Two recent papers have addressed the issue of how MexT regulates

Two recent papers have addressed the issue of how MexT regulates the expression of the mexEF-oprN operon. First, nod boxes, the binding site of the NodD protein required in the nodulation of Rhizobia, were found upstream of the mexEF-oprN

operon, and MexT might regulate the operon upon binding at those boxes. Secondly, an ATCA(N5)GTCGAT(N4)ACYAT consensus sequence was found upstream of the mexEF-oprN operon and this sequence was proposed to be the MexT-binding site (Goethals et al., 1992; Köhler et al., 1997, 1999; Tian et al., 2009). However, the precise mechanism by which they act on the regulatory element(s) of mexEF-oprN mTOR inhibitor remained to be elucidated. We report here the molecular interaction between MexT and the mexT-mexE intergenic DNA, and the positive and negative regulation of mexEF-oprN gene expression. The bacterial strains and plasmids used are listed in Table 1. The P. aeruginosa cells were cultured at 37 °C in Luria–Bertani (LB) broth Selleck SB431542 supplemented with 150 μg mL−1 of gentamicin, or an appropriate amount of isopropyl β-d-thiogalactopyranoside (IPTG) as needed. Escherichia coli DH5α was the host for DNA manipulation. DNA was manipulated by standard methods (Sambrook et al., 1989). The plasmid DNA was extracted from E.

coli using a GenElute™ Plasmid Miniprep Kit (Sigma-Aldrich, St. Louis, MO) according to the manufacturer’s protocol. Transformation-competent P. aeruginosa cells were prepared according to the instruction manual of GenePulser II (Bio-Rad, Hercules, CA). Pseudomonas aeruginosa cells harboring appropriate reporter plasmid were grown in LB broth containing 2 mM IPTG at 37 °C. The cells were harvested at the desired time and β-galactosidase activity in the cell-free extracts was determined according to the method of Miller (Sambrook et al., 1989). The mexT-mexE intergenic DNA was amplified using the primers nmexE1-Eco and nmexE2-Hin (Table 2). The PCR products were digested with EcoRI and HindIII, and ligated into pME4510 carrying the promoter-less lacZ,

yielding pME4510-Ep. Pseudomonas aeruginosa PAO1S and PAO1SC, producing nonfunctional and intact MexT, respectively, were transformed with pME4510-Ep. The role of MexT in the expression of mexE (for Chlormezanone the mexEF-oprN expression) was assessed using the mexE∷lacZ reporter gene. The plasmid carrying the 3′- or 5′-end deletion was constructed in pME4510-Ep by inverted PCR of the desired length of mexT-mexE intergenic DNA. EcoRI-tagged primers (Ep31, Ep51, Ep71, and Ep91, respectively) paired with 4510-1Eco were used for the construction of pME4510-Ep31, pME4510-Ep51, pME4510-Ep71, and pME4510-Ep91 (Table 2). The resulting fragments were digested with EcoRI and self-ligated. HindIII-tagged primers (Ep42, Ep62, Ep82, and Ep42) paired with 4510-4Hin were used for the construction of pME4510-Ep42, pME4510-Ep62, pME4510-Ep82, and pME4510-Ep54 (Table 2). The resulting fragments were digested with HindIII and self-ligated.

Hemolytic activity was determined by mixing an equal volume of ba

Hemolytic activity was determined by mixing an equal volume of bacterial cells with 1% erythrocytes in PBS. This mixture was then incubated at 37 °C for 4 h. Samples (500 μL) were withdrawn and further spun

