bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letters to the Editor
Authors: Cherry James D. 
Published: December 2021

The exanthems noted by Dr. Wolf during the terminal stages of respiratory illnesses in nine patients are of interest. These could all be a manifestation of one infectious agent, but it seems more probable, due to the age spread of the patients and the lack of a more specific syndrome, that multiple etiologic agents are involved. However, the apparent occurrence only in girls is intriguing.
The majority of "newer viral exanthems" have been associated with enteroviruses which, with the exception of certain Coxsackie B and ECHO 11 strains, are not usually noted for respiratory symptomatology.1-3
Ampicillin Dosage
Authors: Nespole A. J. 
Published: December 2021

In the February issue, Young, et al.1 presented a case of Hemophilus influenzae meningitis with apparent relapse following 14 days of ampicillin therapy. The ampicillin, in a dose of 200 mg/kg. day, was given intravenously at 6-hour intervals for 3 days and then the administration was changed to the intramuscular route. The question arises as to whether this case was an example of suppressed continuing infection.
In the first major article published in this country on the use of ampicillin in the treatment of acute suppurative meningitis, Barrett, et al.2 treated 16 patients with meningitis caused by H. influenzae.
A VICTORIAN CHILD READS ABOUT DEATH
Authors: C. T. E. 
Published: December 2021

One of the most popular books written for children in Victorian England was The Peep of Day.1 As with so many other children's books of this period, it contained many religious instructions which were considered to be at the level the child's mind would be capable of receiving and understanding them.
Death of children was a favorite topic in these books and was usually presented to the child in sentimental pietistic terms such as in this passage:
When a little child, who loves God, falls sick, and is going to die, God says to the angels, "Go and fetch that little child's soul up to heaven." Then the angels fly down, the little darling shuts its eye, it lays its head on its mother's bosom, its breath stops;–the child is dead. Where is its soul? The angels are carrying it up to heaven.
How happy the child is now! Its pain is over; it is grown quite good; it is bright like an angel. It holds a harp in its hand, and begins to sing a sweet song of praise to God. Its little body is put into a grave, and turns into dust. One day God will make its body alive again.
Dear children, will you pray to God to send his angels to fetch your souls when you die?
PRIMARY FAMILIAL XANTHOMATOSIS WITH ADRENAL INVOLVEMENT (WOLMAN'S DISEASE)
Authors: Kahana David , Berant Moshe , Wolman Moshe 
Published: December 2021

An apparently sporadic case of primary familial xanthomatosis with adrenal involvement (Wolman's disease) in a Jewish Israeli infant who died at the age of 3 months is described. Clinically, malabsorption and ileus were prominent. Pathological findings included the usual lipid storage process in the intestines, liver, lungs, spleen, and adrenals; storage in interstitial cells in other organs (heart, aorta, etc.); and evidence of lipid storage in the central and peripheral nervous system.
The histochemical findings are believed to suggest that derangement of triglyceride metabolism might be the main feature of the disease.
Islet Cell Adenoma in Newborn
Authors: Ehrlich Robert M. 
Published: December 2021

The article by Salinas, et al., "Functioning Islet Cell Adenoma in the Newborn," in the March issue of Pediatrics (41:646, 1968) raises a number of questions.
If the adenoma was the cause of the hypoglycemia, I am at a loss to explain the mechanism. There was no increase in peripheral venous insulin, as well as no increase in portal vein insulin. Did the authors stain the adenoma for beta cells or insulin granules? Was the tumor extracted for insulin or insulin-like activity?
THE DISAPPEARANCE OF THE GENERAL PRACTITIONER: TWO SIMILAR VIEWS—1872 and 1968
Authors: C. T. E. 
Published: December 2021

