bluuebunny/crossref_metadata_2025_split huggingface dataset:
Letters to the Editor
Authors: DANUFSKY PHILIP C. 
Published: December 2021

Dr. Silverman's Commentary on informed consent (Pediatrics, 38:373, 1966) set me thinking so much I haven't finished reading the September issue. It seems, at last, our profession is examining its legal and moral responsibilities before political and community pressures interfere with clear thinking.
At present the minor's parents or guardians have full legal responsibility for furnishing consent for treatment and investigation; the law is not likely to change soon.
Letters to the Editor
Authors: FIKRIG SENIH 
Published: December 2021

While we are aware of the G-6-PD variants, we have not done the specific tests on our patients. Actually, all of the patients with low G-6-PD activity, irrespective of whether they developed hemolysis or not, were Negroes and, therefore, could be classified as B(-) variant. As far as we know this variant had not been implicated in relation to favism or severe neonatal jaundice.
The enzyme variant had also not been specified for the group of patients reported by Kattamis, et al. We agree that factors beside G-6-PD must play a role in hemolytic anemias due to viral or bacterial infections.
ADOPTING A CHILD
Authors:   COMMITTEE ON ADOPTIONS
Published: December 2021

THE painting Adopting a Child by Frederick Bacon Barwell (1857), calls our attention to the great forward strides effected in adoption procedures. The Committee on Adoptions of the Academy has recommended that, whenever possible, adoptions be consummated through established agencies. While the Committee has not taken the stand that only agency adoptions can be successful, we do believe that adoption agencies, on balance, can render superior service because they have the resources required to serve the diverse persons involved in this delicate and sensitive human relationship.
This English genre or narrative painting affords an interesting insight into what is involved in an adoption. If one is permitted to mix retrospective analysis with speculation about the future, one could predict that the adoption portrayed in this picture would terminate in difficulties.
The central figures are the natural mother and her child. In modern adoption procedures we recognize the importance of casework for the natural mother in her great decision to yield her child for adoption. The poignant despair revealed in the features of the mother indicates the lack of such necessary help to this unfortunate female. The absence of legal and moral privacy between the natural parent and the adopting parents derogates the possibility of a successful transfer of the child from one home to another.
A New Look at Child Health
Authors: CONE THOMAS E. 
Published: December 2021

This little paperback book is a gem which may escape the attention of readers on this side of the Atlantic because it deals mainly with the state of contemporary pediatrics in Great Britain. For us not to be aware of this book would be a mistake; many of the problems and shortcomings which Drs. Joseph and MacKeith discuss are equally germane to the United States.
The authors attempt to define in 11 chapters such elusive things as just what pediatrics really is, what are the crucial current problems, how the changing patterns of death and morbidity in childhood have altered the demands on pediatricians, and—throughout the book as a leitmotiv—how to make medical students and physicians more aware of preventive aspects of medicine.
"EARLY" VERSUS "LATE" FEEDING OF LOW BIRTH WEIGHT NEONATES: EFFECT ON SERUM BILIRUBIN, BLOOD SUGAR, AND RESPONSES TO GLUCAGON AND EPINEPHRINE TOLERANCE TESTS
Authors: Wu Paul Y. K. , Teilmann Peter , Gabler Marjorie , Vaughan Mary , Metcoff Jack 
Published: December 2021

Effects of early (2 hours after birth) and late (24 to 36 hours after birth) feeding were studied in 42 "well born" and clinically well low birth weight infants in the 1,250 to 2,000 gm birth weight range. Twenty-one of these, selected at random, were early fed and 21 were late fed.
In the early-fed infants weight loss was less (mean 4.7% of birth weight) and regained earlier (mean 7.3 days); in the late-fed infants weight loss was greater (7.4% of birth weight) and regained later (mean 12.6 days).
Blood glucose was higher in the early-fed group than in the late-fed group at 24 hours of age.
A higher response in blood glucose level was seen in the early-fed infants following glucagon and epinephrine administration at 24 hours.
No adverse effects were observed as a result of early feeding. Such feedings may indeed have an advantage in reducing serum bilirubin levels, raising blood sugar, and increasing liver glycogen reserves.
A PROGRAM TO INCREASE HEALTH CARE FOR CHILDREN: THE PEDIATRIC NURSE PRACTITIONER PROGRAM
Authors: Silver Henry K. , Ford Loretta C. , Steady Susan G. 
Published: December 2021

