Concerns About ABA-Based Intervention: An Evaluation and Recommendations

Journal of Autism and Developmental Disorders - For over 50 years, intervention methods informed by the principles of applied behavior analysis (ABA) have been empirically researched and...     

Caspofungin in vitro and in vivo activity against Brazilian Pythium insidiosum strains isolated from animals

OBJECTIVES: The present study evaluated the susceptibility of 27 clinical isolates of Pythium insidiosum to caspofungin in vitro and correlated the results with the therapeutic response in vivo in rabbits with experimental pythiosis. METHODS: The macrodilution method was performed in accordance with the CLSI document M38-A technique. Three reading criteria for MICs were adopted: MIC0, MIC1 and MIC2 (100%, 90% and 50% growth inhibition, respectively). The minimum fungicidal concentration was also determined. Ten rabbits inoculated with viable P. insidiosum zoospores were divided into two groups: group 1 (control) and group 2 (treated with caspofungin at a dosage of 1 mg/kg/day for 20 consecutive days). RESULTS: Of the isolates 51.8% had an MIC0 of 64 mg/L, 88.8% of isolates had an MIC1 between 8 and 64 mg/L and 62.9% of isolates had a minimum fungicidal concentration of 64 mg/L. In the in vivo assay, growth of subcutaneous lesions reduced during treatment, but rapidly resumed when treatment was stopped. CONCLUSIONS: The results showed that caspofungin has limited fungistatic activity against P. insidiosum. This work is the first study to analyse the susceptibility of this oomycete to inhibitors of beta-glucans of the cellular wall.     

Diagnosis and management of acute cholecystitis: a single-centre audit of guideline adherence and patient outcomes

BackgroundThe Tokyo Guidelines were published in 2007 and updated in 2013 and 2018, with recommendations for the diagnosis and management of acute cholecystitis. We assessed guideline adherence at our academic centre and its impact on patient outcomes.MethodsThis is a retrospective chart review of patients with acute calculous cholecystitis who underwent cholecystectomy at our institution between November 2013 and March 2015. Severity of cholecystitis was graded retrospectively if it had not been documented preoperatively. Compliance with the Tokyo Guidelines’ recommendations on antibiotic use and time to operation was recorded. Cholecystitis severity groups were compared statistically, and logistic regression was used to determine predictors of complications.ResultsOne hundred and fifty patients were included in the study. Of these, 104 patients were graded as having mild cholecystitis, 45 as having moderate cholecystitis, and 1 as having severe cholecystitis. Severity was not documented preoperatively for any patient. Compliance with antibiotic recommendations was poor (18.0%) and did not differ by cholecystitis severity (p = 0.90). Compliance with the recommendation on time to operation was 86.0%, with no between-group differences (p = 0.63); it improved when an acute care surgery team was involved (91.0% v. 76.0%, p = 0.025). On multivariable analysis, comorbidities (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.19–1.85, p < 0.001) and conversion to laparotomy (OR 13.45, 95% CI 2.16–125.49, p = 0.01) predicted postoperative complications, while severity of cholecystitis, antibiotic compliance and time to operation had no effect.ConclusionIn this study, compliance with the Tokyo Guidelines was acceptable only for time to operation. Although the poor compliance with recommendations relating to documentation of severity grading and antibiotic use did not have a negative affect on patient outcomes, these recommendations are important because they facilitate appropriate antibiotic use and patient risk stratification.     

A clinical crossover trial of the effect of manipulative therapy on pain and passive and active range of motion of the painful hip

ObjectivesThis study aims to determine whether manipulative therapy of the hip joint can increase range of motion (ROM) and/or decrease pain in individuals experiencing symptomatic hip pain.MethodsNon-disabled young adults were recruited on campus of a chiropractic college for this randomized crossover study. Subjects’ hip active and passive ROM and pain perception were measured. Subjects then received a drop-piece hip manipulation (DPHM) or an alternative treatment, followed by measurement of active and passive ROM and pain.ResultsEight males and 12 females (n=20) between the ages of 21–32 years completed the study. Statistically significant improvements in numeric pain scale (NRS) and passive abduction were observed for the manipulation group when compared to the alternative treatment. No significant change was observed for all other hip ranges.ConclusionsDPHM of the symptomatic hip joint in a small sample of young adults resulted in statistically significant improvements in pain and passive abduction when compared to sham manipulation. Due to low sample size, further research is recommended.     

Therapeutic levels of short-term tramadol administration negatively affect testis function in rats

Objective:To investigate the effects of 30-day treatment with therapeutic dose equivalent levels of tramadol on serum testosterone level, sperm parameters, and ...