The use of topical anaesthesia during repair of minor lacerations in Departments of Emergency Medicine:a literature review

There are currently a number of different methods available to obtain anaesthesia in minor dermatological procedures. Although intradermal infiltration of 1% lidocaine is the favoured method for anaesthesia induction in laceration repair, it can cause significant pain in itself. Topical anaesthesia has been investigated as an alternative to infiltration anaesthesia, with the majority of studies looking at preparations of either TAC (tetracaine, adrenaline and cocaine) or LAT (lidocaine, adrenaline and tetracaine).

A.J. Raffles and Arsène Lupin in Literature, Theatre, and Film: On The Transnational Adaptations of Popular Fiction (1905-1930)

As a consequence of the accelerating technological development and the impact of cultural globalisation, the transnational aspects of the process of adaptation have become increasingly crucial in recent years. To go back to the very beginnings of the twentieth century and research the historical connections between popular literature, theatre, and film can shed greater light on the origins of these phenomena. By focusing on two case studies from turn-of-the-century crime fiction, this paper examines the extent to which practices of serialisation, translation, and adaptation of literary works contributed to the formation of a transnational market for popular culture. Ernest W. Hornung’s A. J. Raffles and Maurice Leblanc’s Arsène Lupin were the heroes of two crime series that were immediately translated, imitated, and adapted into countless theatrical plays and films all over the world. Given the resemblance between the two characters, the two franchises frequently ended by overlapping. Their ability to move from a medium to another as well as from a country to another was the result of the logic of ‘recycling, remaking, retelling’ (Brian Naremore) that guides not only the process of adaptation but also the creation of any work of popular culture.

Personalised and Precision Medicine in Cancer Clinical Trials: Panacea for Progress or Pandora's Box?

Cancer clinical trials have been one of the key foundations for significant advances in oncology. However, there is a clear recognition within the academic, care delivery and pharmaceutical/biotech communities that our current model of clinical trial discovery and development is no longer fit for purpose. Delivering transformative cancer care should increasingly be our mantra, rather than maintaining the status quo of, at best, the often miniscule incremental benefits that are observed with many current clinical trials. As we enter the era of precision medicine for personalised cancer care (precision and personalised medicine), it is important that we capture and utilise our greater understanding of the biology of disease to drive innovative approaches in clinical trial design and implementation that can lead to a step change in cancer care delivery. A number of advances have been practice changing (e.g. imatinib mesylate in chronic myeloid leukaemia, Herceptin in erb-B2-positive breast cancer), and increasingly we are seeing the promise of a number of newer approaches, particularly in diseases like lung cancer and melanoma. Targeting immune checkpoints has recently yielded some highly promising results. New algorithms that maximise the effectiveness of clinical trials, through for example a multi-stage, multi-arm type design are increasingly gaining traction. However, our enthusiasm for the undoubted advances that have been achieved are being tempered by a realisation that these new approaches may have significant cost implications. This article will address these competing issues, mainly from a European perspective, highlight the problems and challenges to healthcare systems and suggest potential solutions that will ensure that the cost/value rubicon is addressed in a way that allows stakeholders to work together to deliver optimal cost-effective cancer care, the benefits of which can be transferred directly to our patients.

Medical Students' views of a career in Geriatric Medicine; Multi-Centre Qualitative Analysis

Medical students frequently have negative preconceptions of a career in Geriatric Medicine. In ta qualitative analysis of the free text from 789 response from Medical students in Scotland and Northern Ireland, we show that clinical attachment seffectively challenge negative student views and more positive statements about future careers in Geriatric Medicine emerged at the end of the attachment.