bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHRONIC RESISTANCE TO SLEEP IN INFANCY
Authors: SPOCK BENJAMIN 
Published: December 2021

TWENTIETH century America has no stable tradition about how children should be reared. In fact, it has a tradition against traditions. Parents in a quandary do not ask themselves what their own parents or grandparents would have done under the circumstances. They ask what is the latest theory. Twenty years ago, strictness and regulation were the psychologic and pediatric laws of the land. Now we are in the midst of a strong, even violent, swing in the opposite direction. The first impetus came from psychiatrists and educators who had observed the unfortunate effects on at least some individuals, both children and parents, of extreme rigidity in upbringing. Pediatricians began to experiment with new approaches. The so-called self-demand method of feeding, which seemed anarchistic when it was first reported only a few years ago, is now becoming the normal procedure in various parts of the country. There is a tendency to postpone weaning and toilet training and to inaugurate them with regard for the baby's readiness. It no longer takes courage for a physician or psychologist to advocate cuddling.
We seem to be moving in the right direction; a more friendly attitude toward babies, a more natural, relaxed regimen for their care, a respect for their individual needs and developmental levels is good for both them and their parents. But this swift transition is not without its difficulties. The same unstable responsiveness to a new theory, which 25 years ago made some people so enthusiastic for regulation, is today making the corresponding minority totally and uncritically devoted to self-regulation and self-expression.
A NEW REPOSITORY PENICILLIN (A FORM OF AQUEOUS PENICILLIN G PROCAINE) IN INFANTS AND CHILDREN
Authors: GEZON HORACE M. , CHOY DUKE CHO , HELLYER DAVID T. , SMITH WILLIAM H. , STRICKER FRED L. 
Published: December 2021

Eighty-two children with a variety of infectious diseases were treated with a daily injection of a new repository penicillin, aqueous penicillin G procaine (Abbott).
Clinical success was obtained in 68 of 75 patients. In one, the results were considered fair, in three poor, and in three unknown.
Thirty-five patients had a beta Str. hemolyticus, and 10 a pneumococcus isolated from the nose or throat. Bacteriologic success was obtained in all streptococcal infections, but in only 6 of 10 pneumococcal infections.
All of the streptococci were sensitive to penicillin when tested by in vitro methods.
Penicillin serum levels with a mean maximum of approximately 2 u./ml. were observed at two hours, and mean minimum of approximately 0.063 u./ml. at 24 hours. The curve of intermediate values approximated a normal curve.
STREPTOMYCIN INTRAMUSCULAR DOSAGE PER UNIT BODY WEIGHT CORRELATED WITH SERUM LEVELS IN INFANTS AND CHILDREN
Authors: HUNT ANDREW D. , FELL MARY B. 
Published: December 2021

Predictable serum levels of streptomycin can be obtained by calculating dosage on a basis of mg./unit body weight. Dosage can be determined in this fashion in all age groups.
The serum streptomycin levels following single intramuscular injections of 6.6, 11.0, and 15.4 mg./kg. body weight are graphically illustrated.
The serum level following a single intramuscular injection falls more slowly during the newborn period. This is probably the result of dehydration and consequent low urine output.
Healthy children with apparently normal kidney function show little accumulation of streptomycin in the serum during intermittent intramuscular injection at the three and six hour intervals.
Eleven mg./kg. body weight every six hours is recommended as a satisfactory dosage schedule when it is desirable to keep the blood streptomycin level constantly above 5 µ. per milliliter.
EMBRYOMA OF KIDNEY (WILMS' TUMOR) IN CHILDREN
Authors: DICKEY LLOYD B. , CHANDLER L. R. 
Published: December 2021

