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Thermal conditions in the bathroom in winter and summer, and physiological responses of the elderly during bathing.

Thermal conditions in the bathroom and physiological responses were examined during winter and summer. The subjects were 22 male and 20 female elderly people, between 65 and 88 years old living in 25 houses in Gunma Prefecture, Japan. Heart rate, blood pressure, skin temperature and thermal sensation were measured during bathing. Changes in thermal sensation due to bathing were assessed in the living room and dressing room on a 9-point scale. Then they were asked about the purposes of bathing and the facilities of bathroom and dressing room. The results are summarized as follows: 1. The purpose of bathing in winter was to warm up for more than 80% of the subjects. In summer, all subjects felt refreshed by bathing. Eighty-five percent of the subjects took a bath every other day in both seasons. 2. Fifty-two percent of the bathrooms had no ventilating fans and 32% had no exclusive dressing rooms. 3. The average room temperature in the dressing rooms was 13-14 degrees C in winter. Thermal sensation was 'cool', 'slightly cold' or 'cold' for more than two-thirds of the subjects when they were partially nude, and there were no heaters in most dressing rooms. 4. The heart rate increased steadily, and reached a maximum value in a partially dressed condition in both seasons. 5. In winter, a marked increase of systolic blood pressure was observed in the partially nude condition. There was a significant difference between the before bathing condition and partially nude condition in winter.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Puncture wounds by driftwood catfish during bucket baths: local habits of riverside people and fish natural history in the Amazon.

OBJECTIVE: To assess the prevalence of stings by small spiny driftwood catfish (carataí) of the genus Centromochlus (Auchenipteridae) accidentally caught in buckets during bucket bathing by riverside people along the Brazilian Amazon and to determine the probability of catching specimens of these fish during random throws of a bucket into the river. METHODS: We interviewed 27 adult residents living at the confluence of the Negro and Solimões rivers in Brazil regarding whether or not they had ever been stung by driftwood catfish while bucket bathing. To assess the likelihood of catching catfish in bathing buckets, we randomly threw a typical plastic bucket used for bathing in 4 series of 10 throws into the river at dusk or night around a floating house. RESULTS: Seventeen of the 27 subjects (63%) reported being injured by driftwood catfish during bucket bathing. Three individuals (17.6%) had been injured 2 to 3 times, totaling 23 puncture accidents. All stings occurred at dusk or early night. In the 4 series of 10 bucket throws, we caught 3 driftwood catfish (in 1 series we did not catch any fish). Thus, the chance of catching a driftwood catfish in a single bucket throw at dusk was slightly less than 10%. CONCLUSIONS: The prevalence of stings by driftwood catfish to people bucket bathing in this section of the Brazilian Amazon is high, partly because of the relatively high chances of catching these small catfish during random throws of a bathing bucket into the river.

Adult↗

A large outbreak of Legionnaires' disease due to an inadequate circulating and filtration system for bath water--epidemiologic manifestations.

OBJECTIVE: To study the epidemiologic manifestations of a large outbreak of Legionnaires' disease due to an inadequate circulating and filtration system for bath water. PATIENTS: In June 2000 at Ishioka City, Ibaraki Prefecture, a large outbreak of Legionnaire's disease occurred, as a result of an inadequate circulating and filtration system for communal bath water. This outbreak was the worst ever experienced in Japan, involving a total of 34 patients (20 confirmed, 14 probable), 3 of whom died. MEASUREMENTS AND RESULTS: Legionella pneumophila serogroup 1 was isolated from sputum culture in two patients. Bacteriological culture of the public bath water subsequently yielded large numbers of Legionella species. Cleavage of genomic DNA showed that restriction fragment patterns coming from clinical and environmental isolates of L. pneumophila serogroup 1 were closely related, focusing the inquiry to a public bathhouse where a circulating filtration system was suspected as the source of infection. CONCLUSIONS: It was later concluded that the circulating filtration system adopted for bath water was marred by a serious design flaw that subsequently caused the mass outbreak. Specifically, a line of the bath water was being returned to the bath without undergoing heat exchange or sterilization by chlorine; and the Legionella species that had proliferated in the filter and the bright stone filtration unit were allowed to return to the bath, eventually culminating in a mass infection.

