bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONDUCTION VELOCITY OF MOTOR NERVES IN INFANTS AND CHILDREN
Authors: Dunn H. G. , Buckler W. St. J. , Morrison G. C. E. , Emery A. W. 
Published: December 2021

The literature concerning the measurement of conduction velocity in human motor nerves and its clinical applications is reviewed. The chief value of the test to the clinician lies in the demonstration of a peripheral neuropathy and in its differentiation from myelopathy and myopathy. It is pointed out that this investigation is often particularly useful in infants and children as it is an objective and relatively painless test requiring little co-operation from the patient.
Starting from approximately half the normal adult value at birth in full-term infants the motor nerve conduction velocity normally increases to the full adult level during the first 3 to 5 years of life. In premature infants it begins at a still lower level. This increase is of clinical interest and can be studied serially. There is also a particular developmental aspect in infants in relation to possible delays or disturbances of innervation or myelination.
The results of measurements of conduction velocity, chiefly in the median nerves, are reported in 45 "normal" infants and children and in 100 others who had a variety of neurological disorders. The rate was normal in all but one of 33 children with miscellaneous cerebral disorders, including nonspecific mental retardation, Down's syndrome (mongolism), D1 trisomy, hydrocephalus, and organic convulsive disorders. There was a distinct reduction in metachromatic leucodystrophy (2 cases), infantile amaurotic idiocy (1 case), and recurrent and chronic polyneuropathy (3 cases). In 4 children with acute neuronitis there were no demonstrable gross changes in conduction velocity during the first 2 months, while the diminished voltage and increased temporal dispersion of the action potential were more helpful early diagnostic features. Normal results were obtained in benign congenital hypotonia (10 cases), phenylketonuria (3 cases), and ataxia-telangiectasia (1 case). Five children with Friedreich's ataxia were examined and 2 of these had marked clinical fluctuations in the extent of their weakness suggestive of peripheral neuropathy. One of the latter was seen during an acute exacerbation of his weakness when he had a distinctly reduced nerve conduction velocity, and prolonged terminal latency from wrist to thenar eminence. The other was tested during a phase of relative well-being and had a normal conduction velocity but even more prolonged terminal latency than the first. The remaining children had a slowly progressive illness; all of them had normal conduction velocity, but one had just significantly prolonged terminal conduction time.
Somewhat slow conduction rates for the age appeared to be present in 1 of 6 infants with arthrogryposis multiplex congenita and in 4 of 14 with clubfoot below the age of 2 years, but the statistical significance of these deviations cannot yet be indicated.
The results are discussed, with particular emphasis on developmental aspects and the involvement of the peripheral nervous system in "dysmyelination" and demyelination.
COMMITTEE ON ACCIDENT PREVENTION
Authors:   COMMITTEE ON ACCIDENT PREVENTION
Published: December 2021

A study of the flammability of fabrics involved in wearing-apparel fires was conducted co-operatively by the American Academy of Pediatrics Committee on Accident Prevention and the National Fire Protection Association Committee on Wearing Apparel. A total of 124 fabric samples from 84 accident cases were tested. Of the 124 samples, 94 were of cotton exclusively, bearing out the previously known, but widely unrecognized, fact that cotton is the most flammable of fabrics. All met the currently established standards of normal flammability for fabrics. Other data obtained in the study included age of patients (a total of 84, of whom 41 were children and 7 were aged persons); type of garment (40% were pajamas, nightgowns, bathrobes, or housecoats); and source of ignition (more than half were stoves, heaters, furnaces, or fireplaces).
The relative flammability of fabrics are discussed, with attention to the fiber and the weight and weave of the fabric. Other factors influencing wearing-apparel fires include the type and style of garment; the age of the person involved; and the availability of a source of ignition. Legislation concerning standards of acceptability for the flammability of clothing fabrics are outlined, as are the standards of the National Fire Protection Association. The need for a public education program about the hazards of clothing fires is delineated. Current research in the field of chemical flame retardants for fabrics is outlined.
Possible steps for reducing clothing fires are listed, with special attention to the pediatrician's role.
Keeping Pediatricians in Practice
Authors: HUCHTON PAUL , NICKEY LAURANCE N. 
Published: December 2021

