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The antimicrobial properties of volatile aromatic oils and medium-chain fatty acids derived from edible plants have been recognized since antiquity. To give examples, Origanum oil, used as a food-flavoring agent, possesses a broad spectrum of antimicrobial activity due, at least in part, to its high content of phenolic derivatives such as carvacrol and thymol. Similarly, lauric acid, present in heavy concentrations in coconuts, forms monolaurin in the body that can inhibit the growth of pathogenic microbes. Using Staphylococcus aureus in broth cultures and a microdilution method, comparative efficacy of Origanum oil, and a constituent carvacrol, other essential oils and monolaurin were examined. Origanum oil was the most potent of the essential oils tested and proved bactericidal in culture to two strains of Staphylococcus aureus (ATCC #14154 and #14775) at 0.25 mg/mL. In vitro, monolaurin's effects mirrored Origanum oil. The combination of both was bactericidal at the 0.125 mg/mL concentration of each. In two separate In vivo experiments, injected Staphylococcus aureus (ATCC #14775) killed all 14 untreated mice within a 1-week period. In treated mice, over one third survived for 30 days when given oral Origanum oil daily for 30 days (6/14). Fifty percent of the mice survived for 30 days when receiving daily vancomycin (7/14) and monolaurin (4/8). Over 60% of mice survived when receiving a daily combination of Origanum oil and monolaurin (5/8). Origanum oil and/or monolaurin may prove to be useful antimicrobial agents for prevention and therapy of Staphylococcus aureus infections.

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Background:Recent work has suggested good clinical and functional results with dorsal surface plating of patellar fractures. The primary outcome measurement of this study was reoperation rates for patellar fractures that had been treated with dorsal plating.Methods:This work consists of a retrospective review of clinical and functional outcome data following repair of patellar fractures with dorsal plates. We obtained institutional review board approval for this study and conducted a review of 9 consecutive years of our group’s trauma practice. We also contacted patients to assess patient-reported outcomes (PROs) after 12 months.Results:Eighty-five patellar fractures were treated with open reduction and internal fixation (ORIF) via plating over 9 years. Eight (9.41%) of the patients required reoperation. Of the 72 patients with complete follow-up of ≥12 weeks, 3 (4.17%) had nonunion of the fracture site and 4 (5.56%) had loss of reduction of the fracture. The average Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score among our sample was 18.84 (slight symptoms); 72.41% of the patients in our sample had slight or no symptoms at ≥12 months postoperatively.Conclusions:Our results indicated that plating of comminuted patellar fractures is a safe, viable treatment strategy. The PROs at ≥12 months of follow-up data were promising. Additionally, dorsal plating may allow for early return of function and less postoperative bracing.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.