No abstract

Work is needed on the place of such herds in the ecology of campylobacters, the endemicity of the infection within herds, and the factors leading to contamination of milk.We believe that the evidence points to thermophilic Campylobacter sp being an occasional but important contaminant of milk, which, under certain circumstances, may give rise to considerable outbreaks of enteritis in man. As with salmonella contamination it is probably only important where unpasteurised milk is consumed, but so long as there is a public demand for unpasteurised milk and the law allows such milk to be widely distributed, we believe that there is a risk that outbreaks will continue to occur.

No abstract

Summary Fifty‐three patients were admitted in a 5‐year period to the intensive care unit as a result of a complication of an anaesthetic technique. These patients represented 1 in 1543 anaesthetics carried out in the District in the period and 2.0% of all admissions to the intensive care unit. The mortality rate was 17%. The complication was considered to be wholly or partially avoidable in 14 instances (26%). Five of these subjects died and two had a residual neurological deficit.

As the physiology of deliberate hypotension has been unravelled, and as each new pharmacological agent has become available which either depresses or blocks peripheral vascular tone, depresses myocardial performance, or interferes with the conducting tissues within the myocardium, its possible incorporation into the armamentarium of the anaesthetist who offers induced hypotension has been considered. The result has been a sequence of variations in technique of characteristically recognizable vintage. No matter how the condition of induced hypotension is produced, there is usually vasodilatation, and the characteristic disturbance in physiology is of a loss of postural reactivity in the cardiovascular system. Important lessons have been learned concerning the management of shock states. Though it is difficult to evaluate the morbidity of deliberate induced hypotension, and terms such as "physiological trespass" have been used by its antagonists, it would appear that a well-considered and skilfully managed controlled hypotension is no more of a physiological trespass than anaesthesia, nor indeed than the trespass of the surgeon's knife itself.