bluuebunny/crossref_metadata_2025_split huggingface dataset:
THIRSTING AND HYPERNATREMIC DEHYDRATION —A FORM OF CHILD ABUSE
Authors: Pickel Stuart , Anderson Charles , Holliday Malcolm A. 
Published: December 2021

Three cases of hypernatremic dehydration following periodic water deprivation by psychotic mothers are presented as examples of child abuse. This represents a previously unreported form of child abuse and a previously unrecognized cause of hypernatremia in children in the range from 2 to 8 years of age.
From the acute changes in body weight and sodium concentration in serum in the period of hydration, it was deduced that the dehydration sustained by these children was not associated with NaCl deficits.
THE MOTHER'S TIE TO HER CHILD
Authors: Richmond Julius B. 
Published: December 2021

Several years ago John Bowlby wrote a paper entitled "The Nature of the Child's Tie to His Mother."1 This and the growing literature on "imprinting" pioneered by the ethologists have focused attention on the significances of early experiences for the development of the young organism-human and nonhuman.
The nature of "the mother's tie to the child" has not received as much attention. Therefore, it is heartening to note an early report of a study, "Neonatal Separation: The Maternal Side of Interactional Deprivation," in this issue.2 Maternal behavior has been explored thus far mainly in animal studies. Some years ago we demonstrated that brief separation of newborn goats from their mothers resulted in a significant interference with the specificity of the mother's affection for her young.3
THE USE OF CHLORPROPAMIDE IN DIABETES INSIPIDUS IN CHILDREN
Authors: Ehrlich Robert M. , Kooh Sang Whay 
Published: December 2021

Oral chlorpropamide was administered to 17 children with diabetes insipidus (D.I.). The cause of the D.I. was idiopathic, six; histiocytosis, five; craniopharyngioma, three; pinealoma, two, and post-traumatic, one. Twenty-four-hour urine volume and measurements of serum and urine osmolality at the beginning and end of a 7-hour water deprivation test were used to evaluatechlorpropamide therapy. Administration of 150 to 400 mg of chlorpropamide per day by mouth caused a reduction in urine volume in all patients (range 8 to 67%). No change in aldosterone, 17-hydroxycorticoids, or electrolyte excretion was noted. Serum electrolytes and glomerular filtration rate were not affected by therapy. Glucose tolerance and plasma insulin response remained normal in those patients tested. Mild leucine sensitivity without significant change in plasma insulin was induced in four children.
During water deprivation, seven patients with secondary D.I. but only one with idiopathic D.I. produced hypertonic urine.
Hypoglycemia developed in seven children and is the major hazard of treatment.
Long-term management of D.I. has been possible in nine children. Oral chlorpropamide is a useful drug in children with vasopressin-sensitive diabetes insipidus.
PERIPHERAL AND RENAL VEIN PLASMA RENIN ACTIVITY IN COARCTATION OF THE AORTA
Authors: Strong William B. , Botti Robert E. , Silbert Daniel R. , Liebman Jerome 
Published: December 2021

Fifteen patients (ages 4 to 21 years) with coarctation of the aorta were studied. Ten patients were catheterized prior to surgery and both peripheral and renal vein plasma renin activity (PRA) were measured. Twelve patients were operated upon and peripheral PRA was measured pre-operatively and during the acute (postoperative day 0 to 10) and long-term postoperative (M = 112 days) period.
Three children, not as yet operated upon, have been catheterized. Prior to catheterization, each received a sodium restricted diet (less than 500 mg NaCl) for 48 hours.
The peripheral plasma renin activity was within the range of normal both preoperatively (18 ± 10 ng/ml) and long-term postoperatively (12 ± 5 ng/ml) p &gt; 0.1 . The three patients who received sodium restriction prior to catheterization showed borderline to moderately elevated peripheral and renal vein PRA, suggesting that the renin apparatus responded to appropriate stimulation.
During the acute postoperative period, each patient had a transient elevation of peripheral PRA. This elevation might be a partial stimulus to aldosterone production in the acute postoperative period.
There was no correlation between peripheral PRA and blood pressure levels in the postoperative period. It was concluded that the renin-angio-tensin system does not play a significant role in maintaining the chronic hypertension which is associated with coarctation of the aorta.
Letter To The Editor
Authors: Giunta Frank 
Published: December 2021

