bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL SIGNS OF NEONATAL TETANY: WITH ESPECIAL REFERENCE TO THEIR OCCURRENCE IN NEWBORN BABIES OF DIABETIC MOTHERS
Authors: Craig W. S. 
Published: December 2021

The occurrence of hypocalcemic tetany in seven newly born infants is described. Six of the infants were born to mothers with a history of diabetes mellitus. The mother of the seventh infant was obese and had a prediabetic type of glucose tolerance curve.
Clinical signs of tetany appeared within 24 hours of birth. They were severe in five infants and mild in two. Chemical findings in the blood are summarized. All seven infants were born prematurely. Diagnosis and differential diagnosis are discussed.
It is considered that hypocalcemic tetany probably occurs with a significant frequency in babies newly born to diabetic mothers. It is suggested that the occurrence of hypocalcemic tetany is favored by the temporary decline which normally occurs soon after birth in the concentration of calcium in the serum, more particularly in premature babies; and that disturbance of the normal maternal hormonal adjustments of pregnancy and especially of adrenopituitary function in diabetic mothers, may be a determining factor.
COUNSELING PARENTS OF MENTALLY DEFICIENT CHILDREN
Authors: Watson Ernest H. 
Published: December 2021

DIAGNOSIS of mental retardation, which must precede counseling, is the responsibility of the pediatrician or family physician. In the absence of certain stigmata such as hydrocephalus, microcephaly or unmistakable signs of mongolism, the diagnosis can seldom be made in the neonatal period. The physician should have his suspicions aroused by failure of the newly born infant to suck, cry, exhibit Moro and tonic neck reflexes on proper stimulus. However, predictions based on behavior in the first days of postnatal existence are best kept in the physician's mind or, perhaps, carefully inscribed on the hospital chart. Cyanosis, twitchings on frank convulsions in the postnatal period are ominous, but not necessarily followed by permanent damage. The physician must be as certain as possible in medical prognostication before making parents aware of his fears for the future mental development of their child.
As the infant progresses through the first few months of life he will give clearly discernible signs of mental development if he is normal. By the second month he should be looking at objects, and soon thereafter be able to follow a moving object with his eyes. By the third month he should respond with some facial expressivity to words, to the usual "clucking" sounds or low whistles, commonly directed at small infants. Somewhere between the second and sixth months the physician should be able to detect retarded mental development, preferably before the mother suspects anything is wrong. Dr. Watson believes that the physician should confine his opinions to himself, or a few judicious words entered on the chart, until he is quite certain of the retardation or until the mother raises the question.
THE INFLUENCE OF SURGERY ON RENAL FUNCTION IN INFANCY AND CHILDHOOD
Authors: Rubin Mitchell I. , Calcagno Philip L. , Mukherji P. K. , Singh Walter S. A. 
Published: December 2021

There was no statistical difference in the mean excretion rate of sodium following a test load of hypertonic sodium chloride solution between "control" infants and infants, studied 12 to 24 hours after a variety of surgical procedures.
Normal infants between the ages of 1 and 9 months, when given a hypertonic sodium chloride load, excrete sodium at a rate comparable to adults.
Two of thirteen infants in the post-surgical period excreted sodium at a rate lower than one standard deviation below the mean for the group. Possible reasons for the lowered excretion rate in these two infants are discussed.
Four olden children, given a smaller sodium load than the infants, had a lower excretion rate of sodium pre-surgically. Three of these four children excreted sodium at a lower rate after surgery than they did before surgery. The possible reasons for this are discussed.
As measured by glomerular filtration rate, concentration of sodium in the urine, U/P ratio for sodium and the relationship of sodium to water excretion, there does not appear to be an intrinsic defect of renal capacity in handling sodium in the post-surgical state, even in the patients with a lowered sodium excretion rate.
From the data collected in this study, there seems to be no reason for altering the generally accepted principles of parenteral fluid therapy in regard to sodium and chloride for the uncomplicated post-surgical patient, following recovery from anesthesia, from that designed for sick children in general.
CONCERNING THE NATURE OF THE PROPERDIN SYSTEM
Authors: Wedgwood Ralph J. 
Published: December 2021

