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PubMed2000

Bacterial contamination of bath-water from spinal cord lesioned patients with pressure ulcers exercising in the water.

AIM: To evaluate the bacterial contamination of the water from the microflora of pressure ulcers in para- and tetraplegic patients, when they were exercising in water at 36 degrees C for half an hour. MATERIAL: Twelve spinal cord lesioned (SCL) patients with ulcers participated, and six of the 12 SCL patients with healed ulcers constituted a control group. METHODS: The evaluation was performed both with and without the ulcer covered with a moisture reactive occlusive dressing, DuoDERM. Bacterial samples were taken from the bath-water before and after the exercise programmes and additionally specimens were obtained from the ulcer, the patients skin and urine, and from the skin of the physiotherapist who exercised the patient. A similar procedure was carried out in the controls. RESULTS: The bacteriologic analyses showed no significant difference in the contamination of the bath-water after exercising with or without DuoDERM covering the ulcers. In half of the patients DuoDERM loosened. After all exercise programmes with or without DuoDERM dressing the water was contaminated with facultative aerobic intestinal bacteria, ie E. faecalis and Enterobacteriaceae (E. coli, Klebsiella species, Proteus species, Enterobacter species). In nearly one-third of the exercise sessions the bath-water was contaminated with P. aeruginosa before starting, and after the exercise programmes one fourth of the ulcers were colonized with these pathogens. CONCLUSION: The water specimen showed the bacteria from the intestine to be much more prominent than the bacteria coming from the ulcers. Thus the pressure ulcers were of minor importance for the bath-water and ought not to prohibit patients from the potential benefits of water exercise, but chlorination of the water in the training pool seems appropriate.

Adult↗
PubMed2000

Familial cluster of cutaneous Mycobacterium avium infection resulting from use of a circulating, constantly heated bath water system.

We describe familial cases of cutaneous infection caused by Mycobacterium avium. A 45-year-old father, his 14-year-old son and 11-year-old daughter, among five persons in a family, presented with a 2-month history of inflammatory subcutaneous nodules and ulcerations. Histology of skin biopsy specimens showed granulomatous inflammation, and mycobacterial colonies isolated from the skin of each patient were identified as M. avium by DNA hybridization analysis. The patients were all treated successfully with combined drug therapy consisting of rifampicin, isoniazid and clarithromycin. Their lesions were purely cutaneous M. avium infection, without any visceral involvement. Neither systemic disease nor immunological impairment was detected in the family. However, they all used a circulating, constantly heated bath water system. The bath water was continuously heated to about 40 degrees C without changing the water for a few months, and M. avium was isolated from the filter of the bath tub heating unit. It is considered that this unusual familial cluster of cutaneous M. avium infection in healthy persons may have resulted from the use of contaminated bath water.

Adolescent↗
PubMed2001

Liver cytochrome P450 CYP1A2 is markedly inhibited by systemic but not by bath PUVA in dermatological patients.

BACKGROUND: Methoxsalen (8-MOP) may cause important pharmacokinetic drug interactions as it has been shown to inhibit and/or induce several drug-metabolizing enzymes in vitro, in animal models and in humans. OBJECTIVES: In order to assess the clinical importance of acute and chronic 8-MOP effects on the liver cytochrome P-450 enzyme CYP1A2 in vivo, we measured caffeine clearance in dermatological patients before the onset of systemic or bath psoralen + ultraviolet A radiation (PUVA) (8-MOP + UVA) therapy, on the first day and after 1 week of treatment. METHODS: Data from four patients with systemic PUVA and seven patients with bath PUVA were available (age range 23-71 years, five women and six men). RESULTS: For all of the patients, individual pre-PUVA caffeine clearance values were above the lower limit of previously assessed reference ranges. Systemic PUVA markedly decreased caffeine clearance by factors of 0.17 [90% confidence interval (CI) 0.07-0.42] on the first day and 0.14 (90% CI 0.05-0.36) after 1 week of treatment, respectively, and values thus dropped below the reference ranges. In contrast, bath PUVA had no obvious effect on pre-PUVA clearance values as the latter changed by factors of 1.00 (90% CI 0.81-1.23) and 1.05 (90% CI 0.75-1.49) on the first day and after 1 week of treatment, respectively. CONCLUSIONS: Systemic PUVA causes pronounced inhibition of liver CYP1A2, while bath PUVA has no such effect. The extent of interaction makes a dose adjustment for most CYP1A2 substrates such as theophylline mandatory in patients undergoing systemic PUVA.

Administration, Cutaneous↗
PubMed2001

[Hygiene of bathing waters].

