bluuebunny/crossref_metadata_2025_split huggingface dataset:
BCG VACCINATION AGAINST TUBERCULOSIS IN CHICAGO
Authors: Rosenthal Sol Roy , Loewinsohn Erhard , Graham Mary L. , Liveright Dorothy , Thorne Margaret G. , Johnson Violet , Baison H. C. 
Published: December 2021

A series of 1,716 BCG-vaccinated and 1,665 nonvaccinated infants, all born at the Cook County Hospital in Chicago between February, 1937, and February, 1948, were followed until February, 1960 (23 years). Among the vaccinated there was a total of 17 cases of tuberculosis (0.43/1,000/yr) and 65 cases in the nonvaccinated 1.7/1,000/yr), a reduction of 75%, statistically highly significant (p 0.001). The morbidity was 0.41/1,000/yr (16 cases in 1,716) in the vaccinated subjects and 1.5/1000/yr (59 cases in 1,665) in the controls, or a reduction of 74% (p 0.001). There was one death from tuberculosis in the vaccinated subjects and six in the controls, or a reduction of 83%. The number of deaths is too small for meaningful statistical analysis.
Comparisons of the control and vaccinated groups were made for subsequent contact to tuberculosis in the home and environment, sex, race, birth weight, observation years, follow-up care, general health and reasons for loss from study. The over-all comparability of the two groups was adequate in most respects. Statistically significant differences were assessed for medical importance. In 639 families in which there were both vaccinated and control siblings, 8 of the 790 vaccinated subjects developed tuberculosis as compared with 30 of the 845 control individuals. The difference is highly significant (p 0.001). Thirteen cases of nonfatal tuberculosis developed in the controls 2 years of age and under and none in the vaccinated. There were three deaths from tuberculosis in the controls under 2½ years of age (miliary tuberculosis plus meningitis in all) and one death in the vaccinated group (meningitis). The latter was an infant who had not converted at 6 months of age and was not revaccinated. Following vaccination, 99.3% became tuberculin positive and 82.4% were still positive, after 8 years, to a single vaccination.
PRESIDENT'S MESSAGE
Authors: Fischer Carl C. 
Published: December 2021

FROM TIME to time Presidents of the American Academy of Pediatrics have used this means of sharing with the fellowship, thoughts which seem to them to be of mutual interest.
Last year, President George Wheatley had such a message in every issue, covering a wide variety of interesting and stimulating topics.
I will not plan to necessarily continue this policy of having a message for each issue, but will do so whenever the subject matter seems to warrant one.
At this, the beginning of a new year for the Academy, it seems appropriate to present to the membership at large a few of the thoughts which I presented in Chicago upon my inauguration as your President.
It has recently been my pleasure to reread the two little volumes sent to all Academy Fellows a few years ago, the one containing the Presidential addresses of the first 20 presidents, and the other, Dr. Marshall Pease's stimulating "History of the Academy." I heartily recommend these to any of you who might be interested in the conception, delivery and growth and development of our organization.
Of first importance at this time, it seems to me, is the review of the primary objectives of our Academy as originally drawn up by Dr. Grulee and his associates more than 30 years ago.
These are: "The object of the Academy shall be to foster and stimulate interest in Pediatrics and correlate all aspects of the word for the welfare of children which properly come within the scope of pediatrics."
HYPERTENSION IN EMBRYOMA (WILMS' TUMOR)
Authors: HUGHES JAMES G. , ROSENBLUM HERMAN , HORN LACY G. 
Published: December 2021

A case of Wilms' tumor of the right kidney is presented, in which the dominant clinical features were extreme elevation of blood pressure and hypertensive encephalopathy, associated with cardiac decompensation and death. Generalized convulsions and right hemiplegia developed, believed to have been due to cerebral anoxia incident to angiospasm. No metastases were found, and no other cause for arterial hypertension was discovered. This patient is thought to be the first case reported where death from Wilms' tumor was due to the hypertensive factor.
The literature with reference to the association of hypertension with Wilms' tumor is reviewed.
The mechanisms by which Wilms' tumors may produce unilateral renal ischemia with arterial hypertension are discussed.
The presence of clearcut hypertension in a child with a kidney area mass points toward the probability of a Wilms' tumor.
American Medical Research, Past and Present, Studies of the New York Academy of Medicine Committee on Medicine and the Changing Order
Authors: MAY C. D. 
Published: December 2021

