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PubMed2007

Morphometric study of the human metatarsals and phalanges.

Mathematical relation between metatarsals and between phalanges in terms of their lengths and widths in themselves is considered to be significant with respect to its functional and aesthetic roles. The objective of this study is to conduct measurements for determining lengths and widths of metatarsals and phalanges on the foot radiographs and to determine possible mathematical correlations between metatarsals themselves and between phalanges themselves in terms of their lengths and widths. Anteroposterior right and left foot radiographs were taken from 100 volunteers (50 men and 50 women). Lengths and widths of the metatarsals and phalanges were measured in millimeter on radiographs. The mean, minimum and maximum values, and standard deviations of each bone's length and width were studied and data were put into formulation. The results were evaluated by Regression statistical test, and the relation between metatarsals and between phalanges in terms of their lengths and widths was studied. As a result of the measurements, we found fixed proportions between metatarsals in themselves and between phalanges in themselves in terms of their lengths and widths. Knowing these morphometric relations may be useful for performing any surgical procedures designed to manage any defects or imperfections of the foot, chief among them is shortness.

Adult↗
PubMed1994

Aluminum determined in plasma and urine by atomic absorption spectroscopy with a transversely heated graphite atomizer furnace.

We compared a stabilized-temperature L'vov platform furnace containing an end-heated graphite atomizer (HGA) and transverse Zeeman background-correction system with a side-heated furnace system (transversely heated graphite atomizer; THGA) containing a longitudinal Zeeman background-correction system for the determination of aluminum in plasma and urine. The regression statistics for the correlation analysis of the two systems (slope coefficient = 0.995, intercept = -1.710, Sy/x = 0.021 micrograms/L) indicate that the systems generate comparable results. The newer technology of the THGA furnace with its more uniform and faster heating cycle allows a lower atomization temperature for aluminum, 2200 degrees C. Analyte carryover was significantly reduced in the THGA furnace system. The THGA system generates results equivalent to HGA in about one-third less time, thus making possible a greater throughput of samples in a busy laboratory.

Aluminum↗
PubMed2004

Predicting resistance or response to chemotherapy by proton magnetic resonance spectroscopy in neuroblastoma.

BACKGROUND: We previously showed that proton magnetic resonance spectroscopy (1H-MRS) enables estimation of neuroblastoma tumor viability. Here we investigated if 1H-MRS can predict response or resistance to chemotherapy in neuroblastoma. METHODS: Neuroblastoma cell lines with various drug sensitivities were treated with cytotoxic drugs (cisplatin, etoposide, and irinotecan) and examined by 1H-MRS. Viability was assessed by trypan blue staining and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. Nude rats carrying drug-sensitive or drug-resistant neuroblastoma xenografts were treated for 4 days with irinotecan (n = 11) or saline (n = 11) and were examined with 1H-MRS at 4.7 T before and during treatment. The Wilcoxon matched-pairs test was used to test statistical significance of difference within treatment groups. Independent groups were compared using the Mann-Whitney U test. Correlation was assessed with Spearman's rank correlation. All statistical tests were two-sided. RESULTS: Cytotoxic drug treatment of drug-sensitive SH-SY5Y neuroblastoma cells resulted in increased methylene and polyunsaturated fatty acid resonances and decreased choline resonance. The methylene/choline ratio correlated with cell death (r(s) = .94, P<.001) and was increased in cisplatin-treated drug-sensitive (SH-SY5Y, IMR-32) but not drug-resistant [SK-N-BE2, SK-N-FI, SK-N-AS] cell lines. No changes were observed in SK-N-BE2 cells treated with irinotecan or cisplatin, whereas circumvention of the resistance by arsenic trioxide treatment led to lipid accumulation and choline depletion. Irinotecan therapy of rats carrying drug-sensitive xenografts caused the methylene/choline ratio of tumors to increase eightfold after 3 days (95% confidence interval [CI] = fivefold to 12-fold; P = .005 compared with pretreatment spectra at day 0) and caused tumors to regress statistically significantly on day 10 compared with pretreatment volume on day 0 (difference = -60%, 95% CI = -12% to -100%, n = 6; P = .012). The methylene/choline ratio of nonregressing drug-resistant xenografts was unaffected. No differences were observed after saline treatment. CONCLUSIONS: Response or resistance to chemotherapy is accurately predicted by 1H-MRS in experimental neuroblastoma models in vivo.

