bluuebunny/crossref_metadata_2025_split huggingface dataset:
Presidential Address—1974
Authors: Gillespie James B. 
Published: December 2021

The history of the American Academy of Pediatrics is a chronicle of practical idealism. I will not attempt to recount recent and past achievements of our society, for most have been well documented. It is beyond my capacity to identify the changes in Academy role and structure which may occur in our rapidly changing and complex social and medical environment. However, I do wish to reflect briefly on certain recent programs and actions which point up the expanding role and broader scope of interests of the Academy. These actions and interests, hallmarks of maturity and enhanced concepts of responsibility and accountability, are significant of our times.
Wisdom has been gained as we have stood upon the shoulders of our predecessors. Today's Academy cannot be separated from the past. We are deeply indebted to the perceptive, astute leadership of other days and to a dedicated membership which, for 44 years, has closely adhered to our stated goals. We continue to value their counsel. The contributions of those who preceded us are the principal reason why we are where we are today.
There is justifiable optimism for the assumption that the Academy will continue its leadership role as the major advocate for improved child health in the Americas. I sincerely believe that success will come to a society whose principal objective is placing concern for others higher on the scale of values of more and more people. We are reassured by a membership and leadership dedicated to service above self. In the words of Robert Frost: "There cannot be much to fear in a country where so many right faces are going by.
Areas of Responsibility in the Health Care of Multiply Handicapped Children
Authors: Kanthor Harold , Pless Barry , Satterwhite Betty , Myers Gary 
Published: December 2021

To clarify the roles of primary and consultant physicians in the health care of children with chronic disabilities, 44 mothers of children with spina bifida were interviewed to determine whether a primary physician, a specialist or another source had taken the responsibility for providing the following areas of health care: evaluation and treatment of the chronic disease, advice, future planning, genetic counseling, coordination, emotional support, education, acute illness care, and well-child care.
Specialists provided evaluation and treatment of the chronic disease for all children, while about three fourths of the children received acute illness and well-child care from their primary physicians. The patterns of responsibility for the other areas of health care were less clearly defined. Primary physicians were perceived as contributing little to the rehabilitative and coordinative care for these children; most mothers felt there was no physician responsible for providing overall direction to their children's care.
To provide complete and effective health care to children with chronic disabilities, parents and physicians must clearly understand who is to be responsible for both the specific health services as well as the overall direction of care. A primary physician, a specialty clinic or a "coordinating pediatrician" might effectively play this role.
New Pediatric Male Urinal
Authors: Klauber George T. , Lund Sandra T. 
Published: December 2021

There has been a considerable need for many years to develop a leakproof urinal for small boys with urinary incontinence. Dissatisfaction with available urinals encouraged our development of the present equipment.
The phallus in young boys is too small for attachment of a conventional condom-type device. Our attention was, therefore, focused on a condom which could be sealed against the skin around the base of the penis. The Hill-Davol condom urinal proved suitable for modification. This was achieved by precutting the diaphragm which fits around the penis and is pressed against the skin around the base.
The diaphragm is an integral part of the condom and is pressed against the skin around the penis.
Home Monitoring for Sudden Infant Death
Authors: Mindlin Rowland L. , Allen John E. , Brinkley Joseph W. , Debuskey Matthew , Friedman David B. , Furst William D. , Healy Alfred , Hunter Gertrude , Scully William E. , Siegel Earl , Wagner Marsden G. , Helfer Ray E. , Clayton Robert J. 
Published: December 2021

