bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phagocyte Function in the Neonate: Selected Aspects
Authors: Miller Michael E. 
Published: December 2021

It has become evident that a number of developmental deficiencies exist in the function of neonatal phagocytes. Although the degree to which each contributes to the recognized impairment of host defenses in the normal human neonate is yet unclear, we have derived much valuable information from the study of neonatal polymorphonuclear leukocytes (PMNs) and monocytes (MNLs). In this discussion, we focus upon three functional components of PMN—phagocytosis, bactericidal activity, and movement. This is followed by a brief consideration of correlative studies between neonatal PMNs and MNLs. A more detailed discussion of monocyte functions is found elsewhere in this symposium.
PMN PHAGOCYTOSIS
As with many in vitro systems, phagocytic assays vary considerably in design. Included among the important variables are cell concentration, opsonic concentration, type of particle being ingested, and phagocyte:particle ratio. Despite these differences, results obtained by most investigators studying neonatal PMNs have been reasonably consistent. The data fall into two groups. In the first, PMN phagocytosis has been studied in the presence of normal, or approximately normal plasma (or serum) concentration.1-5 In general, such experiments have yielded data suggesting that the neonatal PMN is equal to the adult PMN in phagocytic ability. A number of particles have been utilized in these studies, including Staphylococcus aureus 502A, Serratia marcescens, Sta pyogenes, Diplococcus pneumoniae, and Pseudomonas aeruginosa. The second group of studies has been carried out under "stress" conditions in vitro or in vivo, and suggest that the neomatal PMN is deficient in phagocytic ability when compared with that of the adult PMN.
Febrile Seizures: A Consensus of Their Significance, Evaluation, and Treatment
Authors: Freeman John M. 
Published: December 2021

The National Institutes of Health recently convened experts from this country and abroad to present current knowledge about febrile seizures and their consequences, and about the risks and benefits of therapy. This information was presented to a panel under the chairmanship of Dr Edwin Kendig, former president of the American Academy of Pediatrics. The panel consisted of both academicians and practitioners. The accompanying statement represents the consensus of that panel.
The statement bears reading in its entirety, for it should influence the way that a pediatrician thinks about the child who has had a seizure with fever, how he evaluates and treats that child, and what he tells the parents.
The panel found that there were only two significant risks associated with febrile seizures: a 30% to 40% risk of recurrent febrile seizures and a slightly increased risk of later epilepsy. They found no evidence of mental or neurologic impairment due to the febrile seizure.
The panel concluded that daily phenobarbital in sufficient dosage to produce a blood level of 15 µg/ml could prevent recurrence of febrile seizures, but that there was no evidence that either the administration of phenobarbital or the prevention of recurrences prevented later epilepsy.
Phenobarbital was noted to produce side effects or toxic reactions in up to 40% of children. These included behavioral changes, sleep disturbances, and possible interference with learning. Valproic acid was also effective in preventing recurrences, but in view of the rare, but reported fatal hepatitis, liver function tests should be closely monitored.
Prevention of Suicide
Authors: Behar David , Stewart Mark A. 
Published: December 2021

The report on teenage suicide by the Committee on Adolescents (Pediatrics 66:144, 1980) was timely and worthwhile. We question their conclusions concerning prevention of adolescent suicide and management of those who have attempted suicide.
Successful suicide by adults is almost always associated with a readily diagnosed condition: depressive illness, alcoholism, dementia, schizophrenia, or antisocial personality.1,2 Unfortunately it is not yet clear which disorders in children or adolescents are likely to lead to suicide, although Shaffer3 has reported a strong association with conduct disorder.
DIGESTION OF PROTEIN BY PREMATURE INFANTS
Authors: FEINSTEIN MYRON S. , SMITH CLEMENT A. 
Published: December 2021

