精浆酸性磷酸酶活性与抗精子抗体

目的：探讨男性不育症精浆酸性磷酸酶（ＡＣＰ）与精子密度、精子成活率、血清和精浆抗精子抗体（ＡｓＡｂ）之间的关系。方法：检测不育男性精子密度、精子活率、血清和精浆ＡｓＡｂ及精浆ＡＣＰ活性。结果：精子成活率＞５０％、３０％～５０％、＜３０％组的精浆ＡＣＰ活性逐渐降低,分别为（１６２．１２±８５．７７）Ｕ／ｍｌ、（１２３．０１±５２．５５）Ｕ／ｍｌ和（１１１．２１±５４．４２）Ｕ／ｍｌ;与成活率＞５０％的精浆ＡＣＰ相比,活率在３０％～５０％和＜３０％组的ＡＣＰ活性降低,具有显著性差异（ＳＮＫ检验,Ｐ＜０．０１）;精子密度＞２０×１０９／Ｌ、（１０～１９）×１０９／Ｌ和＜１０×１０９／Ｌ组的精浆ＡＣＰ活性依次下降,分别为（１６５．９９±８８．６７）Ｕ／ｍｌ、（１３９．１９±７０．７８）Ｕ／ｍｌ和（１１５．２１±６０．５１）Ｕ／ｍｌ;与密度＞２０×１０９／Ｌ组的ＡＣＰ活性相比,密度在（１０～１９）×１０９／Ｌ和＜１０×１０９／Ｌ的精浆ＡＣＰ活性降低,具有显著性差异（ＳＮＫ检验,Ｐ＜０．０１）;血清、精浆ＡｓＡｂ阳性病人的ＡＣＰ活性明显低于二者均阴性的病人,且ＡＣＰ降低具有显著性差异（ＳＮＫ检验,Ｐ＜０．０１）。结论：?     

去除精浆对test－yolk缓冲液保存大猩猩精子效果的改善

Ｔｅｓｔ－ｙｏｌｋ缓冲液被应用于精子的短时期冷藏，可以提高精子的体外受精能力。过去的冷藏方法中保留了精浆。本实验比较了在卵黄液短期保存精液方法中去除精浆和保留精浆两种情况下大猩猩精子的体外受精能力和运动能力。体外受精能力以去透明带地鼠卵穿透试验来评价，精子运动能力以计算机辅助分析系统定量分析。精液标本取自５只人工饲养的成年大猩猩，１２例标本用于卵穿透试验，２２例用于运动分析。冰浴过夜保存于ｔｅｓｔ－ｙｏｌｋ缓冲液后活动精子百分率下降２６．９％～３０．９％，去除精浆的精子运动速度显著高于保留了精浆的精子，直线速度（ＶＳＬ、Ｐ＜０．０１），曲线运动速度（ＶＣＬ，Ｐ＜０．０１），头部侧向位移（ＡＬＨ，Ｐ＜０．０５）；并且卵穿透试验结果显示前者精子穿卵率和平均每卵穿入精子数均高于后者（Ｐ＜０．０１）。本实验结果提示∶在ｔｅｓｔ－ｙｏｌｋ缓冲液的精子短期冷藏过程中，去除精浆更有利于精子受精能力和运动速度的保存。     

