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1.
Arch Phys Med Rehabil ; 105(1): 150-156, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37364686

RESUMO

OBJECTIVE: To investigate the rate of registered protocols published as research papers as a measure of publication bias, and the concordance rates of the primary outcomes between research protocol and published papers as a measure of selective outcome reporting bias in randomized controlled trials (RCTs) related to rehabilitation. DATA SOURCES: Protocols related to RCTs were extracted from electronic databases, the University Hospital Medical Information Network (UMIN), International Standard Research Clinical Trial Number (ISRCTN), ClinicalTrials.gov, and MEDLINE. Published papers were retrieved from MEDLINE. STUDY SELECTION: The inclusion criteria were as follows: (1) initial registration (UMIN, ISRCTN, ClinicalTrials.gov) within the designated period; (2) published as a paper from a research protocol in MEDLINE (PubMed); and (3) written in English or Japanese. The search period was from January 1, 2013, to December 31, 2020. DATA EXTRACTION: The outcome of this study was set as the rate of published papers that were consistent with the extracted research protocol and the concordance rate between the primary outcomes in published papers and in protocols. The concordance rate of the primary outcomes was evaluated by checking whether the description in the research protocol matched that in the paper's abstract and main text. DATA SYNTHESIS: Out of the 5597 research protocols registered, only 727 were published (13.0%). The concordance rates of the primary outcomes were 48.7% and 72.6% in the abstract and main text, respectively. CONCLUSIONS: This study revealed major discrepancies between the number of research protocols and published papers, and difference of description regarding the primary outcomes in published papers which were already defined in the research protocols.


Assuntos
Viés de Publicação , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
BMC Med Inform Decis Mak ; 23(1): 135, 2023 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-37488562

RESUMO

BACKGROUND: Evidence-based medicine education has not focused on how clinicians involve patients in decision-making. Although shared decision-making (SDM) has been investigated to address this issue, there are insufficient data on SDM in physiotherapy. This study aimed to clarify the issues concerning patient involvement in Japan, and to examine whether SDM is related to perceptions of patient involvement in decision-making. METHODS: The study participants were recruited from among acute and sub-acute inpatients and community residents receiving physiotherapy outpatient care, day care, and/or home rehabilitation. The Control Preference Scale (CPS) was used to measure the patients' involvement in decision-making. The nine-item Shared Decision-Making Questionnaire (SDM-Q-9) was used to measure SDM. In analysis I, we calculated the weighted kappa coefficient to examine the congruence in the CPS between the patients' actual and preferred roles. In analysis II, we conducted a logistic regression analysis using two models to examine the factors of patient involvement. RESULTS: Analysis I included 277 patients. The patients' actual roles were as follows: most active (4.0%), active (10.8%), collaborative (24.6%), passive (35.0%), and most passive (25.6%). Their preferred roles were: most active (3.3%), active (18.4%), collaborative (39.4%), passive (24.5%), and most passive (14.4%). The congruence between actual and preferred roles by the kappa coefficient was 0.38. Analysis II included 218 patients. The factors for patient involvement were the clinical environment, the patient's preferred role, and the SDM-Q-9 score. CONCLUSIONS: The patients in Japan indicated a low level of decision-making involvement in physiotherapy. The patients wanted more active involvement than that required in the actual decision-making methods. The physiotherapist's practice of SDM was revealed as one of the factors related to perceptions of patient involvement in decision-making. Our results demonstrated the importance of using SDM for patient involvement in physiotherapy.


Assuntos
Participação do Paciente , Modalidades de Fisioterapia , Humanos , Estudos Transversais , Japão , Medicina Baseada em Evidências
3.
J Phys Ther Sci ; 34(6): 445-453, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35698556