It seems that the topic "The New Pediatrics—Can It Be Practiced?" has become a very popular one for Letters to the Editor. We, who constitute a partnership composed of two young Board Pediatricians, would like to report our own happy experience, while taking exception to several statements made by Dr. Joel Berne of Brooklyn (Pediatrics, 34:297, 1964)
In the first place, we practice in an averagesized (350,000) city on the border, with an equal-sized sister city, Juarez, Mexico.
Hospitalization of Children
Authors: MEYER ROGER J. 
Published: December 2021

In response to the reportorial account of the International Symposium on Hospitalization of Children (Pediatrics 34:1, 1964) there are several points which deserve mention.
It is quite doubtful that any sudden or universal resort to other solutions to the needs for children presently hospitalized would be acceptable in this country. It would appear, however, that the present firmly entrenched system, particularly evident in children's hospitals in the great teaching centers of the country, demands vigorous revision if physicians in training and the patients they care for are to be involved in optimal pediatric care rather than meeting the specialistic rituals of the hospital.
Pyelonephritis in Premature Infants
Authors: BIASINI G. CARLO , CENCIOTTI LEONIDA , MONTAGUTI AUGUSTO , VULLO CALOGERO 
Published: December 2021

Dr. Wheeler's Commentary and the paper by Sweet and Wolinsky in the June Pediatrics which stress once more the problem of pyelonephritis in infants, prompt us to report the results [See Table in source PDF] of a survey on pyelonephritis incidence among premature infants discharged from our small nursery.
Our survey involves patients who were admitted to the nursery between March, 1962, and May, 1963; during this period we discharged 43 premature infants with birth weight ranging from 1,040 to 2,500 gm. One of these died at home owing to causes unknown to us; another one was not taken for control.
Letters to the Editor
Authors: SWEET AVRON Y. 
Published: December 2021

To my knowledge Dr. Biasini et al. have presented the only data dealing with the relative frequency of urinary tract infections in full-term and premature infants. We too are engaged in prospective studies which may shed light on this question but the answer will be some time in coming. Until we know more, I would agree that prematures should be suspect and routinely investigated after the third week of life. Studies also are needed regarding the maternal role in this problem, although we have data which tend to incriminate the nursery rather than the mother.
The findings of Dr. Biasini and his colleagues again point out the late appearance of the illness. This time factor may be very important. Perhaps it reflects the decay of an immunological protective material gotten from the mother.
The Early Diagnosis of Congenital Abnormalities
Authors: MCINTOSH RUSTIN 
Published: December 2021

This is a gem of a book—small, compact, sparkling, a bit expensive for its size. It reflects the growing interest in congenital defects and the realization that early identification is the key to successful correction in an increasing number and variety of anomalies.
The author, consultant pediatrician to Alder Hey and Olive Mount Children's Hospitals in Liverpool, addresses himself to obstetrician and pediatrician alike, placing special emphasis on the conditions which can be recognized or suspected during the four weeks preceding birth and in the neonatal period.
Diseases of Medical Progress
Authors: SISSMAN NORMAN J. 
Published: December 2021

The material of this volume, subtitled "A Contemporary Analysis of Illness Produced by Drugs and Other Therapeutic Procedures," first appeared in print as one of the series, Medical Progress, in the New England Journal of Medicine in 1956. Dr. Moser then expanded it into a monograph published in 1959. Now, he has enlisted the collaboration of twelve of his specialist colleagues in the Army Medical Corps to produce a greatly enlarged treatise.
The book retains the format of the Medical Progress article.
ON AN "IMPRACTICAL" PAPER
Authors: McKAY R. J. 
Published: December 2021

The article on "Appearance and Localization of a Nerve Growth-Promoting Protein during Development" by Winick and Greenberg, which appears elsewhere in this issue of PEDIA-rRICs, is one of a type which tends to bring fire into the eyes of those of our readers who feel that there is an improper balance between "scientific" and "clinical" papers in this journal. As one who has defended the thesis that PEDIATRICS should consciously serve its readers who are practitioners as well as those who are academicians, it seems worthwhile to comment briefly on the reasons for recommending publication of this article.
First, I was favorably impressed by the merits of the manuscript from the purely editorial point of view:
CONGENITAL TOXOPLASMOSIS WITH PLACENTAL INFECTION IN MONOZYGOTIC TWINS
Authors: Glasser Lewis , Delta Basil G. 
Published: December 2021

