bluuebunny/crossref_metadata_2025_split huggingface dataset:
FACTORS INFLUENCING THE SUPPRESSANT EFFECTS OF TWO STIMULANT DRUGS ON THE GROWTH OF HYPERACTIVE CHILDREN
Authors: Safer Daniel J. , Allen Richard P. 
Published: December 2021

The effect of the regular intake of stimulant medication for two or more years on growth in weight and height was evaluated for 63 hyperactive children, 29 of whom received dextroamphetamine, 20 of whom received methylphenidate, and 14 of whom received no medication because of parental objection.
Major findings were: the long-term use of dextroamphetamine in hyperactive children causes a highly significant suppression of growth in weight and height; the long-term use of methylphenidate causes a less striking growth suppression only when daily doses over 20 mg are administered; tolerance develops to the weight suppressant effects of dextroamphetamine, but not to is inhibition of height growth; increasing the total degree of stimulant drug use over time generally increases the degree of growth suppression.
Objective Early Criteria for Ventilatory Assistance in Hyaline Membrane Disease
Authors: O'Boyle Meade P. , Fletcher Anne B. , Avery Gordon B. 
Published: December 2021

Ventilatory assistance utilizing a respirator and/or continuous positive airway pressure (CPAP) is commonly employed in the treatment of severe hyaline membrane disease (HMD).1 Artificial ventilation is indicated when the following classical blood gas criteria are met: (1) Pao2 [unknown] 40 mm Hg in an inspired oxygen concentration (Fio2) of 100%, (2) Paco2 [unknown] 70 mm Hg, (3) pH [unknown] 7.20, or (4) prolonged apnea.2,3 Typically, ventilation is postponed until the infant is moribund.4 Stern5 and Chernick and Vidyasagar6 suggest that earlier intervention might increase the survival of babies with HMD.
The classical blood gas criteria have been used at Children's Hospital of D.C. to indicate whether intervention is required.
ROLE OF THE CHILD PROTECTIVE ORGANIZATION
Authors: Cameron James S. 
Published: December 2021

A Review of recent literature and press pronouncements has no doubt left many confused about what degree of concern should be channeled into the problem of the abused child.
Part of the confusion results from a tendency to resort to the numbers game in trying to highlight the critical child welfare problems that face this nation, state, and city. Rather than wonder which numbers to believe, or whether physical and emotional battering of children is increasing, I think that the abuse and neglect of children in New York City is of such significant proportions as to justify our dedicated concern.
For some years there has been a specialized approach to the problems of the neglected and abused child. This specialized approach has been termed child protective services. It has been developed in response to the problems of abused and neglected children, which the community feels must be looked into and treated.
The Child Welfare League defines protective service as "A specialized child welfare service which carries a delegated responsibility to offer help on behalf of any child considered or found to be neglected."
The New York State Department of Social Services defines protective services as "Those provided to children living in their own homes who are seriously neglected, abused, or subjected to demoralizing circumstances by their parents or others responsible for their care."
Child protective service is not a new service. It has a very illustrious history that really started in this city, back in the late 1800s, through the development of the Society for the Prevention of the Cruelty to Children.
ENERGY METABOLISM AND PROTEIN SYNTHESIS IN HUMAN LEUKOCYTES DURING PREGNANCY AND IN PLACENTA RELATED TO FETAL GROWTH
Authors: Metcoff Jack , Wikman-Coffelt Joan , Yoshida Takashi , Bernal Alfonso , Rosado Adolfo , Yoshida Pablo , Urrusti Juan , Frenk Silvestre , Madrazo Ricardo , Velasco Luis , Morales Myriam 
Published: December 2021

