Studies on the 57Co vitamin B12 plasma level absorption test.

Results of the (57)Co vitamin B(12) plasma level absorption test are described in 163 patients. The use of intramuscular carbachol with the test and the presence or absence of current vitamin B(12) therapy did not affect the test results. Injection of 1,000 mug of unlabelled vitamin B(12) during the test augmented plasma levels in patients with normal absorption but tests without this injection gave satisfactory differentiation between the normal and malabsorption ranges. Results from patients having had a gastrectomy, ileal resection, or a past history of adult coeliac disease are also described. Amongst patients with presumed Addisonian pernicious anaemia, two with unresolved equivocal results and three with falsely normal results were found. The significance of these is discussed.

Haemoglobinometry in Papua New Guinea.

In 1978, doctors in Papua New Guinea were questioned about their practice of haemoglobinometry. Forty one doctors carried out blood haemoblobin measurements themselves, 26 used the Sahli method, 26 used a photoelectric absorptiometer method and 9 used the AO/Spencer haemometer. Thirty doctors had no occasion to ever need a haemoglobin estimation and 58 referred blood elsewhere, mostly to a hospital laboratory. The relative advantages of the methods presently available in Papua New Guinea are discussed and the value of quality control emphasized.

A comparison of a Sahli haemoglobinometer and an AO/Spencer haemometer.

Both the Sahli haemoglobinometer and the AO/Spencer haemometer can give reasonably accurate and precise results under controlled conditions. Both have disadvantages for use in rural areas, but in the absence of any better alternative they will continue to be widely used. A quality control programme to check both instruments and operators is needed until a simpler, more dependable method becomes available.

Comparison of the Sahli and grey wedge haemoglobinometers.

Experiment confirms that the MRC grey wedge photometer is better for haemoglobinometry than the Sahli haemoglobinometer. However, there is considerable observer variation and the precision of those who undertake haemoglobinometry should be studied by analysis of duplicates. Only in this way can the significance of any measurements obtained be assessed.

Myelofibrosis in Western Australia: an epidemiological study of 29 cases.

Survival figures and other epidemiological features are described for 29 patients with myelofibrosis living in Western Australia during the period 1959 to 1963. These patients form part of a larger series of 509 patients with leukaemia and allied disorders. The diagnostic incidence rate was found to be 0.5 per 100,000 population, the mortality rate was 0.4 per 100,000 and the prevalence 1.8 per 100,000. Comparison with related myeloproliferative disorders shows that myelofibrosis occurs somewhat less frequently than chronic granulocytic leukaemia and considerably less so than polycythaemia vera. The sex ratio indicates a small male preponderance and the age distribution is similar to that in other descriptions. Survival times for all patients accord with those reported in the literature, but this series showed a marked female advantage in survival. Findings in other series are described.

Pregnancy and untreated Addisonian pernicious anemia.

The case histories are given of two patients, aged 38 and 35 years, who conceived while suffering from Addisonian pernicious anaemia. The relationship of these findings to the routine use of folic acid during pregnancy is discussed.