bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Nitroblue Tetrazolium Dye Reduction in the Phagocytes of Patients Receiving Prednisone
Authors: Miller Denis R. , Kaplan Henry G. 
Published: December 2021

Nitroblue tetrazolium (NBT) dye reduction by leukocytes of 21 patients receiving prednisone was significantly decreased. Nineteen percent of the patients had values similar to those found in children with chronic granulomatous disease, and 57% had heterozygous-range NBT dye reduction. A qualitative NBT dye reduction "slide test" correlated well with the quantitative assay. The uptake of particles by the phagocytes of steroid-treated patients appeared normal.
The exact mechanism of corticosteroid action remains unknown. The decreased dye reduction observed in vitro suggests an induced defect of intracellular metabolism which may be related to known alterations of host defenses which occur in patients receiving these hormones.
RESEARCH ISSUES IN CHILD HEALTH A HEAD START RESEARCH SEMINAR
Authors: North A. Frederick 
Published: December 2021

The purpose of the conference reported in this series of papers was to find answers to three questions. What do we know from past and current research with enough certainty that it merits widespread application now? What are the most critical needs for new knowledge that might be acquired through research? Which of these needs are of highest priority because they are basic to further understanding or because they are vulnerable to rapid solution by techniques already at hand? Each author answered each of these questions with many specifics, but certain themes recurred throughout all the papers.
Each author pointed out that many of the most important issues in child health are social and political issues, not research issues. Failure to make the distinction between these kinds of issues can lead to inappropriate action in either research or social and political action. All authors emphasized that society and individuals must decide and act now, in the face of imperfect knowledge, and not wait for the kind of evidence that could lead to truly rational decisions.
In the face of this social imperative to make decisions on the basis of imperfect evidence, each author urged that suitable mechanisms for self-evaluation and feedback be built into individual activities, programs, and health care settings. Without such feedback mechanisms, great harm may be done by apparently innocent acts or programs. The design and application of such feedback and evaluation systems for health and health care is one of the major research and development priorities, basic further study of new programs, financing mechanisms, and delivery systems for child health.
Letter To The Editor
Authors: King Katherine C. , Adam Peter A. J. , Clemente Geronima A. , Schwartz Robert 
Published: December 2021

Dr. King and her colleagues comment as follows:
In his letter criticizing the article entitled "Infants of Diabetic Mothers: Attenuated Glucose Uptake without Hyperinsulinemia," Dr. McCann takes issue with both the selection of cases, and the concept that hyperinsulinemia may not exist after 2 hours of age. Before study of the infants, pregnant subjects were selected on the basis of the criterion stated in the article. The glucose disappearance rate of less than 1% per minute is beyond the normal range, and more than two standard deviations below the normal mean in the third trimester.1
Letter To The Editor
Authors: Tefft Melvin 
Published: December 2021

The recovery of an 11-year-old girl with an apparent inoperable grade III astrocytoma of the lower brain stem and upper cervical cord is of interest.
The details of management and the exact clinical course are not well defined.
From the information given, one notes that the child's clinical condition improved approxi-mately 3 months following a "prolonged course" of radiation therapy and placement of an atrioventricular shunt. The improvement is attributed to amphotericin B. Treatment with amphotericin B began , apparently, 3 months after the shunt and completion of radiotherapy.
Letter To The Editor
Authors: Moriyama I. M. 
Published: December 2021

We are grateful to two authorities for the following replies to Dr. Nickey. First, Dr. Moriyama:
Is the differential between the infant mortality rate for the United States (22.4 per 1,000 live births in 1967) and the corresponding rate for Sweden (13.7), the Netherlands (13.4), Norway (14.8), and other countries of low mortality real?1, 2
One possible reason for the large differential is the contribution that the nonwhite population makes to the relatively high mortality rate for the United States.
On the Nonautoimmune Aspects of Endocardial Fibroelastosis: Continued Inquiry into the Significance of Delayed Sensitivity to Mumps Virus
Authors: St. Geme Joseph W. , Noren George R. , Evans Charles M. , Ozwoeld Lois 
Published: December 2021

