Non-infected Sites Research Articles

SPECT Imaging of P. aeruginosa Infection in Mice Using 123I-BMIPP.

Pseudomonas aeruginosa infection is an infectious disease that must be controlled because it becomes chronic and difficult to treat, owing to its unique system of toxin production/injection and elimination of other bacteria. Here, we noninvasively monitored P. aeruginosa using single-photon emission computed tomography (SPECT) imaging. Determining the amount and localization of the P. aeruginosa will enable making faster clinical diagnoses and selecting the most appropriate therapeutic agents and methods. Nonclinically, this information can be used for imaging in combination with biofilms and toxin probes and will be useful for discovering drugs targeting P. aeruginosa. To study P. aeruginosa accumulation, we conducted in vitro and in vivo studies using iodine-123 β-methyl-p-iodophenyl-pentadecanoic acid (123I-BMIPP), which we previously reported using for Escherichia coli. In vitro, 123I-BMIPP accumulated in P. aeruginosa by being taken up into the bacteria and adsorbing to the bacterial surface. In vivo, 123I-BMIPP accumulated significantly more in infected sites than in noninfected sites and could be quantified by SPECT. These results suggest that 123I-BMIPP can be used as a probe for P. aeruginosa for SPECT. Establishing a noninvasive monitoring method using SPECT will allow further progress in studying P. aeruginosa.

Resonance Frequency Analysis for Immediately Placed Dental Implants Replacing Periapically Infected Teeth

Aims: There is a controversy regarding the indication of implant insertion into the sockets of infected teeth. This study aimed to evaluate the outcome of immediate implants replacing periapically infected teeth utilizing Resonance Frequency Analysis (RFA) method. Materials and Methods: Preoperatively, clinical, and radiographic examination accomplished for the patients. After anesthetizing the surgical area, the accused tooth extracted, and the socket curetted by surgical curette to remove the periapical lesion then irrigated by normal saline solution. The implant inserted into its prepared site. Beta-tricalcium phosphate (β-TCP) (combined by collagen membrane) used to fill gaps ≥ 2 mm and to repair bone defects. Implant stability quotient (ISQ) values were measured for the implants during surgery and after 16 weeks. Postoperative clinical and radiographic evaluation were conducted for each patient. Results: Fourteen implants out of 41 immediate implants (34.1%) had been inserted in the extraction sockets of teeth have chronic periapical lesions (infected sites), T-test showed no significant difference in implant stability (ISQ value) between implant placed in infected and non-infected sites neither at baseline nor at 16-weeks. Paired t-test showed highly significant increase in implant stability (ISQ value) of implants placed in infected sites while in the other implants the mean ISQ value increased with no significant difference during the healing period. The success rate was 100% after 4 years of implantation. Conclusions: Presence of periapical lesion is not a contraindication to place immediate implant when properly managed and can provide similar survival rate to that of implants inserted into healthy sockets.

Bacteria-targeting photoactivated antibacterial nanosystem based on oligoalginate-protoporphyrin IX for plant disease treatment

To enhance bacteria-targeting and improve bactericidal activity, a novel GSH-responsive photodynamic antimicrobial nanosystem based on Alginate oligosaccharide-protoporphyrin IX (AOS-ss-PpIX) conjugates were constructed. The fluorescence self-quenching caused by the aggregation of PpIX groups into hydrophobic core could promote the photostability of PpIX and avoid the phototoxicity of the non-infected sites of the target plants. But once exposed to GSH stimulus, the recovery of high photodynamic activity were observed due to the destruction of the system and accompanied by the release of thiolated PpIX, and the photodynamic activity after 2 h was higher than that of PpIX under the same conditions. Furthermore the system showed more efficient photodynamic antibacterial capacity under light exposure. Moreover, the pot experiment also verified that the system showed outstanding control efficacy against cabbage soft rot caused by Erwinia carotovora Sclerotinia. Safety test exhibited that the size of nanoparticles can restrict the entry of nanoparticles into the plant cells to trigger photocytotoxicity. The design strategy provides a platform for promoting the utilization of photoactivated pesticides and reducing or avoiding their harm to target plants and the environment.

