bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RESPONSE OF PREMATURE INFANTS TO INFECTION WITH ATTENUATED POLIOVIRUS
Authors: Pagano Joseph S. , Plotkin Stanley A. , Cornely Donald , Leuterer Walter , Koprowski Hilary 
Published: December 2021

Sixty-five premature infants were given CHAT type 1 live poliovirus vaccine. Seventeen other infants were retained as controls. Although 92% of the infants were infected with the attenuated poliovirus, only 59% of infected infants had a definite antibody response. The size of the infant did not seem to influence the duration of intestinal infection.
In 86% of the infants there were significant levels of transplacentally acquired antibodies with an over-all half-life estimated at 23 days. Moderately high titers of homotypic maternal antibodies in the infants did not interfere with infection, nor was there obvious inhibition of active immunologic responses.
Thirty-one of the infants were given a second feeding of the CHAT virus 2 to 5 months after the first administration. The primarily immunized infants were relatively, but seldom completely, resistant to re-infection. In contrast, infants that did not form antibodies after the primary infection seemed to be fully susceptible to re-infection. Moreover, there was no evidence of immunologic tolerance to poliovirus in these infants, for after the second infection poliomyelitis antibodies were invariably found.
We concluded that, while premature infants are highly susceptible to infection with CHAT poliovirus, their immunologic responsiveness—just as in newborn full-term infants—is distinctly less than in infants 2 or 3 months old, but that exposure to poliovirus in early life does not impair later immunologic functioning.
NUTRITIONAL STUDIES OF CHILDREN WITH PICA
Authors: Gutelius Margaret F. , Millican Frances K. , Layman Emma M. , Cohen George J. , Dublin Christina C. 
Published: December 2021

Thirty Negro children with pica were compared nutritionally with 28 control children from the same socioeconomic background. The following findings were statistically significant: lower hemoglobin concentrations, lower levels of ascorbic acid in plasma, less adequate diets, more reported respiratory illness, more recorded days of hospitalization, and more recorded anemia in infancy. No difference was detected between the two groups in clinical evaluation of nutrition or in the number of physical defects. Evidence from anthropometry showed no inferiority in the pica group. Ancillary information indicated that many unfavorable familial and environmental circumstances were also associated with pica, as well as certain behavior disorders of childhood, especially those involving orality.
In a double-blind experiment 16 children with pica received suitable doses of iron given intramuscularly, and 16 received similar injections of saline solution. Iron was not significantly more effective than saline solution in curing or improving the habit of pica. There was no correlation between changes in pica and changes in hemoglobin concentration. At 2 to 3 months after the treatment period, 10 treated children and 8 controls were without pica. The improvement in hemoglobin concentration was significantly greater in the treated group, but improvement in pica was approximately the same and highly significant in both groups. At 13 to 27 months after the treatment period, 11 of 14 children remaining in the treated group and 9 of 13 remaining controls were reported to be without pica. There were five severe relapses, two in the treated group and three in the controls, all of which took place in children with initial levels of hemoglobin above 10.5 gm/100 ml. These five children also came from the most seriously disturbed family situations in the whole series. If iron medication is a factor in curing certain cases of pica, the number of such cases in the present series is not sufficient to affect the statistical results.
REPORT OF THE SECRETARY
Authors: GRULEE CLIFFORD G. 
Published: December 2021

