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At least 649 records · Page 36Linked to original sources
PubMed1992

Selective intestinal decontamination for prevention of wound colonization in severely burned patients: a retrospective analysis.

In this study the effect of selective intestinal decontamination of the digestive tract (SDD) on wound colonization was investigated. Ninety-one patients with at least 25 per cent total burned surface area (TBSA) were included in this study. All patients received oral polymyxin. In 63 patients oral co-trimoxazole and amphotericin B were added to the regimen. The addition of co-trimoxazole decreased the incidence of Enterobacteriaceae wound colonization from 71 per cent to 11 per cent (P less than 0.005). Colonization with Proteus was eliminated in patients treated with co-trimoxazole, compared with an incidence of 36 per cent in the group treated with polymyxin alone (P less than 0.001). The addition of amphotericin B decreased yeast colonization of the burn wound from 39 per cent to 10 per cent (P less than 0.005). A close relation was observed between burn wound colonization and colonization of the gastrointestinal tract. No resistant bacterial strains emerged during the period of study. These results suggest that SDD is an effective method for prevention of wound colonization. Further controlled studies are needed to establish the role of SDD in preventing burn wound colonization and wound sepsis.

Adult↗
PubMed1995

Role of gut-derived endotoxaemia and bacterial translocation in rats after thermal injury: effects of selective decontamination of the digestive tract.

This study was performed to investigate: (1) the role of gut-derived endotoxin/bacterial translocation in the pathogenesis of sepsis, and (2) the possible effects of selective decontamination of the digestive tract (SDD) on mortality in rats following 40 per cent full-thickness scald injury. In the SDD-treated group, Enterobacteriaceae and yeasts were eradicated from the caecal mucosa, while the mucosal flora consisting of mainly anaerobes was well preserved, within 3 days. The incidence of bacterial translocation to the mesenteric lymph nodes (MLN) and viscerae was significantly lowered on postburn days 1, 3 and 5 (P < 0.05-0.01). Meanwhile, pretreatment with SDD resulted in reductions of the faecal endotoxin levels in different segments of intestinal tract to less than 0.5 per cent (0.04-0.45 per cent) of the untreated control; there was also a significant attenuation of the elevation of endotoxin concentrations in both portal and systemic blood. Intestinal diamine oxidase (DAO) activity returned to baseline on day 5 in rats receiving SDD but not in controls. The 5-day survival rate in the SDD-treated group was elevated by 26.7 per cent as compared with controls (P < 0.05). These data suggested that endotoxin/bacterial translocation took place early and commonly, which in turn contributed to postburn sepsis and mortality. SDD was effective in preventing gut origin endotoxaemia and bacterial translocation, and improving the survival rate in rats following severe thermal injuries.

Amine Oxidase (Copper-Containing)↗
PubMed1995

Raising the decontamination level for thyroid hormone ingestions.

Ninety-two pediatric cases (age < or = 6 years) of acute thyroid hormone ingestions that were reported over a 20-month period to one American Association of Poison Control Centers (AAPCC)-certified regional poison center were reviewed to determine whether significant toxicity in pediatric patients is associated with acute ingestions of < or = 5 mg levothyroxine (T4) equivalent of thyroid hormone and the highest-tolerated milligram-per-kilogram dose. Parameters evaluated included patient weight, amount ingested, drug preparation, treatment type, outcome, management site, and relevant comments. Eight patients had mild symptoms requiring no specific medical intervention and there was no correlation between the amount ingested and symptoms observed. The maximum T4 dose ingested without gastrointestinal decontamination was 0.13 mg/kg (2 mg). A literature review was also conducted. Only one case of moderate toxicity with a dose of less than 5 mg T4 equivalent was found in the literature review. Significant toxicity is not expected with ingestions of less than or equal to 5 mg T4 equivalent of thyroid hormone.

Child, Preschool↗
PubMed2005

Simultaneous decontamination of hexavalent chromium and methyl tert-butyl ether by UV/TiO2 process.

