Characteristics and special challenges of neonatal emergency transports.

BACKGROUND: As a rule, newborns do not require special medical care. If unexpected complications occur peripartum or postpartum, support from and transport to specialised neonatal hospitals might be needed. METHODS: In a retrospective study, all transport protocols of a supraregional paediatric­neonatological maximum care hospital in northwestern Germany from 01.10.2018 through 30.09.2021 were analysed. The particular focus was on transports of newborns (<7 days) and the leading symptoms that led to contact. RESULTS: A total of 299 patients were included (average age of 15.4 h, 61.6 % males). The average complete transport time was approximately 2 h. Five leading neonatal diseases (respiratory, infectious, asphyxia, cardiac, haematological) were found to represent the causes of >80 % of transfers. Respiratory adaptation disorders are the main reason for transferring a newborn to a centre, whereas asphyxia is the most severe condition. The various symptoms differ in their time of onset, a factor which must be taken into account in practice. Differences were also found between different types of hospitals: while a large proportion of transports were carried out from maternity hospitals (80.6 %), children transported from children's hospitals were generally more severely ill. DISCUSSION: Transfers of neonates, especially from maternity hospitals to neonatal intensive care units due to special neonatal diseases, are not rare. In times of increasingly scarce resources, the effective care of sick or at-risk neonates is essential. For low-population regions, this means professional cooperation between maximum care providers and smaller children's hospitals and maternity-only hospitals.

[Viability and Particle Size of Fat Grafts Obtained with WAL and PAL Techniques]. / Vitalität und Partikelgröße bei der autologen Fetttransplantation mit der WAL und der PAL Technik.

BACKGROUND: Water jet-assisted liposuction (WAL) and power-assisted liposuction (PAL) are used for autologous fat grafting. This study analyses the viability and particle sizes of fat grafts obtained by these techniques. PATIENTS, MATERIAL AND METHODS: The WAL and PAL techniques were applied in 9 female patients in identical body regions. In order to analyse cell viability, fat grafts were tested via the WST-8 assay and DNA quantification immediately after liposuction. Furthermore, in order to determine particle size, an optically evaluable water-fat emulsion was analysed by macroscopic inspection and light microscopy. RESULTS: The WST-8 assay showed significantly lower extinction values (OD) for use of the WAL technique - corresponding to a lower metabolical activity - compared to PAL liposuction: WAL 1.85±0.56 OD, PAL 2.25±0.57 OD. The quotient of extinction values and cell DNA concentration determined by DNA quantification also indicated statistically significant differences between both systems of liposuction in favour of using power-assisted systems: WAL 0.061±0.023 OD/µg, PAL 0.083±0.029 OD/µg. On the other hand, microscopic and macroscopic analyses showed significantly greater diameters (d) for fat grafts obtained with the PAL technique than by WAL liposuction: dmakroWAL=0.8 mm and dmakroPAL=1.1 mm or, respectively, dmikroWAL 0.89 mm and dmikroPAL=0.93 mm. CONCLUSION: Power-assisted liposuction obtains fat grafts with a higher metabolical activity than water jet-assisted liposuction. A falsification of extinction values within the WST-8 assay due to diversity of the number of cells was eliminated by additionally implemented DNA quantification. According to the current scientific debate, the particle size of obtained fat grafts is also considered as an important criterion for the success of autologous fat grafting. For clinical use, one should favour techniques which provide the smallest and most viable fat grafts as possible. In our opinion, the significantly lower size of WAL particles compared to the higher viability of PAL grafts indicates a necessity of analysing viability as well as particle size in order to evaluate liposuction systems. Data solely about in vitro viability of fat grafts fail to offer a recommendation for the use of a specific technique.

An analysis of printed breast cancer information for African American women.

BACKGROUND: The 1995-1998 Delta Project was designed to increase breast cancer screening among disadvantaged African American women with limited literacy skills by educating their health care professionals about breast health. The research team intended to provide onsite training and appropriate educational materials; however, they found no suitable materials. This article presents the results of an assessment of available materials and defines the need for suitable materials. METHODS: Nineteen organizations that develop cancer-related publications submitted materials intended for African American audiences. Sixty-one documents were examined for readability and cultural sensitivity. The Flesch Reading Ease (FRE), Flesch-Kincaid (F-K), and Cultural Sensitivity Assessment Tools (CSAT) were used in testing. RESULTS: The mean FRE score of 65 yielded a F-K mean grade level of 7.5 (desired level: 3.5). Using CSAT, 16 documents (26%) were eliminated because they had no visuals. Twenty-two publications (37%) were culturally sensitive for all audiences and 19 (31%) were for white audiences. Four (6%) pieces specifically addressed African American women. CONCLUSIONS: Printed educational materials on breast cancer do not adequately provide information to undereducated, economically disadvantaged African American women.

[Collagenous colitis. Studies on the differentiation and incidence of the syndrome]. / Die kollagene Kolitis. Untersuchungen zur Abgrenzung und Häufigkeit eines Syndroms.

All colon biopsy specimens of 28 months collected in an institute of pathology, providing a region of 660,000 inhabitants were reviewed for thickening of the subepithelial layer above the normal range of 7 mu. 16 cases were found, eleven of them with mild, uncharacteristic symptoms, eight even without diarrhea. Of the five cases with collagen layers above 10 mu, three suffered from intestinal diseases (unspecific protocolitis, active ulcerative colitis and malabsorption after ileum resection); two showed chronic diarrhea as symptoms of collagenous colitis. We conclude, that a subepithelial collagen layer is without any significance. Above 10 mu, two forms can be postulated: a reactive one, following chronic intestinal diseases and the idiopathic collagenous colitis syndrome of unknown etiology and pathogenesis. The presence of 185 cases is assumed in Western Germany, five of them already published.