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PubMedDate not supplied

[In vitro antibacterial activity of neomycin, bacitracin and a combination of both].

Bacitracin and neomycin have been used for a long time for local intestinal antisepsis or decontamination, due to their scarce or nonexistent intestinal absorption. The aim of the present study was to determine the activity of bacitracin and neomycin against recent clinical isolates of aerobic and anaerobic microorganisms and to verify their capacity to have a synergistic effect and to prevent the emergence of bacterial resistance when in combination. The results showed that the activity of either antibiotic against recent clinical isolates (even if resistant to cephalosporins and aminoglycosides) is similar to that originally displayed at the time introduction in therapy. Generally the combination of the two antibiotics showed a synergistic or additive effect and prevented the selection of resistant strains.

Bacitracin↗
PubMed1989

[The general aspects of the epidemiology of hospital infections--the measures for prevention and control].

The author analyzes the 3 important factors of in-hospital infections--the source of infection, route of transmission and the receptive organism, with details regarding the measures of prevention and control. Emphasis is laid on the role of the hospital personal which have an effective contribution in the prevention of these diseases, namely: a) strict application of hygiene measures (hospitalization conditions, microclimate, food, water supply, removal of wastes and residues, sterilization, disinfection, cleaning, etc.); b) choice of procedures of investigations and therapy with minimum risk of infection, application of asepsis and antisepsis techniques, the judicious use of antibiotics; c) accurate, prompt evaluation of the infectious potential and receptivity of the patients; d) clinical surveillance of the patients and health of the personal; e) corresponding professional education of the entire personal of the hospital. Further indications are given regarding correct performance of disinfection and sterilization and the substances used.

Cross Infection↗
PubMed1989

[Surgical sepsis: myths and realities].

The authors review the modern knowledge of sepsis, asepsis and antisepsis in surgery; they underline some surgeon's customary attitudes and convictions no more scientifically significant today.

Air Microbiology↗
PubMedDate not supplied

[Hospital infection at a private hospital in Ribeirão Preto, São Paulo, Brazil].

The aim of this work is to prospectively evaluate the incidence of infection, from June 1986 to June 1987, in 640 patients submitted to surgical treatment at the São Francisco Hospital, in Ribeirão Preto, São Paulo, Brazil. The overall incidence of infection was 10.31%. The incidence of wound abscess was 6.25%, and urinary infection 5.75%. In the surgical procedures considered as clean, the infection rate was 8.62%, in the clean-contaminated 14.81%, in the contaminated 8.33%, and in the dirty 16.94%. The antimicrobian drugs contributed to increase the infection rate. The hospital infection rate for the patients at infirmaries was 10.88%, and for the patients at private rooms 4.92%. The mortality rate due to hospital infection was 12.12%. The authors stress that a constant attention with the hospital infection is needed to verify the infection rate to be able to make a control program of the asepsis, antisepsis and sterilization methods, as well as to improve the operative techniques and the patient's management during the pre, per and postoperative period.

Brazil↗
PubMed1989

[150 years of the "Handbook of Plastic Surgery"--in memory of Eduard Zeis (1807-1868)].

Even before Joseph Lister (1827-1912) discovered and adopted the concept of antisepsis in 1867, pioneering work in the field of plastic surgery had already begun in Germany very early in the nineteenth century. The best known surgeons working in this field at that time were Karl Ferdinand von Graefe (1787-1840) and Johann Friedrich Dieffenbach (1794-1847) in Berlin and Philipp Franz von Walther (1782-1849) in Bonn and Munich. Three early plastic surgeons who were active in Dresden can and should be compared to them. These are, in chronological order, Johann August Wilhelm Hedenus (the elder; 1760-1834), Friedrich August von Ammon (1799-1861) and Eduard Zeis (1807-1868); Zeis' career is reviewed briefly here with the accent on Dresden. Born in Dresden on 1 October 1807, after finishing his training in 1932 he set up in general practice in his home town. Here he wrote his epoch-making "Handbuch der plastischen Chirurgie" (Handbook of Plastic Surgery; published in 1838), thus establishing the term "plastische Chirurgie", which has been adopted and assimilated into different languages all over the world. The best wishes of his friends went with him when Zeis went to take up the professorship in Marburg. This position did not live up to his expectations, however. In 1849 he returned to Dresden, where he worked until his death as senior medical officer in the newly established municipal hospital in Dresden-Friedrichstadt.(ABSTRACT TRUNCATED AT 250 WORDS)

