bluuebunny/crossref_metadata_2025_split huggingface dataset:
AN INQUIRY INTO THE ETIOLOGY OF ACUTE BRONCHIOLITIS OF INFANTS
Authors: WOOD SARAH H. , BUDDINGH G. JOHN , ABBERGER BENJAMIN F. 
Published: December 2021

Tracheal aspirates and nasopharyngeal swabs obtained from 51 infants under 2 years of age with acute bronchiolitis were subjected to a careful bacteriologic study. The cases in this series were encountered during the 13 month period from November 1, 1951, to December 1, 1952.
H. influenzae was recovered from 36 of the 51 infants. Of these, 26 proved to be H. influenzae type a and 6 proved to be H. influenzae type b. The four remaining were rough untypable strains.
An increase in type specific antibody measured by a slide agglutination technic and by the Quellung reaction could be demonstrated in 46 infants. No increase in antibody titer could be demonstrated in 5. An increase in antibody titer to H. influenzae type a was demonstrated in 37 and to H. influenzae type b in 9 of the series.
Combined bacteriologic and serologic evidence indicating that H. influenzae type a was involved in the infectious process was obtained in 26 cases. An increase in antibody titer to type a only was demonstrated in 11 others. In two from whom rough nontypable strains were isolated, an increase in titer to type a was demonstrated. Evidence for infection with type a was thus obtained in 37 of the 51 infants. From 2 infants H. influenzae type a was recovered but no increase in antibody titer could be demonstrated.
Combined bacteriologic and serologic evidence for infection with H. influenzae type b was obtained in 5 infants. An increase in titer to type b was demonstrated in 2 others. A titer increase to type b was demonstrated in 2 more from whom rough untypable strains were isolated. Evidence for infection with type b was thus obtained in 9 of the 51 infants. H. influenzae type b without evidence of titer increase was obtained in one.
No H. influenzae were isolated nor could an increase in antibody titer be demonstrated in the remaining 2 infants of the series.
Cold hemagglutinin reactions were negative in 36 pairs of sera tested. No increase in antihemagglutinating titer to influenza virus A or B could be detected in 46 paired sera. A fourfold, but not greater, increase in antihemagglutination titer to influenza virus C was detected in 5 patients of the series.
Reversion of rough untypable H. influenzae to smooth specifically typable strains was achieved by culturing the micro-organisms in chick embryos infected with influenza virus type A.
It is postulated that H. influenzae types a and b must be strongly considered as participating in the pathogenesis of acute bronchiolitis of early infancy. Whether other bacterial or viral agents alone or a combination of bacteria and viruses can be implicated in the etiology of this disease must be determined by further investigation.
THE TRANSMISSION OF INFECTIONS
Authors: SMITH MARGARET H. D. 
Published: December 2021

IN CASTING about for a topic which would be interesting enough to express to the Academy and to Mead Johnson my gratitude and pleasure at receiving this award, I hit an unsurmountable snag. I was reminded of the situation which often arises when a large party of people set forth for a climb in the mountains: the more energetic members head for the summit by the shortest route, making use of even the rockiest shortcuts; once up, they rest a bit, survey the horizon and then slither down in a matter of minutes, prepared to give to the stay-at-homes a concise description of the expedition. But there are apt to be a few in the party who mosey along, picking blueberries and looking at the view; they are likely to lose themselves along the way and never reach the the summit; on returning home they seem quite content, but are unable to give anyone else a very clear picture of where they have been. Dr. Wilkins and Doctors Robbins and Weller belong in the first category and I, unfortunately for this occasion, in the second. Rather than applying myself to the study of one problem I seem to have meandered among several. So instead of presenting an exact account of each, I shall try to relate some of the ideas which have come to mind along the way.
During the war we were deluged week after week with problems of the most practical sort concerning the management of patients with meningitis, severe diphtheria, croup, rubeola, encephalitis, pertussis, poliomyelitis and so on. And the peacetime experience at the Charity Hospital in New Orleans differs little, in many respects, from wartime experience elsewhere.
ACADEMY PROCEEDINGS—PRESIDENT'S PAGE
Authors: Kennedy Roger L. J. 
Published: December 2021