The lay press has recently published many news items concerning sudden infant death syndrome (SIDS), and especially one concerning the use of home monitoring equipment designed for its prevention. This electronic equipment, which is sold over-the-counter and advertised to prevent SIDS, is not only costly but its sale at this time is premature and should be discouraged. Monitoring should be used only by able research persons until there is better evidence concerning the indications for it.
A number of studies on SIDS are presently in progress at medical centers throughout the United States.1-3 One is examining the relationship of SIDS to sleep apnea; another is studying cardiorespiratory responses and the sleep cycle. It is hoped that these and other studies will soon yield information about the pathogenesis and prevention of SIDS that is lacking at the present time.
The psychological impact on the family of a baby who is being monitored at home must be very great. Failure of the equipment to operate properly is not only a hazard to the baby, but causes the family sleepless nights when there are false alarms, or excessive anxiety if the monitor itself is not attended constantly.
In our present state of knowledge of SIDS, the most important functions of the pediatrician or family physician are to examine the patients he cares for and assure himself that they are in good health; to be well-informed about SIDS; and to give full emotional support to the family of a SIDS baby.
This statement will be modified at the earliest possible moment as warranted by results of scientific research and improvements in the technology of monitoring.
Transcutaneous Determination of Arterial Oxygen Tension
Authors: Fenner A. , Müller R. , Busse H. G. , Junge M. , Wolfsdorf J. 
Published: December 2021

Arterial oxygen tension measurements were performed simultaneously using two different techniques: (1) the conventional method of analyzing a blood sample obtained from the radial artery by means of a Clark electrode and (2) a new method of transcutaneous oxygen tension recording using a newly developed surface electrode containing a built-in heating device to ensure optimal cutaneous perfusion at the site of measurement.
Two groups of newborn infants were used as subjects: (1) 70 clinically healthy babies who were tested during normoxia and hyperoxia (breathing 80% to 100% oxygen) and (2) 20 sick preterm and term infants receiving inspired oxygen concentrations of between 21% and 100% during the measurement.
Our results indicate a satisfactory accuracy for the transcutaneous oxygen tension measurements in normoxia and hyperoxia (percentage coefficient of variation, 15.9% and 24.1%, respectively). In hypoxia agreement between the two methods varies depending on the degree of circulatory derangement. Overall correlation coefficients were greater than 0.85 in each group.
SECOND HAND SMOKE
Authors:   American Lung Association
Published: December 2021

Plenty of ammunition is now at hand to help the nonsmoking majority defend itself against the health menace of "second-hand" smoke.
The American Lung Association rounded up information based on recent research concerning the harmful effects of tobacco smoke on innocent bystanders.
"Sidestream" smoke from the burning end of a cigarette and "mainstream" smoke pulled in by the smoker and then exhaled are more than merely nuisances to the nostrils and eyes of others, the Lung Association said. In an article in its monthly magazine, the Bulletin, entitled ‘Facts About Second-Hand Cigarette Smoke," the agency warned that this "double exposure" offers serious threats to the lungs and circulatory system of the unwilling inhaler. For example:
Twice as much tar and nicotine is found in sidestream smoke from the end of a burning cigarette as in mainstream smoke.
Ten cigarettes an hour smoked in an enclosed auto pollute the air so much that the carbon monoxide doubles in the blood of smokers and nonsmokers alike and could interfere with driving safety.
Parents who smoke at home can aggravate symptoms in asthmatic children and even trigger attacks in some. Even among non-asthmatic children of such parents, researchers found twice as much respiratory illness.
The Lung Association added that researchers found that smoking seven cigarettes in one hour—even in a ventilated room—lifted carbon monoxide levels in the seat next to the smoker to 90 ppm, almost twice the maximum set for industry. In an enclosed auto, smoking ten cigarettes also produced carbon monoxide levels up to 90 ppm.
Another View of Data on Serum Thyroxine in RDS
Authors: Graham George G. 
Published: December 2021

The article by Redding and Pereira reports that a group of premature infants with RDS had lower mean serum thyroxine levels than a group of prematures "comparable by gestational age" who did not develop RDS and implies a possible causative effect.
Table I of the article indicates that of the 40 prematures with RDS, 10 had a gestational age of less than 29 weeks, 10 had a gestational age of 30 to 33 weeks, and 20 had a gestational age of 34 to 37 weeks.
Vaccination against herpes group viruses
Authors: Plotkin Stanley A. 
Published: December 2021

