Nosocomial transmission of group B streptococci.

The acquisition of group B streptococci by babies in a special-care baby unit and two postnatal wards was investigated over a six-month period using serology and phage typing. Sixty-three culture-positive babies were identified in the postnatal wards, one-third of whom had been born to mothers who were not carrying the organism in the genital tract or anorectal area during labour. A non-maternal source was identified for 14 of these 21 infants: either colonised mothers and babies in the same ward or, on one occasion, a member of the hospital staff. In the special-care baby unit, however, only one instance of nosocomial acquisition of group B streptococci was recorded despite a high prevalence of colonisation in the staff on the unit and the presence of heavily colonised babies. The results of this survey suggest that although sepsis caused by group B streptococci may be the result of nosocomial transmission, this may be prevented by careful attention to hygiene.     

The evaluation of novel chromogenic substrates for the detection of lipolytic activity in clinical isolates of Staphylococcus aureus and MRSA from two European study groups

Pinellia ternata , a traditional Chinese herb that has been used in China for over 1000 years, is susceptible to a soft rot disease, which may cause major loss of yield. The use of bacteria as potential antagonists against Pectobacterium carotovorum SXR1, the causal agent of the disease on P. ternata , was evaluated. Altogether, 1107 candidate bacteria were isolated from the rhizosphere and surface-sterilized plants of P. ternata . In Petri dish tests, 55 isolates inhibited the growth of strain SXR1, and 21 of these reduced the disease development on P. ternata slices by over 50%. Four selected antagonists significantly reduced the disease incidence on tissue culture seedlings, and also prevented the disease on the transplants. Agonist P-Y2-2 yielded a good prevention level of 81.9%. The four antagonists rapidly colonized the tissue culture seedlings and transplants, whereas greater populations of the antagonists (10⁷–10⁹ CFU g⁻¹ fresh tissues) were observed in the seedlings and in the preinoculated transplants than in those inoculated during transplanting. The use of pathogen-free tissue culture seedlings pre-inoculated with antagonist may provide a strategy for production of P. ternata plantlets resistant to soft rot disease. This is the first report on the efficacy of biocontrol agents against pathogens on P. ternata .     

Spectinomycin resistant gonococci.

A study was conducted examining the properties of 10 clinical isolates of spectinomycin resistant gonococci from patients attending clinics at St Mary''s and St Thomas''s Hospitals, London. All of the isolates produced beta-lactamase and contained plasmids of 2.6, 4.4, and 24.5 megadaltons and required proline for growth. None produced aminoglycoside modifying enzymes. Resistance to spectinomycin was transferred from some of the isolates by transformation but at a much lower frequency than resistance to streptomycin. The isolates from St Mary''s Hospital were detected after therapy with spectinomycin, whereas those from St Thomas''s Hospital were not. Four recent non-beta-lactamase producing gonococci isolated at St Mary''s Hospital and two isolated at St Thomas''s Hospital also were not related to use of spectinomycin.     

Intravenous Isoprenaline in Treatment of Septic Shock in Man

Intravenous isoprenaline was given to 10 patients in septic shock, of which occult myocardial failure was the main indication. Isoprenaline expedited recovery in cases of “benign hypotension,” where kidney function paradoxically remained satisfactory at low systolic pressures, and was useful in cases of “cold hypotension” which were complicated by renal failure alone. No significant improvement occurred in cases which were complicated by both massive pulmonary oedema and acute renal failure.     

Synthesis and biological analysis of benzazol-2-yl piperazine sulfonamides as 11β-hydroxysteroid dehydrogenase 1 inhibitors

In the last decade the inhibition of the enzyme 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) emerged as a promising new strategy to treat diabetes and several metabolic syndrome phenotypes. Using a molecular modeling approach and classical bioisosteric studies, we discovered a new class of 11β-HSD1 inhibitors bearing an arylsulfonylpiperazine scaffold. Optimization of the initial lead resulted in compound 11 that selectively inhibits 11β-HSD1 (IC₅₀ = 0.7 μM).     

Spectinomycin as initial treatment for gonorrhoea.

The prevalence of penicillinase producing Neisseria gonorrhoeae at this hospital increased exponentially from less than 0.5% in 1978 to 6.5% of all isolates in 1982. In January 1983 first line treatment for uncomplicated heterosexual anogenital gonorrhoea was therefore changed from ampicillin and probenecid to spectinomycin. This subsequently cured 95% of cases seen at the Praed Street Clinic. Although there was an initial fall in the monthly isolation rate of penicillinase producing N gonorrhoeae after the introduction of spectinomycin, this was not maintained. The exponential increase in the prevalence of the strain did slow in 1983, rising to only 8.7%. This, however, may have reflected a general decline in the rate of increase of penicillinase producing N gonorrhoeae throughout Britain. The failure to influence the prevalence of penicillinase producing N gonorrhoeae to any great degree may have been due in part to spectinomycin resistance in both penicillinase producing and non-penicillinase-producing N gonorrhoeae. All of the isolates appeared identical, apart from the presence of the 4.4 megadalton plasmid in penicillinase producing N gonorrhoeae, but they could not be linked epidemiologically. Changing treatment in only one of the many venereal diseases clinics in London, where patients have open access to all such clinics, is unlikely to affect the prevalence of penicillinase producing N gonorrhoeae. This has probably been more important than spectinomycin resistance in limiting the effectiveness of spectinomycin in reducing the prevalence of the strain.     

Continuing medical education: experience and opinions of consultants.

The right of consultants to study leave and expenses is not binding on trusts and has been eroded in directly managed units. Complaints led to a survey of consultants in North West Thames region. This showed that most consultants use their own time and money to maintain their knowledge by buying and consulting journals and textbooks, attending local meetings, and using their annual leave for study, but they feel the need for study leave to attend meetings of specialist societies and courses. Leave is usually granted readily but without cover provided by a locum and with a very limited contribution to expenses. To maintain quality of medical care both the right and obligation to take study leave should be contractual.     

2-Benzazolyl-4-Piperazin-1-Ylsulfonylbenzenecarbohydroxamic Acids as Novel Selective Histone Deacetylase-6 Inhibitors with Antiproliferative Activity

We have screened our compound collection in an established cell based assay that measures the derepression of an epigenetically silenced transgene, the locus derepression assay. The screen led to the identification of 4-[4-(1-methylbenzimidazol-2-yl)piperazin-1-yl]sulfonylbenzenecarbohydroxamic acid (9b) as an active which was found to inhibit HDAC1. In initial structure activity relationships study, the 1-methylbenzimidazole ring was replaced by the isosteric heterocycles benzimidazole, benzoxazole, and benzothiazole and the position of the hydroxamic acid substituent on the phenyl ring was varied. Whereas compounds bearing a para substituted hydroxamic acid (9a-d) were active HDAC inhibitors, the meta substituted analogues (8a-d) were appreciably inactive. Compounds 9a-d selectively inhibited HDAC6 (IC₅₀ = 0.1–1.0μM) over HDAC1 (IC₅₀ = 0.9–6μM) and moreover, also selectively inhibited the growth of lung cancer cells vs. patient matched normal cells. The compounds induce a cell cycle arrest in the S-phase while induction of apoptosis is neglible as compared to controls. Molecular modeling studies uncovered that the MM-GBSA energy for interaction of 9a-d with HDAC6 was higher than for HDAC1 providing structural rationale for the HDAC6 selectivity.