Multiple admissions to an urban psychiatric center: a comparative study.

Based on data from medical records of an urban psychiatric center, 113 patients previously identified as having multiple admissions--three or more admissions in 365 days--were compared with 113 patients without multiple admissions who were matched for age, sex, and admission status. No significant differences were found between the two groups on such variables as racial-ethnic background, diagnosis, or living arrangements before and after their index hospital stay. However, patients with multiple admissions were significantly more noncompliant with medication and significantly more likely to abuse drugs or alcohol. They also were younger at their first hospitalization and had more previous hospital admissions, shorter lengths of stay, and more incidents of leave without consent than the patients who did not have multiple admissions.

Progression of coronary atherosclerosis.

Two hundred sixty-two patients with 50% or greater obstruction of at least one coronary artery on the initial study underwent recatheterization 2-182 months later and were evaluated for progressive arterial changes. Progression was considered present if (1) a change from less than total obstruction to total obstruction occurred in any vessel; (2) a change from 70% or less to 90% or more occurred in any vessel; (3) a change from 30% or less to 50% or more occurred in any vessel not initially obstructed by 50%; or (4) a 20% or more increase in obstruction was noted in any vessel already narrowed 50% or more. Of the 262 patients, 116 of 238 men (49%) and 12 of 24 women (50%) met the criteria for progression. Risk factors determined at the time of the initial catheterization in patients who met the criteria for progression were compared with risk factors in patients who did not. No significant difference could be found between the groups in relation to family history, blood pressure, diabetes, smoking habits, weight, cholesterol levels, triglyceride values, initial ECG and initial catheterization findings. The frequency of detecting progressive arterial changes tended to increase as the interval between studies increased (p less than 0.001). The frequency of multiple vessel progression increased as the interval between studies increased. Progression was more frequent in patients younger than 50 years than it was in patients 50 years and older.

Neonatal asphyxia. I. Relationship of obstetric and neonatal complications to neonatal mortality in 38,405 consecutive deliveries.

The requirement of greater than one minute of positive pressure ventilation was prospectively used to identify infants suffering from asphyxia at birth in 38,405 consecutive deliveries. Multivariate analysis of high-risk factors associated with increased risk of asphyxia showed the prematurity was the most significant predictor of asphyxia. Asphyxia occurred in 62.3% of infants less than 27 weeks' gestation and decreased to 0.4% in infants greater than 38 weeks' gestation. Presence of asphyxia was associated with significant increase in neonatal mortality of infants greater than 36 weeks' gestation. Of the asphyxiated neonates, growth retardation, hypothermia, hyaline membrane disease, and seizures were significantly associated with an increased risk of death.

Neonatal asphyxia. II. Neonatal mortality and long-term sequelae.

Neonatal asphyxia, defined in this study as delay of greater than 1 minute in onset of spontaneous respiration at birth, occurred in 1% of 13,221 live-born infants of birth weight greater than 500 gm between 1970 and 1971. Seventy-five (56%) of 133 asphyxiated infants survived the neonatal period. Survival was directly related to gestational age. The 65 survivors of asphyxia available for study were seen at a mean age of 4.8 years to determine the incidence and extent of neurologic and developmental abnormalities. Twelve children (18.5%) had severe impairment: nine had both neurologic and intellectual handicaps, two had neurologic impairment alone, and one had intellectual impairment alone. The incidence and severity of impairment were not related to gestational age. Postasphyctic seizures were associated with poor outcome.

Measurement of the properties of liquids and gases using a transient hot-wire technique.

A transient method of making simultaneous, in situ measurements of the thermal conductivity, volumetric specific heat, and kinematic viscosity of liquids and gases is presented. The technique utilizes the temperature response record of a fine horizontal wire, functioning as a resistance thermometer, when subjected to a sudden and constant electrical heating. It is shown that a formulation of the transient mechanisms governing the transition from pure conductive to free convective heat transfer from the wire can be used to produce simultaneous determinations of fluid properties from a single wire temperature versus time record. A simple apparatus is presented, along with the results of its use in determining the properties of air.