Abstract:Here we describe the results of a novel type of complementary immunotherapy of cancer that is based on a combination of ketogenic diet, administration of an emulsion made of chondroitin sulfate, vitamin D 3 and oleic acid and of a fermented milk and colostrum product. The results here reported are consistent with current knowledge concerning the biological and clinical effects of each one of the elements used in the approach described in this study. Based on our results, we suggest that, among the different approaches to the complementary immunotherapy of cancer, those strategies based on ad-hoc formulated nutritional plans and on food supplements that stimulate the immune system and fight inflammation appear to be most promising. Thus, these approaches are characterized by inherent low toxicity and the possibility to use them in conjunction with conventional anti-cancer therapies targeting cancer cells such as radiation or chemotherapies.

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AimsIntubations are commonly performed in neonatal units but record keeping is often poor. This study determined the adequacy of documentation surrounding neonatal intubations and the subsequent impact of introducing a new intubation-specific procedure sheet.MethodsData was collected on all babies (n = 138) admitted to NICU over a two month period. The medical notes of each were reviewed and relevant information regarding each intubation extracted. An intubation-specific procedure sheet containing 15 items was then introduced as part of standard care. After six months a second cohort of neonates were studied over a two month period (n = 168) and the same data collected for comparison.Results102 babies were intubated over the 4 month period, with notes available for 89 (87%). Record keeping was universally poor prior to procedure sheet introduction with only 4 categories completed in at least 75% of notes (Table 1). Several categories were extremely poorly documented (present in less than 30% of notes): grade view, length endotracheal tube was cut, position on chest radiograph and final length after adjustment. The most reliably completed category was the signature of the documenter, seen in 84% of cases. There was a significant improvements in all other 14 areas of documentation following procedure sheet introduction (P values <0.001–0.04). Eight categories were completed in over 90% of notes, 11 in 75% and only 1 category was documented less than 50% of the time. However sheets were only completed in 57% of intubations, with the poorest uptake being after delivery room intubations (used in 35%).Abstract G502(P) Table 1ConclusionsDocumentation was severely substandard prior to the procedure sheet introduction. Using the sheet resulted in immediate and significant improvements but uptake needs to be increased. There remains further room for improvement, particularly around recording radiograph findings and final endotracheal tube adjustments. Clear and accurate record keeping in medical notes is of great importance – not only as a legal record but also to aid subsequent professionals, particularly if a difficult task. Procedure sheets such as this provide a rapid way to significantly improve documentation.

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