bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEONATAL RUPTURE OF THE SPLEEN
Authors: Leape Lucian L. , Bordy Marvin D. 
Published: December 2021

Few patients with neonatal rupture of the spleen survive. A patient is presented in whom splenectomy was carried out on the ninth day of age after bleeding had stopped. Diagnosis was suspected because of ecchymoses and a falling hemoglobin.
Palpation of a mass, which was found to be radiolucent on total body opacification studies, confirmed the diagnosis. Spontaneous cessation of bleeding is rare and should not be anticipated when ruptured spleen is suspected in a newborn infant. Prompt surgical intervention is usually required if the patient is to survive.
Cardiac Arrhythmia in a Child Due to Chloral Hydrate Ingestion
Authors: Nordenberg A. , Delisle G. , Izukawa T. 
Published: December 2021

The recommended hypnotic dose of chloral hydrate depresses the cerebral hemisphere and induces sleep without significant change in respiration, blood pressure, or heart rate. With higher doses the respiratory rate may be depressed and the blood pressure reduced due to inedullary depression and peripheral cutaneous vasodilation.1,2
Chloral hydrate "in large doses depresses the contractility of the myocardium and shortens the refractory period."1 Toxic doses produce untoward cardiac effects especially in patients with heart disease.1
Reports of significant cardiac arrhythmia caused by chloral hydrate are rare.3-5. We present what we believe to be the first report of serious cardiac arrhythmia caused by chloral hydrate in a child.
THE TELEMETERED EXERCISE ELECTROCARDIOGRAM IN CONGENITAL AORTIC STENOSIS
Authors: Halloran Katherine H. 
Published: December 2021

Since children with aortic valve stenosis, who are at risk of syncope or sudden death, cannot be identified by the resting electrocardiogram or vectorcardiogram, the exercise electrocardiogram was evaluated and compared with the hemodynamic data obtained during cardiac catheterization. Telemetered exercise electrocardiograms were obtained in 31 children, ages 8 to 18 years, with aortic valve stenosis and in 25 normal children of comparable age. Electrocardiographic leads V1, V5, and V6 were obtained prior to, during, and following exercise on a variable resistance bicycle ergometer. Subjects pedalled until a heart rate of 170 per minute or greater was attained and maintained for at least 2 minutes. An increase in T-wave amplitude was observed in both control children and in those with aortic stenosis. No S-T segment abnormalities were noted in the normal children. Of the 16 patients with peak systolic left ventricular to aortic pressure gradients of less than 50 mm Hg, only one showed a segmental S-T depression. Of the 15 children with aortic valve gradients of 50 to 100 mm Hg, however, all except one showed an S-T segment depression in lead V5 of 2 mm or greater.
No correlation between the resting electrocardiogram or the vectorcardiogram and the aortic valve gradient or left ventricular peak systolic pressure could be made. In addition, the abnormal S-T segment response to exercise could not be predicted from or correlated with the resting electrocardiogram. Since an ischemic S-T segment response to exercise was found uniformly in those with the higher gradients, this test appears to have a high degree of specificity in the clinical evaluation of these patients.
MEASUREMENTS OF EFFECTIVE PULMONARY BLOOD FLOW IN THE NORMAL NEWBORN HUMAN INFANT
Authors: Cotton Ernest K. , Cogswell Jeremy J. , Chir B. , Cropp Gerd J. A. , Losey Rosalind 
Published: December 2021

Effective pulmonary blood flow was measured in 32 normal infants by an indicator gas technique. To check the accuracy of this technique in the absence of shunts, we obtained 39 pairs of measurements of pulmonary blood flow in anesthetized rabbits by the gas technique and dye dilution. The results showed a high degree of correlation between the two methods of measurement (r = 0.986). Effective pulmonary blood flow was 1.1% less than total pulmonary flow (p &lt; 0.005); this difference was attributed to venoarterial shunting through non- ventilated parts of the lung.
Measurements of effective pulmonary blood flow in normal newborn infants increased with age. Before 24 hours of age, mean effective pulmonary flow averaged 138 ml/min/kg or less and gradually rose to a mean value of 166 ml/min/kg (±25.6 SE) at a mean age of 81 hours. It is possible that our measurements of effective pulmonary blood flow before 24 hours of age were falsely low because of the presence of clinically undetectable left-to-right shunts.
Aplasia of the Diaphragm
Authors: Feingold Murray 
Published: December 2021

