Parents' Understanding About Children's Bullying: Fall ConsumerStyles Survey, United States, 2017, 2018, and 2019

The purpose of this study was to explore U.S. parents' and caregivers' understanding about children's bullying-what bullying is and how to address it. We analyzed 2017, 2018, and 2019 Fall ConsumerStyles online panel survey data from U.S. parents/caregivers of children ages 10 to 17 years (N = 1,516), including 20 items representing statements consistent or inconsistent with the bullying prevention evidence and best practices. Percentage of endorsement for each item and a summary measure of understanding about bullying were calculated. The association between low overall understanding about bullying and sociodemographic characteristics was explored. Most parents identified bullying as harmful (77%), repetitive (63%), and involving power imbalance (51%). At least half of parents answered 13 or more items (20 total) consistent with the bullying prevention evidence or best practices. Being male, non-Hispanic Black or Hispanic, having high school or less education, and small household size were associated with higher odds of low overall understanding about bullying. Awareness of parents' understanding about bullying and how to appropriately address it is vital for bullying prevention. Findings can inform the strategic development of bullying prevention health messages for parents.

Perceived Effectiveness of COVID-19 Preventive Practices and Behavioral Intention: Survey of a Representative Adult Sample in the United States

BACKGROUND

Using existing models of behavioral health promotion, specifically the Extended Parallel Process Model, previous research has identified factors that may impact engagement in preventive health behaviors during the COVID-19 pandemic such as perceived threat, perceived susceptibility to the threat, perceived severity, and perceived efficacy.

OBJECTIVE

This study aims to examine the role of perceived effectiveness of COVID-19 preventive behaviors, perceived susceptibility, perceived threat, and perceived severity of COVID-19 in participants' intentions to engage in Centers for Disease Control (CDC)-recommended individual health behaviors in the first year of the pandemic.

METHODS

In October 2020, a representative sample of 506 US adults completed a web-based survey through the RAND American Life Panel.

RESULTS

The study primarily found that participants who perceived that CDC-recommended health practices were effective had stronger intentions to engage in those practices. The second strongest correlate was participants' perceived severity of COVID-19 across the United States. Perceived effectiveness of recommended practices accounted for the largest variance in behavioral intention. However, analysis of individual behaviors indicated a mismatch in the behaviors perceived to be the most effective (avoiding sick people and mask-wearing) and those participants indicated intention to engage in (throwing away used tissues, avoiding sick people, and coughing into their elbows) in the next 30 days.

CONCLUSIONS

The authors recommend tailoring public health messaging to address the perceived threat of COVID-19 and self-efficacy. Thus, health promotion efforts should emphasize the effectiveness of CDC-recommended practices while highlighting the pandemic's severity. Additionally, rebuilding trust in public health messaging and messengers is necessary to increase perceived self-efficacy. As the COVID-19 pandemic continues, health messaging must continue to promote and build trust in CDC-recommended health practices and educate regarding the efficacy of vaccination and other preventive behaviors.

School Connectedness and Risk Behaviors and Experiences Among High School Students - Youth Risk Behavior Survey, United States, 2021

School connectedness, defined as students' belief that adults and peers in their school care about their learning as well as about them as persons, has been linked to positive educational, behavioral, and health outcomes in adolescence and into adulthood. Data from the 2021 nationally representative Youth Risk Behavior Survey, conducted during the COVID-19 pandemic, were used to estimate prevalence of students' perception of school connectedness and examine associations between school connectedness and seven risk behaviors and experiences: poor mental health, marijuana use, prescription opioid misuse, sexual intercourse, unprotected sex, experiencing forced sex, and missing school because of feeling unsafe. Prevalence estimates were generated and pairwise t-tests were used to detect differences among student subpopulations by sex, grade, race and ethnicity, and sexual identity; Wald chi-square tests were used to detect differences in risk behaviors by level of connectedness within a subpopulation. Logistic regression models were used to estimate prevalence ratios comparing the prevalence of risk behaviors and experiences of students with high connectedness with students with low connectedness, stratified by demographics. During 2021, 61.5% of U.S. high school students reported feeling connected to others at school. In addition, school connectedness was associated with lower prevalence of every risk behavior and experience examined in this study, although certain associations differed by race and ethnicity and sexual identity (e.g., school connectedness was associated with better mental health outcomes for youths with heterosexual, bisexual, and questioning or other sexual identities, but not for youths who identified as lesbian or gay). These findings can guide public health interventions that promote youth well-being by creating school environments where all youths have a sense of belonging and feel they are cared for and supported.

