ABSTRACT
BACKGROUND: Increase of immunocompromised patients and frequent use of indwelling catheters cause staphylococcal bacteremia, especially due to coagulase-negative staphylococci (CNS), in contrast with Staphylococcus aureus in the past. And, infections of methicillin-resistant staphylococci have been increasing in number from 1970s. In this study, species of staphylococcal isolates from blood were demonstrated, and their methicillin susceptibilities were evaluated for the empirical choice of antibiotics. METHODS: One hundred and seventy-five staphylococcal strains isolated from blood culture at Pusan National University Hospital during the year 1999 were included. Species identification, susceptibility tests by agar dilution and disk diffusion methods, and mecA gene detection by polymerase chain reaction were performed. RESULTS: S. aureus (41%), S. epidermidis (30%), S. auricuralis, S. intermedius, S. haemolyticus, S. capitis, S. simulans, S. sciuri, S. homis, and S. warneri were identified. Thirty-one stains (43.4%) of S. aureus, 43 stains (83%) of S. epidermidis, and 24 stains (46%) of other CNS are resistant to oxacllin. The results of disk diffusion test were consistant with agar dilution tests in all S. aureus strains and 95.5% of CNS strains. The results of mecA gene detection were consistant with agar dilution methods in 96.8% of S. aureus and 89.6% of CNS. CONCLUSIONS: Not only S. aureus and S. epidermidis but also other various species of staphylococci were recovered from blood, and methicillin-resistant strains reached 43.2% of S. aureus, and 64.4% of CNS. These results would help for physicians to choose primary empirical therapeutic agents of patients who are suggestive of staphylococcal bacteremia.
Subject(s)
Humans , Agar , Anti-Bacterial Agents , Bacteremia , Catheters, Indwelling , Coloring Agents , Diffusion , Immunocompromised Host , Methicillin , Methicillin Resistance , Oxacillin , Polymerase Chain Reaction , Staphylococcus , Staphylococcus aureusABSTRACT
OBJECTIVE: The purpose of this study was to investigate the effect of dietary soluble fibers added to nasogastric tube-fed formulas and to compare the difference of the degree of diarrhea according to the amount of dietary soluble fibers in stroke or traumatic brain injury patients for comprehensive rehabilitative management. METHOD: Fifty-two stroke or traumatic brain injury patients fed by nasogastric tube due to dysphagia were included. They received fiber-free formulas for the first 30 days and then they were randomly assigned to three groups, including the control (fiber-free) group, moderate fiber (3.5 gm fiber/L) group and high fiber (7 gm fiber/L) group. Each group received their respective formulas for the next 30 days. We compared diarrhea score and frequency. RESULTS: In the control group, the degree of diarrhea was not changed with time. In the moderate and high fiber groups, daily diarrhea score and monthly diarrhea frequency were low compared to the control group (p<0.05). Also, the incidence of pseudomembraneous colitis was low in fiber groups. CONCLUSION: We concluded that adding dietary soluble fibers to nasogastric tube-fed formulas may be helpful to reduce the diarrhea and the development of pseudomembraneous colitis. The proper fiber amount will be determined through the following more case studies.
Subject(s)
Humans , Brain Injuries , Colitis , Deglutition Disorders , Diarrhea , Incidence , StrokeABSTRACT
OBJECTIVE: The purpose of this study were to investigate the temporospatial, kinematic data and energy consumption in hemiplegic patients according to the types of ankle-foot orthosis (AFO), and to determine the most effective type of AFO for gait training. METHOD: A prospective study was performed for 10 patients with hemiplegia who was able to walk independently at indoor level. The temporospatial, kinematic data and energy consumption were compared in each five different conditions: 1) barefoot, 2) donning AFO with posterior leaf spring (PLS), 3) donning PLS with the distal part of metatarsal head trimmed off (PLS-C), 4) donning hinged PLS (HPLS), 5) donning hinged PLS with the distal part of metatarsal head trimmed off (HPLS-C). RESULTS: With four types of PLS, maximal ankle plantar flexion was significantly decreased, however we didn't find any difference in kinematic data of the pelvis and hip as compared with barefoot and with PLS, HPLS, HPLS-C and maximal knee extension angle was significantly decreased compared with barefoot. With HPLS-C, cadence and walking speed significantly increased and double support time and oxygen cost significantly decreased as compared with barefoot. CONCLUSION: This study showed increased walking speed, decreased energy cost and improvedgait pattern after donning HPLS-C especially in hemiplegic patients. So HPLS-C may be effective in hemiplegic patients for gait training.
Subject(s)
Humans , Ankle , Foot Orthoses , Foot , Gait Disorders, Neurologic , Gait , Head , Hemiplegia , Hip , Knee , Metatarsal Bones , Orthotic Devices , Oxygen , Pelvis , Plastics , Prospective Studies , WalkingABSTRACT
OBJECTIVE: Spasticity has been reported to be one of the common complications in patients with spinal cord injury. The purposes of this study were to investigate the proper dosage, the therapeutic and undesirable effects of clonidine with combined used of baclofen for the management of spasticity. METHOD: A prospective study was performed for 17 patients with spinal cord injury who did not improve spasticity with 80 mg baclofen administration. The degree of spasticity was assessed in the more-affected knee by modified Ashworth scale, pendulum test at pre-treatment and at 7 days after receiving clonidine. We also investigated the complications and subjective satisfaction. RESULTS: Seven of 13 patients with spinal cord injury showed subjective improvement in spasticity. We found significant improvement in the relaxation index by pendulum test after administration of more than 0.3 mg of clonidine. There was no significant difference between the subgroups depending on the extent of spinal cord injury. We didn't find any serious complication in adjuvant clonidine therapy. CONCLUSION: Adjuvant clonidine therapy can be effective in spasticity of spinal cord injured patients without serious complication.
Subject(s)
Humans , Baclofen , Clonidine , Knee , Muscle Spasticity , Prospective Studies , Relaxation , Spinal Cord Injuries , Spinal CordABSTRACT
OBJECTIVE: The purpose of this study is to evaluate the effects of regular sports activity on psychosocial adaptation, natural killer cell activity (NKCA) as an immunologic measure and HDL-cholesterol level as an indirect index of heart disease in chronic spinal cord injured persons. METHOD: We compared two groups. One is sports group (n=13) who has been doing regular sports activity more than three hours a week for at least one year. Another group who leads sedentary life matched age and body mass index served as a control group (n=13). For the evaluation of psychosocial adaptation, we assessed Rosenberg Self Esteem Scale as subjective measure, Craig Handicap Assessment and Reporting Technique (CHART) as objective measure and Symptom Checklist 90 Revision (SCL-90-R) as a psychologic evaluation. NKCA and serum HDL-cholesterol level were assessed. RESULTS: There was no significant difference in subjective measure and psychologic evaluation between two groups. CHART score and NKCA are significantly higher in the sports group than in the control group (p<0.05). HDL cholesterol level was increased in the sports group compared with the control group. CONCLUSION: Participating in regular sports activity improved the psychosocial adaptation and immune system in chronic spinal cord injured persons.