bluuebunny/crossref_metadata_2025_split huggingface dataset:
PROGRESS OF PREMATURE INFANTS FED A FORMULA CONTAINING DEMINERALIZED WHEY
Authors: Barness Lewis A. , Omans Walter B. , Rose Catharine S. , György Paul 
Published: December 2021

One hundred fifty-two premature infants were fed a formula in which the protein was partially derived from demineralized electrodialyzed whey. The resulting formula has the same fat, carbohydrate, and protein content as the other commercially available "simulated human milks," but 50% of the protein is from whey and the total electrolyte load is lower. In consequence the total osmolar load is considerably reduced. Studies of infants fed this new formula were compared with studies using a "simulated human milk."
The new formula was well accepted. The infants grew well in weight and height. Values for blood urea nitrogen, and total protein and phosphorus in serum, were the same for both formulas. Slight but significant differences were found in cholesterol, albumin, and gamma-globulin levels. The difference in the food efficiency ratio between the two formulas was not statistically significant.
THE ACADEMY AND CHARLIE BROWN
Authors: S. C. A. 
Published: December 2021

THE Scientific Session of the Northern California Chapter of the American Academy of Pediatrics was addressed on May 25 (after dinner) by Charles M. Schulz, creator of the comic strip called Peanuts. Mr. Schulz, whose small characters have become in a sense the neighborhood children of people everywhere, resides in Northern California and is thus the actual neighbor or fellow-townsman of several fortunate and alert members of the group to whom he spoke. Dr. Charles Peck, in an appreciative and neighborly introduction, expressed local pediatric concern over the growth and development of Charlie Brown, a central member of the Peanuts group. Alarmed by their observations of head circumference and cervical anatomy (or its lack), and wishing to caution Mr. Schulz against an unsuspected hydrocephalus or an undiagnosed Klippel-Feil deformity, our Northern California brethren had gone to the trouble of having Charlie Brown drawn with 50 percentile head circumference, and at least some neck, for Mr. Schulz's guidance. A photograph of this drawing, in its unique frame, is reproduced here (Fig. 1) through the kindness of all concerned.
This commendable evidence of diligence in the practice of child health at the local level is but one reason for comments. For in the long run, the originator of these children may tell us more than we can tell him. Has not he, through Charlie Brown, already reported an interesting case in the literature? And may he not enliven and enlighten those pages as well as the newspapers? Many of those who watched and listened with delight while Mr. Schulz drew and described these children that evening must have felt, with Emily Dickinson, that "Much madness is divinest sense." The madness of Charlie Brown and the wisdom of Mr. Schulz are like that. We can learn from them.
BEHAVIORAL OBSERVATIONS ON PARENTS ANTICIPATING THE DEATH OF A CHILD
Authors: Friedman Stanford B. , Chodoff Paul , Mason John W. , Hamburg David A. 
Published: December 2021

There are few tasks in the practice of medicine as difficult as trying to help the parents of a child afflicted with a disease which is invariably fatal. Since the physician cannot change the reality of the tragic situation, he frequently feels totally unable to lessen the parental suffering. However, understanding the nature of the stress as experienced by the parents, and appreciating that there are characteristic ways in which they cope with the situation, should enable the physician to offer helpful support in a majority of cases.
Forty-six parents of children with neoplastic disease were involved at the National Institutes of Health (NIH) in a study of the adrenal cortical response under conditions of chronic psychological stress and this work has been reported elsewhere.1 The present paper is concerned with the clinical impressions gained over a 2-year period while this study was in progress and the implication of these findings to physicians caring for children with similar diseases, adding to what is presently in the litenature.2-8
SUBJECTS AND GENERAL METHOD OF STUDY
The 46 subjects represented one or both parents of 27 children, all of whom had been referred for treatment with chemotherapeutic agents to the Medicine Branch of the National Cancer Institute. In all cases, the child had previously been hospitalized elsewhere for clinical evaluation, and the suggestion for referral was most frequently made by a physician at the time he communicated the diagnosis to the parents. In a minority of cases, the matter of referral was initiated at a time later in the child's clinical course.
THE NEUROMUSCULAR MATURATION OF THE HUMAN INFANT, Myrtle B. McGraw, New York, Hafner Publishing Co., 1963, 140 pp., $3.75
Authors: Byers Randolph K. 
Published: December 2021

