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[Reduction of colonization of new mattresses with bacteria, moulds and house dust mites by complete mattress covers].

BACKGROUND AND OBJECTIVE: We investigated if the colonisation of new mattresses with house dust mites, bacteria, and fungi could be reduced by using synthetic mattress covers as compared to common cotton covers. PATIENTS/METHODS: 84 healthy volunteers were assigned to two groups. Group A (n = 43) received the cotton covers, group B (n = 41) the synthetic covers which were made of a polyester microfaser with a polyurethane surface layer (Pro-Tex, Germed, Schwarzenbek, Germany). RESULTS: The mite antigen concentration after six months was significantly lower in group B. Three months after the start of the study counts of bacteria and moulds were significantly higher in group A compared to group B. CONCLUSIONS: It can be recommended that patients suffering from an allergy to mites or moulds may reduce their domestic allergen exposure by using the synthetic mattress covers tested in this study. Since cotton covers are very likely to become colonised by bacteria and moulds, they must be cleaned periodically (at least every 2nd-3d month).

Animals↗

Environmental contamination by organisms causing urinary tract infection.

We have examined the bedsheets, floor and bedside chairs of 33 patients with urinary tract infections for organisms causing urinary infection. In ten patients the causative organism was recovered from the undersheet, and in two of these it was also recovered from the floor and bedside chair. Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae and Enterococcus faecalis were recovered from sheets, while Group B beta-haemolytic streptococci and Candida tropicalis were also found on floors and chairs.

Bacteria↗

Modifiable risk factors, sleep environment, developmental physiology and common polymorphisms: understanding and preventing sudden infant deaths.

Unexpected death in infancy may be a consequence of recognisable pathophysiological processes, or may remain unexplained after thorough investigation. We review the appropriate investigations that should be performed after unexpected infant deaths, and the recent changes to UK law that will make such investigations mandatory from 2008. Current knowledge of the epidemiology and pathophysiology of unexpected infant deaths, together with knowledge of infant developmental physiology leads to an emphasis on the importance of a range of potential gene-environment interactions occurring in vulnerable infants at vulnerable stages of their development.

Bedding and Linens↗

Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant.

Ten premature infants nursed on servocontrolled radiant warmer beds were studied in three environments designed to alter one or more factors affecting heat transfer (convection, evaporation, and radiation). In the control environment, infants were nursed supine on an open warmer bed. The second environment (walled chamber) was designed to reduce convection and evaporation by placing plastic walls circumferentially around the bed. In the third environment convection and evaporation were minimized by covering infants with a plastic blanket. Air turbulence, insensible water loss, and radiant warmer power were measured in each environment. There was a significant reduction in mean air velocity in the walled chamber and under the plastic blanket when compared to the control environment. A parallel decrease in insensible water loss occurred. In contrast, radiant power demand was the same for control and walled environments, but decreased significantly when infants were covered by the plastic blanket. This study suggests that convection is an important factor influencing evaporation in neonates nursed under radiant warmers. The thin plastic blanket was the most effective shield, significantly reducing radiant power demand.

Bedding and Linens↗

The Melbourne house dust mite study: eliminating house dust mites in the domestic environment.

BACKGROUND: Hypersensitivity to house dust mite allergens is associated with increased asthma morbidity. Asthma severity appears to be related to the degree of mite allergen exposure. Short-term studies suggest that complete avoidance reduces disease severity. OBJECTIVE: The study was designed to assess the effect of different mattress covers and floor coverings on mite allergen concentrations in the homes of mite-sensitive children with asthma in the city of Melbourne, Australia. METHODS: Mite allergen Der p 1 concentration was measured on mattress covers, mattress surfaces, and carpeted and uncarpeted floors in 107 dwellings; and measurement was performed on three occasions over a 5-month period. After the first sampling, all mattress covers and impermeable encasements were permanently removed. RESULTS: The initial geometric mean concentrations of Der p 1 (micrograms per gram of fine dust) from the surfaces of sheepskin, wool, and cotton mattress coverings were greater than those from the surfaces of impermeable mattress encasements (116, 113, and 19 vs 0.4) (p < 0.001); corresponding concentrations on the underlying mattresses were 142, 38, 20, and 0.6, respectively (p < 0.05 to 0.001). At the end of the study these mattress surface concentrations were 79, 65, 9.7, and 3.1, respectively. In 24 dwellings an uncarpeted room was adjacent to a carpeted room. At each visit the concentration of Der p 1 in uncarpeted rooms was below the reported threshold for sensitization and significantly less than that in the adjacent carpeted room. CONCLUSION: In homes of children with asthma, "asthmogenic" concentrations of Der p 1 were found on nonencased mattresses and carpeted floors, but the use of impermeable mattress encasements and carpet exclusion were associated with concentrations of Der p 1 below the reported threshold for sensitization.

Adolescent↗

Malaria vaccine.

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Animals↗

Toxic gas generation from plastic mattresses and sudden infant death syndrome.

