Nutritional status and lymphocyte function in maintenance hemodialysis patients.

Nutritional status and lymphocyte transformation were examined in 30 clinically stable men who underwent maintenance hemodialysis for 1 to 141 months. The men displayed decreased relative body weight, triceps and subscapular skinfold thickness, midarm circumference, midarm muscle circumference, serum total protein, albumin, transferrin, IgG, IgA, IgM, and C3 concentrations. There were many abnormalities in the plasma amino acid pattern. Lymphocyte transformation stimulated by phytohemagglutin or pokeweed mitogen was reduced. Many nutritional parameters correlated with each other and with the rate of lymphocyte transformation. There was a tendency (p = 0.06) for higher mortality in the malnourished patients during a mean follow-up period of 43.3 months. These findings suggest that clinically stable men undergoing maintenance hemodialysis are typically malnourished. Poor nutritional status may be a cause of impaired lymphocyte function. Malnutrition or wasting may indicate that the patient is at risk for a higher mortality rate.

Fine needle aspiration cytologic characteristics of hyalinizing trabecular adenoma of the thyroid.

The cytologic characteristics of a histologically proven hyalinizing trabecular adenoma are presented. The solitary thyroid nodule was diagnosed cytologically as benign and histologically as malignant. Cytologically, the fine needle aspirate showed increased cellularity, with mild nuclear atypia and eosinophilic nuclear pseudoinclusions. Collections of an amorphous colloidlike material were noted surrounded by follicular cells. Inflammatory cells in the background suggested the possibility of a thyroiditis. Since the patient's antibodies were negative, a hemithyroidectomy was performed to rule out a neoplasm. The frozen section was interpreted as suggestive of medullary carcinoma since the tumor showed a poorly differentiated pattern of cells with marked nuclear atypia and abundant fibrous stroma (thought to be amyloid) separating the cells. The results of immunopathology and electron microscopy ruled out a medullary carcinoma. Upon review of the histology at a later date, the case was recategorized as a hyalinizing trabecular adenoma, proving the negative cytologic diagnosis to be correct.

Stability of cohesion in the spoken narratives of language-impaired and normally developing school-aged children.

The short-term stability of the cohesion scores for the spoken narratives of language-impaired and normally developing school-aged children was investigated. Narratives were obtained from 39 language-impaired and 39 normal-language children, aged 8-10 years, at four 2-week intervals. Reliability coefficients for scores from five measures--two for cohesive adequacy and three for verbal productivity--were of adequate magnitude for analysis. Mean cohesive adequacy scores were stable across narratives, but stability coefficients were only moderately large. Stability coefficients for verbal productivity scores were sufficiently large for research purposes; mean scores were most similar between testing Times 2 and 3, indicating that stability increased after children had experience telling stories.

Modifying attitudes toward persons with hearing impairments. A comprehensive review of the research.

Negative attitudes toward persons with hearing impairments adversely affect their opportunities and self-concepts. Thus, modifying such attitudes is of concern to educators and researchers. An exhaustive search of the literature yielded 12 reports of research on modifying attitudes toward persons with hearing impairments. The research results were mixed--some studies even yielded negative attitude outcomes--and the quality of the studies was not high. Of the treatments studied, properly structured contact in particular showed promise for improving attitudes toward persons with hearing impairments.

The relationship of hearing-loss severity to demographic, age, treatment, and intervention-effectiveness variables.

The purpose of this study was to demonstrate how hearing-loss severity and the variables of demographics, age, treatment, and intervention effectiveness were related for 2519 children served by SKI*HI home-based programs between July 1979 and June 1991. Relationships between hearing-loss severity and demographic variables were negligible to small. Severity was inversely associated with identification, amplification, and program-start ages. The relationship between severity and early versus late program start was small; this was also true for the relationship between severity and communication methodology. Severity was positively associated with treatment duration; however, severity was not associated with treatment density. Intervention effectiveness for the severity levels, based on expressive and receptive language scores, was examined using three predictive models. These included the residuals between actual and predicted posttest scores, proportional change indices, and value-added gains per month. The usefulness of the three procedures for clinical and program-evaluation purposes is discussed.

Screening procedures used to identify children with hearing loss.

This study focused on the hearing-screening procedures used to identify children who have hearing losses who were later enrolled in SKI*HI parent/infant programs throughout the country. Responses to a questionnaire for 1,404 children indicated that although auditory brainstem response (ABR) technology provided the lowest mean identification age, informal hearing-screening procedures (parental suspicion and referral) were the procedure of identification for 80% of the children. The data suggest that formal screening programs are not presently locating the vast majority of infants who have hearing losses. Recommendations for professional and parental education in the area of hearing-loss screening are provided.

Effect of vitamin B-6 deficiency on plasma amino acid levels in chronically azotemic rats.

Chronic renal failure is associated with many abnormalities in plasma amino acids. Since patients with renal failure are frequently deficient in vitamin B-6, this study examined whether vitamin B-6 deficiency may be a cause of any of the abnormal plasma amino acid concentrations observed in chronic renal failure. Sham-operated and chronically azotemic rats were pair-fed diets deficient in or replete with vitamin B-6 for 21 d. By the end of 21 d, the EGOT index rose significantly in the B-6-deficient rats but not in the B-6-replete animals. There were several differences in plasma amino acid concentrations between azotemic and control rats. Azotemia and B-6 deficiency each lowered the plasma serine concentration and raised the glycine-to-serine ratio. Plasma glycine was affected by a two-way interaction between azotemia and vitamin B-6 deficiency whereby the highest values were found in the sham-operated vitamin B-6-deficient animals. Plasma alanine and asparagine were reduced by B-6 deficiency and unchanged by azotemia. These results suggest that vitamin B-6 deficiency may contribute to several of the abnormalities in the plasma aminograms observed in chronic renal failure.