The pediatric nurse practitioner program herein described is a new educational and training program in pediatrics for professional nurses which has been developed to provide increased health care for children in both rural and urban areas. The program prepares nurses to furnish comprehensive well child care to well children, to identify and appraise acute and chronic conditions, and to evaluate and temporarily manage emergency situations until medical assistance is available.
The details of the educational and training program and its implications in improving the utilization of scientific manpower are described.
DIAGNOSTIC TESTS FOR TOXOPLASMOSIS
Authors: ADAMS F. H. , KABLER P. , COONEY M. , ADAMS J. M. 
Published: December 2021

Results of a correlation study of the rabbit neutralization, complement fixation, skin and slide neutralization tests for toxoplasmosis are presented. The agreement between these is fairly striking, except those from the complement test.
Reversal of a positive test was found to occur in the sera of six patients, and, in three instances, the prozone phenomenon was revealed.
The new slide neutralization test of Sabin and Feldman appears to be the most accurate, the most economical and the quickest test available at present for the diagnosis of toxoplasmosis.
DOUBLE AORTIC ARCH
Authors: GRISWOLD HERBERT E. , YOUNG MAURICE D. 
Published: December 2021

The anatomic nature of a double aortic arch is described. Reference is made to the history of the malformation. The clinical picture and radiographic findings described by various authors are discussed.
Two cases are reported which demonstrate two types of double aortic arch, One, a relatively common type, had a large right arch with a retro-esophageal component and a left descending aorta; the second, a rare type, had a large left arch with a retro-esophageal component and a right descending aorta. Further, one was an infant who had symptoms of constriction whereas the other was an adult who had no symptoms referable to the double aortic arch.
Analysis is made of these cases and 47 other cases reported in the literature. This analysis reveals that:
1. There is a striking correlation between the occurrence of symptoms and the age and duration of life, but there is no correlation between the occurrence of symptoms and the type of double aortic.
2. A double aortic arch in which both components are patent throughout is more likely to produce symptoms than a double aortic arch in which one component is partially obliterated. The process of obliteration does not appear to give rise to symptoms.
3. There is considerable variation in the relative sizes of the components of a double aortic arch. The right component is usually the larger; part of the left component may be obliterated. To date, no case has been reported of obliteration of part of a persistent right Component.
4. A double aortic arch occurs more commonly with a left descending aorta than with a right descending aorta.
5. It is unusual for a double aortic arch to be associated with a malformation of the heart. The association of a double aortic arch with other vascular abnormalities is less rare.
The two principal problems raised by the demonstration of a retro-esophageal vessel are discussed. The first concerns the nature of the malformation; the second concerns the advisability of operation in the given individual.
Letters to the Editor
Authors: BERGREN WILLIAM R. , NG WON G. , DONNELL GEORGE N. 
Published: December 2021

The point made by Mellman and Tedesco in their note concerning the effect of dithiothreitol on the UDPG consumption assay for galactose-1-phosphate uridyl transferase is well taken. It adds emphasis to our view on the need to consider the conditions in the assay for interpretation of the findings.
Our hypothesis that low estimates of transferase activity in hemolysates of newborns might be obtained by the UDPG consumption procedure was based on our finding of epimerase activity in hemolysates of newborn infants independent of supplementary NAD.
HOUSEHOLD PRODUCTS—OBSOLETE CONTAINERS—INEVITABLE POISONINGS
Authors: BREAULT HENRI J. 
Published: December 2021