Animals↗
PubMedDate not supplied

Correction of QT values to allow for increases in heart rate in conscious Beagle dogs in toxicology assessment.

INTRODUCTION: Estimation of a direct effect of drugs on the duration of the electrocardiogram (ECG) QT interval can be confused by drug-induced increases in heart rate (HR). The objective of this assessment was to identify a correction formula that adequately corrects QT over a wide range of HRs. METHODS: Paired recordings of HR and QT interval measurements were obtained from 177 conscious Beagle dogs from both sexes in 9 toxicology studies. ECGs used for this evaluation were collected in either control vehicle-treated dogs, or from dogs prior to the first dose of a daily dosing regimen. Where more than one recording was available per dog, only one was used in the analyses. The assessments were made based on the lowest and highest pre-dose HR for each dog. Correction factors according to [Bazett, H.C. (1920). An analysis of the time relationships or time-relations of electrocardiograms. Heart 7:353-380], [Sagie, A., Larson, M.G., Goldberg, R.J., Bengtson, J.R., & Levy, D. (1992). An improved method for adjusting the QT interval for heart rate (the Framingham heart study). American Journal of Cardiology 70:797-801], [Fridericia, L.S. (1920). Die sytolendauer in elektrokardiogramm bei normalen menschen und bei herzkranken. Acta Medica Scandinavica 53:469-505.], [Todt, H., Krumpl, G., Krejcy, K. & Raberger, G. (1992). Mode of QT correction for heart rate: implications for the detection of inhomogeneous repolarization after myocardial infarction. American Heart Journal 124(3):602-609.] and [Van de Water, A., Verheyen, J., Xhonneux, R., & Reneman, R.S. (1989). An improved method to correct the QT interval of the electrocardiogram for changes in heart rate. Journal of Pharmacological Methods 22:207-217.] were applied to these QT intervals and plotted against HR. Linear regression statistical analyses using a single or multiple (i.e., baseline, sex and study) parameters model was then applied to trend lines. RESULTS: Although two correction factors ([Todt, H., Krumpl, G., Krejcy, K. & Raberger, G. (1992). Mode of QT correction for heart rate: implications for the detection of inhomogeneous repolarization after myocardial infarction. American Heart Journal 124(3):602-609.] and [Van de Water, A., Verheyen, J., Xhonneux, R., & Reneman, R.S. (1989). An improved method to correct the QT interval of the electrocardiogram for changes in heart rate. Journal of Pharmacological Methods 22:207-217.]) adequately corrected QT for changes in HR [i.e., slope of QTc versus HR not statistically significantly different from zero (p>0.05)] that of Van de Water showed a statistically superior correction. Although the method of analyses accounted for baseline, sex and study it was independently demonstrated that sex did not influence the outcome of the evaluations. Furthermore, higher HRs (i.e., maximum HRs for each dog) were better corrected than the lower HRs. In addition, statistical power analysis applied to these data showed that group sizes of 4-8 could, with 80% chance, detect a 10-5% change, respectively, in appropriately corrected QT. DISCUSSION: Overall, the data suggest that an evaluation of the most appropriate correction factor should be applied to each laboratory using their own data collected by their own method in their particular strain of dog.

Animals↗
PubMed1991

Correlation of lymphocyte lipid composition membrane microviscosity and mitogen response in the aged.

