The Memorial Meal Mates: a program to improve nutrition in hospitalized older adults

A common problem among older hospitalized patients is inadequate nutritional intake. The Memorial Meal Mates project was developed to address this problem. College-aged volunteers were provided a 3-hour in-service taught by an interdisciplinary team. During a 2-month period, the Memorial Meal Mates fed 34 patients, who were compared with 34 other patients fed by nursing staff. The mean intake of the Meal Mates group was 58.88%, compared with the mean intake of the control group of 32.45%. Patients fed by the volunteers nearly doubled their intake over those fed by nursing staff.     

Abdominal blood pool scintigraphy in the management of acute or intermittent gastrointestinal bleeding

Gastrointestinal blood pool scintigraphy, using a modified in-vivo red blood cell labelling technique with technetium-99, is a new, easily performed, non-invasive procedure. It is valuable in screening patients with acute or intermittent gastrointestinal blood loss in whom duodenoscopic and sigmoidoscopic findings are unhelpful. This paper reviews the value of this scintigraphic technique over the first eight months of its use in a major teaching hospital, and compares the results with other published data. The high sensitivity of this procedure, and its ability to demonstrate gastrointestinal bleeding very strikingly, are illustrated with several examples. If used and interpreted appropriately, scintigraphy is sensitive in detecting and localizing the bleeding site, and is very helpful in indicating the optimal timing of emergency contrast angiography. The study further supports the view that scintigraphy should be the initial diagnostic imaging procedure in this group of patients, and that emergency angiography should be reserved primarily for patients in whom there is scintigraphic evidence of continuing blood loss.     

Restrictive factors in strabismus

Either muscle weakness (paresis) or mechanical restrictions can account for diminished ocular rotation. In practice, restrictions are more commonly seen. The forced duction test, differential intraocular pressure measurement and saccadic velocity studies can all assist in documenting the presence of restriction. Restrictions frequently occur with orbital floor fracture, endocrine ophthalmopathy and Brown's syndrome, and following multiple stabismus procedures, orbital or retinal detachment surgery, or muscle transposition surgery. They also occur as a result of antagonist muscle contracture after rectus muscle palsy or they may be due to orbital tumor or inflammation.     

Facilitated diagnosis of the contiguous gene syndrome: tuberous sclerosis and polycystic kidneys by means of haplotype studies

Tuberous sclerosis (TSC) and autosomal dominant polycystic kidney disease (ADPKD) are genetically heterogeneous diseases. The major gene for ADPKD (PKD1) lies adjacent to the TSC2 gene on chromosome 16p13. Some reports in the literature referred to an unusual presentation of TSC with enlarged cystic kidneys at birth, but it was not until the localization of the TSC2 and PKD1 genes that it was possible to analyze the interaction between both genes. We describe a case of a child with TSC and enlarged cystic kidneys. The study of genetic marker segregation in the family pointed to the presence of a deletion involving the 3' region of PKD1. A further study of the region showed a deletion of 40 kb involving both PKD1 and TSC2. We suggest that an additive or synergistic effect between PKD1 and TSC2 may cause this renal phenotype. A contiguous gene syndrome involving PKD1 and TSC2 should be suspected in children with TSC and enlarged polycystic kidneys at birth. The first approach to identify a deletion of both genes could be the analysis of the segregation of PKD1 and TSC2 markers in the family.     

Autistic children and their first-degree relatives: relationships between serotonin and norepinephrine levels and intelligence

Whole-blood serotonin (5-HT) and plasma norepinephrine (NE) were studied in 16 autistic children, 21 siblings of autistic children, and 53 parents of autistic children. Both plasma NE and whole-blood 5-HT were negatively correlated with vocabulary performance. Whole-blood 5-HT and plasma NE did not differ between autistic children with or without histories of self-injurious behavior or decreased pain sensitivity. Eighteen subjects were hyperserotonemic (whole-blood 5-HT greater than 270 ng/ml). For these subjects, plasma NE was significantly higher than for subjects without hyperserotonemia. Seven of 10 families with one hyperserotonemic member had two or more hyperserotonemic members. Observations of familiarity of whole-blood 5-HT suggest that larger-scale and more focused study of whole-blood 5-HT as a possible genetic marker may be productive.     

Cloxacepride and related compounds: a new series of orally active antiallergic compounds

4-[[(p-Chlorophenoxy)acetyl]amino]-5-chloro-2-methoxy-N-[2-(diethylamino)ethyl]benzamide (cloxacepride, 1), exhibited substantial oral antiallergic potential in a reaginic PCA test in rats over a wide range of antigenic challenge times. Available reference compounds with oral activity, such as doxantrazole and 7-(2-hydroxyethoxy)-9-oxoxanthene-2-carboxylic acid (AH 7725, 4), were active only when administered 15 min before challenge: 4, in particular, was not consistent in effect. Oral ED50 values for cloxacepride of 46-49 mg/kg were comparable to that of theophylline and to an intravenous injection of 2 mg/kg of disodium chromoglycate (DSCG) followed by immediate challenge. Following oral ED50 doses, 1 showed slower onset and longer duration of action than theophylline. The absence of inhibition of systemic anaphylaxis and of antihistaminic activity suggests specific effect or reaginic antigen antibody reactions. Structure-activity relationships of various chemical modifications were investigated and discussed in terms of essential substituents.     

Neoplastic human fibroblast proteins are related to epidermal growth factor precursor.

We report the amino acid composition of two polypeptides, p788 and p789. These polypeptides are reliable markers for neoplastic transformation in human fibroblasts. Their compositions are unusually rich in cysteine and serine. Because the recently reported amino acid sequence of mouse epidermal growth factor precursor (prepro-EGF) is also rich in those two amino acids and because the role of p788 and p789 as markers for neoplastic transformation is consistent with the fact that epidermal growth factor has been shown to play some role in transformation, we investigated the hypothesis that p788 and p789 are related to prepro-EGF. We compared the amino acid composition of p788 with that of all possible interior domains of prepro-EGF of appropriate length. We found that the composition of p788 is remarkably similar to that of residues 630-880 of prepro-EGF. The similarity is sufficiently strong to support the conclusion that it reflects amino acid sequence homology.