bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISCUSSING PROBLEMS IN NEWBORN BABIES WITH THEIR PARENTS
Authors: Kennell John H. , Rolnick Alice R. 
Published: December 2021

A STUDY of child rearing is being carried out at Western Reserve University Medical School and University Hospitals of Cleveland by a staff consisting primarily of four pediatricians, three psychiatrists, and four child therapists. In addition there is a psychologist and a nurse. One of the aims is to clarify some of the psychologic factors in the everyday problems of parents, about which they commonly turn to pediatricians for help.
In order that the psychiatrists and child therapists may see problems as they are usually presented to a pediatrician, each of them (as well as each of the four pediatricians) has functioned as a counselor to one family. One of the pediatricians performs physical examinations and acts as physical consultant for the seven non-pediatric counselors.
Each mother had up to an hour of consultation a week with her counselor from the last trimester of pregnancy until her baby was at least 6 months old. It is planned that bimonthly visits will be made by the mother until the child is at least 3 years of age. After each week's clinical session, the staff has had 2 hours for discussion.
Of the 12 babies delivered in this study, 8 had definite neonatal problems of concern to both the physician and family. This is a high proportion, but not surprising considering the small size of the sample as well as figures available from larger series. Statistics gathered during 12 months in the newborn service at University Hospitals of Cleveland show that out of 4,288 infants, 20% present medical problems.
Epidermolysis Bullosa Letalis
Authors: Mautner Hans 
Published: December 2021

A paper of Roberts et al.(Pediatrics, 25:283, 1960) was published in which it was claimed that pemphigus hereditarius was described first by Herlitz. When the paper of Herlitz is read, it can be found out that the disease was first described by me and it has even been called in some of the earlier publications "Mautner's disease."
I would like to ask if there is a possibility of publishing this letter in one of your issues.
PUBLIC HEALTH
Authors: Wegman Myron E. 
Published: December 2021

For the first time in 3 years it is gratifying to note that the infant mortality in the United States has not increased. The estimated rate for 1959, 26.4, was about 2% lower than the 1958 rate of 26.9 and is at the same level as the 1957 rate. Low point thus far for the United States was in 1956, when the rate was 26.0.
There was relatively little change in the other important rates—births, deaths and marriages. The natural increase in the population, that is births (including an estimate for those unregistered) minus deaths, was 2,632,000, giving a rate of increase of 14.9 per 1,000 population, essentially the same as the 1958 rate of 15.0.
AN ACCOUNT OF THE ORIGINS OF THE INVESTIGATIONS OF JAMES L. GAMBLE AND AN ANALYSIS OF HIS CONTRIBUTIONS TO PHYSIOLOGY AND MEDICINE
Authors: Wallace William M. 
Published: December 2021

The investigative work of James L. Gamble found its instigation in the accentuated peculiarities of disease in infants and children, but as much as any other research in the field of pediatrics, his contributions have been universally applicable to all areas of medicine. The enormous and fruitful body of knowledge of water and electrolyte metabolism now at hand had much of its origin and a considerable segment of its basic foundation arise from the pioneer work of a small group of American pediatricians. Not only were their investigations of great value as pure contributions to the natural sciences, but their work has had an enormous practical application. In a review in 1950 by Darrow and Pratt1 it is stated: "Probably the proper use of water and electrolyte solutions is responsible for saving more lives of seriously ill patients than is the use of any other group of substances." Dr. Gamble was the last survivor of this small group of originators of basic concept upon which so much has been constructed.
As a sketch of Gamble's life is available elsewhere,2 it seems more pertinent in this place to undertake a résumé of the history of the period of remarkable scientific achievement in which Gamble played so great a role. The study of the body fluids had its inception in efforts to understand and treat the dysenteric diseases. During the Nineteenth Century a few physicians studied the effects of abnormal losses of intestinal fluids, drew surprisingly correct conclusions and even assayed, with success, treatment with parenteral fluids.
SOME THOUGHTS ON NORMAL, OR STANDARD, VALUES IN CLINICAL MEDICINE
Authors: Schneider Albert John 
Published: December 2021

