Clonal Structure, Extended-Spectrum ?-Lactamases and Acquired AmpC-Type Cephalosporinases of Escherichia Coli Populations Colonizing Patients in Rehabilitation Centers in Four Countries.

Clonal structure, extended-spectrum ?-lactamases and acquired AmpC-type cephalosporinases of Escherichia coli populations colonizing patients in rehabilitation centers in four countries.

Filed under: Rehab Centers

Antimicrob Agents Chemother. 2012 Oct 31;
Izdebski R, Baraniak A, Fiett J, Adler A, Kazma M, Salomon J, Lawrence C, Rossini A, Salvia A, Vidal Samso J, Fierro J, Paul M, Lerman Y, Malhotra-Kumar S, Lammens C, Goossens H, Hryniewicz W, Brun-Buisson C, Carmeli Y, Gniadkowski M,

The prospective project MOSAR was conducted in five rehabilitation units: BM (France), FS (Italy), GI (Spain), and LH and TA (Israel). Patients were screened for carriage of Enterobacteriaceae resistant to expanded-spectrum cephalosporins (ESCs) from admission until discharge. The aim of this study was to characterize clonal structure, and extended-spectrum ?-lactamases (ESBLs) and acquired AmpC-like cephalosporinases in Escherichia coli populations collected. A total of 376 isolates were randomly selected. The overall number of sequence types (STs) was 76, including seven STs that grouped at least 10 isolates from at least three centers each, namely STs: 10, 38, 69, 131, 405, 410 and 648. These clones comprised 65.2% of all isolates, and ST131 alone – 41.2%. Of 54 STs observed only in one center, some STs played a locally significant role, like ST156 and ST393 in GI or ST372 and ST398 in TA. Among 16 new STs, five arose from the evolution within the ST10 and ST131 clonal complexes. ESBLs and AmpCs accounted for 94.7% and 5.6% of the ESC-hydrolyzing ?-lactamases, respectively, being dominated by the CTX-M-like enzymes (79.9%), followed by SHV (13.5%) and CMY-2 (5.3%) types. CTX-M-15 was the most prevalent ?-lactamase overall (40.6%); other ubiquitous enzymes were CTX-M-14 and CMY-2. Almost none of the common clones correlated strictly with one ?-lactamase; although 58.7% of ST131 isolates produced CTX-M-15, the clone expressed also nine other enzymes. A number of clone variants with specific PFGE and ESBL types were spread in some locales, potentially representing newly emerging E. coli epidemic strains.
HubMed – rehab

 

Personal Resources and Support When Regaining the Ability to Work: An Interview Study with Exhaustion Disorder Patients.

Filed under: Rehab Centers

J Occup Rehabil. 2012 Nov 1;
Norlund S, Fjellman-Wiklund A, Nordin M, Stenlund T, Ahlgren C

Purpose The aim of the study was to explore experiences and thoughts in the process of returning to work in employed patients with Exhaustion Disorder. Methods Twelve patients with Exhaustion Disorder (burnout) who had been referred to a Stress Rehabilitation Clinic were interviewed. All patients were employed but a majority was on full or part-time sick leave. Grounded Theory was used as the qualitative method. Results A core category, regaining the ability to work, was developed. Alongside, two categories, internal resources and the external support system, were experienced as being important to the process. The internal resources were expressed through three key features (sub-categories), perceived validation, insights and adaptive coping abilities. The external support system was diverse and described by the sub-categories practical/structural and/or emotional support. Four external support actors were identified; the workplace, health care, the Social Insurance Agency, and the union. The supervisor was described as the most important external actor. Conclusions Internal and external resources are intertwined in the process of regaining the ability to work. The internal resources and external support can directly increase the probability to regain the ability to work. Moreover, these resources can affect each other and thus indirectly have an effect on the process.
HubMed – rehab

 

Comorbidities of asthma: current knowledge and future research needs.

Filed under: Rehab Centers

Curr Opin Pulm Med. 2012 Oct 30;
Cazzola M, Segreti A, Calzetta L, Rogliani P

PURPOSE OF REVIEW: Asthma is often associated with different comorbidities, mainly gastro-oesophageal reflux disease and allergic rhinitis, but also obesity, depression, diabetes mellitus and cardiovascular disease, which may affect its clinical intensity and severity. The prevalence of these comorbidities varies tremendously between studies. Nevertheless, it imposes a significant reflection on the need to explore the phenomenon in depth. RECENT FINDINGS: Both clinical and basic studies have established that inflammation plays a vital role in the initiation and progression of several comorbidities. However, the role of systemic inflammation in asthma is still unclear. Understanding mechanism(s) that link(s) asthma and its comorbid diseases is essential to design an effective therapeutic approach. SUMMARY: In the future, researchers must identify the weight of any comorbidity in patients with asthma, find the true mechanism(s) that link(s) it to asthma and act on these mechanisms that probably create a vicious circle. Conversely, we do not think it reasonable that the generalization of treatment with a holistic approach might affect the link(s) between asthma and its comorbidities.
HubMed – rehab

 

Increased 1-year mortality rates among elderly hip fracture patients with atrial fibrillation.

Filed under: Rehab Centers

Aging Clin Exp Res. 2012 Jun; 24(3): 233-8
Adunsky A, Arad M, Koren-Morag N, Fleissig Y, Mizrahi EH

Prediction of factors associated with survival following hip fracture is important. We studied crude and adjusted survival rates in elderly hip fracture patients with and without atrial fibrillation (AF) to assess possible risk of death associated with AF.A historical prospective cohort study, comprising 1114 consecutive patients with hip fractures. Subjects were divided into three groups: patients with sinus rhythm (SR), paroxysmal atrial fibrillation (PAF) or chronic atrial fibrillation (CAF). The main outcome measures were crude and adjusted survival rates at 30, 90 and 365 days, and end of follow-up.AF patients differed from SR patients by gender (p=0.0018), age (p=0.008), heart failure (p<0.001), ischemic heart disease (p<0.001) and history of a stroke (p<0.001). The lowest death rates were observed among SR and PAF patients, whereas CAF patients had the highest rates at each follow-up time point. CAF (but not PAF or SR) patients were at a significantly higher risk of death at both 365 days and at the end of the study (HR 1.786, CI 1.011- 3.155 and HR 1.835, CI 1.302-2.585, respectively). Older age (HR 1.301, CI 1.135-1.491 and HR 1.321, CI 1.321-1.415) and male gender (HR 1.879, CI 1.271- 2.779 and HR 1.545, CI 1.251-1.909) also predicted higher risk of death at both 365 days and at the end of the study.Atrial fibrillation cannot be considered to adversely affect short-term survival of hip fracture patients. After 365 day, CAF was associated with a significantly higher risk of death. HubMed – rehab

 

 

Christian Rehab Centers Are A Wonderful Choice For People Looking To Overcome Addiction – wwww.transformationstreatment.com Christian rehab and traditional rehab can go hand in hand due to the great need for spirituality in the life of an addict or alcoholic. A loving higher power is the key to being successful in one’s recovery. Combined with the 12 steps of AA or NA which have worked for millions of people, a loving God brings new meaning to one’s life and recovery.

 

Find More Rehab Centers Information…