Bathing is possible without any epidemic risk in Southbavarian lakes. Limit values according to the water monitoring by the EC-Directive 76/160/EC were rarely exceeded and occurred only in 0.3 to 2.1 % of the samples from 1990 to 1998. In river waters, however, limit values occurred in 17 to 35.3 % of the samples and one should beware of bathing there. In 1999 some lakes became fecally polluted by overflows which could be documented by high numbers of total coliforms but not by Escherichia coli. Subsequently total coliforms functioned as an important hygienic parameter. Therefore, total coliforms should not be abolished in the revision of the EC-Directive. Water monitoring of little lakes further revealed that the future limit value of 100 fecal streptococci in 100 ml was exceeded in more than 50 % of the samples. Enterohaemorrhagic E. coli were demonstrated in 2 % of the surface water samples. Thermophilic campylobacters could be isolated from 17.4 % of bathing water samples which were faultless according to the hygienic parameters of the EC-Directive. In this respect all possibilities should be utilized to minimize fecal pollutions at bathing places.

Bathing Beaches↗
PubMed2005

Bath-water PUVA therapy with 8-methoxypsoralen in mycosis fungoides.

PUVA therapy is widely used for early stage mycosis fungoides. While the efficacy of PUVA with oral 8-methoxypsoralen (8-MOP) is well documented, the use of its topical variation, bath-water PUVA therapy with 8-MOP has not been studied. The purpose of this study was to assess the effect of 8-MOP bath-water PUVA therapy in adult patients with early stage mycosis fungoides. We retrospectively evaluated the outcomes of bath-water delivery of 8-MOP (1 mg l(-1)) in 16 patients with early stage mycosis fungoides. In all patients complete response was achieved after a mean duration of 63 days requiring 29 treatments and a mean cumulative UVA dose of 33 J cm(-2). The time to relapse after complete clinical clearance was 45.6 (+/-9.2) weeks. In comparison, oral PUVA therapy with 8-MOP resulted in complete response after 64.5 days (25.8 treatments) with a mean relapse-free period of 30 (+/-3.5) weeks. We conclude that bath-water PUVA therapy with 8-MOP is a valuable photo-therapeutic alternative, which should be considered for patients in whom systemic psoralen cannot be used.

Administration, Cutaneous↗
PubMed2006

The bathing of older adults with dementia.

Older adults who need assistance with bathing often find the activity to be both physically and emotionally demanding, as do their caregivers. Research has identified several contributing factors, including pain; fatigue and weakness; confusion; anxiety resulting from being naked in front of strangers, being afraid of falling, and being in a noisy or unfamiliar place; and discomfort from cold or drafty bathing areas or harsh water sprays. The authors of this article make the case for the elimination of forced bathing. Research supports this change in philosophy and practice, whereby bathing is not a task to be performed but rather a human interaction. Inexpensive, practical, and evidence-based alternatives are discussed.

Activities of Daily Living↗
PubMedDate not supplied

The interactive newborn bath.

The interactive newborn bath is an innovative approach to the traditional baby bath. This article uses a Brazelton infant behavior perspective to describe a rationale and methodology for this family-centered nursing intervention. It offers the nurse detailed suggestions for observing and identifying infant states, interpreting infant behavior, calming and orienting newborns, and eliciting selected reflexes. In this approach, the nurse assumes an expanded role as a facilitator of infant-parent interaction. The baby's behavior and the bath experience are used to engage parents with their newborns. The nurse encourages parents to observe, touch, and respond to their infants in order to develop more responsive parenting skills and better enjoy their babies. The interactive approach can enrich nursing practice by transforming the standard newborn bath into an exploratory adventure in which the nurse joins with parents to better understand and respond to the newest member of their family.

Baths↗
PubMed1999

Effect of a bath on the epicardial transmembrane potential during internal defibrillation shocks.

Using a three-dimensional model of cardiac tissue, we consider a rectangular slab of tissue. We examine the effect of a defibrillating shock from an intracavitary electrode upon the epicardial transmembrane potential (Vm) for two cases: one in which the epicardium is bounded by air and another in which it is bounded by a conductive bath. We find that the inclusion of the bath changes the polarity of the steady-state Vm in the epicardial region that is closest to the shock electrode. In addition, the magnitude of Vm is increased dramatically if the bath is present; the degree of hyperpolarization increases twenty-fivefold, while the degree of depolarization increases elevenfold. The remaining bulk of the cardiac tissue is relatively unaffected by the inclusion of the bath.

Baths↗
PubMed1992

Bath-water compared with oral delivery of 8-methoxypsoralen PUVA therapy for chronic plaque psoriasis.

Forty-four patients with chronic plaque psoriasis were randomly allocated to treatment with bath-water-delivered 8-methoxypsoralen (bath 8-MOP) or oral 8-methoxypsoralen (oral 8-MOP) PUVA therapy. There was a significant reduction in extent of the lesions and psoriasis area and severity index (PASI) after 20 treatments with each modality. There was a fourfold reduction in cumulative ultraviolet A (UVA) dose in the bath group. Side-effects of erythema and nausea were less with bath therapy.

