bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital Rubella and Thrombocytopenia: Report of Two Cases with Initial and Follow-up Viral Cultures
Authors: COCHRAN WILLIAM D. , CORNFIELD MICHAEL , FRIEDBERG DAVID 
Published: December 2021

Recent advances have made it possible to isolate rubella virus from affected persons and to propagate the virus in tissue culture. The virus may be identified by the unique cytopathogenic changes in human amnion tissue culture by interference with ECHO virus type 11 in monkey kidney tissue culture. Thus an even closer correlation between an active rubella infection in the mother in the first trimester of pregnancy and the clinical findings of the rubella syndrome is now feasible.
The rubella epidemic of 1964 can be expected to produce significant numbers of infants with the congenital rubella syndrome. This paper reports the clinical history of two cases of rubella associated with thrombocytopenia in the newborn.
Letters to the Editor
Authors: CLEMENTS JOHN A. , KLAUS MARSHALL H. , TOOLEY WILLIAM H. 
Published: December 2021

Drs. Normand, Reynolds, and Strang pose several important questions concerning our recent paper, "The Pulmonary Hypoperfusion Syndrome." We considered these and other questions bearing on the subject before submitting our preliminary report, and we plan to deal with them in our next paper. We feel that it is desirable, however, to comment on a few points now.
Drs. Normand, Reynolds, and Strang argue that the frequent occurence of respiratory distress in premature babies together with their observations that the amount of surfactant in the lungs increases with increasing maturity indicates a cause-effect relationship.
MANAGEMENT OF ESOPHAGEAL ANOMALIES
Authors: Martin Lester W. 
Published: December 2021

Esophageal anomalies continue to present a challenge to the pediatrician, the surgeon, and the nursing staff.
The rocky road to recovery is fought with a multitude of life-threatening complications demanding immediate attention and requiring all of the services of a specialized institution designed and equipped for the care of infants.
In our series, for the past seven years, we can report a 100% recovery following surgical correction of the anomaly for 37 consecutive infants with a birth weight greater than 2,000 gm. One additional infant died before the anomaly could be corrected. Therefore, 97% of all infants admitted with a weight of over 2,000 gm have survived. For those with a birth weight of less than 2,000 gm, the outlook is most dismal, with only 2 survivors out of 11 infants.
An emergency gastrostomy was performed with local anesthesia on each infant as soon as the diagnosis was confirmed. The definitive operation was then delayed for from 3 to 21 days for treatment of pneumonia, hyperbilirubinemia, or other anomalies of a more urgent nature. The over-all recovery rate for the last seven years has been 80% for 49 infants.
The Prophylaxis of Parental Overdependence
Authors: WEATHERMAN HAROLD V. 
Published: December 2021

I've read Doctor Charles E. Brown's commentary on "A School Administrator's Role in School Health" in the June, 1965, issue of Pediatrics with enthusiasm, and offer him my hearty congratulations for it.
One excerpt from this is priceless to me, a pediatrician, who has been in practice for over thirty years. I am referring to the following: "The doctor, who either consciously or unconsciously encourages a mother to phone him every time a baby cries for more than a few minutes, or runs a temperature for more than a few hours, is not only making his own life difficult, but is contributing to the possible development of problems that will later on be shared by the schools.
Phenylketonuria Detection
Authors: ASHLEY CARL G. , BRANDON GATLIN R. 
Published: December 2021

As a result of the current trend toward mandatory legislation providing for testing of all newborns for phenylketonuria, questions have arisen concerning various problems involving testing programs. We have had numerous inquiries about our program and feel that it might be helpful to show some of our experiences.
We began a pilot program in July, 1960, which involved ferric chloride testing of urinesoaked filter papers returned to our laboratory. Mothers of all live-born infants in two hospitals in Oregon were given instructions to return urine-impregnated filter papers in a return envelope to us when the baby was 4 weeks old.
STUDIES IN CYSTIC FIBROSIS
Authors: Shwachman Harry , Kulczycki Lucas L. , Khaw Kon-Taik 
Published: December 2021