July 1, 1954, marks a milestone in the history of the American Academy of Pediatrics. For 22 years Doctor Hugh McCulloch has served the Academy, first as co-editor of the Journal of Pediatrics and since the establishment in 1948 of our own publication, Pediatrics, as Editor-in-Chief. Throughout his long term of office he has been an outstanding editor and in addition has found time to serve the Academy in many other ways. He was nominated by the Academy for membership on the American Board of Pediatrics and served as Chairman of the Committee on Rheumatic Fever, to mention only a few of his many activities. Few men have given as much of themselves to pediatrics and American medicine. Since he first served as a member of the Committee on Publication in 1931, Doctor McCulloch has been an inspiration to everyone who has had an opportunity to work with him. His superior qualities of executive ability and imagination have been important factors in establishing Pediatrics as an outstanding publication.
Doctor McCulloch has found it necessary to ask to be relieved as Editor-in-Chief because of increasing demands on his time. It was with sincere regret and profound appreciation of Doctor McCulloch's contributions to the American Academy of Pediatrics that the Executive Board acceded to his request. It is impossible to express the magnitude of the debt that the Academy owes Doctor McCulloch for his many years of service.
With the selection of Doctor Charles D. May as Editor-in-Chief, the Executive Board presents to its members a fellow member of the Academy who has a broad viewpoint of the responsibilities of the position. He is typical of the new leadership which steadily develops within the Academy and upon which we depend for even greater advances in the future.
THE USE OF SERIAL HEMAGGLUTINATION TESTS IN FOLLOWING THE COURSE OF TUBERCULOSIS IN CHILDREN
Authors: PEDEN VIRGINIA H. , VINCENT KEITH E. , RICH EDITH 
Published: December 2021

1. In cases of known pulmonary (or meningeal) tuberculosis in which X-ray (or spinal fluid) findings have become stabilized, a rise or fall in a previously stable hemagglutinin titer is a reliable indication that X-ray (or spinal fluid) evidence of improvement of the disease will follow within a few weeks.
2. A change in hemagglutinin titer occurring simultaneously with improvement in X-ray (or spinal fluid) findings serves as reliable additional evidence of improvement of the disease.
3. The significance of a changing hemaglutinin titer must always be evaluated with reference to X-ray (or spinal fluid) findings. A changing titer can be considered evidence of impending or beginning improvement of the disease only if the X-ray (or spinal fluid) findings are either static or improving.
4. A changing hemagglutinin titer was useful in predicting or confirming improvement of tuberculous disease in 38% of the group of cases studied. In the remaining cases, a change in hemagglutinin titer either failed to occur at all, or did not occur until after definite X-ray (or spinal fluid) improvement had taken place.
5. The absolute height of the hemagglutinin titer, in itself, was of no prognostic significance in connection with the course of tuberculosis in children.
6. In following the course of tuberculosis, the hemagglutination test is of more value in older children and in children with relatively mild forms of the disease than in infants or in patients with severe forms of tuberculosis, because the former are more likely to develop positive tests.
7. Tuberculin testing did not interfere with the use of the hemagglutination test in following the course of tuberculous disease.
THE ANTIBODY RESPONSE TO GRAM NEGATIVE ORGANISMS: AN EXPLANATION OF THE DIFFERENCES BETWEEN BACTERIAL AND HEMAGGLUTINATING ANTIBODY TITERS
Authors: RABE EDWARD F. , PLONKO MURIEL 
Published: December 2021

1. 0 antigens to one strain each of Klebsiella type 55-97, Paracolon 0, Group 3, and S. Choleraesuis produce antibodies in rabbits which can be measured by the following techniques: bacterial agglutination, indirect hemagglutination using red blood cells sensitized with bacterial suspension, bacterial polysaccharide or Seitz filtrate of broth culture of the bacteria, and the hemolytic modificaion of the hemagglutination test using bacterial suspension or polysaccharide sensitized red blood cells as antigen.
2. The highest absolute titers are recorded with bacterial suspension sensitized red blood cells in either the hemagglutination test or the hemolytic modification of this test. Titer differences between paired sera are measured as well by the bacterial agglutination test as by the indirect hemaglutination test. This is true for any of the three bacterial antigens studies.
3. Cross absorption tests with a Klebsiella antiserum and four forms of the homologous antigen indicate that the Klebsiella organism least two antigenic components giving rise to distinct antibodies.
4. Differences in titer between bacterial and hemagglutinating antibodies for Klebsiella are the result of the existence of two distinct antigenic components in the bacteria which are measured separately by each test.
REVIEW ARTICLE
Authors: KIBRICK SIDNEY 
Published: December 2021

