Analyses of maximum cardiopulmonary performance during exposure to acute hypoxia at simulated altitude--sea level to 5000 meters (760-404 mm Hg)

The maximum cardiopulmonary performance of seven healthy male subjects was studied repeatedly in graded hypoxia at ambient pressures ranging from 760 to 404 mm Hg (sea level to 5000 m of simulated altitude). Using this approach it has been possible to not only establish a reproducible value for VO2max, but to determine an equation which may be used to predict the VO2 at altitude for healthy, unacclimatized males exercising to exhaustion. Moreover, we have attempted to explain the limits to pulmonary ventilation at decreasing levels of PO2 by comparing a given VO2max (STPD) to the corresponding VEmax (BTPS), showing that any further increase in the latter is impossible when a certain level of altitude has been reached. Finally, our series of experiments indicates that the HRmax falls at altitude. Although statistically significant, this decrement is not conspicuous. Thus, when used with the VO2max to calculate the number of ml of O2 consumed per beat of the heart, the "oxygen pulse" turns out to be more sensitive to the fall in VO2max at altitude than to the corresponding decrease in the HRmax.     

Boric acid single dose pharmacokinetics after intravenous administration to man

Eighth young adult male volunteers with a basic (alimentary) plasma boric acid concentration of <0.10–0.46 mg/l were given a single dose of boric acid (562–611 mg) by 20 min IV infusion. The plasma concentration curves, followed for 3 days, best fitted a three-compartment open model, although two subjects had to be left out due to inconstant basal plasma concentration values or failure to fit to the three-compartment model. The 120 h urinary excretion was 98.7±9.1% of dose, Cl_tot 54.6±8.0 ml/min/1.73 m², t_1/2 21.0±4.9 h and distribution volumes V₁, V₂, and V₃: 0.251±0.099, 0.456±0.067 and 0.340±0.128 l/kg.     

Disaggregating proportional multistate lifetables by population heterogeneity to estimate intervention impacts on inequalities

The mortality pattern from birth to age five is known to vary by underlying cause of mortality, which has been documented in multiple instances. Many countries without high functioning vital registration systems could benefit from estimates of age- and cause-specific mortality to inform health programming, however, to date the causes of under-five death have only been described for broad age categories such as for neonates (0–27 days), infants (0–11 months), and children age 12–59 months. We adapt the log quadratic model to mortality patterns for children under five to all-cause child mortality and then to age- and cause-specific mortality (U5ACSM). We apply these methods to empirical sample registration system mortality data in China from 1996 to 2015. Based on these empirical data, we simulate probabilities of mortality in the case when the true relationships between age and mortality by cause are known. We estimate U5ACSM within 0.1–0.7 deaths per 1000 livebirths in hold out strata for life tables constructed from the China sample registration system, representing considerable improvement compared to an error of 1.2 per 1000 livebirths using a standard approach. This improved prediction error for U5ACSM is consistently demonstrated for all-cause as well as pneumonia- and injury-specific mortality. We also consistently identified cause-specific mortality patterns in simulated mortality scenarios. The log quadratic model is a significant improvement over the standard approach for deriving U5ACSM based on both simulation and empirical results.     

Counselors' reports of their use of self-disclosure with clients

Ninety-six counselors indicated the frequency of their use of 11 types of self-disclosure, which varied in intimacy from incidental information (age, race) to personal weaknesses. Positive emotional responses to clients were used most frequently, and opinions/attitudes were used least frequently. A factor analysis showed three factors to describe the data best. Factor 1 was represented by information related to the personal identify and experiences of the therapist. Factor 2 involved the emotional responses of the therapist to the client. Factor 3 was principally the disclosure of professional experiences and identity. Implications are considered.     

Assessment of anterior cruciate laxity using the Genucom System

Summary One hundred subjects with normal knees and 47 patients with chronic rupture of the anterior cruciate ligament were tested in the Genucom Knee Analysis System; the 13 different laxity tests were carried out on both knees. Measurements on right and left knees in normal subjects showed that only the lateral pivot shift test, performed at 25° of knee flexion, had a good side-to-side correlation, but did not differentiate the involved and uninvolved knees in the patients with anterior cruciate ligament deficiency. The sensitivity of the lateral pivot shift was 30% and specificity 91%. The corresponding figures for the anterior drawer test at 30° flexion using 93 N force were 45% and 88%. Measurements showed great variation. Care should be taken in interpreting the results from the Genucom System. It should be considered as an experimental device with little value in assessing patients with anterior cruciate ligament deficiency.

