bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibody to Hepatitis A and B in Children in New York City
Authors: Cherubin Charles E. , Nair S. Ramachandran , Dienstag Jules L. , Purcell Robert H. , Szmuness Wolf 
Published: December 2021

The rate at which the population of New York City acquires antibody to hepatitis B surface antigen (anti-HBs) has been shown to be related to socioeconomic factors,1-3 as is true for so many other infectious diseases. Similarly, antibody to hepatitis A virus (anti-HAV) has been demonstrated to be influenced in the same way in adults and children from New York City and in adults from other areas in this country.4,5 Unexpectedly it appears that both antibodies accumulate in the population very slowly, beginning in late childhood, and continue to increase in frequency up to middle age.
Because of discrepancies between two surveys of anti-HBs in New York City children,1,3 and because we wanted to define more accurately the rate at which children and young adults of different socioeconomic milieu were exposed to these two viral agents, we collected serum samples from a black population in Bedford Stuyvesant and a white population in Staten Island and tested them both for antibodies to HAV and HBsAg.
SWINE FLU FAILURE
Authors: Altman L. K. ,   Student
Published: December 2021

Mass preventive medicine programs clearly depend on public awareness. In an era when informed consent is not only a moral necessity but a legal right, preventive medicine proponents now recognize they cannot proceed unless they recognize the role of publicity in educating the public—not only about the merits but the necessary dangers in a public health program. Any measure that is taken to prevent an illness, or potential complication of an existing illness, involves risk which must be weighed against the threat of what is being prevented.
The experts say they are the only ones who can make the technical decisions and recommendations, but the emphasis on informed consent puts increased responsibility on the individual to accept or reject that advice. The swine flu immunization decision, like many other immunization policies, was made by a small group of selected "experts." Critics of the decision said they had little or no opportunity to voice opposition. Yet when decisions affecting the medical care of every person and every doctor's practice are made centrally, clearly the process needs modification to allow recognition of those with dissenting views or alternative plans. Otherwise, many suspect, there will be less support from those who are asked to take part in mass preventive medicine programs.
Fit for the Future: Lessons for the United States
Authors: H. R. J. 
Published: December 2021

The United States has its tradition of White House Conferences; the United Kingdom has its Royal Commissions or Special Committees. The report of the Committee on Child Health Services,1 which took three years for a "far reaching inquiry" on how to improve child health services in the United Kingdom, is in this tradition of both countries. It is a report well worth the waiting and worth careful thought by pediatricians and policymakers in the United States. Volume 1, 448 pages long, is the body of the report. Volume 2 is a statistical appendix.
At the outset, any reviewer of this extensive work must limit his comments to only a few areas that seem most pertinent to our own scene.
SCIENTIFIC PUBLICATION
Authors: Relman A. S. 
Published: December 2021

Dr. Kan of Ciba-Geigy [was quoted] as saying that the Anturane Research Team used The New England Journal of Medicine as a "court of last resort" in deciding whether to continue their clinical study of the drug after initial results appeared to be so favorable.... This seems to me to reflect a serious misunderstanding of the role of a scientific publication like The New England Journal of Medicine.... We make no claim to editorial omniscience, nor do we guarantee that everything we publish will stand the test of time. Indeed, we know that ideas are being continuously reshaped in the crucible of ongoing research and clinical experience.
Good journals try to facilitate this process by identifying noteworthy contributions from among the great mass of material that now overloads our scientific communications system. Everyone should understand, however, that this evaluative function is not quite the same thing as endorsement.
Decreased Heart Rate Variation in Decerebration Syndrome: Quantitative Clinical Criterion of Brain Death?
Authors: Kero Pentti , Antila Kari , Ylitalo Veli , Välimäki llkka 
Published: December 2021

