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61.
B Caldwell 《Journal of developmental and behavioral pediatrics : JDBP》1991,12(3):199-205
On September 2, 1990, something very informative about the evolution of early childhood programs in the minds of people appeared in The New York Times. Perhaps only another historian of trivia would have noticed it, but it was significant. The Sunday crossword puzzle had the following cue for 4 down: "Places for day-care" (spelled, with the purist's uncertainty, with a hyphen). Even such a cautious horizontal-vertical weaver as I am did not have to wait very long before filling in the correct 10 letters: "preschools." Preschools = day-cares; day-cares = preschools. I am told that actors and authors and scientists know that they have it made when their names are required as solutions in a Times crossword puzzle. If so, perhaps we now have tangible proof that those of us have at last been heard who have urged acceptance of the concept that early childhood education (or preschool education) and child care (or day care) are really one and the same essential service operated for different lengths of time. Day care, the illegitimate child of the scientific field that gave birth to the early childhood movement, has turned out to be the only offspring sufficiently well endowed and robust to make it in the modern world. It is the only one possessing the characteristics that will enable it to take the family enterprise into the future. At this juncture, near the close of the century during which programs for young children multiplied to the point where they cannot be ignored as significant factors in family and public life, we are on the threshold of a new era.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
62.
C B Caldwell E K Fishell R A Jong W J Weiser M J Yaffe 《AJR. American journal of roentgenology》1992,159(2):295-301
A radiograph is considered of high quality when it allows a radiologist to identify abnormalities with high sensitivity and specificity. Although many methods for assessing image quality have been devised, it is not clear which is most meaningful or how well these methods correlate with one another. A pilot study was undertaken to compare five methods of evaluating mammographic image quality. Each of the methods was used to form separate rankings of 11 mammographic system configurations. In two of the methods, observers (three radiologists and three physicists) subjectively ranked the "image quality" of radiographs of phantoms obtained with each configuration. The third method ranked the systems according to contrast as measured densitometrically with an aluminum step wedge, and the fourth, in terms of lowest to highest mean glandular radiation doses to the breast. In the final method, observers based their rankings on mammograms of patients. The intra- and interobserver variabilities of each ranking method were assessed, as well as the correlations between methods, by using standard nonparametric statistical tests. Intraobserver consistency was high with any of the image quality ranking methods; however, image quality rankings based on either of the two phantoms provided better agreement among observers than did rankings based on images of patients. Surprisingly, no significant degree of correlation was found between any two image quality evaluation methods. Our work may have two implications for the American College of Radiology Mammography Accreditation Program: (1) small variations in phantom scores do not necessarily correlate with subjective variation in image quality in radiographs of patients, and (2) when small numbers of radiographs are used, the assessment of the quality of mammograms of patients may vary considerably among radiologists. 相似文献
63.
Sevoflurane was compared to isoflurane anesthesia alone and in combination with atracurium or vecuronium in 84 rats using the sciatic nerve—anterior tibialis muscle preparation. Both bolus injection and infusion rate techniques were used to evaluate these drug interactions. The ED50 (dose which produced a 50% depression of twitch tension) of atracurium was 311 ± 31 and 360 ± 32µg·kg–1 during 1.25MAC sevoflurane and isoflurane anesthesia respectively. The ED50 of vecuronium was 190 ± 27 and 149 ± 14µg·kg–1 during 1.25MAC sevoflurane and isoflurane anesthesia respectively. The mean infusion rates of atracurium and vecuronium required to maintain a 50% depression of twitch tension were 5.04 ± 0.7 and 2.02 ± 0.3mg·kg–1·hr–1. These infusion rates were 5.04 ± 0.7 and 2.02 ± 0.3mg·kg–1·hr–1 during 1.25MAC sevoflurane and 3.73 ± 0.3 and 1.81 ± 0.4mg·kg–1·hr–1 during 1.25MAC isoflurane anesthesia respectively. With both atracurium and vecuronium, the infusion rate required to maintain a 50% depression twitch of tension was inversely related to the concentrations of isoflurane and sevoflurane. The authors conclude that sevoflurane is similar in potency to that of isoflurane in augmenting a vecuronium or atracurium induced neuromuscular blockade in a dose-dependent manner.(Shin YS, Miller RD, Caldwell JE, et al.: The neuromuscular effects of sevoflurane and isoflurane alone and in combination with vecuronium or atracurium in the rat. J Anesth 6: 1–8, 1992) 相似文献
64.
