bluuebunny/crossref_metadata_2025_split huggingface dataset:
ATHLETIC ACTIVITIES BY CHILDREN WITH SKELETAL ABNORMALITIES
Authors: Diamond Eugene F. , Heffelfinger John C. , Kennell John , Poncher John R. , Shackleford E. C. , Shaffer Thomas E. , Thornton Melvin L. 
Published: December 2021

A physician's recommendations concerning athletic activity for normal, healthy children must take into account a wide range of individual differences in size, age, coordination, stage of maturation, and level of physical and mental development. However, when the child has a skeletal abnormality, the physician must also consider the broad spectrum of variations of the disorder itself. For example, a child with rheumatoid arthritis may be in acute pain with systemic symptoms, may have no evidence of activity, may have mild monarticular arthritis that terminates after two or three years, or may have every joint involved without let-up for ten years.
The following principles will serve as a guide to the physician as he discusses athletic competition with the child and his parents.
It is important to distinguish between participation in athletic activities and participation in competitive sports. Competition is often highly motivating and may be a means for promoting self-satisfaction and developing muscles and coordination. But, this is so only if the child is successful in his competitive efforts. If a child is condemned to constant failure because of limitations in strength, endurance, range of motion, coordination, or for any cause, participation in competitive activities can be destructive to his self-image. A child with limited ability should be guided to an appropriate level of activities with no competition or with a goal of competition against one's previous performance. A child with a serious handicap usually recognizes that he has no opportunity to succeed; however, the child with a mild handicap which keeps him from ever being first or causes him always to come in last may experience considerable frustration and discouragement.
Intravenous Diazepam in Status Epilepticus: A Correction
Authors: West James R. 
Published: December 2021

A question has arisen over the recommendation made by Dr. Sidney Carter1 that diazepam be diluted 10 mg in 8 ml distilled water prior to its intravenous administration in status epilepticus.
We have noticed that the resulting solution appears turbid, and have had second thoughts about giving such a solution. The package insert for Valium suggests that it not be mixed with other solutions. On the other hand, if it is injected into an aqueous intravascular medium it would seem likely that the same physical change is occurring there.
Letters to the Editor
Authors: Carter Sidney , Gold Arnold 
Published: December 2021

It has been brought to our attention that the addition of Valium to sterile water results in a cloudy mixture. Since Valium is insoluble in water, and might result in an unequal dispersion of the compound, the manufacturer recommends that injectable Valium not be diluted.
For this reason our recommendation should be modified to state that injectable Valium should only be administered in the undiluted form.
Clinical Paediatric Endocrinology, by William Hamilton, M.D., F.R.C.P. (Glasgow and Edinburgh) D.P.H., D.C.H. (Postgraduate Paediatric Series under the General Editorship of John Apley, C.B.E., M.D., B.S., F.R.C.P., J.P.). New York: Appleton-Century-Crofts, 1972, 209 pp., $12.75
Authors: Bongiovanni Alfred M. 
Published: December 2021

This small volume is one in a series of postgraduate pediatric publications, and according the book jacket, is not offered to specialists but is prepared rather as a working guide for the practicing clinical pediatrician. Although the author is a truly distinguished pediatrician and endocrinologist, this contribution leaves much to be desired.
All facets of the subject are succinctly described, from diseases of the hypothalamus through the several other hormone-secreting organs. Appropriate clinical tests and recommended further reading are included.
Hepatic Encephalopathy Treated With L-Dopa, Recovery Followed for 18 Months
Authors: Colón A. R. , Sandberg D. H. 
Published: December 2021

Six cases of hepatic encephalopathy (HE) treated with L-Dopa have been described in the literature1-3 but no substantial follow-up is available regarding the surviving patients.
We treated a young girl in HE with L-Dopa and have had an 18-month follow-up to date.
Case Report
A. 13-year-old Negro girl with a one-year history of recurrent urinary tract infections was admitted with anasarca and ascites. She was normotensive and neurologically stable. Hematuria was observed but serum electrolytes, blood urea nitrogen (BUN) and creatinine levels were normal.
Nutrition and Infant Mortality
Authors: Brewer Tom 
Published: December 2021

