Over a period of six months, seven cases were documented oftrauma to the nose as a result of flow driver continuous positive airway pressure in babies of very low birthweight (VLBW). There was a complication rate of 20% in the babies who required it. Deformitiesconsisted of columelia nasi necrosis which can occur within three days, flaring ofnostrils which worsens with duration of continuous positive airway pressure, and snubbing of the nose which persists after prolonged continuous positive airway pressure.These complications should be preventable by modifications to the mechanism and method of use. (Arch Dis Child 1996;75:F209-F212)

The study discussed here summarizes the internet search preferences and mobile device use of 2,830 recent travelers. With regard to gathering information for a hotel stay, business travelers most often follow their company's recommendation for a hotel, although many of them use search engines or online travel agents to learn more about available hotels. In contrast, recommendations of friends and colleagues are most important to leisure travelers, followed by travel-related websites, search engines, and OTAs. Once the information is gathered, however, travelers of all kinds turn more to such sources as the brand website, OTAs, and TripAdvisor. Late in the decision process, the respondents tended to land on the brand websites or go to an OTA, where they can book their room.

SummaryWe undertook a randomised, controlled trial to compare the analgesic efficacy and opioid sparing effect of nerve stimulator-guided femoral nerve block with fascia iliaca compartment block in patients awaiting surgery for fractured neck of femur. Ten-centimetre visual analogue pain scores were measured before and 2 h after the block and opioid consumption was recorded in the 12-h period after the block. One hundred and ten patients were randomly assigned. Femoral nerve block provided superior pre-operative analgesia for fractured neck of femur compared with fascia iliaca compartment block. The difference in the mean reduction of pain score after the block was 0.9 (95% CI 0-1.8); p = 0.047. Patients receiving a femoral nerve block required less morphine after the block than those receiving fascia iliaca compartment block (p = 0.041). In the UK, the target for maximum delay from diagnosis to surgery for patients with femoral neck fracture is 36 h, during which time they require adequate analgesia. Both femoral nerve block [1] and the fascia iliaca compartment block [2] are commonly used peri-operatively for analgesia in patients with a fractured neck of femur. These two techniques are used in our institution and we have equipoise as to their relative efficacy. They are either performed with a nerve stimulator to place local anaesthetic solution close to the femoral nerve or as a fascia iliaca compartment block using surface landmarks and the tactile feedback technique. All blocks are undertaken by four specialist acute pain nurses with training and extensive experience in performing these blocks. To date, over 1600 blocks have been undertaken by this team with no significant complications recorded. The two blocks have not been compared for relative efficacy when administered pre-operatively. This study was designed to resolve the question as to which technique provides superior analgesic efficacy. MethodsThe study was approved by the Local Research Ethics Committee and written informed consent was obtained from all patients. Inclusion criteria were patients presenting with isolated femoral neck fracture who had a mini-mental score [3] of ≥ 8/10 and fulfilled the requirements for full mental capacity for

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