bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEPHROTIC SYNDROME IN EARLY INFANCY AS A MANIFESTATION OF CONGENITAL SYPHILIS
Authors: Papaioannou Angelos C. , Asrow Gertrude G. , Schuckmell Natalie H. 
Published: December 2021

The case of a 10-week-old infant with a nephrotic syndrome due to congenital syphilis is presented.
Negative prenatal history for venereal disease may be misleading. Therefore, a renewed emphasis of congenital syphilis as an etiologic factor of the nephrotic syndrome in early infancy is proposed.
Protein in serum fractionation by paper electrophoresis may be of assistance in the differentiation of a primary or secondary renal disease.
Early diagnosis of congenital syphilis as a cause of the nephrotic syndrome and specific antisyphilitic therapy will result in prompt remission of the clinical manifestations of this disease.
CONCENTRATION OF COPPER IN SERUM OF CHILDREN WITH SCHIZOPHRENIA
Authors: Bakwin Ruth Morris , Mosbach Erwin H. , Bakwin Harry 
Published: December 2021

Levels of copper in serum were measured in the blood of 91 schizophrenic children using the technique of Angel et al. No difference from the levels in control children was found.
Children 5 to 17 years of age have significantly higher levels of copper in serum than normal adults.
PARASITISM BY CAPILLARIA HEPATICA
Authors: Calle Simón 
Published: December 2021

A case of genuine infection with Capillaria hepatica in a child is presented. This is the eighth case to be reported, the fourth to be diagnosed by liver biopsy, and the second case in which the patient is still living.
The literature dealing with the subject is reviewed with a brief summary of the cases on record.
The nature of infection by Capillaria hepatica, its pathogenesis, its etiology and its significant pathologic anatomy are discussed in the light of recorded studies in man and in animals serving as natural hosts of the parasite.
THE CARDIAC SILHOUETTE IN NEWBORN INFANTS: A CINEMATOGRAPHIC STUDY OF THE NORMAL RANGE
Authors: Burnard E. D. , James L. S. 
Published: December 2021

The mediastinum and heart of the newborn baby was studied by a cinematographic method and compared with the roentgenogram. In cinematographs of the resting baby the transverse diameter of the heart shadow varied only slightly with respiration and cardiac cycle. The deduction that the roentgenogram of the quiet baby would give a reliable estimate of the size of the shadow was borne out by reasonable agreement in the measurement of transverse diameter by the two methods.
The heart of the crying baby was broadest during the inspiration before a cry. Even so, transverse diameter was rarely greater than when the baby was at rest.
The roentgenographic changes on crying were studied in relation to respiratory mechanics. They could be well explained by effects, on venous return to the heart, of conditions which resembled the Mueller and Valsalva maneuvers. Two varieties of appearance were mentioned where the phase of the respiratory cycle could be wrongly inferred in the roentgenogram from the state of lung aeration and level of diaphragm. An interpretation based on them, of changes in size of the silhouette in relation to deep breathing in the newborn infant, would be misleading. Explanation of big differences in terms of anatomic change alone without reference to the large contrasting effects of the Mueller and Valsalva may have helped discredit the roentgenogram of the heart in the newborn infant.
Evidence for the prevailing opinion that variations in the thymus interfere to an important degree with the conventional measurement of transverse diameter of the heart is open to question. Reasons are given for the opposite view.
BRAIN ABSCESS IN CONGENITAL HEART DISEASE
Authors: Matson Donald D. , Salam Maria 
Published: December 2021

