bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RECOGNITION AND TREATMENT OF INCREASED INTRACRANIAL PRESSURE IN INFANCY AND CHILDHOOD
Authors: WOODHALL BARNES 
Published: December 2021

THE classical symptoms and signs of increased intracranial pressure may be recognized in the adult with a fair degree of accuracy. They consist, briefly, of headache, vomiting, the appearance of papilledema and a depressed or altered state of consciousness. They appear in the presence of any expanding lesion, be it brain tumor, traumatic hematoma or chronic infection, because of the relatively simple fact that the adult skull may be considered a closed box, incapable of significant expansion in terms of relief of intracranial hypertension.
This famous closed box theory upon which almost all the methodology of neurologic surgery depends was presented first by Monro and Kellie and was later modified to include the cerebrospinal fluid by Burrows. In the era of modern neuro-surgery the work of Dr. Lewis H. Weed has further refined this theory to include chiefly the stretch component of the inner confining membrane of the closed box, the dura mater.
In essence, the closed box theory of this long list of distinguished investigators states: (1) that the skull, pierced but by minor foramina, may be considered inexpansible, (2) that within the skull, brain tissue, arterial and venous circulating blood and cerebrospinal fluid rest in equilibrium influenced in the normal state only by postural head and body changes, (3) that any change such as that of an expanding brain tumor in the relative volume of these components of the closed box must be compensated for by a change in one or all of the constituents, and (4) that when the limits of this normal compensatory mechanism are attained, since the closed box can no longer expand, signs of increased intracranial pressure will develop (Fig. 1). Normal intracranial pressure in the adult is, in simple terms, a measure of the pulsating arterial systolic pressure, an unimpeded venous outflow, a stable brain volume, the normal production and absorption of cerebrospinal fluid and a solid inexpansible skull.
Identical factors operate in the maintenance of normal intracranial pressure in the infant or child although they may be envisaged as progressively changing factors due to the growth of the central nervous system and its envelope, the skull.
Tuberculosis: A discussion of Phthisiogenesis, Immunology, Pathologic Physiology Diagnosis, and Treatment
Authors: WILKINSON ERLE E. 
Published: December 2021

This is a timely synthesis of current clinical knowledge on human tuberculosis and is particularly valuable because of the author's half-century of experience and leadership in the field. His approach to the consideration of the problem is largely immunologic and physiologic. In his discussions the author has attempted to make clinical processes stand out in their immunologic relationships to show tuberculosis in "its dual aspect of a metastasizing-destructive as well as a localizing-healing disease."
The student of childhood tuberculosis will find here a valuable source of information as well as much mental stimulation concerning solved and unsolved problems in this disorder.
ANTIBIOTIC THERAPY
Authors: Neter Erwin , Hodes Horace L. 
Published: December 2021

THE LIBERAL, though not indiscriminate, use of antibiotics in pediatrics has resulted in far more assets than liabilities, although the statement has been made that 90% of antibiotics used in this country today are wasted. Often the pediatrician is able to select the correct and most effective antibiotic on the basis of clinical examination alone. At other times, laboratory examinations are necessary to establish an etiologic diagnosis. This information frequently allows the selection of the most favorable antibiotic when the bacterial species is of predictable sensitivity. Cases in which the bacterial species isolated are of unpredictable sensitivity require determination of the in-vitro efficacy of antibiotics. It must be stressed that many bacterial pathogens are as sensitive to penicillin and other antibiotics today as they were years ago, and that the emergence of antibiotic-resistant bacteria is not a general phenomenon. For example, the vast majority of strains of group A hemolytic streptococcus, gonococcus, pneumococcus, influenza bacillus, and the spirochete of syphilis have not become antibiotic resistant. In contrast, the staphylococcus has become a serious problem, particularly in hospitals and hospital-acquired infections. With the widespread use of penicillin and other antibiotics the percentage of antibiotic-resistant bacteria isolated from lesions in man has increased substantially. In addition, workers in hospitals rather frequently have become carriers of these strains and thus may in turn spread the infection to patients.
Status of Current Antibiotics
During the last few years several antibiotics have been added to the armamentarium of the physician. The present status of these antibiotics or special preparations may be summed up as follows.
Letters to the Editor
Authors: SILVERMAN FREDERIC N. , ROBINOW MEINHERD 
Published: December 2021

