A randomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol

<p>Abstract</p> <p>Background</p> <p>Over the past ten years MRSA has become endemic in hospitals and is associated with increased healthcare costs. Critically ill patients are most at risk, in part because of the number of invasive therapies that they require in the intensive care unit (ICU). Washing with 5% tea tree oil (TTO) has been shown to be effective in removing MRSA on the skin. However, to date, no trials have evaluated the potential of TTO body wash to prevent MRSA colonization or infection. In addition, detecting MRSA by usual culture methods is slow. A faster method using a PCR assay has been developed in the laboratory, but requires evaluation in a large number of patients.</p> <p>Methods/Design</p> <p>This study protocol describes the design of a multicentre, phase II/III prospective open-label randomized controlled clinical trial to evaluate whether a concentration of 5% TTO is effective in preventing MRSA colonization in comparison with a standard body wash (Johnsons Baby Softwash) in the ICU. In addition we will evaluate the cost-effectiveness of TTO body wash and assess the effectiveness of the PCR assay in detecting MRSA in critically ill patients. On admission to intensive care, swabs from the nose and groin will be taken to screen for MRSA as per current practice. Patients will be randomly assigned to be washed with the standard body wash or TTO body wash. On discharge from the unit, swabs will be taken again to identify whether there is a difference in MRSA colonization between the two groups.</p> <p>Discussion</p> <p>If TTO body wash is found to be effective, widespread implementation of such a simple colonization prevention tool has the potential to impact on patient outcomes, healthcare resource use and patient confidence both nationally and internationally.</p> <p>Trial Registration</p> <p>[ISRCTN65190967]</p

Raman spectroscopy and advanced mathematical modelling in the discrimination of human thyroid cell lines

Raman spectroscopy could offer non-invasive, rapid and an objective nature to cancer diagnostics. However, much work in this field has focused on resolving differences between cancerous and non-cancerous tissues, and lacks the reproducibility and interpretation to be put into clinical practice. Much work is needed on basic cellular differences between malignancy and normal. This would allow the establishment of a clinically relevant cellular based model to translate to tissue classification. Raman spectroscopy provides a very detailed biochemical analysis of the target material and to 'unlock' this potential requires sophisticated mathematical modelling such as neural networks as an adjunct to data interpretation. Commercially obtained cancerous and non-cancerous cells, cultured in the laboratory were used in Raman spectral measurements. Data trends were visualised through PCA and then subjected to neural network analysis based on self-organising maps; consisting of m maps, where m is the number of classes to be recognised. Each map approximates the statistical distribution of a given class. The neural network analysis provided a 95% accuracy for identification of the cancerous cell line and 92% accuracy for normal cell line. In this preliminay study we have demonstrated th ability to distinguish between "normal" and cancerous commercial cell lines. This encourages future work to establish the reasons underpinning these spectral differences and to move forward to more complex systems involving tissues. We have also shown that the use of sophisticated mathematical modelling allows a high degree of discrimination of 'raw' spectral data

The specific inherent optical properties of three sub-tropical and tropical water reservoirs in Queensland, Australia

The underwater light climate, which is a major influence on the ecology of aquatic systems, is affected by the absorption and scattering processes that take place within the water column. Knowledge of the Specific Inherent Optical Properties (SIOPs) of water quality parameters and their spatial variation is essential for the modelling of underwater light fields and remote sensing applications. We measured the SIOPs and water quality parameter concentrations of three large inland water impoundments in Queensland, Australia. The measurements ranged from 0.9–42.7 μgl/1 for chlorophyll a concentration, 0.9–170.4 mgl/1 for tripton concentration, 0.36–1.59 m/1 for aCDOM(440) and 0.15–2.5 m for Secchi depth. The SIOP measurements showed that there is sufficient intra-impoundment variation in the specific absorption and specific scattering of phytoplankton and tripton to require a well distributed network of measurement stations to fully characterise the SIOPs of the optical water quality parameters. While significantly different SIOP sets were measured for each of the study sites the measurements were consistent with published values in other inland waters. The multiple measurement stations were allocated into optical domains as a necessary step to parameterise a semi-analytical inversion remote sensing algorithm. This paper also addresses the paucity of published global inland water SIOP sets by contributing Australian SIOP sets to allow international and national comparison

Comparing grazing on lake seston by Dreissena and Daphnia: lessons for biomanipulation

Biomanipulation measures in lakes, taken to diminish algal blooms, have mainly been restricted to the reduction of zooplanktivorous fish with the aim to stimulate the grazing pressure by native filter feeders such as Daphnia. However, larger filter feeders like the exotic zebra mussel, Dreissena polymorpha, have been suggested as an optional tool because of their high filtering capacity. We compared grazing by two filter feeders, D. polymorpha and Daphnia galeata, offered seston from Lake IJsselmeer, the Netherlands in two consecutive years: 2002 and 2003. The seston in both years was dominated by the colony-forming cyanobacterium Microcystis aeruginosa. The grazing studies were performed under controlled conditions in the laboratory and samples were analyzed on a flow cytometer, making it possible to quantify grazing on different seston components and size fractions, including cyanobacteria, other phytoplankton (green algae, diatoms, etc.), and detritus. No differences in clearance rates, on a per weight basis, were found between the two grazer species. The clearance rate on cyanobacteria (especially <20 µm) was lower in 2003 than in 2002. In 2003, the microcystin concentration of cyanobacteria was higher than in 2002, suggesting that the observed lower clearance rate in 2003 was due to the enhanced toxin content of the cyanobacteria. Zebra mussels, although indiscriminately filtering all seston groups out of the water, positively selected for phytoplankton in their mantle cavity, irrespective of its toxicity, and rejected detritus. Since no differences in clearance rates were found between the two grazer species, we conclude that for biomanipulation purposes of shallow lakes, native species like the daphnids should be preferred over exotic species like zebra mussels. When the seston is dominated by phytoplankton that cannot be filtered out of the water column by Daphnia, however, the use of zebra mussels may be considered. Care should be taken, however, in the choice of the lakes since the mussels may have severe ecological and economic impacts.

Iron addition as a shallow lake restoration measure: impacts on charophyte growth

Eutrophication has caused a decline of charophyte species in many shallow lakes in Europe. Even though external inputs of phosphorus are declining, internal loading of P from the sediment seems to delay the recovery of these systems. Iron is a useful chemical binding agent to combat internal phosphorus loading. However, the effects of iron addition on charophytes are not yet known. In this study we experimentally tested the potential toxicity of iron(III)chloride (FeCl3) on two different charophytes, Chara virgata Kützing and Chara globularis Thuiller added at the concentration of 20 g Fe m−2 and 40 g Fe m−2 to the surface water. C. virgata growth was not significantly affected, whereas C. globularis growth significantly decreased with increasing iron concentrations. Nonetheless, biomass of both species increased in all treatments relative to starting conditions. The decrease of C. globularis biomass with high iron additions may have been caused by a drop in pH and alkalinity in combination with iron induced light limitation. Iron addition over a longer time scale, however, will not cause this rapid drop in pH. Therefore, we conclude that adding iron(III)chloride in these amounts to the surface water of a lake can potentially be a useful restoration method.