In your December 1972 issue,1 Myron Wegman presents some "provisional" data on infant mortality in the United States, 1970 and 1971. These data are allegedly received from state health department offices, "a 10% sample of material received . . . between two dates, one month apart, regardless of when the event occurred."
What is the practical significance of such data? What bearing do these statistical manipulations have on the problem of improving human maternal, fetal, and newborn infant health in our nation in the 1970s? How accurately does this sample reflect the real events?
DELIVERY OF CARE TO HEMOPHILIC CHILDREN: HOME CARE VERSUS HOSPITALIZATION
Authors: Strawczynski Hanna , Stachewitsch Andrew , Morgenstern Gert , Shaw Marjorie E. 
Published: December 2021

Medical, economic, and social aspects of home care versus hospitalization in treatment of hemophiliacs were assessed in a two-year study. Thirty-six children were divided into two groups. During the first year of study half the patients were hospitalized when bleeding was reported, the other half were treated at home by Home Care, a team of physicians and paramedical personnel. During the second year groups changed assignments, thus each served as its own control. Home Care provided a 24-hour telephone service; treatment was carried out by a nurse at home or school.
Results showed that great majority of bleedings did not require hospitalization. No complications were noted. While on Home Care more bleedings were reported and they were reported faster; school attendance was better. Home Care, preferred by children and parents, provided an excellent model for teaching and a new role for a nursepractitioner. Hospital days were reduced by 85%.
TOTAL INTRAVENOUS NUTRITION BY PERIPHERAL VEIN IN NEONATAL SURGICAL PATIENTS
Authors: Fox Howard A. , Krasna Irwin H. 
Published: December 2021

A solution for intravenous nutrition which contains amino acids, glucose, electrolytes, and vitamins was infused during long periods through peripheral veins in five neonatal surgical patients. Weight gain and tissue healing were obtained while this solution represented the sole source of nutrition for as long as 51 days. The need for long-term central venous catheterization and its attendant risks were eliminated by the infusion of large volumes (200 to 250 ml/kg/24 hr) of a solution whose solute concentration (total solute 500 to 850 mOsm/kg of water) was significantly lower than that of conventional "hyperalimentation" solutions.
The large fluid volumes were well tolerated and the infants maintained normal serum osmolalities, serum electrolytes, and acid-base status.
Letters to the Editor
Authors: Duff Raymond S. , Rowe Daniel S. , Anderson Frederic P. , Green Morris 
Published: December 2021

The following comments on the two preceding letters were received from the contributors referred to above:
By emulating great pediatricians in betterorganized outpatient departments, Dr. Brem suggests the art of pediatrics may be taught better. Paradise et al. seem to agree when they state that teaching and patient care are better when properly supported "ambulatory faculties" of "full-time, pediatric generalists . . . are available."
Lacking such faculties, Paradise et al. describe an accommodation, also used at Yale, in which students with faculty support often act as "primary physicians."
STUDIES OF THE SUDDEN INFANT DEATH SYNDROME IN KING COUNTY, WASHINGTON: IV. IMMUNOLOGIC STUDIES
Authors: Clausen Carla R. , Ray C. George , Hebestreit Nancy , Eggleston Peyton 
Published: December 2021

Prospective and retrospective studies of immunologic responses in the sudden infant death syndrome (SIDS) revealed the following:
The concentrations of IgM in cord or death bloods from patients with SIDS did not differ significantly from values found in cord blood from healthy infants or death blood from infants dying of explained causes. Similarly, IgE in death blood of patients was not elevated as compared to controls nor was the third component of complement depressed. Specific antibody titers in cord or death serum to 14 common viral antigens did not reveal any aberrant characteristics in the SIDS infants. Other immunological parameters investigated included antinuclear factor and antiantibodies, also with negative results, indicating that immunological mechanisms may not be of primary significance in the pathogenesis of SIDS.
Although this study represents generally negative findings, it is our hope that it will be a useful guide to other interested workers who are planning projects related to this problem.
THE EVALUATION OF RACEMIC EPINEPHRINE IN THE TREATMENT OF INFECTIOUS CROUP
Authors: Gardner H. Garry , Powell Keith R. , Roden Vernon J. , Cherry James D. 
Published: December 2021

