bluuebunny/crossref_metadata_2025_split huggingface dataset:
HEREDITARY PARATHYROID HYPERPLASIA: A SURGICAL EMERGENCY OF EARLY INFANCY
Authors: Goldbloom Richard B. , Gillis D. A. , Prasad M. 
Published: December 2021

Two siblings with idiopathic familial parathyroid hyperplasia were identified in early infancy, bringing to 11 the number of known affected infants. Both survived as a result of early subtotal parathyroidectomy, though continuing hyperfunction of remaining tissue necessitated reoperation in both. Despite the presence of hypoparathyroidism, both infants are developing normally.
Review of the 11 cases suggests strongly that the disorder is of autosomal recessive inheritance. Only two other infants are known to have survived, emphasizing that early diagnosis and surgery offer the only chance of survival.
POLIOMYELITIS IN A HIGH RISK POPULATION: DO WE NEED TO IMMUNIZE THE NEWBORN?
Authors: Miller Louis W. , McGowan John E. , Leffingwell Lois M. 
Published: December 2021

While the incidence of polio has declined steadily in the rest of the United States since 1966, the incidence of polio in Texas has not followed this pattern and almost all these cases have been associated with type 1 poliovirus. In 1970, a total of 38 cases of paralytic disease in children were investigated in Texas, and in 22 Texas residents, type 1 poliovirus infection was confirmed.
The majority of these cases occurred in South Texas and the lower Rio Grande Valley. Of the 38 cases investigated, 33 (87%) were children under 2 years of age. Immunization records on 36 cases showed that 35 (97%) had inadequate or no immunization against polio, and all but one of the children were Caucasians of Latin-American descent.
Some areas of South Texas are representative of regions of the United States that not only have a high risk of poliomyelitis in infants due to type 1 poliovirus infection, but also present special problems for health personnel in immunizing those at risk. In areas such as these, newborn feedings of type 1 oral polio vaccine is suggested.
Occupational Diseases (Royalty Division): Listeriosis, and Unwise Nutrition
Authors: Hart William E. 
Published: December 2021

The effect of the recent article attempting to relate Queen Anne's poor obstetrical history to Listeria infection may be somewhat blunted by an error which appears in the first sentence.
It is not John, but his great-grandfather Henry I, whose death in 1135 is invariably associated with lampreys. The last days of the unfortunate John saw the loss of his treasure and possessions during an ill-advised crossing of a tidal river, an ensuing rage which found outlet in excessive consumption of peaches and new cider, and a subsequent fatal dysentery whose effect was undoubtedly augumented by therapeutic bleeding.
THE UNSOLVED PROBLEM OF KERNICTERUS IN THE SUSCEPTIBLE LOW BIRTH WEIGHT INFANT
Authors: Lucey Jerold F. 
Published: December 2021

The article by Keenan, et al.1 in this issue of Pediatrics once again calls attention to the complex, frustrating problem of kernicterus associated with low serum concentrations of bilirubin in small sick premature infants. The new and important information contained in this article is the observation that despite the use of late phototherapy and exchange transfusion, kernicterus occurred in these four infants. Kernicterus has certainly occurred before in premature infants who have received exchange transfusions.2-6 But with regard to phototherapy, the results are open to two interpretations.
One view will be that phototherapy is not effective. The other will be that it has only been shown here to be ineffective when used too late to expect any effect.
SYMPOSIUM: BEHAVIOR MODIFICATION BY DRUGS
Authors: Eisenberg Leon 
Published: December 2021

