bluuebunny/crossref_metadata_2025_split huggingface dataset:
CUMULATIVE EFFECT OF PERINATAL COMPLICATIONS AND DEPRIVED ENVIRONMENT ON PHYSICAL, INTELLECTUAL, AND SOCIAL DEVELOPMENT OF PRESCHOOL CHILDREN
Authors: Werner Emmy , Simonian Kenneth , Bierman Jessie M. , French Fern E. 
Published: December 2021

This is a report of the relationships found between perinatal complications of the newborn and quality of the early childhood environment, and physical, intellectual and social development at age 2. The study group of 670 is a representative sample of live births during the Kauai (Hawaii) Pregnancy Study in 1955.
Each newborn infant was rated on a 4-point scale based on type and severity of complications recorded during pregnancy, labor, and delivery. Two percent had severe complications and 10% had moderate complications, leaving 88% subject to no complications judged to be more than mild. Distributions of perinatal scores were not significantly affected by ethnic origin, age of mother, socioeconomic status, family stability, or mother's intelligence.
The quality of the environment of each child was also rated on scales based on socioeconomic status, family stability, and mother's intelligence in order to reflect material opportunities, intellectual stimulation, and emotional support available during the first 2 years of the child's life. Three-quarters or more of the families were judged to be average or above by each of the environmental influences.
At age 2, children were given pediatric and psychological examinations. Fourteen percent were rated below average in health status or physical development, 16% in intellectual development, and 12% in social development, findings consistent with previous studies. However, there was relatively little overlap among the children identified as below normal by the three criteria confirming the need for cooperative assessment by pediatricians and psychologists.
With increasing severity of perinatal stress, there was an increase in the proportion of 2 year olds considered to be below normal in physical status and in intellectual and social development. In all three areas, the developmental lag was especially pronounced for children with severe perinatal stress.
In general, the quality of the home environment had a significant effect on both mental and social development by age 2, and the effect increased with severity of perinatal complications.
It is important not to overlook the potential benefits of good early environment not only for children born with perinatal stress but also for the much larger number without stress who are born to families providing an unfavorable home environment. As the effects of environment are already apparent by age 2, it is necessary to provide enrichment programs much earlier than in current practice.
SIGNIFICANCE OF MYCOPLASMA INFECTIONS IN CHILDREN WITH RESPIRATORY DISEASE
Authors: Glezen Wm. Paul , Thornburg Gloria , Chin Tom D. Y. , Wenner Herbert A. 
Published: December 2021

Techniques for the detection of mycoplasma have been utilized in a longitudinal study of respiratory disease in a children's home. M. pharyngis or M. salivarium were detected in almost half of throat samples obtained from children when well or ill. Neither M. pharyngis nor M. salivarium seems to be related etiologically to respiratory disease.
During the first year of observation for mycoplasma, there was no evidence of recent infection with M. pneumoniae. However, in the autumn of 1964, 27 of 46 children had a positive throat sample and/or a significant rise in complement fixing antibodies to M. pneumoniae. M. pneumoniae was recovered from 5 children with a mild pneumonitis and from 10 children who were well. Multiple isolations of M. pneumoniae were obtained as much as 3 months apart from some children. The outbreak was characterized by a rather slow progression of infection and a relatively prolonged carrier state.
COMPARISON OF RECTOSIGMOID MOTILITY IN NORMAL CHILDREN, CHILDREN WITH RECURRENT ABDOMINAL PAIN, AND CHILDREN WITH ULCERATIVE COLITIS
Authors: Kopel Frederic B. , Kim Ih Chin , Barbero Giulio J. 
Published: December 2021

Rectosigmoid motility was evaluated in 18 children with recurrent abdominal pain without evident organic etiology, in 10 children with ulcerative colitis, and in 18 normal children.
A heightened response to prostigmine, with increased rectosigmoid motility, was demonstrated in the children with recurrent abdominal pain. The physiologic implications of this finding are discussed, and the relationship of this entity to the spastic colon variety of the adult irritable colon syndrome is noted.
Reduced rectosigmoid activity was observed in the children with ulcerative colitis.
A POSTVERTEBRAL ENTODERMAL CYST ASSOCIATED WITH AXIAL DEFORMITIES: A CASE SHOWING THE "ENTODERMAL-ECTODERMAL ADHESION SYNDROME"
Authors: Prop N. , Frensdorf E. L. , van de Stadt F. R. 
Published: December 2021

