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PURPOSE: Although puerperal mastitis is a common disease, published data are poor. Increasing rates of community-acquired MRSA (CA-MRSA) cases are reported in the USA. However, information about common pathogens and CA-MRSA in Germany is still insufficient. The aim of this study was to investigate the most common pathogens of puerperal mastitis in the last decade, its therapy, resistance rate and the effectiveness of the current treatment strategies. METHODS: The pathogens, the respective antibiograms and the treatment strategies of patients treated for puerperal mastits at the University Clinic Magdeburg (Germany) between 2006 and 2016 were retrospectively reviewed. Statistical analysis was performed using SPSS Version 21. RESULTS: In our series, 59 cases with puerperal mastitis were reviewed, 26 (44.1%) of these developed a breast abscess. In 37 of 59 (67.3%) cases the symptoms occurred in the first 8 weeks postpartum. The most common pathogens were Staphylococcus aureus (64.9%) and Coagulase-negative Staphylococcus (13.5%). Methicillin-resistant Staphylococcus aureus (MRSA) was found in one case. Of the 19 cases with Staphylococcus aureus, 17 were resistant to Penicillin. Conservative management was mainly performed with Flucloxacillin (60%), which was successful in most cases. Sixteen of 26 (61.5%) women with abscesses underwent ultrasound (US)-guided needle aspiration. CONCLUSION: In this cohort, MRSA was not a main pathogen responsible for breast abscesses. Conservative treatment strategies remained constant during the observed period and Flucloxacillin was the most frequent antibiotic used. The analysis of the courses of diseases leads to the conclusion that surgical incision is progressively replaced by US-guided needle aspiration.
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Mastitis/tratamiento farmacológico , Trastornos Puerperales/tratamiento farmacológico , Absceso/tratamiento farmacológico , Absceso/microbiología , Adulto , Antibacterianos/uso terapéutico , Femenino , Humanos , Mastitis/microbiología , Trastornos Puerperales/microbiología , Estudios Retrospectivos , Staphylococcus aureus/aislamiento & purificaciónRESUMEN
The article "A Mixed Methods Evaluation of Early Childhood Abuse Prevention Within Evidence-Based Home Visiting Programs", written by M. Matone, K. Kellom, H. Griffis, W. Quarshie, J. Faerber, P. Gierlach, J. Whittaker, D. M. Rubin and P. F. Cronholm, was originally published electronically on the publisher's internet portal (currently SpringerLink) on 31 May 2018 without open access. With the author(s)' decision to opt for Open Choice the copyright of the article changed on 27 July 2018 to
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Objectives In this large scale, mixed methods evaluation, we determined the impact and context of early childhood home visiting on rates of child abuse-related injury. Methods Entropy-balanced and propensity score matched retrospective cohort analysis comparing children of Pennsylvania Nurse-Family Partnership (NFP), Parents As Teachers (PAT), and Early Head Start (EHS) enrollees and children of Pennsylvania Medicaid eligible women from 2008 to 2014. Abuse-related injury episodes were identified in medical assistance claims with ICD-9 codes. Weighted frequencies and logistic regression odds of injury within 24 months are presented. In-depth interviews with staff and clients (n = 150) from 11 programs were analyzed using a modified grounded theory approach. Results The odds of a healthcare encounter for early childhood abuse among clients were significantly greater than comparison children (NFP: 1.32, 95% CI [1.08, 1.62]; PAT: 4.11, 95% CI [1.60, 10.55]; EHS: 3.15, 95% CI [1.41, 7.06]). Qualitative data illustrated the circumstances of and program response to client issues related to child maltreatment, highlighting the role of non-client caregivers. All stakeholders described curricular content aimed at prevention (e.g. positive parenting) with little time dedicated to addressing current or past abuse. Clients who reported a lack of abuse-related content supposed their home visitor's assumption of an absence of risk in their home, but were supportive of the introduction of abuse-related content. Approach, acceptance, and available resources were mediators of successfully addressing abuse. Conclusions for Practice Home visiting aims to prevent child abuse among high-risk families. Adequate home visitor capacity to proactively assess abuse risk, deliver effective preventive curriculum with fidelity to caregivers, and access appropriate resources is necessary.
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Técnicos Medios en Salud/psicología , Maltrato a los Niños/prevención & control , Familia/psicología , Servicios de Atención de Salud a Domicilio/organización & administración , Visita Domiciliaria/estadística & datos numéricos , Responsabilidad Parental/psicología , Padres/educación , Evaluación de Programas y Proyectos de Salud/métodos , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Conducta Materna , Pennsylvania , Investigación Cualitativa , Estudios Retrospectivos , Adulto JovenRESUMEN
Using a combination of top-down lithographic techniques, isolated, individual and oriented multi-wall carbon nanotubes (MWNTs) were grown on nickel or iron nanoscaled dots. In the first step of the process, micron-sized catalytic metallic dots (either iron or nickel) were prepared using UV lithography. MWNTs were then synthesized from these catalysts using a direct current plasma-assistance and hot-filament-enhanced chemical vapor deposition (CVD) reactor. Samples were characterized by means of scanning electron microscopy. It turns out that the splitting up of the micron-sized dot is favored in the iron case and that the surface diffusion of the metal is enhanced using ammonia in the gaseous mixture during the CVD process. The results are discussed giving arguments for the understanding of the MWNT growth mechanism. In a second step, a focused ion beam (FIB) procedure is carried out in order to reduce the initial dot size down to submicronic scale and subsequently to grow one single MWNT per dot. It is found that nickel is most appropriate to control the size of the dot. Dots of size 200 nm +/- 40 nm are then required to grow individual MWNTs.
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The low-temperature surface diffusion of isolated Cr adatoms on Au(111) has been determined using nonperturbing x rays. Changes in the x-ray magnetic circular dichroism spectral line shape together with Monte Carlo calculations demonstrate that adatom nucleation proceeds via quantum tunneling diffusion rather than over-barrier hopping for temperatures <40K. The jump rates are shown to be as much as 35 orders of magnitude higher than that expected for thermal over-barrier hopping at 10 K.