The present report is an analysis of 65 patients with cystic fibrosis who are 17 years of age as of January 1, 1964. The oldest patient in this series is 32 9/12, with a mean age of slightly over 20½ years for the entire group. It is unique to have the opportunity to follow a large group of patients from early life beyond adolescence in a pediatric center by the same group of physicians. The follow-up period varied from over 20 years in 2 patients to less than 3 years in 6 patients, with an average of over 11½ years for the whole group. The earliest diagnosis was made at 2 days in an infant with meconium ileus. This boy, now 17 years, is our oldest survivor of meconium ileus corrected surgically.
The diagnosis was made in 8 patients in their first year of life and 34 of the 65 patients were diagnosed under 10 years of age. Fifty-one of the 65 patients were diagnosed by us and 14 were diagnosed prior to referral. Forty-two or 65% of patients are male, whereas the sex incidence is equal in infancy and childhood. Of interest are the 7 patients who are married. None have borne children. The present clinical status of these patients is excellent in 7, good in 19, mild in 29, and moderate in 10. The type of follow-up care was considered good in 43 cases, fair in 13, and poor in 9. Brief attention is given to changing concepts of the disease especially as it relates to diagnosis and therapy. Since 1954 when the sweat test was introduced by us as a practical method we have considered this the most reliable single diagnostic test. Prior to 1954 all patients were subjected to duodenal intubation. These patients with no pancreatic insufficiency but with typical pulmonary features considered to have cystic fibrosis were subsequently found to have a positive sweat test. The changes in therapy as it has evolved over the years are mentioned. The most important single advance noted was the introduction of broad spectrum antibiotics in 1948, followed in the last 10 years by a variety of measures designed to keep the bronchopulmonary tree "clean."
We feel that the early detection of this disease, plus the application of our current modes of therapy, will not only prevent numerous complications but will provide a much better prognosis for life.
HOMOCYSTINURIA: A REPORT IN TWO SIBLINGS
Authors: Kennedy Charles , Shih Vivian E. , Rowland Lewis P. 
Published: December 2021

1. Two cases of homocystinuria at ages 14 and 21 are described, in which the typical features of the disorder were found: subluxation of the optical lenses, mental retardation, seizures, pes cavus, blotchiness of the skin. Additionally, emotional lability was prominent and breath-holding attacks had been present in infancy. Neither had suffered any apparent vascular occlusive episode. Prominent in both of the children described was generalized osteoporosis and narrowing of joint spaces.
2. Homocystine and methionine were found to be elevated in urine, plasma and cerebrospinal fluid.
PEDIATRICIANS AND A COMMUNITY CHILD GUIDANCE CLINIC
Authors: Thorpe Helene Smith , Halpern Werner I. 
Published: December 2021

A personal survey was conducted of fifty-two pediatricians in thirty-two private practices to determine their impressions of psychiatric consultation with a community child guidance clinic. Their comments were correlated with data from Clinic records over a five-year period. Prolonged waiting for initial service and ineffective communication were major problems voiced by pediatricians and confirmed by Clinic records.
Improvements in these problems can occur when attention is given to more expeditious intake procedures, to a better use of professional co-ordination, and to improved educational programs in child mental health care.
Soya Alpha-Galactosides
Authors: RAPKIN RICHARD H. 
Published: December 2021

In their careful study of Soya Alpha-Galactosides (Pediatrics, 36:231, 1965) Gitzelmann and Auricchio do not discuss an important result of their work. If raffinose is capable of producing diarrhea in a healthy boy, would it not do the same in children with "milk allergy," gastroenteritis of viral etiology, or other sundry causes of diarrhea?
Conclusions based on response to Soya formulas in such situations should, therefore, be cautiously made. Uncritical use of formulas should be condemned and these authors have revealed an important piece of information which needs confirmation regarding Soya formulas.
VISUAL RESPONSES IN THE NEWBORN
Authors: Brazelton T. Berry , Scholl Mary Louise , Robey John S. 
Published: December 2021

Ninty-six infants were tested for their ability to fix on, pursue, and alert to a test object visually. These infants were evaluated for subsequent development. Of the 9 infants later deemed to be abnormal or suspect, none showed positive visual responses in the newborn period. However, 57.5% of the normal infants demonstrated this ability. Opticokinetic responses were obtained in 76% of the normal group but in none of the suspect.
Eliciting visual responses as part of the neonatal examination may offer reassurance to the clinician as to the infant's future prognosis. Their absence on any one examination is not a definite indication of central nervous system deficit. The capacity of a neonate to fix, follow, and alert to a visual stimulus appears to be good evidence for an intact central nervous system.
EARLY CHILDHOOD SEPARATIONS
Authors: Kennell John H. , Bergen Mary E. 
Published: December 2021

