Access to Print in Low‐Income and Middle‐Income Communities: An Ecological Study of Four Neighborhoods

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88026/1/RRQ.36.1.1.pd

Accidental Ingestion of Anticoagulant Resulting in a Severe Hemorrhagic Diathesis

This case history of a 45-year-old woman, who had been issued Dicumarol instead of Dronactin in a pharmacy-filled prescription, describes an emergency therapeutic program to control hemorrhage with vitamin K, adrenal corticosteroids, and the giving of fresh blood. In a patient with a bleeding disorder, unintentional ingestion of oral anticoagulants is to be suspected if the prothrombin time is markedly elevated, if the patient has been previotisly treated with an oral anticoagulant, or is engaged in a medical or paramedical occupation. Diagnosis is confirmed by finding a deficiency of factors II, VII, IV, and X. and by the presence of anticoagulant in the plasma through chemical analysis

Genetic Counseling for Hemoglobinopathies: A Model for Large Scale Application

This report describes a project in a large urban, predominantly black, high school which combined a hemoglobinopathy survey with an educational and genetic counseling emphasis. The faculty and students received information on sickle cell disease explaining its genetic and personal implications. About 29% of the 2,700 students received parental permission and volunteered for blood tests in the initial year. Blood was examined by starch gel electrophoresis during the first year and by cellulose acetate electrophoresis during the second year. Of the 1300 total individuals studied, 7% were found to have sickle cell trait and 2% hemoglobin C trait. The cellulose acetate electrophoretic procedure was found to be as satisfactory as the starch gel procedure at less cost ($1.32 per person). Those vnth abnormalities were given counseling which simply emphasized the risk to their progeny should they marry another heterozygote. For adequate genetic counseling purposes, the seriousness of SC disease and the frequency of hemoglobin C trait preclude the use of any screening procedure which fails to detect C hemoglobin. The described program detects hemoglobinopathies common in the black population, is practical, is directed to youth for maximum effect of genetic counseling, and is adaptable to large scale application