Newborns with signs of myasthenia gravis may be divided into two groups, depending on the presence or absence of myasthenia in the mother.
Those infants born of myasthenic mothers are characterized by severe signs at birth or within the first few days of life, usually require immediate neostigmine therapy, and occasionally die. Those that survive, however, become normal in a matter of weeks and show no signs of myasthenia thereafter despite cessation of treatment. These cases are designated as transitory myasthenia of the newborn.
The second group, less common, is composed of infants born of non-myasthenic mothers. Their signs are much less severe at birth but persist and tend to increase with age, the majority requiring neostigmine in childhood. These represent cases of "true" congenital myasthenia.
This paper presents three cases of transitory myasthenia of the newborn, three probable cases of the same syndrome, and one case of congenital myasthenia.
All of the previously reported cases are reviewed and the etiology of myasthenia gravis is considered.
AMERICAN ACADEMY OF PEDIATRICS, INC. PROCEEDINGS AND REPORTS
Authors:   THE COMMITEE ON HOSPITALS AND DISPENSARIES AMERICAN ACADEMY OF PEDIATRICS
Published: December 2021

THE HOSPITALIZATION of children represents a tangible and significant phase of present day practice of pediatrics. It therefore reflects with considerable sensitivity the changes which have been and are taking place in the medical care of children. For example, the prevailing emphasis on Preventive pediatrics and the lessening severity and frequency of infectious diseases which has been accelerated by the general use of antibiotics have both been major factors in bringing about a diminution in demand for numbers of pediatric in-patient beds. On the other hand, the more general use of intricate and expensive diagnostic and therapeutic methods and devices such as contrast medium roentgenology, electrocardiography and encephalography, elaborate chemical and other laboratory observations has led to an increasing use of hospitals on an in-patient or out-patient basis in order to make such facilities available to the child patient.
Furthermore, hospitalization reflects an other characteristic of pediatric practice–that it is a general medical discipline confined to an age span rather than a special discipline confined to an organ system. Therefore a hospital facility for children must accommodate a variety of illnesses as well as a variety of age groups, each with its own peculiar characteristics and needs.
In designing a guide to the pediatric aspects of hospital care, the Committee was immediately faced with the choice of producing either a detailed vade mecum embracing each of the manifold problems or of attempting to distill out, insofar as possible, what appear to be the basic principles underlying hospital care for children during this era of rapid development and change in the nature of pediatric care.
INFANTILE SPASTIC HEMIPLEGIA I. INCIDENCE
Authors: PERLSTEIN MEYER A. , HOOD PHILIP N. 
Published: December 2021

The following facts seem to emerge concerning the nature and clinical correlations of various factors in the infantile spastic hemiplegic population.
A. The mean age for this series at the time of first examination was 6.5 years; means are consistent between large groupings where comparisons were made.
B. There were more right than left spastic hemiplegics (5:4).
C. Spastic hemiplegia occurred more often in males than in females (5:4).
D. The Negro subjects were distributed fairly randomly through the present spastic hemiplegic population; the nonsignificant differences in distribution which occurred were thought to be related to geographical and socio-economic factors and not to race, per se.
E. The incidence of postnatally acquired cases was approximately ⅓ of the spastic hemiplegic series as compared to 1/10 of the total cerebral palsied population.
F. The incidence of convulsions in this series was significantly higher than that reported for the general population, for all types of brain injury, for mixed spastic groups, and for most other series of spastic hemiplegics.
G. Congenital and postnatally acquired cases, convulsive and non-convulsive cases, and males and females were all distributed randomly between the left and right spastic hemiplegics of this series.
H. Congenital and postnatally acquired cases, as well as convulsive and non-convulsive cases, were distributed at random between the males and females of this series.
I. The postnatally acquired cases of spastic hemiplegia showed a significantly greater incidence of convulsions than the congenital group.
HEMOLYTIC AND PANCYTOPENIC SYNDROME ASSOCIATED WITH LETTERER-SIWE DISEASE
Authors: LIPTON EARLE L. 
Published: December 2021

