Search

Background Context-specific evidence-based guidelines on how to prevent and treat substance misuse among adolescents are currently lacking in many countries. Due to the time consuming nature of de novo guideline development, the ADAPTE collaboration introduced a methodology to adapt existing guidelines to a local context. An important step in this method is a systematic review to identify relevant high-quality evidence-based guidelines. This study describes the results of this step for the development of guidelines on adolescent alcohol and drug misuse in Belgium. Methods Rigorous systematic review methodology was used. This included searches of electronic databases (Medline, Embase, Cinahl, PsychInfo, and ERIC in June 2011), websites of relevant organizations, and reference lists of key publications. Experts in the field were also contacted. Included were Dutch, English, French, or German evidence-based practice guidelines from 2006 or later on the prevention, screening, assessment, or treatment of alcohol or illicit drug misuse in persons aged 12-18 years. Two independent reviewers assessed the quality of the guidelines using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument. Scope This overview provides a framework of current knowledge in adolescent alcohol and drug misuse prevention and treatment. Results This systematic review identified 32 relevant evidence-based guidelines on substance misuse among adolescents. Nine guidelines were judged to be of high quality; of which four had recommendations specifically on adolescents: one on school-based prevention, one on substance misuse prevention in vulnerable young people and two on alcohol misuse with specific sections for the adolescent population. There were few commonalities as guidelines focused on different target groups, professional disciplines and type and level of substance misuse. Evidence to support the recommendations was sparse, and many recommendations were based on expert consensus or on studies among adults. Also, the link between evidence and recommendations was often unclear. Conclusions There are a substantial number of guidelines addressing substance misuse in adolescents. However, only four high-quality guidelines included recommendations specific for adolescents. The current level of evidence that underpins the recommendations in these high-quality guidelines is low. [ABSTRACT FROM AUTHOR]

Aim To compare current practice of cuff size selection for noninvasive blood pressure measurement in a single-centre, tertiary-level neonatal intensive care unit (visual assessment of bladder width/limb length closest to 2/3) with common recommendations for appropriate cuff selection. Methods Visual assessment of the appropriate cuff size ('2/3 rule') for upper arm, forearm and calf in 103 neonates (309 cuff selections) was compared with the following recommendations: (i) Method A - guidelines of the cuff manufacturer, (ii) Method B - cuff width/limb circumference ratio 0.44-0.60 and (iii) Method C - cuff width/limb length ratio closest to 0.66. Results The upper arm cuff size was correctly chosen in 84% of cases (Method A), 43% (Method B) and 56% (Method C). The forearm cuff size was correctly chosen in 94% of cases (Method A), 68% (Method B) and 54% (Method C). The calf cuff size was correctly chosen in 96% of cases (Method A), 72% (Method B) and 63% (Method C). Conclusion The accuracy of selecting cuff size by visual assessment is low. Further research on accurate cuff selection for neonates, including at the forearm and calf, is warranted. [ABSTRACT FROM AUTHOR]

Unlabelled: Late neonatal onset of subependymal germinolysis in the caudothalamic groove has been associated with chronic lung disease. This clinical study had two objectives: (i) to clarify the link between chronic lung disease and germinolysis; and (ii) to evaluate the impact of germinolysis on neuromotor development of patients with chronic lung disease. Twenty-four patients with chronic lung disease and germinolysis were compared to 24 patients, matched for gestational age, with chronic lung disease but without germinolysis. There was no difference in the occurrence of perinatal risk factors for impaired cerebral development (small for gestational age at birth, impaired postnatal growth, postnatal steroid treatment, duration of mechanical ventilation) or in the presence of clinical markers potentially related to cerebral ischaemia (need for treatment of hypotension or poor perfusion, seizures, oliguria, hypocapnia). Both groups showed a high incidence of clinically significant developmental delay (mean Bayley Development Index of 72+/-23 [SD] in both groups), regardless of the presence or absence of germinolysis.Conclusions: We were unable to clarify the link between chronic lung disease and germinolysis, and it seems that germinolysis has no major impact on neurodevelopmental outcome of patients with chronic lung disease. [ABSTRACT FROM AUTHOR]

var was eradicated from a Belgian pig farm by using a combination of injections of ivermectin and ivermectin in the feed. The detection of mites in ear scrapings, and calculations of an average dermatitis score and a scratching index were used to evaluate the mange status of the pigs before and after the treatment. Before the treatment 28 per cent of ear scrapings offinishers were positive for the presence of mites, their average dermatitis score (ADS) was 0.92 and their scratching index was 2.0. There was a significant decrease in all three measurements during the year after the treatment, and one year after treatment, no mites were found in the ear scrapings; the ADS of the finishers was 0.31 and their scratching index was 0.16. Adult animals were negative for the presence of mites at all times, the ADS was below the cut-off level before and after treatment, and the scratching index decreased after treatment. There was an economic improvement among the breeding sows and the fattening pigs. The feed consumption of the sows decreased by 5 per cent; rebreeding decreased by 4.55 per cent; average litter size increased by 0.33 live piglets born per litter and the farrowing index increased by 0.075 litters per sow per year. As a result, the production index increased by 1.34 more piglets weaned per sow per year. There was an immediate improvement in feed conversion during the five months after the treatment The costs of the treatment were recovered within 3.7 months. [ABSTRACT FROM PUBLISHER]

