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[Hygiene and methods of decontamination, disinfection and sterilization in dental offices in Yaounde].

Hygiene and asepsis of the dental office depend on medical ethics and legal obligation. The survey done with the participation of 33 practitioners over the 42 practicing in Yaounde allows apprehending the reality of the daily hygiene. The ways of cleaning, decontamination, disinfection or of sterilization of the premises, the dental equipment and instruments, hand-washing, disposable materials and the vaccination protection of the practitioners were analyzed. The cleaning of the floor and door mats is daily (100%); disinfection is done daily in 83% of the departments in all of the centers. The cleaning and disinfection of the dental chair is daily and is done using soap (23%) and/or bleaching-water (56%). Cleaning or disinfection of the suction machine is done with soap (24%) or with bleaching-water (47%). The hand-pieces and the turbines are cleaned and/or disinfected after each usage in (94%) with alcohol (17%) or with bleaching-water (32%) and sterilized with a heat sterilizer (45%), an autoclave(40%) or cold disinfected(15%). The frequency of the treatment of the instruments is well-respected (83%). Nevertheless the products used are very varied and are not always used in the prescribed order. Hand-washing is systematic after each patient; 50% of the practitioners use soap bars or powered soap and 50% use an antiseptic or a disinfectant solutions. With the regard to the vaccination, only 3 practitioners were properly vaccinated against hepatitis B, tetanus, diphtheria, poliomyelitis and tuberculosis. With regard to the protection of the practitioners, 72% do not wear caps, 56% do not wear eyeglasses, 40% do not wear masks, 95% do not use rubber dams, 56% do not disinfect the radiographic films and 37% do not disinfect the impressions; the habitual attire consists of a smock worn over street clothes (78%) and street shoes (90%). The debris is burnt in 35% of the centers. Better knowledge of the different stages (cleaning, decontamination, disinfection or sterilization and the products used, absolute respect of the disposable materials, optimal vaccination protection and the elaboration of the correct procedures written and posted up in the different departments are fundamental points for quality treatment. As a matter of fact, negligence and ignorance of the rules of hygiene and asepsis should not be part and parcel of the therapeutic hazard in the dental department.

Cameroon↗

Gastrointestinal decontamination in paediatric exploratory ingestions.

AIM: To review the effect of treatment changes in paediatric exploratory ingestion at Christchurch Hospital. METHODS: We carried out a retrospective review of paediatric patients presenting with potentially toxic ingestion during six month periods of 1994, 1996 and 1999. RESULTS: All three groups were comparable in respect to age and gender. There were minor changes in the range and proportion of substances ingested - with those in the 1999 group more likely to have taken paracetamol. In 1994, 36% of children were treated with syrup of ipecac. By 1996, only 9% were given ipecac, with 49% treated with activated charcoal. By 1999, 12% were treated with activated charcoal, while 88% received no decontamination. There was a lower admission rate in the 1999 group with no overall change in outcome. CONCLUSIONS: It is rare for paediatric exploratory ingestions to result in significant toxicity. Gastrointestinal decontamination should not be routinely used in these patients as the risk of the procedure may outweigh the risk of the poison exposure.

Acetaminophen↗

[The effect of Lactobacillus acidophilus "Solco" on the immunological indices of totally decontaminated mice under complete gnotobiological isolation].

The possibility of stimulating the immunity of totally decontaminated mice, kept isolated under germ-free conditions, with the use of killed L. acidophilus Solco strains has been studied. As revealed in this study, the oral and intraperitoneal administration of strains O1 and O6 to mice leads to a significant increase in the content of immunoglobulin-synthesizing cells in the jejunal lamina propria of the animals. The oral administration of L. acidophilus Solco strain O6 and the intraperitoneal injection of L. acidophilus Solco strain O1 have been found to lead to a significant rise in the level of luminol-dependent chemiluminescence of mouse peritoneal macrophages. The total decontamination of mice induces the development of secondary immunodeficiency which influences the effectiveness of immunostimulating agents.