Fetal malnutrition may compromise about 3% to 5% of pregnancies; about one-third of infants having birth weights below 2,500 gm may have fetal malnutrition and be "small-for-dates" (rather than premature). Fetal malnutrition predisposes to perinatal episodes of hypoglycemia, to congenital defects, and to poor postnatal growth, and may increase the chance for neurologic defects and/or poor mental development. Beside toxemia of pregnancy, unfavorable socioeconomic status predisposes to fetal malnutrition in our urban and rural populations, as poverty is a major factor in developing countries. To date, only circumstantial evidence relates maternal malnutrition to human fetal malnutrition.
Prevention of fetal malnutrition requires diagnosis early in pregnancy. Because metabolism of the peripheral blood leukocyte is distinctly altered in protein-calorie malnutrition, and at term in mothers who deliver infants with fetal malnutrition, it seemed worthwhile to investigate patterns of metabolism in maternal leukocytes during the last trimester. Metabolism of the peripheral blood leukocyte is presumably a reasonable index of cell metabolism in other organs such as liver and muscle, moreover, in some genetically determined enzyme deficiencies, the enzyme defect may also be found in the leukocyte. It, therefore, seemed likely that maternal leukocyte metabolism might serve as a "marker" for intrauterine growth of the fetus.
The present studies indicate some patterns of energy metabolism and protein synthesis during the last trimester of pregnancy. Energy metabolism, indicated by the ATP levels and adenylate and pyruvic kinase activities of maternal leukocytes, was shown to increase during the last six to eight weeks of gestation; RNA synthesis, reflected by the level of RNA polymerase activity in the maternal leukocyte, also rises and appears to correlate with the birth weight of the infant.
SERUM TOTAL CORTICOID AND CORTISOL LEVELS IN PREMATURE INFANTS WITH RESPIRATORY DISTRESS SYNDROME
Authors: Reynolds John W. 
Published: December 2021

Serum total corticoid and cortisol levels were measured in premature infants with fatal hyaline membrane disease (HMD), nonfatal HMD, and benign respiratory distress syndrome (BRD). The streoids were determined by a competitive protein-binding assay, the cortisol being isolated by LH-20 Sephadex column chromatography.
The mean cortisol level in the first three days of life was significantly greater in fatal HMD than in BRD (22.2 ± 3.7 SEM versus 6.8 ± 1.2 p. &lt; .001). The mean cortisol level also was greater in fatal HMD than in BRD after 6 days of age (10.9 ± 1.5 versus 3.5 ± 0.6 p. &lt; .001). Patients in all diagnostic categories responded to adrenal stimulation by cosyntropin with rises in serum cortisol levels. The elevated serum cortisol levels in fatal HMD are appropriate for the stress of the disease. The study provides no evidence that postnatal adrenal hypofunction plays a role in the pathogenesis or course of HMD.
Safety Clips Prevent Hemorrhage
Authors: Fischer Gerald W. , Scherz Robert C. 
Published: December 2021

Severe hemorrhage has been noted twice in our nursery due to accidental disconnecting of the three-way stopcock from the infusion tubing.
Hemorrhage or exsanguination is a known complication of umbilical artery catheterization and this most often occurs when the catheter is inadvertently removed from the artery by the baby or nursery personnel.
Because numerous manipulations of the stopcock are made during blood gas sampling, this also appears to be a potentially dangerous area for hemorrhage.
METHYLMALONIC ACID
Authors: Barness Lewis A. 
Published: December 2021

Methylmalonate studies have led to some understanding of vitamin B12 metabolism as well as certain inborn errors of metabolism. These, in turn, have served as models of a group of diseases related to acidosis, so that the study of organic aciduria at present is similar to that of amino aciduria 20 years ago. Techniques for studying these have been developed.
Many unanswered questions remain.
(1) What does methylmalonate do? Does it, itself, cause the acidosis? Does it cause a deficiency of succinate in the oxidative cycle?
(2) Are more direct ways of increasing succinate available?
(3) What is the relation of methylmalonate to combined system disease or vitamin B12 neuropathy?
(4) Are enzymes defective or absent?
(5) What is the significance of methylmalonate in the newborn?
(6) How does one counsel or treat families which include members with methylmalonic aciduria?
CHILDHOOD BURN INJURIES AND DEATHS
Authors: Berman William , Goldman Armond S. , Reichelderfer Thomas , Mofenson Howard C. 
Published: December 2021

Accidents kill more people in the United States between 1 and 34 years of age than any single disease. Burns are the second leading cause of nonvehicular "accidental" death. Thirty percent of the 7,800 Americans who die from burns each year are under 15 years of age. In the 1- to 4- year-old age group, burns are the leading cause of accidental death in the home environment and second only to vehicular injuries overall; in the 5- to 14-year-old age group, burn deaths place third, behind motor vehicle and drowning fatalities.1
Each year approximately 2 million people in the United States seek medical attention for burn injuries.
Atrioventricular Block Following Brain Abscess Aspiration
Authors: Rowland Thomas W. , Gharib Mohsen 
Published: December 2021