Clinical medicine, for all its achievements, is built on the logically inconsistent dichotomy of health and disease. Our first function as physicians is somehow to decide whether a patient belongs in an ill-defined category of healthy individuals, or to the general class of nonhealthy individuals. Unless we are content to act on general impressions, we proceed by first dismembering the patient bit by bit until he is not a person at all, but rather an association in time and place of assorted discrete attributes or characteristics. Each of these attributes is considered as being normal or not, either separately or in relation to a few others. If the right combination of abnormal attributes can be found, the patient is then re-assembled as a member of a particular class of previously defined diseases, or becomes the first member of a new class. If no such combination is apparent, he is reborn as healthy, at least for the present.
My apparent facetiousness is not intended to obscure the fundamental fact that we have not found any other satisfactory way to arrive at intelligent decisions. On the contrary, in the historic development of quantitative medicine, we have deliberately cultivated just this approach in contrast to the impressionistic approach. With ever increasing numbers of attributes becoming available for forming judgments, the responsibility for understanding what we are doing becomes greater and greater, both for those who elect to define these attributes and for those who plan to use them in the conduct of medical practice.
PERITONEAL DIALYSIS IN INFANTS AND SMALL CHILDREN
Authors: Segar William E. , Gibson Robert K. , Rhamy Robert 
Published: December 2021

Ten infants and children ranging in age from 3 days to 34 months have been treated with peritoneal dialysis. All 10 were anuric on severely oliguric. Three had salicylate intoxication, and three had boric acid poisoning as additional complications. Three of the 10 children, including the only patient with irreversible renal disease, died. All seven who survived made complete and uncomplicated recoveries from their acute illness. One now has evidence of residual renal damage.
The technique of peritoneal dialysis is described and the indications, contraindications and complications are discussed. The data presented indicate that peritoneal dialysis is an effective type of dialysis, that it is safe, that it can be accomplished with a minimum of equipment and that a highly trained team is not essential for its efficient use. It is superior to exchange transfusion in the treatment of most types of poisonings and is the only practical procedure currently available by which dialysis of an anuric infant or small child can be accomplished.
INTERRELATIONSHIPS OF MATERNAL AND FETAL CIRCULATIONS
Authors: Adams Forrest H. , Assali Nicholas , Cushman Marjorie , Westersten Allan 
Published: December 2021

Epinephrine and norepinephrine injected intravenously into pregnant ewes produced a prompt increase in maternal arterial pressure but a significant and sustained decrease in uterine arterial blood flow.
Angiotensin injected intravenously into pregnant ewes produced a prompt increase in maternal arterial pressure (similar to epinephrine and norepinephrine) and an increase in uterine arterial blood flow.
In the doses used, epinephrine, norepinephrine and angiotensin injected intravenously into pregnant ewes produced no significant observable effects on the arterial pressure and blood flow in the umbilical cord on heart rate in the fetus.
Epinephrine and norepinephrine injected in the umbilical vein of lambs in utero produced a prompt and significant rise in umbilical arterial pressure and umbilical arterial flow only when large doses (five times effective adult doses/kg body weight) were used. Effective adult doses (kg body weight) injected into lambs in utero produced no significant change in arterial pressure or blood flow in the fetus.
Angiotensin injected intravenously into lambs in utero produced no significant change in arterial pressure or blood flow in the umbilical cord.
Vasoactive drugs injected into the mother on into the fetus did not appear to cross the placenta in either direction in physiologically effective amounts.
A VALVE FOR RESPIRATORY STUDIES IN INFANTS
Authors: Golinko Richard J. , Rudolph Abraham M. 
Published: December 2021