少精,无精症者精浆表皮生长因子分析

按ＷＨＯ精液参数标准分析精液常规后,根据精子密度＞ ２０,１１ ～２０,１～１０（ ×１０６ 精子／ｍｌ） 和无精子将研究对象相应分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组,每组２０ 例。用放射免疫法测精浆ＥＧＦ,并与有关参数进行相关分析。结果显示：Ⅰ、Ⅱ、Ⅲ、Ⅳ组精浆ＥＧＦ浓度分别是３ ．４４ ±１ ．０９ ,４．２２ ±１ ．１６,４．４１ ±１．７４ ,４ ．３３ ±１ ．４７（ｎｇ／ｍｌ） ,Ⅰ组显著低于Ⅱ、Ⅲ、Ⅳ组（Ｐ＜ ０．０５）;１ 次射精的ＥＧＦ水平分别是８．０１±３．３１,１０．４１±４．６１,９ ．７５ ±４ ．０７ ,９ ．６６±３ ．９５（ｎｇ／１次射精）,组间比较没有显著差异;相关分析表明,精浆ＥＧＦ浓度（ｎｇ／ｍｌ） 与１ 次射精精子数呈显著负相关关系（ｒ＝ － ０．２５４８,ｎ＝ ６０ ,Ｐ＜０ ．０５）,而在Ⅱ、Ⅲ组中,１ 次射精ＥＧＦ水平与精子计数呈显著正相关关系（ｒ＝ ０．３７１６ ,ｎ＝４０,Ｐ＜ ０．０２） ,精浆α糖苷酶、果糖、精子顶体酶无相关关系。     

己酮可可碱和2—脱氧腺苷提高冷冻复温后精液质量的研究

在光学显微镜下观察和测定了己酮可可碱（ＰＦ）和２－脱氧腺苷（２－ＤＡ）在体外对冷冻复温后精液精子的活率、活力及其毛细管穿透值的影响。结果显示ＰＦ和２－ＤＡ均能提高冷冻复温后精子的活率、活力及其毛细管穿透值，其最适浓度分别为４．０ｍｍｏｌ／Ｌ和２．０ｍｍｏｌ／Ｌ，与对照组比较均有显著性差异（Ｐ〈０．０１）。两组间比较，２－ＤＡ优于ＰＦ（Ｐ〈０．０１）。提示ＰＦ与２－ＤＡ合用不具有协同作用，反而有相互     

弱精症男子与正常人精子膜尿激酶型纤溶酶原激活因子含量的研究

按ＷＨＯ精液参数标准，分别选择精子活力低下的男性不育症患者和正常生育力男子精液标本各２０例，将洗涤后的精子用含１％ＴｒｉｔｏｎＸ－１００的０．１ＭＴｒｉｓ－ＨＣｌ缓冲液处理，提取精子膜结合尿激酶型纤溶酶原激活因子（ｕＰＡ），然后采用抗人尿激酶多克隆抗体，进行各样品ｕＰＡ含量的测定（夹心法ＥＬＩＳＡ）。结果显示：弱精症男子精子膜结合ｕＰＡ（２３．１０±７．３５ｍｕ／１０６ｃｅｌｓ）显著性低于正常人精子膜ｕＰＡ（２９．８９±９．４８ｍｕ／１０６ｃｅｌｓ），Ｐ＜０．０２５。且精子膜ｕＰＡ含量与精子活率呈直线正相关（ｒ＝０．６４，Ｐ＜０．０００１），与精子活力（直线前向运动精子百分率）亦呈线性相关（ｒ＝０．４８，Ｐ＜０．００５）。说明精子膜结合ｕＰＡ可能与精子活力及生育力之间有一定关联。     

海洛因依赖者的精液分析研究

对３０名男性海洛因依赖者（下称吸毒组）进行吸毒史调查,并进行精液常规分析及生化分析,与３０名正常男性精液作对照。结果表明,与对照组相比吸毒组精液量减少（Ｐ＜０．０５）,精子计数减少（Ｐ＜０．０１）,精子活力减低（Ｐ＜０．０１）,活动率降低（Ｐ＜０．０１）,且精子活力与吸毒总量、精子计数与吸毒总量均呈负相关关系（ｒ１＝－０．８３,ｒ２＝－０．６３）。吸毒组精浆果糖浓度降低（Ｐ＜０．０１）。精浆锌、钙浓度低下（Ｐ＜０．０５）,而精浆铁浓度明显升高（Ｐ＜０．０１）。精液涂片观察发现吸毒组精子畸形率明显高于对照组。结果表明海洛因依赖可导致男性精液质与量发生明显异常改变。     