ACUTE ingestions and poisonings are clearly a by-product of rapidly advancing technology, certainly related to aggressive advertising, and completely preventable parts of our tragic twentieth century accident epidemic. These facts are well-known by the pediatrician, whose therapeutic armamentarium does not include an immunizing agent against accidents of any kind.
The communication below from Dr. Breault summarizes an impressive community effort. Although safety cap enclosures and more appropriate packaging are not the only answer to the problems of accidental poisoning, such efforts may create an awareness of the dangers, such as has been achieved in the field of automotive safety.
FOLLOW-UP STUDY OF EXCHANGE TRANSFUSION FOR HYPERBILIRUBINEMIA IN INFANTS IN JAPAN
Authors: Ose Toru , Tsuruhara Tsuneo , Araki Masayoshi , Hanaoka Toshiyuki , Bush Ovid B. 
Published: December 2021

A follow-up study of 157 consecutive patients who had hyperbilirubinemia was undertaken by questionnaire. Parents of 153 patients answered the questionnaire. Complete examination was carried out on 131 (83.4%) patients and, if the 17 who died are included, a 94.2% follow-up was made.
The relationship between the level of the serum bilirubin and the development of cerebral palsy showed that 90% of the patients who had a bilirubin level of 35 mg/100 ml and above either died or had cerebral palsy or physical retardation. Of the 131 cases followed up, there were 17 (13.0%) patients who had definite cerebral palsy, 21 (16.0%) who were physically retarded, and 93 (71.0%) who were normal.
In 129 infants checked for developmental retardation, no instances were found when the serum bilirubin level was below 20 mg/100 ml. There was developmental retardation in 15 patients who had a bilirubin level of 20 mg/100 ml and above. It is felt that this shows there is a definite relation between the height of the bilirubin and the development of cerebral palsy and/or developmental retardation. In this series there were 26 infants with bilirubin levels of 30 mg/100 ml and over. Based on our results, we would suggest that the indication for exchange transfusion should be a total bilirubin level of 20 mg/100 ml for full-term, incompatible infants and for all premature infants; the level for full-term, compatible infants should be 25 mg/100 ml.
PURULENT PERICARDITIS IN INFANCY
Authors: Gersony Welton M. , McCracken George H. 
Published: December 2021

Seven patients less than 2 years of age with purulent pericarditis were encountered. Four infants survived, including the first infant reported with meningococcal pericarditis. Including the present patients, 50 infants with suppurative pericarditis have been described in the literature. The overall mortality was 67%; it was 47% among patients in whom the diagnosis was made clinically. Staphylococcus aureus was the most common infecting organism, and it was responsible for the greatest number of deaths. Pulmonary infection was by far the most frequently observed associated illness, whereas purulent pericarditis occurring as a primary infection was rare.
Survival from purulent pericarditis depends upon adequate pericardial drainage with antimicrobial therapy. Antibiotics alone have not been successful in the treatment of this disease.
ANOMALOUS LEFT CORONARY ARTERY ORIGINATING FROM THE PULMONARY ARTERY
Authors: Wagner Henry R. , Nadas Alexander S. , Hugenholtz Paul G. 
Published: December 2021

The follow-up of two infants subjected to ligation of an anomalous left coronary artery at its insertion in the pulmonary artery, are presented. Both patients are essentially asymptomatic, one 7 years and the other 2 years postoperatively.
Mitral regurgitation, a dominant feature in both infants preoperatively, disappeared some months after coronary artery ligation.
A large preoperative atrial left-to-right shunt, secondary to mitral regurgitation and disappearing postoperatively, masked the presence of the shunt into the pulmonary artery in one patient.
Although both patients are doing extremely well clinically, evidence of appreciable residual cardiac damage is present in the electrocardiogram, in the chest x-ray, at cardiac catheterization, and in the left ventricular volume studies of one patient.
Malaria as a Pediatric Diagnostic Problem in the United States
Authors: SCOTT SAMUEL E. 
Published: December 2021

At the suggestion of Dr. Floyd Denny, Chairman of the Department of Pediatrics at the University of North Carolina School of Medicine, the following interesting and instructive case is presented as a Letter to the Editor.
A difficult diagnostic problem in a 9-year-old girl consisting of high fever, leukopenia, hemolytic anemia and splenomegaly is presented.
C. W., a 9-year-old, white female, is the dependent of an Air Force Captain. She was well until February 17, 1967, when she was sent home from school with a fever.
Relationship of Regional Medical Programs to Children's Cancer Clinics
Authors: Sloan Margaret H. 
Published: December 2021

