bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIAGNOSIS AND TREATMENT: RISKS OF OBTAINING. SAMPLES OF VENOUS BLOOD IN INFANTS
Authors: McKay R. James 
Published: December 2021

THE PAPER by Asnes and Arendar, appearing elsewhere in this issue of Pediatrics, is a reminder that even one of the simplest and most frequently performed procedures of pediatric practice in the hospital may be a source of serious iatrogenic disease.
Unfortunately, no statistical data are available for an analysis of the relative safety of the various methods of venipuncture; complications are infrequent with any of them if the operator is careful, skilled, and familiar with the method he is using. On the other hand, since accidents on complications may also result from any method used, it is self-evident that those procedures in which the complications are relatively minor are preferable to those in which the complications threaten life or may result in permanent handicap. A specific method may carry an unacceptable risk for a particular patient, yet be the method of choice for most others. Under any circumstances the hazard of the procedure, be it great or small, must be weighed against what is to be gained from it, so that good judgment in its use is always an important factor in the safety on hazard of even so simple a procedure as venipuncture.
Although there are at least 14 possible sites from which to obtain venous blood from infants and children, only three (antecubital, external jugular, and femoral veins) are currently widely used in the United States. The internal jugular vein and superior sagittal sinus have been almost universally discontinued as routine sites because of the potentially fatal nature of complications when they occur.
Practicing Pediatrics in a Rather Special Underdeveloped Country
Authors: BOODISH WESLEY 
Published: December 2021

As I near the end of a 12-month tour spent in a 400 bed civilian hospital in South Vietnam as a "pediatrician," I am of course quite interested in Dr. Eskes' letter on pediatrics in underdeveloped countries (Pediatrics, 37:851, 1966).
I head a 16 man Navy medical team situated in Quang Tri, working under a program called MILHAP (Military Provincial Hospital Assistance Program). There are now 21 of these military medical teams in South Vietnam—Army, Navy and Air Force—each consisting of three doctors, an administrative officer, and twelve corpsmen.
LATE EFFECTS OF LOW-DOSE WHOLE BODY X-IRRADIATION OF FOUR-DAY-OLD RATS
Authors: Billings Marta S. , Yamazaki James N. , Bennett Leslie R. , Lamson Baldwin G. 
Published: December 2021

1. Four-day-old male and female Long-Evans x Sprague-Dawley F1 hybrid rats were exposed to a single total body x-ray dose of 125, 25, 5, and 0 r and then were observed during their entire lifespan for weight changes, signs of morbidity and age at death.
2. There was a 10% reduction of life span in the 125 r exposed female rats. None of the male groups showed significant shortening of longevity.
3. Mean body weights were consistently lower in both male and female groups exposed to 125 r total body irradiation.
4. Female rats exposed to 25 and 125 r attained their maximum weights at a younger age than their non-irradiated controls.
5. External tumors appeared earlier in female rats. Tumor incidence was not increased by irradiation in either sex.
6. Male parentage influenced the length of life span of progeny to a greater degree than the irradiation exposure at the employed dose-level. The influence of female parentage upon longevity cannot be evaluated in this study.
7. Low dose radiation life shortening can only be demonstrated in long-lived strains. Hereditary and radiation life shortening effects are not cumulative under conditions of this study.
DIAGNOSIS AND TREATMENT: APPENDICITIS IN CHILDHOOD
Authors: Rowe Marc I. 
Published: December 2021

AS RECENTLY AS 1958, 258 children died in this country as a result of appendicitis. Most of these deaths occurred in young children with perforation. Correct early diagnosis of acute appendicitis and precise and vigorous management of children with advanced appendicitis can prevent these deaths. Particular attention should be paid to the pre-school child with abdominal pain. The historical and physical findings which are generally called classical are more common in older children. The intraluminal pressure of the obstructed appendix of the young child is built up to the same order as in the adult, but the intravascular pressure is lower and the bowel wall thinner. This results in the rapid development of necrosis. These two factors—difficulty in diagnosis and a fulminating course—lead to a high incidence of perforation in children. Combining the statistics of four large series of 551 children, age 4 years and under, with appendicitis, 429 or 77% were found to have perforated appendixes. This high incidence of perforation has not decreased over the years.
THE EARLY DIAGNOSIS OF APPENDICITIS
Abdominal pain is the prime symptom of appendicitis. Its character and location depend on the anatomic position of the inflamed appendix and the stage of development of the disease process. The young child is often not able to verbalize his complaint of abdominal pain or localize accurately the area of his abdominal discomfiture. Fretfulness, crying, disturbed sleep, and resistance to handling are often the first indications that something is wrong. Anorexia and vomiting are common accompaniments of many childhood illnesses. However, the presence of a good appetite casts some doubt on the diagnosis of appendicitis.
ANNUAL SUMMARY OF VITAL STATISTICS—1965
Authors: Wegman Myron E. 
Published: December 2021

