bluuebunny/crossref_metadata_2025_split huggingface dataset:
MILK ALLERGY
Authors: Bachman Kay D. , Dees Susan C. 
Published: December 2021

During two consecutive calendar years, a series of 403 babies receiving routine well-baby care were followed and records kept of all symptoms and illness occurring during their first 2 years of life.
Gastrointestinal disorders and eczematous rash were the symptoms most frequently encountered which appeared to be due to allergy. Many minor digestive, skin and respiratory symptoms were recorded which did not prove to be allergic manifestations during the 2 years of observations.
Colic was present in 52 well babies, of whom 2 were sensitive to milk.
The incidence of allergy to cow's milk in this series of infants was 4 in 403 or 1%.
Scratch tests were negative in 66 of 72 well babies tested, and no strongly positive reactions were observed. The allergens used were cow's milk, bovine lactalbumin, casein and egg. No correlation could be made between skin tests and clinical symptoms.
Three infants showed a few scattered eosinophils in the stool smear, among 156 from whom stool smears were made. These babies had colic but no symptoms suggestive of allergy later.
FAMILIAL ASPECTS OF OBESITY
Authors: Childs Barton 
Published: December 2021

NO SCIENTIFIC investigation is needed to detect the familial nature of obesity, but the extent of the contribution of constitutional, cultural and other environmental components is not at all clear. That it is especially important, however, to understand these etiologic factors is suggested by the failures experienced by those who have undertaken to treat long standing obesity. A firm grasp of the nature of the causes of the condition is the key to prevention, and the time to prevent is childhood.
Before going on to a discussion of heredity in obesity it might be well to state what is possible in genetic studies on human populations. Genetics is the study of heritable variation, and it attempts to describe the degree to which familial like-nesses and dissimilarities result from the action of genes in particular environments. In general, we suppose that gene action is biochemical, and that it is expressed in the control of metabolic reactions in the cells, whether by conferring specificity upon enzymes or by other means.
Several methods for such investigation are available. First we may study discontinuous variation in which differences between individuals are clearly measureable, and a population may be divided into two or several types without misclassification. Such differences are often found to be associated with differences in molecular specificity or quantitative differences in enzyme activity. If these differences are genetic in origin, they are usually found to be due to one or at most a small number of genes, and the intrafamily distribution of the characteristics will follow some mendelian pattern.
A second method involves the analysis of continuous variation. By this is meant differences between individuals which are so small as to make actual measurement of such differences impossible, and covering a wide range or spectrum, so as to form a continuum.
MEASUREMENT OF ACTIVITY OF TRANSAMINASES IN THE SERUM AS AN AID IN DIFFERENTIAL DIAGNOSIS OF JAUNDICE IN THE NEONATAL PERIOD
Authors: Kove Simon , Goldstein Stanley , Wróblewski Felix 
Published: December 2021

Measurements of transaminases in the serum have proven of value in the diagnosis of hepatic diseases in adults. It therefore seemed of interest to apply these techniques to the newborn infant.
To establish the normal range of the activity of these enzymes in the serum for the neonatal period, studies were made of glutamic pyruvic transaminase (GPT) in 63 normal newborn term infants for the first week of life. It was found that values for the activity of GPT up to 90 units must be considered physiologic for this early neonatal period. This compares to a physiologic neonatal range of activity up to 120 units for glutamic oxaloacetic transaminase (GOT), found in a previous investigation on these same infants. Thus the range of activity for these two enzymes in newborn infants is somewhat greater than that of adults in whom values up to 45 units for both enzymes are considered normal.
In neonatal physiologic jaundice the degree of hyperbilirubinemia did not affect the activity of GPT, as was also the case, from previous studies, with respect to GOT.
Serial determinations of the activity of GOT and GPT were also made in a small number of infants with jaundice due to pathologic conditions to determine the value of this test in the differential diagnosis of jaundice of unknown origin in the newborn infant. It was found that in hemolytic disease of the newborn, activity of these enzymes usually remains within the normal neonatal range. In very severe hemolysis, activity of GOT may be increased to about 300 to 400 units, temporarily, although activity of GPT remains within the normal neonatal range. In neonatal biliary obstruction there is a sustained increase of activity of transaminase in the serum which may reach values up to about 800 units for the duration of the obstruction, whether it be temporary, as in the "inspissated bile syndrome" or protracted, as in atresia of the bile ducts.
It would appear that serial measurements of the transaminases in the serum may be of distinct diagnostic value in jaundice of unknown origin in the neonatal period, and it is suggested that this procedure be included in the investigation of a clinical problem involving this syndrome.
EXTENSIVE CRANIAL DECOMPRESSION IN THE TREATMENT OF SEVERE LEAD ENCEPHALOPATHY
Authors: McLaurin Robert L. , Nichols James B. 
Published: December 2021

