bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemophilus influenzae Type b Sepsis in Infant and Mother
Authors: Marston Gail , Wald Ellen R. 
Published: December 2021

Hemophilus influenzae type b is an uncommon cause of neonatal sepsis. Fifteen detailed case reports of neonatal H. influenzae infection appear in the literature1-5; approximately one half of these are type b. Where information was available on the mother, only local cultures of genitourinary tract and/or pharynx were positive in mothers of infants with H. influenzae disease. Puerperal sepsis caused by this organism has not been previously reported. We wish to report a case of generalized sepsis in mother and newborn caused by H. influenzae type b.
CASE REPORT
A 4,972-gm boy was born to a 17-year-old gravida 0, para 0, Caucasian, afebrile mother.
Drs. Cashore and Usher Reply
Authors: Cashore William J. , Usher Robert H. 
Published: December 2021

We are indeed interested to learn that Higgs et al.1 have achieved early growth rates comparable to those in our study with the use of intravenous fat emulsion in small premature infants. Further information on the metabolic complications and autopsy findings encountered in their study would provide important additional evidence concerning the effectiveness and potential hazards of using intravenous fat emulsions in sick newborns.
There was a difference between the two studies in the method of infusing the fat emulsion.
The Sleep State Characteristics of Apnea During Infancy
Authors: Gould Jeffrey B. , Lee Austin F. S. , James Ophelia , Sander Louis , Teager Herbert , Fineberg Naomi 
Published: December 2021

The sleep state characteristics of infant sleep apnea were studied in 36 twins examined by polygraphy at 40, 44, and 52 weeks after conception. The definition of sleep apnea is dependent upon the length of apnea, sleep state, and post-conceptional age.
None of the infants had apnea longer than 20 seconds and apnea of 10 seconds or longer was uncommon. The attack rates for apneas 2 to 4.9 seconds long were highest in REM and lowest in quiet sleep. The attack rates for apneas 5 to 9.9 seconds long were equal in REM and indeterminate and lowest in quiet sleep. The percentage of infants with apnea of 10 seconds or longer at 40 weeks was highest in REM (27%) and indeterminate sleep (42%) and lowest in quiet sleep (12%). At 52 weeks, apnea 10 seconds or longer during REM decreased to 0%.
The effect of maturation on apnea varies with sleep state. Over the period from 40 to 52 weeks, quiet sleep apnea was unchanged and indeterminate sleep apnea decreased only between 40 and 44 weeks. Although REM apnea 2 to 4.9 seconds long was unchanged, REM apnea 5 to 9.9 seconds long decreased between 40 and 44 weeks, and REM apnea of 10 seconds or longer decreased from 27% at 40 weeks to 0% at 52 weeks. This suggests that semi-independent apnea turn-on and turn-off mechanisms operate during REM sleep. A correlation between brief apneas and the longer apneas was seen only during REM sleep. For all sleep states, there was no correlation between the levels of apnea of 5 seconds or longer at 40, 44, and 52 weeks.
Relief of Chronic Upper Airway Obstruction Using a Dental Prosthesis: A Nonsurgical Approach
Authors: Eavey Roland D. , Casagrande Angelo , Blasberg Bruce , Stool Sylvan E. 
Published: December 2021

The spectrum of symptoms of chronic upper airway obstruction ranges widely from merely annoying "noisy respirations" to death from heart failure secondary to cor pulmonale.1 The latter condition occurs because airway obstruction can lead to alveolar hypoventilation which results in hypoxia, hypercapnia, and acidosis which, in turn, produce pulmonary arteriolar construction.2
Chronic upper airway obstruction can also be a management problem for the pediatrician. Depending on the etiology and degree of symptoms, three treatment choices are usually considered: medical management, corrective surgery to recreate an airway; or tracheotomy to bypass the obstruction. We recently have seen a patient who demostrated chronic respiratory difficulty and ECG evidence of early right heart failure who benefited greatly by the use of a simple dental appliance.
Foreign Body of the Right Nostril and Left Bronchus
Authors: Hawkins Donald B. , Kahlstrom Emily J. , MacLaughlin Eithne F. , Margetis Monique F. 
Published: December 2021