A CONTINUED downward trend for births, slightly upward for marriages, and about the same rate as last year for deaths characterize the provisional vital statistics of the United States for 1965 (Table 1).
Despite the falling birth rate almost 2,000,000 persons were added to the United States population through the excess of births over deaths. Births in 1965 were down about 7% from 1964, bringing the total number, estimated at 3,767,000, below 4,000,000 for the first time in 12 years. The number of births was the lowest since 1951, giving a crude birth rate of 19.4 births per 1,000 population and a fertility rate of 96.7.
On Terminal Sterilization of Formulas, and on Disaccharidase Deficiency and Sucrose Exclusion
Authors: LATHROP FRED 
Published: December 2021

An error occurs on page 148, column 2, line 1, of a letter published in the July issue (Pediatrics 38:148, 1966). Dr. Bowman appears to have written "2 level scoops, etc." This should be reversed: "I level scoop for every 2 oz of water."
I appreciated the Review Article by Dr. R. R. W. Townley on disaccharidase deficiency, page 127 of the same issue. This could have been improved if the author had added a few words on more specific dietary management.
XXY CELLS IN A PREDOMINANTLY XX HUMAN MALE: EVIDENCE FOR CELL SELECTION
Authors: Hecht Frederick , Antonius John I. , McGuire Patricia , Hale C. Gordon 
Published: December 2021

An 18-year-old phenotypic male who had been reported to have XX and no Y chromosome was further investigated. He had small (2.4 cm) testes and azoospermia. His testicular biopsy was markedly abnormal with dysplastic spermatic tubules and interstitial fibrosis.
Cytologic studies revealed drumsticks in neutrophils and sex chromatin bodies in skin and various testicular cells. Chromosomal studies disclosed a small proportion (3/270) of XXY cells in cultures of blood and testis and no XXY cells (0/39) in culture of skin. The predominant line of cells in all these tissues had 46 chromosomes with XX and no Y chromosome. Cells with a Y chromosome were thus scarce, although as a zygote the patient presumably possessed a Y.
Reference is made to the idea that sometimes selection may by unknown mechanisms work against the survival of a particular clone of cells after that clone has irrevocably influenced the course of embryonic development. The XXY cells in our patient would thus be a clone which selection has caused to nearly vanish.
PHENYLKETONURIA IN THE AMERICAN INDIAN
Authors: Wagner Marsden G. , Littman Bruce 
Published: December 2021

THE geographic and racial distributions of phenylketonuria have been recorded in the literature for many years, beginning with Jervis in 1939. It has been reported to occur in the Scandinavian countries, Ireland, England the European continent, North and South America, and Japan. Racially it has apparently been recorded equally among all groups with the exception of Jews and Negroes, in whom its incidence is much lower. After a review of the literature, however, only three papers presented the possibility of phenylketonuria occurring in the American Indian or related racial groups (e.g., Mexican). These are summarized in Table I.
A study of the following family has therefore proven to be significant.
FAMILY HISTORY
Mr. Y, age 30, and Mrs. Y, age 20, were born and raised in a Cheyenne-Arapaho Indian community in Oklahoma. Both are in good health and are of normal intelligence. Mrs. Y has had four pregnancies; the first resulted in a spontaneous abortion at 2 months, but the next three were viable. These three children with their clinical status are, in order of birth: Je, diagnosed as phenylketonuric with mental retardation; Su, normal; and Ch, diagnosed as phenylketonuric.
Case 1
Je, age 3½ years, was born in the Oklahoma Indian community; he weighed 3,300 gm at birth; pregnancy and delivery were normal. He has no history of eczema or seizures, conditions frequently associated with phenylketonuria. Development has been as follows: held head at 4 months, sat with support at 5 months, sat without support at 8 months, smiled at 9 months, rolled over at 10 months.
ACCEPTANCE OF PRESIDENCY
Authors: Anderson William S. 
Published: December 2021

