Anaesthesia
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Latex is a ubiquitous part of life today. It is a constituent of many household products and medical devices, although not always obvious on examination. ⋯ Although there have been recent reviews of the general problem of latex allergy, there is little advice available to anaesthetists on how to develop an effective strategy to implement within their own hospitals. The aim of this article is to improve awareness of latex allergy and by describing the development of our strategy to identify and safely manage those at risk in the peri-operative period, facilitate the process for other departments.
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Comment Letter Case Reports
Bacterial meningitis following combined spinal-epidural analgesia for labour.
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We retrospectively compared the changes in serum albumin concentration and colloid osmotic pressure between survivors and nonsurvivors of prolonged (> or = 7 days) critical illness over a 2-year period from 1 July 1995. All patients had serum albumin measured daily, and colloid osmotic pressure measured 5 days a week, throughout their ICU admission. They received crystalloid and colloid infusions as well as parenteral or enteral feeding. ⋯ However, survivors showed an ability to increase serum albumin concentrations, possibly owing to resumption of synthesis. The colloid osmotic pressure varied little between or within either group of patients, possibly because of the use of artificial colloids. There was no relationship between death and colloid osmotic pressure.
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Case Reports
Systemic mastocytosis presenting as profound cardiovascular collapse during anaesthesia.
Mastocytosis is a rare disorder with serious anaesthetic implications. Anaesthetic management is hazardous since trauma, stress, extremes of temperature and drugs may precipitate intra-operative mast cell degranulation. ⋯ We present a case report of a patient with mastocytosis who suffered cardiac arrest during anaesthesia. Anaphylactoid/anaphylactic shock may be delayed and lack supporting signs of histamine release such as cutaneous flushing and bronchospasm.