bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE PEDIATRICIAN AND THE PUBLIC
Authors: Jelliffe D. B. 
Published: December 2021

THE VAST majority of the global child population is located within what have been termed the technically developing subtropical and tropical regions of the world. In India, for example, there is a child population of approximately 150 million with an estimated infant mortality rate ranging in different parts from over 100 to much more than 200 per 1000 live births. Despite these enormous concentrations of population, problems of child health in these areas have been neglected to a large extent until very recently, while pediatric education has usually received but little emphasis.
PRESENT SITUATION
The concentration of trained pediatricians in most tropical regions is extremely low, sometimes literally only 1 or 2 may be practising in a whole country. This is, for the most part, a reflection of the general deficiency of all types of medical and nursing personnel. Of greater importance is the all too common inadequate knowledge of pediatrics possessed by those in general practice in many tropical countries, which is often primarily the result of defective emphasis given to this specialty during undergraduate training. In some regions, including much of South-East Asia and especially India, pediatrics still has the same status that it had in the United States and Britain over 30 years ago—that is as an insignificant fragment of the student's training, perfunctorily dealt with in a few didactic lectures and ward rounds. There is, therefore, great need in some tropical countries to educate those responsible for organising and planning medical education to the understanding that pediatrics is 1 of the 4 major components of the student's clinical curriculum.
ANTIBODY RESPONSES TO NATURALLY OCCURRING POLIOMYELITIS INFECTIONS
Authors: Miller C. Arden , Lenahan Margaret F. 
Published: December 2021

The neutralizing antibody responses of 52 asymptomatic household contacts of patients with poliomyelitis were studied by the metabolic inhibition method. Half of these contacts were fecal carriers of poliomyelitis virus. For purposes of comparison the antibody responses of 25 patients with paralytic poliomyelitis, all fecal virus carriers, were studied. The errors of replication of the test procedure were determined by duplicate testing of 51 serums.
Duplicate testing of serum specimens indicated disagreement regarding the presence or absence of antibody in 6.0 to 8.0 per cent of the serums. The second test gave antibody titers which disagreed with those from the first test by a factor of fourfold or more 37.0 per cent of the time; errors occurred equally in either direction.
Half of all persons studied showed an increase of fourfold or more in the antibody titers of paired serums; this was 3 to 4 times as many as would be expected by chance. It was not possible to distinguish the antibody responses of paralyzed patients from asymptomatic household contacts; or the fecal virus carriers from the nonvirus carriers in the latter group.
Four virus carriers who did not have homologous antibody in convalescent serums were found. By repeat testing homologous antibody was found in all but one of these.
The limitations of the test procedure as a diagnostic tool are discussed.
GROWTH AND DEVELOPMENT OF PERUVIAN CHILDREN
Authors: Trulson M. F. , Collazos C. , Hegsted D. M. 
Published: December 2021

One hundred nine school children from 2 rural areas in the coastal area of Peru were measured and weighed and roentgenograms of the hand and wrist were obtained.
Three-fourths of the children were below Stuart's tenth percentile in height. Roughly, a third of the children were below the tenth percentile in weight. Fifteen per cent of the girls and 30 per cent of the boys were above the fiftieth percentile in weight.
Forty to forty-five per cent of the children were in the stocky to obese channels of the Wetzel grid; 5 to 10 per cent would be classified as fair to poor, and roughly half would be considered average.
Developmental age (Wetzel) was 7.5 ± 15.6 months less than chronological age for boys, 10.5 ± 11.3 months less for girls. A third of the boys and 15 per cent of the girls were advanced in Wetzel developmental age. It was apparent that the heavier children were generally advanced in Wetzel developmental age.
Roentgenograms of the hand and wrist were assessed by comparing the films to the Greulich-Pyle Standards. Skeletal age was -11.3 ± 12.7 months for boys and -7.1 ± 9.8 for girls. Eighteen per cent of the population were advanced in skeletal age. Boys were more retarded than girls in skeletal age.
The correlation and partial correlation coefficients for all combinations of the 4 measurements (retardation in weight, retardation in height, retardation in skeletal age and retardation in developmental age) were calculated. The various pairs were all rather highly correlated, this being particularly true of weight and Wetzel developmental age. The partial correlation coefficients show, however, that skeletal age was not closely correlated with any of the other 3 measurements. Height and developmental age were negatively correlated to a significant degree, and developmental age and weight were so closely related that they appear to be measures of the same characteristic in this population.
Individual dietary histories are not available from these children, but it is known that the diets in the area are considerably below recommended levels in certain nutriients. Whether dietary deficiencies are factors in the apparently abnormal developmental patterns, or if the patterns are truly abnormal for the Peruvian child or indicate an adverse effect on health, remain to be shown.
It is pointed out that there are probably advantages in studies upon growth and development in different areas of the world where a variety of dietary or environmental factors may have specific effects.
MONGOLISM (MONGOLOID DEFICIENCY) DURING EARLY INFANCY—SOME NEWLY RECOGNIZED DIAGNOSTIC CHANGES IN THE PELVIC BONES
Authors: Caffey John , Ross Steven 
Published: December 2021

