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Objective:Honey is recognised to be a good topical wound care agent owing to a broad-spectrum of antimicrobial activity combined with healing properties. Surgihoney RO (SH1) is a product based on honey that is engineered to produce enhanced reactive oxygen species (ROS) and has been reported to be highly antimicrobial. The objective was to investigate the ability of the engineered honey and its comparators to prevent biofilm formation in vitro.Method:We tested the ability of three medical-grade honeys SH1, Activon manuka honey (MH) and Medihoney manuka honey (Med), alongside five antimicrobial dressings (AMDs) to prevent the formation of biofilms by 16 isolates. Honeys were serially double diluted from 1:3 down to 1:6144 and the lowest dilution achieving a statistically significant reduction in biomass of at least 50%, compared with untreated controls, was recorded.Results:Although all the honeys were antibacterial and were able to prevent the formation of biofilms, SH1 was the most potent, with efficacy at lower dilutions than the medical honeys for five isolates, and equivalent dilutions for a further six. Additionally, SH1 was superior in antibacterial potency to three commercially available AMDs that contain honey.Conclusion:SH1 is effective at preventing bioflms from forming and is superior to medical honeys and AMDs in in vitrotests. more...

Antibodies to the core region of endotoxin (endotoxin core antibodies, EndoCAb), which cross-react with endotoxin from a range of Gram-negative bacteria, are maintained in relative homeostasis in health, but undergo marked changes in a number of different diseases associated directly or indirectly with endotoxaemic or septicaemic states. The levels of EndoCAb IgG in the blood and cerebrospinal fluid (CSF) of 35 late-stage sleeping sickness patients and 9 control individuals were measured by ELISA. EndoCAb levels were significantly elevated in the patient blood (mean EndoCAb value 290 MU/ml cf. control 182 MU/ml, P<0·001), and CSF (mean EndoCAb value 254 MU/ml cf. control 150 MU/ml, P<0·001). EndoCAb IgG levels correlated with endotoxin levels in patient blood (r=0·78, P<0·001), but not in the CSF and were not reduced 6 weeks following chemotherapy, unlike the endotoxin levels. It is concluded that late-stage sleeping sickness is associated with chronic exposure to endotoxins from Gram-negative bacteria. more...

In a comparative study, isolates of methicillin-resistant Staphylococcus aureus (MRSA) with known pulsed-field gel electrophoresis (PFGE) and bacteriophage type were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP) for additional discriminatory subtyping information. PFGE was previously performed using standardized, commercially available kits and pre-programmed software. Isolates were examined for coagulase (coa) and protein A (spa) gene polymorphisms following PCR amplification of the coa hypervariable and spa repeat regions. Coa gene RFLPs produced a total of 38 distinct combined patterns after digestion with HaeIII and AluI and identified the predominant epidemic (EMRSA) types 15 and 16. A unique HaeIII restriction site was identified by RFLP and sequence analysis in the coa gene for EMRSA 15 but not EMRSA 16. The spa gene PCR yielded a total of 14 different profiles ranging from 3–18 repeats with the 2 predominant EMRSA types falling into 2 distinct groups. PCR detection of coa and spa polymorphisms offer a rapid preliminary strain identification and discriminatory subtyping information for surveillance of MRSA. more...

Summary The effect of L-deprenyl in combination with L-Dopa was studied in 22 Parkinsonian patients, with various forms of “on-off” phenomena. L-deprenyl is a selective, irreversible inhibitor of monoamine oxidase type B, without tyramine potentiating property. The results were very encouraging with regard to amelioration of “on-off effect”. More than 80% of the patients with nocturnal akinesia, early morning akinesia, end-of-dose akinesia and non-dose-dependent akinesia, showed improvement. In 9 out of 22 patients, the “off” period disappeared. The platelet monoamine oxidase activity, which is of type B and similar to the brain enzyme, was fully inhibited by the daily dose of L-deprenyl. There was no significant change in serum prolactin level during the duration of 6 weeks' treatment with L-deprenyl. more...