In any patient with congenital cardiovascular disease, particularly if he is cyanotic, the development of focal neurologic abnormalities or evidence of increased intracranial pressure must be considered as indicative of the possible presence of a brain abscess until proved otherwise. This is true whether or not there is any suggestion of septicemia, meningitis or focal infection elsewhere in the body. Cultures of the blood and cerebrospinal fluid are usually negative.
The common denominator among patients with congenital heart disease and brain abscess is a central right-to-left shunt, which in the present series has always been accompanied by cyanosis, polycythemia and clubbing. In children under 2 years of age cerebral infarction due to thrombosis is much more common as a cause of neurologic complication than is abscess.
In the presence of abscess, the condition is usually of 7 to 10 days' duration and of gradually increasing severity. The cerebrospinal fluid shows some increase in pressure and may frequently show mild increase in protein content or leukocyte count. Roentgenograms of the skull are normal, unless the abscess is of long-standing duration. Contrast studies such as angiography or pneumoencephalography may be urgently indicated if clinical localization is doubtful. Electroencephalography has consistently shown focal abnormality in the form of high-voltage slowing. Treatment consists of repeated aspiration in deep-seated and poorly encapsulated lesions supported by intensive antibiotic therapy, or aspiration followed by total excision in superficial and well-encapsulated abscesses.
To prevent neurologic complications in this type of anomaly optimum treatment is obviously prophylactic total anatomic correction of the right-to-left shunt. If a brain abscess has occurred and has been successfully treated, the earliest possible anatomic correction of the cardiac anomaly is still indicated.
This paper records the experience of one neurosurgical service with 13 cases of brain abscess in patients with cyanotic congenital heart disease in a 13-year period. Six of the 13 patients in this series had successful surgical treatment. While these results are poor, they have improved remarkably with earlier recognition and treatment. It is of utmost importance, therefore, that all physicians be aware of the frequency of brain abscess in congenital heart disease and suspect it early so that treatment can be carried out before there is irreversible brain damage.
STANDARDS, STETHOSCOPES, STEROIDS AND STATISTICS
Authors: Feinstein Alvan R. 
Published: December 2021

The different results of recent studies of the treatment of rheumatic fever seem to be due not to therapeutic effects but to the inclusion in compared groups of different percentages of patients with inherently different cardiac prognoses. The homogenization of heterogeneous groups has occurred either through insufficient attention to the details of cardiac classification or through inadverent use of different criteria for the classification. The situation has been aptly described by Hill, who wrote, "the essence of a successful controlled clinical trial lies in its minutiae—in a painstaking, and sometimes very dull, attention to every detail." Until the deficiencies in some of these "minutiae" are remedied, many contentions remain unproved.
Massive penicillin treatment, as compared to none, has not demonstrably reduced heart disease. Since massive treatment was not tested against an ordinary streptococcal-eradicating dose of penicillin, the advantages claimed for massive treatment, even if valid, would not pertain to use of the latter regimen. With regard to anti-inflammatory therapy, steroids have been unequivocally superior to salicylates only in temporarily suppressing the acute, overwhelming carditis of a small percentage of patients who are moribund, but even here, steroids have not affected ultimate cardiac status. Such severely ill patients are uncommon. For most patients with rheumatic carditis, the three most satisfactory trials of steroids versus salicylates have indicated a two-to-one vote against any superiority for steroids. In the minority report, the patient population differed significantly from that of the other two reports, and its different results probably arise from this feature. It still remains to be shown convincingly that steroids, salicylates, or both produce more permanent cardiac benefit in most instances than symptomatic therapy alone.
For the practicing clinician, the preceding discussion is intended as a guide for use in reviewing the evidence and making his choice of treatment. For the investigator who performs therapeutic trials, it is intended to indicate the subtle details which are required for a successful study. For both, it should recall the old admonition of an investigative clinician: "Unless prognosis springs from solid diagnostic roots, the tree is unstable."
Letters to the Editor
Authors: SILVERMAN WILLIAM A. 
Published: December 2021

The recommendations for the design of newborn nurseries recently made by the Committee on Fetus and Newborn resulted from the efforts of members of the Committee and well-qualified consultants to evaluate the present state of knowledge concerning the problems in the control of infections in newborn infants. During the deliberations the Committee was painfully aware of the fact that, with respect to many aspects of this subject, there was a dearth of acceptable experimental evidence. Under these circumstances the group was obliged to make educated guesses.
Doctor Harvie points out that the recommendations of the Committee leave "an impression of finality."
Accidents from Doors
Authors: BASS LEE W. 
Published: December 2021