Having reviewed what is known, what is only surmised, and what is not known about the psychopharmacology of stimulant drug use in children, the clinician must decide for which patient to use what drug for how long. Medical practice does not permit the physician the luxury of deferring decisions until knowledge is certain. His task is to weigh putative benefits against putative risks in a strategy designed to maximize the probability of improvement for a particular patient.
The risks that concern the pediatrician are not only those visible in the short run during drug administration but include effects on development, effects which may not become apparent for some time after treatment has been discontinued. In the case of stimulant drugs, public controversy has centered on behavioral rather than pharmacological toxicity, both short and long run. In the short run, are the drugs being used indiscriminately to stifle independence and creativity among exceptional children? Over the long run, does childhood drug use predispose to adolescent drug addiction? Before attempting to answer these questions, let us first consider the medical indications for the use of stimulants and the mode of their administration.
The clinical syndromes which respond to stimulants are characterized by motor restlessness, short attention span, poor impulse control, learning difficulties, and emotional lability. Current American Psychiatric Association diagnostic nomenclature1 includes the term: "hyperkinetic reaction of childhood" to describe this set of symptoms; the World Health Organization2 is proposing: "hyperkinetic syndrome." Both terms have the virtue of stressing the symptom constellation and of by-passing the uncertainties surrounding cause.
ASSOCIATED ACRAL AND RENAL MALFORMATIONS: A NEW SYNDROME?
Authors: Curran Anita S. , Curran John P. 
Published: December 2021

A 7-year-old male with associated anomalies of the limbs and urinary tract, very similar to three previously reported patients, is described.
Acral malformations noted in the four patients have been oligodactyly, ectrodactyly, brachydactyly, and polydactyly in varying but characteristic combination. A pattern of distribution of the limb defects has been evident. The limb anomalies in the present case are a composite of those described in the previously reported patients.
Urinary tract abnormalities include unilateral renal agenesis and duplication of the collecting system. Minor anomalies present in two or more patients were arched palate, sternal deformity, hypoplastic auricular helices, widely spaced teeth, coxa valga, cinodactyly of the fifth finger, hypospadias, cryptorchidism, antimongoloid slanting of palpebral fissures. Findings not previously reported were Brushfield's spots, vertically grooved nasal tip, deficient pectoralis major muscle, hypoplastic twelfth ribs, spina bifida occulta of L5.
All patients have been phenotypic males, with increased paternal reproductive age in three.
The authors suggest that a new syndromic (acro-renal) relationship of unknown etiology has been established.
Otitis Media: Bacteriology and Antibiotics
Authors: St. Geme Joseph W. , Cohn Walter L. , Meyer Donald L. 
Published: December 2021

It will be difficult to match the superb studies of Howie, Ploussard, and Lester1,2 on the clinical and microbial nature of otitis media, as well as their definitive evaluation of different antibiotic regimens. These three clinicians in full-time pediatric practice have contributed the classic piece of investigation in this field.
In 1966 we initiated a similar pilot study of otitis media. We wished to learn how rapidly bacteria were cleared from the middle ear following antibiotic-decongestant therapy or the use of decongestants alone.
THE SCHOOL HEALTH SERVICE: A NEW MODEL
Authors: Nader Philip R. , Emmel Anne , Charney Evan 
Published: December 2021

A pilot school health project delivering services through an OEO-University operated Neighborhood Health Center, has utilized a health paraprofessional, the School Health Assistant. It developed new roles for school physician and nurse through linking the school health service in an inner-city elementary school with a source of a family-focused primary medical care in the same geographic area.
Comparison of it with a traditional school health program indicated further program development and evaluation should be undertaken.
CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY
Authors: Antonowicz I. , Lloyd-Still J. D. , Khaw K. T. , Shwachman H. 
Published: December 2021

Observations over a period of 6 years are reported on 10 children in whom the diagnosis of congenital sucrase isomaltase deficiency (SID) was confirmed by quantitative estimation of disaccharidase activity of the small intestinal mucosa. Repeat biopsies were performed on eight of the ten patients and showed no evidence that sucrase isomaltase activity is acquired. Sucrose tolerance tests (2 gm/kg) showed no significant rise in blood glucose in the seven patients in whom they were performed.
This condition may appear in young infants with severe diarrhea resulting in a malabsorption syndrome and failure to thrive. It may also be manifest in a milder clinical presentation with bothersome diarrhea in spite of normal growth and development in the older infant or young child. The diagnosis in this latter group can be difficult, and is frequently missed.
COMMITTEE ON ENVIRONMENTAL HAZARDS
Authors:   Committee on Environmental Hazards, Wehrle Paul F. , Brent Robert L. , Chisolm J. Julian , Doyle John L. , Fagan Emmett L. , Finberg Laurence , Miller Robert W. , Nahmias André J. , Thompson G. D. Carlyle , Horton Robert J. M. 
Published: December 2021

