Effects of physical activity and life-style factors on uterine contraction frequency

In this cohort study, uterine contractions were recorded in 81 low-risk pregnant women who wore ambulatory tocodynamometers continuously during three 72-hour periods at advancing gestational ages. During these periods, they also recorded their daily activities in a diary. Examination of the data, in general, revealed no association between uterine contraction frequency and habits such as smoking, alcohol consumption, or drinking caffeinated beverages. Physical activities, such as prolonged standing, heavy housework, lifting, or organized exercise also did not appear to affect uterine contraction rates. Only climbing stairs and walking were associated with increased contraction frequencies, but this effect, although statistically significant, was relatively small in magnitude and was present only during the last gestational age period monitored (30 to 33 weeks).     

Congenital hypothyroidism: clues to an early clinical diagnosis

Congenital hypothyroidism is clinically difficult to diagnose early in life. A review of the common signs and symptoms of this treatable disease is presented, and a case diagnosed on the third day of life is discussed. Until neonatal thyroid screening is generally available it behooves all physicians caring for newborns and young infants to have a high index of suspicion for this disease.     

Severe bradyarrythmia induced by tricyclic antidepressants in an elderly patient

The fluoroquinolones have an established role in treatment of infection with aerobic gram negative rods. The increased importance of gram positive nosocomial infection and of acquired fluoroquinolone resistance has stimulated a search for new compounds with enhanced potency and spectrum. CP-99,219 is a novel compound in this class with enhanced activity against gram positive organisms. We have studied the activity of CP-99,219 relative to ciprofloxacin, fleroxacin, ofloxacin, and sparfloxacin using test panels of organisms with a high proportion of ciprofloxacin resistance. CP-99,219 is more potent than any of the other four compounds against both gram positive and gram negative bacteria. The activity of CP-99,219 against many bacteria resistant to the established agents, warrants further in vitro and clinical studies.     

Evaluating the clarity of research reports written for research subjects

It is not simple to report research results to the people who participated in the research as subjects of study. Few evaluations have examined subjects' understanding of written research findings. In two recent studies of solvent exposure, subjects received brief summaries of the research. Before they were sent, the summaries were evaluated by research, health, and communication specialists as well as by representatives of the target audience. For one of the studies, interviews were conducted with subjects before and after they received the reports. Although the subjects said they understood the summary, their answers to questions about its content indicated otherwise. The results suggest that researchers not rely on subjects' self-assessments of their understanding but instead design methods to test subjects' knowledge directly. Those tests would be most valuable if applied in formative evaluations, when the opportunity exists to improve the research summaries.     

Factors associated with appendicular bone mass in older women. The Study of Osteoporotic Fractures Research Group

OBJECTIVE: To determine the factors associated with appendicular bone mass in older women. DESIGN: Cross-sectional analysis of baseline data collected for a multicenter, prospective study of osteoporotic fractures. SETTING: Four clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela valley, Pennsylvania. PATIENTS: A total of 9704 ambulatory, nonblack women, ages 65 years or older, recruited from population-based listings. MEASUREMENTS: Demographic and historical information and anthropometric measurements were obtained from a baseline questionnaire, interview, and examination. Single-photon absorptiometry scans were obtained at three sites: the distal radius, midradius, and calcaneus. Multivariate associations with bone mass were first examined in a randomly selected half of the cohort (training group) and were then tested on the other half of the cohort (validation group). RESULTS: In order of decreasing strength of association, estrogen use, non-insulin-dependent diabetes, thiazide use, increased weight, greater muscle strength, later age at menopause, and greater height were independently associated with higher bone mass. Gastric surgery, age, history of maternal fracture, smoking, and caffeine intake were associated with lower bone mass (all P < 0.05). For example, we found that 2 or more years of estrogen use was associated with a 7.2% increase in distal radius bone mass, whereas gastrectomy was associated with an 8.2% decrease in bone mass. The associations between bone mass and dietary calcium intake and rheumatoid arthritis were inconsistent. Alcohol use, physical activity, use of calcium supplements, pregnancy, breast-feeding, parental nationality, and hair color were among the many variables not associated with bone mass. Multivariate models accounted for 20% to 35% of the total variance of bone mass. CONCLUSIONS: A large number of factors influence the bone mass of elderly women; however, age, weight, muscle strength, and estrogen use are the most important factors.