(1300 g for 5 min) in an Eppendorf 5403 centrifuge at room temperature. The OD405 nm of supernatant was determined by spectrophotometry. As a negative control, erythrocytes were used alone. Hemagglutinin activity was determined as reported previously (Vanterpool et al., 2005a). Twenty-four-hour cultures of P. gingivalis W83 and mutants were harvested by centrifugation (10 000 g for 10 min). Cells were washed twice in PBS buffer and resuspended to a final OD600 nm Selleckchem Afatinib of 1.5. Sheep erythrocytes were washed twice with 1 × PBS and resuspended in 1 × PBS to a final concentration of 1%. An aliquot (100 μL volume) of the bacterial suspension was serially diluted twofold with PBS in wells of a round-bottom 96-well microtiter plate. An equal volume (100 μL) of 1% sheep erythrocytes was mixed

with each dilution and incubated at 4 °C for 3 h. Hemagglutination was assessed visually and the hemagglutination titer was determined as the last dilution that showed complete hemagglutination. KU-57788 mw The presence of Arg-X- and Lys-X-specific cysteine protease (Rgp and Kgp) activity was determined using a microplate reader (Bio-Rad, Hercules, CA) as reported previously (Vanterpool et al., 2005b). In brief, the activity of arginine gingipains

was measured with 1 mM BAPNA (Nα-benzoyl-dl-arginine-p-nitroanilide) in an activated protease buffer (0.2 M Tris-HCl, 0.1 M NaCl, 5 mM CaCl2, 10 mM Cediranib (AZD2171) l-cysteine, pH 7.6). Lysine gingipain activity was measured with ALNA (Ac-Lys-p-nitroanilide HCl). After incubating the substrate and culture, the reaction was stopped by the addition of 50 μL of glacial acetic acid. The OD405 nmwas then measured against a blank sample containing no bacteria. Total RNA from P. gingivalis strains was extracted using the SV Total RNA Isolation System (Promega Corp., Madison, WI) according to the manufacturer’s instructions. cDNA was synthesized using a Transcriptor High Fidelity cDNA Synthesis Kit (Roche Corp., Indianapolis, IN). The primers used are listed in Table 2. The PCR program consisted of 1 cycle of 5 min at 94 °C, followed by 30 cycles of 30 s at 94 °C, 30 s at 54 °C, and 1 min at 68 °C, with a final extension of 5 min at 68 °C. To construct ECF sigma factor isogenic mutants, PCR was used to fuse the upstream and downstream fragments of the target gene to ermF, generating a 3-kb-length fragment, which was then electrotransformed into P. gingivalis W83. To the promoter region upstream of the ATG start codon of ermF, we added a 20-base oligonucleotide 5′-TGACTAACTAGGAGGAATAA-3′ containing three stop codons separated by one nucleotide.

e acquire another function when surface-associated (Jeffery, 200

e. acquire another function when surface-associated (Jeffery, 2009), remains unclear. Current research is ongoing in our lab to determine its precise role on the surface of lactobacilli. In conclusion, the data presented here show that NTD from L. fermentum can be added to a growing list of enzymes that one would expect to see only in the cytoplasm, but which have been detected on the cell surface (Granato et al., 2004). It is not known how these anchorless proteins cross the

cytoplasmic membrane. They are thought to bind to the cell surface through non-covalent interactions and, thus, can be extracted by buffers or released into the culture medium. To our knowledge, we are the first to confirm experimentally the localization of an essential deoxynucleoside see more catabolic enzyme that has dual location both

in the cytoplasm and on the surface in L. fermentum. The results reported here may serve as the basis for further work to characterize the surface-associated NTD, identify the specific roles of surface-associated NTDs RG7422 datasheet in nucleoside metabolism or the extracellular environment, and also determine the surface-association mechanisms of the anchorless proteins. We express our gratitude to Professor Jan Martinussen (Center for Systems Microbiology, Department of Systems Biology, Technical University of Denmark) and the anonymous reviewers for their insightful suggestions, and to Professor Li Ying (Center of Biomedical Analysis, Tsinghua GABA Receptor University) for her excellent technical assistance. This work was supported by the National Science Foundation for Fostering Talents in Basic Research of the National Natural Science Foundation of China (Grant No. J1030622),

