bluuebunny/crossref_metadata_2025_split huggingface dataset:
PROSPECTIVE EXPERIENCE WITH MATERNAL RUBELLA AND THE ASSOCIATED CONGENITAL MALFORMATIONS
Authors: Michaels Richard H. , Mellin Gilbert W. 
Published: December 2021

The Fetal Life Study (1946-1959) recorded 25 instances of rubella infection during pregnancy. Exposure to rubella occurred during 95 other pregnancies. The results of these pregnancies and the follow-up of the infants is reported.
A summary of other prospective studies reported in the literature is also presented. The incidence and number of malformations per live-born child are discussed in relation to the time of maternal rubella during pregnancy. There appeared to be a decreasing risk of malformation in live-born infants from 47% (8/17) in the first 4 weeks, 22% (8/36) in the fifth through eighth weeks, to 7% (3/46) in the ninth through twelfth weeks. Although the trend appears to be definite, the Fetal Life Study and the six other studies summarized are quite diverse and the samples are small.
It is suggested that prospective observations be more completely reported and control observations also be made. There is dire need of objective laboratory techniques for the diagnosis of rubella.
PATHOGENESIS OF HYPOSTHENURIA IN PERSONS WITH SICKLE CELL ANEMIA OR THE SICKLE CELL TRAIT
Authors: Schlitt L. , Keitel H. G. 
Published: December 2021

Hyposthenuria was investigated in subjects with sickle cell trait and in patients with sickle cell anemia. The following were observed: 1) in subjects with sickle cell trait both normal and reduced maxima of urinary concentration are found, whereas all untreated patients with sickle cell anemia over 6 months of age have hyposthenuria; 2) hyposthenuria becomes increasingly more severe with advancing age in both sickle cell anemia and sickle cell trait; 3) in a 6-month-old patient with sickle cell anemia and hyposthenuria, the maxima of urinary concentration returned to normal after two transfusions of normal erythrocytes.
Reasons are presented for favoring the hypothesis that hyposthenuria in sickle cell disease is due to renal damage, possibly from intravascular sickling of erythrocytes in renal vessels or from the presence of "free" circulating S-hemoglobin.
THE INTERACTION OF ENZYMES AND HORMONES
Authors: White Abraham 
Published: December 2021

The majority of living forms depend for their functioning upon two classes of biocatalysts, the enzymes and the hormones. These biocatalysts permit the diverse chemical reactions of the organism to proceed at 38°C with a specificity and at rates frequently unattainable in vitro at elevated temperatures with similar reactants.
The physiologic importance of enzymes and hormones is evident not only under normal circumstances, but is reflected clinically in the diverse descriptions of errors of metabolism, due to lack or deficiency of one or more enzymes, and the numerous hypo- and hyperfunctioning states resulting from imbalance of hormonal supply.
Inasmuch as both enzymes and hormones function, with rare exception, to accelerate the rates of processes in cells, investigators have sought possible interrelationships and interactions of enzymes and hormones, particularly as a basis for the mechanism of hormonal action. It has seemed logical to hypothesize that hormones, while not essential for reactions to proceed but nevertheless affecting the rates of reactions, may function by altering either the concentration or activity of the prime cellular catalysts, the enzymes. This proposed influence of hormones on enzymic activity might be a primary, direct effect achieved by the hormone participating as an integral part of an enzyme system, or an indirect influence based upon the hormone altering the concentration of available enzyme and/or substrate utilized by a particular enzyme.
It is the purpose of this presentation to describe a relatively few, but better defined, examples of the more direct relationships of enzymes and hormones. Five examples of enzyme-hormone interaction will be presented, based on the criterion that an effect of the hormone has been demonstrated on addition of the hormone in vitro to a purifled, or partially purified, enzyme system.
NEUROLOGIC LESIONS IN RELATION TO ASPHYXIA OF THE NEWBORN AND FACTORS OF PREGNANCY: LONG-TERM FOLLOW-UP
Authors: Keith Haddow M. , Gage Robert P. 
Published: December 2021

