bluuebunny/crossref_metadata_2025_split huggingface dataset:
OPHTHALMOLOGIC FINDINGS IN CHILDREN WITH CEREBRAL PALSY
Authors: Schachat Walter S. , Wallace Helen M. , Palmer Myra , Slater Beatrice 
Published: December 2021

In a study of 98 children with cerebral palsy, 67 (68%) had either gross ocular defects or significant refractive errors, or both.
Only 20 children were known to be under the care of an ophthalmologist. Ophthalmologic recommendations were indicated for 69 children.
Seventeen children had a visual handicap severe enough to warrant special educational measures. Forty-three children were found to have strabismus, the most frequent ocular defect found. This was approximately evenly divided between esotropia and exotropia. Children with the spastic types of cerebral palsy had twice as many ocular defects and twice as many refractive errors as the athetoid types.
A complete ophthalmologic evaluation of every child with cerebral palsy is recommended as part of the total examination of the child.
CONGENITAL MALFORMATIONS AND OBSTETRICS
Authors: Davis M. Edward , Potter Edith L. 
Published: December 2021

The existence of a malformation in a fetus is not often associated with abnormalities of pregnancy or labor. The chief concern of the obstetrician is in counseling the parents concerning future childbearing.
Malformations were reported by the National Office of Vital Statistics as responsible for 4.4 neonatal deaths per 1000 live births during the first 3 months of 1950. They accounted for 24% of the deaths of infants weighing over 2500 gm; 7% of the deaths of infants weighing under 2500 gm; that were born in the U.S. during this interval.
In a study of 5000 consecutive births at the Chicago Lying-in Hospital in 1951 and 1952, 210 surviving infants were found to have certain conditions considered to be malformations. It was thought that not more than 10% of these infants, or 4.2 per 1000 births, would be handicapped by the malformations. Coupling this with the deaths and stillbirths occurring during the same period gives a total of 10.6 per 1000 births. Thus about 1% of reported births are infants with lethal or handicapping malformations which can be diagnosed at or soon after birth.
Lethal malformations involved the central nervous system more often than any other part of the body, with anencephaly the most common single anomaly. Cardiac malformations were second, with those of the gastrointestinal and genitourinary tracts about equal in third and fourth places.
Malformations occur more commonly in males than females and in white than non-white and in the children of women who are near the beginning or end of the age when reproduction is possible.
Genetic disturbances can rarely be shown to be the cause of lethal malformations.
PREMATURITY AND RICKETS
Authors: Eek S. , Gabrielsen L. H. , Halvorsen S. 
Published: December 2021

Sixty-nine premature infants receiving different dietaries and with birth weights below 2,000 gm were studied with chemical, clinical and radiologic methods. Vitamin D was given to all infants from the age of 4 days.
The concentrations of calcium, phosphorus and phosphatase in the serum showed variations toward those seen in active rickets. These changes were somewhat more marked in infants fed human milk than cow's milk. Supplementation of human milk with dried skimmed cow's milk did not significantly alter these changes.
Craniotabes was more frequently seen in premature infants fed human milk than cow's milk. Otherwise, no clinical signs of rickets were found.
All the premature infants were born with a metaphyseal zone of rarefaction. These zones are believed to be the result of a disturbance in ossification which occured during the last weeks of pregnancy, perhaps caused by a factor which was also responsible for the premature birth. They gradually merge with the general osteoporosis developing 10 to 13 weeks after birth. Later, periosteal double contours are visible. These double contours are the first signs of an improved mineralization.
There was no correlation between abnormal chemical findings and the most conspicuous radiologic or clinical findings. No case of recognizable rickets was observed among the infants studied.
This risk of rickets, despite an adequate supply of vitamin D, is probably not as great as stated by previous investigators, and is probably the same whether the infants are fed human milk or cow's milk.
A SUMMARY OF SOME CLINICAL ASPECTS OF OBESITY
Authors: Gordon Harry H. 
Published: December 2021

