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PubMed1997

Efficacy of hand washing procedures on bacterial contamination of hydrogel contact lenses.

The effect of various hand washing regimens on transfer of bacterial contaminants from the hands to a hydrogel contact lenses was evaluated. Each of 47 subjects performed 5 different hand washing procedures, and then handled a new, sterile hydrogel contact lens. The lenses were cultured to determine colony-forming units (CFUs) and microbial identity. Median CFUs on lenses handled after washing with water, soap and water, or soap and water followed by towel drying were higher than the median CFU for lenses handled after no hand washing. The median CFU for lenses handled after soap and water washing followed by an alcohol wipe was not different from the no washing group. The majority of the contaminants were identified as Staphylococcus epidermidis. These results show that ordinary hand washing alone does not decrease, and may even increase, the amount of contaminants transferred from the hands to a hydrogel lens. Use of an alcoholic wipe after hand washing reverses this effect. Hand washing is still recommended in contact lens hygiene for removal of more pathogenic contaminants.

Colony Count, Microbial↗
PubMedDate not supplied

Multicenter pin care study.

BACKGROUND: Pin-site infection is a common complication of external fixation. Because few studies have compared methods of pin care that reduce infection rate, there is a need for evidence-based practice guidelines for pin-site care. METHODS: Two of 10 original clinical centers completed a prospective, randomized pin-care study between May 2000 and May 2002 to determine which of seven methods for caring for skeletal pins (external fixator, traction, or halo) resulted in the fewest pin-site infections. RESULTS: The 92 subjects had an average infection rate of 34%, and the 527 pins had a rate of 20%. Thirty patients (98 pins) had stage II infections, two patients (12 pins) had stage III infections, and none had deep infection or osteomyelitis. The protocols were (1) half-strength peroxide cleansing and gauze wraps (45%), (2) half-strength peroxide cleansing and Xeroform wraps (9%), (3) saline cleansing and gauze wraps (33%), (4) saline cleansing and Xeroform wraps (26%), (5) antibacterial soap-and-water cleansing and gauze (38%), (6) antibacterial soap-and-water cleansing and Xeroform gauze (50%), and (7) stable dressings with no pin cleansing (36%). Logistic regression analysis demonstrated significant inverse relationships (p = .05) between infection rate and age, as well as fixator type; the latter may be related to exposed threads. CONCLUSION: Results suggest that other factors outside the realm of this study may affect children's pin-site infection rate and that half-strength peroxide and Xeroform dressings were superior to soap-and-water cleansing. This pilot study indicates a need for further research with a larger sample size and for exploring factors in a younger population.

Adolescent↗
PubMed2005

Damage spreading in two-dimensional trivalent cellular structures with competing Glauber and Kawasaki dynamics.

The damage spreading of the Ising model on several two-dimensional trivalent structures, including soap froth, Voronoi, and hierarchical structures, are studied with competing Glauber and Kawasaki dynamics. The damage spreading transition temperature T(d) and the Curie temperature T(C) of these structures are compared. We find that T(d) of the hierarchical lattices decreases sharply as the probability of occurrence of Kawasaki dynamics increases, whereas for soap froth and Voronoi, T(d) for the Voronoi and soap froth remain nearly unchanged except when the dynamics is dominated by Kawasaki dynamics. T(d) and T(C) in our two-dimensional structures are nearly the same and they behave similarly as we change the relative probability of occurrence of the Glauber and Kawasaki dynamics. A heuristic argument is provided to explain the numerical results.

Journal Article↗
PubMed2004

Skin protection in nursing work: promoting the use of gloves and hand alcohol.

Nursing has been identified as a wet-work occupation, with a high prevalence of occupational irritant contact dermatitis. Reduction of exposure to skin irritants contributes to the prevention of occupational skin disease in nurses. The role of the use of soap and water, hand alcohol and gloves in prevention programmes is discussed. 2 additional measures for reducing exposure to skin irritants are postulated: use of hand alcohol instead of soap and water in disinfection procedures when the hands are not visibly dirty; use of gloves in wet activities such as patient washing to prevent the hands from becoming wet and visibly dirty. We investigated the effectiveness of these recommendations in a model. Mean daily wet-work exposure during nursing work was modelled: regular model. We also modelled exposure to skin irritants in combination with the implementation of these recommendations: prevention model. The hands of healthy volunteers were exposed to the regular or the prevention model over 3 weeks for 5 days a week. The change in transepidermal water loss (TEWL) on the back of the hands was measured after 3 weeks of exposure to these wet-work simulations. An increase in TEWL occurred with the regular model, while mean TEWL decreased in the prevention model. Skin irritation from occlusion by gloves appeared to be more pronounced in the regular model compared to the prevention model. The results of this study justify the conclusion that in nursing work, hand alcohol is the preferred disinfectant. Although the prevention model implies increased occlusive exposure, this has no additional irritant effect, probably because of the absence of soap exposure.