RESUMO

[Purpose] This study aimed to investigate the influence of the evidence practice gap on physiotherapist and occupational therapists through shared decision making using the clinical practice guidelines. [Participants and Methods] A randomized controlled trial was used. The participants included 126 therapists from three institutions. The inclusion criteria was permanent employment in these institutions. Participants' characteristics were masked from the allocator, evaluator, and analyzer. For the intervention group, a workshop on shared decision making was conducted using clinical practice guidelines. Two control groups were set. One group received a lecture on the knowledge of clinical practice guidelines, and the other group received a lecture on the knowledge of shared decision making. The primary outcomes were "education, attitudes and beliefs, and interest and perceived role in evidence-based practice" scale. [Results] The primary outcomes showed a significant difference between the clinical practice guidelines with shared decision making group and the clinical practice guidelines group (mean ± standard deviation, pre/post; clinical practice guidelines with shared decision making group, 2.4 ± 0.9/4.4 ± 1.7; clinical practice guidelines group, 3.0 ± 1.5/3.5 ± 2.0; shared decision making group, 2.6 ± 1.2/ 3.3 ± 1.8). [Conclusion] Shared decision making education using the clinical practice guidelines improves evidence-based practice of self-efficacy in physiotherapists and occupational therapists.

4.
Int J Clin Oncol ; 24(2): 211-221, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30145745

RESUMO

BACKGROUND: To examine the effect of rehabilitation on postoperative pulmonary complication when it is conducted in combination of both before and after lung cancer surgery, as compared with either before or after surgery and no rehabilitation. METHODS: A retrospective cohort study was conducted to examine the effect of rehabilitation before and after lung cancer surgery on the causes of postoperative pneumonia. Data were collected from the diagnosis procedure combination (DPC) database. Patients admitted who received operative treatment for a new primary (ICD codes: C34) were selected. The inclusion criteria were patients who had pneumonectomy, malignant tumor surgery for the lung (thoracotomy), or thoracoscopic surgery (endoscopic; treatment code: K511-00, K513-00~03, and K514-00, 02). The exclusion criteria were patients who had a lung transplantation (treatment code: K514-03~06), suspected diagnosis, and a pneumonia within 3 months before being diagnosed as having lung cancer. Main outcome was onset of postoperative pneumonia. RESULTS: Among 76,739 lung cancer patients, 15,146 who underwent lung cancer surgery were included in the analysis. In the combination of pre- and postoperative group, as compared with the preoperative [odds ratio (OR), 95% confidence interval (CI) 2.8, 1.8-4.4], postoperative (1.9, 1.6-2.3), and no rehabilitation group (2.5, 2.1-2.8), the onset of pneumonia was less frequent. CONCLUSIONS: Combination of preoperative and postoperative rehabilitations significantly prevents postoperative pneumonia as compared with having preoperative, postoperative, or no rehabilitation.


Assuntos
Bases de Dados Factuais , Neoplasias Pulmonares/cirurgia , Pneumonectomia/efeitos adversos , Pneumonia/reabilitação , Complicações Pós-Operatórias/reabilitação , Toracotomia/efeitos adversos , Idoso , Feminino , Humanos , Japão , Neoplasias Pulmonares/diagnóstico , Masculino , Pneumonia/etiologia , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
5.
Int J Qual Health Care ; 31(10): G139-G145, 2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31728518

RESUMO

PURPOSE: To examine the update status of clinical practice guidelines (CPGs) for 24 main diseases in Japan, and to clarify the quality of and issues pertaining to the most recent versions of CPGs for each disease. DATA SOURCES: CPGs were searched in two Japanese guideline databases. STUDY SELECTION: All relevant Japanese CPGs published between January 1999 and July 2016 were selected. DATA EXTRACTION: The developer and issue date were extracted for all target CPGs. The most recent CPGs were assessed using the Appraisal of Guidelines for Research and Evaluation-II (AGREE II) instrument. RESULTS OF DATA SYNTHESIS: Among 106 target CPGs, 24 most recent CPGs were subjected to assessment using the AGREE II instrument. CPGs for 11 diseases (46%) had a mean time interval for update of ≥5 years. Among the 24 CPGs subjected to AGREE II assessment, median domain scores were 74% for "Domain 1: Scope and Purpose," 43% for "Domain 2: Stakeholder Involvement," 46% for "Domain 3: Rigor of Development," 69% for "Domain 4: Clarity of Presentation," 24% for "Domain 5: Applicability" and 27% for "Domain 6: Editorial Independence." CONCLUSIONS: The systematic assessment of CPGs for 24 major diseases in Japan revealed a trend for a delay in timing of update for many CPGs. Moreover, the 24 most recent CPGs had low domain scores for domains 2, 3, 5 and 6. In the future, concrete measures will need to be considered in order to improve the quality of CPGs.


