Pharmacist-led intervention to improve medication use in older inpatients using the Drug Burden Index: a study protocol for a before/after intervention with a retrospective control group and multiple case analysis.

Introduction: Polypharmacy and potentially inappropriate medication use is common in older adults and is associated with adverse outcomes such as falls and hospitalisations.

Methods And Analysis: This study is a pharmacist-led medication optimisation initiative using an electronic tool (the Drug Burden Index (DBI) Calculator) in four hospital sites in the Canadian province of Nova Scotia. The study aims to enrol 160 participants between the preintervention and intervention groups.

Inferior vena cava calibre on paediatric trauma CT may be a useful predictor for the development of shock.

Aim: To investigate whether inferior vena cava (IVC) calibre on paediatric trauma computed tomography (CT) can help anticipate outcomes in children.

Materials And Methods: The imaging and clinical records of 52 paediatric trauma admissions to the level 1 major trauma centre at St George's Hospital, London, UK, were retrospectively reviewed. The IVC dimensions, evidence of significant haemorrhage on CT, and the presence of components of the classical hypoperfusion complex, such as bowel and adrenal hyperenhancement, were recorded.

Left ventricular aneurysm in a four-year-old child: a diagnostic challenge.

We describe spontaneous rupture of a congenital left ventricular (LV) aneurysm with subsequent tamponade and cardiac arrest in a 4-year-old male with staphylococcal septicemia. Emergency resuscitation, thoracotomy, and oversewing were successfully undertaken in the pediatric intensive care unit. There was complete cardiovascular recovery without adverse neurodevelopmental sequelae.

Air enema reduction of intussusception: a registrar-led, protocol-driven service is safe and effective.

Purpose: In the UK, air enema reduction of intussusception is predominantly performed by consultant radiologists. At our institution, it is usually performed by a team involving radiology and surgical registrars. The purpose of this study was to assess who performs air enemas in the UK and the efficacy and safety of our registrar-led service.

Perioperative management of the child on long-term opioids.

The strategies used to manage children exposed to long-term opioids are extrapolated from adult literature. Opioid consumption during the perioperative period is more than three times that observed in patients not taking chronic opioids. A sparing use of opioids in the perioperative period results in both poor pain management and withdrawal phenomena.

C4b binding protein binds to CD154 preventing CD40 mediated cholangiocyte apoptosis: a novel link between complement and epithelial cell survival.

Activation of CD40 on hepatocytes and cholangiocytes is critical for amplifying Fas-mediated apoptosis in the human liver. C4b-Binding Protein (C4BP) has been reported to act as a potential surrogate ligand for CD40, suggesting that it could be involved in modulating liver epithelial cell survival. Using surface plasmon resonance (BiaCore) analysis supported by gel filtration we have shown that C4BP does not bind CD40, but it forms stable high molecular weight complexes with soluble CD40 ligand (sCD154).

Transfection of lung cells in vitro and in vivo: effect of antioxidants and intraliposomal bFGF.

We hypothesized that constitutive formation of reactive oxygen species by respiratory cells is a barrier to gene transfer when liposome-DNA complexes are used, by contributing to rapid degradation of plasmid DNA. When plasmid DNA is complexed to liposomes it is protected against H(2)O(2)-mediated degradation but not that mediated by the hydroxyl radical. Treatment of distal rat fetal lung epithelial cells (RFL(19)Ep) with the vitamin E analog Trolox (50 microM) reduced intracellular plasmid degradation.

Is sonographically demonstrated mild distal ureteric dilatation predictive of vesicoureteric reflux as seen on micturating cystourethrography?

Background: In most paediatric units, the micturating cystourethrogram (MCU) is the gold standard in the diagnosis of vesicoureteric reflux (VUR). Because of the well-known difficulties associated with MCUs, there is interest in any imaging finding which may be predictive of the absence of VUR with enough confidence to avoid the necessity for an MCU.

Objective: To evaluate whether incorporation of measurement of the internal diameter of the retrovesical ureter into a routine urinary tract US protocol can provide a useful predictor of VUR.

Antioxidants as therapy in the newborn: some words of caution.

Reactive oxygen and nitrogen species are considered to play a major role in the pathogenesis of a wide range of human disorders. This may be a particularly important pathogenetic mechanism in the newborn nursery. The phrase "oxygen radical disease of prematurity" has been coined to collectively describe a wide range of neonatal disorders based on the belief that premature newborns are deficient in antioxidant defenses at a time when they are subjected to acute and chronic oxidant stresses.