bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE NEWBORN PATIENT
Authors: Smith Clement A. 
Published: December 2021

TO BE ENTRUSTED with the honor delivering a lecture named for Doctor Clifford Sweet is to be handed no easy assignment. The lecturer's basic problem is increased by the fact that the assignment comes from Doctor Sweet's local professional colleagues. These men, who have worked side by side with him as the Children's Hospital of the East Bay has extended its good influences—and his—not only know Doctor Sweet much better than does your lecturer, but must also know how great is their affection for him. Naturally, they hope I will tell Doctor Sweet some of these things for them. Like Myles Standish long ago on the shores of another and more eastern bay, they expected their Twentieth Century John Alden to put into graceful words those deep feelings they find themselves unable to express.
I am quite unable to carry out such a commission. John Alden, with a little gentle prodding, is said to have decided to speak for himself. I shall speak for myself, too, and for my own colleagues who respect Doctor Sweet as a doctor first, as a pediatrician second, and as a specialized pediatrician third. We say this with admiration in an age when many pediatricians have become so narrowly specialized that their functions as doctors have become almost vestigial. It has been a great pleasure to spend these few days in the company of one so 50 wise in so many aspects of medicine.
I stand before you self-indicted as one of those narrow specialists who has allowed himself to be pushed into increasingly restricted medical territory.
SPLENECTOMY IN MEDITERRANEAN ANEMIA
Authors: Clement David H. , Taffel Max 
Published: December 2021

Although the primary defect in Mediterranean anemia is an inability to synthesize adequate amounts of hemoglobin, a hemolytic component eventually supervenes, associated with splenomegaly which in turn is augmented by the necessary transfusions.
When the disease bias been evident for some time, the spleen is greatly enlarged and the transfusion requirement is big, splenectomy may be effective in greatly reducing the frequency of transfusions to 25 to 50 per cent of the pre-splenectomy need.
Secondary benefits following splenectomy have included improvement in disposition, appetite and activity and lessened fatiguability. Overloading with iron is diminished, a feature theoretically diesirable in view of the ever-present hemochromatosis. Psychic trauma to the child and expenditure of the physician's time in transfusions are proportionately decreased.
Failure to benefit from splenectomy may be expected if the organ is removed early in the course of the disease before it has greatly enlarged and the transfusion need is great. It is also possible that the operation will accomplish little in the terminal phase of the disease when the liver is huge and the marrow over-extended.
Optimum time for splenectomy and the best criteria for the selection of patients remain to be evolved but we are convinced that removal of the spleen under appropriate circumstances is of substantial benefit to these patients. The procedure has been well tolerated in our small series. Complications have not been encountered, though thrombosis remains a threat in view of the high platelet counts encountered postoperatively. Early ambulation and even anticoagulant therapy (not yet employed by us) may be useful. Platelet counts should be followed closely.
NEONATAL HYPOGLYCEMIA
Authors: Schwartz Oscar , Goldner Martin G. , Rosenblum Jacob , Avin Joseph 
Published: December 2021

A case of neonatal hypoglycemia of 23½ months' duration associated with recurrent convulsions has been presented.
The case best fits the classification of "idiopathic spontaneous hypoglycemia in infants."
Dietary management was partially successful for a period of 2½ months.
The therapeutic effects of administration of glucagon, cortisone and ACTH were studied. Only the administration of cortisone and ACTH permitted control of the hypoglycemic state.
ADRENAL FUNCTION IN THE PREMATURE AND NEWBORN
Authors: Gardner Lytt I. 
Published: December 2021

