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1.  Scissor excision of anogenital warts. 
Anogenital warts were treated by scissor excision in 34 patients while under general anaesthesia; most patients were referred by the department of genitourinary medicine. In 28 patients who were adequately followed up the primary success rate was 71.4% and the rate of recurrence of warts was 9.3%. The technique gave good cosmetic results with few complications.
PMCID: PMC1046110  PMID: 7171982
2.  Sugammadex compared with neostigmine/glycopyrrolate for routine reversal of neuromuscular block: a systematic review and economic evaluation† 
BJA: British Journal of Anaesthesia  2010;105(5):558-567.
The cost-effectiveness of sugammadex for the routine reversal of muscle relaxation produced by rocuronium or vecuronium in UK practice is uncertain. We performed a systematic review of randomized controlled trials of sugammadex compared with neostigmine/glycopyrrolate and an economic assessment of sugammadex for the reversal of moderate or profound neuromuscular block (NMB) produced by rocuronium or vecuronium. The economic assessment aimed to establish the reduction in recovery time and the ‘value of time saved’ which would be necessary for sugammadex to be potentially cost-effective compared with existing practice. Three trials indicated that sugammadex 2 mg kg−1 (4 mg kg−1) produces more rapid recovery from moderate (profound) NMB than neostigmine/glycopyrrolate. The economic assessment indicated that if the reductions in recovery time associated with sugammadex in the trials are replicated in routine practice, sugammadex would be cost-effective if those reductions are achieved in the operating theatre (assumed value of staff time, £4.44 per minute), but not if they are achieved in the recovery room (assumed value of staff time, £0.33 per minute). However, there is considerable uncertainty in these results. Sugammadex has the potential to be cost-effective compared with neostigmine/glycopyrrolate for the reversal of rocuronium-induced moderate or profound NMB, provided that the time savings observed in trials can be achieved and put to productive use in clinical practice. Further research is required to evaluate the effects of sugammadex on patient safety, predictability of recovery from NMB, patient outcomes, and efficient use of resources.
PMCID: PMC2955536  PMID: 20935005
clinical trials; neuromuscular block, recovery; neuromuscular block, rocuronium
3.  Sugammadex for reversal of neuromuscular block after rapid sequence intubation: a systematic review and economic assessment† 
BJA: British Journal of Anaesthesia  2010;105(5):568-575.
Sugammadex 16 mg kg−1 can be used for the immediate reversal of neuromuscular block 3 min after administration of rocuronium and could be used in place of succinylcholine for emergency intubation. We have systematically reviewed the efficacy and cost-effectiveness and made an economic assessment of sugammadex for immediate reversal. The economic assessment investigated whether sugammadex appears cost-effective under various assumptions about the value of any reduction in recovery time with sugammadex, the likelihood of a ‘can't intubate, can't ventilate’ (CICV) event, the age of the patient, and the length of the procedure. Three trials were included in the efficacy review. Sugammadex administered 3 or 5 min after rocuronium produced markedly faster recovery than placebo or spontaneous recovery from succinylcholine-induced block. No published economic evaluations were found. Our economic analyses showed that sugammadex appears more cost-effective, where the value of any reduction in recovery time is greater, where the reduction in mortality compared with succinylcholine is greater, and where the patient is younger, for lower probabilities of a CICV event and for long procedures which do not require profound block throughout. Because of the lack of evidence, the value of some parameters remains unknown, which makes it difficult to provide a definitive assessment of the cost-effectiveness of sugammadex in practice. The use of sugammadex in combination with high-dose rocuronium is efficacious. Further research is needed to clarify key parameters in the analysis and to allow a fuller economic assessment.
PMCID: PMC2955537  PMID: 20937718
complications, intubation tracheal; neuromuscular block, recovery; neuromuscular block, rocuronium; neuromuscular block, succinylcholine
4.  Suspected Anaphylactic Reactions Associated with Anaesthesia 
Anaesthesia  2009;64(2):199-211.
PMCID: PMC3082210  PMID: 19143700
7.  Erythromycin stearate in treating chlamydial infection of the cervix. 
A total of 157 women attending departments of genitourinary medicine were treated for chlamydial infection of the cervix with erythromycin stearate 500 mg twice a day. Chlamydiae were eradicated from the cervix in 64/80 women treated for seven days and in 51/77 women treated for 14 days. In 12 of those treated for seven days and 15 of those treated for 14 days, reinfection was the probable cause of reisolation after treatment. The possibility of latent infection with Chlamydia trachomatis could not be excluded in five women, but was not more likely to occur with the shorter treatment course. Erythromycin stearate 500 mg twice daily for seven days appears to be an effective regimen for the treatment of uncomplicated chlamydial infection of the cervix.
PMCID: PMC1046387  PMID: 6518350
12.  Use of the muscle relaxant atracurium in anephric patients: preliminary communication1 
Atracurium is a new, non-depolarizing muscle relaxant which rapidly breaks down in vivo and appears to require neither renal nor hepatic function for its elimination. As the commonly used non-depolarizing muscle relaxants carry the risk of prolonged effect when used in anephric patients, atracurium appears to have special promise in this situation. A preliminary account of the successful use of the relaxant in 20 anephric patients is recorded and evidence presented that atracurium is, indeed, a suitable agent for use in patients with renal failure.
PMCID: PMC1437777  PMID: 6281433
14.  Chlamydia trachomatis and Ureaplasma urealyticum in men attending a sexually transmitted diseases clinic. 
Urethral specimens from 480 heterosexual patients were examined for Chlamydia trachomatis. Chlamydia were isolated from 32.7% of men with non-specific urethritis (NSU), from 16.1% of men with gonorrhoea, and from 4.1% of men without urethritis. Chlamydial isolation was not related to duration of symptoms, presence of discharge, or past history of attendance at the clinic. Urine from 176 heterosexual patients was examined for Ureaplasma urealyticum. Ureaplasmas were present in 53.8% of men with NSU, in 28% of men with gonorrhoea, and in 32.9% of men with no urethritis. Detection rates for ureaplasmas in patients with chlamydia-negative and chlamydia-positive NSU were similar, but ureaplasmas were present in significantly greater numbers in patients with chlamydia-negative NSU than in those with chlamydia-positive NSU.
PMCID: PMC1045888  PMID: 7214120
15.  Hypothermia and Wernicke's encephalopathy. 
British Medical Journal  1976;2(6035):563-564.
PMCID: PMC1688075  PMID: 963433

Results 1-15 (15)