Search

Clinical reports rave about the efficacy of sublingual morphine, but most research data suggest that sublingual morphine lacks the necessary physical characteristics to be absorbed through sublingual tissues. This article clarifies these assertions by reviewing the clinical literature that supports sublingual administration, the theories relevant to sublingual morphine administration, and the pharmacokinetic research that supports or negates the benefit of this route. Recommendations for clinical nursing practice are provided to guide decision-making in care of patients with cancer pain.

This article investigates the relationship of skeletal facial pattern and soft-tissue nasal form. The case sample comprises 123 white female subjects, aged 11.0 to 20.6 years, with no histories of pathology, trauma, surgical intervention, or orthodontic treatment. Measurements were made from cephalometric radiographs, posteroanterior radiographs, and the physioprint photographs. Skeletal classifications were based on the relationship of the maxilla to the mandible; the three classifications were straight profile, retrusive chin profile, and prognathic profile. Pearson product--moment correlation coefficients were used to test intercorrelations of all quantitative variables (including age) with each other. Correlations were highly significant for age, the three profile measurements, and two of the frontal measurements. Hence, noses and skeletal structures showed, as expected, increases with age. Also, profile measurements were highly significantly correlated; larger noses were larger in all profile dimensions. A stepwise discriminant analysis was used to study nonquantitative categories of nasal shape (straight, convex, and concave). This analysis indicated that more than 86% of patients in the sample of 123 demonstrated a correlation of nasal shapes with specific skeletal groupings. Patients with straight profiles tended to have straight noses; convex profiles accompanied convex nasal shapes; and concave profiles were found with concave nasal shapes. The clinical significance of this research is to emphasize the importance of total facial harmony (especially nasal shape) during orthodontic diagnosis and treatment planning.