A series of 12 cases of Wilms' tumor, in which the diagnosis was confirmed in all instances by examination of the gross or microscopic tissue, is reported, with a survival rate of 33.3%. Four patients are living and well, 4, 8, 10, and 15 years, respectively, after treatment. All recurrences appeared less than 10 months after treatment.
The sex incidence, and the sex survival incidence were exactly equal. Six tumors were in the left kidney, and six in the right.
Eight of the patients were under 2 years of age when first diagnosed and treated, and all were under 7 years.
The history of breast or bottle feeding was irrelevant.
In a large number of these and reported cases, the presence of the tumor was the first symptom, and in a considerable number the only symptom. This fact stresses the importance of careful physical examination of infants and young children, regardless of complaint, or of lack of it.
The finding of calcification in the tumor is possibly a good prognostic sign. All three patients in whom calcification was noted in the tumor are living and well.
Immediate removal of the tumor by transperitoneal nephrectomy, with postoperative radiation to the area, seems to be the advisable treatment.
WOLFF-PARKINSON-WHITE SYNDROME WITH CONGENITAL HEART DISEASE
Authors: KLEIBER ESTELLE E. 
Published: December 2021

The syndrome of the shortened P-R interval associated with widened QRS as an anomaly of the conduction system of the heart has long been recognized in the adult.
Since few cases of Wolff-Parkinson-White syndrome have been reported in children in association with congenital heart disease, a case report is presented in a boy whose first episode of paroxysmal tachycardia occurred at seven months of age.
The diagnosis of congenital heart disease seems likely in view of the finding of a pronounced, widely heard systolic murmur first noted at the age of 2½ years, and never associated with rheumatism or other signs of infection.
A history of paroxysmal tachycardia in infants and children warrants cardiographic investigation between attacks.
MECHANISM OF EMERGENCE OF RESISTANCE TO STREPTOMYCIN IN FIVE SPECIES OF GRAM NEGATIVE BACILLI
Authors: ALEXANDER HATTIE E. , LEIDY GRACE 
Published: December 2021

The following evidence has been presented as proof of the mutational origin of streptomycin resistant variants of five different species—E. coli, Salmonellae, Shigellae, S. typhosa and Ps. aeruginosa:
1. Demonstration of their independence of the action of streptomycin by showing their continuous irregular occurrence with different prevalence in independent cultures of same population size and strain.
2. Transmission of resistance unchanged in degree through many subcultures in the absence of streptomycin.
3. A low rate of occurrence of the resistant variants, not varying significantly among different strains of the same species.
A fraction of the resistant mutants of each of these five organisms grows poorly or not at all in the absence of high concentrations of streptomycin.
The therapeutic implications of these facts are discussed.
CURRENT TRENDS IN HEMATOLOGY
Authors: ZUELZER WOLF W. 
Published: December 2021

IT IS a great honor to have been chosen for the first Mead Johnson Award of 1948. As I look over the list of the distinguished men and women who were the earlier recipients of this Award I am aware of the obligation imposed upon me by your choice. At the same time I am grateful for the encouragement which this recognition will mean to my associates and to myself in our future work.
It goes without saying that the contributions which form the basis of your selection were the result of the work and the ideas of many members of our group at the Children's Hospital of Michigan. I want to pay special tribute to the memory of the late Dr. Thomas B. Cooley who founded the hernatologic tradition in Detroit and who opened my eyes to the many interesting problems in this field.
A review of our studies on megaloblastic anemia of infancy was only recently presented to members of the Academy. To avoid repetition, I shall not summarize this work again in detail but merely take certain aspects of it as a pretext and point of departure for a larger and more pretentious subject which I propose to call current trends in hematology. In order to illustrate this theme, I shall draw freely on the work of others.
It is my belief that this topic is a timely one. In the last decade new tools of hematologic investigation have become available with the result that many basic concepts are even today undergoing profound modification. Because of the rapidity of these developments the newer concepts have not yet been generally applied in the clinical practice of pediatrics.
PSYCHOLOGIC ASPECTS OF POLIOMYELITIS
Authors: SEIDENFELD MORTON A. 
Published: December 2021

