Generalized anxiety disorder in women.

Women have a higher prevalence of GAD than do men. This ratio holds true in most clinical and general-population samples. Some variations exist, with evidence to suggest the strong impact of environment and life events. Women are sensitive to lifetime adversity and exacerbation of symptoms in conjunction with their menstrual cycle. Comorbidity is a crucial diagnostic factor when treating anyone with GAD, especially women. Most notably, high comorbidity with other anxiety disorders, MDD and alcohol-abuse disorder occurs for women. Overall, although the prevalence of women with GAD is greater than that of men with GAD, the course of illness and prognosis are not qualitatively different. Across varied methodology, data suggest gender-related differences in the metabolism and potentially in the effects and side effects of the various benzodiazepines and antidepressant psychopharmacologic treatments of GAD. Additional research is needed to better understand these differences.

IPPV plus low-flow intermittent oxygen insufflation (end-exhalation to beginning inhalation) does not improve CO2 elimination.

It has been previously reported that continuous insufflation of low-flow O2 (0.05 to 0.20 L/kg/min), both supracarinally and subcarinally, in addition to intermittent positive-pressure ventilation (IPPV) (IPPV + O2 at a specific flow rate) caused progressive hemodynamic deterioration in patients. As demonstrated in a subsequent mechanical lung model, the hemodynamic deterioration was most probably due to lung hyperexpansion. The purpose of this study was to test the hypothesis that the O2 retarded the outflow of gas from the lung during exhalation and that if the insufflation were limited to the period of time from the end of tidal exhalation (EE) to the beginning of the next IPPV tidal inspiration (BI), lung hyperexpansion would not occur. The use of intermittent O2 in addition to IPPV was studied in both a mechanical lung model and in patients under general anesthesia; the mechanical lung model permitted direct examination of lung volume, and the patient study allowed determination of gas exchange effects. In the mechanical lung model and in the patients, a wide range of EE-BI O2 flow rates were used; respectively, 1 to 40 L/min and 0.05 to 0.20 L/kg/min. In the mechanical lung model, lung pressure and volume at EE and end-inspiration did not increase as long as the O2 flow was kept at or below 10 L/min. In the patients, airway pressure and hemodynamics did not change appreciably, but there was also no increase in CO2 elimination.(ABSTRACT TRUNCATED AT 250 WORDS)

Continuous oxygen insufflation in addition to IPPV causes air trapping in a mechanical lung model.

It has previously been reported that continuous insufflation of either supracarinal or subcarinal oxygen in addition to intermittent positive-pressure ventilation (IPPV) in patients under general anesthesia, and in critically ill patients in the intensive care unit, causes increased proximal airway pressure, decreased systemic blood pressure, and decreased cardiac output. The investigators hypothesized that these deleterious hemodynamic effects were due to intrapulmonary air trapping, resulting in an increased distal intrapulmonary pressure and volume. The purpose of this study was to test this hypothesis in an appropriate mechanical lung model. The study determined end-inspiratory and end-expiratory lung pressures and volumes during eight experimental sequences: (1) IPPV alone; (2) insufflation of oxygen alone at 2.5, 5.0, and 10.0 L/min (O2-2.5, 5.0, 10.0); (3, 4, and 5) IPPV plus insufflation of oxygen (IPPV + O2-0.0, 2.5, 5.0, 10.0) through a supracarinal catheter (sequence 3), subcarinal catheters (sequence 4), and through a CO2 sampling port of an endotrachael tube (sequence 5); (6 and 7) IPPV + O2-5.0 with increased expiratory time caused by an increased inspiratory flow rate (sequence 6) and a decreased respiratory rate (sequence 7); (8) IPPV + O2-5.0 with increased airway diameter. Experimental sequences 1 and 2 resulted in no increases or minimal ones in lung pressure and volume, respectively. With each insufflation catheter system (sequences 3, 4, and 5), each incremental increase in insufflation flow rate resulted in significant increases in lung pressure and volume. Increasing expiratory times (sequences 6 and 7 compared with 3, 4, and 5) decreased lung pressure and volume. Increasing the airway diameter (sequence 8) had only slight effect on lung pressure and volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Radiometric calibration of IR Fourier transform spectrometers: solution to a problem with the High-Resolution Interferometer Sounder.