IN MONGOLOID defectives, stigmas in the skeleton have been reported at several sites: hypoplasia of the base of the skull; hypoplasia of the nasal and other facial bones, and dysplasia and hypoplasia of metacarpals and phalanges. Undergrowth of the vertebral bodies and the tubular bones in the extremities is responsible for the dwarfism which is one of the most consistent components of this syndrome. Maturation of the skeleton varies greatly in different mongoloid infants; it may be advancecd, normal, or retarded. At birth practically all infants with mongolism show normal or advanced maturation, in our experience.
Spitzer and Robinson found the frontal sinuses to be absent in 26 out of 28 individuals with mongolism in contrast to an absence in 4 to 5 per 100 of the remainder of the general population. Only 2 of the 28 individuals with mongolism showed no dental aplasia. The erupted teeth were commonly stunted, eruption of the permanent teeth was often delayed, and there was a higher incidence of the dental anomalies found than in the general population. No pathognomonic lesions in the teeth were found. The partial anodontia, deformed teeth and delayed eruption resemble the changes found in ectodermal dysplasia and in cleidocranial dysostosis.
Smith and McKeown found the mean weights of newly born infants with mongolism to be 2860 gm. in contrast to 3220 gm. for normal newborns. the mean duration of gestation to he shorter for infants with mongolism than for normal newborns, 269 days and 278 days respectively.
So far as we have been able to ascertain, stigmas in the pelvic bones of infants with mongolism have not been reported in either anatomical or roentgenographic studies.
Disorders of Character
Authors: WORK H. H. 
Published: December 2021

In a small but tightly packed volume, Dr. Michaels has compressed his medical career of research into the subject of persistent enuresis and has correlated this with a high incidence of the condition in juvenile delinquents, particularly those of a psychopathic type.
He has elaborated his findings into a triad of maleness, persistent enuresis, and juvenile delinquency. This he has fitted into a rather deeply rooted character structure which he terms as having "bio-psycho-social" connotations.
THE ROLE OF GENETICS AND OTHER PRENATAL FACTORS IN DISORDERS OF CHILDHOOD
Authors: Warkany Josef , Fraser F. C. 
Published: December 2021

