Michael Harmer

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The identification of a serum marker to assist in the diagnosis of cerebral injury after cardiac surgery is potentially useful. S100 protein is an early marker of cerebral damage. It is released after cardiac surgery performed under cardiopulmonary bypass (CPB). Its level is correlated with the duration of CPB, deep circulatory arrest and aortic(More)
OBJECTIVE To observe the effects of introducing an acute pain service to the general surgical wards of a large teaching hospital. DESIGN A study in seven stages: (1) an audit of current hospital practice succeeded by the sequential introduction to the general surgical wards of (2) pain assessment charts; (3) an algorithm to allow more frequent use of(More)
The induction characteristics of sevoflurane in nitrous oxide and oxygen were compared with sevoflurane in oxygen alone and a propofol infusion. A vital capacity technique was used for the gaseous induction groups using a Mapleson A system and a 4-litre reservoir bag. Four end-points of anaesthesia were recorded: time to cessation of finger tapping, time to(More)
A study involving 2738 patients in 15 hospitals in the United Kingdom was undertaken to evaluate the effect of simple methods of pain assessment and management on postoperative pain. The study consisted of four parts: a survey of current practice in each hospital; a programme of education for staff and patients regarding pain and its management; the(More)
Obstetric general anaesthesia is associated with a number of deleterious effects and it has long been recognized that airway management can be challenging and tracheal intubation more likely to fail. Failed intubation and subsequent inadequate ventilation is an important cause of maternal mortality and morbidity. General anaesthesia for Caesarean section(More)
Day-case anaesthesia requires rapidly eliminated anaesthetics which are relatively expensive. This multinational, multicentre European study assessed the relative costs of propofol or sevoflurane anaesthesia in 211 patients. Anaesthesia was induced and maintained with propofol in group 1, with propofol and sevoflurane in group 2, and with sevoflurane in(More)
A total of 1442 patients who had major gynaecological surgery were recruited into three multicentre studies using a standard general anaesthetic technique in order to assess the efficacy of various doses of orally administered ondansetron in the prevention of postoperative nausea and vomiting. A total of 1257 patients were included in this analysis: 420(More)
At the 1991 Conference, SoftLaw presented a paper dealing with issue which arise in the modelling of legislation as English sentences and rules which a computer can process. Using the techniques outlined in that article, knowledge bases may be constructed to model areas of the law, especially those concerned with public administration. This paper(More)