Hexavalent chromium and methyl tert-butyl ether (MTBE) are two important environmental pollutants. Simultaneous decontamination of Cr(VI) and MTBE was studied by UV/TiO2 process. The influences of pH and the concentrations of pollutants on the kinetics of the photocatalytic reactions were evaluated. Dark adsorption tests showed that the acidic pH favored the adsorption of Cr(VI) while neutral pH favored the adsorption of MTBE. Under UV irradiation, Cr(VI) reduction was observed in Cr(VI)/TiO2 system, and MTBE oxidation was observed in MTBE/TiO2 system. The system containing Cr(VI) and MTBE by UV/TiO2 process demonstrated the synergistic effect between oxidation of MTBE and reduction of Cr(VI). The results demonstrated that two pollutants Cr(VI) and MTBE could be eliminated simultaneously by UV/TiO2 process. tert-Butyl formate, tert-butyl alcohol and acetone were identified as primary degradation products of MTBE by gas chromatography-mass spectrometry in the degradation of MTBE by UV/TiO2 process.

Adsorption↗
PubMed2005

Effective uptake of decontaminating agent (citric acid) from aqueous solution by mesoporous and microporous materials: an adsorption process.

The presence of citric acid in decontamination waste can cause complexation of the radioactive cations resulting in interferences in their removal by various treatment processes such as chemical precipitation, ion-exchange, etc., which are employed for the removal of radioactivity and may cause potential danger to the environment. Mesoporous Al-MCM-41 (Si/Al=30, 51, 72 and 97) and Si-MCM-41 molecular sieves were synthesized hydrothermally and characterized by XRD, BET (surface area) and FT-IR to evaluate the removal of citric acid through an adsorption process. Adsorption of citric acid over Al-MCM-41 shows the applicability of Freundlich and Langmuir isotherm and follows first order kinetics. The effects of contact time, concentration of citric acid, adsorbents (various Si/Al ratios of Al-MCM-41, Si-MCM-41, Hbeta zeolite and commercial carbon) and pH have been investigated. It has been found that the amount of citric acid adsorbed per unit gram of catalyst followed the order Al-MCM-41 (Si/Al=30)>Al-MCM-41 (Si/Al=51)>activated charcoal>Al-MCM-41 (Si/Al=72)>Al-MCM-41 (Si/Al=97)>Si-MCM-41>Hbeta zeolite.

Adsorption↗
PubMed2004

Impact of enteral versus parenteral nutrition on the incidence of fungal infections: a retrospective study in ICU patients on mechanical ventilation with selective digestive decontamination.

BACKGROUND: Infections are an important cause of morbidity and mortality in patients in intensive care units (ICUs). Fungal infections have increased substantially over recent years and fungi have become one of the important pathogens in ICU patients. This study tests the hypothesis that the incidence of fungal infections is lower in critically ill patients under mechanical ventilation receiving enteral rather than total parenteral nutrition. METHODS: By using a prospectively built database, we analyzed retrospectively the charts of 110 critically ill, intubated patients hospitalized in surgical and medical ICUs and receiving selective digestive topical decontamination (SDD), which consisted of administering non-absorbable antibiotics. Patients without contraindications, and expected to be intubated for more than 72 h, received enteral nutrition within 24 h after intubation. Patients with contraindications for enteral nutrition received total parenteral nutrition, which was discontinued when the criteria for enteral nutrition were met. The incidence of fungal infections in both subgroups of patients was compared. RESULTS: Seventy-nine patients received enteral nutrition and 31 total parenteral (10 patients did not meet the inclusion criteria). Both subgroups were similar with regard to their APACHE II score, age, sex distribution and comorbidities at the time of study entry. No difference was observed in the rate of fungal infections between enteral nutrition (5/29) and total parenteral nutrition (7/71) patient groups. CONCLUSION: No significant decrease in the incidence of fungal infections in critically ill patients receiving SDD was observed between those receiving enteral and total parenteral nutrition.

Adolescent↗
PubMed2006

Decontamination of poultry carcasses using steam or hot water in combination with rapid cooling, chilling or freezing of carcass surfaces.

