bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE FLUSH METHOD FOR DETERMINING BLOOD PRESSURES IN INFANTS
Authors: Moss Arthur J. , Liebling Wilbert , Adams Forrest H. 
Published: December 2021

Observations were made on 551 Caucasian infants from 1 day to 1 year of age. All subjects had normal cardiovascular status and were free from acute or chronic infections. A total of 1,712 measurements of blood pressure were obtained by the flush technique. It is known that measurements made using the flush technique approximate the mean rather than the systolic blood pressure. The values obtained were analyzed in relation to sex, age and body weight. No correlation is found between sex and blood pressure or between body weight within a given monthly age category and blood pressure. Measurements of blood pressure show a pronounced and highly significance rise following the first week of life. During the first 9 months of life the readings are somewhat higher at the wrist than at the ankle. Thereafter, the converse is true. The significance of these findings is discussed.
Arithmetic means and the range of normal blood pressure are presented. Exclusive of the first week of life, the range of normal blood pressure during the first year is from 51 to 93 mm Hg for the upper extremity and from 44 to 92 mm Hg for the lower extremity.
IATROGENIC DISEASE
Authors: MAY CHARLES D. 
Published: December 2021

SOME revealing papers from a Symposium under the heading "Iatrogenic Disease" appear in this issue. The rapidly increasing array of therapeutic agents affords many opportunities for the physician to do harm as well as to benefit the patient. This precarious position is not new to the physician, but in the sincere desire to rid the patient of his ailment or to relieve his symptoms, one is inclined to overlook the possibility that the treatment may be harmful.
Full realization of this is difficult to acquire in an age when disease is seldom observed to run its natural course without the influence of what is mistakenly termed "heroic" therapy, often recommended as intensive or energetic.
HYPERTONIC DEHYDRATION (HYPERNATREMIA): THE ROLE OF FEEDINGS HIGH IN SOLUTES
Authors: Colle Eleanor , Ayoub Elia , Raile Richard 
Published: December 2021

An epidemic of gastroenteritis during which an unusually high incidence of hypertonic dehydration was encountered in infants is reported.
Analysis of the feedings received by the infants during the initial phase of diarrhea indicates that those who developed hypernatremia had received feedings in which the ratio of solutes to water was higher than that in the estimated continuing losses of fluid through stools, urine, and skin and lungs.
Considerations to be employed in the prevention and treatment of hypernatremia and dehydration during diarrhea are discussed.
The physician must develop his clinical judgment in determining when parenteral rather than oral therapy is required in diarrhea—and not depend on a routine regimen or solution for oral therapy.
VALUES FOR COPPER, IRON AND IRON-BINDING CAPACITY IN THE SERUM IN KWASHIORKOR
Authors: Lahey M. Eugene , Behar Moises , Viteri Fernando , Scrimshaw Nevin S. 
Published: December 2021

The results of a study of 10 Guatemalan children with kwashiorkor indicate that the concentration of copper in serum is substantially reduced and that hypoferremia and a reduction in the iron-binding capacity of serum occur as well.
Although the possibility that a dietary deficiency of copper occurs concomitantly with deficiencies of protein and other nutrients is not eliminated, comparison of these biochemical abnormalities with those noted in experimental animals suggests that the changes are secondary to inadequate protein intake.
GILDED ANTIBIOTICS
Authors: MAY CHARLES D. 
Published: December 2021

THE COMPETITIVE struggle between producers of antibiotics has recently placed emphasis on a supposed virtue of newer derivatives in achieving higher concentrations in the blood faster than previous products. Among the products being promoted as possessing this doubtful advantage are minor combinations or mixtures of the parent antibiotics or their more soluble derivatives with such agents as citric acid, phosphates and glucosamine. Typical of these gilded products are: tetracycline and citric acid (Achromycin V®), tetracycline phosphate complex (Tetrex®, Sumycin®), oxytetracycline and glucosamine (Cosa-Terramycin®) and triacetyloleandomycin and glucosamine (TAO®).
The insignificant extent to which these adjuvants can be credited with producing increased levels of antibiotics in the blood by the new mixtures has been discussed elsewhere.
THE PENTOSE PHOSPHATE PATHWAY IN HUMAN ERYTHROCYTES
Authors: Gross Ruth T. , Hurwitz Ruth E. 
Published: December 2021