An instance of congenital toxoplasmosis affecting identical twin male infants is reported.
This is the first recorded prospective diagnosis of congenital toxoplasmosis discovered by chance histologic observation of the organisms in the placenta. The placental findings enabled an early detection of the disease through close follow-up of the asymptomatic infants. The disease became manifest in both infants simultaneously at the age of 7 months and had a similar course.
Placental toxoplasmosis means fetal infection. Prompt treatment of the infant, even though no symptoms are apparent, may prevent or reduce the degree of permanent oculocerebral damage.
THE EFFECT OF IMMATURITY AND PRENATAL ASPHYXIA ON THE LUNGS AND PULMONARY FUNCTION OF NEWBORN LAMBS: THE EXPERIMENTAL PRODUCTION OF RESPIRATORY DISTRESS
Authors: Reynolds E. O. R. , Jacobson H. N. , Motoyama E. K. , Kikkawa, Y. , Craig J. M. , Orzalesi M. M. , Cook C. D. 
Published: December 2021

1. The effect of immaturity on the lungs and pulmonary function of newborn lambs was assessed by delivering and observing 13 animals of varying gestational ages. In lambs of approximately 125-129 days gestation changes closely resembling those of human respiratory distress syndrome developed without asphyxia. These changes consisted of retraction of the chest wall, poor gas exchange, grossly liver-like lungs, reduced pulmonary surface activity, and, on histological examination, severe atelectasis, alveolar necrosis, and hyaline membranes.
2. Similar changes were found in 4 of 6 lambs subjected to severe prenatal asphyxia lasting for up to 4 hours which were between approximately 130-136 days gestation but not in three of four comparable control animals.
3. Prolonged prenatal asphyxia was followed by changes suggesting respiratory distress in only 1 of 6 lambs above 136 days gestation. One further lamb at 140 days gestation, acutely asphyxiated to the point of cardiac arrest, developed severe changes.
4. It is postulated that the experimental disease and the syndrome seen in the human infant are produced by similar mechanisms, and that the influence of prematurity is more important than that of asphyxia.
IDIOPATHIC EDEMA AND HYPERALDOSTERONURIA: POSTURAL VENOUS PLASMA POOLING
Authors: Fisher Delbert A. , Morris Manford D. 
Published: December 2021

A female adolescent with onset of the syndrome of "idiopathic edema and secondary hyperaldosteronuria" is reported. Investigations conducted over a 28-month period documented hyperaldosteronuria and an increased aldosterone response to salt restriction. The usual diurnal variation of salt and water excretion was observed. Recumbent posture, spirolactone or sympathomimetric drugs were observed to produce salt and water diuresis.
Recumbent renal function tests were normal; erect posture, however, produced a marked decrease in sodium excretion and in PAH and creatinine clearance. Immediately exchangeable plasma volume (30 min I131 albumin space) increased 38% between 8:00 A.M. and 6:00 P.M. during erect posture. An "arterial anemia" pattern of vascular response to erect posture was observed in tilt table studies; diastolic pressure increased normally but pulse rate increase was excessive. Blood pressure response to infusion of exogenous angiotensin II was normal; that to norepinephrine infusion seemed abnormal and was associated with a rather marked decrease in pulse rate and increase in pulse pressure suggesting mobilization of "sequestered" blood volume. Four-hour recumbent excretion of catecholamines and the 4-hour excretion response of norepinephrine to erect posture seemed normal. Partial elimination of the edema occurred with chronic sympathomimetic drug therapy.
It is concluded that this unusual syndrome probably occurs secondary to a defect in peripheral venous structure or autonomic vasomotor innervation leading to excessive blood volume pooling in the lower body, excessive reduction in renal blood flow and glomerular filtration rate, and hyperaldosteronuria. Consequent retention of salt and water with increase in plasma volume and dependent edema ensues. Sympathomimetic drug therapy may enhance peripheral venous tone and produce clinical improvement.
DIAGNOSIS AND TREATMENT: ACUTE RENAL FAILURE
Authors: Holliday Malcolm A. 
Published: December 2021

