Neuropeptide Y-like immunoreactivity in cultured intrinsic neurones of the heart

A novel culture preparation from the atria of newborn guinea-pig hearts was employed to study the intrinsic innervation of the heart under conditions of unequivocal extrinsic denervation. Using an indirect immunofluorescence technique, a subpopulation of intracardiac neurones grown in dissociated cell culture was demonstrated to contain neuropeptide Y (NPY)-like immunoreactivity. This shows that NPY is not confined to sympathetic nerves. Further, since no endogenous catecholamines could be demonstrated in neurone cell bodies in the culture preparation with fluorescence histochemistry, confirming previous studies in situ, the findings also suggest that NPY does not coexist with catecholamine in these intrinsic heart neurones.     

Presenting Symptoms of Nonerosive and Erosive Esophagitis in Pediatric Patients

Children and adolescents with symptomatic gastroesophageal reflux disease (GERD) and erosive esophagitis (EE) of grade ≥2 (n=45) or nonerosive esophagitis (NEE) (n=45) were assessed to determine the relationship between presenting symptoms, esophagitis severity, and patient age. Overall, regurgitation/vomiting, abdominal pain, and cough were the most frequent symptoms. The prevalence and severity of anorexia/feed refusal was significantly greater in EE versus NEE children; this symptom was also significantly more prevalent in younger (1–5 years) children (both NEE and EE groups) compared to older children. Cough was significantly less severe in NEE adolescents than in younger children. Cough, anorexia/feed refusal, and regurgitation/vomiting were more severe and heartburn was less severe in EE children aged 1–5 years compared with older patients. In conclusion, GERD in children manifests differently than that in adults and symptoms vary with patient age. Symptoms were not predictive of presence or lack of mucosal damage.     

Data linkage between existing healthcare databases to support hospital epidemiology

Enhancing the use of existing datasets within acute hospitals will greatly facilitate hospital epidemiology, surveillance, the monitoring of a variety of processes, outcomes and risk factors, and the provision of alert systems. Multiple overlapping data systems exist within National Health Service (NHS) hospitals in the UK, and many duplicate data recordings take place because of the lack of linkage and interfaces. This results in hospital-collected data not being used efficiently. The objective was to create an inventory of all existing systems, including administrative, management, human resources, microbiology, patient care and other platforms, to describe the data architecture that could contribute valuable information for a hospital epidemiology unit. These datasets were investigated as to how they could be used to generate surveillance data, key performance indicators and risk information that could be shared at board, clinical programme group, specialty and ward level. An example of an output of this integrated data platform and its application in influenza resilience planning and responsiveness is described. The development of metrics for staff absence and staffing levels may also be used as key indicators for risk-monitoring for infection prevention. This work demonstrates the value of such a data inventory and linkage and the importance of more sophisticated uses of existing NHS data, and innovative collaborative approaches to support clinical care, quality improvement, surveillance, emergency planning and research.