Imaging diagnosis-computed tomography of traction bronchiectasis secondary to pulmonary fibrosis in a Patterdale Terrier

An 8-year-old, Patterdale terrier was referred for evaluation of tachypnoea, exercise intolerance, and weight loss. Computed tomographic images showed pneumomediastinum, diffuse pulmonary ground glass opacity, and marked dilatation of peripheral bronchi, but no evidence of thickened bronchial walls. The histopathologic diagnosis was diffuse pulmonary interstitial fibrosis, type II pneumocyte hyperplasia, and bronchiectasis. The lack of evidence of primary bronchitis supported a diagnosis of traction bronchiectasis. Traction bronchiectasis can occur as a sequela to pulmonary fibrosis in dogs. (C) 2016 American College of Veterinary Radiology

On Site

Contemporary debates on the transformation of building methods, the structure of the building industry, and the introduction of new technologies (informational, material and structural) in professional literature and in the architectural humanities tend to ignore the realities of work on construction sites. This follows a long history of failure to recognise the importance of workers’ experience and knowledge of building as a process by the key professions in the industry. The absence of the working process in accounts of historical development is exacerbated by abstract reflection on building know-how, categories of expertise, and the structure of the industry, when these are not supported by direct observation and engagement with building work and workers. Key assumptions about the relation between structural and technological changes in the industry and the knowledge, skills, composition, and requirements of the workforce can be challenged by paying attention to day-to-day activities and conditions of site work

Implementation of the Crisis Resolution Team model in adult mental health settings: a systematic review.

Crisis Resolution Teams (CRTs) aim to offer an alternative to hospital admission during mental health crises, providing rapid assessment, home treatment, and facilitation of early discharge from hospital. CRTs were implemented nationally in England following the NHS Plan of 2000. Single centre studies suggest CRTs can reduce hospital admissions and increase service users' satisfaction: however, there is also evidence that model implementation and outcomes vary considerably. Evidence on crucial characteristics of effective CRTs is needed to allow team functioning to be optimised. This review aims to establish what evidence, if any, is available regarding the characteristics of effective and acceptable CRTs

Multicentre observational cohort study of NSAIDs as risk factors for postoperative adverse events in gastrointestinal surgery

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as postoperative analgesia by the Enhanced Recovery After Surgery Society. Recent studies have raised concerns that NSAID administration following colorectal anastomosis may be associated with increased risk of anastomotic leak. This multicentre study aims to determine NSAIDs' safety profile following gastrointestinal resection. Methods and analysis: This prospective, multicentre cohort study will be performed over a 2-week period utilising a collaborative methodology. Consecutive adults undergoing open or laparoscopic, elective or emergency gastrointestinal resection will be included. The primary end point will be the 30-day morbidity, assessed using the Clavien-Dindo classification. This study will be disseminated through medical student networks, with an anticipated recruitment of at least 900 patients. The study will be powered to detect a 10% increase in complication rates with NSAID use. Ethics and dissemination: Following the Research Ethics Committee Chairperson's review, a formal waiver was received. This study will be registered as a clinical audit or service evaluation at each participating hospital. Dissemination will take place through previously described novel research collaborative networks

A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit

We identified a 5-year outbreak of a methicillin-susceptible Staphylococcus aureus (MSSA) strain, affecting 202 babies on a neonatal unit, by routine weekly phage typing all S. aureus isolates. Multiple staged control measures including strict emphasis on hand hygiene, environmental and staff surveillance sampling, and application of topical hexachlorophane powder failed to end the outbreak. S. aureus PT 53,85 (SA5385) was found on opened packs of Stomahesive®, used as a neonatal skin protectant. Only following the implementation of aseptic handling of Stomahesive®, and the use of topical mupirocin for staff nasal carriers of SA5385, and for babies colonized or infected with S. aureus, did the isolation rate of SA5385 decline. DNA fingerprinting indicated that [gt-or-equal, slanted]95% of SA5385 isolates were clonal. In vitro death rates of SA5385 on Stomahesive® with human serum were significantly lower than on Stomahesive® alone (P = 0·04), and on cotton sheet with serum (P = 0·04), highlighting the potential of this material as a survival niche. Phage typing remains a valuable, inexpensive and simple method for monitoring nosocomial MSSA infection