bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHRONIC MULTIPLE PERIPHERAL NEUROPATHY IN CHILDHOOD
Authors: Byers Randolph K. , Taft Lawrence T. 
Published: December 2021

Attention is directed to the occurrence of chronic polyneuropathy in childhood. The difficulty of adequate sensory examination in children and the slow evolution of the disease tend to obscure the diagnosis and cause confusion with dystrophy or other diseases.
A review of the literature indicates that among chronic polyneuropathies of unknown etiology a number of different causes may lead to a common pathology, based on an increase in fibrous tissue and eventuating in hypertrophy. Histologic examination of nerves proves that the pathology of chronic interstitial polyneuritis may occur without palpable hypertrophy. Reference to the literature also suggests that the life span of affected individuals may be reasonably normal.
Early signs in childhood include disability in locomotion out of proportion to measurable weakness, later with frank sensory ataxia, deformities of the spine and feet and increase in the total protein in cerebrospinal fluid. The course is either progressive, or less frequently, remittent. Muscle and, less frequently, nerve biopsies are helpful diagnostically; the latter sometimes suggest the type of disease present.
In this series of patients no clear evidence of thiamine deficiency was detected by measurements of pyruvate in whole blood after administering a glucose load. No achlorhydria was found.
The possibility that continuing allergic factors are of importance was explored by treatment with cortisone. One child exhibited encouraging evidence of improvement on this regimen.
SUPPLEMENTS TO PEDIATRICS
Authors: MAY CHARLES D. 
Published: December 2021

CERTAIN comprehensive investigations as well as considerations of some subjects justly require lengthy presentation. Such thoroughness on the part of authors deserves encouragement. The total pages of editorial text which can be made available to serve all authors and the diverse purposes of this type of medical journal is limited by many circumstances. Whenever manuscripts require more than 20 printed pages in Pediatrics, the right of other authors to prompt publication and a balanced assortment of material in the journal are threatened.
A substantial part of the cost of publishing this journal is borne by the subscribers. Regular publication of lengthy manuscripts from contributors would mean an increase in the price of the journal to subscribers, often for material which has unquestioned fundamental value but is of restricted interest.
NONTUBERCULOUS ACID-FAST BACILLI IN CERVICAL ADENITIS
Authors: Keith Haddow M. , Weed Lyle A. , Needham Gerald M. 
Published: December 2021

THE TUBERCLE bacillus is the most common cause of lymphadenitis with caseous necrosis. Such a condition in the cervical region, while less frequent than in previous decades, still occurs occasionally. While other agents, for example, Coccidioides, Histoplasma, Brucella, Pasteurella and Miyagawanella, are known to produce a similar histopathologic reaction, they are not commonly associated with lesions in the cervical lymph nodes, especially in children. Therefore the finding of acid-fast bacilli in such lesions has generally been considered bona fide evidence of tuberculosis, although previous reports from this clinic indicate that such is not necessarily true. It is recognized that there are other acid-fast bacilli, such as the lepra and smegma bacilli, which may or may not cause disease. In 1944 Gellerstedt reported seven cases of tuberculoid skin lesions due to atypical acid-fast bacilli. He considered these to be due to exogenous infection with acid-fast bacilli differing from the organisms found in tuberculosis, and he considered them as possibly saprophytic organisms. In 1948 MacCallum and co-workers reported six cases of skin lesions due to acid-fast organisms that were not Mycobacterium tuberculosis. The lesions did not contain tubercle follicles, giant cells or caseous material. The name "Mycobacterium ulcerans" was applied to these organisms by Australian workers.
In 1954 Linnell and Nordén described skin lesions that occurred in 80 boys and girls who used a certain swimming pool in a Swedish town. The etiologic organisms were acid fast, differed from those described by MacCallum and associates and were not lepra bacilli. Guinea pigs injected with these organisms presented no evidence of lesions after 7 weeks.
CLINICAL CONFERENCE
Authors: Grumbach Melvin M. 
Published: December 2021

