An unusual case of O157:H7 infection with pseudomembranous colitis-like lesions associated with haemolytic-uraemic syndrome and neurological sequelae.

A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions.

Delayed diagnosis of a cerebrovascular accident associated with anabolic steroid use.

The authors report a case of atherosclerotic stroke in a 46-year-old recreational bodybuilder with a 20 year history of anabolic-adrenergic steroid (AAS) abuse. Cerebrovascular accident (CVA) occurred during his third week of hospital admission for an acute abdomen and on day 8, postemergency laparotomy. CVA presented with collapse, generalised seizures, reduced Glasgow Coma Score and severe hypertension.

Patients' preferences for involvement in clinical decision-making within secondary care and the factors that influence their preferences.

The research aimed to identify what involvement patients want in clinical decision-making and explore the underlying factors influencing that choice, thus identifying aids and barriers to increasing patients' involvement in decision-making. The study design was inspired by interpretative phenomenology, thus the framework for analysis is intended to aid interpretation and comprehension of the patients' experiences and understanding through identifying similarities and differences in their stories. Data were collected through semi-structured interviews of twenty people who were patients in a secondary care milieu at the time of interview.

Prokinetic agents in critical care.

Prokinetic agents are commonly used in intensive care, mainly to aid in early enteral feeding. The present commentary reviews some of the recently published papers and highlights the lack of a sizable evidence base, as well as the possible importance of euglycaemia in this important clinical area.

Postoperative wound oxygen tension with epidural or intravenous analgesia: a prospective, randomized, single-blind clinical trial.

Background: Adequate tissue oxygen tension is an essential requirement for surgical-wound healing. The authors tested the hypothesis that epidural anesthesia and analgesia increases wound tissue oxygen tension compared with intravenous morphine analgesia.

Methods: In a prospective, randomized, blind clinical study, the authors allocated patients having major abdominal surgery (n = 32) to receive combined general and epidural anesthesia with postoperative patient-controlled epidural analgesia (epidural group, n = 16), or general anesthesia alone with postoperative patient-controlled intravenous analgesia (intravenous group, n = 16).