This little book (first published in 1943 and re-issued with new introduction and bibliography is a useful reminder that human neuromuscular development is not a straightforward, simple, single-line graph but is the result of waves of motor development of different sorts occurring at different stages.
The work set out to attempt to correlate various motor activities in the infant with developmental observations in the cerebral tissue of infants. While this was not effectively accomplished the observations did point out that motor development goes through various stages with waxing and waning of different types of involuntary activity, which eventuate into well-integrated motor activity.
THE RELATION OF CARDIOVASCULAR TESTS TO MEASUREMENTS OF MOTOR PERFORMANCE AND SKILLS
Authors: Fowler William M. , Gardner Gerald W. 
Published: December 2021

Children with congenital heart disease or asthma had marked decreases in physical working capacity but only slight changes from their predicted scores in most motor performance tests. Children with early muscular dystrophy had marked decreases from expected values in both physical working capacity and motor performance tests. Fitness apparently depends on the character of the test, and a patient must be severely and acutely ill or have a neuromuscular disease before significant changes occur in motor performance tests.
Submaximal work load cardiovascular tests had a low or insignificant relationship to most tests of motor skills and performance, unless extremes of body build were eliminated or in trained subjects. Most motor performance and cardiovascular tests were highly specific with little correlation to each other, and varied in their relationship to height, weight, and physique. These variables played a minor role in motor performance tests with the possible exception of endurance events. Physical working capacity, however, correlated highly with many of these factors. Cardiovascular and motor performance tests had a similar relationship to age and sex. Both showed increases with age and a superiority of boys over girls. Physical working capacity values had less overlap at the earlier ages and less of the fluctuation or decreases in performance characterized by girls in the motor performance tests.
Reports that American children were less fit than children from other countries are contradictory and open to criticism. The results depend on the type of tests, and differences between various geographical areas in this country were often as great as the differences between European and American children, even when similar tests were used. This suggests the need to exercise caution when comparing physical fitness tests and casts doubt on the use of such data as evidence that American children are physically unfit.
Disgruntled Pediatrician Syndrome Continued, with Improvement
Authors: CHILD STANLEY R. 
Published: December 2021

It is with dismay that again we read of the "Disgruntled Pediatrician Syndrome" (Pediatrics 32:465, 1963). Lest possible future pediatricians be negatively influenced by such commentary let me add a voice of encouragement.
A pediatrician is a physician first, foremost, and always. He should never be a technician or scientist studying the young human organism. A physician is a scientist, humanitarian, teacher, counselor, and community leader.
HYPERBILIRUBINEMIA IN BREAST-FED INFANTS
Authors: Newman Arthur J. , Gross Samuel 
Published: December 2021

The case records of 11 infants with prolonged hyperbilirubinemia have been presented. The elevation of indirect reacting bilirubin in these infants may be due to interference with the normal conjugating mechanism by a substance present in breast milk.
Introduction of cow's milk formulas should be carried out as part of any extensive investigation of prolonged hyperbilirubinemia of the indirect type in otherwise well infants who have been wholly breast fed from birth.
A MICRODIFFUSION TEST FOR CONGENITAL GALACTOSEMIA UTILIZING GALACTOSE-I-C14
Authors: London Morris , Marymont Jesse H. , Fuld Jeanne 
Published: December 2021

A method for the detection of congenital galactosemia is presented. Galactose-1-C14 and whole blood are placed in a microdiffusion apparatus utilizing a rotating wheel to mix and to renew surfaces in the reaction vessel. The C14O2 liberated is collected in a drop of sodium hydroxide, washed into a planchet, dried, and counted in a gas-flow counter.
The technique is simple, does not require expensive equipment, utilizes stable reagents, and is well adapted for use as a screening procedure.
The test does not detect the carriers of the genetic defect for galactosemia.
Gamma-Globulin for Premature Infants
Authors: CAREY DONALD E. 
Published: December 2021