Heart rate variation (HRV) was measured in 12 children with brain death. Computer analysis demonstrated an overall heart rate variation (RMSM) of 3.5 to 9.6 msec (mean, 6.0 msec). The respective figures for beat-to-beat variation (RMSSD) were 4 to 16 msec (mean, 7.7 msec). Normal infants (RMSM, 20 to 30 msec) and children (RMSM, 50 to 90 msec) and infants with respiratory distress syndrome (RMSM, 10 to 20 msec) have a clearly higher HRV than those with brain death.
In all subjects a periodic component of the HRV with a cycle length of 5.9 ± 0.26 seconds was discovered. In five patients an additional periodic component was found that corresponded exactly to the rate of artificial respiration. This study demonstrated the value of accurate digital techniques in the characterization of fixed heart rate in decerebration. This phenomenon could be considered one clinical criterion of brain death.
BIRTH CONTROL AS VIEWED IN 1923 BY A HIGHLY RESPECTED AMERICAN PEDIATRICIAN
Authors: C. T. E. 
Published: December 2021

Dr. Richard Arthur Bolt (1880-1959) was both a greatly respected American pediatrician and an acknowledged leader in the development of maternal and infant hygiene programs.
His chapter entitled "The Mortalities of Infancy" in Isaac Abt's (1867-1955) encyclopedic, nine-volume treatise on pediatrics, published between 1923 and 1926, contains this negative view of birth control.1
This terrific loss of life in utero or shortly after birth constitutes a serious problem from a biological as well as a social standpoint. Of recent years there has been an alarming increase in the frequency and actual number of induced abortions. This has gone hand in hand with the insidious propaganda for so-called "birth control" or "voluntary parenthood"—a movement which has gained momentum in France, Holland and New Zealand, and has gradually spread to England and the United States. While the birth control enthusiasts would indignantly disclaim any connection between the "contraceptive methods" of "voluntary parenthood" and induced abortions, it is very evident that the more "moral technique" of contraception must often break down and relief from the "accidents" which follow be frequently sought in induced abortion. Thus far contraceptive methods have been practiced largely by the elite and better educated classes. Those most able to bear children and meet their support have been the very ones to shirk the responsibility, while those for whom birth control is claimed to be a great boon still proceed to build up large families.
It has been estimated that at least four children to a family are necessary to keep up the stock.
Pediatric Aspects of Hyperlipidemia
Authors: Breslow Jan L. 
Published: December 2021

Pediatricians and nutritionists are often asked about the type and amount of lipid that should be contained in the diet of an infant or a child. Interest is motivated by the high incidence of coronary artery disease in the American population, and the belief that diet is an important etiologic factor in atherosclerotic disease.1 Furthermore, since atherosclerosis is sometimes well advanced by the third decade of life, the true primary prevention of atherosclerotic disease is a pediatric problem and must begin in childhood.2.3 This report will review the relationship between diet, hyperlipidemia, and atherosclerotic disease, and will offer practical recommendations for intervention in the pediatric population.
It is estimated that 40% to 45% of the deaths in the United States are due to atherosclerosis and its complications. The majority of individuals with symptomatic atherosclerotic disease are 65 years or older.4 The disease is often associated with the aging process; however, there are individuals who age without signs of such disease. There also are individuals in the general population who develop symptomatic atherosclerotic disease at a young age. It is estimated that 3% of women and 10% of men will have some first event of coronary artery disease before 55 years of age.4 A large percentage of those in this group are predisposed to atherosclerotic disease because of metabolic or genetic factors such as the inherited forms of hyperlipidemia.5-8
Serum Lipids and Coronary Heart Disease
Atherosclerosis has existed for thousands of years, as evidenced by the autopsy performed on the embalmed body of an Egyptian pharaoh which showed an aorta affected with large calcified atheromatous lesions.9
DR. S. JOSEPHINE BAKER AND THE TONSIL AND ADENOID RIOT AT A NEW YORK CITY PUBLIC SCHOOL ABOUT 1920
Authors: C. T. E. 
Published: December 2021