Every child in this long-term study of child rearing showed significant reactions to ordinary separations by about 1 year of age.
The similar pattern of response in this group of children suggests a biologically determined cause. The clinging reaction appeared when the child became mobile and able to move away from his mother, regardless of the frequency or duration of his separations.
The majority of the mothers did not understand this natural phenomenon and regarded the clinging and crying of the 1-year-old as evidence of spoiled or regressed behavior.
The pediatrician can be helpful to a mother by anticipating and explaining separation responses, by indicating their universality, and by giving specific recommendations for gradual changes to modify these reactions.
COMMITTEE ON INFANT AND PRE-SCHOOL CHILD
Authors:   COMMITTEE ON INFANT AND PRE-SCHOOL CHILD
Published: December 2021

MALTREATMENT OF CHILDREN, or child abuse, takes many forms. It may be serious gross neglect of the child's welfare to the point of starvation, cruelty resulting in emotional damage to the child, or physical assault by a parent, older sibling, or person charged with the care of the child, as described in the term "battered child syndrome." We do not know the actual number of maltreated children, nor their subdivision into physical and emotional abuse. It is likely that the battered child is the least frequent yet currently the most discussed. This paper will concern itself primarily with the physically abused child.
Recently, the problem of maltreatment of children has received much attention. Perhaps part of the recent public interest in this problem has resulted from the dramatic phrase "battered child syndrome," which was first used by Kempe, et al. during a panel discussion at an annual meeting of the American Academy of Pediatrics.
But long before the phrase was coined, interest in the problem of multiple injuries had begun. About 20 years ago Caffey described x-ray findings of multiple fractures in the long bones, and a diagnostic tool was developed. Since then the child with multiple injuries indicating new or recent injuries superimposed on old has come under increasing scrutiny, especially in the last three or four years. Later studies by hospital pediatric and x-ray departments added to the earlier reports of "skeletal trauma in infants" which, in turn, have alerted pediatricians, roentgenologists, and other physicians to the possibility of child abuse.
Desferrioxamine in Acute Iron Poisoning
Authors: MCENERY JOHN T. 
Published: December 2021

In the September issue of Pediatrics (36: 322, 1965) Dr. Charles Whitten reported his experiences in the use of Desferrioxamine-B, an iron specific chelating agent, in children with acute iron poisoning. He stated that the iron-desferrioxamine complex was toxic to dogs.
Since the complexing of desferrioxamine and ferrous salts is a logarithmic progression after binding 50% of the serum iron in excess of the iron-binding protein it is most likely that the dogs died of the effects of iron poisoning.
Crib-Side Sampling of Blood from the Radial Artery
Authors: BUCCI GIOVANNI , SCALAMANDRÈ ANTONIO , SAVIGNONI PIER GIORGIO , ORZALESI MARCELLO , MENDICINI MODESTO 
Published: December 2021

In the newborn infant sampling of arterial blood is usually performed from the umbilical or temporal artery. Both techniques have been employed in our laboratory, the latter with approximately 90% success after the age of 36 hours. However, the introduction of an umbilical catheter may be impossible after the early hours of life and the rare occurrence of pallor of one leg requires the catheter's immediate removal. Sampling from the temporal artery is difficult in infants with scalp edema, which is often present in the first hours after birth.
To the best of our knowledge, sampling from the radial artery has been performed in children and adults but never in newborn infants.
HAND-FOOT-AND-MOUTH-DISEASE RESEMBLING MEASLES A LIFE-THREATENING DISEASE: CASE REPORT
Authors: Gohd Robert S. , Faigel Harris C. 
Published: December 2021