Significant cardiac conduction disturbance in patients with central nervous system disease rarely occurs. While commonly induced in the experimental animal the appearance of such arrhythmias in the human has been limited to single reports of ectopic tachycardia and atrioventricular (AV) block with several CNS disorders.1-5
This article presents a child with cyanotic congenital heart disease who developed persistent AV block following needle aspiration of a right thalamic brain abscess.
Case Report
L.D. is a 9-year-old girl with tetralogy of Fallot for which she has undergone three systemic-pulmonary arterial anastomoses. Following the last of these, a Waterston shunt in 1965, she had done well on digoxin, .090 mg twice a day with minimal exercise intolerance and cyanosis.
THE TEN-STATE NUTRITION SURVEY: A PEDIATRIC PERSPECTIVE
Authors: Lowe Charles U. , Forbes Gilbert B. , Garn Stanley , Owen George M. , Smith Nathan J. , Weil William B. , Filer L. J. 
Published: December 2021

In 1967 the 90th Congress of the United States attached an amendment to the Partnership for Health Act requiring the Secretary of the Department of Health, Education, and Welfare to undertake a survey of "the incidence and location of serious hunger and malnutrition–in the United States." In response to the legislative mandate the Ten-State Nutrition Survey was conducted during the years 1968 through 1970. The sample was selected from urban and rural families living in the following ten states: New York, Massachusetts, Michigan, California, Washington, Kentucky, West Virginia, Louisiana, Texas, and South Carolina.
The families selected were those living in some of the census enumeration districts that made up the lowest economic quartiles of their respective states at the time of the 1960 census. During the eight years after the 1960 census the social and economic characteristics found in some of the individual enumeration districts had changed, so that there was a significant numer of families in the surveys with incomes well above the lowest income quartile. Thus, it was possible in analyzing results to make some comparisons on an economic basis.
Thirty thousand families were identified in the selection process; 23,846 of these participated in the survey. Data regarding more than 80,000 individuals were obtained through interviews and 40,847 of these individuals were examined.
The survey included the following: extensive demographic information on each of the participating families; information regarding food utilization of the family; a 24-hour dietary recall for infants up to 36 months of age, children 10 to 16 years of age, pregnant and lactating women, and individuals over 60 years of age.
Pediatric Cardiology, ed. 3, by Alexander S. Nadas, M.D., F.A.A.P., and Donald C. Fyler, M.D., F.A.A.P. Philadelphia/London/Toronto: W. B. Saunders Company, 1972, 749 pp., $25
Authors: Lind John 
Published: December 2021

The third edition of Alexander Nadas' textbook has maintained the same general indexing as the earlier edition but a lot of the content has been revised and parts rewritten in cooperation with Dr. Donald C. Fyler. The general part on diagnostic work-up is crystal clear with high-class illustrations and covers most of the diagnostic routines in a cardiac unit.
Dr. Nadas, like so many of his transatlantic colleagues, seems convinced that the cardiothoracic index is the method of choice for the assessment of cardiac enlargement, a conviction that the reviewer finds hard to share.
HIPPOCRATES ON THE SEVEN DIVISIONS OF A MAN'S LIFE
Authors: C. T. E. 
Published: December 2021

Hippocrates (c460-c360 B.C.) divided a man's life into periods of seven, connected no doubt with the mystic significance attached at a much earlier time in the world's history to the number seven.
He wrote:
"In man's nature their are seven periods which they call ages; infant, child, adolescent, youth, man, elderly man, old man: an infant is up to 7 years, the cutting of teeth; a boy up to the beginning of puberty, 14 years; an adolescent, up to the appearance of down on the chin at 21 years; youth to the end of development at 28 years; man up to 49 years; elderly, up to 57 years; and after this an old man."1
ANOMALOUS PHENYLALANINE LOADING RESPONSES IN RELATION TO CLEFT LIP AND CLEFT PALATE
Authors: Tocci Paul M. , Beber Bernard 
Published: December 2021

