bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toxicity of Hexachlorophene
Authors: KLUMPP THEODORE G. 
Published: December 2021

We have read with great interest the Letter To The Editor on the toxicity of hexachlorophene (pHisoHex) taken internally by Dr. Don A. Stotzer and the comments by Dr. Allan B. Coleman, Chairman of the Subcommittee on Accidental Poisoning (Pediatrics, 37:1030, 1966).
As the manufacturers of pHisoHex, we are naturally deeply concerned about accidental poisoning with any of our products. As indicated by our statement relative to toxicity and overdosage (symptoms and treatment) in our own publication to which Dr. Stotzer referred ("Information on Symptoms and Treatment of Overdosage of Selected Winthrop Products," 1965), we are fully aware of the potential toxic effects of hexachlorophene on humans, especially on children, if large amounts of pHisoHex are swallowed accidentally.
Exchange Transfusions: Blood Volume, Increment Volume, Efficiency
Authors: PHIBBS RODERIC H. , SPROUL ANN 
Published: December 2021

We wish to call attention to an apparently common misconception about the efficiency of exchange transfusions.
The mechanics of the procedure are: a substance (bilirubin and/or antibody-coated red cells) is washed out of a compartment (the baby's blood volume) by the removal of a fraction of that compartment and its replacement by an equal volume of diluent (donor blood). This flushing process is repeated many times, usually until the total volume replaced is 2 to 3 times the volume of the compartment itself.
Hematologic Problems in the Newborn (Volume IV in the Series Major Problems in Clinical Pediatrics)
Authors: PEARSON HOWARD A. 
Published: December 2021

The title of this small, excellent book markedly understates its content and scope. The authors' stated purpose is to describe the hematologic processes—both normal and abnormal abnormal—of the first month of life. Fortunately, they do not restrict themselves to this limited period of time. Rather, they succinctly review broad areas of pediatric hematology and its biochemical and physiological bases. Unique aspects of the hematology of early life are thus placed into balanced perspective.
Although more than half of the text is devoted to the red cell, the white cell, platelet, and coagulation disorders are also well represented.
Letters to the Editor
Authors: WAHRMAN JACOB , BERANT MOSHE 
Published: December 2021

Thank you for calling our attention to Doctor Wong's interesting patient.
One out of the 11 symptoms mentioned by Doctor Wong, namely the lobulated tongue, is very characteristic of the oral-facial-digital syndrome (OFD), and some of the other symptoms are also frequently found in association with OFD. However, a median cleft in the lower lip, two small median (?) clefts in the upper lip producing a small median process, normal hands and absence of toes in one foot are not favorable for accepting a diagnosis of OFD.
Letters to the Editor
Authors: SEWELL EDWARD M. 
Published: December 2021

Dr. Arnhold expresses a need that we have all felt. As our knowledge of atypical mycobacteria grows, the question of the specificity of the tuberculin reaction frequently comes up. At these times testing with separate antigens for the various mycobacteria may be helpful.
In the American Academy of Pediatrics the need for a commercial source for these antigens was discussed by the Executive Committee of the Section on Diseases of the Chest in October 1965.
CARE OF THE CHILD WITH A LONG-TERM, LIFE-THREATENING ILLNESS: SOME PRINCIPLES OF MANAGEMENT
Authors: Green Morris 
Published: December 2021

THE PHYSICIAN needs to care for the child who has a long-term, life-threatening disease, such as ulcerative colitis, nephrosis or rheumatic fever, with the same competence and sureness as he applies to managing the disease. Such illnesses are psychologically as well as physically hazardous. Because of the variability of physician, patient, family, and disease, principles of care cannot be described nor applied in a simple fashion but rather with attention to individual differences.
DISCUSSION OF THE DIAGNOSIS
Discussion of the diagnosis must be straightforward and honest, reflecting the exact state of affairs without over-or understatement. Although truthfulness is an important principle, the doctor tempers it in order to express it to the parents and child at a time and in a manner that is helpful and understandable rather than overwhelming. Some tolerate it better if they are given the information all at one time while others benefit more from a gradual presentation. The parents may need to have the diagnosis, as well as the treatment, explained many times before they are able to understand and accept the painful reality. Where practical, the use of a consultant to confirm the diagnosis, treatment, and prognosis can be a significant aid to the family's acceptance.
COMPETENCE
Nothing allays unwarranted anxiety as effectively as competent, conscientious care. As Engel has emphasized, this is "the first and major requirement of the correct psychotherapeutic approach." The family's fundamental need to believe that they are entrusting their child to the best doctor available leads them both to over-value his skills and, perhaps not incongruously, to question his experience: "Have you seen other children like this?" "How many children like me have you taken care of?"
THAM in Status Asthmaticus
Authors: NOTTINGHAM R. J. 
Published: December 2021