Between October 1996 and May 1997,94 horses which were suspected of being infected with strongyles were examined clinically, and samples of faeces were examined for strongyle eggs and cyathostome larvae (L4) and adults. Blood samples were monitored for total protein, albumin and β-globulins. In 28 of the horses (30 per cent) cyathostome L4 and adults were detected in the faeces, and were significantly associated with the horses' condition, the occurrence of diarrhoea, with lower concentrations of total protein and albumin, and with higher percentages of β-globulin. Thirty-four of the horses (36 per cent) were excreting strongyle eggs, but in these animals the associations were with high concentrations of total protein and albumin, and lower percentages of β-globulin. The results showed that during the winter, a horse in poor condition which has diarrhoea, an albumin concentration less than 20 g/litre, and a ratio of albumin:globulin less than 0.7 is very likely to be infected with L4 and adult stages of cyathostomes. [ABSTRACT FROM PUBLISHER]

The persistence of the efficacy of doramectin injectable against and was evaluated in two studies in calves. In both, the calves were allocated to six groups of six. Calves in the first control group (c1) and first treated group (Ti) received a daily infection of 200 L3 of and 200 L3 of ; the calves in groups C2 and T2 received a daily infection of 1000 L3 of each species, and groups C3 and T3 received 10,000 L3 of each species per day. The calves in the three treated groups each received 0.2 mg/kg doramectin injectable on day 0. In the first study, the calves were infected for 21 days with and for 28 days with , and they were slaughtered on day 33. In the second study, the calves were infected for 21 days with both species, the infections with and starting from eight and 15 days, respectively, after the treatment, and the animals were slaughtered on day 40. The calculation of the persistence of the activity of doramectin was based on its efficacy against the different developmental and adult stages of the two parasites. The data from both studies indicated that the efficacy of doramectin against persisted for at least five weeks, but no conclusions could be drawn about the effect of the size of the infective doses on the persistence of the activity. In contrast, the worm counts from the second study suggested that the efficacy of doramectin against persisted for at least four weeks when the calves were exposed to a low or moderate infection level, whereas at the highest infection level it persisted for between three and four weeks. [ABSTRACT FROM PUBLISHER]

A controlled trial was carried out to evaluate the persistence of the effect against small strongyles of a 2 per cent moxidectin gel administered orally to foals at a dose rate of 0.4 mg/kg bodyweight. Five of nine helminth-free foals were treated on day 0, and the remaining four foals were used as controls. On days 0, 7, 14, 21 and 28 all nine foals were infected experimentally with 200,000 small strongyle larvae. Three treated and two control foals were necropsied on day 42 and the rest on day 43. Fourteen species of small or medium sized small strongyles were found in the control foals, 10 of them in all four. The mean rate of establishment of the infection was 27 per cent in the control foals and 7 per cent in the treated foals. The numbers of mucosal inhibited early L3 and late L3 were about equal in each group, but there were more than 10 times as many mucosal L4 in the control foals. No lumenal stages were recovered from the treated foals, whereas almost 50 per cent of the total burdens of the control foals consisted of these stages. The establishment of the infection was prevented by moxidectin treatment for at least two and possibly three weeks. [ABSTRACT FROM PUBLISHER]

Aim: To evaluate implementation and results of neonatal hearing screening with automated auditory brainstem response (AABR) by bedside nurses in a single-centre neonatal intensive care unit (NICU)., Methods: Retrospective review of charts of 2074 newborns admitted over a 4-year period., Results: One thousand eight hundred and 24 newborns (88%) were screened. A 'pass' result was obtained in 1761 patients (96.5%). From 63 infants with 'refer', 40 were tested with auditory brainstem response: in 28 hearing loss was confirmed. Three hundred and nine neonates were screened before postmenstrual age (PMA) of 34 weeks: 78% successfully passed the first test. Sixty-seven infants with 'refer' at the first test before PMA of 34 weeks were re-evaluated: 48 had normal hearing tests, 24 of whom still younger than 34 weeks. For 12 of 19 infants with 'refer' before 34 weeks, follow-up was available: in 7 hearing loss was confirmed., Conclusion: Neonatal hearing screening with AABR can be easily performed by the bedside nurse in the NICU even in premature babies before 34 weeks PMA. A 'pass' result can be obtained in almost 80% of them; a 'refer' result at that age, however, must be interpreted cautiously, as false 'refer' occurred in 5/12 of these infants., (© 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.)