Germany↗
PubMed1989

[Iodine overload in newborn infants caused by the use of PVP-iodine for perineal preparation of the mother in vaginal delivery].

The high incidence of transient thyroid dysfunction in newborns from our hospital (0.6%), led us to investigate whether povidone perineal prep. during delivery and daily postpartum antisepsis, induced iodine overload in the newborn, and whether breast milk was the vehiccle. In a controlled randomized trial we used either povidone-iodine or clorhexidine in 36 mothers, and we investigated in them and in their newborns iodine levels and thyroid function. Iodine levels in cord blood, maternal urine and newborn urine were significantly higher in povidone treated group (p less than 0.001) up to the 4th postpartum day. These levels were also significantly higher in breast fed than in formula-fed babies within the group of povidone-iodine-treated mothers. Maternal prepartum urine iodine, and thyroid function in mothers and newborns were not significantly different in both groups.

Delivery, Obstetric↗
PubMed1989

[Spongia somnifera. Medieval milestones on the way to general and local anesthesia].

Medieval medicine was highly innovative compared to ancient and early modern medicine. The achievements then did not merely comprise new models from the viewpoint of the history of science: development of the university, a well-defined curricula and official degrees, obligatory fees and cost reducing measures. They also included therapeutic procedures like nerve suture, antisepsis, chemotherapy (colchicine), cardiac glycosides (scillaren, convallerin), the development of visual aids (binoculars, magnifying glass, microscope, presbyopic glasses) and further improvement of plastic surgery by the application of delayed grafts (lips/nose plastic). Modern medicine at first rejected and forgot these techniques, which were not rediscovered until the 19th and 20th century. This holds true for the extirpation of abdominal tumors as well as for the concept of therapeutic fever. It also pertains to anesthesia, which in the Middle Ages was developed from ancient methods of sedation. Medieval scholars perfected the method into achieving the first total anesthesia (resorption/inhalation anesthesia) and then local anesthesia (application of morphine at the cornea).

Anesthesiology↗
PubMed1989

[Antiseptic resistance of clinical strains of Staphylococcus aureus].

To evaluate the activity of antiseptics and the sensitivity-resistance of bacteria to antiseptics, a number of characteristics has been used, including the minimum inhibiting concentration for different strains, the frequency of statistical and clinical resistance, the antiseptic activity index. A wide spread of S. aureus strains isolated from patients with hospital infections has been revealed. Differences in the resistance of bacterial strains have been established, depending on the type of the antiseptic and the ecovar of bacteria: among hospital ecovars, resistant strains occur more frequently and can resist a wider range of antibiotics. In staphylococcal hospital ecovars the occurrence and level of resistance to a number of widely used antiseptics increase with time. In connection with a wide spread of staphylococcal hospital strains resistant to antiseptics, measures on the control of the circulation of such strains should be introduced into hospitals, and the data thus obtained should be used for the periodic reevaluation of antiseptics used in medical practice and for the choice of preparations to be used for individual therapeutic and prophylactic antisepsis.

Anti-Infective Agents, Local↗
PubMed1989

Prevalence of staphylococcal species in four dairy herds.

