Hong Kong nurses' health-related behaviours: implications for nurses' role in health promotion

The health-related behaviours of a random sample (n=92) of Hong Kong nurses were assessed by a questionnaire written either in English or in English and Chinese. Hong Kong nurse reported negligible smoking or a alcohol use, low levels of breast self-examination, cervical screening behaviour and regular exercising, seat belt use and driving within the speed limit. The sample reported high levels of making efforts to avoid foods high in cholesterol, eating foods high in fibre and eating fruit daily. Dental hygiene was reported to be high. Just over half the sample reported sleeping 7–8 hours each night and eating breakfast daily. Most nurse reported maintaining their body weight at a healthy level and eating snacks between meals. The English language version of the questionnaire produced a slightly better response rate than the bilingual questionnaires. The results are discussed with reference to previous studies of females' health-related behaviours in Hong Kong and elsewhere. The implications for Hong Kong nurses' role in health promotion is discussed.     

Epinephrine reduces the sedative side effects of epidural sufentanil for labour analgesia

PURPOSE: The use of opioids in labour analgesia has primarily been as an adjuvant to local anesthetics. For early labour, satisfactory analgesia with epidural sufentanil alone is possible. This study evaluates the impact of epinephrine on sedative side effects and analgesia related to the latter technique. METHODS: After Institutional Review Board approval and informed consent this prospective, randomized, double-blind study evaluated 43 nulliparous subjects requesting epidural analgesia. The study site, a tertiary care obstetric unit, accommodates 3500-4500 deliveries annually. Group selection was randomized and blinded by selection of a sealed envelope containing a number which corresponded to a premixed labelled syringe of saline or epinephrine (100 microg/mL). An epidural catheter was placed in a standardized fashion. All subjects received 40 microg of sufentanil and 0.5 mL from the premixed syringe, diluted to 10 mL with NaCl. A blinded observer collected data on maternal sedation, lightheadedness, hemodynamics, oxygenation, and fetal heart rate over a one-hour period following sufentanil injection. RESULTS: The addition of epinephrine significantly (P <0.05) reduced the incidence of sedation and lightheadedness after epidural sufentanil at all data collection points, except two. Analgesic duration was also significantly prolonged by this addition (120 +/- 56 vs 84 +/- 32 min). Maternal satisfaction was high regardless of solution. CONCLUSION: Forty micrograms of epidural sufentanil produces satisfactory analgesia in early labour. The addition of epinephrine improves the side effect profile of this technique while prolonging the duration of analgesia. Epidural sufentanil requires attention to maternal monitoring of oxygenation as maternal desaturation occurred in both groups.     

The applicability and utility of the MMPI-based offender classification system in a correctional mental health unit

This study investigated the applicability and utility of Megargee and Bohn's MMPI-based offender classification system in correctional mental health units (MHUs). Previous studies found that 11 MHU samples (n = 1723) had substantially more offenders classified in the more pathological MMPI types than did 21 samples (n = 5881) drawn from general male populations in US prisons. In this study of 63 severely disturbed felons, 43% belonged to the most pathological type (‘group How’). Comparing MHU patients with general offenders from the same IvfIvIPI types on staff ratings and case history variables, we found that the MHU patients were significantly poorer in adjustment. Within the MHU sample, there was no difference in case history variables or adjustment ratings between those in the most and least severe MMPI types. These findings differed from those of studies using less severely disturbed, more heterogeneous, MHU populations. It was concluded that, in settings in which the entire population is flagrantly disturbed, the MMPI-based system is more useful in screening potential admissions than it is in making meaningful distinctions among those already admitted.     

ALFENTANIL PLASMA CONCENTRATION v. EFFECT RELATIONSHIPS IN CARDIAC SURGICAL PATIENTS

Effects of alfentanil, preceded by lorazepam, on suppressionof haemodynamic and somatic responses to noxious stimuli wasstudied in patients undergoing CABG. Plasma concentration ofalfentanil, somatic and haemodynamic responses were measuredat loss of consciousness, tracheal intubation, sternotomy andduring multiple applications of electrocoagulation. Additionalalfentanil was administered i.v. to control unwanted responses.Study 1 (six patients): lorazepam 0.08 mg kg^–1 by mouth1–2 h before operation, alfentanil priming infusion (60µg kg^–1 min^–1 for 10 min) followed by maintenanceinfusion (4.5 µg kg^–1 min^–1). With mean plasmaalfentanil 1178 (SEM 54) ng ml^–1, two patients requiredsupplementary alfentanil to suppress somatic motor responses;one patient required nitroglycerin to control an increase inarterial pressure which was unresponsive to additional alfentanilfollowing sternotomy. Study 2 (13 patients): lorazepam 0.04mg kg^–1 by mouth as premedication; one of three maintenanceinfusion rates of alfentanil: 5.4 (n=4), 6.6 (n=5), or 7.8 (n=4)µg kg^–1 min^–1, each preceded by a proportionalpriming infusion. With plasma alfentanil 2181 (62)ng ml^–1,somatic motor responses requiring additional alfentanil occurredin nine patients; haemodynamic responses in four of seven patientstested could not be controlled by alfentanil. The highest plasmaconcentration of alfentanil to prevent response to a stimulusother than tracheal intubation was different between the twostudies (P<0.05). We conclude that alfentanil alone is insufficientto suppress haemodynamic and somatic motor responses to noxiousstimulation during CABG and that the role of premedication issignificant. *Department of Anesthesia, Bowman-Gray School of Medicine Winston-Salem,NC 27103, U.S.A. 2114 de Mayo Road, Del Mar, Ca. 92014, U.S.A.     