THE PHYSICIAN interested in the etiology of a disease should always try to ascertain as many etiologic factors as possible, because the causal pathogenic web can often be disturbed from different angles. Although hereditary factors will be the main topic of this round table, we shall stress that they never act in a vacuum. The genes direct the development of the embryo and fetus, but the development depends also upon an environment limited by the mother's body and surroundings.
Certain terms are fundamental to an understanding of heredity:
Chromosomes. The nuclear carriers of the hereditary factors, the genes. Each nucleated somatic cell of a person's body has 24 pairs of chromosomes, each pair carrying hundreds of genes. One member of each pair is derived from the person's mother and one from the father. In the female there are 23 pairs of autosomes (non-sex chromosomes) and 1 pair of like sex chromosomes (X-chromosomes). In the male there are 23 pairs of autosomes and 1 pair of unlike sex chromosomes (one X and one Y-chromosome).
Gene. The particulate biochemical factor responsible for a particular hereditary characteristic. As the genes are carried on the chromosomes, they also occur in pairs. Each pair occupies a particular locus on the chromosomes. Genes located at the same locus are termed alleles. A child gets 1 member of each gene pair from each parent. Sometimes by the rare event of mutation, a gene becomes changed into one that may function abnormally—a "pathologic" gene.
Homozygote. An individual in whom the gene pair in question consists of 2 like genes.
Heterozygote. An individual in whom the gene pair in question consists of unlike genes.
Depending upon the type (dominant or recessive) and location (autosome or sex chromosome) of the gene, several types of inheritance patterns are possible.
FAMILIAL NONHEMOLYTIC JAUNDICE WITH KERNICTERUS
Authors: Childs Barton , Najjar Victor A. 
Published: December 2021

Two cases of familial nonhemolytic jaundice have been described. Both patients, though severely jaundiced for periods of 5 and 2 years, have grown and developed normally and show no evidence of damage of the nervous system. This is in contradistinction to the six other patients, presented in the original report of this disease, who died after developing kernicterus. No reasons can be suggested for the escape of these two patients from kernicterus.
Some speculations concerning the nature of the genetically controlled aberration in this disease have been given.
It is suggested as a plausible hypothesis that the lesion consists of deficiency of an enzyme which controls the chelation of indirect-reacting bilirubin so as to form direct-reacting bilirubin. The enzyme, though deficient, is capable of adequate function if a sufficient load of bilirubin is presented to the liver. Under such circumstances bilirubin is excreted in normal amount, but only in the presence of a large accumulation of the pigment in the blood.
CONGESTIVE HEART FAILURE
Authors: Keith John D. 
Published: December 2021

HEART failure is associated with an inability of the heart to empty itself adequately, with the result that there is a high venous filling pressure and a decrease in the effective work done by the heart muscle. There are several factors that, if sufficiently severe, will produce congestive heart failure in either infancy or childhood. These include valvular obstruction or insufficiency; mechanical obstruction of the heart as a whole, as in pericardial disease; the physical effects of large intracardiac shunts which increase the load on one or both ventricles; the presence of raised pressure in the pulmonary or systemic circulation; inflammatory reactions in the heart muscle or oxygen lack; and, finally, certain metabolic disturbances, such as hyperthyroidism or hypothyroidism.
One or more of these factors may be operating in the same child, as in rheumatic fever where myocarditis is associated with valvular insufficiency, or in congenital heart disease with pulmonary stenosis and patent foramen ovale, where the right ventricle has a high pressure to maintain and is at the same time being offered cyanotic blood from the coronaries.
PATIENT MATERIAL
In analyzing 1,580 cases of congenital heart disease at the Hospital for Sick Children, Toronto, 20 per cent were found to have had failure at some time. In 90 per cent of these failure occurred in the first year of life. A list of the various causes of heart failure in the pediatric age group in order of frequency follows. [see table in source pdf]
In certain types of heart defects failure develops in characteristic age groups. For example, during the first week of life the most common cause of heart failure is aortic atresia. From 1 week to 1 month, coarctation of the aorta leads. From 1 to 2 months, transposition of the great vessels predominates. From 2 to 3 months, endocardial fibroelastosis is the chief cause of heart failure, with transportation of the great vessels second to it.
The actual incidence of type of heart defect in relation to age at onset of heart failure is as follows.
DIGOXIN DOSAGE IN INFANTS
Authors: Sapin Samuel O. , Donoso Ephraim , Blumenthal Sidney 
Published: December 2021