Animals↗

[Air decontamination and the fine filtration system "Potok 150MK"].

Longevity of space stations is dependent on efficiency and robustness of the life support systems. The article describes the principle of operation of air decontamination system Potok 150MK intended for providing microbial safety of the orbital station environment. High quality of air disinfection and decontamination has been demonstrated aboard SS Mir and the International space station.

Air Conditioning↗

Practical aspects of decontamination of the unconventional transmissible agents that cause sporadic and variant Creutzfeldt-Jakob disease and other similar human diseases.

Although the unconventional agents that cause transmissible degenerative encephalopathies have not yet been completely characterised, they are known to be relatively resistant to decontamination procedures that are effective with conventional microorganisms. The implications for the safe decontamination and sterilisation of devices and instruments used in human medicine are discussed.

Creutzfeldt-Jakob Syndrome↗

A practical guide to the use of hand decontaminants.

Alcohol-base hand decontaminants should be available to all staff who have contact with patients. Annette Jeanes describes how such decontaminants work, and how they should be used.

Administration, Topical↗

[Medical interventions: external and internal decontamination of people].

In most cases, external contamination of persons can be monitored easily. Nevertheless, proper measurement techniques must be used. For that reason, contamination measurements must be carried out by health physics professionals. In all efforts to decontaminate intact skin, care must be taken to prevent skin damage. Internal contamination can pose much more problems. Here, decontamination is based on dilution and/or complexation therapy, thus reducing the uptake in critical organs and tissues. Also by stimulating the excretion of radionuclides, internal doses can be reduced significantly. Treatment of contaminated wounds always is a priority because of the internal contamination risk. Radioactive waste has to be collected on an individual basis (for dosimetry purposes). Distance must be kept between radioactive waste and monitoring instruments. Every effort should be made to prevent the spread of contamination; only urgent life saving actions may be an exception. There certainly will be a need for counseling those suffering from the psychological impact of (even minor) contamination accidents. From a public health perspective, the long term psychosocial effects of nuclear catastrophes may eventually be more prevalent than their physical health consequences. Each (general) practitioner should be vigilant to suspicious clinical signs that may be radiation related. However, high threshold doses to critical organs (bone marrow, skin, small intestine) must be crossed before clinical signs arise. In Belgium, several most interesting texts regarding radiation problems have already been distributed to medical and paramedical professionals, partly by the authorities.

Body Burden↗

[Decontamination of soil after bacterial warfare experiments on Gruinard Island].

Bombs containing B. anthracis spores were detonated on Gruinard island in 1942 and 1943 as a part of a British research programme set up in response to fears that the Germans were developing biological weapons. In 1986 island was decontaminated by spraying with 5% formaldehyde. As a demonstration of confidence in the success of the decontamination operation a flock of 40 sheep was allowed to graze for several months with no ill effects.

Bacillus anthracis↗

[Variation of C3 in ascitic fluid from cirrhotic patients subjected to intestinal sterilization or selective intestinal decontamination].

Patients with liver cirrhosis with ascites and low levels of C3 and Total Proteins in ascitic fluid show a greater predisposition to the development of spontaneous bacterial peritonitis. The variation of C3 and Total Proteins levels in ascitic fluid in two groups of patients with liver cirrhosis was studied. Group I (n = 14) underwent intestinal sterilization (n = 7) or selective intestinal decontamination (= 7). Group II was a control. A statistically significant increase in C3 (p less than 0.01) and Total Proteins (p less than 0.015) levels in ascitic fluid in Group I patients was found. There were no changes in the control group. The incidence of side effects was higher in those patients who underwent intestinal sterilization. Our results suggest that selective intestinal decontamination may be useful as a prophylactic measure against spontaneous bacterial peritonitis in those patients with liver cirrhosis at high risk of infection by increasing the bactericidal capacity of ascitic fluid.