This monograph is one of a series resulting from studies by the Committee on Medicine and the Changing Order of the New York Academy of Medicine.
The objective in this report was to trace the historical development of medical research and to define and describe the role of medical research in the social order particularly as regards support for research from government agencies.
The comprehensive grasp of the complexities of medical research which Dr. Shryock reveals commands genuine admiration and respect from anyone engaged in such research. Indeed, few engaged in various aspects of medical research could claim anything like his familiarity with the broad outlines of this field.
PRESIDENT'S MESSAGE
Authors: Fischer Carl C. 
Published: December 2021

IT WOULD SEEM most appropriate that if we in American pediatrics were to be given an opportunity, in the words of the immortal Robert Burns, "to see ourselves as others see us" that this be given by a fellow countryman of his! Such is the case in the most interesting article entitled "Pediatrics in America—Impressions of a Visit," the lead article in the July, 1962, issue of the American Journal of Diseases of Children, by Dr. John O. Forfar, Consultant Pediatrician at the Western General Hospital, Edinburg, and Senior Lecturer in Child Health at the University of Edinburgh. Dr. Forfar is kind enough to present us with his impressions of a visit lasting 3 months and including some 10 academic centers in 21 hospitals along the East Coast with some few in the Central and Western America, each visit taking from 1 to 14 days.
He starts by making some interesting comparisons between pediatrics in the United States and Great Britain. He notes that although in general there are definitely more physicians per unit of population in the United States than in the British Isles (e.g., USA 1:760, Great Britain 1:900), the percentage of specialists is considerably higher in our country than in his. He also notes that in the United States there are reported to be three general practitioners for five specialists, as compared with three general practitioners for one specialist in England. He further reports that the United States is said to have approximately 9,000 pediatricians, two-thirds of whom are certified, while all of Great Britain has only 250.
THE PEDIATRICIAN AND THE PSYCHIATRIST
Authors: BYERS RANDOLPH K. 
Published: December 2021

OVER THE PAST DECADES psychiatrists have bemoaned the hostile or neglectful attitude of pediatricians toward psychiatric contributions to medical science. In large measure pediatricians defend their prejudices on the basis that medical advance has been made by the scientific method of objective observation in controlled situations, and that much of psychiatric literature has not adhered to such standards.
From the pediatric point of view psychiatric literature has displayed three major weaknesses. These are exemplified, first, by the anecdotal papers, in which individual cases illustrative of a point may be quoted as of generic value. Secondly, there are the authoritarian papers, in which a psychiatrist considers some such subject as reading difficulty or bed wetting by classification and discussion without the benefit of any objective data.
Pediatrics
Authors: HILL LEE FORREST 
Published: December 2021

The present revision marks the thirteenth for this standard textbook of pediatrics since the original text was written by the late L. Emmett Holt in 1869. John Howland, of Hopkins fame, was associated with the senior Holt in revisions from 1912 to 1926. L. Emmett Holt, Jr., and Rustin McIntosh took over in 1927, and for this last revision they have been joined by Henry L. Barnett.
How should one go about reviewing the present edition of this nearly 1,400-page book which has served so illustriously as a standard text for some 66 years, and now has as author-editors such eminent educators in the pediatric field as Holt Jr., McIntosh, and Barnett?
Ceruloplasmin Test for Wilson's Disease
Authors: SCHINBERG I. HERBERT 
Published: December 2021

The point made in the article by Silverberg and Gellis (Pediatrics, 30:402, 1962) is excellent and important: "In childhood, chronic liver disease of unknown etiology should always be screened for Wilson's disease." But why wait until chronic liver disease has developed? The diagnosis can be made while the patient is still asymptomatic as the authors' own case material demonstrates.
E.M. was examined carefully in 1952 at 8 years of age, when she was asymptomatic, because her sister M.M., then 15 years old, had Wilson's disease.
THE HAND-MOUTH REFLEX OF BABKIN IN PREMATURE INFANTS
Authors: Parmelee Arthur H. 
Published: December 2021

