bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEW PROGRAM OF HEALTH EDUCATION
Authors: OVERALL JAMES C. 
Published: December 2021

IN KEEPING with the tradition established in Pediatrics, I am exercising the privilege of the President of providing copy for an Editorial of special interest to Academy members. It gives me pleasure to report on a development which has been under consideration by the Executive Board and special committees of the Academy for some 9 or 10 years and which has now become a reality.
Eight years ago, a committee served for 3 years trying to solve the problem of public relations as well as lay education. Unable to obtain at that time the necessary funds they felt were needed, this committee was disbanded at its own request. The problem was again attacked by a committee directed by a past president of the Academy and under a new name, the Committee on Health Information. This committee studied the problem from various angles with great vigor but again were unable to resolve the problem because of inability to obtain funds for a full-time staff necessary to carry out the assigned task. It was felt by the Executive Board that the membership should not be subjected to an increase in dues to support this project.
CLINICAL TRIALS IN INFANTS OF ORALLY ADMINISTERED ATTENUATED POLIOMYELITIS VIRUSES
Authors: Plotkin Stanley Alan , Koprowski Hilary , Stokes Joseph 
Published: December 2021

Forty-six infants, ranging from less than 1 day to 6 months of age, were given more than 100 feedings of living, attenuated poliomyelitis viruses without the occurrence of major or minor illness. The strains used were CHAT (type 1), Wistar (type 1), Jackson (type 2), P-712 (type 2) and Fox (type 3).
All strains except the Jackson strain were found to be antigenic on oral administration. Response to vaccination was demonstrated in these infants by the presence after vaccination of antibody levels significantly in excess of those attributable to transplacentally acquired antibodies, and by the detection of fecal excretion of poliomyelitis virus.
Infants less than 2 months old were more difficult to immunize than older infants. The evidence suggests that biologic immaturity rather than transplacental antibodies caused the difference.
When the three types of poliomyelitis virus were fed at 3-week intervals, responses occurred to all types. No interference between types was observed when they were fed in all possible sequences.
Three infants given a second feeding of homotypic, attenuated poliomyelitis virus 3 to 5 months after a successful vaccination showed resistance to intestinal reinfection.
ALDOSTERONISM AND HYPERTENSION: THE INFLUENCE OF COMPLETE ADRENALECTOMY UPON ESSENTIAL HYPERTENSION IN A CHILD
Authors: Slater R. J. , Geiger D. W. , Leeson J. , Gornall A. G. 
Published: December 2021

The favorable influence of complete adrenalectomy upon a 5-year-old boy suffering from severe essential hypertension and cardiac failure is described.
Repeated investigations failed to clarify the etiology of the hypertension. After extensive trials of medical management, including low intake of salt and administration of hypotensive drugs, only a moderate decrease in blood pressure was achieved and the clinical response was unsatisfactory. Since increased excretion of aldosterone and a sensitive hypotensive response to salt restriction implicated disordered adrenal function, a two-stage adrenalectomy was done.
The final achievement has been a marked improvement in cardiovascular status and reversal of impaired renal clearances. The boy has been readily maintained with administration of cortisone and 9-α-fluorohydrocortisone. Despite these preliminary favorable results, emphasis is directed to the extreme caution which must attend the decision to undertake such a procedure.
NEUROBLASTOMA SYMPATHETICUM
Authors: Gross Robert E. , Farber Sidney , Martin Lester W. 
Published: December 2021