Seven patients are presented who were treated for severe lead encephalopathy by massive bilateral cranial decompression.
Of the seven patients, five are alive. One of the fatalities resulted from gastrointestinal hemorrhage 1 week later although it is believed the encephalopathy was controlled.
There is recognized significant mental retardation present in two of the surviving patients although the remaining patients cannot be accurately evaluated at the present age. One of the two showing definite retardation also had craniosynostosis which may itself be associated with cerebral dysfunction.
A plea is made for more widespread use of decompression as a lifesaving measure and it is further suggested that the impairment of mental function following lead encephalopathy may be reduced if cerebral decompression is undertaken when it becomes apparent that the course of the disease is not being altered by medical agents.
USE OF GLUCOSE, INVERT SUGAR AND FRUCTOSE FOR PARENTERAL FEEDING OF CHILDREN
Authors: Lane Harold C. , Dodd Katharine 
Published: December 2021

Eighteen children were infused with 10% solutions of glucose, invert sugar and fructose during a period of 6 hours at a rate of infusion of 1.25 gm of sugar per kilogram of body weight per hour. All but two of the children had less glycosuria from intravenous administration of glucose than from the administration of invert sugar or fructose. In 16 children glucose appeared in the urine only during the first 2 or 3 hours of infusion of glucose, but fructose was generally present in the urine during almost all of the 6 hours of infusion of invert sugar or of fructose. Eleven of the eighteen patients had more melituria during the first 2 hours of infusion of glucose than during the first 2 hours of infusion of invert sugar or fructose. This contrasts with the total amount excreted over an 8-hour period.
When glucose was administered, total concentration of sugar in the blood obtained during the first 2 hours of infusions were higher than concentrations obtained during infusions of invert sugar and fructose; subsequently, there was often little difference in total concentration of sugar in the blood during infusion of the three hexoses. Determinations of concentrations of sugars in the blood revealed that the renal threshold for glucose was above 175 mg/ 100 ml of blood, while the threshold for fructose was frequently as low as 10 mg/ 100 ml of blood.
There was no significant difference in total volumes of urine obtained from each patient at the end of 8-hour collection periods after infusions of the three carbohydrates.
The present study suggests that in some children who require intravenous fluid therapy with maximum caloric intake for periods longer than 2 hours glucose is to be preferred to invert sugar or fructose. Whether glucose is the best choice for children after operation or in situations of severe stress remains to be demonstrated.
NEWER DRUGS WHICH INFLUENCE BEHAVIOR
Authors: Steigman Alex J. 
Published: December 2021

It has been pointed out that certain chemically related compounds can induce mental aberration in man and animals which other chemicals can correct. These latter chemicals are capable of modifying the inherent aggression of certain lower animals and of inducing serenity in some humans with disturbances of mentation and behavior. The duration of effects, the long-range consequences, the possibility of habituation remain important unknowns.
Comparisons have been drawn among the three large areas of pediatric interest— Nutrition, Infection, Behavior. These have been dominated in a natural evolutionary sequence by the applied rules of hygiene until such time as precise methods and potent specifics were available. The dawn of these methods in the field of Behavior may be at hand. It is unnecessary to point out the fantastic importance of scientific study of behavior, particularly in children whose habits and human values are being shaped by the learning process. The orthodox, conservative, methodical, dispassionate methods of medical research, combining the talents of clinical and basic science, have brought rich rewards to children in the areas of Nutrition and Infection. There is hope that this same approach, if untrammeled by the fanfare of hucksterism—medical or lay, will sometime in the future bring important rewards in the area of Behavior.
INTRACRANIAL COMPLICATIONS OF LEUKEMIA IN CHILDREN
Authors: Sullivan Margaret P. 
Published: December 2021

