bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHILD HEALTH IN THE DEVELOPING WORLD
Authors: Kretchmer Norman 
Published: December 2021

It Was November 18, 1960, when President Kennedy requested the formation of task forces to formulate foreign policy and posed a specific question for Africa, "What special propositions should we make-in regard to raising the educational level, the fight against disease and improving the available food supply?" The year before, in mentioning the national preoccupation with the missile gap, he referred to another gap, "the economic gap," by which he meant, "the gap in living standards and income level and hope for the future. It is this gap which presents our most critical challenge today-and it is to this gap we have responded most sporadically, most timidly and most inadequately." During his administration, AID was established, the Peace Corps entered the field, and the percent of total health research funds devoted to international support rose from 9.7% in 1960 to 28.7% in 1963 and, regretfully, the percent has since remained stable.
A critical examination of the title of this talk immediately raises the question-what in fact is the developing world and why is it considered to be developing? We generally speak of developing countries in terms of their political and economic emergence, but from a medical point of view they may be viewed as receptacles of vast, almost overpowering, health problems, in a perpetual struggle between population and fulfillment of the needs for a good life. Consequently, overpopulation cannot be defined simply in terms of square footage of land, but rather it relates the available facilities to the basic needs of man for food, shelter, physical protection, and human dignity.
POSTNATAL GROWTH RETARDATION IN CONGENITAL RUBELLA
Authors: Michaels Richard H. , Kenny Frederic M. 
Published: December 2021

Three patterns of postnatal growth were found among a group of 16 infants with congenital rubella. Most remained smaller than average during infancy but grew at a normal rate. Several showed a "catch up" phase, the growth spurt in some cases occurring at about the time of apparent termination of infection. Others had a marked postnatal deceleration in growth associated with prolonged infection.
Infants of mothers with rubella during the first 8 weeks of gestation showed more stunting than those born of mothers who had had rubella after this time. Males with congenital rubella tended to have greater postnatal growth failure in both length and weight than females. There was some relationship between continued infection and the degree of postnatal growth retardation.
Growth hormone assays and other endocrine studies failed to reveal a hormonal basis for the postnatal growth failure of congenital rubella. No relationship between growth retardation and pituitary, thyroid, cardiac, renal, or hepatic dysfunction was found.
APNEA IN PREMATURE INFANTS: MONITORING, INCIDENCE, HEART RATE CHANGES, AND AN EFFECT OF ENVIRONMENTAL TEMPERATURE
Authors: Daily William J. R. , Klaus Marshall , Belton H. , Meyer P. 
Published: December 2021

The respiratory patterns of 22 premature infants were continuously monitored using an impedance plethysmograph which activated an alarm system for apnea. Apnea of greater than 30 seconds' duration occurred in about 25% of the infants studied in the first 10 days of life. Bradycardia of less than 100 beats per minute occurred within 30 seconds or less of the onset of apnea. The fall in heart rate was more rapid during those apneic episodes most difficult to terminate. All apneic episodes began in expiration during periodic breathing. The response to a standardized method of stimulation to re-initiate breathing was evaluated.
In most instances, cutaneous stimulation resulted in resumption of breathing. However, 8% of the episodes required resuscitation with oxygen by bag and mask. Apneic episodes of 45 or more seconds' duration resulted in mottling, cyanosis, hypotonia, and unresponsiveness to stimulation suggesting that early intervention is required to prevent significant hypoxia and central depression from apnea. In six additional infants having apnea, higher environmental temperatures (near the upper limit of the "thermoneutral zone") were associated with an increased incidence of apnea. Continuous monitoring of respiration in small infants is now clinically feasible.
Diabetic Ketoacidosis with Fatal Cerebral Edema
Authors: Warren Philip , Villaluz Erlinda S. , Rosenberg Harold 
Published: December 2021

