Fifty shades of graft: How to improve the efficacy of faecal microbiota transplantation for decolonization of antibiotic-resistant bacteria

Background

Spontaneous decolonization of antibiotic-resistant bacteria (ARB) takes time: approximately 25% after 30 days for carbapenem-producing Enterobacteriaceae or extended-spectrum beta-lactamase-producing Enterobacteriaceae. Faecal microbiota transplantation (FMT) has been proposed as a new strategy to promote decolonization in order to reduce the risk of superinfection due to these ARB. This paper discusses the literature on the use of FMT for this indication, and the improvement levers available to promote its efficacy.

Paediatric acute care: Highlights from the Paediatric Acute Care–Advanced Paediatric Life Support Conference,Hobart, 2018

The Paediatric Acute Care Conference (PACC) is an annual conference organised by APLS Australia to advance paediatric acute care topics for clinicians in pre‐hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The PACC 2018 was held in Hobart, Tasmania. We provide a summary of some of the presentations.     

Dental education at The University of Adelaide: an evaluation

A bstract — Dental students, staff, and practitioners participated in an evaluation of the dental curriculum at The University of Adelaide between 1978 and 1981. The need for curriculum reform was expressed by all three groups, especially with respect to the teaching of basic sciences, some biomedical subjects, behavioural science, and practice management. Dental staff and practitioners have also indicated serious misgivings about the quality of clinical skills of new graduates. Proposals for reform are directed to resolving these and other curriculum problems revealed in the evaluation.     

Effect of a maxillary glossectomy prosthesis on articulation and swallowing

Swallowing was found to be substantially improved with the prosthesis. Less aspiration, less time necessary to complete the swallow, and greater variation in food consistency tolerated were all positive results of the prosthesis. In addition, videofluoroscopic studies of tongue movements during speech revealed that tip-alveolar /t-d/ and back-velar /k-g/ productions were more normal with the prosthesis. With the prosthesis, the understandibility of /t/ and /d/ was improved 20% and that of /k/ and /g/, 33%. It is clear that compromises must be effected in prosthesis design to facilitate improvement in both speech and swallowing. A large prosthetic mass in the oral cavity can also negatively change speech resonance. These issues are being investigated, as are acoustic and perceptual studies of speech articulation. Future research should address whether a combination of maxillary and mandibular prostheses would result in better speech and swallowing function. A mandibular prosthesis could replace missing teeth and alveolar contour that might influence speech and swallowing. A mandibular prosthesis might also allow construction of a smaller maxillary glossectomy prosthesis to interact with the mandibular prosthesis.