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Introduction: We evaluate the accuracy of postnatal biochemical and lung function tests performed within 3 h from birth for predicting surfactant need in preterm infants ≤34 weeks’ gestation receiving noninvasive respiratory support for respiratory distress syndrome (RDS). Methods: We systematically searched MEDLINE, Embase, The Cochrane Library, PROSPERO, and clinicaltrials.gov databases for studies published from 2000 to November 10, 2021, cross-referencing relevant literature and contacting experts. We included diagnostic accuracy studies and systematic reviews of biochemical or lung function tests identifying the need for surfactant in preterm neonates ≤34 weeks’ with RDS not intubated at birth. The authors individually assessed the risk of bias following a tailored QUADAS-2 tool. Results: Eight studies, including 810 infants, met the inclusion criteria. Four tests were included: the click test, the stable microbubble test, the lamellar body count on gastric aspirates, and the forced oscillation technique. The reference standards were transparent criteria for distinguishing the infants according to oxygen requirement, which reflected the current criteria for surfactant therapy. The risk of bias was judged high because of the population selection and exclusion of participants from the analysis. There were no serious concerns regarding blinding and applicability. The individual study sensitivity and specificity range from 0.60 to 1 and from 0.51 to 0.91, respectively. It was not appropriate to combine the accuracy estimates in a meta-analysis because of the heterogeneity of the study characteristics. Conclusions: Current evidence is insufficient to recommend biochemical and lung function tests for tailoring surfactant therapy.

All-night sleep EEGs were recorded from 7 healthy adult volunteers and stored on magnetic tape. Digital processing, i.e. computation of power, coherence and phase spectra of preselected pieces was performed according to procedures published in detail elsewhere [Dumermuth and Fluehler, 1967; Kleiner et al., 1970; Dumermuth et al., 1972], Discussion of Results1 Power spectra are estimates of the average intensity of the different frequency components within a predefined epoch. The spectrogram provides a condensed spectral representation of complete sleep cycles and allows one to demonstrate the temporal behavior of the main frequency components during the various sleep stages (fig. 1). The obtained power spectra showed unequivocally that a activity is a constant EEG component during sleep stages C, D and E. However, it does not necessarily appear in the

In order to investigate whether sleep deprivation activates the photoconvulsive response 35 patients were investigated electroencephalographically after 24–36 h of waking. In 34 cases with sleep depri

This paper reports on 294 patients with presumptive symptoms of epilepsy but no noteworthy, or only suspicious, EEG findings. With recording during sleep after 24–27 h of sleep deprivation, 138 person

An EEG study was carried out in 4 epileptic patients. In each case, Ro 15-1788 caused the disappearance or marked reduction of the epileptic potentials. In 1 case the patient had been pretreated with diazepam; in the other cases there had been no prior benzodiazepine treatment. In the first case, it is possible that Ro 15-1788 acted by abolishing a paradoxical effect of diazepam; in the other cases, we postulate an intrinsic anticonvulsant effect of Ro 15-1788. This investigation would suggest further study of Ro 15-1788 in epileptic patients for clarification of its anticonvulsant properties. In addition, evaluation of its action on the sedation caused by benzodiazepine antiepileptic medication is suggested.

The specificity of localized periodic complexes (PC) in the EEG is discussed by means of a case. This patient presented rapidly evolving focal symptoms of the CNS together with fever. The EEG showed localized PCs and in the CT scan there was a hyperdense lesion in a region corresponding to the EEG finding. Postmortem examination revealed a subcortical bleeding in the temporal region. Possible mechanisms for the origin of these PCs and their diagnostic value are discussed.

Computerized transaxial tomography was carried out on 112 patients with partial seizures with complex symptomatology. Structural abnormalities were defined in 33% of their studies: tumors in 8 patients, diffuse cerebral atrophy in 2, focal cortical atrophy in 27 and vascular abnormality in 1 case.

The authors themselves studied 26 patients. The EEGs were classified in terms of increasing severity in 5 categories. Incorporating over 400 cases from the literature, the authors correlated the initial EEG findings with the clinical outcome following cardiac arrest. Grade I EEG findings (normal alpha with theta-delta activity) imply a very good prognosis. A complete remission can be expected in most cases. Grade II (dominant theta-delta activity with detectable normal alpha) and grade III (dominant theta-delta activity without detectable normal alpha) findings have no definite prognosis. Grade IV [low-voltage delta, possibly with short isoelectric intervals; dominant, monomorphic, non-reactive alpha-activity (alpha coma); periodic generalized phenomena (spikes, sharp waves, slow waves with very low background activity)] and grade V (very flat to isoelectric EEG) findings have a very serious prognosis.

In medical practice a number of antagonists which are capable of abolishing the effect of endogenous substances are available. The discovery of the benzodiazepine antagonist Ro 15-1788 has opened up new possibilities in the treatment and diagnosis of comas of different aetiology. This compound makes it possible to shorten the duration of unconsciousness and to eliminate selectively the effect of the benzodiazepine in an organism which has been intoxicated by different substances. The benzodiazepine antagonist Ro 15-1788 occupies the benzodiazepine receptors in the brain and, without influencing the receptor itself, prevents an active benzodiazepine from binding to this site and from exercising its pharmacological effect. On the basis of 9 clinical examples in special situations, the efficacy of treatment using the benzodiazepine antagonist is presented and discussed.

In 1983, we reported on the excellent efficacy of the benzodiazepine antagonist RO 15-1788 in cases of acute intoxication with diazepam in intensive care medicine. Upon observing a positive effect in a patient who had taken alcohol as well as diazepam a study aiming at establishing the beneficial effect of RO 15-1788 in alcoholic intoxication was started. In the meantime, we discovered a significant amelioration of the cerebral disturbance in patients suffering from hepatic coma by the same benzodiazepine antagonist. The preliminary results of a multicenter study reflecting the beneficial effect of RO 15-1788 in cases of alcohol intoxication will be presented.

In addition to the benzodiazepine antagonism we report, as a first observation, the effect of flumazenil on carbamazepine intoxication, where a mechanism other than benzodiazepine receptor antagonism must be supposed.