Foreign bodies in the airway often present problems for physicians who treat children. The following case report illustrates some of these problems.
CASE REPORT
A 6-year-old boy was admitted to the Pediatric Respiratory Disease Service of the Los Angeles County-University of Southern California Medical Center with a complaint of persistent nonproductive cough since awakening the morning of the previous day. He also had a history of discharge from his right nostril for eight months, at times foul-smelling. During this time, he had seen doctors on three occasions; twice antibiotics had been prescribed for sinus infection.
He was in no distress, and demonstrated no respiratory difficulty.
Computerized Tomography: A Perspective in the Pediatric Patient
Authors: Harwood-Nash Derek , Grossman Herman , Felman Alvin , Kirkpatrick John , Swischuk Leonard 
Published: December 2021

Computerized tomography (CT), a technique conceptualized by Oldendorf in 19611 and developed by Hounsfield2 of EMI-Tronics Inc. (EMI) Central Research Laboratories, has proven to be a successful innovation in neuroradiology. Reviews by Ambrose3 in England and by Baker et al.4 and by New et al.5 in the United States have clearly demonstrated the value of this new modality in neuroradiological diagnosis. In 1975 Houser et al.6 and Harwood-Nash et al.7 provided the initial clinical and radiological data about CT in infants and children.
More recently this technique has been extended to the study of tissues and organs in the body other than those in the head. This has been accomplished by modification of the original machine into a whole-body CT system. Early reviews by Ledley et al.8 and by Alfidi et al.9 suggest a significant potential for diagnosis of lesions in the abdomen, pelvis, and thorax.
The advantages of CT are that it is less invasive than standard special diagnostic radiological procedures and that for the first time it provides in vivo information regarding the content and the characteristics of tissue composing organs and masses.
DESCRIPTION OF EQUIPMENT
In conventional radiography an image is made on radiographic film by an attenuated X-ray beam. In passing through a core of tissue, each ray of the beam is attenuated as it is absorbed and scattered by the tissue in its path. The intensity of the transmitted ray depends on the sum total of X-ray attenuation by all the different soft tissues in its path.
Primary care: We need all the help we can get!
Authors: Hoekelman Robert A. 
Published: December 2021

Primary care has finally been defined to the satisfaction of almost everyone and educational programs to prepare physicians to provide primary care to children have emerged in response to reason, demand, and dictum.1-3 Questions now arise as to who should provide the bulk of that care and how it can best be organized to ensure that the health care needs of all of our children are met. The politics of primary pediatric care begin then to occupy more of our thought and discussion.
Dodds has reviewed the politics involved at all levels of pediatric care but speaks mostly to the conflicts that exist between general practitioners and pediatricians in the delivery of primary care.4
Transient Tricuspid Insufficiency of the Newborn: A Form of Myocardial Dysfunction in Stressed Newborns
Authors: Bucciarelli R. L. , Nelson R. M. , Egan E. A. , Eitzman D. V. , Gessner I. H. 
Published: December 2021

Fourteen term newborn infants have been recognized as having transient tricuspid insufficiency associated with significant perinatal stress. Five of these infants underwent cardiac catheterization for presumed congenital heart disease, but had only massive tricuspid valve insufficiency. The other nine infants were diagnosed on the basis of a murmur characteristic of tricuspid valve insufficiency and on other clinical grounds. All had a history of significant perinatal stress in the form of asphyxia with or without hypoglycemia. Frequently, congestive heart failure, persistent cyanosis, and ECG evidence of myocardial ischemia were present. Twelve of the 14 survived, and in each of them all cardiac signs and symptoms, including the murmur, spontaneously resolved. The two patients who died had histopathologic evidence of necrosis in the anterior papillary muscle of the tricuspid valve.
The constant features of perinatal stress, ST-T wave abnormalities on the ECG, and spontaneous resolution of the transient tricuspid insufficiency strongly suggest that this syndrome is secondary to a reversible form of myocardial dysfunction, perhaps by affecting papillary muscle specifically. We believe that hypoxia with or without hypoglycemia precipitates the events leading to this clinical syndrome which is distinguishable from other cardiac abnormalities in the newborn by the history, distinctive murmur, and the ECG abnormalities.
LIMITATIONS
Authors: McDonald C. J. 
Published: December 2021