The properdin system, which is composed of properdin, magnesium and complement, has a variety of activities in vitro. Among these are the lysis of certain bacteria and abnormal erythrocytes, the inactivation of some viruses, and the ability to interact with polysaccharides from such diverse sources as bacteria, yeasts and normal or neoplastic mammalian tissues.
Methods are available to demonstrate these activities and to measure the presence of properdin in sera, under various conditions.
The broader biologic interpretation of data regarding the properdin system is difficult; acquaintance with the system is in its infancy. The interactions of properdin have revealed a biologic unity among a variety of seemingly dissimilar agents.
It seems improbable that a system with such diverse activities would exist without a biologic function in vivo, but such a function has yet to be demonstrated.
Further studies are needed to determine what part properdin plays in the host response called "natural resistance."
EVALUATON OF THE EFFICACY OF LAVAGE AND INDUCED EMESIS IN TREATMENT OF SALICYLATE POISONING
Authors: Arnold Franklin J. , Hodges John B. , Barta Rudolph A. , Spector Samuel , Sunshine Irving , Wedgwood Ralph J. 
Published: December 2021

Studies in experimental salicylate poisoning were carried out to ascertain the therapeutic value of gastric lavage and to compare it with the effect of emesis. Fasted dogs, 6 to 10 kg in weight, were given sodium salicylate in tablet form, and lavage was performed or emesis induced at varying time intervals following ingestion. Salicylate recovery was determined in the lavage and emesis fluids.
The data indicate that in the recovery of ingested salicylate: 1) Initial aspiration of the stomach before introduction of fluid is equally as important as succeeding lavage. 2) Lavage carried out within 15 minutes is no more effective than emesis induced within 30 minutes of ingestion; 3) lavage carried out 1 hour after ingestion is inefficient and far less effective than emesis produced within the same time interval. 4) Spontaneous emesis is not as effective as induced emesis. 5) Emesis induced immediately, or even when delayed as long as 1½ hours after ingestion, appears to be the more effective and thus the preferable form of therapy. 6) Neither lavage nor emesis under the most optimal conditions are consistent in their effectiveness, so that all patients after either form of therapy should be followed carefully for signs of increasing drug intoxication, and treated if a specific form of therapy is available.
SCROFULA CAUSED BY ATYPICAL MYCOBACTERIA
Authors: Chapman John S. , Guy L. Ruth 
Published: December 2021

A series of cases of scrofula caused by atypical Mycobacteria is presented and a characteristic syndrome suggestive of this type of infection is described.
The organisms isolated from the children with scrofula and from the pharynges of apparently healthy children belong to the general group of chromogenic Mycobacteria, but differ too much among themselves to be regarded as a single strain.
These organisms are well differentiated by many standard procedures from both bovine and human strains of M. tuberculosis.
The pathology of the lymph node caused by infection with these organisms is described.
The pathogenesis of this disease seems to be invasion by chance of the deeper structures by oropharyngeal contaminants, perhaps preceded by ordinary infections in the oropharynx. No evidence points clearly to person-to-person transmission.
LEUKEMIA AND MEDICAL RADIATION
Authors: Polhemus Donald W. , Koch Richard 
Published: December 2021

Radiation histories were compiled on 251 leukemic children and compared with an equal number of matched controls. In general, exposure to radiation was significantly more frequent among the leukemic group.
Thymic irradiation was found to be associated with six times the usual incidence of leukemia, the data being highly significant (p &lt;.01). Statistical analysis of the data relative to fluoroscopic studies of the heart or gastrointestinal system, even though not highly significant, does indicate the possibility of a relationship between this type of radiation and an increased incidence of leukemia (p &lt;.05). Diagnostic roentgenograms had been performed more frequently in the leukemic group, but the level of significance was not great (p &lt;.05).
Maternal exposure to roentgen rays during pregnancy had occurred somewhat more commonly in the leukemic group, but the difference was too small to be significant (p &lt;.10).
PSEUDO-PSEUDO-HYPOPARATHYROIDISM IN A CHILD
Authors: Ray Esten W. , Gardner Lytt I. 
Published: December 2021