Dr. Grumbach: Barr and associates have demonstrated that in the human the majority of somatic cells of females contain a conspicuous, heterochromatic mass of chromatin in the resting nuclei. Their discovery of a sex-difference in intermitotic nuclei of a number of vertebrate species, including man, has provided a relatively simple method for assessing the sex-chromosome constitution. This chromatin mass is about 1 micron in diameter and often plano-convex in configuration. It is usually located against the inner surface of the nuclear membrane and contains desoxyribonucleic acid. In males, a comparable chromatin mass is rarely found, never in more than a few per cent of the nuclei. There is good evidence that this so-called "sexchromatin" represents the fusion of heterochromatic portions of two X-chromosomes.
The sex chromatin can be conveniently determined by examination of specimens of skin obtained by biopsy (Fig. 1). Recently, more practical methods for determining cytologic sex have been described employing smears from readily available tissues, such as the oral and vaginal mucosa (Fig. 2) and the blood. Davidson and Smith have shown that there is a sex difference in the morphology of polymorphonuclear neutrophils.
Cytologic examination of chromosomal sex has provided an important tool for the investigation of anomalies of sex development. Apart from its ancillary role in diagnosis, cytologic examination of sex chromatin has made a significant contribution to our understanding of the disordered development in these afflictions. However, the results of this determination should not be regarded as an especial indication of the psychosexual orientation of patients with such abnormalities, nor, in the case of infants, of the sex to which they should be assigned.
DIGITALIS INTOXICATION IN INFANCY AND CHILDHOOD
Authors: Joos Howard A. , Johnson John L. 
Published: December 2021

Ten infants and children with digitalis intoxication, overdosage without symptoms, multiple intoxication with cardio-active drugs and other confusing associated circumstances are reported, including three fatalities.
Clinical and electrocardiographic manifestations were not related to the magnitude of the overdosage. Two examples of probable intoxication occurred in children who received digitalis not in excess of the maximum therapeutic doses commonly recommended.
The frequent occurrence of congestive heart failure as a manifestation of digitalis intoxication in early life emphasizes the need to consider this cause in the differential diagnosis of cardiac decompensation.
Dehydration is cited as a possible factor contributing to the occurrence of digitalis poisoning or if resulting from overdosage, aggravating the intoxication.
A wide variety of electrocardiographic disturbances in rhythm and conduction was demonstrated. First degree A-V block occurred in half of the cases. Disturbances in A-V conduction and supraventricular arrhythmias were much more common than abnormalities in ventricular conduction or rhythm. Ventricular arrhythmia was limited to the fatal cases, with one exception.
Digitalis therapy in infants and young children requires particular carefulness from all concerned. Whenever possible, the opportunity for error should be minimized by the use of standardized products, familiar to both physician and pharmacist.
NEWLY ISOLATED VIRUSES IN RESPIRATORY DISEASE
Authors: Parrott Robert H. 
Published: December 2021

Adenoviruses are common agents often found in the respiratory tract in acute illness and from tonsils and adenoids removed at surgery.
These viruses are responsible for certain cases of respiratory infection in man, but a great deal of combined clinical, laboratory and epidemiologic study is necessary before a final picture can be drawn.
At the present time, there is good evidence that type 3 adenovirus causes pharyngo-conjunctival fever, an acute illness characterized by fever, pharyngitis, conjunctivitis and cervical lymphadenopathy. This illness may be considered clinically distinct only when most of the features are present or when an epidemic is occurring.
There is also accumulating good evidence that types 4 and 7 adenovinus cause acute febrile respiratory disease in military recruits. This is characterized by fever, chills, headache, generalized aches and pains, hoarseness and irritated throat; symptoms considered relatively specific by those dealing with military personnel.
Whether these observations can be borne out in children, on indeed whether types 4 and 7 adenovirus infections occur in children, is questionable.
Apparently types 1,2,3,4,5, and 7 adenoviruses may also cause nonbacterial pharyngitis, but sufficient cases have not been reported to allow a full description.
Shared Reading and Risk of Social-Emotional Problems
Authors: Martin Keith J. , Beck Andrew F. , Xu Yingying , Szumlas Gregory A. , Hutton John S. , Crosh Clare C. , Copeland Kristen A. 
Published: December 2021

BACKGROUND AND OBJECTIVES
The American Academy of Pediatrics recommends literacy promotion as well as routine developmental surveillance during well-child visits to improve academic, relational, and health outcomes. In this study, we examined the possible association between shared reading and social-emotional problems among young children.

