Overall “”pass/fail”" performance and different skills were assessed. During the study time period (September 2009-November 2010) no HBB re-trainings were conducted, no local ownership was established, and no HBB action plans were implemented in the labor ward to facilitate transfer

and sustainability of performance in the delivery room at birth. Observational CAL-101 manufacturer data on neonatal management before (n=2745) and after (n=3116) the HBB training was collected in the delivery room by observing all births at the hospital during the same time period.

Results: The proportion of providers who “”passed”" the simulated “”routine care”" and “”neonatal resuscitation”" scenarios increased after HBB training; from 41

to 74% (p=0.016) and from 18 to 74% (p <= 0.0001) respectively. However, the number of babies being suctioned and/or ventilated at birth did not change, and the use of stimulation in the delivery room decreased after HBB training.

Conclusion: Birth attendants selleck chemicals in a rural hospital in Tanzania performed significantly better in simulated neonatal care and resuscitation seven months after one day of HBB training. This improvement did not transfer into clinical practice. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Purpose

Procalcitonin (PCT) and C-reactive protein (CRP) are well known inflammatory markers. This study was designed to determine whether PCT and CRP are useful as early diagnostic markers for bacteremia in cancer patients with febrile neutropenia (FN) in the emergency department (ED).

Materials and Methods

In this retrospective study, 286 episodes of FN in the ED were consecutively included between June 2009 and August 2010. From medical records, clinical characteristics including PCT and CRP were extracted and analyzed.

Results

Bacteremia was identified in 38 (13.3%) of the 286 episodes. The median values of PCT (2.8 ng/mL vs. 0.0 ng/mL, p=0.000) and CRP (15.9 mg/dL vs.

5.6 mg/dL, p=0.002) were significantly higher in the group with bacteremia compared to the group without bacteremia. In univariate analysis, elevated PCT (>0.5 ng/mL) and CRP (>10 mg/dL) as well as older age, hypotension, tachycardia, tachypnea, and high body temperature ARN-509 were significantly associated with bacteremia. On multivariate analysis, elevated PCT (>0.5 ng/mL) (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.4 to 9.2; p < 0.01) and tachypnea (OR, 3.4; 95% CI, 1.4 to 8.5; p < 0.01) were independent early diagnostic markers for bacteremia in FN patients. The area under the curve of PCT was 74.8% (95% CI, 65.1 to 84.6%) and that of CRP was 65.5% (95% CI, 54.8 to 76.1%). With a PCT cut-off value of 0.5 ng/mL, sensitivity and specificity were 60.5% and 82.3%, respectively, while the sensitivity and specificity were 57.6% and 67.3%, respectively, with a CRP cutoff of 10 mg/dL.