Metabolism in erythrocytes was studied in a group of premature and full-term, newborn, healthy infants by assay of the following enzymes: glucose-6-phosphate dehydrogenase, 6-phosphogluconic dehydrogenase and aldolase. Concentrations of fetal hemoglobin and stability of GSH were also determined.
The studies indicate increased metabolic activity in the erythrocytes of young subjects. The pentose phosphate pathway appears to be very active at birth with gradual decline, to values found for adult subjects, in the second 6 months of life.
GSH is unstable in newborns less than 3 days of age despite high levels of activity of G6PD in the same subjects.
Precocity of African Children
Authors: KNOBLOCH HILDA 
Published: December 2021

After reading Dr. Cobb's letter (Pediatrics, 21:867, 1958) concerning the "Precocity of African Children" as reported by Geben et al. (Pediatrics, 20:1055, 1957), I feel it essential to make some comment lest the readers of both the article and Dr. Cobb's letter are left with the impression that the accelerated development of Negro infants has been definitely established, and that there is a biological decline with increasing age. I feel this is particularly important since work in which I participated a number of years ago helped foster this concept in regard to gross motor behavior.
It is true that in a group of Negro infants examined in New Haven in 1944 and 1945, the gross motor developmental quotients were found to be higher than the norms on which the Gesell Developmental Schedules were standardized.
Pneumoencephalograms and Clinical Behavior
Authors: KUGEL ROBERT B. 
Published: December 2021

In the article on "Pneumoencephalograms and Clinical Behavior" (Pediatrics, 22:13, July, 1958), Dr. Knobloch makes a general conclusion "that it is not feasible to predict intellectual functioning on the basis of pneumoencephalographic findings alone, . . . ." Although many people might accept this statement as reasonable, even prior to reading the article, I would question whether the data presented can support this conclusion.
I would call attention in this article to the statement, "for those who are not familiar with the Gesell Developmental Examination, . . . it has been found that correlation between examinations in infancy and at 3 and 7 years is high, being 0.5 for 50 children at 7 years of age."
PATHOGENESIS OF LESIONS IN THE NERVOUS SYSTEM IN HYPERNATREMIC STATES
Authors: Finberg Laurence 
Published: December 2021

Seven infants with hypernatremic dehydration developed subdural effusions or bleeding. One of these was a previously normal infant accidentally poisoned by excessive ingestion of salt. This infant and five of the others had significant neurologic damage, ranging from moderate to severe. It appears that the hypernatremic dehydration was responsible for the subdural lesions in these patients and responsible for permanent damage in at least three of them. Changes in chemical anatomy and lesions of the cerebral vessels are discussed with regard to producing lesions of the central nervous system in hypernatremic dehydration.
At present no salutary therapeutic approach to the complication of subdural effusions occurring during hypernatremic dehydration has been found.
THE RENAL RESPONSE TO ADMINISTRATION OF ACETAZOLAMIDE (DIAMOX®) DURING SALICYLATE INTOXICATION
Authors: Schwartz Robert , Fellers Francis X. , Knapp John , Yaffe Sumner 
Published: December 2021

Advanced salicylate intoxication in young children may produce severe acidosis due not only to the production and accumulation of organic acids in tissues, but also to the diminished content of buffer cation which is secondary to the loss of buffer cation during the excretion of organic acids.
The excretion of an intensely acid urine all but prevents the excretion of free salicylate and thereby perpetuates the toxic effects of this ion.
Despite severe deficit of buffer cation, the kidney responds to administration of a carbonic anhydrase inhibitor with excretion of alkaline urine. The magnitude of the loss of buffer cation is unpredictable both before and after enzyme inhibition. However, the systemic acidosis may be controlled by infusion of solutions of sodium bicarbonate, but frequent determinations of pH and content of carbon dioxide in the serum are mandatory.
While the alterations in acid-base disturbance may be controlled during administration of acetazolamide, the occurrence of neurologic complications late in the course must be accepted as a serious additional hazard which may preclude the successful therapeutic value of this agent.
OBSERVATIONS ON A TRIP TO RUSSIA
Authors: Senn Milton J. E. 
Published: December 2021

