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Surgery in the Hemophiliac

Oscar D. Ratnoff, MD
JAMA. 1968;206(11):2527. doi:10.1001/jama.1968.03150110075032.
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The extraordinary number of books concerning the hereditary hemorrhagic disorders continues to increase, reflecting an interest out of proportion to the number of afflicted individuals. When Tarnay's Surgery in the Hemophiliac appeared in the mail, my first reaction was, "Not another." Happily, this short monograph turns out to fill a need. Tarnay deals explicitly with the therapy of many surgical problems in the hemophiliac, bolstering his text heavily with references to the published literature. His recommendations are specific, and chiefly unexceptionable.

This reviewer does not share Tarnay's enthusiasm for the use of epsilon aminocaproic acid. Repeated double-blind studies have demonstrated the inefficacy of this drug except for the control of hematuria. In this situation, its use has been followed by ureteral obstruction and hydronephrosis. Further, prolonged prophylactic use has been complicated by prostatitis. Tarnay's recommendation, then, that administration of epsilon aminocaproic acid in sufficient dosage should "accompany any hospitalization for


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