The Committee on Environmental Hazards has recommended that the American National Standards Institute (ANSI) revise that portion of the American Standard Z66.1/64 pertaining to the lead content of paint downward from the present 1% to "minimum traces" or &lt; 0.06% of the total weight of the contained solid, including pigment, film solids, and driers. This recommendation is based on a study of recently published materials which appeared after the 1% voluntary standard for lead was originally established in 1955 by ANSI.
At the same time, in response to the notice in the Federal Register of November 2, 1971 (21 CFR Part 191), the Committee recommended that Federal standards for lead content of paint used on surfaces accessible to young children be reduced to "minimum traces" on &lt; 0.06%, and that paints containing more than this amount of lead be banned as hazardous substances.
On review and evaluation of available data in children and adults, an ad hoc committee (B. G. King, Chairman) recently concluded that, for children, the maximum daily permissible intake (DPI) of lead from all sources should not exceed 300 µg Pb/day. If average daily intake is maintained below this level, blood lead concentrations are unlikely to exceed 40 µg Pb/100 gm whole blood. At this level of intake, it is estimated that the amount assimilated by 1- to 3-year-old children could probably be excreted so no net increment in total body lead burden would be anticipated. It is estimated that approximately one half of this 300 µg Pb/day intake would be derived from usual food, water, and air, so intake from all other sources, on the average, should not exceed 150 µg Pb/day.
Isolette® Respirator Modification for Constant Negative Pressure
Authors: Andreasen Christian B. 
Published: December 2021

With respect to the modifications to the Air-Shields Isolette® Respirator to provide a constant negative pressure and resulting problems reported, Air-Shields is offering to all owners of Isolette Respirators a modification kit incorporating many of the recommended changes in order to improve the reliability of these units.
It should be recognized that many of the problems reported are associated with its use in a mode for which it was not originally designed, and for this reason it is unfair to state that the Isolette Respirator was not adequately tested before manufacture.
Letter to the Editor
Authors: Cohen Sanford N. , Neumann Lois L. , Ganapathy Saraswathy 
Published: December 2021

In their recent article, Nathenson and his colleagues reported on the use of diazepam to control withdrawal symptoms in 18 infants born to heroin-addicted women. They suggested, "further experience, including comparative trials, now seems warranted" with this agent. We feel that this suggestion raises questions concerning both the safety of this agent for the newborn infant and the appropriate method for introducing any new drug into the pharmacopeia for nurseries.
In order to select therapeutic agents for introduction into use in newborn infants, there are several criteria that should be met.
PALMAR DERMATOGLYPHICS IN MONGOLISM
Authors: CUMMINS HAROLD , TALLEY CAROLYNN , PLATOU R. V. 
Published: December 2021

It has been demonstrated that characteristic dermatoglyphic changes rank high in frequency among the variable stigmata which go to make up the syndrome of mongolism. Though they are not diagnostic alone, it is believed that these objective, measurable and unchanging evidences of mongolism seen in hand prints should be helpful in establishing an early diagnosis. Positive dermatoglyphics rank high in frequency among stigmata reported in typical examples of mongolism by 82 physicians. The technic for preparing prints is a simple one which requires very little practice for perfection; interpretation based on the empiric but definite criteria defined can be accomplished with relative ease. A series of five prints are reproduced.
These findings are in keeping with the suggestion that factors responsible for the occurrence of mongolism are operative prior to the third month of fetal life, and are consistent with known facts concerning embryologic development of epidermal ridges of the palms.
QUANTITATIVE METHOD FOR MEASURING H. PERTUSSIS ANTIBODY
Authors: ALEXANDER HATTIE E. , MACPHERSON CATHERINE , REDMAN WINIFRED 
Published: December 2021

