In this paper, we summarise the physiology of lactation and discuss the pathophysiology brought about by fasting, stress and anaesthetic drugs. Drug secretion into breast milk and subsequent absorption by the infant is considered. Maternal hydration must be well maintained with intravenous fluids, allowing an added 500 to 1000 ml for daily fluid loss in lactation. Maternal premedication, general anaesthesia and routine postoperative analgesics are also discussed as to the effects on the breast-fed infant. Drug side-effects may be avoided by timing breast feeding just before the next due dose. Sedatives with long half-lives should not be used. Endocrine and metabolic responses to anaesthesia and surgery are less with regional anaesthesia than with general, hence regional anaesthesia is preferred where it is a reasonable alternative technique.
The study described in this paper is part of a project assessing the impact of the HIV epidemic on 535 men who have sex with men. These men were surveyed about their knowledge of HIV, their sexual practices, other issues concerning the transmission of HIV, and AIDS. This paper focuses on these men's beliefs about HIV transmission, their perceptions of the safety of a number of sexual and social practices, and the factors influencing these perceptions. The findings indicate, in general, that the men surveyed were moderately well informed about HIV transmission. Some twenty percent of the men were well‐informed about both ‘safe’ and ‘unsafe’ sexual practices, a small number were ill‐informed and the remainder, the majority, were well‐informed about some aspects and ill‐informed about others. The data suggest that information from the mainstream and gay press is not only differentially available but that information is processed and interpreted by the men in different ways. Variables which influence the manner in which information is interpreted are place of residence (locale), awareness of gay community posters and pamphlets, and the men's sexual practice; these are associated with cautiousness or rashness in the men's judgments of safety and risk.
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