Northwick Park Hospital

About: Northwick Park Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Blood pressure. The organization has 4387 authors who have published 4184 publications receiving 192933 citations.

Remifentanil reduces auditory and somatosensory evoked responses during isoflurane anaesthesia in a dose-dependent manner.

Abstract: We studied 60 patients during stable isoflurane anaesthesia (0.4 MAC) after premedication with temazepam. Patients were allocated randomly to one of three dose regimens of remifentanil: 1 microgram kg-1 i.v. over 1 min and an infusion of 0.2 microgram kg-1 min-1 (low dose); 2.5 micrograms kg-1 and 0.5 microgram kg-1 min-1 (medium dose); and 5 micrograms kg-1 and 1 microgram kg-1 min-1 (high dose). The auditory (AER) and median nerve somatosensory (SER) responses were elicited throughout, and recorded before and after tracheal intubation, and surgical incision, together with systolic and diastolic arterial pressure and heart rate. Venous blood concentrations of remifentanil were measured at the above times. After administration of remifentanil, Pa and Nb amplitudes of the AER increased at the low dose, remained constant at the medium dose and decreased at the high dose. This dose-related effect was linear and significant (P = 0.012, P = 0.05). Pa amplitude correlated inversely with remifentanil blood concentrations before and after intubation and incision (P = 0.002, P < 0.001, P < 0.001 and P < 0.001). In the SER, P15-N20 amplitudes decreased after administration of remifentanil (P < 0.001), whereas P25-N35 and N35-P45 amplitudes increased at all dose concentrations (P < 0.001 and P < 0.001). After intubation, P15-N20 and N35-P45 amplitudes increased at the low dose, did not change at the medium dose and decreased at the high dose (P = 0.001, P = 0.027). After remifentanil, systolic and diastolic arterial pressure and heart rate decreased in a linearly dose-related manner (P = 0.033, P < 0.001, P < 0.001). At all doses the three variables increased after intubation (P = 0.001, P < 0.001, P < 0.01), and systolic and diastolic arterial pressure increased after incision (P = 0.027, P = 0.039).

Day-case inguinal hernia repair in the elderly: a surgical priority

Abstract: Purpose To compare patients over 70 years old with those under 50 years old undergoing inguinal hernia repair.

Juvenile chronic arthritis.

Abstract: Juvenile Chronic Arthritis is a relatively uncommon childhood disease. There are no absolute diagnostic tests and many classification criteria have evolved (4, 15, 7) based variably on joint number, disease course, associated clinical features and rheumatoid factor seropositivity. These are of no help diagnostically, but do allow investigative and follow-up studies to compare like with like. It is generally accepted that there are three main modes of onset, the commonest being pauci-articular with less than five joints in the first 3 to 6 months. Arising from the population immediately around the old MRC rheumatism unit at the Canadian Red Cross Memorial Hospital, Taplow, this accounted for 68%, with a poly-articular onset in 20% and systemic onset in 12%. Despite this low incidence of systemic illness, it remains a great challenge.