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Laboratory evaluation of repellents against Leptotrombidium deliense, vector of scrub typhus.

BACKGROUND & OBJECTIVES: Scrub typhus, a rickettsial disease transmitted by larvae of Leptotrombidium deliense, is of special importance to the Armed Forces personnel, due to the heightened risk to this disease during movement in mite endemic areas during exercise/war. The disease is best prevented by the use of personal protective measures including repellents. Studies were undertaken to determine the relative efficacy of repellents: diethyl toulamide (DEET), dibutyl phthalate (DBP) with an indigenously developed repellent diethyl phenyl acetamide (DEPA) against the larval trombiculid mite. METHODS: The repellents were tested for persistence on impregnated cloth prior to washing, post washing and ironing by means of a specially fabricated testing kit. Acaricidal efficacy estimation was performed on the treated fabrics and topical application efficacy of repellents on mice was evaluated by a novel animal testing model. RESULTS: DEET and DEPA were found to provide maximum protection (repellence and acaricidal efficacy), could withstand two launderings of the impregnated uniform and also had superior efficacy on topical application (8 h). Ironing was found to significantly reduce the repellence of DEET and DBP. INTERPRETATION & CONCLUSION: The findings of this study point towards the superiority of DEPA and DEET for impregnation of the uniform cloth as well as for topical application for the prevention of scrub typhus amongst the troops.

Animals↗

[The Norman Francois Rene Curaudau (1765-1813), pharmacist, unrecognized chemist].

Accepted as member of Paris' Pharmacist College at 22 years, Curaudau was born to Sees in Orne department. He settled pharmacist at Vendome, then in Paris in 1800 where he devoted entirely to chemistry and to adjustment of industrial processes and thermal apparatus. Industrial, he exploited some of his own inventions. Preparation methods for alkaline metals and alum, process adjustments for tanning, soap fabrication, laundering and liquids evaporation, construction of new types of economic stoves and furnaces, and particularly his determining experiments on the chlorine structure, constitute the more important scientific works of this unrecognized chemist which is the subject of this study.

Chemistry↗

Intraoperative bacterial transmission.

A clinical evaluation of bacterial penetration through operating room gowns was made during 100 general surgical procedures. A comparison of the degree of penetration through the standard cloth and a commercially available disposible gown was carried out. Cloth gowns, even in the dry state, were shown to be ineffective bacterial barriers. In addition, routine laundering of scrub suits failed to eliminate pathogenic bacteria.

Alkenes↗

HIV claims 22 lives in China and 10,000 may be infected.

As many as 10,000 Chinese may be infected with HIV, and 22 have died of the disease since China discovered its first case in 1985, an official report said. By the end of July 1994, 1453 people in China had tested positive for HIV. Of those, 1174 were Chinese citizens, 31 were overseas Chinese and 230 were foreigners. But Wang Youfa, of the China Xiehe Medical College, wrote in the Guangming Daily that HIV tests in China have so far been administered only among high-risk groups. "The actual infection rate is far higher. Chinese experts estimate that the (Chinese) mainland currently has 5000 to 10,000 HIV carriers," Wang said. He urged better control of disease, but proposed no specific measures. Most Chinese still have little knowledge of the disease and how it is spread. Some believe that they can catch it through dirty bed sheets or from underwear laundered by hotels or laundromats. The Chinese government long has characterized AIDS as a disease that strikes only foreigners or fringe groups such as drug users and homosexuals. Prevention measures were directed at foreigners coming to China and at Chinese with frequent contacts with foreigners. Chinese health officials were shocked in 1990 when they discovered 146 HIV-positive drug users in southwest China's Yunnan province. Since then, the figure has ballooned to 1133 cases, or 79% of the national total, Wang said. The province borders Burma, which produces much of the world's heroin, and has China's most serious drug problem. The report said the infection rate among Yunnan's intravenous drug users was as high as 78%. Drug users account for 66% of the HIV carriers. The virus has spread to 22 of China's 39 provinces, Wang said. Of the 40 Chinese citizens who have developed advanced AIDS, 22 have already died, he said. Non-Chinese citizens with HIV are deported from China.

