bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiviral Chemotherapy and Neonatal Herpes Simplex Virus Infection: A Pilot Study—Experience With Adenine Arabinoside (ARA-A)
Authors: Ch'ien Lawrence T. , Whitley Richard J. , Nahmias Andre J. , Lewin Edward B. , Linnemann Calvin C. , Frenkel Lawrence D. , Bellanti Joseph A. , Buchanan Robert A. , Alford Charles A. 
Published: December 2021

Among 13 neonates with herpes simplex virus (HSV) infection, eight had disseminated disease, one localized CNS disease, and in four the infection was confined to the skin and eyes. Ara-A, a purine nucleoside with anti-viral activity against DNA-viruses, was given (10 to 20 mg/kg/ day) by a continuous 12-hour intravenous drip for 10 to 15 days. In all, ara-A administration was begun within three to eight days after the appearance of skin vesicles which represented the hallmark of the disease. Both diagnosis and ara-A treatment were much delayed in one infant without skin vesicles and four infants whose skin vesicles appeared late, long after the occurrence of CNS damage. In this group of infants with disseminated disease, four died and one infant was left with severe neurological deficits.
Eight infants (four with disseminated and four with localized skin disease) with skin vesicles as the earliest sign of infection received ara-A early, within three days after the onset of neurologic signs. All survived with no neurologic deficit at 6 months to 1 year of age. There was no apparent toxicity of ara-A to the bone marrow, liver, or kidney.
Danger of Styrofoam Cups
Authors: Reiman Reuben 
Published: December 2021

Accident prevention has commanded the increasingten attention of the pediatrician in recent years. One of the more obvious precautions has been to protect infants and children from toys or other objects which have sharp or small parts which might become dislodged and subsequently swallowed or aspirated.
Now, I wish to direct attention to another possible peril. Recently, believing it to be safe, a mother in my practice gave her 8-month-old infant a Styrofoam cup with which to play.
Guidelines for Living With a Hyperactive Child
Authors: Schmitt Barton 
Published: December 2021

Most pediatricians agree that medications should be prescribed sparingly for hyperactive children and not at all before school age.
The parent with a hyperactive preschooler needs specific advice on how to cope with such a child on a day-to-day basis. The following office handout entitled "Ten Guidelines for Living With a Hyperactive Child" has been utilized for four years. It has been a helpful adjunct to verbal anticipatory guidance and may be useful to other pediatricians.
Endometrial Pathology and Its Relation to Estrogen Therapy in Patients With Hypogonadism
Authors: Rosenwaks Zev , Urban Maria D. , Wentz Anne C. , Lee Peter A. , Parmley Tim H. , Migeon Claude J. , Jones Georgeanna S. , Woodruff J. Donald 
Published: December 2021

Clinical observations suggest that estrogen levels above physiologic plasma concentration can result in pathologic endometrial changes. Patients with feminizing ovarian tumors and those with the polycystic ovary syndrome who have excessive amounts of endogenous estrogens have a high incidence of endometrial cancer.1-4 Several investigators have noted the development of atypical hyperplasia and adenocarcinoma in women receiving prolonged treatment with various estrogen preparations, including the sequential oral contraceptives.5-11 Until recently, the association of exogenous estrogens with carcinoma of the endometrium had been based on clinical impression, but convincing epidemiological data had been lacking. Recent reports by Smith et al.12 and Ziel and Finkle13 indicate that the risk of endometrial cancer is 5 to 14 times greater in women taking exogenous estrogens.
Patients with hypogonadism are frequently treated with estrogenic substances to initiate the development of breasts and menstrual bleeding. Most of these patients are then maintained on estrogenic preparations for years. Therefore, this group of subjects provides a model for the study of possible development of endometnial changes in response to estrogen therapy.
To date, there have been 12 reported cases of endometrial adenocarcinoma in gonadal dysgenesis patients who received estrogen therapy.14-19 Eleven of these women were known to have received diethylstilbestrol; one patient was taking a sequential ethinyl estradiol-dimethisterone preparation at the time of the study and had previously taken an unknown estrogen preparation for four years.
This article presents information about the relationship of estrogen therapy and endometrial histology in 43 hypogonadal patients followed up in the Pediatric Endocrine Clinic and the Department of Gynecology and Obstetrics at The Johns Hopkins Hospital, Baltimore.
Optimistic Finances Questioned
Authors: Vandervoort Robert , Bloom Sheila 
Published: December 2021