Administration, Oral↗
PubMedDate not supplied

Infant bath seats, drowning and near-drowning.

OBJECTIVE: To investigate the possible role of infant bathtub seats in drowning and near-drowning episodes in infants. METHODS: A review was conducted of the files of the Forensic Science Centre and Child Protection Unit, Women's and Children's Hospital, Adelaide, South Australia, for significant immersion incidents in infants involving bathtub seats from January 1998 to December 2003. RESULTS: A total of six cases of drowning occurred over the 6-year period of the study in children under 2 years of age, including two infants. One of these cases, a 7-month-old boy, had been left unattended for some time in an adult bath in a bathtub seat. He was found drowned, having submerged after slipping down and becoming trapped in the seat. Three near-drowning episodes occurred in children under the age of 2 years, including two boys aged 7 and 8 months, both of whom had been left for some time in adult baths in bath seats. Both were successfully resuscitated and treated in hospital. CONCLUSIONS: These cases demonstrate the vulnerability of infants to immersion incidents when left unattended in bathtubs. Bathtubs are particularly dangerous for infants as the slippery and smooth surfaces predispose to loss of balance and make escape from water difficult. Infant bathtub seats may give parents and child carers a false sense of security leading to infants being left unattended. Unfortunately, however, infants may fall out of, or slip and become trapped in, such seats. Infants and young children cannot be left unsupervised in water, and devices used as bathing aids such as bathtub seats may contribute to immersion incidents.

Australia↗
PubMed2005

Probability distributions for showering and bathing water-use behavior for various U.S. subpopulations.

It has been shown that bathroom-type water uses dominate personal exposure to water-borne contaminants in the home. Therefore, in assessing exposure of specific population groups to the contaminants in the water, understanding population water-use behavior for bathroom activities as a function of demographic characteristics is vital to realistic exposure estimates. In this article, shower and bath frequencies and durations are analyzed, presented, and compared for various demographic groups derived from analyses of the National Human Activities Pattern Survey (NHAPS) database and the Residential End Uses of Water Study (REUWS) database as well as from a review of current literature. Analysis showed that age and level of education significantly influenced shower and bath frequency and duration. The frequency of showering and bathing reported in NHAPS agreed reasonably well with previous studies; however, durations of these events were found to be significantly longer. Showering frequency reported in REUWS was slightly less than that reported for NHAPS; however, durations of showers reported in REUWS are consistent with other studies. After considering the strengths and weaknesses of each data set and comparing their results to previous studies, it is concluded that NHAPS provides more reliable frequency data, while REUWS provides more reliable duration data. The shower- and bath-use behavior parameters recommended in this article can aid modelers in appropriately specifying water-use behavior as a function of demographic group in order to conduct reasonable assessments of exposure to contaminants that enter the home via the water supply.

Adolescent↗
PubMed1985

The hot bath test in multiple sclerosis: comparison with visual evoked responses and oligoclonal bands.

We studied 50 patients with definite, probable, and possible multiple sclerosis (MS), prospectively (20 patients) and retrospectively (30 patients), to determine the value of the hot bath test for diagnosing MS and to compare it to visual evoked responses and oligoclonal bands. The hot bath test was abnormal in 8 of the 23 patients with definite MS (35%), and 4 of the 27 patients with probable or possible MS (15%). Only one patient with an abnormal hot bath test did not also have other evidence of definite multiple sclerosis. Our results suggest that the hot bath test seldom adds diagnostic information, especially when tests for evoked responses and oligoclonal bands are available.

Adult↗
PubMedDate not supplied

Bath PUVA--an investigation of the distribution of trioxsalen (TMP) and 8-methoxypsoralen (8-MOP) in bathwater.

Trioxsalen (TMP) bath PUVA avoids the side effects of nausea and headache associated with oral 8-methoxypsoralen (8-MOP) treatment and allows shorter irradiation times that can be advantageous in some patients. However we noted that a number of patients developed unusual patterns of phototoxic burning. We thought that this was related to an uneven distribution of the TMP in the bathwater and for this reason, a study of bath water TMP concentrations achieved using different TMP preparations was undertaken. The distribution of 8-MOP in an 8-MOP bath was also measured for comparison. Our results confirm that an uneven distribution of TMP is achieved using TMP capsules or suspension and would explain our observed patterns of burning. With an ethanolic solution of TMP, or the commercial equivalent Tripsor, or with Puvasoralen-8 (an 8-MOP preparation), a homogeneous psoralen distribution is achieved, and they are therefore preferable for use in bath PUVA.

Administration, Cutaneous↗
PubMed1984

Behavior of amitraz in cattle dipping baths.

