British medical bulletin
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Non-invasive ventilation (NIV) has been shown to be effective in acute respiratory failure of various aetiologies in different health care systems and ward settings. It should be seen as complementary to invasive ventilation and primarily a means of preventing some patients from deteriorating to the point at which intubation is needed. ⋯ Important benefits include the avoidance of endotracheal-tube-associated infections, which carry an important morbidity and mortality, and a reduction in health care costs. The most important ingredient for an acute NIV service is a well-trained enthusiastic ward team.
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Postponing childbearing beyond the teenage years is now adaptive practice for European Americans. European American adults put this cultural priority into action and employ substantial social resources to disseminate the social control message meant for their youth that teenage childbearing has disastrous consequences. ⋯ The entrenched cultural interdependence of and social inequality between European and African Americans lead African Americans to be highly visible and vulnerable targets of moral condemnation for their fertility behaviour. This, in turn, sets up African Americans to pay a particularly high price politically, psychosocially, and in terms of their health.
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British medical bulletin · Jan 2004
Reviewalpha2-Adrenoceptor agonists: shedding light on neuroprotection?
Although alpha(2)-adrenoceptor agonists are widely used for analgesia, anxiolysis, sedation, sympatholysis and as anaesthetic-adjuncts for many years, their potential use as neuroprotectants has so far been confined to laboratory experiments. Despite the large body of evidence from both in vivo and in vitro studies, their exact neuroprotective mechanisms remain elusive. Herein, we review the available literature pertaining to the neuroprotective effect of alpha(2)-adrenoceptor agonists and the possible biochemical and physiological cascades involved in their mechanisms of action. The remarkable safety profile of alpha(2)-adrenoceptor agonists and their high potency of neuroprotection should prompt clinical trials to evaluate their neuroprotective efficacy in humans.