This has been a year of meetings. We have already had Areal Meetings in Buffalo, Milwaukee and Seattle, and now comes the Annual Meeting. For the year 1949, we plan to have but two meetings: the Areal Meeting at Atlanta, Ga., April 13-15, and the Annual Meeting at San Francisco, Calif., November 14-17. There are two reasons why the number of meetings has been reduced. The first is that the force in the central office is too overloaded with work to carry on four meetings a year. The second, and all important, is that the commercial firms will not support so many meetings in one society. As a consequence, we stand likely to have a deficit in each of the three areal meetings. However, in two of these, one of the commercial firms assured us that it would make up any deficit, so that we are now in a position to write these two meetings off the books. I wish to call your attention to the meeting of the Second Pan-American Congress of Pediatrics at Mexico City from November 2-5, 1949, which will be under the direction of the Mexican pediatric group.
Very few of our members have any conception of the amount of work which must precede one of our meetings, nor have they any conception of the amount of routine work which must be done in the central office. It seems likely that, in the not too distant future, we must enlarge our quarters and employ more help.
One of the most encouraging things that has happened in the last year has been the way the committees have taken hold of their jobs and carried them out. Of the Standing Committees, the Committee on School Health has been so regularly efficient that it becomes routine for us to exclaim about it. Such Committees as the Committee on Fetus and Newborn have done outstanding work. The Committee on Legislation has been on the job regularly. The Committee on Governmental and Medical Agencies has been discharged with thanks and its work is taken over by the Committee for Improvement of Child Health. This last committee, under the direction of Dr. James L. Wilson, and with an efficient secretary in the form of Dr. Hubbard, is rounding into form and will have many suggestions to make to the Academy.
THE SPEED OF THE SECONDARY IMMUNE RESPONSE TO TETANUS TOXOID WITH A REVIEW OF WAR REPORTS AND OBSERVATIONS ON SIMULTANEOUS INJECTION OF TOXOID AND ANTITOXIN
Authors: MILLER JOHN J. , RYAN MARY LOUISE , BEARD R. R. 
Published: December 2021

A review of the 30 reported cases of tetanus occurring in actively immunized personnel of the British and American armies permits the following conclusions. The only type of tetanus that need be feared in recently immunized individuals is that which may occur following extensive trauma or massive contamination. It is characterized by short incubation periods, sometimes even less than one week. and a high case fatality rate. The reinjection of toxoid on wounding in two such instances failed to prevent death.
The speed of the antitoxin response during the week subsequent to a reinjection of tetanus toxoid was observed in a group of more than 150 actively immunized children. Marked individual differences were observed. Factors which influenced the speed of response were:
1. The type of toxoid employed in the basic immunization; alum-precipitated or aluminum hydroxide-adsorbed toxoid inducing a superior capacity to react promptly when compared to fluid toxoid.
2. The type of toxoid used for the reinjection (for the secondary stimulus); fluid toxoid inducing a more rapid rise in antitoxin than alum-precipitated toxoid.
3. The interval elapsing since the last injection of toxoid. When this interval was greater than four years the speed of response was occasionally slowed.
Experimental evidence is advanced indicating that the simultaneous injection of prophylactic antitoxin and tetanus toxoid in different extremities does not prevent the secondary immune response to the toxoid. It is therefore suggested that the maximal prophylactic effect against tetanus in severely wounded immunized individuals (and/or when immunization occurred more than four years previously) may be obtained by simultaneous injection of toxoid and antitoxin in different extremities.
THE ETIOLOGY OF EKIRI, A HIGHLY FATAL DISEASE OF JAPANESE CHILDREN
Authors: DODD KATHARINE , BUDDINGH G. JOHN , RAPOPORT SAMUEL 
Published: December 2021

From a clinical, bacteriologic, chemical and pathologic standpoint, one can conclude that Ekiri is mostly bacillary dysentery complicated by tetany, that the diagnosis of Ekiri may occasionally apply to children suffering from tetany and some other infection or perhaps a noninfectious gastrointestinal upset or even tetany alone.
Manifest tetany as seen in hot summer weather, secondary for the most part to bacillary dysentery infection, is a far more serious disease than rachitic tetany without infection. It is characterized by hyperventilation, lethargy or delirium, tonic spasms of the muscles, vomiting, disturbances of the autonomic nervous system and severe clonic or tonic convulsions. The child may die in a sustained tonic spasm or the tetany may aggravate the fever and dehydration caused by the infection, so that circulatory collapse and cerebral anoxia ensue. Early and strenuous treatment of the tetany, the infection and the accompanying dehydration is necessary if the present high death rate of Ekiri is to be greatly reduced. Prevention of tetany in Japanese children by supplementation of their diet with calcium and of dysentery by improved sanitation would be a far better approach to the problem.
GENERALIZED NON-FATAL HISTOPLASMOSIS IN AN INFANT
Authors: BLUMBERG RICHARD W. , RUCHMAN ISAAC , JOHANSMANN RALPH J. 
Published: December 2021

