Angella D. Ferguson

Studies in sickle-cell anemia

Children with sickle cell anemia drink large amounts of fluid, have serum of low osmolality, and void large quantities of urine of low osmolality. These findings may be explained on the basis of habitual ingestion of excessive amounts of fluid rather than renal damage.

Growth and development of Negro infants. VIII. Comparison of the deciduous dentition in Negro and white infants; a preliminary study.

Summary The time of eruption of the firstdeciduous tooth and the number of teeth present at one year of age in Negro and white infants was compared and related to the race, socioeconomic level, and sex of the infant. From this study the following conclusionsare made: 1. The mean time of eruption of thefirst deciduous tooth in Negro male and female infants was 27.7 and 28.9 weeks, respectively. The white male and female infants erupted their first tooth at 29.1 and 31.6 weeks, respectively. This earlier eruption time in Negro infants is possibly due to a racial tendency toward accelerated tooth eruption in this group. 2. The Negro male and female infants had a mean of 6.0 and 5.9 teeth at the age of one year as compared to 6.9 and 6.4 teeth for white male and female infants, respectively. The larger number of teeth found in the white infants at one year of age may be attributed to nutritional advantages, since it was of statistical significance only when the white infants from a middle socioeconomic level (private practice) were compared with Negro infants from a lower socioeconomic level (clinic infants). 3. The influence of sex is demonstratedby the slight acceleration in dentition in the male infants in all groups studied.

Studies in Sickle Cell Anemia XXII. Clinical Manifestations of Sickle Cell Anemia During the First Two Years of Life

first two years of life.~-3 The clinical expressions of this .condition are protean and are influenced to some extent by the age of the patient. This report summarizes the clinical picture in early life, based upon the findings in 18 patients who were diagnosed and followed during the first two years of life. Of these, 14 were males and four, females. It is believed that this uneven distribution of the sexes is accidental, since the disease in no way has been found to be sex-linked.

Studies in Sickle Cell Anemia: XXVII. Complications in Infants and Children in the United States

to transitory vascular occlusion and interfere with the circulation in the organ affected. Sickled erythrocytes have a short life span, contributing to anemia and hypoxia. The interaction of these two pathologic processes, anemia plus focal or generalized vascular occlusion, are responsible for the bizarre symptoms and the physical findings associated with sickle cell anemia (SCA) (Fig. 1). The symptoms and signs of SCA can be

Studies in Sickle-Cell Anemia: XXXIV Observations on Enuresis in Childhood and Nocturia in Adults

T I-I I s R E P o R T is a clinical analysis of 10 children who died suddenly during severe crisis. The clinical manifestations and postmortem findings will be cited and the mechanism of sudden death in uncomplicated sickle cell disease will be discussed. Tomlinson 1 in 1945 called attention to a striking clinical picture of abdominal crises terminating fatally in patients with sickle cell anemia. After reviewing a seri~s of 11 such patients, 10 of whom were children, he attributed the deaths to sudden massive hemolysis of sickled red blood cells, clinical shock with constricted peripheral vasculature, congested viscera, and cerebral edema. Four years later Raper ~ described sudden death resulting from multiple capillary blockage by sickled cells in 4 East African children and 1 adult. We feel that it is timely to re-emphasize the vulnerability of the very young child with sickle cell anemia to severe crises which may terminate in early death. Six of the in1 fants in this report were under 20 months of age at the time of their las t hospitalization. The deaths of 6 children in this series were revealed during a comprehensive analy-

Microradiographic Study of Odontologic Tissues in Cooley's Anemia

SYNOPSIS IN INTERLINGUA STUDIO MICRORADIOGRAPHIC DE Tissu ODONTOLOGIC IN ANEMIA DE COOLEY.— Le presente studio esseva effectuate pro determinar le effectos de anemia de Cooley super le configuration del mineralisation e le morphologia del dentes e de lor structuras de supporto. Sectiones mollite esseva obtenite ab specimens includitein bioplastico. Examines microradiographic revelava que le dentina esseva mal mineralisate e que inusual inclusiones esseva presente in le lumines del tubulos. Esseva constatate proliferation de cemento de radice. In le osso, numerose irregularmente resorbite cavitates esseva presente si ben como areas interstitial con multe lacunas e tenue cortice attenuate e discontinue.

Studies in growth and development. XI. Hemoglobin concentration in adolescents

Summary Hemoglobin concentrations were determined in 484 American Negro college students between the ages of 16 and 19 years. Values for males ranged from 9 to 17.5 Gm. per cent (mean 13.8±1.5 Gm.). In the females, the range was 7.6 to 16 Gm. per cent (mean 12.4±1.1 Gm.). Subjects included in the study had a negative test for sickling of the red blood cells. If one accepts 12 Gm. of hemoglobin as the lower limit of normal, 13.7 per cent of the males and 52.7 per cent of the females had presumptive iron deficiency anemia. However, before initiating therapy in the individual patient, the physician should give diagnostic consideration to other possible explanations for the anemia.

Novobiocin in common pediatric infections

Summary Fifty-six patients with common childhood infections were treated with novobiocin. A good response to the drug was obtained in all patients except one infant treated in the outpatient department. There were no toxic or untoward reactions observed. Higher blood levels were obtained with the calcium salt than with the sodium salt of novobiocin. The drug was well absorbed following oral administration.

Growth and development of Negro infants. VI. Relationship of certain environmental factors to neuromuscular development during the first year of life.

Summary The neuromuscular development during the first year of life of Negro infants from low and middle socioeconomic levels was studied and related to certain environmental and cultural factors. The study groups differed in annual family income, type of occupation, and the amount of education achieved by the parents. An analysis of the data shows: 1. That an inverse relationship exists between the number of siblings and the education of the parents. 2. That the age of “walking alone” apparently is not affected by the number of siblings and the formal academic education of the mother. 3. The there is an inverse relationship between the weight gain and the achievement of “sitting” and “walking alone”, i.e., the greater the weight the slower the development of these two patterns. 4. That no relationship exists between intelligence (at about 13 months of age, measured by the Cattell Infant Scale) and the age of “walking alone” in a sample of normal infants.

Use of a quadruple sulfonamide mixture in acutebacterial infections of infancy and childhood

Summary A mixture containing four derivativesof sulfanilamide, namely, sulfadiazine, Sulfapyrazine, sulfamerazine, and Sulfamethazine, was employed in the treatment of common acute bacterial infections in children. The drug was administered to twenty-one patients in dosage of 0.1 Gm. per kilogram of body weight as the initial dose, followed by 0.025 Gm. per kilogram of body weight every six hours. The clinical and laboratory response to the drug was satisfactory and there were no toxic manifestations or untoward reactions noted.