Implicit in currently available remedies for medical errors is the belief that man is perfectable and his errors can be eliminated by training or coercion. Postgraduate training and recertification can eliminate errors caused by ignorance. Professional Standards Review Organization (PSRO) length-of-stay reviews, malpractice suits and tissue committees can eliminate errors caused by wrong intent. However, man is not perfectable. There are limits to man's capabilities as an information processor that assure the occurrence of random errors in his activities . . . . many medical errors are due to the physician's intrinsic limits rather than to remediable flaws in his fund of knowledge. . .
If this hypothesis is correct, all practice errors cannot be attributed to the human causes of ignorance and avarice. Some are intrinsic to the limitations of the human mind.
Health Needs of the Child in Foster Family Care
Authors:   Committee on Adoption and Dependent Care
Published: December 2021

The health needs of the child will depend upon the type of foster care being offered to him, as the needs for an emergency short-term placement of a healthy child are very different from those of a long-term placement of a handicapped child. When a tentative decision is reached that placement is necessary, arrangements should be made for a medical examination by a physician trained in the care of children. Psychological testing and psychiatric examination may occasionally be necessary to arrive at an understanding of the nature and severity of personality problems.
The adequate provision for safeguarding and promoting the health of children in routine foster care should include periodic health supervision examinations, appropriate medical care for the ill child or child with special health problems, and dental care. Foster families having access to adequate, continuing medical care for themselves and other siblings should incorporate their foster child into their family health care system. By aligning the health services needed by the foster child with the provider of health services utilized by the foster family, the child would not be singled out for differential treatment, hence becoming a more integral part of the family life. When this is not possible, basic medical services should be provided through the agency or other resources whose services are coordinated with a total plan for the child, thus providing for continuity of medical care.
Health services should include preplacement examinations and periodic medical examinations for appraisal of the child's physical growth, development, health status, and the effect of emotional and social factors upon the child's physical well being.
Care of the Child With a Colostomy
Authors: Cooney Diane E. , Grosfeld Jay L. 
Published: December 2021

Colostomy in infancy and childhood is usually performed for benign disease and is of a temporary nature. The colostomy often may be functional for 12 to 18 months, however, and therefore requires skilled care by the patient and/or his parents. The purpose of this report is to describe a combined inpatient-outpatient program of colostomy care that has resulted in improved management of infants and children with colostomies. The physician, parent, nurse, and enterostomal therapist are all intimately involved in the program. It is further intended to acquaint the pediatric physician with complicating factors related to the procedure.
Colostomies in children are frequently performed to relieve colonic obstructions resulting from congenital anomalies such as Hirschsprung's disease, colon atresia, and imperforate anus, and occasionally for pelvic and perineal tumors, Crohn's disease of the colon, and instances of rectal perforation.1,2
In Reply: The Prevention of Recurrent Otitis Media
Authors: Rowe D. Stewart 
Published: December 2021

I agree with Dr. Rako that long-term anitibiotic treatment of recurrent suppurative otitis media appears promising and deserves further study. Such study seems necessary to me for several reasons.
Only two controlled studies of long-term antibiotic treatment have been reported. The results of the study1 of Alaskan Eskimo children cannot be assumed to be valid for most childhood populations in the United States. Confirmation of the Rochester group's encouraging results2 of sulfonamide treatment will be necessary.
Host defense in malnutrition
Authors: Katz Michael , Stiehm E. Richard 
Published: December 2021