Oral phenylalanine loads were given to 15 mothers of children with cleft lip and palate defects and 19 control women. Four of the 15 mothers exhibited unusual tolerance curves, i.e., the phenylalanine levels did not rise appreciably during four hours nor did the tyrosine levels increase normally.
Two of the women studied also showed a deviation from normal in the appearance of tyrosine in the blood after a tyrosine load. Attempts to stress the mothers who exhibited a normal response to the single phenylalanine load by giving them a double load were not successful. The possible implications of these findings are discussed.
THE FINAL ANSWERS TO SINGLE UMBILICAL ARTERY?
Authors: Benirschke Kurt 
Published: December 2021

When the "Collaborative Study"1 was conceived it was undertaken with the hope of obtaining definitive answers to some complex questions in the field of obstetrics and perinatology. It could be anticipated that, by the meticulous collection of data on prenatal, natal, and postnatal events in thousands of pregnancies, indisputable evidence might be gained as to certain causes of mental retardation, birth defects, infectious complications of pregnancy, and the like. Ultimately, it was hoped that the application of such evidence might lead to measures for prevention.
The study was enormous. An incredible amount of data still awaits analysis. The paper by Froehlich and Fujikura1 in this issue is but one small step toward the realization of the goals originally set.
CONTINUING MEDICAL EDUCATION FOR PEDIATRICIANS
Authors: Klingberg William Gene , Bailey John , Bell William Reed , Birdsong McLemore , Cherry Arthur C. , Cortner Jean A. , Fowler Richard E. L. , Gellis Sydney S. , Grossman Moses , Oliver William J. , Robertson William O. , Robinson Saul J. 
Published: December 2021

Recognizing the paramout importance of optimal health care for all children as a legitimate concern of pediatricians and of all society, the American Academy of Pediatrics reiterates its long-standing commitment to pediatric education in its broadest sense including undergraduate, graduate, and continuing medical education. Several approaches to assure the quality of such care, such as peer review, evidence of participation in continuing education activities, and recertification have been suggested by a variety of governmental and other nonprofessional agencies. The Academy believes strongly that such undertakings must remain the responsibility of appropriate medical organizations and that the appropriate organization in all affairs related to the health of children is the American Academy of Pediatrics.
The Academy desires, therefore, to assist its members in maintaining and improving their expertise and in preparing them to demonstrate their ability to respond to the demands of a changing society. Recognizing that society will require demonstration of expertise and ability to maintain quality of health care, the Academy has assumed the initiative in developing methods for the determination of competency. Vital to the maintenance of such competency is the level of continuing education. The Academy reaffirms its determination to assist the pediatrician in maintaining and demonstrating his competence.
BALANITIS XEROTICA OBLITERANS: REPORT OF A CASE IN AN 11-YEAR-OLD AND REVIEW OF THE LITERATURE
Authors: Mikat Dorothy M. , Ackerman Howard R. , Mikat Kurt W. 
Published: December 2021

An 11-year-old male with phimosis was found to have balanitis xerotica obliterans on the foreskin, apparent grossly and microscopically as indurated plaques. This relatively uncommon sclerosing disease is most common between 30 and 49 years of age.
This particular child is the youngest reported in the American literature to have this condition. It may be more common than presently recognized and physicians should be familiar with the appearance and treatment because of the severe, progressive urological complications that may ensue. Recommended therapy includes total excision of the lesion or topical or intralesional corticosteroids if the lesions are unexcisable.
LENNOX'S SYNDROME AND LEAD INTOXICATION
Authors: Fejerman Natalio , Gimenez Estela R. , Vallejo Norma E. , Medina Carlos S. 
Published: December 2021

Three male and two female children with Lennox's syndrome linked etiologically with lead intoxication were followed for up to three years. The diagnosis of Lennox's syndrome was made on the basis of clinical and EEG findings which are categorized in detail. Biochemical determinations used for the detection of "undue absorption of lead" were lead blood levels, urinary lead excretion, and delta-amino-levulinic-acid dehydratase (ALA-D) concentration in erythrocytes, considering a positive diagnosis of lead intoxication upon the finding of decreased enzymatic activity plus values higher than normal for lead blood levels or lead excretion in urine.
Significant improvement in the EEG abnormalities and/or the number of seizures has been observed in these five patients after specific treatment of their plumbism, without changes being made in the concomitant anticonvulsant therapy. Two patients are free of seizures and their EEGs became normal. Two other patients had only one seizure in the last year and their EEGs now show only sporadic spike foci.
These findings open new possibilities for etiological diagnosis and therapeutic approach for some of the patients with chronic epileptic encephalopathies with slow spike-and-wave discharges in the EEG.
Validity of Neonatal Blood Pressure Obtained By The Manometric Method
Authors: Leake Rosemary D. , Williams Paul R. , Oh William 
Published: December 2021

