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Infectious mononucleosis
ABSTRACTS
Connellan, Paediat.
445 and
J.
R.
J. 8:282-286
Solomon.
(October),
Aust. 1972.
A 3-yr-old child with hereditary fructose intolerance had been recognized by her parents as unable to metabolize cane sugar and fruit sugar and remained well until she developed appendicitis with peritonitis. Unfortunately she received an infusion of fructose, which caused hepatorenal failure and death. Three other case histories are presented to support a claim that fructose is potentially harmful, and if used, the urine should be regularly tested for fructose. Surgeons should be aware of the dangers in patients with severe liver disease and in sick newborn babies, especially those with hypoglycemia, and discourage indiscriminate use in patients who need intravenous fluid for only a few days after an operation. -7. R. Solomon
Cholestasis Associated With Long-Term Parenteral Hyperalimentation. Robert J. Touloukian and S. Evans Downing, Arch. Surg. 106:58-62 (January), 1973.
Three of 18 neonates receiving intravenous hyperahmentation for more than z wk developed obstructive jaundice. The major pathological fmdings were cholestasis and a periportal infiltrate showing pronounced eosinophilic hematopoietic activity. Two neonates died; the third survived with clearing of jaundice 13 days after discontinuance of hyperalimentation. Halothane anesthesia was utilized on successive occasions in the first two patients. The agent used for anesthesia in the third patient, or the agents used in any of the other patients in the series of 18, is not reported. The authors believe halothane is not a factor.-Edward 7. Berman Henoch-Schoenlein Silber. Pediat. 1070 (November),
Syndrome. David L. Clin. N. Am. 19:16611972.
Schoenlein reported the association of and joint symptoms in 1837. purpura Henoch reported the association of abdominal symptoms and purpura in 1874. Frank used the term “anaphylactoid purpura” in 1915. Because the disorder may occur without cutaneous purpura, it is suggested that
the term Henoch-Schoenlein syndrome is most appropriate. At any rate, the full symptom complex includes nonthrombocytopenic purpura, arthralgia, abdominal pain, and abnormalities of urinary sediment. The disease has been reported from 6 mo to young adulthood; peak incidence is between 4 and s yr. Laboratory studies are not diagnostic. However, the measurement of serum complement or fllC-globulin may help differentiate the nephritis of HenochSchoenlein purpura from poststreptococca1 nephritis. The etiology is unknown. Treatment is supportive. Mortality rate is esti1. Berman mated at 2% .-Edward Infectious Mononucleosis. Donald J. Fernbath and Kenneth A. Starling. Pediat. C/in. N. Am. 19:957-968 (November), 1972.
Usually a benign, self-limited disease of children and young adults, infectious mononucleosis can be fatal. Its relationship to malignant lymphoproliferative disease is obscure, but it has been observed before and after the development of acute leukemia and concordantly with Hodgkin’s disease. Reed-Sternberg giant cells have been observed. Diagnosis depends upon compatible clinical manifestations, the presence of lymphocytosis with atypical lymphocytes present, and an abnormal differential heterophile titer. Hepatic involvement is nearly universal. “Spot testing” is reliable and inexpensive. Treatment is symptomatic. Corticosteroids are sometimes indicated. -Edward
1. Berman
ANESTHESIA AND INHALATION THERAPY Acute Respiratory Insufficiency. Treatment With Prolonged Extracorporeal Oxygenation. J. 0. Hill, M. R. de Leval, R. J. Fallat, M. L. Bramson, R. C. Eberhart, H. D. Schulte, J. J. Osborn, R. Barber, and F. Gerbode. J. Thorac. Cardiovasc. Surg. 64551-562 (October), 1972.
Fifteen patients having acute seuere respiratory insufficiency due to reparable lung disease were treated with cardiopulmonary bypass from 12 hr to V/z days. Three of nine survived using venoarterial bypass. In the six patients in whom venovenous by-
Connellan, Paediat.
445 and
J.
R.
J. 8:282-286
Solomon.
(October),
Aust. 1972.
A 3-yr-old child with hereditary fructose intolerance had been recognized by her parents as unable to metabolize cane sugar and fruit sugar and remained well until she developed appendicitis with peritonitis. Unfortunately she received an infusion of fructose, which caused hepatorenal failure and death. Three other case histories are presented to support a claim that fructose is potentially harmful, and if used, the urine should be regularly tested for fructose. Surgeons should be aware of the dangers in patients with severe liver disease and in sick newborn babies, especially those with hypoglycemia, and discourage indiscriminate use in patients who need intravenous fluid for only a few days after an operation. -7. R. Solomon
Cholestasis Associated With Long-Term Parenteral Hyperalimentation. Robert J. Touloukian and S. Evans Downing, Arch. Surg. 106:58-62 (January), 1973.
Three of 18 neonates receiving intravenous hyperahmentation for more than z wk developed obstructive jaundice. The major pathological fmdings were cholestasis and a periportal infiltrate showing pronounced eosinophilic hematopoietic activity. Two neonates died; the third survived with clearing of jaundice 13 days after discontinuance of hyperalimentation. Halothane anesthesia was utilized on successive occasions in the first two patients. The agent used for anesthesia in the third patient, or the agents used in any of the other patients in the series of 18, is not reported. The authors believe halothane is not a factor.-Edward 7. Berman Henoch-Schoenlein Silber. Pediat. 1070 (November),
Syndrome. David L. Clin. N. Am. 19:16611972.
Schoenlein reported the association of and joint symptoms in 1837. purpura Henoch reported the association of abdominal symptoms and purpura in 1874. Frank used the term “anaphylactoid purpura” in 1915. Because the disorder may occur without cutaneous purpura, it is suggested that
the term Henoch-Schoenlein syndrome is most appropriate. At any rate, the full symptom complex includes nonthrombocytopenic purpura, arthralgia, abdominal pain, and abnormalities of urinary sediment. The disease has been reported from 6 mo to young adulthood; peak incidence is between 4 and s yr. Laboratory studies are not diagnostic. However, the measurement of serum complement or fllC-globulin may help differentiate the nephritis of HenochSchoenlein purpura from poststreptococca1 nephritis. The etiology is unknown. Treatment is supportive. Mortality rate is esti1. Berman mated at 2% .-Edward Infectious Mononucleosis. Donald J. Fernbath and Kenneth A. Starling. Pediat. C/in. N. Am. 19:957-968 (November), 1972.
Usually a benign, self-limited disease of children and young adults, infectious mononucleosis can be fatal. Its relationship to malignant lymphoproliferative disease is obscure, but it has been observed before and after the development of acute leukemia and concordantly with Hodgkin’s disease. Reed-Sternberg giant cells have been observed. Diagnosis depends upon compatible clinical manifestations, the presence of lymphocytosis with atypical lymphocytes present, and an abnormal differential heterophile titer. Hepatic involvement is nearly universal. “Spot testing” is reliable and inexpensive. Treatment is symptomatic. Corticosteroids are sometimes indicated. -Edward
1. Berman
ANESTHESIA AND INHALATION THERAPY Acute Respiratory Insufficiency. Treatment With Prolonged Extracorporeal Oxygenation. J. 0. Hill, M. R. de Leval, R. J. Fallat, M. L. Bramson, R. C. Eberhart, H. D. Schulte, J. J. Osborn, R. Barber, and F. Gerbode. J. Thorac. Cardiovasc. Surg. 64551-562 (October), 1972.
Fifteen patients having acute seuere respiratory insufficiency due to reparable lung disease were treated with cardiopulmonary bypass from 12 hr to V/z days. Three of nine survived using venoarterial bypass. In the six patients in whom venovenous by-