Immediate Implant Placement in Infected Sockets: Curettage Protocol Plus Disinfection with Hydrogen Peroxide and Rifamycin. Retrospective Analysis at 6 years of Follow-up

Context: Immediate implant placement in a fresh socket after extraction is an increasingly popular and established treatment option. However, active infection at the extraction site can adversely affect the outcome of this procedure. Aims: This study was designed to evaluate the clinical results of immediate dental implant placement in infected extraction sockets. Settings and Design: using a standardized protocol, which included the use of 3% hydrogen peroxide plus rifamycin 500 mg as irrigation for decontamination of the infected socket before implant insertion with submerged healing. Patients and methods: The sample consisted of 227 implants placed in 158 patients, the data were obtained through a retrospective review of the clinical registry selected of patients who received implants according to the protocol described. Statistical analysis used: A generalized binary response regression model was used. For all tests, the statistical significance value was set at p <0.05. Results: Of the 227 implants placed immediately in the infected sites using the described protocol with an average follow-up of 6 years of prosthetic loading, only 11 failed, resulting in a cumulative implant survival rate of 95.2%. Only the medical history / harmful habits factor (HM / HH) was significant (p = 0.002), in this group the success rate was 85.7%. However, in the group of healthy patients without harmful habits, the success rate rises to 98.8%. Conclusion: Immediate implant placement in infected sites using these protocols in healthy patients shows a survival rate similar to that published for implants placed in non-infected sites.

Assessment of Incidence of Presence of Bacteria in Sutures of Maxillofacial Trauma Patients

Background: Sutures under selective host or environmental factors can potentiate postoperative surgical site infection. The present study characterized microbial recovery and biofilm formation from explanted absorbable and non-absorbable sutures from infected and non-infected sites of maxillofacial trauma patients.
 Aim: The aim of the study was to assess the incidence of microbiology of explanted suture segments from infected and non-infected maxillofacial trauma patients.
 Methods and Materials: Non absorbable and absorbable suture segments were collected at Randomly from 80 patients with two groups one group with infected sutures second group with non-infected sutures. Explanted sutures were recovered from maxillofacial trauma surgeries. Suture segments were obtained upon patient return to the clinic after seven days for review. All suture segments were collected aseptically. Designation of non-infected versus infected was determined by clinical presentation and criteria defined by the National Healthcare Safety Network of the Centers for Disease Control and Prevention. All the suture specimens were sent to University Microbiology department for bacterial culture and the results were studied.
 Results: A significant difference in mean microbial recovery between non infected and infected sutures were noted. Age distribution showed, males 86.25% and females 13.75% [Fig. 1]. Fig. 5 shows the Association of infected and non-infected suture groups with presence or absence of bacteria infected suture shows presence bacteria 13.75%, and non-infected suture showed presence of bacteria 6.25%, absence of bacteria 80.0%. Table 1- Presence or absence of infection cross tabulation showed, presence of bacteria in infected suture 11, presence of bacteria in non-infected suture 5 and absence of bacteria 64.
 Conclusion: Within the limitation of study, we found that bacterial presence on the suture has a statistically significant role in causing postoperative infection. Any suture may be considered as a port of entry for infection, which in turn may compromise healing of the surgical wound. It is advised to minimize the duration of the presence of sutures, and their removal should be carried out as early as possible, according to the specific healing conditions.

Immediate Implant Placement in Infected Sockets: A Consecutive Cohort Study.