A case of a seriously ill child with hand-foot-and-mouth disease is presented. In its early stages it resembled rubeola. Coxsackie virus type A-16 was isolated from throat washings. Its presence as the etiologic agent was inferred by serologic tests.
Pitfalls in the clinical diagnosis of hand-foot-and-mouth disease are discussed.
COOPERATIVE MEASLES VACCINE FIELD TRIAL
Authors: Guinee Vincent F. , Henderson Donald A. , Casey Helen L. , Wingo Sara T. , Ruthig Delmar W. , Cockburn T. Aidan , Vinson T. O. , Calaflore Dorothy C. , Winkelstein Warren , Karzon David T. , Rathbun Margaret L. , Alexander E. Russell , Peterson Donald R. 
Published: December 2021

The efficacy of two measles vaccine schedules was tested in a double-blind, placebo-controlled field trial. One group of children received three injections of 0.5 ml of inactivated measles virus vaccine. A second group received two injections of inactivated measles virus vaccine followed by 1400 TCID50 of live attenuated virus measles vaccine. Half of the participating children received placebo injections.
The 4,758 participating children in kindergarten and first and second grades were kept under surveillance over a period of 14 months. Among these children 504 cases of clinically diagnosed measles occurred; 430 were in the placebo group.
The inactivated measles virus vaccine, although providing good protection against cases of typical severity during the immediate 3 months after vaccination, showed a progressively decreasing level of efficacy over a year's period. At the end of a year, efficacy had fallen to 75%. The combined vaccine schedules demonstrated a consistently high order of protection, of about 95% or better, throughout the study period.
The efficacy of two measles vaccine schedules—three injections of 0.5 ml of inactivated measles virus vaccine and two doses of inactivated virus vaccine followed by one dose of live vaccine—was tested in a double-blind, placebo-controlled study among 4,758 children in kindergarten and first and second grades. Measles hemagglutination inhibition antibody titers were measured on a randomly selected sample of study participants immediately before and 1, 8, and 14 months after the third injection.
Although over 90% of those given the inactivated virus vaccine demonstrated detectable hemagglutination inhibition antibody 1 month post-vaccination, only 50% were seropositive 14 months later. Some clinically typical measles cases did occur among children in whom the inactivated virus vaccine had evoked an initial antibody response. Of those children receiving two doses of inactivated virus vaccine followed by live vaccine, 97% showed seroconversion 1 month post-vaccination. Fourteen months later 89% still had detectable antibody.
Fourfold or greater titers occurred in some children in both vaccine groups without evident clinical measles illnesses. These titer "boosts" were considered to be on the basis of subclinical measles infections.
THE RELATIONSHIP OF NON-PROGRESSIVE HYDROCEPHALUS TO INTELLECTUAL FUNCTIONING IN CHILDREN WITH SPINA BIFIDA CYSTICA
Authors: Badell-Ribera Angeles , Shulman Kenneth , Paddock Nancy 
Published: December 2021

Seventy-five patients with variable degrees of spinal cord dysfunction secondary to spina bifida cystica have been studied with special reference to their neurological and psychological status. Their ages ranged from 5 to 21 years. The patients were divided into five different groups on the basis of functional disability secondary to spinal cord dysfunction. Those patients with a history of rapid head enlargement and who had not had neurosurgical treatment for this problem comprised 62% of the population studied (total seventy-five). These patients were considered to have non-progressive hydrocephalus. The hydrocephalic subgroup scored lower in psychological testing and presented a significant discrepancy between verbal and performance scores which could be considered a characteristic sign of brain damage. The psychological test scores of the patient with the same severe paralytic defect but without hydrocephalus were essentially normal. The physical rehabilitation potential of these patients is dependent upon the degree of physical disability, but their over-all rehabilitation achievement is largely determined by their intellectual capacity and psychosocial adjustment.
We believe that if we are to improve the long-range prognosis of such children, one of the objectives of neurosurgery should be early and effective treatment of the hydrocephalus.
THE ORAL-FACIAL-DIGITAL SYNDROME: A MALE-LETHAL CONDITION IN A BOY WITH 47/XXY CHROMOSOMES
Authors: Wahrman Jacob , Berant Moshe , Jacobs Joseph , Aviad Ithamar , Ben-Hur Nahum 
Published: December 2021