The hand-mouth reflex of Babkin consisting of head flexion and rotation with opening of the mouth in response to pressure on the palms of both hands was studied in 57 newborn infants. All but eight of these infants were premature, weighing less than 2,500 gm at birth. Only two infants did not respond at any time. One hundred seventy-nine tests were done, with 153 (85.4%) positive. Of the latter, 105 (68%) showed head flexion, 81 (53%) head rotation, and 106 (68.6%) mouth opening.
The responses seemed to be more easily obtained in the smaller premature infants, but the intensity was greater in the larger infants. Since there was also some indication that the test is state-dependent, especially in the larger infants, it is proposed that possibly the smaller premature infants have a narrower range of state from sleep to alertness. Thus the smaller infants might be expected to always give some degree of response regardless of state, whereas the large infants would only respond if in a somewhat aroused state, including light sleep.
The reflex seems to be very primitive in nature, since it was obtained in one very premature infant of 26 weeks gestation weighing 580 gm as well as in all but two of the other premature infants. No definite correlation of the absence of response or degree of response could be made with lesser degrees of neurological disorders in the newborn period. However, babies who were critically ill or in coma did not respond, or only responded weakly. The hand-mouth reflex of Babkin is still another of several primitive reflexes relating the hand and mouth in a sensory motor relationship. These are discussed.
MILK ALLERGY
Authors: Goldman A. S. , Sellars W. A. , Halpern S. R. , Anderson D. W. , Furlow T. E. , Johnson C. H. , Bean G. W. , Cook T. E. , Crook W. G. , Fein B. T. , Fruthaler G. J. , Harrison W. , Kamin P. B. , Kniker W. T. , McElhenney T. R. , McLaughlin L. A. , Rabinowitz H. I. , Saperstein S. , Thannisch G. E. 
Published: December 2021

Skin testing separately and with equal concentrations of the purified milk proteins, casein, alpha-lactalbumin, beta-lactoglobulin, and BSA was done in 85 milk allergic children. For control purposes, intradermal tests with the same antigens were done in 102 normal children and 31 children allergic to non-milk substances.
Six per cent of the normal children had weakly positive reactions. However, positive skin tests occurred in 68% of the children allergic, but not to milk, and in 59% of the children allergic to milk. In the milk allergic children, the incidence of positive reactions to each milk protein was similar. The incidence of positive skin tests in milk allergic children was higher than previously apprised. Positive skin tests in the milk allergic child were obtained long after the dietary elimination of milk antigens and after the disappearance of circulating milk antibodies as detected by a variety of techniques.
In contrast to the control groups, strongly positive skin tests occurred only in milk allergic patients. Although no correlation was found between the results of all skin tests and the results of oral challenges with the same milk protein, a close correlation was found between the results of strongly positive skin tests and the results of oral challenge with the same milk protein. It appears that weakly positive skin tests with purified milk proteins have a little diagnostic value, but strongly positive skin tests have diagnostic significance.
SPONTANEOUS ALVEOLAR RUPTURE AT BIRTH
Authors: Chernick Victor , Avery Mary Ellen 
Published: December 2021

Spontaneous pneumothorax in the newborn period was recognized in fifteen infants over a 6-year period.
Seven of the 15 infants were symptomatic in the delivery room, which suggests that lung rupture occurred with the first few breaths. Three of the seven were meconium stained. The remaining eight infants were symptomatic within the first 24 hours.
The unique features of the first breath of the newborn infant, namely, the serial opening of ventilatory units and high applied pressures, suggest that any foreign material in the airway would make rupture of opened units likely. Studies on the inflation of airless lungs demonstrate the opening phenomenon.
Four of the 15 infants died, 2 from their pneumothoraces. This bad experience led us to examine principles of treatment of spontaneous pneumothorax with the recommendation that oxygen breathing in some term infants, and prompt aspiration in others would be useful. The majority, however, can be expected to resolve spontaneously.
Measurements of the rate of absorption of air in the pleural cavity in the rabbit show a six-fold increase with 100% O2 breathing.
THE PROBLEM OF HOSPITAL ACCIDENTS TO CHILDREN
Authors: Lowrey George H. 
Published: December 2021