Assuntos
Medicina Baseada em Evidências , Guias como Assunto/normas , Humanos , Japão , Garantia da Qualidade dos Cuidados de Saúde/métodos
6.
J Phys Ther Sci ; 31(5): 429-434, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31164780

RESUMO

[Purpose] To investigate how well rehabilitation is described in Japanese clinical practice guidelines of various diseases or disorders requiring rehabilitation. [Participants and Methods] Clinical practice guidelines were extracted from the MINDS database (Japan Council for Quality Health Care). Japanese clinical practice guidelines of specific diseases or disorders requiring rehabilitation were included. The exclusion criteria were clinical practice guidelines on the procedure, symptoms, and/or medical examination. To select the clinical practice guidelines of diseases or disorders requiring rehabilitation, eight participants evaluated the need for rehabilitation for the disease or disorder through the modified Delphi method. They graded the necessity of rehabilitation from 1 to 9 (1, completely disagree; 9, completely agree). The clinical practice guidelines that had grades 7 or higher as the median were included in the analyses. Systematic reviews were compiled as an indicator of the extent to which rehabilitation is described in clinical practice guidelines. [Results] Forty-four clinical practice guidelines were selected, and 26 (59.1%) included descriptions of rehabilitation. There were 443 existing systematic reviews related to rehabilitation for each disease or disorder enrolled in the present study and 67 (15.1%) systematic reviews quoted in those guidelines. [Conclusion] Rehabilitation was not well described in the clinical practice guidelines of the diseases or disorders that require rehabilitation.

7.
Phys Chem Chem Phys ; 20(20): 13974-13982, 2018 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-29744493

RESUMO

Reactions of the free tantalum cation, Ta+, and tantalum cluster cations, Tan+ (n = 2-10), with ammonia are presented. The reaction of the monomer cation, Ta+, with two molecules of NH3 leads to the formation of TaN2H2+ along with release of two H2 molecules. The dehydrogenation occurs until the formal oxidation number of the tantalum atom reaches +5. On the other hand, all the tantalum cluster cations, Tan+, react with two molecules of NH3 and form TanN2+ with the release of three H2 molecules. Further exposure to ammonia showed that TanNmH+ and TanNm+ are produced through successive reactions; a pure nitride and three H2 molecules are formed for every other NH3 molecule. The nitridation occurred until the formal oxidation number of the tantalum atoms reaches +5 as in the case of TaN2H2+ in contrast to other group 5 elements, i.e., vanadium and niobium, which have been reported to produce nitrides with lower oxidation states. The present results on small gas-phase metal-nitride clusters show correlation with their bulk properties: tantalum is known to form bulk nitrides in the oxidation states of either +5 (Ta3N5) or +3 (TaN), whereas vanadium and niobium form nitrides in the oxidation state of +3 (VN and NbN). Along with DFT calculations, these findings reveal that nitridation is driven by the electron-donating ability of group 5 elements, i.e., electronegativity of the metal plays a key role in determining the composition of the metal nitrides.

8.
J Phys Ther Sci ; 29(2): 198-208, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28265139

RESUMO

[Purpose] This study aimed to investigate Japanese physical therapists' attitudes of evidence-based practice and clinical practice guidelines. [Subjects and Methods] In 2014, a cross-sectional postal mail survey using a self-administered questionnaire was conducted. Of 2,982 physical therapists belonging to the Chiba Prefecture Physical Therapist Association, 1,000 were randomly selected. The questionnaire comprised 42 items pertaining to the attitudes of and behavior toward evidence-based practice and clinical practice guidelines. It was investigated to reveal the relationship between clinical practice guidelines/evidence-based practice and therapist characteristics. [Results] The response rate was 39.6%, and 384 questionnaires were available. The main results were as follows: 83.3% participants agreed to the importance of evidence-based practice, 77.1% agree to that evidence-based practice supports clinical decision of physical therapists, and about 11% agreed to have been educated about evidence-based practice. Then, 29.2% used, 54.9% agreed to the importance of, and 13.3% agreed to the utility of clinical practice guidelines. An important factor related mostly to a positive attitude, knowledge and behavior of evidence-based practice and clinical practice guidelines was participating in research activities. [Conclusion] Many of physical therapists do not use and understand the importance of clinical practice guidelines. Participating in research activities may partially contribute to improving these conditions.

