Summary Community-acquired meticillin-resistant Staphylococcus aureus (MRSA) is becoming an important public-health problem. New strains of S aureus displaying unique combinations of virulence factors and resistance traits have been associated with high morbidity and mortality in the community. Outbreaks of epidemic furunculosis and cases of severe invasive pulmonary infections in young, otherwise healthy people have been particularly noteworthy. We review the characteristics of these new strains of community-acquired MRSA that have contributed to their pathogenicity and discuss new approaches to the diagnosis and management of suspected and confirmed community-acquired MRSA infections.

Community-acquired meticillin-resistant Staphylococcus aureus: an emerging threat.

Prevalence of feeding problems and oral motor dysfunction in children with cerebral palsy: A community survey☆☆☆★

The aim of this study was to estimate the prevalence and severity of feeding and nutritional problems in children with neurological impairment within a defined geographical area. In a cross-sectional study, a validated questionnaire was sent to 377 parents of children (aged 4 to 13 years) on the Oxford Register of Early Childhood Impairments with oromotor dysfunction. The return rate was 72%. Of these, 93% had cerebral palsy; 47% were unable to walk; 78% had speech difficulty; and 28% continuous drooling of saliva. Gastrointestinal problems were commonly encountered: 59% were constipated; 22% had significant problems with vomiting, and 31% had suffered at least one chest infection in the previous 6 months. Feeding problems were prevalent: 89% needed help with feeding and 56% choked with food; 20% of parents described feeding as stressful and unenjoyable. Prolonged feeding times (3h/day) were reported by 28%. Only 8% of participants received caloric supplements and 8% were fed via gastrostomy tube. Even though 38% of respondents considered their child to be underweight, 64% of children had never had their feeding and nutrition assessed. The results highlight that feeding problems in children with neurological impairment are common and severe, causing parental concern. Many of these children would benefit from nutritional assessment and management as part of their overall care.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1469-8749.2000.tb00678.x

Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study.

Maternal postprandial glucose levels and infant birth weight: The Diabetes in Early Pregnancy Study*

Maternal postprandial glucose levels and infant birth weight: The Diabetes in Early Pregnancy Study

Macrosomy despite well-controlled diabetic pregnancy

Glyceryl trinitrate in skin necrosis caused by extravasation of parenteral nutrition.

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Macrosomy despite well-controlled diabetic pregnancy

Glyceryl trinitrate in skin necrosis caused by extravasation of parenteral nutrition.