In 1968 Doctor Helen M. Wallace in writing about the decrease in the number of general practitioners cites the following facts:
It is clear from the existing data on medical manpower that although the total number of all physicians and of all pediatricians is increasing, the ratio of general practitioners to population is decreasing markedly. . . . For example, the ratio of general practitioners to the childhood population under fifteen years of age fell from 345 pen 100,000 in 1940 to a ratio of 135 in 1961.1
About a hundred years earlier Doctor J. B. Fonssagrives was similarly bothered by the disappearance of the family (general) practitioner. In a book widely read by mothers in the 1870's he wrote:
In former times there was such a person as the family physician; he exists no longer, except in a few small towns where old-time customs are still kept up, and in which free thus far from the cosmopolitan mania, the various generations of a family quietly succeed each other under the same roof.
But how vastly different (1872) is the ordinary course of events! The placid home life is becoming the exception; the house is giving place to the tent; we are born in one town reared in another, married in a third, and we shall die, God knows where. Thus situated–encamped as it were–we do not dream of providing ourselves with a physician. There comes an emergency, and we go from door to door in quest of the first one we may meet.
SKIN TESTING WITH LIQUID OLD TUBERCULIN WITH A MULTIPLE PUNCTURE TECHNIQUE
Authors: Kravitz Harvey , Burg Fredric , Lawson Robert B. 
Published: December 2021

An improved multiple puncture technique (MPT) for tuberculin testing is applied with a nine-pointed plastic ring covered by a tube containing a specially concentrated liquid tuberculin. A high degree of positive and negative agreement was obtained with this test when compared to the Mantoux test (PPD, 5 TU). The reactions from the multiple puncture technique are discrete, single, and circular, and they are easy to read and measure.
Erythema and induration from this test are smaller than from the Mantoux test (PPD, 5 TU). Children appear to show less fear and felt less pain with the multiple point test than with the Mantoux test. "Wet" tuberculin on multiple points eliminates two possible variables associated with "dry" tuberculin on the points–the length of time that the tines are held in the skin and the moisture content of the skin.
CYSTIC FIBROSIS AND DOWN'S SYNDROME
Authors: Milunsky Aubrey 
Published: December 2021

The association of cystic fibrosis and Down's syndrome has been documented for the first time in three cases. While the association may be considered as purely fortuitous, features common to both indicate a contrary possibility. Similar shared features include increased sodium content of parotid saliva, abnormal morphology of nailbed capillaries, autonomic dysfunction, an increased frequency of diabetes mellitus, and intestinal atresia.
Cystic fibrosis probably occurs more frequently in children with mongolism than heretofore suspected. A sweat test is mandatory in a child, albeit a mongol, having recurrent pneumonia.
Septicemia and Enterocolitis Due To Shigella sonnei in a Newborn Infant
Authors: Kraybill Ernest N. , Controni Guido 
Published: December 2021

Shigellosis has been considered an infection usually limited to the mucosa and lumen of the large bowel with occasional involvement of regional lymph nodes. This is undoubtedly true in most cases, but well documented instances of bacteremia associated with severe systemic illnessl-5 suggest that significant blood stream invasion can occur. In the majority of cases the bacteremia was due to Shigella fiexneri or Shigella dysenteriae.
Three cases of Shigella sonnei septicemia in children6-8 and one case in an adult9 have been reported. Recently, the first case report of meningitis and septicemia due to this organism in a newborn infant was published.10
Hattie Alexander
Authors: McIntosh Rustin 
Published: December 2021

The death of Hattie Alexander, on June 24 last, took from pediatrics one of its most loyal and effective participants. Her skill as a clinician and as an investigator of communicable disease won her wide recognition which need not be detailed here, except to recall that she was the first woman to be elected president of the American Pediatric Society.
Two striking aspects of her personality should he mentioned, however, for they have been overlooked by the obituary notices I have seen thus far, including the admirable tribute published in the New York Times of June 25. One is her scientific objectivity, the other, her courage.
Letters to the Editor
Authors: Coleman Allan B. 
Published: December 2021

The idea of incorporating an emetic into aspirin tablets is neither "whacky" nor new. Of course, the concept of the self-correcting poison appeals.
Previous attempts at such combinations have been poorly accepted and seem impractical. Those of us old enough to remember the symptomatic treatment of pertussis with syrup of ipecac in drop doses for infants, remember the rather individual dose-juggling required to stay at a "subemetic" nauseant expectorant level. I seem to recall a self-antidoting sedative plus analeptic tablet a few years ago which has faded into the limbo of useless drugs.
SOCIAL, PSYCHOLOGICAL, AND NEUROLOGICAL FACTORS ASSOCIATED WITH NOCTURNAL ENURESIS
Authors: Oppel Wallace C. , Harper Paul A. , Rider Rowland V. 
Published: December 2021