Introduction: Immediate placement of implants in a fresh post-extraction socket is an increasingly popular and established treatment option. However, active infection in the extraction site may adversely affect the outcome of this procedure. This study was designed to assess the clinical results of immediate placement of dental implants in infected extraction sockets using a standardized protocol, which included (a) the use of an Er,Cr:YSGG laser for the decontamination of the infected socket prior to implant insertion, and (b) the utilization of an in situ hardening alloplastic bone graft substitute to augment the gap between the implant surface and the labial plate of bone. Patients and Methods: A retrospective record review was used to identify 68 patients who had implants placed as per the described protocol. A total of 126 implants were placed in 68 patients (65 implants in the maxilla, 61 implants in the mandible). The implants were loaded 136 ± 73 days (mean ± standard deviation; range: 37-400 days) after implant placement. Eight patients (16 implants) were subsequently lost to follow up. Results: 105 of the 110 implants (95.45%) placed immediately in the infected sites using the described protocol survived after prosthetic loading. Conclusion: Immediate implant placement in previously infected sites using the protocols mentioned in our study with laser decontamination of the socket, grafting with an in situ hardening alloplastic bone graft material and non-submerged healing shows a similar survival rate to the published success rates for immediate implants placed in non-infected sites.

Limited Evidence Suggests that the Immediate Placement of Dental Implants Into Infected Sites Versus Noninfected Sites in the Esthetic Zone Show Comparable Clinical Results

Immediate placement of dental implants into infected versus noninfected sites inthe esthetic zone: A systematic review and meta-analysis. Chen H, Zhang G, Weigl P, Gu X. J Prosthet Dent 2018; 120(5):658-71. This study was funded by the authors. Systematic review and meta-analysis.

Histologic Analyses of Immediate Implant Placement in Infected and Noninfected Sockets: An Experimental Pilot Study in Beagle Dogs.

To investigate the histologic differences between immediate implants placed in chronically infected sites and noninfected sites in a canine model. The histologic results of immediate implant placement also were evaluated on the basis of healing time and implant surface modification. Chronic endodontic-periodontic combined lesions were induced on the second, third, and fourth premolars of the hemimandible in six dogs, with the contralateral teeth as controls. Implants were immediately placed following the infected and noninfected tooth extractions using implants with a machined surface, sandblasted with alumina and acid-etched surface, and chemically modified sandblasted with alumina and acid-etched with calcium solution surface. After 1 and 3 months, three dogs were euthanized and the bone-to-implant contact, bone area fraction occupied, buccal and lingual first bone-to-implant contact from the implant platform, and buccal and lingual marginal bone loss were calculated. On histologic evaluation, no inflammation was observed around implants placed in the infected or noninfected sockets. At 1 month, no statistically significant differences were observed between the infected and noninfected sockets in buccal marginal bone loss in the machined implant group (P = .046), lingual first bone-to-implant contact from the implant in the sandblasted with alumina and acid-etched group (P = .046), lingual marginal bone loss in the sandblasted with alumina and acid-etched implant group (P = .028), buccal first bone-to-implant contact from the implant platform in the chemically modified sandblasted with alumina and acid-etched with calcium solution group (P = .028), and lingual first bone-to-implant contact from the implant platform in the chemically modified sandblasted with alumina and acid-etched with calcium solution group (P = .046). At 3 months, no statistically significant differences were observed in parameters between the infected and noninfected sockets for three implant surfaces. Differences between the infected and noninfected sockets were observed between the machined and sandblasted with alumina and acid-etched implant at 1 month (P = .023). Immediate implant placement in an infected socket did not lead to any differences when compared with placement in a noninfected socket when sufficient healing time was provided.

Immediate dental implants placed into infected sites present a higher risk of failure than immediate dental implants placed into non-infected sites: Systematic review and meta-analysis.