AS A POINT of departure for this summary I wish to present an outline of mechanisms for the development of obesity. With minor changes, it is one recently proposed by Van Itallie and is based on the concept that there exist multiple etiologic factors— genetic, traumatic and environmental—in the development of obesity.
The fact that there are two main categories—1) regulatory, i.e., with no primary metabolic abnormality, and 2) metabolic—does not imply that patients with obesity obey some law higher than that of the conservation of energy. Studies by Newburgh and his co-workers established this for all patients beyond argument from wishful nonbelievers. Mayer has stressed, however, that Newburgh's work should not serve as a rigid, at times puritanical, obstacle to consideration of the problems of individual patients, a point of view inherent in Newburgh's listing of different "proximate causes to which some persons respond (in part) by overeating."
Patients with a regulatory disorder may develop obesity as a result of increased caloric intake or decreased caloric output or frequently both. Under increased caloric intake, we have two categories, "organic" and "functional." We have put quotes about both headings because this common form of categorization implies a sharp division in our thinking and sometimes interferes with our therapeutic approach to patients; most of us still feel more comfortable with a patient whose complaints are organic rather than so-called functional. We think of nephrosis and galactosemia as organic diseases but, in the present state of our knowledge, have to fall back on calling the increased glomerular permeability of the former and the enzymatic defect of the latter, lesions in chemical anatomy. Perhaps advances in electronmicroscopy and histochemistry will ultimately make use of this term more literal.
INFLUENCE OF PRIOR ACTIVE IMMUNIZATION ON THE PRESENCE OF POLIOMYELITIS VIRUS IN THE PHARYNX AND STOOLS OF FAMILY CONTACTS OF PATIENTS WITH PARALYTIC POLIOMYELITIS
Authors: Wehrle Paul F. , Reichert Ralph , Carbonaro Ory , Portnoy Bernard 
Published: December 2021

Isolations of poliovirus from 55 household contacts of 12 patients with paralytic poliomyelitis demonstrate that prior immunization does not prevent the acquisition of inapparent infection with poliovirus under conditions of household exposure.
Although there was no apparent interference with enteric multiplication of poliovirus, an accurate estimate of the relative rates of acquisition of infection with poliovirus between immunized and unimmunized children of comparable ages was not possible. However, enteric infection with poliovirus appeared to be slightly less frequently encountered among the age group most frequently immunized.
Poliovirus was present in the pharynges of previously immunized contacts of patients with paralytic poliomyelitis less frequently and in lower titer during the study period than in those without prior immunization.
The apparent diminution in both presence and concentration of poliovirus in the pharynx in infections acquired after immunization may be important in the epidemiology of this infection in an immunized population where high standards of environmental sanitation are observed and good personal hygiene is practiced.
CONGENITAL DEFECTS IN ADRENAL STEROID SYNTHESIS
Authors: Bongiovanni Alfred M. 
Published: December 2021

SCRUTINY of the adrenocortical steroids excreted in the urine of patients with the adrenogenital syndrome (due to congenital adrenal hyperplasia) has afforded an opportunity to localize the biochemical defects attributable to an inborn error of metabolism and has elucidated the normal pathway for biosynthesis in the adrenal gland in man. The studies of Hechter on the biogenesis of hydrocortisone in the beef adrenal has indicated a stepwise oxidation of progesterone toward the fulfillment of the requirements for the final product, namely hydrocortisone. Hydrocortisone is indeed a "final product" in the economy of the pituitary adrenal axis: When its rate of secretion is low, larger amounts of adrenocorticotropin (ACTH) are released in an attempt to stimulate the adrenal cortex. If the target gland cannot properly synthesize hydrocortisone, the pituitary continues to stimulate the gland, which produces large quantities of "abnormal" intermediary metabolites. Certain of these latter substances are androgenic and account for the clinical manifestations.
An oxygen function must be introduced into the progesterone molecule at carbons 17, 21 and 11 in order for the adrenal cortex to manufacture hydrocortisone. The oxygen is introduced at each position, presumably under the control of separate enzymes tentatively termed "hydroxylases" and specified by the position they affect. If one or more of these enzymes is lacking, hydrocortisone is not produced, or is synthesized in limited quantities. Depending upon the particular enzymatic defect, the unusual metabolites measured in the blood and urine vary, as does the type of disease encountered.
In all forms of the adrenogenital syndrome virilization is present.
ENTEROVIRUSES
Authors: EICHENWALD HEINZ F. 
Published: December 2021