Drs Weiss and De Jong (Pediatrics 66:91, 1980) are to be commended for sharing information about the costs and revenues associated with their pediatric continuity program. Such an analysis is important for departments of pediatrics in understanding the financial impact of their training program and for helping them make better informed decisions about the future course of such programs.
However, the authors have presented an even more optimistic picture of the financial position of the continuity practice than seems to be justified by the description of the program.
Letters to the Editor
Authors: Felice Marianne E. 
Published: December 2021

Drs Behar and Stewart raise several issues that merit clarification:
1. Do adolescents who attempt suicide "tend to have previous psychiatric disorders"or disturbed personalities? Drs Behar and Stewart cite two studies1,2 that indicate that adults who successfully complete suicides have serious psychiatric disorders. It is not certain that this conclusion applies to adolescents, particularly those who make a suicide gesture or suicide attempt. Although no reference was given for the study by Crumley and discussed by Drs Behar and Stewart, we presume the reference to be the recent paper by Dr Crumley in the Journal of the American Medical Association.3
JAMES JACKSON ON THE SECOND DENTITION (1855)
Authors: C. T. E. 
Published: December 2021

James Jackson (1777-1867) has been called the most conspicuous physician in the medical annals of Massachusetts. He was a founder of and the first physician to the Massachusetts General Hospital. In 1812 he succeeded Benjamin Waterhouse as the Hersey Professor of the Theory and Practice of Medicine at the Harvard Medical School.
In his immensely popular, Letters to a Young Physician,1 first published in 1855, Jackson described the diseases he believed were caused by the second dentition as follows:
The occurrence of diseases during the first period of dentition is familiarly known, and attributed to the irritation of the coming teeth. It is not so well known that the appearance of the permanent teeth, also, is attended by diseases of various kinds. I feel satisfied, however, that this is the case....
During the second dentition, then, a liability to disease may be remarked as well as during the first, though not so great. Besides this general liability, there are certain morbid affections which are in a good measure peculiar to the period....I think the most common period of suffering from the second dentition is from the tenth to the thirteenth year. The most characteristic affections are wasting of flesh and nervous diseases. The boy loses his comeliness, and his complexion is less clear, while emaciation takes place in every part, though mostly, perhaps, in the face. The nervous symptoms are various; but the most common are a change in the temper, and a loss of spirits. With these there is some loss of strength.
TRENDS
Authors: HUBBARD JOHN P. 
Published: December 2021

AT THE present writing, the 81st Congress has reconvened but it is doubtful whether much, if any, attention will be given to the many health bills which have been discussed at such length in Committee and on the Floor. By the time this review and preview is published, the 81st Congress will have finally adjourned and all unfinished business in the nature of bills which have not been enacted into law will be washed off the slate. But this does not mean that the unresolved issues will necessarily be dead; they may be introduced in the 82nd Congress and appear in similar, if not identical, form. It is timely, therefore, to consider the status of certain of the health bills as a guide to the situation that we may expect to see unfold in the newly elected Congress.
Compulsory Health Insurance
Despite the all-out campaign waged by the AMA and many other powerful organizations, compulsory health insurance will undoubtedly continue to be a storm center. A bill for compulsory health insurance has been introduced, in one form or another, into every Congress since the first Wagner-Murray-Dingle Bill was introduced in 1943. It is not likely that the 82nd Congress will break this chain.
USE OF THE PERTUSSIS AGGLUTINOGEN SKIN TEST IN A WELL BABY CLINIC
Authors: BARYSH NOAH 
Published: December 2021