PULMONARY function studies in small infants have been limited in the past by failure to develop practical methods for collecting expired gas samples. Adaption of a respiratory valve suitable for use in small subjects with small tidal volumes has been difficult and has led to the use of techniques with the body plethysmograph, contour face mask and large head chamber. The body plethysmograph offers only indirect data and requires considerable prepration before each study. In addition, it has the disadvantage that once the infant is placed in the plethysmograph chamber further manipulations of the infant are not possible. Systems using the contour face mask on head chamber involve a large dead space which may be quite significant when one considers the small volumes dealt with. In order to overcome the problem of large dead space, Cayler et al., similar to others, circulated air across the face of the contour mask. However, because of the dilution effect, differences in the composition of the inspired and expired gases were very small and therefore the chance for error in the calculations was increased.
Berglund and Karlberg, and Geubelle et al., while studying functional residual capacity in infants, found that practically all quiet, healthy newborn infants breathe through the nose and can also tolerate the insertion of small tubes in their nostrils for varying periods. On the basis of these observations, a respiratory valve has been designed for insertion directly into the nostrils, permitting collection of total expired air. The valve, especially adapted for use in small infants, offers minimal resistance to respiration and has a dead space of 0.8 ml.
SYSTEMIC MANIFESTATIONS DUE TO ALLERGY
Authors: Crook William G. , Harrison Walton W. , Crawford Stanley E. , Emerson Blanche S. 
Published: December 2021

The data on 50 patients with systemic manifestations due to allergy seen at the Children's Clinic, Jackson, Tennessee, during the period 1956 through 1960 is presented. Detailed case histories are recorded for four of these patients. The findings on the remainder are given in tabular form.
Uniformly, the symptoms and signs in these children were fatigue, irritability, pallor in the absence of anemia, and infraorbital circles. Most of them also had nasal congestion, abdominal pain and headache. A variety of other signs and symptoms, including those of nervous system involvement, may also be present.
The literature on this condition is reviewed in detail showing that this condition has been described under several different names by many observers during the past 40 years. In spite of these descriptions, few physicians are aware that allergy causes such systemic manifestations.
In conclusion, it is suggested that allergy be included in the differential diagnosis of any child with generalized body symptoms of undetermined cause.
PRESIDENT'S MESSAGE
Authors: Wheatley George W. 
Published: December 2021

ONE OF THE characteristics of democracy in the United States is the important role of voluntary associations and of private citizens in organizing and raising funds to combat health and social problems. This phenomenon was already well established more than 130 years ago; it was even then commented on at some length by Alexis de Tocqueville in his classic and monumental study of our democratic institutions. In his view, the health of a democratic society could be measured by the quality of the functions performed by private citizens.
Pediatricians as child health experts and citizens have always taken an active part in the voluntary health movement. In an earlier President's Page I commented at length on some of these contributions. My reason for bringing the subject up again is to call attention to a current Rockefeller Foundation study of health and welfare agencies under the direction of Dr. Robert H. Hamlin. The preliminary report was scheduled to be released in April. Several years ago our Executive Board, impressed with the growth and fund-raising efforts of voluntary health organizations, discussed some of the same questions that Dr. Hamlin's group is now exploring. Among them were: Are so many agencies needed? Is there unnecessary duplication? Are so many solicitations necessary? What are the agencies doing with the contributions they receive? As a result of the Board's concern, a special committee prepared a statement giving the Academy's position, particularly with reference to the use of these funds for research.
Concern with the scope and purpose of voluntary health agencies is not new. Forty years ago the National Health Council came into existence to serve as a clearing-house and advisory body for national voluntary health agencies. This was the first clear-cut endeavor to meet the problem of duplication of effort, and to strengthen the attack on public health issues. Fifteen years ago the Gunn-Platt report, under the auspices of the National Health Council and supported by the Rockefeller Foundation, constituted another landmark in the evaluation of the programs of voluntary health agencies. The report stressed the need for increased agency cooperation in planning.
The National Health Council, now composed of 52 active members, of which, as you know, the Academy is one, is embarked on two special projects in this area: 1) development of a statement of the role of a voluntary health agency; and, 2) a project to produce uniform accounting principles and reporting procedures for voluntary health agencies. Reports are expected in 1961.
Other medical organizations in the Council include the American Medical Association, American Academy of General Practice, Association of American Medical Colleges, National Medical Association, and Association of State and Territorial Health Officers.
GENERALIZED LYMPHOHISTIOCYTIC INFILTRATION
Authors: Nelson Paul , Santamaria Armando , Olson Robert L. , Nayak Nabeen C. 
Published: December 2021

