Intravenous conscious sedation in patients under 16 years of age. Fact or fiction?

Recently published guidelines on the use of conscious sedation in dentistry have published varying recommendations on the lower age limit for the use of intravenous conscious sedation. There are a large number of dentists currently providing dental treatment for paediatric patients under intravenous conscious sedation. The 18 cases reported here (age range 11-15 years), were successfully managed with intravenous conscious sedation. The experience in this paper is not sufficient evidence to recommend the wholesale use of intravenous conscious sedation in patients who are under 16 years. The fact that a range of operators can use these techniques on paediatric patients would suggest that further study should be carried out in this population. The guidance should be modified to say there is insufficient evidence to support the use of intravenous conscious sedation in children, rather than arbitrarily selecting a cut off point at age 16 years

Cosmological Parameter Extraction from the First Season of Observations with DASI

The Degree Angular Scale Interferometer (\dasi) has measured the power spectrum of the Cosmic Microwave Background anisotropy over the range of spherical harmonic multipoles 100<l<900. We compare this data, in combination with the COBE-DMR results, to a seven dimensional grid of adiabatic CDM models. Adopting the priors h>0.45 and 0.0<=tau_c<=0.4, we find that the total density of the Universe Omega_tot=1.04+/-0.06, and the spectral index of the initial scalar fluctuations n_s=1.01+0.08-0.06, in accordance with the predictions of inflationary theory. In addition we find that the physical density of baryons Omega_b.h^2=0.022+0.004-0.003, and the physical density of cold dark matter Omega_cdm.h^2=0.14+/-0.04. This value of Omega_b.h^2 is consistent with that derived from measurements of the primordial abundance ratios of the light elements combined with big bang nucleosynthesis theory. Using the result of the HST Key Project h=0.72+/-0.08 we find that Omega_t=1.00+/-0.04, the matter density Omega_m=0.40+/-0.15, and the vacuum energy density Omega_lambda=0.60+/-0.15. (All 68% confidence limits.)Comment: 7 pages, 4 figures, minor changes in response to referee comment

DASI Three-Year Cosmic Microwave Background Polarization Results

We present the analysis of the complete 3-year data set obtained with the Degree Angular Scale Interferometer (DASI) polarization experiment, operating from the Amundsen-Scott South Pole research station. Additional data obtained at the end of the 2002 Austral winter and throughout the 2003 season were added to the data from which the first detection of polarization of the cosmic microwave background radiation was reported. The analysis of the combined data supports, with increased statistical power, all of the conclusions drawn from the initial data set. In particular, the detection of E-mode polarization is increased to 6.3 sigma confidence level, TE cross-polarization is detected at 2.9 sigma, and B-mode polarization is consistent with zero, with an upper limit well below the level of the detected E-mode polarization. The results are in excellent agreement with the predictions of the cosmological model that has emerged from CMB temperature measurements. The analysis also demonstrates that contamination of the data by known sources of foreground emission is insignificant.Comment: 13 pages Latex, 10 figures, submitted to Ap

Hard X-ray flares in IGR J08408-4503 unveil clumpy stellar winds

Context : A 1000-s flare from a new hard X-ray transient, IGR J08408-4503, was observed by INTEGRAL on May 15, 2006 during the real-time routine monitoring of IBIS/ISGRI images performed at the INTEGRAL Science Data Centre. The flare, detected during a single one-hour long pointing, peaked at 250 mCrab in the 20-40 keV energy range. Aims : Multi-wavelength observations, combining high-energy and optical data, were used to unveil the nature of IGR J08408-4503. Methods : A search in all INTEGRAL public data for other bursts from IGR J08408-4503 was performed, and the detailed analysis of another major flare is presented. The results of two Swift Target of Opportunity observations are also described. Finally, a study of the likely optical counterpart, HD 74194, is provided. Results : IGR J08408-4503 is very likely a supergiant fast X-ray transient (SFXT) system. The system parameters indicate that the X-ray flares are probably related to the accretion of wind clumps on a compact object orbiting about 1E13 cm from the supergiant HD 74194. The clump mass loss rate is of the order of 1E-6 solar mass/yr. Conclusions : Hard X-ray flares from SFXTs allow to probe the stellar winds of massive stars, and could possibly be associated with wind perturbations due to line-driven instabilities.Comment: 5 pages with 5 figures. Published as a Letter in Astronomy & Astrophysic

Patient-maintained sedation for oral surgery using a target-controlled infusion of propofol - a pilot study

OBJECTIVE: To assess the safety and efficacy of a new patient-maintained propofol system for conscious sedation in dentistry. DESIGN: Prospective clinical trial SETTING: Department of Sedation, Glasgow Dental Hospital and School, 2001 SUBJECTS AND METHODS: Patients scheduled for oral surgery with conscious sedation. Exclusions included ASA IV -V, inability to use the handset, opioid use and severe respiratory disease. INTERVENTIONS: Patients were given intravenous propofol to a level of 1.0 microg/ml (reducing from 1.5 microg/ml) using a target controlled infusion system, they then controlled their sedation level by double-clicking a handset which on each activation increased the propofol concentration by 0.2 microg/ml. MAIN OUTCOME MEASURES: Oxygen saturation, patient satisfaction, and surgeon satisfaction. RESULTS: Twenty patients were recruited, 16 female and four male. Nineteen patients completed sedation and treatment successfully. Mean lowest oxygen saturation was 94%. No patients were over-sedated. All patients successfully used the system to maintain a level of sedation adequate for their comfort. Patient and surgeon satisfaction were consistently high. CONCLUSIONS: Initial experience with this novel system has confirmed safety, patient satisfaction and surgeon satisfaction

Second and third season QUaD CMB temperature and polarization power spectra

We report results from the second and third seasons of observation with the QUaD experiment. Angular power spectra of the Cosmic Microwave Background are derived for both temperature and polarization at both 100 GHz and 150 GHz, and as cross frequency spectra. All spectra are subjected to an extensive set of jackknife tests to probe for possible systematic contamination. For the implemented data cuts and processing technique such contamination is undetectable. We analyze the difference map formed between the 100 and 150 GHz bands and find no evidence of foreground contamination in polarization. The spectra are then combined to form a single set of results which are shown to be consistent with the prevailing LCDM model. The sensitivity of the polarization results is considerably better than that of any previous experiment -- for the first time multiple acoustic peaks are detected in the E-mode power spectrum at high significance.Comment: 24 pages, 23 figures, updated to reflect published versio

DASI First Results: A Measurement of the Cosmic Microwave Background Angular Power Spectrum

We present measurements of anisotropy in the Cosmic Microwave Background (CMB) from the first season of observations with the Degree Angular Scale Interferometer (DASI). The instrument was deployed at the South Pole in the austral summer 1999--2000, and made observations throughout the following austral winter. We have measured the angular power spectrum of the CMB in the range 100<l<900 with high signal-to-noise. In this paper we review the formalism used in the analysis, in particular the use of constraint matrices to project out contaminants such as ground and point source signals, and to test for correlations with diffuse foreground templates. We find no evidence of foregrounds other than point sources in the data, and find a maximum likelihood temperature spectral index beta = -0.1 +/- 0.2 (1 sigma), consistent with CMB. We detect a first peak in the power spectrum at l approx 200, in agreement with previous experiments. In addition, we detect a peak in the power spectrum at l approx 550 and power of similar magnitude at l approx 800 which are consistent with the second and third harmonic peaks predicted by adiabatic inflationary cosmological models.Comment: 8 pages, 1 figure, minor changes in response to referee comment