José Strauss, et al. recently cited two cases of status asthmaticus treated successfully with THAM. I wish to point out that during status the primary problem is one of adequate alveolar aeration. Respiratory acidosis can almost immediately be corrected if aeration is returned to normal.
Each of the two patients studied was given steroids, bronchodilators, intravenous fluids, and THAM. Both were out of serious trouble approximately 12 hours later.
Glans Necrosis as a Complication of Circumcision
Authors: ROSEFSKY JONATHAN BENENSOHN 
Published: December 2021

An 8 lb, 7 oz full-term, breech-delivery baby was born after a 36-hour labor. With a technique first described by Kariher and Smith in 1956, circumcision was performed at about 12 hours of age, utilizing a plastic flange-like ring which fitted over the glans and under the excess skin of the prepuce; a ligature was tied tightly over the excess skin which lay on the plastic ring. At age 24 hours, the baby was observed to have a moderately edematous scrotum, one-plus pitting leg edema, and a black, necrotic-appearing glans (Fig.1).
The ligature and the plastic ring were removed, without bleeding, following which the glans gradually became quite swollen and slightly moist over the following 12 hours.
WHO HAS THE LAST WORD?
Authors: Zuelzer Wolf W. 
Published: December 2021

IN ADDRESSING the Pediatric Pathology Club on the occasion of its first anniversary I am equally gratified by the size of the membership as by the quality of the scientific program. Less than a generation ago the pediatric pathologists of this country were easily numbered on the fingers of one hand. The phenomenal growth rate reflected in this meeting shows that the need for workers in this field, men and women trained in developmental pathology and responsive to the special problems of the pediatrician, has come to be recognized. Whether this "Club" is the beginning of the formal organization of a subspecialty or the nucleus of a working community of interests is a question that will be decided by practical considerations and had best be left to the younger men whose task it is to set the goals for the future. Scientifically, pediatric pathology has come of age.
Having spent nearly 30 years in the laboratories and on the wards of children's hospitals, I shall invoke the privilege of the old-timer and give you some rambling disconnected thoughts on the role of the pediatric pathologist in the scheme of things that have troubled me from time to time, drawing on past experience rather than attempting to make predictions. This is, of course, in the best classical tradition of pathology. Ours is the task of describing end results, our preferred tense is the past perfect, our mode is the indicative, or rather, the un-conditional, our punctuation mark par excellence is the period.
MENINGITIS IN PREMATURE INFANTS
Authors: KAGAN B. M. , HESS J. H. , MIRMAN B. , LUNDEEN EVELYN 
Published: December 2021

A review of the literature on the subject of meningitis in premature infants revealed 45 cases. In 10 of these cases from which bacterial agents were cultured, six showed a gram negative bacillus.
Twelve additional cases are added in this study and Esch. coli was cultured from the spinal fluid of nine (with another organism in three of the nine cases).
The symptoms and signs of meningitis in premature infants are discussed.
No reports have been found in the literature of recovery from meningitis in premature infants weighing less than 2,500 gm. The course and treatment of a premature infant who weighed less than 1,000 gm. and who recovered from an Esch. coli meningitis is described in detail.
OBSERVATIONS OF TOTAL SERUM BASE IN CHILDREN AND YOUNG ADULTS BY A CONDUCTIVITY METHOD
Authors: KELSEY W. M. , LEINBACH L. B. 
Published: December 2021