Adult↗

Accidents associated with bathing in home care services for the aged in Japan.

OBJECTIVES: To reveal what kinds of accidents happen associated with bathing in home care services for the aged in Japan. METHODS: The study was cross-sectional in design. In November 1999, a postal questionnaire survey was conducted of 828 councils selected from the list of the National Council of Social Welfare of Japan by a systematic sampling method (extraction rate was 25%). The main outcome measures were characteristics of cases of accidents associated with bathing service for the aged, including patient age, sex, time of occurrence, symptoms, and results of accidents. RESULTS: Replies were received from 683 (82%) councils. Of the councils that replied, 430 (63%) reported providing bathing service for the aged. Of these 430 councils, 108 (25%) have experienced accidents, and 130 cases were analyzed. Affected patients had a mean age of 80.7 years (SD: 9.0 years), and 71 were females (55%). Sixty-two (48%) had symptoms of a disease or had accidents after bathing, and 42 (32%) presented with loss of consciousness. In results of accidents, 14 (11%) were reported to have died. CONCLUSION: This study revealed that there were not a few accidents associated with bathing in home care services for the aged in Japan, the most frequent symptom was loss of consciousness, most accidents occurred after bathing, and that some patients died as a result of bathing provided by home care services.

Accidents, Home↗

Narratives on prolonged baths from psychiatric care in Sweden during the first half of the twentieth century.

Prolonged baths were used within psychiatric care in Sweden during the first half of the twentieth century. Eight reports from nursing staff about experiences of prolonged baths were analysed. The aim is to gain a better understanding of what it could have meant for caregivers to give prolonged baths. The nursing staff described their work with the baths as an extremely tiresome and trying duty that was delegated to inexperienced personnel. They regarded the patients as impossible to communicate with verbally. Prolonged baths were said to have been used on 'the most severely disturbed', violent, or untidy patients. The nurses describe the patients' discomfort and protests, but also point out that the baths had the intended effect of calming down disturbed patients. Prolonged baths also functioned as a restraint.

Baths↗

Effect of artificial carbon dioxide foot bathing on critical limb ischemia (Fontaine IV) in peripheral arterial disease patients.

BACKGROUND: It has been reported that artificial carbon dioxide (CO(2)) foot bathing improves subcutaneous microcirculation in peripheral arterial disease (PAD) patients. However, the effect for critical limb ischemia (CLI) with ulceration or gangrene (Fontaine stage IV) is not identified. The physiological effects of CO(2) bathing and the outcome of limb salvage in such patients were studied. METHODS: In 18 healthy volunteers (Study I), the dorsal pedis peripheral blood flow was measured by a laser Doppler flow-meter during CO(2) foot bathing (1000 ppm, 37 degrees C) for 10 min. A Holter electrocardiogram was also recording in the same period. Blood flow and cell volume significantly increased during bathing. Eighty-three CLI limbs (Fontaine IV) in 68 PAD patients (Study II) underwent artificial CO(2) foot bathing (for 10 minutes twice daily >2 months) were followed up >6 months. RESULTS: In Study I, analysis of heart rate variability showed that high frequency amplitude (HFA) considerably increased and the ratio of low frequency amplitude to HFA (LF/HF) noticeably decreased during bathing. In Study II, 69 limbs (83.1%) could be salvaged. Twenty-seven of 28 limbs (96.4%) which have ulcer and gangrene in only one toe, 13/16 limbs (81.2%) in multiple toes and 29/39 limbs (74.4%) in all toes and/or heel respectively were saved. CONCLUSIONS: The effect of CO(2) enriched water on the subcutaneous microcirculation might be brought about by peripheral vasodilation reflected by increased parasympathetic and decreased sympathetic activity, and the artificial CO(2) foot bathing is clinically effective on salvage of CLI (Fontaine stage IV) limbs.

Adult↗

Human cardiovascular responses to a 60-min bath at 40 degrees C.