Data on 859 children, who have been followed longitudinally from birth through 12 years, display associations of nocturnal enuresis with neurological, social, and psychological factors. To study these associations, various groups were formed, taking into account age of attaining ness and presence or absence of relapse. Most comparisons were of enuretic status at 6 to 8 years versus other measures at 6 to 10 years, as specified. Six-year-old children are at increased risk of having never been dry when they have neurological abnormalities on clinical examination, are middle children in birth order, or when their mothers have an unfavorable evaluation of them, a poor marital adjustment, or a low rating on a social contact scale. Other maternal attitudes are more likely to be associated with the never dry status of girls than of boys. Never dry 7 year olds are more sensitive, more likely to suppress feelings, more with-drawn, less ambitious, and have less fear of failure than the permanently dry group.
Relapsers at 6 to 7½ years are more likely to be of low socioeconomic status, have a large number of siblings and display the following personality traits: decreased fear of failure, decreased anxiety and tension, and increased impulsivity when compared to non-relapsers.
Low birth weight carries an increased risk of both prolonged bedwetting (never dry) and relapsing when it is associated with low I.Q. or poor performance on reading tests. Poor performance on Bender-Gestalt tests also is associated with increased risk of relapsing in children who are of low birth weight.
THE EPILEPTIC CHILD AND COMPETITIVE SCHOOL ATHLETICS
Authors:   COMMITTEE ON CHILDREN WITH HANDICAPS
Published: December 2021

THE RISK of injury during competitive athletics is real and constant for all children, even in the presence of well supervised programs. Injury may occur despite efforts to select the proper sport and to ensure that individual skills are sufficiently developed, that the environment and terrain are suitable, and that the equipment is properly designed and fabricated. To keep this risk at a minimum, it is necessary at times to modify the athletic program of children with certain health disorders. One of these is epilepsy.
In children with epilepsy, as in children with any chronic disorder, it is important that the patient and his family recognize early during the course of the disease that certain adjustments in the daily routine may need to be made. However, in considering adjustments, one must strike a balance between the needs of the child to participate with his peers in their daily activities and the limitations to living a full life which any restriction may impose. With proper balance in these areas and optimal management of the disease process, the child with chronic illness would be able to develop the self-confidence necessary to live independently in the community as an adult.
Epilepsy is a disorder which may accompany or follow a large number of known medical conditions. However, from a quantitative point of view, the major problem is the group of children with seizures of unknown etiology, or idiopathic epilepsy. The convulsive seizure results from a sudden hypersynchronous discharge which disrupts the usual pattern of neuronal activity, resulting in a variable disturbance in some function of the nervous system.
CAT SCRATCH DISEASE: NONBACTERIAL REGIONAL LYMPHADENITIS
Authors: Margileth A. M. 
Published: December 2021

Of 145 patients with nonbacterial lymphadenitis observed over a period of 10 years, 115 had clinical cat scratch disease (CSD) with a positive cat scratch antigen skin test. In this group 86% had a typical benign course of CSD; the remaining 16 (14%) had an atypical form. These unusual forms were: Parinaud's oculoglandular syndrome in 7, encephalopathy in 3, atypical pneumonia in 2, and recurrent suppurative lymphadenopathy in 1. Two typical cases occurred after a dog scratch or bite, and one after a monkey scratch.
The disease was most prevalent in late fall and early winter; 80% of patients were under age 20 years. Primary lesions were detected in 55%, node suppuration occurred in 26%, and lymphadenopathy lasted 2 weeks to 2 months in most patients. Symptoms were absent in 35% of cases. Fever occurred in 26%, and exanthem was present in 4%. Lymphadenopathy was most common in the extremities (57%), and head and neck (43%). Cat scratch antigen was found to be a reliable diagnostic skin test. A negative test was found in 98% of control patients; a positive test was found in 94% of patients who were clinically suspected to have CSD and a history of cat scratch.
Management consisted of reassurance, symptomatic therapy, and closed aspiration of enlarged nodes if suppuration occurred. Antibiotics were not effective. The disease is self-limited and has an excellent prognosis in the majority of patients. An etiologic agent could not be isolated in this study. Until the causative agent is known, it will be difficult to carry out preventive measures.
VITAMIN D AND CRANIOFACIAL AND DENTAL ANOMALIES OF SUPRAVALVULAR STENOSIS
Authors: Rowa Richard D. , Cooke Robert E. 
Published: December 2021

