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Experience with the home-care of tracheotomised paediatric patients (1989)

Campbell, J. B. ; Morgan, D. W. ; Pearman, K.

Springer

European archives of oto-rhino-laryngology and head & neck 246 (1989), S. 345-348

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ISSN: 1434-4726

Keywords: Paediatric tracheotomy ; Home-care

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary Many infants with tracheotomies remain cannulated for prolonged periods while the underlying cause of airway obstruction is either treated or natural resolution is awaited (usually by growth). To enable these children to enjoy a relatively normal family environment despite a tracheotomy, it is desirable that they should be managed at home for at least part of the time. For the past 8 years we have routinely used soft polyvinyl chloride paediatric tracheotomy tubes (Shiley) in our patients. These tubes have proved to be relatively resistant to obstruction with secretions and are changed at 1- to 2-week intervals. They can be modified by making a series of three to four 2-mm through-and-through fenestrations around the shoulder in order to improve speech production and facilitate decannulation. Parents are tutored in tracheotomy care, which includes tube changing, humidification and suction. They are then permitted to take their child home from hospital when they are considered to be competent. Twenty-eight children (13 boys, 15 girls) with a mean age of 14.5 weeks (range 1–525 weeks) at the time of tracheotomy have been managed at home using this system. The median period of hospitalisation was 12 weeks (range 5–75 weeks), and the median duration of home management was 94 weeks (range 13–394 weeks). Sixteen patients have been successfully decannulated, 11 remain cannulated and 1 died at home from sudden infant death syndrome. Despite supportive measures, the majority of the children developed intermittent chest infections. Acute tubal obstruction occurred in 9 cases and the tube displacement occurred in 3 cases; each of these episodes was treated satisfactorily by promptly changing the tube. Our overall experiences have shown that using the system described has resulted in the home-care of our patients being a safe and practical alternative to prolonged hospitalisation.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00463591

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Analysis of unstable recombinant Saccharomyces cerevisiae population growth in selective medium (1986)

Srienc, Friedrich ; Campbell, J. L. ; Bailey, J. E.

New York, NY [u.a.] : Wiley-Blackwell

Biotechnology and Bioengineering 28 (1986), S. 996-1006

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ISSN: 0006-3592

Keywords: Chemistry ; Biochemistry and Biotechnology

Source: Wiley InterScience Backfile Collection 1832-2000

Topics: Biology , Process Engineering, Biotechnology, Nutrition Technology

Notes: Widely applied selection strategies for plasmid-containing cells in unstable recombinant populations are based upon synthesis in those cells of an essential, selection gene product. Regular partitioning of this gene product combined with asymmetric plasmid segregation produces plasmid-free cells which retain for some time the ability to grow in selective medium. This theory is elaborated here in terms of a segregated model for an unstable recombinant population which predicts population growth characteristics and composition based upon experimental data for stable strain growth kinetics, plasmid content, and selection gene product stability. Analytical solutions from this model are compared with an unsegregated phenomenological model to evaluate the effective specific growth rate of plasmid-free cells in selective medium. Model predictions have been validated using experimental growth kinetics and flow cytometry data for Saccharomyces cerevisiae D603 populations containing one of the plasmids YCpG1ARS1, YCpG1ΔR8, YCpG1ΔR88, YCpG1ΔH103, YCpG1ΔH200, pLGARS1, and pLGSD5. The recombinant strains investigated encompass a broad range of plasmid content (from one to 18 plasmids per cell) and probability α of plasmid loss at division (0.05 ≤ α ≤ 0.42). Experimental data for all strains considered is inconsistent with the hypothesis that plasmid-free cells are unable to grow in selective medium. For a given value of a, the fraction of plasmid-containing cells in the population decreases with increasing plasmid content and increases for less stable selection gene products. This conceptual framework and mathematical model will aid in strain development for greater effective stability.

Additional Material: 6 Ill.