ABSTRACT
BACKGROUND: Authors have reported better outcomes, by reducing surgical dissection for carpal tunnel syndromes requiring surgery. Recently, a new sonographically guided technique for ultra minimally invasive (Ultra-MIS) carpal tunnel release (CTR) through 1mm incision has been described. HYPOTHESIS: We hypothesized that a clinical trial for comparing Ultra-MIS versus Mini-open Carpal Tunnel Release (Mini-OCTR) was feasible. MATERIALS AND METHODS: To test our hypothesis, we conducted a pilot study for studying Ultra-MIS versus Mini-OCTR respectively performed through a 1mm or a 2 cm incision. We defined success if primary feasibility objectives (safety and efficacy) as well as secondary feasibility objectives (recruitment rates, compliance, completion, treatment blinding, personnel resources and sample size calculation for the clinical trial) could be matched. Score for Quick-DASH questionnaire at final follow-up was studied as the primary variable for the clinical trial. Turnover times were studied for assessing learning curve stability. RESULTS: Forty patients were allotted. Primary and secondary feasibility objectives were matched with the following occurrences: 70.2% of eligible patients finally recruited; 4.2% of randomization refusals; 26.6 patients/month recruited; 100% patients receiving a blinded treatment; 97.5% compliance and 100% completion. A sample size of 91 patients was calculated for clinical trial validation. At final follow-up, preliminary results for Quick-Dash substantially favored Ultra-MIS over Mini-OCTR (average 14.54 versus 7.39) and complication rates were lower for Ultra-MIS (5% versus 20%). A stable learning curve was observed for both groups. CONCLUSIONS: The clinical trial is feasible. There is currently no evidence to contraindicate nor withhold the use of Ultra-MIS for CTR. LEVEL OF EVIDENCE: III.
Subject(s)
Carpal Tunnel Syndrome/surgery , Minimally Invasive Surgical Procedures/methods , Orthopedic Procedures/methods , Surgery, Computer-Assisted/methods , Adult , Aged , Aged, 80 and over , Carpal Tunnel Syndrome/diagnostic imaging , Feasibility Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pilot Projects , Retrospective Studies , Surveys and Questionnaires , Treatment Outcome , UltrasonographyABSTRACT
Enterococcus faecalis is a pathogenic microorganism. The aim of this investigation was to study the antibiotic susceptibility of the strains isolated in Cordoba in a 20-month period (January 2004 to August 2005). Susceptibility rates to betalactamics were 98% to ampicillin and 99% to amoxicillin/clavulanic acid; high-dose aminoglycosides (streptomycin 1000 microg and gentamycin 500 microg) obtained 56% and 76%, respectively. We found no strains resistant to glycopeptides (vancomycin and teicoplanin) or to linezolid.
Subject(s)
Drug Resistance, Bacterial , Enterococcus faecalis/drug effects , Gram-Positive Bacterial Infections/microbiology , Humans , Microbial Sensitivity Tests , SpainABSTRACT
Enterococcus faecalis es un microorganismo patógeno para el hombre. El objetivo de este estudio fue conocer la sensibilidad a diferentesantibióticos de los aislamientos obtenidos en la provincia de Córdoba en un periodo de 20 meses, de enero de 2004 a agosto de 2005. Losporcentajes de sensibilidad para los betalatámicos fueron del 98% a ampicilina y del 99% a amoxicilina-ácido clavulánico. Los aminoglucósidosestreptomicina y gentamicina, probados a altas dosis (estreptomicina 1000 µg y gentamicina 500 µg), obtuvieron un porcentaje desensibilidad del 56% y el 76%, respectivamente. No se encontró ninguna cepa resistente a glucopéptidos (vancomicina y teicoplanina) ni alinezolid
Enterococcus faecalis is a pathogenic microorganism. The aim of this investigation was to study the antibiotic susceptibility of the strains isolatedin Córdoba in a 20-month period (January 2004 to August 2005). Susceptibility rates to betalactamics were 98% to ampicillin and 99%to amoxicillin/clavulanic acid; high-dose aminoglycosides (streptomycin 1000 µg and gentamycin 500 µg) obtained 56% and 76%, respectively.We found no strains resistant to glycopeptides (vancomycin and teicoplanin) or to linezolid
Subject(s)
Humans , Drug Resistance, Bacterial , Enterococcus faecalis , Gram-Positive Bacterial Infections/microbiology , Spain , Microbial Sensitivity TestsABSTRACT
Estudiamos la sensibilidad a antimicrobianos de las bacterias aisladas en esputos de enfermos con fibrosis quística en nuestro hospital durante los años 2001 y 2002. Los microorganismos más frecuentemente aislados fueron, por orden, Staphylococcus aureus (59,89%), Pseudomonas aeruginosa (49,45%), Stenotrophomonas maltophilia (4,9%) y Haemophilus influenzae (3,8%). El porcentaje de S. aureus resistentes a la meticilina fue de un 18%, y que no se encontró ninguna cepa con sensibilidad disminuida a los glucopéptidos. Los carbapenémicos fueron los antimicrobianos con mayor actividad frente a P. aeruginosa, aunque sin alcanzar el 100% de eficacia (AU)