THE Division of Regional Medical Programs was established about a year ago in the National Institute of Health to implement the legislation known as Public Law 89-239 or the Heart Disease, Cancer, and Stroke Amendments of 1965. This has been a very busy Division and, by the end of this calendar year, we shall probably have awarded about 40 planning grants for regional medical programs involving 38 states, plus or minus. By June 1967 we expect that almost the entire United States will be involved in some kind of regional program, many of which will involve many of you in the audience today. The size of these grants is varied; from one limited to 6 counties to one involving 4 states. The sums awarded have varied markedly according to the population to be served and the needs which have been identified within the regions.
Now, what are the Regional Medical Programs supposed to do? What sorts of things have been supported or are considered for support under such grants? In order to understand the potential of this program, I think some reference to the actual wording of the legislation would be important. First of all, the legislation underwent very marked changes during the course of its legislative history and the "regional medical complexes" described in the President's Commission Report, which was published in December 1964, gradually evolved into "regional medical programs" which would originate from local initiative. Now, the legislation says that the purposes of this title are: "through grants to encourage and to assist in the establishment of regional cooperative arrangements among medical schools, research institutions and hospitals for research and training, including continuing education, and for related demonstrations of patient care in the fields of heart disease, cancer, stroke and related diseases.
Role of the Nurse in a Children's Cancer Clinic
Authors: Tonyan Angela B. 
Published: December 2021

THE Hematology and Oncology Clinic here at Children's Orthopedic Hospital and Medical Center under the direction of Dr. John Hartmann started with one small room. We admitted all patients to the hospital inpatient service for intravenous medication, bone marrows, and blood transfusions. Recognition of the growing importance of outpatient care led to the establishment of our present clinic which consists of four rooms: a waiting room, an office for doctors and nurses, and two treatment rooms. There is a very relaxed atmosphere in our small waiting room which includes a large fish bowl. One of the walls in the waiting room is covered with pictures, either sketched, drawn, or colored by the patients. The personnel give sincere praise when a child comes in with a sample of his art work, and snapshots of every patient are hung plainly in view. The children are always bringing something to the nurse or to the aide. For example, a little 3-year-old child came in the other morning clutching a crushed dandelion for the aide.
Staffing is one of the most important things in setting up a hematology clinic. We have one regular nurse and one aide, Monday through Friday. Weekend and evening coverage is by emergency room nurses, and after midnight it is by the night supervisor. We have a nurse and social worker who make home visits when necessary. There are also two volunteers who give of their time and of themselves in every way.
The nurses rotate in the 40 different specialty clinics of the outpatient department. This is not true of our hematology clinic.
Role of the Social Worker in a Children's Cancer Clinic
Authors: Pieroni Antoinette L. 
Published: December 2021

THE social worker must function as a member of the medical team whose purpose is helping the patient and his family live as normal a life as possible from the first diagnostic visit through the treatment period to the final hospitalization. As a member of this team she has the responsibility of following the philosophy of the center in which she works and of conveying the same thoughts to the parents and to the other members of the family as does the physician. It is terribly important that there be no minority opinion—that no team member gives a "personal" opinion which the parents or the child may interpret differently from that of the others on the team.
The primary responsibility of talking to the parents belongs to the physician, but tile most effective method is the 1-2 punch. It works in this way: approximately 24 to 48 hours after the physician's interview and explanation, the social worker sees the parents and reviews with them what the physician has told them. She must know intimately and in detail what has been said. Experience has shown that very little of the initial interview with the physician has been heard or absorbed. The worker's interview then gives the parents an opportunity to hear it again and ask questions about the topics covered, for example, the philosophy of the clinic, the disease and how its course will affect their child, themselves, the other family members and the community of which the child is a part. It also gives the social worker an opportunity to assess the family.
PHYSICAL, INTELLECTUAL, AND EDUCATIONAL CHARACTERISTICS OF A SAMPLE OF JOB CORPS TRAINEES
Authors: Deisher R. W. , Hammar S. L. , Ramsey Otis , Gode Richard , Seligman Fred 
Published: December 2021

