In most cases of acute transmural infarction, the reciprocal ST segment depressions observed in contralateral leads are less marked than the primary ST segment elevations. Two unusual cases are presented where reciprocal ST depressions were the predominant findings due to the orientation of the injury current vector. Failure to recognize this pattern may impede the diagnosis and localization of acute infarction. Furthermore, these cases illustrate the principle that "hyperacute" T waves may only appear as a slight, relative increase in T wave positivity rather than as a marked absolute increase in T wave amplitude.

Electrocardiography↗

PubMed1981

Minicolumn detection methods for aflatoxin in raw peanuts: collaborative study.

The Holaday-Velasco method and a modified Holaday method have been compared. The former method combines the speed and simplicity of the Holaday extraction and cleanup with the sensitivity of the minicolumn originally described by Velasco. The combination method has been approved by the AOAC and the AACC for determining aflatoxin in corn. The Holaday method was modified by substituting toluene for benzene in the solvent partition, and methylene chloride for chloroform in the minicolumn development to eliminate use of hazardous solvents. The neutral alumina in the Holaday minicolumn was changed from activity V to activity III to provide a more stable column. At aflatoxin levels in raw peanuts of 13-20 ng/g, the presence of aflatoxin was missed by the modified Holaday method in 4 analyses (3 laboratories) of 42 reported. There were no misses in this contamination range by the Holaday-Velasco method. There were no misses by either method with samples containing greater than 20 ng total aflatoxins/g. Analysis of uncontaminated raw peanuts by the modified Holaday method resulted in 2 false positives of 14 reports; the Holaday-Velasco method produced no false positive reports from 15 analyses of uncontaminated peanuts. The Holaday-Velasco method was adopted official first action for peanuts.

Aflatoxins↗

PubMed1980

Medicare reimbursement: apportionment of hospital malpractice expenses.

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Cost Allocation↗

PubMed1979

Predicting minority student performance in the first medical school year.

Impressions and anecdotal evidence have raised concerns that traditional cognitive measures of past performance may not be predictive of the performance among minority students in medical school. This study assessed the relationship between nine objective measures and actual first year academic performance for cohorts of minority students enrolled in a single medical school between 1973 and 1976.The findings support previous impressions that objective measures together explain less than half of the variance in academic performance. Furthermore, the cumulative undergraduate college average and the competitiveness of the undergraduate college are consistently the strongest predictors of academic performance among this group.

Boston↗

PubMed1978

The presence of serum creatine kinase 2 (MB) in acromegalic myopathy.

Increase in size of bone is characteristic of acromegaly. In addition, hypertrophy of other tissues including skeletal muscle and associated myopathy may occur. We recently found 10 U/1 of isoenzyme creatine kinase 2 (MB) or 10.9% of total creatine kinase in a patient with acromegaly who did not show clinical or laboratory evidence of acute myocardial necrosis. The myopathy associated with acromegaly is thus another cause for the presence of serum CK 2 (MB), and CK 2 (MB) is not a specific isoenzyme for myocardial damage since it may be identified in the serum of patients with skeletal muscle conditions.

Acromegaly↗

PubMed1977

The elderly poor in downtown San Diego hotels.

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Aged↗

PubMed1977

The assessment man.

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Audiovisual Aids↗

PubMed1976

Well-child care by pediatric nurse practitioners in a large group practice. A controlled study in 1,152 preschool children.

A controlled two-year study of the effectiveness of well-child care by pediatric nurse practitioners (PNPs) of 1,152 children, newborns through age 22 months, was made at the Kaiser-Peranente Medical Centers in San Francisco and Oakland, Calif. In this setting of a large, prepaid, group practice health care plan, the PNPs were found to be entirely competent in maintaining the health of their patients, and were generally accepted by the parents. Effects on utilization of medical care facilities were minimal. Costs of well-child care were reduced.

California↗

PubMed1976