The serum sensitivity, colonial morphology, serogroup specificity, and outer membrane protein of Pseudomonas aeruginosa strains isolated from several clinical sites

Ninety-three strains of Pseudomonas aeruginosa, isolated from 68 patients hospitalized with respiratory tract infections, burns, urinary tract infections, and other illnesses, were examined for: 1) sensitivity to the bactericidal activity of fresh normal human serum (FHS); 2) colonial morphology; 3) serogroup designation; and 4) outer membrane protein (OMP) profile. The purpose of this study was to determine if there was any relationship between any of these microbial characteristics and the propensity of this microorganism to infect a specific clinical site or tissue. The results of this study can be summarized as follows: 1) slime-producing strains were generally more serum-sensitive than non-slime producers, although serum sensitivity was not related to slime production per se; 2) CF strains were much more serum-sensitive than non-CF strains; 3) the clinical isolation site appeared to be the predominant determinant of a strain's sensitivity to FHS; 4) the ability of P. aeruginosa to colonize/infect a specific clinical site or resist the bactericidal activity of FHS was generally unrelated to serogroup specificity; and 5) whereas the OMP profile of a particular strain does not appear to correlate with its response to the bactericidal effect of FHS, it does appear to be related to its clinical isolation site.     

精神分裂症患者58例职业康复疗效对照及影响因素分析

目的：观察５８例精神分裂症患者职业康复的疗效,并分析影响疗效的因素。方法：将５８例参加职业康复的患者,按不同的职业康复训练内容分组,Ａ组为清扫环境卫生,Ｂ组为流水线车缝作业,Ｃ组为围坐成小组撕棉纱。采有ＩＰＲＯＳ量表分别于训练前、训练３个月、５个月３次评定对照。结果：３组ＩＰＲＯＳ评分治疗前后对照有非常显著意义,尤以Ｂ组为突出（ｔ＝３．４７,Ｐ＜０．００１）;３组间比较有显著意义（Ｆ＝１４．７６,Ｐ＜０．００１）;３组ＩＰＲＯＳ总分均呈逐渐下降趋势;ＩＰＲＯＳ负荷５个因子除社交能力外,其他４个因子均有显著进步。结论：精神分裂症患者参加职业康复训练是康复的积极措施,并且训练应由浅入深,逐步提高训练的技巧难度,对康复效果有积极意义,同时提示职业康复训练不能代替社交能力训练。     

The effects of detoxification, relaxation, and brief supportive therapy on chronic pain

Seven chronic pain patients (six with abdominal pain and one with headache pain) were detoxified from analgesic medications, taught relaxation techniques, and given an average of 3 supportive therapy sessions. The effects of these procedures at posttreatment and at 6 months follow-up were analyzed by means of self-report diaries of pain, mood, activity and medication usage. There was a significant reduction in pain from posthospital in 5 of 7 patients and a significant reduction in pain at 6-month follow-up for all patients. There was a significant reduction in medication use for all subjects. Mood ratings tended to improve when pain was reduced, and some patients reported increased activity levels. Detoxification combined with relaxation and supportive therapy appears to produce significant relief from pain for these 7 patients.     

The effectiveness of Biomechanical Taping Technique on visual analogue scale,static maximum handgrip strength,and Patient Rated Tennis Elbow Evaluation of patients with lateral epicondylalgia: A cross-over study

IntroductionLateral epicondylalgia (LE) is a musculoskeletal injury involving the common extensor origin in elbow manifesting as pain and ineffective handgrip affecting the daily activities of the individuals with LE.ObjectivesThis study determined the effectiveness of Standard Biomechanical Taping (SBMT), Vector Correcting Dysfunction Techniques 1 (VCDT 1) and Vector Correcting Dysfunction Technique 2 (VCDT 2); and compared their differences on effects on pain, grip strength and daily functions of individual with unilateral LE.MethodsA cross-over study design was used. The senior investigator applied three BMT techniques namely: a. SBMT, b. VCDT 1, and c. VCDT 2. On Day 1, SBMT and VCDT1 were randomly assigned. On Day 3, either SBMT or VCDT1 not performed on Day 1 was applied to LE elbows. On Day 5, VCDT2 was applied on LE elbows. Visual Analogue Scale (VAS), Static Maximum Handgrip Strength Test (SMHGT) and Patient-Rated Tennis Elbow Evaluation (PRTEE) were used as outcome measures administered by three blinded junior investigators. On Days 1, 3, and 5, VAS and SMGHT were administered before and during BMT application. PRTEE was administered on Days 1 and 12.ResultsThe following were found in this study: a. significantly decreased VAS scores at Days 1, 3, and 5 of BMT application (p < 0.05); b. significantly improved final VAS, SMHGT strength and PRTEE scores on Day 12 compared to baseline scores on Day 1 (p = /<0.01); and c. significantly decreased VAS scores when using SBMT compared to VCDT2 (p < 0.05).ConclusionBMT is a novel taping technique effective in decreasing lateral elbow pain, increasing handgrip strength and improving function of patients with LE. BMT can be applied on painful elbows effecting a better grip among patients with LE.     