THE special nature of adrenal function in newborn infants has excited the curiosity of physicians for half a century. Three groups of workers in 1911 nearly simultaneously described the strange involution which occurs in the cortex of the newborn's adrenal gland. Since that time much speculation and a few experiments have added somewhat to our knowledge. The recent development of chemical techniques for the estimation of adrenal steroids in the urine and peripheral plasma of the newborn have provided some very interesting data.
Let us review the earlier observations. The newborn adrenal glands weigh approximately .29 per cent of the total body weight, which is quite striking when compared with the adult glands averaging only about .014 per cent of total body weight. At the time of birth the infant's adrenal cortex is composed of 2 histologically distinguishable zones. One is an outer region ("adult cortex"), which is composed of a zona glomerulosa and of short strands of zona fasciculata. The inner region is quite extensive and makes up about 80 per cent of the entire newborn adrenal gland. This inner zone goes by several names: fetal transitional zone, internal cortex, or fetal androgenic zone. This zone is made up of large cells reminiscent of the adult zona reticularis. There is intense vascularization of this area, so much so that one early worker even suggested that it participates as a fetal hematopoietic organ. Involution of the fetal cortex begins just prior to or at birth in both full-term and premature infants.
A NEW DIAGNOSTIC METHOD IN ALLERGIC DISEASE
Authors: Black Arthur P. 
Published: December 2021

A test has been described in which dried protein allergen and plasma from a sensitized or allergic patient are mixed with living leukocytes and platelets either from the patient or a nonallergic donor, kept at 37°C. and observed under the microscope. If specific antibodies to the allergen are present in the plasma the polymorphonuclear leukocytes and platelets show toxic effects and the cells die within 15 minutes to several hours, whereas controls remain viable and actively motile. This cytotoxic reaction has been observed with food, pollen, epidermal, and inhalant allergens, and shows such correlation with clinical sensitivity as to be a helpful guide in determining which allergens are likely offenders and which are innocuous in a particular case. A positive reaction does not necessarily mean clinical sensitivity, but if the reaction is prompt and strong such sensitivity is likely. If the reaction is negative clinical sensitivity has not been found except following anaphylaxis.
It is believed that the technique described and the observations reported constitute a new and useful diagnostic method in allergic disease.
Airborne Contagion and Air Hygine
Authors: TOP FRAKLIN H. 
Published: December 2021

The transmission of infections affecting man has been the object of much thought, theory and conjecture for many centuries. Host to host transfer of infectious agents remained largely in the province of speculation until the "Golden Age of Bacteriology" and the succeeding era of discovery of viruses. In the immediate past half century the experimental method has added considerably to the proposition that certain agents pathogenic to man are transmitted by air.
Well's book is a scholarly treatise on a subject to which he has given earnest consideration for over 20 years, namely, the importance of droplets, droplet nuclei and dust in the spread of infection.
CHANGES IN TOTAL CHLORIDE AND ACID-BASE BALANCE IN GASTROENTERITIS FOLLOWING TREATMENT WITH LARGE AND SMALL LOADS OF SODIUM CHLORIDE
Authors: Cheek Donald B. 
Published: December 2021

Seventeen infants with acute gastroenteritis have been studied. These patients were divided into 2 groups, 1 receiving high sodium loads (average 18 mEq./kg.) and the other low loads (6 to 7 mEq./kg.) during the first 24 hours following admission to the hospital. Adequate fluids and potassium were also administered and the acidbase balance, serum electrolyte concentrations, and total chloride were obtained in most instances at the time of admission, at 24 hours and at 72 following admission. From 24 hours to 72 hours maintenance fluid and electrolyte were given to all patients.
Patients receiving high initial loads of sodium demonstrated persistent acidosis at 24 hours and a trend towards hypokalemia and/or metabolic alkalosis at 72 hours.
The administration of low initial sodium loads was associated with a more consistent reduction of acidosis at 24 hours and the finding of normal serum chemical values at 72 hours. It is pointed out that if diarrhea does not abate after admission, the administration of low sodium loads does not restore hydration or acid-base balance.
Progressive determination of total body chloride and body weight demonstrated large increments in body chloride in patients receiving high sodium chloride loads. This increment persisted in 3 patients and was associated with edema, and probable cell water subtraction.
It is considered that amounts of sodium of similar magnitude to the known deficits should be given initially in gastroenteritis except in the presence of hyperelectrolytemia. Other conditions of dehydration require different fluid therapy and sometimes the complete restriction of potassium (e.g., adrenal insufficiency).
The results suggest an abnormal increase of total body sodium with sodium loading during circumstances of potassium loss, a contention well supported by animal experiments.
REVIEW ARTICLE
Authors: Gardner Lytt I. 
Published: December 2021

