The maintenance and interface of two wheelchairs used by children with cerebral palsy in Kenya: a cross-sectional study.

Current wheelchairs used in low-resource settings lack the adjustability required for children with cerebral palsy and are not well-suited for rough terrain environments. This study aimed to examine the durability and functional interface of two wheelchairs specifically designed for use in low-resource settings. This descriptive study assessed 14 wheelchairs used by children with cerebral palsy living in Kenya, Africa (Momentum Wheels for Humanity's Liberty II wheelchair  = 6, Beeline's Honey Bee wheelchair  = 8).

Development of innovative simulation teaching for advanced general practice clinical pharmacists.

Background: Advanced General Practice Clinical Pharmacists (GPCPs) are expected to manage patients by undertaking clinical assessment then make safe, competent autonomous decisions. Simulation provides a safe learning environment to develop clinical skills, but is rarely used for postgraduate pharmacist development.

Aim: Design and deliver innovative simulation teaching to support Advanced GPCPs in Scotland.

Renal and Ureteric Stone Composition: A five year retrospective study for Northern Ireland.

Introduction: The study aimed to present the types of renal and ureteric stones (calculi) present in the population of Northern Ireland. The data may help in future planning treatment of stone services, patient education and prevention.

Methods: Consecutive retrospective renal and ureteric stones analysed over 5.

Haploinsufficiency of the E3 ubiquitin-protein ligase gene TRIP12 causes intellectual disability with or without autism spectrum disorders, speech delay, and dysmorphic features.

Impairment of ubiquitin-proteasome system activity involving ubiquitin ligase genes UBE3A, UBE3B, and HUWE1 and deubiquitinating enzyme genes USP7 and USP9X has been reported in patients with neurodevelopmental delays. To date, only a handful of single-nucleotide variants (SNVs) and copy-number variants (CNVs) involving TRIP12, encoding a member of the HECT domain E3 ubiquitin ligases family on chromosome 2q36.3 have been reported.

A unique case of penile necrotizing fasciitis secondary to spontaneous corpus cavernosal abscess.

Corpus cavernosal abscess and necrotizing fasciitis occur rarely, and precipitating factors can usually be elicited with careful history and examination. Whilst both conditions share common risk factors such as diabetes mellitus, this is the first reported case of penile necrotizing fasciitis secondary to spontaneous corpus cavernosal abscess in an otherwise healthy patient. A 32-year-old man presented with 4-day history of swollen, painful penis, with ultrasound confirming corpus cavernosal abscess.

Early immune responses in Atlantic salmon (Salmo salar L.) after immunization with PLGA nanoparticles loaded with a model antigen and β-glucan.

Polymeric nanoparticles (NPs) of poly (lactic-co-glycolic) acid (PLGA) possess adjuvant properties. To date, there are few studies exploring their application as antigen carriers for vaccination of fish. This study presents a preclinical assessment of the early innate and adaptive immune responses in Atlantic salmon following immunization with PLGA NPs.

Are we ready to use aliskiren in children?

The objective of this case series was to review the safety and efficacy of aliskiren in combination with losartan in pediatric chronic kidney disease (CKD) patients. This was a retrospective study in which the medical files of all patients who had received aliskiren were reviewed. Four patients were identified between 5 and 18 years of age who had received aliskiren and losartan for the reduction of refractory proteinuria.

Inhaled insulin in diabetes mellitus.

Background: Insulin therapy often relies on multiple daily injections of insulin. However this is a considerable burden to many people with diabetes and adherence to such an insulin regimen can be difficult to maintain, hence compromising optimal glycaemic control. Also, short acting injected insulin is absorbed more slowly than insulin released by the normal pancreas in response to a meal.

Inhaled insulin in diabetes mellitus.

Background: Insulin therapy often relies on multiple daily injections of insulin. However this is a considerable burden to many people with diabetes and adherence to such an insulin regimen can be difficult to maintain, hence compromising optimal glycaemic control. Also, short acting injected insulin is absorbed more slowly than insulin released by the normal pancreas in response to a meal.

Systematic reviews of the effectiveness of quality improvement strategies and programmes.

Systematic reviews provide the best evidence on the effectiveness of healthcare interventions including quality improvement strategies. The methods of systematic review of individual patient randomised trials of healthcare interventions are well developed. We discuss methodological and practice issues that need to be considered when undertaking systematic reviews of quality improvement strategies including developing a review protocol, identifying and screening evidence sources, quality assessment and data abstraction, analytical methods, reporting systematic reviews, and appraising systematic reviews.

Influence of silicone elastomer solubility and diffusivity on the in vitro release of drugs from intravaginal rings.

The in vitro release characteristics of eight low-molecular-weight drugs (clindamycin, 17beta-estradiol, 17beta-estradiol-3-acetate, 17beta-estradiol diacetate, metronidazole, norethisterone, norethisterone acetate and oxybutynin) from silicone matrix-type intravaginal rings of various drug loadings have been evaluated under sink conditions. Through modelling of the release data using the Higuchi equation, and determination of the silicone solubility of the drugs, the apparent silicone elastomer diffusion coefficients of the drugs have been calculated. Furthermore, in an attempt to develop a quantitative model for predicting release rates of new drug substances from these vaginal ring devices, it has been observed that linear relationships exist between the log of the silicone solubility of the drug (mg x ml(-1)) and the reciprocal of its melting point (K(-1)) (y=3.

Factors influencing the adoption of blood alternatives to minimize allogeneic transfusion: the perspective of eight Ontario hospitals.

Objective: To identify and describe the factors influencing the use and nonuse of blood-sparing methods such as preoperative autologous donation, acute normovolemic hemodilution, and the use of cell salvage devices, hemostatic agents and erythropoietin.

Design: An interview survey.

Setting: Eight Ontario hospitals.

Inhaled insulin for the treatment of diabetes mellitus.

(1) Insulin delivery via inhalation, as an alternative to administration by injection, is under development. (2) The available evidence comparing subcutaneous (sc) insulin with inhaled insulin for persons with type 1 and 2 diabetes, shows similar glycosylated hemoglobin (HgA1c) levels after three months of treatment. (3) Clinical trials suggest that insulin delivered by inhalation has a quicker onset of action relative to regular insulin.

Is there a "best" way to detect and minimize publication bias? An empirical evaluation.

Using 14 meta-analyses that included both published (n = 199) and unpublished (n = 50) randomized trials, we evaluated the utility of different analytical approaches to detect, assess robustness, and minimize publication bias in meta-analysis. The rank correlation and graphical tests indicated funnel plot asymmetry in 3 and 7 of the 14 meta-analyses, respectively. The file drawer number estimates using Iyengar-Greenhouse method were between 1.

Awareness and use of the Ottawa ankle and knee rules in 5 countries: can publication alone be enough to change practice?

Study Objectives: We evaluate the international diffusion of the Ottawa Ankle and Knee Rules and determine emergency physicians' attitudes toward clinical decision rules in general.

Methods: We conducted a cross-sectional, self-administered mail survey of random samples of 500 members each of the American College of Emergency Physicians, Canadian Association of Emergency Physicians, British Association for Accident and Emergency Medicine, Spanish Society for Emergency Medicine, and all members (n=1,350) of the French Speaking Society of Emergency Physicians, France. Main outcome measures were awareness of the Ottawa Ankle and Knee Rules, reported use of these rules, and attitudes toward clinical decision rules in general.