A male infant is described showing all the major features of the oral-facial-digital syndrome (OFD): lobulated tongue with hypertrophic frena, fibrous bands extending into alveolar clefts, pseudocleft of upper lip, cleft palate, hypoplastic alae nasi, dystopia canthorum, various digital anomalies, and typical X-ray appearance of the skull. A partial agenesis of the corpus callosum with a lipoma was indicated by pneumoencephalography and angiography.
The OFD syndrome is confined to females. In the present case an XXY chromosome constitution was demonstrated by cytogenetic studies. The occurrence of OFD and Klinefelter's syndrome in one and the same person is ascribed to a very rare coincidence. OFD is considered to be due to an X-linked dominant mutant gene, with a recessive lethal effect. X-linkage is supported by the pattern of a more extreme lethal expression in hemizygous males versus viability of heterozygous females. An XXY individual is viable, presumably because of the normal allele which is active in a fraction of its cells.
Other reports of males with OFD are critically evaluated.
The Biosocial Basis OF Mental Retardation, by Sonia F. Osler and Robert E. Cooke. Baltimore: The Johns Hopkins Press, 1965, 151 pp., $5.50
Authors: Kucel Robert B. 
Published: December 2021

With the increasing interest in mental retardation more articles, monographs, and books appear on the subject. The Biosocial Basis of Mental Retardation is a collection of seven essays originally delivered at the John Hopkins Hospital. Although pediatricians have turned their attention in mental retardation mostly to the biological components of mental retardation, there is a growing awareness that social and psychological factors also play a significant role. The interrelationship of biological and social factors is virtually an unchartered sea.
The several authors who originally presented these essays are attempting to highlight some of the social factors and, where appropriate, to point out how some of the social features relate to biological ones. For example, the well known relationship of the high incidence of prematurity in low socioeconomic group families is a fact most pediatricians know but the implication of this fact as far as prevention is concerned is a large and important concern and as yet poorly understood. With the increasing amount of federal interest in programs for low income families, many pediatricians will want to become better informed about the implications. Some of these points are considered in the chapter by Janet Hardy.
For the person concerned with medical remedies for mental retardation, there will be little of interest in this book. On the other hand, for those who are anxious to know more about social and psychological factors as they relate to mental retardation, this is a very useful and fascinating compendium of articles. Particularly intriguing are the articles by Eli Ginzberg who discusses the mentally handicapped in an increasingly technological society.
STUDIES IN ACUTE IRON POISONING:
Authors: Whitten Charles F. , Chen You-chen , Gibson George W. 
Published: December 2021

Up to 50% of acutely iron-poisoned dogs survived when treated with various dosages of intravenous and intestinal desferrioxamine and supportive therapy. These results support the current optimism relative to the value of this drug in the treatment of acute iron poisoning in children.
The results of the use of adjuvants with intestinal and intravenous desferrioxamine were not encouraging. Corticosteroids and hemodialysis did not improve the survival rate and levarterenol worsened it.
It was confirmed that the iron desferrioxamine complex is absorbed and that both desferrioxamine and ferrioxamine can exhibit toxicity.
OTITIS MEDIA IN THE PRACTICE OF PEDIATRICS
Authors: Coffey John Dixon 
Published: December 2021

In this study cultures of middle ear exudate were obtained from 267 cases of otitis media in infants and children. Pneumococci were found in 34.5%, Hemophilus influenzae in 27%, Group A beta hemolytic streptococci in 1.9%, and pneumococci mixed with hemophilus influenzae in 2.8%. Neisseria, probably Neisseria catarrhalis, were grown in pure culture in 5.2%. Pseudomonas aeruginosa, Staphylococcus hemolyticus (coagulase positive), and Escherichia coli were found in isolated cases. The remaining 27.7% were sterile, these usually being from chronic exudative (secretory) otitis media cases.
The incidence of Hemophilus influenzae otitis media found in this study is higher than that reported in previous studies. The finding of Neisseria catarrhalis in exudate from otitis media has been reported only by Gronroos, et al., and observation of the organisms in an intracellular state was not reported.
Examination of exudate obtained from recurrences or relapses of acute exudative otitis media often reveals a different organism from that found in previous infections; one cannot assume that an apparent relapse is due to the same organism cultured previously.
Most cases of otitis media occur in infants who cannot localize their symptoms, and diagnosis requires careful examination of the ears.
Adequate bacteriological studies of exudate from the tympanic cavity require uncontaminated specimens which are best obtained with an apparatus using a needle attached to a collecting trap and a source of negative pressure.