bluuebunny/crossref_metadata_2025_split huggingface dataset:
Institutional Care, Foster Home Care or Family Care?
Authors: Oyemade Adefunke 
Published: December 2021

Three case histories and an account of an epidemic in a home have highlighted a few of the physical, social and mental problems encountered by motherless babies in their different environmental settings. The institutionalized child may have a normal physical development, but becomes mentally retarded because of lack of social stimulation and individual attention. On the other hand, a motherless baby reared in an environment with poor sanitation and inadequate diet may have poor physical but normal mental development. The study also showed that a child can have normal mental, social and physical development if the right choice of foster parent is made. It is also revealed that long-term, successful foster-home placement does not automatically lead to adoption, and feelings of frustration can arise from regarding a foster-home child as one's own without the legal support usually provided in the Adoption Laws.
As demonstrated by the epidemic described in this study, the course of a disease can be explosive in an institutional setting. This can be related to the quality of staff who have no knowledge or training in the causes of and modes of transmission of disease.
The Bowel Bag: A Sterile, Transportable Method for Warming Infants With Skin Defects
Authors: Sheldon Roger E. 
Published: December 2021

A simple, easily available method can simultaneously protect against heat loss, drying and bacterial contamination in newly born infants with skin defects. The method applies to infants with omphalocele, gastroschisis, meningomyelocele, epidermolysis bullosa congenita letalis, severe hydrops with skin tears and the harlequin fetus among others.
Typically in the past, the child with one of these defects was packed in saline-soaked gauze in an effort to prevent drying.
Racemic Epinephrine in Croup (continued)
Authors: Dardick Kenneth R. 
Published: December 2021

Gardner et al. failed to show the effectiveness of nebulized racemic epinephrine in the treatment of what they called "croup." Perhaps their study failed as a result of their definition of croup. Croup (subglottic edema) and epiglottitis are each distinct clinical entities by anatomy, etiology, pathophysiology, and, therefore, therapy.
It will be interesting to see the fate of the null hypothesis if the data are re-examined from this perspective.
Chelation Therapy in Children With Subclinical Plumbism
Authors: Chisolm J. Julian 
Published: December 2021

Findings in a recent study1 are consistent with the hypothesis that the total body lead burden is divided among three major compartments: (1) a rapidly exchangeable pool consisting of lead in blood and some soft tissue components; (2) another rapidly exchangeable pool consisting primarily of lead in soft tissue and lead loosely bound to bone; and (3) a very large portion (60% to 90% of the total burden2) tightly bound in the skeleton, with a turnover time estimated as one to two decades.
This third large pool is not associated with any known toxicity: it may be considered a "sink" which probably is virtually inaccessible to chelating agents. The effectiveness of chelating agents is associated with their ability to reduce the concentrations of lead in the two small, but mobile compartments where toxic effects do occur. The "metabolically active" fraction3,4 of the total body lead burden is probably similar to the "rapidly exchangeable" compartments.
The three chelating agents used to treat plumbism in the United States are edathamil calcium disodium (CaEDTA), 2,3-dimercaptopropanol (BAL) and d-penicillamine (PCA). PCA is available in oral dosage form only (250-mg capsules) and is classified by the FDA as an investigational drug if used for lead poisoning. When equimolar amounts of these agents were infused in rats under identical experimental conditions, PCA was appreciably inferior to CaEDTA and BAL in terms of the quantity of lead mobilized and excreted.5,7 Furthermore, a transitory increase in the lead content of some soft tissues was noted during mobilization with PCA, but not with either CaEDTA or BAL.
Psychomotor Epilepsy in Childhood
Authors: Gold Arnold P. 
Published: December 2021