In May of 1958 I visited Russia for the purpose of learning about child care and child rearing practices. Although up to that time about 25 scientists had visited Russia in order to make various studies, no pediatrician had been there with the specific purpose that I had in mind. Some of the visitors had been social scientists, and there had been a few social workers. These persons were interested in the behavior of the Russian people, particularly the family life and the manner of educating and rearing children. My purpose was also to visit Professor Nicholas Krasnogorski in Leningrad, who is an honorary member of the American Pediatric Society. I will begin this account with the story of my visit to his laboratory and apartment.
I had met Professor Krasnogorski in 1932 when the American Pediatric Society met at the Mayo Clinic. At that time he presented a paper on the treatment of enuresis by feeding children salty foods at bedtime. I remember him very well, and before leaving for Russia I had written him of my plan to visit Leningrad, with the date set at about May 12. I arrived in Leningrad a day late, but after checking in at the Ministry of Health of that city, I was given a message from Professor Krasnogorski saying that he was expecting me. The following day I arrived at his laboratory at 11:00 A.M., as he had suggested. This was housed in a building of two or three stories, a plain stucco exterior badly in need of paint, and approached by a road which was deeply rutted and worn, and which had never been paved. At the doorway of this institute I was greeted by a woman member of the staff and taken at once to Professor Krasnogorski's laboratory. He greeted me cordially. He is now 76 years old, frail in appearance, but clear in mind. He spoke English very well and understood me perfectly.
I was impressed with the smallness of the rooms of his laboratory and with their overcrowding. There was much electronic apparatus as well as kymographs and conditioning apparatus. He showed me graphs that he had made of infants beginning to speak, and told me that his great interest now was in trying to learn more about the development of human speech, and by use of pavlovian methods to try to understand the workings of the higher nervous centers. He spoke with great enthusiasm, and believed that he had finally overcome some of the obstacles in our understanding of speaking processes. He credited his success to the pavlovian method, which he had first learned from the master, and whose colleague he had been for 26 years.
ANTIMICROBIAL AGENTS
Authors: Lepper Mark H. , Riley Harris D. 
Published: December 2021

Hyperacute infections, i.e., infections which are often fatal within 24 hours from the onset of symptoms, and resistant strains of organisms, account for the vast majority of failures in the use of antibiotics. A few cases cannot be classified into either category and remain as unexplained failures.
The magnitude of the problem of hyperacute infections can be judged by the fact that in a contagious disease hospital about a third of the fatalities from nontuberculous, bacterial infectious diseases occur within the first 24 hours from the onset of symptoms. Meningitis due to meningococcus or pneumococcus, or meningococcemia, are most commonly encountered in this group. In Dr. Lepper's experience, those patients who will die within 24 hours from onset of symptoms can be predicted early from clinical observations, and they command "heroic therapy."
A lively discussion of the use of adrenal corticosteroids as pant of "heroic therapy" in hyperacute infections ensued. Dr. Riley pointed out that they are useful agents but have serious side effects and definite hazards. They are known to decrease the resistance of the host to infection. (The effect of cortisone on streptococcal infections in the rabbit was cited: 58 out of 66 rabbits pretreated with cortisone died; 5 of 60 control animals died.) Instances of empyema developing during treatment of pneumococcal pneumonia with both antibiotics and ACTH were described. The discussants agreed that at no time should adrenal corticosteroids be used in the treatment of infectious processes without simultaneous administration of adequate amounts of appropriate antibiotics.
Letters to the Editor
Authors: POLHEMUS DONALD W. 
Published: December 2021

The perceptive comments of Dr. Miller are basically correct and we are only too aware of the many sources of possible bias in compiling and interpreting data such as these. Perhaps a few of the problems which he raises can be clarified by the following additional information.
Questionnaires were given to parents of normal control children when they left the hospital; they were usually mailed to parents of leukemic children. Except to clarify doubtful information and to secure quantitative data on deep radiation therapy the parents and physicians were not further contacted. The questionnaires were returned by parents of 79% of leukemic children and 67% of healthy control children. We feel that these rates are adequate to exclude bias on the basis of type of patient returning the data.
Methods for Research in Human Growth
Authors: FALKNER FRANK 
Published: December 2021

