raised by Dr. Baum are discussed in the original article, i.e., the importance of the influence of gravity and of uterine contractions as well as the onset of respirations and the time factor.
Because of the many unknown and complex factors, a definition of placental transfusion was not attempted. Concerning Dr. Baum's proposed definition, it would seem to be purely theoretic to consider a "redistribution" of red cells between the placental and fetal circulations since, to our knowledge, neither the total circulating red cell mass of the placenta and baby nor its prenatal distribution is known.
PRESIDENT'S ADDRESS
Authors: Anderson William S. 
Published: December 2021

THE Thirty-sixth Annual Meeting of the American Academy of Pediatrics terminates an eventful year of increased activities expansion, and new responsibilities of far-reaching importance. The Academy membership continues to increase rapidly and the total membership following the recent Executive Board meeting is well over 10,000. The new responsibilities have necessitated the addition of new personnel to the Central Office staff. Mr. George Degnon will work with the Council on Pediatric Practice, especially on pending legislation planned by governmental agencies. Dr. Robert S. Mendelsohn will administer the consultation program of the Academy for all Head Start programs throughout the country.
The current year has also brought increased activity in the relationship of the Academy to the other medical organizations. The Medical Intersociety Council, the AMA Interspecialty Committee, the Council of Medical Specialty Societies, and the more recently organized Joint Council of Pediatric Societies have continued to meet and work together along many lines of mutual interest and concern. The Joint Commission on Mental Health for Children has been exceedingly active and now has six task forces composed of extraordinary talent in every aspect of mental health. It is hoped and expected that the final report of this joint commission will be a monumental document.
It would be impossible for me to delincate the accomplishments of all the various committees of the Academy. However, I would like to pay tribute to two of these committees whose diligence and productivity have been particularly outstanding.
The Council on Pediatric Practice has met many times and the workshop conferences both last October and at this meeting have been very highly successful.