This is a report of the youngest known patient with pseudo-pseudo-hypoparathyroidism and the first child with the syndrome to be described in the American literature. In 1952 Albright et al. first reported this syndrome in an adult. The prefix "pseudo-pseudo-" was adopted because in a previously described syndrome, pseudo-hypoparathyroidism, the clinical findings described below plus convulsions had been associated with elevated concentrations of inorganic phosphorus and depressed concentrations of calcium in the serum.
The patient is a white girl, age 7½ years, with retarded intellectual development and obesity (41.3 kg). There was no history of tetany or convulsions. Physical examination revealed round face, strabismus and stubby fingers. The fingernails and toenails were short and very wide. There were circular bluish areas over the thorax, abdomen and thighs. Concentrations of calcium, magnesium, total protein, albumin and globulin were normal as was the alkaline phosphatase activity. Concentrations of inorganic phosphorus in the serum ranged from 6.9 to 7.8 mg/100 ml. An Ellsworth-Howard test was negative, but the parathyroid extract used may not have been potent. Roentgenograms of the hands revealed abnormally short, bowed metacarpals and short phalanges, with bone age of 13 to 14 years. There was calcification of soft tissues of the feet.
The ratio of width to length of the thumbnail was 2.8. Similar ratios obtained with children of similar age ranged from 1.1 to 1.4. It is suggested that the ratio of width to length of the thumbnail be included in the physical examination of children with convulsions of unknown etiology, in an effort to identify more patients with pseudo-hypoparathyroidism.
The mother had marked shortening of the fifth digit of each hand, with the site of the fifth knuckle replaced by a dimple. Her face was not especially round and she appeared to be of average intelligence. Roentgenogram of the mother's hands showed shortening of the right fourth and fifth metacarpals and the left fourth metacarpal, with extensive calcification of soft tissues in both hands and wrists.
Pseudo-pseudo-hypoparathyroidism and pseudo-hypoparathyroidism exhibit a "vertical" familial pattern. This genetic pattern may be seen in diseases due to genes in the heterozygous state (i.e., so-called dominant genes). There is as yet no evidence that the two syndromes represent sex-linked genetic patterns.
Pediatric Surgery
Authors: MAY CHARLES D. 
Published: December 2021

The dedication pays the tribute seemingly expected in this matriarchal culture by a nod to the wife and children "who patiently endured the preparation of this book." What a shameful excuse for not washing the dishes and changing diapers!
After this groveling start the author assumes his full stature and we have the benefit of his calloused self indulgence. Those who know the author away from his home consider him to be intelligent, forthright, confident and penetrating, but not dogmatic. These qualities permeate his book and make it a stimulating and balanced presentation.
A MODIFICATION OF THE LÓPEZ BANÚS METHOD FOR COLLECTING SAMPLES OF VENOUS BLOOD FROM YOUNG INFANTS
Authors: Ducharme Jacques R. , Grumbach Melvin M. 
Published: December 2021

