Emma Parry

Acute Behavioral Effects of Intrapleural OK-432 (Picibanil) Administration in Preterm Fetal Sheep

Objective: To develop a model to study the fetal effects of intrapleural infusion of OK-432 (Picibanil), a pleurodesis agent derived from killed Gram-positive streptococci. Methods: OK-432 (0.1 mg, n = 5), or normal saline (n = 5) were infused over 20 min into the pleural space of chronically instrumented preterm fetal sheep at 0.7 gestation. Fetal physiological parameters, including breathing and nuchal activity were monitored in utero from 6 h before infusion until 12 h afterward, and fetuses were killed after 7 days recovery. Results: OK-432 was associated with transient suppression of fetal EEG activity, breathing and body movements from 3–6 h after infusion. Hypotension and hypoxia did not occur. At postmortem, local pleural adhesions were seen around the site of OK-432 infusion but not in saline treated fetuses. Conclusions: Intrapleural administration of OK-432 is associated with marked but transient fetal behavioral effects. This model will enable preclinical investigation of the neural and cardiovascular safety of OK-432 at a clinical relevant stage of development.

Successful pregnancy in a woman with glycogen storage disease type III

Although there are a small number of case reports of pregnancy in women with glycogen storage disease type III, there are none in such patients managed conservatively with minimal intervention. We report a case of a patient who presented for specialist care late in her pregnancy, determined to have as normal a pregnancy as possible. In this situation, it was important not to alienate her from the hospital setting.

Improved management in threatened preterm labour with rapid fetal fibronectin testing

Recently, a new rapid system for fetal fibronectin (fFN) analysis (TLIIQ) has been developed with accuracy equal to the gold standard, ELISA (enzyme‐linked immunosorbent assay) testing. The objective of this quality improvement project was to confirm that a reduction in intervention and a reduced length of stay did occur, as expected, after the testing of fFN was introduced at a tertiary referral hospital (National Womens Hospital) for women in threatened preterm labour.

Open Source Software: A Key Component of E-Health in Developing Nations

The global burden of disease falls most heavily on people in developing countries. Few resources for healthcare, geographical and infrastructure issues, lack of trained staff, language and cultural diversity and political instability all affect the ability of health providers to support effective and efficient healthcare. Health information systems are a key aspect of improving healthcare, but existing systems are often expensive and unsuitable. Open source software appears to be a promising avenue for quickly and cheaply introducing health information systems that are appropriate for developing nations. This article describes some aspects of open source e-health software that are particularly relevant to developing nations, issues and problems that may arise and suggests some future areas for research and action. Suggestions for critical success factors are included. Much of the discussion will be related to a case study of a training and e-health project, currently running in the Himalayan kingdom of Bhutan.