Racial differences in institutional trust and COVID-19 vaccine hesitancy and refusal

BACKGROUND

Previous research has indicated that demographic differences affect COVID-19 vaccination rates. Trust, in both the vaccine itself and institutional trust, is one possible factor. The present study examines racial differences in institutional trust and vaccine status among a nationally representative sample of adults in the United States.

METHODS

Data for the current study was collected as part of Wave 8 Omnibus 2000 survey conducted by RAND ALP and consisted of 2080 participants. Responses were collected through the online RAND ALP survey in March 2021.

RESULTS

Trust in the scientific community was the strongest predictor for already receiving at least one dose of the COVID-19 vaccine at the time of study. Asians had a significantly higher trust in the scientific community compared to all other groups. Results also showed a significant difference in level of trust of the government's response to the COVID-19 pandemic with Indian/Alaskan Natives reporting lower trust compared to Whites, Blacks and Asians. Asians also had a significantly higher level of trust when compared to those who identified as racial Other. Those who identify as American Indian/Alaskan Natives had the lowest levels of institutional trust. Trust in the government's response was not indicative of vaccination within the sample.

CONCLUSIONS

Strategies to increase trust of the scientific community can be employed to address vaccine hesitancy through community-based initiatives and building of partnerships between the scientific community and local community stakeholders.

A Global Exploratory Analysis of Men Participating in Gender-Based Violence Prevention

Organizations addressing gender-based violence (GBV) increasingly include men as partners in prevention efforts. However, little is known about men who get involved in those efforts and what specific actions they take. We present analyses of data from an international sample of men involved in gender-based prevention work that aimed to describe (a) the nature of participants' involvement in prevention efforts, in both formal programming and in their daily lives; (b) characteristics of engaged men, including gender and bystander-related attitudes and beliefs, and social networks; and (c) factors that sustain men's involvement in GBV movements over time. Comparisons across global regions for these variables were also conducted. A total of 379 male-identified participants above 18 who had attended a GBV event in the past year completed an online survey (available in English, French, and Spanish). Respondents represented all continents except Antarctica, although North America was over-represented in the sample. Overall, respondents scored well above North American norms for men on support for gender equality and recognition of male privilege, and this was true across all geographic regions. Men in all regions reported moderate support from friends and somewhat less support from male relatives for their involvement in GBV prevention. Respondents in all regions reported high levels of active bystander and violence-preventive behavior. The most commonly reported motivations for involvement in GBV prevention included concern for related social justice issues, exposure to the issue of violence through work, hearing a moving story, or disclosures about domestic or sexual violence. Results were mainly similar across regions, but when regional differences emerge, they tended to be contrasts between the global north and global south, highlighting the importance of cross-fertilization across regions and a willingness to adapt critical learnings in new geographic settings.

Examining Men's Perceptions of GBV Prevention Programming Content

As global efforts to engage men in preventing gender-based violence (GBV) continue to grow, understanding male participants' perceptions of prevention events is needed. Data from a global sample of 319 men who had attended GBV prevention events were used to (a) assess men's perceptions of what topics were covered, (b) determine whether profiles of these perceptions could be identified, and (c) describe the degree to which content prerception profiles are associated with levels of men's motivation and confidence related to antiviolence action. Latent class analysis identified four perception profiles of prevention topics. Implications for GBV prevention programming are discussed.