Adult↗
PubMed1994

Study of the efficacy of antiseptic handrub lotions with hand washing machines.

The effectiveness of quick handwashing in regards to four alcohol-based handrub lotions, including two products already on the market and our original lotions 1, 2, with two different kinds of hand washing machines was studied in vivo. We also tried to evaluate the efficacy of the four lotions in vitro. The in vivo testing of each lotion, including ethanol, was evaluated using two hand washing methods, first with and then without a previous soap wash. Computerized image analysis was used to calculate the bacterial count on the hand surface. The results showed that a 3 second application of the original lotion 2 (0.5% chlorhexidine in a 77% ethyl alcohol solution) preceded by a soap wash eradicated 89.3% of the bacteria on the hands; this was the highest reduction rate of all four detergents. AROKULIN-E (67.9% ethyl alcohol solution) without a prior handwashing produced the lowest reduction, 49.1% against hand surface bacteria. These results were compatible with those in vitro. It seems that an alcohol-based solution containing an effective antimicrobial detergent preceded by a soap wash is necessary to acceptably reduce hand surface bacteria.

Bacteria↗
PubMed1989

Effects of selective oral antimicrobial prophylaxis and systemic antibiotics on the fecal flora and fecal beta-aspartylglycine concentration in patients with acute leukemia.

The influence of selective oral antimicrobial prophylaxis (SOAP) and systemic antibiotic treatment (SAT) on the intestinal flora of fourteen granulocytopenic patients was investigated. For SOAP, patients received Cotrimoxazole, Polymyxin and Nystatin; Gentamicin, Ticarcillin and Cefuroxime were administered for SAT. Under SOAP, a complete elimination of Enterobacteriaceae and a marked reduction of yeasts and staphylococci was found. A reduction in the number of anaerobic species was also observed; however, the concentration of anaerobic bacteria remained constant. In contrast, additional systemic antibiotic treatment caused a significant reduction of aerobic as well as anaerobic bacteria, except for microorganisms pathogenic to neutropenic patients (i.e. Staphylococcus epidermidis and Candida sp.). The fecal concentration of beta-aspartylglycine was inversely correlated with the presence of anaerobic bacteria.

Acute Disease↗
PubMed1985

Evaluation of nongermicidal handwashing protocols for removal of transient microbial flora.

A method has been described which can compare the efficacy of different nongermicidal handwashing protocols for removal of transient microbial flora without the necessity of establishing or relying on a previously determined baseline for an individual subject. The wash effluent is collected, and colony counts for the effluent reflect the number removed by the wash protocol. A second standard wash in a handwashing machine is performed, and the test criterion is the percent removed in the test wash based on the sum of total CFU recovered from the two washes. The method was used to compare an 8-s cycle for a newly developed handwashing machine with a conventional 15-s Ivory soap wash. When machine pressure was adequate (42 lb/in2), there was no statistically significant difference in the percent removal of transient flora by the two methods (48.8% from the machine versus 45.1% from the Ivory soap wash). At 32 lb/in2, the Ivory soap wash recovered 60.3%, whereas the machine recovered 45.1%.

Analysis of Variance↗
PubMed2004

Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs.

The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data from comparative trials are available to reliably rank triclosan. Personnel should be reminded that it is neither necessary nor recommended to routinely wash hands after each application of an alcohol-based hand rub. Long-lasting improvement of compliance with hand hygiene protocols can be successful if an effective and accessible alcohol-based hand rub with a proven dermal tolerance and an excellent user acceptability is supplied, accompanied by education of health care workers and promotion of the use of the product.

Anti-Infective Agents, Local↗
PubMed2005

Epidemiology and prognosis of coma in daytime television dramas.

