Point-of-care prothrombin time testing in paediatric intensive care: an observational study of the ease of use of two devices

Two major difficulties arise when taking blood samples in children: the challenge of venous access and the comparatively large amount of blood required.

A critical appraisal of the legal framework governing the approval in microfinance Establishments within CEMAC

During the mid 80 19s and the early 90 19s the Banking sector of the CEMAC sub-region experienced crisis. This could be seen from the numerous liquidation of Banks within the sub-region during this period, microfinance establishments found a place as an alternative financial institution involved in the provision of savings and loans to the masses. The exercise of the activities of microfinance necessitates an application for approval form the monetary authority. Their potential managers and auditors must equally apply and obtain a license before functioning. After this approval has been obtained the microfinance establishment must register with the National Credit Council and the Trade and Personal Property Credit Register. // Durant les années 80 et au début des années 90 le secteur Bancaire de la sous-région CEMAC on vécue une crise, ceci pouvait ce voit par de nombreuse liquidation des Banques au sein de la sous-région pendant cette période. Les Etablissement de Micro finance ont trouve une place comme une institution financière alternative s’impliquant dans la fourniture de l’épargne et des prêts pour la masses. Mais l'exercice de l'activité de microfinance exige une demande d'agrément remise par l'autorité monétaire après confirmation de la commission bancaire. Mais avant que cet agrément soit remis, ils doivent fournir certain documents et informations. Les microfinances sont également oblige de fournir certaines documents et information s'il veut offrir un agence dans un du état membre de la CEMAC. Quand cette agrément est remise il sont les obligations administrative et professionnelle a remplir. Ceci consiste de s’inscrire auprès du Conseil National du Crédit et le Registre du Commerce et du Crédit Mobilier, adhérer a une Association Professionnelle, mais ils sont le choix adhérer à un réseau ou de poursuivre les activités indépendamment. L'autorité monétaire peut unilatéralement retrait la décision d'agrément pour un raison ou l'autre. Cependant, la décision de retrait de l'agrément est assujettir à un appel devant le conseil d'administration de la BEAC. La commission bancaire a prévu un ensemble de sanctions pour s'assurer que une personne ou établissement en défaut soit appelle en ordre. // Cameroon, Micro-finance, CEMAC, COBAC, Legislation

Morbidity rate of reoperation in thyroid surgery: a different point of view

Goitre recurrence is a common problem following subtotal thyroid gland resection for multinodular goitre disease. The aim of the present study was to evaluate morbidity rate in relation to the side of initial and redo-surgery for recurrent disease.

Liberal Nationalism: A Historical and Critical Analysis of Conceptions

At the end of the 20th century we live in a pluralist world in which national and ethnic identities play an appreciable role, sometimes provoking serious conflicts. Nationalist values seem to pose a serious challenge to liberal ones, particularly in the post-communist countries. Malinova asked whether liberalism must necessarily be contrasted with nationalism. Although nationalist issues has never been a major concern for liberal thinkers, in many countries they have had to take such issues into consideration and a form of 'liberalism nationalism' has its place in the history of political ideas. Some of the thinkers who tried to develop such an idea were liberals in the strict sense of the word and others were not, but all of them tried to elaborate a concept of nationalism that respected the rights of individuals and precluded discrimination on ethnic grounds. Malinova studied the history of the conceptualisation of nations and nationalism in the writings, of J.S. Mill, J.E.E. Acton, G. Mazzini, V. Soloviev, B. Chicherin, P. Struve, P. Miljoukov and T.G. Masaryk. Although it cannot be said that these theories form a coherent tradition, certain common elements of the different approaches can be identified. Malinova analysed the way that liberal nationalists interpreted the phenomenon of the nation and its rights in different historical contexts, reviewed the structure of their arguments and tried to evaluate this theoretical experience from the perspective of the contemporary debate on the problems of liberal nationalism and multiculturalism and recent debates on 'the national idea' in Russia.

Point-of-care testing in the cardiovascular operating theatre

Point-of-care testing (POCT) remains under scrutiny by healthcare professionals because of its ill-tried, young history. POCT methods are being developed by a few major equipment companies based on rapid progress in informatics and nanotechnology. Issues as POCT quality control, comparability with standard laboratory procedures, standardisation, traceability and round robin testing are being left to hospitals. As a result, the clinical and operational benefits of POCT were first evident for patients on the operating table. For the management of cardiovascular surgery patients, POCT technology is an indispensable aid. Improvement of the technology has meant that clinical laboratory pathologists now recognise the need for POCT beyond their high-throughput areas.

Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood

BACKGROUND: The Roche CARDIAC proBNP point-of-care (POC) test is the first test intended for the quantitative determination of N-terminal pro-brain natriuretic peptide (NT-proBNP) in whole blood as an aid in the diagnosis of suspected congestive heart failure, in the monitoring of patients with compensated left-ventricular dysfunction and in the risk stratification of patients with acute coronary syndromes. METHODS: A multicentre evaluation was carried out to assess the analytical performance of the POC NT-proBNP test at seven different sites. RESULTS: The majority of all coefficients of variation (CVs) obtained for within-series imprecision using native blood samples was below 10% for both 52 samples measured ten times and for 674 samples measured in duplicate. Using quality control material, the majority of CV values for day-to-day imprecision were below 14% for the low control level and below 13% for the high control level. In method comparisons for four lots of the POC NT-proBNP test with the laboratory reference method (Elecsys proBNP), the slope ranged from 0.93 to 1.10 and the intercept ranged from 1.8 to 6.9. The bias found between venous and arterial blood with the POC NT-proBNP method was < or =5%. All four lots of the POC NT-proBNP test investigated showed excellent agreement, with mean differences of between -5% and +4%. No significant interference was observed with lipaemic blood (triglyceride concentrations up to 6.3 mmol/L), icteric blood (bilirubin concentrations up to 582 micromol/L), haemolytic blood (haemoglobin concentrations up to 62 mg/L), biotin (up to 10 mg/L), rheumatoid factor (up to 42 IU/mL), or with 50 out of 52 standard or cardiological drugs in therapeutic concentrations. With bisoprolol and BNP, somewhat higher bias in the low NT-proBNP concentration range (<175 ng/L) was found. Haematocrit values between 28% and 58% had no influence on the test result. Interference may be caused by human anti-mouse antibodies (HAMA) types 1 and 2. No significant influence on the results with POC NT-proBNP was found using volumes of 140-165 muL. High NT-proBNP concentrations above the measuring range of the POC NT-proBNP test did not lead to false low results due to a potential high-dose hook effect. CONCLUSIONS: The POC NT-proBNP test showed good analytical performance and excellent agreement with the laboratory method. The POC NT-proBNP assay is therefore suitable in the POC setting.