Cinnamaldehyde inhibits Enterococcus faecalis biofilm formation and promotes clearance of its colonization by modulation of phagocytes in vitro

The nosocomial pathogen, Enterococcus faecalis plays a crucial role in the pathogenesis of variety of infections including endocarditis, urinary tract, and recurrent root canal infections. Primary virulence factors of E. faecalis such as biofilm formation, gelatinase production and suppression of host innate immune response can severely harm host tissue. Thus, novel treatments are needed to prevent E. faecalis biofilm development and pathogenicity due to the worrisome rise in enterococcal resistance to antibiotics. The primary phytochemical in cinnamon essential oils, cinnamaldehyde, has shown promising efficacy against a variety of infections. Here, we looked into how cinnamaldehyde affected the growth of biofilms, the activity of the enzyme gelatinase, and gene expression in E. faecalis. In addition, we looked at the influence of cinnamaldehyde on RAW264.7 macrophages' interaction with biofilm and planktonic E. faecalis in terms of intracellular bacterial clearance, NO generation, and macrophage migration in vitro. According to our research, cinnamaldehyde attenuated the biofilm formation potential of planktonic E. faecalis and gelatinase activity of the biofilm at non-lethal concentrations. The expression of the quorum sensing fsr locus and its downstream gene gelE in biofilms were also found to be significantly downregulated by cinnamaldehyde. Results also demonstrated that cinnamaldehyde treatment increased NO production, intracellular bacterial clearance, and migration of RAW264.7 macrophages in presence of both biofilm and planktonic E. faecalis. Overall these results suggest that cinnamaldehyde has the ability to inhibit E. faecalis biofilm formation and modulate host innate immune response for better clearance of bacterial colonization.

Low-skill fibreoptic intubation: use of the Aintree Catheter with the classic LMA

We describe a series of patients in whom anaesthetists - many of whom were trainees and had no prior experience of using the Aintree Intubation Catheter - successfully intubated the tracheas of patients in whom conventional attempts at intubation had failed. This was achieved by passing a fibrescope loaded with an Aintree Intubation Catheter through a classic Laryngeal Mask Airway (cLMA), which had already been placed to maintain the patient's airway.

Surgery for snoring: are partners satisfied in the long run?

Patients seek surgery for snoring, essentially for the sake of their partners. Few studies have looked into the long-term results from this angle. We herein report the findings of a study of partner satisfaction, following laser-assisted uvulopalatoplasty (LAUP) and uvulopalatopharyngoplasty (UVPP). This was a questionnaire-based survey, with a minimum follow-up of 1 year. A total of 91 procedures (LAUP = 50 and UVPP = 41) were evaluated. Response rate was 65.93%. Both groups were matched for age, gender and duration of the follow-up. Residual snoring was even more frequently following LAUP than it was following UVPP (Mann-Whitney U = 244, P = 0.012). After UVPP, partners were less likely to have trouble falling asleep (Mann-Whitney U = 255, P = 0.041). There was a highly significant reduction in the disturbance of sleep and need to wake up after both types of surgery (McNemar test, chi2 = 25.037, P < 0.001). Both groups reported improvements in quality of life. We propose a grading system to record partner satisfaction. The long-term results show that surgery for snoring is justified in the National Health Service (NHS) in the new millennium.