OBJECTIVE: To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma. DESIGN: Retrospective cohort study. SETTING: Nine soap operas in the United States reviewed between 1 January 1995 and 15 May 2005. SUBJECTS: 64 characters who experienced a period of unconsciousness lasting at least 24 hours. Their final status at the end of the follow-up period was compared with pooled data from a meta-analysis. RESULTS: Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher's exact test both P < 0.001). On the day that patients regained consciousness, most (49/57; 86%) had no evidence of limited function, cognitive deficit, or residual disability needing rehabilitation. Compared with meta-analysis data, patients in this sample had a much better than expected chance of returning to normal function (non-traumatic 91% v 1%; traumatic 89% v 7%; both P < 0.001). CONCLUSIONS: The portrayal of coma in soap operas is overly optimistic. Although these programmes are presented as fiction, they may contribute to unrealistic expectations of recovery.

Cohort Studies↗
PubMed2005

Sexual offenders against children: the influence of personality and obsessionality on cognitive distortions.

Sexual offenders against children are generally inadequate in their social functioning and diverse in their psychopathology. The degree to which this inadequate functioning and psychopathology influences therapeutic interventions brings into question the belief that generic nonclinical programmatic treatment work is always appropriate for such a cohort. The Sex Offenders Assessment Package (SOAP) measures inadequate social functioning and sexual deviance, but has not been linked to broader individual differences and generic psychopathology. We collected information examining the relationship between the SOAP and standard measures of personality (the NEO-FFI) and obsessive-compulsiveness (MOCI) in a sample of 200 sexual offenders against children seen by the Probation Service. Factor analysis was used to reduce the SOAP to three reliable factors: emotional distress, cognitions supporting sex with children, and concern for others. These factors correlated respectively with higher Neuroticism and lower Extroversion; greater obsessive-compulsiveness on the MOCI, and trait Agreeableness, irrespective of whether or not one corrected for socially desirable responding. When partial correlation controlled for the influence of Neuroticism on the correlation between cognitions supporting sex with children and the MOCI, there was no change in the association between these variables. These results show that negative affect and obsessional tendencies are important underlying influences on the feelings and behavior of sexual offenders, that the obsessionality of the group is not attributable to Neuroticism, and suggest useful additional foci to enhance the treatment of this diverse clinical group.

Child↗
PubMed2006

The Ontology Lookup Service, a lightweight cross-platform tool for controlled vocabulary queries.

BACKGROUND: With the vast amounts of biomedical data being generated by high-throughput analysis methods, controlled vocabularies and ontologies are becoming increasingly important to annotate units of information for ease of search and retrieval. Each scientific community tends to create its own locally available ontology. The interfaces to query these ontologies tend to vary from group to group. We saw the need for a centralized location to perform controlled vocabulary queries that would offer both a lightweight web-accessible user interface as well as a consistent, unified SOAP interface for automated queries. RESULTS: The Ontology Lookup Service (OLS) was created to integrate publicly available biomedical ontologies into a single database. All modified ontologies are updated daily. A list of currently loaded ontologies is available online. The database can be queried to obtain information on a single term or to browse a complete ontology using AJAX. Auto-completion provides a user-friendly search mechanism. An AJAX-based ontology viewer is available to browse a complete ontology or subsets of it. A programmatic interface is available to query the webservice using SOAP. The service is described by a WSDL descriptor file available online. A sample Java client to connect to the webservice using SOAP is available for download from SourceForge. All OLS source code is publicly available under the open source Apache Licence. CONCLUSION: The OLS provides a user-friendly single entry point for publicly available ontologies in the Open Biomedical Ontology (OBO) format. It can be accessed interactively or programmatically at http://www.ebi.ac.uk/ontology-lookup/.

Database Management Systems↗
PubMed2006

Web-based learning versus standardized patients for teaching clinical diagnosis: a randomized, controlled, crossover trial.

BACKGROUND: Little evidence exists to guide the selection of methods for teaching clinical diagnosis. PURPOSE: To compare the efficacy, student preference, and cost of a Web-based (WB) program versus a standardized patient (SP) encounter for teaching clinical diagnosis skills to 2nd-year medical students. METHODS: Randomized, controlled, crossover study comparing WB versus SP-based teaching for the clinical diagnosis of abdominal pain and headache. Outcome measures were performance on a 2-case SP examination (scored on the basis of a checklist completed by a faculty observer and an objective score on a postencounter subjective-objective assessment plan [SOAP] note), format preferences as assessed by end-of-course evaluations, and cost. RESULTS: Thirty students consented to participate. WB and SP training produced similar scores on both the Abdominal Pain checklist (66% vs. 62%; p = .17) and Headache checklist (56% vs. 63%; p = .07). WB training produced a higher score on the Abdominal Pain SOAP note (69% vs. 47%; p = .006), but not the Headache SOAP note (69% vs. 67%; p = .85). Students rated the SP format higher than the WB format on all 7 preference measures. Start-up costs were estimated at 2,190 dollars for the SP format and 2,250 dollars for the WB format. Ongoing costs per case per student were estimated to be 45 dollars for the SP format and 30 dollars for the WB format. CONCLUSIONS: WB and SP learning outcomes were comparable, but students preferred the SP format. Start-up costs were comparable, but the ongoing costs of the WB format were less expensive, suggesting that WB teaching may be a viable strategy.

