Segmental absence of intestinal musculature (SAIM): a case report in an adult.

Segmental absence of intestinal musculature (SAIM) is a rare entity of uncertain aetiology. A case of SAIM in an adult is presented, and three other adult cases of SAIM are reviewed. Our case concerns a middle-aged man who underwent a Whipple's procedure for a suspected neoplasm in the head of the pancreas.

Devices for laparoendoscopic single-site surgery in urology.

The quest to make minimally invasive techniques even more 'minimal' has generated a drive within the surgical community to explore novel ways of achieving this. This has led to surgeons attempting to either decrease the number of trocars placed through the abdominal wall or eliminate them completely. This led to the evolution of several approaches, including natural orifice translumenal endoscopic surgery (NOTES), single incision laparoscopic surgery (SILS), single port access surgery and one port umbilical surgery (OPUS) or E-NOTES.

A stuck hemodialysis central venous catheter.

Background: A growing number of hemodialysis patients are dependent upon central venous catheters (CVCs) for long-term vascular access. Although many complications of CVCs have been documented, the phenomenon of the stuck catheter is described relatively infrequently.

Case Report: We describe a case where attempts to remove the line by exploration of the jugular insertion site in theater were unsuccessful and the line was internalized.

Single-dose cefuroxime with gentamicin reduces Clostridium difficile-associated disease in hip-fracture patients.

Antibiotic-associated Clostridium difficile diarrhoea may complicate recovery from surgery for proximal femoral fracture. We undertook a four-year case-control study to evaluate a change in antibiotic prophylaxis in our department. During the period January 2003 to January 2005, patients received three doses of prophylactic cefuroxime (1.

Spasticity treatment with botulinum toxins.

Spasticity is a physiological consequence of an insult to the brain or spinal cord, which can lead to life-threatening, disabling and costly consequences. This typically occurs following stroke, brain injury, spinal cord injury, multiple sclerosis and other disabling neurological diseases and cerebral palsy. It is but one feature of the upper motor neurone syndrome and there have been considerable developments in its management through new drugs and technology.

A survey of trauma alert criteria and handover practice in England and Wales.

Introduction: Appropriate alerting of patients with trauma and informative handover are necessary to allow a smooth transition of care between the prehospital and hospital teams.

Aim: To identify current practice and areas that need to be improved to facilitate the transition from prehospital care to emergency department resuscitation.

Methods: A questionnaire postal study of 100 emergency departments and all 32 ambulance service trusts in England and Wales.

Rising to the challenges of achieving day surgery targets.

Day surgery provides high quality and efficient care for a wide variety of surgical procedures. Patients appreciate the rapid recovery and effective analgesia, while the health service benefits from a streamlined service with lower costs. Despite the numerous advantages, day surgery practices vary enormously and many patients are still denied this excellent form of care.

Paediatric asthma: overcoming barriers to an improved quality of life.

Paediatric asthma has a considerable impact on both society, in terms of healthcare resources, and patients and their families, in terms of impaired quality of life. The principal goals of asthma treatment are to achieve and maintain control of symptoms. Achieving these goals may involve long-term use of appropriate medication in the form of an inhaled corticosteroid (ICS) and a long-acting ss-agonist (LABA).

BIPP madness; an iatrogenic cause of acute confusion.

An 81-year-old man, admitted under the Ear, Nose and Throat Team with persistent epistaxis, developed an acute confusional state. He was previously physically independent and mentally competent. Immediate investigations did not reveal a cause for his deterioration.