Absorption of N from cow's milk mixtures supplemented with equal amounts of N as casein and casein hydrolysates was determined in 20 metabolic periods on five premature infants.
The supplemental protein or hydrolysate furnished from 33.3 to 46.2% of the nitrogen intake and total N fed was equivalent to 4.22 to 8.49 G. protein/kg. body weight. With either supplement from 86 to 94% of the dietary N was absorbed and neither resulted in consistently superior nitrogen absorption.
Weight gains were not consistently better during either type of supplemental feeding.
The evidence of equally satisfactory nitrogen absorption and weight gain would substantiate the prevailing belief that protein digestion is not impaired after premature birth.
THE PEDIATRICIAN AND THE PUBLIC
Authors: DICH JORGEN S. 
Published: December 2021

The subject of this talk concerns social medicine in the Scandinavian countries, not socialized medicine. The term socialized medicine has a political bias which is not in conformity with the conception of social medicine in Scandinavia. Every step in the development of the Scandinavian social medicine program has been adopted unanimously by all parties, irrespective of their attitudes toward socialism itself. Political parties have advocated liberalism and opposed socialism with the same ardor with which they have supported the expansion of social medicine. In Scandinavia, therefore, it is not necessary to advise us to "Keep politics out of this picture." Politics have always been omitted, even to the extent that a phrase corresponding to the American "socialized medicine" has never been used in Scandinavia. And if you were to try introducing it, it would not be understood.
What is social medicine? It can be defined as an organization of the medical services according to a certain conception of individual or human rights and public obligations in a modern society. In all countries it is accepted that there are some basic needs which everyone has the right to satisfy, irrespective of income. Protection of personal freedom belongs to this group; so does education of the children.
CONGENITAL ANOMALIES
Authors: WARKANY JOSEF 
Published: December 2021

I AM greatly honored by the Award which the American Academy of Pediatrics has bestowed upon me and I am certain that this recognition of our studies will stimulate my co-workers and myself to further efforts in the line of work which we began about 12 years ago.
I have repeatedly had the privilege of presenting our experimental work to meetings of the American Academy of Pediatrics and it is not necessary, therefore, to describe to you again in detail the congenital anomalies induced in animals by maternal dietary deficiency. It seems preferable to give you today a brief summary of the general aspects and results of our studies and to present to you some of the conclusions which may be drawn from them.
The incentive to our experimental work was a marked interest in congenital anomalies of children. Adverse factors acting in prenatal life contribute appreciably to the mortality of infants and many children go through life deformed or crippled because of unfavorable intrauterine conditions. Congenital anomalies are at the root of many chronic and of some intractable diseases of childhood, a fact which is brought out with increasing certainty by improved diagnostic methods. Without going into details I wish to point out how many congenital anomalies of the urinary tract are now recognized intra vitam, which only one or two decades ago puzzled us by their nonspecific symptoms. Congenital anomalies of the intestinal tract which were previously diagnosed as "vomiting," "malnutrition," etc., are now better understood and often accessible to surgical treatment.
AUREOMYCIN IN THE TREATMENT OF RUPTURED APPENDICES IN CHILDREN
Authors: JOSLIN BLACKBURN S. , DRAKE MILES E. 
Published: December 2021

A report is given on the use of aureomycin as the sole antibiotic therapeutic agent in 16 cases of peritonitis or abscess complicating appendicitis occurring in children. In four of the cases surgery was postponed because of the child's condition. There were no deaths in this series.
Aureomycin appears to be the drug of choice when combined with surgery in treating appendicitis with abscess or peritonitis or to be used alone when surgery must be postponed. A satisfactory dosage schedule for aureomycin is given.
Acute Psychogenic Stridor in an Adolescent Athlete Treated with Hypnosis
Authors: Smith Mark Scott 
Published: December 2021

