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1.
We studied the antimicrobial susceptibility of AmpC -lactamase-producing Escherichia coli isolates collected at ten medical institutions in the Kinki area of Japan during a 6-month period (November 2002 through April 2003). Of 2845 E. coli isolates tested, 29 (1.0%) showed a minimum inhibitory concentration (MIC) for cefazolin of more than 8µg/ml and were three-dimensional extract test positive. In standard inoculum susceptibility tests against these 29 strains, the MIC90s for the four carbapenems tested ranged from 0.06µg/ml to 0.5µg/ml, and these compounds were more active than the other -lactams, with meropenem being the most active. The MIC90s for -lactams, except carbapenems, ranged from 4µg/ml to 32µg/ml, with cefepime being the most active. In high inoculum susceptibility tests against these strains, the MIC90s for the four carbapenems and cefepime were 8µg/ml or less, and these compounds were more active than other -lactams. The MIC90s for -lactams, except carbapenems and cefepime, were 32µg/ml or more. The MIC90s for the five quinolones tested ranged from 4µg/ml to 16µg/ml, and the order of increasing susceptibility was ciprofloxacin > levofloxacin, gatifloxacin and pazufloxacin > prulifloxacin.  相似文献   

2.
The hypothesis that ultrasound increases antibiotic transport through biofilms of Escherichia coli and Pseudomonas aeruginosa was investigated using colony biofilms. Biofilms grown on membrane filters were transferred to nutrient agar containing 50µg/ml gentamicin. A smaller filter was placed on top of the biofilm and a blank concentration disk was situated atop the filter. Diffusion of antibiotic through the biofilms was allowed for 15, 30, or 45min at 37°C. Some of these biofilms were exposed to 70-kHz ultrasound and others were not. Each concentration disk was then placed on a nutrient agar plate spread with a lawn of E. coli. The resulting zone of inhibition was used to calculate the amount of gentamicin that was transported through the biofilm into the disk. The E. coli and P. aeruginosa biofilms grown for 13 and 24h were exposed to two different ultrasonic power densities. Ultrasonication significantly increased the transport of gentamicin through the biofilm. Insonation of biofilms of E. coli for 45min more than doubled the amount of gentamicin compared to their noninsonated counterparts. For P. aeruginosa biofilms, no detectable gentamicin penetrated the biofilm within 45min without ultrasound; however, when insonated (1.5W/cm2) for 45min, the disks collected more than 0.45µg antibiotic. Ultrasonication significantly increased transport of gentamicin across biofilms that normally blocked or slowed gentamicin transport when not exposed to ultrasound. This enhanced transport may be partially responsible for the increased killing of biofilm bacteria exposed to combinations of antibiotic and ultrasound.  相似文献   

3.
Context Physicians psychological characteristics may influence their communication styles and may thus interfere with patient-centred communication.Objective Our aim was to test the hypothesis that, in interviews with a cancer patient and a relative, physicians with an external locus of control (LOC; who believe that life outcomes are controlled by external forces such as luck, fate or others) have a communication style different from that of physicians with an internal LOC (who believe that life outcomes are controlled by their own characteristics or actions).Design, setting, participants and intervention Eighty-one voluntary physicians practising in the field of oncology were recorded while performing an actual and a simulated interview with a cancer patient and a relative.Main outcome measures Physicians communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians LOC was assessed using the Rotter I–E scale. The communication skills of the upper and lower quartiles of physicians in respect of their scores on this scale were compared using Students t test.Results In actual interviews, physicians with an external LOC talked more to the relative (P=0.017) and used more utterances with an assessment function (P=0.010) than physicians with an internal LOC. In simulated interviews, physicians with an external LOC used less utterances that give premature information (P=0.031) and used more utterances with a supportive function, such as empathy and reassurance (P=0.029), than physicians with an internal LOC.Conclusion These results provide evidence that physicians LOC can influence their communication styles. Physicians awareness of this influence constitutes a step towards a tailoring of their communication skills to every patients and relatives concerns and needs and thus towards a patient-centred communication.This research program was supported by the Fonds National de la Recherche Scientifique—Section Télévie of Belgium, the Fonds dEncouragement à la Recherche de lUniversité Libre de Bruxelles (Brussels, Belgium) and the CAM Training and Research Group (Brussels, Belgium).  相似文献   

4.
A group of 59 child abusers were classified as having either an avoidant (n = 15) or an approach (n = 44) goal regarding deviant sexual activity with children. Level of distorted beliefs about sexual activity with children (cognitive distortions) and distorted beliefs about their own victims (victim blaming attitudes) in both groups were measured before and after treatment. Results indicate that there was an overall reduction in the level of these distorted beliefs at the posttreatment stage in the approach group. Reductions were not found in the avoidant offenders as men in this group did not have distorted beliefs prior to treatment. Results are discussed in terms of appropriate targeting of treatment.  相似文献   