One case of diabetic ketoacidosis with irreversible cerebral edema in a 10-year-old boy is presented. Death ensued in spite of apparently adequate fluid, electrolyte, and insulin therapy, and it followed a brief period of clinical and chemical improvement suddenly and unexpectedly. Although the pediatric literature makes no note of this syndrome, a review of the general medical literature does reveal some scattered case reports which deal with a similar pattern.
The pathogenesis is discussed with several mechanisms presented as possible factors. Suggestions are made regarding modification of therapy, but these are admittedly tentative and require further studies.
Changing the Family, by Warren M. Brodey, M.D. New York: Clarkson N. Potter, Inc. (23 East 67th Street, New York, New York 10021), 1968, 160 pp., $6.00
Authors: Blaine Graham B. 
Published: December 2021

This is a disorganized book, but I think it is purposely so. Dr. Brodey states at one point that the family therapist's main role is that of example, and the style of this volume is an example of the freedom of expression which the author feels is essential to healthy family living.
Dr. Brodey believes that traditions and stereotypes destroy families and cause illness in family members. He emphasizes the importance of the here and now over the past and stresses the value of evolvement and constant change to adapt to changing circumstances and to individual growth.
Retention of radiostrontium, strontium, calcium, and phosphorus by infants
Authors: Kahn B. , Straub C. P. , Robbins P. J. , Wellman H. N. , Seltzer R. A. , Telles N. C. 
Published: December 2021

This study of strontium-90 retention in infants was undertaken by the Research Branch of the Division of Radiological Health (now the Bureau of Radiological Health) to contribute data toward the development of radiation protection standards for what may be the most radiosensitive age sector of the population. The study was begun in 1960, at a time when national and international agencies– the Federal Radiation Council, National Committee on Radiation Protection, and International Commission on Radiological Protection–were particularly interested in obtaining metabolic information for predicting internal exposure from the ingestion of strontium-90 deposited in world-wide fallout. The long-term metabolic balance study was feasible because the strontium-90 content in the normally available food was sufficiently high to be determined accurately when measured with care. The advantages of determining retention under actual home conditions without altering the environment and the diet of the infants were believed to outweigh the known difficulties and the inherent errors in such a balance study.
The 4-year experimental program was performed by Radiological Health Research Activities, Cincinnati, Ohio. It enjoyed the full support of the Chiefs of the Research Branch, Dr. Paul Tompkins and Dr. Arthur Wolff. Specific participation is noted in the Acknowledgment; in addition, many other staff members of Radiological Health Research Activities contributed to the study. The authors cooperated in all phases of the work, but some specialization may be recognized: Dr. Conrad P. Straub conceived, planned, and directed the entire study; Drs. Norman C. Telles, Henry N. Wellman, and Ronald A. Seltzer were the medical officers directly responsible for the study–initiated and supervised by Dr. Telles during the first year, by Dr. Wellman during the second and third years, and by Dr. Seltzer during the final year; Mr. Phillip J. Robbins directed the analytical program at the end of the study; and Dr. Bernd Kahn was responsible for providing analytical procedures and writing the report.
NEONATAL HEPATIC NECROSIS
Authors: Ruebner Boris H. , Bhagavan Belur S. , Greenfield Alan J. , Campbell Peter , Danks David M. 
Published: December 2021

Hepatic necrosis resembling acute yellow atrophy in the neonatal period appears to be rare. Five infants with this condition are described. The three patients who died shortly after birth presented chiefly with hemorrhagic phenomena, while those which survived longer were severely jaundiced. In four of the babies there were few surviving hepatocytes apart from a few giant cells. In the fifth infant there was partial hepatic necrosis. Noteworthy among the histologic features were marked hemosiderin deposition in all cases, focal calcification in one case, and nodule formation in another. Virus studies in three cases were negative.
Unfortunately, the etiology of the hepatic necrosis in our patients has not been established and may well be multiple. The hepatocytic giant cells are reminiscent of those seen in "neonatal hepatitis" but this disease does not represent an etiological entity.
The Health and Education of the Economically Deprived Child, by Sol Adler, Ph.D. St. Louis: Warren H. Green, Inc. (10 South Brentwood Boulevard), 1968, 170 pp., $7.50
Authors: Seham Max 
Published: December 2021