A psychogenic basis for laryngeal stridor has rarely been reported1,2 and, indeed, is often not considered in the differential diagnosis of this problem.3 We report the successful use of hypnosis in the treatment of an adolescent with psychogenic stridor.
CASE REPORT
A 1611/12-year-old white boy, who had been in good health previously, awoke with the sudden onset of inspiratory stridor. He had experienced no antecedent upper respiratory tract infection, cough, or other recent illness. Past medical history was unremarkable, and he was generally in excellent physical condition, competing as a high school wrestler. Family history revealed a younger brother who had recurrent episodes of spasmodic nocturnal croup.
Letter to the Editor
Authors: Maisels M. Jeffrey 
Published: December 2021

Thornbery has a point. Obviously we would prefer to err on the side of safety whenever using a screening technique. Having done the initial study, however, guidelines for screening could only be suggested by post facto analysis. We did provide alternatives for different transcutaneous bilirubin (TcB) indices and different serum bilirubin levels.
We also adopted a TcB index of 21 as a cutoff point for the clinical screening of infants in our "well-baby" nursery. We have now analyzed a further 184 measurements in 121 infants, none of whom received phototherapy prior to the time that the TcB index was obtained.
Assessment of Thumb Placement
Authors: MERLOB PAUL , MIMOUNI FRANCIS , ROSEN ORNA , REISNER SALOMON H. 
Published: December 2021

Normal thumb placement has not been defined topographically, and distally or proximally placed thumbs are defined subjectively. We wish to report an objective method of assessment of the normal range of thumb placement.
MATERIALS AND METHODS
One hundred fifteen infants between the gestational age of 34 to 42 weeks were examined within the first 24 hours of life. All were appropriate for gestational age, without any congenital anomalies. Gestational age was calculated from the first day of the last menstrual period, and it was verified by the Dubowitz scoring system.1 Whenever a difference of 2 weeks on more was found in calculation of gestational age, the infant was excluded.
Guidelines for Infant Bioethics Committees
Authors:   Infant Bioethics Task Force and Consultants
Published: December 2021

BACKGROUND
In recent years a widespread public debate has developed on issues surrounding the care and treatment of critically ill infants. One aspect of this debate concerns the procedures that should be available to ensure that difficult treatment decisions regarding such infants are always made in the most effective manner possible. The American Academy of Pediatrics believes that hospital-based "infant bioethics committees," consisting of both physicians and nonphysicians, can provide consultation and review, ensuring sensitive treatment decisions made in a reasoned, informed, and caring manner. Infant bioethics committees can provide education, develop and recommend institutional policies, and offer consultation to providers and families facing a range of ethical problems or questions about medical treatment of infants. The Academy urges all hospitals to establish such committees either on their own or in conjunction with other hospitals. This document is intended to assist those individuals and institutions who elect to engage in this process.
The American Academy of Pediatrics has been involved in discussion of ethical issues surrounding the care and treatment of critically ill infants since 1982. In 1983, the US Department of Health and Human Services published regulations on this issue, establishing federal law enforcement activities which were intrusive into patient care. The Academy successfully challenged that rule in court. Subsequently, the Department of Health and Human Services issued regulations in the Federal Register (effective Feb 13, 1984, but currently in litigation) that, among other things, endorse the concept of infant review committees as suggested in comments that had been submitted by the American Academy of Pediatrics.
Sports and the Child with Epilepsy
Authors: BERMAN WULFRED 
Published: December 2021

To the Editor.—
The Committee on Children with Handicaps and the Committee on Sports Medicine of the American Academy of Pediatrics are to be congratulated for their concise statement on Sports and the Child with Epilepsy.1 There is little doubt that the child whose epilepsy is under reasonable control and who desires to participate in sports, whether involving body contact or not, should be allowed to do so. Although it is logical to assume that repetitive head trauma—as might possibly occur in contact or collision sports—could not help but have a deleterious effect on the frequency of seizures in the epileptic child, fortunately, no clinical or statistical proof that this is true has ever been published.
W.A.S.T.E
Authors: VITANZA ALFRED T. , MOFENSON HOWARD C. 
Published: December 2021

