bluuebunny/crossref_metadata_2025_split huggingface dataset:
MENTAL AND DEVELOPMENTAL MILESTONES OF NONINSTITUTIONALIZED DOWN'S SYNDROME CHILDREN
Authors: Melyn Michelle A. , White Delilah T. 
Published: December 2021

Developmental data from 612 patients with Down's syndrome have been collected over a period of 20 years from an outpatient clinic for mentally retarded children. Ss' ages ranged from birth through 16 years, all being reared in their homes.
With higher percentages of children with Down's syndrome remaining in the home environment and eventually attending day care programs, questions naturally arise concerning the developmental expectations of such children. To answer some of these questions developmental information was abstracted from the clinical records and subjected to statistical analysis. These data include motor and language development and intellectual growth. Despite the limited sample developmental norms for children with Down's syndrome were established, which should prove useful in clinical evaluation.
Unusual Case of Aminophylline Intoxication
Authors: Barter Bruce , Roberts Robert J. 
Published: December 2021

Although aminophylline and ampicillin have completely different pharmacologic properties, both are employed in the treatment of certain respiratory illnesses such as bronchial asthma. The following case report involves an accidental aminophylline intoxication subsequent to an order for ampicillin being mistaken for aminophylline. Aminophylline blood levels were quantitatively determined during the hospitalization.
CASE REPORT
A 4-year-old female child weighing 17 kg, with a 24-hour history of croup-like symptoms, was admitted to a local hospital. She was febrile (39.2C) and listless with labored respirations and wheezing. The patient was placed in oxygen and mist and an order was written for ampicillin, 500 mg intramuscularly immediately, and 250 mg intramuscularly every six hours.
Triphalangeal Thumbs Associated With Hypoplastic Anemia
Authors: Jones Barbara , Thompson Havelock 
Published: December 2021

Aase and Smith1 reported male siblings with congenital hypoplastic anemia and triphalangeal thumbs, and distinguished their disorder as an entity separate from Fanconi's pancytopenia and radial aplasia-thrombocytopenia. Recently, Murphy and Lubin2 described a third patient, also a male, with a similar thumb anomaly, aregenerative anemia, and several associated anomalies not present in the siblings described in the original report.
This report describes a fourth male patient with this syndrome and adds the data of an eight-year follow-up with hematologic response to prednisone therapy.
CASE REPORT
R.P. was initially evaluated at West Virginia University Hospital in 1964 at 10 years of age; he had a history of chronic anemia.
Encephalopathy Following CNS Prophylaxis in Childhood Lymphoblastic Leukemia
Authors: McIntosh Sue , Aspnes Gregg T. 
Published: December 2021

In our clinic population of children with acute lymphoblastic leukemia an increased frequency of encephalopathy occurred during a 12-month period. During the same period no encephalopathy was observed in 23 leukemic children who had not received prophylactic central nervous system treatment but were receiving systemic chemotherapy. The reason for this high incidence of encephalopathy is far in excess of what has been reported from other centers employing similar CNS prophylaxis. Whether this reflects geographical differences in virus infection or other factors is not clear.
Encephalopathy in a leukemic child must be differentiated among infection, meningeal leukemia, toxic effects of intrathecal methotrexate, or unknown causes. Concurrent respiratory or gastrointestinal symptoms, normal intraspinal pressure, pleocytosis with no evidence of "blast" cells on careful examination of the cerebrospinal fluid, and exclusion of bacteria and fungal infection by appropriate stains and culture suggest a viral, protozoan, mycoplasma, or unknown etiology. Erroneous treatment with intrathecal methotrexate or irradiation may inhibit spontaneous recovery. In most cases the meningoencephalopathy is self-limited and requires only supportive care.
With the advent of new approaches to the therapy of childhood leukemia which have prolonged survival, complications and toxicities of therapy not previously appreciated will probably become apparent. Observation and reporting of such complications will be of benefit and interest to pediatricians who care for leukemic children and to their patients.
Incubator Burns: A Hazard of Improperly Fitted Mattresses
Authors: Dweck Harry S. , Reynolds David W. , Cassady George 
Published: December 2021