Getting men in the room: perceptions of effective strategies to initiate men's involvement in gender-based violence prevention in a global sample

As engaging men in gender-based violence prevention efforts becomes an increasingly institutionalised component of gender equity work globally, clarity is needed about the strategies that best initiate male-identified individuals' involvement in these efforts. The purpose of this study was to examine the perceived relevance and effectiveness of men's engagement strategies from the perspective of men around the world who have organised or attended gender-based violence prevention events. Participants responded to an online survey (available in English, French and Spanish) and rated the effectiveness of 15 discrete engagement strategies derived from earlier qualitative work. Participants also provided suggestions regarding strategies in open-ended comments. Listed strategies cut across the social ecological spectrum and represented both venues in which to reach men, and the content of violence prevention messaging. Results suggest that all strategies, on average, were perceived as effective across regions of the world, with strategies that tailor messaging to topics of particular concern to men (such as fatherhood and healthy relationships) rated most highly. Open-ended comments also surfaced tensions, particularly related to the role of a gender analysis in initial men's engagement efforts. Findings suggest the promise of cross-regional adaptation and information sharing regarding successful approaches to initiating men's anti-violence involvement.

A Comparison of the Structural Factors of the Propensity for Abusiveness Scale for Women and Men in a Domestic Violence Treatment Program

Court-mandated domestic violence (DV) treatment programs across the country have seen a marked increase in female clients. These programs use a variety of measurement tools to assess the needs of their clients. Increased numbers of women in treatment for DV reflect a need to address the measurement of intimate partner violence (IPV) for both males and females. Unfortunately, the reliability and validity of many of measures used to assess IPV and related constructs for women remains unknown. The current study focuses on a particular measure, the Propensity for Abusiveness Scale (PAS). The PAS is not a measure of abusive behavior per se; rather, it assesses risk factors for abuse, including affective lability, anger expression, trauma symptoms, and harsh parenting experienced by the respondent. Specifically, the current study compares the factor structure and the measurement properties of the PAS for males and females in a sample of 885 (647 female, 238 male) participants in a DV treatment program. Findings indicate that the PAS demonstrated configural, metric, and scalar invariance between the female and male samples. These results suggest that it is appropriate for researchers and clinicians to make comparisons between women and men based on PAS factor scores.

Measuring bystander attitudes and behavior to prevent sexual violence

OBJECTIVE

The purpose of this study is to further investigate the factor structure and strength of the Bystander Attitude Scale-Revised and Bystander Behavior Scale-Revised (BAS-R and BBS-R).

PARTICIPANTS

First-year students (N = 4,054) at a large public university in the Northeast completed a survey in 2010 as part of a larger longitudinal study of a sexual violence bystander education intervention program on campus.

METHODS

Exploratory structural equation modeling was used to analyze survey responses to the BAS-R and BBS-R.

RESULTS

For BAS-R, the best fit was a 4-factor model: (1) high-risk situations, (2) postassault support for victims, (3) postassault reporting of perpetrators, and (4) proactive opportunities. BBS-R was a 2-factor model: (1) intervention opportunities before, during, or after an assault, and (2) proactive opportunities.

CONCLUSION

The BAS-R and BBS-R provide reliable tools that can be utilized to evaluate sexual violence bystander programs.

The influence of participation, gender and organizational sense of community on psychological empowerment: the moderating effects of income

