Nasopharyngeal Route Research Articles

Nasotracheal intubation awake in a patient with multiple fractures of the maxilla and cervical spine: A case report.

Nasotracheal intubation is an advanced airway modality used in specific contexts, such as limited mouth opening, macroglossia, cervical spine instability. In addition, it can be performed with the patient awake, especially when predictors a difficult airway are unknown. A 41-year-old male with a lesion in the C1 cervical vertebra, associated with a fracture of the right maxilla, was intubated through the nasopharyngeal route while awake. The forms of induction were discussed. Based on the mechanism of trauma and on the report of pain, associated with imaging examination, fracture of the body of the right maxilla and a complex fracture of the anterior arch of the C1 cervical vertebra were diagnosed. In this case, we present a patient with trauma to the face and spine who was intubated through the nasopharyngeal route while awake and guided by video laryngoscopy and using a rigid cervical collar. The patient was operated on under total general anesthesia (propofol and remifentanil) and plates and screws were placed for maxillary osteosynthesis. The pain was alleviated with a peripheral block of the trigeminal nerve of the maxillary branch with 0.5% levobupivacaine. The patient woke up from surgery, was extubated uneventfully and without pain. Cervical spine injuries were followed up by the neurosurgery team for conservative treatment. Patients with neck injury and facial trauma may need a definitive airway either for emergencies or for elective procedures. Intubating the awake patient may be an option when the anatomy of the cavity is unknown, and inducing the anesthetic act without this knowledge may be a inappropriate option, due to the risk of intubation/ventilation difficulties.

Diagnostic Approaches for COVID-19 and Its Associated Complications.

With almost 4 million deaths worldwide from the COVID-19 pandemic, the efficient and accurate diagnosis and identification of COVID-19-related complications are more important than ever. Scales such as the pneumonia severity index, or CURB-65, help doctors determine who should be admitted to the hospital or the intensive care unit. To properly treat and manage admitted patients, standardized sampling protocols and methods are required for COVID-19 patients. Using PubMed, relevant articles since March 2020 on COVID-19 diagnosis and its complications were analyzed. Patients with COVID-19 had elevated D-dimer, thrombomodulin, and initial factor V elevation followed by decreased factor V and factor VII and elevated IL-6, lactate dehydrogenase, and c-reactive protein, which indicated coagulopathy and possible cytokine storm. Patients with hypertension, newly diagnosed diabetes, obesity, or advanced age were at increased risk for mortality. Elevated BUN, AST, and ALT in severe COVID-19 patients was associated with acute kidney injury or other organ damage. The gold standard for screening COVID-19 is reverse transcriptase polymerase chain reaction (RT-PCR) using sputum, oropharyngeal, or nasopharyngeal routes. However, due to the low turnover rate and limited testing capacity of RT-PCR, alternative diagnostic tools such as CT-scan and serological testing (IgM and IgG) can be considered in conjunction with symptom monitoring. Advancements in CRISPR technology have also allowed the use of alternative COVID-19 testing, but unfortunately, these technologies are still under FDA review and cannot be used in patients. Nonetheless, increased turnover rates and testing capacity allow for a bright future in COVID-19 diagnosis.

Positive rate of COVID 19 in the setting of GGH Ghulam Muhammadabad

Background: The corona virus disease also known as COVID-19 has opened gates to a lot of research about detection, treatment and prevention in the last past year due to lack of information regarding the SARS-CoV-2 virus. PCR corona via nasopharyngeal swab is the standard method of detection in our set-up. Materials and methods: Nasopharyngeal swabs were taken by ENT department using precautions and following proper SOPs. Swabs were sent for rRT-PCR tests. Data was collected and analyzed. All the subjects meeting the inclusion criteria were included in study. Data was analyzed using SPSS version 20. Frequency and percentage was calculated for gender. Positivity rate was calculated using CDC formula. Study design: - Descriptive studies Place and Duration of Study: - Government General Hospital, Ghulam Muhammadabad, Faisalabad. 889 samples were taken from 7.1.2020 to 6.12.2020. Results: Standard PCR for corona test by nasopharyngeal route was taken of suspected corona patients and of patients with contact with corona positive patients. 894 samples were taken from 7.1.2020 to 6.12.2020. 263 were positive for corona. The calculated positive rate is 29.41%. Conclusions: Calculation of positive rates is a very easy metric to give us a quick overview of the spread of the virus. Keywords: COVID-19, Positive rates, PCR-Corona

