Abstract: Introduction The Darzi Report states seven steps are required to maintain and achieve high quality standards in the NHS. This includes measurement of clinical performance as a function of quality and cost-effectiveness. Reproducible performance models may be helpful in developing quality improvement processes. Methods Analysis of all endoscopy procedures performed at Derriford Hospital between January 2007 ? December 2008. Points allocation:two per colonoscopy and one per gastroscopy. Local health economic analysis revealed that ?8 points must be performed to meet costs. Following analysis individualised feedback was given to each endoscopist on their performance and areas for improvement. The audit cycle was completed over the next year. Results In total, 4069 colonoscopies were performed (cf. 3884 in 2007). There was improvement in both crude Caecal Intubation Rate (CIR) from 89.6% (2007) to 91.1% (2008), and Points/List from 8.0 (2007) to 8.4 (2008). ?Clinical Performance? was compared by plotting a capability index of individual crude CIRs against Points/List. The improvement in Points/List equates to an increase in unit profitability of greater than 300,000 pounds. There was reduction in training opportunities possibly due to introduction of the National Bowel Screening Programme. Conclusion Introduction of auditable performance measurements has dramatically improved both quality and productivity of our endoscopy unit. Take-home message: A method of improving the quality and cost effectiveness of an endoscopy unit.

Abstract: The methodology for detecting oxidative stress status at clinical level is hardly to be found in the literature. There are some useful methods for investigating the oxidative profile but they are not applicable to the clinical diagnostic. Worldwide in spite of having a high prevalence of illnesses in which Reactive Oxygen Species are involved (cancer, diabetes, etc.) an integral diagnostic systems have not been developed. It is also insufficient the education and preparation of the professional personnel (doctors and related health personnel) to face the analysis of the data that contributes to a antioxidant/pro-oxidant diagnostic and to impact in the modification of life habits and other measure directed to correct the redox disruption. In the CEIEB-IFAL-UH it was validate a group of analytic methods for the diagnosis of the oxidative stress. The validated analytic methodology was permit to establish the reference values in normal populations, an individualized diagnostic as base to establish the adequate medical prescription, to fallow the evolution of chronic oxidative disorder and follow the effect of nutritional or pharmacological intervention. The methodology include clinical marker of biomolecule damage, antioxidant enzymes, concentration of low level antioxidant and indicators of total antioxidant status. The analytic methodology was adaptable to micro and ultramicro analytic systems and was validated according to the international recommendations. Low cost, high precision, fast analysis and integral evaluation of the redox system in the main characteristic of those methods. The study of an extensive array of oxidative stress indices permitted the examination of the role of oxidative stress in diabetic patients with macroangiopatic complications, HIV subjects, patients with neurodegenerative disorders, dengue infected people, etc. Those results was publishes in international journals. An efficient introduction of those methods in clinic involves educational programs for physicians or health care personnel.

Abstract: In the last decade, there has been an increasing interest in investigating antibiotic use by dentists. Aims: This study aims to evaluate 1) The degree of knowledge that the dental profession has, concerning therapeutic uses of antibiotics. Practices and knowledge of dentists worldwide will be assessed. 2) Deficits in our knowledge about antibiotics, and controversies about the correct use of antibiotics, will also be highlighted. Methods: A literature review was performed in Pubmed during May and June- 2008 using the keywords: antibiotics, dentistry, prescription. All articles that were written in English and which investigated dentists knowledge about antibiotics in different countries were reviewed. Results: A large gap in knowledge was found between dentists practicing in Europe and North America and dentists who work in developing countries. Defects in knowledge about antibiotics were mainly in the fields of: indications for the use of therapeutic antibiotics, duration of antibiotic therapy, and alternatives to penicillin in penicillin-allergic patients. Conclusions: More appropriate methods for dental treatment should be employed to reduce unnecessaary antibiotics consumption. These methods may include appropriate dental treatment, analgesic therapy, and education of the patient. The medical and dental schools should improve their curriculum of microbiology. Efforts should be united to counteract this problem by encouraging collaboration of experts and scientists as well as decision-makers worldwide.

Abstract: The purification of plasmid DNA or recombinant protein is fundamental to life science research, but some isolation methods can be physically and chemically damaging. Magnetic separation offers a gentle alternative. Targets are captured on magnetic particles coated with a target-specific surface, and separated from the sample using a magnetic field. Methods: Nanosized superparamagnetic nanoparticles (Fe3O4) were prepared by chemical coprecipitation method using Fe2+, Fe3+ salt, and ammonium hydroxide under a nitrogen atmosphere. A quick and reliable method for the isolation and purification of transfection-grade plasmid DNA has been developed, using PEI-modified magnetic nanobeads as a solid-phase adsorbent. We demonstrated a useful plasmid, pRSETB-EGFP, encoding the green fluorescent protein with T7 promoter, was amplified in DE3 strain of E. coli. A new immobilized metal ion affinity (IMA) adsorbent containing superparamagnetic nanoparticles and coated with hydrophilic resins are also proposed to improve the purification of His-tagged proteins.The GMA-IDA-coated magnetic Fe3O4 were employed for the direct extraction of recombinant protein, EGFP-(His)6, from E. coli lysates as a model system. Results: Up to approximately 819 ?g of high-purity (A260/A280 ratio=1.86) plasmid DNA was isolated from 100 ml of overnight bacterial culture. The eluted plasmid DNA was used directly for restriction enzyme digestion, bacterial cell transformation and animal cell transfection applications with success.The Cu2+-charged GMA-IDA-coated adsorbent had the highest yield and purification factor at 70.4% and 12.3, respectively. Conclusions: 1) PEI-modified magnetic nanobeads deliver significant time-savings, overall higher yields and better transfection efficiencies compared to anion-exchange and other methods. 2) GMA-IDA-coated magnetic adsorbent could be used as a suitable adsorbent for recombinant His-tagged protein from aqueous solution. Results proved that this new protein purification adsorbent provides a fast and efficient method for purifying His-tagged proteins with high yield and low background.