This study was designed to determine human cardiovascular responses to a 60-min bath at 40 degrees C compared with a thermoneutral bath at 34.5 degrees C. We measured mean blood pressure (MBP), heart rate (HR), skin blood flow (SBF) and core temperature in 8 healthy young males bathing at two different temperatures, 34.5 degrees C and 40 degrees C. During the thermoneutral bath (34.5 degrees C), heart rate tended to decrease, but all other variables showed no significant change. Ten min after entering the 40 degrees C bath, MBP decreased while HR and SBF increased. At the same time core temperature increased. We conclude that bathing at 40 degrees C may induce remarkable changes in the cardiovascular system by increasing core temperature when immersion in a hot bath for more than 10 min.

Adult↗

Familial bathing patterns: implications for cases of alleged molestation and for pediatric practice.

In a cross-sectional study of how 576, upper-middle class children were socialized around bathing behaviors, families were found to be variable in their handling of bathing practices. But as a group, children were found to bathe alone more frequently as they grew older, and parents were found to bathe less frequently with the child of the opposite sex, particularly as children grew older. It was uncommon for mothers to bathe or shower with sons older than 8 years of age or for fathers to bathe or shower with daughters older than 9 years of age, although most had stopped before that age. This cross-sex aversion may be a reflection of the incest taboo. Several suggestions are made about the development-related changes in bathing practices identified in the study.

Baths↗

[The use of sodium chloride baths in children with a heart lesion subjected to long-term exposure to low radiation doses].

Children exposed to low-dose radiation are often treated in sanatoria with mineral baths. Of the latter balneoprocedures widely practiced are sodium chloride (SC) baths with mineralization 20-30 g/l. Mineralization 40 g/l is less frequently used. To specify changes in the function of cardiovascular system induced by SC baths of different concentration (40 versus 20 g/l) 131 senior schoolchildren exposed to low-dose radiation or other environmental pollutants were examined both after a single balneological procedure and after the course treatment (maximum 10 procedures). The baths lasted 8-15 min at water temperature 36-38 OC in a day intervals. The response was assessed by ECG, tetrapolar chest rheography, bicycle exercise. All the children had cardiovascular disorders of non-rheumatic origin. Therapeutic effect was more pronounced after baths with SC concentration 40 g/l. These baths are recommended for improvement of vegetative regulation of the heart, correction of hemodynamic defects. Baths with mineralization 20 g/l are better in upgrading function of the autonomic nervous system.

Baths↗

Bathing premature infants: physiological and behavioral consequences.

BACKGROUND: Routine procedures are a large component of the caretaking day for preterm infants. Such procedures can have profound adverse effects on an infant's condition, to the point of disrupting normal growth and development. Despite this evidence, routine procedures are perpetuated in the neonatal ICU. OBJECTIVE: To determine the physiological and behavioral effects of a supposedly beneficial procedure, a sponge bath, on premature infants. METHODS: The study sample consisted of 14 preterm neonates with no neurological abnormalities at two tertiary neonatal ICUs. The ages of the subjects were 28.1 to 31.8 weeks postconception and 4 to 25 days after birth. The study was a prospective, quasi-experimental, repeated-measures design in which each infant acted as his or her own control. Oxygen delivery, heart rate, oxygen saturation, and behavioral responses were continuously recorded by computer or real-time videotape. Physiological and behavioral parameters were compared across three phases: 10 minutes before a bath (baseline), during a standardized bath, and 10 minutes after the bath. RESULTS: Physiological and behavioral disruptions occurred throughout the bath phase and in many cases beyond that phase. These disruptions included significant increases in heart rate, cardiac oxygen demand, and frequency of behavioral motoric cues. Significant decreases in oxygen saturation also accompanied the bath. Nine infants required increased concentrations of ambient oxygen. A significant association was found between physiological components and the frequency and timing of behavioral motoric cues. CONCLUSIONS: The results provide further evidence that routine care is not innocuous to neonates. Routine sponge bathing is not recommended for care of ill premature infants.

Baths↗

Shape retention in porcine and rabbit nasal septal cartilage using saline bath immersion and Nd:YAG laser irradiation.