BackgroundAlveolar infection is known as a risk factor for implant failure. Current meta-analysis on the theme could not prove statistically that immediate dental implants placed into infected sites have a higher risk of failure than immediate dental implants placed into non-infected sites. The purpose of this meta-analysis was to determine the effectiveness of immediate dental implants placed into infected versus non-infected sites.Material and MethodsSeven databases were sought by two reviewers. Randomized or non-randomized clinical trials that compared the placement of dental implants into infected versus non-infected sites were eligible for the study. Exclusion criteria were: papers in which the survival rate was not the primary outcome; papers without a control group; studies with less than one year of follow-up; studies whose patients did not receive antibiotic therapy; studies with medically compromised patients; duplicated papers. Risk of bias assessment was performed with the Cochrane Collaboration tool.ResultsOf the 3.253 initial hits, 8 studies were included in both qualitative and quantitative synthesis (kappa=0.90; very good agreement). Forest plot for implant failure showed that immediate implants placed into infected sites presented a statistically significant risk of failure that is almost 3 times higher than when placed into non-infected sites (risk ratio= 2.99; 95% confidence interval: 1.04, 8.56; p= 0.04; 935 implants; i2= 0%). Peri-implant outcomes showed no statistical difference.ConclusionsImmediate dental implants placed into infected sites presented a statistically significant higher risk of failure than immediate dental implants placed into non-infected sites. Peri-implant outcomes were not statistically affected in this intervention. Key words:Dental implants, infection, tooth socket, systematic review, immediate placement.

Biotic factors associated with the spatial distribution of the mistletoe Psittacanthus calyculatus in a tropical deciduous forest of central Mexico

Psittacanthus calyculatus (DC.) G. Don (Loranthaceae) is a neotropical hemiparasitic mistletoe and one of the most abundant and widely distributed species of the genus. Like most mistletoes, the interaction with its hosts and dispersers are directly related with its distribution and community dynamics. For the last decade, the infested areas in central México have increased, becoming a potential plant health problem. The aim of this study was to investigate three main biotic factors associated with the distribution of P. calyculatus in a tropical deciduous forest: (1) the plant community structure, (2) the host spatial distribution and level of association with P. calyculatus , and (3) bird consumers. Modified Whittaker plots were used to analyze the structure and composition of the plant community, comparing a highly infected mistletoe sites with non-infected sites. The spatial distribution and association of P. calyculatus with its most frequent hosts were calculated through a spatial analysis by distance indices. Study sites differed in plant diversity and species composition, showing a positive relation of mistletoe abundance with low diversity sites. The distance indices analysis presented a clumped distribution of P. calyculatus and Acacia hosts, as well as a high association with leguminous species such as A. farnesiana (X = 0.31, P = 0.0041) and A. schaffneri (X = 0.3977, P = 0.001). Three species consumed P. calyculatus’ berries: the Northern mockingbird, the Silky-Flycatcher and the Scott’s Oriole.

Immediate dental implant placement into infected vs. non-infected sockets: a meta-analysis.

This meta-analysis was aimed at assessing whether immediate dental implant placement into infected vs. non-infected sites produced different effects on implant failure risk and marginal bone loss. Relevant studies were identified by searching articles in PubMed, Web of Knowledge, and the Cochrane Library through February 2015 and by reviewing the reference lists of the retrieved articles. When an intervention led to dichotomous outcomes, the outcomes were expressed as risk ratios, whereas continuous outcomes were expressed as mean differences in millimeters; each had a 95% confidence interval. Study-specific estimates were combined using fixed-effects models. A total of 1743 articles were identified following the search process. Seven studies were finally included in the meta-analysis, which comprised a total of 1586 implants and 25 failures. Compared to the immediate insertion of a dental implant into a non-infected site, the insertion of an implant into an infected site showed 116% increase in the risk of implant failure, which had borderline statistical significance (risk ratio=2.16, 95% confidence interval: 0.97, 4.80, P=0.058; heterogeneity: I2 =0.0%, Pheterogeneity =0.997). With regard to marginal bone loss, we observed no statistically significant difference between insertions into infected vs. non-infected sites (mean difference=-0.04, 95% confidence interval: -0.09, 0.02, P=0.173, heterogeneity: I2 =0.0%, Pheterogeneity =0.765). This meta-analysis suggests that immediately placing a dental implant into an infected site may increase the risk of implant failure. Given the presence of uncontrolled confounders in the studies that were assessed, the results should be interpreted with caution.

Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: a 3-year prospective study

Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: a 3-year prospective study

HCMV Antibody Titer in Gingival Crevicular Fluid in Chronic Periodontitis

Background and aims. Despite available evidence for the role of herpes viruses in destructive periodontal diseases, no cause-and-effect relationship has been found to date. This study compared the titer of immunoglobulin G (IgG), immu- noglobulin M (IgM) against human cytomegalovirus (HCMV) in gingival crevicular fluid between individuals with perio- dontitis and with healthy periodontium. Materials and methods. Thirty samples of gingival crevicular fluid (ten from infected sites and ten from non-infected sites from ten individuals with periodontitis and ten from ten individuals with healthy periodontium) were provided. The titer of IgG and IgM were evaluated. Data was analyzed by one-way ANOVA, Kruskal-Wallis test, t-test, Duncen's test and Pearson's correlation coefficient. Results. There were no statistically significant differences in the means of IgM titers of the three groups under study (P>0.05), but there were significant differences in IgG titers between the three groups (P<0.001). Conclusion. Within the limits of the present study, it can be concluded that IgG titers against the human cytomegalovirus can increase in patients with periodontal diseases but the IgM titers do not show a significant increase in these individuals.

Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: A 3-year prospective study

ObjectivesTo compare the survival of immediate implants placed in postextraction infected and non-infected sites, restored with cemented crowns. MethodsThirty-six implants were immediately placed in non-infected sockets (control group (CG), n=18), and in infected alveoli (test group (TG), n=18) that had been debrided, curetted, cleaned with 90% hydrogen peroxide, irradiated with yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser, and irrigated with a sterile solution. Guided bone regeneration was performed under antibiotic coverture. All study patients had both a CG and a TG site. The implant osteotomy sites were extended 3–4mm beyond the apical extent of the sockets to achieve primary stability for the implants. The prosthetic phase occurred 4.5 months after surgery. Success criteria were accepted as the presence of implant stability, absence of a radiolucent zone around the implants, absence of mucosal suppuration, and lack of pain. Clinical evaluations were performed at baseline, and at 12, 24, and 36 months of follow-up. ResultsAll of the implants were osseointegrated 3 months after surgery. The 3-year survival rate was 94.44% for TG, and 100% for CG. The clinical and radiographic variables tested yielded no significant differences among groups at 36 months. ConclusionsUnder the tested conditions, immediate implant placement can be considered a predictable treatment option for the restoration of fresh postextraction infected sockets. Clinical significanceImmediate implants may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history when appropriate preoperative procedures are taken to clean and decontaminate the surgical sites.

Immediate Implants Placed in Infected and Noninfected Sites after Atraumatic Tooth Extraction and Placement with Ultrasonic Bone Surgery

Only a few reports deal with implants placed in infected postextraction sites. Survival rates of a cohort of immediate implants cases placed in acute and chronically infected sites were compared with a cohort of noninfected ones while (1) tooth extraction and osteotomy sites were prepared with a piezosurgery device and (2) ultrasonication was applied to abate the bacterial charge at infected sites. Eighty-six patients received 168 immediate implants distributed into three groups: noninfected (85), acute (36), and chronically (47) infected sites. Atraumatic extraction and implant osteotomy were performed with an ultrasonic surgery device without flap elevation. All sites received the same medication and surgical protocol; infected sites were ultrasonicated during 30 seconds at 72 W. Kaplan-Meyer survival rates were calculated at 1 year. The 1-year survival rates of the noninfected, chronically, and acute infected groups were 98.8, 100, and 94.4%, respectively. The differences were not statistically significant. No implant was lost after loading. All teeth and roots could be extracted in one piece. Drilling at extraction sockets was uncomplicated, without skidding. Implant survival rates might be similar in infected and noninfected sites when infected sites receive standard medical and surgical treatment and are ultrasonicated. Atraumatic tooth/root extraction and implant placement can be reliably performed with piezoelectric surgery.