Doctor Amberg's letter voices an opinion which is shared by a good many of our colleagues. At the time that our review "Radiation Hazards in the Field of Pediatrics" was written, our recommendation for the general use of personal radiation diaries was in line with current ideas and with the recommendations of the reports of both the British Medical Research Council and the American National Academy of Sciences.
Since that time, strong objections to the keeping of such records have been raised by many individuals active in the field of radiation and radiation protection.
THE ASSOCIATION BETWEEN ANTIBODIES AGAINST POLIOMYELITIS AND MUSCLE WEAKNESS IN A NORMAL POPULATION
Authors: Sachs David , Bailey Jean , Baumeister Jacqueline , Furcolow Michael L. 
Published: December 2021

A total of almost 450 persons was studied in three communities in an attempt to establish a relationship between subclinical poliomyelitis infection and muscle weaknesses. Each person in the study was examined for muscle weaknesses by a physical therapist, and determinations for neutralizing antibodies in each person were made with each of the three recognized types of poliovirus.
It is shown that the presence of antibodies against poliomyelitis was associated with the presence of mild muscle weakness in two middle class communities, but not in a third community of lower socio-economic status. The association in the first two communities is interpreted as confirmation of the clinical impression that inapparent poliomyelitis infections can cause detectable residual muscle weaknesses. Muscle weaknesses were present in almost all of the children examined in the third community, but were not associated with the presence of antibodies against poliomyelitis. It is conjectured that this high prevalence of muscle weaknesses might be due to deficient nutrition.
In order to investigate the reliability of the muscle evaluation technique, 29 children were independently examined by each of two physical therapists with experience in using the technique. The results confirm the results of Lilienfeld et al. in showing that the technique is relatively reliable.
A FURTHER DESCRIPTION OF THE PATHOLOGIC PHYSIOLOGY OF CONGENITAL MEGACOLON AND THE RESULTS OF SURGICAL TREATMENT
Authors: Hiatt Robert B. 
Published: December 2021

Follow-up results of a series of patients with congenital megacolon operated upon between the years 1947 and 1955 are presented. The operative procedure was complete removal of the rectum and lower sigmoid with replacement by more proximal colon and a sigmoido-anal anastomosis.
A discussion of the problem of anal continence in normal children as well as children upon whom a "pull through" procedure has been done has been presented.
This study revealed that 50% of patients who have had pull through procedures became completely continent within 1 year, 34% became continent within 5 years, and 16% have some residual difficulty with bowel control. Analysis of the reasons for imperfect anal control reveals that enterocolitis and psychologic maladjustment are two prominent features.
It is concluded that the replacement of the rectum and lower sigmoid by proximal colon in congenital megacolon has proven successful as manifested by long-term follow-up study.
Letters to the Editor
Authors: SNYDERMAN SELMA E. 
Published: December 2021

Dr. Milch made some interesting comments about alcaptonuria which, however, are controversial. No attempts were made in my paper, which was a general review article on amino acid metabolism, to explore the various facets of this problem.
First: It would seem to me, that with the demonstration of a defect in a single enzyme system that alcaptonuria is a single disease, not a "syndrome." Alcaptonuric individuals may differ in their clinical manifestations, but the common denominator is the biochemical defect.
APPENDICITIS IN CHILDHOOD
Authors: SHAW EDWARD B. 
Published: December 2021

ELSEWHERE in this issue of Pediatrics is presented a series of cases of appendicitis in childhood in which the end results of surgical care approach perfection. In 1,358 cases there was but a single postoperative death—this from brain abscess!
Comparable results of surgical care are obviously not available everywhere. In 1955 the mortality from appendicitis in the United States was 2,273. Among children less than 5 years of age, there were 102 deaths; from 5 to 9 years, 75; from 10 to 14, 59; and from 15 to 19, 48 (a total childhood mortality of 284).
It is surprising to note uniformly high incidence of appendiceal rupture, abscess, and peritonitis in almost every large surgical series reported from numerous centers.
ANIMAL PARASITES AND HUMAN DISEASES
Authors: Beaver Paul C. 
Published: December 2021