BACKGROUND AND OBJECTIVES: The process of altering the shape of cartilage using heat has been referred to as thermoforming, and presents certain clinical benefits in reconstructive surgical procedures within the head and neck. Thermoforming allows cartilage in the upper airway and face to be reshaped without the use of classic surgical maneuvers such as carving, morselizing, or suturing. The goal of this study was to determine the dependence of cartilage shape change on both temperature and laser dosimetry using two thermoforming methods: saline bath immersion and laser irradiation. STUDY DESIGN/MATERIALS AND METHODS: Ex-vivo rabbit and porcine nasal septal cartilages were mechanically deformed and reshaped using the two thermoforming methods. With saline bath immersion using rabbit cartilage, each specimen was deformed by securing it to a small copper tube (outer diameter 8 mm) using dental bands. For porcine cartilage immersed in a saline bath, each sample was mechanically deformed between two pieces of wire mesh attached to a semicircular acrylic block. With both porcine and rabbit cartilage, the specimen and apparatus were then immersed in a hot saline bath for time intervals varying from 20 and 320 seconds and at constant temperatures between 62 and 74 degrees C. In laser reshaping, the cartilage specimens were mechanically deformed on a jig and consecutively irradiated with an Nd:YAG laser (lambda = 1.32 microm) in several spots for 6-16 seconds and irradiances of 10.2-40.7 W/cm2 per spot. After either saline bath heating or irradiation, cartilage specimens were immersed in room temperature saline for 15 minutes, then upon removal from the jig the length between the ends of each specimen was measured in order to calculate the resulting bend angle. RESULTS: The transition zone for cartilage reshaping was defined as where a significant increase in bend angle was observed between consecutive times of immersion/irradiation at the same temperature/irradiance. For the saline bath experiments, the transition zone was observed between 59-68 degrees C and 62-68 degrees C for porcine and rabbit cartilage, respectively. Similar transition zones occurred with laser irradiation below irradiances of 20.4 W/cm2 for both porcine and rabbit cartilage. In addition, the dosimetry pairs in the transition zones produce peak temperatures below the thresholds determined from the saline bath immersion studies. CONCLUSIONS: The critical transition temperature region was determined by the sharp increase in bend angle at consecutive times of immersion at the same temperature. This range was determined to be 59-68 degrees C and 62-68 degrees C for porcine and rabbit cartilage, respectively. Similar transition zones for dosimetry occurred below 20.4 W/cm2 during cartilage irradiation in both species.

Animals↗

Venous Function in Patients with Venous Disease and Healthy Controls Before and After a Bathing Procedure and Subsequent Cold Stimulus

The object of this study was to determine whether bathing in thermal water acutely affects venous function in patients with venous insufficiency. Measurements were taken of venous function in patients with leg varicosities and healthy subjects before and after a thermal bath and exercise on two days, with subsequent application of a cold stimulus on 1 day. A total of 28 patients with varicose veins in one or both legs (n = 45 legs) and 30 healthy controls (n = 60 legs). On 2 consecutive days all subjects underwent a standardized bathing and exercise procedure in water at 34 degreesC for 20 minutes. On one day, determined randomly for each subject, a cold stimulus was applied to both lower legs after bathing. Measurements were done before subjects entered the bath and after the completion of bathing (including cold stimulus on one day). Without the cold stimulus, venous function of patients and controls did not change. After application of the cold stimulus the venous capacity of both patients and controls was significantly reduced compared with the basal levels. There was no change in maximum venous outflow in the controls, but that of the patient group decreased slightly compared with basal levels. Contrary to widespread belief, bathing in water at temperatures above 28 degreesC does not adversely affect venous function in patients with varicose veins. When applied in moderation (34 degreesC for 20 minutes) this physical therapy should not be regarded as contraindicated in this and related conditions, especially given its known hemodynamic benefits. Further studies are required to determine the long-term effects of repeated immersion.

Journal Article↗

Skin penetration of minerals in psoriatics and guinea-pigs bathing in hypertonic salt solutions.