Algorithms↗
PubMed1989

Multiple cis-acting DNA regulatory elements mediate hepatic angiotensinogen gene expression.

Angiotensinogen is the glycoprotein precursor of angiotensin II, an octapeptide hormone important for the regulation of blood pressure and volume homeostasis. The gene encoding angiotensinogen is expressed in liver and several other tissues, providing a model gene for understanding the role of cis-acting DNA control elements and trans-acting factors in tissue-type specific gene expression. To identify DNA control elements in the rat angiotensinogen gene we prepared an array of fusion genes consisting of either 5' or 3'-deleted sequences of the 5'-flanking region of the gene linked to a firefly luciferase reporter gene and analyzed the relative cellular specificity of expression of these genes after their introduction into hepato-carcinoma cells (Hep G2) that do express and placental cells (JEG-3) that do not express the endogenous angiotensinogen gene. Six transcriptionally active elements were found within 688 base pairs of 5'-flanking DNA. The interactions of DNA binding proteins with these elements was demonstrated by their specific protection to digestion with DNase I in the presence of liver cell extracts. The orientation and spatial requirements for transcription of two of the elements were analyzed further by the construction and expression of synthetic oligonucleotide cassettes incorporating the sequences of these elements when linked to a homologous (angiotensinogen) or a heterologous Simian virus 40 promoter and enhancer. One element located between 60 and 108 base pairs from the start of gene transcription functioned either as a silencer or an enhancer of transcription (SOAP box element), depending upon the distance from the angiotensinogen and viral gene promoters. Moreover, the SOAP box element demonstrated enhancer activity in JEG-3 cells when linked to the Simian virus 40 early promoter. An oligonucleotide mutation of the SOAP box element interfered with protein binding in a gel mobility shift assay and this mutant was transcriptionally inactive in both homologous and heterologous promoters. These observations indicate that expression of the angiotensinogen gene in liver cells is coordinately regulated by multiple cis-acting elements that interact with DNA binding proteins.

Angiotensinogen↗
PubMed2006

Effect of different premilking manual teat-cleaning methods on bacterial spores in milk.

Different teat-cleaning methods were evaluated to determine their effect on the presence of spores from anaerobic bacterial spore-formers in the milk. Artificial contamination was used to achieve uniform contamination of teats to reduce the number of cows and samples needed in the experiments and still obtain adequate power to detect differences among tested methods. Teats were contaminated experimentally with a large amount of Clostridium tyrobutyricum spores in a manure-water slurry. Various types of dry and moistened towels and different combinations of methods using soap or 2 types of towels, together with cleaning times of 10 or 20 s, were compared in 2 Latin square-designed experiments with 7 cows, 7 treatments, and 4 replications in each experiment. In comparison with control (no cleaning and no forestripping), cleaning teats with dry paper towels for 10 s reduced concentration of spores in milk by 45 to 50%. A 50 to 74% reduction was achieved using different types of moist towels for 10 s. Methods using 2 towels, soap, or a longer cleaning time reduced bacterial contamination by 85 to 91%. The most effective methods in reducing milk spore content (96% reduction) were use of a moist washable towel with or without soap followed by drying with a dry paper towel, for a total time of 20 s per cow. One of the best cleaning methods was studied in an additional experiment to determine the effect of different teat contamination mixtures. The Latin square-designed experiment with 8 cows, 8 treatments, and 2 replications showed that cleaning was independent of the tested contamination matrix (manure, soil, or sawdust), type of spores (Cl. tyrobutyricum and Bacillus cereus), or degree of contamination (manure or extra manure).

2-Propanol↗
PubMed1991

Ruminal synthesis, biohydrogenation, and digestibility of fatty acids by dairy cows.