The author of this timely, compact, well documented book of 170 pages is a skilled technician in audiology and speech pathology. He is also a humanist who pulls no punches in stressing the ineffectiveness of current health and educational programs to "help economically deprived youth participate more fully in democracy's presupposed equality of opportunity."
Assuming correctly the unfamiliarity of most physicians with medical sociology, the author first outlines a short clinical introduction to the sociology of poverty and the serious impact this can have on the mental, physical, and emotional health of the deprived child.
THE THERAPEUTIC USE OF LEECHES IN CHILDREN AS DESCRIBED IN 1825
Authors: C. T. E. 
Published: December 2021

Leeches were used in the treatment of many pediatric conditions until relatively recently. Many physicians prescribed leeches, especially in the treatment of the purported symptoms caused by teething. William Moss,1 for example, advised applying two or three leeches at one time on the foot or heel of teething infants where "bleeding is a remedy much to be depended on when the symptoms of heat, fever, drowsiness, and startings are urgent."
The following is an excellent description of the indications for leeching in children, as given by Dr. James Kennedy in 1825:
Leeching, so as to abstract blood from a particular part sustaining inflammation, fulness, or pain, is very useful in many diseases especially those of children. . . . When the leech is of the right or medicinal kind, its body has a blackish brown colour, marked on the back with six yellow spots, and edged with a yellow line on each side:—these spots, however, as well as the lines, grow faint and almost disappear at certain seasons. . . . The mouth forms, as it were, the body of a pump and its tongue the sucker; and, by the working of this . . . mechanism, the blood is made to rise up into the conduit which conveys it to the animal's stomach. . . .
Leeches may be employed in every case where topical bleedings are required, or where venesection cannot be performed. Before applying them, all the parts should be carefully washed;—first, with hot water and soap, for the purpose of removing, as much as possible, the particles of the cutaneous excretion which the leech instinctively dislikes, especially if impregnated in any degree with the odour of medicine;—and secondly, with milk and water as warm as can be endured, with the object of stimulating the superficial vessels and filling them with red blood.
ANDROGEN METABOLISM IN CONGENITAL ADRENAL HYPERPLASIA DUE TO 11 β-HYDROXYLASE DEFICIENCY
Authors: Frasier S. Douglas , Horton Richard , Ulstrom Robert A. 
Published: December 2021

The plasma concentration of androstenedione and testosterone, metabolic clearance rate of androstenedione, and in vivo conversion ratio of androstenedione to testosterone have been studied in a normotensive 5-year-old female with congenital adrenal hyperplasia due to a deficiency of 11 β-hydroxylase.
Prior to glucocorticoid administration, the urinary excretion of 17-ketosteroids varied from 2.2 to 4.9 mg/24 hours, urinary excretion of pregnanetriol varied from 0.7 to 2.2 mg/24 hours, and total 17-hydroxysteroid excretion varied from 1.2 to 7.5 mg/24 hours. Urinary tetrahydro-11-deoxy cortisol (TSH) was detected at a concentration of 550 µg/24 hours. The plasma concentration of androstenedione varied from 100 to 530 mµg/100 ml and the plasma concentration of testosterone varied from 40 to 90 mµg/100 ml. These values are significantly elevated when compared to those obtained in normal prepubertal females. Urinary steroid excretion and plasma androgen concentrations fell to normal in response to glucocorticoid administration.
The metabolic clearance rate of androstenedione was 890 liters per day per M2 and the in vivo conversion ratio of androstenedione to testosterone was 11%. The calculated production rate of androstenedione was 4.7 mg per day per M2. Virilization in congenital adrenal hyperplasia due to 11 β-hydroxylase deficiency can be explained by an elevated plasma concentration of testosterone, which can be accounted for on the basis of conversion from androstenedione.
Letter to the Editor
Authors: Gleason Doris 
Published: December 2021

While I cannot walk a mile in Dr. Concklin's or any other physician's boots, or "scrub up and gown up" as suggested in his letter, I have taken footprints and know that persons can be taught to take good, readable footprints quickly and easily in a delivery room without disrupting any vital time schedules. However, before suggesting how this can be done, one point made in his letter needs clarification.
Nowhere did I make the charge he attributed to me that "faulty technique is the sole cause of improper imprints."
Acid-Base Chemistry in Medicine, by Wilhelm R. Frisell, Ph.D. New York: The Macmillan Company (866 Third Avenue, New York, New York 10022), 1968, 118 pp., $2.95 paper, $6.00 hardbound
Authors: Holliday Malcolm A. 
Published: December 2021