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Résumé Cent personnes avec des genoux normaux et 47 patients avec une rupture chronique du ligament croisé antérieur ont été testés par le système d'analyse du genou Genucom. Un total de 13 différents tests de laxité contenus dans le protocole Genucom ont été effectués sur les deux genoux. L'analyse des mesures faites sur les genoux droit et gauche de sujets normaux a montré qu'un seul test, le Lateral Pivot Shift exécuté sur le genou en flexion de 25°, avait une bonne corrélation entre un côté et l'autre, mais sans être capable de distinguer le genou atteint du genou sain chez les patients ayant un ligament croisé antérieur déficient. La sensibilité de ce test était de 30% et sa spécificité de 91%. La sensibilité du tiroir antérieur sur le genou en flexion de 30°, avec une force de 93 Newton, était de 45% et sa spécifité de 88%. Les mesures ont généralement montré de grandes variations dont il faut tenir compte pour interpréter les résultats du Genucom. Celui-ci doit être considéré comme un instrument d'expérience et il n'a que peu d'utilité pour l'évaluation des patients présentant un déficit du ligament croisé antérieur.

     

Bromazepam in generalized anxiety

Bromazepam was compared with placebo and with chlorprothixene in a randomized, double-blind group-comparative multicenter trial in general practice. Two hundred and forty-five patients with generalized anxiety disorder (DSM-III 1980) were treated for 2 weeks with two daily doses of bromazepam, 3 mg or chlorprothixene, 15 mg or placebo. Median reductions in Hamilton Anxiety rating were 12 (bromazepam), 10.3 (chlorprothixene) and 7.3 (placebo). The study revealed significant superiority of bromazepam over placebo (median differences 3.3, 95% confidence limits: 0.3 and 6.1) but not over chlorprothixene (median difference 1.4, 95% confidence limits –0.8 and +3.5). Significantly higher rates of tiredness, sedation and hypersomnia were found on bromazepam and chlorprothixene compared to placebo. Tolerance was rated as at least good in 85.6% on bromazepam, in 86% on chlorprothixene and in 87.8% on placebo. Neither previous psychopharmacological treatment nor presence of psychosocial stress were of perceptible influence. Bromazepam and chlorprothixene are both superior to placebo in generalized anxiety states treated in general practice, but spontaneous improvements/placebo effects are substantial.General practice The following general practitioners are gratefully acknowledged for their excellent co-operation: K. Andreasen (Grenaa), T. Andreasen (Helsingoer), C. Bjerre-Christensen (Viby J), J. Brix (Aabenraa), N.B. Caning (Stokkemarke), N. Christensen (Odense), P. Dehn-Jensen (Lyngby), J. Eggert (Langebaek), H. Fuglsang-Damgaard (Havndal), I. Fraemohs (Allingaabro), J. Gylling (Nykoebing Sjaelland), E. Halkjaer-Soerensen (Roedding), B. Hansson (Frederiksvaerk), C. Hauge (Espergaerde), S. Hede (Aalborg), G. Jensen (Copenhagen S), T. Knudsen (Arden), P. Kofod (Vejle), K. Kraen (Varde), V. Lade (Hjoerring), S. Mehlsen (Auning), J. Meyer-Christensen (Hobro), R. Michael (Langebaek), J. Munch (Oersted), L. Moeller-Hansen (Alleroed), U. Moeller (Graasten), K. Nielsen (Malling), S. Kjaerem Nielsen (Copenhagen), P.V. Nielsen (Odense), J. Peulicke (Espergaerde), O. Ravn (Roedding), C.U. Rosenberg (Aarhus), J. Rude (Goerlev), S. Spangsberg (Holbaek), H. Soegaard (Oelgod), O. Tang (Hoersholm)