The most poorly understood and most frequently misdiagnosed seizure state of childhood is psychomotor epilepsy. Difficulties in diagnosis are related to the variety of possible clinical manifestations which characteristically differ from one child to another. In addition, psychomotor epilepsy can occur at any age, even during infancy. Therefore, the child's ability to verbalize the perceptive and affective sensations of this seizure state is obviously limited by his chronologic age.
The diagnostic dilemma is further complicated as physicians tend to confuse psychomotor seizures and petit ma! epilepsy.
INCIDENCE AND ETIOLOGY
The terms psychomotor and temporal lobe epilepsy are often used synonymously and interchangeably. At times the seizure state may also be called uncinate epilepsy, epileptic automatisms or epileptic fuges. However, not all psychomotor seizures are associated with temporal lobe lesions, nor is temporal lobe pathology always productive of psychomotor epilepsy. Abnormalities and electrical foci from areas other than the temporal lobe can produce this seizure state. For these reasons, the term psychomotor epilepsy is preferred, and temporal lobe epilepsy, if used, should be restricted to those psychomotor seizures that result from primary temporal lobe pathology.
Ten to 20% of children in most pediatric seizure clinics have psychomotor epilepsy. Focal lesions are often considered to be the responsible etiologic factor, but diffuse encephalopathies, above all in children, are more commonly encountered. Prolonged febrile convulsions, perinatal trauma and hypoxia, craniocerebral trauma or meningoencephalitis can be the specific etiologic condition. Expansive lesions including neoplasms, vascular malformations, cysts and abscesses must be considered, especially when there is clinical or electrical evidence of a focal lesion.
Sigmoid Volvulus in Children
Authors: Campbell John R. , Blank Eugene 
Published: December 2021

Sigmoid volvulus occurred in a boy when he was 6 and 10 years of age. He also had nonobstructive malrotation of the midgut. Reduction both times was effected by proctosigmoidoscopy and the insertion of a rectal tube. Examination of the gastrointestinal tract with barium after the second reduction showed a large sigmoid colon with rough mucosa. At elective operation the dilated, non-obstructed sigmoid was resected.
Sigmoid volvulus is primarily a disease of adults, and in one large series 88% of the patients were 50 years or older. Sigmoid volvulus is also a disease which shows large geographical variations in its incidence. Despite the infrequency of its occurrence in North America and Western Europe and its rarity in children, it may cause acute strangulating obstruction in children.
Environmental Effects on the Embryos and Fetuses of Experimental Animals
Authors: Brent Robert L. 
Published: December 2021

In examining the offspring of experimental animals or man in relation to exposures to environmental agents, account should be taken of certain principles developed over the past five decades.
TERATOGENESIS
Before the Period of Implantation
Experimental embryologic studies have shown that before implantation there is a so-called omnipotential period of development, when all cells have the ability to form a complete embryo. During this interval it is difficult, if not impossible, to induce congenital malformations. This interval extends to 6½ days in the mouse, 8 days in the rat, and about 12 to 13 days in man.
Teratogenic Period
The interval during which teratogenesis may be induced in man is short relative to the total gestational period, in contrast to the period of susceptibility in the mouse or rat, in which it is about one third of the gestational period.
Fetal Period
Subsequently, classical teratogens do not produce gross malformations that are easily observable at birth. Exposures to hazardous agents may still produce other effects throughout the later period of gestation, namely, cell deletions or tissue hypoplasia. This is a new area about which we do not yet understand very much, even with respect to high doses. When the mouse embryo is exposed late in gestation to 200 rad, a marked depletion has been observed in the cerebral cortex. This easily visible difference from normal upon inspection of the brain has little effect on behavior.
In the same way, x-irradiation of the mouse testes produced hypoplasia, but no defect in morphogenesis.
The Role of a Dialyzable Serum Factor in the Increased O2 Affinity of Hemoglobin in the Red Cells of Hypoxic Newborns
Authors: Boda Domokos , Murányi László , Eck Erna , Szilágyi Magda 
Published: December 2021

Attempts to treat infants with neonatal adaptation disturbance by improving the O2 transport function of their blood with exchange transfusion are significant. Oski, in his recent E. Mead Johnson Award Address, noted that the exchange transfusion, in addition to influencing the fetal hemoglobin and 2, 3-DPG concentration in the red cells, alters many other factors that have been claimed to modify both morbidity and mortality in these infants. He said, "Among these factors are included the serum albumin level, blood coagulation factors and the presence of unidentified, but dialyzable toxins."
See image in the PDFfile
An Attacked Committee Replies
Authors:   Committee on Drugs
Published: December 2021

