Complex infantile and congenital hip dislocation: assessment with MR imaging

Twenty-five magnetic resonance hip studies were performed on 19 infants with congenital hip dislocation. These patients had a poor initial treatment response, a teratologic dislocation, or a late presentation. Detailed images of single hips obtained with small surface coils resulted in excellent visualization of all the clinically important soft-tissue and cartilaginous structures of the hip. No other imaging modality demonstrates all of these structures simultaneously.     

Dexamethasone during ovulation induction for in-vitro fertilization: a pilot study

The purpose of the present study was to determine whether adrenalandrogen suppression with dexamethasone (DEX) during ovulationinduction improves the outcome of in-vitro fertilization (IVF)cycles. A total of 25 patients with serum dehydroepiandrosteronesulphate (DHEAS) concentrations>2.5 µg/ml were randomizedto receive either 0.5 mg DEX daily or placebo during ovulationinduction with leuprolide acetate down-regulation plus humanmenopausal gonadotrophins (HMG). Nine patients undergoing asubsequent IVF cycle were crossed over to the other treatmentgroup. Ovarian responsiveness and IVF outcome variables analysedincluded number of follicles>12 mm in diameter, serum oestradiolconcentrations on the day of human chorionic gonadotrophin (HCG)administration, number of ampoules of HMG administered, numberof oocytes retrieved, percentage of oocytes fertilized, numberof embryos transferred, implantation rate and numbers of clinicalpregnancies and live birth pregnancies. The 31 randomized IVFcycles revealed a trend towards a higher implantation rate forthe placebo-treated group compared to the DEX-treated group(24 versus 10%P=0.07). The remainder of the IVF cycle variablesrevealed no statistically significant differences. In conclusion,the suppression of adrenal androgens with DEX in women withDHEAS concentrations >2.5 µg/ml appears to have nobeneficial effects on ovarian responsiveness or clinical orlive birth pregnancy rates.     

Indirect bonding with thermal glue and brackets with positioning jigs

In orthodontics the precise location of bracket placement on the teeth is a goal in order to individualize and optimize treatment outcome. The authors will describe the indirect bonding procedure with thermal glue transfer tray and brackets with positioning jigs for precise bracket placement.     

Maxillary canine retraction with self-ligating and conventional brackets: A randomized clinical trial

Objective:To measure space closure during the retraction of upper permanent canines with self-ligating and conventional brackets.Materials and Methods:Fifteen patients who required maxillary canine retraction into first premolar extraction sites as part of their orthodontic treatment completed this study. In a random split-mouth design, the retraction of upper canines was performed using an elastomeric chain with 150 g of force. The evaluations were performed in dental casts (T0, initial; T1, 4 weeks; T2, 8 weeks; T3, 12 weeks). The amount of movement and the rotation of the canines as well as anchorage loss of the upper first molars were evaluated.Results:There was no difference between self-ligating and conventional brackets regarding the distal movement of upper canines and mesial movement of first molars (P > .05). Rotation of the upper canines was minimized with self-ligating brackets (P < .05).Conclusion:Distal movement of the upper canines and anchorage loss of the first molars were similar with both conventional and self-ligating brackets. Rotation of the upper canines during sliding mechanics was minimized with self-ligating brackets.     

Infection control in delivery care units,Gujarat state,India: A needs assessment

Background

Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India.

Methods

Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009.

Results

Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%.

Conclusions

This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems, protocols and procedures, and for training and research. Simply incentivizing the behaviour of women to use health facilities for childbirth via government schemes may not guarantee safe delivery.

     

Transcultural adaptation of the filial responsibility interview schedule for Brazil

AIRES M., WEISSHEIMER A.‐M., ROSSET I., DE OLIVEIRA F. A., DE MORAIS E. P. & PASKULIN L. M. G. (2012) Transcultural adaptation of the filial responsibility interview schedule for Brazil. International Nursing Review 59 , 266–273 Background: In developed countries, filial responsibility in relation to caring for elderly parents has been systematically studied. In Brazil and other developing countries, however, it is a relatively new topic and has not yet been included in the research agenda on ageing. Objective: To describe the process of cross‐cultural adaptation of the qualitative phase of the filial responsibility interview schedule into Brazilian Portuguese. Methods: An expert committee of six team members participated in the study. In addition, individual interviews were held with 11 caregivers of older persons to evaluate the quality of the final Portuguese version of the schedule. The process included examining conceptual, item, semantic and operational equivalencies. Conceptual and item equivalencies were based on a literature review and on discussions with the expert committee. Semantic equivalence was attained through translation, back‐translation, expert committee evaluation and pre‐testing. The final version was pre‐tested in caregivers of older persons enrolled in the home care programme of a primary health care service in Southern Brazil. Results: Conceptual, item, semantic and operational equivalencies were attained. Through the interviews, responses to the open‐ended questions concerning filial responsibility in the care for elderly parents pertained to the following categories: possibility of institutionalization of elderly parents, caregiver expectations, difficulties in being a child caregiver and responsibility as a natural process. Conclusion: The Portuguese version presented good semantic equivalence and the results showed that the concepts and items are applicable to the Brazilian context.