bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital Malformations, Papers and Discussion Presented at the Second International Conference. New York: The International Medical Congress, Ltd., 1964
Authors: NORMAN A. P. 
Published: December 2021

This collection of the papers and discussion presented at the Second International Conference on Congenital Malformations fills the reader with awe and admiration for the immense strides made in the past few years in knowledge of this subject. Such an accumulation of learning, however, makes much of the book way beyond the capacity of the ordinary clinician, such as the reviewer, to fully understand, or at least to retain clearly in his mind.
A lengthy first section deals with the chromosomes and their abnormalities and ably demonstrates how far research has gone in this field; perhaps it also demonstrates the limitations of the visual method of hunting for variations in chromosome appearance; its application in clinical medicine does tend to recall the old gibe about stamp collecting.
DELAYED CLOSURE OF THE DUCTUS ARTERIOSUS IN PREMATURE INFANTS
Authors: Danilowicz Delores , Rudolph Abraham M. , Hoffman Julien I. E. 
Published: December 2021

Five premature infants with delayed closure of the ductus arteriosus have been presented. In 3 of these infants, hemodynamic data from serial cardiac catheterization studies document a decrease in left-to-right shunt through the ductus with clinical evidence of spontaneous closure.
The possible roles of inadequate muscular development of the ductus, hypoxemia, the degree of prematurity, and the association of neonatal complications in delayed closure are discussed.
COMMUNITIES IN ACTION
Authors: Richmond Julius B. 
Published: December 2021

As a result of the summer experience certain inferences may be drawn:
1. There is great interest—latent until now—in our communities in the health, education, and welfare of our young children.
2. Communities have shown remarkable resourcefulness and energy in developing comprehensive programs for young children.
3. Communities have demonstrated a remarkable capacity to mobilize in a short period of time.
4. Professionals of various disciplines have a deep commitment to applying what they know about the needs of children when offered the necessary support.
5. Alternate administrative patterns make possible a variety of programs and local options which are highly desirable at this stage of our knowledge.
The Emotionally Battered Child
Authors: ISAACSON EDWARD K. 
Published: December 2021

I have been observing the attitude of victory in the actions and statements of fellow pediatricians lately concerning the achievement of the goal of legislative action taken by the several States in the implementation of laws regarding the "Battered Child." I can say with pride that this action is long overdue in a population that cannot logically control its actions at all times for or against other human beings.
This legislative action and pediatric "victory." to me, is only the first phase of the protection of the entire child.
Letters to the Editor
Authors: ROBINAULT ISABEL P. 
Published: December 2021

Thank you for bringing to the attention of the editor of Pediatrics that 47 states now protect children from being battered. Although my letter which quoted 20 states was published in July, it had been written in December 1965. At that time, the excellent statement of February 1966, had not been published yet by Pediatrics.
Your vigilance is most appreciated since it is only by combined effort that sustained change will take place for the benefit of all children.
EXPERIMENTS OF NATURE INVOLVING BRANCH-CHAIN AMINO ACIDS
Authors: S. C. R. 
Published: December 2021

RESEARCH which goes to the core of the problem directly and with finesse can elicit admiration. The investigation reported in this issue by Dancis and colleagues will find a number of readers experiencing such appreciation.
Hypervalinemia has been reported in only one infant in the world, but rarity is not the reason for its interest; this "experiment of nature," discovered as if by accident, has been a most informative disease. Working with as little as 2 ml of blood taken from the patient, Dancis and colleagues studied the metabolism of valine in the white cells in the sample. The simplicity of the "biopsy" and the elegance of the isotope methods are most exemplary.
GALACTOSE METABOLISM IN THE NEWBORN INFANT
Authors: Donnell George N. , Ng Won G. , Hodgman Joan E. , Bergren William R. 
Published: December 2021