National Natural Science Foundation of China (Grant No. 20876088), and the National High Technology Research and Development Program of China (2010AA09Z405). The nucleotide sequence reported in this paper has been submitted to the GenBank with accession number JF331655. “
“Insertion sequences (IS) are important drivers of bacterial evolution. Here, we report a previously undescribed IS element (ISPst4) in Pseudomonas stutzeri, and its unusual interaction with plasmids introduced into this species. Transformation of the pUC19 derivative plasmid pUS23 into P. stutzeri yielded ampicillin-resistant transformants in P. stutzeri, but these grew very poorly. Plasmids recovered from the transformants frequently contained insertions of the IS elements ISPst4 and ISPst5. Hybridisation analysis showed that these two IS elements were common in P. stutzeri strains, but were not found in other pseudomonads. Insertions of ISPst4 in pUS23 were found predominantly between bla and oriV, and plasmids with this type of insertion were capable of robust replication in P. stutzeri, unlike pUS23.

Although Hm1-1 had good production yield and relatively short cul

Although Hm1-1 had good production yield and relatively short cultivation period, its commercial value is limited by its bitter Forskolin price taste. Hm3-10 has shown good potential as a commercial strain in terms of taste in spite of its lower yield and longer cultivation period. Therefore, we tried to develop new varieties of H. marmoreus with a better taste by mating these two strains. Basidiospores of Hm1-1 and Hm3-10 were collected and spread on a PDA plate. Twenty monokaryotic mycelia

from each strain were selected on the basis of growth rate and mycelial growth pattern. Mating was conducted by placing the monokaryotic mycelial blocks of opposite strains on the same plate. The total number of mated mycelia was 400 (20 spores from Hm1-1 × 20 spores from Hm3-10). Of 400 mating pairs, 343 were

observed to make clamp connections, an indication of successful mating. The mating frequency was 85.8%, which BTK inhibitor was unusually high for a tetrapolar mating system. The expected mating frequency in tetrapolar basidiomycetes is 25% (Kronstad & Staben, 1997). However, the mating of a species in a geographically distinct population could be compatible. For example, the compatibility of P. tuberregium, a tetrapolar mushroom, from a New Caledonia collection and a Nigeria or a Papua New Guinea collection was 83% or 84% (Isikhuemhen et al., 2000). Therefore, the unusual mating frequency of H. marmoreus strains is potentially due to geographic isolation. The mated dikaryotic mycelia were cultivated on solid substrate, as described previously (Lee et al., 2009). Subsequently, 58 hybrid strains were initially Selleckchem Tenofovir screened in terms of production yield, shape of cap, and cultivation period. We chose six new hybrids with better taste and cultivation characteristics

(Table 2). The selected strains Hm15-3, Hm15-4, Hm15-5, Hm16-1, Hm16-2, and Hm17-5 tasted better than parental Hm1-1 strain and had better production yield than Hm3-10 strain. Optimization of cultivation conditions may further increase yield and shorten the cultivation period. RAPD analysis yielded multiple amplified DNA bands, some of which were unique for a certain strain (Fig. 1). To develop the strain-specific SCAR markers, we selected 10 distinct DNA bands from the three RAPD gels which were amplified with OPS-1, OPS-10, or OPL-13 primers (Fig. 1). Bands 1, 6, and 7 were unique for Hm1-1 and Hm1-6. Bands 2–5 and 8–10 were unique for Hm3-10. The selected DNA bands were cloned into a TA cloning vector and their sequences were determined. The sequences were deposited in GenBank and were used to design the 15-base primer sets using their 5′- and 3′-ends (Table 1). The specificity of the primer sets was investigated by PCR with an elevated annealing temperature (60 °C). As shown in Fig. 2a, the primer set P6, derived from a 755-bp DNA band of Hm1-1, was able to distinguish Hm3-10 from other strains.

