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Femoral fractures represent about 2% of all fractures in childhood. Children with femoral fractures always need to be admitted to hospital and the use of resources is much higher than for other childhood fractures. During the past decade, there has been a trend towards surgical treatment of these fractures, one advantage being the shorter time required in(More)
Dextran, a common plasma substitute, sometimes induces life-threatening hypersensitivity reactions. In this article Wolfgang Richter and Harriet Hedin discuss recent evidence that these Type III anaphylactic reactions, caused by natural antibodies, can be abolished by pretreatment o f patients with monovalent hapten dextran.
Immune complex-mediated (type III) anaphylaxis is shown to be the pathomechanism of severe dextran-induced anaphylactic reactions in man. Mild reactions may be either antibody-dependent or not. Patients with severe reactions have regularly high titers of preformed, circulating dextran-reactive antibodies and represent a small subpopulation of high(More)
In a prospective study (1993-2000), we measured the isokinetic strength of the quadriceps and hamstring muscles in 31 children aged 5-17 years, on average, 3 (1.5-5) years after treatment for a displaced femoral fracture by external fixation and early mobilization. A group of age-, sex- and weight-matched children without previous injury were used as(More)
In a retrospective investigation of the period 1970-1979, 478 reports on cases of dextran-induced anaphylactoid/anaphylactic reactions (DIAR) were found. In 458 of these dextran was judged to be the causative agent. The number of units of dextran 40 and 70 used during this decade was 313 598 and 1 051 668, respectively. During the last five years, when(More)
All spontaneous reports to the manufacturer and to WHO's database INTDIS regarding adverse reactions to clinical dextran after preinjection of dextran 1 and to dextran 1 alone 1983-1991 were collected. During 1983-1991 a total of 4.8 million doses of Promit were sold in fourteen countries. The incidence of severe DIAR (grades III-V) to clinical dextran(More)
INTRODUCTION There is no consensus as to which is best treatment of femoral fractures in children. PATIENTS AND METHODS We performed a cost analysis comparing three treatments of femoral shaft fractures in children aged 3-15 years at 3 hospitals during the same period (1993-2000). The analysis included total medical costs and costs for the care provider(More)
Femoral fractures in children can be treated effectively and with a low complication rate by using external fixation. However, as with most treatment modalities there is a learning curve to be considered. The aim of this paper is to report "tricks" and different considerations that we have learned to be of value based on experience gained during a(More)
Dextran reactive antibodies (DRA) were studied in 123 patients having experienced dextran-induced anaphylactoid reactions (DIAR) during 1970-1975. No evidence for reaginic DRA was obtained by radioallergosorbent technique and passive cutaneous anaphylaxis in Cynomolgus monkeys; total IgE levels were within normal range. It is concluded that DIAR are not(More)
In an open, prospective multi-center study prevention of dextran-induced anaphylactic reactions (DIAR) was attempted by intravenous injection of 20 ml dextran 1, 15%, Mw 1000 dalton, (Promiten), two minutes before start of infusion of dextran 70 (Macrodex) or dextran 40 (Rheomacrodex). Of 34955 patients investigated, only one developed a severe DIAR of(More)