Although diabetes mellitus is estimated to begin during the period of childhood in 5 to 8 % of all cases (Nelson, 1954) it is quite rare in infancy. Recovery from diabetes at any age is even more rare and the few cases that have been reported have all been in infants. The case described here had a number of unusual features.Case Report Ann C. was admitted to hospital on June 26, 1953, at the age of I month. She was the third child of healthy parents and was born at full term following a normal delivery. No abnormality had been noted at birth and the birth weight was 6 lb. 2 oz. There was no family history of diabetes. She was breast fed for three weeks and then weaned on to feeds of full-cream National dried milk. For a week before admission she had seemed rather cross but she had taken her feeds well. There had been no vomiting, she had been passing formed yellow stools and there had been no polyuria. On the evening of admission her mother noticed that 'her head seemed to have sunk in at the top' and that her colour seemed poor.On admission she weighed 6 lb. 2 oz. (expected weight 7 lb. 6oz.). She was pale, wasted and grossly dehydrated, the most striking feature being the deep depression of the anterior fontanelle. A small boil was present on the left thigh but no other septic lesions were visible and no other abnormal physical signs were present on systemic examination. In view of the severe degree of dehydration intravenous fluid therapy was started imnediately, beginning with half-strength plasma (diluted with Hartmann's solution) of which 300 ml. was given in the first eight hours. This was followed by N/5 saline with 5%0 glucose, 425 ml. being given over the next 15 hours.Thus the total parenteral fluid in 23 hours was 725 ml. based on a requirement of 100 ml. per pound of expected body weight, dehydration being assessed at more than 10°o. Towards the end of this period slight oedena of the eyelids and of the sacral region was noted and 19 hours after the start of the intravenous infusion she had a generalized convulsion lasting for a few minutes. Two further convulsions occurred an hour later while she was being examined. In each of these there was stiffening of the body, arching of the back and a brief period of apnoea. Apart from the slight oedema there were no abnormal findings. The Over the next three weeks, while the baby was taking normal feeds of National dried milk with added sugar, the blood sugar varied from 110 to 240 mg. 00. The estimations were usually done immediately before a feed, the feeding being on a four hourly schedule. Sugar continued to be present in the urine in amounts varying from 0-5 to 2 0 g. 00, until July 17 when it became, and remained, sugar free. Acetone was only detected on one occasion at a time when the child was quite well and the fasting blood sugar level was 190 mg. 00. No sugar was found in the bulked urine for that day. The total volume of urine passed was measured on three separate days and varied from 154 to 344 ml. The lower figure may be incorrect as the dif...
In 1962 Abe, Sato, Kazama and Matsumura reported that two boys suffering from haemophilia had improved during treatment with ε‐amino‐caproic acid (ε‐A.C.A.) as shown by a diminished number of haemorrhages and decreased need for blood transfusions and that this improvement was associated with reduced fibrinolytic activity. In order to assess the effect of ε‐A.C.A. in haemophilia, a trial has been conducted in six boys over a period of 6 months. They were all suffering from haemophilia A and their previous histories were available. During the trial they were seen at fortnightly intervals and on each visit a full record of all haemorrhagic episodes since the last visit was made, together with any subjective comments from the patient or his parents about pain, mobility, etc. At each visit a specimen of venous blood was taken for estimation of fibrinolytic activity, the patients attending at the same time of day in order to minimize physiological diurnal variation (Fearnley, 1960). Any changes in diet, activity or habits during the preceding 24 hours were also noted. Fibrinolytic activity was measured by the method of Lackner and Goosen (1959) (which is a modification of that originally described by Fearnley, Balmforth and Fearnley, 1957). During the first 3 months half of the patients were on treatment with ε‐A.C.A. and during the second 3 months the other half. The dosage was calculated by the percentage method (Catzel, 1962) based on the daily adult dose of 10 g. per day. No treatment was given during the control period.
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