Dr. S. Josephine Baker (1873-1945), Director of the Bureau of Child Hygiene of the New York City Department of Health from 1908 until 1923, described what must have been one of the most unusual riots in the history of American pediatrics.
I first heard of it when I got a ‘phone call that there was serious trouble at one of the public schools on the lower east side and went down to investigate. The school yard was clogged with a mob of six or seven hundred Jewish and Italian mothers wailing and screaming in a fine frenzy and apparently just on the point of storming the doors and wrecking the place. Every few minutes their hysteria would be whipped higher by the sight of a child ejected from the premises bleeding from mouth and nose and screaming with sheer panic. In view of what I saw when I had fought my way inside, I would not have blamed the mothers if they had burned the place down. For the doctors had coolly descended on the school, taken possession, lined the children up, marched them past, taken one look down each child's throat, and then two strong arms seized and held the child while the doctor used his instruments to reach down into the throat and rip out whatever came nearest to hand, leaving the boy or girl frightened out of a year's growth and bleeding savagely. No attempt at psychological preparation, no explanation to the child or warning to the parents.
Telephone Assessment of lllness: What Is Being Taught and Learned?
Authors: Curry Thomas A. , Schwartz M. William 
Published: December 2021

An important part of the educational program of house officers consists of teaching skills that are needed to practice medicine. There is great time and energy expended in the educational process, but rarely are these efforts subjected to critical evaluation. The following study points out the need for an evaluation program to determine if the teaching is effective.
Since pediatricians may spend one eighth of their time on the telephone,1 an important part of house officer training programs should be the development of telephone communication skills. Careful evaluations have demonstrated that pediatricians and house officers have not asked important questions during telephone consultations.
Letter To The Editor
Authors: McCarthy Paul L. , Dolan Thomas F. , Jekel James F. 
Published: December 2021

Dr. Todd has written a thoughtful commentary on our recent article.
All tests, alone or in combination, including the medical history and physical examination, have false-positive and false-negative errors. The balance between these errors is, as Dr. Todd mentions, determined by the cutoff points we choose. Although other cutoff points for WBC count and ESR were studied, a WBC count of 15,000/cu mm or more and an ESR of 30 mm/hr or more demonstrated the best balance of specificity and sensitivity for bacteremia or pneumonia in young children who had a temperature of 4°C or more.
Complication Using A Nasal Oxygen Catheter
Authors: Ackley Harry A. , Brewer M. Frederick 
Published: December 2021

We would like to report a complication that resulted from using a nasal oxygen catheter in a manner similar to that described by Pinney and Cotton.
A 2-month-old boy with a large ventricular septal defect was admitted with fever, severe congestive failure, and hypoxemia. A feeding catheter was inserted 2 to 3 cm into one nare and nebulized oxygen was supplied at a flow rate of 0.5 liters/min. The catheter used was a No. 8 French Cutter Resiflex with a blind tip and two side holes. There was a p-off on the nebulizer.
Apnea, Hypoxemia, and Aborted Sudden Infant Death Syndrome
Authors: Brady June P. , Ariagno Ronald L. , Watts John L. , Goldman Steven L. , Dumpit Fe M. 
Published: December 2021

To find out whether there is any relationship between the ventilatory response to hypoxia and the sudden infant death syndrome (SIDS), we studied the effects of mild induced hypoxia (PIO2, 120 mm Hg = 17% oxygen) in 16 infants aged 2 weeks to 6 months. Eight had recurrent apneic spells (apnea group) (five had aborted SIDS and three had recurrent apnea in the intensive care nursery) and eight were "well" preterm infants about to fly in a pressurized airplane (PIO2, 120 mm Hg) (control group). Mean birth weights were 2,245 and 1,400 gm and mean gestational ages were 35 and 30 weeks. Postconceptual ages (41.8 and 41.3 weeks) were almost identical.
Heart rate was obtained from an ECG, and respiratory rate and pattern were obtained from a pneumogram. In addition, end-tidal PCO2 and PN2 or PO2 were obtained with a nasal catheter and gas analyzers. In the apnea group with inhalation of 17% oxygen, we observed an increase in periodic breathing and an increase in both rate and total duration of respiratory pauses. In the control group there were no significant changes. Heart rate and PCO2 did not change in either group.
Our findings suggest that infants prone to apnea may have unique respiratory responses to mild induced hypoxia.
Comparison of Transcutaneous Oxygen Tension With Arterial Oxygen Tension in Newborn Infants With Severe Respiratory Illnesses
Authors: le Souëf Peter N. , Morgan Andrew K. , Soutter Linda P. , Reynolds E. Osmund R. , Parker Dawood 
Published: December 2021