9.
J Phys Ther Sci ; 28(4): 1307-11, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27190473

RESUMO

[Purpose] The purpose of this study was to elucidate how well patients' perceptions related to the improvements in their hand function during hospitalization. [Subjects] Sixteen patients who were hospitalized after hand surgery. [Methods] Using the Japanese Society for Surgery of the Hand edition of the Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire; tactile roughness discrimination acuity, motor imagery, motor function, sensory function, and pain of the upper limb were assessed at admission and discharge. Spearman's rank-order correlation coefficients were calculated using the differences in all assessment items at admission and discharge. A multiple regression analysis (stepwise method) was performed to investigate factors that correlated with improvements in Quick-Disabilities of the Arm, Shoulder, and Hand scores. [Results] The improvement of tactile roughness discrimination acuity was significantly associated with patient perception of improved hand function. [Conclusion] The results suggest that an improvement in tactile roughness discrimination acuity was most strongly correlated with patient perception of improved hand function.

10.
J Phys Ther Sci ; 27(9): 3003-5, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26504345

RESUMO

[Purpose] The purpose of this study was to investigate the degree of collaboration between practitioners and researchers through research papers related to the implementation of electrical stimulation (ES) for stroke patients. [Methods] A systematic review of the literature was conducted to collect data from ES studies published before January 7, 2015. Five databases were searched for search terms related to stroke and ES. Inclusion criteria were original papers that reported on ES of the upper or lower limbs following stroke, after the exclusion of case reports, brain stimulation studies, and papers written in any languages other than English or Japanese. The outcome was the prevalence of research papers that included a practitioner as an author, that included a practitioner as an author or in the acknowledgements, and in which the practitioner was the first author. [Results] Based on the selection criteria, 165 papers were included in the final analysis. The prevalence of papers in which a practitioner was included as an author was 39%. The prevalence of papers in which a practitioner was included as an author or in the acknowledgements was 50%. A practitioner was the first author of 34% of the papers. [Conclusion] Collaboration on research papers related to ES for stroke patients is limited.

11.
Diagnostics (Basel) ; 14(4)2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38396473

RESUMO

The binocular Esterman visual field test (EVFT) of 120 points was the first method to quantify the defects in the binocular visual field. It is used in many parts of the world as a standard test to determine whether an individual has the visual capabilities to drive safely. In Japan, it is required for the grading and issuance of visual disability certificates. The purpose of this study was to determine the reliability of the EVFT results. We studied 104 patients who had undergone the binocular EVFT at Mie University Hospital. Their mean age was 68.0 ± 11.4 years, and the best-corrected visual acuity of the better eye was 0.18 ± 0.38 logMAR units. The EVFT was performed twice on the same day, and the results of the first and second tests were compared. The mean Esterman scores for the first and second test were 89.3 ± 30.5 and 89.1 ± 30.2, respectively, and the test times were 338.9 ± 86.8 and 336.7 ± 76.4 s, respectively. The differences were not significant (p = 0.69 and p = 0.33). In the Bland-Altman analyses (second-first test) of the Esterman scores, the mean difference was 0.38 without significant fixed errors (p = 0.20) or proportional errors (p = 0.27). The limits of agreement within the 1.96 standard deviation were -8.96 to +9.45 points. The agreement rate for the most peripheral 24 test points was significantly lower than the agreement rate for the other 96 test points (p < 0.01). The agreement rate of the upper visual field was significantly lower than that of the lower field (p < 0.01). The overall reliability rate of the EVFT is acceptable, but the peripheral and upper test points have relatively low reliability rates. These findings are important for interpretations of the EVFT results.