Using both the capillary precipitin and the agar gel immunoprecipitin methods, we were unable to identify cross-reacting antigenic determinants between human heart and chicken tissues. These observations do not support the premise that the positive cutaneous delayed hypersensitivity to mumps antigen in some children with primary endocardial fibroelastosis might represent nothing more than nonspecific avian sensitivity. Furthermore, there was no support for the notion that endocardial fibroelastosis represents an immunopathogenic phenomenon of shared antigenic relationships between mumps virus and human heart like that suggested for the group A beta-hemolytic streptococcus and myocardial and valvular tissue in acute rheumatic fever.4-6
We continue to believe that the positive mumps skin test in certain children with primary endocardial fibroelastosis may represent the immunologic marker of previous intrauterine antigenic exposure to briefly replicating mumps virus.
DR. MICHAEL UNDERWOOD WRITES ABOUT AN INFANT WHO WAS ACCIDENTALLY KILLED BY A PIN
Authors: C. T. E. 
Published: December 2021

The most advanced writer on the diseases of children in the eighteenth century was Michael Underwood (1737-1820)1. He laid the foundation of modern pediatrics in his Treatise on the Diseases of Children, published first in 1784. This book went through at least seventeen editions and remained in great favor all over the world for more than 60 years.
Underwood cites many personal clinical histories in his text, but none is more tragic than the following:
A gentlewoman many years ago informed me, that one of her children, after long and incessant crying, fell into strong convulsions, which her physician was at a loss to account for, nor was the cause discovered until after death; when (shocking to relate!) on the cap being taken off (which had not been changed on account of its illness), a small pin was discovered sticking up to the head (of the pin) in the large fontanelle, or moule.
Underwood was referring to the straight or common pin; the modern safety pin was invented by the American inventor Walter Hunt in 1849. Hunt's pin was not the first safety pin. Thousands of years earlier the ancient Egyptians had used pins similar to those rediscovered by Hunt. But, the idea was lost and until Hunt's day no one thought of developing a safety pin. In England the "new-fashioned safety pin" with a solid guard to cover the point did not appear for general use until 1878.
INCREASED INTRACRANIAL PRESSURE ASSOCIATED WITH PROBABLE VITAMIN A DEFICIENCY IN CYSTIC FIBROSIS
Authors: Keating James P. , Feigin Ralph D. 
Published: December 2021

Two 4-month-old infants with signs of intracranial hypertension associated with vitamin A deficiency are reported. Intestinal malabsorption due to cystic fibrosis was the underlying cause for the hypovitaminosis A. The recognition of vitamin A deficiency was delayed because of failure to appreciate that bulging anterior fontanelle is a sign of deficiency of this vitamin.
These cases serve to reemphasize this infrequently reported association and serve to remind the pediatrician that vitamin deficiency disease in the United States is of more than historical interest. Prompt recognition of this syndrome and appropriate therapy can prevent blindness and death.
THE CRITICALLY ILL CHILD: MANAGEMENT OF TRACHEOSTOMY
Authors: Crocker Dean 
Published: December 2021

The indications for and methods of performing a tracheostomy in children are many and varied. There is still controversy as to the size, types, and placement of the tube; the type of incision; the relative indications for tracheostomy in infants and older children; the use of prolonged endotracheal intubation in preference to tracheostomy; and even the type of instruments used to perform the tracheostomy. However, problems discussed here are mainly the proper care of the child with a tracheostomy tube, including those associated with its removal.
Whatever the disease state from which the child suffers, certain basic principles must be kept in mind during all tracheostomy care. These relate to: (1) inspired gas mixtures, (2) humidification in inspired gas, (3) suctioning of secretions, (4) positive pressure breathing, (5) chest physiotherapy, (6) weaning of a patient from tracheostomy, (7) home care of tracheostomy by parent, and (8) complications of tracheostomy. Let us now examine these factors in detail.
INSPIRED GAS MIXTURES
Gas mixtures most commonly administered via tracheostomy are of oxygen and air, in percentage that will maintain arterial oxygen tension (PaO2) at near normal. Sometimes this will require 100% oxygen or sometimes 100% air, which is, of course, 20% oxygen. Whatever the mixture, the PaO2 should never exceed 250 mm Hg; ideally, it should never approach this figure.
Immediately following tracheostomy, arterial blood gases should be measured with the patient breathing room air, providing that his clinical condition will tolerate this minimal oxygen percentage. If by clinical judgment additional oxygen is required, the inspired percentage should be carefully measured at the time blood is drawn for gas determination.
ON A FIFTEENTH CENTURY TEST FOR STERILITY
Authors: C. T. E. 
Published: December 2021