An Immunotoxicological Evaluation of 4, 4'-Thiobis-(6-t-butyl-m-cresol) in Female B6C3F1 Mice: 1. Body and Organ Weights, Hematology, Serum Chemistries, Bone Marrow Cellularity, and Hepatic Microsomal Parameters

An Immunotoxicological Evaluation of 4,4'-Thiobis-(6-t-butyl-m77-cresol)in Female B6C3F1 Mice. 1. Body and Organ Weights, Hematology,Serum Chemistries, Bone Marrow Cellularity, and Hepatic MicrosomalParameters. MUNSON, A. E., WHITE, K. L., JR., BARNES, D. W.,MUS-GROVE, D. L., LYSY, H. H., AND HOLSAPPLE, M. P. (1988).Fundam. Appl. Toxicol. 10, 691–700. Adult female B6C3F1mice were gavaged with 4,4'-thiobis-(6-t-butyl-m-cresol) (TBBC)in corn oil at doses of 10, 100, or 200 mg/kg daily for 14 consecutivedays. There was no overt toxicity, as manifested by grosslyobservable behavioral changes, decreased growth rate over theexposure period, or mortality. There were also no marked effectson serum chemistries or hematology, with the exception of asignificant increase (41%) in the number of leukocytes at thehighest dose. Absolute differential counts indicated that significantincreases occurred in the number of lymphocytes (31%) and neutrophils(177%). Studies with bone marrow indicated a significant 30%increase in the number of cells/femur from animals treated withthe highest dose of TBBC. The number of macrophage progenitors(CFU-M)/femur was significantly increased by 28%, while thenumber of granulocyte-monocyte progenitors (CFU-GM)/femur wasnonsig-nificantly increased by 20% in the high dose animals.The weight of both the spleen and liver was increased in a dose-relatedfashion, although the histopathology of the spleen of TBBC-treatedmice was not different from control. The livers of mice receivingthe high dose showed mild focal hydropic degeneration, mildhepatitis, and a slight increase in the number of Kupffer cells.No other organs were affected. Liver microsomal protein andcytochrome P-450 levels were increased in a dose-related fashion.Enzyme activities of aminopyrine demethylase and aniline hydroxylase,but not arylhydrocarbon hydroxylase, were also increased ina dose-related fashion.     

Neuropathy in igMλ paraproteinemia

Summary In axonal neuropathies associated with IgM paraproteinemia, reports of antigen specificity of the M-protein are few. A patient with IgM paraproteinemia presented with progressive mononeuritis multiplex. IgM was found deposited in striking amounts in endoneurium and shown to bind specifically to neural proteins and chondroitin sulfates. Direct immune mechanisms, as well as the physical effects of IgM deposition, likely contributed to the development of the neuropathy.     

Immunotoxicity of the Semiconductor Gallium Arsenide in Female B6C3F1 Mice

The effects of gallium arsenide (GaAs) exposure on immunocompetenceof B6C3F1 female mice were investigated. GaAs was administeredas a single intratracheal instillation at doses of 50, 100,and 200 mg/kg. Fourteen days after exposure, various cellularand humoral immune parameters were assessed. GaAs exposure increasedspleen cellularity in a dose-dependent manner. However, thepercentages of Thy 1.2 positive and 1g positive cells were decreasedand that of F4/80 positive cells was increased dose dependency.The IgM and IgG antibody-forming cell response of the spleento the T-dependent antigen sheep erythrocytes was reduced by66 and 48%, respectively, at 200 mg/kg. Levels of the serumcomplement protein, C3, were increased by as much as 16% withno significant change in CH50 levels. The mitogenic responseof splenic T cells to Con A and PHA was unaffected by GaAs,but that of B cells to LPS was increased by 52%. The delayedhypersensitivity response to keyhole limpet hemocyanin and mixedlymphocyte response were significantly reduced in a dose-dependentmanner by GaAs exposure. Natural killer cell activity againstthe YAC-1 mouse lymphoma was enhanced in treated mice. Analysisof peritoneal exudate cells (PEC) revealed a dose-dependentdecrease in number and a shift in the composition of PECs. Thepercentage of PEC monocytes increased from 53% of the populationto 81%, while the lymphocytes decreased from 46 to 20%. Theadherent PEC population demonstrated decreased phagocytosisof covaspheres and increased phagocytosis of chicken erythrocytes(CRBC). GaAs exposure had no effect on host resistance to Plasmodiumyoelii or Streptococcus pneumoniae, but dose dependency increasedresistance of the mouse to Listeria monocytogenes Treated micedemonstrated a significantly decreased resistance to the B16F10melanoma with a sevenfold increase in tumor burden at 200 mg/kg.GaAs affects both humoral and cellular immune parameters inmice and impairs the ability of the immune system to protectagainst B16F10 tumor challenge.