bluuebunny/crossref_metadata_2025_split huggingface dataset:
PUBLIC HEALTH, NURSING, AND MEDICAL SOCIAL WORK
Authors: Wegman Myron E. 
Published: December 2021

Every physician who has been through an internship is familiar with the Standard Nomenclature of Diseases and Operations. Far fewer know the International Statistical Classification of Diseases, Injuries and Causes of Death or appreciate the relationship between the two. Official inauguration of the use of the Seventh Revision of the International Classification of Diseases on January 1, 1958 offers occasion for reviewing some of the considerations affecting the proper naming and classification of diseases and causes of death.
It is necessary to clarify the distinction between a "nomenclature" and a "classification." A nomenclature is a list of all terms considered satisfactory in medical usage at the time the nomenclature was prepared. Its primary purpose is to promote use of the same name for the same disease, a necessity for comparability of reports and effective study of a disease. To achieve such uniformity there must be some background of usage and custom, as well as a systematic reference work to help the physician arrive at and use the standard term as a final diagnosis for his case. The Standard Nomenclature of Diseases and Operations of the American Medical Association is in practically universal use in the major institutions of the U. S. A. The Nomenclature itself, while detailed and inevitably complicated by extent of coverage and inclusiveness, follows such a logical pattern that under the pressure of institutional rules and routines it is not difficult to use the system efficiently. Individual physicians, however, are not so disposed to spend the time necessary to follow the Nomenclature and tend rather to use the terminology popular in the geographic area where they are working. Development of local terminologies and usages is perhaps the greatest limiting factor militating against a really general nomenclature.
Can The New Pediatrics Be Practiced?
Authors: SCHRODER J. R. 
Published: December 2021

In regard to the editorial appearing in the February issue of Pediatrics (23:253, 1959) entitled "Can the New Pediatrics Be Practiced?" You have hit the nail on the head! The questions you raise are being pondered by most practicing pediatricians throughout the land.
For various reasons I feel that certified pediatricians should continue to enter the field of active pediatric practice, but I think it is high time "to bring the public to recognize, and be willing to pay for, the best of professional guidance and treatment."
Letters to the Editor
Authors: SILVER GEORGE A. 
Published: December 2021

I was very impressed with your editorial in the February 1959 issue, "Can the New Pediatrics be Practiced?"
Here at Montefiore Hospital, N.Y., in the Division of Social Medicine, we have been experimenting with methods of practice that may give all the specialties of medicine an opportunity to practice Twentieth Century medicine as they have been taught. Pant of the problem is financing, but I do think a larger part is in the need for restructuring medical practice, and I hope that many more experiments can be developed to test new structures.
I am enclosing a recent publication of mine which outlines our own "new" basis for medical practice as a contribution to family health (See Yale J. Biol. & Med., 31: 29, 1958).
Can the New Pediatrics Be Practiced?
Authors: CUTLER CHARLES H. 
Published: December 2021

This is written in answer to your request for "thoughtful comment" on your editorial "Can the New Pediatrics Be Practiced?" (Pediatrics 23:235, 1959).
My answer is, "Yes, it Can!" It follows that the subject of this communication must be the "how" of that statement.
The mere fact that "vague rumblings of discontent with the practice of pediatrics" are being expressed, and that the official journal of the American Academy of pediatrics contains an editorial on this fact, thus inviting discussion, is a sign of healthy growth. It seems to me that, if properly directed, these trends can be used to anabolize rather than to catabolize our specialty.
It is true that pediatrics as a discipline within the structural framework of medicine is firmly established.
Letters to the Editor
Authors: WINEBERG JULIUS J. 
Published: December 2021

Pediatric practice consists of 85 to 90% of minor illness and well baby care. The remaining 10 to 15% often requires the highly-skillful and specialized training for which pediatricians were prepared. When one becomes dissatisfied, the argument is that he has defects of personality, and after all, it is very wonderful to watch children grow and have patients invest so much faith in their doctor. Regardless of such rationalizations as these, if a man spends 2 years devoted to acquiring a highly-specialized skill and then enters a practice which 90% of the time does not require this skill, then he has not really been trained for a specialty.
The 10% of cases which do serve as a challenge to the skill and training of a pediatrician represents in essence a subspecialty. If it is a subspecialty, then who shall carry on the tradition and knowledge of pediatricians? Where shall pediatric education be directed?
Letters to the Editor
Authors: CODDINGTON R. DEAN 
Published: December 2021

