bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADJUSTMENT OF VENTILATION AND PERFUSION IN THE FULL-TERM NORMAL AND DISTRESSED NEONATE AS DETERMINED BY URINARY ALVEOLAR NITROGEN GRADIENTS
Authors: Krauss A. N. , Soodalter J. A. , Auld P. A. M. 
Published: December 2021

The urinary alveolar nitrogen gradient was measured serially in 20 normal and six distressed full-term newborn infants. When the gradient is small (less than 10 mm Hg) ventilation is evenly distributed throughout the lung. When a large gradient is determined this is a reflection of numbers of alveoli with low ventilation-perfusion (VA/Q) ratios. In healthy adults used as a control for the method, a gradient of less than 10 mm Hg was recorded. Healthy, nondistressed newborn infants were almost all within the normal range from the first day of life.
Infants found to have distress due to meconium aspiration or transient neonatal tachypnea had large gradients throughout the first week of life. The studies indicate that the healthy, full-term infant rapidly achieves a normal distribution of pulmonary ventilation, whereas serious maldistribution of ventilation occurs in meconium aspiration pneumonia.
The Effectiveness of Methylphenidate Hydrochloride (Ritalin) on Learning and Behavior in Public School Educable Mentally Retarded Children
Authors: Blacklidge Virginia Y. , Ekblad Robert L. 
Published: December 2021

Three classes of public school children in EMR classes were administered methylphenidate hydrochloride (Ritalin) and a placebo in a double-blind study, with each child acting as his own control, to evaluate the effects of this medication on classroom behavior, academic performance, and home behavior. Pupils were rated on the Burks Behavior Rating Scale by teachers and parents; and the Gray's Oral Reading Paragraphs, the arithmetic section of the Wide Range Achievement Test, and the Porteus Mazes were administered.
Only the teachers' ratings of classroom behavior showed a statistical difference in response to methylphenidate hydrochloride. Neither the parents' ratings of behavior nor the children's performance on the academic measures showed a statistically significant difference in response to treatment.
Additional studies are needed to clarify the teachers' impression of improved academic performance and to study the effects of medication on the classroom environment as a whole. This additional study might need to be conducted over a longer period of time and different measures of academic improvement might be used. If behavior at home is to be studied, the medication should be given just before the pupil leaves for home.
BOOK OF ACCIDENTS (1830)
Authors: Cone Thomas E. 
Published: December 2021

In nineteenth century America, falls from horses must have been a common cause of accidental death of children because so many parents' manuals of the period contained warnings to keep children away from horses. The lesson below, written for children in 1830, vividly describes what may happen to a little boy who tries to ride his father's horse.1
An amusing proverb occasionally included in these warnings was: "It is a good horse that never stumbles and a good wife that never grumbles."2
Audio-Visual Unit
Authors: Wharton B. A. 
Published: December 2021

We have recently set up a small audio-visual teaching unit at this hospital, for use by our residents, postgraduates, and undergraduates.
Slide and cassette sets have been purchased from the "Teaching Aids at Low Cost" unit (TALC) of the Institute of Child Health, London, and from the Medical Recording Service Foundation, of the Royal College of General Practitioners. We hope that some of our own staff members will make their own sets for us.
Utilization of Allied Health Workers: Does It Solve the Basic Problem?
Authors: Baren Martin , Bell Leo S. , Misbach William D. , McKay R. J. 
Published: December 2021

I have recently received a questionnaire from the Academy concerning my feelings on the training and subsequent utilization of allied health workers, especially the pediatric nurse associate. I feel the time has come to face the fact that we as pediatricians are trying to solve the solution-not the basic problem-when we talk about the utilization of the various assistants.
For the past 10 years or so, pediatricians have been talking about the "New Pediatrics" and other such "changes" in our approach to child care, but as with so many other ideas, the practice continues to rule.
Spot Test for Lead in Paint (Continued)
Authors: Sayre James W. 
Published: December 2021

Questions asked by several people about our sodium sulfide testing of paint for lead1 make us feel we might wisely add several words of caution about the stability of the prepared solution.
Sodium sulfide solutions deteriorate fairly rapidly with age, especially on exposure to air. For this reason, it is suggested that people using the procedure check the odor of the sodium sulfide solution tlley are using, to make sure the odor of hydrogen sulfide is detectable.
ACCEPTANCE OF THE PRESIDENCY
Authors: Arena Jay M. 
Published: December 2021