The treatment of patients with neuroblastoma does not lie solely in the province of a single specialty; it requires cooperation of pediatrician, surgeon, radiologist and tumor therapist. It is essential that they all be aware of the unique characteristics of this particular tumor if optimum results are to be obtained. The many factors found to influence the prognosis for a child with neuroblastoma are discussed.
In those cases wherein there are no demonstrable metastases, the treatment of choice consists of total excision, followed by local x-ray irradiation; this has resulted in a cure rate of 88%. In those cases wherein total excision is not possible, partial surgical removal followed by x-ray irradiation and tumor chemotherapy has given a cure rate of 64%. In those cases where only biopsy has been performed, x-ray irradiation and chemotherapy has still given a salvage, with a cure rate of 38%.
When there are metastases to the liver alone, about two-thirds of babies can be cured by x-ray therapy. Whenever bony metastases have appeared in any case, the prognosis is extremely poor, and it is rare for such an individual to survive, regardless of the form of therapy.
An aggressive attack on neuroblastoma in infancy and childhood, combining sungeny, x-ray irradiation and tumor chemotherapy, has shown a progressive improvement in results. During the period 1950-1957, cure rates have risen to 36.7% for all patients entering the hospital, regardless of age of the patient on extent of the neoplasm. For babies under a year of age, cures have occurred in 56%, and if there were no demonstrable metastases to bone at the time of hospitalization, the cures have been 70%.
ANTIBIOTIC PROPHYLAXIS
Authors: Hodes Horace L. 
Published: December 2021

Chemoprophylaxis is very effective and should be used freely after known exposure to dangerous bacteria which are very sensitive to an antibiotic. Into this category falls prophylaxis against beta-streptococcal, meningococcal and gonococcal infections.
The value of preventing beta-hemolytic streptococcal infections in children who have suffered an attack of rheumatic fever is established beyond a doubt.
Antibiotics generally should not be used during an acute viral infection for protection against possible secondary bacterial invasion.
In general, antibiotic prophylaxis should not be used to attempt to reduce the incidence of bacterial infections in children who are suffering from a chronic disease of nonbacterial origin, such as diabetes or nephrosis.
The use of antibiotic prophylaxis in surgery should be limited to certain specific indications. It should not be used in "clean" elective surgery.
Antibiotic prophylaxis may be of value for small premature infants during the first week of life, but much more data on this point are required. For full-term newborn infants chemoprophylaxis has only limited usefulness, except for ophthalmia neonatorum. In the light of present knowledge, antibiotic prophylaxis should be used to help control outbreaks of staphylococcal and E. coli diseases in the nursery.
THE CHILD WITH MONGOLISM IN THE HOME
Authors: Schipper Martha Taylor 
Published: December 2021

The records of 43 children with mongolism living at home are reviewed to determine what the presence of such a child means to the parents and the normal siblings.
Long-range decisions are usually not needed for the infant with mongolism, and the pediatrician can best serve the child and his family by assuring them that it is "all right" to have the child at home. In this series only two families were disrupted during the neonatal period of the affected infant.
The child with mongolism will require somewhat more than average medical care, and his parents will need more than average support and continuous counseling.
Of 43 families, 31 adjusted to the affected child without adverse effect on their way of living. The families with problems were found to need specific help and were referred to social workers or family agencies.
In 33 families the normal siblings adjusted to the abnormal one with minimal adverse effects; several teen-age siblings were more realistic than their parents in accepting the assets and limitations of the handicapped child.
As the child with mongolism approaches adolescence, he may be deprived of optimal training and personal guidance if he continues to live at home and in a community where no provisions are made for him; and without an adequate plan, he may come to dominate family living. In communities where special classes, social groups and sheltered workships exist, the pediatrician can continue judicious temporizing.
Through his continuing contacts with the affected child and his family, the pediatrician can support the parents in their decisions, at the same time pointing out the values and hazards of keeping the child at home at various stages of development.
STUDIES OF RESPIRATORY PHYSIOLOGY IN CHILDREN
Authors: Cook C. D. , Helliesen P. J. , Kulczycki L. , Barrie H. , Friedlander L. , Agathon S. , Harris G. B. C. , Shwachman H. 
Published: December 2021