不育男性内分泌激素测定与精子密度相关研究

目的：探讨不育男性５项内分泌激素与精子密度的相关关系。方法：采取放免法（ＲＩＡ）对１１０例男性不育症进行卵泡刺激素（ＦＳＨ）、黄体生成素（ＬＨ）、催乳素（ＰＲＬ）、雌二醇（Ｅ２）、睾酮（Ｔ）的测定,实验值与同期检测的精子密度进行统计学相关分析。结果：＜４．６μｇ／Ｌ的Ｔ值与精子密度的等级相关系数ｒ＝０．７６０７（Ｐ＜０．００１）;＞１０Ｕ／Ｌ的ＦＳＨ、ＬＨ值与精子密度的等级相关系数分别是ｒ＝－０．５２８３（Ｐ＜０．００１）、ｒ＝－０．４５３１（Ｐ＜０．００５）。结论：低于正常的Ｔ值与精子密度呈正相关;高于正常的ＦＳＨ、ＬＨ值与精子密度呈负相关。     

少精子症患者精液沉淀物乳酸脱氢酶同工酶凝胶电泳分析

本文运用乳酸脱氢酶同工酶聚丙烯酰胺凝胶电泳分析法，分析比较了少精子症、弱精子症、精液正常者的精液沉淀物乳酸脱氢酶同工酶百分比活性。结果显示：少精子症患者的ＬＤＨ－Ｃ４同工酶百分比活性４６％显著低于精液正常者的７１％（Ｐ＜０．０１）及弱精子症患者的６７％（Ｐ＜０．０１）；相对的，少精子症的ＬＤＨ５同工酶百分比活性１６％显著高于精液正常者的４．８％（Ｐ＜０．０１）和弱精子症的６．３％（Ｐ＜０．０１）。本文认为少精子症者精液沉淀物ＬＤＨＣ４活性降低与其精液中的各类细胞诸如未成熟的精子细胞、白细胞及一些微生物的相对增加有关     

体外应用己酮可可碱和2—脱氧腺苷提高冷冻复温后精液质量的研究

本文在光学显微镜下观察和测定了己酮可可碱和２脱氧腺苷在体外对冷冻复温后精液精子的活率、活力及其毛细管穿透值的影响。结果：两者均能提高上述三项参数。其最适浓度分别为４．０ｍｍｏｌ／Ｌ、２．０ｍｍｏｌ／Ｌ，与对照组比较均有显著性差异（Ｐ＜０．０１）。两组间比较，２脱氧腺苷优于己酮可可碱（Ｐ＜０．０１）。     

尿素动力学模型在持续性非卧床腹膜透析中的应用

对２０例ＥＳＲＤ患者先后给予持续性非卧床膜腹膜透析（ＣＡＰＤ）１Ｌ×５／ｄ和２Ｌ×４／ｄ方案透析，测定其尿素清除指数（ＫＴ／Ｖ）和标化每日蛋白质分解率（ＮＰＣＲ），同时应用１２个临床参数对两方案进行疗效评价．结果显示由ＩＬ×５／ｄ改为２Ｌ×４／ｄ时，ＫＴ／Ｖ和ＮＰＣＲ分别上升０．７４±０．２１和０．１２±０．０９（Ｐ＜０．００１），临床有效率上升８０％（Ｐ＜０．００５）；ＮＰＣＲ和ＫＴ／Ｖ呈正相关（ｒ＝０．４９，Ｐ＜０．０５）．ＮＰＣＲ与每日蛋白质摄入量（ＤＰＩ）呈高度正相关（ｒ＝０．９１，Ｐ＜０．００１），ＫＴ／Ｖ与临床评分也呈正相关（ｒ＝０．６１，Ｐ＜０．０１）．结果表明尿素动力学模型对评价ＣＡＰＤ治疗具有重要意义．     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.