Fifty trainees were selected from a Job Corps Camp for medical and psychological evaluation. A significant number had health problems, many of which might have been modified by regular medical care.
Although mean school grade completed was the ninth, performance on reading and arithmetic tests was estimated at midfourth grade. This was below expectation based on results of intelligence testing and would imply that a more thorough appraisal should be made of the health status and cognitive functioning of these young men if maximal help is to be provided them through the Job Corps program.
DIAGNOSIS AND TREATMENT: ANTIBIOTIC THERAPY OF INFECTIOUS DIARRHEA IN CHILDREN
Authors: Cushing Alice H. 
Published: December 2021

THE PURPOSE of this review is to summarize the present status of antibiotic therapy of diarrhea in infancy and childhood. Such a review is currently pertinent because increased knowledge of the natural history of bacterial enteric diseases and the effects exerted by antibiotics on the course of these diseases enables the physician to approach such therapy on a more rational basis.
Most diarrhea in infancy and childhood is not identifiable as bacterial in etiology. While in some communities 5% or less of such patients can be shown to harbor recognizable bacterial pathogens, as many as 60% of patients in other areas may yield bacterial pathogens on culture. The etiology of diarrhea in the absence of identifiable bacterial pathogens is obscure, although the results of a number of studies indicate that certain enteroviruses are frequently responsible.
BACTERIOLOGIC STUDIES
Of paramount importance in the management of patients with diarrhea is a careful search for bacterial pathogens because the decision as to whether to employ an antibiotic—and, if so, which antibiotic—is based upon the results of appropriate studies. Such studies comprise culture of the stool on specific media or examination by fluorescent antibody techniques. Serologic examinations are ordinarily unavailable for infections due to shigellae and EPEC, and they are of value in only a few salmonella infections; in addition, they do not afford prompt answers.
The expense involved in such bacteriologic examinations is considerable and indicates the need for some selectivity in determining which patients should be studied for the presence of bacterial pathogens.
Bronchiolitis and Asthma
Authors: HOROWITZ LEON 
Published: December 2021

Dr. Holdaway and his associates would make it appear that bronchiolitis is a clearly defined entity in which, although it may be simulated by asthma (and other diseases), "attention to the details of the case history and clinical findings will usually exclude these conditions." I wish it were that simple.
I find the differential diagnosis of the wheezing infant "most difficult" as do others, particularly with reference to asthma. The fact that the wheezing does not respond to sympathomimetics does not prejudice in favor of bronchiolitis since it is well-known that the presence of dehydration or infection with asthma will make these drugs relatively ineffective.
BODY COMPOSITION OF THE MALE REFERENCE INFANT DURING THE FIRST YEAR OF LIFE
Authors: Fomon Samuel J. 
Published: December 2021

DESCRIPTION of the changes with age in gross chemical composition of an "average" infant, referred to as the male reference infant, should aid considerably in developing a broader concept of normal growth in infancy. In addition, such a description may have important nutritional implications. For example, estimates of the average daily requirement for protein between two ages during infancy might be based, in part, on a knowledge of the gain in protein content of the body between these ages. Similarly, since much of the caloric requirement for growth may be accounted for by synthesis of lipid and protein, knowledge of the net gain in each of these components between two ages would permit a rough estimate of that portion of caloric intake needed for growth.
While it is not yet possible to provide a precise description of changes in body composition of individual infants or even of an "average" infant, the general direction of the changes can be indicated. An attempt will be made to identify areas in which important data are lacking and to examine the assumptions on which the calculations are based.
Data on total body water and several of the assumptions employed here are believed to be superior to those presented previously.
METHOD OF APPROACH
In the presentation that follows, the body is considered to consist of lipid and a lipid-free portion. This latter portion, spoken of as fat-free body mass, is considered to include water, protein, and a residual of dry, protein-free, lipid-free material referred to as "other."