Other studies have demonstrated that differences in rates of IPV

Other studies have demonstrated that differences in rates of IPV among women can be largely explained by socioeconomic variables [41, 42]. However, it is important to acknowledge that ethnicity

may shape a woman’s experience of IPV, including her willingness to disclose and seek help [43]. There were several limitations to our study. Our ability to infer causality is limited by the cross-sectional design. We also recognize that the small sample size limited our power to detect true associations between IPV and other variables. There is likely to have been selection bias, but it is difficult to predict whether women who Sirolimus manufacturer had experienced IPV would have been more or less likely to participate. We excluded 16 women with severe mental health problems and we were not able to recruit any IDUs, which suggests that we may have underestimated

the prevalence of IPV in our population. Furthermore, 110 women (25%) were not approached by clinic staff to participate in the study. This may have been a consequence of various factors including lack of time or other more pressing matters such as ill health. In some cases it may have been because the staff member did not feel it was appropriate to ask them to participate, which may contribute to selection bias. However, we do not feel this was a dominant factor. BYL719 datasheet When comparing the 191 women who participated in this study with all women attending the clinic in 2011, we found the women in the study to be broadly similar in terms of age, ethnicity, acquisition risk and CD4 count. This suggests that our sample was representative of the clinic population. A final limitation is that our outcome measure was based on self-defined

lifetime experience of IPV. We cannot exclude the possibility that women answered incorrectly because of either poor recall or social desirability. The majority of the women in our study, regardless of their experience of IPV, wanted their clinic doctor to receive a copy of their completed questionnaire. This suggests that screening Lepirudin within our clinical setting would be acceptable. Previous research based in general practice and secondary care in the UK has demonstrated that enquiring about IPV is generally acceptable to women [44]. Another recent study found that abused women wanted their GP to enquire about IPV; however, they wished to then be referred on to specialized advocacy services [45]. The high prevalence of IPV in women in this study suggests that HIV clinics should screen routinely for IPV. The relative lack of associated factors that could identify those at risk suggests that screening should be universal. Although other UK centres may have a smaller proportion of female patients, our sample is likely to be representative of women attending for HIV care in the UK and our findings can be generalized.

Anonymous data were gathered from call records by NHSDW staff and

Anonymous data were gathered from call records by NHSDW staff and collated in an Excel spreadsheet. The sample data included; patient demographics, selleck inhibitor the question(s) asked and the medicine(s) involved. A NHSDW nurse advisor assigned each question to a category from a pre-determined

list. The British National Formulary (BNF)1 chapter/section classification for each medicine was added to the spreadsheet by a qualified pharmacist. In addition, a computer generated report identified the disposition for all medicines-related calls. The number of calls in each category and BNF section were counted and compared. The local research governance committee advised ethics approval was not required. During 2010/11 NHSDW received 311,343 calls of which 5342 (2%) LGK-974 were medicines related and dealt with by nurse advisors. Within the sample

of 769 calls, 772 medicines listed in the BNF were identified. Medicines used to treat CNS disorders and infections were asked about most frequently, (39% and 16% respectively), followed by cardiovascular (8%), musculoskeletal, (8%), endocrine (7%), gastro-intestinal (6%) and respiratory (6%) medicines. Analgesics (BNF section 4.7) accounted for almost a quarter of questions (23%, 176/772) with the most common question being whether paracetamol/co-codamol could be taken with other medicines (n = 74). Antibacterials (BNF section 5.1) ranked second (15%, 114/772) with callers asking about interactions and clarifying dosing instructions including how long the antibacterial should be taken for. Antidepressants, antiepileptics and antipsychotics accounted for 11% questions (87/772) with dosing queries and questions about how to get further supplies occurring most frequently. Self

