bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arterial Thrombosis Following Femoral Venipuncture in Edematous Nephrotic Children
Authors: GOLDBLOOM RICHARD B. , HILLMAN DONALD A. , SANTULLI THOMAS V. 
Published: December 2021

In a recent discussion McKay emphasized certain hazards which may attend venipunctures which are performed for blood sampling.
We wish to call attention to a particular situation in which attempts to perform femoral venipuncture may be hazardous. We have seen three children who were affected with the idiopathic nephrotic syndrome and were edematous. In each instance attempts at femoral puncture were followed by arterial thrombosis requiring amputation of part of the lower extremity.
Case No. 1
An 18-month-old boy with nephrosis and edema was seen by one of us in consultation because evidence of acute right femoral artery occlusion had developed following femoral venipuncture.
THE ELECTROENCEPHALOGRAM IN CHILDREN WITH MINIMAL CEREBRAL DYSFUNCTION
Authors: Capute Arnold J. , Niedermeyer Ernst F. L. , Richardson Frederick 
Published: December 2021

The electroencephalogram (EEG) of 106 children with the syndrome of "minimal cerebral dysfunction" showed normal tracings in 53 cases and abnormalities in 53 cases. In 45 children the abnormalities ranged from "slight" to "moderate" while only 8 patients had markedly abnormal records. The incidence of paroxysmal abnormalities was low (14 patients, 6 of them exhibiting markedly abnormal EEG's), and non-focal abnormalities were more frequently encountered than focal deviations. Only five abnormal tracings were obtained in a control group of 33 physically and mentally healthy children. Patients with overt convulsive disorder, mental retardation, and gross neurological deficits were not included in the study.
This study de-emphasizes the diagnostic significance of the 14 and 6 per second positive spike pattern. There is also little reason to attribute the hyperkinetic and aggressive outbursts to epileptic mechanisms since seizure potentials were seldom encountered in our material.
The EEG is a valuable diagnostic tool in minimal cerebral dysfunction in spite of the fact that no specific findings can be expected. The diagnosis of minimal cerebral dysfunction should not be based upon the EEG alone.
ENDOGENOUS RENAL TRANSPORT OF FREE AMINO ACIDS IN INFANCY AND CHILDHOOD
Authors: Brodehl Johannes , Gellissen Karl , Jäkel Annemarie 
Published: December 2021

Endogenous renal transport of free amino acids was determined in 12 infants, between the ages of 16 days and 4 months, and in 12 children, between 2 and 13 years of age. Values of the serum concentrations, urinary excretion, renal clearance rates, net tubular reabsorption, and percentage tubular reabsorption of 17 amino acids were obtained by short-term clearance studies, including the determination of the glomerular filtration rate by inulin. The amino acids were determined by ion exchange chromatography.
A comparison of the values of infants and children revealed a specific feature of the kidney function in infancy. The urinary excretion of threonine, serine, proline, glycine, and alanine and the clearance rates of serine, proline, glycine, and alanine were significantly higher in infancy. The percentage tubular reabsorption of all amino acids was characteristically lower in infancy than in childhood, while the values of the net tubular reabsorption related to the glomerular filtration rate (TAA/CIn) were equal in both groups. These findings are thought to be due to a greater degree of heterogeneity of nephrons with increased glomerulotubular imbalance during the period of postnatal kidney development.
IgG-B1C CRYOGLOBULINS IN ACUTE GLOMERULONEPHRITIS
Authors: Grupe Warren E. 
Published: December 2021

