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1.  Warmth is Analgesic in Healthy Newborns 
Pain  2012;153(5):960-966.
This study identifies a behavioral and nonpharmacologic means of preventing and reducing newborn pain. Our objective was to determine whether warmth is analgesic in newborn infants undergoing vaccination—a routine painful hospital procedure. We used a prospective randomized controlled trial of 47 healthy full-term newborn infants.
Infants were randomized into one of three conditions prior to vaccination: warmth exposure, pacifier suckling, or sucrose taste. Crying, grimacing, and heart rate differences were analyzed between groups before, during, and after vaccination as outcome measures. Warmer infants cried significantly less than sucrose taste or pacifier suckling after vaccination. Heart rate patterns reflected this analgesia. Core temperature did not differ between study groups. Providing natural warmth to newborn infants during a painful procedure decreases the crying and grimacing on par with the “gold” standard treatments of sucrose or pacifier.
PMCID: PMC4219317  PMID: 22424877
Infant; newborn; pain; analgesia; vaccination; crying; grimacing; heart rate; autonomic; sucrose; pacifier
2.  A randomized trial to evaluate a launderable bed protection system for hospital beds 
Hospital beds are potential reservoirs of bacteria in hospitals. Preventing contamination of the bed and providing a cleaner surface should help prevent hospital-acquired infections (HAIs). Most hospital beds are cleaned between patients (terminal cleaning) using quaternary ammonia compounds (quats).
The study had two objectives: identify levels of bacterial contamination on beds (including the mattress and bed deck) and evaluate a new launderable cover.
Hospital beds on a bariatric surgery ward were randomized to either receive or not receive a launderable cover (Trinity Guardion, Batesville, IN). Bacterial counts on the surface of the mattress, the bed deck, and the launderable cover were then collected using Petrifilm™ Aerobic Count Plates (Petrifilm™, 3M™, St. Paul, MN, USA) (Petrifilm™) at three time periods (before patient use, after discharge, and after terminal cleaning). Standard hospital linen was used in all rooms.
The launderable cover (n = 28) was significantly cleaner prior to patient use than were the cleaned mattresses (n = 38) (1.1 CFU/30 cm2 vs. 7.7 CFU/30 cm2; p = 0.0189). The mattresses without launderable covers became significantly contaminated during use (7.7 CFU/30 cm2 on admission vs. 79.1 CFU/30 cm2 after discharge; p < 0.001). The mattresses with launderable covers did not become contaminated (3.0 CFU/30 cm2 on admission vs. 2.5 CFU/30 cm2 at discharge; p = 0.703). After terminal cleaning, the mattress surface contamination decreased to 12.8 CFU/30 cm2 (median 3 CFU/30 cm2; SD 7.8), but the bed deck was more contaminated (6.7 CFU/30 cm2 after discharge compared to 30.9 CFU/30 cm2 after terminal cleaning; p = 0.031).
Terminal cleaning fails to eliminate bacteria from the surface of the hospital mattress. The launderable cover provides a cleaner surface than does terminal cleaning with quats, and the cover protects the bed from contamination during use.
PMCID: PMC3441859  PMID: 22958605
3.  Sodium Nitrite-Mediated Killing of the Major Cystic Fibrosis Pathogens Pseudomonas aeruginosa, Staphylococcus aureus, and Burkholderia cepacia under Anaerobic Planktonic and Biofilm Conditions▿  
Antimicrobial Agents and Chemotherapy  2010;54(11):4671-4677.
A hallmark of airways in patients with cystic fibrosis (CF) is highly refractory, chronic infections by several opportunistic bacterial pathogens. A recent study demonstrated that acidified sodium nitrite (A-NO2−) killed the highly refractory mucoid form of Pseudomonas aeruginosa, a pathogen that significantly compromises lung function in CF patients (S. S. Yoon et al., J. Clin. Invest. 116:436-446, 2006). Therefore, the microbicidal activity of A-NO2− (pH 6.5) against the following three major CF pathogens was assessed: P. aeruginosa (a mucoid, mucA22 mutant and a sequenced nonmucoid strain, PAO1), Staphylococcus aureus USA300 (methicillin resistant), and Burkholderia cepacia, a notoriously antibiotic-resistant organism. Under planktonic, anaerobic conditions, growth of all strains except for P. aeruginosa PAO1 was inhibited by 7.24 mM (512 μg ml−1 NO2−). B. cepacia was particularly sensitive to low concentrations of A-NO2− (1.81 mM) under planktonic conditions. In antibiotic-resistant communities known as biofilms, which are reminiscent of end-stage CF airway disease, A-NO2− killed mucoid P. aeruginosa, S. aureus, and B. cepacia; 1 to 2 logs of cells were killed after a 2-day incubation with a single dose of ∼15 mM A-NO2−. Animal toxicology and phase I human trials indicate that these bactericidal levels of A-NO2− can be easily attained by aerosolization. Thus, in summary, we demonstrate that A-NO2− is very effective at killing these important CF pathogens and could be effective in other infectious settings, particularly under anaerobic conditions where bacterial defenses against the reduction product of A-NO2−, nitric oxide (NO), are dramatically reduced.
PMCID: PMC2976131  PMID: 20696868
5.  Clinical Use of 16S rRNA Gene Sequencing To Identify Mycoplasma felis and M. gateae Associated with Feline Ulcerative Keratitis 
Journal of Clinical Microbiology  2005;43(7):3431-3434.
Routine bacterial cultures of corneal scrapings from seven cats with either ulcerative feline keratitis, keratomalacia, or both yielded colonies which were identified by 16S rRNA gene sequencing as Mycoplasma felis (six cases) and Mycoplasma gateae (one case). Identification of the pathogens allowed the use of less empirical and more organism-specific therapy.
PMCID: PMC1169116  PMID: 16000470

Results 1-6 (6)