The prevalence of staphylococcal species isolated from bovine mammary glands was determined in four dairy herds. Staphylococcus aureus and S hyicus were the predominant organisms isolated from cows in a herd with a bulk milk somatic cell count (SCC) greater than 900 X 10(3). One herd with a bulk milk SCC of 565 X 10(3) had a high incidence of S aureus while the predominant coagulase-negative species were S epidermidis and S hyicus. S hyicus predominated in two herds with bulk milk SCC less than 200 X 10(3); prevalence of S aureus was low. The impact of herd management practices such as post-milking teat antisepsis on distribution of staphylococcal species is discussed.

Animals↗
PubMed1988

[Our surgical heritage. The surgical clinic of the Berlin Charité and its contribution to progress in surgical medicine in the past and present].

An account is given of the making of surgery on the premises of Charité against the background of the 260-year history of this centre of clinical teaching. In that course of time, surgery has changed from craft to science. -Surgery was primarily applied to cope with surface wound and diseases in the 18th century, while pathological processes in the abdominal cavity and cranium became operable in the 19th century, owing to introduction of anaesthesia and antisepsis. In the 20th century, modern medicine and equipment enabled surgical interventions with all regions of the human body. -Osseous and articular diseases as well as cerebral and pulmonary diseases are priorities in surgical practice at Charité. Reference should be also made to transplantation surgery, with results of international weight having been scored from Dieffenbach to our days.

Berlin↗
PubMed1988

Wounds of the abdomen. Part 1: In war.

Until the turn of the 20th century, penetrating wounds of the abdomen in war were treated conservatively, with a very high death rate. Survivors were those who recovered from or escaped hemorrhage and shock, were fortunate enough to avoid vital organ injury and lived in spite of wounds of the viscera complicated by a high incidence of sepsis. Laparotomy could not be justified as the treatment of choice until World War I when anesthesia, intravenous administration of fluids, blood for transfusion and antisepsis were available. Even so, death rates at the close of that war were 60%. It has become increasingly apparent with each successive war that the progressive reduction in morbidity and mortality in penetrating abdominal wounds depends not only on the quality of the surgery but also on advanced life support on the battlefield and early, direct evacuation to field hospitals where intensive resuscitation, skilled anesthesia and comprehensive postoperative care are available.

Abdominal Injuries↗
PubMed1978

A randomized prospective evaluation of orally administered antibiotics in operations on the colon.

In this randomized, prospective study of 91 patients undergoing operations on the colon, we found that neomycin, neomycin-phthalylsulfathiazole and neomycin-erythromycin base all provided adequate intestinal antisepsis. Wound infection rates for all groups were also similar and close to the national average for operations on the colon. A detailed analysis of the wound infections in our series revealed that 60 per cent of these infections were from organisms different from those found on the colonic mucosa. This evidence indicates the possible advantage of parenteral antibiotic therapy to achieve adequate tissue levels of antibiotics not presently possible with orally administered agents.

Administration, Oral↗
PubMed1986

[Puerperal infection].

Puerperal infections are of great importance also under the conditions of modern obstetrics. There is a close connection with the problematic nature of hospitalism. The prospective study from 1,409 patients shows a puerperal fever at a percentage of 32.1%. Only 19.0% of the patients meet the criteria of a "standard puerperal morbidity". Within the complications occurring during the childbed period subinvolutio uteri holds the first place with 16.3%. The incidence of puerperal infections is influenced by predisposing factors dominated by the mode of accouchement. Ampicillin and chloramphenicol are the most used antibiotics. The preventive and therapeutic application of antibiotics is discussed. In the experimental part of the study the settlement of the vagina, the cervix, and the amniotic fluid is analysed. The evidence of causative organism for oxybiontic pathogenes partly also for anoxybiontic pathogenes and fungi is made. The fight against puerperal infections is particularly based on preventive measures. There must be mentioned a strict consideration of the antisepsis and asepsis as well as the restriction of predisposing factors. Under this precondition the wellaimed and indicated application of a therapy based on antibiotics will be successful.

Anti-Bacterial Agents↗
PubMed1987

Striking memories of medical education: a glimpse of three physician writers.