It has not been possible to relate a particular immune failure or deficiency to absence of a specific nutrient. All of these studies have viewed the totality of malnutrition and, yet, it would seem reasonable to expect that specific nutrient deficiencies would affect the response differently and that the almost infinite number of possible interactions among nutrients may have their particular effect. Furthermore, it has not been possible to evaluate any of these studies in terms of the influences that infections themselves have brought to bear. These considerations have led us to conclude that studies of man cannot be carried out with a precision required for the definitive answers. This is not a defeatist notion, but rather a value judgment that prompts us to recommend a more intensive series of investigations in animal model systems, the conclusions of which could then be applied selectively to clinical studies of man.
The important question that must be considered is possible nutritional interventions in severely infected patients, such as those undergoing major surgery or immunosuppressive therapy. Potential dangers of using live attenuated viral vaccines in malnourished populations must be evaluated. It is necessary to assess the possibility that such vaccine viruses unchecked by normal immune response in malnourished individuals may lead to the establishment of states of latency and, ultimately, slow infections.
The need for further studies has been given recognition by a workshop conference held in May 1975 under the title "Malnutrition and the Immune Response"; the proceedings are soon to be published in book form.57 The question of the influences of infection upon the state of nutrition has also been considered in a recent workshop, the proceedings of which will also be published.58 We believe that the current critical approach to this important health problem will generate answers long wanting. When these answers do become available, they will guide us into better care not only of the malnourished in the developing world, but also of those in the industrialized countries.
Techniques for Analysis of Micturition Reflex Disturbances in Childhood
Authors: Bradley William E. , Andersen Jens T. 
Published: December 2021

During the past two decades, improvements in technology and changes in conceptualization have contributed to greater objectivity in the assessment of micturition reflex disturbances.1,2 These changes have been applied principally to analysis of adult dysfunction and have recently been implemented in evaluation of neuromuscular dysfunction of the urinary bladder in infancy and childhood.
These newer methods include gas cystometry,3 integrated sphincter electromyography (EMG),4 measurement of reflex-evoked potentials in micturition reflex pathways,5 and electroencephalography (EEG).6 Complementary urodynamic methods include uroflowmetry,7 measurement of urethral pressure profiles,8,9 and observation of pressure-flow relationships during voiding.10
These studies, when appropriately selected and individualized to the patient as a result of the history and examination, provide valuable information. They delineate the site and nature of the impairment of the nervous mechanisms used in the neural and muscular infrastructure in micturition during infancy and childhood. Finally, they provide a rational basis for selection of pharmacologic agents11 and surgical techniques12 to restore urinary continence.
Gas cystometry technique
Gas cystometry has replaced water cystometry in the evaluation of patients for detrusor reflex instability. The patients are catheterized, and the bladder is inflated with carbon dioxide at room temperature at a constant flow rate of up to a maximum of 200 ml/min. Intravesical pressure is recorded by an isovolumetric strain gauge and transducer amplifier calibrated in centimeters of water.4 Because of the high perfusion rate and brief test interval, additional testing for reflex instability is facilitated. These additional procedures include (1) change in posture from supine to upright, (2) determination of response to subcutaneous injection of bethanechol, and (3) sleep cystometry.
Inguinal Hernia in Premature Infants
Authors: Walsh S. Zoe 
Published: December 2021

I was interested to read the article by Harper et al. in the July 1975 issue on the incidence of hernias in premature infants weighing 1,000 gm or less at birth. According to these authors, no one thus far has recognized the remarkably high incidence of inguinal hernias (30%) in premature infants weighing less than 1,000 gm.
I should like to point out, however, that a high incidence of such hernias in very-low-birth-weight premature infants was reported by Knox1 in 1959 and Walsh2 1962.
Prenatal detection of neural tube defects: False positive and negative results
Authors: Milunsky Aubrey 
Published: December 2021