We bring attention to an incubator hazard responsible for thermal burns in a neonate.
A 2,280-gm black female born after 35 weeks' gestation was cared for in a non-servo-controlled incubator (Air Shields Model #C-86). Incubator temperature was maintained from 31.2 C to 32.7 C with maintenance of the baby's axilliary temperature between 36.5 C and 37 C.
Four days after birth while routine vital signs were taken, the baby's arm and leg were noted to extend beyond the mattress on to the supporting metal deck of the incubator.
Indian Health Services, Continued
Authors: Kohen Daniel P. , Yost Gerald , Lyle Jerry 
Published: December 2021

We applaud Dr. Edward Mortimer's Commentary on the health status of the American Indian population (Pediatrics, 51:1065, 1973). Public statements that "Indian health care is inadequate because it is inadequately funded" and ". . . less than the minimum (money) is provided" are long overdue, and we concur completely with the necessity for us all to help Indians express and fulfill their health needs.
We wish, however, to take issue with several remarks regarding the quality and scope of care provided in and through the Indian Health Service.
RHEUMATOID SERA AND SOLUBLE COMPLEXES: NITROBLUE TETRAZOLIUM DYE TEST AND HEXOSE MONOPHOSPHATE SHUNT ACTIVATION
Authors: Pachman Lauren M. , Jayanetra Panida , Rothberg Richard M. 
Published: December 2021

An increased number of cells containing reduced dye in the nitroblue tetrazolium (NBT) test were observed when peripheral blood leukocytes of adult rheumatoid arthritis (RA) patients having rheumatoid factor (RF), as well as RF-negative pediatric RA patients were studied. Therefore, the relationship between soluble antigen -antibody complexes and NBT dye reduction following phagocytosis was investigated. After intravenous injection of 131I labeled bovine serum albumin (IBSA) into six rabbits, the mean onset of immune clearance was 8.2 days (range, 7 to 9). NBT-positive cells increased from control levels (3% to 10%) at four to six days and were maximal at six days. The mean maximal response was 35% (range, 22% ot 47%).
In vitro studies of the hexose monophosphate (HMP) shunt activity of human leukocytes exposed to BSA-anti-BSA complexes demonstrated a twofold to threefold stimulation in the range of slight antigen excess. Leukocyte NBT reduction was not consistently increased above that of the controls. However, when high titer RF sera was incubated with normal human leukocytes, maximal NBT responses were observed when the RF titer was 200 to 600 units (mean, 27%; controls, 2% to 8%) and 14CO2 evolution via the HMP shunt was accelerated. RF-negative sera from children with RA elicited a slight increase in NBT-positive cells and a definite increase in 14CO2 evolution was observed.
It was then concluded that soluble antigen-antibody complexes in slight antigen excess altered hexose monophosphate shunt activity and increased NBT dye reduction. The NBT-positive cell in RA may be due to phagocytosis of RF accompanied by metabolic activation.
ANXIETY IN THE DYING CHILD
Authors: Spinetta John J. , Rigler David , Karon Myron 
Published: December 2021

Twenty-five leukemic children aged 6 to 10 years related significantly more stories that contained elements of preoccupation with threat to their body integrity and functioning than did 25 control children with nonfatal chronic illnesses. Although they made no overt reference to the concept of death, the children with fatal illness showed an awareness of intrusion into their body integrity and functioning, and expressed a greater degree of both hospital-related and nonhospital- related anxiety than did the children in the control sample.
The fatally ill child of 6 to 10 years appears to be aware of the seriousness of his illness, even though he may not yet be capable of talking about this awareness in adult terms.
ACETAMINOPHEN POISONING
Authors: Goulding Roy 
Published: December 2021