A NUMBER of years ago, investigations utilizing monkeys resulted in the recovery of three types of poliomyelitis viruses from the human gastrointestinal tract. More recently, the use of infant mice led to the discovery of an entirely new family of enteric viruses, the Coxsackie agents, which, on the basis of histopathologic reactions in mice, are divisable into two subgroups: A, with 19 serologically distinct members; and B, with 5.
A further advance in methodology, the use of simplified methods of tissue culture, resulted in the isolation of a third family of viruses from the intestinal tract, named, by general agreement, the enteric cytopathogenic human orphan (ECHO) group.
STOSSTHERAPY IN ACUTE RESPIRATORY INFECTION IN CHILDREN
Authors: STEIGMAN ALEX J. 
Published: December 2021

STOSSTHERAPY is a word of Germanic origin, Stoss referring to "a thrust" or "a push." The term has been used to describe a method of treating rickets with a single massive dose of vitamin D. In a recent article (Brit. M. J., 1:487, March 1, 1958) the author "thrusts" antibacterial agents at children and compares the results with conventional treatment by antibacterial agents over a period of some days.
The chief contribution of this paper is to remind the reader that careful earlier studies showed that a single massive dose of sulfonamide can be curative of pneumococcal pneumonia in children, a fact established almost 20 years ago. In the debit side is the introduction of a burdensome word in a paper remarkably devoid of appropriate documentation.
Between October, 1952, and October, 1954, 174 children with acute lower-respiratory-tract infection were treated at the Evelina Children's Hospital of Guy's Hospital, London, with penicillin by injection or oral sulfonamide, or a combination of both. The personal preferences of no less than 14 doctors who admitted these patients dictated the decisions regarding therapy.
THE ADMINISTRATION OF OXYGEN TO INFANTS AND SMALL CHILDREN
Authors: Batson Randolph , Young William C. 
Published: December 2021

Oxygen therapy techniques have been discussed and data have been presented which support the contention that most commerically available equipment does not fulfill the prerequisites for adequate oxygen therapy, especially when such devices are to be used for the treatment of infants and small children.
The open-top oxygen box method for oxygen therapy is superior in every respect including efficiency, economy, and practicality. Observations supporting this have been reported.
The open-top oxygen box constructed with transparent material and equipped with humidification apparatus and cooling chamber, has the following advantages: The speed (10 minutes) with which one can obtain therapeutic concentrations of oxygen with satisfactory humidity and temperature; the maintenance of therapeutic concentrations of oxygen during patient care procedures; easy observation of patient through transparent plastic walls; claustrophobia is not experienced by patient; adequate wash out of carbon dioxide with no necessity for soda-lime tube; easy accessibility to patient for care, observation and conversation; ideal suitability for high humidity or "mist" treatment of tracheobronchitis and other upper respiratory infections; portability (total weight 19 kg); economy (incurs less than half the expense of oxygen tents during operation and the initial cost of equipment is far less).
There are precautions that should be taken in employing open-top oxygen box therapy: due to air currents the device should not be placed in direct drafts or in the vicinity of electric fans. Because of the small size of the box in its present form it is impractical for use in children over the age of 8 years. Medical personnel should be constantly alert to the possibility of apertures that can develop because of improper application or rents in the sleeve.
CONGENITAL DISORDERS OF THE MECHANISM FOR COAGULATION OF BLOOD
Authors: Didisheim Paul , Lewis Jessica H. 
Published: December 2021