A postvertebral tissue mass excised from the lumbosacral region of a 10-week-old child contained a small coelomic cavity and a convoluted enteric cyst with a blind branch. Some cleft vertebrae occurred at the level of the tissue mass.
The ontogenetic development of this complex of anomalies is explained on the basis of an amended theory of Beardmore and Wiglesworth. The primary etiological factor is supposed to have been an adhesion among entodermal and ectodermal cells in the median plane of the embryo in a bilaminar stage. An adhesion of this type can be assumed to cause the following developmental disturbances: (1) a dorsal enteric diverticulum (or fistula), (2) a split (or diverted) notochord and a cleavage of vertebrae, (3) a cleft spinal cord. These defects can be modified by growth and processes of repair. With a reference to the primary anomaly produced, "the entodermal-ectodermal adhesion syndrome" has been proposed as a name for the final complex of malformations.
CHILD DEVELOPMENT: A BASIC SCIENCE FOR PEDIATRICS
Authors: Richmond Julius B. 
Published: December 2021

ALTHOUGH I have considered presenting some of the work of our group on this occasion, I have elected, rather, to discuss an issue which I feel to be of importance not alone to those of us interested in child development, but to all pediatricians (and indeed to all interested in child welfare). I refer to the role of child development in pediatrics—most particularly academic pediatrics.
To the members of this section it is no surprise to observe that teaching and research in child development have not been integrated into the mainstream of academic pediatrics. It continues, with rare exceptions, to be treated as a minority group in the academic community, even though a knowledge of child development is a major concern of the practicing pediatrician. This relative neglect causes me to inquire as to whether we are to have two cultures or one in pediatrics. At the outset I wish to indicate that my bias is clearly in favor of a unitarian view. For, I believe we continue this dichotomy at our peril in pediatric teaching and research.
Perhaps we can deal with this problem better if we understand how we came to be this way. I will, therefore, attempt to develop my thesis from an historical perspective. These periods are arbitrarily defined; although starting dates are given, there are no end points, since each new period is telescoped into the rich history of its antecedents (Fig. 1).
The prescientific era in pediatrics (prior to 1900) was rich in contributions to our understanding of child development.
Informed Consent
Authors: HERSHEY NATHAN 
Published: December 2021

Although I could write at great length to express all my criticisms of Dr. Silverman's proposal to permit a "physician-friend" of a minor child to be substituted for the child's parent as the person who could authorize the child's participation in the research study which offers the child no immediate benefit, I will endeavor to be brief.
First, are there any scientifically-derived data to show that attempts to obtain consent from parents of minor children for participation in studies have been rebuffed on such a scale that the requirement for consent has interfered with the proper conduct of one study?
METHODS USED IN TREATMENT OF DIARRHEA WITH POTASSIUM AND SODIUM SALTS
Authors: FLETT JAMES , PRATT EDWARD L. , DARROW DANIEL C. 
Published: December 2021

The actual procedures used in the treatment of 153 cases of diarrhea with potassium chloride in addition to the other established therapeutic methods are described.
The mortality was 6% and study of the fatal cases indicated that a large proportion of these cases apparently died from nutritional injury developing before the onset of the diarrhea or from injury as a result of dehydration developing before treatment was started.
The serum bicarbonate returns to normal somewhat more slowly than when larger doses of sodium bicarbonate (or lactate) are given. However, the absence of alkalosis, the infrequency of low serum calcium and the infrequency of the "postacidotic state" suggest that slow restoration of the concentration of serum bicarbonate may be advantageous.
In no instance was low concentration of potassium in serum encountered. On the other hand serum potassium remained normal or slightly high during recovery. In no instance were symptoms referable to potassium intoxication encountered and in no instance was death associated with high concentration of potassium in serum.
The method of treatment is safe and produces results as good as have been obtained in any similar group of cases. The method is relatively simple to carry out and is equally applicable to diarrhea of the newborn and that of older infants.
FATAL BORIC ACID POISONING IN A NEWBORN INFANT
Authors: ABRAMSON HAROLD 
Published: December 2021