Members of the Academy and guests: It is with a feeling of humble dedication that I assume the position of President of the American Academy of Pediatrics. I am grateful to you for the honor you have bestowed upon me and I am well aware of the responsibilities of the office. Following in the footsteps of our outgoing President, Jim Hughes, I shall endeavor to carry forward the progressive course he has so ably set during his term of office. Never before in the history of the Academy have we had such an opportunity for leadership as we have today. I am convinced that the Academy can and will meet every new challenge.
During the next few years, we will see many changes in the practice of pediatrics. Problems of private practice have become more and more complicated. Having been in the private solo practice of pediatrics for over 30 years, I am proud to be in that, almost extinct, group of pediatricians who still make house calls. I am well aware of these problems and, as one of you, I am honored to serve as your representative in the office of President.
A year ago a telegram from Surgeon General William Stewart welcomed consultation with the American Academy of Pediatrics. Since that time there has been an "open line" of communication between the Academy and governmental health agencies. During the coming year these lines of communications will be kept open to insure that the highest standards of pediatric care be established and maintained, to preserve the identification of the pediatrician in private practice, and to guarantee that he will receive proper remuneration for services rendered.
AN OFFER TO PAY 5 GUINEAS TO THE PATIENT IF VACCINATION FAILED TO PREVENT SMALLPOX
Authors: C. T. E. 
Published: December 2021

For a number of years after Jenner's brilliant report of the efficacy of vaccination, several institutions in the United Kingdom tried to foster interest in this procedure by guaranteeing a handsome sum to be paid to the patient if the vaccination should prove unsuccessful in preventing smallpox. A good example of this may be found in the following resolutions put forth by the Vaccine Pock Institution of Edinburgh in 1805.
VACCINE POCK INSTITUTION, BROAD-STREET, GOLDEN-SQUARE, EDINBURGH
General Quarterly Court, November 5:-Resolved, That, according to the experience of the medical establishment of this institution, it appears that the inoculation for the cow-pock affords security against the small-pox equally with variolus inoculation, and that the new practice possesses all the advantages already stated to the public.
Resolved, That, in order to give a further proof to the public, and to afford an inducement for information adverse to the new practice, the following proposal be made public, viz.
That, in future, every patient who shall be vaccinated at this institution, on discharge, shall receive a certificate, stating, that such patient has gone through the cow-pock, and engaging, that if hereafter the said patient shall take the smallpox, he or she shall be entitled to the sum of five guineas, to be paid from the funds of this institution, at the first general court, after the proofs have been given, according to the rules of the medical establishment.
ROLE OF CAROTID CHEMORECEPTORS IN THE INITIATION OF EFFECTIVE BREATHING OF THE LAMB AT TERM
Authors: Harned Herbert S. , Griffin Clarence A. , Berryhill William S. , MacKinney Loren G. , Sugioka Kenneth 
Published: December 2021

Respiratory patterns after deliberate cord occlusion of four fetal lambs with bilaterally divided carotid sinus nerves were compared with those of four control lambs subjected to similar surgery without actual division of the nerves.
The animals with divided carotid sinus nerves did not develop sustained rhythmic respiration and showed fall in Po2, which persisted, and progressive fall in pH and rise in Pco2 during the 10-minute period of observation after cord occlusion. The mock-operated animals developed sustained rhythmic respirations and showed rise in Po2, fall in Pco2 and less fall in pH than the animals with divided carotid sinus nerves.
This striking inability of the lambs deprived of carotid chemoreceptor function to initiate effective respiration indicates that this mechanism has an important role in the initiation of breathing under these conditions.
THERAPEUTIC VALUE OF ALCOHOL IN CHILDREN
Authors: C. T. E. 
Published: December 2021

