MIDAZOLAM IS A SAFE AGENT BY COMPARISON WITH THIOPENTONE ON ARRHYTHMIAS IN ISCHAEMIA AND REPERFUSION CONDITIONS IN ISOLATED PERFUSED RAT HEARTS

An involvement of the angiotensin AT₂receptors in some behavioural effects of angiotensin II (Ang II) and its 3–7 fragment [Ang II(3–7)] in rats was studied. To inhibit AT₂receptors we used their selective antagonist CGP 42112A (nicotinic acid-Tyr-N-benzoxyl-carbonyl-Arg-Lys-His-Pro-Ile-OH). Ang II and Ang II(3–7), given intracerebroventricularly (i.c.v.) at the dose of 1 nmol each, significantly enhanced recall of the passive avoidance behaviour and learning of the conditioned avoidance responses (CARs). CGP 42112A (2 μg i.c.v.), inactive on its own in all tests, significantly attenuated facilitation of recall of passive avoidance caused by Ang II and Ang II(3–7). Also, CGP 42112A diminished Ang II improvement of CARs acquisition but not that caused by Ang II(3–7). None of the treatments produced significant anxiolysis in an elevated `plus' maze. Likewise, in an open field no statistically significant differences were recorded except for the abolishment of the Ang II(3–7)-induced increase of rearings and bar approaches by CGP 42112A. It appears that the cognition improving activity of Ang II and Ang II(3–7) is mediated by similar mechanisms and angiotensin AT₂receptors are engaged in these processes.     

Nasal midazolam in children, plasma concentrations and the effect on respiration

Twenty ASA 1 children, one to six years old, weighing 10–20 kg, scheduled for a combination of general and caudal anaesthesia received at random midazolam 0.2, 0.4, or 0.6 mg·kg^?1 or NaCl 0.9% (control group) intranasally. Drug or NaCl 0.9% were administered in one nostril, after inhalation induction of anaesthesia, intubation without relaxant and caudal anaesthesia. Spontaneous respiration was via a circle system and fresh gas flow of 61·min^?1 (N₂O/O₂= 2:1), PEEP 5 cm H₂O, endtidal halothane 0.4%. Immediately before and 2, 5, 8, 12, 16, 20, 30, 60 and 120 min after application of the drug 2.5 ml blood was sampled for plasma levels of midazolam. Endtidal CO₂, respiratory rate, and oxygen saturation were recorded as long as the children were intubated. Endtidal CO₂ and respiratory rate showed no statistical difference between the groups at any time, however, in the group receiving 0.6 mg·kg^?1, -endtidal CO₂ increased significantly from 5.3 kPa (41 mm Hg) at the start to 5.9 kPa (45.5 mm Hg) after 30 min. Plasma levels of midazolam were detected 2 min after application in 10 of 15 patients. Median peak levels were found between 12 and 16 min. Medians of peak plasma levels showed no statistical difference between the three groups (0.2 mg·kg^?1:111 ng·ml^?1, 0.4 mg·kg^?1:136 ng·ml^?1, 0.6 mg·kg^?1:277 ng·ml^?1). After 30, 60 and 120 min medians of midazolam plasma concentration were significantly higher in the group 0.6 mg·kg^?1.     

Nephrocalcinosis in newborn

Nephrocalcinosis is uncommon in childhood, and almost always develops outside the newborn period. Over the last decade, nephrocalcinosis due to multifactorial pathogenesis has increased in very low birth-weight infants. In this report a 23 day old full-term baby with nephrocalcinosis secondary to distal renal tubular acidosis is described.     

Seizures associated with poisoning in children: tricyclic antidepressant intoxication

BACKGROUND: The aim of this study was to examine the characteristics of seizure due to poisoning. METHODS: This was a retrospective analysis, throughout 4 years of hospital admissions for poisoning. Data of patients with seizures due to poisoning were evaluated with respect to the causes, frequencies and complications of seizures. RESULTS: Among the 1561 admissions due to intoxication during the review period, seizures developed in 26 cases (1.6%). Tricyclic antidepressant overdose (n = 11, 42%) was the leading cause of seizure due to poisoning. Generalized tonic-clonic seizures were observed in 24 patients. Status epilepticus developed in six patients (23%). Mechanical ventilation was applied in 12 (46%) patients. Cardiac complications were observed in 11 (42%) patients with seizures. Two patients who had cardiac arrest due to acepromazine maleate and imipramine intoxication died. CONCLUSION: One of the causes of seizures in pediatric age group is intoxication. Seizures due to intoxications may cause serious clinical conditions. Intoxications should be thought when a patient is admitted with the diagnosis of afebrile seizure even if there is no history of drug intake.     

The effectiveness of treatment in institutional and community settings

Contrary to the ‘nothing works’ doctrine, there has been a recent revitalisation in attitudes to offender ‘treatment’ . New approaches to research integrating evaluations by meta-analysis have substantially contributed to this. This paper reviews these approaches and evaluates how far the revitalisation is justified empirically. Although much previous work is of value, including pointers to the relatively beneficial effects of some kinds of treatment approach, and particularly those informed by sound theoretical models, gaps in knowledge have been identified, particularly in the area of treatment context. Data are lacking, not only in distinguishing the impact of a physical institution compared with a more open environment, but also in the effect of organisational, staff and treatment process characteristics.