Coronavirus disease 2019: fundamentals, chronology and vaccine evolution

The coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, which is recognized as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The recent pandemic caused by SARS-CoV-2 is a concern of major public health emergency globally. The virus is highly contagious, enters through nasopharyngeal route into lungs and infects respiratory tracts and later disseminate to other organs in the body. If body immune response fails to eliminate or over responds to infection in affected persons, the condition turns to severe acute respiratory syndrome or pneumonia, multiple organ failure, septic shock and finally end-up with life in critical cases. Currently, there are no antiviral drugs available to eradicate the complete infection and the only treatment available to patients with critical illness is providing oxygen supply through ventilators along with few antiviral and anti-inflammatory drugs to relieve from the symptoms. Recently developed COVID-19 vaccines are available to the public in several countries for protecting against SARS-CoV-2. Further, researchers are vigorously being focused on development of novel vaccines, recombinant interferons, monoclonal antibodies against virus, finding of antiviral drugs to block coronaviral specific structural proteins or multiplication in infected persons, drugs for suppression of over production of pro-inflammatory cytokines by the human body and disease mechanisms of virus. However, because of combined treatment strategies and reduced pathogenicity of SARS-CoV-2, the current mortality rate has been reduced to less than 1-1.5% globally from 5 to 6% of initial COVID-19 pandemic. Unfortunately, sudden increase in number of cases in several countries and evolution of new pathogenic strains of SARS-CoV-2 variants from existing strains make another challenging task both for public and scientific communities. Hence, public health officials are recommending public to continue social distancing, avoid contact with infected persons, isolation and quarantine of exposed persons till COVID-19 prevention is under control. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.

COVID -19 Pandemic- A Literature Review

The coronavirus pandemic which has originated in Wuhan province of China has brought the whole world on its knees. Despite many scientific advancements since 1900s in the field of medicine the world still remains clueless of controlling this pandemic. U.S.A remains on top with the highest number of cases and counting while the rest of the world is also not far behind. To understand about corona virus disease we did an extensive research of literature and have summed up our findings in our article. SARS- COV2 also known as COVID-19 gains entry via nasopharyngeal route where it attaches itself with the help of ACE 2 receptor thus causing infection. It most commonly affects lungs followed by heart , kidney and liver . Most of the cases present with fever, dry cough, shortness of breath and loss of taste and smell among other manifestations. RT-PCR remains the investigation of choice. Social distancing, practising hand hygiene and use of face mask has been advocated. Many of the drug trials are under way with recent FDA approval of remdesivir. Use of hydroxychloroquine has been debated however trials are underway for a more definite conclusion. The world is fast tracking the approval of vaccine with many of the vaccines in various stages of trials.

Introduction

Introduction

Surgical treatment of a retropharyngeal abscess in a bull

A 12-month-old bull with chronic respiratory stridor and dysphagia was presented. Endoscopic evaluation of the upper airway revealed a large swelling of the dorsal pharynx, partially obstructing the airway. The...

Type I diabetes mellitus: genetic factors and presumptive enteroviral etiology or protection.

We review type 1 diabetes and host genetic components, as well as epigenetics and viruses associated with type 1 diabetes, with added emphasis on the enteroviruses, which are often associated with triggering the disease. Genus Enterovirus is classified into twelve species of which seven (Enterovirus A, Enterovirus B, Enterovirus C, and Enterovirus D and Rhinovirus A, Rhinovirus B, and Rhinovirus C) are human pathogens. These viruses are transmitted mainly by the fecal-oral route; they may also spread via the nasopharyngeal route. Enterovirus infections are highly prevalent, but these infections are usually subclinical or cause a mild flu-like illness. However, infections caused by enteroviruses can sometimes be serious, with manifestations of meningoencephalitis, paralysis, myocarditis, and in neonates a fulminant sepsis-like syndrome. These viruses are often implicated in chronic (inflammatory) diseases as chronic myocarditis, chronic pancreatitis, and type 1 diabetes. In this review we discuss the currently suggested mechanisms involved in the viral induction of type 1 diabetes. We recapitulate current basic knowledge and definitions.