THE IDENTIFICATION and measurement of adrenocortical steroids in body fluids over the past 2 decades have made possible an extensive exploration of adrenal function. This review is restricted to adrenocortical metabolism in the fetus, infant and child. No attempt will be made to cover all of this rapidly developing area of endeavor. Certain aspects have been treated in other review articles, to which the reader is referred. The reviews by Moore on fetal endorinology, Klein on neonatal adrenal physiology, Lieberman and Teich and Roberts and Szego on steroid biochemistry, White and Wettstein and Anner on adrenal cortical hormones, Ingle on cortisone and Gaunt, Renzi and Chart on aldosterone are especially useful. The books by Wilkins and by Talbot and colleagues contain helpful treatments of this area. Due to the prolific nature of even the review literature, it is necessary to make a rather arbitrary selection of material.
NEWER METHODOLOGY
Within recent years a number of methods have been developed for the estimation of hormones in urine and plasma. Several techniques for the chromatographic separation of the 17-ketosteroids in urine have been described. Of particular value in the diagnosis of virilizing adrenal tumor has been the development of colorimetric methods for the estimation of dehydroepiandrosterone in urine. Some progress has been made in the estimation of corticosteroids in the urine. Techniques for the measurement of 11-oxygenated neutral 17-ketosteroids, pregnanetriol and pregnanediol in the urine of patients with congenital adrenal hyperplasia have been described.
There has been a blossoming of methods for estimating steroids in plasma. Several varieties of techniques are now available for the measurement of corticosteroids and 17-ketosteroids in plasma.
Phenylbutazone
Authors: BATES TALCOTT 
Published: December 2021

Phenylbutazone (Butazolidin®), introduced into clinical usage in 1952 as an antirheumatic agent in gout, rheumatoid arthritis and other periarticular diseases, has gained widespread usage among adults, and a report of its accidental ingestion by a 2-year-old infant may therefore be of interest.
On March 8, 1955, during a period of parental strife, a 24-month-old female infant was left alone at home with a 39-month-old sibling. At 9:30 A.M. she was discovered to have ingested 2 or 3 tablets of aspirin and phenacetin, and a small bottle of cough syrup, containing no potentially toxic or systemically active ingredients.
ATRESIA OF THE VAGINA IN INFANCY
Authors: Whittlesey Robert H. , Atik Mohammad , Jones James C. 
Published: December 2021

Cystic lower abdominal masses in female infants may be due to enormous distention of the upper vagina, secondary to either atresia of the vaginal canal or to an imperforate hymen.
Obstruction of urinary or gastrointestinal systems may result, and may cause the only symptoms.
Diagnosis can usually be made preoperatively by careful and adequate roentgenographic studies.
Safe treatment of the condition requires open operation for the establishment of an outflow tract.
NEW TECHNIQUES IN THE DIAGNOSIS AND TREATMENT OF MEGALOURETERS
Authors: Swenson Orvar , Fisher John Herbert 
Published: December 2021

Studies on 60 patients with megaloureters are described.
Thirty-two patients proved to have a defect in parasympathic innervation of the bladder. The defect in bladder function was the cause of ureteral dilatation. Bladder neck resection is the treatment of choice.
Fifteen patients proved to have defects in ureteral peristalsis as the cause of ureteral dilatation. Replacement of some of these defective ureters with narrowed segments of ileum has proved successful.
PEDIATRIC GYNECOLOGY AND ENDOCRINOLOGY
Authors: Greenblatt Robert B. , Bennett James W. 
Published: December 2021