Acetaminophen* is being increasingly used as a mild analgesic/antipyretic both as a replacement for phenacetin and as a substitute for aspirin. In Britain the current consumption of acetaminophen has been estimated to be about 50% of that of aspirin, which in turn has been calculated to be the equivalent of 6,000 million tablets per year.1
The consumption of acetaminophen has risen progressively over the past decade owing to the virtual absence of adverse effects from it when taken in ordinary doses, but this has been matched by a steady increase in the number of deaths per year from acetaminophen overdose during this time. However, the total number of deaths from acetaminophen relative to its usage when compared with aspirin is still very small. In 1971 in England and Wales there were 29 deaths due to overdosage of acetaminophen alone compared with 233 due to aspirin or salicylate alone.2
In Britain, acetaminophen tablets are as freely and widely available as aspirin tablets, and brand names are actively promoted. In view of this widespread usage it is perhaps surprising and gratifying that the number of admissions to hospital in England and Wales for accidental acetaminophen overdosage in children under 5 years of age during 1970 was considerably less than 8003 compared with about 6,000 for aspirin.4 One can speculate on the reasons for this difference and these could include the fact that acetaminophen tablets are usually larger than aspirin tablets and, more especially, there are very few specially flavored pediatric tablets of acetaminophen.
THE LATER GROWTH OF THE BRAIN AND ITS VULNERABILITY
Authors: Dobbing John 
Published: December 2021

In recent years there has been an increasing interest in a new kind of vulnerability of the developing brain which is concerned with disturbances and distortion of its later growth program, rather than with gross morphological anomaly, destructive lesions, or metabolic error. Thus there has grown up the concept of heightened sensitivity of the brain to growth retardation during its "growth spurt," a period arbitrarily defined as the time when the brain is passing through its most rapid phase of growth. The following remarks represent a personal view of the present situation and are amplified fled elsewhere.
Almost all the evidence for the special vulnerability of the brain growth spurt comes from experimental animals, usually rats, in whom nutritional growth restriction has been imposed during gestational, suckling and postweaning periods, or selectively in any one or two of these.
NOISE LEVELS IN INFANT INCUBATORS (ADVERSE EFFECTS?)
Authors: Blennow Gösta , Svenningsen Nils W. , Almquist Bengt 
Published: December 2021

Certain environmental factors in neonatal intensive care have attracted large interest and have been studied thoroughly. However, less attention has been paid to the noise level inside infant incubators. The present study of four different types of incubators revealed high sound levels of 70 to 80 dB sound pressure level (SPL) at 125 Hz.
Some infants are nursed in incubators for weeks or months and thereby exposed to these noise levels for an undue period of time. It is suggested that the high noise levels in infant incubators should be considered a perinatal risk factor with regard to later hearing impairment. It deserves more attention as hitherto, especially with consideration to the construction of incubators, but also in follow-up studies of long-term sequelae after an abnormal perinatal period.
EARLY TREATMENT OF THE UNIVERSAL OTITIS MEDIA OF INFANTS WITH CLEFT PALATE
Authors: Paradise Jack L. , Bluestone Charles D. 
Published: December 2021

In 138 infants with cleft palate, secretory or suppurative otitis media was a universal complication. Middle ear aeration was instituted by means of myringotomy, aspiration of middle ear liquid, and insertion of tympanostomy tubes, and this procedure was repeated whenever recurrence of middle ear effusion followed blockage or extrusion of the tubes. In infants with either complete or incomplete clefts of the palate, satisfactory middle ear status could usually be maintained. Otorrhea through tympanostomy tubes occurred frequently, but usually responded promptly to treatment. Palate repair resulted in sharp improvement in middle ear status.
Early relief of middle ear effusion anti establishment and maintenance of middle ear aeration in infants with cleft palate may help maintain normal hearing acuity throughout infancy, with favorable implications for language and intellectual development, and may reduce the risk of permanent middle ear damage and hearing impairment. Further study is necessary to determine the long-term efficacy of this regimen.
Hypoplastic Pelvis in Association With Multiple Anomalies
Authors: Baden Melvin , Ortiz Amil , Goyette Richert E. , Kirks Donald R. 
Published: December 2021

The association of esophageal, anorectal and sacral anomalies with malformations of the urinary tract has been well recognized.
See figure in PDF file
In addition the presence of facial, pulmonary, and musculoskeletal malformation with oligohydramnios and amnion nodosum has been frequently described in what has been termed "Potter's syndrome."
However, the existence of a hypoplastic pelvic outlet with anomalies of the urinary tract has received no mention in the pediatric literature and only two previous reports in the recent radiology literature. In each report two infants presented with multiple anomalies consistent with a diagnosis of Potter's syndrome and the importance of an associated contracted pelvic outlet was discussed.
Letter to the Editor
Authors: Ellis Elliot F. , Taylor John C. , Lefkowitz Martin S. 
Published: December 2021