Four groups of children were studied over periods of 1 to 14 years. Group 1 included 402 children who had been born after prolonged labor. Follow-up studies were made of 321 of the 402 children. Twelve children (3.7%) were noted to have convulsions, but only one child had a recurring convulsive disorder (epilepsy). The remainder had so-called febrile convulsions. No other persistent neurologic difficulties were found.
Group 3 included 236 children who had asphyxia (anoxia) or delayed respiration at birth. Follow-up data were available on 180 children. The only resulting neurologic difficulties noted were febrile convulsions in two children. None had persistent convulsive disorders (epilepsy).
Group 5 included 124 babies whose mothers had had toxemia of pregnancy. Fourteen were stillborn or died in early infancy. Four of the remaining 110 (3.6%) had a febrile convulsion at some time, but to our knowledge persistent convulsions did not develop.
Groups 2 and 4 were control groups and included a total of 633 children, who were born after relatively short uncomplicated deliveries. Follow-up data were available for 498 of the children; among them 16 children (3.2%) had convulsions at some time, and 13 of the 16 had convulsions at some time between the ages of 8 and 14 years. No other persistent neurologic conditions were found. Four children had recurring convulsive disorders and four others had a single convulsion or occasional convulsion of unknown etiology. Eight others had so-called febrile convulsions. No other persistent neurologic conditions were found.
The findings of the present study reinforce the conclusions in the previous report from this clinic—that prolonged labor, asphyxia, or delayed respiration at birth did not cause any neurologic abnormality in children who survive the early months of life, and that convulsions of any type are not commoner among children who had difficulty at birth than among children who did not have difficulty at birth.
INSTITUTIONAL CARE OF CHILDREN
Authors: Gula Martin 
Published: December 2021

For Two Centuries now, child caring institutions have helped families in caring for their children. Every generation brings its toll of dependent, neglected, disturbed, delinquent, and mentally retarded youngsters to institutional doors.
Such rearing of children away from their families has always been of interest and concern to pediatricians—especially the care of infants and the care of children with severe mental or emotional handicaps. Both these areas are explored in a recent Children's Bureau publication, Child Caring Institutions—Their New Role in Community Development of Services (Publication No. 368, 1958).
Institutional care for well babies is steadily decreasing in our country.
EMOTIONAL AND BEHAVIOR PROBLEMS IN CHILDREN
Authors: Shirley Hale F. 
Published: December 2021

The fostering of mental health during the early periods of childhood is an area in which the pediatrician plays a vital role. There are two parts which have particular relevance for the pediatrician. One has to do with counseling around a particular problem or symptom, and the other is concerned with helping parents to understand the various stages of child development in order to prevent some of the difficulties which might otherwise be encountered. These two aspects were considered in this presentation.
COUNSELING IN RESPECT TO A CHILD'S BEHAVIOR
When a mother complains about her child's behavior, how can a pediatrician go about investigating it? What does one look for? And if emotional disturbances are uncovered, what can one do about them? In the field of child psychiatry there is no neat answer to every problem. A behavior problem is not a clinical syndrome any more than a symptom like fever or headache is a disease. Furthermore, the clinical syndromes in the field of child psychiatry are not as yet very well defined. There are variables among the determinants of most human behavior which are hard to identify and to evaluate, and usually there are some that are unknown. This leads to the necessity of tentativeness at first in planning for a child's treatment, and uncertainty, often, as to prognosis.
For anyone, the effectiveness of what is done depends greatly upon how adequate an understanding of the child's environmental background one is able to acquire. Such aspects of the environmental background as the emotional atmosphere of the home, the personalities and emotional adjustment of the parents, the feelings of the parents toward the child and his behavior, and the feelings of the child about the people around him, are all important.
EARLY FEEDING OF DEXTROSE AND SALINE SOLUTION TO PREMATURE INFANTS
Authors: Bauman William Allen 
Published: December 2021

