Source investigation of two outbreaks of skin and soft tissue infection by Mycobacterium abscessus subsp. abscessus in Venezuela.

Outbreaks of soft tissue or skin infection due to non-tuberculous mycobacteria are reported frequently in scientific journals but in general the infection source in these outbreaks remains unknown. In Venezuela, in two distinct outbreaks, one after breast augmentation surgery and another after hydrolipoclasy therapy, 16 patients contracted a soft tissue infection due to Mycobacterium abscessus subsp. abscessus. Searching for the possible environmental infection sources in these outbreaks, initially the tap water (in the hydrolipoclasy therapy outbreak) and a surgical skin marker (in the breast implant surgery outbreak), were identified as the infection sources. Molecular typing of the strains with a variable number tandem repeat typing assay confirmed the tap water as the infection source but the molecular typing technique excluded the skin marker. We discuss the results and make a call for the implementation of stringent hygiene and disinfection guidelines for cosmetic procedures in Venezuela.

Enhanced responsivity of non-steady-state photoinduced electromotive force sensors using asymmetric interdigitated contacts.

The responsivity at a constant detection area of non-steady-state photoinduced electromotive force (photo-emf) detectors is improved by a factor equal to the number of contact pairs contained in asymmetric interdigitated surface contacts. The polar nature of photo-emf current generation requires contact asymmetry in which one increases the total signal by blocking the illumination between alternate contact pairs, in distinct contrast to the behavior of conventional interdigitated contacts fabricated upon isotropic photoconductors.

Autonomy-based informed consent: ethical implications for patient noncompliance.

The problems presented by the noncompliant patient are not new to health care professionals, including physical therapists. Although many of the factors that influence the incidence of noncompliance have been studied, important ethical concerns are often overlooked. This fact has led many health care professionals to make the following assumptions: 1) All cases of noncompliance are problems in need of a solution, 2) the solution to the problem of noncompliance is compliance, 3) all instances of compliance are nonproblematical, and 4) the locus of the problem of noncompliance is the patient. In this article, the issue of patient noncompliance is examined based on an analysis of the moral foundations of informed consent. The above assumptions are shown to be problematic from the moral point of view. Three patient cases are presented to highlight some of the implications for physical therapists who encounter noncompliant patients. Understanding the moral foundation of informed consent can help guide therapists in their communication with all patients, and especially in their interactions with noncompliant patients.