A randomized controlled trial of modified constraint-induced movement therapy for elderly stroke survivors: changes in motor impairment, daily functioning, and quality of life

OBJECTIVE: To examine the benefits of modified constraint-induced movement therapy (mCIMT) on motor function, daily function, and health-related quality of life (HRQOL) in elderly stroke survivors. DESIGN: Two-group randomized controlled trial, with pretreatment and posttreatment measures. SETTING: Rehabilitation clinics. PARTICIPANTS: Twenty-six elderly stroke patients (mean age, 72 y) with 0.5 to 31 months postonset of a first-ever cerebrovascular accident. INTERVENTIONS: Twenty-six patients received either mCIMT (restraint of the unaffected limb combined with intensive training of the affected limb) or traditional rehabilitation for a period of 3 weeks. MAIN OUTCOME MEASURES: Outcome measures included the Fugl-Meyer Assessment (FMA), FIM instrument, Motor Activity Log (MAL), and Stroke Impact Scale (SIS). The FMA evaluated the severity of motor impairment; the FIM instrument and MAL reported daily function; and the SIS detected HRQOL. RESULTS: The mCIMT group exhibited significantly greater improvements in motor function, daily function, and the physical domain of HRQOL than the traditional rehabilitation group. Patients in the mCIMT group perceived significantly greater percent of recovery after treatment than patients in the traditional rehabilitation group. CONCLUSIONS: These findings suggest mCIMT is a promising intervention for improving motor function, daily function, and physical aspects of HRQOL in elderly patients with stroke. The mCIMT was well tolerated by the elderly patients even though it is a rigorous training program.     

RESNA: Yesterday,Today, and Tomorrow

Few things in our field are more distinguished than RESNA itself, especially its history. RESNA does not have a long history compared to some organizations; however, it is in many ways unique. Its uniqueness is based on the fundamental idea that technology can profoundly affect the lives of people with disabilities. And all persons, including those with disabilities, who share this vision can combine their talents, energies, and experiences in such a way that it facilitates the realization of a larger vision. This organizational concept is different from most associations or societies designed to serve the interests of a single professional or disability group. This visionary concept not only gives RESNA its strength and purpose, but it also has drastically shaped its young history.     

A report on disability and rehabilitation medicine in Pakistan: past, present, and future directions

Rathore FA, New PW, Iftikhar A. A report on disability and rehabilitation medicine in Pakistan: past, present, and future directions.Disability is a stigma in Pakistan, and cultural norms are a hindrance to the integration of the disabled into the community. Additional barriers to addressing the needs of the disabled include the lack of reliable disability epidemiologic data, inadequate funding and poor health care infrastructure, and workforce shortages. The aim of this report is to present an overview of Physical Medicine and Rehabilitation (PM&R) in Pakistan, covering its origins, current status, and future directions. An electronic literature search (1950–2009) was conducted using the Medline, ScienceDirect, Springer Link, CINAHL, and Google Scholar databases. The key words used were “disability,” “persons with disability” (PWDs), “rehabilitation,” “Pakistan,” “developing countries,” “stroke,” “spinal cord injury,” “causes,” “attitudes,” “physiotherapy,” “occupational therapy,” and “speech therapy.” Only publications in English involving physical disability were selected. Statistical data were obtained from the Federal Bureau of Statistics. Interviews with pioneers of rehabilitation medicine in Pakistan, PWDs, and their families were conducted. The origins of PM&R in Pakistan date to the 1960s, but the formal training program began only in 1997. There are only a few rehabilitation departments, and none have all the standard components of a rehabilitation team. The number of practicing rehabilitation consultants is 38. There are an estimated 1000 physical therapists and 150 occupational therapists. There is a need to increase the number of rehabilitation facilities significantly, staff them appropriately, and make them accessible to all who need them, including rural and remote regions. Discrimination should be addressed by education and legislation.     

Effects of Educational Intervention on State Anxiety and Pain in People Undergoing Spinal Surgery: A Randomized Controlled Trial

Preoperative educational intervention for anxiety and pain affects patients undergoing spinal surgery. The effects, however, have never been examined using randomized controlled designs. To investigate the effects of education on anxiety and pain for patients undergoing spinal surgery, a randomized trial with block design was used. Patients were recruited from a medical center in central Taiwan. We invited 90 patients to participate in this study. Inclusion criteria were (a) age ≥20 years, (b) voluntary participation, (c) able to understand Taiwanese Mandarin Chinese or Taiwanese, and (4) no hearing or vision impairments after using aids. Patients (n = 86) undergoing lumbar spinal surgery were randomized into either an Intervention group (using educational intervention; n = 43) or a Control group (n = 43); four patients voluntarily dropped out after surgery (one in Intervention group; three in Control group). Patients had their anxiety (using the State-Trait Anxiety Inventory; STAI) and pain (using a visual analog scale) measured the day before surgery, 30 minutes before surgery, and the day after surgery. After controlling for demographics, the adjusted anxiety and pain levels were significantly lower for the Intervention group: mean STAI scores were 52.67 at baseline and 47.54 at 30 minutes before surgery (p < .001); mean pain scores were 6.07 at baseline and 5.28 on day after surgery (p < .001). Preoperative educational intervention is effective in informing patients undergoing spinal surgery that can lead to a reduction in pain, anxiety, and fear postoperatively.