Wilhelm Frisell was an admiring student of William Mansfield Clark, who was a scholar capable of bringing to medical students and interested physicians some of the less familiar concepts of physical chemistry in an imaginative and appealing manner that did not do violence to the principles he was dealing with.
In the present book, the author has greatly narrowed his scope to the field of acid-base chemistry. Starting from the assumption that his students have yet to be introduced to high school chemistry, he continues to write in this vein thereafter.
THE CRITICALLY ILL CHILD: MANAGEMENT OF STATUS EPILEPTICUS
Authors: Carter Sidney , Gold Arnold P. 
Published: December 2021

Status epilepticus is the clinical definition of a state in which the patient has a series of recurrent convulsions without recovering consciousness between episodes. It can occur with any seizure type, but a true medical emergency usually exists only with the generalized or focal motor varieties of status. This definition of status epilepticus clearly excludes epilepsia partialis continua, in which there is no alteration of the state of consciousness, and serial epilepsy, where consciousness is regained between attacks.
Status epilepticus occurs in 5 to 10% of children with epilepsy and requires immediate and continued medical attention, for, if uncontrolled, death or permanent neuronal damage could result. Death occurs in approximately 15% of patients with status and may either be related directly to status epilepticus or, as emphasized by Lombroso, may result from the untoward effect of intravenous sedatives or hypnotic compounds on the already depressed medullary centers. The immature nervous system is particularly vulnerable to status epilepticus; and, in one recently reported study, 50% of the children were 2 years of age or less. Prompt management is mandatory, as both the neurologic residua from irreversible cerebral damage and mortality are higher in this young age group.
The true pathophysiology of status epilepticus is poorly understood. However, the condition is more common in children with symptomatic epilepsy of infectious, metabolic, vascular, or structural etiology. Rapid or sudden withdrawal of anticonvulsants and intercurrent infections are the common triggering mechanisms. Injudicious withdrawal of drugs either prior to an electroencephalogram or after a seizure-free state of relatively short duration, and a sudden change in the anti-convulsant regimen, are frequent precipitating factors.
Urine Screening for Disorders of Mucopolysaccharide Metabolism
Authors: Klein M. , Whelan D. , Clow C. , Scriver C. 
Published: December 2021

In our laboratory, we have been troubled by difficulties in the interpretation of alcian blue and toluidin blue spot tests for mucopolysacchanide disorders. We have tried to provide the clinician with information that would assist him in diagnosis, but were hampered by the apparent high incidence of "false positive" tests. In response to this problem, we reviewed our expenience with 67 referred patients and with 181 retarded institutionalized patients.
A positive correlation between test results and chemical disease was found mainly in patients where the diagnosis of mucopolysaccharidosis was already obvious.
TRADITIONAL SAFETY MEASURES AND ACCIDENTAL POISONING IN CHILDHOOD
Authors: Sobel Raymond 
Published: December 2021

Although few drugs, surgical technique, and public health measures are put into widespread use today without rigorous testing and evaluation, such assessment of efficacy is the exceplion rather than the rule with countermeasures against accidental injury. Many countermeasures now in use have never been evaluated; others continue in use long after they have been proved to be ineffective. Driver education, for example, is being widely adopted in the face of mounting evidence that it does nothing to prevent accidents. Programs of "home safety education" continue to be formulated despite considerable evidence that they do not produce the intended results.
This unconcern for—if not downright resistance to—systematic research on effectiveness has several consequences: (1) It permits programs of questionable value to absorb funds and manpower that might better be used in developing effective programs. (2) It precludes the possibility of a cost-effectiveness approach, which promises to be at least as useful in injury control as it has been in other areas of social concern. (3) It develops and strengthens vested interests connected with established programs—and thus it increases the resistance against objective evaluation. (4) It lulls the lay public into a false sense of security, since the public is likely to assume that accident countermeasures have the same degree of validity as other public health measures.
The signal contribution of the paper that follows lies in its challenge of a "safety measure" that has long been accepted and disseminated by professionals and laymen alike. Although the population studied is both small and in some respects atypical, the findings are strong enough to warrant further study of larger and different populations.
The methodology employed is also worth emulating. Recognizing the bias inherent in medical records and the difficulty of obtaining valid and representative responses to mail questionnaires, the investigator resorted to both interviewing and observation, which, though unquestionably expensive, are probably the most effective methods of data collection available to the research worker studying accidental injury.
CHILDHOOD INJURY CONTROL: WHO WILL TAKE WHAT ACTION
Authors: Harrison Stanley L. 
Published: December 2021