The screen door shown in the Figure is the cause of frequent preventable accidents occurring especially during the summer months. The accident usually involves a young child who is running out the doorway and as the door slams shut, puts a hand out to stop it. If enough force is exerted, the hand, arm or possibly head and neck will crash through the thin glass. The results may be either mild or severe lacerations of the arm; most of the trauma may be incurred when the child withdraws the arm back across the jagged glass. Laceration of the neck area may be life threatening.
The doors are built with two or three sections and the sections are filled with either glass or screen fillers.
The Pathology of Cerebral Palsy
Authors: LOW NIELS L. 
Published: December 2021

Anyone writing about cerebral palsy, whether he is dealing with clinical, therapeutic or pathological aspects, is beset with the same difficulties: He is not writing about a disease, not even about one well defined syndrome. Therefore, he must write about a vague subject and must by necessity treat many unrelated disorders.
Dr. Towbin has organized his text well, and he has divided the material into clear and practical chapters. A valiant effort is made to correlate etiology with pathology. The author has emphasized that one single causative factor, anoxia, can cause different pathologic responses but also that different etiologic factors can cause a similar pathologic end-result. Although case histories are given to support anoxia as the presumed etiology in many cases, definite proof that anoxia caused the damage is lacking.
STUDIES IN THE PHYSIOLOGY OF SWEATING IN CYSTIC FIBROSIS
Authors: Sibinga Maarten S. , Barbero Giulio J. 
Published: December 2021

With repeated methacholine (Mecholyl) chloride stimulation, experimental sweat gland fatigue was induced in 21 control subjects and 19 patients with cystic fibrosis of the pancreas. The relationship between rate of secretion and concentration of sodium in sweat was studied in these experiments. A concept of two different types of sweat gland fatigue was developed, based on the anatomic parts of the sweat gland.
Sweat glands of patients with cystic fibrosis are subject to fatigue much like normal glands. An earlier decline in sweating rate during the experimental sweat gland fatigue was observed in patients with cystic fibrosis, showing a greater sensitivity to intense stimulation.
Although greater variability in concentration of sodium was observed in patients with cystic fibrosis undergoing a sweat gland fatigue experiment, the over-all fatigue response in both groups was comparable. Tubular function was not interpreted to be abnormal, but an abnormality in the coil seems to be a possible site for the secretory defect in cystic fibrosis. Under intense stimulation the sweat of patients with cystic fibrosis varies with factors that operate in the normal sweat gland. Sweat glands of patients with cystic fibrosis, however, are more unstable in relation to concentration of sodium than are normal sweat glands.
PRESIDENT'S MESSAGE
Authors: Wheatley George M. 
Published: December 2021

