A. Allen Goldbloom

A case of infectious mononucleosis with jaundice and thrombocytopenic purpura

Abstract A case of infectious mononucleosis with complicating jaundice and thrombocytopenic purpura is presented because of its rarity. The hemorrhagic phenomena of epistaxis, hematemesis, bleeding gums and petechiae simulated true thrombocytopenic purpura. However, the presence of a blood picture typical of infectious mononucleosis indicated a favorable prognosis which was vindicated by the short duration of the hemorrhagic diathesis. The mechanisms of the production of the jaundice and thrombocytopenic purpura in infectious mononucleosis are discussed.

Clinical studies in blood lipid metabolism. IX. Effect of lipotropic agents on serum lipid partitions in fifty patients with generalized atherosclerosis; a three year study.

1. Fifty patients with clinical generalized atherosclerosis and chronic coronary artery disease were maintained on a low-fat, low-cholesterol diet for thirty-six months. Twenty-five of these patients were given therapeutic dosages of a lipotropic preparation during this period. 2. Serum lipid fractions such as cholesterol, phospholipids, total lipids and neutral fats were determined and averaged on all fifty patients at the onset of the study and at six month intervals for a period of three years. 3. Except for a slight decrease in blood serum cholesterol of all the fifty patients, attributable to the low-fat dietary restrictions, there were no significant differences in any of the other serum lipid fractions. 4. Changes in the ratio of phospholipid to cholesterol were practically the same in the control and lipotropic groups of patients. 5. Low-fat, low-cholesterol diet will attain the same end result as lipotropic agents upon reducing serum lipid partitions. 6. Loss of weight had no bearing on the diminution of the lipid partitions. 7. There is no clinical or laboratory confirmation for the value of the administration of the present known lipotropic preparations in the treatment or prophylaxis of human atherosclerosis. Thanks and appreciation are expressed to Miss Dorothy Schork for the preparation of the graphs.

Newer clinical and laboratory studies in the aged III. Urinary test for gastric secretion of hydrochloric acid in patients 80 to 100 years of age

1. Tubeless gastric acidity was studied in “normal” geriatric patients 80–100 years of age, male and female. 2. Achlorhydria was found in 30% of “normal” geriatric patients while acidity was present in 70% of the patients. 3. Gastro-intestinal x-rays showed normal studies in 52% of the patients. Only one case of gastric malignancy, two of gastric ulcer, and one of duodenal ulcer were encountered. 4. Positive tubeless gastric acidity values (69.5%) approximated the normal and varied insignificant gastro-intestinal x-ray findings (70.4%). 5. Discrepancy between the negative tubeless gastric acidity method and the positive gastric intubation for acidity was 11.1%. 6. The convenience and economy of the tubeless gastric acidity method makes it possible to screen large numbers of geriatric patients and eliminate unnecessary x-ray examinations. 7. The urinary test for gastric secretion of hydrochloric acid (tubeless method) should be advocated in geriatric patients and in conditions that would contra-indicate intubation.

Malnutrition and vitamin deficiency in recently released prisoners of war

The remarkable recuperative power of the human body after prolonged periods of marked systematized undernourishment is illustrated by careful physical examination of 121 American soldiers released three weeks previously from 18 different prisoner of war camps in Germany. Only one of these prisoners showed moderate undernourishment and vitamin deficiency. More than 53% showed no evidence of any vitamin deficiency clinically, and the others showed minimal evidence (one-plus) of vitamin de ficiencies to varying extents. Analysis shows that the supplementary rations furnished in the Red Cross Packages were the most important single factor in preventing serious nutritional failure in these prisoners of war.