Low-dose corticosteroids (defined as less than or equal to 10 mg/d of prednisone or equivalent) are used increasingly for the management of rheumatoid arthritis. They are frequently substituted for nonsteroidal antiinflammatory drugs (NSAIDs), particularly in patients with gastrointestinal or other intolerance to NSAIDs, or as "bridge therapy" while patients await the benefits of delayed-acting, disease-modifying agents. Despite their clinical acceptance, published data concerning efficacy are meager. Adverse effects to low-dose corticosteroids are not so frequent nor so severe as those that occur with higher doses. Nevertheless, alterations in glucose metabolism, cutaneous atrophy, cataracts, and glaucoma are common. Osteoporosis, steroid-myopathy, a steroid-withdrawal syndrome, and dysfunction of the hypothalamic-pituitary-adrenal axis appear in some patients. Osteonecrosis, gastrointestinal, cardiovascular, infectious, or neurological complications probably do not occur. Fetal wastage, prematurity, or congenital malformations have not been proven with this dosage. 相似文献
65.
A booklet, "Assessment of Maternal Nutrition," has been published by the American College of Obstetricians and Gynecologists in cooperation with The American Dietetic Association as a useful guide for physicians, nurses, dietitians, and nutritionists. Nutritional risks during pregnancy are clearly outlined. Clinical, dietary, and biochemical factors, as well as medical, obstetric, and social factors, are delineated as components of nutritional assessment. An A.D.A. Liaison Committee had major responsibility for the development of the "Eating Habits Questionnaire," a tool to screen dietary intake for major deficits and excesses, which is included in the booklet. It should be useful also as a starting point for nutrition education. Additional evaluation of the use and reliability of the screening tool is recommended. 相似文献
66.
Impact of education for physicians on patient outcomes 总被引:4,自引:0,他引:4
NM Clark M Gong MA Schork D Evans D Roloff M Hurwitz L Maiman RB Mellins 《Pediatrics》1998,101(5):831-836
67.
Hemoglobin and albumin adducts of benzene oxide among workers exposed to high levels of benzene 总被引:3,自引:0,他引:3
Yeowell-O'Connell K; Rothman N; Smith MT; Hayes RB; Li G; Waidyanatha S; Dosemeci M; Zhang L; Yin S; Titenko-Holland N; Rappaport SM 《Carcinogenesis》1998,19(9):1565-1571
Benzene oxide (BO) reacts with cysteinyl residues in hemoglobin (Hb) and
albumin (Alb) to form protein adducts (BO-Hb and BO-Alb), which are
presumed to be specific biomarkers of exposure to benzene. We analyzed
BO-Hb in 43 exposed workers and 42 unexposed controls, and BO-Alb in a
subsample consisting of 19 workers and 19 controls from Shanghai, China, as
part of a larger cross-sectional study of benzene biomarkers. The adducts
were analyzed by gas chromatography-mass spectrometry following reaction of
the protein with trifluoroacetic anhydride and methanesulfonic acid. When
subjects were divided into controls (n = 42) and workers exposed to < or
=31 (n = 21) and >31 p.p.m. (n = 22) benzene, median BO-Hb levels were
32.0, 46.7 and 129 pmol/g globin, respectively (correlation with exposure:
Spearman r = 0.67, P < 0.0001). To our knowledge, these results
represent the first observation in humans that BO-Hb levels are
significantly correlated with benzene exposure. Median BO-Alb levels in
these 3 groups were 103 (n = 19), 351 (n = 7) and 2010 (n = 12) pmol/g Alb,
respectively, also reflecting a significant correlation with exposure
(Spearman r = 0.90, P < 0.0001). The blood dose of BO predicted from
both Hb and Alb adducts was very similar. These results clearly affirm the
use of both Hb and Alb adducts of BO as biomarkers of exposure to high
levels of benzene. As part of our investigation of the background levels of
BO-Hb and BO-Alb found in unexposed persons, we analyzed recombinant human
Hb and Alb for BO adducts. Significant levels of both BO-Hb (19.7 pmol/g)
and BO-Alb (41.9 pmol/g) were detected, suggesting that portions of the
observed background adducts reflect an artifact of the assay, while other
portions are indicative of either unknown exposures or endogenous
production of adducts.