The number of the Letters to the Editor in response to the reply of the Committee on Drugs to the letter by Drs. Livingston et al. regarding amphetamines and epilepsy indicates that the Committee has kicked a hornet's nest. This is perhaps due to the fact that the Committee is in a sense challenging the empiric use of drugs, a practice which we all engage in everyday.
There is no question in the Committee's opinion that certain drugs are used in the physician's best judgment in instances where scientifically acceptable data are not available.
The Disabled Learner: Early detection and intervention (Modern approaches to the diagnosis and instruction of multi-handicapped children, vol. 8), edited by P. Satz, and J. Ross. The Netherlands: The Rotterdam University Press, 1973, 297 pp., $18.65
Authors: Cavanaugh James J. A. 
Published: December 2021

In The Disabled Learner editors Satz and Ross present a potpourri of articles previously delivered at a conference held to acquaint physicians, educators and psychologists with new basic information in the field of learning disorders and to review new methods of intervention. The book falls far short of this goal.
The biology is naive, the language development section is uninformed, or at least systematically ignores a broad literature in this discipline, and the chapters that deal with specific learning disability and developmental dyslexia are unrewarding.
FOLLICLE STIMULATING HORMONE (FSH) AND LUTEINIZING HORMONE-HUMAN CHORIONIC GONADOTROPIN (LH-HCG) CONCENTRATIONS IN PAIRED MATERNAL AND CORD SERA
Authors: Penny Robert , Olambiwonnu N. Olatunji , Frasier S. Douglas 
Published: December 2021

Penny, R., Olambiwonnu, N. O., and Frasier, S. D.: Follicle stimulating hormone (FSH) and luteinizing hormone-human chorionic gonadotropin (LH-HCG) concentrations in paired maternal and cord sera. Pediatrics, 53:41, 1974.
An error was made by the authors under the Materials and Methods section of the above article which appeared in the January issue. The last two sentences should read:
To convert to nanograms of LER 907, multiply FSH concentrations by 24 and LH concentrations by 17. For conversion to International Units of commercial HCG, divide LH-HCG concentrations by 0.55.
Training pediatricians for primary medical care
Authors: Shiller Jack G. 
Published: December 2021

A recent issue of this Journal carried the Kenneth G. Blackfan Memorial Lecture delivered to the Children's Hospital Alumni Association in Boston on May 30, 1973.1 It was given by Dr. Cicely Williams and entitled "Health Services in the Home." In her message directed at pediatric academia, Dr. Williams essentially said, "Be off with your ultrascience, your superspecialists ... Give thought instead to the thousands who are sick ... Teachers, stop seducing the very best into your snare of enzymes, isotopes and transducers, leaving only a small group to replace our dwindling cohort of primary care deliverers."
That very same issue carried a commentary entitled "Primary Medical Care and Medical Research Training" by Dr. David G. Nathan of the Children's Hospital Medical Center.2
DR. JOHN LOVETT MORSE OF BOSTON ON A CHILD WITH DIABETES MELLITUS (1916)
Authors: C. T. E. 
Published: December 2021

Dr. John Lovett Morse (1865-1940), Professor of Pediatrics, Harvard Medical School, published a popular texthook in 1913 entitled Case Histories in Pediatrics. The method of case teaching which had been used in the Harvard Law School from about 1890 on, was introduced into the Harvard Medical School in 1900 at the suggestion of Dr. Walter B. Cannon, then a student in the school. Dr. Morse was an enthusiastic supporter of case history teaching because he believed that "this method of teaching is far superior to recitations, quizzes, and conferences."1 The case history below of a child with diabetes mellitus, taken from the second edition of Morse's book (1916), points out the grim prognosis of this disease in the pre-insulin days.
Charles W., eleven years old, was the child of healthy parents. One brother was living and well. There had been no deaths or miscarriages. His maternal grandfather had had diabetes, but had died of tuberculosis.
He was born at full term, was normal at birth and weighed six pounds. He had whooping-cough when one year old, mumps and chicken-pox when small, and measles at four years, but had otherwise been well. He had always eaten much candy and had craved sweet foods. He had passed much more urine during the last month than formerly, and had drunk large quantities of water. He had to get up several times at night to urinate and to allay his thirst. His appetite was large. He had had no itching of the skin and no eruption.
Gingival and Periodontal Problems in Children
Authors: Polson Alan M. 
Published: December 2021