According to Butler and Claireaux,1 approximately 8% of congenital malformations causing death during the first few days of life are secondary to diaphragmatic defects. The reported incidence is 1 out of every 2,200 births.2 To our knowledge, diaphragmatic defects in siblings, specifically aplasia of the diaphragm, have not been reported in the American literature although there have been six reported families in the European literature.3-8 Passarge, et al.7 have recently reported a family and reviewed the literature. We would like to report another family with aplasia of the diaphragm and stress the importance of proper genetic counseling.
CASE HISTORIES
The first infant was the product of the first pregnancy of a 25-year-old mother and a 27-year-old father.
ECTOPIC HORMONE SYNDROMES ASSOCIATED WITH TUMORS IN CHILDHOOD
Authors: Omenn Gilbert S. 
Published: December 2021

Ectopic production of hormones by tumors can serve as a clue to diagnosis of the tumor and as a focus for management of the patient.
Impressive numbers of cases of hypercortisolism, hypoglycemia, precocious puberty, and hypercalcemia due to tumors of nonendocrine tissues have been reported in children already, and it is likely that many others go unrecognized.
The types of tumors and the effects of ectopic hormones in children are quite similar to those in adults, though the tumors most commonly associated reflect the relative frequencies of those tumors in the different age groups.
The unifying hypothesis of genetic derepression accounts for the ectopic hormone syndromes and predicts that additional unusual tumor products can be detected.
Letters to the Editor
Authors: Moriyama I. M. 
Published: December 2021

We showed Dr. Nichols' letter to Drs. Moriyama and Yankauer. Dr. Moriyama writes:
Dr. Nichols makes reference to problems of definitions and registration practices in three countries, namely, the Netherlands, Sweden, and the United Kingdom. By applying these criteria to data from several hospitals in the United States, he points out the large differences between the derived and observed rates.
I will not comment on the "artefacts" that Dr. Nichols has created with his arithmetic. Rather, I shall confine my remarks to the specific issues which Dr. Nichols has raised.
INCIDENCE OF HYPOGLYCEMIA IN NEWBORN INFANTS CLASSIFIED BY BIRTH WEIGHT AND GESTATIONAL AGE
Authors: Lubchenco Lula O. , Bard Harry 
Published: December 2021

The incidence of hypoglycemia was determined in newborn infants in a general obstetric service.
A random sample of patients was studied from nine birth weight-gestational age groups before the first feeding at 3 to 6 hours after birth. The highest incidence of hypoglycemia, 67% (serum glucose level &lt; 30 mg/100 ml), occurred in the preterm SGA group. It was 25% in the term SGA infants and 18% in post-term SGA babies. Full term appropriately grown infants were noted to have a 10% incidence, and the preterm AGA group had a general shift toward lower prefeeding glucose levels. Infants of diabetic mothers were generally large for gestational age and delivered before term; hence, there was a 38% incidence of hypoglycemia in the preterm LGA group. When a serum glucose level of &lt; 20 mg/100 ml was used to define hypoglycemia, the incidence in the preterm SGA groups was least reduced, i.e., to 40 and 21% respectively.
Except for IDM's, evidence of intra-uterine growth retardation from the physical examination and confirmed by the weight/length ratio was demonstrated in infants who became hypoglycemic.
An added stress in the form of birth hypoxia was present in the majority of the infants who became hypoglycemic. The combination of reduced energy reserves in newborn infants with intra-uterine growth retardation, plus the increased utilization of carbohydrates during birth hypoxia, resulted in a high incidence of neonatal hypoglycemia in the first few hours after birth.
IgE LEVELS IN SERA OF CHILDREN WITH ASTHMA
Authors: Kumar Lata , Newcomb Richard W. , Ishizaka Kimishige , Middleton Elliott , Hornbrook Margaret M. 
Published: December 2021

Concentrations of the immunoglobulin that is associated with reaginic activity, IgE (γE), were measured in sera of 116 children with bronchial asthma. High γE (&gt;700 ng/ml) were found in only 30. High γE levels were found in children with many positive skin tests (P &lt; 0.01) and with active atopic dermatitis (P &lt; 0.01). Long term, systemic corticosteroid therapy was found to be associated with normal γE values (P &lt; .001) even when the characteristics of the disease would otherwise have indicated high values.
As no correlation is found to be evident between severity of the disease and γE levels, it may be suggested that corticosteroids may decrease intravascular γE. The serum γE values failed to reveal two or more clinically different groups among our patients.
THE XYLOSE EXCRETION TEST IN NORMAL CHILDREN AND IN PEDIATRIC PATIENTS WITH TROPICAL SPRUE
Authors: Santiago-Borrero Pedro J. , Santini Rafael , Maldonado Norman 
Published: December 2021

