The role of genetic counseling in visually impaired adolescents.

The presence of genetic disorders in a high percentage of adolescents with significant visual impairments emphasizes the important role that genetic counseling can play in this population. However, its intended goals have been controversial. Responses to structured interviews about genetic counseling services from three groups of former students from the Kentucky School for the Blind were compared. One group consisted of students who had received genetic counseling; another, of students who had declined it; and a third, of students who had graduated before the service was available. In all groups, genetic counseling was viewed as a valuable service which would have been pursued by the majority of those who did not have the opportunity to receive it, and by many of those who refused it initially. Although genetic counseling did little to enhance knowledge of the cause of the specific visual impairment, it appeared to be useful in providing information regarding the risk of visual impairment in future offspring. A relatively high rate of unplanned pregnancies was noted in the group who had refused genetic counseling. The significance of this observation is uncertain. One interpretation is that the group refusing genetic counseling may have consisted of individuals who had fewer concerns as adolescents about family planning issues. These observations suggest that it may be appropriate to recommend to adolescents with significant visual impairments to defer childbearing until independent life experiences are accumulated outside the school setting. Then, prior to considering childbearing, genetic counseling should be sought.

Immune-mediated hemolysis in a postoperative patient Case report: anti-U and differential diagnosis.

We present the differential diagnosis for a Coombs-positive immune hemolysis having onset during hospitalization and, in particular, during the postoperative period. The stimulus for this article was a delayed hemolytic transfusion reaction (DHTR) due to anti-U following open-heart surgery. The initial clinical and serologic findings led us to consider other causes of immune hemolysis which are reviewed in this article. To our knowledge, this is the fourth case of a DHTR due to anti-U to be reported in the medical literature.

Innovative clinical teaching.

Participating faculty are entering their third year using this type of student rotation and have found that it continues to be a positive teaching-learning experience for faculty, staff, and students. It has enabled a greater number of students to enjoy a positive clinical experience in areas that previously were limited to a smaller number of students. Perhaps this strategy, or a part of it, may be of benefit to other nurse educators as a method of improving undergraduate clinical experiences.

Calcium requirement for gliding motility in myxobacteria.

The ability to glide on a solid surface was inducible by calcium ion in Stigmatella aurantiaca. The induction of motility but not motility itself was prevented by chloramphenicol and erythromycin. Calcium ion was also required for cells to glide, even when they were previously induced. The ability of Myxococcus xanthus to glide in groups using the S motility system but not as single cells (A system) was prevented by chloramphenicol and erythromycin.

Auto anti-M. Clinical and serologic findings of seven patients from one hospital and review of the literature.

Auto-anti-M antibodies are not commonly documented serologically. A review of the literature reveals only ten cases with no consistent clinical or laboratory findings. In their institution, over a 12-year period, the authors have identified this autoantibody in seven patients, suggesting that it may not be such a rare entity but rather may be underdiagnosed. In this article the authors describe the pertinent clinical and serologic findings in their seven patients, as well as review the salient features of the previously reported cases.

Aberrant creatine kinase and lactate dehydrogenase response in a myocardial infarct patient.

A 65-year-old woman failed to develop increased creatine kinase or lactate dehydrogenase activity after a myocardial infarction. She had no measurable creatine kinase MB isoenzyme and no detectable patterns of normal LD isoenzyme activity. These determinations five months after the infarction showed normal values for total activity and isoenzyme patterns.

New control algorithms via brain theory.

New concepts and viewpoints are needed to develop control algorithms for large scale systems. It is hypothesized that brain functions in human beings clearly demonstrates the existence of superior techniques for controlling complex systems with multiple objectives. The theory of compacta is investigated as a basis for learning, memory, and perception.

Approximate identification and digital simulation of the respiration--heart-rate system.

This paper considers the problem of determining a digital computer model for the heart-rate system that includes nonrespiratory as well as respiratory effects on the heart rate. A sampled-data model is shown to be exact in certain cases and can be used with some errors for other cases. Several methods are developed for finding the model transfer function parameters as well as the parameters of a signal added to the system output. Linear and nonlinear models are considered.