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Lactobin-R is a commercial hyperimmune bovine colostrum with potent anticryptosporidial activity. It was administered to a 4 year old child with AIDS and severe diarrhoea associated with cryptosporidiosis. There was significant clinical improvement in the diarrhoea and permanent elimination of the parasite from the gut as assessed through serial jejunal biopsy and stool specimens. [ABSTRACT FROM AUTHOR]

The effect of nebulised fenoterol was compared with that of a similar dose administered by metered aerosol in 14 children, aged 7 to 17 years with moderately severe asthma. The initial response to fenoterol delivered by metered aerosol or nebuliser was the same, but a second dose by nebuliser after a dose by metered aerosol produced maximum potential bronchodilatation which was not seen when a second dose by metered aerosol was given after that by nebuliser. Administration of a bronchodilator by nebuliser does seem advantageous in the treatment of some children. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of attendance at the first Scottish Sexually Transmitted Infections Foundation (STIF) course, on the knowledge of family planning staff. Methods: This prospective study was carried out in the Sandyford Initiative in Glasgow, which houses both genitourinary medicine and family planning and reproductive healthcare. Eighteen members of family planning staff were assessed on their knowledge of vaginal and cervical infections before and after attendance at the STIF course using clinical case scenarios with accompanying clinical pictures. A maximum score of 12 was achievable for each assessment. Results: The mean score for all 18 participants increased from 8.2 to 10.7 (increase 2.5; 95% CI 1.1 to 3.9; p = 0.001) and for doctors from 8.6 to 10.6 (increase 2.0; 95% CI 0.7 to 3.3; p = 0.006). The mean increase in the nurses' score was 5.0, however the number of nurse participants was small (n = 3). Conclusion: Attendance at the STIF course was of educational value to family planning staff. The STIF course is an important tool in providing staff with the skills that are required. A larger study with prolonged follow up would enable further evaluation of the STIF courses' impact on knowledge. [ABSTRACT FROM AUTHOR]

We performed a randomised controlled crossover trial of clinic letters. Structured letters were compared with conventional letters containing problem lists. There were 32 participants; 25 preferred the structured letter. Median rating and items identified were higher for the structured letter. Structured clinical correspondence with paragraph headings is strongly preferred and increases comprehension. [ABSTRACT FROM AUTHOR]

A 7 year old girl referred for investigation of hypogammaglobulinaemia had hypoalbuminaemia and severe necrotising oesophagitis on oesophagogastroduodenoscopy. Nissen fundoplication resolved all clinical and laboratory abnormalities, but she remains under surveillance because of histological findings of Barrett's oesophagus. Erosive reflux oesophagitis can present with minimal localising symptoms, and hypogammaglobulinaemia and hypoalbuminaemia, presumably from protein loss. [ABSTRACT FROM AUTHOR]

The article discusses a study about the quality of educational supervision in Great Britain. Several principles underpinning educational supervision are active listening, constructive feedback, mentoring, reflective practice, development of insightful or self-aware practice in the trainee, and creation of a supportive learning environment. Emphasis is given on the importance of providing guidance and feedback on matters of personal, professional and educational development.

Objective: To compare current clinical strategies for the management of women presenting with vaginal discharge to genitourinary medicine (GUM) and family planning (FP). Methods: A prospective within subject comparative study performed at the Sandyford Initiative, Glasgow, which houses GUM and FP. Both GUM and FP strategies were performed on every participant. The sequence of testing was randomised. Day 1 diagnoses were made by the FP strategy (history and examination) and the GUM strategy (near-patient microscopy added). Day 7 results were obtained from final analysis of all specimens. Day 1 and day 7 results were compared with the reference standard provided by all test results. The main outcome measures were incorrect diagnoses on day 1 and day 7. Results: 200 consecutive women with vaginal discharge completed the study. Exclusion criteria comprised: antibiotic therapy within 4 weeks, pregnancy, systemic illness, genital ulceration, and known STI contacts. FP and GUM attenders demonstrated similar demographics. On day 1 the FP strategy resulted in significantly more incorrect diagnoses than the GUM strategy when compared with the gold standard (73 v 32; p = <0.001). On day 7, the GUM strategy resulted in significantly more incorrect diagnoses than the FP strategy when compared with the gold standard (32 v 17; p = 0.019). Conclusions: Vaginal discharge can be managed effectively in non-GUM settings. Attending GUM produces a more accurate immediate diagnosis when compared with FP. Attending FP produces a more accurate final diagnosis when compared with GUM. The additional costs of on site microscopy must be considered. [ABSTRACT FROM AUTHOR]