Letter: Sodium valproate and platelet function.
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Biomedical subjects
Publications and source records attributed to C Petrich.
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Vitamin E deficiency in premature infants has been described as being associated with low hemoglobin levels in the 2nd month of life. Recently, low vitamin E concentrations were suspected as being associated with sudden death in infancy. As vitamin E is absorbed incompletely from the premature's intestine, vitamin E levels in the serum were determined in 80 prematures on the 10th day of life. The result was correlated to the clinical course of the infants and to the hemoglobin levels up to the 30th day. Low concentrations of vitamin E and lower hemoglobin levels were found more frequently in new borns, whose clinical course was characterized by additional complications and who received parenteral nutrition. A group of uncomplicated newborns showed no correlation of vitamin E to hemoglobin values. Thus early diagnosis of vitamin E-dependent anemia is not possible and the usefulness of vitamin E should be investigated only in newborns with an uneventful clinical course.
Two methods of determining bleeding time (Ivy's and Duke's) were compared using a standardized method. Skin cuts were made with either a disposable scalpel or a precision plunger. Ivy's method gave results which were markedly superior to those with Duke's. It was, furthermore, shown that reproducibility of two successive determinations in the same person largely depended on the experience of the investigator. Best results were obtained using the precision plunger and automatic collection of blood. But even when these were used, there were frequent deviations of more than 20% in duplicate samples.
It is the purpose of this study to standardize platelet aggregation according to the method of Born. It was found that aggregation is influenced by the time of storage, the pH and temperature of plasma. However, there is no significant correlation between platelet number versus aggregation in healthy subjects. To get reproducible results, the plasma samples should be investigated within 2 hours after venipuncture. During storage temperature of all samples should be constant.
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In healthy, 24-72 hour-old newborns, platelet retention is significantly elevated compared to adults. A relationship could not be established between the retention and the erythrocyte count, bilirubin in the serum or the content of energy-rich phosphates in the erythrocytes. The above results indicate that the platelet function in newborns is elevated and/or comparable with the adult norm. The basic cause of the frequent symptoms of hemorrhage during the newborn period cannot be traced back to disturbed thrombocyte function.
A case of a severe heroin withdrawal syndrom in a newborn infant is reported. Diagnostic and therapeutic aspects of the disease are reviewed.
Among 116 120 children born between 1964 and 1973, 512 (0.44%) required treatment for haemolytic disease of the newborn caused by the presence of irregular antibodies. While the incidence between 1964 to 1970 ranged between 0.42 to 0.56%, it fell from 1971 to 1973 to 0.28%, evidence for effective anti-D prophylaxis since 1971. Those cases still occurring after 1971 were largely due to pregnancies which had started before 1971. In addition there were abortions, sensitizations during the first pregnancy, but also blood transfusions as cause for new sensitizations. Sensitization after pregnancy despite anti-D prophylaxis was observed twice. In the last few years there has been a relative increase of rare antibodies, increasing the complexities of serological diagnosis. Safety and speed of treatment can be further improved by more frequent identification of irregular antibodies in the mother and regular reports to the paediatrician.
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The effect of ribose on the 2,3-diphosphoglycerate concentration (2,3-DPG) of human red blood cells was investigated and compared to the effect of inosine. Ribose as well as inosine increases 2,3-DPG. Most impressing effects can be demonstrated on stored blood, which is poor in 2,3-DPG concentration. Physiologic 2,3-DPG-concentrations, however, may be increased too. Generally the effect of inosine is greater than the effect of ribose. When ribose is applicated intravenously a slight increase in 2,3-DPG is found. Both compounds own characteristic side-effects, which diminish their value for therapeutical purposes.
Two boys aged up to 2 weeks suffered from enterobacter-sepsis. In both cases osteomyelitis developed in spite of treatment with Gentamycin or Gentamycin combined with Chepazolin. Both children were, taking accont of the risks, then treated with Chloramphenicol (100 mg/kg body weight/24 hours) and the first patient also, for a short time, with tetracyclin. In the second patient we saw a marrow depression dependent on Chloramphenicol and its dosage which disappeared rapidly, when the drug was withheld.
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