MANY mothers bring their young daughters to the pediatrician because they have noticed a discharge on the child's underclothing. Most of such discharges are nothing more than desquamation of the epithelial cells at perhaps a more rapid pace than usual. Such a discharge, commonly referred to as "whites," occurs normally in the adult female. No pathologic process is involved in either the child or the woman and no treatment is indicated. On the other hand, a discharge which is irritating, malodorous, and provokes an inflammatory response, has a pathologic background. By far the greater number of such cases fall into one of the following categories:
(a) Nonspecific vaginitis which may be due to the presence of organisms which find their way into the vaginal canal either through insertion of the child's finger or some foreign object, or may appear for no apparent predisposing reasons. Among the organisms found are pneumococcus, streptococcus, staphylococcus, diphtheroids, colon bacillus, etc. The treatment consists primarily of removing or correcting the underlying factor and cleansing measures. Frequently, attention to the technique of cleansing the rectal area following a bowel movement, daily bathing and a pitcher douche with saline twice a day will clear up the discharge. Sulfonamides by mouth, locally, or both may be effective in some cases. In other cases, the local use of a specific antibiotic such as Terramycin® or Aureomycin® has been effective (a 50 mg. capsule may be inserted into the vaginal canal daily for 5 to 7 days).
(b) Another group of cases is due to the presence of foreign bodies in the vaginal canal. Any number and type of foreign bodies have been found in the vaginal canals of small children, such as safety pins, pencils, sticks, etc. The presence of a foreign body sets up an irritant reaction and causes a discharge, in most instances with a bloody component. The diagnosis may be made by inspection or by gentle rectal examination, pressing the vaginal wall through the rectum.
CARCINOMA OF THE THYROID IN CHILDHOOD
Authors: Winship Theodore 
Published: December 2021

Data from 334 collected cases of childhood thyroid carcinoma have been compiled and studied. Possible etiologic factors are discussed, including congenital and geographic influences, and the effects of soybean diet, cobalt medication and the irradiation to the neck in infancy.
The clinical and pathologic manifestations and the prevalence of this disease are discussed on the basis of the large series.
Various methods of treatment and the results are reviewed. The usual 5-year follow-up period is of little value in thyroid carcinoma. Data from a 20-year follow-up of a large series of cases may indicate the best methods of therapy.
DIAGNOSIS AND MANAGEMENT OF DYSAUTONOMIA
Authors: Linde Leonard M. 
Published: December 2021

The variability of severity and of presenting complaint in both classical and variant forms of dysautonomia is stressed.
Psychological evaluation of these children has not borne out the initial clinical impression of mental retardation.
Drug treatment of the vomiting crises and preventive psychological management of the emotional instability is discussed.
Awareness of the widespread evidences of autonomic and central nervous system dysfunction will eliminate unnecessary diagnostic procedures and delayed diagnosis of dysautonomia.
AN APPRAISAL OF PNEUMOENCEPHALOGRAPHY IN MENTAL RETARDATION AND EPILEPSY
Authors: Charash Leon I. , Dunning Henry S. 
Published: December 2021

A series of 151 pneumoencephalograms done on children in the New York Hospital during the last 16 years as a diagnostic procedure in mental retardation and epilepsy, classified as idiopathic, is surveyed.
Analysis of these cases and evidence from a review of the literature are cited to demonstrate the paucity of useful information to be derived from this procedure in these conditions.
Two deaths and nine nonfatal, but serious, complications are reported, in contrast to the usually stated concept of the safety of the procedure in these conditions.
Based on this experience and on reports in the literature, it is recommended that pneumoencephalography be abandoned as a diagnostic procedure in the study of these conditions.
THE ENERGY METABOLISM OF INFANTS AND YOUNG CHILDREN DURING POSTPRANDIAL SLEEP
Authors: Lee Virginia A. , Iliff Alberta 
Published: December 2021

The energy metabolism of healthy infants, from 1 through 37 months of age, was measured with an open circuit chamber within 3½ hours of the time they had been fed and while they slept with little or no motion. Satisfactory results were obtained in 248 tests on 38 boys and 246 tests on 40 girls.
A statistical analysis of the results of these determinations included the means, the standard error of the means, and the standard deviations of the means for cal/hr, cal/hr/m2, cal/hr/kg, and cal/hr/cm referred to age, as well as cal/hr referred to weight, height, and surface area, respectively, for boys and girls.
Scatter diagrams for cal/hr and cab/hr/ m2 referred to age for boys were given.
In order to differentiate normal thyroid activity from abnormal activity in children of this age, it was found that the best methods of reference to use for comparison, i.e., the methods which gave the least dispersion from the mean in healthy infants, were cal/hr/m2 referred to age and cal/hr referred to surface area, while the least desirable methods of reference for such use, i.e., the methods which showed the widest dispersion from the mean, were cal/hr/kg and cal/hr referred to age. Tentative standard values obtained from the mean trend lines were given for cal/hr/m2 for age and cal/hr for surface area.
It was found that, from ½ to 3½ hours after feeding, there was no change in the effect of food on the metabolic rate or on the respiratory quotients. No significant changes were found in the respiratory quotients with age.
It was concluded that differences between the energy production of boys and girls up to 3 years of age could be attributed to differences between the sexes in body size for age and body weight for height.
The mean heat production of children from 18 to 36 months of age was found to be from 3 to 9% lower in tests done during sleep in the postprandial state than in those done during the usual awake fasting conditions.
RECENT ADVANCES IN THE MANAGEMENT OF RENAL DISEASE IN CHILDREN (PART 1)
Authors: McCrory Wallace W. , Macaulay Duncan 
Published: December 2021