Pathologic findings in the brain and meninges in untreated patients with leukemia have been reviewed. Involvement of the meninges and cerebral parenchyma were not unusual and occurred in acute and chronic disease regardless of cell type.
Despite the frequency of intracranial involvement in untreated patients with leukemia, resultant clinical symptoms were infrequently noted. In the English literature only nine published reports suggestive of increased intracranial pressure in the patient with untreated disease could be found.
A number of leukemic children who have received adrenal steroid hormones and chemotherapy have developed signs of increased intracranial pressure. Approximately one-fourth of the children with leukemia followed at this hospital in the last 18 months have developed this complication. Symptoms and signs are variable but usually include irritability, headache, vomiting, papilledema, separation of sutures, increase in circumference of the head, increased pressure and concentration of protein in the spinal fluid and normal or low concentration of sugar. In rare instances children with this sydrome have also developed hypertension, increased appetite with resultant obesity and various neurologic abnormalities.
The pathogenesis of this syndrome is unknown. The available evidence suggests that such agents as 6-mercaptopurine and Methotrexate® which are known to cross the blood-brain barrier in greatly reduced amounts fail to control the intracranial progression of leukemia even though the disease may be under fair control elsewhere in the body.
The most effective treatment for this complication at the present time is therapy with roentgen rays to the entire skull. Usually a total of 250 to 500 r given in 7 to 10 days will cause symptoms to disappear and spinal fluid findings to improve without adversely affecting the course of the disease in general. There is also some evidence that oral therapy with adrenal steroid hormones is also effective if resistance to this type of therapy has not already developed.
PHAGOCYTOSIS IN PREMATURE INFANTS
Authors: Gluck Louis , Silverman William A. 
Published: December 2021

The paucity of data regarding phagocytosis in the newborn is reviewed. A method of evaluating phagocytosis in the human is presented, in which the proportion of "effective phagocytes" (cells containing 10 or more carbon particles) is scored, rather than the total number of cells engulfing particles. Employing the criteria described, we have found significant differences in phagocytic ability between the blood of premature infants and that of adults or full-term infants. Differences observed between full-term infants and adults in respect to phagocytic capacity of leukocytes were not clearly significant. In general, increasing phagocytosis was observed, approaching adult levels with increase in birth weight. Addition of fresh, normal adult serum to invitro preparations of premature infants' blood significantly enhanced phagocytosis. The substances in serum which stimulated phagocytosis were identified by electrophoresis to be in the fractions generally known as α1-, α2-, and β-globulin.
A possible therapeutic use for adult serum in the premature is postulated and is being studied.
IMMUNOLOGIC STUDIES IN CONGENITAL AGAMMAGLOBULINEMIA WITH EMPHASIS ON DELAYED HYPERSENSITIVITY
Authors: Porter Herbert M. 
Published: December 2021

Immunologic studies of a patient with agammaglobulinemia are reported. The delayed type of hypersensitivity was normally produced in response to antigenic stimuli, but circulating antibodies of the gamma globulin fraction of the serum were not. It is postulated that delayed hypersensitivity is responsible for the apparent immunity developed against measles and chicken pox. The tuberculin response is independent of gamma globulin in the serum.
The family tree of first cousins with congenital agammaglobulinemia is presented and supports the concept that the disease is a sex-linked recessive trait appearing only in male children.
DETERMINATION OF SOME STREPTOCOCCAL ANTIBODY TITERS AND ACUTE PHASE REACTANTS IN PATIENTS WITH CHOREA
Authors: Harris T. N. , Friedman Sidney , McLean David C. 
Published: December 2021

