2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

<p>Abstract</p> <p>Background</p> <p>The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS).</p> <p>Methods</p> <p>All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting.</p> <p>Results</p> <p>The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D.</p> <p>Conclusion</p> <p>These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence.</p

Hazards to humans and animals associated with antibiotic misuse

The increasing resistance of community and hospital acquired bacterial strains has become a challenge to the current health policy in Poland. Although some bacteria are known to have a peculiar resistance towards a given agent, antibiotics have a well-established position in clinical practice and are broadly available in our lives. The universal access to antimicrobial therapy and its overuse have created an issue of previously susceptible bacteria now presenting antibiotic resistance. All bacteria that survive antibiotic treatment, continue growth and reproduction. This phenomenon is also observed in livestock rearing. An inadequate implementation of antibiotic therapy leads to the transfer of resistant bacterial strains into the environment of people, who eat products of animal and plant origin. Moreover, the non-compliance to law in terms of antibiotics added to animal fodder or negilgence of withdrawal periods seems to further exacerbate the situation. Various research projects conducted in Poland and elsewhere have demonstrated that antibiotics produce an immunosuppressive effect, which exposes both humans and animals to different infections. Antibiotics also interfere with the growth of many microorganisms, recognized as part of the human and animal physiological microflora, as a result of which dysbacteriosis may develop. In order to limit the use of antibiotics in animal husbandry, research should be focus on finding alternative agents based on plant extracts that undergo biodegradation