Conflicting opinions concerning the optimum age at which to commence feeding premature infants have resulted in either early or late regimens. In order to test the hypothesis that the early administration of fluids to premature babies was beneficial, a controlled study of 50 newborn premature subjects was undertaken. Fluids consisting of 5% dextrose in 0.45% saline were started before the age of 6 hours by constant drip through a nasogastric plastic catheter in 24 subjects selected by a predesigned method using a table of random permutations. The average intake during the test period was 54.5 ml/kg/24 hours. The other 26 control subjects received no fluids until age 36 hours, when both groups were started on formula.
There was no alteration of symptoms of respiratory distress in the group receiving early feedings. One-half of these subjects did not lose weight while being fed the dextrose and saline solution. They promptly lost weight, however, when regular milk feedings were commenced.
The seven infants who died had similar pathologic findings. It was noted that three of the five in the fluid treated group also had pulmonary hyaline membranes. There were no hyaline membranes in the lungs of the two subjects deprived of water.
From this study neither beneficial nor detrimental effects of early feeding could be demonstrated by use of the criteria of dyspnea or mortality. The question of when to start to feed premature babies is still unanswered. There is need for further feeding trials, in which associations among age of commencement, nature of substances fed and the consequent physiologic responses, can be observed.
PATTERNS IN ELECTROLYTE AND NITROGEN BALANCE IN THE NEWBORN PREMATURE INFANT
Authors: Butterfield Joseph , Lubchenco Lula O. , Bergstedt Jens , O'Brien Donough 
Published: December 2021

The sodium, potassium and nitrogen balances of 24 small premature infants during the first 3 weeks of life have been determined. During the first week of life there was a sodium deficit of 6 to 16 meq/kg in clinically well infants. Prior to milk feeding there was a loss of potassium and nitrogen, followed by change to retention once milk feedings were started.
See Image in the PDF file
Some sick infants showed a similar pattern; others showed a relative salt retention during illness or during moderate increases in sodium intake.
Three infants were treated with cortisone during the first week of life. Two retained potassium as well as sodium during that time. Another demonstrated an apparent migration of sodium into the cells while receiving the cortisone.
Low and more labile sodium values in serum were noted more often in the ill infants, while higher potassium levels in serum were more frequently encountered in the same infants, although these two phenomena were not necessarily associated.
During the second and third weeks of life, all babies studied began to retain sodium irrespective of the degree of immaturity at birth and the positive nitrogen and potassium balance continued.
See Image in the PDF file
It is conjectured that the sodium diuresis observed during the first week of life may represent a physiologic reduction of the total body water.
RENAL DIABETES INSIPIDUS
Authors: Schoen Edgar J. 
Published: December 2021

In a family with renal diabetes insipidus, members of four generations were studied; the history of five generations was available. In this kindred the disease appeared to be transmitted as a sex-linked dominant gene attached to the X chromosome, with variable penetrance in the female heterozygous carriers.
Renal diabetes insipidus was present in three male children and two men; six additional males died of unknown causes in infancy or early childhood. In males the medical problem is early recognition to avert death or serious brain injury secondary to dehydration.
Of five female heterozygous carriers studied, three demonstrated persistently normal urinary concentration following thirsting. Two evidenced marked diminution in renal concentrating ability and could be considered to have mild renal diabetes insipidus. History suggested that one other female member of the kindred had manifest disease. In the female the medical problems are diagnosis in the occasional female with manifest disease and detection of the heterozygous carrier prior to the birth of her child. In this kindred we found the urinary concentration test a reliable detector of the female heterozygous carrier only if the results were abnormally low.
Intussusception in Infants and Children, Mark M. Ravitch, M.D. Springfield, Illinois, Charles C Thomas Publisher, 1959, 121 pp., $9.00
Authors: Pickett Lawrence K. 
Published: December 2021

This is the first book to be published in a new series entitled "Pediatric Surgical Monographs" edited by Mark M. Ravitch, M.D. This first volume is authored by Dr. Ravitch on a subject that has been one of his major interests.
Dr. Ravitch has done an excellent and complete job, covering all aspects of the problem of intussusception. He has emphasized early in the book the rarity of the condition, since many busy children's hospitals have relatively few cases each year.
MIXED GROUP PRACTICE
Authors: Burke Donald M. 
Published: December 2021