PARASITES fall only roughly into the two categories implied in the title of this discussion. While a few of them are totally dependent upon human hosts, and some are able to develop only in other animals, a majority of the parasites commonly referred to as "parasites of man" are in reality parasites of other animals. In the latter group are such familiar examples as Trichinella, found in rats and many other animals, including pigs; Balantidium and some lesser protozoa of pigs; Toxoplasma, which occurs in many wild and domesticated animals. Trypanosoma cruzi, which is carried by a variety of animals, is the cause of Chagas' disease commonly seen in parts of South America and found recently in a child in Texas. Other examples include Isospora of undetermined hosts, possibly including the dog; Trichostrongylus species that commonly are found in sheep and goats; the small tapeworms, Hymenolepis nana and Hymenolepis diminuta, of rats and mice; and the common dog tapeworm, Dipylidium caninum. There are others whose endemicity in any area depends somewhat on the presence of suitable non-human hosts, and still others that are able to reach maturity in man but are rarely involved in medical problems because infection is acquired only by eating uncooked earthworms and insects. It might be mentioned, as a matter of interest, that occasionally other animals may acquire parasitic diseases from their human associates, as for example dysentery and diarrhea in dogs, caused by Entamoeba histolytica and Strongyloides stercoralis.
In all of the above mentioned parasitic infections, diagnosis is usually based on conventional laboratory methods, and both clinical and laboratory workers are generally familiar with the problems presented by them.
OPHTHALMIA NEONATORUM
Authors: Mellin Gilbert W. , Kent Mary P. 
Published: December 2021

Silver-nitrate prophylaxis for gonorrheal ophthalmia neonatorum was discontinued from April, 1957 through October 25, 1957 in the Sloane Hospital for Women of the Columbia-Presbyterian Medical Center.
Six nurseries were kept under surveillance for discharging eyes. The incidence of discharging eyes was 3.2% of 1,974 infants observed. This incidence rate is analyzed by nursery and by months.
Specimens from the 64 infants with discharging eyes and 19 controls were cultured. The results of the cultures from the discharging eyes and the controls were very similar except for four isolations of N. gonorrhoeae from discharging eyes.
This represented a marked increase in incidence of gonorrheal ophthalmia neonatorum over the 10 cases which had occurred in the Medical Center in the previous 25 years.
Two cases of gonorrheal ophthalmia neonatorum were clinically obvious on the second day. One had only a minor discharge on the eighth day. The other was home on the fourth day and returned to the hospital on the sixth day with obvious symptoms. All recovered uneventfully.
None of the mothers were suspected of having gonorrheal infection, although two had positive cultures from the cervix post partum.
Prophylaxis for gonorrheal ophthalmia has been reinstituted in this Medical Center.
Testing Urine for Phenylpyruvic Acid
Authors: PAINE RICHMOND S. 
Published: December 2021

May I be permitted to reply to Dr. Manuel Ingall's comment in Pediatrics (22:408, August, 1958) concerning the degree of freshness required in testing urine specimens for phenylpyruvic acid with ferric chloride?
I had not meant to imply in my article (Pediatrics, 20:290, 1957) that a positive test could be obtained only with specimens voided immediately previously. Undoubtedly, most samples from phenylketonuric patients will give positive tests with ferric chloride even when hours or days old, especially if refrigerated.
SEVERE GENERALIZED DISEASE (ENCEPHALOHEPATOMYOCARDITIS) OCCURRING IN THE NEWBORN PERIOD AND DUE TO INFECTION WITH COXSACKIE VIRUS, GROUP B
Authors: Kibrick Sidney , Benirschke Kurt 
Published: December 2021

Two fatal cases of generalized infection in the neonatal period with Coxsackie virus, Group B, Type 4 were studied. The virus was present in high titer in the myocardial tissue of both infants and recovered as well from the spinal cord and liver of one. In the latter case, the infection was acquired in utero as indicated by the onset of illness at 13 hours of age and death at 36 hours.
Both virus strains, when inoculated into newborn mice, produced acute destruction of the anterior horns of the spinal cord, indistinguishable from that induced by poliomyelitis virus.
The clinical and pathologic features in 25 cases of this disorder are reviewed.
Infectious Diseases of Children
Authors: BRADFORD WILLIAM L. 
Published: December 2021

