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Catheter-related blood stream infections may be reduced by interdialytic locking with Taurolidine, a nontoxic antimicrobial agent. A formulation of 1.35% Taurolidine in 4% citrate (TC) is associated with a greater need for thrombolysis to maintain catheter patency than 5000 U/ml heparin. Our aim was to determine whether addition of 500 Units/ml of heparin to TC reduces the need for thrombolysis. TCH (1.35% taurolidine, 4% citrate and 500 U/ml heparin) was compared to TC and Heparin 5000 U/ml using retrospective data. Hundred and six adult hemodialysis patients with internal jugular tunnelled intravascular catheters using TCH were compared with 34 patients using TC and 34 patients using heparin 5000 U/ml respectively. Outcomes were time to first use of thrombolysis and bacteremia rates.TCH reduced the need for thrombolysis compared to TC (hazard ratio, 0.2; 95%CI: 0.06, 0.5; p < 0.001) and was not significantly different from heparin 5000 U/ml (hazard ratio, 1.4; 95%CI: 0.5, 3.9; p = 0.5). The bacteremia rates from all causes were 1.33, 1.22 and 3.25 per 1000 catheter- days (p < 0.001) in the TCH, TC and heparin groups respectively. Addition of 500 U/ml heparin to TC reduces the need for thrombolysis without increasing bacteremia and may achieve patency comparable to heparin 5000 U/ml.

In 1997, the author was involved as an expert witness in a civil case in which a man claimed to have suffered from an overwhelming urge to have sexual intercourse with his furniture and domestic appliances following his participation in a stage hypnosis show. In addition, in the subsequent months and years he reported an extraordinary variety of bizarre symptoms and problems which received a range of diagnoses including major depression, post-traumatic stress disorder, schizo-affective disorder and paranoid psychosis. The two psychiatrists who represented the plaintiff considered that his problems had been caused by two factors: (i) the stage hypnotist's suggestion that the volunteers would feel extremely sexy when they went to bed that night, and (ii) the plaintiff's not being properly taken out of his trance at the end of the show. They also asserted that the plaintiff had been traumatized by his experience either during the show itself or afterwards when he was indulging in sexual behaviour with his household effects. The author, who appeared for the defendant, considered that the plaintiff was clearly malingering in his claims to have been afflicted with his unusual sexual compulsions; however, there was a case for considering his more long-lasting problems as belonging in the category of factitious disorder. The trial took place more than four years after the event, the plaintiff reporting further symptoms. On the fifth day of the proceedings the hearing collapsed when the plaintiff's funding was withdrawn. Copyright © 2000 British Society of Experimental and Clinical Hypnosis

Objective: Cognitive therapy (CT) has been used in anorexia nervosa, but little is known about its effectiveness, A randomized controlled trial was undertaken comparing dietary advice (DA) with cognitive therapy in the outpatient treatment of AN.Method: Thirty-five patients were randomly allocated to either cognitive therapy (n = 25) or dietary advice (n = 10). There were no significant differences in the groups pre-treatment. Twenty sessions of cognitive therapy or dietary advice were offered.Results: At 6 months 23 cognitive therapy patients remained engaged whereas all the dietary advice controls dropped out. Cognitive therapy patients showed significant changes in Body Mass Index (p = 0.001). Eating Disorder Inventory Scores (p = 0.035). Beck Depression Inventory Scores (p < 0.0001) and Locus of. Control of Behaviour Scores (p = 0.017),Conclusions: Significant improvements were observed in patients allocated to cognitive therapy, but not in those allocated to dietary advice on an intention to treat analysis. Cognitive therapy has advantages of promoting engagement and facilitating recovery. Copyright (C) 1999 John Wiley & Sons, Ltd and Eating Disorders Association.

A case is described of a 26-year-old woman who consulted a private therapist for treatment for depression and anxiety. The therapist described himself as an ‘internationally recognized psychoanalyst’. His treatment lasted 21 sessions before the patient gave up in despair. He had hypnotized her on a number of occasions and asked her to imagine vividly terrifying fantasies and frightening events of her childhood. He further intimated that she had been sexually abused, although there was no evidence to support this. By the end of this treatment, the patient was considerably worse and diagnosable as suffering from post-traumatic stress disorder. Inspection of the therapist's qualifications did not reveal anything to justify his using the designation ‘psychoanalyst’ and it appeared that he had trained in hypnotherapy by means of a private correspondence course which recommended the above procedures. Copyright © 1996 British Society of Experimental and Clinical Hypnosis

Two groups of subjects were compared for their free recall and recognition memory of 40 words, half of which they had processed at the ‘deep’ level and half at the ‘shallow’ level. Prior to testing recall and recognition, one group received a standard hypnotic induction and deepening routine and the other group listened to a ‘dummy’ induction, which consisted of instructions to keep their eyes closed but remain oriented to their immediate situation. Both groups were given identical suggestions for hypermnesia before testing their recall and their recognition. As expected, deeply processed words were recalled and recognized better than shallowly processed ones, but unlike the findings of Shields and Knox (1986), the hypnotic group did not show improved recall and recognition for deeply processed words. In fact the non-hypnotic group had significantly higher recall scores overall than the hypnotic group. Measures of time estimation, awareness of external reality, and relaxation did not discriminate the two groups, indicating that, at least in terms of these experiences, the hypnotic and dummy inductions had no differential effects. Ad hoc analysis revealed a significant modest correlation between ratings of unawareness of the real world and deep-shallow processing differences in recall. Some tentative implications for claims of hypnotic hypermnesia are suggested. Copyright © 1996 British Society of Experimental and Clinical Hypnosis