A case is reported of a 9 day old baby who died from boric acid poisoning. The chemical was applied as an ointment to a large excoriated area of the baby's buttocks and as a powder on the diapers.
It is suggested that boric acid should be discarded in medical practice, since its potential toxicity represents a hazard that is out of proportion to the doubtful therapeutic value of the drug. Boric acid has been outmoded by more effective modern medications.
LUNG PHOSPHOLIPIDS AND SURFACE TENSION CORRELATIONS IN INFANTS WITH AND WITHOUT HYALINE MEMBRANE DISEASE AND IN ADULTS
Authors: Brumley George W. , Hodson W. Alan , Avery Mary Ellen 
Published: December 2021

Infants who have died with hyaline membrane disease have low concentrations of pulmonary phospholipids and reduced concentrations of saturated fatty acids at the alpha position of lung phosphatidyl choline. There is a highly significant correlation (p&lt; .001) between levels below 12.6 mg of pulmonary phospholipid per gram wet weight lung and high minimum surface tension values of lung saline extracts.
Infants without hyaline membrane disease have high concentrations of pulmonary phospholipids (22.3 mg per gram wet weight). Infants who recovered from HMD and died of other causes show values intermediate to those of HMD and non-HMD infants. The excess above the critical minimum noted here suggests a reservoir of pulmonary surfactant.
COMMITTEE ON NUTRITION
Authors: LOWE CHARLES U. , COURSIN DAVID BAIRD , HEALD FELLX P. , HOLLIDAY MALCOLM A. , O'BRIEN DONOUGH , OWEN GEORGE M. , PEARSON HOWARD A. , SCRIVER CHARLES R. , FILER L. J. , KLINE O. L. 
Published: December 2021

THE Committee on Nutrition of the American Academy of Pediatrics has strongly endorsed the use of milk and infant formula products as primary vehicles for vitamin D supplementation to ensure a total vitamin D intake of 400 I.U. per day by all infants and children. Although in the United States there are significant regional differences with respect to dairy practices in fortifying fluid milk, almost three-fourths of all whole milk sold at retail is fortified with vitamin D, and almost all evaporated milk and infant formula products contain 400 I. U. of vitamin D per reconstituted quart. In addition, vitamin D is readily available in vitamin supplements, and, undoubtedly as a result of the wide distribution and ready availability of vitamin D, the incidence of infantile rickets in the United States has remained at a very low level.
This report draws attention to the lack of vitamin D in nonfat dry milk, a product used in significantly increasing amounts for preparing milk for home use for children, and possibly for infants. The use of nonfat dry milk has been accelerated recently by the increase in prices of fluid milk. For example, in 1965, the last year for which figures are available, consumer sales of nonfat dry milk amounted to 2.5 billion pounds of fluid equivalent, or about 5% of the total national consumption of milk. This total reflects an increase in consumption of almost 70% over the past 10 years.
The lack of vitamin D in certain major sources of milk for the population invites the reappearance of rickets.
Letters to the Editor
Authors: VALDES-DAPENA MARIE 
Published: December 2021

It has recently come to my attention that in the review article "Sudden and unexpected death in infancy: A review of the world literature 1954-1966" I failed to make mention of a current and very valid hypothetical explanation, that involving a genetically determined disorder of cardiac conduction. This subject should have appeared together with the section on "Neural Mechanisms" on page 133.
I regret that this entity was not included in the original presentation because certainly that discussion of recently suggested etiologic mechanics is incomplete without it.
CONGENITAL MALFORMATIONS IN OFFSPRING OF PHENYLKETONURIC MOTHERS
Authors: Stevenson Roger E. , Huntley Carolyn C. 
Published: December 2021