METHODS
We conducted a retrospective review of longitudinal records for children aged 30 to 66 months presenting for visits to an academic pediatric primary care center between July 1, 2013, and February 1, 2019. The outcome was evidence of social-emotional problems, defined by an Ages and Stages: Social Emotional Questionnaire (ASQ:SE) score above the established cutoff. The predictor was caregiver-reported frequency of shared reading (most = 5–7 days per week, some = 2–4 days per week, rarely = 0–1 days per week) at a previous visit. Generalized linear models with generalized estimating equations were used to assess the association between the longitudinal outcome and predictor, adjusting for child demographics and needs reported on routine social history questionnaires.

RESULTS
Analyses included 5693 children who completed at least 1 ASQ:SE (total of 7302 assessments) and had shared reading frequency documented before each ASQ:SE assessment. Children were predominantly Black (75%) and publicly insured (80%). Sixteen percent of ASQ:SE scores were suggestive of social-emotional concerns; 6% of caregivers reported sharing reading rarely. Children with rare shared reading had a higher risk of an ASQ:SE above cutoff compared with those with shared reading on most days (adjusted risk ratio, 1.62; 95% confidence interval, 1.35–1.92).

CONCLUSIONS
Less-frequent caregiver-reported shared reading was associated with higher risk of social-emotional problems in young children presenting for primary care. This highlights potential relational and social-emotional benefits of shared reading.
Frequency and Consequences of Routine Temperature Measurement at Well-Child Visits
Authors: Dang Rebecca , Patel Anisha I. , Marlow Julia , Weng Yingjie , Wang Marie E. , Schroeder Alan R. 
Published: December 2021

OBJECTIVESTo determine the (1) frequency and visit characteristics of routine temperature measurement and (2) rates of interventions by temperature measurement practice and the probability of incidental fever detection.METHODSIn this retrospective cohort study, we analyzed well-child visits between 2014–2019. We performed multivariable regression to characterize visits associated with routine temperature measurement and conducted generalized estimating equations regression to determine adjusted rates of interventions (antibiotic prescription, and diagnostic testing) and vaccine deferral by temperature measurement and fever status, clustered by clinic and patient. Through dual independent chart review, fever (≥100.4°F) was categorized as probable, possible, or unlikely to be incidentally detected.RESULTSTemperature measurement occurred at 155 527 of 274 351 (58.9%) well-child visits. Of 24 clinics, 16 measured temperature at &gt;90% of visits (“routine measurement clinics”) and 8 at &lt;20% of visits (“occasional measurement clinics”). After adjusting for age, ethnicity, race, and insurance, antibiotic prescription was more common (adjusted odds ratio: 1.21; 95% CI 1.13–1.29), whereas diagnostic testing was less common (adjusted odds ratio: 0.76; 95% CI 0.71–0.82) at routine measurement clinics. Fever was detected at 270 of 155 527 (0.2%) routine measurement clinic visits, 47 (17.4%) of which were classified as probable incidental fever. Antibiotic prescription and diagnostic testing were more common at visits with probable incidental fever than without fever (7.4% vs 1.7%; 14.8% vs 1.2%; P &lt; .001), and vaccines were deferred at 50% such visits.CONCLUSIONSTemperature measurement occurs at more than one-half of well-child visits and is a clinic-driven practice. Given the impact on subsequent interventions and vaccine deferral, the harm–benefit profile of this practice warrants consideration.
RESPONSE OF THE YOUNG INFANT TO POLIOMYELITIS VACCINE GIVEN SEPARATELY AND COMBINED WITH OTHER ANTIGENS
Authors: Batson Randolph , Christie Amos , Mazur Bertha , Barrick Jewell H. 
Published: December 2021

Two groups of infants received poliomyelitis immunizations beginning at the age of 6 weeks and completing the series by the age of 10 months. One group was given the vaccine as a separate injection while the other received the vaccine mixed in the same syringe with pertussis or diphtheriapertussis-tetanus vaccine. The responses of these infants to poliomyelitis vaccine were analyzed and the following general conclusions were reached:
Poliomyelitis vaccine administered to infants as young as 6 weeks, and given according to the usually recommended schedule results in a satisfactory antibody response.
The response to poliomyelitis vaccine mixed with pertussis and DPT vaccines and given as one injection is satisfactory.
The combination of antigens gave no practical interference to development of antibodies to diphtheria and pertussis.
There were no apparent hazards or adverse reactions associated with combined poliomyelitis-pertussis or poliomyelitis-DPT vaccines.
There were no differences in poliomyelitis antibody responses following immunizations with separate and combined vaccine injection.
The existence of maternal antibodies at the time of poliomyelitis immunization had no apparent influence on the production or persistence of active antibodies.
These findings indicate that poliomyelitis immunization procedures can very easily be integrated into routine pediatric immunization programs, thereby affording the earliest possible protection.
MODIFIED METHOD OF PREPARING CONCENTRATED SMEARS OF BONE MARROW
Authors: McGovern J. J. , Duane M. , Hebert R. 
Published: December 2021

