Doubts, fears and misconceptions. What is the future of thrombolysis in acute stroke?

Alteplase for acute ischemic stroke may be the first stroke intervention to have a significant public health impact. In February 1999, this therapy was conditionally licensed in Canada for acute ischemic stroke within three hours of symptom onset. However, considerable controversy exists regarding its safety, its wider applicability outside clinical trials, and its ultimate availability. In this article we review the thrombolytic literature, attempt to answer many of the concerns, provide new guidelines for its use, and cite the need for more information about whom we should and should not be treating with this therapy.     

回春液补肾助阳药效学的实验研究

回春液由人参、鹿茸、貂鞭等名贵中药组成。有补肾助阳,填精益气等功效。药效学研究证实,该药有促进幼鼠发育及增加去势大鼠前列腺——精液囊的重量,亦显著增加小鼠血红蛋白的含量,表明回春液有雄性激素样作用。     

Incidence and severity of intravenous drug errors in a German hospital

Objective To determine the incidence of errors in preparing and administering intravenous (i.v.) drugs, identify the stages in the process at which errors occurred and evaluate their clinical importance.Methods A prospective ethnographic study using disguised observation was carried out on two wards in one German non-university hospital.Results We observed 22 nurses administering 122 i.v. drug preparations and administrations. One or more errors occurred in the preparation and administration of 58 of 122 i.v. drug doses (error rate 48%, 95% confidence interval 39–57%). In total, 65 errors were identified. Of doses, 4 had potentially severe errors (3%), 38 (31%) potentially moderate errors and 16 (13%) potentially minor errors. Common errors included multiple step preparations and the co-administration of potentially incompatible drugs as intermittent infusions.Conclusion A high incidence of i.v. drug errors was found in the study hospital. Effective strategies to reduce potentially harmful errors are urgently needed. Measures could include a reduction in the number of ward-based i.v. drug preparations, improvement of staff training and the introduction of ward-based clinical pharmacy services.     

Management of HIV in pregnancy

A cohesive multidisciplinary team approach is key in the management of HIV in pregnancy. The primary aim is to prevent transmission to the neonate but also to support the mother in any issues arising from her pre-existing, or new, diagnosis of HIV. Specialist advice should be sought, wherever possible.Key areas discussed in this review include antenatal management of the mother (particularly pharmacological management), obstetric management, pharmacological treatment for the neonate and infant feeding. Due to progress made in both in HIV testing, and in the way all patients with HIV in the UK are managed over the last few decades, most women who present with HIV in pregnancy are aware of their diagnosis and on treatment. However, it is not entirely uncommon for women to be diagnosed in pregnancy and it is these cases that present the greater challenge. The cases in this review cover the most common scenarios encountered.     

Exploring the online learning experience of first-year speech–language pathology students in a Johannesburg-based university

BackgroundUnderstanding the learning experiences of first-year speech–language pathology (SLP) students during the coronavirus disease 2019 (COVID-19) pandemic is essential to ensure that academic staff are able to support and enhance the transition from secondary to tertiary education. An understanding of the student experience could lead to improved support strategies that could be beneficial for the blended learning environment that the University of the Witwatersrand will be entering from 2022.ObjectivesThis research explored the experiences of first-year SLP students in online learning during the COVID-19 pandemic.MethodAn exploratory mixed-method concurrent triangulation design was employed. Quantitative data were collected from likert scales. Qualitative data were collected from critical incident timelines. Themes were identified from both the Likert scales as well as the critical incident timelines using bottom-up thematic analysis.ResultsThe majority of participants reflected that their online learning through the pandemic in 2021 was successful. The themes that emerged from this year pertain to 2021 and the specific participants however, it provides an important insight that the students’ needs change during a year. As a lecturer, one needs to consider these evolving needs to ensure students have the support that they require to be successful in their learning.ConclusionThis research provided insights into the evolving nature of the support first-year SLP students require in the online learning space during the COVID-19 pandemic.