Peri-operative management of the obese surgical patient 2015: Association of Anaesthetists of Great Britain and Ireland Society for Obesity and Bariatric Anaesthesia.

Guidelines are presented for the organisational and clinical peri-operative management of anaesthesia and surgery for patients who are obese, along with a summary of the problems that obesity may cause peri-operatively. The advice presented is based on previously published advice, clinical studies and expert opinion.

A comparison of automatic and intentional instructions when using the method of vanishing cues in acquired brain injury.

Thirty-four participants with acquired brain injury learned word lists under two forms of vanishing cues - one in which the learning trial instructions encouraged intentional retrieval (i.e., explicit memory) and one in which they encouraged automatic retrieval (which encompasses implicit memory).

Using face-to-face interpreters in healthcare.

This article discusses the use of professional interpreters in healthcare. Interpreters can improve clinical outcomes by bridging the gap in access to and quality of care between native and non-native speakers. The article also offers guidance on how to work with interpreters.

IL-22 suppresses IFN-γ-mediated lung inflammation in asthmatic patients.

Background: IL-22 controls tissue homeostasis by both proinflammatory and anti-inflammatory effects. However, the anti-inflammatory mechanisms of IL-22 remain poorly investigated.

Objective: We sought to investigate the anti-inflammatory role for IL-22 in human asthma.

Partial nonlinear reciprocity breaking through ultrafast dynamics in a random photonic medium.

We demonstrate that ultrafast nonlinear dynamics gives rise to reciprocity breaking in a random photonic medium. Reciprocity breaking is observed via the suppression of coherent backscattering, a manifestation of weak localization of light. The effect is observed in a pump-probe configuration where the pump induces an ultrafast step change of the refractive index during the dwell time of the probe light in the material.

Coherent control of the motion of complex molecules and the coupling to internal state dynamics.

We discuss coherent control of the centre of mass motion of complex molecules by de Broglie interferometry. We describe an experiment to couple the dynamics of internal state population of complex molecules to their centre of mass motion. We discuss how this can be used to probe state population and transition, especially the photo-switching of flourinated di-azobenzene molecules between their cis- and trans-configuration.

eSGA: E. coli synthetic genetic array analysis.

Physical and functional interactions define the molecular organization of the cell. Genetic interactions, or epistasis, tend to occur between gene products involved in parallel pathways or interlinked biological processes. High-throughput experimental systems to examine genetic interactions on a genome-wide scale have been devised for Saccharomyces cerevisiae, Schizosaccharomyces pombe, Caenorhabditis elegans and Drosophila melanogaster, but have not been reported previously for prokaryotes.

The effect of a mandibular advancement splint in subjects with sleep-related breathing disorders.

Objective: This study assessed the effectiveness of a mandibular advancement splint (MAS) in subjects with sleep-related breathing disorders using both objective and subjective outcome measures.

Design: The study was carried out as a retrospective analysis.

Setting: The study was conducted within the Sleep Studies Unit at the Queen Victoria Hospital, East Grinstead, between May 1997 and March 2000.

The influence of timing and route of administration of intravenous ketorolac on analgesia after hand surgery.

A double-blind clinical trial was conducted on 47 patients scheduled for hand surgery under general anaesthesia to determine whether ketorolac given as part of an intravenous regional anaesthesia technique could provide better postoperative analgesia than ketorolac given intravenously either before or after surgery. Patients were randomly allocated to one of three groups to receive ketorolac 20 mg: intravenously in the non-operative arm before surgery (systemic presurgery group); intravenously to the operative arm after tourniquet inflation (regional presurgery group); intravenously in the non-operative arm after surgery (systemic postsurgery group). Postoperative pain scores were similar in the systemic presurgery and regional presurgery groups.

Management of Jehovah's Witness patients undergoing major head and neck surgery.

Background: Several diverse strategies have been recommended to manage Jehovah's Witness patients undergoing surgery when significant blood loss is expected. However, many of the proposed management strategies cannot be used when the urgent nature of the disease precludes adequate preoperative preparation of the patient. We present our experience of the management of two Jehovah's Witnesses with oral carcinoma requiring extensive resection, neck dissection, and reconstruction with free tissue transfer.

Fibreoptic intubation through a laryngeal mask airway in an infant with Robin sequence.

Airway management is a major concern in Robin sequence, where micrognathia, glossoptosis and a cleft of the soft palate exist. The management of an infant with a potentially difficult airway is discussed where tracheal intubation was aided by the use of a 2.2-mm fibrescope mounted with a 3-mm endotracheal tube passed through a size 1 laryngeal mask airway.

Combined radial forearm and pharyngeal flap for soft palate reconstruction.

The use of a free vascularised fascio-cutaneous radial forearm flap in combination with a cranially based pharyngeal flap for soft palate reconstruction has not been previously reported. We present the technique and illustrate its use in two cases of total and one case of subtotal soft palate reconstruction. The functional outcome is discussed with particular reference to nasal airway patency, speech and swallowing.

Detection of extrinsic bronchial compression during foreign body removal by pulse oximetry.

A case of stridor is described which was due to the presence of a foreign body in the larynx of an infant. Following partial removal, compression of the right main bronchus was detected because of continuing low arterial oxygen saturation. The use of pulse oximetry allowed this complication to be identified, and the advantages of this method of monitoring are discussed.

Effect of fluid preloading on cardiovascular variables after spinal anaesthesia with glucose-free 0.75% bupivacaine.

We studied the effect on systemic arterial pressure of fluid preloading with 1 litre of crystalloid fluid before spinal anaesthesia in 40 patients undergoing minor lower abdominal or lower limb surgery. Fluid was given at a rate of either 1 ml min-1 (no preload group), or 1000 ml in the 15 min (preload group) immediately before induction of spinal anaesthesia with 3 ml of 0.75% glucose-free bupivacaine.

Evaluation of the Ambu CPAP system.

We have assessed a Venturi driven device for delivering continuous positive airway pressure (CPAP) using a reservoir bag and expiratory valve under conditions of continuous flow and simulated spontaneous breathing. The system performed well and was economical, consuming only 3.5 litre min-1 of fresh gas.