Longitudinal survey of Clostridium difficile presence and gut microbiota composition in a Belgian nursing home.

Background: Increasing age, several co-morbidities, environmental contamination, antibiotic exposure and other intestinal perturbations appear to be the greatest risk factors for C. difficile infection (CDI). Therefore, elderly care home residents are considered particularly vulnerable to the infection.

Clostridium difficile from food and surface samples in a Belgian nursing home: an unlikely source of contamination.

This study investigates the contamination of foods and surfaces with Clostridium difficile in a single nursing home. C. difficile PCR-ribotype 078 was found in one food sample and in none of the tested surfaces.

Elbow arthroscopy: surgical techniques and rehabilitation.

Elbow arthroscopy allows for direct visualization into the elbow joint, minimizes the potential for postoperative edema and discomfort, as well as protects the ligamentous structures. Arthroscopic procedures for the elbow and postoperative management are described for patients who have undergone loose body removal, synovectomy, and capsulectomy. The effect of early mobilization on the elbow complex and the role that splinting may play, as well as the controversies surrounding the use of continuous passive motion are discussed.

An update on the management of carpal fractures.

This article reviews the appropriate management of common carpal fractures. The fundamental principles used by clinicians to choose appropriate stabilization and length of immobilization for these various injuries are discussed. The principles behind the progression of therapeutic intervention and the relation of progression to the stages of healing are emphasized.

The rationale for and efficacy of surgical intervention for electrodiagnostic-negative cubital tunnel syndrome.

Because conservative management of McGowan grade 1 cubital tunnel syndrome (symptoms only) may be successful in a high percentage of patients, normal electrodiagnostic studies and the absence of intrinsic muscle weakness or decreased sensation or both may be viewed as contraindications to operative intervention. Because the results of surgery are known to be inferior once objective motor weakness and abnormal 2-point sensory discrimination (McGowan grades 2 and 3) develop, however, we advocate surgical intervention for patients with symptoms only, even when electrodiagnostic studies are normal. We enrolled 16 patients (18 elbows) with McGowan I cubital syndrome who underwent in situ ulnar nerve release and medial epicondylectomy.