This study explored the influence of participation, gender and organizational sense of community (SOC) on both the intrapersonal and interactional components of psychological empowerment (PE). Participants were residents (n = 562) involved in community organizing efforts in five U.S. communities. Measures of participation and SOC were tailored to community organization contexts. SOC assessed three dimensions: (1) connection of members to the organization; (2) perceptions about the organization as a bridge to other groups and organizations in the broader community; and (3) bond or attachment to the community at large. Income (low, middle and high-income) was tested as a moderator of these relationships. Results showed significant moderating effects of income on the relationship between participation, gender and SOC on both components of PE. Participation was positively related with intrapersonal empowerment across income levels, but positively related with interactional empowerment only for low-income individuals. Gender was only associated with intrapersonal empowerment, and only for low-income individuals. SOC, as expressed through bridging to the broader community, was positively related with interactional PE for all income levels, but with intrapersonal PE for only low and middle-income individuals. In contrast, member connection to the organization was not related to interactional empowerment and significantly related to intrapersonal empowerment only for individuals with higher income. The importance of participation, gender and SOC for different types of empowerment and the impact of income on the SOC-empowerment relationship are discussed.

Gender symmetry, sexism, and intimate partner violence

This study of a predominantly Hispanic sample of 92 male and 140 female college students examines both gender symmetry in intimate partner violence (IPV) and inconsistent relationships found in previous studies between sexist attitudes and IPV. Results indicate that although comparable numbers of men and women perpetrate and are victimized in their relationships with intimate partners, the path models suggest that women's violence tends to be in reaction to male violence, whereas men tend to initiate violence and then their partners respond with violence. Benevolent sexism was shown to have a protective effect against men's violence toward partners. Findings highlight the importance of studying women's violence not only in the context of men's violence but also within a broader sociocultural context.

Why I Hit Him: Women's Reasons for Intimate Partner Violence

This study examines motives for intimate partner violence (IPV) among a community sample of 412 women who used IPV against male partners. A "Motives and Reasons for IPV scale" is proposed, and exploratory factor analyses identified five factors: expression of negative emotions, self-defense, control, jealousy, and tough guise. To our knowledge, the study is the first to investigate the relationship between women's motives for IPV and their perpetration of physical, psychological, and sexual aggression, as well as coercive control, toward partners. Hierarchical regression analyses revealed participants' aggression was driven by complex, multiple motives. All five motives were related to a greater frequency of perpetrating IPV. Treatment programs focusing on women's IPV perpetration should address both defensive and proactive motives.

Subchronic exposure to ellagic acid impairs cytotoxic T-cell function and suppresses humoral immunity in mice

Ellagic acid (EA) is present in a variety of foods such as grapes, strawberries, raspberries, and nuts. It is a dietary plant phenol that has been shown to inhibit oxidative stress and chemical carcinogenesis. Although several studies have examined the protective mechanisms of dietary EA including the induction of detoxifying enzymes, regulation of cell cycle, chelation of nickel, and prevention of DNA methylation, none have addressed the role of EA in immunological surveillance. This study investigates the status of immune function in B6C3F1 mice exposed continuously to EA in drinking water at 0.5, 1.0, or 2.0 mg/kg/day for 28 days. Although this range of exposure is above the estimated human daily intake (approximately 940 microg/day for 70 kg person or 13.4 microg/kg/day), these levels would not be unreasonable if EA were used as a dietary supplement or as a chemotherapeutic agent. Previous reports have demonstrated the anticarcinogenic effects of EA at levels 10- to 250-fold greater than those applied in this study. Immunological parameters assessed included natural killer (NK) cell activity, cytotoxic T lymphocyte (CTL) activity, IgM antibody plaque forming cell (PFC) response, thymus, spleen, kidney, and liver mass, and total cellularity for the thymus and spleen. Subchronic exposure to EA for 28 days in drinking water caused significant suppression of specific IgM antibody responses in the 2.0 mg/kg EA treatment group and suppressed cytotoxic T-cell function in the 0.5 and 1.0 mg/kg EA treatment groups. All other immunological parameters were within normal ranges. Kidney and liver mass were not altered after treatment with EA. The results from this study indicate that EA suppressed both IgM antibody responses and CTLs. These observations suggest important implications on human health should EA be prescribed as a chemotherapeutic agent or a preventative dietary supplement for cancer.