The report of Gardner et al. regarding the use of racemic epinephrine in croup prompts us to comment as follows.
The administration of racemic epinephrine aerosol with a face mask is the therapy presently in vogue in many pediatric centers for treatment of croup. The basis of the use of racemic epinephrine in croup is its topical vasoconstrictive effect when applied to mucous membranes resulting in decreased mucosal edema. Nowhere to be found in any of the six published reports discussing this modality of therapy is a precise definition of the composition of racemic epinephrine.
Letter to the Editor
Authors: Thompson Robert S. 
Published: December 2021

I should like to offer the following comments about the recent article by Gardner, and others, on the use of racemic epinephrine in croup.
1. Unfortunately the racemic epinephrine was not delivered by IPPB, using a respirator, as by those who have reported impressive successes, albeit uncontrolled, with that method.
2. Based on their initial positive experience with postanesthetic croup, Jordan et al. took the battle directly to the surgeons and won many surgical converts by initially performing the racemic epinephrine procedure only on patients about to undergo tracheotomy.
Galactokinase Deficiency in Twins: Clinical and Biochemical Studies
Authors: Olambiwonnu N. Olatunji , McVie Robert , Ng Won G. , Frasier S. Douglas , Donnell George N. 
Published: December 2021

Identical twin girls with galactokinase deficiency are described. The diagnosis was made at 4 months of age when a random urinalysis in one twin showed a nonglucose reducing substance subsequently identified as galactose. Clinical findings were limited to bilateral perinuclear cataracts in both infants. There was no jaundice or hepatomegaly.
While receiving an evaporated milk formula, the urines contained large amounts of galactose and galactitol. Erythrocyte galactokinase activity was absent in both patients, and 50% of normal activity was found in both parents.
A "lactose-free" formula was instituted at 43½ months of age. Growth and development has been normal over 24 months of treatment. The cataracts, however, showed no significant change. Galactose and galactitol excretion was markedly decreased, but not completely eliminated. The turnover of endogenous galactose-containing compounds may be responsible for the residual galactose and galactitol excretion.
Reye's Syndrome: Clinical Diagnosis and Treatment With Peritoneal Dialysis
Authors: Samaha Frederick J. , Blau Edward , Berardinelli John L. 
Published: December 2021

Twenty-four cases of Reye's syndrome are studied with regard to the effect of peritoneal dialysis on survival and with regard to the clinical criteria for diagnosis. A good correlation is observed between the typical clinical presentation with abnormal prothrombin time, SGOT, SGPT and blood ammonia levels and the abnormal liver histology described in Reye's syndrome.
Of the 11 patients treated with hepatic coma regimen and peritoneal dialysis, 9 (82%) lived. Two of the 13 patients (15%) treated only with the hepatic coma regimen lived (p &lt; .025). When used before evidence of irreversible brain stem damage, peritoneal dialysis is a mode of therapy which may offer hope in reversing the high mortality of Reye's syndrome.
Letter to the Editor
Authors: Walters Thomas R. 
Published: December 2021

This is to express my disappointment in your publication of "Anesthetic Risks in Sickle Cell Trait." Reference words in the abstract such as "sickle cell trait, anesthesia risks, and sudden anesthetic death" expand the implication of the title.
There are several criticisms. Case 2 in the Table identifying the five Negro children with sickle cell trait shows hemoglobin electrophoresis results as S-C. Current terminology in sickle cell disease indicates that this patient has a double-heterozygote state, is not a patient with sickle cell trait and, therefore, cannot be included.
Letter to the Editor
Authors: Cherry James D. , Powell Keith R. , Gardner H. Garry , Roden Vernon J. 
Published: December 2021

Thank you for giving us the opportunity to comment on this latest communication about the treatment of croup by Adair and disciples. It would appear that most aspects of their letter which are worthy of a response have already been presented in our two previous letters. We do have the last word however:
Banter and fury have their place And to stir controversy is no disgrace But to take as fact without control One must have faith within his soul.
The Use of Blood Levels of Antiepileptic Drugs in Clinical Practice
Authors: Kutt Henn 
Published: December 2021