Healthy aged and young blood donors were investigated for the role of membrane lipid composition in the age-related increase in membrane microviscosity and decline of mitogen responsiveness. Membrane microviscosity was shown to correlate positively with membrane cholesterol/phospholipid molar ratios, which were significantly elevated in the elderly. A positive correlation also was confirmed between lymphocyte membrane microviscosity, which was measured using the probe 1,6-diphenyl 1,3,5-hexatriene, and phytohemagglutinin responsiveness of cells from the same donor. Using stepwise regression statistical analysis, the variables age, cholesterol, cholesterol/total phospholipid and phosphatidyl ethanolamine/phosphatidyl choline molar ratios were all shown to have a significant positive influence on membrane microviscosity, whereas total phospholipids had a negative effect. No statistically significant difference was seen in content of any single saturated or unsaturated fatty acid between young and old donors. After pooling, however, the proportion of all unsaturated fatty acids was significantly higher in cells from the elderly as a consequence of an increase of n-6 and n-3 polyunsaturated fatty acids. Changes in lipid composition and physical properties of lymphocyte plasma membranes may, therefore, be responsible (at least partially) for the diminution of immune reactivity in old age.

Adult↗
PubMed2005

Utilization of psychotherapy in patients with personality disorder: the impact of gender, character traits, affect regulation, and quality of object-relations.

OBJECTIVES: The aim of the study was to generate hypotheses for examining gender differences in variables with predictive value for the utilization of psychotherapy in patients with personality disorders (PDs). DESIGN: Personality traits, affect experience and regulation, the quality of object relations and interpersonal problems within the process of psychotherapy planning were assessed in 140 psychiatric outpatients. METHODS: Besides the structured clinical interviews for DSM-IV I+II, variables were assessed with the Shedler-Westen assessment procedure (SWAP-200), the affect regulation and experience Q sort (AREQ), the quality of object-relations scale (QORS), and the Inventory of Interpersonal Problems (IIP). Correlation and group difference statistics, regression and canonical correlation analysis were performed. RESULTS: Predictors concerning the utilization or non-utilization of psychotherapy were a schizoid PD rating a self-report of subassertive behaviour related to interpersonal problems in women, and a narcissistic PD rating in men. Canonical correlations between predictors and quality of object relations or interpersonal problems were found in women, while in men there was merely a tendency for predictor and affect regulation to be related. CONCLUSION: The results suggest that for men it is more important to interpret the dominating affect, while for women, understanding the pathological object relation pattern is useful for successful therapy planning.

Adult↗
PubMed1996

Recent trends in U.S. breast cancer incidence, survival, and mortality rates.

BACKGROUND: Clinical trials have demonstrated that use of mammographic screening and advances in therapy can improve prognosis for women with breast cancer. PURPOSE: We determined the trends in breast cancer mortality rates, as well as incidence and survival rates by extent of disease at diagnosis, for white women in the United States and considered whether these trends are consistent with widespread use of such beneficial medical interventions. METHODS: We examined mortality data from the National Center for Health Statistics and incidence and survival data by extent of disease from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, all stratified by patient age, using statistical-regression techniques to determine changes in the slope of trends over time. RESULTS: The age-adjusted breast cancer mortality rate for U.S. white females dropped 6.8% from 1989 through 1993. A significant decrease in the slope of the mortality trend of approximately 2% per year was observed in every decade of age from 40 to 79 years of age. Trends in incidence rates were also similar among these age groups: localized disease rates increased rapidly from 1982 through 1987 and stabilized or increased more slowly thereafter; regional disease rates decreased after 1987; and distant disease rates have remained level over the past 20 years. Three-year relative survival rates increased steadily and significantly for both localized and regional disease from 1980 through 1989 in all ages, with no evidence of an increase in slope in the late 1980s. IMPLICATIONS: The decrease in the diagnosis of regional disease in the late 1980s in women over the age of 40 years likely reflects the increased use of mammography earlier in the 1980s. The increase in survival rates, particularly for regional disease, likely reflects improvements in systemic adjuvant therapy. Statistical modeling indicates that the recent drop in breast cancer mortality is too rapid to be explained only by the increased use of mammography; likewise, there has been no equivalent dramatic increase in survival rates that would implicate therapy alone. Thus, indications are that both are involved in the recent rapid decline in breast cancer mortality rates in the United States.