Letter to the Editor

4 January 2009 Dear Editor, RE: EPIDEMIOLOGY OF ACUTE RHEUMATIC FEVER IN NEW ZEALAND 1996–2005 BY JAINE R ET AL. 2008;44:564 Jaine et al. using hospital discharge data, outline the large ethnic disparities for acute rheumatic fever (ARF) in New Zealand over a recent decade suggesting that ARF epidemiology has not been reviewed recently. Importantly, this subject was reviewed by the New Zealand Child and Youth Epidemiology Service and published online in 2007 reviewing hospital discharge data by age, ethnicity and geographic area of origin but adding interpretation to disparities found by using the New Zealand Deprivation Index (NZ Dep Index) score. Maori and Pacific children are over-represented in the bottom quintile of the NZ Dep Index with a risk ratio for having ARF of 28.65 (95% CI 17.43–47.08) compared with the top quintile as the index.1 The NZ Dep Index is a small area index of deprivation used as a proxy for socio-economic status and made up of variables likely to influence health outcome, for example, income, employment, telephone access, transport access, living space and education. While genetic/ethnic status cannot be ruled out as a precursor to rheumatic fever, public health measures seem likely to overcome this propensity as witnessed by the very low recurrence rates in a well-delivered secondary prophylaxis programme in New Zealand.2 Household crowding is an important facilitating factor for the spread of infectious disease.3 This was especially well shown in a New Zealand case control study for meningococcal disease, another disease spread via the naso-pharyngeal route,4 where the odds ratio for a case having a crowded house was 10.7 (95% CI 3.9–29.5). Improved housing would be an obvious intervention. However, for cases living in crowded houses, medical interventions can override environmental risk factors at least as shown in inner city Baltimore, USA, in the 1960s, where access to community primary health care clinics was enhanced and rheumatic fever declined by 60% over 10 years.5 Thus, in the absence of direction from the medical literature, we conducted a school-based sore throat clinic programme in a randomised controlled trial designed to improve access to health care known to be a problem in disadvantaged New Zealand Maori and Pacific populations. In spite of the size of this study and more than 86 000 person years, we were able to show only a clinically important effect on ARF and not able to support this statistically.6 This then led to a meta-analysis7 of community and school-based studies of streptococcal throat treatment programmes to prevent rheumatic fever. Of 653 studies screened, only six met the criteria of a randomised controlled trial or trials of before/after design examining treatment of sore throats in a community setting with ARF as an outcome. The data were pooled and a meta-analysis of these trials for ARF control produced a relative risk of 0.41 (95% CI 0.23, 0.70 P= 0.001), which favoured this approach with a suggestion of ∼60% reduction in rheumatic fever. This directs us towards this approach to rheumatic fever control, and we believe new public health initiatives are warranted for ‘at risk’ communities. This supports the approach already being undertaken, with success, in smaller New Zealand communities.8 An economic analysis is being performed to support such an initiative in larger populations.

Nasopharyngeal oxygen (NPO) as a safe and comfortable alternative to face mask oxygen therapy

Nasopharyngeal oxygen (NPO) therapy is an emerging alternative to conventional face mask oxygen administration. It warrants consideration for treating hypoxaemia when face mask therapy is impractical or when patient intolerance or non-compliance regularly interrupt treatment. The effectiveness of the NPO route has been validated in post anaesthetic care and paediatric intensive care units (PICUs), but use in the adult ICU remains minimal. Recent research in the adult ICU setting 1 has shown the nasopharyngeal route to be as effective as face mask oxygen administration in alleviating mild to moderate hypoxaemia, and is significantly more comfortable for patients. Therefore, NPO, administered via a fine catheter advanced into the nasopharynx, should be considered when face masks (FMs) or nasal prongs (NPs) are impractical or poorly tolerated and, because of its effectiveness and improved comfort, in patients for whom traditional non-invasive oxygen therapy is indicated. Implications for resource utilisation and costs also exist.

Oropharyngeal and Nasopharyngeal Suctioning of Meconium-Stained Neonates Before Delivery of Their Shoulders: Multicenter, Randomized, Controlled Trial

