Use of refractometry to identify opioid-containing solutions

The purpose of this laboratory study was to assess the value of refractometry in identifying the contents of a variety of opioid-containing solutions. A hand-held refractometer was used to document the refraction produced by the undiluted contents of alfentanil, fentanyl, morphine, sufentanil ampoules and by solutions of Ringer’s lactate, 0.9% saline, 3.3% dextrose in 0.3% saline, and distilled water. Each opioid was then serially diluted in serial 1:2, 1:4, and 1:8 dilutions in each of these solutions and the refractions of each determined. Based on this information, blinded identification of various diluted opioid solutions was attempted. Refractometer values for undiluted fentanyl and sufentanil were identical with those for distilled water. Those for undiluted alfentanil and morphine were almost identical with each other and with 1:2 and 1:4 dilutions of either drug in Ringer’s lactate or 0.9% saline. We conclude that refractometry is an unreliable screening method to detect tampering with opioid solutions.     

Interleukin 3 enhances cytotoxic T lymphocyte development and class I major histocompatibility complex "re-presentation" of exogenous antigen by tumor-infiltrating antigen-presenting cells.

We show that interleukin 3 (IL-3) enhances the generation of tumor-specific cytotoxic T lymphocytes (CTLs) through the stimulation of host antigen-presenting cells (APCs). The BALB/c (H-2d) spontaneous lung carcinoma line 1 was modified by gene transfection to express ovalbumin as a nominal "tumor antigen" and to secrete IL-3, a cytokine enhancing myeloid development. IL-3-transfected tumor cells are less tumorigenic than the parental cell line, and tumor-infiltrating lymphocytes isolated from these tumors contain increased numbers of tumor-specific CTLs. By using B3Z86/90.14 (B3Z), a unique T-cell hybridoma system restricted to ovalbumin/H-2b and implanting the tumors in (BALB/c x C57BL/6)F1 (H-2d/b) mice, we demonstrate that the IL-3-transfected tumors contain an increased number of a rare population of host cells that can process and "re-present" tumor antigen to CTLs. Electron microscopy allowed direct visualization of these host APCs, and these studies, along with surface marker phenotyping, indicate that these APCs are macrophage-like. The identification of these cells and their enhancement by IL-3 offers a new opportunity for tumor immunotherapy.     

Vomiting and aspiration pneumonitis with the laryngeal mask airway

We report a case of severe aspiration pneumonitis in the dependent lung of a 74-yr-old man following Austin-Moore arthroplasty. A laryngeal mask airway provided a clear airway until anaesthesia became too light during manipulation of the fractured femoral head. Active vomiting occurred and gastric contents were "reflected" back into the trachea. Tracheal intubation and suction were immediately performed but the patient required postoperative ventilatory and inotropic support for three days.     

Age-related differences in spontaneous trait judgments from facial appearance

We tested whether there are age-related declines in detecting cues to trustworthiness, a skill that has been demonstrated to be rapid and automatic in younger adults. Young (M_age = 21.2 years) and older (M_age = 70.15 years) adults made criminal appearance judgments to unfamiliar faces, which were presented at a duration of 100, 500 or 1,000 ms. Participants’ response times and judgment confidence were recorded. Older were poorer than young adults at judging trustworthiness at 100 ms, and were slower overall in making their judgments. Further, the cues (i.e. perceptions of anger, trustworthiness and happiness) underlying criminality judgments were the same across age groups. Judgment confidence increased with increasing exposure duration for both age groups, while older adults were less confident in their judgments overall than their young counterparts. The implications are discussed.     

Irrational Happiness Beliefs Scale: Development and Initial Validation

International Journal of Mental Health and Addiction - This study sought to develop a new scale of irrational happiness beliefs (IHB) and test its reliability and validity across two British...     

The cognitive nature of forgiveness: using cognitive strategies of primary appraisal and coping to describe the process of forgiving

The present study investigated forgiveness in a traditional cognitive model of stress appraisal and coping and in a more recent model that includes the construct of low control stressors. One-hundred sixty six men and 168 women completed measures of forgiveness, primary stress appraisals, and coping strategies. For men, forgiveness was found to be positively associated with the use of challenge appraisals, and negatively associated with the use of loss appraisals and emotion-focused coping. For women, forgiveness was found to be positively associated with emotion-focused coping and acceptance, and negatively associated with avoidance. The results for women indicate that when forgiveness situations are conceptualized as low-control stressors, we are able to explain the relationships between forgiveness, appraisal, and coping. The results for men are broadly in line with a more traditional model of coping, which does not consider the construct of low control. Crucial differences in the ways that men and women appraise and cope with situations involving forgiveness are discussed.