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Adrenal insufficiency is an endocrine condition defined as the inadequate production or action of glucocorticoids, principally a steroid hormone called cortisol. While rare in childhood, it carries the risk of adrenal crisis in the event of a child becoming unwell as a result of intercurrent illness, injury or surgery. Children's nurses must be vigilant in caring for a child with adrenal insufficiency and have a clear understanding and awareness of the principles of emergency management at home and in hospital. [ABSTRACT FROM AUTHOR]

Waterborne transport is widely believed to be one of the most sustainable modes of commercial transportation. However, factors often overlooked such as unmeasured pollution and costs, hazards to crew and general society call into question this particular assessment of the industry. This paper highlights the need for the application of a holistic approach for guiding shipping and related stakeholders towards sustainability using economically viable, less polluting and more human-friendly operating models, and it proposes a structured assessment methodology to achieve it. For it, ships are divided in onboard systems (e.g. propulsion systems, waste generation and ballast water management system) and their sustainability performance is assessed in order to see the ship's whole sustainability index. A definition of sustainable shipping is proposed. There is also a review of the critical pollution, cost and social drivers of ships in operation as well as a discussion about the capabilities and limitations of the current environmental/economical/social assessment tools for quantifying shipping sustainability. [ABSTRACT FROM AUTHOR]

Certain mineral oils and hydrocarbons require repeated topical application to cause irritation. A structure activity relationship of pure n-alkanes was undertaken in a mouse ear edema model to investigate the mechanism of cumulative irritancy. Alkanes were applied twice daily over a 4-day period. Dodecane was found to be non-irritating, while tridecane elicited a response only at 96 h. Tetradecane was the strongest irritant with significant increases ( p<0.05) in ear thickness observed at 48 h. Hexadecane, octadecane, and eicosane exhibited progressively decreasing activity. Permeability of the ears to hydrocortisone was monitored in vitro during tridecane-and tetradecane-induced irritation. Significant increases in permeability were observed 24 h before edema formation. A positive correlation was found between the extent of edema formation and enhancement of permeability. Loss of barrier function would result in increased cutaneous availability of the alkanes. Increased permeability prior to edema formation indicates that induction of barrier dysfunction may be a factor in the mechanism of alkane-induced irritation. [ABSTRACT FROM AUTHOR]

An abstract of the study "Hyperandrogenism Secondary to Topical Testosterone Exposure" by A. Carroll et al is presented.