A quantitative chemical method which determines the agglutinin nitrogen content has been shown to be applicable to H. pertussis therapeutic antisera.
The two human H. pertussis antisera available for therapeutic purposes contain approximately the same agglutinin nitrogen content per vial, about 1 mg. A vial of the two rabbit antisera analyzed contains approximately 20 mg. of agglutinin nitrogen.
A simple slide agglutination test is offered as a procedure for determining the degree of antibody excess in the sera of patients after serum therapy. The greater the content of agglutinin nitrogen in the therapeutic antiserum administered, the higher the relative agglutinin titer in the patient's serum.
STUDIES OF AN OUTBREAK OF POLIOMYELITIS IN IOWA
Authors: WENNER HERBERT A. , BRANSON VERNON L. 
Published: December 2021

In certain families poliomyelitis attacks many, if not all, members of the household. Not all members of the household develop paralytic poliomyelitis. The onset of illnesses among members occurs at the same time, suggesting a common exposure. The factors responsible for an intense common exposure of most, if not all, members in a household at risk are largely unknown.
In a search for poliomyelitic virus at extra-human sources in a rural epidemic, virus was detected in sewage and creek water. Poliomyelitis was not found in the entrails of birds, frogs or fish collected in the immediate areas of human cases of poliomyelitis.
NEPHROTIC SYNDROME
Authors: BARNESS LEWIS A. , MOLL GRETCHEN H. , JANEWAY CHARLES A. 
Published: December 2021

The records of 208 patients with the nephrotic syndrome seen in the Children's and Infants' Hospitals of Boston from 1926 to 1948 have been reviewed.
The main criteria found for differentiating between lipoid nephrosis and the nephrotic stage of chronic glomerulonephritis have been the presence of hypertension or azotemia for longer than one month in patients with the latter disease, which occurs more frequently in children over four years of age. Other features of the two diseases may be indistinguishable. Nonetheless, it is desirable to differentiate between them, as apparently few if any patients recover from the nephrotic syndrome if the evidences of glomerulonephritis are clear-cut.
Lipoid nephrosis is characterized by the insidious onset of edema in young children, usually between the ages of one and four. Findings include edema, hypoproteinemia, hypercholesterolemia and heavy proteinuria. Blood pressure may be elevated for short periods, but rarely over one month. Microscopic hematuria does not exclude the diagnosis, though macroscopic hematuria is usually evidence of glomenular involvement.
Symptoms and findings in lipoid nephrosis may persist for from one to three years without specific therapy. Exacerbations with infection, followed by remissions shortly after the infection, and remission soon after the onset of the disease are relatively common. Prognosis is not related to the number or duration of exacerbations. Death before 1942 was chiefly due to an intercurrent infection. Since 1942, with the advent of sulfadiazine and the newer antibiotics, death from infection has become less common, and has usually occurred at home, presumably because treatment was not promptly instituted.
There is apparently no constitutional defect in these children before the onset of the disease, and growth and development are normal after recovery.
No form of treatment has been found wholly satisfactory. Paracentesis, transfusion and low salt diet are the most common supportive measures used here. Antibiotics are valuable during infections and have apparently lowered the mortality of the disease in recent years. Focal sources of infection should be eliminated by operative procedure only when surgical intervention is definitely indicated. Injections of salt-poor concentrated human serum albumin and the induction of measles are being evaluated as methods of inducing a diuresis.
In this series approximately one half of the patients with a clinical diagnosis of lipoid nephrosis have apparently recovered completely without residual disease, while a small number show persistent albuminuria or hypertension. It is hoped that with closer supervision of the patients and with adequate chemotherapy, this figure can be significantly increased in the future.
SPECIAL REVIEWS
Authors: SIMMONS VAUGHAN P. 
Published: December 2021