June 12-13, 1931, in Atlantic City at the first regular meeting of the American ademy of Pediatrics, Dr. Isaac A. Abt, the first president, defined the purpose of this new society. There was no need, he claimed, for another scientific society, but "it has been our desire to build an association so that every qualified pediatrician could seek membership . . . We must perfect our department of medicine where imperfections exist." He went on to say that the Academy should be an organization for action in behalf of the health and welfare of all children.
Forty years later, the Academy has become just that–an "organization of action." This is clearly demonstrated by its 35 national committees, many of which are truly outstanding and have made innumerable contributions over the years to child health and the delivery of health care (Committee on Infectious Disease, Accident Prevention, Fetus and Newborn, Nutrition, and the Council on Pediatric Practice, to mention a few).
There are many challenges that confront us today, but the most serious in my opinion is the grave manpower shortage and maldistribution in the delivery of primary health care to all of our children. We have the "chiefs but not the Indians." In most instances we have ample numbers, talented and productive in most subspecialties. In a few, we many even have too many. But as for the hard-working, dedicated "local pediatrician," with the constant challenge of a private practice and its physical and emotional demands, there is a woeful scarcity and a great need.
HAZARDS OF LAUNDRY PRODUCTS USED IN THE NEWBORN NURSERY
Authors: Yaffe Sumner J. , Bierman Charles W. , Cann Howard M. , Gold Arnold P. , Kenney Frederic M. , Riley Harris D. , Schafer Irwin , Stern Leo , Weiss Charles F. , Shirkey Hary C. , Ballin John C. , Bishop Jeffrey , Farchione Louis , Lockhart Jean D. , Sawchuk Steven 
Published: December 2021

Published reports and unpublished communications to the Committee on Drugs of the American Academy of Pediatrics indicate that substances potentially hazardous to the premature and full-term newborn infant continue to be used in the laundering of clothing, diapers, and bedding for hospital nurseries. In 1962 the Subcommittee on Accidental Poisoning called attention to occurrences of methemoglobinemia in premature and full-term newborn infants whose diapers were autoclaved after a final laundry rinse with the bacteriostatic agent, 3-4-4' trichlorocarbanilide (TCC).1 Subsequent reports in the pediatric literature confirmed and added to these "epidemics" of neonatal methemoglobinemia2-4 and suggested that aniline–a wellknown cause of methemoglobinemia5–resulting from the break-down of TCC during autoclaving, was absorbed from diapers and other nursery clothing through the skin of the infants. Although direct proof of the etiologic role of TCC is lacking, the association is of sufficient concern that the forthcoming Academy manual, Standards and Recommendations for Hospital Care of Newborn Infants, Second Edition, makes reference to the hazards of using TCC. Although a limited and informal survey of hospital nurseries in the United States and Canada indicates that most hospital laundry procedures have abandoned TCC in treating clothing and bed linens of newborn infants, sporadic instances of neonatal methemoglobinemia associated with exposure to this substance still come to the attention of local, state, and national health agencies, manufacturers, and the Committee on Drugs.
In 1967, deaths and severe illness occurred in epidemic form in the newborn nursery of a small Midwestern maternity hospital.6 Investigation revealed that the sodium salt of pentachlorophenol (PCP)— which was present in the antimicrobial neutralizer product used in the final rinse of the laundry process for diapers, infant undershirts, and crib linens for the nursery–intoxicated babies by percutaneous absorption.7
Allergy and Urinary Infections: Is There an Association?
Authors: Gerrard J. W. , Jones Betty , Shokier M. K. , Zaleski Anne 
Published: December 2021

We were very interested in the letter1 from Dr. Harrison1 in which she commented both on the high incidence of genitourinary infections families in which there was a high incidence of allergic problems, and also on the frequency with which genitourinary and allergic problems appeared to be concentrated in families. She asked if there was any explanation. We think there is.
We ourselves have recently studied a group of 89 girls with recurrent urinary infections, and expect soon to publish our results.
Allied Health Workers in Pediatrics
Authors: Pick Walter 
Published: December 2021