Eight children have been examined with cryoglobulinemia in association with acute post-streptococcal glomerulonephritis, representing 31% of patients admitted with that diagnosis in a 28-month period. The clinical features distinguishing these eight children include anemia (Hct &lt;28%), a more marked elevation of the erythrocyte sedimentation rate than usually seen (&gt;60 mm/hr) and hypergammaglobulinemia (&gt;20%). The cryoglobulins have persisted from 2 weeks to 3 months after the onset of the renal lesion. Electrophoresis of fresh serum disclosed a distinct band with a mobility in the fast gamma region which disappeared with removal of the cryoglobulin; in these instances, the electrophoretic mobility of the isolated cryoglobulin was similar to the band seen in whole serum. All isolated cryoglobulins contained IgG and B1C globulins by immunodiffusion and immunoelectrophoresis; one of them contained trace amounts of IgA in addition and another contained small amounts of IgM.
Renal biopsy in four cases confirmed acute proliferative glomerulonephritis, and granular deposition of IgG and B1C along capillary loops has been observed by fluorescence microscopy in the three cases examined. Although their significance is unknown, the presence of a cold precipitable complex of IgG and B1C globulins in the serum and the presence of these same proteins in the glomeruli of children with this disease would suggest that cryoglobulins might be of immunopathologic importance in certain cases of acute glomerulonephritis.
Torsion of the Hydatid Testis: A Review of Thirteen Cases
Authors: Bender Leon , Prinz Leon , Presman David 
Published: December 2021

The clinical and pathological findings in 13 cases of torsion of the hydatid testis are reviewed.
The etiology of this condition can be correlated with the morphological characteristics of the hydatid present in children and young adults.
Emergency exploration is mandatory because of the difficulty in differential diagnosis from torsion of the spermatic cord with gangrene of the testis.
THE AGE OF ATTAINING BLADDER CONTROL
Authors: Oppel Wallace C. , Harper Paul A. , Rider Rowland V. 
Published: December 2021

Data in life table form are presented from a 12-year prospective study of 859 children on the age of attaining bladder control for waking and sleeping hours by three indices: (1) age of initial dryness, (2) age of final dryness, and (3) the prevalence of dryness. By use of these indices the large contribution of relapsers to enuresis is seen.
The prevalence of bedwetting in the study population was greater than that reported in other studies; the validity of this finding is defended.
A larger proportion of female than male children attained both day and night dryness during the first 2 years of life. The percentage of Negro boys who first attained dryness was less than that of the other three race-sex groups after 2 years of age and was significantly less than that of Negro girls until 9 years of age.
One quarter of the 817 children who attained initial nighttime dryness by age 12 relapsed; these relapsing episodes had a median duration of 2.5 years. One tenth of 855 children who attained initial daytime dryness had relapses, and the median length of these was 1.2 years. Relapsing occurred much more frequently in Negro than Caucasian children; it also was seen more often in Caucasian males than in Caucasian females. Low birth weight children had a higher percentage of children wet for both waking and sleeping hours than did full birth weight children.
ADVANTAGES AND COMPLICATIONS OF UMBILICAL ARTERY CATHETERIZATION IN THE NEWBORN
Authors: Cochran William D. , Davis Heather T. , Smith Clement A. 
Published: December 2021

During a period of 5 years, 8 months, umbilical artery catheterization was performed on 387 infants in a newborn nursery. The indwelling catheter, at first introduced only to secure arterial blood for diagnostic and investigative purposes, was subsequently employed for intravascular fluid therapy in the same infant, and ultimately (in 51 of the 387 infants) for such fluid therapy alone. Complications observed were either vasospasm and temporary blanching of an extremity (13 infants: 11 surviving without apparent sequelae, 2 dying but without local complications at autopsy) or thrombosis, arteritis, or other inflammation noted at postmortem (18 infants).
Such complications were not causes of death at autopsy, but their finding suggests the need for limiting the procedure to infants in whom any other route of blood sampling or fluid administration is particularly difficult.
SLEEP CYCLE CHARACTERISTICS IN INFANTS
Authors: Stern Evelyn , Parmelee Arthur H. , Akiyama Yoshio , Schultz Marvin A. , Wenner Waldemar H. 
Published: December 2021

