Managing appendicitis during the COVID-19 era: A single centre experience & implications for future practice.

Aim: During the COVID-19 pandemic, emergency surgery was modified in line with Royal College guidance to accommodate the evolving climate. This study compared management of appendicitis before and during the pandemic by assessing disease presentation severity, modes of investigation, surgical management and patient outcomes. Outcomes assessed included length of stay, readmissions and rates of postoperative wound infections.

Some ethical considerations for the "off-label" use of drugs such as Avastin.

Is off‐label use of drugs legal?

A reliability study of the modified new Sheffield Sedation Scale.

Summaries of what sleep is, the need for sleep and the effects of lack of sleep, in relation to sedation, have been reviewed. The reliability of a modified sedation scale in one intensive care unit is examined and demonstrated. All available sedation scales were critiqued and the most suitable one chosen and developed for use within one intensive care unit.

Lateralization of parathyroid adenomas by intra-operative parathormone estimation.

A simple method for intra-operative lateralization of parathyroid adenomas by venous sampling for intact parathormone (PTH [1-84] is described. After induction of anaesthesia, percutaneous right and left internal jugular and arm vein PTH [1-84] was estimated within 30 minutes by a modification of the Allegro PTH [1-84] assay. Twenty-three patients with primary hyperparathyroidism due to adenoma were explored, 21 with one adenoma and two with two adenomas.

Giant right atrial diverticulum: an unusual cause of Wolff-Parkinson-White syndrome.

A case of a giant right atrial diverticulum associated with neonatal supraventricular tachycardia is reported. The electrocardiogram in sinus rhythm showed pre-excitation that may have been caused by the right atrial diverticulum adhering to the right ventricle.