Role of antibiotic treatment after surgical debridement of superficial hand infections in 180 patients.

Considering the rising prevalence of antimicrobial resistance and the lack of recommendations on antibiotic treatment, the present study evaluated the necessity of local and systemic antibiotic therapy in addition to surgical debridement in superficial hand infections. Superficial hand infections were defined as not involving tendons, joints or bone. Data were analyzed for 180 patients, assigned to three study groups according to postoperative antimicrobial treatment. Patients in group I were treated with both systemic and local antibiotics; in group II antimicrobial therapy was limited to local antibiotics in the form of subcutaneous gentamicin bead chains; group III did not receive any antibiotic treatment after surgical debridement. Patients were followed up at two weeks and at three months. Immobilization time and length of stay were longer in group I, but there were no significant differences between the groups in terms of revision rate or recovery of hand function assessed by measurement of finger mobility, grip strength and the Disabilities of the Arm, Shoulder and Hand score at follow-up. Antibiotic treatment of hand infections should be considered carefully and reserved for specific indications: e.g., severe infections and selected patients such as those with diabetes or immunocompromising diseases.

Pathways to maladaptive parenting with mothers and their conduct disordered children.

Maladaptive parenting with conduct disordered children appears to involve two social interaction traps called compliance and inconsistency. A mother's participation in these traps is thought to be influenced by her child, by the quality of the mother's life, and by her perceptions of child behavior. This study was an attempt to assess these influences and to examine their correlations with maternal trap participation. To do so, 33 clinic-referred conduct disordered children and their mothers were evaluated through direct observation, maternal self-reports, and maternal observations of home videotapes depicting mother and child. The data were then analyzed as correlational paths among trap measures and measures of the suspected influences. Results showed the two traps to be distinctly different processes, and inconsistency appeared to represent a more complex process than did compliance. Discussion of the findings centered on problems in maternal care of conduct disordered children and prospects for clinical interventions with these mother-child dyads.