How do trainee doctors introduce themselves to patients?

Objectives: To identify how trainee doctors introduce themselves to patients.

Design: Survey.

Setting: Chelsea and Westminster Hospital, London.

Anaesthesia for the obstetric patient with (non-obstetric) systemic disease.

The number of women with serious (non-obstetric) systemic diseases achieving pregnancy and requiring obstetric anaesthetic management is increasing. The conditions that are most likely to cause maternal morbidity and mortality are cardiac disease, respiratory disease, neuromuscular disease, haematological disease, connective and metabolic diseases and psychiatric conditions including substance abuse. This article discusses the anaesthetic management of the pregnant mother with such serious systemic diseases.

Effect of pregnancy on clinical status and ventricular function in women with heart disease.

Background: Pregnant women with heart disease (HD) are at an increased risk for maternal and neonatal adverse events. However, the effect of pregnancy on clinical status and ventricular function in women with HD has not been examined in a controlled study.

Methods And Results: Ninety-three women with HD were studied longitudinally.

Controversies in pregnancy and congenital heart disease.

As increasing numbers of children with congenital heart disorders reach adulthood, the family physician, cardiologist, and obstetrician will increasingly be called upon to give advice regarding the safety of pregnancy. This need has been further highlighted by the recognition that maternal mortality associated with cardiac disease is rising. Unfortunately, this field of practice remains relatively "evidence-sparse" with many management decisions being guided by anecdote and "best guess" common sense.

Contesting the science/ethics distinction in the review of clinical research.

Recent policy in relation to clinical research proposals in the UK has distinguished between two types of review: scientific and ethical. This distinction has been formally enshrined in the recent changes to research ethics committee (REC) structure and operating procedures, introduced as the UK response to the EU Directive on clinical trials. Recent reviews and recommendations have confirmed the place of the distinction and the separate review processes.

P NUTS--a nutritious method of teaching respiratory physiology.

Teaching basic respiratory physiology can be made more interesting and fun by means of a simulation involving active transport (and consumption) of peanuts by the participants. Simple rules simulate the basic features of oxygen transport, hypoxia and hypoxaemia and provide an opportunity to discuss physiological principles at intervals during the simulation.

Maternal temperature monitoring during labor: concordance and variability among monitoring sites.

Objective: Elevated maternal temperature in labor is associated with adverse immediate and long-term neonatal outcomes. Conventional methods of temperature measurement may not reflect the intrauterine temperature, which constitutes the fetal environment. The purpose of this study was to ascertain the most reliable noninvasive method of temperature monitoring in labor that would best reflect changes in intrauterine temperature.