Diabetic ketoacidosis: reappraisal of therapeutic approach.
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Biomedical subjects
Publications and source records attributed to L Morris.
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Seven cases of rare "Neonatal Death Dwarfism" observed recently in three major Children's Hospitals in Australia are reported. These include Diastrophic Dwarfism, Achondrogenesis II, Lethal Form of Hypophosphatasia, Homozygous Achondroplasia, Minor Form of Asphyxiating Thoracic Dystrophy, Achondrogenesis II (?) and Unclassified Lethal Bone Dysplasia. In all the patients the clinical diagnosis was uncertain or incorrect, whereas a conclusive radiographic diagnosis could be made after X-ray examination in all but one of the cases. Skeletal survey should be performed in each case of neonatal death dwarfism.
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The most commonly recognized cause of mesenteric venous thrombosis following splenectomy is hypercoagulation secondary to reactive thrombocytosis. A case is reviewed in which hypercoagulation followed splenectomy for idiopathic thrombocytopenic purpura (ITP) in spite of persistent thrombocytopenia. Episodic mesenteric venous occlusion occurred due to antithrombin III deficiency. This hypercoagulable state may be the cause of primary acute mesenteric venous occlusive disease. Symptoms and signs suggesting thrombosis in the portal circulation demand immediate coagulation studies since even in the thrombocytopenic patient thrombotic proglems can occur. Surgical intervention is the treatment of choice for segmental small bowel ischemia; warfarin therapy is indicated when there is evidence of antithrombin III deficiency.
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Contraceptive continuation rates-the rates at which people continue to use a particular contraceptive method-can be a great help in determining whether a family planning program is effective or whether new contraceptive methods should be introduced. Until now, very little systematic work has been done to study contraceptive continuation rates in Latin America. The present article reports the results of one of the few existing studies on this subject, which examined the IUD experiences of women admitted to a large family planning clinic in Guatemala City. The study showed that these experiences compared favorably with the IUD experience of groups previously studied in Costa Rica, Taiwan, and the United States.
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Water-soluble contrast radiculography has been used for many years. Earlier contrast media were highly irritant and subjects required preliminary spinal anesthesia but, recently, better-tolerated contrast media such as meglumine iocarmate (Dimer X) and metrizamide (Amipaque) have been used. The findings from 300 examinations with meglumine iocarmate are presented. Methodology is discussed. The diagnostic accuracy of this contrast medium was high and side effects were minimal. Comment is made on the newest spinal contrast medium--metrizamide--and its use in 29 examinations in Canada.
The most severe outbreak of smallpox in Brazil in 1969 took place in the municipio of Utinga, Bahia. Of 507 cases, 246 occurred in residents of the urban area of the municipio. This paper describes the findings of the detailed study of the urban area outbreak. An inverse relationship between age and susceptibility was evident; fully 91% of the children less than 5 years of age as well as 75% of the school-age children had no history of smallpox and had never been vaccinated. The overall attack rate was 11% with nearly three-fourths of the cases in children under 15 years of age. Only 4 of the 246 patients had a vaccination scar, and the estimate of vaccine efficacy was 94%. The continued occurrence of cases after the initial vaccination containment measures prompted detailed studies during 2 follow-up visits to the community which demonstrated that 1) transmission of smallpox may continue in a pocket of susceptibles although the overall immune status of a community is high following containment measures, and 2) clinical illness may have been aborted in those affected individuals who were only in their second to fourth day of incubation at the time of vaccination.
Fatty infiltration of the liver has been identified roentgenographically in several young children. Awareness of this possibility will sometimes allow a radiologist to contribute to the understanding of the patient's metabolic and nutritional state. If a child's liver is shown to be abnormally radiolucent, cystic fibrosis should be considered.
In recent years the United States has made considerable progress in providing family planning services for those in need. This does not mean, however, that the problems posed by unwanted pregnancies and unwanted births have been completely overcome. Estimates of the number of low-income women needing and receiving family planning services indicate that roughly 3.6 million women at risk of an unwanted pregnancy were receiving family planning services in 1973. This represented almost two-thirds of those in need at the time. Many programs are also seeking to meet the teenage need demonstrated by very high rates of out-of-wedlock births, premarital conceptions, obstetric problems, and legal abortion demands of women 15 to 19 years of age. As of 1973, it appeared that between 1.3 and 2.2 million never-married teenagers were in need of organized family planning services, and that of these, services were being received by between 25 and 42 per cent.
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