Penetration of electrolytes through the human skin was measured in healthy volunteers and in psoriatic patients after bathing in the Dead-Sea or in simulated bath-salt solutions. Significant increases in the levels of serum Br, Rb, Ca and Zn were noticed only in the psoriatic patients after daily bathing in the Dead-Sea for a 4-week regimen. Guinea-pigs "bathed" in simulated Dead-Sea bath-salt solutions containing radionuclides of Ca, Mg, K and Br. Traces of each radionuclide were detected in the blood and in some internal organs after 60 minutes of bathing. The radionuclides showed a physiological pattern in their organ distribution. Even though the whole investigation was carried out in hypertonic solutions, there is a definite penetration of salts through healthy (human and guinea-pigs) and damaged (psoriatic) epidermis. This finding suggests that improvement of the psoriatic condition after bathing in the Dead-Sea, may be partly attributed (in addition to ultraviolet irradiation) to the minerals' effect on the psoriatic skin.

Adolescent↗

Single-dose pharmacokinetics of flumequine in the eel (Anguilla anguilla) after intravascular, oral and bath administration.

Knowledge of the pharmacokinetic properties of drugs to combat bacterial infections in the European eel (Anguilla anguilla) is limited. One antimicrobial agent likely to be effective is flumequine. The aim of this study was to investigate the pharmacokinetic properties of flumequine in European eels in fresh water. Flumequine was administered to eels (Anguilla anguilla) intravenously (i.v.) and orally (p.o.) at a dose of 10 mg/kg body weight, and as a bath treatment at a dose of 10 mg/L water for 2 h. The study was performed in fresh water with a temperature of 23 + 0.3 degrees C, pH 7.15. Identical experimental designs were used. Two additional bath treatments were also performed, one in which the pH in the water was lowered by approximately 1 unit to 6.07 (dose: 10 mg/L) and one at a dose of 40 mg/L for 2 h in a full-scale treatment. Following i.v. administration, the volume of distribution at steady state was 3.4 L/kg. Total body clearance was 0.012 L/h per kg and the elimination half-life (t1/2lambda z) was calculated to be 314 h. Mean residence time was 283 h. Following oral administration, the t1/2lambda z was 208 h. Maximal plasma concentration (Cmax) was 9.3 mg/L, at 7 h after administration (Cmax). The oral bioavailability (F) was calculated to be 85%. Following bath administration in 10 mg/L for 2 h, maximal plasma concentration was 2.1 mg/L, observed immediately after the end of the bath. The 'bioavailability' in eel following a 2-h bath treatment was 19.8%. Reducing the pH in the bath to 6.07 produced a maximal plasma concentration of 5.5 mg/L, observed immediately after the end of the bath. The 'bioavailability' was increased to 41% by the lowering of the pH. A similar effect was observed in a full-scale treatment (1 kg eels/L water). The CO2 produced by the eel lowered the pH and increased 'bioavailability' to 35%.

Administration, Oral↗

Two-dimensional Raman and infrared vibrational spectroscopy for a harmonic oscillator system nonlinearly coupled with a colored noise bath.

Multidimensional vibrational response functions of a harmonic oscillator are reconsidered by assuming nonlinear system-bath couplings. In addition to a standard linear-linear (LL) system-bath interaction, we consider a square-linear (SL) interaction. The LL interaction causes the vibrational energy relaxation, while the SL interaction is mainly responsible for the vibrational phase relaxation. The dynamics of the relevant system are investigated by the numerical integration of the Gaussian-Markovian Fokker-Planck equation under the condition of strong couplings with a colored noise bath, where the conventional perturbative approach cannot be applied. The response functions for the fifth-order nonresonant Raman and the third-order infrared (or equivalently the second-order infrared and the seventh-order nonresonant Raman) spectra are calculated under the various combinations of the LL and the SL coupling strengths. Calculated two-dimensional response functions demonstrate that those spectroscopic techniques are very sensitive to the mechanism of the system-bath couplings and the correlation time of the bath fluctuation. We discuss the primary optical transition pathways involved to elucidate the corresponding spectroscopic features and to relate them to the microscopic sources of the vibrational nonlinearity induced by the system-bath interactions. Optical pathways for the fifth-order Raman spectroscopies from an "anisotropic" medium were newly found in this study, which were not predicted by the weak system-bath coupling theory or the standard Brownian harmonic oscillator model.