Measurement of blood levels of antiepileptic drugs has been carried out for over a decade. In earlier years, mostly spectrophotometric and colonmetric methods were used to determine diphenylhydantoin and phenobarbital concentrations. In more recent years, gas-liquid chromatographic methods have been employed which generally offer greater specificity and allow determination of several drugs simultaneously.
Ceneral experience from the determination of antiepileptic drug blood levels indicates that there is some correlation between (1) the drug dose and blood level, (2) blood level and therapeutic effects, and (3) blood level and some toxic effects. The relationships are evident and usually reproducible in any individual patient. However, there are marked variations in these relationships among different patients due to variations in their individual-specific pharmacokinetic characteristics and/or external factors. Thus a wide range of blood levels may be seen in patients receiving the same dose and a wide range of clinical effects may be seen in patients having the same blood level. Nevertheless, an expected range of blood levels from a given dose can be defined, as well as an expected range of blood levels in which toxic or therapeutic effects are usually seen in the majority of patients. These expected values are clinically useful in that they caution the physician to look for specific causes in those patients whose blood levels fall far above or below the expected range.
WHAT DOSAGE REGIMEN TO USE
The majority of antiepileptic drugs are eliminated slowly and cause relatively stable blood levels to be maintained as long as the drug intake is constant.
Who Should Have Children: An Environmental and Genetic Approach, by Dwight J. Ingle. Indianapolis/New York: The Bobbs-Merril Company, Inc., 1973, 141 pp., $1.95
Authors: Baumiller Robert C. 
Published: December 2021

Population is a problem. The handicapped, the retarded, the dull, the culturally deprived, and the criminal are all problems. Scientifically, all these problems can be attacked and with sufficient funding, propaganda, and legislation, these problems can be reduced, if not eliminated. To have this capability and not actualize it is frustrating for the scientist.
Dr. Ingle very honestly qualifies the title of this book with "an environmental and genetic approach." And so it is. The limitations on the data presented, which is not the main theme of the book, are well understood by the author.
On the Use of Nasal Continuous Positive Airway Pressure
Authors: Harris Thomas R. , Stevens Richard C. , Nugent Michael 
Published: December 2021

Although the application of continuous positive airway pressure (CPAP) by endotracheal tube, head chamber and face mask is quite straightforward, its successful application by nasal cannula or prongs as recently described by Novogroder et al. and Kattwinkel et al. presupposes an understanding of certain crucial points not emphasized in these original articles.
The new factor that comes into play when applying CPAP by nasal route is the variable leak at the mouth. When a large mouth leak is present in a delivery system that also has an appreciable flow resistance at the site of the nasal prongs or beyond in the nasal passages, a significant pressure drop may occur across these points.
Monitoring for Human Mutagenesis
Authors: Sutton H. Eldon 
Published: December 2021

Mutation is an intrinsic property of genes and has provided the variability that we value as a characteristic of human populations as well as the variability that was necessary for evolution to occur. Nevertheless, an increase in mutation rate is almost universally regarded as undesirable. The likelihood that a random change in a gene will be beneficial to the host is small. The likelihood that it will be detrimental is much larger. There is much argument as to the proportion of genes that truly are neutral, but these are of no special concern to the present discussion.
When a detrimental mutation occurs, it is expressed ultimately as failure of a zygote to develop, as abortion, as overt disease, or as reduced fertility. The expression may be immediate or delayed, depending on the degree of dominance of the mutalion. The social consequences of these different outcomes are different, much more so than the genetic consequences. A genetic death is failure to survive and reproduce, whether that failure be due to early death (as in Tay-Sachs disease) or to reduced fertility in an otherwise healthy person.
Such detrimental genes are removed eventually from the population through natural selection—rapidly if the mutant allele is expressed in the heterozygote, much more slowly if the allele is completely recessive. Eventually an equilibrium is reached, with the number of mutant alleles eliminated by selection equal to the number produced by mutation. In the case of recessive alleles, many generations are required to establish a new equilibrium.