CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Beta-blocker therapy is associated with an increase in the severity and, possibly, the incidence of acute anaphylaxis. The population at risk consists of people with allergic conditions who are given a beta-blocker for an unrelated condition. Anaphylaxis under these conditions may be severe, protracted and resistant to conventional treatment because of the beta-adrenergic blockade. ⋯ Clinical allergists, internists and family practitioners in particular should be aware of the need for aggressive and prolonged support in patients who experience anaphylaxis while receiving beta-blocker therapy and should report all such occurrences to the federal registry of adverse drug reactions. Allergy skin testing or immunotherapy is inadvisable in patients who take a beta-blocker orally or in the form of ophthalmic eyedrops. The list of relative contraindications to beta-blocker use should be extended to include susceptibility to recurrent anaphylaxis, whether it is idiopathic or due to an identifiable cause.
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A survey of Canadian hospitals providing obstetric care was undertaken to assess preparation, protocols, training and staff availability for neonatal resuscitation. Of the 721 hospitals contacted 577 (80%) responded. The reported availability of written guidelines for resuscitation varied greatly, depending on hospital size and proximity to a tertiary care centre. ⋯ Nurses were permitted to perform intubation in 21 hospitals (4%), 7 of them in Alberta. National professional bodies should develop guidelines for training and skill maintenance, and hospitals should develop protocols for maintaining equipment and for neonatal resuscitation team activities, including regular practice. Training should be improved in family practice and obstetrics programs, and consideration should be given to training senior obstetric nurses and respiratory therapists in intubation of neonates.
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Comparative Study
Prevalence of iron deficiency among Chinese children aged 6 to 36 months in Montreal.
Screening for iron deficiency was undertaken among a group of Chinese children aged 6 to 36 months to determine the prevalence of the condition and its association with infant feeding. Of the 346 children studied, 12.1% were found to be iron deficient. The overall prevalence rate of thalassemia minor was 6.7%. ⋯ No such difference was found among those older than 12 months. The observed prevalence of iron deficiency was closer to the rate reported for black children than to that reported for white children in the United States. The findings stress the importance of conducting further studies of iron deficiency among Chinese subpopulations in North America.