A newly recognised neurotoxic syndrome due to pyridoxine (B6) overdose is described. It is the largest series of B6 intoxication hitherto reported. A raised serum B6 level was present in 172 women of whom 60% had neurological symptoms, which disappeared when B6 was withdrawn and reappeared in 4 cases when B6 was restarted. The mean dose of B6 in the 103 women with neurological symptoms was 117 +/- 92 mgs, compared with 116.2 +/- 66 mgs in the control group. There was a significant difference (P less than 0.01) in the average duration of ingestion of B6 in the neurotoxic group of 2.9 +/- 1.9 years compared with 1.6 +/- 2.1 years in controls. The symptoms were paraesthesia, hyperaesthesia, bone pains, muscle weakness, numbness and fasciculation, most marked on the extremities and predominantly bilateral unless there was a history of previous trauma to the limb. These women were taking a lower dose of B6 than previously described (1,2), which may account for the complete recovery within 6 months of stopping B6.

A two part, prospective study was undertaken to establish the existing frequency of total parenteral nutrition-(TPN) related mechanical, metabolic, and septic complications in an institution with a consultative TPN team (group A) and to determine if increasing the involvement of the TPN team in patient monitoring and verifying adherence to TPN infection control guidelines would reduce the incidence of these complications (group B). The initial 28 consecutive patients were managed entirely by their primary physicians with the role of the TPN team limited to consultative activities while the next 29 patients receiving TPN were managed jointly by their primary physicians and the TPN team. Analysis of the results show group B to have a significant reduction in metabolic complications, decreased incidence of mechanical abnormalities, and approximately equal incidences of documented sepsis. However, when compared to the results of an institution in which the TPN team has complete control of TPN therapy, even the group B patients had a relatively excessive number of TPN-related complications especially in the categories of mechanical and metabolic abnormalities. Thus, consultative TPN teams do not necessarily ensure optimum TPN therapy and institutions using this approach to provide nutrition parenterally must be prepared to establish the incidence of TPN-related complications and to expand the involvement of the TPN team as required to control the frequency of these anomalies.

Previously published research has not moved beyond studying the general association between retention and high school dropout. This longitudinal study seeks to evaluate within-group differences, exploring the characteristics of those students who are retained and subsequently drop out as compared to those students who are retained and do not drop out. A transactional-ecological view of development is presented to assist in situating the findings within a framework of longterm outcomes across development. The results of this study suggest that there are early socioemotional and behavioral characteristics that distinguish which retained students are most likely to drop out of high school. In addition, maternal level of education and academic achievement in the secondary grades were also associated with high school graduation status. These findings provide information that extend beyond the association between grade retention and later dropout. In particular, this investigation suggests that it is especially important to attend to the socioemotional and behavioral adjustment of children throughout their schooling to facilitate both their immediate and long-term academic success.

This prospective longitudinal study followed a sample of 106 kindergarten students through 11th grade examining the effects of family characteristics, school readiness, socialization, and student demographics on academic achievement and behavioral adjustment outcomes. These educational outcomes were contrasted among four groups consisting of: 1) early grade retainees; 2) transitionally placed retained students; 3) students recommended for transitional placement, but promoted; and 4) regularly promoted students. While previous studies examining the efficacy of early grade retention focus exclusively on between-group comparisons, this study examines the family and individual characteristics of successful and unsuccessful retained students by including both between-group and within-group effects on academic and behavioral outcomes. The results of this study demonstrate that retained students' initial school readiness, socioeconomic status, mother's level of education, parental value of education, kindergarten personalsocial functioning, and chronological age are distinctly associated with subsequent academic or behavioral outcomes. Variables associated with relative educational success following early failure are delineated and research implications are discussed.