Free erythrocyte porphyrin (FEP) l e v e l s and red c e l l indices (Coalter Counter Model S) were determined i n 70 norm+ subjects, 52 with i r o n deficiency and 29 with thalassemia t r a i t i n order t o determine i f these procedures were s u i t a b l e a s screening techniques f o r t h e d e t e c t i o n and i n i t i a l diagn o s i s of i r o n deficiency and thalassemia minor i n subjects with microcytosis. FEP l e v e l s were increased i n 90.2% of s u b j e c t s with i r o n deficiency (mean 167 mcgI100 ml RBC's; range 18-7001, while i n 96.6% of subjects with thalassemia t r a i t , FEP l e v e l s were normal ( l e s s than 70 mcg/100 m l RBC's) . Mean FEP values increased s l i g h t l y a s transf e r r i n s a t u r a t i o n s decreased but became abnormally elevated when t h e t r a n s f e r r i n s a t u r a t i o n was l e s s than 15%. Although subj e c t s with i r o n deficient exhibited mean corpuscular volumes i n t h e range 46-84 us, subjects with beta thalassemia t r a i t had values of 70 u3 o r l e s s (mean 62 u3; range 53-70).A l l non-thalassemic subjects with mean corpuscular volumes l e s s than 70 u3 had t r a n s f e r r i n s a t u r a t i o n s of l e s s than 15%. I n p a t i e n t s with microcytosis, t h e combined use of the e l e c t r o n i c determination of mean corpuscular volume and rapid assay of FEP should be s u i t a b l e f o r i n i t i a l separation of p a t i e n t s with i r o n deficiency from those with thalassemia minor. URBAN HOSPITALIZATION COST ANALYSIS OF PATIENTS WITH SICKLECELL DISEASE Sylvia M. T e t r a u l t , Roland B. Scott. Center f o r Sickle C e l l Disease, Howard University College of Medicine, Washington,D.C.A sample, from a 2 year period , of h o s p i t a l records f o r 57 p a t i e n t s with s i c k l e c e l l anemia were examined t o determine the cost of h o s p i t a l i z a t i o n and treatment t o a s s e s s medical expenses and t o obtain a t e n t a t i v e p r o f i l e of age, length of s t a y , and type of services u t i l i z e d . The average age of p a t i e n t s was 16.7 years (R:5 mos.-39 y r s . ) . Length of s t a y averaged 13.8 days (R:1-196 days). Breakdown of data per h o s p i t a l i z a t i o n i s presented a s averages: age (N=57) 16.7 y r s . , days i n h o s p i t a l (N=57) 13.77, room and board (N=57 (N=57) $876.40. I n terms of age categories, the 0-11 year old group average h o s p i t a l costs were nearly half t h e c o s t of the 20-39 year old group. Approximately 50% of the payments were made by health insurance companies, 31% by Medicaid, and 17% by p r i v a t e means.This information can be u t i l i z e d i n the comprehensive planning and management of p a t i e n t s with s i c k l e c e l l anemia. Isolated examples of inappropriate A D H s e c r e t i o n following VCR therapy have been described. Stimulated by t h e observat i o n of 3 separate episodes of inappropriate ADH secretion i n a p a t i e n t receiving VCR f o r acute lymphatic leukemia (ALL), an a d d i t i o n...
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