Transcutaneous oxygen tesion (tcPO2), measured by two skin electrodes of different design, and arterial oxygen tension (PaO2), measured by an intravascular oxygen electrode, were continuously recorded for periods of six hours in 15 newborn infants with serious respiratory illnesses. Ten of the infants needed mechanical ventilation and three needed continuous positive airway pressure. One skin electrode had three microcathodes surrounded by a heated ring-shaped anode, and the other had a large heated cathode. The temperature of both electrodes was set at 44°C and they were calibrated in vitro.
The tcPO2 recorded by the electrode with the microcathodes was found to estimate PaO2 reasonably accurately for the whole six-hour duration of the study. The tcPO2 recorded by the electrode with the large cathode gave a similar estimate of PaO2. for three hours, but then tcPO2. often fell relative to PaO2. This fall was probably caused by skin changes at the electrode site.
For a variety of reasons, our results suggest that measurement of tcPO2. is unlikely to replace continuous intravascular measurement of PaO2. in infants with severe respiratory illnesses.
Transcutaneous Oxygen Monitoring in Aminophylline-Treated Apneic Infants
Authors: Peabody Joyce L. , Neese Allen L. , Philip Alistair G. S. , Lucey Jerold F. , Soyka Lester F. 
Published: December 2021

Transcutaneous PO2 (tcPO2) monitoring offers a new approach to the evaluation of drug effects. We investigated the effect of theophylline on ten premature infants with apnea. Theophylline was administered as aminophylline, 8 mg/kg per rectum every 12 hours for two doses and 4 mg/kg every 12 hours for a total of two or five days (short and long courses). The tcPO2, heart rate (beat-to-beat), and thoracic impedance were continuously monitored during each of three 4-hour study periods: 12 hours before theophylline administration, 12 hours after initiation of theophylline therapy, and 24 to 48 hours after discontinuing the drug's use. Plasma levels were measured by a radioimmunoassay developed in our laboratory. Polygraphic recordings were analyzed without knowledge of treatment for frequency of apneic spells, mean duration of apneas, total duration of hypoxemia (tcPO2 ≤40 torr), total duration of hyperoxemia (tcPO2 ≥100 torr), basal tcPO2, heart rate, and respiratory rate.
In each case during theophylline use, cardiorespiratory patterns were altered, respirations were more regular, apneic spells were reduced, PO2 was stabilized with less hypoxia and hyperoxia, and bradycardic episodes were decreased. There was considerable variation in the response of the ten infants and a significant difference in the frequency of return of symptoms between those receiving short-term therapy and those receiving the longer course.
Pneumococcal Polysaccharide Immunization in Infants and Children
Authors: Cowan Morton J. , Ammann Arthur J. , Wara Diane W. , Howie Virgil M. , Schultz Linda , Doyle Nancy , Kaplan Michael 
Published: December 2021

By using indirect hemagglutination antibody responses of normal infants and children to an octavalent pneumococcal vaccine that contained pneumococcal polysaccharide types 1, 3, 6, 7, 14, 18, 19, and 23 were evaluated. By 2 years of age, there was a significant rise in hemagglutination titers to all the polysaccharide types, except type 19. By 6 to 8 months of age, five of the eight types of pneumococcal polysaccharides tested resulted in up to 60% responders and, by 2 years, a significant number responded to all pneumococcal polysaccharide types in the vaccine. Pneumococcal polysaccharide type 3 resulted in a significant antibody response as early as 3 months of age, whereas type 19 never resulted in a significant antibody response. Except for type 3, it seemed that when the other pneumococcal polysaccharides tested produced an antibody response, the degree of response did not subsequently change significantly with increasing age.
The relationship of antibody response to age for pneumococcal polysaccharides is similar to that found for other polysaccharide vaccines. Based on the results of our study, we would recommend immunization with pneumococcal vaccine at 6 months of age with repeat immunization at 2 years of age, especially in high-risk children.
Enzymuria as a Marker of Renal Injury and Disease: Studies of N-Acetyl-βglucosaminidase in the General Population and in Patients with Renal Disease
Authors: Kunin Calvin M. , Chesney Russell W. , Craig William A. , England Albert C. , DeAngelis Catherine 
Published: December 2021