Microbiology of Explanted Suture Segments from Infected and Noninfected Surgical Patients

Sutures under selective host/environmental factors can potentiate postoperative surgical site infection (SSI). The present investigation characterized microbial recovery and biofilm formation from explanted absorbable (AB) and nonabsorbable (NAB) sutures from infected and noninfected sites. AB and NAB sutures were harvested from noninfected (70.9%) and infected (29.1%) sites in 158 patients. At explantation, devices were sonicated and processed for qualitative/quantitative bacteriology; selective sutures were processed for scanning electron microscopy (SEM). Bacteria were recovered from 85 (53.8%) explanted sites; 39 sites were noninfected, and 46 were infected. Suture recovery ranged from 11.1 to 574.6 days postinsertion. A significant difference in mean microbial recovery between noninfected (1.2 isolates) and infected (2.7 isolates) devices (P < 0.05) was noted. Staphylococcus epidermidis, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Peptostreptococcus spp., Bacteroides fragilis, Escherichia coli, Enterococcus spp., Pseudomonas aeruginosa, and Serratia spp. were recovered from infected devices, while commensal skin flora was recovered from noninfected devices. No significant difference in quantitative microbial recovery between infected monofilament and multifilament sutures was noted. Biofilm was present in 100% and 66.6% of infected and noninfected devices, respectively (P < 0.042). We conclude that both monofilament and braided sutures provide a hospitable surface for microbial adherence: (i) a significant difference in microbial recovery from infected and noninfected sutures was noted, (ii) infected sutures harbored a mixed flora, including multidrug-resistant health care-associated pathogens, and (iii) a significant difference in the presence or absence of a biofilm in infected versus noninfected explanted devices was noted. Further studies to document the benefit of focused risk reduction strategies to minimize suture contamination and biofilm formation postimplantation are warranted.

Immediate Loading of Dental Implants Placed in Periodontally Infected and Non‐Infected Sites: A 4‐Year Follow‐Up Clinical Study

The aim of the present study is to compare the outcomes of immediate loading of implants in replacing teeth with and without chronic periodontal lesions at 4 years of follow-up. Thirty-seven patients were included in this study. A total of 275 implants were placed and immediately loaded in extraction sockets, 197 in periodontally infected sites (infected sites group [IG]), and 78 implants in non-infected sites (non-infected sites group [NG]). Marginal bone levels and clinical parameters (plaque accumulation and bleeding index) were evaluated at baseline and 12, 24, and 48 months after implant placement. Comparisons between IG and NG values over time were performed by the Student two-tailed t test. At 48 months of follow-up, the IG presented a survival rate of 98.9% because two implants were lost 1 month after placement; the NG reported a survival rate of 100%. The marginal bone level was 0.79 +/- 0.38 mm for the IG and 0.78 +/- 0.38 mm for the NG, plaque accumulation was 0.72 +/- 0.41 for the IG and 0.71 +/- 0.38 for the NG, and the bleeding index was 0.78 +/- 0.23 for the IG and 0.75 +/- 0.39 for the NG. No statistically significant differences were reported between the IG and NG over time and between time points. At 48 months of follow-up, dental implants that were placed and immediately loaded in periodontally infected sockets showed no significant differences compared to implants placed in uninfected sites.

Immediate Placement of Implants Into Infected Sites: A Systematic Review of the Literature

