bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONGENITAL MEGACOLON
Authors: SWENSON ORVAR 
Published: December 2021

TWO years ago I had the privilege of presenting to this Academy our concepts of the pathology, the related dysfunction of the colon, and the surgical treatment of congenital megacolon. I should now like to relate our interim clinical experience with these patients and particularly to stress diagnostic criteria of this disease.
Children with constipation should, from a practical standpoint, be divided into two groups: those with chronic constipation on a habit or psychologic basis who should be treated medically; and those with congenital megacolon who should be treated surgically. The differentiation of the two groups is usually not difficult from the information gained in taking the history and performing the physical examination. The large majority of our patients with congenital megacolon have a history of constipation from birth. Often obstipation, vomiting and abdominal distention have been of such prominence during the first few days of life that a diagnosis of intestinal obstruction has been entertained and exploration occasionally performed. A considerable number of infants die of congenital megacolon in the first weeks of life. The surviving infants continue to have varying amounts of constipation with intermittent abdominal distention and require frequent enemas or some other aid in evacuation. In contrast to this the children with chronic constipation on a habit basis have histories of no symptoms until they are 2 or 3 years of age, and abdominal distention is rarely present. Furthermore, there is usually a history of parental overanxiety concerning intestinal function, and this emotional attitude toward the child's problem accounts for their tendency to exaggerate symptoms.
ADRENAL FUNCTION IN PREMATURE INFANTS
Authors: LANMAN JONATHAN T. 
Published: December 2021

The urinary formaldehydogenic steroid excretion was measured in 5 ACTH-treated premature infants and in 3 premature infants born of toxemic mothers. One of these toxemic mothers received no therapy, one received ACTH antepartum, and one cortisone antepartum. Na, K and N balance studies were conducted in three of the above infants.
Steroid excretion rose during ACTH administration and fell 2 to 4 days after discontinuance of ACTH therapy. The fall was followed by a moderate rise, or rebound, in some cases. These findings indicate that the adrenals of young infants have a functional reserve and are capable of responding to either an increase or a decrease in the adrenocorticotrophic stimulus by a corresponding change in steroid production. This response resembles that seen in normal adults and is further evidence that this aspect of adrenal function is not impaired during involution of the fetal adrenal cortex.
ACTH administration in one infant produced an increase in sodium excretion during the first 16 days of therapy. This response is the opposite of that usually found in normal adults, and confirms a similar previous finding reported by Klein. Under continued ACTH therapy, the infant ultimately retained Na as does the normal adult. The cause for this early abnormal response is unknown, but it resembles one seen in adults with Cushing's disease, in whom desoxycorticosterone induces a loss of sodium.
The infant born of the cortisone-treated toxemic mother had normal postnatal urinary steroid values; the infant born of the ACTH-treated toxemic mother had unusually high postnatal values. These observations suggest that cortisone failed to cross the placenta in sufficient quantity to influence steroid excretion of the infant, but that ACTH administered to the mother reached the fetus and stimulated his adrenals.
ESTUDIO SOBRE EL NIÑO DESNUTRIDO
Authors: GÓMEZ POR FEDERICO , GALVÁN RAFAEL RAMOS , CRAVIOTO JOAQUIN , FRENK Y SILVESTRE 
Published: December 2021

The study of the enzymatic activity in duodenal contents of 40 patients affected with third degree malnutrition shows that this activity was decreased with specially low figures for lipase.
A definite increase in enzymatic activity was discovered when the nutritional state of the patient improved, but no correlation was found between the figures for serum albumin and the amounts of pancreatic enzymes. Neither was there any correlation found among enzymatic activity, appetite, and diarrhea.
This study seems to prove there is a delay in the absorption of nonmodified protein in patients affected with third degree malnutrition.
The finding of decreased enzymatic activity in both Kwashiorkor and third degree malnutrition is another reason to consider that both illnesses are only a group of syndromes caused in most instances by the same common factor which is chronic undernourishment.
SPECIAL REVIEWS
Authors: HORSFALL FRANK L. 
Published: December 2021