A family study has been presented in which two PKU females on non-restricted diets have had 16 abortions, 6 offspring who died in infancy, and 4 presently surviving children. All live births to these females have had varying combinations of premature birth weight, microcephaly, cardiac defects, mental and physical retardation, dislocated hips, and strabismus. Each of the offspring tested was non-phenylketonuric. Thus, adverse effects of elevated maternal blood phenylalanine or associated metabolic abnormalities on the developing fetus are suggested.
An additional finding of interest was the presence of normal phenylalanine tolerance tests in the three children of the PKU mothers available for testing.
The problem thus presented by reproduction in a PKU mother may become more prevalent with the advent of the many state programs now operating to detect and treat PKU in the neonatal period. From the cases reported previously and those of the present study, it would seem desirable to keep the blood phenylalanine levels of PKU females in the normal range during the child bearing years. Lowering of high levels after the usual delay in diagnosing pregnancy may prove to be inadequate. However, because phenylalanine levels have not yet been controlled in a PKU mother during gestation, there is no proof that such control will preclude the birth of defective offspring.
A practical disadvantage associated with the only presently available method of lowering blood phenylalanine, the low phenylalanine diet, is the inability of adults to tolerate the taste.
DIAGNOSIS AND TREATMENT: PSYCHOGENIC, RECURRENT, ABDOMINAL PAIN
Authors: Green Morris 
Published: December 2021

RECURRENT abdominal pain represents a frequent cause for medical consultation. At least 1 school child in 10 suffers from this complaint. Slightly more common in girls than in boys and unusual before the age of 5, recurrent abdominal pain has its greatest incidence in children 9 to 10 years of age. In 1,000 unselected school children Apley found the complaint to occur more frequently in girls (12.3%) than in boys (9.5%); more than one fourth of all girls at age 9 were affected.
Both organic and psychogenic etiologic possibilities need be considered together in each such case. The present discussion will be largely concerned with the latter. It is intended that a subsequent article will be concerned with organic abdominal pain.
CHARACTERISTICS OF PSYCHOGENIC, RECURRENT, ABDOMINAL PAIN
About one half of the children whose pain is psychogenic will have been symptomatic less than 1 year at the time of consultation; others will have had complaints for 1 to 5 years. Some children experience six or seven episodes a day while others one a week or one a month. Although this symptom may be related directly to stressful situations, this relationship is uncommon. A temporal relation to meals is rare, and the pain almost never awakens the child from sleep. Individual attacks are usually 5 to 30 minutes in length but may persist for hours.
Episodes usually began gradually rather than abruptly. The pain is generally constant and mild or moderate rather than colicky and severe. Descriptions are vague: "It just hurts," "It feels funny," or "I don't know."
Early Introduction of Solid Foods
Authors: ACKERMAN BRUCE D. , YARBROUGH ELSIE 
Published: December 2021

In a recent issue of Pediatrics, Helen A. Guthrie suggested that the current practice of early introduction of solid foods to the infant's diet might be undesirable. Some comments regarding the data and conclusions presented appear to be in order.
The data presented in Table II imply that an infant's iron requirement is 4 mg per day. Calculations based on iron stores at birth and iron requirement for normal hemoglobin concentration at 1 year of age suggest that the requirement is actually 8 mg per day.
SMOKING BEHAVIOR OF NEWTON SCHOOL CHILDREN—5-YEAR FOLLOW-UP
Authors: Salber Eva J. , Abelin Theodor 
Published: December 2021

