Coombs-positive hemolytic anemia preceding ulcerative proctitis

A 12-year-old girl is described who developed rectal bleeding 5 months after being diagnosed as having a Coombs-positive hemolytic anemia. Colonoscopy showed that the rectal bleeding was due to ulcerative proctitis. This is the first case report of Coombs-positive hemolytic anemia preceding the onset of ulcerative proctitis in a child.     

Weight change among participants in a large sample minimal contact smoking relapse prevention trial

Weight at baseline and posttreatment was measured for 1096 participants in a smoking relapse prevention trial: 42.1% maintained their weight, 42.5% gained more than 1 kg and 15.4% lost more than 1 kg during the eight-week treatment program. Abstainers (n = 383) gained more than four times the weight gained by relapsers (n = 713) (Abstainers: 1.6 kg, Relapsers: 0.4 kg, p less than .0001). In order to examine the anorexic properties of nicotine gum. Abstainers were classified into nicotine gum user and non-user categories. Users gained significantly less weight than non-users although the difference was small (Users: 1.1 kg, Non-users: 1.8 kg, p less than .004). A dose-response relationship was observed between number of cigarettes smoked per day at baseline and weight gain. Higher cigarette consumption was associated with increased weight gain in both gum user (p less than .004), and non-user groups (p less than .02). There was no significant difference in weight gain between Abstainers who later relapsed at 6 months and those who maintained abstinence (p less than .29). Although the impact of nicotine gum on weight gain was small, this apparent property of the substance may be useful in encouraging cessation among smokers who perceive weight gain as a potential stumbling block to success.     

Home teaching of nocturnal nasogastric feeding

Nocturnal nasogastric feeding (NGF) supplementation is an effective means of supplying calories to children with chronic diseases which may impair caloric and nutritional intake. Herein, we describe our experience with 18 patients who were taught NGF. They were divided into two groups: one group was instructed in the hospital which is the typical situation, whereas the second group was instructed at home. No complications were associated with NGF taught either at home or in the hospital. Our experience, therefore, indicates that nocturnal NGF can be successfully taught at home.     

Skeletal effects of calcitonin in ovariectomized rats

Although calcitonin (CT) has been shown to be effective for the prevention of bone loss in early postmenopausal women, the skeletal effects of the hormone specifically during the early stages of estrogen deficiency have not been characterized histomorphometrically to date. The current study involves use of the ovariectomized (OVX) rat as an animal model for early postmenopausal bone loss to perform such a histomorphometric analysis. One group of OVX rats was injected sc with salmon CT on alternate days for a 6-week period. Additional groups of OVX and sham-operated control rats were treated with vehicle alone. In comparison to control rats, the proximal tibia of vehicle-treated OVX rats were characterized by a 3-fold decrease in cancellous bone volume and significant increases in osteoblast surface (+200%), osteoclast surface (+143%), mineralizing surface (+111%), mineral apposition rate (+36%), bone formation rate (+181%), and longitudinal bone growth (+38%). In contrast, treatment of OVX rats with CT normalized tibial cancellous bone volume and significantly decreased all of the above cellular- and fluorochrome-based indices of bone turnover to near control levels. The results indicate that CT treatment depresses bone turnover and prevents the development of osteopenia in OVX rats. These findings are consistent with the bone protective effect of CT in early postmenopausal women and further support the OVX rat as an animal model for the preclinical evaluation of prophylactic treatments for postmenopausal bone loss.     

Day-to-Day Variation in Iron Status Indexes is Similar for Most Measures in Elderly Women With and Without Rheumatoid Arthritis

Objective To determine the day-to-day variation in biochemical measures of iron status in a group of elderly women with rheumatoid arthritis compared with a group of healthy elderly women.Design Venous blood samples were collected from each subject on 3 nonconsecutive days during a 2-week study period; subjects had fasted overnight. Variability in hemoglobin level, hematocrit value, serum iron concentration, total iron-binding capacity, transferrin saturation, serum ferritin concentration, and plasma transferrin receptor level was determined.Subjects Two groups of women, one with rheumatoid arthritis (n=10) and another that was apparently healthy (n=10).Statistical analyses Variance component analysis was used to estimate the biological variation (σ²_day) and analytic variation (σ²_rep) for each iron index. The coefficient of variation (CV) for each variance component was calculated: coefficient of biological variation = CV_day, coefficient of analytic variation = CV_rep, and coefficient of a single future determination = CV_fd.Results The CV_rep for all iron indexes was smaller than the CV_day in both groups. The CV_day was considerably higher for serum iron concentration and for transferrin saturation than for the other indexes in both groups (16.6% arid 16.6% in healthy subjects and 33.6% and 28.2%, respectively, in subjects with rheumatoid arthritis). The higher CV_day for serum iron concentration and transferrin saturation translated into a higher CV_fd for these indexes. Because of the higher variance for these two indexes, more sampling days were required for reliable estimates. CV_da and CV_fd for plasma transferrin receptor level were relatively low.Conclusions These findings corroborate our previous finding that variation of serum ferritin concentration in the elderly is lower than that demonstrated in younger populations. This aging effect persists in the presence of rheumatoid arthritis. Fasting appeared to improve reliability in the determinations for serum iron concentration and transferrin saturation. Variability estimates for the indexes other than serum iron concentration and transferrin saturation were not altered by the inflammation of rheumatoid arthritis. Plasma transferrin receptor level is a reliable index for assessing iron status in populations with rheumatoid arthritis. J Am Diet Assoc. 1996; 96:247-251.