The 5-hour urinary xylose excretion test was performed in 158 normal Puerto Rican school children 2½ to 13 years of age after the administration of a 5 gm oral dose of D-xylose. The values ranged from 0.7 to 2.3 gm with a mean of 1.44 gm and a standard deviation of ± 0.35 gm. Seven children excreted 0.9 gm or less (18% of the oral dose), which was the upper limit of excretion by the patients with untreated tropical sprue. All except one of the values below 1.0 gm occurred in children less than 6½ years of age.
Thirty children with proven untreated tropical sprue showed a range of 0.2 to 0.9 gm, with a mean of 0.54 gm and a standard deviation of ± 0.20 gm Seventeen patients with tropical sprue treated for 6 months to 2 years showed a xylose excretion of 1.0 to 2.3 gm with a mean of 1.48 gm and a standard deviation of ± 0.36 gm. The lowest value obtained in this group, 1.0 gm, is higher than the seven lowest values in the control group. Our study confirms that the xylose excretion test is a simple and very reliable test of intestinal absorption. It is very useful as a screening test for the diagnosis of tropical sprue and in the follow up of treated patients.
THE DANGER OF PUTTING A BABY TO BED IN A LARGE BED
Authors: C. T. E. 
Published: December 2021

Sarah Brown writing in 1779 in her pamphlet entitled A Letter to a Lady on the Management of the Infant gives the following vivid account of her sleeping infant's narrow escape from mechanical suffocation.
I sincerely hope no child will ever experience the like narrow escape of being suffocated as one of mine did when 6 weeks old. I went to spend the day with a friend in the country and took my youngest girl and my infant with me. The evening proving wet we stayed all night and, not having a servant with me, I got up early in the morning to dress my child whom I had suckled and put to sleep on the bed; but being used to a cradle I forgot to pin him to the pillow. While I dressed his sister I desired a little boy who was standing by me to go and listen whether the baby cried. He brought me word that it was fast asleep. I then took the opportunity of dressing myself for the day, during which time I desired my little girl to go and look at her brother; who returned and informed me she could not see him but heard him cry very faintly. I instantly went into the room and to my great surprise found the child at the very bottom of the bed. He had cried till he was almost dead and sweat dropped off him fast. . . . To all appearance at this time the child seemed dead and every one about me pronounced he was quite gone.
The Umbilical Artery Catheter: Prevention of Bleeding After Its Removal
Authors: Phelps Dale L. 
Published: December 2021

During the course of removing a number of umbilical arterial catheters, I have come upon this helpful trick to avoid bleeding.
First, turn off the constant infusion pump. Next, turn the stopcock and slowly draw back with a small syringe until you can just see the intravenous (IV) fluid-blood interface; shut off the stopcock so that no flow can occur from the infant. Note: The IV fluid-blood interface is pulsatile.
With the infant restrained, withdraw the catheter until there are only 3 cm remaining within the infant and stop.
The Steam Vaporizer
Authors: Washington John A. 
Published: December 2021

The report "Steam Vaporizers—Therapy or Tragedy," in the January 1972 issue, points out that little scientific data substantiates the use of these appliances. It must be conceded that practitioners, who measure their successes partly on their avoidance of hospitalizations, tend to follow well worn routines wearing blinders.
I share with Dr. Barich a dread of devices, common in the past, which heat to scalding temperatures a half gallon or more of water. Since the introduction of squat plastic vaporizers which emit steam from a core fed from an unheated reservoir, I have seen no accidents.
BACTERICIDAL FUNCTION OF HUMAN POLYMORPHONUCLEAR LEUKOCYTES
Authors: Quie Paul G. 
Published: December 2021