Forty-three patients with chorea were examined by a number of laboratory tests: These consisted of two streptococcal serologic titrations, antistreptolysin-O and antihyaluronidase, and three acute phase tests, the erythrocyte sedimentation rate, and the concentrations of C-reactive protein and mucoproteins in the serum. The patients were divided into two groups, those with apparently "pure" chorea, who did not show any other clinical evidence of rheumatic fever in conjunction with an episode of chorea, or at any other time to our knowledge, and those with some other evidence of rheumatic fever. In the case of each of these tests the frequency distribution of values found in the rheumatic chorea group was different from that of the "pure" chorea group, the former having a higher center and range of distribution. Also, the results of both the acute phase tests and the streptococcal serologic tests gave evidence of contamination of the "pure" chorea group with rheumatic subjects.
The data suggest that there are, in fact, two such clinical groups of patients with chorea, and that laboratory aid toward the differential diagnosis between them would be applied in the same way as in other differential diagnoses involving rheumatic fever.
CLINICAL CONFERENCE
Authors: Schulman Irving 
Published: December 2021

Dr. Schulman: The case we would like to discuss is one chosen for its own intrinsic interest and also because it provides a good opportunity to illustrate some of our newer knowledge of coagulation in general, and hemophilia in particular.
The patient is a 4-year-old boy who was referred to this hospital for investigation of a hemorrhagic diathesis. His birth was normal and at the age of 7 days he was circumcised without difficulty. At 1 year of age he developed bleeding from a traumatic laceration of the left upper eyelid, which persisted for 5 days. At the age of 3 years he apparently fell and bit his tongue. This led to persistent bleeding for a period of 14 days, despite the administration of three transfusions. At 3 6/12 years of age, an upper central incisor became loose, resulting in bleeding for 3 days. At 4 years he suddenly developed a painful swelling of the right knee, which increased in severity for 5 days. Joint aspiration yielded 20 ml of blood. At no time did this boy have any other manifestations of bleeding. There had been no nose bleeds.
The members of the family are indicated in Figure 1. This patient has two brothers who are unaffected and three sisters who are also unaffected. The mother and father are unaffected. However, the mother's paternal uncle had a severe hemorrhagic disease and, in addition the mother's sister has two sons who also have bleeding manifestations. The disease, then, apparently occurs only in males. It skips a generation and is apparently transmitted by females. This is the classic sex-linked, recessive inheritance which we have come to associate with hemophilia.
Salmonella Osteomyelitis and Abnormal Hemoglobin Disease
Authors: HAMMOND DENMAN 
Published: December 2021

In the September, 1957, issue of Pediatrics (20:439, 1957) appeared an article by Henry K. Silver et al., in which a case was reported as the first instance of salmonella osteomyelitis in a patient with hemoglobin C-D disease. This report will perhaps attract more interest as the first recorded case of hemoglobin C-D disease, with or without associated complications.
Documentation of the hemoglobinopathy as C-D disease is reported to have been concluded from paper electrophoretic patterns of hemoglobin C trait in one parent, a pattern similar to hemoglobin S trait in the other parent and a pattern similar to hemoglobin S-C disease in the patient, with failure to demonstrate sickling in either parents or child.
HYPERTENSION AND HYPERCALCEMIC NEPHROPATHY DUE TO VITAMIN D INTOXICATION
Authors: Way William G. , Morgan David L. , Sutton Lee E. 
Published: December 2021

A case is presented of hypercalcemic nephropathy secondary to vitamin D intoxication in a child 26 months of age.
The patient exhibited hypertensive encephalopathy. The management of severe hypertension in this case is discussed in detail.
Severe renal impairment was present and regressed as the patient improved.
The pathogenesis and treatment of vitamin D intoxication is discussed.
PRESENT PROBLEMS PERTAINING TO PATENCY OF THE DUCTUS ARTERIOSUS
Authors: Engle Mary Allen , Holswade George R. , Goldberg Henry P. , Glenn Frank 
Published: December 2021