While many more contributions may be made by the physician in caring for the child with poliomyelitis there are at least five principal areas in which he plays a major psychologic role in addition to his ordinary responsibilities in regard to medical care of the patient. These are:
(a) in dealing with the relief of the patient's psychologic reactions to the acute phase of the disease; (b) in reducing psychologic trauma attendant upon the removal of the patient from his normal environment and placing him in the treatment environment of the hospital or nursing institution; (c) by explaining and correcting misconceptions that the patient may have about his illness and its ultimate effects; (d) by aiding the parents to avoid erroneous concepts, feelings of personal guilt and improper attitudes toward their child and the family as a whole during the child's illness; and (e) by correcting community misconceptions regarding the needs of the child with polio and by fostering adequate community cooperation in helping disabled children make the best possible socio-economic and psychologic adjustment to life.
IMMUNIZATION AGAINST PERTUSSIS DURING THE FIRST FOUR MONTHS OF LIFE
Authors: MILLER JOHN J. , FABER HAROLD K. , RYAN MARY LOUISE , SILVERBERG ROSALIE J. , LEW EDITH 
Published: December 2021

Agglutinative reactions with H. pertussis were performed on 108 pairs of maternal and cord blood sera. A correspondence in titer within the range of experimental error was demonstrated in 77% of the pairs. Fifty per cent of the maternal sera contained demonstrable agglutinins. Transplacental transmission of antibody was demonstrated in 63% of the 54 sero-positive mothers.
Saline-suspended H. pertussis vaccine was administered to infants on the fifth day of life and repeated at one and at two months of age. With total doses of 50 billion H. pertussis only 15% of 41 infants produced agglutinins in a titer of 1-320 or higher—the level which in older children has been found consonant with clinical immunity. When the total dose in a second group of infants was increased to 100 billion H. pertussis, the above titer was demonstrated in 25% of 145 infants.
The serologic response of infants whose cord blood had contained no agglutinins was not superior to that of infants with agglutinins. Thus no depression of the immune response by transplacentally acquired antibody was demonstrable.
In a third group of 134 slightly older infants, saline-suspended H. pertussis vaccine was administered in a total dose of 80 billion cells divided into three monthly injections. The first injection was given at four to eight weeks of age. Forty-eight per cent of these infants manufactured agglutinins in a titer of 1-320 or higher. However, three months later only 36% were carrying this high titer. General febrile reactions were not uncommon and one proved case of mild pertussis occurred in this group.
In a fourth group of 151 infants, alum-precipitated H. pertussis vaccine was injected in a total dose of 40 billion cells divided into three injections at monthly intervals. The first injection was given at four to eight weeks of age. Only two febrile reactions, one associated with a local reaction which did not break down, occurred. Sixty-two per cent of 115 infants whose sera were tested four to eight weeks later developed H. pertussis agglutinins in a titer of 1-320 or higher. Twelve months later 60 per cent still carried these high titers. This satisfactory response at this age with this product is confirmatory of the studies of Sako, Treuting, Witt and Nichamin. It adds support to their thesis that active immunization with alum-precipitated vaccine can be accomplished before the sixth month of life.
A schedule for immunizations during the first year of life, embodying H. pertussis immunization beginning at four to eight weeks of age, is described.
HEMOPHILUS INFLUENZAE MENINGITIS
Authors: CROOK WILLIAM G. , CLANTON B. REED , HODES HORACE L. 
Published: December 2021