Pyridostigmine Bromide (PYR) Alters Immune Function in B6C3F1 Mice

Pyridostigmine bromide (PYR) is an anticholinesterase drug indicated for the treatment of myasthenia gravis and neuromuscular blockade reversal. It acts as a reversible cholinesterase inhibitor and was used as a pretreatment for soldiers during Operation Desert Storm to protect against possible nerve gas attacks. Since that time, PYR has been implicated as a possible causative agent contributing to Gulf War Illness. PYR's mechanism of action has been well-delineated with regards to its effects on the nervous system, yet little is known regarding potential effects on immunological function. To evaluate the effects of PYR on immunological function, adult female B6C3F1 mice were gavaged daily for 14 days with PYR (0, 1, 5, 10, or 20 mg/kg/day). Immune parameters assessed were lymphoproliferation, natural killer cell activity, the SRBC-specific antibody plaque-forming cell (PFC) response, thymus and spleen weight and cellularity, and thymic and splenic CD4/CD8 lymphocyte subpopulations. Exposure to PYR did not alter splenic and thymus weight or splenic cellularity. However, 20 mg PYR/kg/day decreased thymic cellularity with decreases in both CD4+/CD8+ (20 mg/kg/day) and CD4-/CD8- (10 and 20 mg/kg/day) cell types. Functional immune assays indicated that lymphocyte proliferative responses and natural killer cell activity were normal; whereas exposure to PYR significantly decreased primary IgM antibody responses to a T-cell dependent antigen at the 1, 5, 10 and 20 mg/kg treatment levels for 14 days. This is the first study to examine the immunotoxicological effects of PYR and demonstrate that this compound selectively suppresses humoral antibody responses.

Light versus heavy sedation after cardiac surgery: myocardial ischemia and the stress response. Maritime Heart Centre and Dalhousie University

The influence of light versus heavy sedation after coronary artery bypass graft (CABG) surgery on the development of postoperative myocardial ischemia has not been described. After uncomplicated CABG surgery, 50 patients were randomly assigned to receive LOW (n = 24; target Ramsay Sedation Score [RSS] = 2) or HIGH (n = 26; target RSS = 4) sedation with propofol. Analgesia was provided to maintain a visual analog scale (VAS) pain score <7. Myocardial ischemia was identified perioperatively using continuous 3-lead Holter monitoring. By measuring creatine kinase (CK) MB levels preoperatively, at entry to the intensive care unit (ICU), and every 12 h for 48 h; and by obtaining serial 12-lead electrocardiograms (ECG) (preoperatively; 2, 4, 12, 24, and 48 h after ICU admission, 8:00 AM the morning after surgery; and 5 min pre- and postextubation), myocardial infarction was identified. Endocrine stress response was assessed by measuring serum cortisol levels preoperatively, on admission to the ICU, and 24 h postoperatively. In a subset of patients (LOW n = 10, HIGH n = 11), plasma and urinary catecholamine levels were also measured. There were no between-group differences in demographics, operative course, hemodynamic variables, or cortisol levels while in the ICU. The VAS pain score and target RSS were achieved and sustained, and they differed between groups. There were three myocardial infarctions in each group by CKMB criteria alone. No ECG-identifiable myocardial infarction occurred. The ST segment versus time curve (LOW 187 +/- 295 versus HIGH 1071 +/- 2137 mm/min) differed between groups. Urinary and plasma catecholamine levels were similar between groups over the observation period. We conclude that the use of a reduced sedation regimen in combination with adequate analgesia did not result in an increased endocrine stress response or risk of myocardial ischemia.

IMPLICATIONS

This randomized study of patients after coronary artery bypass surgery examined whether light (versus heavy) sedation with propofol in the intensive care unit was associated with an increased degree of myocardial ischemia. Using techniques to detect myocardial ischemia, including Holter monitoring, electrocardiogram, and myocardial enzyme measurements, no differences were found. We conclude that light sedation does not increase the endocrine stress response or the risk of myocardial infarction.