Adult↗
PubMed2005

FAS/FAS ligand ratio: a marker of oxaliplatin-based intrinsic and acquired resistance in advanced colorectal cancer.

PURPOSE: Oxaliplatin-5-fluorouracil combinations have increased responses in first-line therapy up to 40% in advanced colorectal cancer. Unfortunately, those patients who will respond are unknown and initially sensitive patients become rapidly resistant to current therapies. FAS (CD95) and FAS ligand (FASL; CD95L) have been implicated in chemosensitivity through leading to apoptosis in response to DNA-damaging drugs. Whereas the proapoptotic role of FAS and FASL is well characterized, the function of their soluble forms as predictors of chemosensitivity remains unknown. PATIENTS AND METHODS: Blood samples were obtained from 68 patients with advanced colorectal cancer who received oxaliplatin-5-fluorouracil combinations in first-line therapy. Computed tomographic scans were done every 3 months and responses were evaluated by Response Evaluation Criteria in Solid Tumors criteria. ELISA soluble FAS and soluble FASL analysis were done before treatment and every 3 months until disease progression. Ratios between soluble FAS and soluble FASL were established and its values and variations through time were related to treatment responses. RESULTS: We found a significant increase in soluble FAS levels and a significant decrease in FASL at 3 months compared with baseline (13.2 versus 10.02 ng/mL; P=0.0001; 0.07 versus 0.14 ng/mL; P=0.007, respectively). A significant increase in the soluble FASL levels up to 9 months (fourth to fifth extractions; 0.26 ng/mL) of therapy compared with first to third extractions (0.11 ng/mL; P=0.003) was also found. A random effect regression statistical model determined that >1.2-fold increase in soluble FAS/soluble FASL ratio was a marker of chemosensitivity (P = 0.001). CONCLUSIONS: These data strongly indicate that an increment of soluble FAS/soluble FASL ratio after treatment could be an excellent marker of chemosensitivity in colorectal cancer. On the other hand, a decreased ratio after treatment can be a predictor of chemoresistance despite an initial response.

Adult↗
PubMed2001

The crash reduction effectiveness of a network-wide traffic police deployment system.

Random Road Watch (RRW) is a traffic policing program in operation in Queensland, Australia. It differs from conventional traffic policing in that an explicit resource management technique is used which randomly schedules low levels of police enforcement in a manner intended to provide long-term, widespread coverage of a road network and hence maximise road safety benefits. Implementation of the program studied in Queensland covered 55% of total crashes within the state. This study aimed to measure the crash effects of the RRW program in Queensland. A quasi-experimental study design was used for the evaluation incorporating Poisson regression statistical analysis techniques. Analysis of the effects of the Queensland RRW program on crash frequency has shown the program to be effective overall. Estimated program effects were largest on fatal crashes, with an estimated reduction of 31%. Estimated aggregate program crash effects reduced with crash severity and increased with time after program introduction. Crash reductions in the third year after program introduction translated into savings, at state level, of some 12% of the state's crashes of all severities and some 15% of the state's fatal road crashes. Overall, the program produced a significant 11% reduction in total crashes in areas outside of metropolitan Brisbane. The opportunity-cost benefit/cost ratio for the program was estimated to be 55:1.

Accidents, Traffic↗
PubMed1999

Improving neural network prediction of amino acid levels in feed ingredients.