Serum from most normal persons contains specific antibodies which react with common bacterial species preparing their surfaces so that phagocytosis by leukocytes can take place. The Fab part of these antibodies reacts with immunologic specificity with antigens on the surface of bacteria. Another part of the immunoglobulin molecule termed the Fc portion is activated during the attachment of the Fab portion to bacteria and becomes a site for attachment of bacteria to receptors on the surface of phagocytic cells. This activity is greatly amplified by heat-labile serum factors.
Normally bacteria are rapidly killed by human polymorphonuclear leukocytes after engulfment occurs. However staphylococci and gram-negative species of bacteria survive in the leukocytes of patients with the syndrome "Chronic Granulomatous Disease of Childhood."
These patients have suffered recurrent severe infections with bacterial species that are part of the body's resident bacterial flora. By contrast these patients are not at increased risk to infection from such pyogenic bacterial species as group A streptococci or pneumococci. The leukocytes from patients with chronic granulomatous disease produce little hydrogen peroxide during phagocytosis. Catalase-producing staphylococci and gram-negative bacteria are not killed, but hydrogen peroxide-producing streptococci and pneumococci are killed. A normal metabolic response to phagocytosis as well as release of lysosonial factors are essential for the bactericidal activity of human polymorphonuclear leukocytes.
FEASIBILITY STUDY OF A PEDIATRIC TELEPHONE CONSULTATION SERVICE
Authors: Mapes Russell W. , Lewis Elmore W. , Covell David G. , Peterson Hugh M. , Manning Phil R. 
Published: December 2021

A pediatric telephone consultation service with consultants based at Childrens Hospital of Los Angeles has been made available to a group of physicians practicing in Southern California. Data collected reveal that this service has been utilized by many pediatricians and general practitioners. Ninety-one percent of the calling physicians indicated that they were helped by the consultation, and in over one-third of the instances both the practitioner and the consultant felt that the outcome of the problem was changed by the consultation.
In the majority of instances, incoming calls were efficiently handled by an experienced nurse-operator and an appropriate consultant was made available within 5 minutes 38% of the time and within 1 hour in 86% of all calls.
Among the pediatric telephone consultants who provided the service, the majority (76%) felt that this kind of service, if expanded, would favorably affect patient care in a signifficant way. Among practitioners who used the service, 94% asked that such a service be continued.
Letter to the Editor
Authors: Faigel Harris C. 
Published: December 2021

Kenny et al. are wrong in their assertion that because the medical evaluations of 92 children with an assortment of problems affecting their ability to learn in school showed no consistent pattern, medical evaluation has little to offer such youngsters. Denhoff et al. have shown medical evaluation can be very helpful.
Lumping all children with school problems together and looking for common symptoms is indeed a fruitless exercise. Kenny et al. do not permit the reader access to the specific data on which they base their conclusions, nor do they even provide general data on the subgroups within the larger group of youngsters.
The Pediatric Nurse Practitioner, by Fernando J. deCastro, M.D., M.P.H., F.A.A.P., F.A.P.H.A. and Ursula T. Rolfe, B.A., M.D. Saint Louis: The C. V. Mosby Company, 1972, 154 pp., $6.50
Authors: Yankauer Alfred 
Published: December 2021

This text is apparently intended for a wide variety of nurses: those desiring "to expand their empirical knowledge of ambulatory pediatrics," "recnt pediatric nurse practitioner graduates," "public health nurses," and "nurses working in a doctor's office." Its 138 pages (at five cents pen page) are divided into a section on health appraisal, a section on clinical problems, and a section on social problems. The first two sections occupy 88% of the content.
Altogether the volume provides a sparse taste of ambulatory pediatric procedures and problems, many of which are dealt with in greater depth and with more precision in standard nursing textbooks.
CYCLOPHOSPHAMIDE IN THE TREATMENT OF THE NEPHROTIC SYNDROME IN CHILDHOOD
Authors: Spitzer Adrian 
Published: December 2021

To what extent, if any, adrenocortical steroid drugs have changed the ultimate outcome of children with the nephrotic syndrome is, and probably will remain, a moot question. This mode of therapy, however, has modified the natural course of this syndrome so dramatically that it has resulted in a reclassification of patients according to their response to steroid treatment. Two categories of problem patients thus have emerged: those who fail to attain remission (nonresponders), and those who do respond but relapse frequently, becoming steroid-dependent and steroid-toxic (frequent relapsers).
A new hope for these patients has arisen from the increasing body of anecdotal evidence suggesting that a favorable effect can be obtained by treatment with various antimetabolites and alkylating agents.
Pathogenicity of H. parainfluenzae
Authors: Krishnaswami R. , Schwartz J. , Boodish W. 
Published: December 2021

