Hospital medicine (London, England : 1998)
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Levomepromazine (previously known as methotrimeprazine), despite virtually no high quality scientific data to support its use, has become a very popular antiemetic for use in patients with advanced cancer. This article considers the reasons for this.
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Neurological injuries after epidural/spinal analgesia are a serious but uncommon problem. Spinal haematoma cause a proportion of these complications, and can be minimized by avoiding central nervous blockade in high-risk patients, especially those receiving anticoagulant therapy. Early recognition of spinal haematoma by basic neurological monitoring allows early intervention and improves outcome.
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The methods of monitoring the injured brain in intensive care have relied mainly on intermittent measurement. There is now increasing clinical interest in newer continuous forms of bedside monitoring that can help direct therapy earlier and more precisely. This article reviews continuous methods of monitoring cerebral perfusion, oxygenation, brain chemistry and function.
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In 1997, Hong Kong became a Special Administrative Region of the People's Republic of China. The new government took control of a Western style health-care system and a population whose health is comparable to the rest of the developed world. This article describes the existing health-care system, the state of public health and some of the challenges and opportunities facing the new administration.
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Morbidly obese patients are prone to many clinical conditions that can effect anaesthesia. Of major concern to the anaesthetist are difficulties with airway management and abnormalities of cardiorespiratory function. Safe anaesthesia requires an appreciation of potential problems and a thorough understanding of the pathophysiological changes that accompany morbid obesity.