A case of systemic infection with Histoplasma capsulatum with recovery is reported. The organisms were recovered from the blood, bone marrow, and liver. No specific therapy was administered.
Change in skin sensitivity to histoplasmin from negative in the early stage to positive in the convalescent stage was noted. No cross reactions with various other fungus antigens were observed.
TRENDS IN HEALTH LEGISLATION AND ADMINISTRATION
Authors: WALL JOSEPH S. 
Published: December 2021

AS GENERALLY expected, the proponents of national compulsory health insurance lost no time after the opening of the 81st Congress.
In his State of the Union Address delivered to Congress on January 5, 1949, President Truman called again for legislation for a national health program—a request he made in his first health message to Congress November 19, 1945. At that time, three years ago, he said:
"In the past, the benefits of modern medical science have not been enjoyed by our citizens with any degree of equality. Nor are they today. Nor will they be in the future unless Government is bold enough to do something about it.
"People with low or moderate incomes do not get the same medical attention as those with high incomes. The poor have more sickness, but they get less medical care. People who live in rural areas do not get the same amount or quality of medical attention as those who live in our cities.
"Our new economic bill of rights should mean health security for all, regardless of residence, station, or race—everywhere in the United States."
On the same day (November 19, 1945) the Wagner-Murray-Dingell Bill was introduced as S. 1606. After extensive hearings and some modifications, a similar bill (S. 1320) was introduced in the 80th Congress by Senator Murray with the additional sponsorship of Senators Pepper, Chavez, Taylor and McGrath, all Democrats.
In his message to the Democratic 81st Congress President Truman said:
"We must spare no effort to raise the general level of health in this country. In a nation as rich as ours, it is a shocking fact that tens of millions lack adequate medical care. We are short of doctors, hospitals, and nurses. We must remedy these shortages. Moreover, we need—and we must have without further delay—a system of prepaid medical insurance which will enable every American to afford good medical care."
On the same day Senator Murray introduced for himself, and senators Wagner, Pepper, Chavez, Taylor and McGrath a bill 5.5, "to provide a national health insurance and public health program." Two identical bills had already been introduced in the House, HR. 345 by Representative Celler and HR. 783 by Representative Dingell. All three bills are exact copies of last year's bill, S. 1320. (Copies of these bills may be obtained from the Superintendent of Documents, Government Printing Office, Washington 25, D.C., or from the committees to which they have been referred.)
CHILD HEALTH SERVICES AND PEDIATRIC EDUCATION
Authors: SISSON WARREN R. , HUBBARD JOHN P. 
Published: December 2021

The Study of Child Health Services and Pediatric Education has been reported in summary for the country as a whole and is being reported in more detail for the individual states. To summarize a summary approaches a reductio ad absurdum. But now that this momentous Study is not only completed but published, it is timely to point to a few of its most conspicuous highlights.
With the permission of the Commonwealth Fund, to whom we are indebted for publication of the report, we have reproduced below the final chapter of the report itself. These few pages are in the nature of a few drops of juice squeezed out of the fruits of our labors.
The full published report has been boiled down as much as has seemed consistent with an undertaking taking of this magnitude. In a first volume is to be found a general summary of child health services and pediatric education with a number of charts illustrating some of the most important findings. We have purposely avoided over-weighting this volume with heavy statistical tabulations. For those who are interested in more detail and a further analysis of the data, a second volume has been prepared containing methodology, definitions, comprehensive tabulated data, and the basic schedules used in collecting the desired information. So now, in two volumes, the report is available, prepared both for those who have general interest and for those who have more particular concern with the health of children and the training of the doctors responsible for their care—John P. Hubbard, M.D.
THE EFFECT OF SMALLPOX VACCINATION DURING PREGNANCY ON THE INCIDENCE OF CONGENITAL MALFORMATIONS
Authors: GREENBERG MORRIS , YANKAUER ALFRED , KRUGMAN SAUL , OSBORN JOHN J. , WARD RICHARD S. , DANCIS JOSEPH 
Published: December 2021