Dr. Giunta commented as follows:
The doctor is perfectly correct in questioning whether there was a reason for doing the study as we did.
From the start, it was apparent that the study would include very sick premature infants such as those with respiratory distress syndrome who would require intensive nursing care, frequent monitoring of equipment, as well as blood gas determinations and chemistries.
Since supplemental lighting such as with gooseneck lamps had been used in the past during feeding, monitoring, and drawing blood samples, it was felt that clothing the control group would expose them to a minimum of additional light.
Testicular Leukemia
Authors: Leef F. , Kende G. , Ramot B. 
Published: December 2021

The paper by Dr. Finklestein and others,1 leaves one with the impression that testicular involvement in acute leukemia, an almost general finding at post mortem, is an uncommon clinical problem.
We wonder whether lack of awareness might not be responsible for this, as our own experience suggests. In a clinic that follows at any time about 20 children and young adults with acute leukemia, we had seen only one case of testicular involvement (presenting symptom) in 3 years.
Physical Abuse of Children
Authors: Fontana Vincent J. 
Published: December 2021

The article entitled "Physical Abuse of Children" by Gil,1 in a recent supplement to Pediatrics on "Childhood Injuries-Approach and Perspectives," deserves comment concerning the pediatrician's viewpoint in order to avoid any misconceptions that might arise from reading this article.
Dr. Gil is not a physician or a pediatrician and probably has not had the unfortunte experience of seeing an abused or "battered" child. He has stated his findings and expressed his recommendations and opinions concerning the problem.
Letter To The Editor
Authors: Gezon Horace M. 
Published: December 2021

Dr. Gezon commented:
Dr. Lee's comparing the ecology of the Siaphylococcus in the newborn nursery to that of soft-shell clams on the coastline is quite appropriate. It is entirely possible that some of the success attributed to hexachlorophene bathing and handwashing was in fact the natural disappearance from the nursery of Staphylococcus aureus phage patterns 80/81, 80 and 80/81/52/52a which were the principal pathogenic strains in U.S. hospitals in the late 1950's and early 1960's.
GENETIC AND CLINICAL CONSIDERATIONS OF LONG-ARM DELETION OF THE X CHROMOSOME
Authors: Hsu Lillian Y. F. , Hirschhorn Kurt 
Published: December 2021

A 13-year-old girl with short stature and obesity was found to have 46, XXq-in 90% of cultured leukocytes and 45, X in 10%. Autoradiographic studies showed the long-arm deleted X to be the late replicating X chromosome. In no cell was the normal X chromosome found to be late replicating. Our findings, combined with others from the literature, imply genetic inactivation of all structurally abnormal X chromosomes. Therefore, a previous hypothesis regarding the location of the Xga gene on the short arm of the X chromosome is not valid.
The hypothesis that normal somatic development in females may require the presence of the short arm of both X chromosomes prior to X inactivation remains likely. The XO line found in our patient probably accounts for her short stature.
Screening for Lead Poisoning
Authors: Lin-Fu Jane S. 
Published: December 2021

As one deeply interested in the problem of childhood lead poisoning, I am glad to see that the American Academy of Pediatrics has recently issued a statement on this important but neglected pediatric problem.1 This comprehensive statement will be a useful guideline to pediatricians and other health workers.
However, I am concerned about the screening tests recommended for lead poisoning. The statement "Pending improvements in the analysis of lead in blood, the urine ALA test of Davis and Andelman and the analysis of lead in hair, which are currently under study, offer the best substitute for the purpose of mass screening" would have been correct if it were made 2 years ago when these tests were first reported, before they were studied by other investigators.
Pediatric Decalogue
Authors: Schnitzer William F. 
Published: December 2021

You might find these commandments suitable for publication among the Letters. I wrote them several years ago:
PEDIATRIC COMMANDMENTS
1. Never use the word hurt: it's use creates more apprehension and fear.
2. Please hold the child securely: when necessary, it is much more considerable than repeated restraint.
3. Empty mouths of chewing gum and candy: and please don't bring crackers, cookies or soda to the office.
4. No climbing on furniture: it is embarassing as well as painful to sustain an injury here.
GENETIC DETERMINATION OF ACUTE DISSEMINATED HISTIOCYTOSIS X (LETTERER-SIWE SYNDROME)
Authors: Juberg Richard C. , Kloepfer H. Warner , Oberman Harold A. 
Published: December 2021

