Brit J Hosp Med
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While use of mechanical circulatory support is increasing, knowledge of its fundamental role and limitations remains poorly understood by many medical professionals. This article summarises the main types of mechanical circulatory support and how they work, particularly focusing on the key information medical professionals should know should they encounter them in hospital. ⋯ Extracorporeal membrane oxygenation can provide both respiratory and circulatory support to patients. Ventricular assist devices can provide support for not only patients with acute cardiogenic shock, but also for ambulant patients in the community setting.
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Desflurane has a carbon equivalence 20 times greater than sevoflurane. This article discusses alternative anaesthetic techniques, including sevoflurane, xenon, total intravenous anaesthesia and regional techniques, and methods of reducing venting of gases, which might lower the environmental impact of anaesthesia.
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Metastatic spinal cord compression is compression of the spinal cord or cauda equina as a result of metastatic deposits in the spinal column. It affects approximately 4000 cases per year in England and Wales. ⋯ Survival of patients with common malignancies has improved significantly with the ongoing development of radiotherapy and chemotherapy, as well as improved surgical treatment of resectable primary tumours. This article outlines the clinical approach to presentation, pathophysiology, diagnosis and management.
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E-cigarette or vaping product use-associated lung injury is a recently recognised, acute pulmonary syndrome which has been reported (particularly from June to October 2019) throughout the USA, but not in Europe (although one probable case, in the UK, has been reported; Medicines and Healthcare products Regulatory Agency, 2020). It presents acutely, most often in young men, as severe pulmonary consolidation, usually with respiratory failure. ⋯ Vitamin E acetate, often present in tetrahydrocannabinol-containing vape products as a solvent, has been implicated, as it has been identified in the bronchoalveolar lavage fluid of patients with e-cigarette or vaping product use-associated lung injury. This article reviews the recent literature, including clinical features, presentation and investigations, and possible mechanisms, in the context of vaping practices in the USA and the UK.
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Biography Historical Article
Sir James Young Simpson: pioneer of anaesthesia in childbirth.
This year is the 150th anniversary of James Young Simpson's death in 1870. As well as being responsible for the introduction of general anaesthesia into obstetric practice, he made other important contributions to obstetrics and also to surgery as well as in the control of hospital infection.