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Heart surgery on pregnant women can lead to substantial complications and even death for both mother and baby. A review of heart surgeries on 161 pregnant women between 1984 and 1996 revealed mortality rates of 30% among the babies and 6% among the mothers. The rate of complications and death was greater if the surgery was performed close to delivery. Pregnant women appear to have a greater risk of death or complications from heart surgery than non-pregnant women.

Severe fetal asphyxia may result in neurological damage because blood flow to the brain does not increase. Researchers closed off the uterine artery in six pregnant sheep to induce asphyxia in the fetuses. Fetal circulation was monitored while asphyxia was maintained until the fetus had seizures. After an initial drop in fetal heart rate and increase in blood pressure, these parameters returned to normal. Changes in vascular resistance resulted in decreased blood flow to the spleen, intestines, kidneys and skin, and increased blood flow to the heart and adrenals. Blood flow to the brain showed no significant increase. This failure in physiologic compensation appears to cause brain damage.

Pharmacotherapy in patients with neuropathic pain syndromes (NPS) can be associated with long periods of trial and error before reaching satisfactory analgesia. The aim of this study was to investigate whether a short intravenous (i.v.) infusion of lidocaine may have a predictive value for the efficacy of oxcarbazepine.In total, 16 consecutive patients with NPS were studied in a prospective, uncontrolled, open-label study design. Each patient received i.v. lidocaine (5 mg/kg) within 30 min followed by a long-term oral oxcarbazepine treatment (900–1,500 mg/day). During an observation period of 28 days, treatment response was documented by a questionnaire including the average daily pain score documented on a numeric rating scale (NRS).A total of 6 out of 16 patients (38%) were lidocaine responders (defined as pain reduction >50% during the infusion), and 4 of 16 (25%) were oxcarbazepine responders. In total, 6 out of 16 participants (38%) discontinued oxcarbazepine treatment due to side effects. In an interim analysis predictive value of the lidocaine infusion was low with a Kendall’s tau correlation coefficient of 0.29 and coefficient of determination R2of 0.119 (95% confidence interval –0.29 to 0.72). As a consequence of this low correlation, the study was discontinued for ethical reasons.In conclusion, lidocaine infusion has a low predictive value for effectiveness of oxcarbazepine—if at all.

Due to the ever growing use of epoxy resins for structural applications, more information is required about their structure-properties relationship. Much work was done on this subject by us and by others, but many questions still remain unanswered. Some problems which require more detailed studies are the influence of factors like compositional changes in the resin (ratio of prepolymer-curing agent), postcuring and cooling of the polymerized resin from temperatures above Tg to room temperature, on physical properties of the product.

This review describes several non-invasive and invasive diagnostic procedures that are available to help the clinician to evaluate the condition of the fetus antenatally and intrapartum. Fetal distress should be detected early enough to avoid damage to the newborn.

The effects on gastric pH of the H2-receptor antagonist ranitidine (R) with 0.3 molar (M) sodium citrate (SC) as an oral effervescent and those of plain SC were studied in 25 patients scheduled for elective surgery. Following induction of general anaesthesia, the gastric contents were evacuated via a nasogastric tube, and a pH electrode was placed in the stomach. Then, eight patients received R 300 mg plus SC dose (Group R300), ten received R 150 mg plus SC dose (Group R150), and seven received 50 ml SC alone (Group SC). The drugs were administered orally in a double-blind fashion, and the gastric pH was recorded continuously over a period of 24 hr. Mean (range) baseline pH values were 1.2 (0.8–1.8), 1.3 (1.0–1.8), and 1.2 (0.9–1.6) in the R300, R150, and SC groups, respectively (P = NS among groups). These values increased to 7.0 (6.2–7.5), 6.9 (6.3–7.3), and 4.9 (1.9–7.3), respectively, at emergence from anaesthesia (P < 0.05 for R300 vs SC and R150 vs SC). Two minutes after administration of R300 and R150, a mean (range) gastric pH of 6.8 (5.8–7.5), and 5.6 (1.2–7.0), respectively, was reached, and remained above 2.5 for 14 hr (P = NS). Plain SC increased the gastric pH within two minutes to a mean of 6.8 (6.7–7.0), and maintained it above 2.5 for six hours (P < 0.05 for R300 vs SC at 8, 10, 12, and 14 hr after induction). We conclude that both the combination of R plus SC, and SC alone are rapidly effective in neutralizing gastric acid when administered orally after induction of anaesthesia. However, the effectiveness of plain SC is shorter-lived, and if maintenance of gastric pH above 2.5 for longer than six hours is needed, the R plus SC combination should be administered.

We describe a positive correlation between the extent of sequential counting in a random-number generation task and the magnitude of the interference effect in Stroop's color-naming task. This finding is compatible with the view that both counting and reading are highly automatized processes which constitute an inevitable source of interference in randomization and Stroop paradigms, respectively. On the other hand, cognitive psychological theories proposing that a generally biased concept of randomness would be responsible for human subjects' inability to generate true random sequences do not readily account for this correlation. Literature on repetition avoidance indicates this universal effect in random generation is likewise not explainable in terms of some “biased concept of randomness.” Repetition avoidance (“spontaneous alternation”) also occurs in lower invertebrates, is largely independent of mathematical sophistication in humans, dissipates with increasing time between consecutive responses, and is diminished by amnesia. We conclude that the failure of functionally intact organisms to display random behavior is due to basic neuropsychological limitations. In neglecting these biological foundations, “concept of randomness” theories of randomization behavior lack explanatory value.