This review will concentrate on the gingival and periodontal problems which the pediatrician may see as part of his care of the child patient. The age period covered is from the time of first tooth erruption to the middle teens. In considering specific conditions, the clinical appearance will be described, together with etiology and recommended management. Although the majority of gingival and periodontal problems are chronic in nature, a section is included on acute conditions.
The periodontium is the investing and supporting structure of the tooth. It comprises the gingiva, periodontal ligament, alveolar bone and cementum. The tooth is suspended in the alveolar bone socket through the periodontal ligament fibers which are embedded at one end in the cementum covering the root surface and in the alveolar bone at the other end. The gingiva is that portion of the oral masticatory mucosa which surrounds the teeth and is attached to the alveolar process of the jaws. In order to recognize pathological changes in the gingiva it is necessary to know how the normal appears (Fig. 1). The gingival tissues which extend into and fill the interdental or interproximal area form the gingival papillae. The gingiva has a thin edge where it meets and surrounds the tooth in a collar-like fashion. There is a potential space between the tooth and the marginal gingiva into which a blunt probe may be passed to a depth of 1 to 2 mm. The gingiva in health is pale pink and firm, and does not bleed on probing, brushing, mastication or spontaneously.
Interaction of ultrasound and biologic tissues-potential hazards
Authors: Meyer Richard A. 
Published: December 2021

The application of diagnostic ultrasound in pediatrics has become widely accepted and is being utilized more frequently in the diagnosis and management of patients. Since the technique is accurate, painless and without known risk, it has great appeal as a noninvasive diagnostic method. When a method is extensively used, it is essential to know about its safety. The purpose of this discussion is to provide some understanding of the interaction of ultrasound and biologic tissue and the possible potential hazards of the technique.
Diagnostic ultrasound as applied in medicine may be utilized in three ways-as continuous Doppler, pulsed-sonar or Doppler-sonar.
Chronic Granulomatous Disease in a Child With Klinefelter's Syndrome
Authors: Sanders Doris Y. , Goodman H. O. , Cooper M. Robert 
Published: December 2021

A 1-year-old white male child with Klinefelter's syndrome (chromosomal count of 47 XXY) was diagnosed as having chronic granulomatous disease (CGD). As this association is previously unreported to our knowledge, the case is recorded briefly.
CASE REPORT
This 1-year-old white male child was followed in the pediatric clinic of the Bowman Gray School of Medicine since the age of 3 months for hepatosplenomegaly, recurrent ear infections and a persistent skin rash involving the external nares and right submandibular area. The genitalia were observed to be small by the attending physician although both testes were palpable in the scrotum.
Laboratory studies at the age of 3 months included a hemoglobin of 9.6 gm/100 ml, hematocrit of 26%, red blood cell count of 3.2 million, white blood cell count of 24,300/cu mm, with a differential count of 55 neutrophils, 28 lymphocytes, 14 monocytes and 3 eosinophils.
Placidyl® Poisoning or Withdrawal?
Authors: Nieburg Phillip 
Published: December 2021

In the November issue of Pediatrics, Rumack and Walravens reported a case of ethchlorvynol (Placidyl) withdrawal in a neonate.1 A careful reading of their report led me to a diagnostic conclusion somewhat at variance with theirs.
Based on the data presented, I would propose that their infant was suffering the effects of ethchlorvynol poisoning (i.e., toxicity) rather than withdrawal. The reported CNS depression and jitteriness correspond as well to intoxication symptoms of this drug as they do to possible withdrawal symptomatology.2
Letter to the Editor
Authors: Rumack Barry H. , Walravens Phillip 
Published: December 2021

We must reject Dr. Phillip Nieburg's conjectures as invalid.
Central nervous system depression and jitteriness do not correspond well to the ethchlorvynol intoxication syndrome. Patients treated for acute overdosage here, as elsewhere,1-3 demonstrate marked CNS depression, hypothermia, hypertension, hyporeflexia and respiratory depression. This classic syndrome of ethchlorvynol intoxication is not to be confused with the withdrawal syndrome4 of tremors, hallucinations and convulsions. Chronic ingestion of large quantities of ethchlorvynol does not produce toxic features but rather the abstinence syndrome upon termination of the drug.
Nasotracheal Tubes Preferred for Epiglottitis
Authors: Sweeney D. B. 
Published: December 2021

