Cost-effective clinical microbiology.
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Bacteriological Techniques↗
Biomedical subjects
J Nyiendo
Publications and source records attributed to J Nyiendo.
Reproducibility of biotypes using enterotubes.
Using both stock and clinical isolates, the Enterotube system was examined for reproducibility of its biotype identification. Fifty stock strains of Enterobacteriaceae were tested on each of 22 separate days (interrun evaluation), and ten Enterotubes per strain were inoculated from one subculture (intrarun evaluation). It was found that 2 of the 50 strains (4 percent) demonstrated reproducibility of biotypes, defined as no variation in the results of the 22 interrun Enterotubes. Twenty-one of the 50 strains (42 percent) demonstrated reproducibility of biotypes, defined as no variation in the results of the ten intrarun Enterotubes. In addition, 20 replicate Enterotube biotype identifications were performed on each of 114 urine cultures which had greater than 10(5) morphologically identical colonies per milliliter of urine. Forty-two of these 114 clinical urine cultures (34 percent) demonstrated no variation in biochemical test results with the 20 replicate Enterotubes. In 47 (44 percent) of the 20 replicate urine cultures, one biochemical test result varied. Two or more biochemical test results were different in the 20 Enterotubes from 25 (22 percent) of the urine cultures.
Bacteriological Techniques↗
Preparation and storage of high-titer lactic streptococcus bacteriophages.
Various techniques were employed for preparation of high-titer bacteriophage lysates of Streptococcus lactis, S. cremoris, and S. diacetilactis strains. Infection of a 4-h host culture in litmus milk at 30 C yielded the highest titers (2 x 10 to 4 x 10 plaque-forming units/ml) for most phages. Host infection in lactose-containing broth produced similar virus numbers only when 0.1 M tris(hydroxymethyl)aminomethane buffer stabilized the pH. The pH at the time of infection as well as the inoculum phage titer were critical in obtaining high titers. Optimum conditions for infection in broth were coupled with a polyethylene glycol concentration procedure to routinely produce milligram quantities of phage from 1 liter of lysate. Neutralization of whey lysates, as a means of storage, offered no survival advantage over unneutralized samples. Storage of phage lysates in a 15% glycerol whey solution at -22 C yielded a high rate of survival in most cases, even with repeated freezing and thawing, over a period of 24 months.
Journal Article↗
A descriptive study of medical and chiropractic patients with chronic low back pain and sciatica: management by physicians (practice activities) and patients (self-management).
BACKGROUND: A practice-based study of ambulatory patients with low back pain noted a long-term outcome advantage for self-referred chiropractic (DC) patients over medical (MD) patients within a subgroup of patients with chronic low back pain and radiating pain below the knee. The frequency of self-care education by physicians in both provider cohorts coupled with current thinking on management of chronic low back pain led to an exploration and description of physicians' noncore practice activities and patients' self-management attitudes and behaviors. METHODS: A longitudinal, practice-based, observational study was undertaken in 14 general practice and 51 chiropractic community-based clinics. We enrolled 2945 consecutive patients with ambulatory low back pain of mechanical origin; of these, 268 comprised the subgroup of patients with chronic low back pain and radiating pain below the knee. The patients' low back status was followed for 1 year. Data on physicians' practice activities were obtained from doctor questionnaires completed at each patient visit and from chart abstraction. Patient data obtained from self-administered questionnaires at enrollment included sociodemographics, complaint characteristics, health status, and health encounter preferences. Questionnaires mailed at 2 weeks, 1 month, 3 months, 6 months, and 12 months collected data on low back complaint status and satisfaction with treatment. At 1 to 3 years follow-up, mailed questionnaires collected data on patients' self-management attitudes and behaviors. RESULTS: Physicians' core practice activities were as expected. Exercise plans and self-care education (>55%) were conspicuous in the frequency of their use in the DC cohort. MD patients appeared to rely more on family and friends for support during periods of back trouble. DC patients were characterized by greater self-efficacy motivation (P = .000). Both groups showed evidence of self-care activities during and between bouts of back pain, although MD patients were far more likely to choose bed rest (P = .007). CONCLUSIONS: The chiropractic encounter may have enhanced patients' self-efficacy motivation, leading to better coping abilities and better pain and disability outcomes. Understanding, respecting, and capitalizing on the role and influence of psychosocial factors can help all physicians become more effective healers and counselors for their patients with back pain.