ACUTE RENAL FAILURE is an uncommon emergency which faces pediatricians. It is usually easy to recognize. The management in the early phase is critical to the survival potential of the patient. The purpose of this review is to cite the causes, characteristics, and principally the management of acute renal failure.
Renal failure is defined as a state in which there is not sufficient kidney function to prevent the development of severe uremia or to maintain plasma electrolyte values in a range compatible with ordinary activities. Clinically the condition is associated with mental confusion, stupor, and frequently convulsions. Persistent hiccoughs, irregular respirations, and muscle cramps also may occur. Usually though not always, there is obvious oliguria. Since urine flow is ordinarily but 0.2-2,0% of glomerular filtration rate, and since glomerular filtration rate reduction to 5-10% may be associated with uremia, it is possible to have renal failure without oliguria. It is also possible to have physiological oliguria (&lt; 300 ml per square meter) in response to rigid water restriction that is not related to renal failure. Hence, the term must be defined in terms of its effect on plasma composition rather than in terms of urine flow.
The presence of certain clinical conditions known to result in acute renal failure should alert the physician. These include: nephrotoxie agents; hemoglobinuria or myoglobinuria; shock with anoxic damage; acute, diffuse renal disease; acute dehydration in patients with chronic advanced renal disease; and acute obstructive uropathy. Nephrotoxic agents, hemoglobinuria, and shock all result in acute tubular necrosis, and recovery depends upon the capacity of the nephron to regenerate on an intact basement membrane.
Massive Gastrointestinal Hemorrhage in the Newborn Infant
Authors: STANLEY-BROWN EDWARD G. , STEVENSON STUART S. 
Published: December 2021

During the nine-year period from 1955 to 1964 we have cared for eight newly born infants with massive gastrointestinal hemorrhage. No patient died, none was operated upon, and all eight required blood replacement by transfusion. In each case there was hematemesis as well as tarry stools with the onset of bleeding as early as 24 hours of age to as late as 5 days. Each patient received Vitamin K medication and none had hematuria, purpura, or any evidence of bleeding from sites other than the gastrointestinal tract.
Brayton suggests that peptic ulceration of the duodenum or stomach is probably the actual cause of many gastrointestinal hemorrhages which have heretofore been classified as idiopathic.
Human Milk and Breast-Feeding
Authors: HUDSON BARBARA W. 
Published: December 2021

It was refreshing and reassuring to read an article on human milk and breast-feeding (Pediatrics, 34:837, 1964), after thumbing through eleven advertisements for artificial feeding in the same issue.
The joy of breast-feeding is fast becoming a lost art in our modern culture. Breast-feeding is a natural and unique system of supply and demand which best serves mother and baby. Breast-feeding has not become complicated, only our attitudes toward it have created problems.
PROSPECTS IN PRENATAL PHYSIOLOGY, DIAGNOSIS, AND TREATMENT
Authors: DAWES G. S. 
Published: December 2021

A GROUP of papers in this issue summarize new and very interesting advances in the treatment of erythroblastosis fetalis and in our understanding of the pathophysiological processes which lead to death from this condition. They also mark a new technical feat; for the first time it has been possible to treat, and to treat successfully, the human infant in utero for a hitherto fatal condition. It is interesting to follow the processes by which these advances in knowledge have developed, and to survey the wealth of new information on many different problems which has accrued.
Diagnosis precedes treatment, and the first need was to obtain a better forecast of the rate of development of the disease in Rh-isoimmunized pregnancies than the maternal antibody titer.
SYMPTOMATIC HYPOGLYCEMIA, VISCERAL FATTY METAMORPHOSIS, AND AGLYCOGENOSIS IN AN INFANT LACKING GLYCOGEN SYNTHETASE AND PHOSPHORYLASE
Authors: Parr Justin , Teree Thomas M. , Larner Joseph 
Published: December 2021

An infant 4 months of age had severe hypoglycemia, acidosis, and hepatomegaly. She died with what was thought to be a glycogen storage disease. Glycogen was absent from liver, skeletal muscle, kidneys, and adrenal glands. Enzymatic assays of liver and muscle revealed a marked deficiency of glycogen synthetase and phosphorylase. Marked fatty metamorphosis was present in liver and kidneys. The clinical, pathological, and biochemical findings are correlated.
Three siblings died in early infancy. All presented with apnea, coma, and central nervous system signs. Two were examined postmortem, and fatty metamorphosis of liver was a common finding.
Correlations between the three siblings and the infant 4 months of age are suggested.
LAPAROTOMY FOR RECTAL BLEEDING
Authors: Shandling Barry 
Published: December 2021