I would like to present my point of view regarding the use of allied health workers in pediatrics.
The Colorado plan under Dr. H. Silver, as well as the Feldshen experience in the Soviet Union, are excellent ways to bring pediatric help into areas that would otherwise go without. However, to make a virtue out of such necessity and to convince pediatricians that this is the preferred way to practice pediatrics swings the pendulum backwards.
SPECIAL ARTICLE: SHEDDING LIGHT ON THE USE OF LIGHT
Authors: Klein Richard M. 
Published: December 2021

Radiation from the sun or from artificial sources is part of the basic environment impinging on all organisms. Its causal role in health and disease of man is seen daily by the clinician. Within the past decades, however, radiation has become important as a clinical and research tool. The generation, control, and measurement of radiation requires some application of photobiological and photophysical principles, not only to satisfy the editor of a periodical, but also to allow other investigators and clinicians to evaluate the results and conclusions, to permit confirmation and extension of reports, and to use radiation effectively in research and in practice. Although this brief resume of some of the perils and pleasures of photobiology is not comprehensive, it may provide a base for studies and reports in which radiation is a parameter.
You will note that the term radiation has been used, rather than the more common term, light. Actually, there are two systems of nomenclature, one dealing with radiation as a physical entity, the other with what is called the photometric or psychophysical system. Light is a people-word, referring to that small segment of the electromagnetic spectrum that stimulates the optic nerve. If a mosquito were the dominant and articulate life form, the word light would be restricted to wavelengths below those perceived by man; the region we call the ultraviolet. Since much of radiation research does not involve the human eye, photometric terminology has little meaning and, as we shall see, may provide information that is very misleading.
Non-Puerperal Induced Lactation
Authors: Jelliffe Derrick B. , Jelliffe E. F. Patrice 
Published: December 2021

The December 1971 issue of Pediatrics has just become available here and we are writing to amplify the letter by Dr. Robert Cohen (p. 997) "Breast Feeding Without Pregnancy," and the note by the Associate Editor.
Briefly, the phenomenon sometimes termed "non-puerperal induced lactation" has been, and, in some areas, still is, a well-recognized, culturally accepted emergency method of feeding young babies whose mothers have died in childbirth. There is considerable literature in anthropological and historical records1,2 and the writers have personally observed induced lactation in various parts of the world, including the Yoruba community of Nigeria, when samples of breast milk from such women were found to show a low normal protein content.3
JOHN LOCKE (1632-1704) ON THE CHILD'S BED
Authors: C. T. E. 
Published: December 2021

In his Thoughts concerning Education, John Locke, the philosopher-physician, gave a Mr. Edward Clarke of Chipley, near Taunton, England, detailed rules for bringing up his son. Locke's advice about Mr. Clarke's son's bed follows:
Let his Bed be hard, and rather Quilts than Feathers. Hard Lodging strengthens the Parts; whereas being buried every Night in Feathers, melts and dissolves the Body, is often the Cause of Weakness, and the Fore-runner of an early Grave. And, besides the Stone, which has often its Rise from this warm Wrapping of the Reins; several other Indispositions, and that which is the Root of them all, a tender weakly Constitution, is very much owing to Downe-Beds. Besides, He that is used to hard Lodging at Home, will not miss his Sleep (where he has most need of it) in his Travels abroad, for want of his soft Bed, and his Pillows laid in order. And therefore, I think it would not be amiss, to make his Bed after different Fashions, sometimes lay his Head higher, sometimes lower, that he may not feel every little Change he must be sure to meet with, who is not design'd to lie always in my young Master's Bed at home, and to have his Maid lay all Things in print, and tuck him in warm. The great Cordial of Nature is Sleep. He that misses that, will suffer by it: And he is very fortunate, who can take his Cordial only in his Mother's fine Gilt Cup, and not in a Wooden Dish.
THE SMALL-FOR-DATE INFANT. II. NEUROLOGICAL AND INTELLECTUAL SEQUELAE
Authors: Fitzhardinge P. M. , Steven E. M. 
Published: December 2021

