Detection of macrolide and disinfectant resistance genes in clinical Staphylococcus aureus and coagulase-negative staphylococci

<p>Abstract</p> <p>Background</p> <p><it>Staphylococcus aureus </it>and Coagulase-negative staphylococci (CoNS) are a major source of infections associated with indwelling medical devices. Many antiseptic agents are used in hygienic handwash to prevent nosocomial infections by Staphylococci. Our aim was to determine the antibiotic susceptibility and resistance to quaternary ammonium compound of 46 <it>S. aureus </it>strains and 71 CoNS.</p> <p>Methods</p> <p><it>S. aureus </it>(n = 46) isolated from auricular infection and CoNS (n = 71), 22 of the strains isolated from dialysis fluids and 49 of the strains isolated from needles cultures were investigated. Erythromycin resistance genes (<it>erm</it>A, <it>erm</it>B, <it>erm</it>C, <it>msr</it>A and <it>mef</it>) were analysed by multiplex PCR and disinfectant-resistant genes (<it>qac</it>A, <it>qac</it>B, and <it>qac</it>C) were studied by PCR-RFLP.</p> <p>Results</p> <p>The frequency of erythromycin resistance genes in <it>S. aureus </it>was: <it>erm</it>A+ 7.7%, <it>erm</it>B+ 13.7%, <it>erm</it>C+ 6% and <it>msr</it>A+ 10.2%. In addition, the number of positive isolates in CoNS was respectively <it>erm</it>A+ (9.4%), <it>erm</it>B+ (11.1%), <it>erm</it>C+ (27.4%), and <it>msr</it>A+ (41%). The MIC analyses revealed that 88 isolates (74%) were resistant to quaternary ammonium compound-based disinfectant benzalkonium chloride (BC). 56% of the BC-resistant staphylococcus isolates have at least one of the three resistant disinfectants genes (<it>qac</it>A, <it>qac</it>B and <it>qac</it>C). Nine strains (7.7%) among the CoNS species and two <it>S. aureus </it>strains (2%) harboured the three-<it>qac </it>genes. In addition, the <it>qac</it>C were detected in 41 strains.</p> <p>Conclusions</p> <p>Multi-resistant strains towards macrolide and disinfectant were recorded. The investigation of antibiotics and antiseptic-resistant CoNS may provide crucial information on the control of nosocomial infections.</p

The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome

The aim of this study was to evaluate the efficacy of steroid injection for the treatment of the carpal tunnel syndrome (CTS), with F-wave parameters and sympathetic skin response (SSR). Seventeen hands of 10 women patients were treated with local steroid injection with 2-month follow-up. All patients underwent single injection into the carpal tunnel. Response to injection was measured nerve conduction studies (NCSs), median nerve F waves, and SSR before and after treatment. To determine the normal values, 42 hands of 21 healthy women were also studied. There was a significant improvement of sensory and motor nerve conduction values when compared to baseline values (P < 0.01). At the end of follow-up period, the median sensory distal latency and the sensory latency differences between the median and the ulnar nerve were improved 35 and 65%, respectively. The maximum, mean F-wave amplitudes and chronodispersion showed a slight improvement with respect to baseline values and controls, but statistical significance was not achieved after treatment. Although no statistically significant improvements were observed in SSR parameters, slightly decreased amplitudes and increased habituation of SSR were noted at the end of the treatment. The present study shows that the local steroid injection results in improvement in NCSs values, but the F-wave parameters were not effectual in short-term outcome of CTS treatment. These findings suggest that the sensory latency differences between the median and the ulnar wrist-to-digit 4 are better parameters in the median nerve recovery after treatment than the median sensory distal latency. Furthermore, the SSR does not seem to be a sensitive method in follow-up of CTS treatment

Measurement properties of the Dizziness Handicap Inventory by cross-sectional and longitudinal designs

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A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

<p>Abstract</p> <p>Background</p> <p>The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB), acromioclavicular joint (ACJ) and glenohumeral joint (GHJ).</p> <p>Methods</p> <p>Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA) and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR) to diagnostic blocks.</p> <p>Results</p> <p>In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively) and MRA (65% and 76% respectively). The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR) for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; <it>p </it>< 0.05). Ultrasound evidence of a biceps tendon sheath effusion (OR 8.0; <it>p </it>< 0.01) and an intact rotator cuff (OR 1.3; <it>p </it>< 0.05) were associated with PAR to GHJ injection. No imaging findings were strongly associated with PAR to ACJ injection (<it>p </it>≤ 0.05).</p> <p>Conclusions</p> <p>Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion and an intact rotator cuff were associated with an intra-articular GHJ pain source. When combined with clinical information, these results may help guide diagnostic decision making in primary care.</p

Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome.</p> <p>Methods/Design</p> <p>This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization.</p> <p>The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks.</p> <p>Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants' adherence to the protocol, use of additional treatments for the shoulder, direct and indirect costs, and sick leave due to shoulder complaints will be recorded in a shoulder log-book.</p> <p>Discussion</p> <p>To our knowledge this is the first trial comparing individualized physiotherapy based on a defined decision making process to a standardized exercise protocol. Using high-quality methodologies, this trial will add evidence to the limited body of knowledge about the effect of physiotherapy in patients with SIS.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN86900354</p

Управління бізнес-інноваціями: систематизація наукового доробку у сфері формування лідерських компетенцій

Фактори лідерства та компетенцій, що його формують постійно досліджуються науковою спільнотою, що тим самим підтверджує актуальність вивчення даної тематики. Авторами наголошено, що у широкому сенсі лідерство формує поведінку співробітників і сприяє процесам досягнення загальних цілей і завдань організації. У сучасному інноваційному та швидко мінливому світі практичне та якісне лідерство є важливою темою для вивчення. Ефективне та зразкове лідерство, також відоме як позитивне лідерство, мотивує неефективних співробітників, розвиває їхні компетенції, нівелює негативне ставлення, підвищує ефективність управління стресом та елімінує вигорання. Позитивна психологія – це нова сфера знань про організаційну поведінку. Позитивне лідерство в значній мірі залежить від характеру особистості та загальноприйнятих чеснот. Чесноти, які є джерелом добробуту, формують мислення та поведінку особистості, які проявляються як принципи ділової етики у бізнес-середовищі. Чесноти відіграють впливову та життєво важливу роль у різних стилях лідерства, таких як етичне, духовне та трансформаційне лідерство. З іншого боку, ці стилі лідерства не в повному обсязі визначають основні характеристики доброчесного лідера. У цьому напрямку за останнє десятиліття розроблено численні теорії та моделі доброчесного лідерства, які визначають незмінність та доцільність врахування чеснот. Огляд попередніх досліджень виявив прогалину в літературі про доброчесне лідерство. Проблема цього дослідження полягає в тому, що доброчесне лідерство розглядалося в основному з точки зору етики. Це дослідження має на меті сформувати теоретико-методологічний базис доброчесного лідерства на основі результатів узагальнення наукового доробку у цій сфері. У статті використано такі методи дослідження як наукової абстракції та узагальнення. Авторами систематизовано підходи до трактування поняття доброчесне лідерство. Узагальнено теорії і моделі доброчесного лідерства, підходи до класифікації, а також представлено теорії лідерства, що відображають специфіку врахування чеснот.The concept of leadership continues to develop as a concept that still maintains its importance. In the most general sense, leadership shapes employees’ behaviours and facilitates all processes to achieve common goals and objectives. In today's innovative and rapidly changing business world, practical and good leadership is an important study topic in management studies. Effective and good leadership, also known as positive leadership, motivates ineffective employees, develops their skills, improves negative attitudes and behaviours and copes with stress and burnout. Positive Psychology is the newly advancing field of organisational behaviour sciences. Positive leadership highly addresses its relevance with positive character traits as defined virtue. Virtues, which are the source of well-being and glorify people's feelings, thoughts and behaviours, manifest as business ethics principles in business life. The virtues play an influential and vital role in various leadership styles, such as ethical, spiritual and transformational leadership. On the other hand, these leadership styles do not extensively define the core characteristics of a virtuous leader. In this direction, over the past decade, numerous virtuous leadership theories and models have recently developed that cite virtues as essential and indispensable. A review of previous studies revealed a gap in the literature on virtuous leadership. The problem of this study is that virtuous leadership has been examined in primarily ethical literature. This study aims to conceptualise by examining the prominent approaches of virtuous leadership according to the current literature. Traditional literature scrutiny is used as the research method in the paper. Studies are scattered in the relevant literature. This paper summarises the existing virtuous leadership literature and brings out a literature review. The study provides an overview of virtuous leadership theories and models among the definitions and classifications listed in Table 1 and also presents virtues-relevant leadership theories in the literature. Thence, it is expected to contribute to management, leadership and organisational behaviour. The research is a current study in terms of the subject discussed