A diagnostic strategy in general paediatric practice of using a simple clinical case definition for suspected IBD in combination with a positive faecal calprotectin result increases the specificity to detect IBD and reduces the need for referral to a paediatric gastroenterology centre with a very low risk of missing cases.

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Please cite this paper as: van Lonkhuijzen L, Groenewout M, Schreuder A, Zeeman G, Scherpbier A, Aukes L, van den Berg P. Perceptions of women, nurses, midwives and doctors about the use of video during birth to improve quality of care: focus group discussions. BJOG 2011; DOI:10.1111/j.1471‐0528.2011.02943.x. The use of video during birth for quality of care was discussed in focus groups with women, nurses, midwives and doctors. Qualitative analysis revealed three categories of importance. First, goals and benefits: improving quality of care, teaching, research and legal issues are important potential applications. Second, limitations: concerns for privacy, fear of feedback and use of video in case of adverse events. Third, rules and regulations: goals and scope of the use of video need to be clearly described, access to video needs to be secured, and time until destruction needs to be specified. Video capture of birth is considered useful and seems acceptable if specific conditions are met.

Therapies to prevent severe neonatal unconjugated hyperbilirubinemia and kernicterus are phototherapy and, in unresponsive cases, exchange transfusion, which has significant morbidity and mortality risks. Neurotoxicity is caused by the fraction of unconjugated bilirubin not bound to albumin (free bilirubin, Bf). Human serum albumin (HSA) administration was suggested to increase plasma bilirubin-binding capacity. However, its clinical use is infrequent due to difficulties to address its potential preventive and curative benefits, and to the absence of reliable markers to monitor bilirubin neurotoxicity risk. We used a genetic mouse model of unconjugated hyperbilirubinemia showing severe neurological impairment and neonatal lethality. We treated mutant pups with repeated HSA administration since birth, without phototherapy application. Daily intraperitoneal HSA administration completely rescued neurological damage and lethality, depending on dosage and administration frequency. Albumin infusion increased plasma bilirubin-binding capacity, mobilizing bilirubin from tissues to plasma. This resulted in reduced plasma Bf, forebrain and cerebellum bilirubin levels. We showed that, in our experimental model, Bf is the best marker to determine the risk of developing neurological damage. These results support the potential use of albumin administration in severe acute hyperbilirubinemia conditions to prevent or treat bilirubin neurotoxicity in situations in which exchange transfusion may be required.