Hereditary antithrombin deficiency and pregnancy. Pregnancy course in six women with known hereditary antithrombin deficiency

Inherited antithrombin (AT) deficiency is a major cause of venous thromboembolism, especially in relation to surgery and pregnancy. We present six AT deficient pregnant women, who successfully delivered seven babies at the Department of Gynaecology/Obstetrics, Aalborg Hospital. From conception, or if possible prior to conception, the women were treated with unfractionated (UFH) or low molecular weight heparin (LMWH) throughout the pregnancy. If the pregnancy was without complication, AT substitution was only used at delivery and for approximately a week post-partum, when warfarin treatment was re-instituted.     

Radical dissection of the axilla in Madden type mastectomy (author's transl)

During mastectomy using the Madden technique full dissection of the axillary and supraclavicular lymph nodes can readily be achieved by the anterior approach, after transverse separation of the upper fibers of the pectoralis major.     

Congenital deficiency of factor VII (author's transl)

Authors report a four month old patient, admitted to hospital because of blood in stools. Diagnosis of congenital deficiency of factor VII was established because such factor was practically absent; on the contrary, other coagulation factors were normal. His parents and sister presented a mild deficit of factor VII without clinical manifestations. An up-to date review of the problem is presented.     

Unusual course of traumatic intracranial bleedings (author's transl)

Intracranial bleedings occurred in three patients as complications of h-ad trauma, without any initial acute disturbance of consciousness. Only careful observation, which revealed slow deterioration in consciousness, made it possible to establish the diagnosis of intracranial haemorrhage, confirmed angiographically in all three instances.     

The use of microlaryngoscopy in phoniatry (author's transl)

Definite diagnostic advantages exist in the use of combined microlaryngoscopy and microstroboscopy in vocal rehbilitation since objective determination of vocal pathology can be made. The phoniatric considerations used in determining the indications for operative investigation are described. Reference is made to specific clinical problems, including the "hormone voice" in the Reinke edema from medications used in therapy and arytenoid dislocations from insufflation anesthesias. The postoperative prognosis after endolaryngeal surgery depends on the effectiveness of the surgical intervetion and the appropriate phoniatric-logopedic care employed. The author suggests that post-operative voice pauses should be minimized and not depend upon complete re-epithelialization of operative sites. Phoniatric and logopedic treatment used is based on considerations for appropriate vocal cord movements. The advantages of endolaryngeal faradization for vocal rehabilitation are discussed. In addition, the theoretical considerations of fitness for work are also discussed.     

Follow-up study in patients with neuritis retrobulbaris (author's transl)

In 11 patients with multiple sclerosis (MS) and eight patients in whom MS was not verified visus, computerized perimetry, bipolar flash evoked cortical potential (H-EP) and pattern-reversal evoked cortical response (M-EP) were recorded in the acute stage and convalescent period of neuritis retrobulbaris. In the acute stage visual field deficiencies, diminutions of H-EP and M-EP amplitudes and increases in H-EP latencies were seen in both eyes in all cases. The most severe pathologic changes were found in the worst eyes in the group without MS. In the convalescent period a complete restitution of the electro-ophthalmological parameters was found in neither group of patients by statistical methods. Restitution was more common in patients who were not suffering from MS.     

Iron deficiency anemia in childhood. A case with associated deficiency of folic acid (author's transl)

The case of a six year and ten months old girl with an iron deficiency anemia of long duration is reported. The lack of iron was associated with folic acid deficiency, which disguished the hematologic pattern, presenting a normocromic and aniso-poiquilocytic anemia. Long duration of iron deficiency allowed for evaluation of the iron deficiency effects on weight and height growth which were diminished as well as on the functioning and morphology of the gastrointestinal system, showing malabsorption syndrome which improve with iron supply.     

Peripheral gangrene in a congenital sucrase isomaltase deficiency (author's transl)

A case of ischaemic necrosis of extremities due to haemodynamic shock with disseminated intravascular coagulation (DIC) is reported. The onset of haemodynamic shock and the appearance of vascular disorder were produced at once. Both processes, haemodynamic shock and DIC were originated by the administration of food containing sucrose and starch to an infant whose posterior study confirms to suffert a congenital sucrase isomaltase deficiency. Sucrase isomaltase deficiency was documented by oral sucrose loading tests and by enzymatic assay of small intestinal mucose biopsy.