12.
Emerg Infect Dis ; 18(11): 1882-5, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23092603

RESUMO

A population-based influenza surveillance study (using PCR virus subtyping) on Izu-Oshima Island, Japan, found that the cumulative incidence of influenza A(H1N1)pdm09 virus infections 2 seasons after the pandemic was highest for those 10-14 years of age (43.1%). No postpandemic A(H1N1)pdm09 case-patients had been infected with A(H1N1)pdm09 virus during the pandemic season.


Assuntos
Influenza Humana/epidemiologia , Orthomyxoviridae/genética , Pandemias , Adolescente , Criança , Pré-Escolar , Humanos , Incidência , Vírus da Influenza A Subtipo H1N1/genética , Influenza Humana/virologia , Ilhas , Japão/epidemiologia , Orthomyxoviridae/classificação , Vigilância da População , Estudos Retrospectivos , Estações do Ano , Adulto Jovem
13.
Antimicrob Agents Chemother ; 56(12): 6389-92, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23006756

RESUMO

Five VanN-type vancomycin-resistant Enterococcus faecium strains were isolated from a sample of domestic chicken meat in Japan. All isolates showed low-level resistance to vancomycin (MIC, 12 mg/liter) and had the same pulsed-field gel electrophoresis profile. The vancomycin resistance was encoded on a large plasmid (160 kbp) and was expressed constitutively. The VanN-type resistance operon was identical to the first resistance operon to be reported, with the exception of a 1-bp deletion in vanT(N) and a 1-bp substitution in vanS(N).


Assuntos
Galinhas/fisiologia , Enterococcus faecium/efeitos dos fármacos , Carne/microbiologia , Resistência a Vancomicina/fisiologia , Animais , Primers do DNA , Bases de Dados Genéticas , Eletroforese em Gel de Campo Pulsado , Regulação Bacteriana da Expressão Gênica/genética , Japão , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Tipagem de Sequências Multilocus , Óperon , Plasmídeos/genética , Vancomicina
14.
PLoS One ; 17(12): e0274659, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36584097

RESUMO

In the research literature on factors associated with gallstones, large population-based cohort studies are rare. We carried out a study of this type to explore risk factors for the onset of gallstones. This study included Japanese participants aged 40-107 years who were followed prospectively from January 2012 to September 2020 using a dataset composed of two individually linked databases, one containing annual health checkup records and the other containing medical claims for beneficiaries of the National Health Insurance System and the Medical Care System for Elderly in the Latter Stage of Life in Shizuoka Prefecture, Japan. Among the 611,930 participants in the analysis set, 23,843 (3.9%) were diagnosed with gallstones during the observational period (median [max]: 5.68 [7.5] years). Multivariate analysis revealed that risk of gallstone disease was increased by male sex, cerebrovascular disease, any malignancy, dementia, rheumatic disease, chronic pulmonary disease, hypertension, and H. pylori-infected gastritis. These findings provide essential insights into the etiology of cholelithiasis and may contribute to efforts to reduce the incidence of the disease.


Assuntos
Cálculos Biliares , Hipertensão , Idoso , Humanos , Masculino , Cálculos Biliares/complicações , Cálculos Biliares/epidemiologia , Estudos de Coortes , Japão/epidemiologia , Fatores de Risco
15.
J Cardiol ; 76(2): 177-183, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32199753

RESUMO

BACKGROUND: Although recent attention to palliative care for patients with cardiovascular diseases has been increasing, there are no specific recommendations on detailed palliative care practices. We proceed on a discussion of the appropriateness and applicability of potential quality indicators for acute cardiovascular diseases according to our previous systematic review. METHODS: We created a multidisciplinary panel of 20 team members and 7 external validation clinicians composed of clinical cardiologists, a nutritionist, a physiotherapist, a clinical psychologist, a critical and emergent care specialist, a catheterization specialist, a primary care specialist, a palliative care specialist, and nurses. After crafting potential indicators, we performed a Delphi rating, ranging from "1 = minimum" to "9 = maximum". The criterion for the adoption of candidate indicators was set at a total mean score of seven or more. Finally, we subcategorized these indicators into several domains by using exploratory factor analysis. RESULTS: Sixteen of the panel members (80%) were men (age, 49.5 ± 13.7 years old). Among the initial 32 indicators, consensus was initially reached on total 23 indicators (71.8%), which were then summarized into 21 measures by selecting relatively feasible time variations. The major domains were "symptom palliation" and "supporting the decision-making process". Factor analysis could not find optimal model. Narratively-developed seven sub-categories included "presence of palliative care team", "patient-family relationship", "multidisciplinary team approach", "policy of approaching patients", "symptom screening and management", "presence of ethical review board", "collecting and providing information for decision-maker", and "determination of treatment strategy and the sharing of the care team's decision". CONCLUSION: In this study we developed 21 quality indicators, which were categorized into 2 major domains and 7 sub-categories. These indicators might be useful for many healthcare providers in the initiation and enhancement of palliative care practices for acute cardiovascular diseases in Japan.


