Need for endotracheal intubation and suction in meconium-stained neonates.

In a prospective study, we determined whether routine immediate tracheal aspiration at birth is necessary in meconium-stained but otherwise normal infants delivered vaginally and having a 1-minute Apgar score greater than 8. A total of 572 newborn infants who met these criteria were randomly allocated to one of two groups. All infants underwent oropharyngeal suctioning with a DeLee catheter while the head was still on the perineum. In group I (n = 308) suctioning of the trachea under direct vision was performed instantly at birth; in group II (n = 264) this procedure was not done. There was no mortality among infants in the study, but morbidity, mainly pulmonary and laryngeal disorders, occurred in six of 308 group I infants and in none of the group II infants (P less than 0.025). Immediate tracheal suction is not a harmless intervention, and should be considered superfluous in a vigorous term neonate born with meconium-stained amniotic fluid.

Hydrolase activities in the rat aorta. V. Comparison to activities in liver and kidney after thyroidectomy and relation to dynamic clearance of circulating low density lipoproteins.

Thyroid hormones influence circulating low density lipoprotein (LDL) levels in humans; they could have an effect on LDL catabolism. Male rats were thyroidectomized (H); half were treated for 7 days with 2 micrograms triiodothyronine/100 g body weight (T) and both groups were compared to controls (C). Aorta, liver, and kidney were assayed for cellular marker enzymes, including lysosomal acid cholesteryl esterase (ACE). Specific activities of ACE (mU/mg DNA; mean +/- SD) were: Aorta, C, 0.19 +/- 0.01; H, 0.16 +/- 0.01; T, 0.21 +/- 0.01; Liver: C, 15.55 +/- 1.49; H, 9.16 +/- 1.54; T, 15.43 +/- 2.28; Kidney: C, 1.70 +/- 0.23; H, 1.04 +/- 0.13; T, 2.08 +/- 0.35. Half lives for injected unmodified 125I-labeled human LDL were 11.5 +/- 0.7 hour in C, 16.2 +/- 3.1 in H, and 12.9 +/- 0.9 in T groups. Fractional catabolic rates (FCR) of LDL in %/hr were 6.5 +/- 0.6 in C; 4.8 +/- 0.5 in H, and 6.0 +/- 0.3 in T. Reductively methylated 125I-labeled human LDL had half-lives of 14.9 +/0 1.4 hour in C and 15.1 +/- 1.6 hour in H and the FCR of this modified LDL was 5.3 +/- 0.5 %/hr in C and 5.2 +/- 0.7 %/hr in H groups. Thus, thyroidectomy results in marked decreases in ACE specific activity of liver and kidney and a marked decrease in FCR and prolonged half-life of non-modified LDL (all P less than 0.05). On the other hand, methylated LDL showed a similarly reduced FCR and prolonged half-life in control and thyroidectomized rats (P less than 0.05). This suggests a major effect of thyroid deficiency on receptor-mediated uptake of LDL in vivo and demonstrates the influence of hormonal status on dynamic clearance and catabolism of LDL.

Solomon design analysis of multiple-choice Rorschach animal content.

The Solomon four-group design was used to study the effects of a persuasive message on a selected multiple-choice Rorschach index--animal content. The independent variable elicited behavior in a predictable manner. Pretesting as a main effect was not significant, but as an interactional effect obviated the effect of the persuasive message. Although knowledge of test rationale can elicit behavior that conforms to experimental demand characteristics, some subjects nonetheless acted in defiance of such information. A condition for defiance in this experimental arrangement, however, was pretesting. Other possibilities regarding the study of compliance behavior and the use of pathognomonic indicators were suggested. Ethical issues were raised.