Ruminal synthesis and biohydrogenation of fatty acids in dairy cows were determined by sampling duodenal digesta through T-cannulas. Fatty acid digestibility in the total tract also was measured. Five diets (concentrate:alfalfa hay:alfalfa haylage:corn silage, 2:1:1:1, DM) in a 5 x 5 Latin square contained either no added fat; 3 or 6% added calcium soap; or 3 or 6% animal-vegetable blend fat. Seventy percent of dietary fatty acids were recovered at the duodenum, and 106 g/d were synthesized in the rumen regardless of diets. Fatty acids synthesized in greatest amounts were odd or branched chains, whereas more than 90% of the fatty acids shorter than 14 carbons disappeared. Fatty acids in calcium soap were biohydrogenated 57% and in animal-vegetable blend 87%. Fatty acids in calcium soap were more digestible (80.0 vs. 75.7%) than those in the blended fat due to greater unsaturation in the small intestine. Ruminal microorganisms selectively synthesized fatty acids.

Animal Feed↗
PubMed1985

Effects of dietary fat level on laying hens fed various concentrations of calcium.

The effects of supplementing laying hen diets with 0, 5, or 10% fat in the presence of 3.0, 3.6, or 4.2% dietary calcium was investigated using laying hens over a 7-week period. There was no significant effect of the fat or calcium treatments on laying hen performance as judged by feed intake, weight gain, egg production, egg weight, and egg shell deformation. Although there was an increase in fat retention with an increase in dietary fat level (P less than .01), a larger proportion (P less than .05) of unabsorbed fat was present as soap in the excreta of birds on these diets relative to those fed the control diet. There was evidence to indicate that most of the soap observed in the excreta of laying hens was formed in postabsorptive areas of the gut, thereby explaining why the detrimental effects of soap formation were not seen in the laying hen. Increasing the dietary calcium level reduced both percentage calcium (P less than .01) and magnesium (P less than .05) retention. There were no significant effects of the treatments on nitrogen and phosphorus retention. There were also no significant effects of the treatments on shell ash, shell calcium, magnesium, and phosphorus content. Increasing the dietary calcium level increased bone ash (P less than .05) while reducing bone magnesium content (P less than .05). There were no significant effects of the fat and calcium treatments on bone calcium and phosphorus content.

Animals↗
PubMed1999

Laboratory evaluation of lambda-cyhalothrin a microencapsulated formulation on mosquito nets for control of vector mosquitos.

Two formulations of lambda-cyhalothrin (EC-Emulsion concentrate and MC-Microencapsulated) were impregnated into bednets made of polyethylene and polyester. The nets were treated at a dosage of 15 mg/m2. For bioassay of insecticidal efficacy, female Anopheles maculatus and Aedes aegypti were exposed to the nets for two minutes and mortality was scored 24 hours later. The nets were also tested after repeated washings with water and with soap and water. Microencapsulated (2.5CS) formulation was more effective than emulsion concentrate (2.5EC) formulation on both net materials--polyethylene and polyester. Repeated washing with water and soap reduces the efficacy of all bednet treatment combinations. Microencapsulated formulation on polyethylene gave best results; it could sustain up to five washes with water and two with soap and water.

Aedes↗
PubMed2000

Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism.

UNLABELLED: BACKGROUND AND HYPOTHESES: A substantial percentage of school absenteeism among children is related to transmissible infection. Rates of transmission can be reduced by hand washing with soap and water, but such washing occurs infrequently. This study tested whether an alcohol-free instant hand sanitizer (CleanHands) could reduce illness absenteeism in school-age children. METHODS: A 10-week, open-label, crossover study was performed on 420 elementary school-age children (ages 5-12). Students were given a brief orientation immediately prior to the start of the study on the relationship of germs, illness, and hand washing. Each student in the treatment group then received the test product in individual bottles, with instructions to apply one to two sprays to the hands after coming into the classroom, before eating, and after using the restroom, in addition to their normal hand washing with soap and water. The control group was instructed to continue hand washing as normal with non-medicated soap. After 4 weeks of treatment and a 2-week wash-out period, the control and experimental groups were reversed. Data gathered on absenteeism were classified as gastrointestinal or respiratory related and normalized for nonillness-related absenteeism and school holidays. RESULTS: Compared to the hand washing-only control group, students using CleanHands were found to have 41.9% fewer illness-related absence days, representing a 28.9% and a 49.7% drop in gastrointestinal- and respiratory-related illnesses, respectively. Likewise, absence incidence decreased by 31.7%, consisting of a 44.2% and 50.2% decrease in incidence of gastrointestinal- and respiratory-related illnesses, respectively. No adverse events were reported during the study. CONCLUSIONS: Daily use of the instant hand sanitizer was associated with significantly lower rates of illness-related absenteeism.

Absenteeism↗