The smoking habits of Newton, Massachusetts, high school students attending the tenth grade were investigated in 1959 at the age of 15. In 1965 a stratified random sample of these students was again studied in order to examine change in smoking behavior and to identify characteristics which predict future smoking behavior in teenagers.
Between the ages of 15 and 21, the percentage of smokers doubled among the girls and almost doubled among the boys, with 55% of the girls and 63% of the boys now smoking. The heavier smokers at age 15 smoked even more at 21. Only 12% of the 15-year-old smokers had stopped smoking, but 36% of nonsmokers had become smokers and 71% of discontinued smokers had resumed smoking, thus pointing to the stability of the smoking habit and to the instability of the discontinued smoking status among young people.
Variables predicting relapse by discontinued smokers included parents who smoked, poor academic achievement at school, heavier consumption of cigarettes before discontinuing, judgment of smoking as harmless and a disbelief in the causative role of smoking in lung cancer. Students who had stopped smoking because of influence of others relapsed more readily while those who had stopped because they did not enjoy it were less likely to relapse.
A powerful predictor of change from nonsmoker to smoker was the student's own anticipation of smoking. Nonsmokers were less likely to become smokers if they objected to smoking on moral or aesthetic grounds.
Social class, parental smoking, and school achievement are still related to smoking at age 21, but mainly due to an effect before the age of 15.
It is suggested that antismoking programs might be more effective if conducted before the age of 15.
THE INVOLVEMENT OF THE LABIAL MUCOUS SALIVARY GLAND IN PATIENTS WITH CYSTIC FIBROSIS. II. THE HETEROZYGOTE STATE
Authors: Sweney Laura R. , Hedrick Michael C. , Meskin Lawrence H. , Warwick Warren J. 
Published: December 2021

Eosinophilic plugs occur frequently in the acini of the labial mucous salivary glands of children with cystic fibrosis. Similar changes are rare in normal children or in siblings of patients with cystic fibrosis. These changes become frequent in adults. Although they appear earlier and more frequently, and significantly more severely in adults who are heterozygotic for cystic fibrosis, this criterion cannot be used to identify the heterozygote.
These observations suggest that factors are operating in patients with cystic fibrosis which affect certain tissues or their secretions in such a way that changes occur in childhood which would ordinarily not be seen until later in adult life.
Care of the Family of the Child with Cancer
Authors: Friedman Stanford B. 
Published: December 2021

EACH parent of a fatally ill child must adjust, in his own way, first to the threatened loss and then to the actual death of his child. The nature of this adjustment reflects, to varying degrees, the parent's mode of coping with past crises, his previous experiences with illness and death, and the idiosyncratic meaning this particular child may have to him. Thus, the physician can be of most help to the parents if he is aware of important landmarks in the history of the family and problems that they have had to face. His knowledge of previous patterns of family behavior in times of stress can aid him in encouraging parents along lines that have been successful in the past and in supporting attempts to adapt to the present situation. For many parents, this may be their first personal experience with death, and this may place additional demands and requests upon the physician.
Unfortunately, such family history is usually not available to the physician who ultimately assumes the care of a fatally ill child. Furthermore, it is often difficult, and inadvisable, to obtain such information in detail at the time parents are preoccupied with an acute crisis. It therefore is useful for physicians to realize that there are many problems these parents face in common, and a number of studies have described more or less characteristic ways of reacting to them. This does not imply that stereotype behavior will be observed in parents sharing this common experience. However, if the physician is consciously aware of common modes of adjustment used by parents, he will be in the position of anticipating some of their needs, problems, and sources of anxiety.
BENIGN VI NERVE PALSIES IN CHILDREN
Authors: Knox David L. , Clark David B. , Schuster Frank F. 
Published: December 2021

The case histories of 12 patients who developed a VI nerve palsy after an apparently benign illness have been presented. The palsy developed in children of any age in 7 to 21 days after fever or upper respiratory illness and cleared, in all but one child, within 10 weeks. Two etiologic mechanisms are possible: otitis media and its complications, or neuritis after systemic viral illness.
The most important conclusion is that this is a relatively benign entity which first presents with malignant implications. Recognition of this syndrome allows the clinician to cautiously defer complicated diagnostic studies, such as arteriogram and pneumoencephalogram, with the expectation of improvement in the VI nerve palsy.
CITRULLINEMIA WITH DEFECTIVE UREA PRODUCTION
Authors: Morrow Grant , Barness Lewis A. , Efron Mary L. 
Published: December 2021

The second case of citrullinemia is described in a 21-month-old female. In contrast to previous patients with urea cycle enzyme defects, the present child fails to produce normal amounts of urea. Physical growth has been adequate, except for microcephaly. Unfortunately, her psychomotor milestones are slow.
Triiodothyronine, pyridoxine, and neomycin were given with no beneficial effects. Nitrogen balances in addition to protein and arginine loading studies suggest alternate pathways for the degradation of arginine.