The development of viral vaccines, like everything else, becomes more complicated with time. Success has been spectacular with vaccines against viral infections such as polio, measles, and rubella. The factor common to this success has been the protective effect of humoral antibody together with (in some cases) antibody secreted on mucosal surfaces. Now virologists are turning their attention towards the herpesvirus group, which presents problems not previously met.
The new problems may be summarized as follows:
(1)The possible oncogenicity of human herpesviruses. Several herpesviruses of animals have been shown beyond reasonable doubt to be oncogenic in homologous or heterologous species. These include the Lucké virus of frogs,1 the Herpesvirus saimiri of squirrel monkeys (oncogenic in other primates),2 and the Marek's virus of chickens.3
Histocompatibility locus antigen W27 and the rheumatic diseases
Authors: Rachelefsky Gary S. , Stiehm E. Richard 
Published: December 2021

A new clue in the quest for an etiology of the rheumatic diseases may be the newfound association of certain of these disorders with the presence of the genetically inherited histocompatibility antigen, HL-A W27. The frequency of this antigen is 5% to 10% in the general population; by contrast, its frequency is 85% to 90% in adults with ankylosing spondylitis and Reiter's syndrome and 35% to 40% in children with juvenile rheumatoid arthritis.
Histocompatibility transplantation antigens are present on the surface of most cells (not erythrocytes) which are capable of inducing a cellular immune response in another of the same species and result in rejection of transplanted tissue or cells.
Effect of Food Supplementation During Pregnancy on Birthweight
Authors: Lechtig Aaron , Habicht Jean-Pierre , Delgado Hernán , Klein Robert E. , Yarbrough Charles , Martorell Reynaldo 
Published: December 2021

The high prevalence of low-birtheight ( (≤ 2,500 gm) babies in many poor communities is a major public health problem. Studies in humans in situations of acute starvation suggest an effect of maternal nutrition on birth-weight, but less clear results appear under situations of moderate maternal malnutrition. We studied the effects of food supplementation during pregnancy on birthweight in four rural villages of Guatemala, in which two types of supplements were distributed: protein-caloric and caloric.
The caloric supplementation increased the total caloric intake during pregnancy. In both supplements, the amount of calories supplemented during pregnancy showed a consistent nt association with birthweight. In the combined sample the proportion of low-birthweight babies in the high-supplement group (G ≥ 20,000 supplemented calories during pregnancy) was 9% compared with 19% in the low-supplement ent gro≤ (&lt; 20,000 supplemented calories during pregnancy). The relationship between caloric supplementation and birthweight (29 gm of birthweight per 10,000 supplemented ented calories) was basically unchanged after controlling for the maternal home diet, height, head circumference, parity, gestational age, duration of disease during pregnancy, socioeconomic status, and different rates of missing data. Moreover, a similar association was found in consecutive pregnancies of the same mother. We concluded that caloric supplementation during pregnancy produced the observed increase in birthweight.
The Interrelationship of Enterokinase and Trypsin Activities in Intractable Diarrhea of Infancy, Celiac Disease, and Intravenous Alimentation
Authors: Lebenthal Emanuel , Antonowicz Irena , Shwachman Harry 
Published: December 2021

Enterokinase initiates digestion of protein by conversion of trypsinogen into trypsin. The interactions between enterokinase and trypsin were investigated in 6 patients with intractable diarrhea of infancy and 34 children with celiac disease. The six infants between 2 and 3 months with intractable diarrhea of infancy had reduced mucosal enterokinase activity (9.5 ± 4.8µM per gram of protein per minute) and reduced intraluminal trypsin activity (2.9 ± 0.7µM per gram of protein per minute) as compared with healthy controls (109 ± 34.2µM per gram of protein per minute and 14.3 ± 5.8µM per gram of protein per minute) respectively. The activities of all enzymes returned toward normal following treatment with intravenous alimentation. The mucosal morphology of all pretreatment biopsies in all cases showed Grade III atrophy which improved. These findings suggest that enterokinase deficiency and reduced intraluminal trypsin activity in intractable diarrhea of infancy may be one of the contributing factors to protein malabsorption and consequent malnutrition. Thirty-four children with celiac disease were between the age of 9 months and 13 years. The 11 newly diagnosed patients with celiac disease demonstrated Grade III to IV atrophy of the mucosa. The 23 patients with treated celiac disease on a gluten-free diet showed a normal to Grade II atrophy. In both treated and untreated celiac disease the enterokinase activities and the intraluminal trypsin activity were within normal limits.
The enterokinase activity in celiac disease is near normal in contrast to the marked reduction noted in intractable diarrhea of infancy even though the intestinal mucosa shows marked morphological alteration and the disaccharidase activities are greatly reduced in celiac disease. After a prolonged alimentary fast of up to 26 days on intravenous alimentation, two patients with intractable diarrhea of infancy showed improvement in the activities of enterokinase and trypsin. These findings demonstrate that enterokinase and trypsin activities in the gut were present and improved in the absence of oral feeding.
Rheumatic Pneumonia: The Need for a New Approach
Authors: Serlin Steven P. , Rimsza Mary Ellen , Gay John H. 
Published: December 2021

