Alternative antimicrobials: the properties of fatty acids and monoglycerides

With the rising antibiotic resistance of many bacterial species, alternative treatments are necessary to combat infectious diseases. The World Health Organization and the US Centres for Disease Control and Prevention have warned that some infections, such as those from Neisseria gonorrhoeae, may be untreatable within a few years. One avenue of exploration is the use of antimicrobial fatty acids and their derivatives for therapeutic prevention or treatment of bacterial infections. Several studies have explored the activity of fatty acids and their derivatives, including monoglycerides against a variety of bacterial species. These are reviewed here, assessing the antimicrobial properties that have been demonstrated and the feasibility of therapeutic applications.     

Post-marketing surveillance of the safety of cimetidine: twelve-month morbidity report

A total of 9928 patients taking cimetidine and 9351 controls were included in a post-marketing drug surveillance study in Glasgow, Nottingham, Oxford and Portsmouth; 98.8 per cent of the takers and 97.7 per cent of the controls were successfully followed up for at least one year during which hospital visits and deaths were recorded. Methods of identification of subjects and 12-month mortality results have been reported previously. A general analysis of the morbidity experienced by these patients during the study year is presented here. Thirty-nine per cent of takers and 21 per cent of controls were seen at outpatient clinics, and 18 per cent of takers and 8 per cent of controls were admitted to hospital; 15 325 individual diagnoses in takers and 5002 diagnoses in controls were reviewed. An association with cimetidine treatment was found, as expected, for gastrointestinal diseases. Weaker associations were found for haematological disorders, some tumours, infections, disorders of the locomotor system and respiratory diseases. Detailed examination revealed that these were mainly due to confounding from several sources, for example, from the underlying cause of the dyspepsia which resulted in cimetidine use, from the higher level of physician contact in cimetidine takers, and smoking. The scheme successfully detected and quantified some already known adverse effects of cimetidine and did not detect any new effects. It is concluded that this method of collecting information is feasible and useful, but several interpretive pitfalls arise, some of which can be avoided by careful analysis. No evidence of any major unrecognised risk of cimetidine treatment emerged from the study.     

Heterogeneity of Matrin 3 in the developing and aging murine central nervous system

Mutations in the MATR3 gene encoding the nucleotide binding protein Matrin 3 have recently been identified as causing a subset of familial amyotrophic lateral sclerosis (fALS) and more rarely causing distal myopathy. Translating the identification of MATR3 mutations into an understanding of disease pathogenesis and the creation of mouse models requires a complete understanding of normal Matrin 3 levels and distribution in vivo. Consequently, we examined the levels of murine Matrin 3 in body tissues and regions of the central nervous system (CNS). We observed a significant degree of variability in Matrin 3 protein levels among different tissues of adult animals, with the highest levels found in reproductive organs and the lowest in muscle. Within the adult CNS, Matrin 3 levels were lowest in spinal cord. Further, we found that Matrin 3 declines significantly in CNS through early development and young adulthood before stabilizing. As previously reported, antibodies to Matrin 3 primarily stain nuclei, but the intensity of staining was not uniform in all nuclei. The low levels of Matrin 3 in spinal cord and muscle could mean that that these tissues are particularly vulnerable to alterations in Matrin 3 function. Our study is the first to characterize endogenous Matrin 3 in rodents across the lifespan, providing the groundwork for deciphering disease mechanisms and developing mouse models of MATR3‐linked ALS. J. Comp. Neurol. 524:2740–2752, 2016. © 2016 Wiley Periodicals, Inc.     

A review of diagnostic accuracy and clinical impact from the focused use of perioperative ultrasound

Purpose

To perform a narrative review of the current trials examining the use of perioperative ultrasound to diagnose common issues related to the heart, lungs, stomach, and airway.

Method

A review of the current literature was conducted in June 2017 on all trials involving ultrasound, including both surface and transesophageal ultrasound, in the perioperative period. The search included the terms ‘ultrasonography’, ‘perioperative care’, ‘point-of-care’, and ‘bedside’. Trials were limited to human subjects with no language or time restrictions being applied. The results were then collected and a narrative review was completed with the available information.

Results

In total 1,176 reports of original investigation or systematic reviews were collected and reviewed. Of those 1,176 reports and reviews, a total of 80 original articles met the inclusion criteria for this review. Topics were broadly defined based on common themes emerging from the literature including cardiac disease, lung pathology (pneumothorax, pleural effusion, pulmonary edema, and pulmonary consolidation), volume and contents of the stomach, confirmation of endotracheal tube position, confirmation of lung isolation, and the application of ultrasound for guiding cricothyroidotomy. Where possible, the sensitivity and specificity of the trials are presented. Few trials reported on patient outcomes, although several discussed provider outcomes such as a change in anesthesia practice. In addition, trials reporting outcomes, although few in number, were included.

Conclusion

Perioperative point-of-care ultrasound is a useful method for the diagnosis of many important perioperative conditions. The impact of this diagnostic approach on patient outcomes however remains to be determined.