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Rationale and Objectives: To evaluate a large area, cesium iodide amorphous silicon flat-panel detector (CsI/a-Si) at 3 tube voltages to detect simulated interstitial lung disease, nodules, and catheters., Methods: Simulated interstitial lung disease, nodules, and catheters were superimposed over a chest phantom. Images were generated at 125 kVp, 90 kVp, and 70 kVp at the same surface dose and reduced effective dose equivalent for 90 kVp and 70 kVp and printed on hard copies. Fifty-four thousand observations were analyzed by receiver operating characteristic (ROC)., Results: Detectability of linear, miliary, reticular pattern, and nodules over lucent lung as well as of catheters and nodules over obscured chest areas increased at 90 and/or 70 kVp with higher Az values; however, only it was statistically significant for reticular pattern at 70 kVp and nodules at 90 kVp compared with 125 kVp (P < 0.05). The detection of ground-glass pattern was worse at lower kVp (P > 0.05)., Conclusion: For most simulated patterns, differences in diagnostic performance at 70 kVp/90 kVp and 125 kVp were not significant, except for reticular pattern and nodules over lucent lung.

We studied the impact of unwed status on infant mortality in the state of Iowa, where obstetric and newborn care is readily accessible. Our purpose was to document the extent of the contribution of unwed status to infant mortality and to compare unwed gravidas with their married counterparts. We hoped the comparisons would provide information that could be used for future programs of prevention. Our data encompassed a 10-year period (1977-1986) during which the incidence of infant deaths occurring in offspring of unmarried women was significantly greater than expected. The unwed population commonly consisted of younger, poorly educated, primigravid women who frequently did not seek prenatal care. We suggest that personal factors inherent in this group of women may be more operative than lack of access to perinatal care in determining pregnancy outcome. We believe our data underscore the need to redouble efforts to prevent unintended pregnancy.

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. Additional data about the regionalized system of care in Iowa are presented to illustrate why mortality may rise in a referral center and yet be consistent with a salutary effect on perinatal outcome in the region.