Following an outbreak of variola in New York City early in 1947, more than five million people were vaccinated. Among these there were observed 4,172 women in the first trimester of pregnancy. They gave birth to 68 children with malformations, an incidence of 1.63%. A control, nonvaccinated group of 2,186 women in the same period of pregnancy, gave birth to 30 malformed infants, an incidence of 1.37%.
The vaccinated group gave birth to 343 premature infants, a rate of 8.2%, while the nonvaccinated group gave birth to 185 prematures, a rate of 8.5%.
Deaths from congenital malformations in New York City during the four months representing the first trimester of pregnancy of the observed women numbered 259, a rate of 48.8 per 10,000 live births. In the corresponding months of the preceding year the number of deaths was 290, a rate of 47.2 per 10,000 live births.
There was no apparent increase in the ratios of stillbirths to total births in 1947, during the months when the stillbirths may have been conceived, over the ratios of the corresponding months of the previous year.
There is no evidence from these studies that smallpox vaccination of women in the first trimester of pregnancy has any deleterious effect on the developing embryo.
FINANCIAL ASPECTS OF PEDIATRIC EDUCATION
Authors: HUBBARD JOHN P. , MITCHELL JOHN MCK. 
Published: December 2021

A year ago we presented at the Annual Meeting of the Academy some of the findings that were beginning to emerge from the Study of Child Health Services. This comprehensive nation-wide survey is now complete and in publication. One of the most important aspects of this study is the fact that it has coupled with a study of services an evaluation of the training of those who are rendering the services.
Many members of the Academy participated in the collection of information from practicing physicians, hospitals and community health agencies. The results of these inquiries are now in the hands of state chairmen who are reporting the findings for their own areas. These state reports which are appearing in increasing number contain not only a summary of the data but also include recommendations as to what ought to be done within the state to fill existing gaps and to improve the health of children.
But the information on pediatric education is less familiar to the many who participated in state programs. This part of the study was necessarily conducted from a central office with one of us, Dr. Mitchell, making a personal visit to each of the 70 approved medical schools and nearly all of the hospitals approved for pediatric residency.
Now that we have reached a point where we can see the whole picture, the Study of Pediatric Education appears in a place of prominent, if not dominant, importance. Service is, after all, a dynamic function, and can be only so good as the training, skills and abilities of the individuals who give it. In the last analysis, good medical care for children depends not so much on the physical facilities of the hospitals or the expansion of health services as upon the judgment and skill of physicians. This skill is the result of training and experience. It was this very fact which at the outset led to the inclusion of an evaluation of pediatric education and which now appears as the logical starting point for a program for the improvement of child health.
Problems of Blood Pressure Measurement in Childhood
Authors: RUDOLPH ABRAHAM M. 
Published: December 2021

Drs. Moss and Adams have presented the results of their investigations on the measurement of blood pressure in children and infants and have also reviewed the whole subject. Their careful observations on the significance of cuff size in the auscultatory method and their experiences with the flush method of pressure measurement in infants are of extreme importance to all pediatricians. This information is presented in great detail, as is the technique for direct intra-arterial pressure measurement. A section on manometry and recording equipment for direct recording of arterial pressure by needle puncture is rather superficial but is adequate for an understanding of the types of equipment available.
This monograph is recommended to all concerned with measurement and recording of blood pressure in infants and children, as a careful evaluation of the problems, advantages, and disadvantages of various techniques.
The Resident in the Non-University Hospital (Continued)
Authors: HARRINGTON EDWIN D. 
Published: December 2021