The settling rates of 0.025% w/v amitraz (used as a 50% w/w active ingredient wettable powder) and lime stabiliser (0.7% Ca(OH)2) were studied in cattle dipping baths in the Tick Quarantine Area of northern New South Wales. Although lime settled more rapidly than amitraz, the rate for both decreased as the number of cattle dipped increased. After a total of 1,200 head had been dipped the settling rate during the hour following stirring was negligible, and re-stirring was not necessary within the hour following use. Baths could also be cleaned of heavy sediment by scooping without significant loss of chemicals. When the bath volume was allowed to decrease to 2,100 liters below working volume no significant changes in amitraz and Ca(OH)2 concentrations occurred. Data collected from 796 baths showed a significant concentration change of +0.00066% amitraz and -0.017% Ca (OH)2 per 1,000 head of cattle. Replenishment per 700 liters of water with 254 g amitraz was found to be in good agreement with 250 g recommended by the manufacturer, while 12.53 kg for lime was substantially more than the 10 kg recommended.

Animal Husbandry↗
PubMed2004

[Legionella pneumonia which occurred in a private whirlpool bath user].

A 88 year old female with active rheumatoid arthritis treated by low dose of prednisolone and methotrexate was admitted to our hospital because of severe bilateral pulmonary infiltration and acute respiratory distress syndrome. On admission, she had consciousness disturbance and was intubated because of severe respiratory failure. We heard from her family of her habit she had taking a private whirlpool bath 2 or 3 times everyday. So, we suspected a Legionella pneumophila infection. We started intravenous erythromycin (EM) (1,500mg/day) and methylprednisolone pulse therapy (1,000mg x 3days) and full controlled mechanical ventilation supported with PEEP. Her respiratory failure was gradually improved and she was discharged on the 44 the hospital day. Legionella pneumophila (serogroup 6) was isolated in her sputum by B-CYE alpha culture. Legionella pneumophila (serogroup 6) was isolated in her private whirlpool bath too. Both samples revealed the same by genetic analysis with pulse field gel electrophoresis (PFGE). This is the first adult case of Legionella pneumophila pneumonia infected from a private whirlpool bath confirmed by genetic analysis. We should always suspect Legionella pneumonia as one of the severe community-acquired pneumonia, because Legionella pneumophila were frequently detected among various water sources including the private whirlpool bath.

Aged↗
PubMed1986

Treatment of first episodes of acute anal fissure: prospective randomised study of lignocaine ointment versus hydrocortisone ointment or warm sitz baths plus bran.

One hundred and three patients with an acute first episode of posterior anal fissure were randomised to receive a three week trial of lignocaine ointment (n = 33) versus hydrocortisone ointment (n = 35) or warm sitz baths combined with an intake of unprocessed bran (n =35). Seven patients were withdrawn owing to failure to adhere to the trial protocol. After one and two weeks of treatment symptomatic relief was significantly better among patients treated with sitz baths and bran than among patients treated with lignocaine ointment or hydrocortisone ointment. After three weeks there was no difference in symptomatic relief among the three groups. Patients treated with lignocaine, however, had significantly fewer healed fissures (60%) than patients treated with hydrocortisone (82.4%) or warm sitz baths and bran (87%). In this study warm sitz baths plus an intake of unprocessed bran came out as the treatment of choice for an acute first episode of posterior anal fissure. This treatment is cheap, has no potential serious side effects, and brings the best and quickest relief of symptoms.

Acute Disease↗
PubMedDate not supplied

High plasma levels of 8-methoxypsoralen following bath water delivery in dermatological patients.

With respect to the clinical advantages known for bath PUVA therapy, it was of interest to compare the plasma levels of 8-methoxypsoralen (8-MOP) in bath therapy with those after oral administration for a better insight into the pharmacokinetics of 8-MOP following different modes of application. Considerable high plasma levels of 8-MOP were observed after bath therapy with interindividual variability. The half-life of plasma 8-MOP was markedly shorter after bath PUVA than after oral application. The pharmacokinetic profile of 8-MOP differs according to the mode of application.

Administration, Cutaneous↗
PubMed2003

Sauna-bathing with sutures. A prospective and randomised study.

BACKGROUND AND AIMS: Bathing in sauna is a Finnish habit with numerous beliefs and traditions. One belief has been that one is not allowed to go to sauna postoperatively with sutures. This belief is in practically every patient information sheet in Finland on postoperative wound care. There is no scientific proof of the harmfulness of sauna-bathing with sutures and no articles on the matter, either. The aim of this study was to evaluate whether sauna-bathing has a negative impact on wound healing. MATERIALS AND METHODS: Prospective, randomised study with 79 patients scheduled for an elective hernioplasty in a day care surgical department. The other group was advised to go to sauna from 3rd postoperative day on, and for the other group, sauna was prohibited until sutures were removed. RESULTS: There was no differences in wound healing between two groups. CONCLUSION: There is no reason to prohibit sauna-bathing with sutures in this patient group.

Adult↗