Suppression of pituitary-adrenal axis in children on beclomethasone dipropionate inhalation therapy.
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Biomedical subjects
Publications and source records attributed to N H Pijls.
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In the assessment of myocardial perfusion by ECG-triggered digital radiography, time parameters are calculated from the time density curve (TDC) and related to blood flow. Recently we developed a method which uses mean transit time (Tmn) as time parameter, and which is in accordance with the original principles of indicator dilution theory. In this approach, variability in vascular volume is excluded and Tmn-1, determined at maximal hyperemia, showed an excellent correlation with maximal flow in animal validation studies. For calculation of Tmn, however, a large part of the descending limb of the TDC has to be known for reliable extrapolation, and especially this part of the curve is subject to variability in image quality in man. Therefore we tested reproducibility of Tmn in 30 arteries in 20 patients. Tmn was derived from the TDCs, obtained from paired studies under identical circumstances with an interval of 10 minutes. Satisfactory images could be obtained in all but one patient. Image processing was performed in an identical way in the paired studies. Reproducibility proved to be excellent for all three coronary arteries. The absolute value of the relative differences between the first and second determination was 7 +/- 7% for the LAD, 6 +/- 3% for LCx and 4 +/- 2% for the RCA (mean +/- SD). Correlation coefficients between both measurements were 0.97, 0.95 and 0.95 for the respective arteries. Therefore, it is concluded that, using this approach, Tmn at maximal hyperemia can be determined reproducibly in man and used for maximal myocardial flow assessment.
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OBJECTIVE: To investigate the ability of qualified general nurses to perform cardiopulmonary resuscitation and to compare these skills with those of a group of ambulance nurses. DESIGN: Cross-sectional assessment of practical cardiopulmonary resuscitation skills. SUBJECTS: 141 Dutch general nurses. OUTCOME MEASURES: The practical skills were tested with six primary variables that describe the quality of cardiopulmonary resuscitation techniques in a training situation. A total score on the skills was computed based on a predefined scoring system. RESULTS: The percentage of general nurses who were able to achieve a pass score (i.e., the total score did not exceed 15 penalty points) was 6.4 percent. The average score was 37.8 penalty points. Eighty-eight percent of the ambulance nurses achieved a pass score. The average number of penalty points was 10.5. CONCLUSIONS: The practical skills in cardiopulmonary resuscitation are insufficient in the majority of this sample of general nurses in The Netherlands. The findings of this study should be used as a base to design an optimal form and content of an educational re-instruction program. We expect that a considerable improvement could be achieved by more frequent cardiopulmonary resuscitation re-instruction.