Infants born through meconium-stained amniotic fluid (MSAF) are at risk of meconium aspiration syndrome (MAS), a life-threatening respiratory disorder. Conflicting claims are made about the effectiveness of intrapartum suctioning of MSAF by the oropharyngeal and nasopharyngeal routes. This randomized, controlled trial was conducted at 11 Argentinian centers and 1 in the United States. A total of 2514 patients with MSAF of any consistency, at a gestational age of at least 37 weeks and in cephalic presentation, were randomly assigned to suctioning of the oropharynx and nasopharynx, including the hypopharynx, or to no suctioning. Suctioning was done before the shoulders were delivered. Infants born vaginally or by cesarean section were suctioned, beginning oropharyngeally and followed by bilateral nasopharyngeal suctioning when possible. Pharyngeal suctioning was avoided after delivery unless there was clinically evident airway obstruction. Demographic variables were comparable in the 2 treatment groups, as were the frequency of thick MSAF, the rate of cesarean section, and an abnormal fetal heart rate. MAS was comparably frequent in the 2 groups, as was the need for mechanical ventilation and the number of infants who died. Four infants in the suctioning group and 2 in the no-suction group died of respiratory failure. Mortality in all infants with MAS was 10.1%. The type of management made no appreciable differences in the duration of oxygen treatment, mechanical ventilation, or hospital care. There also were no substantial differences in the frequency of other respiratory disorders, the risk of pneumothorax, 1- or 5-minute Apgar scores, or the need for positive-pressure ventilation in the delivery room. Prenatal suctioning caused no complications. The investigators believe that, in term meconium-stained infants, MAS and its complications are not prevented by routine intrapartum oropharyngeal and nasopharyngeal suctioning.

Semen from boars infected with porcine reproductive and respiratory syndrome virus (PRRSV) contains antibodies against structural as well as nonstructural viral proteins

The seminal excretion of antibodies against porcine reproductive and respiratory syndrome virus (PRRSV) was examined in a group of five boars experimentally infected by the nasopharyngeal route. By using phage-displayed peptide epitopes from the PRRSV replicase and envelope glycoproteins as ELISA antigen, we were able to separately and specifically assay antibody responses against structural and nonstructural viral proteins. Antibodies against structural as well as nonstructural viral proteins were consistently found in the semen of all boars, beginning from 1–4 weeks postinfection. This is the first report documenting the presence of anti-PRRSV antibodies in boar semen. Seminal antiviral IgA was also detected, and we observed a correlation between seminal IgA responses against nonstructural viral proteins, and the duration of PRRSV RNA excretion in semen. The implications of these findings for the diagnostics and pathogenesis of venereal PRRSV infection are discussed.

Nasopharyngeal cavity narrowing associated with posterior maxilla and pterygoid plate fracture: report of three cases

The CT appearances of three cases with severe nasopharyngeal cavity narrowing are described. In all cases the facial trauma was due to a motor vehicle accident. These cases demonstrate that posterior maxilla and pterygoid plate fractures can cause significant nasopharyngeal soft tissues swelling, most likely due to haemorrhage and/or oedema. Severe nasopharyngeal cavity narrowing could cause difficulty in elective nasogastric tube and endotracheal tube intubation via the nasopharyngeal route.