Tidal volume, respiratory rate and lung volumes have been measured in 64 patients with cystic fibrosis of the pancreas while lung compliance and resistance were measured in 42 of these. Serial studies of lung volumes were done in 43.
Tidal volume was reduced and the respiratory rate increased only in the most severely ill patients. Excluding the three patients with lobectomies, residual volume and functional residual capacity were found to be significantly increased in 46 and 21%, respectively. These changes correlated well with the roentgenographic evaluation of emphysema. Vital capacity was significantly reduced in 34% while total lung capacity was, on the average, relatively unchanged. Seventy per cent of the 61 patients had a signficantly elevated RV/TLC ratio.
Lung compliance was significantly reduced in only the most severely ill patients but resistance was significantly increased in 35% of the patients studied. The serial studies of lung volumes showed no consistent trends among the groups of patients in the period between studies. However, 10% of the surviving patients showed evidence of significant improvement while 15% deteriorated. [See Fig. 8. in Source Pdf.]
Although there were individual discrepancies, there was a definite correlation between the clinical evaluation and tests of respiratory function, especially the changes in residual volume, the vital capacity, RV/ TLC ratio and the lung compliance and resistance.
THE EFFECT OF MATERNAL NARCOTIC ADDICTION ON THE NEWBORN INFANT
Authors: Cobrinik Ralph W. , Hood R. Thornton , Chusid Emanuel 
Published: December 2021

During the past 5 years there have been 22 newborn infants born of mothers who were narcotic addicts at the Flower and Fifth Avenue Hospitals and the Metropolitan Hospital in New York City. It is the purpose of this paper to present the clinical findings in these infants and notes on treatment.
Of the 20 mothers (there were two sets of twins), 18 were taking heroin, one morphine, and in one the drug could not be determined. The maternal dosage of heroin ranged from 2 to 45 mg/day. The route of administration was intravenous in 14, subcutaneous in one, intranasal as snuff in one, and unknown in four.
Birth weights ranged from 1,100 to 3,600 gm with a mean of 2,600 gm. Nine weighed less than 2,500 gm and three weighed more than 3,200 gm. All of the infants were normally developed.
Twenty newborn infants demonstrated clinical findings with onset from birth to the fourth day. In 16 of these, symptoms and signs were present during the first 24 hours. In all of these 20 infants there were tremors, excessive crying, sleeplessness, restlessness, or hyperirritability. Vomiting and poor feeding were observed in 10 infants, diarrhea in 6, yawning and sneezing in 6, fever in 4, and convulsions in 1. There was apparently a direct relationship between severity of the infant's signs and symptoms and the size of the maternal narcotic dosage.
There was complete recovery of all the newborn infants.
The diagnosis presented no problem when a clear history of maternal narcotic addiction was available. However, this history was often not elicited or was emphatically denied. Careful physical examination of the mother usually revealed needle marks and other stigmata of narcotic addiction.
PRESIDENT'S MESSAGE
Authors: OVERALL JAMES C. 
Published: December 2021

The American Academy of Pediatrics, in attempting to fulfill one of the principal objectives of the Academy, has this year entered into a new phase of medical education by arranging a series of postgraduate courses for pediatricians. The need for such courses has been studied and considered by the Executive Board and the Committee on Medical Education for several years. Two years ago, the first step was taken when the Academy agreed to co-operate in publicizing a course on Pediatric Orthopedics that was presented in New Orleans at Tulane University School of Medicine by Drs. Ralph V. Platou and Clifford G. Grulee, Jr. This course was so successful and the arrangement so satisfactory that the Committee on Medical Education recommended that two regular Academy-sponsored courses be given early in 1959.
These two courses were held in March of this year; the first course at Ann Arbor was presented by the Pediatric Department of the University of Michigan under Drs. James L. Wilson and Harry A. Towsley, and the second course was at Nashville under the direction of Drs. Amos Christie and O. Randolph Batson of the Pediatric Department of Vanderbilt University. These courses were extremely well received as attested by the numerous commendatory letters that were directed to the officers of the Academy as well as to those who directed the courses. This great interest in the postgraduate program was considered sufficient evidence of the need for such courses and, therefore, warranted the plan to increase the number of courses to four during the coming school year.
The Subcommittee on Postgraduate Courses at a recent meeting laid the groundwork for the courses in the coming year. The schedule of courses as planned is as follows:
RECENT OBSERVATIONS ON PATHOGENESIS OF CYSTIC FIBROSIS OF THE PANCREAS
Authors: di Sant'Agnese Paul A. 
Published: December 2021