The effectiveness of racemic epinephrine in the treatment of croup was evaluated by a retrospective review, a prospective protocol, and a controlled study. Although the majority of children who were treated with racemic epinephrine and evaluated prospectively had significant immediate clinical improvement, the therapeutic regimen did not seem to affect the overall duration of hospitalization or the incidence of tracheotomy during the study period. Ten of the 20 children who participated in the double-blind controlled study had significant improvement; five received racemic epinephrine and five received the placebo. These findings suggest that the apparent effectiveness of racemic epinephrine might be due to the nebulization of moisture rather than a direct effect of the drug.
The present study points out the critical need for controlled studies in the evaluation of therapeutic procedures in the treatment of croup.
ANTIBACTERIAL EFFECTIVENESS OF ROUTINE HAND WASHING
Authors: Sprunt Katherine , Redman Winifred , Leidy Grace 
Published: December 2021

A broth rinse method was used to determine the indigenous bacteria of the hands of nursery personnel and to demonstrate its stability under the test conditions. The efficacy of five wash agents in removing infant-acquired organisms from the hands was then explored. All agents were equally effective including water when followed by drying on a paper towel.
The data show that the routine-type quick hand wash usually employed by busy aides and nurses is effective in removing patient-acquired organisms and provide additional emphasis on the importance of the hand wash procedure in prevention of spread of bacteria from patient to patient.
Definition of the Russell-Silver Syndrome
Authors: Szalay Glenn C. 
Published: December 2021

Haslam et al.1 appear to accept the concept of the combined "Russell-Silver syndrome" postulated by a number of authors. I do not, and I believe that the study of craniofacial proportions allows one to differentiate three types of intrauterine drawfs (Table I).2,3
See the Table in PDF File
Finally, Haslam et al.1 do not tell us what the asymmetry is in their first two patients; as an example, should unilateral ptosis or unilateral cryptorchidism qualify a patient for inclusion under the category of body asymmetry?
Shigellosis in the First Week of Life
Authors: Barton Leslie L. , Pickering Larry K. 
Published: December 2021

The diagnosis of shigellosis is only rarely considered in the infant whose diarrhea commences during the first week of life. Haltalin1 reported six cases and reviewed seven others that had appeared in the literature up until 1967. Three other cases have been reported.2-4 We would like to describe an additional infant with onset of diarrhea due to Shigella flexneri infection on her second day of life.
Case Report
Patient C.E. (SLCH #72-6528) was admitted to St. Louis Children's Hospital at 36 hours of age with fever and bloody diarrhea. The mother had a third trimester urinary tract infection treated with parenteral ampicillin. No diarrhea was noted during her pregnancy.
Safety of Infants in Automobiles
Authors: McDonald Quentin H. 
Published: December 2021

At the recent Academy Meeting in Boston, we had a most unusual experience. Although we have exhibited the Bobby-Mac Baby Chair at Academy Meetings during the past three years as a safe infant seat-car seat-high chair, we were surprised to have an Academy member state that he "always recommends that the very young baby be held in the mother's arms even in a car," and "did not approve of car restraints for infants".
In view of the available research on car seat safety for infants and children, it is difficult to believe that a physician counseling young mothers could maintain such an attitude.
NEWER CONCEPTS IN EMERGENCY CARE OF CHILDREN WITH MAJOR INJURIES
Authors: Haller J. Alex 
Published: December 2021

Childhood trauma and other life-threatening emergencies require facilities operational on a 24-hour basis, with surgical and medical components, x-ray facilities, and blood and chemistry laboratories organized to provide primary resuscitation and initial management for extensive and multiple injuries in children. Staffed to provide high quality treatment for simpler injuries and emergency illnesses in children, a trauma unit should represent a complete emergency treatment center for children; it should be tied administratively and professionally to the intensive care units within the larger medical complex.
From this type of organizational framework and a physically separate trauma unit for children, improved teamwork and more efficient management of multiple injuries should result. The basic principles of rapid, careful evaluation and sequential correction of altered physiology remain the back-bone of successful therapy in children. The unique metabolic demands and miniature anatomic relationships, especially of small children, present the physician with a special challenge and a tremendous responsibility. Rewards for the successful management of multiple trauma are high–the younger the injured child, the greater is our total investment in his welfare and in his future.
DEVELOPMENT OF NEUROPHYSIOLOGICAL INDICES OF MENTAL RETARDATION: I. INTERHEMISPHERIC ASYMMETRY OF THE AUDITORY EVOKED CORTICAL RESPONSE
Authors: Richlin Milton , Weinstein Sidney , Giannini Margaret 
Published: December 2021

