We conducted a retrospective chart review of all hemophiliacs followed by our pediatric hematology service from January 1, 1980 to December 31, 1989 inclusive, to determine the frequency and nature of their visits to our Emergency Department (ED). Of 36 patients studied, 26 were Factor VIII deficient (13 mild, 3 moderate, and 10 severe) and 10 had Factor IX deficiency (7 mild and 3 severe). No patient had red blood cell (RBC) antibodies or factor inhibitors. One patient was HBsAg positive and 4 patients were HIV positive. One hundred and twenty-six ED visits [98 (78%) in the 1-5 age group] occurred. Soft tissue hematomas accounted for 48% of total injuries, hemarthroses for 24%, and head injuries for 12%. Twelve patients were admitted to hospital for observation or ongoing factor replacement. Of 15 episodes of head injuries, 1 patient had intracranial hemorrhages on 2 occasions, while 13 received prophylactic factor replacement and recovered uneventfully. Despite the availability of home factor replacement, the ED remains an important locus for the management of the pediatric patient with hemophilia.

Adolescent↗

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Effect of pH buffers on proton secretion from gastric oxyntic cells measured with vibrating ion-selective microelectrodes.

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Animals↗

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Virulence of infectious laryngotracheitis viruses: comparison of modified-live vaccine viruses and North Carolina field isolates.

Virulence of six modified-live (ML) infectious laryngotracheitis (ILT) vaccine viruses was compared with that of 11 field isolates (indistinguishable from vaccine viruses by DNA restriction endonuclease analyses) by intratracheal exposure of 4-week-old, specific-pathogen-free chickens. Virulence of ILT viruses was based on an intratracheal pathogenicity index, mortality, and tracheal lesions. Intratracheal pathogenicity indices for ML vaccine viruses ranged from 0.0 to 0.14, while those for field isolates were 0.20 to 0.82. Mortality was a consistent clinical feature of field isolates; all produced mortality, with seven of the 11 isolates causing two or more deaths per inoculation group. In contrast, only one of six ML vaccine viruses produced mortality (one death per inoculation group). In general, tracheal lesions were more severe in chickens inoculated with field isolates and were produced more consistently than in chickens inoculated with vaccine viruses. These studies indicate that virulence of ILT field isolates was greater than that of ML vaccine viruses. Together with previous restriction endonuclease analyses, these findings suggest the possibility that field isolates originated from ML vaccine viruses through reversion to parental-type virulence.

Animals↗