THERE has arisen recently a tendency toward thinking that infectious diseases no longer present problems of social importance in the economically more advanced countries. This tend is more notable among a few biologists who are concerned with ideas about diseases than among physicians who are confronted daily with infectious diseases as established facts. The origin of the idea is easily traceable to the striking effects that modern antimicrobial drugs have had on the mortality of many severe infectious processes. Not only has the over-all mortality from microbial infections been diminished, but also, and more dramatically, the mortality in childhood has been greatly reduced. Judged from the viewpoint of the mortality statistician, the millennium is at hand and microbial infection need not be an important cause of untimely death. However, as every physician knows, infections are as common as in the old days and morbidity statistics have not been much improved by chemotherapeutic successes.
If viral diseases of the respiratory tract were the killers that untreated microbial infections of this tract are, no one could suppose that infectious diseases may be considered as only of minor importance. Although relatively few patients die of respiratory viral infections, the burden of disease they cause is enormous, greater than that of all other maladies in combination. It appears that mankind suffers throughout at least one-tenth of its life span from viral diseases of the respiratory tract. One may take the view that a cold on some other acute respiratory illness is an unpleasant inevitability which may go away in a week on so. However, the patient with one has a different view of the misery experienced and the time lost and knows, too, that another won't be too long in coming. His question is: What can be done to stop these things and let me get on with what I was doing?
At least seven separate viral diseases of the respiratory tract have been recognized and identified through careful study.
HEREDITARY ELLIPTOCYTOSIS ASSOCIATED WITH INCREASED HEMOLYSIS
Authors: Josephs Hugh W. , Avery Mary Ellen 
Published: December 2021

Three cases of hereditary elliptocytosis have been presented. The criteria for diagnosis have been (1) the presence of a high percentage of elongated cells in stained smears and wet preparations, and (2) the finding of elongated cells in other members of the family including one parent in each case.
All 3 children had a marked anemia when first seen. Case 1 had an outspoken hemolytic anemia at 2 months of age. His hemoglobin is now practically normal, but he still has a slight but persistent reticulocyte increase. Cases 2 and 3 were first thought to be due to iron deficiency anemia. While iron deficiency may have been responsible for the degree of anemia that brought the cases under observation, a slight but persistent elevation in both reticulocyte count and stool urobilin concentration indicated the presence of increased hemolysis. The findings of a shortened erythrocyte life span in Case 3 supports this conclusion.
A review of the literature makes it clear that hereditary elliptocytosis is a potentially hemolytic disease. However, in the great majority of the cases the elliptocytosis appears as a harmless anomaly without pathological significance. In a certain number, to which considerable attention is now being paid, there may be a hemolytic anemia sometimes of a severity sufficient to require splenectomy. Between these 2 extremes there lies an indeterminate group in which there is evidence of hemolysis if one looks for it, in which there may or may not be anemia, and in which it is not always easy to know if the patient's symptoms are part of the disease. It is to this group that our patients belong.
LOW BIRTH WEIGHT IN FIBROCYSTIC DISEASE OF THE PANCREAS
Authors: Boyer Paul H. 
Published: December 2021

The mean birth weights of 75 white females and 98 white males with fibrocystic disease of the pancreas were compared with the mean birth weights of control female and male infants. For each sex the mean birth weight of patients with fibrocystic disease of the pancreas was significantly lower than the mean for the control population.
The proportion of male and female infants whose birth weights were above 3000 gm., in the control population and in the group of patients with fibrocystic disease of the pancreas, was calculated. The percentage for patients with fibrocystic disease of the pancreas was much less than the one for control infants. The difference between the 2 groups was statistically significant.
The analysis of these figures favors the hypothesis that in fibrocystic disease of the pancreas there is a fetal or maternal metabolic disturbance of undetermined nature that apparently interferes with the normal growth of the fetus.
The mean birth weight of unaffected infants born to women who had followed a special pregnancy diet after having had a previous pregnancy resulting in a child with cystic fibrosis, was higher than the average birth weight for control newborns. The difference was of no statistical significance.
The mean birth weight for infants with fibrocystic disease of the pancreas whose mothers followed a special pregnancy diet was higher than the calculated mean birth weight for patients with fibrocystic disease of the pancreas whose mothers received no comparable dietary advice during pregnancy. The difference was not significant.
The known effect of a high protein intake during pregnancy, in enhancing the infant's birth weight, appears to apply even when the infant proves to have fibrocystic disease of the pancreas.
There is no clear explanation for the tendency to low birth weights in infants with fibrocystic disease of the pancreas. It seems logical to suggest that maternal or fetal metabolic factors may be responsible. The fact that the birth weight and perhaps the incidence of the disease may be modified by a liberal diet during pregnancy is a point that deserves further study.
REVIEW ARTICLE
Authors: Gajdusek D. Carleton 
Published: December 2021