Male twins first developed maculopapular eruption of the scalp at 9 months of age and then of other cutaneous areas during the next 3 months. They manifested otorrhea, anemia, and abdominal enlargement at 11 months. They had fever, massive hepatosplenomegaly, and moderate lymphadenopathy when admitted to the hospital at 12 months. There were histiocytes in the skin and bone marrow. The clinical impression of monozygosity was confirmed by several criteria.
One twin died at 15 months with diarrhea, and the other twin died at 21 months after developing scattered osteolytic lesions and diabetes insipidus. Autopsy findings in both twins were characteristic of acute disseminated histiocytosis X with diffuse infiltration of nonlipidic histiocytes. An unusual finding was extensive liver involvement in both twins.
Evidence for genetic determination of the disease consists of analysis of the literature reports in three categories. Twin studies show three of four pairs of monozygotic twins concordant for the trait. Sibship analysis of the familial occurrence by the a priori method with correction for multiple ascertainment is consistent with the genetic hypothesis. One consanguineous mating has been reported among the seven sibships of familial occurrence.
We conclude that at least some instances of this disease result from a single, autosomal, recessive gene with slightly reduced penetrance.
THE RELATIVE RATES OF SYNTHESIS OF HEMOGLOBINS A AND F IN IMMATURE RED CELLS OF NEWBORN INFANTS
Authors: Bard Harry , Makowski Edgar L. , Meschia Giacomo , Battaglia Frederick C. 
Published: December 2021

Studies were carried out to explore whether the proportion of adult and fetal hemoglobin synthesized by immature red cells of cord blood would provide a precise correlation with the degree of maturity of the newborn infant.
Cord blood samples were obtained from newborn infants ranging from 25 to 43 weeks' gestation in whom the gestational age estimates from menstrual history and physical examination, including neurological examination, were in close agreement. The blood samples were incubated in an amino acid mixture containing Cl4 leucine, followed by column chromatography on DEAE Sephadex for separation of adult and fetal hemoglobin fractions. The radioactivity in the adult and fetal hemoglobin fractions was measured. The percent of radioactive fetal hemoglobin synthesized by immature red cells provided a more precise correlation with the infant's gestational age than the percent of fetal hemoglobin present in cord blood at the time of birth. The percent of radioactive fetal hemoglobin was unaffected in infants with severe erythroblastosis who had in utero transfusions. In infants with intra-uterine growth retardation, the proportion of fetal hemoglobin being synthesized was significantly greater than expected for the estimated gestational age.
CHARLES DICKENS AND HENRY MORLEY DESCRIBE THE DIFFERENCES BETWEEN THE PRACTICE OF PEDIATRICS AND ADULT MEDICINE
Authors: C. T. E. 
Published: December 2021

Between 1850 and 1859, Charles Dickens published his own magazine, Household Words; The articles for which were written by Dickens alone or in collaboration with less wellknown writers.
The issue of April 3, 1852, contained an article called Drooping Buds, written by Dickens with the assistance of Henry Morley; in this article Dickens and Morley point out the particular needs a physician must consider when treating the illnesses of infants and children. The following superbly expresses these differences:
It does not at all follow that the intelligent physician who has learnt how to treat successfully the illnesses of adults, has only to modify his plans a little, to diminish the proportions of his doses, for the application of his knowledge to our little sons and daughters. Some of their diseases are peculiar to themselves; other diseases, common to us all, take a form in children varying as much from their familiar form with us as a child varies from man. Different as the ways are, or ought to be, by which we reach a fault in a child's mind, and reach a fault in the mind of an adult; so, not less different, if we would act successfully, should be our action upon ailments of the flesh. There is another thing, also, which puzzles the physician who attends on children. He comes to us when we are ill, and questions us of this symptom and of that; and on our answers he is taught, in very many cases, to base a large part of his opinion.
RESEARCH ISSUES IN CHILD HEALTH A HEAD START RESEARCH SEMINAR
Authors: Wagner Marsden G. 
Published: December 2021