The effects of the application of steam at atmospheric pressure for times up to 20 s on the numbers of inoculated Campylobacter jejuni and Escherichia coli on whole chicken carcasses were investigated in a pilot steam cabinet. Steam treatments reduced the numbers of C. jejuni AR6 by ca. 1.8, 2.6 and 3.3 log(10) cfu cm(-2) in 10, 12 and 20 s, respectively. Corresponding reductions in numbers of E. coli K12 were 1.7, 2.3 and 2.8 log(10) cfu cm(-2). However, such treatments caused the skin to shrink and change colour. The optimum treatment for maximum reductions of C. jejuni and E. coli, least skin shrinkage and change of colour was concluded to be <12 s. Further work was carried out to determine whether a modified air chilling system in combination with steam or hot water decontamination treatments could be used to reduce numbers of pathogens, particularly campylobacters, on the surface of poultry carcasses. Whole chicken carcasses inoculated with C. jejuni and E. coli were either not treated, treated with steam at atmospheric pressure for up to 10 s or treated with hot water at 80 degrees C for up to 20 s, then either chilled by crust freezing, chilled at 0 degrees C, or chilled at 15 degrees C, in a pilot chilling chamber. The optimum combination was treatment with water at 80 degrees C for 20 s followed by crust freezing, which reduced the numbers of C. jejuni and E. coli by ca. 2.9 and 3.2 log(10) cfu cm(-2), respectively, without extensive degradation of carcass appearance.

Animals↗
PubMed2004

Dermal absorption of isopropyl alcohol from a commercial hand rub: implications for its use in hand decontamination.

Isopropyl alcohol-containing hand rubs are widely used in healthcare for hand decontamination. Ten healthy adult volunteers applied a commercially available isopropyl alcohol-containing hand rub to their hands every 10 min over a 4 h period. Blood isopropyl alcohol levels were measured at the beginning and end of the study. At the end of the study, measurable blood isopropyl alcohol levels (range 0.5-1.8 mg/l) were recorded in nine subjects. We confirmed that isopropyl alcohol could be absorbed through the intact skin of adult humans. The social and medical implications are discussed.

2-Propanol↗
PubMed2006

Efficacy of super-oxidized water fogging in environmental decontamination.

The efficacy of decontamination using Sterilox fog was assessed against meticillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. Ceramic tiles were inoculated with the test organisms and, once dried, were subjected to Sterilox fogging using a stationary vaporizing machine sited at a distance of 3m for 10 min and then left for a further hour. In a second experiment using the same organisms, the first 10-min fogging period was followed by a directed fogging period of 30s at a distance of 1m. Organisms were cultured from the tiles, plated on to tryptone soya agar and incubated for 48 h. Initial counts of approximately 10(9) colony-forming units/mL for both organisms were reduced approximately 10(4) fold for MRSA and 10(5.8) fold for A. baumannii when using a single fogging. The second fogging resulted in 10(6.8)-fold reductions for both organisms. Sterilox fog is safe and simple to use, and can reduce levels of nosocomial pathogens by a factor of almost 10(7). It is worthy of clinical evaluation in clinical settings to determine whether it maintains its microbicidal effects against a variety of organisms on different surfaces.

Acinetobacter↗
PubMed2005

Appropriate technology for rural India - solar decontamination of water for emergency settings and small communities.

A commercial solar water heating system was evaluated for its effectiveness in decontaminating drinking water with a view to use in emergency situations. A total of 18 seeding experiments carried out over 6 months with 10(5) to 10(7)Escherichia coli/ml showed that the solar heater produced 125 l of bacteriologically safe water in 4 h when the ambient temperature was above 30 degrees C, with a holding time of at least 2 h. The solar water heating system is inexpensive, easy to transport and set up and could provide safer drinking water for 50 people a day. It would be effective in the decrease and prevention of waterborne disease in emergency situations, and is appropriate for use in small communities.

Colony Count, Microbial↗
PubMed1988

Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime, and microbiological surveillance for prevention of acquired infection in intensive care.

All 324 patients admitted over sixteen months to a general intensive therapy unit (ITU) were prospectively studied to assess the effect of a novel prophylactic antibiotic regimen on the incidence of acquired infection. Consecutive control (161 patients) and test (163 patients) groups were analyzed. In the control group, antibiotic administration was determined by clinical and microbiological evidence of infection. In the test group, treatment consisted of a triple regimen of selective decontamination of the digestive tract (polymyxin E, tobramycin, and amphotericin B) administered throughout the ITU stay, systemic cefotaxime administered for the initial four days, and regular microbiological screening of multiple sites. The test group showed a striking and consistent reduction in colonisation of the digestive tract with aerobic gram-negative bacilli, and there was a substantial reduction in the incidence of acquired infection (24% to 10%). Mortality in certain categories of patients was also reduced. There is now a considerable body of evidence to justify the more widespread use of this selective parenteral and enteral anti-sepsis regimen (SPEAR) in general intensive care practice.