Within the sleep of adults and infants there are cyclic fluctuations between quiet and active sleep. These fluctuations may also persist during wakefulness as rest-activity cycles but are less readily detected. They constitute a fundamental biological rhythm on which other daily rhythms are superimposed.
In adults the rest-activity cycle is 90 minutes in duration. The quiet-active sleep cycles of term, 3-, and 8-month-old infants were determined by polygraphic recording of eye and body movements, respirations, and electroencephalogram. The cycle length at term was 47 minutes and 49 and 50 minutes at 3 and 8 months. The increase in cycle length with maturation was not significant, but there was a significant change in the proportion of quiet to active sleep within a cycle. At term they were equal, while at 8 months quiet sleep was twice as long as active sleep. Quiet sleep is a highly controlled state requiring complex feedback mechanisms. The increasing proportion of quiet sleep may be a significant measure of normal brain development.
THERAPY IN CONGENITAL HYPERBILIRUBINEMIA: PHENOBARBITAL AND DIETHYLNICOTINAMIDE
Authors: Ertel Inta J. , Newton William A. 
Published: December 2021

Two different drugs, phenobarbital and diethylnicotinamide (Coramine), were compared for their efficacy in treating congenital hyperbilirubinemia. Phenobarbital is known to be effective in reducing bilirubin levels in children and adults. The therapeutic effect of oral diethylnicotinamide has not been evaluated; the drug has only been used intramuscularly in newborn twins.
Two sisters, ages 4 and 10, with the clinical picture of the Crigler-Najjar syndrome were given therapeutic trials of phenobarbital and diethylnicotinamide. Both drugs lowered the serum bilirubin levels, but there were quantitative differences in their lowering effect. Phenobarbital (4 mg/kg/day, orally) caused a marked drop of the total bilirubin (from 23.6 to 4.8 mg/100 ml in the older child and from 11.6 to 2.4 mg/100 ml in the younger child), and both children became anicteric. Diethylnicotinamide (60 mg/kg/day, orally) was less effective in lowering their bilirubin. The lowest levels achieved in these two patients were 13.2 mg/100 ml and 8.8 mg/100 ml, respectively, and both remained jaundiced. There was also an enhanced lowering effect observed with a larger dose of phenobarbital (5 mg/kg/day) which was not observed when a larger dose of diethylnicotinamide (100 mg/kg/day) was administered.
These studies suggest that phenobarbital is the agent of choice for therapy of congenital hyperbilirubinemia. The medical indications for therapy are the prevention of kernicterus and the psychological advantage of rendering these children anicteric.
PENICILLAMINE-INDUCED NORMALIZATION OF CLINICAL SIGNS, AND LIVER MORPHOLOGY AND HISTOCHEMISTRY IN A CASE OF WILSON'S DISEASE
Authors: Falkmer Sture , Samuelson GÖsta , SjÖlin Stig 
Published: December 2021

After 27 months of daily penicillamine administration (250 mg 3 or 4 times daily) a portal cirrhosis in a 10-year-old girl was found to have healed clinically and histopathologically.
This case shows that even an advanced portal liver cirrhosis in Wilson's disease can be healed by adequate penicillamine therapy. Hence, it is important that all patients with liver cirrhosis who are younger than 30 years of age are examined for any signs of Wilson's disease.
Copper metabolism studies with Cu64-labeled copper citrate revealed characteristic differences between the homozygote patient and her heterozygote parents and healthy subjects.
Letter To The Editor
Authors: Harrison Stanley L. 
Published: December 2021

Dr. Clement A. Smith, Editor of Pediatrics, has forwarded your letter of February 11, 1970, on child abuse, to the Central Office of the Academy for reply.
I read with great interest your very thoughtul letter, with its proposal for child abuse centers similar to poison control centers to be located strategically in communities throughout the United States; and for the creation within the Academy structure of a standing committee on child abuse.
The Academy's Committee on Infant and Preschool Child has been very interested in this subject.
A NASOJEJUNAL TUBE FOR INFANT FEEDING
Authors: Rhea James W. , Kilby John O. 
Published: December 2021

Nasojejunal feeding was used in 48 infants and found to be a practical and useful means of feeding premature and otherwise ill infants in whom conventional feeding was judged hazardous. A limp, polyvinyl tube with an outside diameter of 1.5 mm and a .9 mm bore was passed from the stomach through the pylorus. A tiny, reusable gold bead helped weight-direct the tip of the tube.
Full enteral infant feeding can be accomplished nonsurgically for a period of weeks with less regurgitation, aspiration, and gastric distention than seen with gastric tube, gavage, or gastrostomy feeding. In order to avoid the potential dangers inherent in bypassing the pylorus, the need for close attention to the amount, the type, and, especially, the osmolarity of the jejunal feeding is stressed.
STUDIES IN CYSTIC FIBROSIS
Authors: Shwachman Harry , Redmond Aileen , Khaw Kon-Taik 
Published: December 2021