THIS REVIEW makes no claim to be exhaustive. In the discussion of topics selected we have not hesitated to make judgments based on our clinical experience when reports give vague or conflicting views. We have given background information when this was felt necessary to make clear the reasons for some aspects of treatment. In cases where there have been no notable recent advances, we have, for the sake of completeness, given brief accounts of currently accepted methods of management. It is hoped that the paper will thus be helpful, not only as a guide to the recent literature, but also in the management of patients.
ACUTE GLOMERULONEPHRITIS
Before attempting to evaulate recent developments in the management of this disease in children, it is salutary to review some of the results obtained by earlier workers. Frisk and Klackenberg report a 10-year follow-up study of 239 cases of which 230 were typical acute glomerulonephritis. Two hundred fourteen of the patients were located and wherever possible the follow-up examination included recording of blood pressure and an Addis count of the urinary sediment. The survey gave the following results: death during the acute phase, 5 (2.3%); permanent renal damage after 10 years, 12 (5.6%) (8 were symptom-free despite the urinary changes); doubtful urinary findings, 10 (4.7%) (all in good health); completely recovered, 187 (87.4%). Davis and Faber report from California a 2-year follow-up of 102 children which revealed an immediate mortality of 5.9% and an over-all recovery rate of 81.3%. They referred to other series with very similar results.
INTRACELLULAR COMPOSITION AND HOMEOSTATIC MECHANISMS IN SEVERE CHRONIC INFANTILE MALNUTRITION
Authors: Frenk Silvestre , Metcoff Jack , Gómez Federico , Ramos-Galván Rafael , Cravioto Joaquin , Antonowicz Irena 
Published: December 2021

Data obtained in a study of chemical composition of tissues in malnourished pre-school children are reported. In most cases, muscle and skin show an increase in total content of water, sodium and chloride. These changes are less striking but persist during "dehydration" judged on clinical grounds.
The content of potassium in muscle was slightly to moderately decreased particularly in clinically edematous children. Edematous patients also had a markedly decreased intracellular concentration of potassium. In general, no correlation between intracellular concentration of sodium and potassium was found in muscle. Muscle obtained shortly before death or immediately after death frequently showed a marked shift of water and sodium into the intracellular compartment. A low ratio of concentration of potassium to noncollagenous nitrogen as compared to normals generally was observed.
The skins of subjects without clinically demonstrable edema had comparable amounts of water but less fat per unit of dry fat-free solids than those of children with pitting edema. No particular correlation was found between overhydration and increase in content of the ("excess") chloride of the non-extracellular phase.
Perinatal Mortality in New York City: A Study of 955 Deaths, Committee on Public Health Relations of the New York Academy of Medicine
Authors: HARPER PAUL 
Published: December 2021

This is the second report of a study of infant mortality in New York City undertaken by the Committee on Public Health Relations of the New York Academy of Medicine. The first report was concerned with hospital facilities for infants and mothers.
The present report concerns the clinical study of 955 individual infant deaths. The purposes were:
1. To determine as accurately as possible the causes of perinatal mortality.
2. To determine the extent of preventability of perinatal deaths.
3. To obtain additional data concerning past obstetrical history and prenatal care of mothers, analgesia and anesthesia, medical care and detailed pathologic findings.