Intradermal skin tests with pertussis agglutinogen were performed on 234 infants.
In one group of 100 infants skin tested with this material, at least three months after pertussis prophylaxis, it was found that 92% had positive (immune) skin reactions.
In a second group of 134 infants skin tested prior to pertussis vaccination, 83% (111) had negative skin reactions. In 66 of these 111 infants tested after pertussis prophylaxis, 92% developed a positive skin response.
The pertussis skin agglutinogen test can be used to determine the efficiency of materials used for pertussis prophylaxis.
The pertussis skin agglutinogen test is a reliable indicator of the immune response of an infant to H. pertussis immunization and is recommended as an effective agent for determining the susceptible infant—one lacking the minimal clinical protection against pertussis—after pertussis vaccination.
SPHEROCYTOSIS AND INCREASED FRAGILITY OCCURRING IN ERYTHROBLASTOSIS FETALIS ASSOCIATED WITH ABO INCOMPATIBILITY
Authors: ROBINSON GEOFFREY C. , PHILLIPS RUTH M. , PRYSTOWSKY MILTON 
Published: December 2021

Four cases of hemolytic disease of the newborn infant are reported. There was ABO incompatibility and high maternal immune antibody titre after delivery. Immune antibody was demonstrated in the sera of 3 of the 4 infants.
The difficulties in making an unequivocal diagnosis are discussed and the diagnostic value of immune antibody in the infant's serum is emphasized.
The presence of spherocytosis and altered erythrocyte hypotonic fragility during the hemolytic phase is noted. These findings are similar to cases of acute hemolytic anemia in adults previously reported.
RESPONSE OF THE SERUM HYALURONIDASE INHIBITOR AND MUCOPROTEINS TO ADRENOCORTICOTROPIC HORMONE IN RHEUMATIC STATES
Authors: ADAMS FORREST H. , KELLEY VINCENT C. , DWAN PAUL F. , GLICK DAVID 
Published: December 2021

ACTH was administered to 13 patients with acute rheumatic fever and to two with rheumatoid arthritis. The following observations were made: [See Chart 6 in Source Pdf]
1. The elevated nonspecific hyaluronidase inhibitor concentration of the serum dropped rapidly, usually to normal values, within 10 to 15 days, and subsequently the values became subnormal. This seemed to follow closely the subjective improvement in the patient's condition.
2. The elevated serum mucoprotein concentrations slowly returned to normal over a period of 3 to 4 months.
3. In instances in which the ACTH was withdrawn, or in which the dosage was reduced before a substantial drop of the mucoprotein level had taken place, the disease recurred.
4. ACTH administered to a patient with combined diabetes mellitus and rheumatic fever effected an increase in the insulin requirement to approximately double that of the pre-ACTH period. As the ACTH was gradually withdrawn, the insulin need returned to the pre-ACTH amount. The effect of ACTH on this patient's rheumatic fever was similar to the others receiving the hormone.
VOLUMETRIC AND MICROSCOPIC PATTERN OF BONE MARROW IN NORMAL INFANTS AND CHILDREN
Authors: STURGEON PHILLIP 
Published: December 2021

With the use of the described bone marrow aspiration and concentration (volumetric) technic, the percentage distribution of the major categories of cells appears to follow the general pattern reported from studies of bone marrow in infants and children by the direct smear technics.
The percentage distribution of nucleated cells from sternal and iliac aspirations in the age range studied showed no apparent differences between the two sites nor influence of age on the data.
In normal individuals as young as 1½ years of age and with advancing age thereafter, an increasing number of tibial aspirations show a very low percentage of normoblasts (0-5) and a majority of lymphocytes and segmented neutrophils.
ELECTROENCEPHALOGRAPHY OF THE NEWBORN INFANT
Authors: HUGHES JAMES G. , DAVIS BILLIE CAMP , BRENNAN MARJORIE LEAK 
Published: December 2021

A report is given concerning normal electroencephalographic patterns of premature infants in the first days of life. Thirty-one EEGs on 22 premature babies constitute the basis of the report.
Three main frequency bands were noted: waves of 2.5 to 4/sec. which usually appeared singly at amplitudes of 45 to 80 microvolts; waves of 5 to 7/sec. occurring in episodes of 1 to 1½ sec. at 25 to 40 microvolts; and frequencies of 11 to 15 cycles/sec. which appeared in episodes of 3/5 to 2½ sec. at amplitudes of 10 to 20 microvolts. The 11 to 15 cycle waves appeared more consistently than did the other frequencies observed, and were usually more prominent in the frontal region.
These findings indicate that in premature infants cortical electric activity from the frontal region is more well developed in regard to frequency, amplitude and rhythm than are the brain potentials from other areas of the cortex.
This observation is contradictory to what would be expected from a consideration of the embryonic maturation of the human cortex.
THE PRESIDENT'S PAGE
Authors: BEAVEN PAUL W. 
Published: December 2021