Digoxin is suggested as the drug of choice for digitalis therapy in infants and children, primarily because of its rapid dissipation.
The use of average dosage figures, while necessary in starting therapy, is often unsatisfactory and may be hazardous unless one appreciates the great range of sensitivity to digitalis amongst patients. The principle set forth by Withering and repeated by many since then that each patient treated with digitalis is a titration experiment, still holds.
Our studies and experience with digoxin in normal infants as well as in those with heart disease enable us to propose a digitalizing regimen which has proven effective and yet safe in most of the infants who can benefit from digitalis therapy.
We recommend an initial "digitalizing dose" of 75 µg/kg in 24 hours, orally or intramuscularly. One-half or one-third is given first and the remainder in equal portions every 6 to 8 hours. If the desired clinical effect is evident, a maintenance dose of 25 µg/kg once daily is administered. If, however, the desired clinical effect has not been achieved after the initial "digitalizing dose," 25 µg/kg should be given under careful clinical and electrocardiographic observation every 6, 8 or 12 hours (depending upon the severity of the failure) until either a satisfactory effect or toxic signs appear. The maintenance dose may then be proportionately larger. Changes in S-T segment and T wave in the electrocardiogram are not considered signs of toxicity. The development of vomiting or the appearance in the electrocardiogram of significant conduction defects, or arrhythmias are indications of digitalis toxicity.
Relatively large amounts of digoxin may be necessary in some infants both initially and for maintenance in order to obtain maximum benefit from the drug.
SCHOOL AND THE ADOLESCENT
Authors: Farnsworth Dana L. 
Published: December 2021

TO THE adolescent school is not only of great interest, it is his life, the activity that occupies the greater portion of his waking hours, the standard by which almost everything else is judged. If he does not like school, or does not do well in his studies, his future progress is almost always seriously impaired. Instances of aversion to school are numerous, so numerous in fact that it would not be possible to have all those older children who have a "school phobia," as it is sometimes called, treated by psychiatrists, desirable as that might be in theory. It is very much the business of the physician who sees young people to know some of the reasons why the adolescent and the school sometimes become at odds with one another.
It is a reasonable assumption that if the young boy or girl has a natural curiosity (and almost all do), and his interest in the things about him and in the written word have been encouraged by his parents, he will almost always enjoy school and be able to put up with influences which would be highly harmful to a less fortunate youngster. We seldom have to worry about the adolescent who comes from a home where cultural things are valued, providing he has good intelligence and the school keeps his mind stimulated up to its capacity. Unfortunately, the opportunities for something to go wrong are numerous.
The most important bit of good fortune a young person can have is to fall under the supervision of teachers who like children, who like books, are curious, secure within themselves, are able to maintain discipline by their manner and example rather than by authoritarian methods, and who think of their pupils as young, growing personalities to be given responsibility and helped into self control, rather than as wild animals to be kept caged and under control.
COLIC IN INFANTS
Authors: Glaser Jerome 
Published: December 2021

This may well have been a historic occasion because so far as I have been able to ascertain, this was the first time that a symposium on the important subject of colic in infants had ever been presented at a national meeting of pediatricians. Due to the fact that little attention is paid to colic in institutions, this disorder has rarely received the attention of the full-time academic pediatrician (unless he has experienced it in his own family). For that reason interns and residents all too commonly encounter this frustrating problem only on starting private practice when it becomes a matter of great importance and concern.
Our fundamental knowledge of what is termed "colic" is so uncertain that it is appropriate in discussing this subject to quote a remark by Tenney, "And so it is with colic; maybe there is no such thing, but there is certainly something that makes perfectly healthy babies cry almost unbelievably loud and long without interfering with their perfect health." For the purposes of this discussion colic may be defined as a symptom complex of early infancy characterized by evidence of intermittent abdominal pain of varying degrees of severity for which no organic or obvious physiological cause can be regularly demonstrated.
For discussion of this subject pediatricians were selected who for the most part, because of part-time positions on the teaching staffs of medical schools, would be expected to have academic as well as practical interest in this problem and who, because of their varying interests, have considered the problem from different viewpoints. Attention is directed particularly to the fact that among the 8 papers presented at this symposium only 2 were by pediatric allergists, Dr. Fries' and Dr. Ratner's.
The Teacher and the Child
Authors: STROUD JAMES B. 
Published: December 2021

