A comparison of midazolam and temazepam for premedication of day case patients

One hundred patients who underwent day case surgery took part in a randomized double-blind comparison between midazolam 15 mg and temazepam 20 mg orally as premedicants. Postoperative recovery was studied using tests of psychomotor function. Midazolam produced a similar degree of anxiolysis to temazepam and a greater incidence of drowsiness. Recovery was similar after either premedicant and psychomotor function was still depressed 4 hours postoperatively (p less than 0.001). Nearly 90% of patients felt that they had benefitted from either premedicant. We conclude that midazolam is a suitable drug for premedication in day case surgery.     

A Study of the Menopause, Smoking, and Contraception in Women with Crohn's Disease

One hundred and ninety-six women with Crohn's disease from south-eastWales were asked to provide details of their menstrual cycles,age at menopause, history of surgery, smoking habits and useof oral contraceptives. One hundred and forty-six provided theinformation (response rate 77 per cent). Eighty-four were stillmenstruating, three were pregnant, 10 had undergone hysterectomy,one had a pharmacologically-induced menopause and 48 had hada physiological menopause. Of these 48 women, 33 were diagnosedas having Crohn's disease before the menopause. Twenty-fiveof these were smokers. The mean age at menopause was similarin smokers and non-smokers and in those diagnosed before andafter the menopause. The mean age at menopause was between 46and 47. A logistic analysis using the ‘status quo’method showed that 50 per cent of women with Crohn's diseasehad the menopause at 47.6 years compared with 49.6 years ina group of healthy women from the same area. The two groupshad similar smoking habits and it would seem that a prematuremenopause is associated with Crohn's disease.     

HUMAN CHORIONIC GONADOTROPHIN AND SUBUNITS—HETEROGENEITY IN SERUM OF MALE PATIENTS WITH TUMOURS OF THE GENITAL TRACT

The pattern of secretion of human chorionic gonadotrophin (hCG) and its subunits in male subjects with tumours of the genital tract was examined by gel filtration, radioimmunoassay, immunoradiometric assay, bioassay and binding to Concanavalin A. The predominant form of hCG was the intact molecule but all patients had increased levels of free beta subunit. The intact hCG was active in a mouse Leydig cell bioassay and was normally glycosylated. High concentrations of free alpha subunit were not found and the ratio of alpha subunit: beta subunit was less than that in normal pregnancy. It is concluded that hCG-secreting tumours of the male genital tract are similar to choriocarcinoma in the female in that large quantities of intact hormone are produced with a disproportionate increase in free beta sub-unit.     

Evaluation of a presentation skills course for pharmacists

As the role of the pharmacist develops, expands and changes, it is crucial that those involved in the provision of education and training programmes address areas of current need. One such area is that of delivering presentations to groups, since this is a task which pharmacists are increasingly expected to perform. This paper describes a communication skills training (CST) course for pharmacists, targeting on the area of presentation skills. Starting with a brief overview of the content of the course, where five specific presentation strategies are elaborated, the article goes on to describe the key instructional techniques used. Programme evaluation was through analysis of a post-course questionnaire designed to assess the perceived effects of the training on participants. Against the stated criteria the course achieved an overall 85 per cent score. Strategies for introducing, structuring and concluding a presentation, and for defining new terms scored highest in terms of skill use outcome whereas techniques for engaging audience participation obtained the lowest scores. The implications of these results are discussed, together with recommendations as to how this type of training can be optimised.     

Immunoreactive oestrogens and progesterone in amniotic fluid in twin pregnancies

Summary. Amniotic fluid concentrations of immunoreactive oestrogens and progesterone were measured at the time of caesarean section in 32 twin pregnancies; 25 women had an elective section and seven were in labour at the time of operation. No significant differences between concentrations in the amniotic fluid of the first and second twin were found in respect of conjugated and unconjugated oestrone, oestradiol, oestriol, oestetrol and unconjugated progesterone either before or during labour. It is unlikely that changes in oestrogens or progesterone in the amniotic fluid are responsible for the selective changes seen in prostaglandins and fetal adrenal steroid during labour in the first twin.     

Potential consequences from possible changes to Nordic retail alcohol monopolies resulting from European Union membership

This paper projects the consequences of modifying or eliminating the current national alcohol retail monopolies in Sweden, Norway and Finland as a possible result of those countries' membership in the European Union (EU). First, the authors project absolute alcohol consumption in each country based on different possible changes in alcohol price and availability. Then they predict the future levels of alcohol-related problems likely to result from increased per capita alcohol consumption (Sweden and Norway only). All of the scenarios examined in this paper are expected to lead to increases in per capita alcohol consumption. The smallest increase in consumption would result from a partial elimination of the current monopoly and a modest reduction in alcohol prices. In that case, projected per capita consumption in Sweden for inhabitants 15 years and older would rise from 6.3 to 9.3 litres; in Norway, from 4.7 to 6.7 litres; and in Finland, from 8.4 to 11.1 litres. The greatest projected increase in consumption would result from a complete elimination of the state monopolies such that all beer, wine and spirits were sold in food shops, grocery stores and gasoline stations, along with a substantial drop in alcohol prices as a result of private competition within each country and increased cross-border alcohol purchases. That scenario would result in projected per capita consumption of 12.7 litres in Sweden, 11.1 litres in Norway and 13.7 litres in Finland. The authors project that a 1-litre increase in consumption would result in a 9.5% increase in total alcohol-related mortality in Sweden and a 9.7% increase in Norway. Further, alcohol-related assaults would increase by 9% in Sweden and 9.6% in Norway. A 5-litre increase in consumption would result in a 62% increase in alcohol-related mortality in Sweden and a 60% increase in Norway, and a 57% increase in alcohol-involved assaults in both countries.