Of 176 urine isolates from female students positive for Escherichia coli, 29.6% were trimethoprim-sulfamethoxazole resistant and none were nitrofurantoin resistant. Among students with a history of urinary tract infection (UTI) (n ‫؍‬ 119), resistance to ciprofloxacin was 11.8%, compared to 1.8% among those without prior UTI. Nitrofurantoin should be considered for empirical therapy of lower tract UTI.Urinary tract infections (UTIs) are a common cause of morbidity in women (7). The majority of cases involve only the lower urinary tract, and the most common pathogen is Escherichia coli (9, 21). For uncomplicated infections, especially those without signs of upper tract infection, empirical therapy without culture and susceptibility analysis are recommended (3,4,19). Resistance to amoxicillin has been established for years, and resistance to trimethoprim-sulfamethoxazole (TMP-SMX) has emerged more recently, with rates of Ͼ20% in some areas (9). The Infectious Diseases Society of America recommends that in regions where resistance rates to TMP-SMX exceed 10% to 20%, TMP-SMX should not be used for empirical therapy (19). Fluoroquinolones, in particular ciprofloxacin, are used increasingly (10, 11), but resistance to ciprofloxacin is also increasing (12,15).College women have a high incidence of uncomplicated UTIs and are frequently treated empirically. Unfortunately, since studies of resistance patterns include mostly complicated UTIs in older women (9, 21), resistance may develop undetected among college students with lower tract UTIs.The objective of this analysis was to determine resistance patterns among E. coli isolates from young women with UTIs in a college setting in the southeastern United States.All urine isolates in this study were processed at the Duke University Clinical Microbiology Laboratory. The records of female students presenting to a university student health clinic with symptoms of UTI and who had urine culture and sensitivity results positive for E. coli were examined retrospectively. The susceptibilities to common antibiotics were analyzed and compared to those for all urinary E. coli isolates, as described in the antibiogram of the health system clinical microbiology laboratory. The clinical records were analyzed for the following variables: age, presence of a urinary anomaly, presence of upper UTI symptoms (fever or flank pain), and history of previous UTI.Statistical analysis was performed using the chi-square test and the Fisher exact test for dichotomous variables.Over the three calendar years 2005 to 2007, in the entire health system, there were 10,289 urinary isolates positive for E. coli, which were analyzed for antibiotic susceptibilities. One hundred seventy-six isolates of culture-positive UTI were obtained from 167 female patients presenting to the student health clinic. The average age (Ϯ standard deviation) was 22.0 (Ϯ6.2) years. Ampicillin resistance occurred in 3,857 (37.5%) of the health system isolates and 65 (37%) of the students (P ϭ 0.88). TMP-SMX resistance occurred in 2...

BackgroundStructured preoperative assessment has been reported to improve operating room efficiency as measured by metrics such as day of surgery cancellations (DOSCs). However, not all patients require comprehensive assessment; routine full assessments can result in unnecessary duplication of tests and investigations. Selective nurse screening under the supervision of anesthesiology may provide adequate information gathering in lower risk patients. This study is undertaken to assess if DOSC rates vary with different assessment processes.MethodsAt a single academic tertiary care hospital, from Jan 2 to May 31, 2013, the consecutive patients undergoing comprehensive preoperative assessment (CPA) and nurse screening (NS), as well as the patients not assessed by the anesthesiology-supervised preoperative process, were followed for the occurrence and reason for DOSC. The operating room schedule of all elective surgery patients was analyzed to allow calculation of rates of DOSCs. Reasons for cancellations were documented as one of ten structured reasons by preoperative holding area clerical staff.ResultsOverall, there were 14,893 elective surgery patients in this time period, with 183 DOSCs, giving a rate of 1.23 % (95 % CI 1.06, 1.42). Patients who received CPA numbered 5980; 29 of them had a DOSC, giving a rate of 0.48 % (95 % CI 0.33–0.70) (P < 0.0001 vs. no assessment). Patients receiving NS numbered 1840; 11 of them had a DOSC, giving a rate of 0.60 % (95 % CI 0.30–1.10) (P < 0.0001 vs. no assessment). The most common reason for cancellation was new medical condition.ConclusionsA very low DOSC rate can be achieved with a comprehensive preoperative process where some patients are selectively telephone screened by nurses, with complete assessment deferred to the anesthesiologist on the day of surgery.

Study Design:Single group test-retest repeated measures. Objectives: To determine the effects of lumbar traction with 3 different amounts of force (1 0%, 30% and 60% body weight) on pain-free mobility of the lower extremity as measured by the straight leg raise (SLR) test. Background: There are several recommendations on how lumbar traction should be performed, but the duration, frequency, force, and type of technique to be applied differ among the sources. Methods and Measures:Ten subjects with subjective complaints of low back pain or radicular symptoms with a positive unilateral SLR test below 45' participated in this study. The pain-free mobility of the lower extremity in the SLR test position was measured prior to and immediately following 5 minutes of static traction in the supine position. Random assignment in the order of the amount of applied traction was implemented. Results: The straight leg raise measurements were found to be significantly greater immediately following 30% and 60% of body weight traction as compared to pretraction and 10% of body weight traction. The mean (SD) SLR measurements were pretraction (24.1' 2 13.0), 10% of body weight traction (27.4' 2 14.5), 30% of body weight traction (34.0" 2 14.3), 60% of body weight traction (36.5" 2 15.8). Conclusions:The results of this study indicate that traction in this group of patients improved the mobility of the lower extremity during the SLR test. Both 30% and 60% of body weight tractions were shown to be effective for increasing motion beyond pretraction levels. / Orthop Sports Phys Ther 2000;30:595-601.

Normative data for cardinal plane movements of the lumbar spine provide therapists with a baseline for assessing spinal mobility of children of these ages.