The conclusions of Amer et al. (Pediatrics 32:4, July, 1963) associating benefits with the administration of gamma-globulin to premature infants are provocative.
I was bothered, however, as was the commentator (Dr. Hodes) by the "disproportionate loss of participants between the two groups," 45 from the gamma-globulin groups and 68 from the controls. The authors state that there was no evidence these losses biased the final samples. If, on the other hand, the populations actually were comparable, one would have expected the chances of a family dropping out of either group to be equal. This would have meant about 56 dropouts from each group.
Mothers' Milk Bank at the Delaware Hospital
Authors: HANDY MARGARET L. 
Published: December 2021

It has been called to our attention that the services of The Delaware Hospital Mothers' Milk Bank are not adequately publicized. For this reason we would like to mention a few salient facts about our milk bank.
For sixteen years this milk bank has been supplying breast milk to all areas of the United States. During these years frozen breast milk has been sent as far as Califorina with excellent results.
Upon request from the attending physician, breast milk is available for premature and allergic infants. Also, we have supplied large quantities of breast milk for research purposes.
This milk is available at a cost of $.30 an ounce which meets the cost of production. However, in indigent cases the milk is provided free of charge.
PROBLEMS IN NEONATAL OBSTRUCTIVE JAUNDICE
Authors: Bennett Dale E. 
Published: December 2021

All cases of neonatal obstructive jaundice at St. Louis Children's Hospital were reviewed. The total of 57 included 32 cases of extrahepatic biliary atresia and 16 biopsy-proven cases of giant-cell hepatitis. As a result, the author has reached the following conclusions:
Giant-cell hepatitis can be distinguished from extrahepatic atresia in almost all cases by study of a liver biopsy. The important morphologic criteria include the presence in atresia of bile duct proliferation and of intraductal bile stasis, and the absence of significant hepatic architectural disorganization early in the course of the disease. Clinical data and most laboratory tests are of little use in distinguishing between atresia and neonatal hepatitis. Serial bilirubin determinations are useful, as falling levels over a period of weeks is strong evidence for hepatitis. At laparotomy cholangiography is the most valuable diagnostic tool, with frozen section of value when radiographic studies cannot be made.
Biliary atresia carries an extremely poor prognosis, for few patients have a correctable lesion (12% in this series). Furthermore, the mortality and morbidity of biliary tract surgery in infants is high, irrespective of the age of the patient at operation. This poor prognosis is not due to delay in operation, since cirrhosis and hepatic insufficiency develop relatively late in biliary atresia. Delay of operation until age three months will adversely affect only a very rare patient with atresia.
Neonatal hepatitis is a frequent cause of neonatal obstructive jaundice. Exploratory laparotomy in these patients has a high morbidity and mortality, especially when a prolonged ductal dissection is performed. Early operation (4-8 weeks) will result in more cases of hepatitis being subjected to a hazardous procedure. There is evidence to indicate that if operation is delayed until 3 months of age, many of these patients will show evidence of resolution of their disease, especially a serial fall in bilirubin, and need not be explored.
It is the final conclusion of the author that the management of obstructive jaundice in this age group should be conservative, and that operation should not be performed until a patient is three months of age, and even later if a falling trend is noted in serial bilirubins.
AORTIC STENOSIS IN INFANCY
Authors: Feldman Bernard H. , Scott Lewis P. 
Published: December 2021

1. Four infants with congenital aortic stenosis of varying severity have been presented.
2. Clinical findings of severity include congestive heart failure, diminished pulse volume, and electrocardiographic evidence of left ventricular hypertrophy and strain.
3. Congestive heart failure which responds to digitalis therapy is not, in itself, a criterion for surgical intervention in infancy.
4. The presence of left ventricular hypertrophy and strain usually indicates the need for surgical intervention.
PEDIATRIC RECREATION
Authors: Blumgart Eleanor , Korsch Barbara Maria 
Published: December 2021