Adult↗

[Microbial decontamination by aerobic purification of liquid manure from swine-breeding farm complexes].

Studied was the microbial decontamination of swine mature with the employment of a laboratory model of an aerobic lagoon as well as in a purification station, having a mechanical step, two biologic steps, and a facultative lagoon. It was found under modelled conditions that a substantial decontaminating effect was produced with regard to coli bacteria and Salmonella organisms. The effect was less with regard to the microbial count. The studies carried out in stations showed the effectiveness of the individual steps in reducing the microbial content of manure.

Aerobiosis↗

[Physical methods (ultrasound) and disinfecting agents for decontaminating the water in poultry meat processing].

Productional and laboratory experiments were carried out to study the effect of ultra sound with a view to decontaminating the water in the vats for cooling poultry carcasses and skin cover as well as that of disinfection means (inkosan, actofor, yomil S, chalamide, and chloramin). In vitro studies revealed that the use of ultra sound in the decontamination of cooling water and poultry meat surface did not produce the necessary effect. The iodofor preparations inkosan and yomil S as well as the agents chalamide and chloramine added in fixed concentrations to the water in cooling vats were not shown to be able to inactivate Salmonella organisms on the surface of experimentally contaminated poultry carcasses. Inkosan at the rate of 1:1000, and yomil S at 0.2 and 0.4 per cent produced a 100 per cent bactericidal effect against the microflora in vat waters regardless of their initial contamination. Except for yomil S at 0.4 per cent these agents did not affect the organoleptic properties of poultry meat.

Animals↗

Decontamination of dental equipment. A validation of three devices designed for cleaning, disinfecting, and lubricating of dental high-speed turbines and handpieces.

This study deals with the decontamination of dental turbines and handpieces (DTH) aiming at eliminating the cross-infection risk in dental practice. Three types of equipment designed for cleaning/lubricating DTH were validated. The effect of the three devices was determined for four different types of DTH, which were artificially contaminated with Streptococcus salivarius ATCC 13419 in a controlled manner. Sampling was carried out by collecting one ml water flushed through the DTH connected to a dental unit. The study resulted in a model for testing the decontamination potential of a cleaning/lubrication device for DTH. One of the devices could not reduce the contamination, while two others were able to reduce the bioburden with at least 3.9 logarithmic steps. However none of the devices tested could constantly eliminate the contamination, for which reason an additional heat treatment of the DTH is recommended.

Alcohols↗

Effect of different regimens of gut decontamination on bacterial translocation and mortality in experimental acute pancreatitis.

OBJECTIVE: To assess the effect of four regimens of antibiotics (compared with a control regimen of distilled water) given orally on gut decontamination, bacterial translocation, and mortality in acute necrotising pancreatitis in mice. DESIGN: Randomised experimental study. SETTING: University hospitals, USA and Italy. MATERIALS: 150 young Swiss Webster mice. INTERVENTION: All mice were fed a diet deficient in choline and supplemented with ethionine. They were then randomised to be given by gavage (36 hours after starting the diet): distilled water (controls, group 1); aztreonam along (group 2); neomycin, erythromycin, metronidazole (group 3); polymyxin B and amikacin (group 4); polymyxin B, amikacin, amphotericin B (group 5). 20 Mice in each group were treated for 10 days, and the remaining 10 in each group were killed after 3 days. MAIN OUTCOME MEASURES: Survival, and qualitative and quantitative cultures of the liver, lungs, pancreas and caecum. RESULTS: The best survival rate during the first 7 days was in group 5, but by day 10 there was no difference among the groups. All the antibiotic regimens reduced the number of bacteria in the caecum and all but aztreonam alone (group 2) reduced the rate of translocation of both Gram negative and Gram positive bacteria to all organs studied. Translocation of yeast occurred in those animals in groups 2, 3, and 4 in which there was overgrowth of fungi in the caecum. CONCLUSION: Gram negative and Gram positive organisms and fungi may have an important role in infective morbidity and mortality in acute pancreatitis, and selective decontamination with polymyxin B, amikacin, amphotericin B reduced the incidence of translocation related infections and early mortality in mice with acute necrotising pancreatitis.