I read Dr. Fink's letter in the April issue of Pediatric (29:678, 1962) with great interest.
As we have considered this problem at a community hospital in suburban Philadelphia it has seemed to us necessary to answer two questions: (1) What is the problem? and (2) Who is responsible for the solution of the problem?
Essentially, we see the problem of adequate inpatient coverage as a service problem, not a problem in medical education. I would agree with Dr. Fink that his patients "would undoubtedly receive better care with a qualified resident on duty."
CARDIAC COMPLICATIONS OF CEREBRAL ARTERIOVENOUS FISTULA IN INFANCY
Authors: Levine O. Robert , Jameson A. Gregory , Nellhaus Gerhard , Gold Arnold P. 
Published: December 2021

Four infants with congenital arteriovenous malformation of the vein of Galen are discussed, in each of whom there was clinical or roentgenographic evidence of cardiac involvement secondary to the arteriovenous shunt.
Infant 1 was a neonate who presented solely with signs of severe circulatory congestion. The infant died at 48 hours of age despite therapy directed at relief of congestion and improvement of cardiac function.
Infant 2 presented during infancy with roentgenographic evidence of cardiomegaly secondary to cerebral arteriovenous fistula. Chest roentgenograms showed decrease in size of the cardiac image after reduction of the fistula. Partial anomalous pulmonary venous drainage was an associated finding at autopsy.
Infant 3 underwent operation for complete removal of a cerebral arteriovenous aneurysm, and died 7 hours postoperatively with clinical evidence of circulatory overloaded.
In Case 4 cardiovascular studies were done prior to successful reduction of cerebral arteriovenous fistula, and were repeated 4 weeks postoperatively. The shunt was demonstrated by a marked elevation of oxygen saturation of internal jugular venous blood as compared with iliac venous blood; this discrepancy was markedly diminished after operation. Cardiac output was measured by the dye-dilution technique and postoperatively showed a 50% decrease as compared with the abnormally high preoperative determination.
The hemodynamic effects of arteriovenous fistula are discussed. The precise mechanisms responsible for the compensatory increase in blood volume are incompletely understood. The increased cardiac output is accomplished by means of augmented stroke volume in accordance with the Starling law of the heart. While phlebotomy may appear to be indicated in an attempt to reduce the circulatory load resulting from a large arteriovenous shunt, it also deprives the patient of a homeostatic response useful in maintaining adequate perfusion distal to the shunt. Digitalis should be administered when myocardial failure contributes to circulatory congestion.
REPORT OF THE COMMITTEE ON NUTRITION
Authors:   COMMITTEE ON NUTRITION
Published: December 2021

MANAGEMENT of the allergic infant often includes extensive dietary restriction in addition to avoidance of milk. A milkfree formula may thus become a major or even sole source of most essential nutrients for many months. Furthermore, the occasional coexistence of anorexia and intercurrent infection in children with allergic manifestations, and losses of proteinthrough the skin of patients with severe eczema, makes adequacy of diet a major concern of the physician caring for such patients.
Published reports of deficiency diseases developing in infants receiving various milk-free formulas indicate the importance of an awareness of composition and nutritional properties of these diets. Deficiencies of vitamin A and thiamine, have occurred in infants receiving milk-free formulas not fortified with vitamins, and goiter due to iodine deficiency (or increased iodine requirement) has been reported to occur in infants receiving a soya bean formula unsupplemented with iodine.
The present report provides information regarding composition and nutritional adequacy of certain infant formulas commonly employed as cow milk substitutes.
SOYA BEAN PRODUCTS
Composition
Information on the composition of the most frequently used commercial preparations is given in Table I.
Soyalac: Liquid and powder products are prepared from an aqueous extrat of whole soya beans to which has been added soya oil, sucrose, dextrose, dextrins, maltose, and iodised sodium chloride, When diluted with water to supply 67 cal/100 ml (20 cal/oz). Soyalac liquid supplies 2.05 gm of protein/100 ml, the least protein content of commercially available soya bean formulas. Formulas of Soyalac Powder with the same caloric strength provide 2.85 gm of protein/100 ml and differ in other important respects from Soyalac liquid (Table I).