Three cases representing a familial disease not previously described are reported. The disease occurred in children under the age of 7 years and was characterized clinically by an acute but protracted course, with fever, anemia, leukopenia, thrombocytopenia, hepatosplenomegaly, pneumonitis and meningitis. Pathologically, there was extensive infiltration of many organs and tissues by lymphocytes and histiocytes with remarkable involvement of the central nervous system and neurohypophysis.
The nature of this disease is uncertain, but a generalized cellular, metabolic or biochemical etiology is suggested.
Significant differences from Letterer-Siwe disease and Chédiak-Higashi syndrome are pointed out.
GROWTH DISTURBANCES AND VALUES FOR HORMONE EXCRETION IN VARIOUS FORMS OF PRECOCIOUS SEXUAL DEVELOPMENT
Authors: Ferrier Pierre , Shepard Thomas H. , Smith Elizabeth Knapp 
Published: December 2021

Forty-two children with precocious sexual development have been classified according to: a) constitutional sexual precocity, b) premature adrenarche, and c) premature thelarche.
Constitutional sexual precocity and premature adrenarche are associated with excessive growth, advance in bone maturation, and elevation of the urinary 17-ketosteroids. In contrast, in premature thelarche growth, bone maturation and 17-ketosteroids were normal.
The presence of estrogenization of the vaginal smear was the most helpful laboratory finding in differentiating constitutional sexual precocity from the other two conditions.
The presence of detectable urinary gonadotropins in precocious puberty is of limited help.
Two patients with primordial dwarfism and associated precocious puberty are reported.
The occurrence of constitutional precocious puberty in a brother and a sister is described. This is apparently the first reported instance in which familial precocious puberty occurs in either sex.
LONG-TERM FOLLOW-UP OF 100 CHILDREN WHO RECOVERED FROM TUBERCULOUS MENINGITIS
Authors: Lorber John 
Published: December 2021

IT IS MORE THAN 13 years since streptomycin became available for the treatment of tuberculous meningitis. Since then treatment has become progressively more efficient and much less complicated.1-7 Between 1947 and the end of 1955, 170 children were treated for tuberculous meningitis by the Department of Child Health of the University of Sheffield. One hundred of these survived for 5 years or more.
The purpose of this paper is to review the long-term results in these 100 survivors, 33 of whom have been followed for more than 10 years (Table I). Thirty children had been treated with streptomycin, 35 with streptomycin and aminosalicylic acid (PAS), and 35 with isoniazid, streptomycin and PAS. All had intrathecal treatment with streptomycin, although the length of the intrathecal therapy and the number of injections was progressively reduced as the newer antibiotics were introduced. No child had less than 20 intrathecal injections.
At the beginning of their illness 47 were less than 5 years of age, 43 between 5 and 9, and 10 between 10 and 14 years of age (Table II). Thirty-one survivors were in the early stage of disease, 53 were in the intermediate and 16 in an advanced stage on admission. After discharge from the hospital they were all followed at regular intervals. In the follow-up period much stress was laid on the assessment of their personality, their achievement, and their adjustment to life. During this period closer acquaintance with the parents and their siblings helped in placing the patients' achievements and problems in perspective.
SURGERY IN A HEMOPHILIAC CHILD WITH INTRACRANIAL HEMORRHAGE
Authors: Fuerth John H. , Teng Paul , Goldenberg Erwin 
Published: December 2021