ILLNESS creates difficult problems for a child and hospitalization adds to these by separating him abruptly from his parents and from the customary ways of life. Concerned with these problems, the Division of Pediatric Recreation at New York Hospital—Cornell Medical Center has developed a program which attempts to provide a maximum of individualized support for both the child and the parent during hospitalization. Many hospitals have recognized the importance and value of this type of pediatric service. For example, the Cleveland Metropolitan General Hospital, Western Reserve University, has developed a comprehensive program of child care on a pediatric service in a general hospital situation. Emma N. Platt has given a detailed description of this in "Working with Children in Hospitals." A program at the Boston Floating Hospital, Tufts University School of Medicine, has been described by Veronica B. Tisza, M.D., and Kristine Angoff.
The Pediatric Department of the New York Hospital–Cornell Medical Center has a long-standing tradition of emphasizing the importance of comprehensive patient care and of devoting special attention to the emotional, social, and recreational needs of the patients. To implement these aims the Division of Child Development was organized in 1947; the sub-Division of Pediatric Recreation is one of the major aspects of its activities. The Division's facilities include a nursery school which is used as a laboratory to teach and demonstrate normal growth and development. The school is attended by a group of "well" children from the neighborhood and a trained nursery school staff provides a typical nursery school program.
BCG Vaccination and Profound Lymphopenia
Authors: MATSANIOTIS N. , ECONOMOU-MAVROU CLEOPATRA 
Published: December 2021

In the February, 1964, issue of Pediatrics a letter to the Editor was published by Rosen and Janeway, in which a strong point was made that fatal progressive vaccinia following smallpox vaccination in children with agammaglobulinemia may be the result of coexisting congenital thymic alymphoplasia. It is the purpose of this letter to draw attention to the fact that children with thymic alymphoplasia may be equally susceptible to fatal generalized BCG infection.
We have rapidly reviewed the cases of fatal generalized BCG infection reported in the literature and have found both direct and indirect evidence that all cases in whom pertinent information is available had profound peripheral lymphopenia.
CONGENITAL NEUROBLASTOMA INVOLVING THE PLACENTA
Authors: Strauss Lotte , Driscoll Shirley G. 
Published: December 2021

Two cases of placental involvement by congenital metastasizing neuroblastoma are reported. The diagnoses were made upon histological examination of the placenta. The tumors apparently arose in the periadrenal sympathetic plexus and may have been multicentric. These appear to be the first reported instances of placental metastasis of fetal neoplasms.
Clinically both cases resembled severe erythroblastosis fetalis. Similarities in the gross and histological appearance of these placentas and those seen in severe isoimmunization disease are discussed. While transplacental metastasis from mother to fetus is known to occur, the reverse has not been encountered. An explanation for this is sought in immunological mechanisms. Analogies are drawn to other types of placental and fetal disease.
THE RELATIONSHIP OF MATERNAL ANTIBODY, BREAST FEEDING, AND AGE TO THE SUSCEPTIBILITY OF NEWBORN INFANTS TO INFECTION WITH ATTENUATED POLIOVIRUSES
Authors: Warren Robert J. , Lepow Martha L. , Bartsch Glenn E. , Robbins Frederick C. 
Published: December 2021

1. Over 1,000 infants were fed attenuated polioviruses during the first 3 months of life and susceptibility to infection with these agents was shown to be related to dose of virus, titer of maternal antibody, method of milk feeding, and age at vaccination.
2. Larger doses of virus elicited a response in a high proportion of infants, but even the smallest dose employed was of nearly optimal effectiveness in infants with little or no maternal antibody.
3. No significant differences between the 3 types of polioviruses were observed other than those which could be related to differences in maternal antibody titer for the 3 types.
4. Maternal antibody had a direct relationship to the incidence of infection, particularly in breast-fed babies and in bottle-fed infants vaccinated on the first day of life.
5. Human milk contains poliovirus neutralizing substances (probably antibody but not specifically characterized) in concentrations related to the antibody titer in the mother's serum. However, a number of significant discrepancies between the antibody content of the serum and milk or colostrum were observed. It is postulated that infection is prevented by neutralization of the virus in the lumen of the infant's gut.
6. Susceptibility of bottle-fed babies increases rapidly during the first three days of life, but remains relatively unchanged thereafter. A reasonable hypothesis to explain this phenomenon is that maternal antibody in the infant's gut, whether from ingested amniotic fluid or by leakage from his circulation into the intestine, inactivates virus given on the first few days of life, but not later.
THE COMPOSITION OF MUSICS FOR MAN Or Decoding From Primitive Cultures The Scores For Human Behavior
Authors: Gajdusek D. Carleton 
Published: December 2021