The incidence of marked retardation of growth in children with patency of the ductus arteriosus was reviewed in an operative series from the New York Hospital and from the literature. Retardation in growth was present in approximately one-third to one-half of the children.
Almost all of the patients in the New York Hospital series with serious growth impairment remained retarded following otherwise successful surgery on the ductus at ages 3 to 14 years. Periods of postoperative observation ranged from 1 to 10 years, averaging 4 years.
Possible reasons for persistent impairment of growth are considered.
This observation is the basis for a recommendation of early operation for patients with patent ductus arteriosus who become retarded in height and weight. It is anticipated that this will afford a better chance of reversibility of the abnormal growth pattern, if the retardation has not persisted too long during the period of most rapid growth.
INCIDENCE OF CRANIAL NERVE PARALYSIS IN POLIOMYELITIS IN RELATION TO PRESENCE OR ABSENCE OF TONSILS
Authors: Top F. H. 
Published: December 2021

Evidence is presented from data covering the period 1940 to 1952 which corroborates the conclusion of previous studies that prior tonsillectomy probably adversely affects the occurrence of brainstem paralysis (bulbar and bulbospinal) in poliomyelitis. Neither this study nor any preceding studies relating to this problem have proved the contention. On the basis that the hypothesis is correct, an attempt is made to find an answer by studying the incidence of the common paralysis of cranial nerves (VII, IX and X and XI) in bulbar and bulbospinal cases of poliomyelitis on the basis of presence or absence of tonsils.
Rates of incidence of paralysis of cranial nerves, not adjusted for age, indicate a decidedly higher proportion of paralysis of the facial nerve (VII) among nontonsillectomized patients whereas tonsillectomized persons are preportionately more affected by palatal and pharyngeal paralysis (nerves IX and X). Paralysis of the facial nerve appears from two studies to occur more commonly at earlier ages, particularly in the age group 0 to 4 years. However, age adjustment did not erase, although it did somewhat lower, the TR/TP ratio. This finding lends credence to a real difference but can only be applied to this study, as Paffenbarger in a smaller study found no significant difference in frequencies of paralysis of the facial nerve between groups with tonsils removed and tonsils present, and Southcott, also in a small study, found paralysis of the facial nerve more common among tonsillectomized patients with bulbar (includes bulbospinal) involvement. The differences noted for palatal and pharyngeal paralyses (nerves IX and X) in the unadjusted rates as between tonsillectomized and nontonsillectomized patients remain statistically different and in some instances significant when corrections for age are made.
The results of this study are suggestive but give no entirely satisfactory explanation for the differences noted. Various explanations previously offered are cited and briefly discussed. Perhaps more definitive studies in animals along the approach suggested by Southcott will prove more fruitful, namely, labelling virus by some radioactive element in order to trace the route it takes to the central nervous system.
IMPROVED LOCAL TOLERANCE TO BENZATHINE PENICILLIN G
Authors: Krugman Saul , Ebin Eva V. 
Published: December 2021

Four types of penicillin for intramuscular injection were compared for incidence of local reaction: (1) suspension of benzathine penicillin G, 600,000 units in 1 ml; (2) benzathine penicillin G, 600,000 units, with 5 mg of prednisolone, in 1 ml; (3) benzathine penicillin G, 600,000 units, plus aqueous procaine penicillin, 600,000 units, in 2 ml; and (4) aqueous procaine penicillin, 1,200,000 units in 2 ml.
A total of 320 children were evaluated at 24 hours, and the following percentages of severe local reaction were recorded for the four penicillin preparations listed: (1) 54%; (2) 9%; (3) 11.5%; and (4) 4%. The incidence of mild local reactions was the same following all four preparations, 11 to 12%.
The local tolerance to benzathine penicillin G, 600,000 units, was significantly improved by combining it with either 5 mg of prednisolone, or an equal dose and volume of aqueous procaine penicillin.
THE PLACE OF METHACHOLINE (MECHOLYL®) IN THE MANAGEMENT OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA
Authors: Husson George S. 
Published: December 2021

Methacholine has a distinct place in the management of paroxysmal supraventricular tachycardia.
It is recommended as the drug of choice when a patient is moribund and a fastacting drug is indicated.
Certain indispensable precautions are outlined for its use.
The interaction of methacholine and popularly used drugs such as quinidine and digitalis is discussed.
The observations on an infant with recurrent supraventricular tachycardia, successfully treated with methacholine on several occasions, are presented.