The pathogenesis of cystic fibrosis, the common denominator responsible for the widespread dysfunction of so many or perhaps all exocrine glands, is not known. The basis defect, whatever its nature, is genetically transmitted and there is suggestive evidence that it may be present in varying degrees and so affect the variety and severity of clinical manifestations in different individuals. There are accumulating data to indicate that the heterozygous state may be identified by biochemical or physiologic tests.
The abnormal chemical structure of mucoproteins in duodenal contents of patients with cystic fibrosis tends to decrease the solubility, while the abnormal physicochemical behavior shows that these mucoproteins are easily denatured and rendered insoluble. If this were true of mucous secretions throughout the body it would be possible for a change in the physicochemical environment of these mucous secretions to cause irreversible precipitation of mucoproteins in organs such as the pancreas, liver and others, thus initiating the chain of clinical events and leading to many of the symptoms manifested by patients with the disease.
Despite the almost constant and striking association of Staphylococcus aureus and the respiratory involvement in cystic fibrosis, the distribution of bacteriophage types of this microorganism resembles that found in other hospitalized patients.
GLUTAMIC-OXALACETIC TRANSAMINASE OF SERUM IN INFANCY AND CHILDHOOD
Authors: Stanton Robert E. , Joos Howard A. 
Published: December 2021

Activity of glutamic-oxalacetic transaminase in serum (S-GOT) has been evaluated in normal infants and children and in a wide variety of diseases, including convalescent rheumatic fever, renal disease, hemolytic disease, infections and various hepatic disorders.
In 46 normal children, the observed range was 7-41 units. The range of normal values in newborn infants was somewhat wider, 29-79 units.
Convalescent rheumatic fever and infections not involving the liver were associated with normal S-GOT. S-GOT was normal with the hemolytic diseases in the absence of fulminant hemolysis. It was frequently exceptionally low in association with renal disease, and slightly elevated for a few days after major surgery.
S-GOT is elevated in diseases of the liver, but the results are too variable for specific differentiation of hepatic diseases in early life. The test is best employed in conjunction with careful clinical evaluation and with other measures of liver function.
RELATION OF DURATION OF BED REST IN ACUTE RHEUMATIC FEVER TO HEART DISEASE PRESENT 2 TO 14 YEARS LATER
Authors: Lendrum Bessie L. , Simon Albert J. , Mack Irving 
Published: December 2021

THE MEDICAL management of children with acute rheumatic fever has undergone remarkable changes in the past decade. It is no longer considered "radical management" to mobilize a patient promptly upon disappearance of the acute signs and symptoms of rheumatic activity instead of imposing prolonged periods of bed rest. A few investigators have recently advocated permitting ambulation and physical activity to tolerance within the first few days after the onset of the acute attack even in the presence of myocarditis.
There are very few data available in the literature, however, to support the clinical impression that prolonged bed rest is not necessary to secure optimal myocardial healing. For this reason it seems desirable to record clinical studies designed to test the validity of this impression.
In 1946 when Herrick House was converted from a summer residence for children convalescing from rheumatic fever to a year-round convalescent home, it became one of the first institutions to abandon prolonged bed rest. Detailed description of the Herrick House program has been published previously. A long-term study was undertaken by the medical staff at that time to determine whether abandonment of prolonged bed rest was harmful. The cardiac status of children who had been treated at Herrick House was determined by periodic examinations. All the children in the study were examined by at least one of the authors. The medical care, however, was not provided by the physicians who performed these follow-up examinations. Observations made during the first 4 years after the initiation of the study have been reported. The conclusion was reached that abandonment of prolonged bed rest and restriction of activity did not appear to affect the heart adversely and may have benefited it. The purpose of this paper is to present further observations on the same and additional children followed from 2 to 13 years.
GENETIC STUDIES IN GALACTOSEMIA
Authors: Donnell George N. , Bergren William R. , Roldan Maria 
Published: December 2021

