Family-centered Care for Sick Newborns: A Thumbnail View

Family-centered care (FCC) for sick newborns is emerging as a paradigmatic shift in the practice of facility-based newborn care. It seeks to transforming a provider-centered model into a client-centered one and thus build a new therapeutic alliance. FCC is the cornerstone of continuum of care, imparting caregiving competencies to parents/caregivers both within institutions as well as after the discharge. This has potential gains for the newborn, family members, and facility-level staff. The initial model piloted in tertiary-care settings is now undergoing translation at five sites across the country; the outcomes are keenly awaited.     

A systematic review of capacity assessment tools in pediatric surgery: Global Assessment in Pediatric Surgery (GAPS) Phase I

Background

The Lancet Commission on Global Surgery highlighted global surgical need but offered little insight into the specific surgical challenges of children in low-resource settings. Efforts to strengthen the quality of global pediatric surgical care have resulted in a proliferation of partnerships between low-and middle-income countries (LMICs) and high-income countries (HICs). Standardized tools able to reliably measure gaps in delivery and quality of care are important aids for these partnerships. We undertook a systematic review (SR) of capacity assessment tools (CATs) focused on needs assessment in pediatric surgery.

Assessment of Serum CoQ10 Levels and other Antioxidant Markers in Breast Cancer

Background: The balance of the oxidative state in the body is fundamental for the maintenance of homeostasis. It has been implicated in the onset and progression of several diseases including breast cancer. The way in which the Reactive Oxygen Species (ROS) / antioxidants balance leads to or responds to disease is still controversial. In this study, TAC is used as a reference for the total antioxidant power of the body and Coenzyme Q10 (CoQ10) for its vital importance in cellular antioxidant action and being the only lipid soluble antioxidant synthesized endogenously. Copper and zinc were measured as trace elements reflecting the antioxidant micronutrient profile of the body. Methods: After approval of the ethical committee, 60 recently diagnosed non-intervened breast cancer patients were recruited from the Medical Research Institute hospital, Alexandria University along with 20 apparently healthy volunteers as control group. Full patient history was taken including breastfeeding history, parity, hormone replacement therapy use, body mass index, pathological examination, metastatic work up results, past medical history and drug use. CA 15-3 and laboratory investigations evaluating blood glucose, kidney and liver functions were performed. Q10 levels were measured by HPLC using a kit from Recipe®. TAC was assayed spectrophotometrically (Biodiagnostics®). Copper and Zinc levels were determined by inductively coupled plasma-optical emission spectrometry. Results: There was a statistically significant increase in the CoQ10, TAC and copper levels in the breast cancer group when compared to the control group. Zinc showed no statistically significant difference between the studied groups. Conclusion: Inspite of the fact that a high antioxidant level is usually considered as a favourable state, TAC, CoQ10 and copper levels showed significantly higher levels in the breast cancer group when compared to the control group. It is worth mentioning that the cancer group were all recently diagnosed, non-intervened and showed no signs of metastasis. It is still unclear whether the increased antioxidant levels offer a selective growth advantage to tumor cells over their surrounding normal cells or serve as a protective measure by the body in an attempt to correct the assault triggered by the ROS.     

低胆红素血症对机体抗氧化能力和脂质过氧化的影响及VitE的干预效果

目的 :探讨低胆红素血症对机体抗氧化能力和脂质过氧化的不良影响并观察VitE的干预效果。方法 :从体检健康人群中有意选择 4 5例胆红素水平偏高者 (≥ 15 μmol/L)和 4 0例胆红素水平偏低者 (≤ 9μmol/L)作为研究对象 ,抽空腹静脉血检测血清总抗氧化能力 (T -AOC) ,丙二醛 (MDA)及血浆氧化修饰低密度脂蛋白(Ox -LDL) ,并给低胆红素组每人每天口服VitE 10 0mg ,连续 2周 ,复测上述指标。结果 :与高胆红素组比 ,低胆红素组T -AOC明显降低 (P <0 .0 1) ,而MDA和Ox -LDL明显升高 (P <0 .0 5和P <0 .0 1) ,但低胆红素组补充VitE干预后 ,T -AOC显著升高 ,而MDA和Ox -LDL显著降低 (均P <0 .0 1) ,分别达到甚至超过了高胆红素组的相应水平。结论 :低胆红素血症可显著降低机体抗氧化能力 ,促进脂质过氧化 ,但这一不良影响可以通过补充VitE得到有效纠正。     

Determination of needed radiographic room capacity to serve an emergency department