Early diagnosis and treatment can alter the morbidity and mortality of patients with cystic fibrosis (CF). This conclusion is based on a study of 130 patients in whom the diagnosis was made under the age of 3 months during the 20year period from 1949 to 1969. These patients were observed for a total of 912 patient-years.
The patients were segregated into three groups as follows: Group A (63) were diagnosed prior to the development of symptoms; Group B (13) had mild symptoms; Group C (54) were diagnosed during hospitalization. Immediately following the diagnosis all patients were started on a therapeutic program and followed at regular intervals. There were 29 deaths, 11 in Groups A and B, and 18 in Group C, 8 of which occurred under 1 year of age.
The present clinical status of the 101 surviving children is an follows: 14 are in excellent condition, 71 have mild disease or are in good health, and 12 are moderately or severely ill and have a poor prognosis. For all the 130 patients the calculated survival rate at age 20 is 77%.
ENTEROVIRUSES ASSOCIATED WITH THE HEMOLYTIC-UREMIC SYNDROME
Authors: Ray C. George , Tucker Virginia L. , Harris David J. , Cuppage Francis E. , Chin Tom D. Y. 
Published: December 2021

Nine cases of the hemolytic-uremic syndrome and one case of purpura fulminans were studied clinically and virologically. All were thought to represent examples of varying degrees of intravascular coagulation.
Virological studies demonstrated a high frequency of infections with enteroviruses, particularly Coxsackie viruses. Evidence of such infections was found in 7 of the 10 subjects, and similar viral Infections were found among family contacts of 5 of the subjects.
Studies of the various subjects and the available family contacts demonstrated evidence of having recent enteroviral infection in the patient and/or the immediate family in 9 of the 10 subjects studied.
It is suggested that enteroviruses may have a role in initiating the sequence of events involved in the pathogenesis of these illnesses.
ON A PECULIAR FORM OF INFANTILE CONVULSIONS (HYPSARRHYTHMIA) AS DESCRIBED IN HIS OWN INFANT SON BY DR. W. J. WEST IN 1841
Authors: C. T. E. 
Published: December 2021

In a poignant letter to the Lancet in 1841 Dr. W. J. West clearly described infantile spasms and the accompanying mental subnormality. The patient was his own son and the letter below is an anguished appeal for possible help for West's son from readers of the Lancet.
TO the Editor of THE LANCET:-
Sir:-I beg, through your valuable Journal, to call the attention of the medical profession to a very rare and singular species of convulsion peculiar to young children.
As the only case I have witnessed is in my own child, I shall be very grateful to any member of the profession who can give me any information on the subject, either privately or through your excellent Publication.
The child is now near a year old; was a remarkably fine, healthy child when born, and continued to thrive till he was four months old. It was at this time that I first observed slight bobbings of the head forward, which I then regarded as a trick, but were, in fact, the first indications of disease; for these bobbings increased in frequency, and at length because so frequent and powerful, as to cause a complete heaving of the head forward towards his knees, and then immediately relaxing into the upright position, something similar to the attacks of emprosthotonos: these bowings and relaxings would be repeated alternately at intervals of a few seconds, and repeated from ten to twenty or more times at each attack, which attack would not continue more than two or three minutes; he sometimes has two, three, or more attacks in the day; they come on whether sitting or lying; just before they come on he is all alive and in motion, making a strange noise, and then all of a sudden down goes his head and upwards his knees; he then appears frightened and screams out: at one time he lost flesh, looked pale and exhausted, but latterly he has regained his good looks, and, independent of this affection, is a fine grown child, but he neither possesses theintellectual vivacity or the power of moving his limbs, of a child of his age; he never cries at the time of the attacks, or smiles or takes any notice, but looks placid and pitiful, yet his hearing and vision are good; he has no power of holding himself upright or using his limbs, and his head falls without support.
UTILIZATION OF A PEDIATRICIAN IN A COMMUNITY CHILD GUIDANCE CLINIC
Authors: Ackerly William 
Published: December 2021

