Swiss medical weekly
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Swiss medical weekly · Sep 1979
Case Reports[Selective aplasia of neutrophils: auto-immune origin].
Autoimmunity is a recognized factor in pure red cell aplasia and in some cases of aplastic anemia, but not in agranulocytosis. The case reported here demonstrated that pure neutrophilic aplasia of autoimmune origin may exist in man. ⋯ After 6 weeks, remission was induced by immunosuppressive treatment and 22 months later the patient is doing well without therapy. The absence of known cases of agranulocytosis, a good response to immunosuppressive therapy, and the demonstrated fact that the patient's peripheral blood mononuclear cells inhibit the growth of granulocytic colonies of normal human marrow in vitro allow the conclusion that this patient had pure neutropenic aplasia, probably due to autoimmune phenomena.
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Swiss medical weekly · Sep 1979
[Immunosuppression, bone marrow infusion and low dose androgens, successful therapy of severe aplastic anemia].
18 patients with severe aplastic anemia (SAA) but without an HLA-identical sibling were treated by antilymphocyte globulin (ALG) followed by infusion of marrow cells from a semi-compatible family donor. 13 of these received low dose androgens after ALG: 11 (85%) achieved stable remission without transfusion requirement. One patient relapsed after 4 months, one patient with only partial remission died from infection. None of the 4 patients who did not receive androgens after ALG achieved remission. ALG, marrow and low-dose androgens represent a promising therapy for SAA and can be favorably compared with allogeneic bone marrow transplantation.
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Swiss medical weekly · Aug 1979
[Experiences with an oral cocaine-morphine solution (Brompton mixture) in the treatment of severe pain in patients with neoplasms].
One year's experience is reported in the treatment of terminally ill cancer patients with an oral solution of morphine and cocaine on a fixed schedule. 36 consecutive patients were treated for an average of 51 days. Excellent or good pain relief was achieved with 26 patients (72%). The initial mean daily dose of morphine was 35 mg. ⋯ Side effects were not uncommon but were without clinical consequences in most patients. Side effects caused discontinuation of treatment in only 2 patients. Terminally ill cancer patients often derive great benefit from this treatment.
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From 1971 to 1977 a total of 32 nearly-drowned children were admitted to the University Pediatric Hospital, Berne, and the Children's Hospital, Lucerne. 5 died within 15 h to 10 days. Neurological damage was seen in 5 cases. 20 children were under 5 years of age and only 8 over 7 years. ⋯ The pathophysiology of fresh water drowning and current treatment are summarized. Situations leading to near drowning are specified and some aspects of prognosis discussed.