Myocardial protection in the acutely injured heart: hyperpolarizing versus depolarizing hypothermic cardioplegia

OBJECTIVES

The superiority of hyperpolarized arrest with adenosine triphosphate-sensitive potassium channel openers over standard hyperkalemic depolarizing cardioplegia during normothermic ischemia has been documented. This study examined the hypothesis that pinacidil would provide superior protection in a more clinically relevant model of an acutely injured heart and hypothermic cardioplegic arrest.

METHODS

In a blood-perfused, parabiotic, rabbit heart Langendorff model, hearts underwent 15 minutes of unprotected global normothermic ischemia before the administration of 50 ml of cardioplegic solution at 4 degrees C, followed by 50 minutes of hypothermic (15 degrees C) ischemia and 30 minutes of reperfusion. The cardioplegic solutions administered consisted of Krebs-Henseleit solution alone (N = 6), Krebs-Henseleit solution with pinacidil (50 mumol/L; N = 10), Krebs-Henseleit solution with pinacidil (50 mumol/L) and glibenclamide (a potassium channel blocker, 10 mumol/L; N = 8), or St. Thomas' Hospital solution (N = 8). The percent recovery of developed pressure, linear diastolic pressure-volume relationships, and coronary blood flow were compared.

RESULTS

The percent recovery of developed pressure was 32.8% +/- 2.8%, 43.0% +/- 4.3%, 46.5% +/- 2.2%, and 49.3% +/- 2.7% for the Krebs-Henseleit, the Krebs-Henseleit with pinacidil and glibenclamide, the St. Thomas' Hospital, and the Krebs-Henseleit with pinacidil groups, respectively. No hearts had ventricular fibrillation on reperfusion.

CONCLUSIONS

During hypothermic hyperpolarized arrest, as opposed to normothermic ischemia as in our previous studies, there was neither an increased incidence of ventricular fibrillation nor prolonged electrical activity when compared with results during traditional hyperkalemic arrest. Myocardial protection by St. Thomas' Hospital solution and pinacidil was superior (p = 0.009) to that with Krebs-Henseleit solution alone. The protection provided by pinacidil was lost with the addition of glibenclamide, indicating that the drug has adenosine triphosphate-sensitive potassium channel activity during hypothermia.

Myocardial protection with potassium-channel openers is as effective as St. Thomas' solution in the rabbit heart

BACKGROUND

Previous work from our laboratory has demonstrated the advantage of adenosine triphosphate-sensitive potassium-channel openers as cardioplegic agents when compared with hyperkalemic (20 mmol/L KCl) Krebs-Henseleit solution. However, Krebs-Henseleit with 20 mmol/L KCl is not an ideal hyperkalemic cardioplegia. Therefore, we investigated the hypothesis that hyperpolarized arrest with pinacidil and aprikalim could provide equal or superior myocardial protection to hyperkalemic arrest with the widely accepted St. Thomas' solution.

METHODS

Myocardial protection was compared in the blood-perfused isolated parabiotic rabbit heart Langendorff model. Twenty-four hearts were protected with a 50-mL infusion of cardioplegia for a 30-minute global normothermic ischemic period followed by 30 minutes of reperfusion. Systolic function (percent recovery of developed pressure) and the diastolic properties of the left ventricle were measured. Coronary blood flow was measured throughout each experiment.

RESULTS

The percent recovery of developed pressure (mean +/- standard error of the mean) for St. Thomas' solution, pinacidil, and aprikalim was 53.1% +/- 5.4%, 64.0% +/- 3.0%, and 62.4% +/- 3.2%, respectively. The time (minutes) until mechanical and electrical arrest was significantly longer in the pinacidil (4.82 +/- 0.10 and 12.06 +/- 1.07) and aprikalim (3.33 +/- 0.28 and 11.12 +/- 0.94) groups when compared with the St. Thomas group (1.84 +/- 0.74, and 3.17 +/- 1.44). Coronary blood flow upon reperfusion was significantly greater in the pinacidil (16.4 +/- 2.1 mL/min) and aprikalim (19.4 +/- 2.8 mL/min) groups compared with the St. Thomas' solution group (8.0 +/- 1.0 mL/min), and this returned to baseline after 15 minutes of reperfusion.