THE FOLLOWING brief communication concerns a method of obtaining bone marrow smears which are practically devoid of dilution with cells from the peripheral blood. In the authors' experience bone marrow particles are not usually obtained from small infants and children. Therefore it has not been possible to make use of the standard technique of aspiration of the bone marrow into a heparinized syringe, placing the aspirate on a watchglass, and then selecting a particle of bone marrow for smear or imprint. Neither has the alternative method of centrifuging heparinized marrow in Wintrobe hematocrit tubes proved satisfactory, because the small quantity of marrow generally taken from infants is insufficient to fill a Wintrobe tube. Another difficulty is in separating the buffy coat from the erythrocyte layer in the Wintrobe tube. [SEE FIG. 1 IN SOURCE PDF]
METHOD
The present method consists of expelling two or three small drops of bone marrow from the aspirating syringe on to a glass slide; this is transferred by means of capillary attraction into a micro-hematocrit tube. The micro-hematocrit tube is heat-sealed as in the determination of the micro-hematocrit of peripheral blood. The tube is centrifuged for 5 minutes at high speed, and then broken at the interface of the erythrocytes and buffy coat. This is accomplished by the use of an ordinary metal file such as is used for cutting glass vials. The buffy coat with the supernatant plasma is expelled on to a coverslip, smeared and stained in the usual manner (Fig.1).
This method has proved useful in providing a concentrated preparation of marrow cells and in yielding a more informative picture of the activity of the bone marrow than has been available with the use of ordinary smears.
A COMPARISON OF THE EFFECTS OF WHOLE BLOOD AND SEDIMENTED ERYTHROCYTES IN EXCHANGE TRANSFUSION
Authors: Sisson Thomas R. C. , Whalen Lorraine E. , Telek Amalia 
Published: December 2021

The relative efficiency of whole blood compared with sedimented erythrocytes in exchange transfusion was studied in regard to the correction of anemia. Two groups of infants with hemolytic disease of the newborn due to maternal-fetal Rh incompatibility were transfused with one or the other type of blood. Determinations of concentration of hemoglobin; packed cell volume; plasma, erythrocyte, and total blood volumes; and total circulating hemoglobin mass were made and compared.
It was concluded that the use of sedimented erythrocytes does not lead to a deficit of erythrocyte volume and circulating hemoglobin mass as does the use of whole blood.
Analysis of data from 47 infants, 23 of whom received whole blood, and 24 of whom received sedimented erythrocytes, indicates that a significant difference in concentration of bilirubin occurs. The increase in concentration of bilirubin subsequent to exchange transfusion was lower and less rapid in most infants of the group receiving sedimented erythrocytes.
For these reasons the use of sedimented rather than whole blood is suggested in exchange transfusion for hemolytic disease of the newborn.
INFANT FEEDING
Authors: MAY CHARLES D. 
Published: December 2021

IN THIS ISSUE of Pediatrics (p. 288) is the report of a survey of the types of preparations used routinely in feeding newborn infants during their stay in hospital nurseries. As the author states, the information obtained is of "historic" interest. He points out judiciously that the formula selected for routine use in a hospital, for the sake of simplicity, is apt to convey a subtle implication to parents, residents in training, and other physicians that this one must be the best food for infants.
Thus the choice of a preparation for routine use imposes a responsibility on the attending physician to make the selection on a sound nutritional basis.
RESPIRATORY ILLNESS IN SIX INFANTS INFECTED WITH A NEWLY RECOGNIZED ECHO VIRUS
Authors: Cramblett Henry G. , Rosen Leon , Parrott Robert H. , Bell Joseph A. , Huebner Robert J. , McCullough Norman B. 
Published: December 2021