To the Editor.—
The American Academy of Pediatrics' policy statement announcing "The Injury Prevention Program" of the Committee on Accident and Poison Prevention has elevated injury prevention to a status where it will be considered an important and appropriate part of pediatric practice and not a minimum standard of pediatric care.
During a discussion on injury prevention at morning report with our interested house staff, a resident introduced a mnemonic in regard to what the committee recommends that physicians caring for children should advise parents to acquire for their children's safety.
`Failure to Thrive' or the Failure to Define
Authors: STICKLER GUNNAR B. 
Published: December 2021

Smith and Berenberg wrote a commentary, "The Concept of Failure to Thrive," in these pages in 1970.1 After recounting the history of the term, they added: "We hope that as a label it will not become indistinct or obscured by uncertainty as to its past, current, or future diagnostic implications." Their warning was appropriate, but numerous authors have failed to accept their concern.
Failure to thrive is assigned as a diagnosis to many children. To some physicians, it means that a child fails to gain weight; others intend it to include failure to grow. It is widely assumed that a failure to gain entails inevitably a failure to grow.
Preface
Authors: FOEGE WILLIAM H. 
Published: December 2021

In November 1981, Dr Edward N. Brandt, Assistant Secretary of Health, Department of Health and Human Services, commissioned the Task Force to examine the scientific evidence regarding infant feeding and infant health in both the United States and developing countries. In addition, the report was to include recent information on trends, infant-feeding practices, and factors associated with infant-feeding decisions. The purpose of the Task Force was to determine those areas that were reasonably well studied and well proven and also to indicate where important deficiencies in knowledge existed. Because of the enormous volume of scientific literature dealing with infant feeding, the Task Force elected to concentrate on the most recent studies.
In addition, studies of health effects were reviewed if they primarily addressed clinical outcomes in infants or children as end points. This approach necessarily excluded many of the laboratory studies that provide the theoretical framework under which breast-feeding would be expected to have important positive health effects relative to other forms of infant feeding.
The Task Force also realized that because of the nature of clinical and epidemiologic research in this area, few of their conclusions could be based on the gold standard of causal research, namely, the randomized clinical trial. Nevertheless, to avoid arriving at conclusions and to say merely that more research was needed, would not live up to responsibility the Task Force was given.
Accordingly, the authors of this report have tried to indicate which observational studies were of sufficient quality and consistency that reasonably firm conclusions could be reached, while indicating methodologic difficulties as they were found.
Infant Feeding and Infant Growth
Authors: Seward Jane F. , Serdula Mary K. 
Published: December 2021

Growth in infancy is a complex process affected directly or indirectly by numerous interrelated factors. The predominant factors include diet, the nutritional status and health of the mother, and the occurrence of infections. In addition, social factors (family structure and cohesiveness), economic status, cultural practices, and biologic factors—such as the sex of the infant, birth weight, birth order, birth interval, and genetics—may also play a significant role in growth.
Nutritional factors may affect growth in infancy both before and after birth. Maternal and infant nutrition are intimately related. For breast-fed infants, nutrition of the mother and that of her young are interrelated from conception until weaning; therefore, dietary intake of pregnant and lactating women is very important.67 Underweight mothers with poor weight gain in the last trimester of pregnancy bear infants with lower mean birth weights.111 Although there are ethnic differences in low birth weight in the United States, the incidence is relatively low.45 In contrast, in developing countries, low birth weight (≤2,500 g), mainly caused by the high proportion of growth-retarded newborns, is a major public health problem.126,138 Infants who have suffered from intrauterine growth retardation remain smaller, on average, than normal babies throughout infancy and early childhood.30,39,44
In developing countries, many nondietary factors also play an important role in determining growth. Infections, particularly gastroenteritis, are among the most important of these factors.91,124 Case-control studies examining factors that differ between malnourished (weight-for-age less than Harvard third or tenth percentile) and adequately nourished children in the second 6 months of life have found significant associations between the following nondietary factors and growth failure: high birth order (greater than six or seven), lower mean maternal age, low maternal weight, children from families in which one or more siblings had died, greater mean number of children less than 5 years old in the home, birth weight less than 2.4 kg, twinning, infections (measles, whooping cough, severe or repeated diarrhea), death of either parent, or a broken marniage.4,96
Zinc and Low Birth Weight: Relationship Questioned
Authors: CARPENTIERI UGO , DAESCHNER C. W. , SMITH LEIGH R. , HAGGARD MARY ELLEN 
Published: December 2021

