The potential benefits of targeted attentional bias modification on cognitive arousal and sleep quality in worry-related sleep disturbance

Attentional bias for sleep-related negative information is believed to contribute to symptoms of insomnia by elevating arousal during the presleep period. In the present study, we examined whether the delivery of an attentional bias modification (ABM) procedure in the presleep period could produce transient benefits for sleep-disturbed individuals by reducing presleep cognitive arousal and improving ease of sleep onset. In a counterbalanced repeated A-B design, participants alternated completing an ABM training task and a nontraining control task across six nights and reported on presleep cognitive arousal and sleep onset latency. Significant reductions in presleep cognitive arousal and sleep onset latency were observed on nights where the ABM task was completed relative to nights where the control task was completed. These results suggest that delivery of ABM can attenuate cognitive arousal and sleep onset latency and highlights the possibility that targeted delivery of ABM could deliver real-world benefits for sleep-disturbed individuals

Bronchobiliary fistula due to acute cholecystitis in a suprahepatic gall bladder.

We describe a patient presenting with painless jaundice, anorexia and pruritus. The gall bladder was found to be lying above and behind a hypoplastic right lobe of liver. There was no evidence of cholangitis or biliary obstruction. The patient subsequently developed a bronchobiliary fistula with severe wheeze, cough and bile-stained sputum. Emergency percutaneous drainage of the gall bladder led to immediate cessation of bronchospasm and biloptysis, rendering the patient fit for definitive surgery

The use of the electronic (computer) cross-match

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