Your editorial in the February issue of Pediatrics was most apropo and frank—a just criticism of the economics of the "new pediatrics." Your invitation for further comment has stimulated me to write concerning two other aspects of the problem.
First of all, a conflict of interests arises in the young pediatrician's mind when, on the one hand, he wants to encourage the mother to return as often as necessary in order to build up his practice while, on the other hand, he is attempting to help her develop independence. If he truly helps her to handle the many vexing problems of child rearing and minor illnesses, he will develop a pleasant practice with a limited number of frustrating telephone calls and few night visits. However, this is poor economics for the pediatrician starting out in practice.
Transplacental Passage of Vitamin K Analogue
Authors: GARDNER LYTT I. 
Published: December 2021

In the March issue of Pediatrics (23:553, 1959), Lucey and Dolan reported an interesting study of hyperbilirubinemia in newborn infants associated with the administration of a vitamin K analogue to the mothers. These authors hypothesized that the vitamin K analogue passed through the placenta and had a hepatotoxic effect on the newborn infants. In support of this concept, we have obtained evidence suggesting that a synthetic vitamin K analogue given to a mother prepartum may pass across the placenta and become incorporated into the tissues of the newborn infant.
This observation was made fortuitously during a study of adrenal corticosteroids in adrenal tissue from the human newborn (Helvet. paediat. acta, 12:147, 1957). Analyses were made by paper chromatographic techniques on adrenal tissue obtained at necropsy of 12 infants, 9 of whom were less than 11 days old.
FAILURE OF SULFONAMIDES TO INCREASE THE THERAPEUTIC EFFECTIVENESS OF PENICILLIN IN THE TREATMENT OF STREPTOCOCCAL INFECTIONS
Authors: Breese Burtis B. , Disney Frank A. , Talpey William B. 
Published: December 2021

A group of children with beta hemolytic streptococcal infections were divided by lot into two comparable groups. One was treated with penicillin orally, the other with penicillin plus a sulfonamide. No difference could be found in the initial response to therapy or the subsequent recurrence or carrier rate in the two groups.
It is therefore concluded that, in the treatment of streptococcal infections in children, the addition of a sulfonamide to penicillin offers no therapeutic advantage.
Recent Progress in Hormone Research, Vol. XIV. The Proceedings of the Laurentian Hormone Conference
Authors: GARDNER LYTT I. 
Published: December 2021

This is the 14th volume of this valuable series of the Laurentian Hormone Conference. The editor continues the same excellent format as in the previous volumes. There are 14 monographs on various aspects of endocrinology each followed by a bibliography and verbatim record of the discussion.
The volume is divided into five sections: I. Hormone Structure and Function; II. Hormones in Growth and Development; III. Aspects of Reproduction; IV. Hormones and Metabolism; and V. Neurohumors.
Of special interest to pediatricians is the section on cytologic tests of chromosomal sex by Grumbach and Barr.
STAPHYLOCOCCAL INFECTIONS
Authors: Wheeler Warren E. 
Published: December 2021

THE STAPHYLOCOCCUS problem has been placed high on the agenda of the Public Health Service for this year. Last year it was Asian flu vaccine. The year before it was poliomyelitis vaccine. This year it is the problem of hospital-acquired staphylococcus infection.
It is pleasing to me to see the position pediatricians have taken as one of the first national organizations to realize the importance of this situation. The Academy was one of the first bodies to urge the formation of hospital infection committees. Pediatricians by training, experience, tradition and in many other ways are eminently qualified to lead in this regard.
We have seen the establishment of many of these hospital infection committees. Some of these committees find themselves in the position of consultants, and they sometimes hardly know what to do. So, my remarks this morning will be directed to you as though half of you were serving on infection committees in your hospitals and the other half were chiefs of services of newborn nurseries. I shall confine my remarks to the newborn nursery. One word regarding hospital infection committees—the formation of such a committee, even of an active committee, does not abrogate the responsibilities of a chief of service nor the individual physician. One cannot delegate to others the responsibility of protecting your patients from hospital-acquired disease. You cannot as chief of a nursery expect the committee to protect you from the staphylococcus problem.
I should like simply to state a few principles, and then tell you a little bit about where you can obtain some help as members of infection committees (summarized in the table).
The first principle is that as far as the newborn nursery goes, most of the staphylococcal lesions appear after the baby goes home, and you may not know about them. This indicates that one must look hard for trouble. One can't wait until it comes to him. The primary function of the infection committee is surveillance, and knowing when you have trouble and when you don't. The best way I know of to assess this situation is to establish some kind of survey after babies go home.
TECHNIQUE FOR INSERTION OF PLASTIC CATHETER INTO SAPHENOUS VEIN
Authors: Randolph Judson 
Published: December 2021