Accidents do occur with an alarming frequency to children who are in the hospital. Fortunately, the majority of such accidents do not result in any serious injury to the child. Nevertheless, many of them are potentially serious in nature. The medicolegal implications are of considerable importance to the hospital, physician, nurses, and other personnel. A very high percentage of the accidents can be traced directly or indirectly to errors on the part of these hospital personnel. The material presented in this survey is not complete but leads to certain conclusions.
1. There could be greater uniformity in accident reporting with an attempt to define an accident more specifically. It is felt that the actual number of accidents that occur in pediatric wards is probably much higher than indicated by this paper, but many accidents are not reported, since they do no actual injury to a patient.
2. Orientation toward accident prevention should be carried out and repeated at regular intervals for all hospital personnel. This should be designed to stress all potential dangers and to give all staff working in pediatric areas greater knowledge in this field.
3. The prevention of medication errors might be reduced by a number of factors. These include the preparation of medicaments in a more isolated area so that there is less opportunity for distraction. The orders required for any medicaments should be very specific. This is particularly true when parenteral fluids are administered, and this should include quantity, duration of administration, and the type of fluids or medicaments to be used. Finally, the stocking of pediatric dosages of commonly used medicines is to be encouraged.
4. The preparation of a detailed accident report by the person involved in each of the accidents, whether it is his fault or not, should be a required hospital procedure. One of the aims of such a report is to further education in this field, and secondly, to bring about solution to the repeated occurrence of a similar type of accident.
5. The formation of an accident committee to review data from accident reports and to inspect the pediatric areas in a hospital at regular intervals is highly recommended.
THE DEVELOPMENT OF THE IMMUNE RESPONSE
Authors: Smith R. T. , Eitzman D. V. 
Published: December 2021

Immunization of newborn infants with Salmonella vaccines results in agglutinin formation to the flagellar antigen as early as 7 days of life, and in 80% of infants by 14 days. This agglutinin is a gamma-l macroglobulin with a sedimentation rate of approximately 17 to 20S, and is susceptible to reductive cleavage. Production of a 7S sedimenting gamma-2 globulin agglutinin occurred by the 30th or 40th day after immunization in some infants.
In the adult, macroglobulin agglutinins against the flagellar antigen appeared 4 to 5 days after immunization, followed by appearance of 7S agglutinins 3 or 4 days later. Both the macroglobulin and the slower sedimenting gamma-2 globulin agglutinin were thus qualitatively similar in the adult and infant and differed only in the timing of their appearance. Transplacentally acquired agglutinins specifically inhibited the response to the homologous flagellar antigen.
Evidence was found for an agglutinin of intermediate sedimentation rate which had the electrophoretic mobility of gamma-l globulin, and was susceptible to reductive cleavage. This type agglutinin appeared after the macroglobin and before the 7S agglutinin.
These studies support the concept that immunity, like all developmental processes, must not be measured to adult norms. At each stage of ontogeny, the mechanisms which have evolved should be judged by their appropriateness in dealing with the threats to survival peculiar to the epoch rather than those of full maturity.
Letters to the Editor
Authors: VANDERSALL THORNTON A. 
Published: December 2021

The major points of my letter appear to have been accepted by the Drs. Randall, i.e., that there are differences between the residency and the community experience, that residency programs need constant re-evaluation and that most pediatricians could use a much wider experience in Psychiatry.
The idea that pediatricians are the most dissatisfied specialists has been well documented elsewhere. My suggestion was that, in other cases as well as my own, it was not economic factors or professional ambition that led to dissatisfaction.
Early Gastrostomy in Feeding Prematures
Authors: STEIGMAN ALEX J. 
Published: December 2021

The good results of Berg et al. reported as "The Use of Gastrostomy in Feeding Premature Infants" will encourage others to explore this technique.
There has long been a reluctance to consider surgery for a so-called medical condition. In 1837, W. Stokes (in connection with tracheostomy in diphtheria) wrote: "There is always that kind of feeling connected with a surgical operation in acute diseases, which prevents its being proposed, assented to, or performed, unless under nearly desperate circumstances and when all other means have failed."
ECHO 9 Virus Infection or Galactosemia
Authors: VAN GELDER DAVID W. 
Published: December 2021