Artificial neural networks (ANN) were trained to predict the amino acid (AA) profile of feed ingredients. The ANN more effectively identified the complex relationship between nutrients and feed ingredients than linear regression (LR). Three types of ANN (NeuroShell 2): three-layer backpropagation (BP3), Ward Backpropagation (WBP), a general regression neural network (GRNN); and LR (SAS Proc GLM) were used to predict the AA level in corn, soybean meal, meat and bone meal, fish meal, and wheat based on proximate analysis. In contrast to a past study, a variety of alternative ANN training parameters were examined to improve ANN performance. Predictive performance was judged on the basis of the maximum R2 value resulting from all defaults tested. Advanced selection of ANN training parameters led to further improvement in performance, especially within the GRNN architecture. In 34 of 35 ANN developed, the maximum R2 value for each individual AA in each feed ingredient was higher for GRNN than for LR, BP3, or WBP prediction methods. For example, the highest R2 value for Met in corn was 0.32 for LR, 0.40 for 3LBP, 0.51 for WBP, and 0.95 for GRNN analysis. Predictive performance was also improved overall as compared to results of a previous study. For example, corn maximum R2 values (GRNN) for Met, TSAA, and Trp were: 0.78, 0.81 and 0.44, previously, and 0.95, 0.96 and 0.88, in the current study. Current soybean meal maximum R values (GRNN) were: Met, 0.92; TSAA, 0.94; and Lys, 0.90. Current meat and bone mean maximum R2 values (GRNN) were: Met, 0.97; TSAA, 0.97; and Lys, 0.97. The ANN computation is a successful alternative to statistical regression analysis for predicting AA levels in feed ingredients.

Amino Acids↗
PubMedDate not supplied

An analysis of referrals and referral rates.

This article summarizes a study showing the major factors that affect referral rates of Oklahoma City Area Indian Health Service primary-care professionals. The article also summarizes a referral rate prediction model. The multiple linear regression statistical analysis, employed in the study, produced three factors that largely determined the referral rates of physicians practicing in tertiary-care and secondary-care facilities: hospitalized morbidities per 1,000 population, the total medical-care professionals associated with a facility, and the number of specialists associated with a facility. The referral rates of physicians practicing in primary-care facilities were associated with morbidities per 1,000 population, median age of primary-care professionals, and distance to the closest medical referral center. The findings of this article take on new meaning and importance with the advent of diagnostic related group (DRG) reimbursement legislation. If administrators understand more about physician referrals, they will better understand one significant aspect of the cost of DRGs in their facilities.

Data Collection↗
PubMed1999

Randomized trial testing the effect of peer education at increasing fruit and vegetable intake.

BACKGROUND: The National Cancer Institute recommends that Americans eat at least five daily servings of fruits and vegetables. National strategies to increase consumption may not reach minority and lower socioeconomic populations. In a randomized trial, peer education was tested for effectiveness at increasing fruit and vegetable intake among lower socioeconomic, multicultural labor and trades employees. METHODS: Employees (n = 2091) completed a baseline survey and received an 18-month intervention program through standard communication channels (e.g., workplace mail, cafeteria promotions, and speakers). Ninety-three social networks (cliques) of employees were identified, which were pair matched on intake. At an interim survey (during months 8 and 9), 11 cliques no longer existed and 41 matched pairs of cliques containing 905 employees remained, with one clique per pair being randomly assigned to the peer education intervention. Employees who were central in the communication flow of the peer intervention cliques served as peer educators during the last 9 months of the intervention program. Fruit and vegetable intake was measured with 24-hour intake recall and with food-frequency questions in baseline, outcome (i.e., at 18 months), and 6-month follow-up surveys. All P values are two-sided. RESULTS: By use of multiple regression, statistically significant overall effects of the peer education program were seen in the intake recall (increase of 0.77 total daily servings; P<.0001) and the food-frequency (increase of 0.46 total daily servings; P =.002) questions at the outcome survey. The effect on the total number of servings persisted at the 6-month follow-up survey when measured by the intake recall (increase of 0.41 total daily servings; P =.034) but not the food-frequency (decrease of 0.04 total daily servings; P =.743) questions. CONCLUSIONS: Peer education appears to be an effective means of achieving an increase in fruit and vegetable intake among lower socioeconomic, multicultural adult employees.

Adult↗
PubMed1989

Interrelationships among carcinogenicity, mutagenicity, acute toxicity, and chemical structure in a genotoxicity data base.