5.
Two studies are reported that investigated the processes involved in stopping worry. Study 1 found that the use of as many as can stop rules was significantly related to measures of trait worry and beliefs about the positive and negative consequences of worrying, and Study 2 demonstrated that the reported use of as many as can stop rules significantly predicted perseveration on behavioral measures of catastrophic worrying. Reported use of feel like continuing stop rules was unrelated to any measures of worry in both studies. These results indicate that the use of as many as can stop rules is a highly significant predictor of worry frequency and perseveration, and that beliefs about the positive and negative consequences of worry also independently predict the use of as many as can stop rules. These findings are consistent with (1) the view that the stop rules used by worriers are closely associated with, or directly derived from, the more stable, global beliefs that worriers hold about the utility of the worry process, and (2) predictions from the mood-as-input model of catastrophic worrying (H. M. Startup & G. C. L. Davey, 2001).  相似文献   

6.
Small bowel bypass procedures for morbid obesity have been associated with many postoperative complications. With the use of the Scott procedure, the bypassed or excluded small bowel segment has recently been the focus of 2 syndromes — bypass enteritis and defunctioned bowel syndrome. We describe these postoperative complications and present their significant radiologic features.  相似文献   

7.
It is suggested that humanistic and cognitive therapies share some similar goals. Both see the employment of rigid absolutistic shoulds as generative of dysfunctional behavior. Both value self-acceptance, in the form of discouraging the client from forming negative overgeneralized trait-like self-judgements. Both value viewing one's failures and mistakes as part of a process of exploration and coping. Hypothesis-testing and holding constructs tentatively is also valued. At the level of practice some of Beck's cognitive strategies appear to help the client learn to stick to his/her moment to moment experiencing, and to be more phenomenological. Similarly Rogers' client-centered interventions appear to lay bare the client's negative self-statement process, and to counter and correct overgeneralized negative cognitions.  相似文献   

8.
Goals Complementary/alternative medicine (CAM) is widely used by patients but rarely discussed with oncologists. To understand reasons for the communication gap, this study compares physicians and patients on perceived reasons for CAM use and nondisclosure of use, reactions of physicians to disclosure, and expectations for CAM.Patients and methods Cross-sectional studies assessed 82 physicians (response 68.3%) and 244 of 374 outpatients (response 65.2%) identified as CAM users at the MD Anderson Cancer Center. Data were summarized by frequency and compared using chi-square tests.Main results Physicians were more likely (p<0.001) than patients to attribute CAM use to hope (2=17.7), control (2=17.5), incurable disease (2=42.8), or a nontoxic approach (2=50.9). Both physicians and patients agreed CAM could relieve symptoms/side effects, but physicians were less likely (p<0.001) than patients to expect that CAM improved immunity (2=72.2) or quality of life (2=17.1), cured disease (2=42.5), or prolonged life (2=58.4). Physicians and patients responded differently (p<0.005) on reasons for nondisclosure. Physicians believed patients felt CAM discussions were unimportant (2=7.9) and physicians would not understand (2=48.1), discontinue treatment (2=26.4), discourage or disapprove of the use (2=131.7); patients attributed nondisclosure to their uncertainty of its benefit (2=10.4) and never being asked about CAM (2=9.9) by physicians. Physicians were more likely (2=9.5, p<0.002) to warn of risks and less likely (2=23.5, p<0.001) to encourage use than patients perceived.Conclusion Oncologists and cancer patients hold discrepant views on CAM that may contribute to a communication gap. Nevertheless, physicians should ask patients about CAM use, discuss possible benefits, and advise of potential risks.  相似文献   

9.
This study investigated the role of control beliefs in childhood anxiety disorders. The sample comprised 117 youth aged 9–17 years (86 met diagnostic criteria for an anxiety disorder and the remaining 31 were nonreferred comparison participants). Participants' anxiety levels and their perceptions of control over anxiety-related events (e.g., things that might be harmful, feeling shaky or nervous) were assessed. Findings indicated that perceived control over anxiety-related events was significantly negatively correlated with self-reported anxiety levels. Moreover, youth with anxiety disorders reported significantly lower perceived control about anxiety than the nonreferred participants. Findings were consistent with theory and suggest that anxiety disorders in youth are associated with beliefs that anxiety is uncontrollable.  相似文献   

10.
Objective Understanding the biological mediators involved in the complex inflammatory response of sepsis and acute lung injury offers the possibility of future investigations targeting treatment based on these mediators. This study investigated whether macrophage activator -glucan has a protective effect on acute lung injury in an experimental model of sepsis.Design and setting Experimental study in an experimental research center.Materials 30 rats randomized into three groups (sham, sepsis, and -glucan).Interventions Cecal ligation and puncture were performed in the -glucan and sepsis groups. The -glucan group was given a single intraperitoneal dose of -glucan (4 mg/kg) following cecal ligation.Measurements and results Rats treated with -glucan had fewer circulating neutrophils, more blood monocytes, and higher serum interleukin 6 levels than septic animals. The percentages of neutrophils and lymphocytes from the bronchoalveolar lavage fluid and the myeloperoxidase activity measured in the lung tissue were lower in the -glucan group than in the sepsis group. Less alveolar hemorrhage and neutrophil infiltration were observed in lungs from animals in the -glucan group in the septic groups.Conclusions In this rat model of intra-abdominal sepsis -glucan treatment partially protected against secondary lung injury, decreased lung hemorrhages, and lung neutrophilia. These results suggest that -glucan protects against sepsis-associated lung damage.  相似文献   

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