To assess the efficacy of ciprofloxacin in neutropenic patients, we conducted a randomized prospective trial comparing the combination of ciprofloxacin and netilmicin against piperacillin plus netilmicin as an empiric treatment of fever in cancer patients with neutropenia. Of 214 evaluable episodes, 115 and 99 were randomly assigned to the ciprofloxacin and the piperacillin arms, respectively. The overall response rates were very similar (59 and 62% for the ciprofloxacin and piperacillin arms, respectively). The response for the gram-positive bacteremias was almost identical (around 40%); this low response was due in part to an outbreak of infection by a multiply resistant strain of Staphylococcus epidermidis (for which the ciprofloxacin MIC was greater than or equal to 128 micrograms/ml) which occurred during the second half of the trial. Among gram-negative bacteremias, 9 of 11 infections (82%) responded to the ciprofloxacin combination compared with 3 of 7 (43%) that responded to the piperacillin combination (P = 0.23). The incidences of persistent, profound neutropenia were comparable in both treatments, but the susceptibility of the gram-negative organism to ciprofloxacin and netilmicin was significantly higher than was susceptibility to the other combination. Ciprofloxacin was well tolerated, and patients were able to convert from intravenous to oral therapy in 64 of 115 episodes. more...

Objective: To compare four vancomycin‐containing agar media for the isolation of glycopeptide‐resistant enterococci (GRE) from clinical fecal specimens: kanamycin‐aesculin‐azide (KAA) agar; bile‐aesculin‐polymixin (BAP) agar; aztreonam‐amphotericin blood (CBAA) agar; and neomycin blood (CBN) agar. more...

This paper describes a stand-alone PC-based computer simulator for mooring design and operations. Both program logic and mathematics are discussed. Competing algorithms for solving several classical mooring problems are compared. The program contains a design module, static and dynamic mooring simulators, and mooring calculator modules. The design module performs an automatic optimum design of anchor deployment for any environmental condition, or allows the user to perform an interactive design. The static simulator predicts system responses in all mooring operations. The dynamic simulator is an implementation of the recent requirement of regulatory bodies for simulating slow-drifting motions of the vessel after a line failure. The calculator includes modules that compute weather forces, system stiffness, elastic catenary mechanics, and others. The program is interactive, menu-driven, and includes graphics. more...

Thirty isolates of Torulopsis glabrata were examined by pulsed-field gel electrophoresis, which resolved 13 DNA pieces, allowing the identification of 12 types. Bands at 1,400, 1,200, 1,070, 1,025, 681, and 500 kbp were conserved. When applied to 18 isolates from an outbreak, 10 distinct types were identified by this technique. Seven patients had isolates which were identical. more...

A cell free system from Staphylococcus aureus52A5 which incorporates UDPMurNAc‐L‐ala‐D‐isoglu‐L‐lys‐D‐ala‐14C‐D‐ala into lipid intermediates and peptidoglycan is described. During peptidoglycan synthesis, glycine binding to the lipid intermediates and peptidoglycan is also demonstrated as well as release of the terminal D‐alanine from the pentapeptide moiety. This release of D‐alanine is strongly inhibited by penicillin G. more...

β-haemolytic streptococci were identified in bacteriological cultures from 14 of 24 chronic venous leg ulcers in 21 patients. Multi-element odour detection (MEOD) analysis demonstrated a significant difference in odour in those ulcers from which β-haemolytic streptococci were isolated (p<0.01). MEOD has potential to detect pathogenic organisms instantaneously in the clinical setting. more...

Abstract: This audit of 408 synovial fluid samples, analysed for cell counts and crystals, revealed that crystals were present in only 25 samples (6.1%). Of these, in only three patients was the diagnosis uncertain and therefore the analysis helpful. Cell counts and types generally reflected known underlying diagnoses of inflammatory arthritis or osteoarthritis. Routine synovial fluid analysis does not contribute to diagnosis or management in established rheumatic disorders and should be performed only when the underlying cause is uncertain or in newly presenting patients. Major savings can be made by abandoning routine synovial fluid analysis. more...

Methicillin resistant Staphylococcus aureus (MRSA) is endemic within many hospitals worldwide. Critically ill patients on intensive care units have increased risk factors making them especially prone to nosocomially acquired infections. This review addresses the current situation regarding the evolution of MRSA and the techniques for identifying and epidemiologically typing it. It discusses specific risk factors, the morbidity and mortality associated with critically ill patients, and possibilities for future antibiotic treatments. Br J Anaesth 2004; 92: 121–30 more...