Journal Article↗

Class II MHC antigens in early rheumatoid arthritis in Bath (UK) and Madrid (Spain).

OBJECTIVE: A number of studies have indicated that rheumatoid arthritis (RA) is a less severe disease in Mediterranean countries than in Northern Europe. We investigated whether differences in the frequency of class II MHC antigens might contribute to this variation in disease severity. METHODS: Typing at HLA-DR and -DQ loci was carried out at low and high resolutions by polymerase chain reaction amplification in patients with early RA of less than 6 months' duration (68 patients in Madrid and 68 in Bath) and in control subjects (929 in Madrid and 226 in Bath). Only ethnic Spanish and British individuals were included as patients and controls. RESULTS: Shared epitope (SE) alleles represented 19.8 and 28.9% of the total number of class II MHC alleles in controls from Madrid and Bath respectively (P: = 0.00001), this difference being largely due to increased numbers of DRB1*0401 individuals in the British subjects (P: = 0.0000001). Analysis of the patients showed the expected increase in SE alleles when compared with their respective control groups (Madrid, 31.6 vs 19.8%; Bath, 42.6 vs 28. 9%). In Bath the SE was mainly encoded by HLA-DR4 alleles (74.1%), while in Madrid it was encoded almost equally by DR4 (51.1%) and DR1 (44.7%) alleles. The risk of developing RA in carriers of SE alleles was similar in the two cities (Bath, odds ratio 1.83, 95% confidence interval 1.23-2.78; Madrid, odds ratio 1.87, 95% confidence interval 1.25-2.77), and was largely accounted for by HLA-DRB1*0401 alleles. CONCLUSION: We conclude that rheumatoid patients in Bath differ from their Spanish counterparts in class II antigen expression and allele frequency. This may be explained partly by genetic differences between the control populations in the two centres, and may help to explain the greater incidence of more severe rheumatoid disease expression seen in RA patients in the UK.

Alleles↗

Damped harmonic oscillator: pure states of the bath and exact master equations.

Time evolution of a harmonic oscillator linearly coupled to a heat bath is compared for three classes of initial states for the bath modes-grand canonical ensemble, number states, and coherent states. It is shown that for a wide class of number states the behavior of the oscillator is similar to the case of the equilibrium bath. If the bath modes are initially in coherent states, then the variances of the oscillator coordinate and momentum, as well as its entanglement to the bath, asymptotically approach the same values as for the oscillator at zero temperature and the average coordinate and momentum show a Brownian-like behavior. We derive an exact master equation for the characteristic function of the oscillator valid for arbitrary factorized initial conditions. In the case of the equilibrium bath this equation reduces to an equation of the Hu-Paz-Zhang type, while for the coherent states bath it leads to an exact stochastic master equation with a multiplicative noise.

Journal Article↗

Waterbirth: water temperature and bathing time--mother knows best!

OBJECTIVES: The Frauenfeld Clinic for Obstetrics and Gynecology introduced waterbirths in 1991. This work examines whether guidelines for water temperature and bathing are actually necessary. METHODS: This 8-year prospective clinical study follows 10,775 births in a regional women's hospital (non-selected population). Neonatal and maternal body temperature and morbidity parameters were compared between land and waterbirths. A smaller study (n = 47) selectively focused on body temperature differences as influenced by bathing time and water temperature in waterbirths as compared to land births. RESULTS: Neonatal and maternal birth and perinatal parameters, and body temperatures do not differ between water and land births, except at birth, when waterbearing temperatures were 36.9 degrees C vs. 36.3 degrees C on land. Neonatal rectal temperatures did not differ significantly between the two groups. Water temperature increased from the beginning of the bath (35.2 degrees C) to 35.7 degrees C, and fell at the end of the bath to 32.9 degrees C. Water temperature range: 23 degrees C to 38.9 degrees C. Bathing duration: 28 min. to 364 min. CONCLUSIONS: Waterbirths pose no thermal risk. The parturient, with her "inborn code of body temperature regulation," regulates water temperature and bathing duration to ensure body temperatures of mother and child remain within the physiological range. Cumbersome guidelines for water temperature and bathing duration are therefore superfluous.

Body Temperature↗