Barren marriages until the present century were usually considered a sign of Divine displeasure. But as knowledge of the phsyiology of reproduction was a closed book until recently, many preternatural methods for determining whether sterility was the fault of either husband or wife may be found in the medical literature of the Renaissance. None is more fanciful than the following from an English leechbook of the fifteenth century:
Knowing the default of conception, whether it belong to the man or the woman. Take two new earthen pots, each by itself; and let the woman make water in the one, and the man in the other; and put in each of them a quantity of wheatbran, and not too much, that it be not thick, but be liquid or running; and mark well the pots for identification, and let them stand ten days and ten nights, and thou shalt see in the water that is in default small live worms; and if there appear no worms in either water, then they be likely to have children in process of time when God will.1
Dawson2 writes that this and similar experiments are ancient ones and are described in Egyptian papyri.
RENOVASCULAR HYPERTENSION IN CHILDREN
Authors: Leumann Ernst P. , Bauer Robert P. , Slaton Paul E. , Biglieri Edward G. , Holliday Malcolm A. 
Published: December 2021

Three children with renovascular hypertension are presented in order to demonstrate the wide clinical spectrum of this disease. Two patients had relatively minor symptoms, but one with neurofibromatosis showed frank hypokalemia, polyuria, and hyponatremia.
Three different anatomical lesions were found: bilateral renal artery stenosis in the patient with neurofibromatosis, fibromuscular hyperplasia in the patient with stenosis of one renal artery, and an isolated malformation of one small intrarenal artery.
The last of our patients presented a complicated diagnostic problem which required repeated arteriograms and renal vein catheterizations for differential renin assay. Renovascular hypertension should be excluded in any pediatric patient with otherwise unexplained hypertension.
REYE'S SYNDROME: AN EPIDEMIOLOGIC APPROACH
Authors: Glick Thomas H. , Likosky William H. , Levitt Lawrence P. , Mellin Harold , Reynolds David W. 
Published: December 2021

In a selective epidemiologic study of Reye's syndrome (acute encephalopathy with fatty degeneration of the viscera) 62 cases were reported from parts of the United States and Puerto Rico over a 30-month period. Most of these cases were reported from a few areas where the diagnostic index of suspicion was high, suggesting that the overall national incidence may be considerably higher than has been generally appreciated. Several areas reported epidemic patterns in February and March 1969, concurrent with outbreaks of influenza B virus infection. Seven additional sporadic cases in the 30-month period were associated with chickenpox. Patterns of incidence of such viral infections may account for variations in incidence of Reye's syndrome beyond those attributable to differences in index of suspicion and case finding. Epidemiologic data do not support an etiologic role for exogenous toxins or medications. An inverse relationship between the manifestation of hypoglycemia or hypoglycorrhachia and age of patient was demonstrated.
The growing evidence found associating Reye's syndrome with infection by common viral agents, such as influenza B, suggests a potential role for immuno- or chemo-prophylaxis.
MEASLES (RUBEOLA) IN PREVIOUSLY IMMUNIZED CHILDREN
Authors: Baratta Robert O. , Ginter Myrna C. , Price Morris A. , Walker James W. , Skinner Richard G. , Prather E. Charlton , David Joseph K. 
Published: December 2021

