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The use of epidural fentanyl infusion with patient-controlled epidural analgesia (PCEA) is becoming popular for postoperative analgesia in adults. Its use has not been reported in the pediatric population. We report our initial experience with this technique in pediatric patients. The charts of all children who received epidural fentanyl infusions for postoperative analgesia between June 1991 and February 1992, were reviewed. Thirty-one patients, ages 6 to 17 years (mean +/- SD, 13.2 +/- 2.7) received epidural fentanyl infusion with PCEA for 36 operative procedures. Epidural catheters were either inserted in the lumbar (n = 14) or thoracic (n = 22) epidural space at a level based on the surgery. A fentanyl bolus of 1.38 +/- 0.43 micrograms/kg was delivered via epidural catheter just prior to the conclusion of surgery. A continuous infusion of fentanyl (0.56 +/- 0.18 micrograms/kg/h) with a PCEA bolus (0.53 +/- 0.17 micrograms/kg) available every 15 minutes was initiated in the recovery room and was utilized for 8 to 110 hours (59 +/- 27 hours). Pain and sedation were assessed by verbal descriptive scales, and side effects were noted. Alterations in dosing regimen were made for inadequate analgesia or side effects. Analgesia was assessed as excellent or good in 78% of the patients, 91% in the thoracic catheter group and 57% in the lumbar catheter group (P < .02). Patients with thoracic catheters were more likely to need their infusion and PCEA doses decreased, whereas those with lumbar catheters more often needed their doses increased (P < .05). No patient had respiratory depression.(ABSTRACT TRUNCATED AT 250 WORDS)

The AIDS Social Assertiveness Scale (ASAS) and a measure of AIDS knowledge were administered to 490 high school students from 10 South Australian schools selected across a range of public/private, rural/urban, and socioeconomic statuses. Age, grade, hours of AIDS education, and sexual experience (and condom use) also were ascertained. Data indicated the factor structure of the ASAS was similar to that obtained in a previous sample. A close association existed between both age and hours of AIDS education, and AIDS knowledge. Students from country and working class area schools were less knowledgeable about AIDS. These data suggest AIDS social assertiveness is measurable and that it is associated with AIDS knowledge, age, and previous sexual experience. AIDS knowledge in high school students differed between country and urban adolescents and between students in working and middle class areas, but AIDS education is associated with the same level of improvement in all schools sampled.

Examination of the ilvF locus at 54 min on the Escherichia coli K-12 chromosome revealed that it is a cryptic gene for expression of a valine-resistant acetohydroxy acid synthase (acetolactate synthase; EC 4.1.3.18) distinct from previously reported isozymes. A spontaneous mutation, ilvF663, yielded IlvF+ enzyme activity that was multivalently repressed by all three branched-chain amino acids, was completely insensitive to feedback inhibition, was highly stable at elevated temperatures, and expressed optimal activity at 50 degrees C. The IlvF+ enzyme activity was expressed in strains in which isozyme II was inactive because of the ilvG frameshift in the wild-type strain K-12 and isozymes I and III were inactivated by point mutations or deletions. Tn5 insertional mutagenesis yielded two IlvF- mutants, with the insertion in ilvF663 in each case. These observations suggest that the ilvF663 locus may be a coding region for a unique acetohydroxy acid synthase activity.

Educational efforts to prevent the spread of AIDS require a combination of accurate information and the application of that information to personal behavior. In this preliminary study, a scale was developed to evaluate the social and interpersonal skills of adolescents in AIDS-related and non-AIDS-related interactions. The instrument was administered to 101 Australian students in grades 10 and 11 of an urban high school. Findings indicate ratings of AIDS-related activities of the adolescents were not significantly different from their other social activities, suggesting levels of comfort and assertiveness among adolescents in AIDS-related activities can be modified. Students felt most anxious about problems with sexually transmitted diseases or drug use, suggesting difficulty in dealing with the possible public disclosure of these stigmatized conditions. Data suggest both individual and group scores among adolescents may improve on the five dimensions of the scale following interventions to promote social and interpersonal skills designed to apply knowledge obtained from AIDS education.