In Order to deal with the question1 in an intelligent manner it will be necessary to define both "new pediatrics" and "mixed group." It will be further illuminating to ask why the question should be asked: Can the new pediatrics be practiced?" It seems fair to state in answer that the question is asked chiefly because of the discrepancy between the type of patient who is seen in pediatric residency and the type of patient encountered in everyday pediatric practice. It should be pointed out that implicit in this discrepancy is a known change in the character of pediatric practice in general; the pediatrician of today sees few of the diseases considered both common and serious in the practitioner's office a generation ago.
The ex-resident entering practice today may find that the knowledge gained from the more difficult periods of his residency training is not put to frequent use. He might further find that he is at a loss to cope with some of the many questions a mother can ask regarding her child, which do not seem related to the child's organic illness; her attention may be focused on something which appears minor in the eyes of the pediatrician. He finds himself often in the position of health counselor and practitioner of preventive medicine rather than a physiologist delving into the newly-known metabolic disturbances or the fine techniques of cardiac catheterization. He must learn the truth of Dr. Wyman C. C. Cole, Sr.'s statement that, "We must think of the pediatrician as the child's physician, not merely as one who treats the diseases of childhood."2
REPORT ON 1960 WRITTEN EXAMINATION
Authors:   The Examinations Committee
Published: December 2021

THE EXAMINATION
The Examinations Committee of the American Board of Pediatrics has decided not to change the general format of its 1961 written examination from that used over the past several years. A detailed account of this format was published in Pediatrics, 22:1001, 1958. Candidates who will take the examination in January 1961 are advised to read this previous publication.
The written examination of January 8, 1960 was taken by 520 American candidates and by 126 foreign candidates. In accordance with policy decided upon a year ago (Pediatrics, 24:848, 1959), the passing grade was selected after study of the marks achieved by the American candidates only.
NEWS AND ANNOUNCEMENTS
Authors: Fischer Carl C. , Polk D. Stewart 
Published: December 2021

Bronx Pediatric Society
The Bronx Pediatric Society will meet on Wednesday, December 14, 1960 at 8:30 pm at the Morrisania, Bronx. Dr. Edmund P. Fowler of the College of Physicians and Surgeons, Columbia University, will present the James Harkins Memorial Lecture, Problems in Pediatric Otobogy.
American Psychosomatic Society
The American Psychosomatic Society will hold its 18th Annual Meeting at Chalfonte-Haddon Hall in Atlantic City on April 28, 29, and 30, 1961.
The program committee would like to receive titles and abstracts of papers for consideration.
The Child in Hospital: A Study of His Emotional and Sosical Well-Being, Hedley G. Dimock. Philadelphia, F. A. Davis Company, 1960, 236 pp., $4.50
Authors: Work Henry H. 
Published: December 2021

One often gets the feeling that our British and Canadian colleagues are considerably ahead of us in planning for the care of children who need to be hospitalized. This text offers a new organization of a great deal of recent work on this particular subject. It is a book written for pediatricians, hospital administrators and nurses.
More comprehensive than Robertson in his recent book, the author includes a considerable biography as well as an excellent description of the relatedness of ward activities, staff activities and actual patient needs.
BACTERIAL ENDOCARDITIS IN CHILDREN WITH HEART DISEASE
Authors: Blumenthal Sidney , Griffiths Sylvia P. , Morgan Beverly C. 
Published: December 2021