Careful research by numerous investigators has shown the thymus to be a producer of lymphocytes and myelocytes (and possibly also erythrocytes) which reach the circulation via the veins and lymphatics. It is therefore no longer necessary to consider the thymus as an enigmatic organ—an organ of unknown function—when its hematopoietic role is apparent. Likewise, it is sheer folly to go on believing that the thymus is merely an organ of infancy and childhood after it has been pointed out repeatedly by numerous workers in the field that this view is incorrect. One must have a moving dynamic concept of the organ as it is capable of swift and extensive changes in form and structure which take place under physiologic conditions chiefly by an unloading of its cortical cells into the vascular system and by the production of more to augment and replace them.
The thymus plays a far more important role in the genesis and perpetuation of leukemia than has hitherto been believed. The old but erroneous ideas about the immigration of cells into the thymus have led previous investigators astray in the interpretation of the histologic pictures presented in the thymus in both normal conditions and in leukemia. Leukocytes seen in the periphery of the lobules and in the interlobular septa have almost invariably been described as entering or "infiltrating" the thymus without any basis in fact; actually the cells are formed in the thymus and are migrating from it. The ultimate function of the thymus will not be clarified until the role of these leukocytes it produces—its chemical messengers—has been completely elucidated.
CLINICAL CORRELATES OF THE FAST AND THE SLOW SPIKE-WAVE ELECTROENCEPHALOGRAM
Authors: LENNOX WILLIAM G. , DAVIS JEAN P. 
Published: December 2021

In order to test an hypothesis that slow spike and wave formations may be only the immature form of the 3/sec. dart and dome formation of "petite absence" and to learn more about the meaning of a dysrhythmia that consists of an alternation of wave frequency, a comparison was made of the clinical histories and examinations of 200 patients belonging to each group. The group with the slow pattern contained relatively more males; the patients were younger both when seizures began and at the time of examination, their history contained a greater variety of seizure phenomena and their EEGs more associated abnormalities. The evidence of brain damage that antedated seizures was much greater and the family history of epilepsy was somewhat less in the slow group as contrasted with the fast; and yet, heredity played as great a part in the slow group as in a large unselected group of "genetic" epileptics. Intelligence of the slow group was lower than that of the fast.
Slow spike-hump discharges are more diverse in configuration and distribution, more often localized and solitary than dart-dome discharges. The slow form is less often identified with specific clinical symptoms, though in this group of children, 53% had a history of one or more of the petit mal quartette. Astatic (akinetic) falls or simple or massive myoclonic jerks may accompany solitary discharges. Massive jerks were confined to the very young. Of the infants, 55% had this form. Periods of sudden stillness, staring, sagging, small jerkings or mild tonicity, often without full loss of consciousness, may be the clinical correlates of serial discharges. Though less responsive to tridione® or other therapy than the faster variety, control of seizures and even of this peculiar spike-hump dysrhythmia may be possible.
CARDIAC AND AORTIC ARCH ANOMALIES IN THE OFFSPRING OF VITAMIN A DEFICIENT RATS CORRELATED WITH SIMILAR HUMAN ANOMALIES
Authors: WILSON JAMES G. , WARKANY JOSEF 
Published: December 2021

Fetal and newborn rats from mothers fed vitamin A deficient diets prior to and during pregnancy exhibited some degree of malformation in 75% of the cases. Twenty-eight of 64 severely abnormal young studied after serial sectioning showed congenital cardiovascular malformations. These consisted of defects in the interventricular septum and in the aortico-pulmonary septum; and of various aortic arch anomalies, such as retroesophageal subclavian artery, right aortic arch, double aortic arch, absence and other variations of the ductus arteriosus and absence of a pulmonary artery. There were also several cases in which the fourth aortic arch was absent and the heart communicated with the descending aorta through the pulmonary trunk and an enlarged ductus arteriosus; in other instances the communication was affected through a persisting third arch which rose high into the neck.
Many of the cardiovascular anomalies observed in the rats closely simulated malformations observed in man ; others have not been reported to occur in man but they are considered theoretic possibilities. If they are encountered in children, their interpretation may be facilitated by the description of these experimental results in the rat. It is emphasized that present clinical and experimental observations indicate that environmental as well as genetic factors may alter the development of the cardiovascular system.