Rheumatic pneumonia is a well-described, poorly understood, rare manifestation of rheumatic fever that is generally fatal. Until 1958, when Brown and his colleagues presented their comprehensive discussion, pediatric journals provided only five references. Since then, only one article has appeared in the pediatric literature. As illustrated by the following case report, pediatricians need to be aware of rheumatic pnuemonia in order to determine optimal therapy and management.
CASE REPORT
A.M., a 13-year-old Mexican-American boy, was in apparent good health until he developed fleeting arthralgia, abdominal pain, and low-grade fever. The day following the onset of symptoms acute appendicitis was suspected, and a laparotomy was performed at a community hospital.
Intravenous Injections and Infusions in Infants
Authors: Hanid Tessy K. 
Published: December 2021

Classically the scalp vein and the antecubital veins are used for intravenous infusion in the neonate. For the former, the scalp has to be shaved and parents find this unaesthetic especially as the regrowth of hair may take several months; the latter has the disadvantage of difficult immobilization and the added risk of the infusion needle going into the surrounding tissue. The superficial veins on the back of the hands offer an excellent route for intravenous injection and infusion. This paper describes a constant vein which lends itself to this procedure.
Observation of the back of the hands of many adults reveals this constancy of the vein between the fourth and fifth metacarpals.
Developmental Effects of Seizures: Role of Malnutrition
Authors: Wasterlain Claude G. 
Published: December 2021

Eighty-eight rats were paired at birth according to sex and weight. One member of each pair received two electroconvulsive seizures a day during the neonatal period (days 2 to 11). Access of its control littermate to the mother was restricted so that the body weights of any two paired rats never diverged by more than 2 gm on any day of life, and were usually within one half gram of each other. This guaranteed that the nutritional status of seizuretreated and control animals was similar throughout development.
On day 30 of life, seizure-treated rats had smaller brains (-56 mg, P &lt; .05) and reduced numbers of brain cells (-13.106, P &lt; .05) compared to their control littermates. It was concluded that the reduction of brain DNA brought about by neonatal seizures was not simply caused by malnutrition of seizure-treated animals.
Commentary on Breast-Feeding and Infant Formulas, Including Proposed Standards for Formulas
Authors: Barness Lewis A. , Mauer Alvin M. , Holliday Malcolm A. , Anderson Arnold S. , Dallman Peter R. , Forbes Gilbert B. , Goldbloom Richard B. , Haworth James C. , Jesse Mary Jane , Scriver Charles R. , Winick Myron , Kline O. L. , Miller Robert W. , O'Brien Donough 
Published: December 2021

This statement proposes recommendations toward increasing the practice of breast feeding. Specific recommendations made for standards of infant formulas as to calorie, protein, fat, vitamin, and mineral levels apply to both milk-based and milk-substitute infant formulas. Such formulas, when used in place of breast-feeding, must supply most or all of the nutrients infants require during the first weeks or months of life.
The minimum levels of nutrients per 100 kcal recommended for formulas provide good growth and development in healthy, full-term infants; distinct hazards may be encountered at levels below these. However, no significant advantage is to be gained by providing levels in excess of these minima in normal infants. Recommendations for maximum levels are made only where quantities in excess lead to toxicity; generally, levels near the minima recommended are most desirable because they are the most likely to reflect the composition of human milk, and the least likely to result in any undesirable nutrient to nutrient interaction.
The recommendations also can be used as reference standards for formulas for special dietary uses of "medical" formulas. The Committee recommends that "medical" formulas be classified by FDA into a special group under the paragraph dealing with infant formulas.
Leukemia in Childhood. By Andre D. Lascari, M.D. Springfield, Illinois, Charles C. Thomas, 1973. $16.75; 486 pp
Authors: Fernbach Donald J. 
Published: December 2021