Asia↗

Ammoniacal dermatitis. Clinical observations on an efficacious, economical and neglected treatment.

Several pediatricians in one community began instructing mothers of infants with ammoniacal diaper rash to use o-benzyl-p-chlorophenol (OBPC) in laundering diapers. This simple, previously reported item of management was prescribed in 87 cases of ammoniacal rash. In almost all uncomplicated cases the rash cleared in an average of four days; when complicated by Staphylococcus aureus or Monilia albicans infection, clearing took a few days longer. The few cases of less than satisfactory results were attributable to improper use of the chemical. Several of the mothers had mild irritation of the hands from use of OBPC.

Candidiasis↗

Occupational mortality of California women, 1979-1981.

A review of California's mortality data for 1979 through 1981, encompassing 61,561 female and 111,877 male deaths, shows differential female mortality risk by labor force status and by occupation. High patterns of risk were found for women in a number of occupations, including waitresses, licensed vocational nurses and health aides, cosmetologists, telephone operators, housekeepers and janitors, and launderers and dry cleaners. Patterns of mortality risk were similar for each race within these occupational groups. The mortality risks for women were generally higher than those for men. The association of mortality with certain occupational does not necessarily imply a causal relationship but is certainly a signal that further research is required and that physicians need to consider work-related factors in evaluating the health of women.

Adolescent↗

Wood fiber contamination of reusable cotton laparotomy pads.

If the thesis that disposable fabrics are responsible for granulomatous peritonitis is correct, surgeons who operate within the abdominal cavity and use these products would be reporting instances of granulomatous peritonitis in epidemic proportions. Such is not so. Consequently, there can be valid concern expressed as to implied medicolegal problems. While the observations and conclusions were made in obvious good faith, nevertheless, there appears to be sufficient grounds for questioning this apparent cause and effect conclusion and for focusing interest on a more important consideration, the indiscriminate collection, sorting and laundering of the reusable cotton laparotomy pad. Certainly, attention should be directed to the more rigidly controlled use and disposition of these pads by the individual hospital.

Equipment and Supplies, Hospital↗

Laboratory and field evaluation of the molluscicidal properties of Phytolacca dodecandra.

Dried berries of endod (Phytolacca dodecandra) (known also as soapberry) are widely used in Ethiopia instead of soap for laundering clothes. It was observed that in natural bodies of water where endod had been used there was a high mortality of snails. Subsequently, the molluscicidal potencies of various parts of male and female endod plants were determined and the berries were found to be the most potent. The potency of endod remained stable over a wide range of temperatures and pH values, in the presence of various concentrations of river-bed mud and after ultraviolet irradiation of solutions. The toxicity of endod to mammals and plants has been shown to be very low. Its toxicity to snail eggs also is low but it has been shown that this difficulty can be overcome in the field by repeated treatments. Endod kills leeches and schistosome cercariae and miracidia at very low concentrations. Comparative tests with endod and several standard molluscicides have given encouraging results.Being a natural product, endod could become a cheap and effective means of controlling schistosomiasis in certain areas since, under suitable climatic conditions, the plant grows rapidly and bears fruit twice a year.

Ethiopia↗

Forfeiture of the profits and proceeds of drug crimes.