The results obtained in the treatment of 110 infants and children with H. influenzae meningitis are presented and the various agents used in the therapy of the disease are evaluated. Eighty-seven (79%) survived. Sixty-eight (62%) recovered completely. Eight of the 23 deaths occurred within the first 24 hours after hospital admission. Slightly over one half the children were less than one year of age. Only 69% of this group survived as compared with 90% in the group over one year of age; only 50% of the younger group recovered completely as compared with 75% of the older group.
The plan of therapy underwent various modifications and additions during the eight year period covered in this study. Forty-four per cent of the patients were treated with specific H. influenzae rabbit antiserum and sulfadiazine; 48% were treated with these agents together with streptomycin (and in many instances penicillin). The remaining 8% were treated with streptomycin alone or in combination with sulfadiazine. The survival and complete recovery rates of those treated with serum, sulfadiazine and streptomycin were not significantly different from the rates of those treated with serum and sulfadiazine alone. The number of patients treated with streptomycin without serum was too few for analysis.
Specific antiserum used early and in large doses seemed to be a valuable therapeutic agent in these studies. It is believed that this antiserum should be used in the treatment of all patients except perhaps older children and younger children who are only mildly ill. The high cost of this serum, however, remains a major problem. Streptomycin undoubtedly is a valuable therapeutic agent in the disease; in this study, however, there has been no striking improvement in the over-all results since its introduction.
Sulfonamides and especially sulfadiazine appear to have been of limited but definite value in the treatment of this disease and their continued use in all patients is recommended. Penicillin when given in high dosages would also seem to be a helpful therapeutic adjunct when used along with other agents.
Follow-up data on 64 of the 87 surviving patients are presented.
LIMB-GIRDLE MUSCULAR DYSTROPHY: ITS LARGER SIGNIFICANCE
Authors: C. S. 
Published: December 2021

The current literature reflects the interest of pediatricians, neurologists, and internists in the neuromuscular disorders of childhood.1-5 Clinical awareness and the availability and refinement of ancillary procedures, such as electromyography, measurement of nerve conduction velocities, determination of serum enzymes and muscle biopsies, have made it possible to differentiate many of these conditions and correctly localize the pathology of these lower motor neuron disorders to the anterior horn cells, the peripheral nerves, and/or the muscles.1
Primary muscle disease is the most frequent cause of progressive muscular weakness in children with neuromuscular disorders.2 The primary myopathies are either hereditary or acquired. The muscular dystrophies and the myotonic syndrome are representative of the genetic variety, while the acquired disorders are recognized clinically as polymyositis and dermatomyositis.
RESECTION OF METASTASES IN WILMS' TUMOR: A REPORT OF THREE CASES CURED OF PULMONARY AND HEPATIC METASTASES
Authors: Wedemeyer Phillips P. , White James G. , Nesbit Mark E. , Aust Joseph B. , Leonard Arnold S. , D'Angio Giulio J. , Krivit William 
Published: December 2021

Three cases of Wilms' tumor metastatic to both the lungs and liver are described. The first case had pulmonary metastases on three occasions. The initial episode was treated with radiation, the second by excision, and the third by combined chemotherapy. The second case also had three recurrences of pulmonary metastases; the first two were treated by excision and the third was treated by radiation followed by excision of residual tumor. Pulmonary involvement occurred only once in the third case and was treated by combined radiation and actinomycin D.
All three cases had hepatic metastases. Hepatic lobectomy was employed in two cases and radiation was used in a third. The apparent cure of these cases emphasizes the importance of vigorously applying the therapeutic modalities currently available.
The frequent use of surgical excision in these cases was based upon three advantages of this modality: minimal damage to normal tissues, undiminished effectiveness on repeated use, and ability to discover metastases otherwise undetectable. The indications for resection for pulmonary metastases are discussed. Hepatic lobectomy, previously unreported in Wilms' tumor, would appear to merit more extensive use.
RED CELL METABOLISM IN THE PREMATURE INFANT
Authors: Oski Frank A. , Smith Charles , Brigandi Ernestine 
Published: December 2021

Erythrocyte glucose consumption was measured in the cells from premature and term in fants, adults, and subjects with reticulocytosis. Glucose consumption was related to red cell age as reflected in red cell G-6-PD and GOT activities. The erythrocytes of the premature infant appeared to consume less glucose than would be expected from their mean cell age.
Studies in reconstituted hemolysates indicated that the hexokinase reaction was the rate limiting step in cells from all groups and that glucose consumption could be markedly increased in newborn hemolysates by the addition of adenosine triphosphate. The presence of a different isoenzymatic form of hexokinase in cells of the neonate is discussed as one possible factor contributing to the difference in glycolytic rate.
POPLITEAL PTERYGIUM SYNDROME
Authors: Gorlin Robert J. , Sedano Heddie O. , Cervenka J. 
Published: December 2021