FOR THE sure delivery of fluid into the blood stream of a patient, it sometimes becomes necessary to place a plastic tube in a selected vein. This procedure can be accomplished by anyone who possesses a moderate knowledge of anatomy and sterile technique and is familiar with the apparatus involved. In infants and obese children the isolation and catheterization of a suitable vein is more difficult.[See FIG. 1., FIG. 2. in Source PDF]
On most pediatric services it is the responsibility of the pediatric resident staff to perform such "cutdown" procedures, when indicated. In many community hospitals this task falls to the lot of the busy attending pediatrician. In the middle of the night, with a tiny patient in profound shock, the insertion of a catheter into a vein may be a demanding assignment. In such a situation the attempts of the uninitiated are [See FIG 3 In Source PDF] usually characterized by a generous incision, with much spreading and dissection of the tissues. This invites infection; in addition, any significant delay may be costly.
A saphenous vein "cutdown" is frequently used in conjunction with major operative procedures at the Children's Medical Center. Saphenous phlebitis is rare, and its occurrance in a child does not have the more serious connotation that it does in the adult. Under the stimulus of good-humored chiding by the senior residents, each incoming junior house officer acquires a flare in the art of cannulating veins. The time elapsing from preparation of the skin to bandaging averages under 5 minutes. The factors responsible for such rapidity are: an anesthetized patient, repetition of a routine, and an exact knowledge of the anatomy involved.
Four anatomic characteristics make the saphenous vein ideal for cannulation under direct vision (Fig. 2). These are: 1) its constancy (one can depend upon its presence just anterior to the medial malleolus); 2) it is the only structure of importance in this location (there are no arteries or tendons in the space immediately anterior to the malleolus; the tiny saphenous nerve should offer no confusion, and its division is of no great moment); 3) the vein lies on tough periosteum; and 4) its elasticity allows it to be withdrawn from a short incision without danger of rupture. Each of these facts serves importantly in the delivery of the vein, which, after all, is the key to the "cutdown" procedure.
ENTEROVIRUSES
Authors: Syverton Jerome T. 
Published: December 2021

IT IS AN HONOR and responsibility to present this Tenth Annual Don W. Gudakunst Lecture. Dr. Gudakunst, as first Medical Director of the National Foundation for Infantile Paralysis, was administrator and participant in a productive research program. In 1950, the year Dr. Charles Armstrong gave the first Annual Lecture, the program received new impetus with results now familiar to us all. The list of distinguished lecturers of succeeding years, including Sabin, Bodian, Paul, Salk, Enders, Francis, Horstmann and Huebner, is a record of workers and achievement that opened the way to control of poliomyelitis, and vastly expanded our understanding of viruses, nucleic acids, cells, and their interaction to produce cellular infection. Dr. Gudakunst would be proud of his early association with and contribution to the research program which continues under generous support of The National Foundation. Apart from its record of outstanding contributions to prevention of poliomyelitis, this annual series of lectures is evidence that the distinction between pure and applied research has less and less meaning. With this example before me, in discussing enteroviruses I shall proceed freely from epidemiologic to basic research. Work done at Minnesota represents contributions of a group of associated investigators.
THE ENTEROVIRUS TRIBE
In the days when our virologic tools were limited, we used to speculate that the human environment might include many viral nonpathogens or opportunist pathogens, as well as the viruses of known diseases. Study of the enteroviruses illustrates technologic advances achieved since 1950, to uncover more than 100 viruses now characterized, and many others unidentified but distinguished from known types.
DIAGNOSIS OF CYSTIC FIBROSIS OF THE PANCREAS
Authors: Barbero Giulio J. 
Published: December 2021

THIS PAPER is a discussion of present concepts in diagnosis of cystic fibrosis of the pancreas. Such concepts should develop from an examination of the definition of this disease. Cystic fibrosis is now known as a disease which appears as focal involvement of various exocrine glands in the body, with its principal symptomatic manifestations in two main anatomic areas. These two areas are the gastrointestinal tract where symptoms are exhibited as more frequent, foul-smelling and bulky stools, and the respiratory tract where involvement is shown principally as cough, wheezing or respiratory distress.
PARTICULAR CLINICAL FEATURES
My purpose here is not to discuss the well-recognized picture, but rather to emphasize some of the clinical characteristics. The clinical picture has widened in its range because of improved diagnostic tests such as determination of electrolytes in sweat and greater awareness by physicians. As a result, there are now known to be patients who show more or less gastrointestinal or respiratory involvement. On the one hand, there is an enlarging group of patients who have principally respiratory involvement and very little gastrointestinal disorder. These patients, of course, are frequently confused with patients with other chronic pulmonary disease or asthma. On the other hand, there is now a small group of patients with gastrointestinal symptoms and very little respiratory disease. These patients often are confused with those having chronic diarrhea or celiac disease.
There are a few points which might be emphasized as clinically diagnostic characteristicis. Cystic fibrosis is often associated with the diarrheal group of diseases, but it is not truly a diarrheal disease in the sense of more fluid bowel movements with acute exacerbations. The stools are bulky, foul-smelling and unformed movements, usually passed three to four times a day. A very large appetite has been constantly emphasized, but among a large enough group of such children one is impressed that this is not a constant symptom.
THE USE OF HYPOTHERMIA IN CHILDREN
Authors: Shields John R. S. 
Published: December 2021