THE latest Academy directory has been sent to the membership. I want to call your attention to the first part of this directory. The first few pages are taken up with the district and state chairmen. These are important in a democratic organization such as ours. Note the name of your state chairman and give him your cooperation in whatever he is doing. He was elected to that office and wants your ideas. Note the name of your district representative, for he was also elected, and by reason of this office is a member of the Executive Board which is the governing body of the Academy.
If you turn to page 9 and following, you will note some changes in committees. This is an attempt at clarification, based on some of the recommendations of the Reorganization Committee which was appointed by Dr. Sisson when he was President. The standing committees were the suggestion of that committee and are seven in number.
The Advisory Committee for Child Health is a purely advisory committee. It has no power except to render an opinion for the Executive Board. Its chairman is the immediate past president and its members are, in almost every instance, chairmen of other Academy committees. Ex officio members of this committee are the Scientific Program Chairman and the Editor of Pediatrics and of course the President. This gives the Executive Board, through the President, the collective opinion of those that are particularly well acquainted with the several areas of work in which the Academy interests itself. It is in effect a cabinet for the President.
Augmented Ventricular Rate Following Verapamil Treatment for Atrial Fibrillation with Wolff-Parkinson-White Syndrome
Authors: Rowland Thomas W. 
Published: December 2021

Verapamil has gained increasing acceptance as a first-line drug in the treatment of paroxysmal supraventricular tachycardia in both adults1 and children.2-4 Conversion to sinus rhythm in more than 90% of cases has been reported, an effect related to the drug's prolongation of refractory period and conduction through the atrioventricular node.
The electrophysiologic effects of verapamil on accessory atrioventricular conduction pathways are more variable, and in some patients the drug will cause a decrease in refractory period.5-7 In individuals with reentrant paroxysmal supraventricular tachycardia this action is inconsequential, but in those with ventricular preexcitation accompanied by atrial fibrillation or flutter the effect may be catastrophic.
New Therapy for Severe Cystic Acne
Authors:   Committee on Drugs
Published: December 2021

Isotretinoin, 13-cis-retinoic acid (Accutane, Hoffmann-LaRoche), is brightening the bleak outlook for adolescents and young adults with nodular, cystic, and conglobate acne—a severe, scarring disease—that has resisted treatment with topical or systemic antibiotics, benzoyl peroxide, retinoic acid, and intralesional corticosteroids. Adolescents with less severe forms of acne who learn about the therapeutic triumphs of isotretinoin in severe recalcitrant nodular and cystic acne may assume that the drug also would be beneficial for them. Pediatricians should inform these adolescents that the drug has not been studied in, found effective for, or labeled for the treatment of typical acne.
Patients with multiple, active, deep dermal or subcutaneous cystic and nodular acne lesions are usually given 1 to 2 mg of isotretinoin per kilogram of body weight per day (although dosage as low as 0.05 mg/kg/d has been reported as beneficial), orally, in two divided doses for 15 to 20 weeks or until the cyst count decreases by 70%, if this happens sooner than 15 to 20 weeks. Use of this drug is associated with a reduction in sebaceous gland size and activity (a decrease in sebum excretion by as much as 75% to 90%), with inhibition of sebaceous cell differentiation, and with a reversion to prepubertal skin surface lipid composition. Although isotretinoin is expensive, a course of treatment usually clears the troublesome lesions and a prolonged remission often follows.
Side effects and alterations in patients' laboratory test results do occur; these appear to be lessened by reduction in dosage and to be fully reversible when the drug is discontinued.
THE MEDICAL VIEW OF ROLLER SKATING IN 1885
Authors: C. T. E. 
Published: December 2021