This and the two following articles (pages 874 and 884) conclude the Seminar. Papers I and II by Drs. A. Frederick North and Robert J. Haggerty appeared in Pediatrics, 45: 690 and 702, 1970. Reprints for the entire series, to be bound aS one, will be available through Dr. North's office, 2125 Thirteenth Street, N.W., Washington. D.C. 20009.
It has been stated that a health problem, to be of importance, must have a definite impact on the day-to-day functioning of the child. Perhaps this criterion applies equally to any aspect of a program such as Head Start, whose goal is increased health and development of children. Is there research data or can we obtain data to answer questions such as, "What does this program mean to the family?," and "Can a school or Head Start health program be so integrated into the family subculture as to initiate desirable change in family health behavior?" This family health behavior, including nutritional habits, sleeping habits, traditional health remedies, child care arrangements, and so forth, is, of course, infinitely more important to the health of the young child than those rare visits to a physician or clinic which are most likely far removed from his own milieu. The field of medical anthropology provides a number of documented examples of attempts to superimpose an outside system of health care onto groups.1-8 The subsequent failure of most of these attempts has been due to a failure to consider such questions as those just raised concerning Head Start.
EVALUATION OF THE ROUTINE PHYSICAL EXAMINATION OF INFANTS IN THE FIRST YEAR OF LIFE: REVIEW
Authors: Webb Clarence H. 
Published: December 2021

In view of the fact that this reviewer has spent a considerable part of his professional career rendering the type of service which Dr. Anderson decries as unnecessary, it is difficult to review the article without doing what the author found difficult to avoid, which is to be swayed by preconceptions. It is hoped that the author will temper his bias with the reviewer's bias to bring conclusions and recommendations out of the study which the figures justify and which are nearer the middle of the road.
There are physicians in pediatrics who consider regular examination of infants and children to be desirable and productive; there are physicians who prefer that a variety of methods be used in pediatrics until it is fully demonstrated that one is superior to the other and do not wish to be forced into a "new pediatrics" unless it is demonstrably better; and, there are parents who bring their babies to pediatricians for reasons other than those mentioned, i.e., for treatment or prevention of abnormal conditions.
Their babies are precious commodities and they wish to know that the babies do not have abnormalities but also want reassurance that they are caring for the babies properly, affording them attention and supervision which is not just good but is superior, and being good parents who are helping their babies in every way to develop the best of their potentials. Herein lies an innate difference between public health and private health in pediatrics which seems to have been highly desirable to pediatricians and parents in the past.
Letter To The Editor
Authors: Papadatos Constantine , Pavlatou Maria , Alexiou Demosthenes 
Published: December 2021

We would like to thank Dr. W. Hughes for his stimulating comment on our paper on "Cephalosporium Meningitis."
It is true that the term "yeast-like" organisms was misleading, as the elements seen on the direct smear were not budding cells but elliptical spores.
In our patient, as Dr. Hughes mentions, Candida albicans was isolated from the nose, throat, and rectal cultures but not from the Cerebrospinal fluid. We were led to believe cephalosporium was the etiologic agent of the disease in this baby because the same elliptical spores, distinct from C. albicans, have been isolated in two different CSF cultures taken with all possible precautions for accidental contamination.
FETAL HEART SIZE MEASURED IN VIVO BY ULTRASOUND
Authors: Garrett William J. , Robinson David E. 
Published: December 2021

In the course of routine, two-dimensional ultrasonic echoscopy, echograms have been obtained which show the outline of the fetal heart and interventricular septum. Measurements of the echograms show the fetal heart to occupy 21% of the cross-sectional area of the chest at its widest transverse diameter and to occupy 52% of the transverse diameter of the chest at the same level.
The ratio of the tranverse diameter of the left ventricle to that of the right (L.V. ÷ R.V.) is 1.23. The fetal heart grows at the same rate as the fetal chest in the last 8 weeks of pregnancy.
Letter To The Editor
Authors: Rosenlund Mary Loretta , Koop C. Everrett 
Published: December 2021