The interrelationships among carcinogenicity, mutagenicity, acute toxicity (LD50), and a number of molecular descriptors were studied by computerized data analysis methods on the data base generated by the International Program for the Evaluation of Short-Term Tests for Carcinogens (IPESTTC). With the use of statistical regression methods, three main associations were evidenced: (1) the well-known correlation between carcinogenicity and mutagenicity; (2) a correlation between mutagenicity and toxicity (LD50 ip in mice); and (3) a correlation between toxicity and a recently introduced estimator of the free energy of binding of the molecules to biological receptors. As expected on the basis of the large variety of chemical classes represented in the IPESTTC data base, no simple relationship between mutagenicity or carcinogenicity and chemical descriptors was found. To overcome this problem, a new pattern recognition method (REPAD), developed by us for structure-activity studies of noncongeneric chemicals, has been used. This allowed us to highlight a significant difference between the whole patterns of relationships among chemicophysical variables in the two groups of active (mutagenicity and/or carcinogenic) and inactive chemicals. This approach generated a classification rule able to correctly assign about 80% of carcinogens or mutagens.

Carcinogens↗
PubMed2005

Outcomes of term vaginal breech delivery.

In December 2001, the American College of Obstetricians and Gynecologists revised their recommendations for breech delivery. These recommendations acknowledge that although a planned vaginal delivery may no longer be appropriate, there are instances in which vaginal breech delivery is inevitable. Moreover, there continues to be patients who for any number of reasons will choose vaginal over cesarean delivery when faced with a fetus in the breech presentation. We sought to review maternal and fetal outcomes in such circumstances when vaginal breech delivery occurs, and compare these outcomes to elective cesarean deliveries for breech presentation. We performed a retrospective review of all singleton breech deliveries at our county hospital from January 2002 through June 2003. We reviewed maternal age, ethnicity, gestational age, gravity, parity, birthweight, mode of delivery, Apgar scores, umbilical arterial blood gases, and maternal and infant complications of both cesarean deliveries and vaginal breech deliveries. Univariate and logistic regression statistical analyses were performed with NCSS software. We had a total of 150 term breech deliveries with gestational ages between 37 and 42 weeks. Of these, 41 were vaginal breech and 109 were cesarean deliveries. Greater than 95% of patients are of Hispanic origin. There were no statistically significant differences in maternal age, ethnicity, gravity, or gestational age. Mean birthweight was significantly lower and parity was significantly higher in the vaginal delivery group. There was also a higher proportion of patients who underwent labor induction/augmentation in the vaginal group. We found no differences in the outcomes of 5-minute Apgar scores, umbilical arterial blood gas values, neonatal intensive care unit admissions, deaths or maternal/fetal complications reported between the two groups. Mean umbilical arterial blood gas values were greater than 7.18 in both groups. Vaginal breech delivery cannot always be avoided. Moreover, at our county hospital several patients continue to choose vaginal breech delivery. Our data would suggest that vaginal breech delivery remains a viable option in selected patients.

Apgar Score↗
PubMed2003

Quantitative CT indexes in idiopathic pulmonary fibrosis: relationship with physiologic impairment.

PURPOSE: To determine whether measurements of skewness, kurtosis, and mean lung attenuation on thin-section computed tomographic (CT) histograms in patients with idiopathic pulmonary fibrosis (IPF) correlate with pulmonary physiologic abnormality in a nonspirometrically controlled multicenter study. MATERIALS AND METHODS: The authors analyzed baseline digital thin-section CT data from 144 patients with IPF who enrolled in a double-blind placebo-controlled clinical effectiveness trial of interferon beta 1a in the treatment of IPF. All patients underwent thin-section CT in the supine position at full inspiration. The lungs were isolated by using a semiautomated thresholding technique, with an upper threshold of -200 HU. An attenuation correction algorithm was used. Pulmonary function tests (PFTs) included forced vital capacity, total lung capacity, forced expiratory volume in 1 second, and diffusing lung capacity. Univariate and multiple correlation and regression statistical analyses were used to determine relationships between histogram features and results of PFTs. RESULTS: Moderate correlations existed between histogram features and PFT results. Kurtosis showed the greatest degree of correlation with physiologic abnormality (r = 0.53, P <.01). Strength of correlation increased with exclusion of suboptimal scans but did not change significantly after application of an attenuation correction algorithm. Attenuations for lungs, gas, and soft tissue varied considerably between scanner manufacturers. Kurtosis alone provided predictions of pulmonary function that were virtually as good as those from all histogram features combined. CONCLUSION: Thin-section CT histograms of the lungs were found to correlate with results of PFTs in patients with IPF, which supports the claim that histogram features can be used as valid indexes of IPF in a multiinstitutional nonspirometrically controlled study.