Urinary excretion of N-acetyl-β-D-glucosaminidase (NAG) was shown to be reproducible in random urine specimens when expressed as the ratio of NAG to milligrams of urinary creatinine. The enzyme/creatinine ratio in 815 healthy people was relatively constant throughout childhood and adult life except for the first two years after birth and in individuals 56 years or greater. High ratios in the young children may be explained by low urinary creatinine excretion probably related to small body mass and reduced glomerular filtration rate at this age. The ratio was increased in adult uremic patients and children and adults with a variety of neurologic and obstructive lesions of the voiding mechanism. The presence of bacteriuria did not appear to increase the ratio.
Significant enzymuria (&gt; 2 SD above the mean for age and sex) was detected in 38 of 81 children with well-characterized renal disease. Among patients with predominantly glomerular disorders there was a close relationship between activity of the disease and enzymuria. In patients with tubulointerstitial disease enzymuria was frequent even in the absence of proteinuria. One of the highest enzyme/creatinine ratios was observed in a child with cystinosis. These studies indicate that NAG enzymuria is a sensitive indicator of activity of renal disease and may prove to be a suitable screening test for significant renal disease or injury in childhood.
On the Terminology of Adolescent/Adolescence
Authors:   Committee on Adolescence
Published: December 2021

In 1972 the American Academy of Pediatrics stated that the purview of pediatrics begins in the period prior to birth when conception is apparent and continues to age 21 years. The Committee on Adolescence believes that the terminology used in all Academy materials should be changed to reflect the pediatrician's expanded role.
The words "infant," "child," "adolescent," and "young adult" connote different images which, in turn, provoke the age-specific response. The Committee on Adolescence recommends that all references to pediatric patients give proper semantic recognition to infants, children, and adolescents, and that the Academy adopt the policy that the term "child" should no longer be used for all age groups. The words "youth," "adolescent," or "adolescence" should be used when referring to those between puberty and maturity.
Health promotion program of the Academy
Authors: Robinson Saul J. 
Published: December 2021

This year the American Academy of Pediatrics has embarked on a health promotion program which will lead to a schedule of events for its participation in the Year of the Child—1979, as proclaimed by the United Nations. It will reach a climax in 1980 with the celebration of the 50th anniversary of the founding of the American Academy of Pediatrics. The motto the Academy has adopted for this is "The Academy of Pediatrics Speaks Up for Children."
A Committee under the chairmanship of Dr. Sprague Hazard, a member of the Executive Board, has organized a program which emphasizes four aspects of child health: accident prevention, nutrition, immunization, and health education.
Dose-Response Effect of Maternal Smoking
Authors: Garn S. M. , Shaw H. A. , McCabe K. D. 
Published: December 2021

Several questions have been raised about the effects of maternal smoking during pregnancy on the fetus, as measured by the dimensions of the newborn and the length of gestation. One question is the dose-response relationship, taking the extent of smoking into account. A second question relates to the "constitutional" explanation, i.e., that women who smoke have an intrinsic constitutional tendency to have small and premature neonates.1
Using data on more than 19,000 normal singlings from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Diseases and Stroke (NINCDS),2 a fairly linear relationship exists between the level of cigarette usage and various measures of size and prematurity.3
BAD RESULTS OF DRUNKEN COPULATION—REDISCOVERED?
Authors: Berkely Henry J. 
Published: December 2021

The lession taught by the study is of much practical interest in demonstrating that drugs, particularly of the ethereal alcohol series, may exert an undoubtedly deleterious influence upon the embryo during the period of gestation—an influence that in the human being should be carefully shunned if the future of the race is to be regarded.
The influences of alcohol upon the normal development of the foetus has been recognised and commented upon in various classic works (Plutarch et al). "A drunkard is unprofitable for any kind of good service," says Plato—and least of all in the begetting of children. Intemperance in pronounced degree on one side of the family usually results in mental feebleness of the children. When both parents are equally at fault, the progeny usually show well-defined brand-marks. It is a well-recognized fact that drunkenness at the moment of copulation is frequently responsible for the lowest forms of congenital idiocy.