Response to oral administration of galactose, with dosage related to body surface, has been examined in 39 members of 13 families in which galactosemia has occurred.
Genetic analysis of the families indicates an autosomal recessive mode of transmission of the defect. The finding of decreased tolerance to galactose in groups of parents and siblings is consistent with this analysis. Controls are included.
The oral galactose tolerance test is not considered suitable for detection of an individual galactosemia carrier. The range of values of normals and heterozygotes overlap. Specific enzymatic methods may be more applicable.
COMPOSITION OF TRACHEOBRONCHIAL SECRETIONS IN CYSTIC FIBROSIS OF THE PANCREAS AND BRONCHIECTASIS
Authors: Chernick Warren S. , Barbero Giulio J. 
Published: December 2021

Tracheobronchial secretions obtained by bronchoscopic aspiration from patients with cystic fibrosis and patients with chronic bronchiectasis were analyzed for the major organic and inorganic constituents. The tracheobronchial secretions from patients with cystic fibrosis contained, on a weight basis, at least twice the quantity of organic material found in bronchiectatic secretions.
Analysis of the secretions for nitrogen, carbohydrate, hexosamine and lipids indicated that, on a dry weight basis, similar quantities of these organic constituents are found in the two types of secretions. The only organic component which was found to be consistently different was desoxyribonucleic acid; a higher content was found in cystic fibrosis secretion.
Analysis of the inorganic constituents revealed a higher content of sodium and potassium in the bronchiectatic secretion when calculated both on the basis of wet and dry weight, whereas phosphorus was found to be higher in the cystic fibrosis secretion.
The calcium content in the total cystic fibrosis secretion was found to be twice that in the bronchiectatic material; however, when calculated on the basis of dry weight, both types of secretion contained similar amounts of calcium.
The influence of ionic composition of the surrounding media on high molecular weight polymers is discussed and the postulation made that an alteration in the ionic concentration may be responsible for the peculiar characteristics observed in the tracheobronchial secretions of patients with cystic fibrosis.
Carcinogenesis: Mechanisms of Action
Authors: DARGEON HAROLD W. 
Published: December 2021

This is a meticulous record of the symposium on "Carcinogenesis: Mechanisms of Action" held June 24-26, 1958 at the VII International Cancer Congress in London.
The volume contains 17 different papers by distinguished investigators in many experimental disciplines from England, United States, Australia, Germany, France, Holland and India. At the end of each paper, there are additional brief but succinct discussions and inquiries from those attending the symposium.
This effort to clarify the processes through which the phenomena known as cancers are initiated, promoted and accelerated by the constantly growing awesome list of recognized carcinogens is particularly timely. While the contributions are almost entirely from the laboratory the clinical implications, particularly to the pediatrician, of the influences of age, environment immunity, genetic factors, are challenging even if at present highly speculative.
FAMILIAL FIBROCYSTIC PULMONARY DYSPLASIA AND ITS RELATION TO THE HAMMAN-RICH SYNDROME
Authors: Donohue W. L. , Laski Bernard , Uchida Irene , Munn J. D. 
Published: December 2021

Attention is drawn to a peculiar "interstitial pneumonitis" in five infants from three families.
In one of these families with three infants, there was chronic pulmonary disease in four adults; in another family, in one infant and one adult. In each adult the total picture, from data available, was identical with that of the Hamman-Rich syndrome.
In order to distinguish these cases from others included in the Hamman-Rich syndrome, the term familial cystic fibrosis of the lungs or familial fibrocystic pulmonary dysplasia is suggested.
The genetic implications are discussed.