The effect of five different transferrin variants (TFv1, TFv2, TFv3, TFv4, and TFv5) on the hemoglobin level, mean corpuscular volume (MCV), ferritin level, percent transferrin saturation (%TS), and the unsaturated iron binding capacity (UIBC) was investigated in subjects with defined HFE haplotypes, 919 persons undergoing health screening and 113 patients with clinical hemochromatosis. The most common variant is TFv4; the population distribution of this variant was also studied. None of the variants were found to have an effect on any of the parameters of iron metabolism that were investigated. Moreover, the frequency of these variants in patients with clinically significant hemochromatosis was no different from that in the general population. We conclude that these polymorphisms in transferrin do not play a role in the expression of hemochromatosis, nor do they produce any other significant changes in iron metabolism.

Alleles↗

PubMedDate not supplied

Absorption and safety of rectally administered phenytoin.

Parenteral phenytoin solution (Dilantin) was given rectally three times a day for three days to two beagle dogs. This was well tolerated, with no evidence of mucosal irritation noted either on endoscopic nor on rectal mucosal biopsy. When given in this manner, phenytoin is absorbed to a limited degree in canines. Parenteral phenytoin solution can be safely administered rectally, despite a pH of 12. Further study in normal volunteers is needed to assess the usefulness of this route of administration in situations in which the oral and/or parenteral route of administration is unavailable.

Administration, Rectal↗

PubMedDate not supplied

Changes in psychiatric diagnoses from admission to discharge: review of the charts of 159 patients consecutively admitted to a geriatric psychiatry inpatient unit.

The diagnosis of psychopathology among geriatric acute inpatients requires comprehensive evaluation. To our knowledge, no recently published papers in the geriatric psychiatry literature have systematically examined diagnostic changes during single admissions. We reviewed the charts of 159 patients consecutively admitted to an acute geriatric psychiatry unit over 18 months. We recorded admission diagnoses from initial treatment plans, and discharge diagnoses from discharge summaries. Mean patient age was 80 years and average length of stay was 17 days. The most common primary diagnoses were psychotic and depressive disorders. The most common secondary diagnoses were dementias and depressive disorders. Primary diagnoses changed from admission to discharge in 31 patients (20%), and secondary diagnoses changed in 76 patients (48%). There was a significant change involving the diagnosis of dementia, but not that of depressive or psychotic disorders. A large proportion of inpatients had their diagnoses altered, especially those involving dementias, during hospitalization. Inpatient admission may be valuable for clarifying the diagnoses of elderly psychiatric patients.

Aged↗

PubMedDate not supplied

Specific deficits in component reading and language skills: genetic and environmental influences.

Phonological coding, measured by the oral reading of nonwords, and orthographic coding, measured by the discrimination of words from homophonic nonwords (e.g., rane, rain), were compared for pairs of older children with reading disabilities (RD) and younger nondisabled readers matched on word recognition. Phonological coding was substantially lower for most children with RD, indicating a unique developmental deficit in phonological coding rather than an equal developmental lag across all component reading skills. Data from identical and fraternal twins indicated that the phonological coding deficit of the children with RD was highly heritable and accounted for most of the heritable variance in their word recognition deficits. The deficits of the twins with RD in segmental language skills (rhyming and phoneme segmentation) were related to the heritable variance in their phonological coding deficits. Orthographic coding was not significantly heritable, and it accounted for much of the environmental variance in word recognition deficits. Implications of the results for the remediation of reading disability are discussed.

Child↗

PubMedDate not supplied

Camp Can-Do. Outcomes of an experiential learning experience.

Because the most effective way to learn is by doing, faculty need to develop experiential learning experiences for students. The authors discuss one such experience, a multiple sclerosis camp where nursing students lived with and cared for their clients for 6 days. The camp experience illustrates how educators can partner with community organizations to the benefit of both.

Activities of Daily Living↗

PubMedDate not supplied

Severe opportunistic infections in AIDS patients with late-stage disease.

BACKGROUND: Clinicians caring for patients who have acquired immunodeficiency syndrome (AIDS) need to be aware of the wide variety of infectious diseases that can occur. Although Pneumocystis carinii pneumonia (PCP) is the most common AIDS-defining infection, other opportunistic infections associated with advanced immunodeficiency can develop after an initial diagnosis. METHODS: To ascertain AIDS-defining opportunistic infections that developed at the time of or after an AIDS diagnosis, and intensive chart review was conducted for 45 homosexual men with AIDS who died from 1990 through 1992. Time to death after first occurrence of these infections was also determined. RESULTS: The most common opportunistic infection occurring as the initial AIDS-defining illness was PCP (31 percent). The most common opportunistic infection occurring as a secondary disease was cytomegalovirus (CMV) disease (40 percent), followed by disseminated Mycobacterium avium complex (33 percent) and invasive candidiasis (31 percent). Each of these latter infections was associated with a poor prognosis (median time to death < or = 8 months). CONCLUSIONS: Diseases caused by CMV, disseminated M. avium complex, and invasive candidiasis were uncommon presenting manifestations of AIDS but were common secondary diseases that tended to be associated with limited survival. With increasing survival and a declining incidence of PCP as a result of medical therapy, other severe opportunistic infections might become increasingly recognized.

AIDS-Related Opportunistic Infections↗