ALCOHOL AND SOCIAL INFLUENCE: FEMALE YIELDING TO MALE AND FEMALE GROUP PRESSURE

Thirty college women were randomly assigned to either an alcohol,a placebo, or a control group. The alcohol group drank 0.8 mlof 100% alcohol/kg body weight. Subjects estimated the lengthof lines and were exposed to a simulated group pressure. Yieldingto the group pressure constituted the dependent variable. Boththe alcohol and the placebo groups showed increased number ofyieldings compared to the control group. Different theoreticalexplanations are discussed suggesting psychological mechanismsto be the most important.     

NUTRITION IN LOW-BIRTH-WEIGHT INFANTS: II. Repeated Intravenous Injections of Fat Emulsion

Abstract. Gustafson, A., Kjellmer, I., Olegård, R. and Victorin, L. (Department of Paediatrics, Children's Hospital, and of Medicine I, Sahlgren's Hospital, Goteborg, Sweden). Nutrition in low-birth-weight infants. II. Repeated intravenous injections of fat emulsion. Acta Paediat Scand, 63: 177, 1974.–The elimination of an exogenous fat emulsion from the blood stream after repeated intravenous injections was investigated in two groups of low-birth-weight infants: 11 appropriate-for-date (AFD) pre-term babies and 8 light-for-date (LFD) pre- and full-term infants. During a period with six injections hourly of 0.15 g fat/kg 'b.w. the total lipids of plasma increased only moderately in the AFD group, from 264 to 351 mg/100 ml, while in the LFD group a progressive rise of total lipids occurred from 244 to 466 mg/100 ml. The plasma turbidity increased correspondingly more in the LFD than in the AFD group. In 5 LFD babies, where a progressive accumulation of total lipids occurred with each injection of fat emulsion, heparin was given intravenously after eight fat injections. The plasma was rapidly cleared of fat although fat injections were continued. It is concluded that AFD infants are able to hydrolyse fat emulsions given at an hourly rate of 0.15 g/kg b.w., while this amount of fat to LFD babies will cause an accumulation of plasma lipds unless heparin is supplied simultaneously.     

The work of the student doctor: a pilot project

The primary task of the student doctor in the third year of medical school is to inquire into problems of illness, in co-operation with patients, house officers and other staff. This is a new kind of work for most medical students, who have spent the previous two years reading textbooks and listening to lectures. How do students get out of these passive forms of learning into active inquiry? How do they learn to work co-operatively with other people in the technical difficulty and emotional upheaval of illness? We know that most medical students somehow manage to become practicing physicians, but we have known very little about this critical transition. We would expect that this phase of training, like any major transition in the life cycle, leads to great strain and the formation of new patterns of thinking and behaviour that will last through a lifetime of clinical practice. These considerations lead directly to practical matters of medical education and research. How can we best study this critical period? How can we offer the best education to student doctors forming working relationships with patients? This paper describes a working model of training and research to meet these concerns, adapted from the work of Michael Balint and colleagues in the ‘G.P. (General Practitioner) Seminars’( Balint, 1954, 1957 ; Bourne, 1975 ).     

Lipid and carbohydrate metabolism in uraemia

Lipid and carbohydrate metabolism variables were studied in twenty-eight patients with chronic renal failure (mean GFR 7.7 +/- 2.5 ml/min) and uraemic symptoms. 71% of the patients had hypertriglyceridaemia (greater than or equal to 2.2 mmol/l). Total serum cholesterol was normal while VLDL cholesterol was high and alpha-lipoprotein cholesterol was low. The fractional elimination rate of Intralipid was low and inversely correlated to serum triglyceride levels. Intravenous glucose tolerance was reduced with normal or slightly increased fasting blood glucose and insulin values before and during the test. Serum triglycerides were correlated to plasma insulin but not to residual renal function or serum urea levels. The cause of hypertriglyceridaemia and lowering of alpha-Lp cholesterol is not unequivocally clear. Present evidence indicate that retarded catabloism of triglyceride-rich lipoproteins is important but accentuated release of triglyceride-rich lipoproteins may have occurred in a number of cases. The commonly used treatment with beta-blocking agents for hypertension in chronic renal failure may accentuate certain of the metabolic responses in uraemia.     

An institutional experience with epidural analgesia in children and young adults undergoing cardiac surgery

Background: Allowing spontaneous respiration after cardiac surgery eliminates complications related to mechanical ventilation and optimizes cardiopulmonary interaction. Epidural analgesia has been proposed to promote early extubation after cardiac surgery. Objective: To identify the characteristics of patients with epidural analgesia and safety profiles with respect to the timing of extubation following cardiac surgery. Design and method: A retrospective chart review of patients who underwent cardiac surgery during a 5‐year period. Demographic, procedural, and perioperative variables were analyzed to investigate factors that affect the timing of extubation. Results: A total of 750 records were reviewed. The patients’ median age was 12 months, and 52% were infants (<1 year). Seventy‐five percent of the patients utilized cardiopulmonary bypass. The study population was classified into three groups according to the timing of extubation: 66% were extubated in the operating room or upon arrival at the PICU (Immediate), 15% were extubated within 24 h (mean, 10.8 h; 95% CI, 9.0–12.6) (Early), and 19% were extubated after 24 h (Delayed). For the Immediate and Early groups, multivariate logistic regression identified young age, increased cross‐clamp time, and inotrope score as independent risk factors for the need for mechanical ventilation. Postextubation respiratory acidosis (mean P_aCO₂, 50 mmHg; 95% CI, 49–51) was well tolerated by all patients. There were no neurologic complications related to the epidural technique. Conclusion: Epidural analgesia in children undergoing cardiac surgery provides stable analgesia without complications in our experience.     

Reduced High Density Lipoproteins as a Risk Factor after Acute Myocardial Infarction

ABSTRACT. FranzÉn J, Johansson BW, Gustafson A (Department of Internal Medicine, University Hospital, Lund and Section of Cardiology, Department of Internal Medicine, MalmÖ General Hospital, MalmÖ, Sweden). Reduced high density lipoproteins as a risk factor after acute myocardial infarction. In a group of normocholesterolemic, non-diabetic middle-aged males surviving an acute myocardial infarction for 4±2 years (mean ± SD), we have previously described a low apolipoprotein A-1 and a deficient fibrinolytic activity as two major characteristics. In the present study we have followed morbidity and mortality risk factors for five years in these males. Mortality was 40% in a hypertensive group and 16% in a normotensive group. In the normotensive group mortality was related to reinfarction. Furthermore, patients with a poor prognosis in the normotensive group had lower high density lipoprotein (HDL) cholesterol and lower apolipoprotein A-I concentration in plasma than patients with a good prognosis. Unexpectedly, in the hypertensive group death was related to a low (p<0.05) cortisol concentration in urine. It is concluded that a low HDL level may be a bad prognostic sign in males who have sustained an acute myocardial infarction and show no evidence of other risk factors, such as diabetes, hypercholesterolemia or hypertension.