Uropathogens and empiric antibiotics for the treatment of urinary tract infections in spinal cord injured patients at rehabilitation center, Thai Red Cross Society during 2001 to 2005.

BACKGROUND: Urinary tract infection (UTI) is common in spinal cord injured patients. The authors investigated the epidemiology of bacteria associated with UTI to select an appropriate antibiotic for empirical treatment of UTI before obtaining a bacterial culture. OBJECTIVE: To determine the prevalence, as well as the causative bacteria and their susceptibility pattern of urinary tract infection in spinal cord injured patients hospitalized to the Rehabilitation Center, Thai Red Cross Society, Samutprakarn, Thailand from January 2001 to December 2005. MATERIAL AND METHOD: A retrospective chart review of 76 spinal cord injured patients. RESULTS: Of all spinal cord injured patients, there were 50 males and 26 females, with the average age of 44.70 years. The average length of hospitalization was 104.5 days. 71.2% of the patients needed intermittent catheterization for bladder drainage, and only 2.7% had suprapubic cystostomy. None of patient had indwelling catheterization. Forty-six patients had 68 episodes of UTI (60.52%). Eighteen patients had recurrent UTI (14 patients had two episodes and four patients had three episodes). E. coli was the most common isolated pathogen (74.36%) followed by K. pneumoniae (12.82%), E. faecalis (5%) and P. mirabilis (5%). Most gram-negative pathogens were susceptible to amikacin and third generation cephalosporins. The susceptibility of these organisms to cotrimoxazole, amoxicillin/clavulanate, and ciprofloxacin were in the range of 34.6-60.0%, 44.0-50.0% and 25.9-50.0%, respectively. CONCLUSION: Urinary tract infections were commonly observed among spinal cord injured patients in the presented institution. E. coli was the most common isolated pathogen. Surprisingly, most gram-negative pathogens were resistant to cotrimoxazole, amoxicillin/clavulanate, and ciprofloxacin. An antibiotic of choice for UTI in our patients should be aminoglycoside or third generation cephalosporins.

Effects of imagery-weight exercise.

OBJECTIVE: To study the effects of imagery-weight exercise on muscle strength. MATERIAL AND METHOD: Preliminary study of a before and after designed experiment was conducted at the Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Bangkok, from June to September 2004. Fifteen healthy sedentary volunteers: 5 males, 10 females, mean age 28.7 +/- 3.5 years were enrolled The participants were instructed to perform imagery-weight exercise training with their non-dominant arms. The program consisted of 3 sets of 10 repetitions of elbow flexion, 3 days/week, for 8 weeks. The arm muscles strength were assessed with computerized isotonic machine. One-Repetition Maximum (1-RM) at before and after the training program, was compared RESULTS: The mean 1-RM of elbow flexors increased by 44.9% (from 6.78 +/- 2.10 kg to 9.83 +/- 2.32 kg, p = 0.000). The mean 1-RM of elbow extensors increased by 32.0% (from 4.03 +/- 1.98 kg to 5.33 +/- 2.32 kg, p = 0.000). CONCLUSION: Imagery-weight exercise is another effective technique of low impact strength training.

Age and gender effects on postural stability and static balance in Thai community dwelling adults.

BACKGROUND: A study of postural stability was undertaken to identify the effects of age and gender as a preliminary study in one Thai community dwelling adults. It will be useful to prevent falls in the future. METHOD: The authors measured the postural stability in 120 males and females aged 30-40, 60-70 years using a Balance Master 8.0, Neurocom, OR to perform the modified Clinical Test for the Sensory Integration of Balance (mCTSIB) and the Unilateral Test protocols. RESULTS: The authors found that the females aged 60-70 were more stable than the males at the same age. CONCLUSION: Age and gender were significant variables that influence postural stability and static balance.