In a population of 425 individuals with Down syndrome, we observed 5 persons (1.2%) with Tourette's disorder. Because the prevalence of Tourette's disorder in the general population has been estimated to be between 0.03% and 1.6%, it is not likely that there is an increased prevalence of Tourette's disorder in Down syndrome, or that there is an interrelationship between Down syndrome and Tourette's disorder. This lack of relationship argues against an atypical Tourette's disorder. The absence of family histories of Tourette's disorder in our patients, the relatively late onset of the disorder in most of our patients, their previous treatment with neuroleptic and psychostimulant medication, and the lack of relationship between Down syndrome and Tourette's disorder in this Down syndrome population are factors that support the diagnosis of tardive Tourette's disorder.

Adolescent↗

PubMedDate not supplied

Severe acute metabolic acidosis (acute beriberi): an avoidable complication of total parenteral nutrition.

Total parenteral nutrition is one of the most important recent advances in medicine. The delivery of total parenteral nutrition, however, can be associated with a broad spectrum of complications ranging from mechanical (catheter related) to metabolic. We have recently seen a previously unreported complication of total parenteral nutrition - three patients maintained on total parenteral nutrition, who did not receive vitamins and experienced the acute onset of life-threatening metabolic acidosis with pH values as low as 6.70. All responded promptly and completely to the administration of intravenous thiamine, and thus were probably examples of acute beriberi. Acute beriberi is a well-documented syndrome which usually occurs in nutritionally compromised individuals outside the hospital setting who lack thiamine in their diet. Without thiamine, glucose cannot enter the Krebs cycle in order to be completely oxidized for energy production and therefore, accumulates as lactic acid. This lactic acidosis is refractory to any treatment except thiamine and will result in cardiovascular collapse if the vitamin is not administered.

Acidosis↗

PubMedDate not supplied

Psychopathology in heart transplant candidates.

Psychodiagnostic data are reported on 69 heart transplant candidates. Twenty-seven patients actually received a transplantation. A high prevalence of anxiety and depression appeared related to their desperate cardiac status. Distressful symptoms did not predict postoperative psychiatric complications. Reduced coping skills as reflected by diagnoses of personality disorders or organic mental impairment were associated with many behavioral problems capable of jeopardizing survival. Psychiatric input is necessary for, and was helpful in, the management of these patients.

Adolescent↗

PubMedDate not supplied

Massive proteinuria after renal transplantation. A case report.

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

A community health report card: comprehensive assessment for tracking community health (CATCH).

A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

Community Health Planning↗