Two cases of Letterer-Siwe disease are described in which a hemolytic mechanism was the probable cause of the associated anemia. A review of the pertinent literature indicates that this may be an integral part of the disease in some cases.
The laboratory evidence and clinical response to adrenocorticotropin in the first case indicate an extrinsic and probably immunologic mechanism. It is speculated that an analagous process is also responsible for the total pancytopenia. Future acute reticuloendotheliosis cases should be studied in detail in order to further elucidate the etiology of the hematologic changes.
COR PULMONALE IN INFANCY SIMULATING CONGENITAL HEART DISEASE
Authors: MAXWELL IAN , WILSON REGINALD 
Published: December 2021

1. Two cases of pulmonary arteriolar obstruction associated with hypertension of the lesser circulation have been described. Both cases were considered during life to be suffering from some form of congenital heart disease.
2. The pathogenesis of the pulmonary vascular lesions has been discussed. In one case, the lesion appears to have been a congenital dysplasia of arterioles throughout both lungs. In the other necrotizing arteriolitis was present in one lung which was also atelectatic. It was absent in the other well aerated lung though vascular lesions associated with pulmonary hypertension were present bilaterally.
3. The clinical picture of these patients has been described. It is suggested that this is sufficiently distinctive to permit clinical recognition and differentiation from congenital cardiac anomalies.
WATER AND ELECTROLYTE METABOLISM IN INFANTS FED COW'S MILK MIXTURES DURING HEAT STRESS
Authors: DARROW DANIEL C. , COOKE ROBERT E. , SEGAR WILLIAM E. 
Published: December 2021

Complete balances of water, fat, N, Cl, Na, K, P and Ca were determined on normal infants during exposure to a hot and a cool environment. Milk diets were used offering different osmolar loads at the usual intakes of water per 100 calories. Two infants were fed on evaporated milk providing only 100 gm. of water per 100 calories.
The data show that high evaporative water losses decrease urine volumes at hot environmental temperatures. At water intakes of 150 ml. per 100 calories, the usual cow's milk mixtures with or without added carbohydrate do not lead to urines approaching the physiological limitations of urinary concentration at 90° to 93°F.(32.2 to 33.9°C). Protein or electrolyte greater than evaporated milk induces more concentrated urines. Limitation of water to 100 gm. per 100 calories of evaporated milk induces maximal urinary concentration at this temperature and beginning symptoms of heat prostration. The water intake of these infants on this diet was large owing to high caloric food intake. Under the stimulation of the metabolism by high food intake and the limitation of water intake in relation to osmolar excretory load, heat balance could not be attained without concentrating body electrolyte. Recovery at a lower temperature occurred on this diet.
The osmolar loads of infant food was discussed in relation to extrarenal losses of water. Low osmolar loads provide a margin Of safety if water intake is low, if extrarenal expenditure of water is high or if renal ability to concentrate the urine is limited. The osmolar load of cow's milk is such that reducing this load by dilution with water and addition of carbohydrate is indicated until the caloric concentration is that of human milk, i.e., 150 gm. of water per 100 calories.
Round Table Discussion
Authors: SMITH CARL H. , SCHULMAN IRVING , ERLANDSON MARION 
Published: December 2021

