Correlates of life satisfaction for old Libyans compared with the judgments of Libyan youth.

Two hundred fifteen Libyans-106 young male and female undergraduate students and 109 aged male and female relatives--responded to a questionnaire designed to measure correlates of life satisfaction in old age. It was predicted that current cultural and social changes associated with the industrialization of Libya would result in significant differences in responses between young and old men and women. The young Libyan men rated close ties with their children, social relationships with individuals outside the family, and having basic physical needs met as more important than did the old Libyan men who considered social prestige, living with their spouse, and independence as more important for satisfaction in old age. The young Libyan women also considered social relationships outside the family and having basic physical needs met in old age as more important than did their older counterparts. Health and adequate living conditions were rated more highly by the young Libyan women than by the old. All participants rated social prestige equally high, but old women rated it higher than any other aspect except belief in God and self-understanding. Findings and implications for services to Libya's elderly are discussed.

Portal and pulmonary hypertension with microangiopathic hemolytic anemia.

Marked pulmonary hypertension developed in a 40-year-old man with known cirrhosis and a previous portosystemic shunt. Terminally, he also showed signs of microangiopathic hemolytic anemia. At postmortem examination, he had severe plexiform dilatation lesions in the pulmonary vasculature, with deposition of fibrin in the vasculature channels. It is suggested that the site of microangiopathic red cell damage was the pulmonary microvasculature.

Toxic shock syndrome associated with a contraceptive diaphragm.

PIP: A case report is presented of toxic shock syndrome associated with the use of a contraceptive diaphragm and recent removal of an IUD. A 23 year old woman was admitted to St. Paul's Hospital in Vancouver, British Columbia because of frequent watery diarrhea and vomiting that had begun suddenly 2 days earlier, as well as generalized abdominal and muscular pain, fever and sweating of 1 day's duration. The patient's last menstrual period had ended 3 weeks earlier. Oral contraceptive (OC) therapy had been stopped 9 months earlier, and 2 weeks before admission an IUD had been removed because of dyspareunia. A diaphragm had been inserted 24 hours before the onset of symptoms and was in place at the time of admission. Removal of the diaphragm revealed about 10 ml of greenish yellow pus. Laboratory tests showed multiorgan involvement. The blood urea nitrogen level was 35 mg/dl and the serum creatinine level 2.9 mg/dl. The serum amylase level was 125 IU/l at the time of admission but rose to 1021 IU/l by day 6. The prothrombin time was 16 seconds. Arterial blood gas studies while the patient was breathing room air showed the following: pH 7.36, carbon dioxide tension 20 mm Hg and oxygen tension 84 mm Hg. Urinalysis showed pus and a small amount of glucose. Treatment consisted of blood volume expansion and electrolyte replacement. The patient showed improvement within 48 hours. 6 days after admission an exfoliative desquamating rash developed on the volar surfaces of the fingers and feet, and a slight scaling rash was noted on the face. These cleared spontaneously, without residual scarring. 6 criteria for the diagnosis of toxic shock syndrome have been defined: an increased body temperature; skin manifestations; shock, frequently with orthostatic hypotension and syncope; involvement of multiple organs; diarrhea; and myalgia. Clinicians need to appreciate that tampons are not the only cause of toxic shock syndrome and that the syndrome can occur at times other than during menstruation. Diaphragms may only rarely be associated, but their relation to toxic shock syndrome must be recognized. Counseling on the use of diaphragms should stress the avoidance of prolonged use.^ieng

Functional hyposplenism, a diagnostic clue in amyloidosis. Report of six cases.

Six cases of functional hyposplenism associated with amyloidosis are presented. This association has been infrequently reported. Typical erythrocytic changes were found at initial presentation in five patients, and provided an early clue to the correct diagnosis. Extensive amyloid effacement of the splenic cords was the anatomic basis of the functional hyposplenism. Comments are made on the etiology and infective consequences of adult-acquired functional hyposplenism. A more sensitive method of screening peripheral blood for changes of functional hyposplenism is discussed.

Ethnic differences in death anxiety among the elderly.

The Dickstein Death Concern Scale was used to examine the death anxieties of a sample of elderly people in north and central Florida consisting of whites and blacks, males and females. Analysis of the data revealed that black elderly males display the greatest death anxiety, followed in decreasing order by black females, white females, and white males. Analysis of variance yielded a statistically significant main effect attributable to race. The overall effects attributed to sex were not significant, nor were there any significant interactions. The implications of these findings for practicing counselors were considered.