Doctor Abraham Jacobi's influence upon American pediatrics was greater than any other physician's of the present or past. It may surprise the younger pediatrician to read the following two quotations from Jacobi's writings concerning the esteem in which he held alcohol as a therapeutic agent for children.
But practical observation shows us that there is at the present time no antiseptic which can be administered internally of equal value with alcoholic beverages. The worst forms of typhoid infection die without them; the septic forms of diphtheria which are inaccessible to antitoxin may still be reached by whiskey or brandy. In this seemingly hopeless condition it may be life-saving. Theoretical objections, ethical opposition should not count. A child of three or four years may be saved by 100 or 200 ccm. of whiskey given daily, if by nothing else and escape the undertaker.
There is no better antiseptic than alcohol beverages. I claim as one of the most meritorious facts in my professional life, if there be any, to have proclaimed long before the time of most of you the necessity of giving large doses of alcoholic dilutions in the grave forms of diphtheria; indeed every case may be or become grave. There is almost no dose that is not well tolerated. What I have observed, and written these forty years, still holds good. Septic cases, with high fevers (also others so septic as to exhibit collapse), that will not improve after 100 or 200 centimetres of whiskey daily, are apt to do well with two or three times the dose, which, however, will cease to be tolerated as soon as the septic fever has passed by. Indeed I have seen such septic children of three or four years take 500.0 [ccm.] of whiskey a day, which had no bad influence on the brain while the sepsis lasted, but would cause alcoholic delirium as soon as convalescence began.
For a marked antipyretic effect rather large doses of alcohol are required; that is why it should not be given except in sepsis when the reduction of temperature—while necessary—can be obtained in other ways. There is no reason, for instance, why the first stages of pneumonia should be treated with alcohol. At that time inanition is not threatening, and therefore the indication fulfilled by alcohol in moderate doses, viz., to avoid the disintegration of albuminoids and of fat, does not yet exist. It is only in later stages, and in chronic diseases, when starvation is threatening, that diluted alcohol, which is readily absorbed in the stomach and therefore quicker in its action, is of the greatest value.
THE EFFECT OF SEVERE PROTEIN CALORIE MALNUTRITION ON THE RENAL FUNCTION OF JAMAICAN CHILDREN
Authors: Alleyne G. A. O. 
Published: December 2021

The renal function of 32 malnourished Jamaican children was investigated by serial tests from admission until recovery. It has been established that in the malnourished as compared to the recovered children there are several functional renal lesions.
There is a reduction in G.F.R. and R.P.F., and evidence of impaired tubular function as shown by aminoaciduria, occasional renal phosphaturia, impaired urinary concentration, and inability to excrete an acid load.
There is no demonstrable difference in G.F.R. or R.P.F. between the edematous and non-edematous malnourished children. With recovery there was steady improvement in renal function. The etiology of these lesions may be related to the deficiencies of magnesium and potassium which are known to occur in malnourished children.
Immaturity, the Blood-Brain Barrier, Bilirubinemia, and Kernicterus
Authors: BELTER LESTER F. 
Published: December 2021

Your invitation for comments and questions on the article, "Kernicterus: Revised Concepts of Pathogenesis and Management," appearing in the October, 1966 issue of Pediatrics (38:539, 1966) is accepted.
I do not question the validity of the first two sentences of the first paragraph of page 541; however, the third, "Thus, newborn and adult animals did not differ fundamentally in the functional characteristics of the blood-brain barrier for bilirubin," is misleading and probably provides little or no evidence against the concept of "immaturity" of the blood-brain barrier.
SELECTIVE IMMUNOGLOBULIN DEFICIENCY ASSOCIATED WITH THYMIC ALYMPHOPLASIA
Authors: Buckley Rebecca H. , Bradford William D. , Butcher Suzanne R. 
Published: December 2021

Serum immunoglobulin, fluorescent antibody and pathological studies were performed on tissues from a 9-month-old infant who died of Pneumocystis carinii pneumonia.
The serum levels of IgG and IgA were found to be greatly diminished, whereas IgM and IgD were present in normal amounts. In addition, a moderate number of immunoglobulin-M-containing-cells were demonstrated in the spleen by fluorescence microscopy. Rare cells were seen which contained IgA or IgG.
The thymus was poorly developed, contained no Hassall's corpuscles and few lymphocytes. Peripheral lymphoid tissue was scant; only two lymph nodes and no tonsils were found at postmortem examination. The largest peripheral aggregation of small lymphocytes appeared in the appendix. During life the child manifested varying degrees of lymphopenia.
CARBOHYDRATE AND ENERGY METABOLISM IN THE NEWBORN—AN INTERNATIONAL EXPLORATION
Authors: Cornblath Marvin 
Published: December 2021