Selleck Sirolimus care with support from community pharmacy was recommended by NHSDW nurse advisors in 56% calls (3008/5342) compared with contacting the GP in 20% calls (1068/5342). In the context of over 70 million prescription items dispensed in Wales during 2010–11 the number of medicines-related calls to NHSDW is small and therefore these results must be interpreted cautiously. Despite opportunities for the exchange of information with patients during prescribing and dispensing some patients continue to have questions about their medicines. Advanced services have been introduced in England and Wales to support patients for example Medicines Use Reviews and the New Medicine Service 2(England only) however these services predominantly focus on medicines for chronic conditions. This study has highlighted the needs of patients in knowing how to take analgesics and antimicrobials safely and effectively. Pharmacists are well qualified to address the majority of medicines-related calls received by NHSDW and the profession may wish to reflect on why some patients choose to contact NHSDW instead and whether pharmacy could be doing more to support patients. 1.

, 1995) IF3 is known to promote subunit dissociation and to disc

, 1995). IF3 is known to promote subunit dissociation and to discriminate other tRNAs from the initiator tRNA; mutations at positions 787, 791, 792, and 795

result in a decrease in subunit association (Tapprich et al., 1989; Santer et al., 1990; Lee et al., 1997). The decreased binding affinity of IF3 to 30S when residues at 791 and 792 are altered (Tapprich et al., 1989; Santer et al., 1990) indicates that this is not due to a lack of antiassociation activity, but rather a loss of ability of the initiator tRNA to select or bind to the P-site, resulting in a decrease in subunit association. The footprinting and structural data suggest that Crizotinib order these residues are heavily involved in tRNA selection in the P-site and it is likely that these sites may form a structural motif that interacts with IF3 and recruits the initiator 5FU tRNA to the P-site. The P-site-specific antibiotics edeine, pactamycin, and kasugamycin, which stabilize

the P-site-bound tRNA, show a footprint in the 790 loop; this also supports the involvement of the 790 loop in the recruitment of initiator tRNA to the P-site. Here, we describe how we functionally analyzed the role of G791 in protein synthesis. This residue has been shown to be an invariant and essential residue for ribosome function (Lee et al., 1997; Song et al., 2007). To investigate the functional role played by G791 during the process of protein synthesis, we adopted a novel genetic approach (Lee et al., 1997, 2001; Kim et al., 2009) by introducing a base substitution at position 791 and then selecting multicopy suppressors that partially restored the protein synthesis ability of the mutant ribosomes. We identified IF1 as a multicopy suppressor of the mutant ribosome bearing a G to U substitution at position 791. Based on functional analyses of the effects of IF1 on the mutant ribosome, we suggest the involvement Tau-protein kinase of IF1 in the restoration of the P-site that

was perturbed by a nucleotide substitution at position 791. All plasmids were maintained and expressed in E. coli DH5α (Hanahan, 1983). Cultures were grown in Luria–Bertani (LB) medium (Luria & Burrous, 1957) or LB medium containing 100 μg mL−1 ampicillin (LB–Amp100). To induce the synthesis of plasmid-derived rRNA from the lacUV5 promoter, IPTG was added to a final concentration of 1 mM and 0.1% of l-arabinose was used to induce the synthesis of initiation factors from the BAD promoter. Plasmids pRNA122 and pRNA16 ST were described previously (Lee et al., 1997, 2001). The construction of pKAN3, pKAN4, and pKAN6 was described previously (Tamura et al., 2006). To construct pRNA122-U791U1192 and pRNA122-G770U1192, the XbaI and SexAI fragment from pRNA122-U1192 (Lee et al., 1996) was subcloned into the same sites in pRNA122-U791 (Song et al., 2007) and pRNA122-G770 (Kim et al., 2007).