The well qualified authors of this book have fulfilled their stated purpose, namely, "to provide a concise and handy description of certain common infectious diseases."
On casual inspection one might get the erroneous impression that it is too concise, an impression completely erased by careful reading of individual chapters. The material consists of a rare combination of conciseness and completeness.
CLINICAL CONFERENCE
Authors: Sobel Edna H. , Taft Lawrence T. 
Published: December 2021

Dr. Barnett: The patient to be presented and discussed by Dr. Taft and by Dr. Sobel provided a series of perplexing problems relating to diagnosis, treatment and prognosis. Some of the questions raised have been answered but others relating particularly to prognosis and future treatment remain. To preserve the chronologic order of the problems as they were presented to us, the presentation will be introduced by Dr. Taft, to whom the patient was referred initially because it was believed that the primary difficulty was one of mental retardation.
Dr. Taft (Assistant Professor of Pediatrics): This infant, at the age of 18 months, was referred to the Developmental Evaluation Clinic by his private physician. The physician had requested an investigation to determine why the infant was slow in psychomotor development and why he was obese.
The relevant history revealed that this was the mother's first pregnancy which was uneventful. Except for vitamins no other medications were taken during the gestation. The delivery and the immediate post-natal course were unremarkable. The patient weighed 5 lb 4 oz at birth.
During the neonatal period the infant was extremely apathetic and listless. He sucked poorly. At 6 weeks of age he was hospitalized for bronchopneumonia.
From the history, his motor development was delayed. He gained head control at 6 months; rolled over at 8 months; and sat unsupported at 1 year of age. He followed objects at 4 months; spoke single words at 1 year; and had conditioned tricks at 13 months.
At approximately 8 months of age it was noticed by the parents that the patient was gaining weight rapidly and had a spurt in linear growth. At this time his appetite became ravenous.
Pneumocystis Carinii Pneumonia
Authors: MCNEAL JOHN B. , GRUNT JEROME A. 
Published: December 2021

Since 1955, six cases of Pneumocystis carinii pneumonia have been reported from the United States. These have been widely distributed geographically and we wish to report the seventh case—the first one from Louisiana—to remind pediatricians of the clinical features of this peculiar disease which occurs mainly in infants.
The patient, a 9-month-old white male, had lived in the New Orleans area his entire life. At about 3 months of age, he developed a chronic unproductive cough which persisted despite administration of a wide variety of antibiotics prescribed by a number of Physicians. For 3 weeks prior to admission, there had been progression of the symptoms of respiratory distress, and for 3 days the baby had been dyspneic and cyanotic.
THE PERSISTENCE OF POLIOMYELITIS ANTIBODIES AFTER PRIMARY IMMUNIZATION OF YOUNG INFANTS
Authors: Batson Randolph , Christie Amos , Turner Dorothy , Michal Mary , Barrick Jewell H. 
Published: December 2021

Data has been presented showing that, although 4 months after the third injection of poliomyelitis vaccine, antibody levels were quite high, at 12 months there was a definite and striking decrease in antibody titers.
It is suggested that serious consideration be given to the routine administration of a fourth, 1-ml, injection of poliomyelitis vaccine 12 months after the third injection.
It would seem advisable to follow this practice unless it can be demonstrated that the state and degree of hypersensitivity, without detectable antibodies, is sufficiently great to result in a protective response when natural infection occurs.
CURRENT MANAGEMENT OF NEPHROSIS
Authors: Riley Conrad M. , Scaglione Peter R. 
Published: December 2021

A statistical evaluation is presented, which reveals a significantly improved survival of children with nephrosis under modern management.
The status of the survivors in a small sample seems much better in the current series.
The evidence that such improvement is due to the more intensive use of adrenalactive steroid therapy is circumstantial but highly credible.
A program for steroid administration, which has seemed satisfactory, is presented. The risks inherent in such hormone treatment appear to be more than counterbalanced by the reduction in early mortality.
PRACTICAL THERAPEUTIC IMPLICATIONS OF IMMATURITY
Authors: KRETCHMER NORMAN 
Published: December 2021