So MUCH has already been said and written about hypothermia in the past decade that one hesitates to add yet another paper. The excuse for doing so is that our experimental and clinical work over the last 5 or 6 years has led to some practical results and conclusions which have greatly reduced the mortality and increased the usefulness of this technique.
There are so many occasions on which benefit can be seen from the lowered metabolism resulting from the reduction of the body temperature and so many cases where the ill effects of anoxia may be lessened by hypothermia, that we believe many cases must benefit from its application, provided the method of cooling is safe and readily controlled.
General Considerations
The principal advantages from cooling are:
1. Reduction in metabolic rate and a lowering of oxygen consumption to something in the order of 50% of normal at 30°C.
2. Reduction in cardiac output.
3. Reduction in clotting time, which may prove useful in cases of cardiac disease with polycythemia.
Our clinical experience has been predominantly in the surgical field, but hypothermia does also have important applications in other than surgical cases and its employment should be extended. In particular, we firmly believe that children are often most suitable subjects for this technique. Not infrequently one hears a physician doubting if an infant on small child should be subjected to the "stress" of hypothermia; the truth would appear to be just the opposite—that hypothermia, properly managed, actually protects against shock.
Genital Abnormalities in Infants Associated with Administration of Progesteroids to Their Mothers
Authors: Leibow Sheldon G. , Gardner Lytt I. 
Published: December 2021

PRESENTATION OF CASES
Dr. Sheldon G. Leibow: Case 1. The first patient is an infant girl who was first seen here on October 6, 1958 at the age of 2 months by Dr. Gardner. She was referred for evaluation because of an enlarged clitoris present since birth.
The child was born on August 5, 1958, the ninth pregnancy of a 39-year-old mother. Her mother had a history of three spontaneous abortions, two of which had preceded the birth of the patient. In view of this obstetric history, her mother was given hormone therapy in her second month of pregnancy (December 9, 1957). Treatment consisted of: U.S.P. desiccated thyroid, 65 mg/day; 17-alpha-ethinyl-19-nortestosterone (Fig. 1), 5 mg twice daily; and diethylstilbestrol 5 mg twice daily. On December 30, diethylstilbestrol was increased by 5 mg/day, once weekly, until a daily dose of 75 mg was achieved. The other hormones were continued at the original dosage. All therapy was discontinued in the thirty-fifth week of gestation.
Two other developments of interest occurred during this pregnancy. Glycosuria was noted for the first time during the second month and was treated with a 1,500 calorie diet and 27 units of isophane (NPH) insulin daily. There was no antecedent history of maternal diabetes, and insulin was not required after termination of the pregnancy. The child's mother fell during her fifth month of pregnancy, developing some spotty vaginal bleeding which ceased promptly after several days of bed rest.
A full-term infant weighing 3,430 gm was delivered on August 4, 1958.
In Reply: Myleran and Malformations
Authors: Diamond Israel 
Published: December 2021

I am indebted to Dr. Sherman for calling attention to the two Myleran case reports; and apology is more than due for having overlooked them. As he says—"the dosage was lower and therefore the experiences may not be comparable."
He is also quite right in pointing out that the experimental evidence suggests that 6-mercaptopurine exerts its damaging effect at the time of implantation. Perhaps our position on this point must stand solely on Mersky and Regal's experience; although the administration of the drug during both pregnancies is too striking a coincidence to be ignored.
Mental Subnormality, Richard L. Masland, Seymour B. Sarason, and Thomas Gladwin. New York, Basic Books, Inc., 1959, 442 pp., $6.75
Authors: Kugel Robert B. 
Published: December 2021

This is an extraordinary book in many respects. In this volume one sees the unusual collaboration of a physician, a psychologist and an anthropologist who bring together the very different points of view that each discipline has in a highly skillful manner. This is an exceedingly useful and comprehensive book on mental retardation and without a doubt it will certainly be a must for anyone dealing with any aspect of mental retardation.
Perhaps there is some mark of distinction the autors have already received in the fact that the first section written by Masland was published in the A.M.A. Journal of Diseases of Children (Vol. 95, Jan. 1958, No. 1), and the second portion by Sarason and Gladwin was published in Genetic Psychology Monograph (1958-57, pp. 3-290).