Bob Dunn

Updated information about the procedure of abdominal paracentesis and the analysis of ascitic fluid.

Updated details in the Bowel Obstruction section mostly regarding the radiological features of each of them

Updated information regarding variations in metabolism of codeine in the Opioid Toxicity section of the Toxicology chapter.

Updated section on “Coronary Artery Disease’ following recent release of the 3rd universal definition of an MI in Circulation.

Updated sections with new evidence from an RCT of IABP published recently in Journal of Intensive Care Medicine that did not show any overall mortality benefit from IABP. Patients < 50 years of age did have better outcomes however the power of the study was inadequate to indicate if this is a real difference.

Updated information that suggests inhaled corticosteroids in prepubertal children with asthma causes (rather than just an association) a slight reduction in overall growth.

A section on Factorial designs of randomised trials has been added to the ‘Study methods’    section of the Research Skills chapter.

Ascertainment bias has been added to the  ‘Analysis of the Medical literature’ section of the Research Skills chapter.

Indications, tips on how to read head CTs and related CNS anatomy images have been included as new pages in the ‘Neurological assessment’ section of the Neurology Chapter.

Updated information regarding bronchiolitis diagnosis and management.

Updated sections on ‘Prevention of secondary brain injury’ and Resusciation fluids’ following the latest review of hyper osmolar therapy published recently in the NEJM.

The section on Thrombolysis in stroke has been updated following release of the IST3 trial and accompanying meta-analysis of tPA for the treatment of stroke that casts doubts over the efficacy of tPA after 3 hours.