CURRENT opinion is divided as to the role of the encephalomyocarditis (EMC) group of viruses in human disease. In the serologic survey of Tarahumara Indians reported elsewhere in this issue it has been shown that antibody neutralizing significant amounts (namely, 20, 80, 1000, and 6000 LD50, respectively) of the AMS strain of EMC virus was found in 4 of the 56 serum specimens studied. This finding serves to focus attention again on the scattered reports suggesting the EMC virus as an etiologic agent in human disease.
History of the Discovery of EMC Viruses
Jungeblut and Sanders isolated from cotton rats inoculated with Yale-SK strain of poliomyelitis virus, a virus different from that which they had inoculated. They designated this new agent "Columbia-SK." Later Jungeblut and Dalldorf isolated an agent they called MM-virus from hamsters inoculated with central nervous system (CNS) tissue of a fatal case of undiagnosed paralysis suspected of being poliomyelitis. Many workers have assumed that these first isolations were of viruses latent in the laboratory rodents. Helwig and Schmidt obtained encephalomyocarditis (EMC) virus from a captive chimpanzee with myocarditis and hydrothorax in Florida; and Dick, Best, Haddow, and Smithburn obtained so-called Mengo encephalomyelitis virus in Uganda from a paralyzed rhesus monkey, later from mosquitoes (Taeniorrhynchus fuscopennatus), and from a wild mongoose caught near the monkey compound in Entebbe, Uganda. Accidental infection of a laboratory worker in Entebbe with Mengo virus demonstrated the pathogenicity of this agent for man. The worker developed an encephalitic illness and the virus was isolated from his serum.
THE TREATMENT OF HYPERTHYROIDISM IN CHILDHOOD WITH THIOURACIL DRUGS
Authors: Van Wyk Judson J. , Grumbach Melvin M. , Shepard Thomas H. , Wilkins Lawson 
Published: December 2021

During the past 10 years thiouracil and propylthiouracil have been used to treat all children with hyperthyroidism in the Harriet Lane Home Endocrine Clinic. Follow-ups are available on 16 children whose disease began before 13 years of age. Eight of this group are now in a period of prolonged remission; 4 have required subsequent surgery, and 4 are still under treatment. The occurrence of adolescence has not been found to induce a relapse in any child who was previously in remission.
Reduction in the size of the goiter while the patient is receiving treatment has been found to be the best prognostic sign. The combined use of thyroid with antithyroid drugs has caused involution of the gland in those patients whose goiters remained large after treatment with propylthiouracil alone. The ultimate value of this combined treatment remains to be determined.
It is recommended that surgery be reserved for those children who are sensitive to antithyroid drugs, who fail to co-operate or cannot be followed closely. In the remainder, treatment with antithyroid drugs should be continued until there is substantial reduction in the size of the gland. A period of 2 years of continuous therapy is suggested as the minimal period of treatment.
The Pathogenesis of Poliomyelitis
Authors: WENNER HERBERT A. 
Published: December 2021

This book, written by one who can speak as an authority, is commended to students of medicine, to practitioners, and to investigators in the infectious diseases. The author has spent more than 20 years investigating the movement of poliomyelitis virus in body tissues. This monograph brings together much of that research and interprets it in the light of the author's experiences.
The theme of the monograph is that poliomyelitis virus has a basic neuronocytotropism. Dr. Faber considers the primary sites of virus multiplication to be the peripheral ganglia of the nervous system.
COMMITTEE ON NUTRITION
Authors:   EXECUTIVE BOARD, American Academy of Pediatrics, Inc.
Published: December 2021

THE Committee on Nutrition of the American Academy of Pediatrics was established as a Scientific Committee by action of the Executive Board on April 1, 1954. It was created through due recognition of the importance of nutrition in the welfare of infants, children and adolescents. It had become evident that there should be an authoritative body, particularly concerned with the science and practice of nutrition in the periods of rapid growth which occupy the attention of pediatricians. In this manner it was hoped that special consideration of factors which affect the nutrition of infants, children and adolescents could be emphasized.
The Committee should include persons capable of compiling and appraising the pertinent facts and who also would be sensitive to the needs of practitioners and to the position of purveyors of products intended for the nutrition of infants, children and adolescents.
This Committee of the Academy shall offer guidance in selecting means of achieving optimal nutrition in those periods of rapid growth. Consultation and cooperation with other existing authoritative bodies are considered desirable.
The Executive Board of the Academy on September 29, 1955, defined the scope and functions of the Committee on Nutrition to include:
1. Compilation of the essential facts which are the scientific basis for practical nutrition of infants, children and adolescents.
2. Publication of the findings of the Committee in a form suitable to convey the information to physicians, such as brief reports and commentaries in the official journal and publications of the Academy.
This Committee shall concern itself with standards for nutritional requirements, optimal practices and the interpretation of current knowledge of nutrition as these affect infants, children and adolescents.
COMMITTEE ON SCHOOL HEALTH
Authors:   COMMITTEE ON SCHOOL HEALTH
Published: December 2021