A close association has been established between onset of infection with an ECHO virus (JV-1) and the onset of a mild clinical respiratory illness in six infants 5 months to 14 months of age. The illnesses were characterized by coryza, pharyngitis, and fever of short duration. Other manifestations included abnormal stools, erythema of the ear drums, and mild conjunctival congestion.
Examination of paired acute and convalescent sera from the infants demonstrated a rise in titer of both neutralizing and complement-fixing antibodies against the prototype JV-1 virus. Conversely, tests of sera taken from the same time period of the illnesses did not, with one exception, reveal rising antibodies against adenoviruses, Coxsackie A viruses, ECHO type 8 virus, and influenza A, B, and C viruses.
AORTIC STENOSIS IN INFANTS AND CHILDREN
Authors: Ongley Patrick A. , Nadas Alexander S. , Paul Milton H. , Rudolph Abraham M. , Starkey George W. B. 
Published: December 2021

Aortic stenosis is a relatively common lesion in childhood. In severity, it may vary from extreme mildness to cases terminating in sudden death. The prognosis is worse in the presence of left ventricular strain as shown by the electrocardiogram.
Progression of signs of left ventricular "strain" by electrocardiogram should be studied by catheterization of the left side of the heart prior to deciding upon aortic valvotomy.
CONCENTRATION OF PENICILLIN IN THE SERUM FOLLOWING INTRAMUSCULAR ADMINISTRATION OF BENZATHINE PENICILLIN G TO CHILDREN WITH INACTIVE RHEUMATIC FEVER
Authors: Lade Roswith I. , Diehl Antoni M. , Snyder Irvin , Hamilton Tom R. 
Published: December 2021

Ninety-six children between the ages of 4 and 20 years with inactive rheumatic fever received 1,200,000 units of benzathine penicillin G every 28 days by intramuscular injection and were studied from the standpoint of effective and consistent concentrations of penicillin in the serum. The concentrations of penicillin in the serum could be determined with certainty in 81% of the specimens; concentrations ranged from 0.002 to 0.125 unit/ml.
The mean concentration of penicillin reached in the serum of females was three times higher than in males. The concentration of penicillin in the serum of females increased with age and weight from the tenth to the seventeenth years. No such increase was observed in the sera of males in relation to age and weight.
The differences in concentration of penicillin reached in the sera of the two sexes from 12 through 17 years of age were statistically significant (p less than 0.01). No significant difference in concentration of penicillin in the serum was found in comparing obese and thin girls of 10 through 15 years of age. The explanation for the differences between the two sexes is not apparent.
During the period of the study, 491 swabs from the nose and throat yielded only one positive culture for beta hemolytic streptococcus of group A; this organism could not be typed and was not associated with an increase in the titer of antistreptolysin O. One other patient had a significant rise in antibody titer, but there was no antecedent positive culture for streptococcus. There were no recurrences of rheumatic fever.
CONGENITAL DEFECTS IN THE BIOSYNTHESIS OF THYROID HORMONE
Authors: Mosier H. David , Blizzard Robert M. , Wilkins Lawson 
Published: December 2021

Two patients with goitrous cretinism were studied by use of I-131 and chromatographic analyses of the thyroid gland, plasma and urine.
These studies showed normal mechanisms existed to carry iodine through the steps of organic binding of iodide and deiodination of free iodotyrosines.
There was nearly complete failure to form iodothyronine derivatives (e.g., thyroxine and tri-iodothyronine). The nature of this reaction in the normal thyroid is not known and the nature of a defect at this stage can only be the subject of speculation.
The possible mechanisms involved are discussed in the light of current concepts of thyroidal metabolism of iodine.
PROTEINS IN THE CEREBROSPINAL FLUID IN THE NEWBORN
Authors: Arnhold Rainer G. , Zetterström Rolf 
Published: December 2021

The fractions of protein in cerebrospinal fluid of 10 infants with hemolytic disease of the newborn, and 12 newborn infants with other illnesses, have been analyzed by paper electrophoresis.
Relative concentrations have been found to be almost constant, despite wide individual variations in total concentration of protein—except in inflammatory disease with involvement of the central nervous system.
Relative concentrations of gamma globulin are higher in serum than in cerebrospinal fluid, while concentrations of beta globulin are greater in cerebrospinal fluid.
It is suggested that the total concentration of protein in cerebrospinal fluid in newborn infants may reflect the degree of functional maturity of the blood-brain barrier system.