Influence of less than full-time or full-time on totality of training and subsequent consultant appointment in anaesthesia.

Changes in medical training have increased the popularity of less than full-time training. However, there are no data on the impact on training time or consultant workforce. We reviewed a three-year cohort of trainees via the Royal College of Anaesthetist's training and recruitment databases. Eighty-eight (96%) less than full-time trainees and 677 (95%) full-time trainees were appointed to a substantive consultant post (p = 0.82). Three (3%) less than full-time trainees and 12 (2%) full-time trainees gained part-time consultant posts (p < 0.001). Average length of training (years, months, days) was 8 y, 5 m, 6 d (median (IQR [range]) 5 y, 0 m, 14 d (4 y, 11 m, 29 d - 9 y, 8 m, 3 d [4 y, 2 m, 18 d - 12 y, 0 m, 0 d]) for full-time and 10 y, 8 m, 23 d (median (IQR [range]) 7 y, 3 m, 28 d (6 y, 7 m, 24 d - 11 y, 1 m, 23 d [4 y, 11 m, 29 d - 11 y, 9 m, 10 d]) for less than full-time trainees. The average length of training for both groups is significantly longer than the seven years used in workforce planning.

Circulating immune complexes in healthy, HIV-antibody positive subjects.

The components of the circulating immune complexes (CICs) were characterised in asymptomatic HIV seropositive individuals. Forty four of 214 individuals (20.56%) showed the presence of CICs. Specific HIV anti-HIV CICs were detected in 33 of them (75%). The isotypic specificity of antibodies found to these CICs was measured. IgG and IgA immunoglobulin classes were detected in CICs.

PIP: The incidence of circulating-immune complexes (CICs) and their human immunodeficiency virus (HIV) antigen and antibody content and isotopes are described in 214 healthy, HIV-infected seropositive individuals from Pune, India. The subjects were commercial blood donors, sexually transmitted disease (STD) clinic patients, foreign students, prostitutes, hemophiliacs and suspected acquired immunodeficiency syndrome (AIDS) cases. Controls were seronegative persons from similar groups and employees of the research institution. Immune complexes were precipitated, dissolved, and tested for Clq binding with a commercial with a commercial enzyme immunoassay kit (DiaMedix, Florida). Specific HIV-anti HIV immune complexes, HIV-antigens in the CICs, and HIV- antibodies in CICs were determined with EIA and ELISA techniques. 44 of the 214 seropositive subjects had Clq binding above control levels of 20 mcg, and 6 were borderline. Positive values ranged from 20-120 mcg. All controls were normal. 33 of the 44 positives had specific HIV- anti-HIV CICs on solid-phase EIA. 31 persons had detectable HIV antigen in hydrolyzed CIC supernatant solutions. The antibody isotopes in CICs, assessed by single radial immunodiffusion were IgG and IgA immunoglobulins, with IgGs predominating at 250 mg/dl and IgAs measuring 200 mg/dl compared to normal healthy controls. The IgM levels in seropositive subjects did not differ from controls.

Difficult intubation--when can we predict it?

Anaesthetists at times encounter difficult intubation in an apparently normal individual in spite of using the best possible positioning and most profound relaxation. This study was carried out to find out the most simple and easy measurement that may predict a difficult intubation. The study was conducted in three groups of patients of twenty each. The first group consisted of patients in whom intubation was easy. Second group consisted of anticipated difficult intubation. Cases in whom very difficult intubation was encountered were analyzed retrospectively and were included in third group. An attempt has been made to predict difficult intubation with the roentgenographic study of lateral view of mandible along with the measurement of distance from chin to thyroid cartilage. Of all the parameters, ratio of effective mandibular length to posterior mandibular depth and distance from chin to thyroid cartilage were found to be important to predict difficult intubation.