Morphine-Infused silver sulfadiazine (MISS) cream for burn analgesia: a pilot study.

Pain is considered the most distressing symptom of a burn wound, with analgesia usually provided via oral or parenteral medications. Use of systemic opioids can be complicated by fluctuations in bioavailability, absorption, and clearance of drugs caused by the burn. There has been little research done in the area of topical medications for burn analgesia. The following is a double-blind, placebo-controlled pilot study assessing the safety (side effects) and efficacy (pain ratings and medications administered) of morphine-infused silver sulfadiazine cream for burn pain. Four patients are reported on (2 in each group). Only participants taking placebo reported side effects related to morphine and necessitated anxiolytic medications. Pain ratings in the treatment group ranged from 0 to 7 with a mean of 2.1, whereas the placebo group's ratings ranged from 2 to 8 with a mean of 5.6. The placebo group averaged 55.3 mg oral morphine per half day, whereas the treatment group averaged 42.9 mg.

Acute ibuprofen toxicosis in a ferret.

A 20-month-old 1.44-kg (3.2-lb) castrated male ferret was examined because of vomiting, defecating in an abnormal location, dyspnea, and signs of depression. Within 5 minutes of initial evaluation, the ferret became nonresponsive to all stimuli except deep pain. Despite intensive supportive treatment, the ferret died. Toxicologic analyses for ibuprofen were performed on serum, urine, and liver, using gas chromatography and mass spectrophotometry. Serum ibuprofen concentrations were 245 micrograms/g before and 269 micrograms/g after death. Acute ibuprofen toxicosis may cause severe lethargy progressing to coma, apnea, and death in ferrets. Ibuprofen toxicosis should be considered in differential diagnoses for ferrets with signs of depression, with or without clinical signs of gastrointestinal tract dysfunction.

Success in life for older adolescents with cerebral palsy.

In this article, the psychosocial themes emerging from an exploratory qualitative study are reported. Using a constant comparative method, the authors describe how older adolescents with cerebral palsy defined success in life and the factors they viewed as helping or hindering their success. Participants were 10 adolescents with cerebral palsy between 18 and 20 years of age who took part in a semistructured interview exploring their perceptions of success. For these adolescents, success meant being happy in life. Three key psychosocial factors were related to success in life: being believed in, believing in yourself, and being accepted by others (belonging). The findings are useful in guiding the design of services to meet the life needs of individuals with disabilities.

Treatment of painful skin ulcers with topical opioids.

Recent research suggests that opioid receptors on peripheral nerve terminals may play an important role in the modulation of pain. Clinical applications of this knowledge have been rather slow to evolve. We describe a consecutive series of nine patients with painful skin ulcers due to a variety of medical conditions. All patients were treated with a topical morphine-infused gel dressing. Seven of the nine patients experienced substantial and another experienced a lesser (but still significant) degree of analgesia. The ninth reported no relief, but his wound was not an open ulcer. Discussion centers on the practical application of this development in the large number of patients with painful skin lesions.

Sexuality and the adolescent with a physical disability: understandings and misunderstandings.

The purpose of this descriptive study was to examine the areas of sexual knowledge, sexual behavior, and beliefs about sexuality among adolescents with congenital physical disabilities. The sample consisted of 15 males and 14 females, ranging in age from 12 to 22 years. The Sexual Knowledge Interview Schedule (SKIS) was administered to all participants during face-to-face interviews. In addition, the participants were asked questions regarding their ability to engage in intimate relationships and their future childbearing potential. Overall, the findings suggested that these adolescents are uninformed or misinformed about general sexual knowledge, have many misconceptions about sexuality and their disability, and depend on health care professionals and parents for sex education. Implications of this research are discussed.

Emotionally disturbed children's reactions to violent media segments.

This study examined the reaction of children with a diagnosed disruptive behavior disorder (DBD) to violent movie scenes. Children without one of these disorders were tested as well. DBD children ranged in age from 8 to 12 years and were outpatients at The University of Kansas Medical Center's Department of Child Psychiatry. These children were diagnosed by a child psychiatrist as meeting Diagnostic and Statistical Manual of Mental Disorders (4th edition) (American Psychiatric Association 1994) (DSM-IV) diagnostic criteria for having at least one of three emotional disorders: attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Results showed that the disordered children differed from the nondisordered children on several dimensions. This suggests that DBD children process the anti-social messages in violent movies differently from children without a psychiatric disorder. An unabated diet of antisocial media could have harmful effects on children with a psychiatric illness.

Serum chemistry and hematology values for anesthetized American bullfrogs (Rana catesbeiana).

Samples taken from seven male and seven female adult American bullfrogs (Rana catesbeiana) were evaluated by complete blood count and serum chemistry to establish baseline data on commercially available frogs destined for laboratory use. Differences between sexes were analyzed and females had higher plasma protein, calcium, and sodium levels.

Self-evaluation and self-concept of adolescents with physical disabilities.

Fifty-three adolescents aged 14 to 18 years with diagnoses of cerebral palsy (n = 27), cleft lip or palate or both (n = 17), or spina bifida (n = 9) took part in this study examining their self-esteem, self-concept, self-acceptance, social self-efficacy, and values, as measured by standardized instruments. Comparisons were made separately for males and females with norms developed for adolescents without disabilities. Significant differences were found only on several aspects of self-concept: females with physical disabilities were lower in perceived social acceptance, athletic competence, and romantic appeal than the normative sample, and males with physical disabilities were lower in perceived scholastic competence, athletic competence, and romantic appeal. In addition, social self-efficacy was found to be a significant predictor of both independence and persistence in adolescents with disabilities, who were significantly less independent and persistent than were normative samples. The discussion focuses on the usefulness of the findings regarding social self-efficacy and the implications of the findings for occupational therapists.