The fact that there are possibly two different antirestriction pr

The fact that there are possibly two different antirestriction proteins encoded by Tn6000 suggests that it may be able to inhibit a broader range of type I restriction systems than Tn916. Following orf18 in Tn6000, there is an insertion of a fragment of DNA that shares nucleotide

identity and gene order to a region of the virulence-related locus (vrl) from Dichelobacter nodosus, the causative agent of ovine foot rot (Billington et al., 1999). The vrl is Selleck Doramapimod a 27.1-kb region of DNA associated with more virulent strains of D. nodosus. Recently, it has been identified in Desulfococcus multivorans, indicating that it is likely to undergo horizontal gene transfer. The vrl is hypothesized to be disseminated by horizontal gene transfer between bacteria, possibly mediated Thiazovivin solubility dmso by a bacteriophage such as DinoHI (Cheetham et al., 2008). In Tn6000, the genes vap and hel (Fig. 1) are in the same order as vrlR and vrlS, a virulence-associated protein and a DEAD helicase of the Super-family 2 from vrl. The proteins Vap and Hel are 35% and 36% identical to VrlR and VrlS, respectively. The DEAD-DEAH helicases are involved in ATP-dependent unwinding of nucleic acids and it is therefore conceivable to imagine a role in the conjugation process of Tn6000. Next in Tn6000 are the remainder of the Tn916 conjugation-associated ORFs, orf17–orf13. Remarkably, orf14 contains a group

II intron, which is 99% identical at the nucleotide level to that found originally in Tn5397, a conjugative transposon originally isolated from Clostridium difficile. The group II intron from Tn5397 can splice from the orf14 pre-mRNA

(Roberts et al., 2001) and, due to the sequence identity between the two, the group II intron from Tn6000 is also likely to splice. We have, however, shown that splicing is not a prerequisite for the conjugative transfer of Tn5397 (Roberts et al., 2001). The DNA sequence Florfenicol of the remainder of the element has been reported previously (Roberts et al., 2006) and includes tet(S) and the Tn6000 integrase. The Tn6000 region from tet(S)–orf7 is 99% identical at the nucleotide level to tet(S) and the equivalent flanking region (Fig. 1, Table 3) from the broad host-range plasmid pK214 from Lactococcus lactis (Perreten et al., 1997). Database searches also revealed that the region from 25 160 to 28 766 bp on Tn6000 [which includes tet(S) and most of orf6] are present (100% nucleotide identity) on an E. faecium plasmid p5753cB (accession number GQ900487). The Tn6000 integrase protein Int6000 is homologous to Int (42% identical) and Sip (41% identical), the integrases from the bovine staphylococcal pathogenicity islands SaPIbov and SaPIbov2, respectively (Ubeda et al., 2003). In conclusion, we have demonstrated that Tn6000 is a chimerical element of the Tn916-like family of conjugative transposons.

The fact that there are possibly two different antirestriction pr

The fact that there are possibly two different antirestriction proteins encoded by Tn6000 suggests that it may be able to inhibit a broader range of type I restriction systems than Tn916. Following orf18 in Tn6000, there is an insertion of a fragment of DNA that shares nucleotide

identity and gene order to a region of the virulence-related locus (vrl) from Dichelobacter nodosus, the causative agent of ovine foot rot (Billington et al., 1999). The vrl is selleck compound a 27.1-kb region of DNA associated with more virulent strains of D. nodosus. Recently, it has been identified in Desulfococcus multivorans, indicating that it is likely to undergo horizontal gene transfer. The vrl is hypothesized to be disseminated by horizontal gene transfer between bacteria, possibly mediated Selleckchem Forskolin by a bacteriophage such as DinoHI (Cheetham et al., 2008). In Tn6000, the genes vap and hel (Fig. 1) are in the same order as vrlR and vrlS, a virulence-associated protein and a DEAD helicase of the Super-family 2 from vrl. The proteins Vap and Hel are 35% and 36% identical to VrlR and VrlS, respectively. The DEAD-DEAH helicases are involved in ATP-dependent unwinding of nucleic acids and it is therefore conceivable to imagine a role in the conjugation process of Tn6000. Next in Tn6000 are the remainder of the Tn916 conjugation-associated ORFs, orf17–orf13. Remarkably, orf14 contains a group