Drug trafficking is controlled by well-organized international criminal syndicates, whose only motives for becoming involved are to make profits and secure influence, which in turn help perpetuate illicit drug distribution networks. For example, one producer of illicit opium receives approximately $Can 650 for 10 kilograms of opium, from which one kilogram of heroin is produced and sold to end-users for up to $Can 12 million. The risks involved for those at the highest level of international criminal syndicates is extremely low since they are financiers who may never come in direct contact with illicit drugs or the law enforcement authorities. The proceeds of drug crimes are laundered through sophisticated international transactions often covered by legitimate operations. Current legislative provisions at both national and international levels are inadequate to support effective action to trace, freeze, seize and secure the forfeiture of the proceeds of crimes and to prosecute individuals who knowingly possess such proceeds. In pursuance of recent resolutions of the Commission on Narcotic Drugs, the Division of Narcotic Drugs of the United Nations Secretariat convened two expert group meetings, one in 1983 and the other in 1984, to consider ways and means of dealing with this problem. The meetings recommended the establishment of machinery that would facilitate, at both national and international levels, concerted action to deprive drug traffickers of the proceeds of their crimes. The annex to this article contains provisions recommended by the second expert group meeting for inclusion in an international instrument to supplement existing provisions of the international drug control treaties in order to deal more effectively with the profits of drug crimes.

Crime↗

Reduction of pesticide exposure with protective clothing for applicators and mixers.

Systemic pesticide illness in agricultural workers may result from excessive dermal exposure to pesticides. Workers who apply and mix pesticides (applicators and mixers) are not at special risk. Both acute and chronic exposures can occur from spillage or by environmental contamination of clothing. Two exposure assessment studies were conducted of Central Florida citrus grove workers who applied ethion daily. Measuring the percentage of penetration of ethion through clothing and measuring the daily urinary excretion of diethyl phosphate (DEP) were the techniques used to assess the protection afforded by changing daily to freshly laundered 100% cotton coveralls. Coveralls provided significantly greater protection than did regular clothing and the use of respirators.

Agricultural Workers' Diseases↗

Domestic care dependency in the aged: a total community survey in Israel.

Two hundred and sixty elderly residents of 10 rural Israeli communities were screened for the presence of a variety of domestic disabilities using the Domestic Care Dependency Index. The Index measures ability to function without help in shopping, cooking, laundering, housekeeping, reaching a source of primary medical care and identifying doctor-prescribed medication. Sixty-four per cent of the population screened showed dependency in at least one category. Dependency increased with age and was much more common in men (94.7 per cent) than women (33.3 per cent). We emphasize the importance of identifying domestic needs in the elderly, both real and potential, so that family members or community workers can provide help where it is needed and the necessity for prolonged professional or institutional care can be avoided or postponed.

Activities of Daily Living↗

A new disposable bowie-Dick-type test pack for prevacuum high-temperature sterilizers.

A new, smaller disposable test pack has been devised to replace the stack of folded linen towels still widely used to test for air leaks in prevacuum high-temperature sterilizers. The new disposable pack allows more consistent and reproducible results to be obtained and small air leaks to be detected more readily. A single-use prepackaged item with uniform physical properties and performance characteristics, the disposable test pack eliminates (a) operator error and hence inconsistent results, (b) cost of replacing, processing, folding, wrapping, and laundering towels, and (c) errors caused by variations in test materials.

Bedding and Linens↗

Environmental health. Nappies: the bottom line.

Increasing use of disposable nappies presents a major environmental hazard. Manufacturing processes consume vast amounts of resources; disposal is a significant pollution problem, although laundering nappies too generates pollution. Teresa Webb believes parents should be presented with the comparable facts about nappies, to enable them to make an informed choice.

Disposable Equipment↗

Greening the OR: an Australian perspective.

1. Many hospitals in Australia have become proactive about environmental issues, including use of plastics, disposable drapes, and glutaraldehyde; laundering of linen; and disposal of waste. 2. Although some standards are not mandated (as in the United States), timely, comprehensive guidelines are being published. 3. Environmental advocacy demonstrates the resourcefulness and creativity of perioperative nurses, as well as a commitment to preserving the environment for future generations.

Australia↗

The effect of normalization of plasma amino acids on hepatic encephalopathy in man.