Ninety-two new cases of hemophilia A and 16 of hemophilia B are reported.
The data, together with those from other reported series, suggest that hemophilia A and B comprise over 90% of all congenital hemorrhagic diseases due to defective formation of a fibrin clot. Of those with deficiencies of AHF or PTC, the incidence of PTC deficiency is about 16%.
The rise in age at death of patients with hemophilia from 14.5 to 29 years since 1940 is largely attributed to the wide use and availability of fresh blood and its derivatives.
The usefulness of various coagulation tests in the differential diagnosis of the congenital abnormalities of the clotting mechanism is demonstrated.
With the development of more sensitive diagnostic techniques, the concept of hemophilia has broadened to include many cases of very mild clinical disease in patients with essentially normal life expectancy. Specific assay procedures are necessary for diagnosis.
AVITAMINOSIS E IN CYSTIC FIBROSIS OF THE PANCREAS
Authors: Blanc William A. , Reid Joseph D. , Andersen Dorothy H. 
Published: December 2021

Ceroid-pigment is present in the smooth muscle fibers of the gastrointestinal tract of patients with cystic fibrosis of the pancreas. It is first seen during the second year of life. It is found in all patients of 5 years of age and older, and the amount increases with age.
It has not been found in other pediatric conditions with the exception of biliary atresia and cirrhosis of the liver.
Extensive ceroid deposit probably represents an expression of prolonged and severe vitamin-E deficiency, related to protracted malabsorption of fat-soluble tocopherols.
Alterations of striated muscle appear to be rare and minimal in cystic fibrosis of the pancreas.
ACUTE POISONING ASSOCIATED WITH INHALATION OF MERCURY VAPOR
Authors: Matthes Fred T. , Kirschner Rudolph , Yow Martha D. , Brennan James C. 
Published: December 2021

Four cases of pneumonitis associated with the inhalation of mercury vapor are described in detail. Three of the four cases were fatal.
The illness was characterized by the sudden onset of tachypnea, cough, fever, gastrointestinal disturbances and central nervous system manifestations.
Ordinary laboratory tests were not helpful in establishing the diagnosis. Quantitative analysis of the urine for mercury was suggestive but not diagnostic. Roentgenograms of the lungs revealed interstitial pneumonitis.
Analysis of tissue for mercury in the lungs, liver and spleen of two of the cases showed substantially increased mercury content.
The outstanding pathologic features in the three fatal cases were erosive bronchitis and bronchiolitis, with severe interstitial pneumonitis.
The presently accepted mode of therapy for acute poisoning due to ingestion of mercury is early use of BAL. Its use is probably also indicated in acute poisoning due to inhalation of mercury vapor. Supportive care in the form of oxygen, mist, and parenteral fluids is indicated.
PEDIATRIC OUTPATIENT DEPARTMENTS
Authors: Korsch Barbara Maria 
Published: December 2021

The author of the following statement is one of a group of pediatricians with special interests in the functions of an outpatient department, especially in regard to the role of ambulatory care in pediatric education. This group has engaged in a series of informal discussions at the times of meetings of the American Pediatric Society and the Society for Pediatric Research.
It was generally agreed that general statements pertaining to the importance of the outpatient department, "pep talks" urging senior staff to participate in outpatient activities, and missionary zeal on the part of a few, will not suffice to achieve the maximum potentialities of outpatient departments.
The group discussions have demonstrated the need for objective standards for outpatient care, formulation of essential principles of good teaching in the outpatient department, and a further realization of the possibilities for research in the problems presented by ambulatory patients.
The remarks presented here do not constitute a comprehensive or formal report of the opinions of all who took part in the discussions, but are intended to be the author's formulation of some of the current problems in order to promote consideration by a larger audience.
TREATMENT OF HEPATIC COMA
Authors: SASS-KORTSAK ANDREW 
Published: December 2021

A PECULIAR neurologic syndrome, combined with alteration in consciousness and culminating in coma, is one of the most serious manifestations of liver failure. Better understanding of the fundamental metabolic changes leading to the development of hepatic coma have resulted lately in improved methods of treatment and prevention.
The accumulation of ammonia in the blood and tissues was shown to be at least one of the important factors in the causation of hepatic coma. The ammonia derives from nitrogenous substances of unknown nature which are produced by the normal bacterial flora in the bowel from dietary protein and are absorbed into the portal venous system. An inability of the failing liver to convert ammonia to urea and the presence of natural or artificial shunts between the portal and systemic venous bed, allowing for these substances to bypass the liver, are the two key factors, either one or both of which may result in accumulation of ammonia in the body.
DECREASED AORTIC ATHEROSCLEROSIS IN CYSTIC FIBROSIS OF THE PANCREAS
Authors: Holman Russell L. , Blanc William A. , Andersen Dorothy 
Published: December 2021