Acute Disease↗

[Results of cytogenetic examination of participants in the decontamination after the accident at the Chernobyl nuclear power station, 5 years later].

Results of the cytogenetic investigation on the Chernobyl accident decontamination participants, 5 years after the accident, have been disclosed. Cytogenetic analysis was performed on circulating blood lymphocytes, using a standard cultivation technique. Differences were detected between control group and decontamination participants on frequency of aberrant cells and aberrations of chromosome type in peripheral blood lymphocytes. Maximal cytogenetic effect on this data was detected in persons, who had worked between May and August 1986. On the base of cytogenetic investigation data, the authors proposed to form high-risk groups, including oncologic risk groups, which need a profound dynamic investigation.

Accidents↗

Effectiveness of potash alum in decontaminating household water.

To evaluate the effectiveness of potash alum in purifying household water, this study was carried out in a suburban community in Yangon, Myanmar. It was designed to test whether the application of potash alum (0.05%) regularly into household water storage vessels during water replenishment was capable of decontaminating household water in homes using shallow well water. It was conducted in 100 households (50 each in intervention and control groups). After alum (0.05%) was added, the contamination level of water decreased on the 2nd and 3rd days. The alum-treated water was well tolerated by the users; only one member complained of a metallic taste. We conclude that potash alum was effective and acceptable in this community in decontaminating household water.

Alum Compounds↗

Trends in gastrointestinal decontamination for deliberate self poisoning in Christchurch.

AIM: To examine changes in the choice of gastrointestinal decontamination for deliberate self poisoning in Christchurch. METHOD: A review of adult deliberate self poisoning cases for 9 months from July 1 1995 to March 31 1996 and a comparison with previously published figures from 1989 and 1992. RESULTS: Only 5% of patients received gastric lavage (compared with 26% in 1992 and 78% in 1989) and 52% received activated charcoal (compared with 46% in 1992 and 0.4% in 1989). No patients received syrup of ipecacuanha (compared with 1% in 1992 and 25% in 1989) and 43% had no gastrointestinal decontamination at all. CONCLUSION: The trend towards the use of activated charcoal and away from gastric lavage is consistent with sentiments expressed in the literature.

Adult↗

[A modern equipment package for conducting the thorough sanitary decontamination of personnel].

The authors inform that a new mobile personnel decontamination equipment site has been developed for a field sanitary treatment of troops and their battle uniforms at the same time. The authors prove the necessity of its development and provide full information on its items. They also present a comparative analysis of domestic and foreign sanitary sites that puts the new one to the best advantages as an example of a new generation of sanitary equipment for decontamination and shower of personnel. The site has been recommended to the medical service of the army to replace obsolete sites, like DDA-66, DDA-3 and DDP-2.

Decontamination↗

Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients.

Suppression of the gut luminal aerobic flora to reduce nosocomial infections was tested in a prospective, randomized, double-blind, placebo-controlled clinical trial in patients in a surgical intensive care unit who had persistent hypermetabolism. Forty-six patients were randomized to receive either norfloxacin, 500-mg suspension every 8 hours, together with nystatin, 1 million units every 6 hours, or matching placebo solutions administered through a nasogastric tube within 48 hours of surgical intensive care unit admission. Selective gut decontamination with the experimental therapy or placebo solutions continued for at least 5 days or until the time of surgical intensive care unit discharge. Patients were monitored with routine surveillance cultures for the development of nosocomial infections, as defined by criteria from the Centers for Disease Control. All other therapy was given as clinically indicated, including systemic antibiotics. The selective gut decontamination group experienced a significant reduction in the incidence of nosocomial infections and a reduced length of stay. However, these results were not associated with a concomitant decrease in progressive multiple organ failure syndrome, adult respiratory distress syndrome, or mortality.

Adult↗