Assuntos
Doenças Cardiovasculares/terapia , Cuidados Paliativos/normas , Indicadores de Qualidade em Assistência à Saúde , Adulto , Consenso , Técnica Delphi , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade
16.
Phys Rev E Stat Nonlin Soft Matter Phys ; 80(1 Pt 2): 015304, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19658762

RESUMO

We report a deformation phenomenon occurring at the interface between two immiscible liquids. The two liquids are in a cylindrical container and set into motion by a rotating lid positioned above the interface. The upper liquid is more viscous than the lower and the difference in densities between the liquids is fairly small. As the rotational speed of the lid (Omega) is increased in small increments, the center of the interface rises and the height increases. Depending on Omega , the topology of the interface changes drastically. The shape of the interface depends strongly on Omega and also the volume fraction of the liquids. Some dynamical behavior of the interface accompanies the changes in topology: interfacial waves, the generation of droplets, and interfacial instability.

17.
Microb Drug Resist ; 25(6): 915-924, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30897025

RESUMO

We investigated the prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among 356 residents of nine long-term care facilities (LTCFs) in Japan during 2015 and 2017. In total, 800 specimens were tested and 39 MRSA isolates were recovered from 31 (8.71%) residents. PCR-based open reading frame typing (POT) and pulsed-field gel electrophoresis typing were performed for the 39 MRSA isolates; five of them showing identical pulsotypes, and POT scores were excluded in further analysis. Staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing, and toxin gene detection were performed for one representative MRSA isolate per resident. Among the 34 unrelated MRSA isolates, 15 (44.1%) and 19 (55.9%) were of SCCmec types II and IV, respectively, and belonged to seven sequence types (STs). Among the 15 SCCmec II isolates, 11 (73.3%), 3, and 1 belonged to ST764 (clonal complex [CC]5), ST5 (CC5), and ST630 (CC8), respectively. Among the 19 SCCmec IV isolates, 13 (68.4%), 3, 2, and 1 belonged to ST1 (CC1), ST474 (CC1), ST8 (CC8), and ST380 (CC8), respectively. Among the 14 CC5 lineage-SCCmec II isolates, one ST5 isolate and 7 of the 11 ST764 isolates (63.6%) carried seb gene, and 14 (87.5%) of 16 CC1 lineage-SCCmec IV isolates had sea gene (p < 0.05). The results indicate that the seb-positive SCCmec type II-ST764 clone has spread in Japanese LTCF environments. As LTCF residents have multiple comorbidities and increased susceptibility to infections, it is necessary to monitor MRSA colonization in LTCFs through periodic screening to prevent dissemination.


Assuntos
Antibacterianos/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Meticilina/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Idoso , Povo Asiático , Toxinas Bacterianas/genética , Cromossomos Bacterianos/genética , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , DNA Bacteriano/genética , Exotoxinas/genética , Genótipo , Humanos , Staphylococcus aureus Resistente à Meticilina/genética , Testes de Sensibilidade Microbiana/métodos , Tipagem de Sequências Multilocus/métodos , Fatores de Virulência/genética
18.
Antimicrob Agents Chemother ; 52(10): 3795-800, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18694945

RESUMO

The mutation frequency for carbapenem resistance in Pseudomonas aeruginosa strains that were selected with carbapenems was enhanced in the presence of subinhibitory concentrations of fluoroquinolones. The mutants showed either a loss of OprD activity or increased mexAB-oprM expression. The highest mutant isolation frequency was obtained by selection with meropenem, while doripenem inhibited mutant growth.