To the Editor.—
Kumar and Anday1 recommended the addition of zinc deficiency to the list of causes of generalized edema in low-birth-weight infants.
In our opinion, none of the three patients they described support this conclusion, although the conclusion itself may be true. One patient, in fact, improved with protein supplementation alone, although over a longer period of time, and the other two patients improved with protein and zinc supplementation over a period of four to five days.
Marijuana in Urine
Authors: SILBER TOMAS 
Published: December 2021

To the Editor.—
Congratulations on the moving and accurate report on marijuana that was published to "open some pediatric eyes to the need to drop the current all too prevalent laissez-faire attitude about this problem."1 I use this opportunity to call attention to an extremely useful tool that is available to the pediatrician working with patients and their families around the issue of drug use; namely, the cannabinoid urine assay for the detection of marijuana metabolites in the urine.2
An Autosomal Recessive Bone Dysplasia Syndrome Resembling Hypochondroplasia
Authors: DESCH LARRY W. , HORTON WILLIAM A. 
Published: December 2021

Hypochondroplasia is an autosomal dominant skeletal dysplasia characterized by mild-to-moderate shortening of the limbs, a stocky build, lordosis, and occasionally mental deficiency.1-4 Hall and Spranger5 have recently defined distinct radiographic criteria for the diagnosis of this condition. We wish to describe two siblings of normal parents whose features are quite similar to those of individuals with hypochondroplasia. The characteristics that these siblings exhibited are distinguishable from hypochondroplasia by subtle radiographic differences as well as the differing inheritance pattern.
The mother and father of these two girls are, respectively, 167.6 cm and 180.3 cm tall. The third and fourth children in this family, a girl and a boy, have normal stature.
Hot Tub Drownings
Authors: TRON V. A. , BALDWIN V. J. , PIRIE G. E. 
Published: December 2021

Drownings are a major source of morbidity and mortality for children in Canada, accounting for 9% of accidental deaths in children less than 5 years of age.1 Several aspects of drowning in a hot tub are worth emphasizing. This paper describes the treatment of two children following resuscitation after submersion in a hot tub. The clinical and pathologic implications are also reviewed.
CASE REPORTS
Case 1
An 11-month-old male infant was found submerged in a hot tub (water temperature 38°C). The duration of submersion was approximately ten minutes. The infant was rushed to a local hospital where he was found to be asystolic.
Neonatal Intensive Care: Cost-Benefit Analysis
Authors: MANGRAVITE DONALD N. 
Published: December 2021

To the Editor.—
I would like to commend Walker and colleagues1 for their comprehensive examination of the costs and benefits of neonatal intensive care for infants weighing less than 1,000 grams. However, examining only one group of infants served by a tertiary neonatal intensive care unit (NICU) can be misleading.
By definition, a tertiary level NICU is designed to provide a broad range of services to infants with a wide variety of illnesses. As is true for any system expected to provide a broad range of services, some services will result in a more favorable cost-benefit ratio than others.
Rehydration Therapy
Authors: BARNESS LEWIS A. 
Published: December 2021

To the Editor.—
A significant change, as evidenced by recent advertisements, has been made in the composition of Pedialyte oral rehydration solutions. Pedialyte, flavored or unflavored, now contains 45 mEq of sodium per liter (an increase of 15 mEq) and 2.5% glucose (a decrease of 2.5%), and it is suitable for maintenance as well as mild dehydration. The sodium content of Pedialyte RS has been increased to 75 mEq/L, suitable for initial repair of losses of moderate or severe diarrhea, but it should be used with caution in any maintenance regimen in young infants.