A marked increase was noted in the production of labeled carbon dioxide from galactose-1-C14, and a lesser increase from glucose-1-C14, by erythrocytes of newborn infants as compared to those of adults. It is considered that the increased metabolic activity reflects a greater capability of erythrocytes of newborns to phosphorylate the particular sugars.
Estimates were made of galactose-1-phosphate uridyl transferase and galactokinase activities of intact erythrocytes by incubation with galactose-1-C14. Intracellular transferase activity, as measured by the ratio of labeled galactose-1-phosphate to labeled uridine diphosphate galactose, correlated with hemolysate measurements, but the amount of labeled nucleotide alone did not. Intracellular galactokinase activity correlated with hemolysate values provided that galactokinase activity was considered to be represented by the sum of the galactose-1-phosphate and nucleotide produced during incubation with galactose.
The rate of removal of galactose from the blood of newborns after intravenous administration was slower than with adults. However, the rate of disappearance cannot be considered to reflect galactose utilization until more is known concerning regulatory factors in the newborn infant.
COMPLICATIONS OF SMALLPOX VACCINATION UNITED STATES 1963
Authors: Neff John M. , Levine Ronald H. , Lane J. Michael , Ager Ernest A. , Moore Helen , Rosenstein Beryl J. , Millar J. Donald , Henderson Donald A. 
Published: December 2021

Four thousand nine hundred physicians in four states, representing 4.8% of the population of the United States, were surveyed in order to assess the frequency and types of complications that occurred during 1963 in association with smallpox vaccination. Four hundred ninety-one physicians initially reported observing 810 complications during this year. On follow-up of these cases, many were not actually complications or were complications that occurred in a year other than 1963.
Accidental infection was the most common complication. Generalized vaccinia and eczema vaccinatum occurred at a frequency of 238 and 80, respectively, per million primary vaccinations. Severe complications were infrequent. No deaths and only one case each of post-vaccinal encephalitis and vaccinia necrosum were detected. The high frequency of many preventable complications and the disproportionate frequency of complications in infants suggest that morbidity and mortality now associated with smallpox vaccination could be significantly reduced if primary vaccination could be deferred until after the first year of life and if more care were taken to detect individuals in whom complications can be expected to occur.
Pediatric Consultation in a Public Mental Hospital
Authors: BOVERMAN HAROLD , MENDELSOHN ROBERT S. 
Published: December 2021

The number of children in state mental institutions is inevitably increasing. At the same time it is increasingly difficult to generate enough staff adequate for caretaking, training, and supervision. There are no instant solutions to this problem; no hidden panaceas that might make it right soon. Hoping for some partial help, it makes sense to review the place of the pediatrician in the state mental hospital and the hospital's traditional sources for program design as well as staff training and supervision.
Such hospitals were designed for adults. In addition, they both benefit and suffer from a massive tradition and inertia.
Letters to the Editor
Authors: FISCHER CARL C. 
Published: December 2021

The Council on Pediatric Practice has, as Dr. Wineberg states, gone on record as recognizing the increasingly important role of ambulatory care programs in the pediatrics of the future.
We do not, however, share his pessimism for steps in this direction are not only rapidly coming but also, in many of our teaching institutions, are already here.
Dr. Wineberg seems to imply that the department chairmen are the major influence in delaying the evolutionary process. Rather, it seems to me practitioners and teachers alike must work together to show the pediatricians of the future the importance of this major portion of pediatric practice not only through improving the quality of both the staff and the faculties of these services but through curricular changes designed to demonstrate both the need for and the benefits of experience in this area.
Skin Dimples
Authors: TUTTLE ROBERT 
Published: December 2021

In Doctor Keith Hammond's brief report concerning skin dimples and rubella1 in the February issue of Pediatrics he states that no one has reported a peculiar, discrete, deep dimpling of the skin over the patella and certain bony prominences as a physical finding of early infancy.
This statement is somewhat unusual in that this phenomena has been well described by Doctor Caffey and is well illustrated in his textbook of Paediatric X-ray Diagnosis, fourth edition, where these characteristic dimples have been seen in infants suffering from prenatal bowing which commonly regresses during early childhood.
School Excuse Card
Authors: WOLF I. J. 
Published: December 2021

The amount of paper work in pediatric practice is increased by the number of excuses that have to be written for patients who are out of school due to illness, who are delayed in the office during school hours, or who have to be excused from physical education.
In order to reduce the necessary amount of paper work, the author has devised the illustrated School Excuse card.
Pediatricians may have the same card printed up by their own printers or may request the name of the author's medical stationery service.
AN EVALUATION OF ELECTROENCEPHALOGRAPHY IN THE DIAGNOSIS OF BRAIN TUMORS OF CHILDREN
Authors: DRUMHELLER JOHN F. , KEITH HADDOW M. , BICKFORD REGINALD G. 
Published: December 2021