Today's symposium focuses on the use of the pediatrician in a community child guidance clinic. My discussion of that subject will be extended to include the broader subject of total comprehensive care for low-income families. The concept of such care seems to me the most important topic for discussion by physicians engaged in family medicine, whether as independent pediatricians, psychiatrists, general practitioners, or internists, or in neighborhood clinics. I would like to present certain philosophical notions as well as the hard facts in relation to this concept, particularly from my viewpoint as Director of a Community Child Guidance Clinic in a low-income area.
In the philosophical view, comprehensive care is a wish fulfillment and an ideal. In reality, as physicians we do not provide anywhere near the total care for most of the families that we see, particularly in a lowincome area. For example, a teen-ager in the average multiproblem family that comes to our clinic may be a school failure, intoxicated on drugs, consuming alcohol, truant, and delinquent. He probably has come in contact with school guidance counselors, police officers, settlement house workers, family doctors, and now our mental health team, not to mention the agencies which follow this family (e.g., welfare workers, family service, medical clinics, and, maybe, Alcoholics Anonymous). For this teen-ager and his family we must develop a model with both a philosophy and the resources to begin to approach the reality and the ideal of comprehensive care.
At the present time, we only scratch the surface in providing the leadership, coordination, and service necessary to implement what any of us would consider to be true comprehensive care–a myth only approximated even in the wealthier communities.
THE MANAGEMENT OF AGENESIS OF THE PHALLUS
Authors: Young Hugh H. , Cockett A. T.K. , Stoller Robert , Ashley Franklin L. , Goodwin Willard E. 
Published: December 2021

Personal experience with four cases of complete agenesis of the phallus are recorded. The principal question is whether to raise the newborn infant as a boy or a girl. The answer was deduced from the major psychological and social problems encountered in raising two of these patients as boys. In one of these cases multiple, previous attempts at plastic construction of a phallus had been complete cosmetic failures, and the patient suffered from extreme psychological trauma. A cosmetic and psychological improvement was obtained by covering the existing pedicle flap with scrotal skin.
Both the psychological and surgical considerations have led us to raise two newborn infants with agenesis of the phallus as girls. The testicles were placed in the inguinal region so that the endocrine relationships of childhood were not disturbed. The scrotum was preserved for later use in construction of a vagina. From an unusual case of transexualism, we found that it is possible to obtain a completely normal female appearance by giving estrogens to a normal male at puberty. Feminization will be achieved in a similar manner in these patients with agenesis of the phallus. Following construction of a vagina, these children will be completely normal, female sexual partners, except that they will not be able to reproduce. Furthermore, these children will go through childhood and adolescence with a more acceptable appearance as a girl than they could as a boy.
We place great emphasis on a rapid decision on sex assignment within a day or so after the child's birth. After that the legal problems of sex change and the social problems of ambiguity among relatives and friends are compounded.
THE CLINICAL AND BIOCHEMICAL EFFECTS OF EXCESS MAGNESIUM IN THE NEWBORN
Authors: Lipsitz Philip J. 
Published: December 2021

The effect of two regimens of magnesium sulfate therapy in the toxemic mother and her newborn is reviewed. When magnesium sulfate is given intramuscularly to the mother, the newborn is usually not compromised by excess magnesium but may be affected. If continuous intravenous infusion of magnesium sulfate is used and especially if given for more than 24 hours, one can anticipate a newborn manifesting all the signs of hypermagnesemia.
Serum levels in the cord blood and serial samples of the newborn do not necessarily correlate with the clinical picture and may be of little diagnostic value.
In contrast to the adult, the newborn does not excrete a magnesium load satisfactorily.
Magnesium toxicity should be recognized and treated as outlined in the infant of a toxemic mother who has received a large dose or prolonged magnesium sulfate therapy.