CONCLUSIONS

Myocardial protection with pinacidil and aprikalim is comparable with that of St. Thomas' solution in the blood-perfused isolated rabbit heart despite prolonged mechanical and electrical activity during ischemia.

Myocardial protection with pinacidil cardioplegia in the blood-perfused heart

BACKGROUND

Adenosine triphosphate-sensitive potassium-channel openers are potent vasodilators that have been found to be cardioprotective during myocardial ischemia. The potassium-channel opener pinacidil was investigated to determine its efficacy as a cardioplegic agent.

METHODS

A blood-perfused, parabiotic, isolated rabbit heart Langendorff preparation was used. Fifty-six hearts underwent 30 minutes of global normothermic ischemia after a 50-mL infusion of cardioplegia, followed by 60 minutes of reperfusion. The cardioplegia consisted of Krebs-Henseleit solution with either vehicle alone (control), 20 mmol KCl, or pinacidil (10, 50, 100, 150, or 200 mumol/L). The developed pressure was measured at baseline and after reperfusion. Coronary blood flow was measured with an in-line ultrasonic probe.

RESULTS

Pinacidil (50 mumol/L), as opposed to potassium cardioplegia, provided significantly better postischemic percentage recovery of developed pressure compared with controls (68.3% +/- 4.0% versus 44.6% +/- 5.5%; p < 0.05). The time until electrical arrest was significantly shorter in the hyperkalemic group than in all other groups. Linear end-diastolic pressure-volume relationships revealed an increase in slope after ischemia in all groups. Coronary flow after 5 minutes of reperfusion was significantly higher in both the 50-mumol/L and 100-mumol/L pinacidil groups compared with traditional hyperkalemic arrest, and this returned to baseline after 15 minutes.

CONCLUSIONS

The potassium channel opener pinacidil provided dose-dependent myocardial protection during global ischemia in the blood-perfused rabbit heart model. Potassium-channel openers are a promising class of drugs that may provide an alternative to traditional hyperkalemic cardioplegia.

Inline blood gas analysis by gas chromatography in patients during and after coronary artery surgery

A system was evaluated of measuring Pao2 and Pao2 by an inline sensor in the brachial artery and gas chromatography. Eight patients having coronary artery vein grafts were studied during anaesthesia, operation, perfusion and for 24 hours afterward. Compared to conventional blood gas analysis by polarography (electrodes), the chromatographic method gave readings for Pao2 which were not significantly different during normothermia. During hypothermic perfusion, the chromatographic system read significantly higher than the bench electrode, due at least in part to a difference in temperature correction. For Pao2 the correlation between the two methods was close and differences were clinically insignificant. The Sentorr blood-gas analyser provides a sensitive, accurate indicator of changes in oxygenation, ventilation and circulation during anaesthesia and in the intensive care unit.

Hypoglycemia as a complication of removal of a pheochromocytoma

In a patient with a solitary pheochromocytoma severe hypoglycemia developed following excision of the tumour. The possible causative mechanism was thought to be a reactive relative increase in insulin production secondary to increased endogenous production of glucose, induced by the large amounts of epinephrine produced by the tumour. Alternatively, epinephrine withdrawal following removal of the tumour under phentolamine infusion may have induced increased insulin production and hence potentiated the development of hypoglycemia. Careful monitoring of the blood glucose concentration during and after the operation is recommended to obviate this potentially fatal complication.

Apparatus for emergency intubation in laryngeal obstruction

A cannula and conveniently arranged ancillary apparatus designed to assist endotracheal intubation of patients with upper respiratory tract obstruction prior to tracheostomy are described.