Previous work from this laboratory has suggested that the plasma amino acid pattern, known to be deranged in hepatic encephalopathy, may be related causally. In order to test this hypothesis, 23% dextrose and a special amino acid solution whose components were calculated to normalize the plasma amino acid pattern were infused in 11 patients, eight with chronic cirrhosis and acute exacerbation (Group 1) and three patients with fulminant hepatitis (Group 2), in amounts of up to 120 Gm. of protein equivalent per 24 hours. Plasma amino acids were abnormal but different in both groups. In Group 1 (cirrhosis) changes in plasma amino acid pattern including elevated phenylalanine, tyrosine, glutamate, aspartate, and methionine and decreased valine, leucine, and isoleucine. In Group 2 all amino acids were elevated, with the exception of the branched chains which were normal. Hepatic encephalopathy improved in all patients in Group 1 and in one of three patients in Group 2 following the infusion. The ratio (see article) showed an excellent correlation with a grade of encephalopathy. When this ratio, previously 1.0 in the presence of encephalopathy, returned to the normal value near 3.0 to 3.5, encephalopathy improved. An excellent correlation was obtained between the ratio and the grade of encephalopathy and was dose related as well. The results suggest that different amino acid patterns in hepatic encephalopathy of differing etiologies require treatment modalities which may differ for the two types of encephalopathy. Whereas amino acid infusion appears to be a valuable, efficacious way of providing nutrition in treating hepatic encephalopathy in patients with cirrhosis and acute deterioration and coma, other means of therapy such as plasms "laundering" appear to be necessary in patients with fulminant hepatitis.

Adult↗

Comparison of stool containment in cloth and single-use diapers using a simulated infant feces.

Single-use diapers and cloth diapers with vinyl pants were compared for their relative abilities to contain stool within the diaper. Artificial feces with carbon black as an additive allowed a quantitative measure of fecal containment by image analysis in 60 infants. This method showed complete containment of feces in the diaper in 50% of the single-use diapers whereas only 10% of the cloth diapers showed complete containment. In infants where the border of the vinyl pants was used as the boundary of containment with the cloth diapers, complete containment occurred only 33% of the time. Fluorescein dye ratings for containment/leakage in 69 infants showed that 83% of single-use diapers and 30% of the cloth diapers were rated as having no or minor leakage of feces. Cultures were taken of laundered vinyl pants that had previously been used over cloth diapers to determine microbial contamination. Thirty-nine percent of the pants contained Gram-negative, lactose-fermenting bacilli indicating fecal contamination. This study comparing single-use and cloth diapers for containment of artificial feces by use of image analysis and fluorescein dye ratings showed better containment by single-use diapers. The study also raises the question of possible spread of feces-borne pathogens by the vinyl pants used over cloth diapers, particularly in a day-care center.

Bacteria↗

[Traveling with small children].

Traveling with children especially in the tropics requires special planning. Contraindications are rare but care providers should obtain information about medical and transfusional facilities at the destination. Children should receive all vaccinations required for international travel and for specific countries, taking into account age, location, duration of stay, and purpose of trip. A first aid kit should be packed containing a thermometer, bandages, antiseptic agents, a total sunscreen preparation, a mosquito net, sterile compresses, tablets for water disinfection, and indispensable medications (antimalarial agents, antipyretics, oral rehydration solutions, antiemetics, and eye wash). The main indication for chemoprophylaxis is malaria. Chloroquine is recommended for most locations but proguanil may be necessary in areas of resistance. Special attention must be paid to skin care in infants: maintaining cleanliness, avoiding cuts insofar as possible, and treating any wounds. Clothing must be carefully laundered and adequate to prevent overexposure to sunlight and insect bites. Insect bites must also be prevented by applying repellents, using mosquito nets, and wearing insecticide-treated garments. Handwashing by people who prepare meals and by the children before eating is important to prevent food poisoning. Breast feeding is advisable for infants. Thorough cooking of meats, rinsing of fresh produce, drinking of bottled beverages, and sterilization of water are also important food safety measures. These precautions are usually adequate to allow safe travel with children.

Child↗