Examining non-syndromic autosomal recessive intellectual disability (NS-ARID) genes for an enriched association with intelligence differences.

Two themes are emerging regarding the molecular genetic aetiology of intelligence. The first is that intelligence is influenced by many variants and those that are tagged by common single nucleotide polymorphisms account for around 30% of the phenotypic variation. The second, in line with other polygenic traits such as height and schizophrenia, is that these variants are not randomly distributed across the genome but cluster in genes that work together. Less clear is whether the very low range of cognitive ability (intellectual disability) is simply one end of the normal distribution describing individual differences in cognitive ability across a population. Here, we examined 40 genes with a known association with non-syndromic autosomal recessive intellectual disability (NS-ARID) to determine if they are enriched for common variants associated with the normal range of intelligence differences. The current study used the 3511 individuals of the Cognitive Ageing Genetics in England and Scotland (CAGES) consortium. In addition, a text mining analysis was used to identify gene sets biologically related to the NS-ARID set. Gene-based tests indicated that genes implicated in NS-ARID were not significantly enriched for quantitative trait loci (QTL) associated with intelligence. These findings suggest that genes in which mutations can have a large and deleterious effect on intelligence are not associated with variation across the range of intelligence differences.

Family physician attitudes about HIV screening.

This study examined why and for whom family physicians are likely to require HIV screening according to general policies or procedures, based on a national survey of 2,660 family practice physicians. Of those contacted, 1,678 responded, yielding a response rate of 63.7%. The study also examined whether attitudes toward screening differed for physicians in different types of practices, of varying educational backgrounds, and with differing opinions regarding treating persons with AIDS (PWAs). The results showed that required screening was most strongly endorsed for pregnant women who had other risk factors and for i.v. drug users. Those physicians who most favored mandatory screening were also most likely to favor the mandatory reporting of AIDS cases to public health officials. They also had the least formal medical training (were not residency trained or board certified) and expressed the greatest apprehension regarding their own and their staff's preparedness and willingness to treat PWAs. A major implication of the findings is that family physicians and others who do mandatory testing should be provided opportunities, through residency training, board-certification preparation, or continuing medical education, to learn how to care for those patients they test who turn out to be seropositive.

Management of the near-drowning victim.

The family physician should be skilled in the treatment of victims of immersion accidents. Specific management at the scene and in the emergency room is critical to survival and a good neurologic outcome. Hospital admission with careful evaluation and observation is usually indicated. Patients and community groups must be reminded of precautions that will prevent many injuries and deaths.

Diagnosis and treatment of chlamydial infections.

The major chlamydial infections are conjunctivitis and pneumonia in infants and urethritis, cervicitis, salpingitis and ocular infection in adults. Tetracyclines are usually the drugs of choice for the treatment of chlamydial infections. Erythromycin therapy is preferred for pregnant women and for neonates with conjunctivitis. Follow-up examination and treatment of sexual partners are required for the control of chlamydial infections.

The female role in the transmission of HIV infection.

Women are increasingly recognized as a significant population at risk for human immunodeficiency virus (HIV) infection. In major cities in Africa, the Americas, and Europe, HIV infection is the leading cause of death in women aged 25 through 29 years. New patterns have emerged in the epidemic, the most dramatic of which is the increased rate of transmission for heterosexuals, directly associated with an increase in seropositivity among women and children. Between 1989 and 1990, the number of women diagnosed with the acquired immunodeficiency syndrome rose 34% compared with a 22% rise in men. The Centers for Disease Control and Prevention have increased support for studies related to prevention of HIV infection in response to these trends. Health professionals should demonstrate an understanding of the complex nature of sexuality, femininity, and the female role in society when educating female patients about virus avoidance, so that preventive behavior will be perceived as consistent with a woman's personal standards for sexual relationships.

Intrathecal morphine as analgesia for labor pain.

In this descriptive study of intrathecal morphine sulfate used for pain control during labor, 49 parturients received morphine intrathecally, 78 were administered butorphanol tartrate (Stadol), and 34 received no analgesia. Significant differences for the intrathecal group included: (1) decreased requirement of nitrous oxide for delivery, (2) lower number of doses of postpartum intramuscular pain medication, and (3) increased use of forceps. The intrathecal morphine group showed no prolongation of labor and no major side effects in mothers or newborns. The results suggest that the use of lower levels of intrathecal morphine sulfate (0.5 mg) is as safe and effective as the more traditional intravenous analgesia for labor.

Emergency room practice among family physicians.

An attempt was made to determine the extent to which physicians trained and certified in family medicine are involved in emergency medicine. An 18-item, self-report questionnaire was mailed to 73 graduates of a family practice residency program to obtain information on their practices, their professional and emergency medicine experiences, and their attitudes toward the practice of emergency medicine by family practitioners. Ten percent of the 60 responding physicians were currently involved in full-time emergency medicine in either emergency rooms or minor emergency clinics. Twenty-eight percent of the respondents were currently practicing emergency medicine on either a part-time or sporadic basis. Supplemental income was cited the most often as a reason for becoming involved in emergency medicine. Only variables related to the physicians' attitudes discriminated between those who were practicing emergency medicine and those who were not.