Frequency of small-colony variants and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus in cystic fibrosis patients

Background

Small-colony variants (SCVs) are a distinct phenotype of Staphylococcus aureus, known for their role in chronic, difficult to treat infections, including cystic fibrosis (CF) lung disease. The goal of this study was to characterize SCV MRSA infection in an adult and pediatric CF population and to identify antibiotic susceptibility patterns unique to SCV MRSA.

Prevalence and predictors associated with severe pulmonary hypertension in COPD

Background

Pulmonary hypertension (PH) is one of the most common complications of COPD (chronic obstructive pulmonary disease), but its severe form is uncommon. Various factors play an important role in the occurrence and severity of pulmonary hypertension in patients.

急性缺血性脑卒中患者幽门螺杆菌感染与CRP、PCT关系探讨

目的 探讨急性缺血性脑卒中患者的幽门螺杆菌(HP)感染状况及其与C-反应蛋白(CRP)、降钙素原(PCT)在急性缺血性脑卒中临床上的意义.方法 分析2012年7月-2014年1月在宁波市第二医院神经内科接受治疗的急性缺血性脑卒中患者的临床资料.将入组的急性缺血性脑卒中患者作为观察组,都在发病7d内入院,对照组选择同期门诊的健康体检者.入院治疗次日上午、对照组在体检当天抽取9 ml的肘正中静脉血,分别检测患者的CRP、PCT及HP抗体.比较2组患者的一般资料、Hp感染状况以及Hp感染状况与CRP、PCT的相关性.结果 本研究共纳入研究对象150例,其中观察组患者77例,对照组73例,2组受试者的基线资料差异无统计学意义(P＞0.05);观察组患者的Hp-IgG阳性率(x2=11.72,P＜0.01)、Hp-CIM阳性率(x2=9.770,P＜0.01)均显著高于对照组;Hp现症感染患者[Hp-CIM阳性组,(7.8±1.8) mg/L]、Hp既往感染者[Hp-IgG阳性组,(5.4±1.3) mg/L]及正常对照组[(2.2±0.6)mg/L]所对应的CRP水平比较结果差异具有统计学意义(F=305.3,P＜0.01),且Hp-CIM阳性组患者最高,正常对照组最低;Hp现症感染患者[(1.9±0.7)ng/ml]、Hp既往感染者[(1.4±0.3) ng/ml]及正常对照组[(0.3±0.1)ng/ml]所对应的PCT水平比较结果提示差异具有统计学意义(F=305.3,P＜0.01),且Hp-CIM阳性组患者最高,正常对照组最低.结论 缺血性脑卒中与Hp感染关系密切,而Hp感染状况与CRP和PCT有着一定的相关性.     

Bilateral movements increase sustained extensor force in the paretic arm

Purpose: Muscle weakness in the extensors poststroke is a common motor impairment. Unfortunately, research is unclear on whether bilateral movements increase extensor force production in the paretic arm. This study investigated sustained force production while stroke individuals maximally extended their wrist and fingers on their paretic arm. Specifically, we determined isometric force production in three conditions: (a) unilateral paretic arm, (b) unilateral nonparetic arm, and (c) bilateral (both arms executing the same movement simultaneously).

Methods: Seventeen chronic stroke patients produced isometric sustained force by executing wrist and fingers extension in unilateral and bilateral contraction conditions. Mean force, force variability (coefficient of variation), and signal-to-noise ratio were calculated for each contraction condition.

Results: Analysis of two-way (Arm?×?Type of Condition: 2?×?2; Paretic or Nonparetic Arm?×?Unilateral or Bilateral Conditions) within-subjects ANOVAs revealed that the bilateral condition increased sustained force in the paretic arm, but reduced sustained force in the nonparetic arm. Further, although the paretic arm exhibited more force variability and less signal-to-noise ratio than the nonparetic arm during a unilateral condition, there were no differences when participants simultaneously executed isometric contractions with both arms.

Conclusions: Our unique findings indicate that bilateral contractions transiently increased extensor force in the paretic arm.

• Implications for Rehabilitation

• Bilateral movements increased isometric wrsit extensor force in paretic arms and redcued force in nonparetic arms versus unilateral movements.

• Both paretic and nonparetic arms produced similar force variability and signal-to-noise ratio during bilateral movements.

• Increased sustained force in the paretic arm during the bilateral condition indicates that rehabilitation protocols based on bilateral movements may be beneficial for functional recovery.

     

How physical therapists instruct patients with stroke: an observational study on attentional focus during gait rehabilitation after stroke

Purpose: People without neurological impairments show superior motor learning when they focus on movement effects (external focus) rather than on movement execution itself (internal focus). Despite its potential for neurorehabilitation, it remains unclear to what extent external focus strategies are currently incorporated in rehabilitation post-stroke. Therefore, we observed how physical therapists use attentional focus when treating gait of rehabilitating patients with stroke.

Methods: Twenty physical therapist-patient couples from six rehabilitation centers participated. Per couple, one regular gait-training session was video-recorded. Therapists’ statements were classified using a standardized scoring method to determine the relative proportion of internally and externally focused instructions/feedback. Also, we explored associations between therapists’ use of external/internal focus strategies and patients’ focus preference, length of stay, mobility, and cognition.

Results: Therapists’ instructions were generally more external while feedback was more internal. Therapists used relatively more externally focused statements for patients with a longer length of stay (B?=??0.239, p?=?0.013) and for patients who had a stronger internal focus preference (B?=??0.930, p?=?0.035).

Conclusions: Physical therapists used more external focus instructions, but more internally focused feedback. Also, they seem to adapt their attentional focus use to patients’ focus preference and rehabilitation phase. Future research may determine how these factors influence the effectiveness of different attentional foci for motor learning post-stroke.

• IMPLICATIONS FOR REHABILITATION

• Physical therapists use a balanced mix of internal focus and external focus instructions and feedback when treating gait of stroke patients.

• Therapists predominantly used an external focus for patients in later rehabilitation phases, and for patients with stronger internal focus preferences, possibly in an attempt to stimulate more automatic control of movement in these patients.

• Future research should further explore how a patients’ focus preference and rehabilitation phase influence the effectiveness of different focus strategies.

• Awaiting further research, we recommend that therapists use both attentional focus strategies, and explore per patient which focus works best on a trial-and-error basis.