Few pediatric disorders have undergone such fascinating extensions to their clinical picture as has been the case in idiopathic hypercalcemia of infancy during the past decade.
Features of the infantile illness were described in the early 1950 by workers in England and Europe. Ten years later an apparently unrelated vascular disorder comprising a peculiar facies, mental retardation, supravalvular aortic and pulmonary stenosis and dental anomalies was reported from New Zealand and Germany. Black and Bonham Carter, at the Hospital for Sick Children, Great Ormond Street, through recognizing a similarity between the facial apperance of these retarded older children and the elfin facies characteristic of infantile hypercalcemia, were able to postulate a relationship between the two clinical entities.
Neuroblastoma, Presenting as Myasthenia Gravis in a Child Aged 3 Years
Authors: Robinson M. J. , Howard R. N. 
Published: December 2021

A case is recorded of ganglioneuroblastoma in a child of 3 years of age, who has to date survived for 18 months after treatment by combined surgery, radiotherapy, and chemotherapy.
Clinical features of this case were those of myasthenia gravis, and they disappeared after excision of the tumor. Such an association has not previously been reported.
The capacity of the ganglioneuroblastoma group to act as "functioning" tumors is discussed.
John Thomson: Pioneer and Father of Scottish Paediatrics, by W. S. Craig. Edinburgh and London: E. and S. Livingstone Ltd., 1968, 96 pp., 21 s ($2.50)
Authors: Cone Thomas E. 
Published: December 2021

Of the triumvirate who created and ennobled British pediatrics, the names of two, Sir George Frederic Still (1868-1941) and Sir Thomas Barlow (1845-1945) are well-known; the third, Dr. John Thomson (1856-1926), is far less known, not only to the cisatlantic pediatrician but also to his transatlantic counterpart.
Fortunately, Professor Craig's short biography of John Thomson will introduce most readers for the first time to one of the greatest pediatricians of this century. The book is obviously a labor of love because the author-as did everyone else who knew Thomson-was deeply inspired by his gentleness, his kindness, and his ungrudging, unsparing, and unyielding efforts to improve the care and cure of children.
The Neonate with Congenital Heart Disease, by Richard D. Rowe, M.D., Ch.B., F.R.C.P. (Edin.), and Au Mehrizi, M.B. Philadelphia: W.B. Saunders Company, 1968, 445 pp., $12.50
Authors: Dushane James W. 
Published: December 2021

The Neonate with Congenital Heart Disease should prove to be a successful member of the monograph series on major problems in clinical pediatrics. The book is highly recommended for the physician interested in neonatobogy, pediatrics, or pediatric cardiology.
The early chapters cover those aspects of the anatomy, physiology, physical examination, electrocardiography, radiology, incidence, and etiology of congenital heart disease that pertain to the newborn. The text, while brief, successfully summarizes the subject in a concise and lucid manner, using a strikingly extensive and current bibliography.
PATHOGENESIS OF SEIZURES OCCURRING DURING RESTORATION OF PLASMA TONICITY TO NORMAL IN ANIMALS PREVIOUSLY CHRONICALLY HYPERNATREMIC
Authors: Hogan Gwendolyn R. , Dodge Philip R. , Gill Sheila R. , Master Susan , Sotos Juan F. 
Published: December 2021

The present study describes the results of rehydration of rabbits rendered chronically hypernatremic by the administration of one molar sodium chloride solution by nasogastric tube for 23½ to 5 days. When these animals were rehydrated intravenously over a 4-hour period with 2.5% dextrose in water, returning the plasma sodium level to normal, 55% of them developed focal or generalized convulsions.
The mean water content of brain tissue of the group of animals who had seizures was significantly greater than that of a normal group of animals and comparable to that found in a water-intoxicated group of animals. This elevation of water content could be accounted for by both an elevated content of potassium and chloride in the brain. The potassium content of the brain was higher in the rehydrated group of animals without than those with seizures. Ways by which the observed changes may be related to the development of seizures are discussed.
CONGENITAL ATRESIA AND STENOSIS OF THE DUODENUM
Authors: Fonkalsrud Eric W. , deLorimier Alfred A. , Hays Daniel M. 
Published: December 2021

