A guide to best practice dementia care: lessons learnt from a serious case review

This reflective paper discussed a clinical scenario and compares best practice guidelines with published literature against a backdrop of evidence taken from a serious case review (SCR). Mrs B (pseudonym) was a 94 year old lady with dementia and blinds, plus several other co-morbidties, including a previous stroke, She lived in a care home and had a history of falling. The last fall was fatal, due to aspiration pneumonia and fractured vertebrae of the neck. A serious case review process highlighted a number of failures in interdisciplinary working practice which contributed ultimately to Mrs B's avoidable death. The article discusses how applying evidence based best practice could have led to better care outcomes. A series of severn recommendations and lessons learned are presented for multi-agency approach to best practice in dementia car

Learning disability today fourth edition: The essential handbook for support staff, service providers, families and carers

This fully revised and updated edition of Learning Disability Today provides an accessible and thought-provoking introduction to some of the key issues in the lives of people with learning disabilities and the practice of those who support them. Learning Disability Today was first published in 2007 to meet the need for a handbook which, while well-grounded in latest research and practice, was accessible for staff occupying many roles, such as support workers and managers in learning disability service settings, community learning disability teams and professionals who may find themselves supporting a person with an intellectual disability from time to time, families and voluntary supporters, as well as students of learning disability/intellectual disability. It has continued to be a highly successful title, and has been published in three previous editions over the past nine years. This new, fourth edition is a complete revision, aiming to address key knowledge requirements, challenges and concerns for people working in the field and provide opportunities for reflection and continuing professional development. The content is illustrated throughout by case studies to help the reader explore how best to address issues in practice

Antenatal diagnosis of urological disorders by ultrasound: a critical review

The suspected diagnosis of urological disorders made on the basis of antenatal ultrasonography was compared with the final outcome in 23 cases. In 18 cases the initial diagnosis could be confirmed, whereas 5 showed no postnatal urological anomalies. Further efforts should be undertaken to improve prenatal diagnosis in order to facilitate treatment as early as possible

Puncture of unilateral renal cyst in utero

Although most authors do not recommend prenatal puncture of a unilateral single cystic renal mass, in case the contralateral kidney is normal and there is sufficient amniotic fluid, this case report shows that the procedure, which can be done very carefully under ultrasonic guidance, can be helpful in establishing the presumed diagnosis

Cultured neurons release an inhibitor of astroglia proliferation (astrostatine).

Using in vitro techniques, we looked for a possible downregulation of rat astroglia proliferation by neuronal cells. We demonstrate that medium conditioned by 7-day-old rat cerebellar granule neurons or by 16-day-old rat embryo hippocampal neurons strongly inhibits the proliferation of cultured astroglial cells. Two neuronal cell lines, the PC12 rat pheocromocytoma and the neuro 2A (N2A) murine neuroblastoma also release such an activity. This release in N2A-conditioned medium (CM) occurs when the cells are at high density and show a low proliferation rate. This activity is present in media conditioned by neuronal cells, but not in media conditioned by normal astrocytes, by two glioma cell lines, or by one fibroblastic cell line. This proliferation inhibitor addresses normal astrocytes: the proliferation of two glioma cell lines, of a fibroblastic cell line, and of the two neuronal cell lines (PC12, N2A) is not inhibited by N2A CM. Moreover, this activity is directed against type 1 astrocytes, but not against type 2. Using three different assays, we demonstrate that DNA synthesis by astroglial cells is inhibited. N2A CM has no cytotoxic effect on astrocytes and does not modify their overall protein synthesis. Using affinity and gel filtration chromatography, we show that this activity is associated with a protein whose molecular weight ranges between 15 and 20 kDa. The possible relationship between this N2A cell-derived astroglia proliferation inhibitor and other types of potential glial proliferation inhibitors has been investigated. A brain glycoprotein immunologically related to epidermal growth factor receptor (EGFR) was reported to inhibit astroglial cell proliferation in vitro. Using polyclonal and monoclonal antibodies against EGFR, we were unable to immunoprecipitate the astrocyte proliferation inhibitor in N2A CM or to demonstrate by immunoblotting the presence of an EGFR-like immunoreactivity in the N2A CM or in the active chromatographic fractions of N2A CM. Transforming growth factor beta (TGF beta) is a well-known modulator of the proliferation of various cell types and was shown to be present in N2A CM. Using a polyclonal anti-TGF beta antibody that recognizes TGF beta on Western blots of N2A CM, we were unable to immunoprecipitate the astrocyte proliferation inhibitor of N2A CM. It seems thus far that the neuronal astroglia proliferation inhibitor is a new protein for which we propose the name astrostatine