This is a fine book. Basically it reports and interprets the experiences of 92 elementary and secondary school teachers as they attempted to practice certain principles of mental hygiene in school situations. It presents an account of teachers' own perceptions of the needs and feelings of pupils and the behavior of these teachers as they tried to effect wholesome interpersonal relationships.
The fact that it is teachers who did the things reported, rather than a worker in group therapy or interview therapy or some other specialist, should make the book appealing to the education worker.
A CASE OF CRYPTOCOCCUS NEOFORMANS MENINGOENCEPHALITIS COMPLICATING BOECK'S SARCOID
Authors: Lepow Harold , Rubenstein Leo , Chu Foo , Shandra Joseph 
Published: December 2021

A case is presented of diffuse systemic sarcoidosis complicated by fatal meningoencephalitis caused by Cryptococcus neoformans in a 10-year-old child.
The frequency of coincidence of diseases of the reticulo-endothelial system and infections with cryptococcus neoformans, as well as possible causes for this relationship, are discussed.
STUDIES OF THE PHARYNX
Authors: Merritt W. H. , Nielsen M. , Bosma J. F. , Goates W. A. , Haskins R. , Ramsell C. , Lamb R. H. 
Published: December 2021

An unusual occlusion of the mesopharynx is described in two patients with poliomyelitic impairment. This occlusion results from apposition of the lordotic cervical spine to the retrodisplaced structures of the mouth and face. The whole area of mouth, pharynx and larynx was immobilized by severe contracture of its musculature.
Methods of therapeutic mobilization and restoration of function to these structures of the bulbar area are described.
Paper Electrophoresis
Authors: FOMON SAMUEL J. 
Published: December 2021

Although the book deals with both technique and applications of paper electrophoresis, the major emphasis is on methodology. The participants are of world-wide representation and are mainly individuals who have made important contributions to the development of the methods and apparatus.
The material presented includes opinions and presentation of evidence favoring the choice of buffers, filter paper, voltage, stain, etc., and of the identification and quantitative analysis of the separated materials. Paper-solvent interaction, paper-solute interaction and the influence of evaporation and diffusion are among topics of physicochemical interest.
CHILDHOOD PROBLEMS IN RELATION TO THE FAMILY
Authors: Kanner Leo , Eisenberg Leon 
Published: December 2021

HISTORICAL
THE CHIEF focus in child psychiatry at the present time is on family relationships. It is of considerable interest that the concept of family relations did not really come into being until about the turn of the century and since then has come to occupy a position of increasingly greater emphasis in our thinking. This change in thinking took place mainly because of the efforts of Freud in Europe and Meyer in this country. It was in the first decade of the Twentieth Century that psychiatric history taking came to include a biography. However, even at that time, little attention was paid to children's behavior difficulties. It is of considerable interest that Freud's theories on infantile sexuality were published before Freud had ever seen a child professionally.
The greatest impetus came in the Twenties with the establishment of child guidance clinics at various places throughout the country and these began to study family attitudes and the relationships between various members of the family.
ATTITUDES
When we introduce the subject to medical students, we like to tell them that they have learned in medical school about various sets of agents which may be normally necessary for the proper body economy, may, on some occasions, be pathogenic, and may, under different circumstances, be remedial. Chemical substances, for example, are vitally important as foodstuffs, detrimental as toxins, and remedial as drugs. We have come to recognize that there is one other set of agents that is just as important and can have similar effects. These agents we choose to refer to as attitudes. In general, a person's feeling about himself and about the world in general will depend on the attitudes of the people who constitute his world. Certain attitudes provide an emotional climate that is ideal for the growing child and likely to provide for emotional stability. In summarizing the various attitudes that are necessary, we like to think of them in terms of the three A's: Affection, Acceptance, and Approval. It is certainly true that any child has a better chance of developing emotional security if he is surrounded by this attitudinal constellation.