Ann Acad Med Singap
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The mechanism of anaesthesia is still a black box, although many investigators have been concerned about this theme since the 19th century. It is too complex to clarify the mode of anaesthetic action, as a variety of compounds have been adopted as anaesthetics. Hill coefficients calculated from the righting reflex dose-response curve in enflurane, isoflurane sevoflurane and halothane anaesthesia in a certain strain of mice were from 14 to 56. ⋯ It is suspected from Overton's experiment that the action site is not in the core of lipid bilayer but on the surface of membrane. It was demonstrated by 2 methodologies. Two-dimensional nuclear Overhauser effect spectrum in H1-NMR spectra of dipalmitoyl phosphatidylcholine (DPPC) vesicle membrane in the presence of methoxyflurane revealed from the existence of the cross-peak between the methoxy-proton and the choline methyl-proton that methoxyflurane molecule interacted only to the polar head of lipid membrane at lower temperatures.(ABSTRACT TRUNCATED AT 400 WORDS)
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Ann Acad Med Singap · Jul 1994
Education of specialists in anaesthesia and intensive care in Europe--A Swedish perspective.
Sweden as well as most other countries in western Europe are parts of a common labour market where free movement of the labour force is encouraged. As in all recognised specialties of medicine, most national Anaesthesia societies or colleges have joined the Specialist Committee of the Union Européenne des Médicins Spécialistes (UEMS) as well as the European Board of Anaesthesiology in a joint European effort intended to promote the highest possible standard in the practice of Anaesthesia and Intensive Care throughout the European Union and the European Economic Space. ⋯ The European Academy of Anaesthesiology is working together with these organisations and is offering the specialist organisations or colleges in Europe to take part in their specialist examination, hospital recognition programme and in-training examinations. Our country, among others, has adopted the European Diploma of Anaesthesiology and Intensive Care as the national examination for future specialists in our discipline.
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Ann Acad Med Singap · Jul 1994
Septic shock in a surgical intensive care--validation of multiorgan and APACHE II scores in predicting outcome.
We analysed retrospectively the records of 353 admissions to the National University Hospital's Surgical Intensive Care Unit over a one-year period and found 25 patients with septicaemic shock requiring vasoactive therapy. The mortality rate was 68%. ⋯ Only the APACHE II was a significant predictor of outcome, the rest having poor predictive ability. We conclude that the present scoring systems are too inaccurate for us to base important clinical decisions on.
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Ann Acad Med Singap · Jul 1994
Specialist training and examinations in anaesthesia and intensive care in Australia and New Zealand.
The Australian and New Zealand College of Anaesthetists approves specialist training positions and requires specified periods of training in anaesthesia and intensive care. A common Primary examination in basic sciences is used by both specialties. ⋯ The syllabus for the Final examination is based on two College documents entitled Objectives of Training, one for anaesthesia and one for intensive care. Other requirements and anticipated future changes to the present training, examination and recertification systems include examination review, in-training assessment, a formal project, a new pain management qualification and a maintenance of standards (recertification) programme.
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Ann Acad Med Singap · Jul 1994
Specialist anaesthetic training and certification process in England.
Specialist accreditation in anaesthesia in the United Kingdom currently requires a minimum of six years recognised training after full medical registration. In future, the training programme will become more structured, with more emphasis on regular in-training assessment, and attempts are being made to reduce the overall training period. ⋯ It is one of the first postgraduate bodies to introduce the Objective Structured Clinical Examination (OSCE) into its examination structure. A more formal programme of Continuing Medical Education is also being considered.