Comparative accuracy of recent abbreviated methods of gestational age determination

Fifty healthy newborn infants were studied in an attempt to test the accuracy of several recently reported shortened methods of gestational age determination. The Finnstrom method with seven external characteristics was more accurate than those that contained only five or less criteria. In the statistical analysis it also yielded results that were very similar to those obtained using the original Dubowitz technique which has 21 criteria.

Narcotic effects of nitrous oxide and compressed air on memory and auditory perception

Three experiments were conducted to examine the effects of 35% N2 O (nitrous oxide) on human memory and auditory perception. In Experiment I, dichotic listening performance was found to be impaired. Experiment II used the same technique but was controlled for attenuation of sound transmission in the middle ear. No impairment was found. The perceptual effect found in Experiment I was peripheral, not central, and N2O did not impair short-term memory (STM). Experiment III used one-trial free recall of a word list. The shapes of the serial position curves were interpreted as indicating that N2O impairs long-term memory (LTM) but not STM. Experiment III provided no evidence, using cued recall, that the LTM deficit was due to impaired retrieval. Comparing these results with those for compressed air led to the conclusion that both N2O and hyperbaric nitrogen display an identical pattern of effects. A reason for the decrement found in some N2O STM studies may have been confounding the measurement of STM with that of LTM.

Perinatal asphyxia II: Clinical management of multisystemic sequelae

This paper discusses the management of multisystemic sequelae of perinatal asphyxia. Appropriate intrapartum and subsequent adequate neonatal monitoring are an absolute necessity for the early detection of systemic dysfunctions. Prophylactic and therapeutic measures applicable to the various organ malfunctions are described.

Perinatal asphyxia I: Pathogenesis of multisystemic sequelae

This paper describes the clinical and pathologic sequelae of perinatal asphyxia manifested by 17 neonates treated at Howard University Hospital over an 18-month period. Multiple systemic complications, occurring in 76.5 percent of the patients, were the rule rather than the exception. All vital organs were involved, singly or in combination. Understanding the pathogenesis and extent of these complications is of utmost importance not only to those rendering health care to acutely ill newborns, but also to those responsible for prenatal and maternal intrapartum care.

Use and wastage of prescribed medicines in the home

A survey of prescribed medicines was carried out in 192 homes, broadly representative of households in England and Wales. The average home had 3.2 containers of such medicines; 56 per cent were in current use, 16 per cent in occasional use, and 28 per cent were never used. One fifth of all oral antibiotics found in the study were wasted. A rough estimate suggests that pound23 million of prescription products (5.6 per cent of the total) are wasted annually in England and Wales.

Vitamin preparations: proper use in medical practice

The prescription of vitamin preparations as dietary supplements should be limited to specific instances of need and should be accompanied by appropriate measures to correct poor diets. Similarly, specific vitamins in therapeutic amounts should be prescribed only in the presence of vitamin deficiencies or increased requirements.

Who are we missing and why?

The concept of "missing" is defined as failure to diagnose cancer before it has spread beyond the organ of origin. Data are presented for the 11 sites at which cancer occurs most frequently in the United States. There is a clear association between the survival of patients with cancer of a particular site and the percentage of cancers of that site diagnosed in a localized stage. However, the reasons for variation in the proportion of cases discovered while localized, which varies from 79% for uterine corpus to 12% for pancreas, appear to be varied and complex. Available data suggest that the nature of the tumor-host relationship and metastatic potential of the neoplasm are probably more important than alertness on the part of the patient and the physician, and probably have a more profound influence on stage of disease at diagnosis than currently available screening techniques.