A prospective study has been done on 96 full term small-for-date infants to determine the incidence and type of neurological and intellectual sequelae. Major neurological defects were uncommon with an incidence of 1% for cerebral palsy and 6% for convulsions. Minimal cerebral dysfunction characterized by hyperactivity, a short attention span, learning difficulties, poor fine coordination and hyper-reflexia was diagnosed in 25%. EEG abnormalities predominantly of a diffuse mild nature were seen in 59% of the boys and 69% of the girls (similar EEC tracings are reported in 27% of apparently normal children). Speech defects featuring immaturity of reception and expression were present in 33% of the boys and 26% of the girls. Hearing and vision were not appreciably affected.
The average IQ was 95 (boys) and 101 (girls). However 50% of the boys and 36% of the girls had a poor school performance.
THE PUZZLE OF PERIODICITY
Authors: Hornbein Thomas F. 
Published: December 2021

While the last gasp enjoys rather catholic cognizance, the first seems to be primarily the domain of a breed of physiologically curious pediatricians concerned with the respiratory health of newborns. In this issue Drs. Henrique Rigatto and June P. Brady,1,2 present studies attempting to unravel the mechanisms underlying the periodic breathing seen at times in otherwise "healthy" preterm infants. As is often the case, their efforts provoke more questions than they answer.
Periodic breathing is considerably more common than its adult counterpart, Cheyne-Stokes ventilation, occurring in 30% to 40% of premature infants. The ventilatory pattern consists of a series of breaths interspersed with 3- to 15-second periods of apnea.
PERIODIC BREATHING AND APNEA IN PRETERM INFANTS. II. HYPOXIA AS A PRIMARY EVENT
Authors: Rigatto Henrique , Brady June P. 
Published: December 2021

We studied nine healthy preterm infants during the first 35 days of life to define the relationship between periodic breathing, apnea, and hypoxia. For this purpose we compared ventilation/apnea (V/A), minute ventilation, and alveolar and capillary blood gases during periodic breathing induced by hypoxia and during spontancous periodic breathing in room air. We induced periodic breathing by giving the baby in sequence 21, 19, 17, and 15% O2 to breathe for 5 minutes each, and also by giving 21, 15, and 21% O2. We measured ventilation with a nosepiece and a screen flowmeter. With a decrease in arterial oxygen tension, preterm infants (1) hypoventilated, (2) breathed periodically more frequently, and (3) showed a decrease in V/A due to an increase in the apneic interval. In one baby this led to apnea lasting 30 seconds.
These findings support our hypothesis that preterm infants breathing periodically hypoventilate and suggest that hypoxia may be a primary event leading to periodic breathing and apnea.
WHAT A HEALTHY TWO- OR THREE-YEAR-OLD CHILD WAS FED IN 1839
Authors: C. T. E. 
Published: December 2021

Compared with the varied diet of today's 2- or 3-year-old child, that advised by Dr. Caleb Ticknor in 1839, and given below, will strike us as being rather unappetizing.
A healthy child, of 2 or 3 years old, commonly awakes, hungry and thirsty, at five or six o'clock in the morning; sometimes even earlier. Immediately after awaking, a little bread and sweet milk should be given to it (sic), or (when the child is too young to eat bread), a little bread pap. The latter should be warm; but in the former case, the bread may be eaten from the hand, and the milk allowed to he drunk cold, as it is as well, at this meal, to furnish no inducement for eating, beyond that of hunger. After eating, the child will generally sleep again for an hour or two; and about nine o'clock, it should get its second meal, of bread softened in hot water, which latter is to be drained off, and fresh milk, and a little sugar, added to the bread. Between one and two, the child may have dinner, consisting, at the younger ages, of beef, mutton, or chicken broth, (deprived of all fat), and bread. When a sufficient number of teeth are developed to admit of chewing being performed, a little animal food, as chicken, roast or boiled mutton, or beef, not too much dressed, should be allowed, with a potato or bread, and some fresh, well-dressed vegetable, as turnips or cauliflower. After dinner, some drink will be requisite; and a healthy child requires, or indeed wishes for, nothing but water.
How Much Medical Evaluation for Reading Disability?
Authors: Snyder Russell D. 
Published: December 2021