Reply

Professor of Anesthesia, UCSD Medical Center, Department of Anesthesiology, 402 Dickinson Street, 8812, San Diego, California 92103-8812.In Reply:--I thank Alfery, Bapat, Ullman, and Burk for their thoughtful comments. Three of the authors suggested new methods to obtain either a greater depth of tracheal insertion and/or increase the size of the endotracheal tube (ETT) when performing tracheal intubation through a laryngeal mask airway (LMA), and the fourth author suggested yet another supraglottic ventilatory mechanism for the "cannot ventilate, cannot intubate" situation.To gain a greater depth of tracheal insertion, Alfery suggested insertion of a 34-cm long, 6.0-mm-internal diameter (ID) cuffed nasal RAE ETT (Mallinkrodt Medical, St. Louis, MO) through a #3 and #4 LMA instead of a standard 29-cm long, 6.0-mm-ID cuffed ETT and a 36-cm-long, 7.0-mm-ID cuffed nasal RAE ETT through a #5 LMA instead of a standard 31-cm-long, 7.0-mm-ID cuffed ETT. I followed his suggestion several times and he is correct in all claims; a greater depth of tracheal insertion is obtained and with proper lubrication; the preformed curve does not present a problem in any respect. One needs to be cognizant of the depth of tracheal insertion (i.e., be aware of the centimeter marking at or near the incisor or LMA adaptor level) because a right mainstem bronchial intubation is possible.To increase the safety of changing a small-bore ETT to a large-bore ETT, Bapat suggested the simultaneous use of both an appropriately sized fiberoptic bronchoscope (FOB) and reintubation guide (elastic bougie or tube exchanger) within the larger ETT when actually placing the larger ETT into the trachea. The concept is sound, and various permutations of using a FOB along with another guide for changing ETTs in other situations (e.g., all four permutations of interchanging oral and nasal ETTs) have been published. [1]It would be helpful to interested readers if Dr. Bapat would publish a small table of different-sized ETTs and compatible-sized intraluminal guides and FOBs.To increase the depth of tracheal insertion, Ullman suggests lengthening the 6.0-mm-ID ETT by splicing in a plastic connection (narrow "neck" of an ETT adaptor) that will allow attachment of another length of 6.0-mm-ID ETT. I came to the same idea a year ago and used both the hard plastic sheath that surrounds a 22-gauge spinal needle in an unopened sterile package and the plastic connectors that are used to lengthen wide-bore suction tubing in the operating room as the plastic connection. The method works fine, provided one does not want/need to remove the 6.0-mm-ID cuffed ETT from the #3 or #4 LMA. The problem with removal of the 6.0-mm-ID cuffed ETT from the #3 or #4 LMA is that the ridge created by the plastic connector-distal 6.0-mm-ID cuffed ETT interface can impact on or hang up on the ridge created by the LMA adaptor-LMA shaft interface. Forceful pulling on the proximal end of the 6.0-mm-ID ETT extension can cause the distal end of the 6.0-mm-ID cuffed ETT to separate from the plastic connector; the result is that the distal full length of the 6.0-mm-ID cuffed ETT is unattached and free within the LMA shaft and trachea, and is not necessarily retrievable. In fear of this complication, I stopped using this method to increase the depth of tracheal insertion.Burk suggests using a nasotracheal tube (or an appropriately adapted soft nasopharyngeal airway; sometimes refered to as a "Nosworthy chimney") as a supraglottic ventilatory mechanism for the "cannot ventilate, cannot intubate" situation. I have often ventilated in this manner in elective situations, especially when teaching fiberoptic intubation (either orally or nasally), because the method works reasonably well, and for fiberoptic intubation, the method is visually noninterfering. However, for the "cannot ventilate, cannot intubate" situation, the method has two serious limitations. First, because the ventilation mechanism is supraglottic, it suffers from the same limitations I outlined in my article for the supraglottic ventilatory mechanisms of the LMA and Combitube (i.e., the ventilatory mechanism can be proximal to a periglottic pathologic obstruction). Second, use of the nasopharyngeal route may cause nasopharyngeal bleeding, a most unwelcome happenstance in a "cannot ventilate, cannot intubate" situation. Although Burk may be dismayed that the ASA Difficult Airway Algorithm does not specifically mention his first choice emergency ventilation method, and many other practitioners have reminded me of not-specifically-mentioned tricks they have, the ASA Difficult Airway Algorithm does not exclude these methods. It is appropriate to conclude by reminding the anesthesia community that the ASA Difficult Airway Algorithm states that the recommendations therein "may be adopted, modified, or rejected according to clinical needs and constraints" and that "the techniques chosen by the practitioner in a particular case will depend upon specific needs, preferences, skills and clinical constraints". [2]Jonathan L. Benumof, M.D., Professor of Anesthesia, UCSD Medical Center, Department of Anesthesiology, 402 Dickinson Street, 8812, San Diego, California 92103-8812.(Accepted for publication June 17, 1996.)

Occupational exposure to bidi tobacco increases chromosomal aberrations in tobacco processors

In India, workers engaged in processing of tobacco for the manufacture of bidis (the indogenous substitute for cigarettes) are chronically exposed to tobacco flakes and dust via the cutaneous and nasopharyngeal routes. Hence, workers in a tobacco processing factory were monitored for chromosomal aberrations (CA) using peripheral blood lymphocytes as the test system. Cytogenetic analysis revealed a significant increase in deletion fragments and chromatid gaps in the exposed group. The frequency of aberrant metaphases and the proportion of individuals with CA were significantly higher in workers than in controls, indicating that occupational exposure to tobacco imposes considerable genotoxicity among tobacco processors.

Neutralizing activity in bovine secretions against foot-and-mouth disease virus.

Neutralizing activity in bovine secretions against foot-and-mouth disease virus.