Algorithms↗
PubMed1989

Productivity of the clinical dietitian: measurement by a regression model.

Productivity of 283 clinical dietitians employed in 40-bed to 1,200-bed medical centers and community and general hospitals nationwide was measured from a survey. Stepwise multiple linear regression statistical analyses were used to analyze data. Five measures of productivity were developed; hours in non-patient care divided by total hours worked and the activity level in activities nonproductive in relation to the job description activities produced the better models for measuring productivity of the clinical dietitian. Activity levels measured in the study showed high-level task activities (consuming a large amount of work time) were conducting individual diet instructions, conducting nutrition assessments, reviewing and recording in medical records, and supervising support personnel. Taking anthropometric measurements, participating in medical rounds, attending professional conferences, and purchasing and dispensing specialized products were found to be low-level task activities (consuming little work time). The average amount of time spent on the job per week was 42.7 hours with a mean of 20.4 hours spent in direct patient care, 13.6 hours in indirect patient care, and 7.3 hours in nonpatient care.

Dietary Services↗
PubMed1990

Perinatal factors associated with the respiratory distress syndrome.

Perinatal factors related to the incidence of respiratory distress syndrome were analyzed by the multiple logistic regression statistical method in 263 mothers and their 298 offspring delivered between 24 and 35 weeks' gestation in a 1-year period in a regional referral perinatal center. The risk of respiratory distress syndrome in white infants rose with decreasing gestational age (p less than 0.0001) while prolonged rupture of membranes of greater than 24 hours in the absence of maternal infection (28% of cases) was highly protective (p less than 0.0001). Compared with vaginal delivery, cesarean delivery without labor increased the risk of respiratory distress syndrome (p = 0.03). The administration of tocolytic drugs was unrelated to the incidence of respiratory distress syndrome, but corticosteroid therapy given at least 72 hours before delivery was protective (p = 0.03). Male and female infants were equally at risk for respiratory distress syndrome as were black and white infants, but other races had a lower incidence (p = 0.004). Infants with respiratory distress syndrome were on mechanical ventilators longer than those with other respiratory illnesses.

Adrenal Cortex Hormones↗
PubMed2002

Comparison of glucose levels in capillary blood samples obtained from a variety of body sites.

The AtLast Blood Glucose System was developed to eliminate painful finger punctures by testing samples from less sensitive body sites. Studies were designed to evaluate subjects under various glycemic states and to compare glucose concentrations in samples obtained from the forearm and palm to those found in the finger. The palm is more similar to the finger in blood flow rates, while the forearm is less perfused. AtLast measurements of forearm samples from subjects at a minimum of 2 h postprandial produced good regression statistics when compared to reference finger results with a correlation coefficient of 0.978. Agreement was quite weakened in subjects undergoing extreme glucose loads, resulting in a slope of 0.85, an intercept of 30.82, and a correlation coefficient of 0.938. Time course data indicate that forearm glucose levels often appear lower than finger concentrations when glucose is rapidly rising and somewhat higher when glucose is quickly falling. On the other hand, glucose levels of palm samples produced a close correlation to finger concentrations under all glycemic states. In participants undergoing rapid glucose change, the linear correlation resulted in a slope of 1.01, an intercept of 2.46, and a high correlation coefficient of 0.983, with steady tracking of palm and finger concentrations throughout the study. The palm of the hand was also identified as a comfortable testing site that equals the forearm in affording painless testing. Glucose monitoring of blood samples from the forearm is suitable when expecting steady state glycemic conditions. At times of rapid glucose change, the palm of the hand offers a painless sampling site that compares well with the finger.

Adolescent↗