Routine neonatal examination: effectiveness of trainee paediatrician compared with advanced neonatal nurse practitioner.

OBJECTIVE: To compare the effectiveness of routine neonatal examination performed by senior house officers (SHOs) and advanced neonatal nurse practitioners (ANNPs). DESIGN: A prospective study of all infants referred to specialist orthopaedic, ophthalmology, and cardiology clinics. A standardised proforma was used to record details of the professional performing the neonatal check, any abnormalities discovered, source of ultimate referral to the specialist clinic, and specialist findings. RESULTS: 527 eligible infants were recruited. For hip abnormalities, ANNPs displayed greater sensitivity than SHOs (96% v 74%; p < 0.05). Similarly for eye abnormalities, ANNPs were more sensitive (100% v 33%; p < 0.05). There were no significant differences between ANNPs and SHOs in terms of positive predictive values or effectiveness of detecting cardiac abnormalities. There was no difference in underlying incidence of abnormalities between the two hospitals. CONCLUSION: ANNPs are significantly more effective in detecting abnormalities during the neonatal check. This has implications both for future workforce planning and current methods of medical training.

Estimation of high pressure liquid chromatographic retention indices of narcotic analgetics and related drugs.

A method for the prediction of the retention index of drugs on C18 reversed-phase columns was developed and then applied to a series of drugs that were structurally related to morphine and to a series related to fentanyl. The HPLC retention index (/) of the test compounds was estimated using the equation: / = 200 pi + /ref. where pi was the sum of the Hansch substituent constants for the compound, and /ref. was the index experimentally observed for the reference compound of the series. It was also found that the observed index could be used to assign the stereochemistry of the fentanyl analogues.