Vitamin K deficiency in breast-fed infants.
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Biomedical subjects
Publications and source records attributed to A J Aballi.
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Two infants with hepatic subcapsular hemmorrhage presenting as abdominal masses at age 17 days and 49 days are reported. The first had a slowly progressive course and the second had initial internal bleeding. Aortography assisted in the management of the second case.
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Seventeen children with sickle cell anemia received 40 partial exchange transfusions for serious complications of sickle cell anemia, and preoperatively to reduce the risk of anesthesia. Each patient received two partial exchange transfusions at 24-hour intervals and all patients tolerated the exchange transfusions well. The mean hematocrit level rose from 22.9% before the exchange transfusion to 40.6% at the end of the second exchange. The mean sickle hemoglobin level decreased from 93.8% before the exchange to 28.0% after the second exchange. Patients with acute lung syndrome had remarkable improvement in clinical symptoms and PaO2 levels, and those with acute liver crisis had substantial reduction in serum bilirubin levels. All the other patients showed marked clinical improvement following the exchange transfusions.
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We evaluated hematological findings, with special reference to the monocyte count, in ten infants with congenital syphilis. One patient had a monocytic leukemoid reaction and eight had absolute monocyte counts considerably higher than normal control infants. Monocytes appear to be an essential participant in the cellular reaction to treponema pallidum. To our knowledge, this is the first report of a monocytic leukemoid reaction in congenital syphilis.
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A group of 150 healthy American black children were found to have neutrophil counts significantly lower than those of a similar group of healthy American white children. Absolute lymphocyte counts were similar in the black and white children. The lower neutrophil counts in black children may represent a genetic or hitherto unidentified acquired differences.
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The clinical and hematological features of 100 patients with sickle cell anemia are reviewed. The heart was enlarged and a murmur was heard in nearly 80 percent of patients. Pneumonia and pulmonary infarction occurred in 43 percent and 12 percent of patients, respectively. Musculoskeletal involvement included the hand-foot syndrome (15 percent), leg ulcers (55 percent), aseptic necrosis ofbone (11 percent), and osteomyelitis (4 percent). Symptoms and signs related to the gastrointestinal system included jaundice (55 percent), hepatomegaly (50 percent), splenomegaly (23 percent), hepatitis (11 percent) and gallstones (9 percent). Three patients underwent cholecystectomy and three patients had their spleens removed. Pyelonephritis occurred in 17 patients, priapism in five and hematuria in seven. Nineteen women had 39 pregnancies, of which 35 resulted in the birth of healthy infants. At least 328 painful crises occurred in 73 patients. There were also 13 hemolytic crises, eight sequestration crises, and five aplastic crises. A trail of alkali therapy in 33 crises in children failed to produce beneficial effects greater than hydration and analgesics alone as used in the control group. Laboratory findings in the 100 patients were comparable to those previously reported in the literature. The renal concentrating defect in most patients was confirmed. There were six deaths: hepatic coma secondary to post-transfusion hepatitis, thrombosis of inferior vena cava, congestive heart failure, exsanguination from erosion of the pancreaticoduodenal artery, extensive bronchopneumonia, and pulmonary infarction.
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