We studied the antimicrobial susceptibility of bacteria isolated from sputum from patients with cystic fibrosis in our hospital during 2001 and 2002. The most frequently isolated microorganisms were Staphylococcus aureus (59.89%), Pseudomonas aeruginosa (49.45%), Stenotrophomonas maltophilia (4.9%) and Haemophilus influenzae (3.8%). The rate of methicillin-resistant S. aureus was 18%, and no strains with low susceptibility to glycopeptides were found. Carbapenems showed the highest activity against P. aeruginosa, although this did not reach 100% (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Cystic Fibrosis/microbiology , Microbial Sensitivity Tests , Cross-Sectional Studies , Retrospective Studies , Sputum/microbiologyABSTRACT
We studied the antimicrobial susceptibility of bacteria isolated from sputum from patients with cystic fibrosis in our hospital during 2001 and 2002. The most frequently isolated microorganisms were Staphylococcus aureus (59.89%), Pseudomonas aeruginosa (49.45%), Stenotrophomonas maltophilia (4.9%) and Haemophilus influenzae (3.8%). The rate of methicillin-resistant S. aureus was 18%, and no strains with low susceptibility to glycopeptides were found. Carbapenems showed the highest activity against P. aeruginosa, although this did not reach 100%.
Subject(s)
Cystic Fibrosis/microbiology , Microbial Sensitivity Tests , Adolescent , Adult , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Retrospective Studies , Sputum/microbiologyABSTRACT
BACKGROUND: Study of antifungal sensitivity can help in treatment screening and evaluation of patients suffering from some fungal infections. The purpose of this study is to compare fluconazole MICs obtained by E-test and agar dilution with the NCCLS method. MATERIAL AND METHODS: The in vitro activity of fluconazole against 158 yeast strains by three systems: E-test, agar dilution and the microbroth NCCLS M27P method. RESULTS AND CONCLUSION: A correlation between 84 to 100% was observed the degree varying in the result among different species. The E-test was found to be comparable to the NCCLS M27P microbroth method, was easier to perform and provides MIC result for Candida species within 24 h.
Subject(s)
Antifungal Agents/pharmacology , Fluconazole/pharmacology , Microbial Sensitivity Tests/methods , Yeasts/drug effects , HumansABSTRACT
The E test is a quantitative technique for determining antimicrobial susceptibility; it is based on the diffusion of a stable predetermined gradient of a specific antifungal agent along an inert plastic strip which is applied to a solid culture medium. The E test is an alternative method for determining inhibitory concentrations of antimicrobial agents. The aim of the present study was to determine the in vitro susceptibility of different yeasts to 5 antifungal agents using the E test. The antifungal susceptibility of 87 strains, 73 of which were yeasts obtained from clinical samples, 11 were Prototheca strains and 3 controls, were examined using a gradient diffusion technique (E test). Of these isolates, 13% of Candida albicans were resistant to flucytosine, and 20%, 17% and 33% showed resistance to ketoconazole, itraconazole and fluconazole, respectively. All Candida krusei isolates showed resistance to flucytosine and fluconazole. The Candida parapsilosis and Candida tropicalis strains all presented in vitro susceptibility to all the agents tested. Prototheca strains were only susceptible in vitro to amphotericin B. It was found that the E test was easy to perform, and provided MIC values similar to those obtained with other well documented techniques. It was therefore concluded that the E test could be implemented as a standard procedure in clinical mycology laboratories.
Subject(s)
Antifungal Agents/pharmacology , Candida/drug effects , Cryptococcus neoformans/drug effects , Microbial Sensitivity Tests/methods , Prototheca/drug effects , Amphotericin B/pharmacology , Drug Resistance, Microbial , Fluconazole/pharmacology , Flucytosine/pharmacology , Humans , In Vitro Techniques , Itraconazole/pharmacology , Ketoconazole/pharmacologyABSTRACT
The microorganisms capable of producing opportunist infections include the yeast-like organisms of the genus Candida, and the unicellular algae of the genus Prototheca, which share common features and can, therefore, lead to confusion. Their colonies are almost identical and they grow in the same culture media used routinely in mycology. CHROMagar Candida is a new chromogenic differential isolation medium that facilitates the presumptive differentiation of some of the most clinically important yeast-like organisms. To our knowledge, the use of CHROMagar Candida with Prototheca spp. has not been reported in the literature. This report describes the growth of 151 strains of Prototheca on CHROMagar Candida compared to the growth of a total of 326 well-characterized yeast organisms of the genera Candida, Cryptococcus, Trichosporon, Geotrichum, and Saccharomyces. It is clinically relevant to note that algae of the genus Prototheca (P. wickerhamii, P. zopfii, and P. stagnora) and of the genus Candida parapsilosis produced similar cream-colored colonies on CHROMagar Candida medium. Based on their growth on CHROMagar, a new species of Candida is described, C. zeylanoides, which has blue-green colonies. The colonies of two species of Trichosporon are also differentiated: the blue-green colonies of T. beigelii and the pink colonies of T. capitatum.