Auditory evoked cortical responses (AECR) were studied in three groups of children (8 to 15 years old): normal dextrals, retarded dextrals, and retarded sinistrals. Hemispheric asymmetry of the maximum amplitude of the AECR was found in the following pattern: left greater than right in normal dextrals, right greater than left in retarded dextrals, and no difference in the retarded sinistrals.
If this preliminary sign based on AECR asymmetry were employed for the 15 subjects, there would have been one false positive, and two false negatives (both sinistrals).
BACTERIAL MENINGITIS
Authors: Smith David H. , Ingram David L. , Smith Arnold L. , Gilles Floyd , Bresnan M. J. 
Published: December 2021

Prior to the introduction of specific antibacterial therapy, bacterial meningitis was a disease with a universally fatal or disastrous outcome. The introduction of typespecific antiserum, and then of the antibacterial drugs, improved this situation dramatically.
Improvements in the general medical care of acutely ill children, and the introduction of a series of more potent antibiotics against its bacterial causes helped to generate an attitude that bacterial meningitis was, or soon would be, a disease of the past. The experience of the past two decades belies this thesis. Today, interest in many facets of this disease has been renewed by many physicians concerned with the health of children: the epidemiology, pathophysiology, diagnosis, and treatment. This symposium attempts to summarize for the practitioner the highlights of current knowledge in this area, and to outline certain areas in which recent advances can be anticipated, or will be studied.
Tuberculous meningitis will be omitted for the sake of brevity, as will the special problems of meningitis in the newborn infant.
There has been a resurgence of interest in developing vaccines to prevent Hemophilus influenzae b, pneumococcal, and meningococcal Group A, B, and C meningitis. These organisms cause almost all the bacterial meningitis after the first two months of life. If, as now seems possible, vaccines against most or all of these organisms will soon become available, those children having the greatest risk must be defined to determine who, and at what age should have priority in receiving the vaccine(s).
A. THE CURRENT MAGNITUDE OF THE PROBLEM
The Significance of Pulmonary Petechiae in Crib Death
Authors: Guntheroth Warren G. , Breazeale Donald , McGough George A. 
Published: December 2021

Intrathoracic petechiae have been regarded as a characteristic postmortem finding in crib death, suggesting to some that upper airway obstruction was involved. Ninety rats were asphyxiated in various ways, and the frequency of petechiae was determined. Abrupt and unremitting tracheal occlusion produced petechiae in only 7%, whereas breathing 100% nitrogen produced petechiae in more than 80% of the animals. Respiratory paralysis with succinylcholine caused petechiae in only 20%, and cardiac arrest with potassium chloride in 27%.
We conclude that hypoxia, prior to cardiac arrest, and vigorous respiratory movements are necessary to produce intrathoracic petechiae, and that unremitting airway obstruction is unlikely as the cause of SIDS. Instead, we propose that crib death is due to primary apnea, secondary to moderate hypoxia.
Fatal Coxsackie B2 Infection In One Dizygous Twin
Authors: Nankervis George A. , Rome Leonard P. 
Published: December 2021

Devastating coxsackie B virus infection has been reported in a number of neonates during the past several years.1-4 Although transplacental infection may occur, characteristically the viral infection is acquired during passage through the birth canal or shortly thereafter. The neonate is usually asymptomatic until 4 to 5 days of age when the onset of lethargy, poor feeding, and temperature instability are noted. Significant morbidity or mortality frequently ensues. This report describes a fatal case of neonatal coxsackie B2 infection in one dizygotic twin.
CASE REPORT
E. D. was the first of twins delivered to a 29-year-old gravida 3, para 2, white female after 37 weeks' gestation.
RESPONSES OF CHILDREN IMMUNIZED WITH THE CAPSULAR POLYSACCHARIDE OF HEMOPHILUS INFLUENZAE, TYPE b
Authors: Smith David H. , Peter Georges , Ingram David L. , Harding A. Lynn , Anderson Porter 
Published: December 2021

