British journal of anaesthesia
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NHS Blood and Transplant (NHSBT) was established in 2005 as a Special Health Authority when the National Blood Authority and UK Transplant merged. This helped to bring tissue banking and organ transplantation services under one umbrella organization. This merger means that ~!95% of all deceased donors (whether tissue, organ or both) are now facilitated by one organization. ⋯ Annually there are ~450 multi-tissue donors and 2500 eye donors in the UK, resulting in many thousands of transplants, including 3564 cornea transplants in 2010-2011. The separation of tissue- and organ-specific donors is largely artificial, and while organ transplantation can be life-saving, tissue transplantation can also have a dramatic effect on a patient's quality of life. It is hoped that all donors, both organ and tissue, will be recognized for the gift they make to society after their death.
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'Cardiomyopathy' (CM) is defined by the World Health Organization as 'a disease of the myocardium associated with cardiac dysfunction'. In a child, it is associated with a significant risk for anaesthesia. In addition, cardiac arrest under anaesthesia has been attributed to an undiagnosed CM. ⋯ This review describes the different forms of the disease in terms of pathology, aetiology, and clinical presentation. Dilated, hypertrophic, and restrictive CM are the most common forms. We examine recent advances in therapy, including the management of severe end-stage disease, while highlighting the specific anaesthetic considerations for children with each type of CM.
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Formal research priority setting is a recognized way of identifying important clinical research questions and promoting these as topics for commissioned research. This paper describes a research priority setting exercise conducted by the National Institute of Academic Anaesthesia (NIAA). ⋯ A total of 14 research priorities were identified by the exercise, two of which have been submitted to the NIHR Health Technology Assessment (HTA) programme as statements of research need. Potential funding streams for the remaining questions are being sought. We discuss some implications of this exercise for research strategy in the speciality.
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It remains unclear whether N-methyl-D-aspartate (NMDA) receptors contribute to cerebral parenchymal vasodilatation, and any effects of clinically used anaesthetics on the dilatation. The present study was designed to examine whether NMDA induces neuronal nitric oxide synthase (NOS)-mediated dilatation, in the cerebral parenchymal arterioles, and whether propofol and superoxide modulate the dilatation in relation to the NMDA receptor activation. ⋯ NMDA dilates cerebral parenchymal arterioles possibly via neuronal NOS activation, whereas it produces superoxide via NADPH oxidase. In these arterioles, propofol reduces both the dilatation and superoxide production in response to NMDA.
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Randomized Controlled Trial Comparative Study
Simulating face-to-face tracheal intubation of a trapped patient: a randomized comparison of the LMA Fastrach™, the GlideScope™, and the Airtraq™ laryngoscope.
We undertook a prospective randomized comparison of the LMA Fastrach™, Airtraq™ laryngoscope, and GlideScope™ used for face-to-face tracheal intubation simulated to mimic an entrapped patient. ⋯ The Airtraq™ laryngoscope was superior to both the GlideScope™ and LMA Fastrach™ during simulated face-to-face difficult tracheal intubation.