Values for total serum base in 96 normal children under 12 years of age as determined by the conductivity method fell between 143 to 160.5 mEq./l. The mean was 153. Standard deviations for each age group are given.
The values in 73 normal persons above the age of 12 varied from 142 to 160.5 mEq./l. The mean was 147 mEq./l. A statistically significant difference between the total serum base in children and adults was found.
EARLY TREATMENT OF METATARSUS VARUS (ADDUCTUS)
Authors: SIRBU A. B. , COLLOFF BEN 
Published: December 2021

Early recognition and treatment of a common deformity of the foot in infants is urged.
The pathology of metatarsus varus has been described, emphasizing the normal hindfoot in the pre-ambulant child. Metatarsus varus may be the precursor of a late hallux valgus deformity. The most efficient method of treatment is the use of wedge casts. None of the cases reported required operative procedures for correction.
Antigens for Testing Atypical Mycobacterial Infections
Authors: FERGUSON S. HOWARD 
Published: December 2021

The pleas of Cramblett (Pediatrics, 38:381, 1966) and Arnhold (Pediatrics, 39:310, 1967) undoubtedly stem from a need which is felt more urgently in the southern states.
I have not infrequently been asked to assist in obtaining such antigens for diagnostic purposes, not only by pediatricians in a number of general hospitals but also by pediatricians working in two university hospitals; and, unfortunately, I have not been able to help as antigens are not available for these purposes.
Letters to the Editor
Authors: MENKES MIRIAM M. , MENKES JOHN H. , Kennedy Joseph P. 
Published: December 2021

Dr. Schwalb appears to object to our study partly on moral grounds. Also, we feel that, if he reread our data and conclusions carefully, this would do away with most of his other objections. The main ones seem to us to be:
1. Our sample is no good because the age range is too wide. It is true that the age of the 18 original patients ranged from 2 years, 7 months to 15 years, 6 months, but, of these, 14 were between 5 and 10 years.
THE EFFECTS OF PLACENTAL TRANSFUSION ON RESPIRATORY MECHANICS OF NORMAL TERM NEWBORN INFANTS
Authors: Oh William , Wallgren Göran , Hanson John S. , Lind John 
Published: December 2021

Lung compliance and crying vital capacity of 52 normal, term, newborn infants were measured by a reverse plethysmograph during the first 5 days of life. Twenty-seven infants had late cord clamping (3 to 5 minutes after birth) and 25 had early cord clamping (within 5 seconds after birth). In 23 of these infants (12 late clamped and 11 early clamped) an additional determination of functional residual capacity was made during the first 6 hours of life.
During the first 6 hours of life, the earlyclamped infants had a slower respiratory rate and higher compliance associated with a larger functional residual capacity.
It is suggested that these findings are related to smaller heart volume and less pulmonary capillary venous filling in the earlyclamped infants as compared to the lateclamped infants.
ON A SIMPLE METHOD OF PREVENTING SORE THROAT
Authors: C. T. E. 
Published: December 2021

Therapeutic nihilism was at its peak in the late nineteenth century. An excellent example of a drugless therapeutic procedure is that described almost 80 years ago by Dr. H. V. Knaggs.
The interest that often attaches itself to simple methods of treatment must be my excuse for resuscitating an old but, at the same time, very little known remedy for preventing the recurrence of ordinary sore throats.
Most people, when they hear of it for the first time, are very apt to smile incredulously, and to at once put it down among the category of superstitions, "old women's remedies," etc. In fact, nearly every patient to whom I have suggested it has appeared sceptical of its utility at first, although subsequently a careful trial has frequently convinced them to the contrary. Its prophylactic powers are undoubted.
The treatment alluded to consists merely in placing round the neck from ten to twenty threads of Berlin wool. This must be worn continuously night and day, and not taken off except for the purpose of making ablutions. With some cases it is necessary that the wool should be worn all the year round; with others, during the months when the complaint is likely to return. When it is thought desirable to discontinue its use, it should be done gradually by discarding a single thread each day until none are left. If objected to on the score of unsightliness, a small coin or locket may be attached, which will effectually keep the wool out of sight, and, after a time, out of mind.
Laryngitic and tonsillitic forms for disease, which are especially prevalent among children, are due in very many instances to exposure and cold, and are particularly apt to recur periodically, especially in the colder and more changeable periods of the year. It is in such cases that the treatment is productive of marked benefit.
A considerable number of cases, both among children and adults, have been thus treated in our practice. Observations as to its efficacy have extended over a number of years. Strange as it may seem, scarcely in any single instance has it failed in our hands to avert future attacks.
The question naturally arises, How can a simple remedy like a few threads of wool possibly effect this object? or in what manner does it act? In the first place, we know that wool is a bad conductor of heat. Secondly, according to the principles laid down by Dr. Jaeger in his system of sanitary clothing, ventilation is one of the best means at our disposal for promoting skin action, and for retaining the body at an equable temperature both in summer and winter. It is probable, therefore, that the skein of wool, when attached round the neck, keeps up a belt of skin-action, and so acts continuously, and in a slight degree, as a mild counter-irritant.
THROMBOSIS OF THE FEMORAL ARTERY FOLLOWING FEMORAL VENIPUNCTURE
Authors: MCKAY R. J. 
Published: December 2021