A study was made of the electroencephalograms of 50 children who had proved neoplasms of the brain. In 9 of 12 children who had tumors of the cerebral cortex, the localization afforded by the EEG was correct. In 8 children who had supratentorial tumors of or near the brain stem no localizing or consistent electroencephalographic pattern was observed.
In 21 (70%) of 30 children who had tumors of the posterior fossa a bilateral abnormality was observed in the EEG recorded from the occipital region or occipital and contiguous regions.
It is acknowledged that the abnormality found in this last group also is found occasionally in conditions other than in brain tumors of the posterior fossa. These conditions usually can be excluded by use of the history and other laboratory aids.
Electroencephalography in the study of brain tumors in children should not be considered as an infallible test but rather as a diagnostic aid to be used and evaluated with the help of a clinical history and other diagnostic and laboratory aids.
CONGENITAL MYASTHENIA GRAVIS
Authors: LABRANCHE HERNANDEZ G. , JEFFERSON RONALD N. 
Published: December 2021

A case of congenital myasthenia gravis has been presented. Familial and possible hereditary cases of this disease previously reported have been listed, and a short discussion of the disease presented.
No definite statement can be made that myasthenia gravis is hereditary or familial, but this case and those previously reported indicate familial and possible hereditary aspects.
PENICILLIN THERAPY OF DIPHTHERIA CARRIERS
Authors: SHEN JEROME T. Y. 
Published: December 2021

The diphtheria carrier problem and its importance in children is discussed. Non-penicillin therapy of diphtheria carriers is briefly reviewed and commented upon. Literature on penicillin therapy in the diphtheria carriers is reviewed.
An analysis of the results of 70 cases of diphtheria carriers treated by different forms of penicillin therapy is presented and commented upon, especially in regard to the correlation between the effectiveness of the therapy and the pathology of the nose and throat. Rational treatment of diphtheria carriers is suggested in the conclusion of the paper.
STUDIES IN PANCREATIC FIBROSIS
Authors: SHWACHMAN HARRY , PATTERSON PAUL R. , LAGUNA JOSÉ 
Published: December 2021

A simple new test is described which estimates roughly the proteolytic activity of stools by determining their ability to liquefy gelatin. Fecal suspensions are placed upon gelatin film (unexposed and unfixed) and the extent of removal of the gelatin film noted.
Two groups of patients were studied: (a) 500 normal and sick individuals, and (b) 50 patients with pancreatic fibrosis.
In group (a), less than 5% of the infant group lacked this proteolytic power. As one advanced into the older age groups, this percentage increased. The administration of a laxative to some older children with absent tryptic activity resulted in stools possessing tryptic activity.
A total of 220 separate stool specimens were examined from patients in group (b). In 209 specimens, there was no tryptic activity. The remaining 11 specimens from seven patients showed definite tryptic activity. Three patients in this group had minimal tryptic activity in the duodenal fluid.
When oral pancreatin was given to patients with pancreatic fibrosis, the stools became positive for trypsin. When laxatives were given to a few patients with pancreatic fibrosis, the stool trypsin test remained negative.
The duodenal fluid was assayed in a number of infants with acute and chronic nutritional disturbances, and, when tryptic activity was demonstrated in the duodenal fluid, the stools showed the presence of trypsin.
The possibilities of bacterial or food origin of fecal tryptic activity have been considered and largely eliminated.
Three separate stool examinations by this test in infants are proposed as sufficient either to eliminate or to make probable the diagnosis of pancreatic insufficiency. Conclusions and interpretations based on a single examination is hazardous. At least three menspecimens should be studied and whenever doubt arises duodenal intubation is indicated.
BALANCE AND ELECTROCARDIOGRAPHIC STUDIES IN A CHILD WITH POTASSIUM DEFICIENCY
Authors: WALLACE WILLIAM M. , MOLL FREDERIC C. 
Published: December 2021

