The anaesthetic management of Caesarean section for placenta praevia: a questionnaire survey

The purpose of this study was to determine current UK anaesthetic practice regarding the use of regional anaesthesia in the management of patients with placenta praevia presenting for Caesarean section. We asked the members of the Obstetric Anaesthetists Association to complete a postal questionnaire in which a range of clinical situations involving varying degrees of placenta praevia were presented. In each case respondents were asked whether they would be willing to use regional anaesthesia. A wide variety of clinical practice was demonstrated. Anaesthetists with two or more obstetric sessions were more willing to use regional anaesthesia for Caesarean section in the presence of placenta praevia in both elective and emergency situations associated with haemorrhage.     

The molecular basis of muscarinic receptor diversity

The cloning of cDNAs and genes for five different muscarinic acetylcholine receptors provides a new basis for characterizing muscarinic receptor function. Studies of the cloned receptors when introduced into cells not expressing endogenous receptors have allowed the initial identification of two classes of functional response. The m1, m3 and m5 receptors belong to a class characterized by agonist-induced stimulation of phosphatidylinositol metabolism and are structurally more related to each other than they are to the m2 and m4 receptors, which belong to a class associated with agonist-induced inhibition of adenylate cyclase. While functional differences within these classes may yet be found, it appears likely that much of the difference between functionally similar receptors will be found to lie in their regulation.     

Evaluation of aztreonam, cefoperazone, latamoxef and ceftazidime in the hamster colitis model

Aztreonam, ceftazidime, cefoperazone and latamoxef (moxalactam) were evaluated in a hamster model for antibiotic-associated colitis. Aztreonam, a novel monocyclic beta-lactam antibiotic specifically directed against aerobic Gram-negative bacteria with limited activity against Gram-positive and anaerobic bacteria did not cause haemorrhagic caecitis and death in hamsters when administered intraperitioneally or orally. Quantitative caecal cultures showed no changes in the anaerobic caecal microflora of hamsters treated intraperitoneally with aztreonam and only a temporary decrease in anaerobic Gram-negative bacilli in hamsters treated orally. Clostridium difficile and its cytotoxin were not present in these animals. Parenteral administration of ceftazidime also did not affect the anaerobic caecal microflora or cause caecitis. However, when given orally, ceftazidime suppressed the anaerobic caecal microflora and a lethal C. difficile-induced caecitis developed. Latamoxef or cefoperazone given parenterally resulted in caecitis and death in five days with marked changes in the anaerobic caecal microflora and C. difficile present in the caecal contents of these animals. The lethal haemorrhagic caecitis observed in this study was indistinguishable from that seen in the clindamycin-induced colitis model in the hamster. The possible correlation of these findings to gastrointestinal disturbances as a complication of antibiotic therapy in humans is discussed.     

Rate of hydrolysis of seven organophosphate pesticides

Conclusion All of the organophosphates studied were degraded by hydrolysis at varying rates in a slightly acidic aqueous medium. Of course the conditions of this study were not intended to duplicate conditions in the field, but the results indicate that, while all of these pesticides are eventually hydrolyzed, most of them seem to have a much greater residual life than might have been anticipated. This is especially surprising when it is realized that the hydrolysis conditions in our study were probably more rigorous than those encountered in the field.Organophosphate pesticides may therefore retain their toxicity for a longer period than expected after application, and as a consequence are more hazardous than commonly supposed.It should also be remembered, as pointed out earlier, that the products of hydrolysis (such as p-nitrophenol in the case of parathion) are, in themselves, quite toxic.