In neonatal intensive care units where direct arterial blood pressures obtained via a transducer are unavailable, a fluid-filled spinal manometer has been used. The latter method is practical and convenient although its validity has not been confirmed. This study is designed to establish the precise relationship between the blood pressure obtained by the manometric method and by direct recording via the arterial transducer.
Materials and Methods
Eleven infants with umbilical artery catheters in place 1 to 2 cm above the diaphragm were selected for the study. In all instances, the arterial catheters were placed for clinical management of various illnesses.
Letters to the Editor
Authors: Metcalf Thomas J. 
Published: December 2021

Drs. Piomelli et al.1 propose the free erythrocyte protoporphyrin (FEP) test as a screen for "undue lead absorption." With the backing of Dr. Chisolm's Commentary,2 the FEP test may become the method of choice for screening population at risk for lead toxicity.
I would like to suggest three points of caution: (1) By defining "undue risk" in terms of "ambiguous levels" of 40 to 59µg/100 ml of whole blood lead, the authors may miss the significant number of children shown by Drs. de la Burdé and Choate3 to have behavioral and fine motor deficits after asymptomatic lead exposure (&gt; 30 to 40µg/100 ml with radiological evidence of ingestion).
LINEAR NEVUS SEBACEOUS SYNDROME: REPORT OF TWO CASES AND A REVIEW OF THE LITERATURE
Authors: Lovejoy Frederick H. , Boyle William E. 
Published: December 2021

Two cases of linear nevus sebaceous syndrome are described and a review of the eleven cases now reported in the literature is undertaken.
The first patient has retardation, seizures, and classic ectodermal lesions while the second patient manifests typical cutaneous lesions and only an elevated cerebrospinal fluid protein as evidence of neurologic disease. The rationale for defining the syndrome as an entity distinct from other neurocutaneous syndromes is discussed and a pleomorphic presentation of the syndrome is suggested.
HEALTH EDUCATION
Authors: Rinker Andrew , Eldredge L. L. , Poncher John R. , Rogers Kenneth D. , Shackleford E. C. , Schell Norman B. , Sia Calvin C. J. , Smull Ned W. , Schneider Elsa , Shultz Carl S. 
Published: December 2021

The American Academy of Pediatrics has long supported preventive health measures as part of comprehensive health care to all children and youth. Health education of children is an essential ingredient in the prevention of disease and the promotion of good health and optimal development.
Good health is a dynamic state of physical, mental, and social well-being which is influenced by many environmental and hereditary factors over which an individual exercises varying degrees of control. It is a constantly changing entity, and acquisition of good health should never be left to chance.
Many Americans do not understand, accept, or utilize current biologic, psychologic, and social knowledge. They obviously are not profiting from medical and technological achievements. The dissemination of general health information and its utilization for healthful living both need to be improved.
Parents and parental attitudes are the most important and basic elements of any successful health education program. Health education begins during infancy in the home, and the school is a supplementary and complementary element to the home experiences. Further development, correction, and reinforcement of knowledge, attitudes, and habits of health begun in early life should be among the essential objectives of formal education.
The pediatrician is experienced in caring for the total child and is well aware of personal and social tragedies that might have been avoided by adequate health education, therefore, he is especially sensitive to the need for optimal health education programs in the schools. Health education is a core element in comprehensive health care delivery. Understanding of this fact by schools and parents is essential if all children are to enjoy the good health and successful living potentially available to them.
FETAL MALNUTRITION IN WHITE NEWBORN INFANTS: MATERNAL FACTORS
Authors: Miller Herbert C. , Hassanein Khatab 
Published: December 2021

Fetal malnutrition was diagnosed in white, full-term infants who had low ratios of birth weight to body length in the presence of characteristic physical signs of malnutrition and in the absence of clinical evidence of congenital defects and intrauterine infections.
The maternal factors significantly associated with fetal malnutrition included a poor maternal weight gain, lack of prenatal visits, the unmarried state, preeclampsia, chronic major illness, and obesity. Two or more of these six maternal factors occurred in 51% of pregnancies involving malnourished infants, and in 9% of pregnancies involving control infants.