II intron, which is 99% identical at the nucleotide level to that found originally in Tn5397, a conjugative transposon originally isolated from Clostridium difficile. The group II intron from Tn5397 can splice from the orf14 pre-mRNA

(Roberts et al., 2001) and, due to the sequence identity between the two, the group II intron from Tn6000 is also likely to splice. We have, however, shown that splicing is not a prerequisite for the conjugative transfer of Tn5397 (Roberts et al., 2001). The DNA sequence Amylase of the remainder of the element has been reported previously (Roberts et al., 2006) and includes tet(S) and the Tn6000 integrase. The Tn6000 region from tet(S)–orf7 is 99% identical at the nucleotide level to tet(S) and the equivalent flanking region (Fig. 1, Table 3) from the broad host-range plasmid pK214 from Lactococcus lactis (Perreten et al., 1997). Database searches also revealed that the region from 25 160 to 28 766 bp on Tn6000 [which includes tet(S) and most of orf6] are present (100% nucleotide identity) on an E. faecium plasmid p5753cB (accession number GQ900487). The Tn6000 integrase protein Int6000 is homologous to Int (42% identical) and Sip (41% identical), the integrases from the bovine staphylococcal pathogenicity islands SaPIbov and SaPIbov2, respectively (Ubeda et al., 2003). In conclusion, we have demonstrated that Tn6000 is a chimerical element of the Tn916-like family of conjugative transposons.

1 The area has been evolving rapidly as an academic and professio

1 The area has been evolving rapidly as an academic and professional discipline. This First Edition of Cases in Pre-Hospital and Retrieval Medicine is timely as it contributes toward the urgent need for textbooks to support the growing number of academic and professional training programs in aeromedical retrieval/evacuation globally. It has been presented as a case-based textbook, which has a Table of Contents, two Forewords (by Allan MacKillop, Australia, and by Gareth Davies, UK), a Preface, Acknowledgments, About the

Authors, List of Reviewers, an Introduction, three main sections containing 50 cases most with suggestions Selleck DZNeP for Additional Reading, Dasatinib four Appendices, a Key to Cases, a Glossary (including a list of Abbreviations), and a Comprehensive Index. There are nearly 100 figures, mostly well-presented color plates. The textbook is generally consistent in its presentation with excellent use of “Key Point” boxes. Cases in Pre-Hospital and Retrieval Medicine discusses the practical approach to common scenarios in aeromedical retrieval. Each section contains cases around each of three important themes in retrieval medicine, including Section A “Pre-hospital theme” containing 22 cases; Section B “Retrieval theme” containing 19

cases; and Section C “Service development and special circumstances” containing 9 cases. It would have been useful to ascribe a name to each of the cases and provide an index of these for ready reference for training purposes. The cases are scantily referenced and the reader may need to look toward a more definitive international textbook of aeromedical retrieval, particularly if they are looking for the supporting evidence or guidelines. There are four Appendices. Appendix 1 has five

sub-appendices, including “Airway”; “Advanced vascular access”; “Thoracostomy”; “Thoracotomy”; and “Escharotomy.” Appendix 2 has two sub-appendices, including “Equipment list” and “Personal equipment.” Appendices 3 and 4 cover “Transfer and retrieval checklist” and “Major incidents.” The Glossary and list Resminostat of Abbreviations could have been more comprehensive. There are a number of special highlights in Cases in Pre-Hospital and Retrieval Medicine. Cases 49 and 50 describe international commercial and military retrieval medicine cases, respectively, which include some excellent general principles of international aeromedical retrieval; however, it may disappoint some of those looking for more in these areas. For the travel health advisor, there are a number of cases of direct interest, eg, Case 16 describing a diving-related emergency presentation and Case 46 describing the various issues in handling of an emergency on a commercial flight.