On reading Dr. Rapkin's article, "Tracheostomy in Epiglottitis,"1 I feel that his series is rather small to recommend tracheostomy as an alternative to intubation as treatment for epiglottitis.
I agree with him that elective airway relief on diagnosis is the treatment. This view is further supported by Baxter,2 who recommends immediate tracheostomy on diagnosis, but I do not agree that tracheostomy is still the method of choice. Dr. Rapkin quotes only five cases of elective tracheostomy and although he states they all survived, he gives no details of morbidity or complications.
Comment on TV Ads
Authors: Feinbloom Richard I. 
Published: December 2021

The findings of the effects of television advertisements on the health beliefs and behaviors of school children reported in the March issue1 have led the authors of the article to design a classroom exercise in which commercials pertaining to health are critically analyzed and students are trained in decision-making. I suggest an additional course of action.
In January 1973, on the television program The Advocates, Nicholas Johnson, until recently a commissioner of the Federal Communications Commission, and I took the pro position on the topic "Should Drug Advertisements Be Banned From TV?" My basic argument was that any commercial advertisememit on a health matter is inherently misleading.
Noise Pollution: Neonatal Aspects
Authors: Miller Robert W. , Brendel William B. , Brent Robert L. , Chisolm J. Julian , Doyle John L. , Ebbin Allan J. , Fagan Emmett L. , Finberg Laurence , Mendez-Cashion Dolores , Mulvihill John Joseph , Falk Stephen A. , Flynt J. William , Frantz Christopher , Knelson John H. , Knutti Sarah H. 
Published: December 2021

The deafening effect of high intensity noise is well known—from rock music, aircraft, snowmobiles, motorcycles and the shooting of guns. The effects of hospital noise and its interaction with ototoxic drugs are less well known. The subject is of particular importance to pediatricians, because infants in incubators are exposed to substantial noise from the motor, airflow, respirators, slamming of incubator doors and the baby's own crying. Furthermore, animal experimentation1 shows that the ototoxic drug, kanamycin (often given to the premature infant to combat sepsis), can potentiate the effect of noise on hearing loss as much as 100-fold. Whether or not an interaction between noise and potentially ototoxic drugs occurs in man is as yet unknown.
MEASUREMENT
Noise has frequency and intensity. Frequency is measured in cycles per second, designated hertz (Hz). The young human ear is sensitive to a frequency range of 20 to 20,000 Hz. White noise, the auditory counterpart of white light, has equal energy in each frequency in the audible range.
Intensity is measured in decibels on a scale which is linear with respect to audible frequencies. This measurement is designated dB (linear). Since the human ear is more sensitive to the damaging effects of high frequency sound than to low frequency, a better correlate with noise-induced hearing loss can be obtained when low frequencies are filtered out. Filtered sound level, measured on a so-called A-weighted scale, is designated dB(A). Room conversation produces 60 to 70 dB(A), rock music 100 to 120 dB(A) and snowmobiles 105 to 135 dB(A) for the driver.
Hyperactivity: The Henderson-Dahlin-Partridge-Engelsing Hypothesis
Authors: Oettinger Leon 
Published: December 2021

In the October 1973 issue, Henderson et al.1 discuss hyperactivity and its etiology. The short discussion deals with early symptoms and not with etiology. No approach to the cause of the colic and hypertonicity is made.
All we who have worked with hyperkinetic behavior syndrome in children have been aware of these symptoms for many years. The therapeutic approach is interesting and worth following up. The difference between etiology and symptoms is a real one, and the two should not be confused.
Dr. Manning's Reply
Authors: Manning P. J. 
Published: December 2021

The short commentary article published in the Febniary issue of Pediatrics was a condensation of a larger work, and several references were deleted from the original work. No reference to health conditions of Eskimos could be made without quoting from investigations by Otto Schaefer. Unfortunately, a mistake was made in the deletion of one of Dr. Schaefer's publications, as he has pointed out.
Our point about breast-feeding arises from our own observations in this Zone.