Within a 3-month countywide epidemic of measles in Jacksonville, Florida, 28 cases occurring among a kindergarten enrollment of 145 were carefully studied since 25 of these children had been previously immunized with a live, attenuated measles virus vaccine and immune globulin. Nineteen children had been vaccinated prior to their first birthday. Six children were vaccinated at 13 to 20 months of age. The median measles (rubeola) hemagglutination-inhibition (HI) antibody titer in sera of five convalescent patients immunized before their first birthday was 1:320 and for complement fixation it was 1:128. Sera from nine classmates who did not contract the disease showed a median HI antibody of 1:40 and a median complement fixing antibody (CF) of 1:16. Six had been vaccinated before their first birthday.
In a control group of five other children, three had been immunized prior to 12 months of age, one at 13 months, and one at 18 months. Sera from the three earliest contained no antibody; however, sera from the other two had detectable antibody.
The analysis of serologic data supported the contention that the outbreak was causally related to defective protection associated with the use of vaccine plus globulin in infants. It also demonstrated persistence of CF antibody many years after immunization and suggested the presence of a booster phenomenon.
A review of the clinical illness of the 25 children who had been given the vaccine and 22 who had not revealed little difference in the severity of the disease.
DIFFUSE NEONATAL HEMANGIOMATOSIS
Authors: Holden Kenton R. , Alexander Fred 
Published: December 2021

Two infants with diffuse neonatal hemangiomatosis are presented. One infant developed thrombocytopenia and bleeding while the other infant with more widely diffuse lesions succumbed to extensive central nervous system involvement.
Steroid therapy caused no obvious alteration in either of the patient's course. The vascular lesion in this disease is possibly congenital absence of vessel wall pericytes.
Six previous cases of diffuse neonatal hemangiomatosis are briefly reviewed in relation to the sites of the lesions, cause of death and malignant potential.
Letter To The Editor
Authors: Charles Seymour , Shelness Annemarie 
Published: December 2021

Thank you for giving us the opportunity of replying to Dr. Johnson's remarks.
The omission immediately below the column heading "Annual Mileage" in the table referred to occurred in the printing.
Although Iowa may require the reporting of all accidents, it is doubtful if every scratch and bump is recorded.
Pupil mileage is difficult to ascertain. The National Safety Council (Accident Facts 1969) estimates it to be 40% of the total. The mileage recorded is the actual number of miles traveled by each vehicle; no attempt has been made to compute "passenger miles."
Letter To The Editor
Authors: Mortimer Edward A. 
Published: December 2021

I think Dr. Klein has probably already answered your letter of April 6, but I shall also add a comment or two. I hope that Dr. Klein and I agree in our answers and that my comments do not serve to muddy the waters.
You are correct that most infections due to H. flu are type b. You are also correct that a proper search for H. flu in the upper respiratory tract of normal individuals, using appropriate media, yields the organism from at least half of normal children and adults, and probably even more.
SHOULD INFANTS BE ALLOWED TO DRINK TEA?
Authors: C. T. E. 
Published: December 2021

An apothecary named James Nelson (1710-1794) who lived in Red Lion Street, Holborn, London in the 1750's wrote an excellent book about the art of rearing children titled, An Essay on the Government of Children Under Three General Heads: viz. Health, Manners and Education. Nelson's book, according to Still,1 shows more of balance and common sense than John Locke's Thoughts on Education, first published in 1692-1693.
Tea drinking had become very fashionable in England by the time Nelson wrote his book. (Tea was first sold in England at Garway's Coffee House in London in 1657). Nelson cautioned against its use in children as follows:
Tea to young child, if we omit the milk, has not a single Ingredient to recommend it: . . . the water, (as Tea is usually drank too hot,) serves to scald (sic) Mouth and Throat, or at best relax the Stomach and weaken the tone of it...
Tea may be consider'd like some certain Drugs, which in skilful (sic) hands are safe and useful, but in ignorant ones poisonous. That the intemperate and indiscriminate use of Tea is hurtful, is too well known to be disputed; some it is true are manifestly refresh'd, comforted and enliven'd by it; others feel not the least sensible effect from the longest use of it, and drink it purely thro' Custom; but again there are others, and those much the majority, who impair their Health so visibly by this pernicious Practice, that they shorten their Lives. . . . Now who that considers these things well, or but once reflects, that `tis at least' ten to one that their Children are Sufferers by it, can speaking be hasty in bringing them to it; especially too if we reflect, that by a seeming magic Power it often enslaves People even to Infatuation.
AN APPROACH TO THE ESTIMATION OF THE TRUE NUMBER OF CONGENITAL MALFORMATIONS
Authors: Khalili Abbass , Marienfeld Carl J. , Wright Harley T. , Weiss Edward S. 
Published: December 2021

