The use of SMS text messages as a reminder may reduce the failure to attend rate for outpatient paediatric dental appointments.
AbstractsConclusions It is feasible to use an oximeter during low-risk deliveries at home or in hospital, but was not considered an important contribution for evaluation in majority of the cases. However, midwives would prefer the availability of this device in case of suboptimal neonatal condition. Mastitis is defined as an inflammation of the mammary gland. It often presents with the disease already at an advanced stage when the treatment is less effective and the health consequences for nursing mothers and their newborn babies are more severe. ALKALINE PHOSPHATASE ACTIVITY IN HUMAN COLOSTRUMS ASFrom the pediatric viewpoint it is extremely important to predict occurrence of lactating mastitis as early as possible in order to prevent vertical transmission of infections from mother to infant as well as to prevent stopping of newborn breast feeding.Biochemical investigations have shown that indigenous milk enzyme such as alkaline phosphatase (ALP) which is detectable in the cuboidal (epithelial) mammary gland cells, plays a very important diagnostic role in clinical medicine, since its activity varies in different tissues and serves as a specific indicator of diseased states.The purpose of this study was to evaluate ALP activity in human colostrum as a possible early predictive biomarker for lactating mastitis in nursing mothers.During a period from May to July 2010, a total of 60 healthy nursing mothers were prospectively followed from day 1 postpartum to the end of their lactation.There was a significant difference in colostrum ALP activity (p<0.001) from the breast with mastitis when compared with both the contralateral asymptomatic breast and "healthy" breasts.In our opinion, determining ALP activity in colostrums could be a valuable biochemical marker for an early prediction of mastitis in nursing mothers. Background and Aims Neonatal pneumothorax is a potentially fatal condition if not managed promptly and effectively. The little training in chest drain insertion is highlighted by doctors regularly. This is compounded by various factors including decreased incidence of pneumothorax and decreased working hours. CHEST DRAIN INSERTION AND TRAINING OF NEONATAL DOCTORS: USE OF AN ANIMAL MODELThe animal models have been used for such training. We started and tested such training model in our unit to improve the skills and confidence of junior doctors in chest drain insertion. Methods The workshop included presentation (theoretical), videos of procedure and then the hands on experience on dead rabbits. The rabbits were prepared by the local butchers and were easily available. The training was delivered (2 hour) as part of regular departmental teaching programme and was conducted in the first few weeks of start of job. A three point likert scale was used to record the feedback.
In the original audit (1998)(1999)(2000)(2001) medical, nursing, social and resource issues contributing to long stay paediatric admissions (>100 days) were identified. 11 children were found with stays in excess of 100 days (4505 bed days) with an estimated cost of £1.5 million. It was also shown that, over time, social and resource factors became the predominant reasons preventing children's discharge, rather than medical or nursing issues.As a result our Trust developed a services package aimed at facilitating early discharge and maintaining home placements for children with complex needs, including a Transitional Care Team, which provides care within the hospital based Transitional Care Unit and community settings. Additionally, there is a Community Paediatric Nursing Team who facilitate care packages, respite and competency based training for those involved in the children's care. Furthermore, there is a dedicated community paediatrician with expertise in palliative care.We have repeated the audit 10 years later. Only 5 children stayed over 100 days resulting in 625 bed days (mean 125). This was an 86.1% reduction in bed days for patients staying greater than 100 days. Case note review suggests that in 80% (4/5) of these cases the primary reason for prolonged hospitalisation was the child's intensive medical and nursing needs. In addition the 4 children, for whom service involvement documentation was available, had active involvement from our new services.We believe this audit confirms our impression that development of expert community based care has significantly contributed to shortening stays for our most complex and vulnerable children.
14 15 Keywords: African trypanosome, tsetse fly, Enterobacter, Sodalis, sterile insect 16 technique (SIT) 17 Abstract 18 Tsetse flies (Glossina spp.) vector pathogenic trypanosomes (Trypanosoma spp.) in 19 sub-Saharan Africa. These parasites cause human and animal African20 trypanosomiases, which are debilitating diseases that inflict an enormous socio-21 economic burden on inhabitants of endemic regions. Current disease control strategies 22 rely primarily on treating infected animals and reducing tsetse population densities.23 However, relevant programs are costly, labor intensive and difficult to sustain. As such, 24 novel strategies aimed at reducing tsetse vector competence require development.25 Herein we investigated whether an Enterobacter bacterium (Esp_Z), which confers 26 Anopheles gambiae with resistance to Plasmodium, is able to colonize tsetse and 27 induce a trypanosome refractory phenotype in the fly. Esp_Z established stable 28 infections in tsetse's gut, and exhibited no adverse effect on the survival of individuals 29 from either group. Flies with established Esp_Z infections in their gut were significantly 30 more refractory to infection with two distinct trypanosome species (T. congolense, 6% 31 infection; T. brucei, 32% infection) than were age-matched flies that did not house the 32 exogenous bacterium (T. congolense, 36% infected; T. brucei, 70% infected).33 Additionally, 52% of Esp_Z colonized tsetse survived infection with entomopathogenic 34 Serratia marcescens, compared with only 9% of their wild-type counterparts. These 35 parasite and pathogen refractory phenotypes result from the fact that Esp_Z acidifies 36 tsetse's midgut environment, which inhibits trypanosome and Serratia growth and thus 37 infection establishment. Finally, we determined that Esp_Z infection does not impact the 38 fecundity of male or female tsetse, nor the ability of male flies to compete with their wild-39 type counterparts for mates. We propose that Esp_Z could be used as one component 40 of an integrated strategy aimed at reducing the ability of tsetse to transmit pathogenic 41 trypanosomes. Author Summary44 Tsetse flies transmit pathogenic African trypanosomes, which are the causative agents 45 of socio-economically devastating human and animal African trypanosomiases. These 46 diseases are currently controlled in large part by reducing the population size of tsetse 47 vectors through the use of insecticides, traps and sterile insect technique. However, 48 logistic and monetary hurdles often preclude the prolonged application of procedures 49 necessary to maintain these control programs. Thus, novel strategies, including those 50 aimed at sustainably reducing the ability of tsetse to transmit trypanosomes, are 51 presently under development. Herein we stably colonize tsetse flies with a bacterium 52 (Enterobacter sp. Z, Esp_Z) that acidifies their midgut, thus rendering the environment 53 inhospitable to infection with two distinct, epidemiologically important trypanosome 54 strains as well as an entomopath...
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