In his admirable Foreword to this book, Professor Ashley Weech describes how he would reply, somewhat nettled, to those remarking that growth investigators had first to chart normal seas before paediatricians could spot the abnormal. His laudable reply was that doctors must describe what must be considered abnormal. He goes on to say what a pleasure it is in this volume to find a joining of minds. Indeed there has been.
The authors state, in an excellent introduction that each chapter could be expanded into a separate monograph but that the book is expressly modest. It is noteworthy that in spite of truly voluminous data collected and published on growth and development in the past, rarely has method been described, critically, educationally, or in detail.
Ciba Foundation Colloquia on Endocrinology, Volume XII
Authors: VAN WYK JUDSON J. 
Published: December 2021

The Ciba Colloquia on Endocrinology continue to provide the most penetrating discussions available on specific endocrine topics. Volume XII of this series is devoted exclusively to a consideration of functional tumors of the endocrine glands.
The volume contains 20 formal presentations of work carried on by leading American and European investigators. Each report brings together in a meaningful way observations which are scattered throughout various technical journals. Each paper is followed by a verbatim transcript of the discussion which ensued. Frequently the discussion proved to be more illuminating than the original presentation.
Secreting tumors of the endocrine glands occur spontaneously with considerable frequency in laboratory animals.
THE RESPIRATORY DISTRESS SYNDROME AND ITS SIGNIFICANCE IN PREMATURE INFANTS
Authors: Bauman William Allen 
Published: December 2021

THE RESPIRATORY distress syndrome of the newborn period is recognized as a clinical entity predominantly afflicting newborn premature infants. Although disorders of the cardiovascular and central nervous systems as well as metabolic derangements are capable of causing a newborn infant to have dyspnea, in those who die the pathologist more frequently finds pulmonary disease. Microscopic examination of the premature infant's lung often discloses atelectasis, emphysema, edema, pneumonia, hemorrhage, aspiration of amniotic debris and the presence of hyaline membrane. In a previous study a significant relationship between respiratory difficulty in early life, pulmonary roentgenographic abnormalities, and the presence of pulmonary hyaline membrane at necropsy was demonstrated.
Curtis has most recently reviewed much of the literature relating to etiology and treatment of "hyaline membrane disease." The clinical manifestations of the syndrome, however, have been infrequently recorded. Miller and Jennison in a survey of more than 4,000 births indicated that the infants who died with hyaline-like material in the lungs had had symptoms characterized by marked respiratory difficulty including retraction of the lower chest wall on inspiration. Parmelee stated that dyspnea was frequently associated with retractions of the rib margins and lower sternum and that there also was grunting and cyanosis to a varying degree. Blystad showed that 15 of 25 dyspneic newborn prematures who died had hyaline membrane formation in the lungs. It is the purpose of this paper to present a clinical appraisal of the respiratory distress syndrome and further to demonstrate its relationship to the presence of pulmonary hyaline membrane at necropsy.
CLINICAL DIAGNOSIS
The newborn premature infant may manifest the respiratory distress syndrome by several physical findings. Characteristically he breathes as if he has glottic obstruction; intercostal retractions accompany strong inspiratory movements.
Staphylococcus Pyogenes and Its Relation to Disease
Authors: SPRUNT KATHERINE 
Published: December 2021

This is a lengthy review of the current state of our information on the "Staphylococcus pyogenes." As the author points out in his preface, workers in quite unrelated fields writing in many different tongues in journals of varied disciplines have all contributed to this pool of information, but the pool has become so vast and subspecialization therein so minute that there is real need for a monograph to help in the "merging of ideas."
The book goes a long way toward filling that need. There could not be much work that the author has not at least noted and his references are clearly documented. If for no other reason, his book would be valuable for its collection of about 200 pages of references which fortunately include titles.
RESPIRATORY ILLNESS IN CHILDREN SIMULTANEOUSLY INFECTED WITH HEMADSORPTION VIRUS TYPE I AND A NEWLY RECOGNIZED HeLa ENTEROVIRUS (HE)
Authors: Cramblett Henry G. , Kasel Julius A. , Utz John P. 
Published: December 2021