One hundred forty-one children of 5 to 59 months of age were immunized with a single intramuscular dose of 0.67, 3.3, 17, or 67µg polyribophosphate (PRP), the capsular antigen of Hemophilus influenzae, type b. The immunizations were well tolerated, particularly at doses of .67 to 17µg. Antibody activity was measured by radioactive antigen binding, using 3H-labelled PRP. Doses of 3.3 and 17µg produced significant antibody rises in nearly 90% of recipients; 0.67 and 67µg in approximately half. The geometric mean titers were similar at three and six weeks after immunization and were greater with the middle doses.
The net antibody increase in responding children was strongly age dependent, but was not related to the preimmunization antibody concentration. Rises in serum bactericidal activity against H. influenzae type b generally accompanied rises in antibody concentration as measured by the antigen-binding assay.
Pediatrics in the Sticks
Authors: Reeds Thomas O. 
Published: December 2021

Many physicians feel that private pediatrics is primarily well-child care1 and envision a waiting room full of irate children and unreasonable parents waiting for a DPT. That this is not always the case is indicated by a summary of some of the problems I have been asked to evaluate during my first three months in a small Idaho community even though my practice is as yet anything but large. It has included:
It is apparent that my practice has included a significant number of hospitalized children with unusual illnesses.
PRIMARY MEDICAL CARE AND MEDICAL RESEARCH TRAINING
Authors: Nathan David G. 
Published: December 2021

Dr. Cicely Williams delivered a challenging Blackfan Lecture, reproduced elsewhere in this issue of the Journal,1 at the Children's Hospital Medical Center on May 30, 1973. It should be carefully studied by all pediatricians, and particularly by pediatricians involved in academic programs. Dr. Williams speaks with the experience and wisdom gathered during more than 50 years of service to the field of maternal and child health and with unimpeachable academic credentials. She first described kwashiorkor in the Western medical literature in 1931.
Dr. Williams' message to academic pediatrics is loud and clear. It may be paraphrased in the following manner: "Be off," she states, "with your ultrascience, your superspecialists and your rapt attention to the few with so called interesting illnesses.
ALEXIS DE TOCQUEVILLE ON THE ADOLESCENT AMERICAN GIRL
Authors: C. T. E. 
Published: December 2021

In May 1831, the 26-year-old French nobleman, Alexis de Tocqueville (1803-1859), arrived in the United States, and departed its shores in February 1832, only nine months late. His analysis of the American way of life which he wrote in 1835 as a result of his visit, remains, even today, one of the great classics in political literature. Tocqueville had this to say about the freedom of the adolescent American girl:
In the United States, the doctrines of Protestantism are combined with great political liberty and a most democratic state of society; and nowhere are young women surrendered so early so completely to their own guidance.
Long before an American girl arrives at the marriageable age, her emancipation from maternal control begins: she has scarcely ceased to be a child, when she already thinks for herself, speaks with freedom, and acts on her own impulse. The great scene of the world is constantly open to her view: far from seeking to conceal it from her, it is every day disclosed more completely, and she is taught to survey it with a firm and calm gaze. Thus the vices and dangers of society are early revealed to her; as she sees them clearly, she views them without illusion, and braves them without fear; for she is full of reliance on her own strength, and her confidence seems to be shared by all around her.
An American girl scarcely ever displays that virginal softness in the midst of young desires, or that innocent and ingenuous grace, which usually attend the European woman in the transistion from girlhood to youth.
Aeromonas Hydrophila Infections
Authors: Phillips John A. , Bernhardt Harvey E. , Rosenthal Samuel C. 
Published: December 2021

Five cases in which A. hydrophila was cultured are reported. The organism is found in natural water sources and most isolates have been from diarrheal stools. Our cases suggest that severe Aeromonas infections occur more often in water-associated wounds than previous reports indicate.
All isolates were sensitive to chloramphenicol, gentamicin, kanamycin, nalidixic acid, nitrofurantion, sulfonamides and tetracycline. Sensitivity to ampicillin and carbenicillin was absent and it was variable to cephalothin and colistin.