Vascular catheter apparently well-placed

Synaptic transmission: Well-placed modulators

Metabotropic glutamate receptors are involved in the modulation of synaptic transmission; their localization in perisynaptic areas would appear to limit their activation by endogenous glutamate, but recent reports suggest that this strategic placement allows use-dependent activation of these synaptic modulators.

The breaking of an intrathecally-placed epidural catheter during extraction.

IMPLICATIONS Misplacement of an epidural catheter into the subarachnoid space is a recognized complication. However, breakage of an intrathecal epidural catheter during removal presents a dilemma. Appropriate imaging, a neurosurgical consultation, and aggressive surgical exploration and extraction of the retained piece are warranted, even in the asymptomatic patient.

Metallosis in an apparently well fixed total knee replacement

One of the findings of prosthetic failure seen either on pre operative radiograph or at surgery is metallosis. To our knowledge, this has not been described in an apparently well-fixed noninfected prosthetic joint. Metallosis can be due to polyethylene bearing wear resulting in metal on metal wear and has been seen with macro motion of prosthesis against underlying cement or bone1. CASE REPORT ...

Emergency departments are well placed to identify alcohol misuse problems.

Preventing vascular catheter-related infections: current controversies.

Prevention of vascular catheter-related infection remains an important priority. This review focuses on salient controversies regarding optimal preventive methods. Intensity of surveillance for nosocomial infections was the single most important predictor of prevention in the Study of the Efficacy of Nosocomial Infection Control (SENIC). Used suboptimally by most hospitals in the SENIC study, s...