PRIMITIVE MAN has attracted the imagination, curiosity, and romanticism of men of Western culture for centuries—even millennia. Herodotus and Xenophon were compelled to report their brief contacts with him and his cultures, and centuries of explorers, travelers, adventurers, and poets have marveled at and enthusiastically recounted their experiences in uncivilized societies. Civilized man may see in the surviving remnants of primitive cultures his own origins and realize intuitively in observing them that other solutions to the problem of society and communal life are possible than those which historical events have selected to be his own lot, or condition humaine.
The South Pacific, particularly, has been the source of romantic yearnings, and a large number of gifted artists and scientists have voyaged there from Europe and America in search of Rousseau's Noble Savage. The Elysium which men of the romantic Western world have seen in the homeland, and the idyll they see in the lives of the South Sea Islanders, especially of the Polynesians, have preserved to this day their mysterious attraction. Pierre Loti, Robert Louis Stevenson, Joseph Conrad, Paul Gauguin, our Americans, Henry Adams and Herman Melville, and, more recently, Somerset Maugham and James Michener, have told the tales of the South Pacific with brush and pen more dramatically, if less exactly, than Bronislav Malinowsky, Alfred Russell Wallace, Charles Darwin, and Captain Cook. I think that I need no further defense or excuse of my concentration upon, and my prolonged sojourns in, the South Pacific region during the past decade than this list of illustrious predecessors.
DYSGAMMAGLOBULINEMIA: REPORT OF A CASE WITH A FAMILY HISTORY OF A CONGENITAL GAMMA GLOBULIN DISORDER
Authors: Ackerman Bruce D. 
Published: December 2021

An additional male child with dysgammaglobulinemia is reported. In this instance an older sibling, deceased, had clinical and histopathologic findings suggestive of a congenital gamma globulin deficiency.
The preponderance of males among recognized examples of dysgammaglobulinemia, and the presently reported patient whose male sibling also appears to have had a congenital gamma globulin deficiency, suggest that dysgammaglobulinemia, in this particular family, was transmitted as a sexlinked recessive characteristic.
It remains unclear whether agammaglobulinemia and dysgammaglobulinemia represent two closely related genetic abnormalities, or whether they represent variable expression of a single genetic disorder. Study of additional pedigrees containing examples of dysgammaglobulinemia will be required to answer this question.
CHILDHOOD AND ADOLESCENT ADDICTIVE DISORDERS
Authors: Freedman Alfred M. , Wilson Ethel A. 
Published: December 2021

While the average pediatrician may seldom see a young addict in his practice, he should be alerted to the extent to which such possibility presently exists in all strata of our society. Since there has been an increasing trend among middle- and upperclass high school and college students to experiment with a variety of addictive and hallucinogenic substances, problems of addiction are no longer found only in the lower socioeconomic classes. We repeat that such behavior represents a general pathological response to inner and outer stresses with which young people cannot cope. The reasons for this particular behavioral response are complex and much remains unknown about the individual psychic and physical factors that predispose certain individuals to it. Nevertheless, this is no excuse for discouragement or inaction but rather a challenge to the creative capacity of the medical and allied professions which have successfully met such challenges in the past.
Legal obstacles to medical discretion in the treatment of addicts must be removed. Addiction must be seen as a civil, not a criminal matter, and the criminal behavior that may result from addiction must not be confused with the disease itself. The medical profession must assume responsibility for scientific investigation and carefully controlled experimentation with all treatment modalities. Finally, there must be a careful examination of the society in which addiction develops and spreads. It is our belief that vigorous and thoroughgoing investigation and scientific experiment may lead to the possibility of much-needed change in the environment in which addiction flourishes and in the human beings already addicted.