Adult↗
PubMed1997

Spontaneous bacterial peritonitis in patients with cirrhosis undergoing selective intestinal decontamination. A retrospective study of 229 spontaneous bacterial peritonitis episodes.

BACKGROUND/AIMS: Selective intestinal decontamination with norfloxacin is widely used to prevent spontaneous bacterial infections in cirrhosis. The study was performed to compare the spontaneous bacterial peritonitis occurring in patients with and without prophylactic norfloxacin. METHODS: Two hundred and twenty-nine consecutive episodes of spontaneous bacterial peritonitis, (193 in patients without (Group A) and 36 in patients with norfloxacin prophylaxis (Group B)), were retrospectively analyzed. In 100 episodes (86 and 14, respectively), the responsible organism was isolated in ascitic fluid. RESULTS: Clinical and laboratory data at diagnosis were comparable in both groups. There were marked differences (p < 0.001) between group A and B in the frequency of peritonitis caused by gram-negative (67.4% vs. 14.3%) and gram-positive (30.2% vs. 78.6%) bacteria. There were three polymicrobial episodes. Bacteria resistant to cefotaxime and gram-negative bacilli resistant to quinolones were isolated in ascitic fluid in nine (seven in Group A and two in Group B) and three episodes (all in Group A), respectively. No differences in the course of infection and patient survival were observed between groups. CONCLUSIONS: Spontaneous bacterial peritonitis in patients with and without prophylaxis with norfloxacin are not different in clinical features, response to treatment and prognosis. Spontaneous bacterial peritonitis caused by gram-negative organisms resistant to quinolones is extremely uncommon in patients with cirrhosis receiving prophylactic norfloxacin.

Adult↗
PubMed2001

Ultrasound to decontaminate heavy metals in dredged sediments.

Sediments contaminated with heavy metals due to past disposal practices threaten the environment and require remediation. This study was an attempt to develop a technology to decontaminate heavy metals in dredged sediments using ultrasound coupled with vacuum pressure. A set of laboratory scale experiments were conducted using dredged sediments obtained from New York/New Jersey harbor. This sediment sample is considered as category III, a material that failed to meet USEPA requirements for toxicity or bioaccumulation, and required secure disposal. Acoustic cavitation due to ultrasound energy coupled with vacuum pressure was used to facilitate the removal of chromium (the selected metal contaminant) from the sediments. Full factorial experimental designs were performed to evaluate the above treatment technique and to optimize the processes. Two coupled processes were used to separate and to treat both coarse (Process #1) and fine (Process #2) fractions of sediments. Selected variables for evaluation of Process #1 were ultrasound power, soil-to-water ratio, vacuum pressure and dwell time, and for Process #2 were ultrasound power, soil-to-water ratio and dwell time. Laboratory scale experiments were carried out with various combinations of these parameters according to the factorial design. The optimum removal was found to be 92% with the parameter levels at 1200W power, 1:15 soil-to-water ratio, 15 psi vacuum pressure and 15 min of dwell time. After the application of Process #2 for fine sediments it was found that the fines were separated into silt and clay. Only the silt faction had a considerable metal removal while the clay fraction was insensitive to the treatment. A maximum removal of 83% was obtained for silt fraction when factor levels were at 1200W power, 1:50 soil-to-water ratio and 90 min of dwell time. Further analysis of clay fraction showed that the chromium in clay is immobile and stable. The toxicity characteristic leaching procedure (TCLP) test on clay fraction confirmed that the treated clay fraction is safe to dispose. The study showed that the proposed treatment technique is effective and economical for sediments with lower clay contents.

Cost-Benefit Analysis↗
PubMed2001

Dredged material decontamination demonstration for the port of New York/New Jersey.

Management of contaminated dredged material is a significant challenge in the Port of New York and New Jersey as a result of more stringent regional ocean placement regulations with escalating costs for upland placement. One component of an overall management plan can be the application of a decontamination technology followed by creation of a product suitable for beneficial use. This concept is the focus of a project now being carried out by the US Environmental Protection Agency, Region 2, the US Army Corps of Engineers, New York District, the US Department of Energy, Brookhaven National Laboratory, and regional university groups that have included Rensselaer Polytechnic Institute, Rutgers University, New Jersey Institute of Technology, and Stevens Institute of Technology. The project has progressed through phased testing of commercial technologies at the bench scale (15 liters) (Marcor, Metcalf & Eddy, Gas Technology Institute, Westinghouse Science & Technology, BioGenesis, International Technology, and BioSafe) and pilot-scale (1.5-500m(3)) (BioGenesis, Gas Technology Institute, and Westinghouse Science & Technology) levels. The technologies developed by Gas Technology Institute and BioGenesis are now going forward to commercial demonstration facilities that are intended to treat from 23000 to 60000m(3) of dredged material during their first operational period in 2001-2002. Beneficial use products are soils and cement. Treatment costs for the final commercial facilities are estimated at US$ 39 per m(3). Selection of the technologies was made based on the effectiveness of the treatment process, evaluation of the possible beneficial use of the treated materials, and other factors. Major elements of the project are summarized here.