Immediate implant placement of dental implants into fresh extraction sockets was shown to be a predictable and successful procedure when proper protocols were followed. Placement into infected sites has been considered a relative contraindication. However, data from animal research, human case reports and case series, and prospective studies showed similar success rates for implants placed into infected sites compared to implants placed in non-infected or pristine sites. The focus questions addressed in this review are: Does the presence of infection compromise the osseointegration of immediate placement of implants? Does the presence of infection compromise immediately placed implant success? What protocols have been used to address the infection prior to immediate implant placement? A systematic search of MEDLINE/PubMed articles published from 1982 up to and including November 2009 was independently performed by two investigators (JAW and CIE). The search strategy used combinations of the following terms: dental implants, immediate, immediately, extraction, infection, infected, and pathology. The search included data from animal and human studies. The selection criteria excluded animal studies that did not include a pristine control group and human case reports and case series with <1 year of follow-up. All prospective human studies were included. Studies were limited to those published in the English language, and review article data were excluded. The search strategy initially yielded 417 references. After screening the abstracts for those related to the focus questions, 12 publications qualified for inclusion. The majority of studies examined sites with chronic periapical infection; however, the classification of infection was often vague and not categorized to be related to the outcome. The data from animal studies demonstrated high levels of implant survival, although conflicting data showed that the bone-to-implant contact may be impaired. Human studies showed high levels of implant survival consistent with therapy in non-infected sites, but evidence was limited to a small number of studies and patients. Thorough debridement and the use of systemic antibiotics were employed in all studies. Evidence suggests implants can be placed into sites with periapical and periodontal infections. The sites must be thoroughly debrided prior to placement. Guided bone regeneration is usually performed to fill the bone-implant gap and/or socket deficiencies. Although controversial, systemic antibiotics should be used until further controlled trials prove otherwise.

Novel Antibacterial and Emollient Effects of Coconut and Virgin Olive Oils in Adult Atopic Dermatitis

Atopic dermatitis (AD) skin is dry and readily colonized by Staphylococcus aureus (SA). Coconut and olive oils are traditionally used to moisturize and treat skin infections. To compare virgin coconut oil (VCO) and virgin olive oil (VOO) in moisturizing dryness and removing SA from colonized AD skin. This was a double-blind controlled trial in two outpatient dermatology clinics with adult AD patients who were diagnosed by history, pattern, evolution, and skin lesions and who were randomized to apply VCO or VOO twice daily at two noninfected sites. SA cultures, photography, and objective-SCORAD severity index (O-SSI) scoring were done at baseline and after 4 weeks. Twenty-six subjects each received VCO or VOO. Of those on VCO, 20 were positive for SA colonies at baseline versus 12 on VOO. Post intervention, only 1 (5%) VCO subject remained positive versus 6 (50%) of those on VOO. Relative risk for VCO was 0.10, significantly superior to that for VOO (10:1, p = .0028; 95% CI, 0.01-0.73); thus, the number needed to treat was 2.2. For the O-SSI, the difference was not significant at baseline (p = .15) but was significantly different post treatment (p = .004); this was reduced for both oils (p < .005) but was greater with VCO. VCO and monolaurin's O-SSI reduction and in vitro broad-spectrum activity against SA (given clinical validity here), fungi, and viruses may be useful in the proactive treatment of AD colonization.

Tobamoviral movement protein transiently expressed in a single epidermal cell functions beyond multiple plasmodesmata and spreads multicellularly in an infection-coupled manner.

Cell-to-cell movement of a plant virus requires expression of the movement protein (MP). It has not been fully elucidated, however, how the MP functions in primary infected cells. With the use of a microprojectile bombardment-mediated DNA infection system for Tomato mosaic virus (ToMV), we found that the cotransfected ToMV MP gene exerts its effects in the initially infected cells and in their surrounding cells to achieve multicellular spread of movement-defective ToMV. Five other tobamoviral MPs examined also transcomplemented the movement-defective phenotype of ToMV, but the Cucumber mosaic virus 3a MP did not. Together with the cell-to-cell movement of the mutant virus, a fusion between the MP and an enhanced green fluorescent protein variant (EGFP) expressed in trans was distributed multicellularly and localized primarily in plasmodesmata between infected cells. In contrast, in noninfected sites the MP-EGFP fusion accumulated predominantly inside the bombarded cells as irregularly shaped aggregates, and only a minute amount of the fusion was found in plasmodesmata. Thus, the behavior of ToMV MP is greatly modulated in the presence of a replicating virus and it is highly likely that the MP spreads in the infection sites, coordinating with the cell-to-cell movement of the viral genome.