We have reviewed the literature and our experience with 58 patients with bacterial endocarditis superimposed upon pre-existing heart disease, observed during the 30-year period, January 1930 through December 1959. There has been no change in the relative incidence of bacterial endocarditis in children with heart disease observed at the Babies Hospital since the introduction of antibiotics. Twenty-one patients (0.49/1,000 admissions) were observed from 1930 through 1943 and 37 patients (0.52/1,000 admissions) from January 1944 through December 1959. In the majority (40) infection was superimposed upon a congenital malformation of the heart, while in 17 there was evidence of rheumatic heart disease. In one, a rheumatic infection complicated a congenital anomaly.
The history usually revealed unexplained fever and fatigue in a child known to have heart disease. Additional symptoms often reflected the nature of the underlying cardiac pathology. Patients with tetrad of Fallot developed symptoms secondary to hypoxia which in some instances was later shown to be attributable to vegetations at sites resulting in obstruction to pulmonary blood flow.
The pathogenesis of bacterial endocarditis is defined in terms of bacteremia superimposed upon abnormal endocardial or endothelial surfaces; the further role of hemodynamic trauma secondary to congenital or acquired lesions is discussed.
The results of bacteriologic studies were as vital in confirming the diagnosis and planning treatment as in the management of patients with meningitis. Blood cultures were usually positive in the first sample obtained (86%) and always by the sixth. Bacterial endocarditis is uncommon in the presence of sterile blood cultures providing an adequate number (six), each of sufficient quantity (10 ml), are obtained sufficiently long after antibiotics have been discontinued and providing they are incubated in aerobic and anaerobic media for 3 weeks.
In children, the most important prognostic features were (1) recognition of the disease, (2) the nature of the infecting organism, and (3) adequate antibiotic treatment. In seven instances in our experience the correct diagnosis had not been considered prior to necropsy examination. Among the patients with bacterial endocarditis treated with antibiotics, recovery occurred in each of the 20 due to viridans streptococci, in 1 due to gamma-streptococci, and in 3 of the 8 due to Staphylococcus aureus.
The principles of management are discussed and suggestions outlined for antibiotic therapy of children with bacterial endocarditis. Penicillin alone is recommended for infection due to viridans streptococci, if the organisms are highly sensitive, whereas for infection due to Staphylococcus coccus aureus a combination of chloramphenicol, erythromycin and penicillin is advocated as initial therapy. The importance of the use of antibiotics in therapeutic dosage for prophylaxis in patients with heart disease prior to dental manipulation or other surgical procedures is stressed.
IDIOPATHIC HYPERGLYCINEMIA: A NEW DISORDER OF AMINO ACID METABOLISM
Authors: Nyhan William L. , Borden Margaret , Childs Barton 
Published: December 2021

The amino acids of blood and urine have been investigated using chromatography on cation exchange columns in the study of a patient with idiopathic hyperglycinemia. Marked increases in concentrations of glycine, serine, alanine, isoleucine and valine were found in the plasma. These changes were not reflected in increased excretion of these amino acids in the urine (with the exception of glycine). Restriction of the dietary intake of protein resulted in a decrease in the concentrations of glycine and other amino acids in the blood and urine, and there was a concomitant decrease in the frequency and severity of episodes of acute illness.
The oral administration of leucine was found to induce a decrease in the levels of a number of amino acids in the patient and in controls. Continued decrease during the 3 hours of observation was noted for serine, isoleucine and valine. A mild but progressive decrease in threonine concentration was observed in the controls, while in the patient the concentration increased after the administration of leucine. Decreased levels at 1½ hours, returning toward the fasting levels at 3 hours, were observed for alanine, taurine and glycine. These apparently normal responses to leucine loads were not mediated through increase in the urinary excretion of the amino acids involved, and the data are interpreted to indicate entry of these amino acids into cells.
LIMITS OF VARIABILITY OF CONCENTRATION OF SODIUM IN SERUM OF NORMAL CHILDREN
Authors: Joseph John B. , Bergstrom William H. 
Published: December 2021

The mean concentration of sodium in serum of a group of normal children in Syracuse, N.Y., in midsummer was 146 meq/l.
The total standard deviation for within-individual variation was 4 meq/l, comprising a laboratory error of ±2.5 meq/l and a "true" within-individual variability of ±3.2 meq/l.
No significant difference between individuals was demonstrated.
Within 90% confidence limits, the maximum chance difference between two successive concentrations of sodium in the serum, whose mean falls within the normal range for means of two samples was found to be 11 meq/l.
Within 95% confidence limits, the maximum chance difference between any two values, duplicate or successive, due to laboratory error was 6.9 meq/l.
The implications of these findings for the interpretation of sodium levels in serum of patients are discussed.