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It has been suggested that birds prefer to use a particular eye while learning to detect cryptic prey and that this eye preference enhances foraging performance. European starlings (Sturnus vulgaris) with the left, right, or both eyes available learned to detect inconspicuous cues associated with the presence of hidden prey. Acquisition scores were not significantly different between left and right-eyed birds; however, performance in the binocular condition was significantly higher than in the two monocular conditions. When binocular birds were tested with familiar and unfamiliar cues present simultaneously, the familiar cue was selected significantly more often than the unfamiliar cue, suggesting that the birds were searching for specific cue features. When monocular birds were tested using only the naïve eye, performance dropped significantly. In right-eyed birds using the naïve left eye, performance remained at chance levels over transfer trials. However, left-eyed birds using the naïve right eye had a superior performance compared to the initial acquisition scores of right-eyed birds and also showed a significant improvement in performance over transfer trials. Thus, although there was no direct evidence of lateralization during acquisition, there was unilateral transfer of the prey detection skill from the right to the left hemisphere.

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The hypothesis that social learning is an adaptive specialization for social living predicts that social species should learn better socially than they do individually, but that nonsocial species should not exhibit a similar enhancement of performance under social learning conditions. The authors compared individual and social learning abilities in 2 corvid species: the highly social pinyon jay (Gymnorhinus cyanocephalus) and the less social Clark's nutcracker (Nucifraga columbiana). The birds were tested on 2 different tasks under individual and social learning conditions. Half learned a motor task individually and a discrimination task socially; the other half learned the motor task socially and the discrimination task individually. Pinyon jays learned faster socially than they did individually, but nutcrackers performed equally well under both learning conditions. Results support the hypothesis that social learning is an adaptive specialization for social living in pinyon jays.

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Healthcare professionals caring for children with cerebral palsy should be aware of an association between it and latex anaphylaxis. Between 1989 and 1992 we had 22 patients with intraoperative anaphylactic reactions to latex at our institutions. Of these, six had cerebral palsy. The case histories of these six children are reported here. Most had had multiple operations and ventriculoperitoneal shunts. Preoperative recognition is key to prevention. If suspected from a patient's history, latex antibody testing is available. If needed, anesthesia for these individuals should be given using a latex-free environment with or without medical prophylaxis.

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Edema contributes substantially to the postoperative discomfort and morbidity of adenotonsillectomy. In a double-blind study, 58 children undergoing adenotonsillectomy were given a single intraoperative dose of either dexamethasone or saline. The steroid markedly affected the postoperative course in the first day after surgery. According to parental reports, the percentage of patients vomiting was reduced from 48 to 4%. Severe throat pain was reported in 57% of controls and only 20% of dexamethasone patients. Twice as many steroid patients as controls tolerated some soft food on the first postoperative day. It appears that dexamethasone can greatly improve patient diet and comfort after adenotonsillectomy.

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Intraoperative anaphylaxis secondary to exposure to latex is a serious and potentially life-threatening phenomenon that has been recognized more frequently in recent years. Between 1989 and 1992, twenty-one patients had a Type-I (anaphylactic) reaction to latex intraoperatively at The Children's Hospital of Philadelphia. Twelve (57 per cent) of these patients had spina bifida. Six patients (29 per cent) had cerebral palsy, and five of them had a ventriculoperitoneal shunt. Of the remaining three patients, one (5 per cent) had exstrophy of the bladder, one had VATER syndrome, and one had Duchenne muscular dystrophy. All of the patients had had at least two previous operative procedures. Overall, sixteen patients (76 per cent) had a ventriculoperitoneal shunt. The manifestations of the allergic reaction included a rash in fifteen patients (71 per cent), hypotension in fifteen, tachycardia in eleven (52 per cent), bronchospasm in ten (48 per cent), bradycardia in two (10 per ent), and cardiac arrest in two. The symptoms occurred within minutes after the induction of the anesthesia in all but one patient, in whom hypotension and cardiovascular arrest developed approximately one hour after the beginning of the operation. Two patients had a full cardiopulmonary arrest while under the anesthesia. All twenty-one patients responded to management; there were no deaths. Of the six patients who had cerebral palsy, five had been managed with a ventriculoperitoneal shunt because of hydrocephalus following a previous intraventricular hemorrhage that was related to prematurity.(ABSTRACT TRUNCATED AT 250 WORDS)

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Use of the laryngeal mask airway (LMA) permits the maintenance of a patent airway with successful insertion rates of the LMA on the first attempt varying between 67%-92% in children. The recommended insertion technique involves deflation of the mask using a syringe, and application of a lubricant jelly. In a randomized study of 122 children, we compared the time to complete LMA insertion, the number of attempts before successful placement, and the occurrence of laryngospasm and Spo2 < 90% during insertion using the standard deflated method and an alternative method of insertion with the LMA cuff partially inflated. Independently, the children were randomly assigned to have K-Y sterile lubricating jelly or 2% lidocaine topical solution applied to the back of the mask. The occurrence of coughing, laryngospasm, and vomiting during emergence were recorded. Insertion of the LMA partially inflated required significantly less time (16 vs 23 s, P < 0.05), and was associated with a higher success rate on first attempts (85.5% vs 96.7%, P < 0.05). In those who did not receive morphine, 2% lidocaine topical solution decreased the incidence of coughing on emergence (10.3% vs 36.4%). The ease of insertion of the LMA in children was improved by partial inflation of the cuff and in addition, 2% lidocaine topical solution was as beneficial as morphine in reducing coughing on emergence.

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In a 10-year period, 22 neonates with esophageal atresia (EA) and tracheoesophageal fistula (TEF) required high pressure ventilatory support soon after birth because of respiratory distress syndrome (RDS). Eleven of the 22 or 50% survived overall, but if the 5 patients who died before definitive surgical repair could be attempted are excluded, 11 of 17 or 65% survived. More importantly, 4 of 7 (57%) patients who had gastrostomy performed first survived while 7 of 10 (70%) who had fistula ligation performed first survived. The difficulties with intraoperative management of those who had gastrostomy performed first were even more impressive. Our experience leads us to conclude that patients with EA and TEF with severe RDS who require high pressure ventilation preoperatively represent a group of patients who require special consideration. The danger to such patients with increased pulmonary resistance is not gastric distention but sudden loss of intragastric pressure. In the presence of poor lung compliance, the upper gastrointestinal tract functions in continuity with the tracheobronchial tree. A sudden loss of intragastric pressure, as with placement of a gastrostomy tube, results in an acute loss of effective ventilating pressure. Resuscitation of such a patient is not possible until leakage from the esophagus is controlled by ligation of the fistula or transabdominal occlusion of the distal esophagus. Placement of a Fogarty catheter into the fistula via a bronchoscope is effective but may not be feasible in every case. Early thoracotomy and ligation of the fistula in patients with progressive RDS provides immediate improvement in ventilatory efficiency and relief of gastric distention.

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