An outbreak of undifferentiated respiratory illness among children in a convalescent hospital is described. The illness was characterized by fever of short duration, erythema of the palpebral conjunctivae, rhinorrhea, cough, pharyngeal erythema and rhonchi.
Serologic and virologic evidence is presented indicating simulanteous infection in the involved children with type 1 hemadsorption virus and a newly-recognized HeLa enterovirus (HE virus).
GENETIC ASPECTS OF PEDIATRIC ENDOCRINOLOGY
Authors: Gardner Lytt I. , Rosenthal Ira M. , Feinberg Richard J. 
Published: December 2021

Dr. Gardner: Historically pediatricians have been in the vanguard of the social and scientific forces improving the health and well-being of their patients—the children of this country. Indeed, we have the heavy responsibility of carrying on the proud tradition of our professional great-grandfather, Dr. Abraham Jacobi, who came to these shores in the aftermath of the German Revolution of 1848, and who eventually rose to the presidency of the American Medical Association. As the pioneer in American pediatrics, Jacobi never failed to let his position be known on controversial issues. His intuitive Jeffersonian grasp of the democratic process facilitated his rôle in the early development of pediatrics here. Jacobi's coat has, in a sense, fallen upon our shoulders, and American pediatrics must continually be on the alert to live up to what he would have expected of us.
Therefore let me come directly to the problem at hand. As we know, the relative number of children with congenital defects in our hospitals is very much greater than 25 years ago. Recently in our hospital we tabulated the cases over a 5-month period, and found that 30% of the pediatric inpatients were there because of congenital defects. This apparent increase is almost certainly due in large part to the reduction in patients with infectious disease, but the figure of 30% still must remind us that the care of children with congenital defects is a field of major importance in modern pediatrics. How many of these defects are genetically determined is not known for sure, but certainly a considerable part of this group of patients represents inherited disease. As is obvious from the syndromes we will take up in this endocrine round table, nearly every one of these conditions is genetically determined, that is to say, the result of a mutation which has taken place in the human hereditary material.
Pediatric Neurology
Authors: PRICHARD JOHN STOBO 
Published: December 2021

It is generally considered that a good textbook should be either very complete or relatively short and readable, describing the most important clinical conditions in some detail and briefly mentioning the rest. This book is certainly not a comprehensive account of the neurologic diseases of childhood. Neither is it very short. But it does contain some useful material. In particular there is a practical account of the problems of cerebral palsy, and the cerebral infections are covered in some detail.
Some people will disagree with a number of statements in the book.
DELAYED NEUROPATHY AFTER INJURY TO THE CERVICAL SPINE IN CHILDREN
Authors: Zike Kenneth 
Published: December 2021

Two young children with severe, progressive, delayed neuropathy after trauma to the cervical spine were studied. The syndrome has not been reported previously in this age group. One patient succumbed 3 years after the injury, and the other is totally and permanently disabled 5 years after the injury by a spastic quadriplegia.
The danger of delayed neurologic disability after cervical trauma may be minimized by the following diagnostic and therapeutic considerations:
The possibility of cervical injury after trauma must be recognized and appropriate caution exercised in moving the patient, in planning diagnostic study and in assuring persistent close follow-up, even in young children.
When a patient is first seen with neuropathy after a silent interval, diagnostic suspicion is no less essential. Probing inquiry may be necessary to disclose the original injury. Careful attention to physical findings may localize the injury, suggest its nature and possible mechanism of occurrence.
Apparently normal routine roentgenograms of the cervical spine should not be allowed to exclude the diagnosis, particularly if they are incompatible with historic and physical information.
Whether the case is acute or chronic, no diagnostic path should be neglected until a firm diagnosis is clearly established.
Persistent follow-up is essential, even during periods of apparent remission.
Consultation should be undertaken freely with pertinent specialists whose particular skills may assist or be essential to a favorable outcome.