Conservation of Natural Resources↗
PubMed1997

Gastrointestinal decontamination after poisoning. Where is the science?

The approach to the use of gastrointestinal decontamination procedures in the treatment of ingested toxins has changed in recent years. Many toxicologists and physicians have taken strong positions either for or against the use of emesis, gastric lavage, activated charcoal, or other procedures. What is the scientific basis for these positions? This article reviews and comments on the published studies comparing the effectiveness of these widely used procedures.

Animals↗
PubMed2001

Chemical speciation used to assess [S,S']-ethylenediaminedisuccinic acid (EDDS) as a readily-biodegradable replacement for EDTA in radiochemical decontamination formulations.

Preliminary investigations into the replacement of widely used chelating agents for industrial cleansing of radionuclide contaminated items using readily biodegradable alternatives which have equivalent effectiveness, have been made using chemical speciation simulation programs and databases such as the JESS system. The chelation of radionuclide cations by [S,S']-EDDS has been compared with traditional decontamination agents, EDTA and citrate. Models indicate that in many respects, [S,S']-EDDS compares favourably with EDTA.

Americium↗
PubMedDate not supplied

[Selective digestive decontamination].

OBJECTIVES: The objectives of the study were: to explain our protocol of selective digestive decontamination (SDD); to know the therapeutic activity that the protocol implies in the nursing staff; to assess the impact on the incidence of ventilatorassociated pneumonia. METHODS DESIGN: Prospective descriptive study for time measurements, and non randomized comparative study for the incidence of ventilatorassociated pneumonia. We calculate time means and 95 percent confidence interval (CI). We calculate ventilatorassociated pneumonia relative risk and number-needed-to-treat (NNT). SETTING: Intensive care unit with 13 beds reference for neurocritical illness. STUDY PERIOD: Control group from November-2001 to April-2002. Treatment group from May-2002 to November 2002. PATIENTS: consecutive patients who were admitted in our intensive care department with mechanical ventilation for more than 48 hours.Results. A total of 122 consecutive patients were included: control group 62 patients, treatment group 60 patients. We have recorded 136 SDD administration time and 16 vigilance culture records. The SDD administration mean time was 8.11 minutes (95% CI, 7.59-8.63). Morning Nursing Duty Schedule spent significantly more time mean 10.7 minutes (95% CI, 9.87- 11.89) than afternoon 8.1 (95% CI, 7.20-9.08) (p < 0.05) and night 6.9 (95% CI, 6.39-7.46). There was a significant difference between time spent in SDD administration in trauma patients (p < 0.05) 7.45 (95% CI, 6.63-8.27) and medical patients 8.71 minutes (95% CI, 8.41-9.01). We spent a mean of 9 minutes (CI 8-10) in culture sampling. In the treatment group the ventilator associated pneumonia incidence relative risk was 0.28 (CI 0.13-0.63) with a NNT of 4 (CI 3-8). CONCLUSION: In our patients SDD administration represents the 2.5% of our therapeutic activity time per patient and reduces the ventilator associated pneumonia risk.

Administration, Topical↗
PubMed2003

Potential uses of ultrasound in the biological decontamination of water.

In the past there was a prevailing feeling in industry that power ultrasound would be too expensive to use for water treatment on an industrial scale. This was based on calculations involving the direct scale up of power consumption in small-scale (generally batch) laboratory experiments. In recent times this attitude has changed somewhat as a result of the installation of a number of ultrasonic devices in operational water or sewage treatment plants. In our laboratories we have investigated the decontamination of water under the influence of ultrasound alone and in conjunction with other treatments. The results, particularly when applied to flowing systems, indicate a real future for sonochemistry in water treatment.

Bacteria↗