Clinically significant alloimmunization to red cell antigens occurred in 28 percent of transfused patients in a sickle cell clinic. Therefore, a prospective study was undertaken to determine whether matching donors carefully for 17 blood group antigens would diminish the risk of further alloimmunization in patients on a chronic transfusion program. Alloantibodies had developed previously in 8 of the 12 patients. After chronic transfusion with selected donors, four new antibodies developed in three patients. Three antibodies were due to errors in phenotyping or matching, and one was due to an antigen that was not tested for in the protocol. The incidence of developing antibodies per unit transfused was diminished tenfold when selected donors were used. Autoantibodies developed in five patients (42%), but these did not seriously interfere with the transfusion therapy. It was concluded that matching for red cell antigens may diminish the incidence of alloimmunization in patients with sickle cell anemia requiring transfusion.

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H yperkalemia is common in hospitalized patients, with an estimated prevalence of 1%-10%. 1,2 Hyperkalemia can lead to life-threatening cardiac arrhythmias. The risk of arrhythmias increases with serum potassium values >6.5 mmol/L, and hyperkalemia is associated with increased in-hospital mortality. 3 Treatment for hyperkalemia is indicated by a combination of the absolute serum potassium level, the rate of change of potassium level, and the presence of electrocardiogram abnormalities.Intravenous insulin stimulates the sodium/potassium-ATP pump, leading to intracellular uptake of potassium. Recommendations vary regarding the optimal dosing of insulin and dextrose for the treatment of hyperkalemia. 4 Hypoglycemia is a common complication following treatment of hyperkalemia with insulin/dextrose. The reported incidence in hospitalized patients ranges from 6% to 75% depending on the population studied, the doses of insulin/ dextrose administered, and the definition of hypoglycemia. [5][6][7][8] Hypoglycemia itself is associated with increased morbidity and mortality in hospitalized patients. 9 The aims of this study were to describe the incidence of hypoglycemia following hyperkalemia treatment with intra-venous insulin/dextrose in inpatients in a large (900-bed) UK teaching hospital and to determine the risk factors predisposing to hypoglycemia.

As the number of culturally and linguistically diverse (CLD) learners with disabilities increases in the United States, many educators and policymakers purport that teacher education programs (TEPs) must incorporate multicultural education more substantively. However, we know very little about the impact of multicultural education on the thinking and actions of preservice teachers. Moreover, we know very little about how changes in content and format affect their outcomes on evaluative measures.This study traces the conceptual change of 26 preservice teachers enrolled in an introductory special education course with a multicultural component. Concept mapping and comparative essays were used to analyze quantitatively and qualitatively which concepts the preservice teachers found most salient and specific. Results indicated statistically significant changes in the concepts the students' deemed most central and specific. Also, qualitative analysis revealed that students' post-maps were more complex than their premaps. Implications for research and practice are included.

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