We introduce a novel infrastructure supporting automatic updates for dynamic content browsing on resource constrained mobile devices. Currently, the client is forced to continuously poll for updates from potentially different data sources, such as, e-commerce, on-line auctions, stock and weather sites, to stay up to date with potential changes in content. We employ a pair of proxies, located on the mobile client and on a fully-connected edge server, respectively, to minimize the battery consumption caused by wireless data transfers to and from the mobile device. The client specifies her interest in changes to specific parts of pages by highlighting portions of already loaded web pages in her browser. The edge proxy polls the web servers involved, and if relevant changes have occurred, it aggregates the updates as one batch to be sent to the client. The proxy running on the mobile device can pull these updates from the edge proxy, either on-demand or periodically, or can listen for pushed updates initiated by the edge proxy. We also use SMS messages to indicate available updates and to inform the user of which pages have changed. Our approach is fully implemented using two alternative wireless networking technologies, 802.11 and GPRS. Furthermore, we leverage our SMS feature to implement and evaluate a hybrid approach which chooses either 802.11 or GPRS depending on the size of the update batch. Our evaluation explores the data transfer savings enabled by our proxy-based infrastructure and the energy consumption when using each of the two networking capabilities and the hybrid approach. Our results show that our proxy system saves data transfers to and from the mobile device by an order of magnitude and battery consumption by up to a factor of 4.5, compared to the client-initiated continuous polling approach. Our results also show that the batching effect of our proxy reduces energy consumption even in the case where the user never visits the same page twice.

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Objectives To evaluate early results of the intra-ureteric instillation of capsaicin for the treatment of loin pain haematuria syndrome (LPHS). Patients and methods Ten patients with LPHS were treated using intra-ureteric capsaicin instillation. A solution of capsaicin was infused into the affected ureter through an embolectomy catheter, under anaesthesia. The success of the treatment was assessed using patient questionnaires and the quantitative reduction in the patients' analgesic requirements measured. Results During a mean follow-up of 6 months, six of the 10 patients had short-to medium-term symptomatic relief after one or more treatments; four had no relief from their symptoms. One patient had a mucosal ulceration in the bladder after extravasation of the capsaicin solution. Two patients subsequently underwent simple nephrectomy for symptomatic nonfunctioning kidneys. Conclusion These results are consistent with other preliminary reports of the ef®cacy of capsaicin treatment in LPHS and such treatment therefore has a de®nite therapeutic role in this dif®cult condition. We are uncertain if the treatment contributed to the deterioration of the excised kidneys. This early experience suggests a need for careful consideration when contemplating this treatment, with attention directed to both the initial diagnosis and possibly the technique of capsaicin/instillation. We include a protocol to follow when preparing patients for capsaicin treatment.

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We report a case of total upper airway obstruction occurring immediately after extubation after elective bi-maxillary osteotomy. The obstruction was caused by severe, progressive supraglottic oedema, which totally obscured the laryngeal inlet. No swelling had been present at initial laryngoscopy and intubation. Immediate re-intubation of the patient's trachea was difficult but life saving. Subsequent investigations revealed extensive soft tissue swelling, maximal at the level of the hyoid and extending downwards into the trachea. The cause of such severe oedema in this case is not certain, but may be related to vigorous submental liposuction carried out at the end of operation. We have found no other reports of total airway obstruction occurring immediately after extubation as a result of this cause. We review the appropriate literature, describe the postoperative management and suggest precautions in similar patients.