Dr. Smith (Chairman): To start the evening, I might remind you that 6 years ago a similar group took advantage of their presence at the International Congress in Montreal to gather together informally for the exchange of ideas about hyaline membrane disease. The one major result of that discussion was the agreement that, whatever hyaline membrane disease is, it should thereafter always be called the idiopathic respiratory distress syndrome. As you may know, the syndrome is now referred to more firmly than ever as hyaline membrane disease; nevertheless, something of value was accomplished in the exchange of ideas and in the focusing of international attention upon central rather than peripheral aspects of a previously ill-defined problem.
In organizing tonight's meeting, I know Dr. Cornblath hopes something of a similar nature can occur with regard to problems of carbohydrate and fat metabolism in newborn infants. Some of us, I am afraid, would have said 6 years ago that newborn infants actually had no problems of this sort. It was largely through Marvin Cornblath's alertness and continued investigations that we now know the subject as one of great importance and interest. Yet, I think one of the reasons we are here is not only to discuss how these matters look to all the rest of us, but to find out if anyone else sees quite as many infants with significant hypoglycemia as seem to be encountered in Chicago. What it is that we are missing in other cities, or what Dr. Cornblath is doing that we are not, are aspects which, I hope, can come out in the discussion tonight.
The Battered Child
Authors: BLOCH HARRY 
Published: December 2021

Dr. Vincent J. Fontana in a letter (Pediatrics, 38:1078, 1966) expresses the urgency of early recognition of the "maltreatment syndrome." However, he continues to isolate the "battered child" from the children battered by society.
In my letter (Pediatrics, 38:856, 1966) I suggested that we take up the cudgels for the uncountable numbers of children outraged by society. The victims of slums, poverty, inadequate educational facilities, discrimination; the millions of starving children; the many criminally ruined by drug addiction; the thousands of children injured and killed in accidents; the tragic black child emotionally, physically, and mentally battered; the burned and broken children, victims of war, napalm, and chemicals; the more than one million children murdered in Nazi cremaoria and concentration campus.
Cold Agglutinins and Eaton Agent Infections
Authors: MACAULAY DUNCAN 
Published: December 2021

I read with interest the article, "Cold Agglutinins, Eaton Agent and Respiratory Infections of Children," by Dr. Sussman and his colleagues, (Pediatrics, 38:571, 1966). The authors state, "Experience with cold agglutinins has been derived principally from adults." May I draw their attention to a paper published in 1951 in which I reported the results of an investigation into this phenomenon in 114 infants and children?
That work was done at a time when virological studies were impracticable, and the only correlations that could be attempted were with clinical findings.
The Prophylactic Use of Folic Acid in Neonatal Hypertyrosinemia
Authors: PARTINGTON M. W. , MATHEWS J. 
Published: December 2021

Thirteen small birth weight babies were studied; six were given folic acid by mouth (5 mg twice a day from the third to the twenty-first day of life) and seven were given a placebo mixture. The babies' behavior was rated in terms of activity or lethargy by the nurses and the plasma tyrosine levels were measured chromatographically. The administration of folic acid failed to prevent the occurrence of hypertyrosinemia and no association was found between the babies' activity and the plasma tyrosine level.
This work was supported by a Public Health Grant (No. 605-7-280) of the National Health Grants Programme and the Queen Elizabeth II Canadian Research Fund.
Sudden and Unexpected Death
Authors: BRINGS ELIZABETH G. 
Published: December 2021

With the greatest interest I read the Review Article, Sudden And Unexpected Death in Infancy (S.U.D.I.), and Sudden Unexpected Death in Infancy: With Special Reference to the Parathyroids in the January 1967 issue of Pediatrics which summarize the different aspects and present the latest attempts to explain this subject.
I would like to bring to consideration two factors which might be of importance in some cases, which I have never seen mentioned in any of the discussions dealing with the mystifying event of S.U.D.I.