The name of popliteal pterygium syndrome is suggested for a well defined complex that consists of popliteal pterygium (usually bilateral), intercrural pterygium, various digital anomalies that include hypoplasia or agenesis of digits, valgus or varus deformities of the feet and syndactyly, genitourinary anomalies (such as cryptorchidism, absent or cleft scrotum, inguinal hernia, hypoplasia or aplasia of the labia majora, and oral anomalies (such as cleft lip-palate, syngnathia and lower labial pits). There may also be filiform adhesion of the eyelids.
This syndrome is but one of perhaps 20 or more that involve clefting of the lip and/or palate. It is inherited as an autosomal dominant trait with variable expressivity. Rarely is it transmitted from affected parent to offspring due to genital hypoplasia. The authors point out the importance of the awareness of the surgeon who corrects the popliteal pterygium since the sciatic nerve runs beneath the fibrous septum that forms the free edge of the pterygium.
RELAPSE FOLLOWING AMPICILLIN TREATMENT OF ACUTE HEMOPHILUS INFLUENZAE MENINGITIS
Authors: Young Lily M. , Haddow James E. , Klein Jerome O. 
Published: December 2021

A case of meningitis due to Hemophilus influenzae in a 6-month-old child treated with ampicillin is presented. The child had a recurrence of bacteremia with orbital cellulitis 3 days after the conclusion of 14 days of parenteral treatment with 200 mg per kilogram per day. Although a substantial amount of clinical experience has already been presented as to the value of ampicillin in acute bacterial meningitis due to the common agents, careful observation of each patient for signs of lingering infection is still necessary.
This case represents a failure of ampicillin to eradicate H. influenzae infection.
A SWEDISH REGISTER OF CONGENITAL MALFORMATIONS
Authors: Källén Bengt , Winberg Jan 
Published: December 2021

A national register of congenital malformations covering about 80,000 annual births is described. The registration is intended to serve as an early warning system, should a new teratogen become widely spread in the environment. Such an instrument is very much needed, since existing methods for evaluation of teratogenic effects of exogenous factors–-especially drugs and other chemical substances–give no reliable protection to the human embryo.
The essential of the registration procedure is that malformations observed during the newborn period are reported monthly to a malformation register by a verbal diagnosis or description–not by code numbers. The frequency of different malformations is thus kept under continuous control.
The method was tested with available Swedish data from the thalidomide period. The results suggest that, had the register been at work at that time, it should have identified an epidemic some 5 months after the appearance of the first thalidomide embryopathies.
A special effort has been made to analyze infants with multiple malformations. In only a minority of such cases can the child have been affected by two or more unrelated teratogens.
AN EIGHTEENTH CENTURY FATHER ASKS HIS SON TO GET HIS HAIR CUT
Authors: C. T. E. 
Published: December 2021

The current antipathy of many boys toward barbers is a common cause of friction between fathers and sons. It may comfort today's fathers to learn that other fathers in other times were similarly bothered, as is evident in the letter below written almost 200 years ago by Henry Fox to his son at Eton.
One thing you know I much wanted to see your hair cut to a reasonable and gentlemanlike shortness. You and some Eton boys wear it as no other people in the world do. It is effeminate, it is ugly and it must be inconvenient. You gave me hopes that if I desired it, you would cut it. I will, dear Ste (Steven), be much obliged if you will.1
Once again, plus ça change, plus c'est la méme chose!
Lactic Dehydrogenase and SGOT in the Newborn
Authors: Lopez Rafael 
Published: December 2021

In the November 1967 issue of Pediatrics (40:847) the following article is published: "Thrombocythemia in the Myeloproliferative disorder of Down's syndrome," by Miller, Sheril, and Hathaway. The following notation appears in the case report: "A lactic dehydnogenase of 6750 units (normal 100-350 units) SGOT of 58 units (normal of 8-40 units)." No time is given as to when the tests were carried out, but surely it was before 5 weeks, the date of expiration.
May I call attention to the fact that these values are not in accord with recent publications.