The effect of essential oils on methicillin-resistant Staphylococcus aureus using a dressing model.

Patchouli, tea tree, geranium, lavender essential oils and Citricidal (grapefruit seed extract) were used singly and in combination to assess their anti-bacterial activity against three strains of Staphylococcus aureus: Oxford S. aureus NCTC 6571 (Oxford strain), Epidemic methicillin-resistant S. aureus (EMRSA 15) and MRSA (untypable). The individual essential oils, extracts and combinations were impregnated into filter paper discs and placed on the surface of agar plates, pre-seeded with the appropriate strain of Staphylococcus. The effects of the vapours of the oils and oil combinations were also assessed using impregnated filter paper discs that were placed on the underside of the Petri dish lid at a distance of 8mm from the bacteria. The most inhibitory combinations of oils for each strain were used in a dressing model constructed using a four layers of dressings: the primary layer consisted of either Jelonet or TelfaClear with or without Flamazine; the second was a layer of gauze, the third a layer of Gamgee and the final layer was Crepe bandage. The oil combinations were placed in either the gauze or the Gamgee layer. This four-layered dressing was placed over the seeded agar plate, incubated for 24h at 37 degrees C and the zones of inhibition measured. All experiments were repeated on three separate occasions. No anti-bacterial effects were observed when Flamazine was smeared on the gauze in the dressing model. When Telfaclear was used as the primary layer in the dressing model compared to Jelonet, greater zones of inhibition were observed. A combination of Citricidal and geranium oil showed the greatest-anti-bacterial effects against MRSA, whilst a combination of geranium and tea tree oil was most active against the methicillin-sensitive S. aureus (Oxford strain). This study demonstrates the potential of essential oils and essential oil vapours as antibacterial agents and for use in the treatment of MRSA infection.

Improved methods of detection of meningococcal DNA from oropharyngeal swabs from cases and contacts of meningococcal disease.

In the UK the increasing use of pre-admission parenteral antibiotic therapy in meningococcal disease has lessened the value of routine cultures as a tool to confirm diagnosis, and laboratory confirmation of invasive meningococcal infection is achieved increasingly by non-culture, nucleic acid amplification methods. The purpose of this study was to evaluate a DNA extraction and meningococcal-specific DNA amplification methodology for detection of meningococci from oropharyngeal swabs. One hundred and six swabs from suspected or confirmed cases of meningococcal disease, and 94 swabs from contacts of meningococcal disease cases were examined. Of laboratory-confirmed cases, 38/65 (58.5%) yielded a positive oropharyngeal swab PCR result and 5/24 (20.8%) swabs from suspected but laboratory-unconfirmed cases were PCR positive. No significant differences in PCR positivity rates were found between the types of swab transport systems utilized, but transport time to the testing laboratory was found to affect PCR positivity (P < 0.05). Application of meningococcus-specific PCR to oropharyngeal swabs, in addition to routine culture of swabs, can provide valuable epidemiological information as well as case confirmation for contact management. PCR amplification of meningococcal PCR from oropharyngeal swabs will also increase the ascertainment in swabbing surveys carried out as part of meningococcal disease outbreak investigation and management.

A survey into toxic shock syndrome (TSS) in UK burns units.

Toxic shock syndrome (TSS) is a rare complication of a Staphylococcus aureus infection and is primarily seen in children with small burns. The true incidence of TSS in burns patients is not known and the number of presumptive cases rarely reported. This survey was undertaken to determine if the incidence of TSS in children with burns could be related to the type of dressing used to cover the wound. A questionnaire was compiled and sent to the Senior Nurse in charge of each of the UK burns units. General information on the number of admissions, age of the patient, cause of injury and burn wound management was sought. An 81% response was obtained after two mailshots and follow up telephone calls. Seventy percent (23/33) of units which answered the survey nursed children. Of these, eight units had either not encountered TSS previously or not had a case within the past two years. These units were small, admitting a maximum of 50 patients each year. Of the units where TSS was encountered, approximately 2.5% of children admitted showed symptoms of TSS. Of the units who nursed both adults and children, seven units had seen TSS in burned adult patients which has not been reported in the literature. Of the eight units where TSS had not been recently encountered, four routinely administered prophylactic antibiotics to prevent infection whereas routine administration of antibiotics occurred in only two of the 15 units where TSS was seen. Although wound management procedures differed slightly there were many similarities. These included wound cleaning with normal saline, covering with either silver sulphadiazine (1%) or povidone iodine (10%), depending upon the infection status, and dressing with a paraffin tulle, gauze and crepe bandages. No association between the management of the burn wound and subsequent development of TSS could be established.

[Paralysis of the M. serratus anterior as an occupational disease in a scaffolder]. / Paralyse van de M. serratus anterior als beroepsziekte bij een steigerbouwer.

