The status and future of small maternity services in Iowa.

Small Iowa community hospitals (fewer than 500 deliveries annually) are currently the site of approximately 37% of hospital births in the state. Many of these facilities face severe financial constraints aggravated by reduced Medicare payments and diagnosis-related group payment mechanisms. The quality and quantity of services provided by small hospitals are illustrated by birth and mortality data for the period that spans the development of Iowa's regionalized perinatal care system.

The effect of ten years of regionalized perinatal health care in Iowa, U.S.A.

In 1973, Iowa, a rural, midwestern state in the U.S.A.

Changes in blood pressure, fluid volumes and glomerular filtration rate during long-term treatment with prizidilol, an antihypertensive drug with combined vasodilatator and beta-adrenoceptor blocking actions.

The long term effects on blood pressure, body fluid volumes, glomerular filtration rate and plasma renin concentration were studied in 11 patients with essential hypertension during treatment with prizidilol, which is an antihypertensive compound with combined vasodilatator and beta-adrenoceptor blocking actions. After the patients had been treated for four weeks with placebo, the active treatment was given for 12 weeks. Prizidilol reduced both supine and erect blood pressure by 26/14 mmHg (p less than 0.

Comparing perinatal mortality.

Comparisons of perinatal outcome data among regions or hospitals can be misleading if the risk status of the population served is not considered. Data are presented from two large perinatal centers (Medical Center Hospital in San Antonio, Texas, and University of Iowa Hospitals in Iowa City, Iowa), which report substantially different institutional neonatal and fetal mortality rates. However, examination of neonatal and fetal mortality by birth weight groupings demonstrates the difference between outcome in the two hospitals to be considerably less than the overall rates might imply.

Iowa's system for screening and tracking high-risk infants.

A statewide system for the screening, tracking and referral of high-risk infants has been in operation in Iowa since 1978. During the first five years of the Iowa High-Risk Infant Follow-up Program, pediatric nurse-practitioners have screened 1,440 infants at ages 4, 9, 18, and 30 months. Nineteen percent of the infants failed screening and were referred to developmental centers for further evaluation.

Cardiorespiratory arrest with laryngeal oedema in pregnancy-induced hypertension.

A 17-year-old black female with pregnancy-induced hypertension (PIH) suffered cardiorespiratory arrest on arrival in the recovery room after Caesarean section under general endotracheal anaesthesia. Successful resuscitation included orotracheal intubation, complicated by severe laryngeal oedema. Causative mechanisms are discussed.

A comparison of the activity of the sympathoadrenal and adrenocortical system under inhalation anesthesia techniques.

Epinephrine, norepinephrine, ACTH and cortisol plasma levels as well as heart rate and blood pressure were studied in 32 patients undergoing ophthalmic surgery. Epinephrine levels rose significantly during nitrous oxide anesthesia and also during enflurane-nitrous oxide anesthesia, whereas they fell slightly during halothane-nitrous oxide anesthesia. Norepinephrine levels remained unchanged.

[Use of neomycin-bacitracin irrigating solution with intraoperative autotransfusions during orthopedic operations].

Although there is doubt about the importance of rinsing the operative field with a solution containing locally acting antibiotics, it is frequently done. In this paper we tried to answer the question, wether intraoperative autotransfusion (IAT) with the Haemonetics Cell Saver is contraindicated during rinsing the operative area with locally acting antibiotics or vice versa. The measured serum concentrations for neomycin and bacitracin (Nebacetin) were extremely low.

[Effect of nitrofurylpropenylidene benzhydrazides against trichomonads, bacteria, yeasts and fungi with particular consideration of the results in the Ames test and host-mediated assay].

11 out of 13 N-[3-[5-nitrofuryl-(2)-propenylidene)]-benzhydrazides described by us showed an in vitro activity against T. vaginalis almost equivalent to or approaching that of the standard substances metronidazole and tinidazole. One compound was markedly more effective; two compounds exhibited much weaker activity than the two reference substances.

Testosterone metabolism of fibroblasts grown from prostatic carcinoma, benign prostatic hyperplasia and skin fibroblasts.

The metabolism of [1,2,6,7-3H]testosterone was assessed in fibroblast monolayers derived from tissue of 5 prostates with benign hyperplasia (BPH), 4 prostates with carcinoma (PC), and 3 biopsy samples of skin, 2 nongenital skin (NG) and 1 genital skin. The following metabolites could be identified: androstanedione androstenedione, dihydrotestosterone, androsterone, epiandrosterone, androstane-3 alpha, 17 beta-diol and androstane-3 beta, 17 beta-diol. Testosterone was metabolized much more rapidly in fibroblasts originating from prostatic tissue than in fibroblasts derived from NG.