No abstract

Dysmenorrhea is the most common gynaecological complaint and the leading cause of recurrent short-term school absenteeism among adolescent girls. To explore adolescent girls' self-care strategies for dysmenorrhea, we conducted four focus groups in Kaohsiung, Taiwan, with 23 female adolescents with primary dysmenorrhea. Thematic content analysis was used to explore and organize the data. The self-care strategies for dysmenorrhea reported by participants included reducing physical activity, modifying diet using herbal remedies or medication, applying complementary therapies, paying attention to symptom clusters of discomforts, and expressing emotions. This is the first study to describe the self-care strategies adopted by adolescent girls with dysmenorrhea in Asia. Data were analyzed in cultural contexts. Knowledge of beneficial food-related or herbal health practices can enable professionals to counsel this population more effectively.

Early secretory antigen 6 (ESAT-6) and cell filtrate protein 10 (CFP-10) are two antigens secreted as a complex by the replicating Mycobacterium tuberculosis complex (MTC). Recently, an immunochromatographic assay (ICA) using a monoclonal antibody against the ESAT-6/CFP-10 complex was developed for the purpose of MTC detection. In this study, the efficacy of the assay was tested with 603 BACTEC cultures that were incubated for 3 additional days after positive signals appeared in the BACTEC MGIT 960 system. Bacterial isolates were recovered from these 603 BACTEC cultures, and 332 MTC isolates, 270 nontuberculosis mycobacterial isolates, and 1 Nocardia isolate were identified by using standard biochemical assays. The ESAT-6/ CFP-10 assay detected 322 MTC cultures, resulting in a sensitivity of 97% and a specificity of 97.4%. To reduce the false-negative rate and improve the sensitivity, either serpentine cording in an acid-fast bacillus stain of the cultural smear, the ESAT-6/CFP-10 assay, or a combination of both was used for MTC detection. The sensitivity was then increased to 99.1%, and the negative predictive value increased to 98.9%, but the specificity decreased to 94.8% and the positive predictive value decreased to 95.9%. However, a combination of serpentine cording in cultural smears and the positivity of the ICA resulted in the specificity and positive predictive values of 100%. Therefore, BACTEC cultures with both serpentine cording and positivity of the ESAT-6/CFP-10 assay could be reported to contain MTC directly. The ESAT-6/CFP-10 assay may be an alternative of the Capilia assay (MPB64-ICA) as a convenient and cost-effective method for identification of MTC in culture.

The in vitro activities of isepamicin against 117 Mycobacteria abscessus, 48 Mycobacterium fortuitum, and 20 Mycobacterium chelonae isolates were evaluated by a microdilution test. Isepamicin MIC 90 s were <16 g/ml for the three species. Isepamicin was as active as amikacin and kanamycin and more active than tobramycin, capreomycin, gentamicin, and streptomycin.Rapidly growing mycobacteria (RGM) can cause a wide spectrum of disseminated or localized diseases, especially pulmonary, skin, or soft tissue infections (6). Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum are the three major pathogenic RGM species. The management of RGM remains very difficult, especially for the problems associated with infection caused by M. abscessus (12).Aminoglycoside agents have the potential to be extremely active against RGM (1,5,15). Amikacin has shown excellent activities against RGM in several studies and currently is the most widely used aminoglycoside in the treatment of RGM (1,5,15,18). Amikacin and isepamicin, an aminoglycoside used in Asia, were developed by introducing the (S)-4-amino-2-hydroxybutyryl and (S)-3-amino-2-hydroxypropionyl side chains into the 1-amino groups of kanamycin and gentamicin, respectively (8). Isepamicin has shown excellent activities against a wide range of bacteria (4). The cyclic peptide capreomycin is sometimes considered an aminoglycoside because of its actions on bacterial ribosomes (7). This study compared the activities of isepamicin with those of five other aminoglycosides (amikacin, gentamicin, kanamycin, tobramycin, and streptomycin) and capreomycin against RGM.RGM isolates were collected between November 2005 and July 2006 and identified by the conventional biochemical methods (10). Some of these (136 isolates) were confirmed by PCR restriction enzyme analysis of the 65-kDa hsp gene (13). Totals of 117 M. abscessus, 48 M. fortuitum, and 20 M. chelonae nonduplicate clinical isolates were collected. Of them, 71 (61%), 12 (25%), and 7 (35%), respectively, were recovered from patients with probable RGM infections (in which cases identical RGM species were recovered from three or more specimens from the same patient).Broth microdilution MIC testing was performed according to CLSI guidelines (11,(16)(17)(18). The isolates were subcultured on Trypticase soy agar plates with 5% sheep blood (BBL Microbiology Systems) and incubated at 30°C for 72 h. Bacteria on the agar plates were collected and adjusted to a final inoculum (5 ϫ 10 5 CFU/ml) in cation-supplemented MuellerHinton broth (Difco, Detroit, MI). Serial double dilutions of the tested antimicrobial agents were prepared with the same broth, and the concentrations in the wells ranged from 0.25 to 128 g/ml. The inoculated trays were incubated at 30°C, and MICs were recorded after 3 to 5 days.RGM isolates with amikacin MICs of Ն64 g/ml are interpreted as resistant to amikacin and those with amikacin MICs of Յ16 g/ml as susceptible to amikacin according to the CLSI cutoff criteria (11). No interpretive criteria ha...

In the elderly nursing home residents, QFT-G conversion is a more reliable tool to predict the development of active TB. Meanwhile, TST is a valuable tool for predicting the chance of not developing active TB.