An instance of potassium deficiency is described which was caused by excessive gastrointestinal loss, the parenteral administration of excessive NaCl and glucose and by lack of potassium intake.
The changes produced in the ECG are described.
Treatment with parenterally administered K was effective. Although a rise in the level of serum K accompanied the improvement, it returned to normal more slowly than the electrocardiogram and the clinical state.
The balances of Na, K, Cl and N during the recovery period are presented and discussed.
PERITONEAL LAVAGE IN THE TREATMENT OF ANURIA IN CHILDREN
Authors: SWAN HENRY , GORDON HARRY H. 
Published: December 2021

Three children with acute anuria treated by peritoneal lavage and two others from whom it was withheld are reported. Peritoneal lavage should be reserved for the treatment of a progressing uremic state associated with an acute yet probably reversible anuria of renal origin. The procedure, when suitably indicated, is effective for removal of nitrogenous waste products and may prove life-saving.
Technical aspects of the method are discussed, and the use of variation of the glucose concentration in the lavage fluid as a means of controlling water retention is demonstrated.
Peritoneal lavage is a complex, expensive, yet effective method of partially simulating the kidney glomerulus. The absence of tubular function in anuric patients who are receiving peritoneal lavage makes management of their acid-base balance a difficult problem.
THE BRUTAL TREATMENT OF YOUNG CHILDREN EMPLOYED IN THE MINES AND COLLIERIES OF THE UNITED KINGDOM A LITTLE MORE THAN A CENTURY AGO
Authors: C. T. E. 
Published: December 2021

If an age is judged by its treatment of the weak and helpless, the nineteenth century deserves condemnation. The callous indifference in that century toward the employment of young children in the mines and collieries of the United Kingdom was never more vividly described than by Anthony Ashley Cooper, Seventh Earl of Shaftesbury (1801-1885) in his speech to the House of Commons in 1842. By his persistent agitation in Parliament, covering several decades, Shaftesbury eventually forced society's recognition that all children, regardless of social class, deserve the same humane treatment. Some of the cruelties inflicted by the early industrial community on these filthy and ignorant children of the poor are described by the Earl of Shaftesbury in these passages from his speech:
With respect to the age at which children are worked in mines and collieries in South Staffordshire, it is common to begin at 7 years old; in Shropshire some begin as early as 6 years of age; in Warwickshire the same... In Derbyshire many begin at 5... Near Oldham children are worked as low as 4 years old, and in the small collieries towards the hills some are so young that they are brought to work in their bedgowns....
It must be borne in mind that the regular hours of a full day's labour are 14, and occasionally 16; and the children have to walk a mile or two at night without changing their clothes... In Oldham the mountain seams are wrought in a very rude manner. There is very insufficient drainage.
Liver Biopsy
Authors: Brent Robert L. 
Published: December 2021

In the December issue of Pediatrics, Dr. Lucey discussed the usefulness of liver biopsy in the management of children with undiagnosed or complicated liver disease. He coneludes that in the proper hands liver biopsy can be a safe and helpful procedure. This is probably true. Any physician interested in acquiring this skill could, presumably, do so in a short period of time whether he is at a medical center or small community hospital.
There is one aspect of liver biopsy that Dr. Lucey alluded to but did not clarify.
INTESTINAL IgA NEUTRALIZING ANTIBODIES IN NEWBORN INFANTS FOLLOWING POLIOVIRUS IMMUNIZATION
Authors: Keller Robert , Dwyer Julia E. , Oh William , D'Amodio Mabel 
Published: December 2021

The development of poliovirus neutralizing coproantibodies was studied in 14 newborn infants following a single immunization with either live oral trivalent or parenterally administered inactivated poliovirus vaccine. Poliovirus coproantibodies, predominantly directed against poliovirus type 2, appeared in stool specimens of all orally immunized infants within 2 to 3 weeks. Oral reimmunization of one infant 47 days after the primary dose resulted in the production of coproantibody to all three types of poliovirus. In contrast, parental immunization of five infants did not stimulate fecal antibody production.
IgA was the predominant, and sometimes the only, immunoglobulin detected in fecal extracts. Although stools of newborn infants usually did not contain IgA, the infants secreted fecal IgA at the time of the appearance of polio coproantibodies. Furthermore, alimentary IgA was demonstrable in the control group of older infants, even in the absence of detectable serum IgA.
Our results indicate that local intestinal antigenic stimulation is a necessary requirement for the production of polio antibodies by the secretory IgA immunoglobulin system of the alimentary tract. These findings are presented as a mechanism for the alimentary immunity to homotypic poliovirus reinfection which follows oral polio immunization of natural infection.
Letter to the Editor
Authors: Smith Clement A. 
Published: December 2021