THE REPORT of three instances of arterial thrombosis following femoral venipuncture in edematous nephrotic children by Goldbloom, Hillman, and Santulli in this issue of Pediatrics re-emphasizes the importance of weighing the risks of puncture of deep veins for diagnostic purposes against the benefits to be derived therefrom.
That the risk of femoral arterial thrombosis following femoral venipuncture in edematous patients with the nephrotic syndrome is real is clearly demonstrated by this report. Lest these be thought to be isolated instances, this writer knows of an additional instance within his own experience, and, by word of mouth, he has heard of five others occurring in only two institutions.
QUADRUPLETS SURVIVING WITHOUT ANY SPECIAL CARE IN 1789
Authors: C. T. E. 
Published: December 2021

The report below, if true, proves that what the ancients called vis mediatrix naturae must surely play an important role in the survival of the human race. Even today with the best specialized medical and nursing care survival of all four infants in quadruple births is the exception rather than the rule.
A Negro woman, named Benebah, was brought from Africa to Dominica in the year 1782. . . . On the 22nd of February 1789, when, according to her own computation, she had been about nine months pregnant, she was seized with labour-pains; and, by the assistance of a Negro woman on the estate to which she belonged, who officiated as midwife, she was delivered of a boy, to appearance healthy, and of ordinary size. But no placenta coming away, and marks of pregnancy still continuing, an accoucheur was sent for, who, about 24 hours after the birth of her first child, delivered her of three girls, all of the ordinary size; after which, he extracted a placenta of an enormous size, which he computed would have weighed about fifteen pounds. After this she had a very good recovery, and was able to walk about the eighth day. She gave suck to all her four children, also employing, however, with them at the same time a good deal of spoon-meat. Mr. Spencer, an ingenious man-midwife, saw them when about five months old. At the time they were all stout children, and, as well as their mother, in perfect health.
When Benebah was delivered of these children, she was about the 30th year of her age. She measured five feet two inches in height. Her husband, who was in his 35th year, was a stout wellmade man, about the middle size: and it may perhaps be mentioned as a singularity, that both she and her husband were twins.
MAGNESIUM STUDIES IN RELATION TO VITAMIN D-RESISTANT RICKETS
Authors: Anast Constantine S. 
Published: December 2021

Magnesium metabolism was found to be unaltered in a 4-year-old boy with untreated vitamin D-resistant rickets who manifested abnormalities of calcium and phosphorous metabolism commonly found in this disease. This is at variance with the previously reported finding of altered magnesium metabolism in a patient with resistant rickets acquired at adolescence. The possibility that this difference may reflect either a variation in the underlying disease process in the two age groups or a difference in the severity of the disease process is discussed.
It is of significance that the gastrointestinal absorption of calcium was decreased while that of magnesium was normal in our untreated patient. This suggests that the mechanisms involved in intestinal transport of these two minerals are not identical.
Treatment with 200,000 to 300,000 I.U. of vitamin D per day resulted in a decrease in the serum magnesium levels with no consistent changes in the urinary excretion, intestinal absorption, or retention of magnesium; during this time, however, the intestinal absorption, urinary excretion, and retention of calcium were all increased. The administration of 350,000 I.U. of vitamin D per day was associated with an increase in both the urinary excretion and intestinal absorption of magnesium. At this dose the retention of magnesium initially increased and subsequently decreased as the increase in urinary magnesium offset the increased intestinal absorption of this mineral. It is not known if the effects of vitamin D on the intestinal absorption and urinary excretion of magnesium represent primary actions of this vitamin on the kidney and gastrointestinal tract or whether they are secondary to changes in calcium and phosphorous metabolism. The fact that vitamin D administration resulted in a lowering of the serum magnesium level before there were any consistent alterations in fecal and urinary magnesium is in keeping with previously reported animal studies which indicate that vitamin D acts to cause a redistribution of magnesium in the body.
The Physician and the Children's Cancer Center
Authors: Hartmann John R. , Hartmann John R. 
Published: December 2021

