The use of fresh frozen plasma and of human and animal anti haemophilic fractions in the management of patients with classical haemophilia A allows effective treatment of their bleeding episodes, so that the risk to life is reduced and life expectancy itself is prolonged. Ramgren (1962) has estimated that there has been a doubling of the age at death of haemo philiacs in Sweden since 1942 compared with the period 1900-42. There have, however, been no parallel advances in the prevention of the disease, apart from genetic counselling and sterilization, since there is no method of correcting the genetic anomaly at the chromosome level. Thus there is a steadily increasing haemophilic population whose medical and social care results in an increasing burden to the community. The increasing importance of the medicosocial aspects of haemophilia has merited several excellent retrospective studies (Favre-Giliy, 1957 ; Ikkala, 1960 ; Ramgren, 1962 ; Wilkinson, Nour-Eldin, Israels, and Barrett, 1961) of the course of the disease and its social and economic consequences. The inherent disadvantages of any retrospective study are no less evident when applied to haemophilia. While accurate records can be made of school attendance, periods of unemployment, hospital admissions, etc., it is much more difficult to acquire clinical details of the less severe episodes which have necessitated tem porary los? of work or schooling but which have not required referral to hospital.
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Stuart et al. (1966) studied this question.