相似文献
68.
Increased aneusomy and long arm deletion of chromosomes 5 and 7 in the lymphocytes of Chinese workers exposed to benzene 总被引:4,自引:1,他引:4
Zhang L; Rothman N; Wang Y; Hayes RB; Li G; Dosemeci M; Yin S; Kolachana P; Titenko-Holland N; Smith MT 《Carcinogenesis》1998,19(11):1955-1961
Two of the most common cytogenetic changes in therapy- and chemical-
related leukemia are the loss and long (q) arm deletion of chromosomes 5
and 7. The detection of these aberrations in lymphocytes of individuals
exposed to potential leukemogens may serve as useful biomarkers of
increased leukemia risk. We have used a novel fluorescence in situ
hybridization (FISH) procedure to determine if specific aberrations in
chromosomes 1, 5 and 7 occur at an elevated rate in the blood cells of
workers exposed to benzene. Forty-three healthy workers exposed to a wide
range of benzene concentrations (median 31 p.p.m., 8 h time-weighted
average) and 44 unexposed controls from Shanghai were studied. Whole blood
was cultured and metaphase spreads were harvested at 72 h. Benzene exposure
was associated with increases in the rates of monosomy 5 and 7 but not
monosomy 1 (P < 0.001, P < 0.0001 and P = 0.94, respectively) and
with increases in trisomy and tetrasomy frequencies of all three
chromosomes. Long arm deletion of chromosomes 5 and 7 was increased in a
dose-dependent fashion (P = 0.014 and P < 0.0001) up to 3.5-fold in the
exposed workers. These results demonstrate that leukemia-specific changes
in chromosomes 5 and 7 can be detected by FISH in the peripheral blood of
otherwise healthy benzene-exposed workers. We suggest that aberrations in
chromosomes 5 and 7 may be useful biomarkers of early biological effect for
benzene exposure.
相似文献
69.
70.
Large concentrations of alpha(2) agonists cause vasoconstriction. However, the threshold of the vasoconstrictive effect in humans is not known. We studied seven volunteers to determine the lower limit of the vasoconstrictive effect of clonidine. Subjects were studied while they were awake, and they were anesthetized with propofol/alfentanil/N(2)O. Arterial blood pressure was continuously monitored via radial arterial catheter and vasoconstriction via finger volume plethysmography measuring infrared light transmitted through a fingertip (LTF). Clonidine was administered, targeting plasma clonidine concentrations of 0.3, 0.45, 0.68, 1.0, 1.5, and 2.25 ng/mL. The maximum change from preclonidine values for systolic blood pressure (SBP) and LTF was analyzed by using repeated measures analysis of variance. In awake subjects, clonidine (2.25 ng/mL) decreased LTF by 14%+/-13% and SBP from 141+/-7 to 110+/-15 mm Hg (P<0.0001). In contrast, clonidine (2.25 ng/mL) increased LTF in anesthetized subjects by 21%+/-16% and SBP from 91+/-7 to 106+/-19 mm Hg (P<0.0001). We conclude that the same dose of clonidine that decreased blood pressure and caused vasodilation in awake subjects had the opposite effect in anesthetized subjects with reduced sympathetic tone, increasing blood pressure and causing vasoconstriction in human digital vasculature. Our findings suggest that the lower threshold for clonidine-induced vasoconstriction in human digital vasculature is 1.0 ng/mL. 相似文献