Vital statistics reports of congenital malformations are of widely varying quality and completeness. They remain, however, the major data source for population studies of birth defects.
The Environmental Surveillance Center of the University of Missouri in using birth defects as a measure of possible environmentally caused health effects required an estimate of the true number of such defects occurring in a particular place during a specified time.
This article presents a method for making such an estimate and is based upon the matching of birth certificate reports describing birth defects and infant death certificates. The reasonable assumption is made that the death rate among the children with known birth defects is the same as the death rate among all infants with congenital anomalies.
The estimated rates using this method closely resemble those rates obtained in hospital record studies.
ALPHA1-ANTITRYPSIN DEFICIENCY AND DISEASE
Authors: Alper Chester A. , Johnson A. Myron 
Published: December 2021

The major serum inhibitor of proteolytic enzymes is the α1-globulin, α1-antitrypsin. Hereditary deficiency of this protein is immediately recognizable on inspection of stained serum electrophoretic strips (agarose, agar, and cellulose acetate, as well as paper) in that the normal α1 band is absent (Fig. 1). Although the protein concentration of the α1-globulin zone is usually subnormal in deficient sera, it is not always so; and, the ultimate criterion for the establishment of the diagnosis must be made by genetic typing, as will be shown.
Almost coincidental with the discovery of α1-antitrypsin deficiency by Laurell and Eriksson,1 in Sweden, was their observation that many persons with this abnormality had early onset chronic obstructive lung disease.
IMMUNOFLUORESCENT DEMONSTRATION OF ENTEROPATHOGENIC ESCHERICHIA COLI IN TISSUES OF INFANTS DYING WITH ENTERITIS
Authors: Drucker Moshe M. , Polliack Aaron , Yeivin Rina , Sacks Theodore G. 
Published: December 2021

Intestinal sections from twenty-eight autopsies of infants with diarrhea were examined by immunofluorescent (IF) staining for the presence of enteropathogenic E. coli (EEC). EEC were identified in seventeen (61%) of these infants, and in more than 80% of them the serotype was 0111:B4. In only six of the sixteen cases identified by the retrospective staining had the causative organism been cultured during life or at autopsy. All seventeen infants showed inflammatory changes in the intestine, and in nine infants the changes were found to be severe. Escherichia coli were identified in the lungs in seven infants.
It is suggested that IF staining for EEC is a useful method for arriving at a specific etiological diagnosis, when bacteriological findings during life were negative.
In view of the evidence of spread of the bacteria beyond the intestinal mucosa, it is suggested that systemic treatment with antibiotics may be indicated in certain cases of gastroenteritis.
Letter To The Editor
Authors: Feldman William 
Published: December 2021

I take issue with many of the points raised in Drs. Stone and Barbero's article on recurrent abdominal pain.1 First, their conclusion that recurrent abdominal pain in childhood is a form of "the irritable bowel syndrome" is not helpful-it is like substituting the word idiopathic for unknown.
Second, they exposed their patients to considerable irradiation-102 upper gastrointestinal series and barium enemas were done. All of these examinations were normal, as anyone who has dealt with recurrent abdominal pain in childhood might have predicted.
Infektionskrankheiten, Vol. III, edited by O. Gsell and W. Mohr. New York: Springer-Verlag, 1969, 311 pp., $24.20
Authors: Eichenwald Heinz F. 
Published: December 2021

Volumes I and II dealing with viral and bacterial diseases of man, respectively, were published simultaneously and were discussed in a previous review. The present volume covering diseases due to fungi was issued more recently. The chapters on pneumococcal and klebsiellal diseases are somewhat incongruously incorporated in this last volume, perhaps in order to produce a series of books of approximately equal size.
Basically, there is little that need be said. The book represents a workman-like job, with, not unexpectedly, the same strengths and weaknesses pointed out in the earlier review: a certain unevenness of emphasis, an occasional hint of quaintness, a lack of selectivity between what is important and what is not, combined with fine clinical descriptions and great clarity of expression.