Subject(s)
Culture Media , Prototheca/growth & development , Candida/genetics , Chromogenic Compounds , Prototheca/cytology , Yeasts/growth & developmentABSTRACT
With the exception of müllerian-like glandular inclusions in women, reports of nonendometriotic benign glandular inclusions in abdominal lymph nodes are uncommon. We report the case of a 50-year-old woman with an apparently unique, non-müllerian, benign cystic epithelial choristoma in a celiac lymph node found incidentally at cholecystectomy. This case further expands the spectrum of benign lesions that must be differentiated from metastatic adenocarcinoma. Possible histogenesis is discussed.
Subject(s)
Choristoma/pathology , Cysts/pathology , Lymph Nodes/pathology , Lymphatic Diseases/pathology , Epithelium , Female , Humans , Middle AgedABSTRACT
The in vitro susceptibility of Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium avium, Mycobacterium fortuitum, and Mycobacterium chelonae (M. chelonei) to ticarcillin in combination with calvulanic acid (CA) was studied by the agar dilution method. All the M. tuberculosis, M. bovis, and M. africanum strains were inhibited at a ticarcillin concentration of 32 micrograms/ml or lower in combination with 5 micrograms of CA. M. chelonae and M. avium strains proved resistant to more than 128 micrograms of ticarcillin plus 5 micrograms of CA per ml. M. fortuitum strains needed 128 micrograms of ticarcillin plus 5 micrograms of CA to inhibit approximately 30% of the isolates.
Subject(s)
Clavulanic Acids/pharmacology , Mycobacterium/drug effects , Penicillins/pharmacology , Ticarcillin/pharmacology , Clavulanic Acid , Drug Combinations , Mycobacterium avium/drug effects , Mycobacterium bovis/drug effects , Mycobacterium tuberculosis/drug effects , Nontuberculous Mycobacteria/drug effects , Penicillin ResistanceABSTRACT
The in vitro susceptibility of Mycobacterium fortuitum and Mycobacterium chelonei to cefmetazole was studied by the agar dilution method. At a concentration of 16 micrograms/ml or lower, 44 isolates (96%) of M. fortuitum and 8 isolates (40%) of M. chelonei were inhibited.
Subject(s)
Cephamycins/pharmacology , Mycobacterium/drug effects , Nontuberculous Mycobacteria/drug effects , Anti-Bacterial Agents/pharmacology , Cefmetazole , Microbial Sensitivity TestsABSTRACT
The in vitro action of sisomicin, gentamicin and tobramycin against 62 strains of Mycobacterium fortuitum and 20 strains of M. chelonei was investigated. At a drug concentration of 4 micrograms/ml, 31, 31 and 11%, respectively, of M. fortuitum strains and 90, 25 and 15%, respectively, of M. chelonei strains, were inhibited.
Subject(s)
Gentamicins/pharmacology , Mycobacterium/drug effects , Nontuberculous Mycobacteria/drug effects , Sisomicin/pharmacology , Tobramycin/pharmacology , Microbial Sensitivity TestsABSTRACT
A study was made of the in vitro susceptibility of 37 strains of Mycobacterium fortuitum to 14 antimicrobial agents using disc diffusion techniques on Mueller-Hinton agar plates. Nitro-5-hydroxy-8-quinoleine and pipemidic acid inhibited all strains, while furantoin, mandelamine, metronidazole, nalidixic acid, oxolinic acid and trimethoprim proved to be inactive. In addition, various sulphonamides inhibited 59% of the strains tested. Sulphadiazine inhibited 54.1%, sulphafurazole 64.9%, sulphamethizole 64.9%, sulphametoxypyridazine 62.2% and sulphisoxazole 59.5%. Trimethoprim-sulphamethoxazole was effective against 48.6% of the strains due to its sulph component. The sensitivity to sulphonamides varied in accordance with the origin of the strains, those of human origin being generally much more susceptible than those of non-human origin.
Subject(s)
Anti-Bacterial Agents/pharmacology , Mycobacterium/drug effects , Nontuberculous Mycobacteria/drug effects , Sulfonamides/pharmacology , Microbial Sensitivity TestsABSTRACT
A simple, new test to differentiate species in the Mycobacterium fortuitum complex by determining susceptibility to pipemidic acid is described. A 20-mug pipemidic acid disk provides a rapid and reliable means of distinguishing M. fortuitum from M. chelonei.
