Pretreatment with ketorolac and venous occlusion to reduce pain on injection of propofol.

We performed a randomised, double-blind, prospective trial to discover whether intravenous ketorolac 10 mg made up to 2 ml with saline, with or without venous occlusion for 2 min, reduces the pain on injection of propofol. In 90 patients, pain scores were obtained during injection of propofol following pretreatment of the vein with saline, ketorolac or ketorolac with venous occlusion. Pain on injection of ketorolac was more common than with saline (p = 0.

Staff grades and associate specialists: their continuing professional development and aspirations.

A survey of staff grades and associate specialists in the Oxford deanery showed that there were slightly more females (53%). There were 44% who had on-call commitments, a third of these were first on call. Thirty-eight per cent of the staff grades and 55% of the associate specialists had membership or fellowship of their relevant Royal College.

Prospective evaluation of unexplained syncope, dizziness, and falls among community-dwelling elderly adults.

Background: Unexplained syncope, dizziness, and falls may present a difficult diagnostic challenge to primary care and emergency room physicians. The aim of this study was to evaluate a diagnostic algorithm in the assessment of a cohort of community-dwelling elderly people with symptoms of unexplained syncope, falls, or dizziness.

Methods: Fifty-four consecutive elderly patients (mean age + SD = 76.

A study of 42 episodes of overwhelming post-splenectomy infection: is current guidance for asplenic individuals being followed?

Individuals without a spleen have an increased risk of overwhelming post-splenectomy infection (OPSI). Improved awareness in recent years has stimulated increased efforts to prevent OPSI. Published guidelines have described policies for immunization, chemoprophylaxis and other measures considered beneficial to asplenic patients, yet OPSI episodes continue to occur.

Cigarette smoking in pregnancy.

1. One in three women still continue to smoke in pregnancy. 2.

A reflection of a Therapeutic Touch experience: case study I.

The purpose of this case study was to explore the experiences of giving and receiving Therapeutic Touch. Attempts were made to capture the subjective qualities of the experience by providing a description of the Therapeutic Touch interaction that took place. The central theme of this study is the process of reflection-in-action.

Continuous measurement of arterial blood gas status during total hip replacement: a prospective study.

The arterial blood gas chemistry was measured continuously in ten patients during primary cemented total hip replacement in order to define more precisely the patterns of changes in blood gases during various stages of the operation. All ten patients demonstrated significant drops in PaO2 after femoral cement implantation and nine of the ten after acetabular cement implantation. The mean drop in PaO2 following acetabular cement expressed as mean +/- SD was 18 +/- 8 mmHg (16 +/- 6%) (P < 0.

Treatment of a symptomatic hepatic cyst by tetracycline hydrochloride instillation sclerosis.

We report the case of an 84-year-old woman with abdominal pain, distension and inferior veno-caval compression due to a large non-parasitic hepatic cyst. She was treated by instillation of tetracycline hydrochloride into the hepatic cyst. Six months after treatment, the patient is asymptomatic, with no reaccumulation of the hepatic cyst.

Treatment of neutropenic oral ulceration in human immunodeficiency virus infection with G-CSF.

We report the novel use of granulocyte colony-stimulating factor in the treatment of severe oral ulceration in human immunodeficiency virus-associated neutropenia. A 38-year-old man with acquired immunodeficiency syndrome developed severe refractory oral aphthous ulceration that persisted for 6 months despite a range of empirical treatments including corticosteroid. Rapid resolution of the ulceration occurred once the neutrophil count was restored to normal with granulocyte colony-stimulating factor.

'Good prognosis tumours' in breast cancer screening.

The Forrest Report led to the introduction of the breast screening programme with the aim of reducing mortality from breast cancer. In 1989 a breast screening programme was introduced to the South Bucks District and now two cycles have been completed. The findings are of a high yield of good prognosis tumours 71% and 72%, respectively.

Serological testing in a microbiology laboratory of specimens from patients with suspected infectious disease.

Aims: To determine how the microbiology laboratories of one region process serological requests from patients with suspected infectious illness, referred to as "clinical syndrome" type patients in this study; to consider areas where improvement in the associated serology service could be made.

Methods: A prospective two month collection of data on all serological requests from patients with suspected infectious illness was undertaken. A questionnaire on laboratory policies/procedures was also completed by the 10 departments taking part.

Intravascular device-associated systemic infections: a 2 year analysis of cases in a district general hospital.

The increasing use of intravascular devices (IVDs) throughout medicine has been accompanied by significant morbidity and mortality associated with catheter-related sepsis (CRS). Within the South Buckinghamshire district, 330 episodes of bacteraemia/fungaemia were recorded over the 2 year period 1992-1993. Thirty-nine episodes (12%), occurring in 37 patients, were associated with IVDs and these were divided into three groups according to the type and site of device.

Continuous measurement of blood gases using a combined electrochemical and spectrophotometric sensor.

The use of a combined electrochemical and fibreoptic continuous intra-arterial blood gas sensor is described. The purpose of the study was to evaluate the performance of the sensor in 10 patients in the intensive therapy unit following insertion through a femoral arterial cannula. To our knowledge this is the first published study on the valuation of an intravascular blood gas sensor through a femoral arterial cannula.