[Biometry of the large bones of fetal extremities in the 3d trimester]. / Biometrie der grossen fetalen Extremitätenknochen im III. Trimenon.

Ultrasound measurement of head, thorax and the limb bones femur, tibia, humerus and radius was made of 285 fetuses with known gestational age. In addition measurements of the fibula were obtained in 120 fetuses and of the ulna in 125 fetuses. With the use of these data a normal growth curve for each limb bone was established, which can be helpful in detecting late fetal limb malformations as heterozygous achondroplasia. All limb bones show a nearly linear growth rate so that the length of the bones can alternatively be used to determine gestational age. The linear relationship between growth of the limb bones and the fetal head can be used to diagnose fetal head malformations as microcephaly.

Ultrasonic mensuration of fetal limb bones in the second and third trimesters.

Growth of fetal limb bones has been examined in a prospective cross-sectional study in 530 patients between 13 and 42 weeks of gestation by ultrasound. The length of the femur, tibia, humerus, and radius were measured in all cases, and fibula and ulna in 393 cases. For each week of gestation mean lengths (+/- 2 standard deviations) were calculated. All limb bones showed linear growth from 13 weeks to 25 weeks of gestation, after which the growth curve appeared nonlinear. A strong linear relationship (r greater than 0.98) between the BPD and bone length was found for each bone. In five aborted fetuses, prenatal sonographic measurements of the ossified diaphyses were compared with the postnatal radiologic measurement (30 limb bones). A good agreement was found (difference between ultrasound and X-ray measurements 0.7 +/- 0.5 [SD] mm or 3.0 +/- 2.4 [SD]%), indicating that ultrasound images the ossified diaphysis.

Physician and nursing (personnel) requirements for ICUs. Therapeutic Intervention Scoring System (TISS) versus time requirements for patient care--a comparative study in an interdisciplinary surgical intensive care unit.

OBJECTIVE: To measure total physician manoeuvres and total nursing manoeuvres in intensive care patients and to compare the results with calculated personnel requirements on the basis of TISS scores. DESIGN: Open prospective study. SETTING: Sixty-three ICU patients on two consecutive days. MEASUREMENT: 1. Total physician activities (TPM) in minutes/patient-day; total nursing manoeuvres (TNM) in min/patient-day. 2. TISS Calculation of personnel requirements on the basis of both parameters. RESULTS: TPM averaged at 3.9 hours. No fixed correlation was established between TISS and TPM. TNM averaged 1,073 minutes/patient-day and demonstrated a good correlation with TISS. CONCLUSIONS: Physician activities on a surgical ICU averaged 3.9 hours/patient-day. Nursing manoeuvres average 17.9 hours/patient-day. Individual measurements must be made before calculating personnel requirements on the basis of TISS scores.