Relationship among physical impairment, distress, and well-being in older adults.

The relationship between activity limitation and self-report on a variety of mental health measures was investigated through a longitudinal study of 124 noninstitutionalized older adults between 60 and 80 years of age, recruited either as recently disabled (N = 62) or as a matched control (N = 62). Fifty-five of these respondents (disabled, n = 28; controls, n = 27) selected persons who could be contacted to provide informant informations. Results showed the relationship between disability and mental health measures to be highly significant and stable across time. Further older adults classified as severely disabled experienced higher levels of anxiety, suicidal ideation, and overall distress than did the moderately disabled participants. Evidence was found for reciprocal causal relationships between health and mental health. Informants' reports supported findings based on self-report.

Cefonicid kinetics in subjects with normal and impaired renal function.

Cefonicid is a cephalosporin with a longer t1/2 than currently available cephalosporins. Cefonicid kinetics after an intravenous dose of 7.5 mg/kg were followed in four groups of subjects: group 1, four subjects with normal creatinine clearance (Clcr greater than 80 ml/min); group II, seven subjects with mild renal insufficiency (Clcr 50 to 80 ml/min); group III, five subjects with moderate to severe renal impairment (Clcr 8 to 49 ml/min); and group IV, five subjects with end-stage renal disease who were receiving maintenance hemodialysis (Clcr less than 8 ml/ml). Cefonicid volume of distribution ranged from 6.9% to 17.6% body weight but was not related to Clcr. Elimination t1/2 was 4.6 +/- 0.7 hr in group 1,6.0 +/- 2.7 hr in group II, 25.6 +/- 14.0 hr in group III, and 65.3 +/- 43.6 hr in group IV. There was a strong correlation between plasma cefonicid clearance and Clcr. Nonrenal clearance did not change with decreasing Clcr. Hemodialysis clearance calculated from plasma concentrations and recovery in dialysate was 2.5 +/- 0.9 ml/min. These kinetic parameters were used to formulate dosage regimens for patients with renal impairment.

The nursing role in the Special Olympic program.

Special Olympics is an international program of physical fitness, recreation and sports for the handicapped of all ages and provides competition at all ability levels by grouping participants into divisions according to age, sex and performance ability. Special Olympics, a year-round program of physical training for mentally handicapped children and adults, contributes positively to the physical, social and psychological development of these individuals. Special Olympic participants must have a physical examination prior to the training activities or athletic competition to determine limitations and to prescribe special precautions to follow while participating. School nurse practitioners play an important role in seeing that physical examinations are completed prior to scheduled events in addition to identifying immediate health needs, counseling students, teachers and parents about specific problems, updating medical information and seeking appropriate referrals for the participants. School nurse practitioners' attendance at Special Olympics competition is vital to the success of the program.

Sotalol kinetics in renal insufficiency.

Kinetics of sotalol, a beta adrenoceptor blocker, was studied in 20 patients with varying renal function. In subjects with creatinine clearance (Clcr) greater than or equal to 39 ml/min/m2, sotalol plasma clearance (x +/- SD) was 71 +/- 31 ml/min/m2, elimination half-life (t 1/2) was 8.1 +/- 3.4 hr, and renal clearance was 46 +/- 26 ml/min/m2. In patients with moderate renal impairment (Clcr = 8 to 38 ml/min/m2) elimination t 1/2 rose to 24.2 +/- 7.5 hr, and plasma clearance fell to 24 +/- 7 ml/min/m2. In patients receiving dialysis, elimination t 1/2 rose to 33.9 +/- 27.1 hr. Elimination t 1/2 during hemodialysis was 5.8 +/- 2.1 hr and was associated with a 56.7 +/- 21% reduction in plasma levels.