CHEMICAL studies in premature and newborn infants have been hampered by the difficulties inherent in current techniques for collecting blood. Although capillary blood has been used for a wide variety of microchemical analyses, certain determinations require larger quantities of blood or venous blood.
Lépez Banús described a technique for obtaining samples of venous blood which, with modifications, has proven most useful in our experience. This procedure avoids the risks of repeated punctures of the femoral or internal jugular veins, and provides a means of sampling as much as 3 to 4 ml of venous blood without significant trauma to the infant. Proficiency in the performance of the scalp-vein technique is required; once this is achieved, success can be expected in a high proportion of attempts.
MATERIALS
1. 20-or 21-gauge Gardner-Murphy needle.
2. 13-gauge needle.
3. Short test tube, approximately 5 cm in length and 1.5 cm in external diameter.
4. Propipette (Instrumentation Associates, 17 West 60th St., New York 23, New York).
5. Apron-type rubber stopper (National Surgical Supplies Co., 458 Broadway, New York 13, New York).
6. Polyethylene catheter No. PE-60, approximately 15 cm in length.
7. Plastic tubing approximately 30 cm in length and 5 mm in internal diameter (the distal portion of an infusion set can be used).
8. Becton Dickinson vacutainer adapter (No. 3200A).
9. Male Luer slip adapter for 5 mm tubing (B-D No. 5000A).
10. Mosquito forceps.
11. Siliclad®, water-soluble silicone preparation (Clay-Adams Inc., 141 East 25th St., New York 10, New York).
ASSEMBLY OF APPARATUS
The apparatus is shown in Figure 1. A 21-gauge Gardner-Murphy scalp-vein needle is attached to a PE-60 polyethylene catheter. The free end of the catheter is threaded through a 13-gauge needle into a short test tube covered with an apron-type rubber stopper (insert, Fig. 1). A 30-cm section of plastic tubing is connected at one end to a B-D vacutainer adapter which is inserted into the rubber stopper and, at the other end, to a male Luer slip adapter which is attached to the S-arm of the Propipette. The Propipette provides a means of obtaining constant suction and can be operated easily with one hand.
ACUTE GLOMERULONEPHRITIS WITH THE NEPHROTIC SYNDROME
Authors: Wilson S. G. F. , Heymann Walter 
Published: December 2021

Five cases in children of acute glomerulonephritis associated with mild and transient nephrotic syndrome are described. At the beginning of the illness each patient developed more marked edema than usually seen, marked proteinuria, hypoproteinemia, hypoalbuminemia and hyperlipemia and thus presented the characteristic features of the nephrotic syndrome. A diagnosis of acute glomerulonephritis was established by (a) the short duration of the disease, (b) the presence in four of the five patients of elevated titers of antistreptolysin "O" and the presence of beta hemolytic streptococci in throat cultures, and (c) followup examination, which showed that all had recovered completely without exacerbations.
Mild nephrotic syndrome may complicate approximately 4 to 5% of cases of acute glomerurlonephritis in children.
DERMOID CYSTS OF THE OVARY PRESENTING AS A CAUSE OF ACUTE ABDOMINAL PAIN IN CHILDHOOD
Authors: Ferguson Colin C. , Goodhand Thomas K. 
Published: December 2021

Benign dermoid ovarian cysts uncommonly cause symptoms in young girls. It is estimated that they constitute 0.35% of all tumors occurring in children of both sexes less than 15 years of age.
Symptoms produced by the cysts may mimic other intra-abdominal disease, and in three of the four cases reported in this series the girls were initially considered to have either acute appendicitis or infection of the urinary tract. All three had a pelvic mass palpable per rectum. The fourth girl was found to have bilateral calcified densities in the ovaries when examined roentgenographically for low back pain.
In three of the four children, calcified or ossified material in the pelvis was seen in roentgenograms of the lower abdomen, and this finding was considered by the radiologist to be indicative of ovarian dermoid cyst.
In two patients the cysts and associated Fallopian tubes had undergone torsion with infarction, and salpingo-oophorectomies were performed. In one girl, a simple oophorectomy was carried out, and, in the fourth child with bilateral dermoids, a bilateral ovarian cystectomy with preservation of tubes and as much ovarian tissue as possible was performed.
All four girls have subsequently made satisfactory progress.
PERFORATION OF THE RECTUM OR COLON IN INFANCY DUE TO ENEMA
Authors: Santulli Thomas V. 
Published: December 2021

Nine cases of perforation of the rectum or colon in infancy due to enema are presented and the scant literature is reviewed.
Although rare, perforation is a catastrophic complication of a simple procedure which carries a high mortality.
The mechanism of perforation and the factors contributing to the complication are discussed.
SYMPOSIUM ON OFFICE EVALUATION OF INTELLIGENCE AND SPECIAL SENSES
Authors: Bordley John E. 
Published: December 2021