During the 1880s roller skating had become enormously popular among American children.1 To counteract the widely-held fear that this pastime was detrimental to the health of young children, the following editorial was published in 1885 in one of our best-known nineteenth-century journals.2
THE MEDICAL VIEW OF ROLLER-SKATING
It seems as if America were peculiarly susceptible to epidemic influences of a mental kind. We hear of no other country so violently perturbed by "waves" of temperance crusading, religious revivals, velocipede crazes, pedestrianism, and, finally, roller-skating, upon which latter pastime the thoughts and feelings of three-fourths of the rising generation are at present centered. In intensity and extent, the roller-skating mania has far exceeded all its predecessors, and it must be inferred, either that the psychological contagium is particularly strong, or that the susceptibility of young America to affective epidemic influences is increasing.
Modern scientists of the "Psychical Research" school are putting forward the theory of brain-waves as a possibly potent element in the production of panic fears and epidemic fashions and feelings. The mind acts "exoneurally," we are told, and the vibrating brain-cells of the enthusiastic roller-skater communicate their rhythmical pulsations to the previously insensitive spectator. Whatever the mechanism, there is certainly at present a morbidly exaggerated passion for, and indulgence in, roller-skating. And the question comes home to the physician, whether it is doing any physical or mental harm.
On the whole, we are inclined to take a rather lenient view of the present craze. Considerable inquiry has failed to elicit any facts showing that roller-skating, temperately indulged in, does any harm to growing children; or produces any diseases and injuries peculiar to the sport.
The Neutral Temperature of Very Low-Birth-Weight Infants
Authors: SAUER PIETER J. J. , VISSER HENK K. A. 
Published: December 2021

Recently, guidelines for perinatal care were published by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.1 In a chapter on thermoregulation of newborn infants, recommendations for the neutral temperature of newborn infants are given. These recommendations are based on studies done more than 15 years ago.2,3 Although most of the recommendations are still valid, the values given for very low-birth-weight infants during the first week of life might need reconsideration based on more recent studies.
In the original studies, infants were grouped by birth weight and not by gestational age. The group called the "smaller prematures" had a mean birth weight of 1,276 g; all weighed less than 1,500 g.
Feeding of Infants with Cleft Palate
Authors: PARADISE JACK L. , MCWILLIAMS BETTY JANE , ELSTER BARBARA 
Published: December 2021

To the Editor.—
We do not agree that the "gravity-flow" nipple described by Martin1 constitutes an advance in the feeding of infants with cleft palate. In our experience, its use has usually proved unsatisfactory. What is needed to compensate for the inability of infants with cleft palate to generate effective oral suction is not a special nipple but rather a compressible feeder. A decade ago, we discussed the basis for feeding difficulties in infants with cleft palate.2
The Uvula and Sudden Infant Death Syndrome
Authors: HARPEY JEAN-PAUL , RENAULT FRANCIS 
Published: December 2021

To the Editor.—
Guilleminault et al1 mentioned the case of a child with near-miss sudden infant death syndrome who had an abnormally long uvula and who eventually underwent uvulotomy. When interviewing the Moroccan parents of an infant who died suddenly while asleep at age 2 months, we learned that sudden infant death syndrome had been known for years in Morocco. It was well known, too, that infants who eventually were victims of sudden infant death syndrome had often had hypersialorrhea, snoring, coughing, and regurgitation since the first days of life.
The Face in Otitis Media
Authors: SHARON BRUCE I. 
Published: December 2021

To the Editor.—
The distinctive facial features of children who breathe through the mouth as described by Bresolin et al1 may also apply to children with other clinical conditions. Based on gross observation, I have suspected that many children with recurrent otitis media have special craniofacial characteristics that make them more prone to recurrent infections. My suspicion, that these children have comparatively elongated facies, is similar to the findings reported by Bresolin et al in children with chronic nasal obstruction.
Unconvinced of Value of Antenatal Transfer to Level 3 Intensive Care Units
Authors: PANETH NIGEL , SUSSER MERVYN W. , KIELY JOHN L. 
Published: December 2021

In Reply.—
Sepkowitz's arguments are flawed by his use of proportional mortalities instead of actual death rates. The low proportion of neonatal deaths occurring in the first four hours in an Oklahoma community hospital may indeed reflect a favorable first-four-hour death rate. But it might also be due to an unfavorable four-hour to 28 day death rate. Without the actual rates no conclusion can be drawn.
Although it is true (as pointed out in our article) that some of the deaths averted in the first four hours at level 3 units were deferred to later in the neonatal period, a statistically significant and clinically important mortality advantage for low-birth-weight level 3 births was seen in all of our analyses, extending out as far as 3 months of age.1