Research in the community hospital.

Research is an essential component in professional nursing practice. Although nursing research efforts have increased, there is little evidence of a consistent infrastructure within the community hospital to promote research utilization and the conduct of nursing research. There are multiple mechanisms for nurse administrators to support research efforts in the community hospital. We discuss the value of research and research utilization in the community hospital and suggest some practical strategies for nurse administrators to support research efforts.     

In defense of the stethoscope

The stethoscope is widely considered to be an unreliable instrument. Many studies document the significant observer variability in its use. Numerous other diagnostic tools are available that are generally regarded to provide more reliable diagnostic information. Some even argue that teaching of the ancient art should be de-emphasized in medical schools. Yet auscultation with an acoustic stethoscope can provide important, even life-saving, information. The purpose of this article is to present evidence that supports the use of the stethoscope in clinical medicine. The argument for the stethoscope will be made by presenting relevant investigations, including clinical studies acknowledged to meet the criteria of evidence-based medicine. It will focus on studies that have employed computerized acoustic technology to correlate lung sounds with disease states. This technology has advanced in recent years, which has stimulated a resurgence of interest in auscultation. Numerous studies have been done that utilized objective methods that circumvented the problem of observer variability. There is now a good deal of scientific evidence to support the hypothesis that lung sounds contain information that is clinically useful. This technology also allows this information to be collected more efficiently than previously possible. Advances in educational technology have made it possible to impart information on auscultation much more easily than was possible in the past. Contrary to predictions, the stethoscope is not likely to be relegated to the museum shelf in the near future. Computer technology is making it an even more useful clinical instrument.     

In vitro activities of the Rx-01 oxazolidinones against hospital and community pathogens

Rx-01_423 and Rx-01_667 are two members of the family of oxazolidinones that were designed using a combination of computational and medicinal chemistry and conventional biological techniques. The compounds have a two- to eightfold-improved potency over linezolid against serious gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant streptococci, and vancomycin-resistant enterococci. This enhanced potency extends to the coverage of linezolid-resistant gram-positive microbes, especially multidrug-resistant enterococci and pneumococci. Compounds from this series expand the spectrum compared with linezolid to include fastidious gram-negative organisms like Haemophilus influenzae and Moraxella catarrhalis. Like linezolid, the Rx-01 compounds are bacteriostatic against MRSA and enterococci but are generally bactericidal against S. pneumoniae and H. influenzae.     

Nocardiosis in the community hospital. Report of three cases

Nocardiosis is an infectious disease that occurs in both normal and immunocompromised hosts. In North America, the most common presentation is that of primary subacute pneumonia. In Central and South America, primary cutaneous infections are more common. The diagnosis is often missed because of contamination of cultures and the need to culture specimens for extended periods. Because of this difficulty in diagnosis, the incidence of nocardiosis may actually be higher than what published data reveal. Incision and drainage of abscesses and extended drug therapy (eg, with sulfonamides) are the cornerstones of treatment.