The degree of fatty streaking of the aorta (percentage of the intimal surface that stains red with Sudan IV) in 18 cases of fibrocystic disease of the pancreas was compared with that in 21 control cases of the same age group (6-13 years inclusive). All cases were of the white race. The average percentage of the intimal surface involved with fatty streaks was over four times as great in the control group as in the group with fibrocystic disease.
The metabolic abnormalities in cystic fibrosis of the pancreas are reviewed in an attempt to discover the mechanism whereby atherosclerosis of the aorta is suppressed. The low levels of most lipids and of chloride in the blood in this disease are pointed out, but in view of the complexity of both fibrocystic disease and atherosclerosis no satisfactory conclusions as to their relationship were attained.
Regardless of the ultimate interpretation of these data, fibrocystic disease of the pancreas appears to be the first human disease with decreased atherosclerosis to be documented.
NEONATAL THYROTOXICOSIS
Authors: Javett S. N. , Senior B. , Braudo J. L. , Heymann Seymour 
Published: December 2021

Two cases of congenital goiter with severe thyrotoxicosis are described. In one instance, unusual tachycardia was noted in utero. The mothers, treated before conception with radioactive iodine and thyroidectomy, respectively, were, at the time of delivery, not only thyrotoxic, but markedly exophthalmic.
Treatment of the infants with Lugol's solution intravenously and orally, with the addition of propylthiouracil in one case, resulted in a return to normal after a few weeks.
Appraisal of the pathogenesis of neonatal thyrotoxicosis favors the transplacental passage of a thyroid-stimulating agent, probably derived from the mother's pituitary.
The thyroid status of neonates born of mothers taking medication for thyrotoxicosis reflects the interaction between the transmitted thyroid-stimulating agent and the particular drug being employed.
CLINICAL CONFERENCE
Authors: Arias Irwin , Schorr Julian B. , Fraad Lewis M. 
Published: December 2021

Dr. Barnett: I think few of us would consider that we know enough new about pyloric stenosis to justify presenting an infant with it to a group of this type. However, the patient to be presented had what appears to be a complication of pyloric stenosis, which we had not encountered previously and one which is of both practical and theoretic interest. The patient will be described and the discussion opened by Dr. Fraad.
Dr. Lewis Fraad: Infants with congenital hypertrophic stenosis with or without complications continue to fascinate pediatricians, even though the first American cases were reported in 1788.
The patient is a boy, the first-born infant of a 21-year-old mother. The pregnancy and delivery were uneventful. The birth weight was 2.5 kg. Upon discharge from the newborn nursery at 6 days of age, occasional regurgitation of feeding was noted. By the age of 3 weeks the infant had gained only 90 gm. Five days prior to admission to the hospital, vomiting became profuse and projectile. One day before admission the infant's skin appeared yellow to the mother. Upon admission to the hospital at the age of 4 weeks, the infant's weight had decreased to 2,360 gm. He appeared dehydrated and markedly jaundiced. The liver was palpated at the costal margin. An olive-shaped mass measuring approximately 2.5 by 1.5 cm was easily palpated in the midepigastric region.
The pertinent laboratory findings in the blood at the time of admission were as follows: Hemoglobin, 19.5 gm/100 ml; CO2 content, 37.2 meq/l; chlorides, 79 meq/l; sodium, 142 meq/l; potassium, 3.0 meq/l; bilirubin, 18 mg/100 ml of which 13.1 mg was reported to be of the indirect-reacting variety.
Oral feedings were discontinued. With hydration by intravenous fluids, the electrolyte concentrations in the serum returned to normal values but the high value for bilirubin and the jaundice persisted. Identification of the type of bilirubin by paper chromatography revealed that it was all of the indirect variety. Ramstedt pylorotomy and liver biopsy were performed on the third hospital day.