Letter to the Editor are often the most interesting thing in the daily mail. When they concern a teaching and patient-care program in a hospital so long and affectionately known to the recipient, he may perhaps be allowed to offer an answer.
We would first thank Dr. Brazleton for writing. Then we would remark that the Editor finds much of the spirit—if not all the letter (in Biblical sense)—reminiscent of earlier and simpler times. Outstanding memories of houseofficership in the thirties are the participation of Miss Amy Greene as Head of Social Service on many of Dr. Blackfan's regular rounds, the regular attendance of the Nursing Supervisor, and the frequent, highly personal, assistance of Dr. Crothers (a pediatrician in search of mental hygiene) often with Miss Elizabeth Lord, his associate in psychology.
A STUDY OF THE NEED FOR ALTERNATIVE TYPES OF HEALTH CARE FOR CHILDREN IN HOSPITAL
Authors: Shah Chandrakant P. , Papageorgis Demetrios , Robinson Geoffrey C. , Kinnis Claire , Israels Sydney 
Published: December 2021

In a population of hospitalized children, 45% of the 611 parents whose children qualified for day care stated they would have preferred day care if such an alternative had been available at the time and if the choice of type of care had been left to them.
Factors which seemed related to the parents' choice of care were the child's age, the distance from home to hospital, the parents' education, the parents' perception of the degree of safety afforded by hospitalization, and the ability to make the necessary arrangements to care for the child at home following day care. No relationship was found between parental choice of care and such variables as type of day care recommended (medical or surgical), sex of child, number of employed family members, occupational class, and family income.
INFANTS OF DIABETIC MOTHERS: ATTENUATED GLUCOSE UPTAKE WITHOUT HYPERINSULINEMIA DURING CONTINUOUS GLUCOSE INFUSION
Authors: King Katherine C. , Adam Peter A. J. , Clemente Geronima A. , Schwartz Robert 
Published: December 2021

Blood glucose, plasma insulin, and free fatty acid interrelationships were examined in newborn infants during and after continuous hourly glucose infusions at rates varying from 4 to 24 mg/kg/minute. Normal newborn infants disposed of glucose efficiently until glucose was infused at rates greater than 6 mg/kg/minute. Plasma insulin levels rose gradually during glucose infusion. When large loads of glucose infusion were initiated (12 mg/kg/minute), however, there was a delay in plasma insulin rise.
At the slow rates of glucose infusion, the infants of gestational or insulin-dependent diabetic mothers disposed of the exogenous glucose more slowly than the normal newborns. Plasma insulin levels in the infants of gestational diabetic mothers were similar to those in the normal infants. These observations suggest that, with comparable glucose stimulus by continuous infusion, the infants of diabetic mothers do not have excessive insulin output.
Letter to the Editor
Authors: Frazier Robert G. 
Published: December 2021

The Academy's decision to request the resignation of Dr. Mendelsohn, as Director of the Medical Consultation Service for Project Head Start, was made in spite of our past and present conviction that "the vigorous implementation of this program has been due to the experience, sensitivity and enthusiasm of Dr. Robert Mendelsohn." Continuing disagreements with Dr. Mendelsohn in regard to policies and administrative procedures made the discontinuation of his responsibilities necessary.
The Academy's record demonstrates its commitment to speak as an advocate of the child on health and health-related issues.
Education of the Cerebral Palsied
Authors: Nader Philip R. , Allmond Bayard 
Published: December 2021

Dr. Berenberg's commentary is timely for pediatricians and other physicians having contact with school children and educators. We believe, however, that the physician must reinterpret the school referral "which asks, ‘Does he have minimal brain damage?’ "
Dr. Berenberg states, "It should stimulate the physician to a more detailed examination of the ‘softer’ neurologic signs which might answer the question posed to him." We raise the following two questions in response to Dr. Benenberg:
Does the presence of "softer" neurologic signs answer the question?