Based on an international consensus conference held in Copenhagen in the autumn of 1994, a set of guidelines for Good Clinical Research Practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents are presented. The guidelines are intended to be a help for people working in this research field, and it is hoped that the guidelines will assist researchers, editors, and drug companies to enhance the quality of their pharmacodynamic studies of neuromuscular blocking agents.

Spray layer-by-layer assembly is used to create hemostatic films containing thrombin and tannic acid. The spray assembly technique enables coating of porous and absorbent commercial gelatin sponges with these films. Coated sponges are able to promote instantaneous hemostasis in a porcine spleen bleeding model.

Oral prednisolone severely suppressed QFT-IT and TST performance, whereas the long-acting corticosteroids methotrexate, azathioprine, and 5-ASA did not have a similar detrimental effect. Patients should be screened for LTBI with QFT-IT or TST prior to initiation of prednisolone therapy and negative QFT-IT or TST results interpreted with caution in patients treated with any corticosteroid until further data are available.

Clinical evaluation of recovery of neuromuscular function does not exclude significant residual paralysis following the intermediate-acting muscle relaxant rocuronium, but the problem of residual block can be minimized by use of AMG.

SUMMARY In a population‐based study, 3021 women in a central Copenhagen district received a questionnaire on environmental and psychological factors during mid‐gestation. Of these, 70 women were selected consecutively on the basis of moderate to severe stressful life‐events (DSM‐111‐R categories 3 to 5), in combination with an inadequate social network. They were compared with 50 non‐stressed women with an intact social network. Stress and smoking significantly affected birthweight and head circumference. When birthweight was corrected, stress remained a significant determinant of small head circumference, indicating a specific effect on brain development. Stress also led to a sub‐optimal Prechtl neonatal neurological score. These findings suggest the existence of a fetal stress syndrome with adverse effects on fetal development, including deficient brain development. RÉSUMÉ Les stress prénataux de la vie journalière affectent le développemeni cérébral foetal Au cours d'une étude de population, 3021 femmes d' un district central de Copenhague reçurent un questionnaire concemam les facteurs environnementaux et psychologiques a miterme. Dans ce groupe, 70 femmes furent choisies sequentiellement sur la base d'evenements provoquant un stress modere à severe (categories 3 a 5 du DSM‐111‐R) associe a un environnement social inadapte. Elles furent comparees a 50 femmes non stressees et avec environnement social intact. Le stress et le tabac affectaient significativement le poids de naissance et le tour de tete. Aprés correction sur le poids de naissance, le stress demeurait un facteur significatif de faible tour de tête, indiquant un effet specifiqiie sur le developpemeni cérébral. Le stress produit egalement un score neurologique neonatal dc Prechtl sous‐optimal. Ces donnees suggerent I'existence d'un syndrome foetal de stress avec des effets nocifs sur le developpemeni foetal, incluant un developpemeni cérébral deficient. ZUSAMMENFASSUNG .Pránatale Stressfaktoren des täglichen Lebens beeinflussen die fetale Hirnentwicklung In eincr die gesamte Bevölkerung eines Kopenhagener Wohnbezirkes umfassenden Studie erhielten 3021 Frauen cinen Fragebogen über Umwelteinflüsse und psychologische Faktoren wahrend des zweiten Sehwangerschaftstrimesters. Von diesen wurden 70 Frauen mit maßigen bis schweren Stressercignissen (DSM‐III‐R Kategorie 3–5) in Kombinaiion mit unzureichender sozialer Absicherung ausgcwahlt. Diese wurden mit einer Gruppe von 50 nicht gestressten und sozial abgesicherten Frauen verglichen. Stress und Rauchen beeinflußten signifikant Geburtsgewicht und Kopfumfang. Nach Korrektur für das Geburtsgewicht blieb Stress ein signifikanter Faktor für den Kopfumfang, d.h. Stress hat eine spezifische Wirkung auf die Hirnentwicklung. Stress war auch die Ursache für ein nicht optimales Ergebnis beim neurologischen Neugeborenentest nach Prechtl. Diese Befunde weisen auf die Fxistcnz eines fetalen Stress‐Syndroms hin, das die fetale Entwicklung und insbesondcre die Hirnentwicklung ungünstig beeinflußt. RESUMEN Los faaores est...

In 1973, a Cholinesterase Research Unit was established in Denmark (DCRU). The primary aim was to provide a central service for determining genotypes and activity of plasma cholinesterase (BChE) in patients showing abnormal response after succinylcholine. The purpose of the present study was, on the basis of 20 years experience with this Unit, to establish accurate reference intervals for BChE activity and inhibition values for the different genotypes of BChE. Also we wanted to evaluate the influence of age and sex on the BChE activity in genotypically normal patients. Plasma cholinesterase activity was measured using benzoylcholine as substrate. The genetic variations of the enzyme were identified using differential inhibitors, i.e.: Dibucaine, Sodium Fluoride, Succinylcholine, Urea and Ro-2-0683. We investigated 6,688 patients. The reference values for the 13 genotypes represented agree with previous findings. In genotypically normal patients, no age or sex differences were found in BChE activity in children below the age of 10 years. From the age of 10 years the activity decreased significantly in both males and females, the activity in females being significantly lower than in males. In females the activity was lowest in the age group 30-40 years, returning to prepuberty level at about 60 years of age. In males the activity decreased slightly up to 50-60 years of age. Hereafter the activity was stable or tended to increase slightly. Most genotypes could be recognized using the results of the different inhibition studies. We found the inhibitors Dibucaine, Sodium fluoride, Urea and Ro-2-0683 most helpful, whereas succinylcholine was of less value.(ABSTRACT TRUNCATED AT 250 WORDS)

We designed this multicenter trial to evaluate the performance and safety of the Ambu laryngeal mask, a new disposable supraglottic airway device, in patients scheduled for elective surgery. One-hundred-eighteen nonparalyzed, anesthetized patients (ASA physical status I-II, age, 18-65 yr, body mass index, 18-30 kg/m(-2)) receiving total IV anesthesia were included in this study. After device insertion, fiberoptic position and oropharyngeal leak pressure were determined at an intracuff pressure of 60 cm H2O. Ease of ventilation was determined by controlling ventilation at 6 mL/kg tidal volume. Any complications were noted and recorded. Device placement was successful in all patients on the first or second attempt (92.4% or 7.6%, respectively) with an insertion time (removal of face mask until first tidal volume) of 44.9 +/- 37.91 s. Adequate ventilation was achieved in all patients and the vocal cords could be visualized by fiberoptic endoscopy in 91.5% of patients. Oropharyngeal leak pressures were 24.1 +/- 5.44 cm H2O. Blood was detected on the device in 8.5% of patients. Complications and patient complaints were minor and quickly resolved. The Ambu laryngeal mask is easy and quick to insert and provides a safe and efficient seal during positive pressure ventilation in nonparalyzed patients scheduled for elective surgery.

Daily treatment with a low dose rhGH of 0.7 mg for 40 weeks stimulated thymopoiesis expressed by thymic index, density and area, TREC frequency and total TREC content in CD4 cells in HIV-infected patients on highly active antiretroviral therapy.