Search

A 19-year-old construction worker from Virginia who had traveled in Bolivia had sporotrichoid lesions on the left arm. Only after unsuccessful therapy for sporotrichosis was a diagnosis of cutaneous leishmaniasis considered. Biopsies revealed necrotizing granulomatous changes, and culture of the biopsy specimens grew Leishmania (Viannia) braziliensis. The sporotrichoid pattern seen in this patient is a rare but recognized presentation of cutaneous leishmaniasis, more commonly seen in American cutaneous leishmaniasis than in Old World cutaneous leishmaniasis. This case illustrates the necessity of careful and early consideration of tropical infections in the differential diagnosis of disease in a traveler.

As changes are being made in the health care system, the roles and responsibilities of the pharmacist are evolving in direct patient care. The knowledge and skills necessary to succeed in these clinical positions are obtained through postgraduate training through pharmacy practice and specialty residencies and fellowships. Residency candidates are faced with important decisions in choosing which training programs to select and planning the course of the training. This article approaches the questions and decision-making process in residency selection from pharmacy residents' points of view.

The GABAA receptor subunits are candidate genes for panic disorder because the receptor is the site of action for the anxiolytic effects of the benzodiazepines. We tested for linkage between a tetranucleotide repeat polymorphism at the GABAA beta 1 locus, located on chromosome 4p13-p12, and panic disorder defined by DSM-III-R criteria in 5 Icelandic pedigrees. Both a narrow affection status (definite panic disorder and agoraphobia) and a broad one (including probable cases of these disorders) were tested. With the narrow definition, at a recombination fraction of 0.00, the lod scores in the 5 pedigrees ranged from -3.240 to +0.063, the total score across all 5 pedigrees being -8.299. With the broad definition at the same recombination fraction, the individual lod scores ranged from -2.614 to -0.489, with the total being -8.089. Thus, linkage between panic disorder/agoraphobia and the GABAA beta 1 locus in these pedigrees is exceedingly unlikely.

This controlled experimental study examines the effect of two teaching methods on achievement outcomes from a 15-week, 2 credit hour semester course taught at two midwestern universities. Students were randomly assigned to either computer-managed instruction in which faculty function as tutors or the traditional classroom course of study. In addition, the effects of age, grade point average, attitudes toward computers, and satisfaction with the course on teaching method were analyzed using analysis of covariance. Younger students achieved better scores than did older students. Regardless of teaching method, however, neither method appeared to be better than the other for teaching course content. Students did not prefer one method over the other as indicated by their satisfaction scores. With demands upon university faculty to conduct research and publish, alternative methods of teaching that free faculty from the classroom should be considered. This study suggests that educators can select such an alternative teaching method to traditional classroom teaching without sacrificing quality education for certain courses.

The identification of norms relating to the status of stroke patients is significant to community plans to provide contemporary health services for stroke patients. This two-phase research study assessed the status of stroke patients for a large metropolitan area. The first phase of research was a retrospective hospital record review conducted on 1,665 subjects admitted to 13 Cincinnati hospitals with the primary diagnosis of stroke. This study showed that the Cincinnati outcomes were consistent with the outcomes demonstrated in the literature. The most typical stroke patient was a 71-year-old woman with right hemiplegia, who was living at home with another adult after spending 17.5 days in the acute care hospital. The behavioral functional levels of 105 disabled stroke patients were assessed in the second phase, using the Level of Rehabilitation Scale. Subjects were analyzed in five functional areas to determine their level of independent living. Demographic data were used to analyze the findings in comparisons. In general, stroke patients function higher in activities of daily living than they do in social interactions. Stroke patients living with another adult demonstrated a lower degree of functioning in activities of daily living than those who lived alone, but scored higher in social interactions.