A calibrated Fourier transform spectrometer, known as the High-Resolution Interferometer Sounder (HIS), has been flown on the NASA U-2 research aircraft to measure the infrared emission spectrum of the earth. The primary use-atmospheric temperature and humidity sounding-requires high radiometric precision and accuracy (of the order of 0.1 and 1 degrees C, respectively). To meet these requirements, the HIS instrument performs inflight radiometric calibration, using observations of hot and cold blackbody reference sources as the basis for two-point calibrations at each wavenumber. Initially, laboratory tests revealed a calibration problem with brightness temperature errors as large as 15 degrees C between 600 and 900 cm(-1). The symptom of the problem, which occurred in one of the three spectral bands of HIS, was a source-dependent phase response. Minor changes to the calibration equations completely eliminated the anomalous errors. The new analysis properly accounts for the situation in which the phase response for radiance from the instrument itself differs from that for radiance from an external source. The mechanism responsible for the dual phase response of the HIS instrument is identified as emission from the interferometer beam splitter.

An unusual case of penicillinase-producing Neisseria gonorrhoeae resistant to spectinomycin in California.

We report a case of gonorrhea due to a penicillinase-producing strain of Neisseria gonorrhoeae resistant to spectinomycin in a 26-year-old man who had not been out of the United States for a year-and-a-half. His sexual contact also had no recent travel out of the United States. The genital and oropharyngeal infections were successfully treated with cefoxitin (1 g im) plus probenecid (1 g orally) and trimethoprim-sulfamethoxazole (80 mg of trimethoprim and 400 mg of sulfamethoxazole). The patient took nine of the latter tablets daily for five days. The organism was a serovar IB-3, proline-requiring auxotype. The patient's isolate contained both 2.6-megadalton and 4.4-megadalton plasmids. Measurement of minimal inhibitory concentrations (MICs) of antibiotics for the isolate confirmed the penicillin resistance and showed an MIC of spectinomycin of greater than 256 micrograms/ml. The epidemiologic investigation suggested that the source of the infection was a male contact with unusual clinical features, including bloody urethral discharge and a possible incubation period of 28 days.

Nimbus-6 earth radiation budget experiment.

This paper describes the Nimbus-6 earth radiation budget experiment including its prelaunch calibration and in-flight performance. A preliminary assessment of the data shows the ERB measurement of the solar constant to be 1392 W/m(2) which is 1.6% higher than the expected value of 1370 W/m(2). Both values are traceable to the cavity radiometer scale. There is a disagreement between the fixed wide-angle and scanning narrow-angle measurements of planetary outgoing longwave radiation flux. Since the scanning channels are calibrated in-flight and show good agreement with previous observations of the Nimbus-3 satellite, the discrepancy is believed to be due to erroneous wide-angle flux estimates. The erroneous estimates may be caused by the misinterpretation of the transfer function for the wide-angle-earth-flux sensing thermopile detectors when viewing the earth which, unlike the prelaunch calibration source, does not fill the field of view of the detector and is not an isotropic radiation source. A field of view factor for the wide-angle channels is determined using an in-flight calibration procedure using the night-time scanning channel longwave radiation flux measurements as the absolute standard. The planetary global albedoes, longwave radiation fluxes, and net radiation are about 30%, 240 W/m(2), and -4 W/m(2) for the months of July and August 1975, which is in good agreement with previous Nimbus-3 estimates.

Nimbus-5 ITPR Experiment.

The Nimbus-5 infrared temperature profile radiometer (ITPR) experiment was designed to measure upwelling infrared radiation in appropriate spectral intervals and with sufficient geographical resolution for sounding the atmosphere's temperature distribution down to the earth's surface even under partly cloudy sky conditions. A primary scientific goal of the experiment was the specification of the mesoscale features of surface and atmospheric temperature and water vapor that are associated with intense weather systems. In this paper the ITPR instrument is described and some initial spacecraft results are given that demonstrate the success of the experiment in achieving its scientific goals.

Some aspects of the optical estimation of microstructure in fog and cloud.

Indirect measurement of parameters related to the drop size distribution in fog and cloud is discussed. Analysis of the kernel functions in the integral equation relating physical measurements (of transmission, forward scattering, and back scattering, respectively) to the drop size distribution reveals the number of useful independent inferences which can be made, with a specified error in measurement and from a given number of observations.