Fifty-seven cleft palate patients underwent primary repair with Furlow palatoplasty by the same surgeon from January 2001 to January 2005. There were 8 fistulae, 7 of which occurred out of 9 patients treated between July 2003 and January 2004 when operations were resumed after the outbreak of severe acute respiratory syndrome in Hong Kong; 1 minute fistula occurred after this period and closed spontaneously. Longer operation time and higher proportion of Veau classes III and IV clefts were noted in the fistula group. The high incidence and cluster occurrence immediately after SARS could be related to changes in the provision of nursing care and the level of parental supervision, in addition to more difficult operations encountered as reflected by more extensive clefts and longer operation time. We would like to emphasize that expert nursing care and close supervision with the help of parents play a very important role in achieving the best possible clinical outcome from cleft palate surgery in pediatric patients.

The measures of democracy commonly used in empirical research suffer notable limitations, primarily the exclusion of participation. As a result, quantitative studies may undervalue the effect of democracy on important social outcomes or misinterpret the aspect of democracy responsible for that effect. We respond by introducing and validating two variants of a new indicator, the Participation Enhanced Polity Score (PEPS), which augments institutional factors with the breadth of citizen parBruce E.

The effect-compartment concentration (C(e)) of a drug at a specific pharmacodynamic endpoint should be independent of the rate of drug injection. We used this assumption to derive an effect-compartment equilibrium rate constant (k(eo)) for propofol during induction of anesthesia, using a target controlled infusion device (Diprifusor). Eighteen unpremedicated patients were induced with a target blood propofol concentration of 5 microg x ml(-1) (group 1), while another 18 were induced with a target concentration of 6 microg x ml(-1) (group 2). The time at loss of the eyelash reflex was recorded. Computer simulation was used to derive the rate constant (k(eo)) that resulted in the mean C(e) at loss of the eyelash reflex in group 1 being equal to that in group 2. Using this population technique, we found the k(eo) to be 0.57 min(-1). The mean (SD) effect compartment concentration at loss of the eyelash reflex was 2.39 (0.70) microg x ml(-1). This means that to achieve a desired C(e) within 3 min of induction, the initial target blood concentration should be set at 1.67 times that of the desired C(e) for 1 min, after which it should revert to the desired concentration.

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