The stated purpose of this text is to serve as a reference source of the significant literature in the English language for physicians treating children with leukemia. Dr. Lascari has accomplished this with a well-organized, lucid text which includes the author's admitted "bias" in a few controversial areas. The strength of the book is in several excellent chapters on uncommon manifestations and complications and unusual leukemia-like diseases.
In the early chapters there is an excellent discussion on etiology which includes a concise review of the possible role of viruses and the potential hazards of chemical leukemogens, among other factors.
Anaerobic Infections in Children: A Prospective Study
Authors: Dunkle Lisa M. , Brotherton Thomas J. , Feigin Ralph D. 
Published: December 2021

The prevalence and significance of anaerobic infections in patients at St. Louis Children's Hospital were studied prospectively for a one-year period. Blood, selected body fluids, and aspirates obtained from abscesses or areas of cellulitis were cultured using special anaerobic collection and processing techniques.
Infected peritoneal fluid from patients with gastrointestinal disease yielded a large proportion of all anaerobic isolates. The types of organisms isolated were common inhabitants of the intestinal tract. Anaerobic organisms were recovered from only 0.75% of all blood cultures; anaerobic bacteremia accounted for 5.8% of all clinically significant bacteremic episodes (8.7% in the neonatal period and 4.8% in children over 1 month of age).
Serious anaerobic infections occurred more frequently in the compromised host or in newborn infants than in otherwise healthy children. Since anaerobic organisms cause a small proportion of infectious diseases in a general pediatric population, the cost of refined bacteriologic techniques for the isolation and identification of these organisms is not warranted in most community hospitals. However, such a program should be available in selected tertiary care centers to aid in the management of certain high-risk patients.
Podophyllum–A Dangerous Laxative
Authors: Rosenstein Gladys , Rosenstein Herman , Freeman Martha , Weston Nathan 
Published: December 2021

A physician asked the Food and Drug Administration (FDA) for information regarding podophyllum. He had under his care an infant born with phocomelia manifested by bilateral absence of the radii. During her pregnancy, the child's mother had occasionally taken a laxative which contained podophyllum as one of its active ingredients. This inquiry led to an intensive search for available information on this subject. The discussion below is a summary of this information. From the data it was determined that podophyllum is too toxic a drug to be used as a laxative, especially since much safer laxatives are available.
The FDA Advisory Review Panel on Over-the-Counter (OTC) Laxative, Antidiarrheal, Emetic and Antiemetic Drug Products, in a recently completed independent evaluation, similarly concluded that podophyllum resin is an unsafe laxative.
Mucocutaneous Lymph Node Syndrome (MLNS) in the Continental United States
Authors: Goldsmith Richard W. , Gribetz Donald , Strauss Lotte 
Published: December 2021

This report details a case of mucocutaneous lymph node syndrome (MLNS) recognized in the continental United States. Reported originally by Kawasaki in 1967,1 the syndrome has since occurred widely in Japan.2 Except for Melish et al.'s report of nine cases in Hawaii, MLNS has thus far not been reported from any other area.3
CASE REPORT
T. S., a 2-year-old white boy, became ill with fever on August 19, 1974, and was examined on the third day of illness. His temperature had fluctuated between 38.9 and 39.4 C; when examined he had a markedly tender 2 x 4-cm single anterior cervical node accompanied by redness of the overlying skin.
Under Scrutiny of Optometry
Authors: Seiderman Arthur S. 
Published: December 2021

I am writing this letter in reference to Silver's article on learning disabilities which appeared in the March 1975 issue of Pediatrics.1 The article certainly was a much needed one, since pediatricians are frequently confronted with questions relating to children with learning disabilities. In general, I must commend the excellent representation and delivery.
The portion of the article which related to my own area of expertise, optometry, I felt was misleading and unfairly dealt with.