SEVERAL months ago I had the privilege of visiting Winnipeg, in Saskatchewan, Canada, at the invitation of the Academy Chapter there, to address the 52d annual meeting of the Children's Hospital. My talk at the meeting was an effort to answer the question: "What lies ahead for children's hospitals?" I know that many pediatricians and others, much more experienced in this complex subject than I, are seeking the answer. Perhaps exposing you to some excerpts from my Winnipeg talk will stimulate discussion of the future of this important factor in child health.
The progress made in the care of children in general hospitals and the strengthening of pediatric service in university medical centers raises the question: "Do we need special hospitals for children?" Dr. J. W. Gerrard, Professor of Paediatrics at the University of Saskatchewan, in a recent letter to me sums up the case for children's hospitals very well. He says:
1. Children's hospitals set the standards of treatment, care and investigations for routine pediatric problems. There is no doubt, for example, that acute infantile gastroenteritis is handled very much more efficiently in a children's hospital by pediatricians than in a general hospital where children are cared for, possibly by pediatricians, but more probably by general practitioners. Not only will the treatment be better in the children's hospital, but the children's hospital will be to an advantage because its services, and in this particular, its biochemical services, will be tailored to meet the needs of children; analyses will be carried out on small amounts of blood, not on the large quantities required by laboratories dealing mainly with adults.
2. A children's hospital is advantageous because not only do perplexing problems, but skilled pediatricians as well, tend to gravitate towards it, and there is always the opportunity, should the need arise, to call in colleagues in consultation.
3. In a children's hospital, common problems tend to be grouped together, e.g., children with leukemia, heart disease, nephrosis and so on, providing the opportunity for pediatricians to specialize in a particular field; they then gain experience which helps to raise the standards of treatment and research in these fields.
4. A children's hospital provides students and interns with a chance to review all or most pediatric problems within a relatively short span of time, so that when they go out into practice they will be able to recognize the rare and the strange, for they will be seeing diseases which they have already had a chance to study and treat.
5. Children's hospitals provide excellent centers for the dissemination of new knowledge to those in practice, particularly at so-called "refresher courses," and in this way keep those in practice up to date.
PRIMARY FAMILIAL XANTHOMATOSIS WITH INVOLVEMENT AND CALCIFICATION OF THE ADRENALS
Authors: Wolman M. , Sterk V. V. , Gatt S. , Frenkel M. 
Published: December 2021

THIS PAPER deals with the description of clinical, pathologic, histochemical and biochemical findings in two cases of generalized xanthomatosis with calcification of the adrenals. The infants were siblings of a previously described patient,1 and and the findings warrant the conclusion that the disease process was identical in all three.
The study of these cases and review of pertinent literature indicates that primary xanthomatosis (idiopathic lipidosis with deposition of cholesterol and triglycerides) is a metabolic disease entity that is independent of the granulomatous process called histiocytosis X, or eosinophilic xanthomatous granuloma. It will be shown in the discussion that primary xanthomatosis may occur in various forms, and that the form described in this paper is a rare but distinct clinical and pathologic type. This type differs in the distribution of lesions from other types of primary xanthomatosis, such as the type of cerebral xanthomatosis described by van Bogaert, Scherer and Epstein, and the type associated with involvement of bones that sometimes produces the Hand-Schüller-Christian syndrome.
For reasons that wiil be clarified in the discussion, the term "Hand-Schüller. Christian disease" is not adopted in this paper. The term "Hand-Schüller-Christian syndrome" indicates a well-known syndrome with exophthalmos, diabetes insipidus and peculiar bone changes. The term "primary xanthomatosis" describes a primary (i.e., idiopathic) storage process in which triglycerides and cholesterol are deposited in various tissues.
CASE REPORTS
Case 1
Family History: The two infants described in this article and the infant previously described1 were female siblings born to closely related parents. The father and mother, both Persian Jews, were cousins.
HYDROCEPHALUS AND OBSTRUCTION OF THE SUPERIOR VENA CAVA IN INFANCY
Authors: Hooper Reginald 
Published: December 2021

The clinical manifestations of obstruction of the superior vena cava are discussed, and the infrequent occurrence of this condition in childhood is noted. A case is reported in which obstruction of the superior vena cava caused early enlargement of the head, and the condition was diagnosed when the child was referred for management of hydrocephalus. Increased intracranial venous pressure causes cerebrospinal fluid to be produced in excess of absorption. When this occurs in early childhood, enlargement of the head occurs without manifestations of cerebral dysfunction.
The management of this condition and the intracranial complication is discussed.
PRACTICE OF PEDIATRICS
Authors: Wishik Samuel M. 
Published: December 2021

WITH THE RECENT INTEREST in re-evaluation of the practice of pediatrics, it is gratifying to obtain some tangible evidence concerning the demands that are being made upon practicing pediatricians and information on the effectiveness of certain aspects of their work. Such documentation is contained in the fine, thoughtful report on health supervision of young children in California, recently issued by the Bureau of Maternal and Child Health of the Department of Public Health of the State of California.*
The comprehensive report presents the combined findings of a child health survey made in 1956 with Children's Bureau support and of other studies on the status of health supervision of infants and preschoolage children in California.
Infantile Colic: An Evolutionary View
Authors: Levin S. 
Published: December 2021