A review is presented of 503 patients with congenital duodenal obstruction, compiled from 65 hospitals by the Surgical Section of the American Academy of Pediatrics. Four hundred eighty-seven patients underwent primary operative correction of the malformation with an overall early and late mortality rate of 36%.
Complications from associated major congenital malformations were the leading cause of death. Many of these anomalies were potentially correctable had they been recognized and early treatment instituted. More than half of the infants with duodenal atresia had associated malformations. Thirty percent of the patients had Down's syndrome.
End-to-side or side-to-side duodenoduodenostomy or jejunostomy are the most commonly used operative techniques for duodenal atresia. General anesthesia and tube gastrostomy are usually employed.
HYPOGLYCEMIA AND HYPERINSULINEMIA ASSOCIATED WITH ERYTHROBLASTOSIS FETALIS
Authors: Raivio Kari O. , Österlund Kalle 
Published: December 2021

In a survey of blood glucose levels in 232 erythroblastotic infants during the first 3 days of life, 12 cases of significant hypoglycemia were revealed. Most of these had a severe primary disease; the incidence of hypoglycemia was 17.8% in patients with cord hemoglobin concentrations below 10 gm per 100 ml and 1.9% in those with higher cord hemoglobin levels. The low glucose values were usually observed during the first day of life and were unassociated with recognizable symptoms. Plasma insulin levels, determined in 39 cases before age 24 hours and prior to treatment, were shown to be negatively correlated with the cord hemoglobin concentrations.
Hyperinsulinemia, directly correlated with the severity of the erythroblastosis, is postulated to be the cause of the low blood glucose levels. As another consequence of the hyperinsulinemia, a depression of the plasma free fatty acid concentrations was documented.
The mechanism of the hyperinsulinemia, the therapeutic and prognostic implications of the hypoglycemia, as well as the effect of the depression of free fatty acid levels on the bilirubin-binding capacity of serum are briefly discussed.
AVAILABILITY, EFFECTIVENESS, AND ECONOMY OF CHILD HEALTH SERVICES
Authors: Butler Allan M. 
Published: December 2021

The critical state of medicine in the United States has been amply documented by the National Conference on Medical Costs, June 1967, and the Report of the National Advisory Commission on Health Manpower, November 1967. In spite of our wealth, science, technology, medical schools, hospitals, research facilities, and budgets; our relatively high ratio of 1 doctor per 700 people; and the exemplary quality of our best medicine, international health indices give the United States not only poor, but also falling ratings-due of course to the poor education, nutrition, socioeconomic circumstances, and health care that result in the high mortality and morbidity of 30% of our population.
RETURN ON THE HEALTH DOLLAR SPENT
Meaningful and accurate comparative costs of medical care are hard to come by. But the following approximations give an order of magnitude of costs that, with our relatively poor health ratings, indicate a poor return on the health dollar in the United States. In 1963 the medical care of the 45,000,000 people of Great Britain cost approximately $4,000,000,000-or $90 per person-while the medical care of our 180,000,000 people cost approximately $33,000,000,000-or $194 a person. In 1965 Great Britain spent roughly 4.5% of its Gross National Product on health care as compared to our 6%-and her per capita Gross National Product was, of course, less than ours. The United States is now spending approximately 6.3% of its annual Gross National Product of approximately $800,000,000,000, or $50,000,000,000 on annual health care. This is $250 a person per year for our 200,000,000 people.
Pasteurella multocida in Dog and Cat Bite Infections
Authors: Torphy D. E. , RAY C. G. 
Published: December 2021

The infected dog or cat bite is a common problem, particularly in pediatrics. These infected bites can produce moderate tissue destruction, and, if on the face or neck, disfigurement may result. Careful debridement is indicated; and, unless primary repair is necessary for cosmetic reasons, the wound should not be sutured.
Although a variety of organisms have been cultured from infected bites, Pasteurella multocida is the most common. Since P. multocida is extremely sensitive to penicillin, the prophylactic use of this antibiotic in potentially disfiguring wounds should be considered. In the already infected animal bite wound, penicillin or one of its analogues is recommended.