This study describes a method for determining the number of radiographic rooms devoted to emergency radiology that would be required to keep mean patient waiting time at a desired level. A desired mean waiting time for patients must be determined. In our setting, a mean waiting time of 8 minutes resulted in few complaints. The waiting time then sets the required utilization rate of available capacity. Daily and hourly volume and variability in volume of examinations were measured over a 3-month period. This represents the demand. The needed number of rooms is determined by comparing demand with effective available capacity for different numbers of rooms. To maintain an 8-minute mean waiting time, 50% utilization of capacity is required. Mean demand on Sundays is 176 examinations. Five rooms are required, since this gives a 180-examination effective capacity. Using waiting time as the primary decision criterion for making capacity decisions in emergency radiology has several advantages: the method is easy to use, volume variability is taken into account, and the focus is on service to patients.     

Body composition,work capacity,and work efficiency of active and inactive young men

On 46 healthy young men, of whom 18 took part in strenuous sport at least once a week, height, weight, total body fat (as % of body mass) and lean body mass (LBM) were determined. The subjects performed submaximal exercise on a bicycle ergometer and climbing on an upwardly inclined treadmill at work loads of 60, 110, and 140 watts. Oxygen consumption ( ), respiratory quotient (RQ), energy expenditure (), and heart rate (f _H) were measured at rest and at each work load, and maximum oxygen intake ( max) and physical work capacity (PWC₁₅₀, PWC₁₇₀) were calculated.Anthropometric parameters did not differ significantly between sportsmen and sedentary subjects. max, PWC₁₅₀, and PWC₁₇₀ had higher correlations with LBM than with the other anthropometric parameters. max expressed in terms of LBM (ml/kg LBM/min) was the parameter which showed the clearest distinction between sportsmen and sedentary individuals. The sportsmen had higher max on the treadmill test than on the bicycle ergometer. PWC₁₅₀ and PWC₁₇₀ were higher on the bicycle than on the treadmill and had high correlations with max. Work efficiency was of the same order in both groups and showed negative correlation with the degree of obesity on the bicycle ergometer and positive correlation on the treadmill.     

Quantitative displacement of blood acid base equilibrium in acutely water depleted dogs

Summary Dogs were water depleted 2% of their body weight by the intraperitoneal injection of a hyperosmotic solution of saline and glucose (550 mOsm/l). During a 3-h experiment these water-depleted (WD) animals showed a significant decrease in blood pH, base excess (BE) and plasma bicarbonate (Bic_p) and an increase in both hematocrit (Ht) and blood buffer capacity (BBC). These changes were quantitatively time-dependent. The rate change of pH, BE, and Bic_p were –0.072 units h^–1, –4.7 mEq/l h^–1, and 2.9 mEq/l h^–1, respectively. As control dogs showed no significant time-dependent changes in their blood acid-base status, the observed modifications in the experimental dogs were ascribed to water depletion. Increased endogenous acid production related to tissue hypoxia is suggested to be the mechanism that could explain the increased fixed acid accumulation observed in the water-depleted animals.     

评“McCall观察方法”——对一种色谱系统分配效果观察方法的商榷

本文通过理论分析和文献数据的分析,对McCall提出的色谱系统分配效果的观察方法提出了不同的看法,认为McCall方法中的所谓logK并不是常数。McCall的方法无论在理论上和实践上都是不妥的。     

高原不同海拔地区儿童肺活量肺通气量与形态指标的相关性

目的了解高原不同海拔地区儿童肺活量肺通气量与形态指标的相关性,以便为制定高原性疾病防控策略提供参考依据。方法于2019年1月至2020年6月采用随机抽样调查法,选择青海西宁地区(海拔2260 m,低海拔组)、青海海西地区(海拔2900 m,中海拔组)、青海玉树地区(海拔4493 m,高海拔组)7~15岁中小学生作为研究对象,检测受试儿童肺活量、肺通气量和形态指标。结果低海拔组、中海拔组、高海拔组肺活量、肺通气量和形态指标比较,差异均有统计学意义(P均<0.05)。肺活量、肺通气量与肺容积呈正比关系,与肺密度、肺径线呈反比关系(P<0.05)。研究数据的logistic回归分析显示,影响儿童肺活量和肺通气量的因素有以下3个:肺密度平均值、全肺横径、全肺容积,且以上因素差异间有统计学意义(P<0.05)。结论监测儿童形态指标,关注肺密度平均值、全肺横径、全肺容积可有效判断儿童肺功能,对防治相关高原性疾病的发生具有一定价值。