STATISTICAL studies undertaken in many communities of this country show rather marked variation as to the percentage of children suffering from significant handicaps in communication. However, none of those making such surveys would feel it an exaggeration if one ventured to state that the instance of handicapping impairments of hearing range somewhere between 1 and 2% in the preschool and early school age children. The number of crippling hearing problems apparently is growing. This growth paradoxically seems to be proportional to the improvement in the obstetrician's and pediatrician's ability to save children, particularly children born after severe trauma, and premature children.
The national picture of the hearing handicapped child is changing. Thirty years ago our deaf schools were filled with children whose hearing impairments were caused by sequelae of meningococcic meningitis or of other infections that involved the ears. This no longer pertains, and we are faced today with a population of children whose hearing handicaps include lesions not localized to the middle or inner ear on even to the auditory nerve. Very few of these children arc completely deaf. They suffer either distorted hearing as the result of damage to the end-organ, or, due to some central damage they are unable to understand speech because they cannot properly comprehend on synthesize speech patterns without special training. Often such youngsters suffer from multiple neurologic handicaps.
Many children have an amazing ability to learn communication both from an auditory and a speech point of view, provided that their problem is detected early and carefully evaluated, and that they are placed in a well-designed training program. After the age of 6 on 7 years, children with such injuries can rarely be trained with as good results as are obtained in the preschool group. Early detection therefore is of the utmost importance.
OFFICE EVALUATION OF SPECIFIC READING DISABILITY IN CHILDREN
Authors: Eisenberg Leon 
Published: December 2021

An operational definition of the clinical syndrome of specific reading disability is proposed. Its clinical symptomatology is described, with emphasis on the invariably present emotional concomitants. A scheme for differential diagnosis is outlined. Theories of etiology and the evidence on which they rest are briefly reviewed. The basis for a treatment plan is provided.
Throughout, emphasis is placed on the role of the pediatrician, both as a key figure in early diagnosis and prompt treatment, and as community leader in the development of adequate educational resources for the non-reader.
There is even reason to believe that methods for the early detection and rehabilitation of children with reading disorders may make a significant contribution to the problem of juvenile delinquency. The high rate of reading disability among delinquents suggests that at least some of the poor motivation for academic achievement among these children, and their reactive antisocial behavior, may have one source in the repeated experience of frustration and failure that accompanies their reading difficulty.
PSYCHOLOGIC EFFECTS OF HOSPITALIZATION IN INFANCY
Authors: Schaffer H. R. , Callender W. M. 
Published: December 2021

Although increasing recognition is being given to the psychologic needs of children in hospital, many gaps still exist in our knowledge about this topic. The present paper is concerned with one of these, namely, the significance of maternal deprivation occurring in the early months of life.
Under standardized conditions of observation and analysis of data, 76 infants less than 12 months of age were observed while undergoing short-term hospitalization. Observations were focused on three points: the period immediately after admission, the period preceding discharge, and the period after return home. From the data thus obtained two main syndromes emerged, each linked to a certain age range, with a dividing point at approximately 7 months. Those above this age showed essentially the same type of behavior as that described in other studies of the preschool group, namely, considerable upset when admitted to hospital and a period of disturbance after return home, both centering around the need for the physical presence of the mother. In the group less than 7 months of age, on the other hand, separation from the mother evoked no observable disturbance and, instead, an immediate adjustment to the new environment and the people in it was found. On return home a marked change of behavior occurred in most of these younger infants, but it was generally of very brief duration.
On the basis of the data presented it is suggested that the critical period, when separation from the mother is experienced as a traumatic event, does not commence until after the middle of the first year of life, and that consequently in those cases where there is a choice, hospitalization should be arranged to occur before the crucial age is reached.
The Child with a Handicap
Authors: DENHOFF ERIC 
Published: December 2021

Occasionally, a simple, heart-warming document appears unexpectedly to win the public's heart. In the parlance of show business, such a presentation is called a "sleeper," i.e., a film or play that makes a hit.
The Child with a Handicap, edited by Dr. Martmer, a past-president of the American Academy of Pediatrics, deserves the right to be called a "sleeper." Those of us who devote a major part of our practice to the handicapped child are often exposed to articles and textbooks which more often complicate an already complicated subject. The Child with a Handicap helps neutralize material which tends towards frightening pediatricians away from knowing more about an important phase of pediatric practice.