The purpose of this round table as stated by Dr. Carl H. Smith was to review those phases of the anemias of infancy and childhood which commonly confront the practitioner. It was emphasized that the approach to a pediatric hematologic problem is unique in that a blood dyscrasia must be evaluated against the shifting blood levels inherent in the growth of children and also that it frequently necessitates on appraisal of fetal conditioning factors as well as post-natal hematopoietic influences. Dr. Smith pointed out that many of the essential diagnostic procedures, such as a meticulous history and physical examination, the basic blood studies including complete blood count, reticulocyte count and interpretation of the blood smear, and the comparison of the above studies with the normal range of blood values for each age group, are well within the working realm of any pediatric practitioner. An etiological classification of anemias into blood loss, excessive blood destruction and hemolysis, bone marrow depression or infiltration, and deficiency of building materials for hemoglobin or red cell formation was suggested. Reference should be made to the age periods of most frequent occurrence. Further specialized procedures were discussed, as well as laboratory tests of which stool guaiac, serum bilirubin, blood urea nitrogen, Coomb's tests, and red cell fragility test were considered to be essential in the investigation of any problematic anemia.
In a discussion of the physiology of neonatal blood formation and the anemia of prematurity by Dr. Schulman, cumulative data from the literature were shown to illustrate that the hemoglobin and red cell concentrations in the fetus increase through the second trimester of intrauterine life and tend to level off during the third trimester.
CONGENITAL MALFORMATIONS OF THE CARDIOVASCULAR SYSTEM IN A SERIES OF 6,053 INFANTS
Authors: Richards Mary R. , Merritt Katharine K. , Samuels Mary H. , Langmann Alfred G. 
Published: December 2021

The incidence of cardiovascular malformations has been studied in a large series of unselected infants. The overall rate was 0.83 per cent, and it varied from 7.7 per cent in infants who were either stillborn or died within the first month (16 of 209), to 0.6 per cent in infants who survived for more than 1 month (see Table I).
The accuracy of these incidence rates is discussed, and it is concluded that they are probably somewhat low.
Live-born infants weighing less than 2500 gm. at birth who survived for a month or more have a higher incidence of cardiovascular malformations than do those weighing more than 2500 gm. at birth. This difference is of statistical significance.
A careful evaluation of etiologic factors in this group of 50 cases revealed the following:
a) Maternal age and parity are of some importance as predisposing factors in the causation of cardiovascular malformations. The risk of having an infant with a congenital malformation of the heart or great vessels is greater in the third pregnancy than in the first, especially in women over 30.
b) No association between maternal infections early in pregnancy and the occurrence of cardiovascular malformations in the offspring was noted, except for a suggestive bit of evidence that herpes simplex in the first 3 months may be related to the tetrad of Fallot. However, the number of cases of first trimester maternal herpes in this group of 50 cases was not significantly greater than in the entire population, and in all probability the observed association is coincidental.
c) Obstetric and medical complications failed to show any correlation with the incidence of vascular anomalies.
d) Genetic factors could not be satisfactorily evaluated.
The types of malformations encountered are listed, and the methods of diagnosis are discussed. Twenty-three of the fifty cases are still not completely diagnosed, and of these, 20 are alive, and are still under observation.
The development of the symptoms in the tetrad of Fallot and in patent ductus arteriosus is discussed. A rather marked difference in maternal age and parity in the two conditions is apparent, but unexplained.
Routine RG of the chest in newborn infants was considerably less valuable than clinical evidence in the diagnosis of congenital heart disease.
The mortality rates for the group of 50 cases are discussed. Twenty-seven of the fifty patients survived more than 2 years.
Associated malformations, involving systems other than the cardiovascular system, occurred in 18 of the 50 cases (36 per cent), and organs derived from the embryonic ectoderm were most frequently affected. Mongolism (4), and cleft palate, cataract, diaphragmatic hernia (3 each) were the most frequently noted anomalies, and the association was thought to be of definite significance in the case of mongolism, and in fatal cases of diaphragmatic hernia.
HEMOLYTIC DISEASE OF THE NEWBORN DUE TO ANTI-A AND ANTI-B
Authors: Shumway Clare N. , Miller Gerald , Young Lawrence E. 
Published: December 2021

Ten infants with hemolytic disease of the newborn due to ABO incompatibility were studied. In every case the investigations were undertaken because of jaundice occurring in the first 24 hours of life. The clinical, hematologic and serologic observations in the infants and the serologic findings in the maternal sera are described. Evidence is presented to show that the diagnosis of the disorder rests largely upon the demonstration of spherocytosis, increased osmotic fragility of the red cells, reticulocytosis, and hyperbilirubinemia in a newborn infant whose red blood cells are incompatible with the maternal major blood group isoantibody and against whose cells no other maternal isoantibody is demonstrable.
The anti-A or anti-B in each of the maternal sera tested in this series hemolyzed A or B cells in the presence of complement. Other serologic findings in the maternal sera were less consistently demonstrated.