Comparative review of the adverse effects of sedatives used in children undergoing outpatient procedures

Children often fear medical procedures and interventions. Sedative agents enhance the care of these children who undergo outpatient procedures by decreasing anxiety, increasing cooperativity, and providing amnesia. Although higher dosages and intravenous administration of sedatives often produce improved sedation, adverse effects and complications are more frequent. The goals of therapeutic efficacy and safety must be balanced in all patients. The presence or anticipation of anxiety and pain helps in deciding whether to use a sedative alone, or a regimen also providing analgesia. The patient's clinical cardiorespiratory or neurological status, other relative contraindications, the duration of the intended procedure, and the presence or absence of an intravenous line will help in choosing specific drugs. Drug complications are a common cause of adverse events in patients. The combination of a sedative and analgesic, especially a benzodiazepine and an opioid given intravenously, is associated with a higher risk of serious complications. The practitioner responsible for the administration of a sedative to a child must be competent in its use and have the ability to detect and manage complications. Patients who are deeply sedated should be continuously monitored and observed by an individual dedicated to this task. Vital signs and oxygen saturation should be documented at frequent intervals and the patient should be appropriately monitored until discharge criteria have been met. The risk of serious complications with these agents may be reduced with vigorous monitoring and a judicious choice of dosage.     

News Media Use and Adolescents' Attitudes about Nuclear Issues: An American-Soviet Comparison

Both Soviet and American youth show a great concern about the possible effects of nuclear war, with heavy media users in both countries more optimistic, but the relation was stronger among Soviet students.     

Immunity to Cryptosporidium muris infection in mice is expressed through gut CD4+ intraepithelial lymphocytes

The role of gut intraepithelial lymphocytes (IEL) in immunity to cryptosporidial infection was investigated with a murine infection model involving Cryptosporidium muris. Oocyst shedding was monitored in severe combined immunodeficiency (SCID) mice infected with C. muris following intravenous injection of mesenteric lymph node (MLN) cells or intestinal IEL from BALB/c donor mice which were naive or previously infected with C. muris. SCID mice receiving no lymphoid cells developed chronic infections and excreted large numbers of oocysts until the end of the experiment. SCID mice injected with IEL from immune animals, however, were able to overcome the infection, and furthermore, these animals produced fewer oocysts and recovered sooner than ones which received IEL or MLN cells from naive BALB/c donors. Similar levels of protection were obtained in SCID mice injected with either 2 X 10(6) IEL or MLN cells from immune donor mice. Depletion of CD4+ cells from immune IEL, however, abrogated the ability to transfer immunity to SCID mice, while depletion of CD8+ cells only marginally reduced the protective capacity of immune IEL. Finally, control SCID mice which received no lymphocytes had < or = 1% CD4+ cells in the IEL from the small intestine, whereas the IEL from SCID mice recovered from infection, as a result of injection with immune IEL, contained 15% CD4+ cells. Thus, the ability to control C. muris infection correlated with the presence of the protective CD4+ cells in the gut epithelium.     

Esophagitis in Sprague-Dawley rats is mediated by free radicals

Free radical-mediated esophagitis was studied during duodenogastroesophageal reflux (mixed reflux) or acid reflux in rats. The influence of reflux on esophageal glutathione levels was also examined. Mixed reflux caused more gross mucosal injury than acid reflux. Gross mucosal injury occurred in the mid-esophagus. Total glutathione (GSH) in the esophageal mucosa of control rats was highest in the distal esophagus. The time course of esophageal GSH in rats treated by mixed reflux showed a significant decrease 4 hr after initiation of reflux, followed by a significant increase from the 12th hour on. Mucosal GSH was increased in both reflux groups after 24 hr but significantly more so in the mixed than in the acid reflux group. The free radical scavenger superoxide dismutase (SOD) prevented esophagitis and was associated with decreased GSH levels. GSH depletion by buthionine sulfoximine (BSO) prevented esophagitis and stimulated SOD production in the esophageal mucosa. It is concluded that gastroesophageal reflux is associated with oxidative stress in the esophageal mucosa. The lower GSH levels in the mid-esophagus may predispose to damage in this area. Duodenogastroesophageal reflux causes more damage than pure acid reflux. Oxidative stress leads to GSH depletion of the esophageal mucosa in the first few hours following damage but then stimulates GSH production. GSH depletion by BSO does not worsen esophagitis since it increases the esophageal SOD concentration.     

End-user reactions towards working with Computer-Based Information Retrieval Systems (CBIRS)

This paper reports the results of an investigation of users' perceptions of and feelings towards working with Computer-Based Information Retrieval Systems (CBIRS). Detailed questionnaires were distributed to members of the United Kingdom Online User Group (UKOLUG), to database users within a large organisation (Site A), and to end-users of a complex commercial database containing information about electronic components (Codus). The three groups differed significantly in their perceptions towards working with a CBIRS, with UKOLUG members holding the most positive perceptions. More frequent use of the CBIRS was found to be significantly related to perceived functional utility of the CBIRS in all three groups. In only two of the groups (UKOLUG and Codus) was perceived difficulty in operating the system negatively related to frequency of use. Job attitudes were not significantly related with perceptions towards working with a CBIRS, but were significantly related with current usage of the CBIRS. For all three groups, reported 'planfulness' (tendency to plan) when using a CBIRS was positively related to feelings of pressure when using the system. The paper discusses the implications of the study's findings for future research and development in the field of human-computer interaction.     

Studies of space-averaged mass transport in the FM01-LC laboratory electrolyser

Measurements of the mass transport limited current for the reduction of ferricyanide in 1M m potassium hydroxide and of copper(II) in 1.5 m sulphuric acid as a function of electrolyte flow rate are used to characterize the space-averaged mass transport properties of the FM01 laboratory electrolyser, with and without six types of polymer mesh turbulence promoters. In the absence of a promoter, the results followed the equation For the cell with the preferred turbulence promoter, the corresponding equation is Pressure drop data are also reported and it is confirmed that the presence of a turbulence promoter need not lead to a significant increase in the pressure drop over the reactor.