Microbial generation of toxic gases from antimony, arsenic, or phosphorus in compounds used as fire retardants in cot mattresses has been proposed as a cause of sudden infant death. To test this hypothesis, 23 polyvinyl chloride mattress samples from cot death cases were incubated on malt agar plates until good microbial growth was obtained. Silver nitrate and mercuric chloride test papers were then inserted and the colour reactions recorded. The predominant organism, recovered from all mattresses tested, was not, as claimed in earlier work, the fungus Scopulariopsis brevicaulis, but a mix of common environmental Bacillus spp. Test paper colour changes occurred whenever bacterial growth was present, but these reactions also occurred in control tests in which no mattress material was present on the plates. Chemical and instrumental analyses of exposed test papers showed that the colour reactions were not due to deposits of antimony, arsenic, or phosphorus. Our findings do not support the hypothesis that toxic gases derived from antimony, arsenic, or phosphorus are a cause of sudden infant death. More sulphur was found in test papers exposed in plates containing bacterial growth than in those without such growth. This result suggests that the test paper reactions were due to the generation of sulphur-containing compounds during bacterial growth on the agar medium.

Bacillus↗

Pressure on the patient.

The primary cause of pressure sores is the interference with the blood supply of the tissues which, if prolonged, will result in their death. In most cases, the prolonged pressure which occludes vessels is caused by the inability of the patient to feel pain and/or move. Fortunately the surface area of the body available for the support of the patient is such that it is possible to design patient-support systems which will prevent the pressure per unit area exceeding the critical value. The criteria for an ideal patient-support system are given.

Bedding and Linens↗

Observations on mattress covers: results of a pilot study.

Samples of covers from three commercially available mattresses were examined in the laboratory using test methods originally devised for testing surgical dressings. These revealed that although the covers shared many common features, there were differences in the conformability and tensile properties which may be of some clinical relevance. The study also confirmed that with some minor modifications, the experimental techniques used would be suitable for a future, more comprehensive review of mattress performance. In a separate investigation designed to examine the consequences of a failure of a mattress cover, the bioburden of a foam core removed from a damaged cover revealed the presence of very large numbers of microorganism, well in excess of 10(10) per gram of foam which could act as a recevoir of contamination and thus a source of cross infection.

Bedding and Linens↗

Comparison of house dust mites found on different mattress surfaces.

BACKGROUND: House dust mites have been considered the most important source of allergens for humans. These allergens have been encountered at different indoor sites, mainly on mattresses and pillows. OBJECTIVE: To evaluate the number and different specimens of mites on Brazilian bunk-bed mattresses. METHODS: Dust samples were collected once using a standardized method on the upper mattress surface (US) and lower mattress surface (LS) (bed frame also included in the latter) of 58 mattresses. RESULTS: The total number of mite bodies on the LS was 3.5-fold higher than on the US, with a mean concentration of 932 mites per gram of fine dust (mites/g) on the US (range, 0-3,375 mites/g) and 3,254 mites/g on the LS (range, 125-14,500 mites/g) (P < .001). Additionally, the number of house dust mite bodies on the LS was 2.4 higher than on the US (P < .001); the mean concentration was 750 mites/g on the US (range, 0-2,875 mites/g) and 1,816 mites/g on the LS (range, 0-10,875 mites/g). Approximately 91% (n = 52) of the US and all LS dust samples had more than the limit of 100 mites/g. The most frequent family was Pyroglyphidae in both mattress surfaces, with Dermatophagoides pteronyssinus the most important species found. Storage mites, including Glycyphagidae (P < .001), Acaridae (P < .001), and other families (P < .001), also showed significant differences in the number of mites between both sample counts. CONCLUSIONS: This study shows a significant difference in US and LS mite counts, with higher counts on the LS. Mite allergen avoidance should include the LS and bed frame as potential targets.

Air Pollution, Indoor↗

Evidence of large particle allergen inhalation from contact with surfaces.

BACKGROUND: To establish a more accurate relationship between dust mite allergen on surfaces such as bedding with respiratory uptake, an exposure method is needed which correlates exposure of allergen on surfaces with respiratory dose. OBJECTIVES: Assess if aerodynamically large allergen particles (> 10 microm), similar in nature to dust mite allergen, is inhaled into the nose from direct head-and-hand contact with allergen contaminated surfaces. METHODS: Short ragweed pollen (20-microm diameter) was used as a surrogate for dust mite allergen exposure because of its similar aerodynamic and physiologic properties. Pillows and a section of linoleum (followed by a hand press) were embedded with 99MTechnetium labeled pollen. Particles on the linoleum were transferred to the sampler after a hand press to the surface. Simulated human exposure was performed by surface-sampling particles, at a capture velocity of the nose, onto a filter. Human evaluation of hand transfer to the nose or direct inhalation from a pillow was performed with three subjects. Percentage respiratory uptake and deposition location was determined by gamma camera imaging. RESULTS: Simulated respiratory uptake of pollen by hand-to-nose transfer and directly off pillows was 20% and 1.4%, respectively. Human subject respiratory uptake by hand-to-nose transfer and directly off pillows was 6.6% and 1.5%, respectively. Most of the regional activity was found immediately in the nasal vestibule with 13% to 39% of the total activity localized in the pharyngeal region. CONCLUSIONS: Aerodynamically large allergen particles (pollen) are inhaled and deposited into the anterior nose and pharyngeal areas of the respiratory tract from direct contact with allergen-containing surfaces.

Administration, Inhalation↗