A review of 43 cases of tetanus neonatorum.

Forty-three patients with neonatal tetanus admitted to the Infectious Diseases Ward of the Istanbul University Faculty of Medicine Children's Hospital at Capa from 1982-1989 are presented. Thirty-two (74.4%) of the subjects were boys. The overall mortality was found to be 60 percent and the mean incubation period 6.1 +/- 20 days. The mean period between onset of symptoms and hospital admission was 1.7 days. Thirty-nine (90.7%) of the 43 patients were unhygienic home deliveries and only two cases were delivered with a midwife in attendance. None of the mothers of the children in our series had been immunized with tetanus toxoid. The incidence of neonatal tetanus in Turkey is on the decline, but a fraction of the population, the so-called urban poor, is still at high risk for preventable diseases. Every contact an unvaccinated person has with a health care professional should be viewed as an opportunity for tetanus immunization.     

Polyester film strips coated with photographic gelatin containing immobilized glucose oxidase hardened by chromium(III) sulphate.

Glucose oxidase was immobilized into photographic gelatin hardened by chromium(III) sulphate. The enzyme-gelatin mixture was coated on polyester film strips which allowed easy and simple handling during assays. The effect of gelatin and cross-linker concentrations on water content and enzymatic activity was studied. The effect of pH during immobilization and that of incubation temperature on maximum activity were examined. Enzyme leakage tests were carried out during reuse number studies. Consecutive use of strips followed by washing and resting between uses were found to affect the reuse number. A maximum immobilization of 68% was reached under optimal conditions. Mechanical stability and leakage were found to be functions of gelatin and cross-linker concentrations. Photographic gelatin was found to have many capabilities with extraordinary characteristics as a carrier on immobilization.     

Waiting list hurdles and the role of the pre-surgical booking clinic

Patients requiring surgery have two main hurdles to cross--long waiting lists and the risk of late cancellation when dates become available. A study was conducted to investigate the inconvenience caused by late cancellation, and to show how the pre-surgical assessment clinic can be utilised to reduce the dissatisfaction and disappointment of the current waiting list system in surgery.     

What is the most useful and cost-effective strategy to screen for left ventricular systolic dysfunction in clinical practice?: reply

We agree with many of the comments made by Yamada et al.,¹namely that the ECG and NTproBNP are fundamental tests usedin the diagnosis of heart failure and that