Henry K. Silver

Studies on the etiology of exanthema subitum (roseola infantum).

Summary 1. The first experiment described has persuasively demonstrated the infectious nature of exanthema subitum, by means of a transmission experiment from a human donor to a susceptible subject. 2. Subsequent experiments utilizing monkeys have demonstrated the presence of a fever-producing agent in the serum of human beings on the third day of the febrile period of exanthema subitum illness, as well as in the throat washings of a susceptible recipient. It also was shown to be present in the serum of previously infected monkeys. This fever-producing agent has not been shown to be present in the blood of human patients during the first day of the febrile period. 3. The challenge experiments have shown that blood taken on the third day of the febrile period of exanthema subitum was still able to produce a febrile disease in control monkeys, but failed to do so in monkeys previously experiencing a febrile inoculation disease. 4. Egg passage material has, to date, failed to produce febrile reactions in four monkeys tested.

Abnormalities in the secretion of the adrenal cortex during early life.

Summary This paper deals with the clinical, chemical, and pathologic findings of seven children who presented abnormalities in secretion of the adrenal cortex. All cases, save one, were congenital in origin. Five of these patients presented the picture of insufficiency of the substances regulating salt and water metabolism. In each of them the most prominent symptoms were dehydration with poor gain of weight and/or vomiting. The latter often was projectile in character, and in the young infants sometimes led to an erroneous diagnosis of pyloric stenosis. Pigmentation of the skin and mucous membranes was not a prominent finding. The characteristic blood findings consisted of a depression of sodium and chloride and an elevation of potassium. The fasting blood sugar was normal. Four of the five patients with adrenal insufficiency have been successfully controlled with the help of supplemental replacement therapy for periods up to six and one-half years. One patient with congenital Addisons disease died at the age of 10 months. Post-mortem study showed almost complete absence of the adrenal cortex and vascular changes of the kidneys, which probably resulted from overdosage with desoxycorticosterone acetate which had been given for the adrenal deficiency. Marked eosinophilia of the peripheral blood was present in several patients with adrenal insufficiency, and it is suggested that this abnormality be considered in certain patients with unexplained eosinophilia. Whatever the blood eosinophilia level may be, the manner in which injection of adrenocorticotropic hormone affects it constitutes a useful test of adrenal function, as pointed out by Forsham and collaborators. 16 In three patients excessive secretion of adrenal androgenic hormones was present simultaneously with the previously mentioned insufficiency of adrenal salt- and water-controlling hormones. Two of these patients were females in whom pseudohermaphroditism was thus produced. The other was a male with sexual precocity. Increased androgen secretion by the adrenal cortex was manifested by acceleration in the appearance of the epiphyseal centers, accelerated growth in the length of the long bones, precocious sexual development, and abnormally high excretion of 17-ketosteroids in the urine. The eruption of the permanent teeth was not markedly advanced in the 7-year-old patient with other evidences of precocious sexual and physical maturation. The increased excretion of 17-ketosteroids may be the only abnormal finding which is evident during the first year of life in a male patient with the adrenogenital syndrome. A family history of a similar condition was found in two of our female patients with pseudohermaphroditism and adrenal insufficiency. Knowledge of such previous familial occurrence may be of considerable help in the early recognition of congenital adrenal abnormality.

Physicians' assistants. The pediatric nurse practitioner at Colorado.

“Our studies have shown that nurses can make a substantial contribution in the total care of the well child and in the care of children with relatively minor illnesses…. Nurse practitioners have been able to care for almost all of the well children, but 50 percent of the other youngsters have needed some type of consultation or referral….”

Health care practice. An expanded profession of nursing for men and women.

The concept that nursing is strictly a feminine profession is conveyed to boys in earliest childhood when they are exposed to the idea that being a nurse or participating in nursing functions is something that should be avoided by the male. Such psychologic and sociologic inhibitions and barriers undoubtedly continue to influence the male even when he has become a man(1,2). The feminine connotation also pertains to most definitions of nursing. Thus, among the 10 definitions of the word nursing in the unabridged edition of the Random House Dictionary of the English Language that pertain to the provision of personal assistance, nurturing, or care to others, six refer specifically to the feminine role of the nurse or allude to a process, suckling, that can only be performed by the female. No wonder men hesitate to enter a profession that is almost universally perceived as being related to the feminine role and feminine activities.

Graphs of the head circumference of thenormal infant

Summary To aid in the clinical appraisement of the normal infant and in the earlyrecognition of hydrocephalus, retarded mental development, or premature closure of the cranial sutures, graphs of the head circumference of infants are presented, which offer a convenient means of comparing with normal values both single measurements of circumference and the increment of growth of the head.

Roentgenographic examination of infants in an incubator; a new device insuring environmental constancy.

Development of an improved roentgenographic technic utilizing a simple, inexpensive modification of the standard incubator has overcome the serious objections to adequate roentgenographic study of ill or delicate infants. The danger of compromising the constancy of the environmental temperature, humidity, or oxygen supply has been eliminated. Speed and manipulation are no longer important factors in satisfactory examination. Essentially, the standard incubator is used with no alteration of its mechanics. Instead of the metal deck and rubber mattress, however, a plastic radiolucent platform, measuring 6(5 × 35.5 cm., is introduced for the infant to lie upon. The radiolucent plastic platform is raised by ledges approximately 5.5 cm. from the floor of the incubator, to permit easy introduction of a cassette. (Fig.1). For the examination, a standard 10 × 12-inch cassette is covered by a sterile sheet or pillow slip and introduced beneath the platform, the incubator hood being lifted only briefly for this purp...

Microbiological Determination of Apparent Free Methionine in the Blood of Children

Conclusion The concentration of apparent free L-,methionine in the plasma of children is significantly lower than has been recorded in the literature for adult male subjects. The plasma of the blood in the umbilical cord at the time of delivery contains, on the average, the same amount of L-methionine as is recorded for adult males, and more than three times as much as is present in the plasma of “normal” children.