THE UNUSUAL bleeding tendency in hemophiliacs has been known since biblical times, and its hazards have been recognized in even such simple surgical procedures as circumcision.1 Perhaps the most dangerous complication of hemophilia is bleeding into the central nervous system.2 It therefore seems worthwhile to report the case of a 2-year-old hemophiliac who survived several intracranial hemorrhages, with two surgical interventions, but who 4 months later had a fourth and fatal hemorrhage.
CASE REPORT
History
D. H. was a 2-year-old hemophiliac with numerous admissions to the Kaiser Foundation Hospital, Los Angeles, for bleeding episodes. He was born at another hospital, was circumcised shortly after birth and had excessive bleeding following this. His first admission was at the age of 1 year for bleeding following a tongue bite. At that time he had an abnormal result of a prothrombin consumption test, with 55% residual prothrombin in the serum. The prothrombin consumption was corrected by fresh normal plasma and barium sulfate adsorbed plasma, but not by serum or plasma from a known hemophiliac type A. The diagnosis of hemophilia type A was thus established.
He had two brothers who were investigated and found to be normal. There was no abnormal bleeding tendency on his father's side, but two uncles of his mother and two first cousins were said to be "bleeders." No further details were known.
Physical and Laboratory Findings
The boy was admitted to the hospital on the evening of October 13, 1957, with a history of vomiting and progressive lethargy of 2 days' duration.
Determination of Blood Sugar in Newborn Infants
Authors: BAENS GLORIA S. , OH WILLIAM , LUNDEEN EVELYN , CORNBLATH MARVIN 
Published: December 2021

To the Editor:
Recently, there has been a renewed interest in the level of blood sugar in the newborn period, with very low or zero blood sugars being reported1, 2 In some of these reports there is no mention of how the blood was collected, how long it was permitted to stand, how it was precipitated, or analyzed. As reviewed by Peters and Van Slyke,3 the disappearance of sugar from blood in vitro has been well documented since the time of Claude Bernard.
DIGOXIN DOSAGE IN PREMATURE INFANTS
Authors: Levine O. Robert , Blumenthal Sidney 
Published: December 2021

An attempt has been made to determine a maximum safe digitalizing dose of digoxin for healthy premature infants. The experimental design has utilized a three-by-three Latin square, in which premature infants in three predetermined weight and age categories have been assigned at ran dom to each of three digitalizing dosages: 30, 50 and 75 µ/kg body weight of digoxin. The total scheduled dosage was administered intramuscularly in three equally divided doses at 8-hour intervals. Control electrocardiograms were taken, and tracings were obtained after two-thirds of the dosage had been given, 4 hours after digitalization was completed, and at 24-hour intervals thereafter. Digitalis intoxication was defined in terms of electrocardiographic criteria. Twenty-seven infants were tested with 30 µg/kg body weight of digoxin, 26 with 50 µg/kg and 27 with 75 µg/kg. The incidence of digitalis intoxication was 2.5% at the 30 µg/kg dosage level, 9.4% at 50 µg/ kg, and 33.3% at 75 µg/kg. The null hypothesis is rejected with a high degree of probability.
Insufficient data were available for statistical analysis of age differences in incidence of intoxication. The data indicates, however, that premature infants tested during the first 72 hours of life may have a diminished tolerance to the glycoside. Side-effects of glycoside administration were noted in only a few of the infants, were rarely severe and were short-lived.
The electrocardiographic manifestations of digitalis intoxication were widely varied. Sinus node depression with ectopic supra-ventricular beats and rhythms, and atrio-ventricular conduction disturbances were the most common arrhythmias observed. An irritable ventricular focus was observed in only 1 of the 12 intoxicated infants. In most cases a regular sinus rhythm had returned with 48 hours of full digitalization. However one infant still had evidence of arrhythmia 9 days later.
On the basis of the data presented, the following conclusions are reached: 1. The administration of 75 µg/kg body weight of digoxin, for the digitalization of healthy premature infants, in the manner described, incurs an excessive risk of digitalis intoxication. 2. Although 50 µg/kg represents a more reasonable risk among these infants, and 30 µg/kg a minimal risk, one must be alert to the occasional infant who may have an unusual intolerance to the drug.
It is recommended that digitalization be carried out under close electrocardiographic control, as no clinical criteria correlated well with the development of digitalis intoxication in these infants. Tracing of adequate length, in which the P waves are well defined, should be obtained during digitalization and at daily intervals until the infant is being given a stable maintenance dosage.