RECENTLY, there has been considerable agitation concerning harmful effects of a few particular drugs administered to premature infants and also to infants during the neonatal period. It may be presumptuous to state that the administration of drugs at any period during life involves risk, but hazard increases with lack of knowledge of biochemistry and physiology of the organism. Inadequacies in pharmacologic knowledge are in particular evidence in pediatric medicine. It is becoming more and more apparent that the neonatal infant demonstrates characteristic organ and tissue functions much different from those encountered in the mature individual. This new information has not been sufficiently utilized by some clinical investigators or by manufacturers of pharmaceutical agents.
When a drug is administered it is metabolized in a definite fashion, and an overdose may yield unpleasant and sometimes deadly effects.
SEVERE APNEA AND IRREGULAR RESPIRATORY RHYTHMS AMONG PREMATURE INFANTS
Authors: Miller Herbert C. , Behrle Franklin C. , Smull Ned W. 
Published: December 2021

Premature infants with severe respiratory insufficiency (respiratory Group III) had more irregular respiratory rhythms and more severe apnea than healthy premature infants (respiratory Groups I and II). Birth weight did not appear to be a factor in the occurrence of severe apnea unless severe respiratory insufficiency was present.
The prognosis for survival was significantly poorer among infants with severe apnea than among those who did not have severe apnea. The greater the delay after birth before the first attack of apnea occurred, the better were the chances for survival.
Severe apnea seemed to be an extreme form of irregular breathing in premature infants. There was a direct relationship between the degree of irregularity of the respiratory rhythms and the occurrence of long, single periods of apnea. Clinical attacks of severe apnea were observed almost exclusively among infants having the most irregular respiratory rhythms.
It is suggested that markedly irregular respiratory rhythms and attacks of severe apnea are the results of enfeebled respiratory centers and that the latter is one of the characteristic features of premature infants with severe respiratory insufficiency (respiratory Group III).
Atmospheres of 40% oxygen were associated with longer periods of apnea than was room air. However, better oxygenation of the blood appeared to be maintained through long periods of apnea in 40% oxygen than in room air.
METABOLIC CONSEQUENCES OF PANCREATIC INSUFFICIENCY IN CYSTIC FIBROSIS OF THE PANCREAS: A STATISTICAL ANALYSIS
Authors: Lowe Charles Upton , Pessin Vivian 
Published: December 2021

OVER the years opinion has varied on the nature of the dietary regimen which most effectively compensates for the specific digestive defect in cystic fibrosis of the pancreas. This paper comprises a review of the literature and a statistical analysis of available data to determine whether the accumulated evidence supports any dietary recommendations.
HISTORICAL BACKGROUND
All reviews of pancreatic function begin with the work of Claude Bernard. This is appropriate since he first correctly described in two papers, 1849 and 1856, the role of the pancreas in the digestive process in dogs. A series of confusing experiments, many of them faulty, led in the next 80 years to changing estimates of the importance of this gland in digestion.
The first point at issue was whether the pancreas was involved in digestion. Some investigators questioned, while others substantiated, Bernard's observations. Abelmann, working in the laboratory of Minkowski, was principally responsible for confirming the work of Bernard.
After the necessity of the pancreas for normal digestion had been established, the route of excretion of the pancreatic digestive ferments was disputed. Some claimed all excretion was via the blood, some were uncertain of the route; finally Hess and Pratt et al. showed that the secretion was directly into the bowel. Hess, by careful dissection, demonstrated that the dog has from two to five accessory pancreatic ducts, and Pratt and his associates showed that ligation of all ducts to exclude pancreatic juice from the intestinal tract always produced marked impairment in absorption of fat and nitrogen. These early reports have been critically reviewed by Handelsman.
The observations of Pratt et al. have been confirmed repeatedly. Coffey et al. published extensive metabolic data which seem to have ended any confusion. Experimental achylia pancreatica was produced in dogs by either ligation of all pancreatic ducts or by extirpation of the pancreas. Both operations had the same effect on fat and nitrogen absorption.