An analogue approach to audit in anaesthesia

The predicted outcome of anaesthesia and surgery was compared with the immediate outcome in 508 patients by means of two 100 mm linear analogue scales. The results were used to obtain a statistically based rule by which the anaesthetist may consistently select three groups of patients for audit: group 1, patients in whom immediate outcome of anaesthesia and surgery is worse than predicted; group 2, patients whose outcome is better than predicted; and group 3, the remaining patients. The rule, which is simply adapted to departmental audit, does not necessarily need a computer but is suited to the computer as it is numerically based.     

Effect of somatostatin analogs on gastric acid secretion in dogs and rats

The effects of several superactive analogs of somatostatin on gastric acid response to various exogenous and endogenous stimulants were investigated in conscious dogs and rats with gastric fistulae (GF). The inhibition was compared to that induced by somatostatin-14 (S-S-14) at two dose levels. Several octapeptide analogs of somatostatin including (RC-160) and (RC-121), which were superactive in tests on suppression of GH levels, were 4-5 times more potent than S-S-14 in inhibiting desglugastrin-stimulated gastric acid secretion in GF dogs. The analog RC-160 also reduced the rise in serum gastrin levels and gastric acid secretion induced by sham feeding (SF) in dogs with gastric and esophageal fistulae (EF), but did not decrease food consumption. Gastric acid secretion induced by histamine (80μg/kg/h) in dogs was not affected by 1-5μg/kg/h of analog RC-121 or by 5μg/kg/h of S-S-14. Analogs RC-160, RC-121, and RC-98-I and others also powerfully inhibited desglugastrin-induced gastric acid secretion in GF rats. Hexapeptide cyclo(-Pro-Phe-D-Trp-Lys-Thr-Phe) was only about half as potent as S-S-14 in dogs but its activity was higher in rats. The results indicate that octapeptide analogs which are superactive in GH-inhibition tests are also more potent than S-S-14 in suppressing gastric acid secretion. These findings may be of clinical value.     

Pernicious anemia from Addison to folic acid

I have tried to review and clarify steps leading to our present knowledge ofpernicious anemia as a clinical and etiologic entity. The early history is mostilluminating. The development of the present concept of this complicated diseaseis a triumph of medical research. Many great names both in clinical and researchfields are associated with the advance in knowledge of pernicious anemia. Furtherresearch will almost certainly clarify problems still unsolved.