Arthur E. McElfresh

Bone-Marrow Depression resulting from the Administration of Methicillin: with a comment on the Value of Serum Iron Determination.

DEPRESSION of bone marrow leading to aplastic anemia or pancytopenia is frequently observed after the administration of a wide variety of drugs. This serious toxic effect must be watched for in the...

The hageman factor: determinations of its concentration during the neonatal period and presentation of a case of hageman factor deficiency

Summary A 9-year-old boy with deficiency of the Hageman factor is presented. As in other instances of this deficiency, the patient is completely free of hemorrhagic symptoms despite a prolonged clotting time, an abnormal prothrombin consumption, and an abnormal thromboplastin generation test. The content of the Hageman factor has been measured during the newborn period and has been found to be low in many infants during the first days of life. Many infants, however, have normal concentrations of the Hageman factor from birth and all appear to achieve normal levels of it by the fourteenth day of life.

TREATMENT OF PAINFUL CRISES OF SICKLE CELL DISEASE. A DOUBLE BLIND STUDY.

Summary Under the conditions of this double blind study, rapid infusion of sodium bicarbonate did not relieve the symptoms of painful sickle cell crises when compared to infusions of comparable quantities of saline used as control. Although in vitro and clinical studies have shown that acidosis promotes the formation of sickle cells and the onset of clinical crises, the crisis, once present, does not seem to be relieved by alkalinization of the blood of the degree achieved in this study.

Hemodynamic findings in acuteglomerulonephritis

Eleven children with acute glomerulonephritis and roentgenographic evidence of cardiomegaly and pulmonary vascular congestion were studied by means of cardiac catheterization, hematologic investigations, and renal biopsy. The findings of elevated left atrial pressure, elevated cardiac index, and low arteriovenous oxygen difference indicate that the central venous congestion present in this disease is not on the basis of myocardial failure. This is confirmed by the absence of effect of administration of digoxin. There is some evidence to indicate that sodium nitrite may exert a favorable hemodynamic effect in patients with acute glomerulonephritis. An unexplained finding was a shortened erythrocyte survival time in 3 of 10 patients.

Secondary hypersplenism occurring in a seven-month-old infant with thalassemia major

Summary A patient is described with thalassemiaand secondary hypersplenism at 5 months of age. Shortened survival time for transfused normal erythrocytes, extremely limited benefit from transfusions, and thrombocytopenia were present. Following splenectomy the survival time for transfused normal cells was normal, the platelets rose to above 200,000 per cubic millimeter, and there was striking clinical improvement.

Elution of anti-A and anti-B antibody from erythrocytes of incompatible newborn infants

Summary It was found possible to elute homospecific antibody from the red blood cells of 13 per cent of infants incompatible with their mothers with respect to Type A or B, more often where the incompatibility involved A than when it involved B. Only 4 of 12 infants in whom a positive eluate was found had clinical evidence of possible hemolytic disease due Type A or B incompatibility; one of these received an exchange transfusion. Inasmuch as the majority of infants in whom positive eluates were found had no jaundice, and since 36 per cent of 76 infants were icteric in whom no eluates were found, the ability to elute antibody from the red blood cells of the infant incompatible with his mother with respect to A or B must be concluded to be of no value in the prediction or confirmation of hemolytic disease due to A or B incompatibility.

An anticoagulant property of antibiotics from streptomyces species; its possible relation to ecchymoses at injection sites.

DURING the course of a clinical study to determine the effectiveness of kanamycin1 as a parenterally administered antibiotic ecchymoses were observed at the sites of injection in a few patients. Th...