Each of these three works focused on indelible memories of its writer's medical education. Thomas Browne spoke about autopsies, medical theories, religion. Tobias Smollett exposed the horrendous conditions aboard naval vessels and some of the problems facing young physicians. John Brown depicted surgery before anesthesia and antisepsis. Uniformly, the events and circumstances that seemed to have affected them were on the forefront of medical and social history. Religio Medici, Roderick Random, and "Rab and His Friends" were each the first major literary work of the authors discussed; each achieved instant success, yet somehow their popularity waned. Perhaps, the evolution of medicine has eclipsed what was once sensational, disturbing, interesting, and marketable, leaving only the dry and lifeless bones of stories--remnants of what once they were.

Education, Medical↗
PubMedDate not supplied

[Ambulatory phlebectomy].

Being disappointed in the failures of sclerotherapy in varicose veins, the author resorted to ambulatory phlebectomy. Through very tiny incisions (0.5 to 1 mm) the varicose veins are prepared and completely removed. The arch and the proximal part of the internal saphenous vein are left to the surgeon. This technique described 2,000 years ago by Celsus is easy, effective and innocuous, leaves no marks (no stiches or ligatures) and is also inexpensive because of asepsis, antisepsis and anesthesia. A critical review of 1000 of our cases discloses 70 per cent excellent results. The 30 per cent of accidents were benign and transitory. This technique is almost ideal : A harmless cure that improves the appearance of all type of patients with varicose vein.

Ambulatory Care↗
PubMed1979

Valentine Mott (1785-1865), the father of American vascular surgery: a historical perspective.

Valentine Mott was one of the most eminent physicians of the first half of the 19th century. Recognized as a pioneer vascular surgeon, he is credited with having performed at least eight original surgical procedures. Included within his lifetime operative record are ligations of the innominate artery, the common and external carotids, the right subclavian artery, the common, external and internal iliac arteries, the femoral artery, and the popliteal a;tery for the treatment of aneurysmal disease. In addition, he was highly regarded for his innovative approach to venous problems. This is most remarkable in that all of this work was done prior to the discovery of anesthesia, antisepsis, and the use of transfusions. Through research, utilizing primary archival and secondary source material in the form of previously unpublished manuscripts, correspondence, and background information, a biography of his life is presented. When his many surgical successes are placed in proper historical perspective, Valentine Mott can truly be called the Father of American Vascular Surgery.

History, 18th Century↗
PubMed1977

[Hygienic problems in intensive care units (author's transl)].

Microbiological tests have established that intensive care units act as a reservoir from which hospital infections spread. The mode of their spread is reviewed. The increased incidence of nosocomial infections to intensive care wards is attributable partly to deficient antisepsis and asepsis and partly to inadequate planning of the building and organization of these wards. Plans for two intensive care wards are put forward which would reduce the risk of contact, smear and air-borne infections. In the planning of these units greater attention than has so far been the case should be paid to preventing the spread of pathogenic micro-organisms.

Air Microbiology↗
PubMed1982

[Bacterial nosocomial infections in urology: defective wound healing].

The highest incidence of defective wound healing in all surgical disciplines is observed after urological operations. Wound infections occur in more than 8% of all urological patients. Defective wound healing appears in about 17% of unselected nephrectomy cases, rising to 50% when pyonephrosis is present. Simple adenomectomy is associated with wound infection rates of between 8 and 12% in preoperatively uninfected patients and up to 50% in patients with preoperative bacteriuria. Numerous factors may influence wound healing, e.g. age, obesity, cachexia, chronic infectious and non-infectious diseases, anaemia, thrombopathy, faulty asepsis and antisepsis, preoperative showering and shaving, skin preparation, hand degerming, skin draping, duration of hospitalization, traumatic operative technique, suture material, diathermy, timing and length of operation, duration of hospitalization, and antibiotic regimen. Strict attention has to be paid to these factors if the incidence of postoperative wound infection is to be kept within reasonable limits.

Age Factors↗