A 30-year-old scaffolder developed acute shoulder complaints after lifting a heavy weight. There was complete failure of the long thoracic nerve resulting in a serratus anterior muscle palsy on the right side. Physical examination revealed only right scapula winging. A combination of stretching of the nerve and high mechanical pressure on the nerve had probably been the cause of this occupational injury. The shoulder complaints remained, resulting in disability and unemployment.

Cloning of cardiac, kidney, and brain promoters of the feline ncx1 gene.

The Na+-Ca2+ exchanger (NCX1) plays a major role in calcium efflux and therefore in the control and regulation of intracellular calcium in the heart. The exchanger has been shown to be regulated at several levels including transcription. NCX1 mRNA levels are up-regulated in both cardiac hypertrophy and failure. In this work, the 5'-end of the ncx1 gene has been cloned to study the mechanisms that mediate hypertrophic stimulation and cardiac expression. The feline ncx1 gene has three exons that encode 5'-untranslated sequences that are under the control of three tissue-specific promoters. The cardiac promoter drives expression in cardiocytes, but not in mouse L cells. Although it contains at least one enhancer (-2000 to -1250 base pairs (bp)) and one or more negative elements (-1250 to -250 bp), a minimum promoter (-250 to +200 bp) is sufficient for cardiac expression and alpha-adrenergic stimulation.

Lymphokine activated killing of fresh human leukaemias.

The relative susceptibility of 10 human leukaemias comprising acute phase leucocytes from 5 acute myeloid and 5 lymphoid neoplasms, and 2 immunoblastic lymphomas to killing by peripheral blood mononuclear cells (PBMC), before and after target cell treatment with phytohaemagglutinin (PHA), and by interleukin-2 (IL-2) activated peripheral blood lymphocytes (PBL) was investigated in short term 51Cr release assays using effector cells from 10 allogeneic donors. Optimal lectin-dependent cellular cytotoxicity (LDCC) was verified against K562 and L1210 cells and lymphokine-activated killing (LAK) against K562 and Daudi cells. Under these conditions, the majority of the leukaemias tested revealed only a finite sensitivity to any of the cytotoxic mechanisms, which was dependent on the donor origin of the effectors. The leukaemias were more consistently susceptible to LDCC than LAK and removal of adherent cells to enrich for the latter activity in effector populations, was ineffective. Lymphocytes from a patient in long term (greater than 5 yr) remission exhibited LAK against the autologous target E84, a natural killer (NK)-sensitive acute myelomonocytic leukaemia. These cells failed to cross-compete for lysis of K562 by LAK cells, suggesting the existence of different recognition structure(s) on the two targets.

Involvement of cell surface macromolecules sensitive to alkylating ketones in lysis by human peripheral blood NK cells.

Natural cytotoxicity (mediated by the B73.1+ subset) of human peripheral blood lymphocytes against the K-562 erythroleukaemia cell line is dramatically inhibited in a dose-dependent manner, by the small molecular weight protease inhibitors, tosyl-L-lysyl chloromethyl ketone (TLCK) and tosylamide phenyl-ethyl-chloromethyl-ketone (TPCK), incorporated into the cytotoxicity assay or after brief effector cell (but not target cell) pre-treatment. The alkylating ketones primarily affect post-binding events in the lytic process by interference with cellular functions dependent upon protein synthesis. Although non-toxic under the conditions used, recovery of cytolytic function requires at least 72 h, implicating involvement of protein(s) with a minimum turnover time of 3 days. Protection of effector cell function from TLCK by prior treatment with the lectin Lens culinaris (lentil) agglutinin, which binds human peripheral blood lymphocytes to a three-fold greater extent than concanavalin A, indicated that the initial action of the agent is with cell surface rather than intracytoplasmic components. The data suggest that the alkylating ketones inhibit natural killer function by slowly reversible functional inactivation of cell-surface protease(s), which although not cytotoxic per se, may control the secretion of soluble lytic factors.

The effect of reinforcement and verbal rehearsal on selective attention in learning-disabled children.

A central-incidental task of selective attention was administered to 100 learning-disabled boys--48 younger children (8 1/2-10 1/2 years) and 52 older children (10 1/2-12 1/2 years). Subjects at both age levels were assigned to one of four conditions: (a) a standard condition; (b) a rehearsal condition, in which subjects were taught a verbal rehearsal strategy; (c) a reinforcement condition, in which correct responses were rewarded; and (d) a combined rehearsal-reinforcement condition. Older subjects recalled more central task but not more incidental task information than younger subjects. A measure of selective attention efficiency was also greater for older than for younger subjects. Central recall in the rehearsal-reinforcement condition was greater than in any other condition. Central recall was greater in the rehearsal condition than in the standard and reinforcement conditions. Selective attention efficiency was greater for both rehearsal conditions than for both nonrehearsal conditions. Incidental recall was higher for reinforcement subjects than for rehearsal subjects. Results suggest that induced verbal rehearsal improves central recall and selective attention in learning-disabled children. Reinforcement alone does not improve central recall but may when paired with rehearsal.