Doctors Rosenlund and Koop comment as follows:
We are sorry Drs. Prouty and Oakley missed the objective of our article, which was merely to share the experience of a pediatric hospital regarding the incidence of duodenal ulcer disease. We did this because of the many conflicting reports, not to initiate further conflict. If our study presents a "distorted picture" regarding the incidence of ulcer disease in children, perhaps this is because of our strict criteria for the diagnosis (see article).
Left Ventricular Rhabdomyoma: A Rare Cause of Subaortic Stenosis in the Newborn Infant
Authors: Kuehl Karen S. , Perry Lowell W. , Chandra Roma , Scott Lewis P. 
Published: December 2021

A newborn infant with cardiac failure resulting from a rhabdomyoma of the left ventricle obstructing the aortic outflow tract is described. Mild subvalvular pulmonary stenosis was also present because of a tumor in the ventricular septum. Tuberous sclerosis occurs in at least half of infants with such tumors and was present pathologically in this child, although not apparent clinically.
Rhabdomyomas must be considered in the differential diagnosis of heart disease in the newborn infant and may be associated with tuberous sclerosis even when nervous system and cutaneous signs are not present.
CONGENITAL DEFICIENCY OF FACTOR XIII: REPORT OF A FAMILY FROM NEWFOUNDLAND WITH ASSOCIATED MILD DEFICIENCY OF FACTOR XII
Authors: Hanna Mary 
Published: December 2021

In a family with 14 children severe deficiency of factor XIII was found in three living members who suffered from moderate to severe bleeding manifestations. A fourth child died with intracranial hemorrhage. In addition to the above deficiency, two of the three propositi and two siblings were mildly deficient in factor XII. The bleeding manifestations of these cases are solely due to factor XIII deficiency; siblings with factor XII deficiency alone were asymptomatic. Both factor deficiencies here seem to be separately inherited.
The most striking findings in factor XIII deficiency are bleeding from the umbilical cord, which is invariably found, and intracranial hemorrhage frequently encountered in the pediatric age group. The present communication, for the first time, reports on gastrointestinal hemorrhage as a manifestation of this disease. Also, in this family hemarthrosis was not uncommon and characteristically did not lead to residual crippling.
ATYPICAL PHENYLKETONURIA IN A FAMILY WITH A PHENYLKETONURIC MOTHER
Authors: Yu J. S. , O'Halloran M. T. 
Published: December 2021

A family study demonstrates the current complexity of the phenylketonuria group of diseases.
Conventional testing methods are unable to discriminate confidently between the carrier state of atypical and classical phenylketonuria. It is therefore impossible at the present time to evaluate the possibility of multiple alleles at the phenylalanine hydroxylase locus or to exclude the effects of one or more modifying genes as the cause of atypical phenylketonuria.
In the family reported, a phenylketonuric mother and father, heterozygous for the phenylketonuric gene, have produced three children, two with atypical phenylketonuria and the other a heterozygote. All the children were microcephahic and retarded, reflecting the intra-uterine damage caused by the mother's phenylketonuria.
DIGITALIS TOLERANCE IN YOUNG PUPPIES
Authors: Halloran Katherine H. , Schimpff Steven C. , Nicolas Jean G. , Talner Norman S. 
Published: December 2021

Tolerance to acetyl strophanthidin, a rapid-acting cardiac aglycone, was determined in 28 anesthetized mongrel puppies, ages 16 to 56 days, and compared to tolerance in 16 littermate puppies in whom acute hypercapnic acidemia was produced. The tolerance was also compared to that of four adult mongrel dogs. The toxic dose was defined as the intravenous amount required to produce four consecutive premature ventricular contractions.
A marked variation in the toxic dose was found in the 28 control puppies (range 83 to 353 µg/kg, mean 169 µg/kg) which could not be correlated with age, arterial blood gases or pH, serum potassium or sodium, arterial pressure, or heart rate. The toxic dose was significantly greater in the puppies than in the adult dogs, in whom the mean toxic dose was 64 µg/kg (range 50 to 89 µg/kg). A significant increase in tolerance was also observed in the puppies with hypercapnic acidemia (mean toxic dose 220 µg/kg, range 93 to 375 µg/kg) in comparison to tolerance in the control puppies and despite the wide range of tolerance, each of the puppies with hypercapnic acidemia showed greater tolerance than its littermate control puppy. Assessment of the clinical implications of these findings will require study of the effects of alterations in acid-base balance on the inotropic effect of acetyl strophanthidin in addition to the toxic electrophysiologic effects.