Local Intramedullary Delivery of Vancomycin Can Prevent the Development of Long Bone Staphylococcus aureus Infection.

Current treatments for methicillin-resistant Staphylococcus aureus (MRSA) infections require intravenously delivered vancomycin; however, systemically delivered vancomycin has its problems. To determine the feasibility and safety of locally delivering vancomycin hydrochloride (~25 mg/Kg) to the medullary canal of long bones, we conducted a pharmacokinetics study using a rat tibia model. We found that administering the vancomycin intraosseously resulted in very low concentrations of vancomycin in the blood plasma and the muscle surrounding the tibia, reducing the risk for systemic toxicity, which is often seen with traditional intravenous administration of vancomycin.

The influence of sensitisation to pollens and moulds on seasonal variations in asthma attacks.

No large study has described the seasonal variation in asthma attacks in population-based asthmatics in whom sensitisation to allergen has been measured. 2,637 young adults with asthma living in 15 countries reported the months in which they usually had attacks of asthma and had skin-prick tests performed. Differences in seasonal patterns by sensitisation status were assessed using generalised estimating equations.

Comparison of exposure estimation methods for air pollutants: ambient monitoring data and regional air quality simulation.

Air quality modeling could potentially improve exposure estimates for use in epidemiological studies. We investigated this application of air quality modeling by estimating location-specific (point) and spatially-aggregated (county level) exposure concentrations of particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM(2.

Lethal arrhythmias in Tbx3-deficient mice reveal extreme dosage sensitivity of cardiac conduction system function and homeostasis.

TBX3 is critical for human development: mutations in TBX3 cause congenital anomalies in patients with ulnar-mammary syndrome. Data from mice and humans suggest multiple roles for Tbx3 in development and function of the cardiac conduction system. The mechanisms underlying the functional development, maturation, and maintenance of the conduction system are not well understood.

Reduction of road traffic noise and mental health: an intervention study.

Road traffic noise exposure leads to annoyance and impairment of quality of life and may impair health. If this association is causal, a reduction in noise exposure should result in a reduction in noise annoyance and improvement in quality of life. This study examines whether the reduction in road traffic noise following the introduction of a bypass leads to reduction in noise annoyance and common mental disorder and an improvement in quality of life.

Heterogeneity in randomized controlled trials of long chain (fish) omega-3 fatty acids in restenosis, secondary prevention and ventricular arrhythmias.

Randomized controlled trials of marine omega-3 fatty acid supplementation in relation to coronary heart disease (CHD) have inconsistent outcomes, yet public health messages are uniformly positive. Originally, fish were seen as a low saturated fat protein source, and later as a valuable source of omega-3 fatty acids. Early trials indicated that increased fish oil consumption prevented restenosis after coronary angioplasty.

Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis.

Background: A recent Cochrane meta-analysis did not confirm the benefits of fish and fish oil in the secondary prevention of cardiac death and myocardial infarction. We performed a meta-analysis of randomized controlled trials that examined the effect of fish-oil supplementation on ventricular fibrillation and ventricular tachycardia to determine the overall effect and to assess whether heterogeneity exists between trials.

Methods: We searched electronic databases (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, CINAHL) from inception to May 2007.

Secondary prevention of CHD in UK men: the Diet and Reinfarction Trial and its sequel.

The Diet and Reinfarction Trial (DART) involved 2033 men (mean age 56.5 years) recovering from myocardial infarction. They were randomly allocated to receive advice or to receive no advice on each of three dietary factors: an increase in fatty fish intake; a reduction in fat intake with an increase in polyunsaturated fat:saturated fat; an increased intake of cereal fibre.

An intuitive approach to measuring protein surface curvature.

A natural way to measure protein surface curvature is to generate the least squares fitted (LSF) sphere to a surface patch and use the radius as the curvature measure. While the concept is simple, the sphere-fitting problem is not trivial and known means of protein surface curvature measurement use alternative schemes that are arguably less straightforward to interpret. We have developed an approach to solve the LSF sphere problem by turning the sphere-fitting problem into a solvable plane-fitting problem using a transformation known as geometric inversion.

Left ventricular systolic dysfunction and atrial fibrillation in older people in the community--a need for screening?

Background: Heart failure and stroke are major causes of morbidity and mortality in older people. Angiotensin converting enzyme inhibitors improve symptoms and survival in left ventricular systolic dysfunction. Anticoagulants are effective in stroke prevention in atrial fibrillation with aspirin being a less effective alternative.

European reference values for Doppler indices of left ventricular diastolic filling.

The European Study Group on diastolic heart failure requires objective evidence of abnormal left ventricular diastolic function to establish the diagnosis of diastolic heart failure, which is common in older people. Reference values for Doppler indices of transmitral flow, used to assess left ventricular diastolic function, have not been reported for people 70 years and over in Europe. The aim of this study was to establish reference values for these Doppler indices of transmitral flow in older people.

Inhaler technique in older people in the community.

Background: Good inhaler technique and medication concordance is important for symptom and disease control in chronic airways disease.

Objectives: Establish the prevalence of inhaler use; the main inhaler devices used by older people at home; their ability to use the inhalers they have been prescribed; and the relationship between perceived ease of use and actual performance.

Design: Cross-sectional population based study.

Diastolic heart failure in older people.

Objectives: To determine the prevalence of diastolic heart failure in older people in the community, identify associated risk factors and measure its impact on function and quality of life.

Design: Cross-sectional population-based study.

Methods: A two-stage random sample of 500 subjects was drawn from 5,002 subjects aged 70 years and over living at home.

Advice to eat fish and mood: a randomised controlled trial in men with angina.

People with high intake of fish have lower reported rates of depression and a small trial in psychiatric patients suggested that fish oil supplements reduced episodes of depression and mania. As part of a factorial trial of interventions to reduce mortality in angina 452 men were randomised to advice to eat more fatty fish or no fish advice. Maxepa fish oil capsules were supplied to men who found the fish unpalatable.

Methylenetetrahydrofolate reductase 677C-->T genotype modulates homocysteine responses to a folate-rich diet or a low-dose folic acid supplement: a randomized controlled trial.

Background: Low folate status and elevated plasma homocysteine are associated with increased risk of neural tube defects and cardiovascular disease. Homocysteine responses to folate may be influenced by genetic variants in folate metabolism.

Objective: We determined the effect of folate-enhancing dietary interventions on plasma folate and plasma total homocysteine (tHcy) with respect to the methylenetetrahydrofolate reductase 677C-->T genotype.

Nutritional advice to increase soluble fibre intake does not change plasma folate or homocysteine in men with angina: a randomised controlled trial.

Objective: To study the effect of advice to increase dietary soluble fibre, including fruit and vegetables, on plasma folate and homocysteine in men with angina.

Design: Data were collected on a subset of subjects from the Diet and Angina Randomised Trial (DART II). In a randomised (2 x 2) factorial design, subjects received advice on either, neither or both interventions to: (1) increase soluble fibre intake to 8.

Mortality in British vegetarians.

Objective: To compare the mortality of British vegetarians and non-vegetarians.

Design: Analysis of original data from two prospective studies each including a large proportion of vegetarians--the Oxford Vegetarian Study and the Health Food Shoppers Study. Standardised mortality ratios (SMRs) compared with the population of England and Wales were calculated from deaths before age 90 for vegetarians and non-vegetarians in each study.