After several years of extensive experience in evaluating children with reading problems, I agree with Kenny et al. that medical and neurological evaluations of these children have only a minimal role. Previously unrecognized poor vision, previously unrecognized epilepsy, and previously unrecognized mental retardation are just not found. Also, any teacher or parent can recognize clinically significant hyperactivity.
However, the authors have overlooked a very important function of the physician's evaluation. In many parts of this country the children with reading problems are left to the whims of aggressive school districts and rigid programs of remediation.
Otitis Media, Milk Allergy, and Folk Medicine
Authors: Phillips Barry L. 
Published: December 2021

In his recent article, "Otitis Media in the First Six Weeks of Life." Dr. Bland suggested that middle ear infection occurred predominately in bottle-fed babies because breast-fed babies perhaps enjoyed the advantage of IgA in breast milk.
An alternative explanation would be an allergy to cow's milk with resultant inflammation and blockage of the eustachian tubes leading to middle ear infection.
I would suggest that a baby with a history of recurrent otitis media in the first year of life be given a three-month trial on a strict cow's milk elimination diet.
FOLLOW-UP: THE BACTERIAL ETIOLOGY AND ANTIBIOTIC MANAGEMENT OF SEPTIC ARTHRITIS IN INFANTS AND CHILDREN
Authors: Nelson John D. 
Published: December 2021

In 1966 we published our experience with 117 cases of septic arthritis seen on the pediatric services of Parkland Memorial Hospital and Children's Medical Center in Dallas. That review brought to attention the hitherto unrecognized frequency of Hemophilus influenzae in this disease and, by emphasizing the wide variety of bacteria involved, tried to make the point that precise bacteriological diagnosis was essential to optimal therapy.
This follow-up report of 221 patients adds the 104 patients treated from 1966 through 1970 to the previous series. The tabular material is arranged in the same manner as in the report covering the years 1955 through 1965 for easy comparison. (Tables I to IV) This analysis excludes patients with joint involvement secondary to osteomyelitis except for the unique situation of septic hip in which it is difficult to determine whether joint infection or bone infection is the primary event.
The average number of cases per year has steadily risen but this appears to reflect mainly the even-enlarging medical population served rather than a real increase in frequency of septic arthritis. For example, total pediatric admissions rose by 32% from 1960 to 1970 while septic arthritis cases increased 46%.
1955-59: 6.4 cases per year
1960-65: 14.2 cases per year
1966-70: 20.8 cases per year
A bacteriological diagnosis was established in 66.5% of cases overall (Table I) but the figure is higher during the past decade when the quality of diagnostic bacteriology was improved.
1955-59: 34%
1960-65: 71%
1966-77: 73%
Part of the improved percentage of bacteriological diagnosis stems from better use of blood cultures.
Utilization Review
Authors: Rako Jules 
Published: December 2021

The article by Duff et al. regarding inpatient care is a very important article because it focuses on the many unnecessary hospital admissions at community hospitals. My own personal experience coincides with their figures.
Why are there so many unnecessary hospitalizations? I am sure that pediatrics is not the only field that has many unnecessary hospitalizations, but community hospitals are very ill equipped for intensive pediatric care, unless the hospital has a sound university affiliation.
Accidents and Automobiles
Authors: Mofenson Howard C. 
Published: December 2021

The article in Pediatrics by Pless et al. brought several very important issues in Accident Prevention to the attention of the pediatrician. The most important were:
1. Almost half of the deaths in children from 1 to 14 years of age are the result of accidents, not diseases that take up most of the time in pediatric training.
2. Nearly half of the accidental deaths involved motor vehicles.
3. Pediatric departments and pediatricians, in general, are not interested in this facet of pediatrics.
Diseases of the Newborn, ed. 3, by Alexander J. Schaffer, M.D., and Mary Ellen Avery, M.D. Philadelphia/London/Toronto: W. B. Saunders, 1971, 919 pp., $22.00
Authors: Vulliamy David 
Published: December 2021

Six years after publication of the second edition, Dr. Schaffer has produced a third revised version of his well-known book, this time in collaboration with Dr. Mary Ellen Avery. Dr. Milton Markowitz has contributed by writing the cardiological section and Dr. Laurence Finberg that on fluid and electrolyte therapy.
The book remains essentially a comprehensive practical clinical guide to the subject of neonatal disease, intended primarily for "the medical student, the resident, the pediatrician and the general practitioner," but surely most medical students would be daunted by its size and the wealth of detail therein.