We would like to report an experience with H. parainfluenza meningitis in a 4-year-old boy at our hospital. The organism, recovered from both cerebrospinal fluid and blood cultures, was confirmed as H. parainfluenzae. With a clinical presentation and course not appreciable different from the usual H. influenzae type B meningitis, an unremarkable recovery occurred on ampicillin therapy.
Barnshaw and Phillips reported their case of H. parainfluenzae infection in a 4-year-old boy who also made a good recovery on ampicillin; review of the recent literature revealed one other such case, this in a newborn infant reported by Gullekson and Dumoff.
Health Problems of Migrant Children: A Dissenting View
Authors: Gilbert Arnold 
Published: December 2021

Eisner et al. recently described an unproductive screening program but omitted any consideration of the serious issues that affect the health of migrant children. There is no longer a need to document the health problems of California's rural poor, nor the ineptness with which health facilities handle those needs. The health concerns of farm workers remain sanitation, housing, diet, child care, and access to ongoing medical care.
The following data may correct the possible implication from their article that there is no serious health problem among "migrant" children:
HUMAN FETAL GROWTH RETARDATION: III. PROTEIN, DNA, RNA, ADENINE NUCLEOTIDES AND ACTIVITIES OF THE ENZYMES PYRUVIC AND ADENYLATE KINASE IN PLACENTA
Authors: Rosado A. , Bernal A. , Sosa A. , Morales M. , Urrusti J. , Yoshida P. , Frenk S. , Velasco L. , Yoshida T. , Metcoff J. 
Published: December 2021

Placentas were obtained at the moment of delivery from mother-infant pairs comprising 35 small for gestational age infants with intrauterine growth retardation (considered as intrauterine malnutrition, [IUM]), 28 prematurely born, but of appropriate size for gestational age (AGA), and 17 normal full-term (FT) infants. The placentas were chilled and perfused immediately, aliquots were analyzed for DNA, RNA, protein/DNA, some enzymes, and adenine nucleotide contents.
Body weight of the infants at birth was directly correlated with placental weight. Placentas of IUM and ACA infants were of similar size, and were smaller than FT placentas. Nuclear (DNA) and cytoplasmic (RNA) contents of the IUM placentas were smaller, but cell size (prot/DNA) was larger than FT placentas. Cytoplasmic mass (RNA/DNA) of IUM placenta was largest. There was a direct linear correlation between cell size and cytoplasmic mass in all groups. Pyruvic (PK) and adenylic kinase (AK) activities of IUM placentas were equal to those of FT and higher than the AGA. In all groups PK activity correlated with birth weight. ADP and ATP levels of IUM placenta were similar to those of the FT, but greater than the AGA. AMP content of IUM placentas was lower than FT; but higher than AGA. Apparently the metabolic features of the small IUM placentas do not differ appreciably from those of FT infants, in contrast to previously demonstrated differences in cord blood and maternal leukocytes. The low values found for AGA infants suggest that the parameters of placental metabolism which we studied reflect gestational age. Except for the reduced DNA content, but larger cytoplasmic mass, the metabolic components of the placenta after 38 weeks do not reflect the prior growth process of the fetus, in contrast to metabolism of the maternal or fetal leukocytes, which may be an index of fetal growth.
RAPID PROTOPORPHYRIN QUANTITATION FOR DETECTION OF LEAD POISONING
Authors: Kammholz Larry P. , Thatcher L. Gilbert , Blodgett Frederic M. , Good Thomas A. 
Published: December 2021

A rapid fluorescent method for estimation of free erythrocyte protoporphyrin (FEP) is described. Simple ethyl acetate-glacial acetic acid extractions are performed, fluorescence quantitated in a fluorimeter and expressed numerically by comparison with known coproporphyrin standards.
Fifty-six children were studied and the extent of lead poisoning was evaluated initially and at different follow-up intervals. A clear relationship was shown between FEP fluorescence and blood lead levels. A correlation was also seen for the intensity of fluorescence and evidence for increased absorption of lead, as estimated by x-ray evidence of ingested lead and deposits in bone. Children with iron deficiency anemia also showed elevations of FEP fluorescence.
This FEP fluorescence test allows for a rapid, numerical determination which appears to be useful as a screening test for lead intoxication. It can quickly select patients that may have markedly increased lead absorption and need prompt therapy or select those that at least require further studies for possible lead exposure or the presence of anemia.