IT HAS BEEN suggested that my role in this conference be twofold: first, supposedly the confessions of a pediatric oncologist; second, the description of our program here in Seattle. The first one is rather difficult to detail concretely. Having been in general pediatric practice at one time, I think the role we oncologists have is one of the most frustrating and difficult but, at times, the most gratifying one in medicine. No one wants to take care of dying children by preference. Most of us have been hematologists and have gotten into the field of oncology because of the therapeutic effects of chemotherapeutic agents, especially in children with leukemia. I think from prior experience we recognize immediately upon original diagnosis the fatal outcome of a child with leukemia. We also try to transmit our deep compassion to the parents and to give them some ray of hope. We often look upon this area as that of a religious experience in which one has to have some beliefs to go on taking care of these children. We must believe within ourselves that a cure is possible, rarely at the present time, but hopefully in the future. I do not think this is being untruthful to the parent because we must give them some ray of hope—either control of the child's disease for a specific length of time or, aside from leukemia, more hope for potential cure.
We are sometimes a little schizoid in our actions because we will treat a child with acute leukemia believing that the treatment of the child is worthwhile, while on the other hand we may cause considerable prolonged emotional conflict in the parents with repeated episodes of crises.
MORTALITY AND MORALITY
Authors: YANKAUER ALFRED 
Published: December 2021

AS REPORTED by James Joyce, the following explanations of the problem of infant mortality were advanced by the house staff of a Dublin Maternity Hospital:
Mr. M. Mulligan (Hyg. et Eng. Doc.) blames the sanitary conditions. . . . These factors, he alleges, and the revolting spectacles offered by our streets hideous publicity posters, . . . mutilated soldiers and sailors . . . paranoic bachelors and unfructified duennas . . . were responsible for any and every falling off in the calibre of the race. Kalipedia, he prophesied, would soon be generally adopted. . . . Mr. J. Crotthers (Disc. Bacc.) attributes some of these demises to abdominal trauma in the case of women workers subjected to heavy labours . . . but by far the vast majority to neglect, private or official. . . .
THE EFFECT OF MALNUTRITION ON THE SYNTHESIS OF A MYELIN LIPID
Authors: Chase H. Peter , Dorsey James , McKhann Guy M. 
Published: December 2021

The synthesis of sulfatide, a lipid which is a component of the myelin sheath, can be used as a biochemical marker for myelin formation.
Nutritional deprivation during the early life of the rat is associated with a decreased synthesis of sulfatide, as determined by both in vivo and in vitro methods.
The decreased synthesis of sulfatide after a period of poor nutrition is not corrected by refeeding.
These results indicate that the time of active myelin formation is a vulnerable period for the developing nervous system.
ENTEROVIRAL MENINGITIS IN VERY YOUNG INFANTS
Authors: Nogen Alan G. , Lepow Martha L. 
Published: December 2021

Enteroviral meningitis was studied in five infants less than 6 weeks of age.
Eight additional cases of suspected enteroviral meningitis from the Cleveland Metropolitan General Hospital were reviewed with regard to symptoms, CSF findings, neurologic examination, prognosis, and epidemiology.
The entity of enteroviral meningitis should be considered in and viral cultures obtained from any young infant when examination of the CSF reveals a pleocytosis, normal glucose, and absence of organisms on Gram's stain and culture.