The alarming trend of substance abuse in anesthesia providers.

The role of the anesthesia provider requires a high level of awareness and constant vigilance. Literature indicates, however, that the substance abuse rate in certified registered nurse anesthetists (CRNAs) and anesthesiologists has reached staggering levels. The literature also shows that there has been a change in which controlled drugs are being misused. It is imperative that perianesthesia nurses be aware of the current problem and take steps when indicated to protect both providers and patients. This article discusses the current trends of addiction in anesthesia providers, treatment, and reentry, as well as the role of the perianesthesia nurse in recognizing, reporting, and preventing substance abuse.     

Comparative study of the effectiveness of cefixime and penicillin V for the treatment of streptococcal pharyngitis in children and adolescents.

An open label randomized trial conducted in rural Kentucky compared the efficacy and safety of cefixime (CFX), 8 mg/kg once daily, with those of penicillin V (PEN), 250 mg 3 times daily, in 110 pediatric patients with Group A beta-hemolytic streptococcal pharyngitis. Forty-eight CFX and 47 PEN patients were evaluable for efficacy. At the end of therapy bacteriologic eradication was 45 of 48 (94%) and 36 of 47 (77%) in the CFX and PEN V groups, respectively (P < 0.05). Up to 6 weeks posttherapy 10 (21%) CFX patients and 21 (45%) PEN patients had positive Group A beta-hemolytic Streptococcus cultures (P < 0.05). Concordant serotypes were identified from 4 of 7 CFX and 15 of 17 PEN patients with positive repeat cultures. All discordant serotypes (5 of 31) were identified at greater than 19 days posttherapy. Symptomatic treatment failures (concordant serotypes) occurred in 1 (2%) CFX and 8 (17%) PEN patients (P < 0.05). Drug-related adverse experiences consisted of 2 cases of mild diarrhea and loose stools in the CFX group and none in the PEN group. No clinically significant laboratory test abnormalities occurred in either group. CFX, once daily, was as safe as and significantly more effective than PEN given 3 times daily for the treatment of Group A beta-hemolytic streptococcal pharyngitis.     

Nonimmune hydrops caused by massive fetomaternal hemorrhage and treated by intravascular transfusion.

Fetal hydrops at 26 weeks' gestation was diagnosed following a massive fetomaternal hemorrhage. Fetal intravascular transfusion was performed, and the hydrops completely resolved within 72 hours. The fetus required one more transfusion at 27 weeks' gestation. A subsequent percutaneous umbilical blood sampling at 30 weeks' gestation demonstrated a normal fetal hematocrit. A vaginal delivery at term resulted in a normal newborn. Massive fetomaternal hemorrhage is a well-known cause of nonimmune hydrops and may occur spontaneously in an otherwise normal pregnancy. Confirmation by percutaneous umbilical blood sampling and treatment by intravascular transfusion is recommended when massive fetomaternal hemorrhage causes hydrops in preterm gestations.     

Prevalence and intensity of Cephalobium microbivorum (Nematoda: Diplogasterida) infection in three species of Gryllus field crickets

Here we report on the results of a survey for nematode parasites in three species of field cricket, Gryllus integer, Gryllus lineaticeps, and an undescribed Gryllus species. The nematode, Cephalobium microbivorum, was recovered from the intestine of the crickets. To our knowledge, this paper is just one of two to report on the biology of C. microbivorum. This nematode was first described from the cricket, Gryllus assimilis. It has not been documented in any other Gryllus species to date. G. integer were collected from two locations: Aguila, Arizona and Davis, California. G. lineaticeps were collected from Davis, CA and an undescribed species of Gryllus cricket was collected from Aguila, AZ. Results of the survey revealed the presence of nematodes in all three species of Gryllus, at all collection sites. The intensity of infection ranged from 1 to 113 nematodes.     

Suppressor of cytokine signaling 1 is required for the differentiation of CD4+ T cells

Suppressor of cytokine signaling 1 (Socs1) is critical for the regulation of interferon-gamma responses and T cell homeostasis. Although the presentation of the inflammatory disease of Socs1-deficient mice is complex, we have tested here the hypothesis that it originates from inappropriate T cell development and the appearance of autoreactive T cells. Socs1-deficient T cell receptor-transgenic mice showed severely impaired positive selection and a substantial alteration in CD4-CD8 T cell fate specification. These defects were dependent on interferon-gamma. Moreover, negative selection was also impaired, suggesting that autoimmunity contributes to the disease observed in Socs1(-/-) mice. We conclude that the constitutive expression of Socs1 in the thymus protects the process of thymic development and selection from the effects of systemic inflammation.