A comparison of canine distemper vaccine and measles vaccine for the prevention of canine distemper in young puppies

Two groups of six-week-old beagle puppies were vaccinated with either high titre canine distemper virus or human measles virus, a third group remaining unvaccinated. All the puppies were subsequently challenged by the nasopharyngeal route at 10 weeks old with the virulent Snyder-Hill strain of canine distemper. Severe clinical signs were observed in 90 per cent of the unvaccinated dogs but both groups of vaccinated dogs survived the challenge. High temperatures were recorded in 20 per cent of the measles vaccinates and abdominal petechial rashes were observed in 60 per cent of them. The only clinical signs observed in the puppies vaccinated with distemper virus were transient rashes in 20 per cent of the group. The high titre canine distemper vaccine stimulated a humoral response quickly in 78 per cent of the puppies in the presence of maternally derived antibody and protected them against challenge with the virulent Snyder-Hill strain of distemper virus. The remaining dogs responded sluggishly but were still protected against challenge. The results of field surveys showed that 95 per cent of young puppies with different levels of maternally derived antibodies responded to the distemper component in a vaccine also containing canine parvovirus. No incompatibility was observed between the two components.

Occupational exposure to tobacco and resultant genotoxicity in bidi industry workers

In India, over 3 million workers employed in the bidi industry receive massive, chronic exposure to unburnt tobacco, mainly by the cutaneous and nasopharyngeal routes. While the hazards of habitual tobacco usage are well established, very little information is available about the effects of occupational tobacco exposure. In the present study, tobacco processing plant workers (TPPW) and bidi rollers (BR) with or without tobacco habits were monitored for occupation-related exposure to tobacco and resultant genotoxicity. Salivary cotinine levels were determined as an index of tobacco exposure and micronucleated buccal epithelial cell (MNC) frequency was recorded as a genotoxic endpoint. Occupational tobacco exposure led to the detection of cotinine in the saliva of 19% of BR and 100% of TPPW with no tobacco habit (NH). The greater degree of exposure in TPPW was evident from the significantly higher mean salivary cotinine level in TPPW-NH as compared to BR-NH (2.86 ± 0.48 vs. 0.84 ± 0.26 μg/ ml; p < 0.01). The effect of occupational exposure was also evident in TPPW and BR with the masheri habit. A moderate but statistically significant increase in MNC frequency was observed in habit-free as well as masheri-habituated TPPW and BR as compared with the respective controls. The findings provide preliminary evidence for the clastogenic effects of occupational tobacco exposure.

Randomized controlled trial of very early continuous distending pressure in the management of preterm infants

Application of continuous distending pressure at birth (very early CDP) should stabilize the immature airways and reduce the severity of respiratory distress syndrome (RDS) in preterm infants. Eighty-two preterm infants of less than 32 weeks gestation were randomly assigned at birth to early treatment group (TG), in which CDP of 6 cm water pressure was applied at birth by the nasopharyngeal route (NP-CDP), or to control group (CG), in which CDP was applied when indicated for established criteria (pO 2 < 50 mmHg in FiO 2 > 0.5). Characteristics of the infants in the two groups were comparable. No statistically significant difference between the two groups was found in the incidence of RDS. The course of RDS, and oxygen and ventilatory requirements also did not appear to be changed. In blood gas parameters of most of the time frames, no significant difference was found between the two groups when the results were analyzed according to the assigned group. When the results were analyzed separately for the infants who developed RDS, infants in TG appear to have fared worse from the therapy in terms of oxygenation, as indicated by significantly higher FiO 2 ( P < 0.01) and lower a/A ( P < 0.01) values on the third day of the course of RDS, as compared to infants in CG. The incidence of complications was comparable in the two groups. Four infants from TG (9.3%) and one from CG (2.6%) died ( P = NS). We conclude that VECDP by nasopharyngeal route does not reduce the incidence of RDS and does not appear to improve the outcome and may worsen the severity of RDS when compared to application of CDP for established criteria

The effect of alcohol on dopamine metabolism in the caudate nucleus of an unanesthetized monkey.

Previously it was shown that the acute administration of ethanol to the rat significantly alters the metabolism of the dopamine (DA) in liver but not in brain tissue. To extend this finding to the primate, two push-pull perfusion cannulae were implanted in the regions of the left and right caudate nucleus of a Macaca nemistrina. After 14C-DA was injected into the caudate, the site ws perfused with an artificial CSF and the perfusate analyzed for the major metalolites of DA. Ethanol was then administered in a dose of 6 g/kg by the nasopharyngeal route. The results show that very little alteration occurs in the metabolism of DA during or postethanol intoxication.