Assessing the use of minimally invasive self-sampling at home for long-term monitoring of the microbiota within UK families.

Monitoring the presence of commensal and pathogenic respiratory microorganisms is of critical global importance. However, community-based surveillance is difficult because nasopharyngeal swabs are uncomfortable and painful for a wide age range of participants. We designed a methodology for minimally invasive self-sampling at home and assessed its use for longitudinal monitoring of the oral, nasal and hand microbiota of adults and children within families. Healthy families with two adults and up to three children, living in and near Liverpool, United Kingdom, self-collected saliva, nasal lining fluid using synthetic absorptive matrices and hand swabs at home every two weeks for six months. Questionnaires were used to collect demographic and epidemiological data and assess feasibility and acceptability. Participants were invited to take part in an exit interview. Thirty-three families completed the study. Sampling using our approach was acceptable to 25/33 (76%) families, as sampling was fast (76%), easy (76%) and painless (60%). Saliva and hand sampling was acceptable to all participants of any age, whereas nasal sampling was accepted mostly by adults and children older than 5 years. Multi-niche self-sampling at home can be used by adults and children for longitudinal surveillance of respiratory microorganisms, providing key data for design of future studies.

Survival at older ages: are greater influenza antibody titers protective?

Antibodies are a core element of the immune system's defense against infectious diseases. We hypothesize that antibody titres might therefore be an important predictor of survival in older individuals. This is important because biomarkers that robustly measure survival have proved elusive, despite their potential utility in health care settings. We present evidence supporting the hypothesis that influenza antibody titres are associated with overall survival of older individuals, and indicate a role for biological sex in modulating this association. Since antibody titres can be modulated by vaccination, these results have important implications for public health policy on influenza control in aging populations.

Early impact of rotavirus vaccination in a large paediatric hospital in the UK.

The impact of routine rotavirus vaccination on community-acquired (CA) and healthcare-associated (HA) rotavirus gastroenteritis (RVGE) at a large paediatric hospital, UK, was investigated over a 13-year period. A total of 1644 hospitalized children aged 0-15 years tested positive for rotavirus between July 2002 and June 2015. Interrupted time-series analysis demonstrated that, post vaccine introduction (July 2013 to June 2015), CA- and HA-RVGE hospitalizations were 83% [95% confidence interval (CI): 72-90%) and 83% (95% CI: 66-92%] lower than expected, respectively. Rotavirus vaccination has rapidly reduced the hospital rotavirus disease burden among both CA- and HA-RVGE cases.

Close encounters of the infectious kind: methods to measure social mixing behaviour.

A central tenet of close-contact or respiratory infection epidemiology is that infection patterns within human populations are related to underlying patterns of social interaction. Until recently, few researchers had attempted to quantify potentially infectious encounters made between people. Now, however, several studies have quantified social mixing behaviour, using a variety of methods. Here, we review the methodologies employed, suggest other appropriate methods and technologies, and outline future research challenges for this rapidly advancing field of research.

The invasion and coexistence of competing Wolbachia strains.

Cytoplasmic incompatibility between arthropods infected with different strains of Wolbachia has been proposed as an important mechanism for speciation. However, a basic requirement for this mechanism is the coexistence of different strains in neighbouring populations. Here we test whether this required coexistence is possible in a spatial context. Continuous-time models for the behaviour of one and two strains of Wolbachia within a single well-mixed population demonstrate the Allee effect and founder control, such that one strain is always driven extinct. In contrast, discretised spatial models show patchy persistence of the two strains although coexistence within the same habitat is rare. A simplified model of such founder control suggests that it is fragmentation of (or barriers within) the habitat rather than space itself that leads to persistence.

Human moricizine metabolism. I. Isolation and identification of metabolites in human urine.

1. Using synthetic standards and/or spectral data, seven moricizine metabolites were structurally identified in human urine. Two novel metabolites were identified as phenothiazine-2-carbamic acid and ethyl [10-(3-aminopropionyl) phenothiazin-2-yl] carbamate. Two novel human moricizine metabolites, 2-amino-10-(3-morpholino-propionyl) phenothiazine, a previously identified dog metabolite, and 2-aminophenothiazine, a previously identified rat metabolite, were also identified. Three additional human metabolites, phenothiazine-2-carbamic acid ethyl ester sulphoxide (P2CAEES), moricizine sulphoxide, and ethyl ¿10-[N-(2'-hydroxyethyl)3-aminopropionyl] phenothiazin-2-yl¿ carbamate, all previously described in the literature, were observed. 2. Both 2-amino-10-(3-morpholinopropionyl) phenothiazine and ethyl [10-(3-aminopropionyl) phenothiazin-2-yl] carbamate, and possibly ethyl ¿10-[N-(2'-hydroxyethyl) 3-aminopropionyl]phenothiazin-2-yl¿ carbamate, possess the structural characteristics thought to be necessary for class 1 antiarrhythmic activity.

Cysticus cruris giganticus.

A case report of epidermal inclusion cyst formation is presented as it occurred in a young male patient. The mass is noteworthy because of its location, rapid growth and bizarre size. Treatment consisted of surgical excision without recurrence.

Achilles tendon hypercholesteremic xanthoma.

A case report of bilateral Achilles tendon xanthomatosis is presented. The literature is reviewed and the systemic condition discussed. Treatment consisted of surgical excision of the offending masses and medical management of the hyperlipidemic state. Follow-up results were excellent.

Rhabdomyolysis-myoglobinurea: consequences of prolonged tourniquet.

The authors review the literature on rhabdomyolysis and myoglobinuria and relate these phenomena to prolonged intraoperative tourniquet time in a case report. They alert the practitioner to the clinical manifestations, diagnosis, and treatment of such problems and emphasize the importance of early recognition.

Sterile topical lignocaine jelly in plastic surgery: an assessment of its systemic toxicity.

Topical local anaesthesia offers an important adjunct to several plastic surgery procedures, provided that it does not cause systemic toxicity or prevent the healing process. Absorption of a sterile topical lignocaine jelly was assessed in patients undergoing treatment of skin graft donor sites, flap donor sites and burns. There was a marked degree of absorption only in patients with thermal burns, in which case it depended on the surface area of the wound; although no toxic effects due to absorption were noted, caution in dosage is advisable. No complications of healing attributable to the preparation used were encountered.

Labial fold reconstruction with relocation of the phallus and urethra in an intersex patient.

An intersex patient is reported and a description of the correction of the external genital appearance to resemble that of a female is given. Relocation of the phallus and contained urethra was carried out, the emphasis having been placed on the creation of labial folds. The reason for preservation of the phallus and urethra is discussed.