RESEARCH
Three areas of research were listed by many at the National Childhood Injury Symposium:
1. Epidemiologic study of injury circumstances, relating these to cause and prevention: (a) Demographic data on social class, incidence data, sex-age related to injury, to determine those who are at greatest risk from what methods of trauma. More uniform methods of classification, reporting, and participation are urged; (b) specific study of children and their development, the human environment that failed them and permitted injury, i.e., risk-taking behavior, impulse control of both children and adults. (c) Environmental hazards and why specific individuals or groups were singled out and injured by them. (d) Multivariant cluster analysis to determine circumstances of causation and natural history of injury, particularly by each method of injury. (e) Traditional incidence data, from health departments, physicians, hospitals, National Health Survey, and others, on continuing basis to determine nature of the problem.
2. Operational research: assessment of existing programs' effectiveness, and ongoing tests of programs as they are developed, e.g., do laws passed actually alter the childhood injury problem, and do codes, statutes, campaigns do anything? What is being taught in schools and colleges, and to what effect?
3. Research into underlying factors not directly concerned with the above, hut relevant to injuries: development of perception, risk-taking, attitude study, etc. A need was felt by many to periodically assess child safety research and communicate this to those in a position to use it most effectively.
Ambulatory Pediatricians, Continued
Authors: Gersh Marvin J. 
Published: December 2021

I agree with Dr. Richard B. Goldbloom's comment concerning the awkwardness of the term "Ambulatory Pediatrics," which appeared in August Pediatucs. I have a proposal which I suspect would obviate this semantic difficulty.
Since it is only the relatively rare child who is admitted as an inpatient or non-ambulatory patient, I propose the term ambulatory pediatrics be dropped, and that the department be referred to simply as pediatrics. What was formerly the In-patient Service, should be referred to as Decubitus Pediatrics.
Cellular Immunology, Books I and II Combined, by Sir F. Macfarlane Burnet, K.B.E., O.M., F.R.S. New York: Cambridge University Press, American Branch, 1969, 725 pp., $18.50
Authors: Smith Richard T. 
Published: December 2021

One of the rare privileges in the life of an academician is to interact with a truly germinal intellect. This opportunity comes only a few times in a professional life time. This reviewer was first privileged to meet Sir Macfanlane Burnet in 1957, when he was on his way to Nashville, Tennessee, to evocate his clonal theory of immunity for the first time.
Sir Mac, as he is known by friends all over the world, had been invited to a Ross conference on developmental immunology in Dallas, Texas.
HEREDITARY ADRENOCORTICAL UNRESPONSIVENESS TO ACTH
Authors: Franks Robert C. , Nance Walter E. 
Published: December 2021

The syndrome of hereditary congenital adrenal unresponsiveness to ACTH is described in an additional consanguineous kindred. Abnormal pigmentation from birth was noted in affected male and female offspring. Investigations between 3 and 4 years of age in the female proband revealed that plasma ACTH values determined by both radioimmunoassay and bioassay were greatly elevated. However, subnormal levels of plasma and urinary 17-hydroxycorticosteroids and impaired responses to exogenous ACTH were associated with a normal response to sodium deprivation. These findings are interpreted as representing normal development of the adrenocortical zona glomerulosa but in utero failure of the zona fasciculata and reticularis to differentiate in response to normal ACTH.
Analysis of an autosomal recessive hypothesis as the mode of inheritance reveals an excess of males and a deficiency of consanguineous matings among reported cases. Although data are limited, they suggest the occurrence of both autosomal recessive and X-linked recessive forms of the disorder.