Fetal alcohol syndrome in adolescents and adults

Article Abstract:

Fetal alcohol syndrome (FAS) is the leading cause of mental retardation in the United States. Alcohol use by mothers during pregnancy produces a wide range of disabilities, with FAS representing the most severe effects. FAS produces a specific, recognizable pattern of malformation, accompanied by low intelligence. Fetal alcohol effects (FAE) represent a milder form of the syndrome. In spite of the prevalence of FAS, there has been no previous follow-up of adolescents and adults with the syndrome. FAS is characterized by growth deficiency, minor abnormalities of the face, and central nervous system deficits, including small head, delayed adjustment, attention deficits, learning disabilities, low IQ, and seizures. Sixty-one patients, 70 percent with FAS and 30 percent with FAE, were studied. Most of the patients were American Indian. Mental retardation did not always accompany FAS, but most of these patients had major psychosocial problems. Short stature and small head size were the most apparent effects as the children grew older, but the thinness that was so apparent before puberty gave way to a normal weight for height, and even plumpness in adolescent girls. Abnormalities of the face, such as the narrow eye slit, lack of vertical ridges between the nose and lip, and thin upper lip became less apparent with advancing age. Abnormalities affecting the fingers and elbows were common. Although the patients were alert and verbal on clinical examination, they were especially deficient in mathematics and problem-solving requiring abstract reasoning or judgment. Although 42 percent had IQs above 70, none of the patients were independent in both housing and income. The full syndrome affects one in every 700 live births. In one Canadian Indian village, the incidence was one in eight births. The economic costs of FAS are high, and the social maladjustment of these patients makes them unsuitable for job training programs developed for other developmentally disabled adults. The parents of these children were chronic alcoholics, but studies of social drinkers have also recorded subtle IQ and achievement deficits. All the studies suggest that women should not drink during pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Demographic aspects, Native Americans, Native North Americans, Alcoholism, Pregnancy, Fetal alcohol syndrome, Alcohol use, Alcoholism in pregnancy

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Evaluation of hematuria in adults

Article Abstract:

Hematuria, or blood in the urine, may occur as gross hematuria (GH), the obvious presence of blood, or microscopic hematuria (MH), microscopic quantities of blood; either condition may indicate serious kidney disease. There is currently no consensus of opinion of what level of MH deserves attention. A review of hematuria in adults was performed with an emphasis on evaluation procedures and recommendations for evaluating patients with MH. Studies on MH have not revealed any significant demographic factors. MH may be a transient condition and often occurs in subjects without kidney disease. In general, screening for MH in adults with a 'dipstick', a cellulose strip which reacts with hemoglobin (a component of red blood cells), is unreliable. In addition, because of the low incidence of serious kidney disease associated with MH, routine screening with this method is not recommended. However, for those in a high-risk group for kidney cancer, the urine dipstick may be helpful. Medical history and review of drugs the patient may be taking are important considerations. If MH persists and the medical history, physical examination, and urinalysis do not reveal the cause, screening laboratory studies, such as intravenous pyelogram (IVP) and cystoscopy, are the next step. IVP involves intravenously injecting a dye so that the urinary tract can be visualized on X-ray; cystoscopy involves the microscopic examination of cells taken from the urinary tract. IVP has been the mainstay of diagnostic tests for hematuria, but recent studies indicate that it has limitations and may need to be supplemented with ultrasound and computerized tomographic (CT) scan of the urinary tract and kidneys. In general, low-risk patients with transient MH do not need further examination. However, patients with intermittent or persistent MH should be further evaluated. Factors such as age (over 60 years), risk for urologic cancer, tobacco use, drug abuse, and environmental exposure should be considered in planning the evaluation of patients with MH. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Kidney diseases, Hematuria

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Zonisamide for weight loss in obese adults: a randomized controlled trial

Article Abstract:

The drug zonisamide combined with a reducing diet can be an effective weight loss method, according to a study of 60 obese men and women. Over an eight-month period, those who took the drug along with dieting lost about 10% of their body weight compared to a 2% weight loss in those who only dieted. Zonisamide is an anti-convulsant drug that was found to cause weight loss as a side effect of treatment.

Drug therapy, Obesity

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