The brief case report titled "Fatal Neonatal Illness Associated with ECHO 9 (Coxsackie A-23) Virus" by Rawls et al. which appeared in Pediatrics, 33:278, may have given an erroneous interpretation of the cause of death. At nine days of age the infant was noted to be lethargic, anorexic, and irritable with jaundice and hepatomegaly. Certainly these are all signs compatible with severe galactosemia. In addition the authors demonstrated galactosuria both by yeast fermentation and paper chromatography.
Because of the lack of family history of galactosemia plus the isolation of ECHO 9 virus from tissues at necropsy the authors concluded the fatal illness was associated with an ECHO 9 virus infection.
LEAN BODY MASS AND FAT IN OBESE CHILDREN
Authors: Forbes Gilbert B. 
Published: December 2021

Measurements of total body potassium in obese children were made in the whole body scintillation counter, and from this value lean body mass was calculated, and then fat by difference. A series of normal children was available for comparison.
There was a good correlation between total body fat and relative body weight, abdominal circumference, and buttocks circumference, and a fair correlation with triceps skin-fold thickness.
Although the series is a small one, it suggests that there are two types of obesity in childhood. The first is characterized by increased LBM in addition to fat, by a tendency to tallness and advanced bone age, and to have been overweight since infancy. The second group shows no increase in LBM; these subjects tend to have a normal bone age, to be of average height, and the majority have become obese during the childhood years.
Accidental Multiple Drug Poisoning
Authors: HARVEY NORMAN A. 
Published: December 2021

Certain problems arise in cases of multiple drug accidental poisoning which are not encountered with single drug ingestion.
An illustrative case was a 3-year-old male who ingested 6 anorexigenic ("obesity") tablets of the sustained action variety, each containing 15 mg methamphetamine and 60 mg phenobarbital. Gastric lavage was performed 3 hours later and some pink material removed.
At this time the child exhibited hyperexcitability and hyperkinesia indicating a predominance of amphetamine effect. He was given 0.1 gm sodium phenobarbital s.c. (a short-acting barbiturate would have been a better choice), quieted, and went to sleep in 20 minutes. An intravenous infusion of 500 ml 10% dextrose in water was then started and the child made a subsequent uneventful recovery.
Letters to the Editor
Authors: KAGAN B. M. 
Published: December 2021

I appreciate the opportunity to comment on the letter of Dr. Howard Setleis.
No matter how carefully a book—or even an article, for that matter—is prepared or edited, there is always the possibility of an error either of commission or omission. Dr. Setleis' recommendation that a complete mailing list of physicians be maintained is possible for those who subscribe to journals. Such corrections as are needed are often published in subsequent issues of the same journal, which is usually distributed to a subscriber list. Dr. Setleis' suggestion that a list of the purchasers of all medical books be maintained is likewise worthy of consideration.
Need for More Medical Attention to Accident Prevention Program
Authors: SOUTHARD SAMUEL C. 
Published: December 2021

The Committee on Accident Prevention of the American Academy of Pediatrics recently surveyed a group of pediatricians and general practitioners in New York State to learn more about the role played by the medical practitioner, and especially the pediatrician, in accident prevention.
The survey, reported in the August, 1964, News Letter of the Academy, verified the opinion of some committee members that the practicing physician generally neglected to include accident prevention as part of his purpose in patient care and that he lacked a missionary zeal in combating the number one killer and disabler of children.
Neurosis in the Family and Patterns of Psychological Defense: A Study of Psychiatric Epidemiology
Authors: STOCKING MYRON 
Published: December 2021

The embattled general pediatrician, harried by the anxious demands of neurotic mothers and confronted by the frequency of emotional disorder and psychosomatic illness in childhood, could scarcely afford to overlook any book that shed real light on the problems of neurotic interaction within the structure of the family. Dr. Ehrenwald's title might suggest that this is just such a book. Unhappily, it is not.
Dr. Ehrenwald, a psychoanalyst with an eclectic orientation, has tried to fill a gap that has existed in the field of the study of the family.