THE PROBLEM of the infant or child with rectal bleeding is familiar to all clinicians. The term "rectal bleeding" has through common usage come to mean the passage of blood from the rectum–whether it be bright red or dark, unrelated to, on the surface of, or mixed with the stool. Anal or gastrointestinal bleeding would be a more accurate term, but for the purposes of this paper rectal bleeding will be used in its widest connotation. This study was undertaken to attempt to evaluate the place of surgery in the investigation and treatment of this perplexing condition.
The literature is surprisingly barren of any series of this kind. Several authors of textbooks on pediatric surgery do not even mention the possibility of a fruitless abdominal exploration. Others appear to hazard a guess. However, Nixon and O'Donnell state that probably one-third of patients with rectal bleeding never have the cause diagnosed. White and Dennison give 20% as a likely figure. Gross, in a small review of 65 patients presenting with rectal bleeding as a diagnostic problem, could find no cause for the bleeding in 18, i.e., 27%. Of the 18 patients who were operated upon, only 4 had negative laparotomies. Nevertheless, he states that in an astounding proportion of cases the cause for the rectal bleeding is never found, even after extensive investigation and laparotomy.
Macbeth in a recent paper refers to the difficulties in gathering a series of cases with available methods of coding. Fortunately, at The Hospital for Sick Children, Toronto, case notes are coded in such a way that the histories of patients with rectal bleeding are readily available.
GENETIC ORIGIN OF SOME SEX DIFFERENCES AMONG HUMAN BEINGS
Authors: Childs Barton 
Published: December 2021

Sexual reproduction helps to ensure the survival of species by providing opportunities for new combinations of chromosomes in individuals. Organisms have evolved means to accomplish this end by establishing special sex-determining chromosomes which must contain the genes which decide the reproductive attributes of the individual. This decision sets in motion a train of events determining many characteristics related to and stemming from the reproductive sex of the individual which, taken in the aggregate, formulate much of his or her role in life as a male or female. Differences between the sexes are thus created which sometimes appear to be unrelated to reproductive functions, but which are traceable ultimately to them, and some of these differences might represent a hazard to one or other sex, due either to biological or cultural inequalities.
Though there are occasional errors and imperfections of sex determination, the mechanism is on the whole a good one and even unsophisticated people are seldom unsure or imprecise in the diagnosis of sex among human beings. But establishment of the sex chromosomes in the forms they have taken in various organisms has resulted in certain consequences which, though they might be beneficial in some instances, certainly contribute to inequalities between the two sexes in ways not necessarily related to the reproductive aspects of sex. The disparity in size between the X and Y chromosomes, for example, means that the homogametic sex (female) is diploid with regard to many loci, while the heterogametic sex (males) must be always haploid. If these chromosomes contain genes which control functions apart from aspects of reproductive sex, even though these be compensated, the genes will be making contributions to aspects of maleness and femaleness which are not accommodated in the usual, practical definition of sex.
Response and Responsibility
Authors: GANELIN ROBERT S. 
Published: December 2021

I find the letter of Dr. Stowens which was published in the February issue of Pediatrics (35:355) an extremely disturbing one; not because of its defense of original thinking which is being followed by appropriate, controlled observations, but for its petulant rebuke of an honest request for objective information.
It is true that the inquiring physician will make observations regarding poorly understood illnesses and develop therapeutic approaches therefrom. The person who stops at this point, however, deludes himself regarding his objectivity and becomes a menace to his patients.
Urethral Lesions in Infancy and Childhood
Authors: PERLMUTTER ALAN D. 
Published: December 2021

Convincing arguments for the usefulness of micturition cysto-urethrography in the study of childhood urinary tract disorders are presented in this excellent monograph. Considerable effort and thought have obviously been given to analysis of data which have been derived from the examination of a large group of children. The bibliography is extensive and current.
Some aspects of the technique of performing micturition cysto-urethrography might be questioned. For example, it is possible and useful to do a residual urine determination prior to cystography, with a co-operative child, and this should be attempted routinely.