The incidence of serious complications associated with Anaesthesia appears to have decreased in recent years. There are many reasons for this—better anaesthetic drugs and equipment, widespread availability of modern monitoring devices, improved standards of pre‐, intra‐ and postoperative care, increasing interest in techniques to identify and control common risk factors and increased number of qualified anaesthetists. Nevertheless, accidents continue to occur. The most common cause of death or serious injury is still failure to ventilate the patient. All recent studies agree that the majority of accidents in modern practice are the consequence, not of equipment failure or adverse drug reactions, but of human error. Mistake, lack of vigilance, inexperience, inadequate supervision and failure of communication are identified as recurring problems. These problems need to be addressed if anaesthesia‐related complications are to be further decreased. It seems reasonable to suggest that the use of anaesthesia simulators to train and test anaesthetists in difficult situations should be given a higher priority—both in basic training and in continued postgraduate education. Furthermore, since anaesthesia‐related adverse outcomes are rare, strict safety procedures must be applied to thousands of patients in order to prevent one catastrophe. During times of increasing competition for health care money, anaesthetists must be resolute in defending and improving standards of training, monitoring and clinical care. Otherwise the substantial improvement in anaesthesia practice accomplished over recent years may quickly be lost again.

Summary Pain caused by intravenous injection in

The effects of a high fructose diet on the control of blood glucose and serum lipids were studied in 10 non-insulin-dependent diabetic patients (mean age 64.4 years, mean duration of diabetes 5.6 years). Comparison was made following 28 days on the usual diabetic diet and 28 days during which 25% of the usual carbohydrate was substituted with fructose. There was no change in mean (+/- SEM) fasting plasma glucose (on usual diet 9.2 +/- 0.5 mmol/l, on fructose diet, 9.1 +/- 0.4 mmol/l), but there was a fall in mean plasma glucose levels at 30, 60, and 120 min in a 75 g OGTT following the fructose diet. There was no significant change in fasting lipids: on usual diet mean serum cholesterol 5.8 +/- 0.2 mmol/l, on fructose diet 5.6 +/- 0.2 mmol/l; serum triglyceride, on usual diet 1.3 +/- 0.1 mmol/l, on fructose diet 1.3 +/- 0.1 mmol/l; HDL cholesterol on usual diet 1.4 +/- 0.1 mmol/l, on fructose diet 1.4 +/- 0.1 mmol/l. Mean body weight did not vary significantly between the two diets. Incorporation of fructose into the diabetic diet may lower post-prandial glucose levels without disturbing serum lipids.

To establish a rapid test for Cushing's syndrome we measured serum cortisol during and following iv dexamethasone infusion (5 \ g=m\ g

The effectiveness of lysine acetyl salicylate (LAS) 1.8 g, equivalent to aspirin 1 g, in relieving severe, immediate, postoperative pain has been compared with that of morphine 10 mg in comparable groups of patients. A single injection of LAS 1.8 did not give effective or consistent relief of pain, while morphine was both effective and consistent in its action. However, LAS was shown to have some analgesic activity.