Accidents involving off-road motor vehicles in a northern community.

The increasing number of accidents associated with off-road motor vehicles used for recreational purposes prompted this prospective study. During 1985 the records of victims of all motor vehicle accidents who were seen at the Hudson Bay Union Hospital, Hudson Bay, Sask., were studied; patients involved in on-road vehicle accidents were included for comparison. Emphasis was placed on age, vehicle type, mechanism of accident, injury severity and the use of safety features. Almost half of the victims of off-road vehicle accidents were under 16 years of age. The poor adherence to government legislation and manufacturer recommendations was evident in the number of people who did not wear helmets or use headlights.     

The Influence of Morphology on Prognosis in Acute Leukemia

The presence of definite cytoplasmic granulation in at least some of the malignant cells was used as the sole criterion to separate 156 patients with acute leukemia into two groups: 110 with myeloblastic (AML), and 46 with lymphoblastic or stem cell leukemia (ALL). The median survival from the onset of symptoms in patients with AML was 20 weeks, and those with ALL 37 weeks. The difference in survival in these two groups is much greater for patients under the age of 25 than for those over the age of 25.     

Treatment of acute myeloblastic leukemia in adults: remission induction with a combination of cyclophosphamide,cytarabine and vincristine

A regimen of intravenous cyclophosphamide, cytarabine and vincristine, given over a four-day period and repeated every two to three weeks, was used to treat 33 patients with acute myeloblastic leukemia. Of the 30 evaluable patients 9/18 previously untreated patients achieved complete remission and two others marked improvement, and 4/12 previously treated patients achieved complete remission. Twelve of 16 patients under the median age of 38 responded while only 3/14 patients over this age responded. There was no difference in response between those with elevated muramidase levels and those with normal levels. Three patients developed a previously unrecognized syndorme of fever, malaise, rash and orbital suffusion. Cytarabine was probably responsible.At least four courses of treatment are required before abandoning this regimen of therapy. Patients who achieve a complete remission and live for more than 150 days spend about 25% of their total survival time from diagnosis in hospital.     

Congenital Hypofibrinogenemia in Five Members of a Family

The bleeding tendency in five members of one family with fibrinogen levels ranging from 58 mg. % to 158 mg. % was mild and chiefly related to dental extractions. Abruptio placentae in one patient produced severe bleeding. Reports of menstrual bleeding patterns in patients with defects of hemostatic mechanisms suggest that normal platelets, vascular function and extrinsic and possibly intrinsic coagulation systems, except for fibrinogen, control menstrual blood loss. An autosomal dominant gene with variable penetrance may determine fibrinogen levels.