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The practice of storing health care records in electronic format, rather than the traditional paper, is becoming increasing popular, especially since the advent of legislation that provided a framework for transmission of these data and encouragement to convert. However, this process is not without challenges and there are significant concerns over how to maintain the security of these data. On one hand, EMRs are expected to increase efficiency and provide cost savings. On the other hand, they increase the risk to privacy. This paper discusses both the risks and benefits of EMRs in the current legal framework in order for us to gain a better understanding of these systems. Awareness of the risks will help in building more secure EMRs which may be mandated in most countries.

A method to investigate the origin of EPSPs has been introduced and its application to recordings from spinal motoneurons allows an estimate to be made of the proportion of spontaneous EPSPs being of monosynaptic muscle afferent origin. Furthermore its application to the largest muscle stretch evoked EPSPs indicates that they can be of either monosynaptic muscle spindle Ia action or can be interneuronally mediated.

Information regarding in vitro characteristics and in vivo behaviour of microspherical drug delivery systems in animal models has accumulated and many have been developed to the stage of clinical assessment. A vital requirement for clinical trial is a stable product with a long shelf-life and reproducible properties. Thus, we have investigated whether adriamycin-loaded albumin microspheres can be freeze-dried without deterioration of important characteristics. The following properties of this delivery system were compared in the freeze-dried and freshly prepared state: particle size and state of aggregation (by Coulter Counter); drug content (by HPLC) and drug release rate (in a flow-through system). It was observed that freeze-drying and subsequent storage of adriamycin-loaded albumin microspheres resulted in no substantial difference in these properties compared to freshly prepared product. Thus, the freeze-dried product, with its considerable advantages as regards prolonged storage, appears suitable for clinical use.

Messrs. Harrison and S.F. Pearce present, in this contribution, a comprehensive account of trend- extrapolation techniques, as practised in Imperial Chemical Industries Ltd. The authors deal explicitly with six basic trend curves, available in the current ICI Central Management Services computer forecasting programme: which are: straightline; parabola; exponential; log parabola; modified exponential; and Gompertz curves. In their presentation the authors far surpass the customary exposition of mathematical detail by presenting practical examples, liberally supported with historical and technical detail, which cover: U.K. Alkali Consumption U.K. Sulphuric Acid Production U.S. Chloride Production U.S. Titanium Dioxide Consumption U.K. Man-Made Fibres Consumption U.S. Polythene Consumption U.K. Polyolefines Consumption

The relative contribution of recruitment and rate coding to the generation of muscle force appear to depend critically upon the distribution of motor unit mechanical properties. With this in mind it is reasoned that recruitment and rate coding both provide a constant proportion of the total muscle force.

Publisher Summary This chapter describes the significance of motor unit size relative to Ia excitation for the gain of the stretch reflex. A widely accepted principle of movement control is that motor units are recruited in order of the motoneuron size. One factor is that the muscle spindle Ia afferent monosynaptic projection to homonymous motoneurons is related to the mechanical properties of the innervated motor units. In particular, this excitation provides a bias favoring the recruitment of small motor units before large ones. Each source of excitation and inhibition of the motoneuron pool may provide some sort of bias, though not necessarily the same as that of the Ia projection. It is found that because a total of 12 mV depolarization is needed to recruit motoneurons, the force developed by the muscle will be fixed by the lowest point on any particular curve at which the depolarization from other sources, plus that from the Ia afferents, is equal to or greater than 12 mV. An interesting feature of such a representation is that it gives a means of predicting the gain of the stretch reflex, defined as the force increment resulting from unit increment in Ia firing frequency.

Azelastine is a novel histamine H1 antagonist with putative antileukotriene activity in guinea pigs. With three different doses of oral azelastine, we have performed a dose-response study to determine its protective effect on the airways against histamine-induced bronchoconstriction in 12 patients with mild, atopic asthma. On 4 separate days, patients undertook standardized inhalation-challenge tests with increasing concentrations of histamine (0.03 to 32 mg/ml) 4 hours after placebo or azelastine, 4.4, 8.8, and 17.6 mg, administered double blind and in random order. On 2 additional days, patients underwent methacholine challenge tests after placebo or azelastine, 17.6 mg. Baseline FEV1 between treatment days and 4 hours after placebo and azelastine did not change significantly. The three doses of azelastine, 4.4, 8.8, and 17.6 mg, increased the concentration of histamine required to cause a 20% fall in FEV1 (PC20) from 0.16 mg/ml geometric mean (GM) after placebo to 1.98 (p less than 0.01), 8.8 (p less than 0.01), and 8.1 (p less than 0.01) mg/ml, respectively. GM potency ratios derived from the PC20 values obtained for each patient indicated that the three increasing doses of azelastine displaced the histamine dose-response curve to the right by factors of 12.8, 54.4, and 50.2. Azelastine had no effect on the airway response to methacholine with GM PC20 values of 0.16 and 0.19 after placebo and azelastine, 17.6 mg. Azelastine is a potent H1 histamine-receptor antagonist on human airways in vivo without demonstrable anticholinergic effect.