May I communicate an idea unaccompanied by data, but perhaps justified by the following Biblical text: "Remember the days of old, consider the years of many generations." Deuteronomy, 32:7
How old is man? If recent finds in East Africa can be substantiated, tool-using man is not a half-a-million, but nearer to 2 million years old. Homo is certainly 75,000 generations, and perhaps double that since the time that he branched off from the primate stem.
In Reply: Circumcision and the Tribe
Authors: Spock Benjamin 
Published: December 2021

1. If I could only find the secret of how to know for sure what is best for children's welfare, I too could write more authoritatively. Meanwhile I'm glad there are parents to share the responsibility with. They antedated all the child care professions by thousands of years, and most of them have kept their feet on the ground during the shifting professional doctrines of the twentieth century.
2. I gave what I thought were several good reasons for circumcision.
THE PROPHYLAXIS OF ALLERGIC DISEASE IN INFANCY
Authors: Glaser Jerome 
Published: December 2021

Whatever the personal feelings of anyone regarding the method of prophylaxis of allergic disease just reviewed may be, its importance is such that it deserves rechecking by unprejudiced observers. Although these studies cover a period of over 25 years of personally observed patients, it should not take nearly that long to determine whether or not potentially allergic infants, as here defined and treated in the manner discussed, will show a lessened incidence of atopic dermatitis than a control series. It is not necessary to show that infants with atopic dermatitis are more likely to develop subsequent allergic disease than infants who have not had atopic dermatitis, as this is well documented and the verification of this portion of the study is not so urgently required. Practically speaking, the most desirable type of study can not well be done by a co-operative investigation involving many physicians and does not lend itself easily to a clinic study except possibly in one particularly organized for that purpose. The infants must be followed from birth by a pediatrician with a genuine interest in and knowledge of allergy. He should be particularly familiar with the differential diagnosis between atopic dermatitis, which is an allergic disease, and seborrheic dermatitis, which is not an allergic disease, although both are called lergic disease, although both are called eczema, since these are so frequently confused in early infancy.
In conclusion, one may state that the pediatrician, through applied science, has solved the problem of adequate nutrition of the human infant and in addition the infant can now be successfully protected against many serious infectious diseases. However, in the light of present day knowledge this is not enough. The immunologic status of the infant with respect to allergy must also be considered. For this purpose human breast milk is doubtless the ideal food. If the trend away from breast feeding cannot be reversed, then the use of a well-tolerated nutritionally adequate substitute for the customary cow's milk feeding of the newborn infant, which has less serious consequences immunologically, must be considered. The increased cost of such feeding over cow's milk cannot be regarded as a legitimate reason for not doing this in view of the suffering and economic loss that may be incurred in some infants as a result of possible sensitization to cow's milk. At present soy bean milk appears to be a suitable and practical substitute, although it is possible that eventually other preparations yet to be discovered may prove to be equally or more satisfactory.
Hyperbilirubinemia of the Newborn and Prenatal Administration of Vitamins
Authors: D'Adesky Raymond G. 
Published: December 2021

It is now admitted that hyperbilirubinemia suffices to produce kernicterus in the neonate. Therefore, the prophylaxis of kernicterus parallels that of hyperbilirubinemia. Any factor thought to favor or induce hyperbilirubinemia commands full investigation. Among the different pharmacologic agents responsible for the production of hyperbilirubinemia, the administration of large doses of vitamin K or its precursors to the newborn has been incriminated in many instances.
Recently, I have come across two cases in which the ingestion by the mother of a multi-vitamin preparation containing 0.5 mg of vitamin K, daily up to the morning of delivery, was followed by the development of hyperbilirubinemia high enough in one case to necessitate two exchange transfusions.