An estimated 6,000 to 8,000 babies with neural tube defects (NTDs) are born each year in the United States. The suffering of both child and family has been well documented.1-3 Prenatal detection early in the second trimester of pregnancy became possible in 1972 when elevated α-fetoprotein (AFP) concentrations in amniotic fluid in association with open NTDs were demonstrated in Edinburgh.4 These results have been amply confirmed.5-10 The AFP test is best used and most reliable between 14 to 16 weeks of gestation.8 With such prenatal diagnosis, termination of the abnormal pregnancy can be offered to the family.
AFP is synthesized by the yolk sac and fetal liver and normally passes from the fetal serum into fetal urine and then into the amniotic fluid.
Dr. Rapkin Replies
Authors: Rapkin Richard H. 
Published: December 2021

I agree with most of the points made by Dr. Phelan in his letter, especially those related to the need for skill in performing nasotracheal intubation. It is unreasonable to assume that this degree of skill will be available in most hospitals, and, therefore, tracheostomy will continue to be an important procedure for securing the airway of a child with epiglottitis.
Since the submission of my article, which indicated possible dangers of nasotracheal intubation in viral croup, there have been two articles published that support Dr. Phelan's contention that such intubation is safe and effective in the treatment of this disease.1,2
Can Vitamin E Deficiency Occur in an Infant Receiving Total Parenteral Nutrition?
Authors: Johnson A. Myron , Morris Mary Ann Williams 
Published: December 2021

Reports in the July 1975 issue of Pediatrics of total parenteral nutrition (TPN) in newborn infants, with and without lipid supplementation,1,2 have prompted a brief report of our experience with a small premature infant given TPN because of upper gastrointestinal obstruction and postoperative intolerance of enteral nutrition. Although cause-and-effect relationships are far from clear, this infant's course raises a question about the adequacy of vitamin E supplementation for premature infants receiving TPN.
Case Report. F.I. (No. 31-10-62) was the first born in a pair of dizygotic black twins, weighed 1,370 gm, and was the product of a 30-week gestation terminated by spontaneous rupture of membranes.
Questions Need for Prophylaxis With Silver Nitrate
Authors: Shaw Edward B. 
Published: December 2021

Why should Credé prophylaxis with silver nitrate be continued? Nishida and Risemberg still recommend this (Pediatrics 56:368, 1975) but admit that it often provokes chemical conjunctivitis (which is benign and clears in 24 hours, before gonococcal infection usually occurs). Because of chemical conjunctivitis, it is not used in 20% of the nation's hospitals.
Introduction of silver nitrate drops is definitely traumatic-just opening the lids is frequently a struggle. (Obstetrical services that are most meticulous about introducing the silver nitrate solution have the most severe reactions from it.)
Urinary Tract Anomalies in Neonates With Spontaneous Pneumothorax and/or Pneumomediastinum
Authors: Bashour Bassam N. , Balfe J. Williamson 
Published: December 2021

Spontaneous pneumothorax is reportedly occurring in 0.05% to 1% of all live births.1,2 Pediatricians have long been aware of the apparent association between spontaneous pneumothorax, with or without pneumomediastinum, and congenital anomalies of the urinary tract. However, reports of the incidence of this relationship have been inconclusive, based on small numbers of infants.3-5 We therefore sought to determine this incidence in a large clinical population.
METHODS
We reviewed the records of all 6,236 infants admitted to the neonatology unit during 1961-1967 and selected all cases of spontaneous pneumothorax or pneumomediastinum or both (lung rupture) and of congenital urinary tract anomalies.
Implications of Pathologic Findings in the Treatment of Neonatal Necrotizing Enterocolitis
Authors: Joshi Vijay V. 
Published: December 2021

The pathologic findings in neonatal necrotizing enterocolitis (NNE) have been well described,1-3 but the following features need emphasis because of their implications in the treatment of the disease.
1. A common misconception is that the dark-red dull-appearing affected portion of the intestine in NNE is indicative of infarction of the intestine, i.e., necrosis of total thickness of the bowel. But, in fact, the necrosis seen in the affected portion of the intestine is almost exclusively confined to the mucosa1-3 and is transmural only in a focal area or areas in cases in which a perforation or perforations occur.