A single nucleotide polymorphism identification assay for the genotypic characterisation of Neisseria meningitidis using MALDI-TOF mass spectrometry.

The ability of matrix-assisted laser desorption-ionisation time-of-flight mass spectrometry (MALDI-TOF) to identify virulent clones of meningococci quickly and accurately is investigated. A single nucleotide polymorphism (SNP) within the fumC gene which differentiates between the hypervirulent ET-15 strain and other ET-37 complex strains is used to determine the usefulness of this method. In this study, MALDI-TOF proved to be a fast, effective alternative to traditional DNA sequencing for the identification of an individual nucleotide.

Pneumococcal disease and asplenia: the importance of vaccination.

Pneumococcal disease is an important cause of morbidity and mortality, particularly in certain patient groups including those who have been splenectomised or have no functioning spleen. Recent deaths in two asplenic patients from pneumococcal disease should remind doctors of the importance of vaccination in asplenic individuals. The current guidelines for vaccination in such patients are highlighted and discussed.

Treatment of pain in severe burns.

Burn pain can cause psychologic and functional difficulties, and is difficult to predict from wound depth. The initial painful stimulation of nerve endings by the burn with continued painful stimuli result in peripheral and central mechanisms causing amplification of painful stimuli, and the development of chronic pain syndromes that can be difficult to treat. In order to assess the effect of analgesic interventions it is essential to measure the patient's pain in a simple and reproducible manner.

At what level of coronary heart disease risk should a statin be prescribed?

Statin therapy has been conclusively shown to offer patients clinical benefit, virtually irrespective of their baseline risk status. However, the absolute risk reductions observed in different clinical trials, which have recruited patients across a spectrum of lipid levels and vascular disease states, show that baseline global risk determines the absolute benefit gained and in turn will specify the number of patients needed to be treated in order to realize this benefit. Global risk assessment is therefore central to the clinically meaningful use of statin therapy, and a strong case is now argued in the literature for a high-risk primary prevention strategy that goes hand in hand with standard secondary prevention.