COMPETITIVE athletics for children is an important subject; it is also a controversial one. It is generally agreed that athletic programs for children of all ages are a necessary part of their education and recreation. There are differences of opinion as to the time in a child's life at which games requiring considerable co-ordination should be introduced and the extent to which such games should be organized on a competitive basis. Because of this, educators, community leaders in recreation, and particularly parents, often turn to physicians, especially pediatricians, for guidance and direction when they consider the development of athletic programs. To aid physicians in this advisory role, the Committee on School Health of the American Academy of Pediatrics has summarized its study of the subject.
A considerable fund of information as to extent of organized competitive athletic programs among children and as to the effects these programs has been accumulated from the experience and investigation of recognized leaders in the fields of education and recreation, who have collaborated with interested and informed physicians. Those concerned with sports programs for children should give careful consideration to the opinions repeatedly expressed by these groups. Many of these opinions are contained in the appended reference list. The American Academy of Pediatrics definitely encourages and promotes continuing research to establish sound policies.
The Committee on School Health has considered the subject under the following headings:
Age
We are concerned in this statement with the question of competitive athletics for children 12 years of age and under.
IN-VITRO RESPONSE OF ENTEROPATHOGENIC ESCHERICHIA COLI TO VARIOUS ANTIBIOTICS
Authors: Metzger William I. , Jenkins Charles J. 
Published: December 2021

Bacteriostatic and bactericidal action of various drugs were determined against 147 and 112 strains, respectively, of enteropathogenic E. coli of diverse origin.
Because of its over-all effectiveness combined with a high degree of killing action, neomycin would seem to be the drug of choice for the treatment of infantile diarrhea of E. coli etiology.
Of the bacteriostatic drugs tested, both the tetracycline group and chloramphenicol exhibited a degree of activity that would account for their clinical usefulness in this disease. However, fewer strains of E. coli were resistant to chloramphenical than to the tetracyclines.
Variation in bacteriostatic response occurred with all drugs but was most pronounced with the tetracyclines. The degree of variation emphasizes the need for laboratory control in the treatment of infantile diarrhea due to enteropathogenic E. coli.
The tetracycline drugs do not always show equal activity in the lower drug ranges, although cross resistance is common, and free substitution of one for the other is not recommended.
Streptomycin showed poor activity against most of the strains tested and probably would be of little value in most clinical cases.
All four serotypes exhibited the drug patterns noted but the group 0127:B8 contained the largest number of resistant strains.
CLINICAL CONFERENCE
Authors: Cassels Donald E. 
Published: December 2021

Dr. Cassels: In April, 1954, a 19-month-old white female was admitted to the hospital. Her family history was irrelevant. She had a normal birth and had not been ill until about a week before admission. At that time, while sitting at the table eating, she suddenly made a noise, threw up her hands and became unconscious, and would have fallen if she had not been caught. She regained consciousness, and promptly again lost consciousness. On the way to a neighborhood hospital she regained and lost consciousness twice. During the first 24 hours of illness she had eight episodes of unconsciousness. In each of these she was limp and flaccid. At no time was there any rigidity or movement nor did she vomit or lose sphincter control. At that hospital it was noted that the eyes were swollen somewhat and the abdomen was protuberant. Urinalysis revealed 2+ albumin. No other abnormalities were found.
On admission to Bobs Roberts Hospital there was only a trace of albumin in the urine without other abnormalities. The eyes were swollen, the abdomen greatly distended, and the liver was very large. There was no evidence of cardiac disease and the blood pressure was normal in all extremities.
During the first month or two of hospitalization she was quite distressed. She had difficulty in breathing, urinated poorly, and developed marked generalized edema. She had astonishing dyspnea without orthopnea and, curiously, she sought peculiar positions of comfort in the oxygen tent. One of the peculiar positions of comfort was lying on the left side, turned at about a 45-degree angle toward a face-down position. She resumed this position repeatedly when moved for examination or nursing care and resisted the usual sitting position assumed for comfort by a patient with respiratory distress.
FURTHER OBSERVATIONS ON HOMEOSTATIC DISTURBANCE IN ACRODYNIA
Authors: Cheek Donald B. 
Published: December 2021

On the basis of data obtained from four cases of acrodynia, it was found that deficits of total body chloride and water were present. Normal concentrations of electrolytes and acid-base balance were, for the most part, preserved while the volumes of the fluid compartments were reduced.
Investigations relating to sweat in one patient showed that the volume was excessively high while the concentration of electrolyte was low—circumstances that arise to a lesser degree when a normal infant is subjected to heat stress. It was demonstrated that such losses could lead to chloride deficiency when the intake of food is inadequate. The insensible water loss was also very high, a prediction of increase in body metabolism.
Balance studies did not suggest a stable restoration of chloride and water. It was postulated that mercury gives rise to loss of salt through the kidneys with polyuria and sharp loss of weight early in the course of the disease, followed by a continued state of water and chloride deprivation.
The venous pressure was significantly elevated in three patients and in one patient the concentration of 17-hydroxcorticosteroids in the plasma was at the upper limit of normal. The findings concerning urinary excretion of 17-ketosteroids confirmed once again an increased production. Evidence was cited that patients with acrodynia can be resistant to the sodium-retaining action of desoxycorticosterone.