Adult↗
Lumbar motion trends and correlation with low back pain. Part I. A roentgenological evaluation of coupled lumbar motion in lateral bending.
OBJECTIVE: A radiographic study was undertaken to describe the relationship between coupled lumbar motion in lateral bending and the presence of low back pain symptomatology, evaluate trends of coupled motion and determine if these trends were attributable to chance confluence of independent motions. DESIGN: Survey. SETTING: Chiropractic college student health center and private chiropractic clinic. PARTICIPANTS: 249 subjects: 114 with low back pain, 29 asymptomatic with no history and 106 asymptomatic with history. Of these, 194 were freshman volunteers and 55 were new private clinic low back pain patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Lumbar segmental coupled motion categories according to the scheme of Cassidy and Grice, as well as a modified scheme. RESULTS: Statistical analysis demonstrated no significant relationship (p = .01) between coupled lumbar motion and low back pain. When viewed intersegmentally, approximately half of all lumbar motion was type II; symmetric motion was rare and attributable to chance confluence of individual segmental motion. CONCLUSIONS: This study suggests that back pain is not an indication for the routine use of lateral bending films for the identification of abnormal coupled motion. Furthermore, each segmental categorization appears to be independent of contralateral categorization as well as motion at all other segmental levels. It is also suggested that type II motion cannot be ruled out as a normal variant. Finally, the ubiquity of coupled motion asymmetry suggests that symmetry must be reevaluated as a criterion for normal spinal function.
Adolescent↗
Disabling low back Oregon workers' compensation claims. Part I: Methodology and clinical categorization of chiropractic and medical cases.
This paper reports on a case-control study of 201 randomly selected workers' compensation cases involving disabling low back injuries. To control for claim severity prior to comparison studies on time loss and treatment cost, a classification scheme based on documented clinical signs and symptoms was used to subgroup the claims from two provider groups, chiropractic (DC) and medical (MD), into three categories of clinical presentation. Soft tissue strain/sprain predominated in both provider groups. The two provider groups differed in the proportion of claimants who had physical factors contributing to low back compromise. DC claimants were less likely than MD claimants to have sought initial treatment in the emergency room, more likely to have a history of chronic, recurrent low back pain and more likely to have suffered exacerbation episodes. These differences suggest a greater level of chronicity among chiropractic claimants.
Back Pain↗
Interexaminer concordance in detecting joint-play asymmetries in the cervical spines of otherwise asymptomatic subjects.
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Cervical Vertebrae↗
Outcomes research in chiropractic: the state of the art and recommendations for the chiropractic research agenda.
OBJECTIVE: To examine and document the state of the art in outcomes research in chiropractic, including the limitations of available data, and to make recommendations for further progress in this area. METHODOLOGY: An extensive search of the literature from 1990 through 1994 was undertaken using electronic databases (Medline, Index to Chiropractic Literature, EMBASE, and ERIC) and hand searches were conducted for relevant studies published in 1995. Publication in English, publication in a peer-reviewed journal, weight of evidence (study design) and measurement of patient-relevant outcomes were primary inclusion criteria. We prepared a draft with recommendation, rationale, actions required, responsible parties and expected outcomes for each seed statement. An outcomes workgroup, convened at the Research Agenda Work shop, added its perspective to the seed recommendations and actions required. Finally, the white paper authors prepared the final recommendations for outcomes research in chiropractic. RESULTS: This white paper presents six recommendations, emphasizing four general areas in which to develop the outcomes research agenda in chiropractic: research culture, infrastructure, opportunities and topics in outcomes research. CONCLUSION: The long-term goals of the chiropractic research agenda must be to advance the profession and to better meet the health needs of the public. Our final recommendations serve as a foundation for the development of proposals for future strategy with outcomes research a priority.
Case-Control Studies↗