Assuntos
Carbapenêmicos/farmacologia , Fluoroquinolonas/farmacologia , Mutação/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/genética , Tienamicinas/farmacologia , Resistência beta-Lactâmica/genética , Sequência de Bases , Primers do DNA/genética , DNA Bacteriano/genética , Doripenem , Genes Bacterianos/efeitos dos fármacos , Humanos , Técnicas In Vitro , Meropeném , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação
19.
Microb Drug Resist ; 24(10): 1513-1520, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29791251

RESUMO

We investigated the prevalence and characteristics of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli among 258 residents of long-term care facilities (LTCFs) in Japan. Out of 258 fecal samples collected from nine LTCFs between November 2015 and March 2017, we recovered 59 ESBL-producing E. coli isolates. All isolates carried blaCTX-M genes, mainly blaCTX-M-27 (42.4%), blaCTX-M-14 (23.7%), and blaCTX-M-15 (18.6%). The isolates showed 7 serotypes (STs), including ST131 (n = 49, 83.1%) and ST38 (n = 4, 6.8%), and 47 (79.7%) out of 49 isolates belonging to ST131 were identified as H30R. The 59 ESBL producers were divided into four groups, B2 (86.4%), D (8.5%), A (3.4%), and C (1.7%); 44 (74.6%) were epidemic clone B2-O25-ST131 H30R, of which 21, 11, and 6 harbored blaCTX-M-27, blaCTX-M-15, and blaCTX-M-14, respectively. Most plasmids were of IncF replicon types (n = 33), and 22 blaCTX-M-27-carrying plasmids showed multiple replicon types, including IncFII, FIA, and FIB. The ESBL producers were susceptible to imipenem, amikacin, and fosfomycin, but resistant to ceftazidime (49.2%), and ciprofloxacin (88.1%); in particular, the isolates harboring the blaCTX-M-15 gene showed significantly high resistance rate to ceftazidime (p < 0.01). Our findings indicate that a considerable proportion of the examined LTCF residents carried ESBL-producing E. coli isolates in feces and had high prevalence of epidemic clone B2-O25-ST131. Furthermore, continuous investigations would be very necessary to monitor actual carriage states of ESBL-producers among the LTCF residents from the viewpoint of both public health and healthcare viewpoints.


Assuntos
Antibacterianos/farmacologia , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli/genética , Escherichia coli/isolamento & purificação , beta-Lactamases/genética , Idoso , Idoso de 80 Anos ou mais , Escherichia coli/enzimologia , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Feminino , Humanos , Japão/epidemiologia , Assistência de Longa Duração , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Plasmídeos , Prevalência , Resistência beta-Lactâmica
20.
Front Behav Neurosci ; 11: 173, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28979197

RESUMO

The parietal operculum (PO) often shows ipsilateral activation during tactile object perception in neuroimaging experiments. However, the relative contribution of the PO to tactile judgment remains unclear. Here, we examined the effect of transcranial direct current stimulation (tDCS) over bilateral PO to test the relative contributions of the ipsilateral PO to tactile object processing. Ten healthy adults participated in this study, which had a double-blind, sham-controlled, cross-over design. Participants discriminated grating orientation during three tDCS and sham conditions. In the dual-hemisphere tDCS conditions, anodal and cathodal electrodes were placed over the left and right PO. In the uni-hemisphere tDCS condition, anodal and cathodal electrodes were applied over the left PO and contralateral orbit, respectively. In the tDCS and sham conditions, we applied 2 mA for 15 min and for 15 s, respectively. Computational models of electric fields (EFs) during tDCS indicated that the strongest electric fields were located in regions in and around the PO. Compared with the sham condition, dual-hemisphere tDCS improved the discrimination threshold of the index finger contralateral to the anodal electrode. Importantly, dual-hemisphere tDCS with the anodal electrode over the left PO yielded a decreased threshold in the right finger compared with the uni-hemisphere tDCS condition. These results suggest that the ipsilateral PO inhibits tactile processing of grating orientation, indicating interhemispheric inhibition (IHI) of the PO.

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