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PubMed1988

[Antimicrobial activity of antiseptics].

In the study, the antimicrobial activities of 7.5% povidone-iodine, 4% chlorhexidine gluconate, 1.5% chlorhexidine gluconate, 1.5% chlorhexidine gluconate with cetrimide mixture, 10% benzalconium chloride, dust detergent and soap as well as changes in activity in due course of time have been investigated. It has been observed that the effect of germicides on Staphylococcus aureus, Pseudomonas aeruginosa, Enterobacter cloacae and Candida strains increased in time. Soap had no germicidal effect. The difference between the of antiseptics on the residuent flora of the hands immediately and those two hours later was found to be statistically insignificant.

Anti-Infective Agents, Local↗
PubMed1986

[Cerebral paragonimiasis with peculiar calcified foci: a case report].

In Japan more than 400 cases of intracranial invasion of Paragonimus westermani have been reported. In recent years, however, because of the decrease of incidence of parasitic disease, erroneous diagnosis is apt to be made. Peculiar but characteristic calcified cystic lesions in chronic stage of cerebral paragonimiasis were described as "soap bubble appearance" in x-rays by Oh in 1968. We report such a case with calcified lesions of soap bubble appearance in plain x-ray films in the right parieto-occipital region. The patient was a 30-year-old man who had generalized convulsive seizures since childhood. CT scan revealed these lesions to have high density in the margin and relatively low density in the center. Recently some cases of cerebral involvement by Paragonimus miyazakii were reported in Japan. The immunoserological tests are most useful for the diagnosis of paragonimiasis. Bithionol administration is the treatment of choice in acute stage. Calcified lesions with positive serological tests in two years after the onset of cerebral signs should be removed surgically, if possible.

Adult↗
PubMed1978

A novel semiautomated method for the estimation of free fatty acid in serum or plasma.

A modification of the semiautomated assay method of Antonis (1965. J. Lipid Res. 6:307-312) for free fatty acid is presented. Free fatty acids are extracted from serum or plasma into di-n-butyl ether-2-methoxyethanol; the extract is almost free from phospholipids. The acids are analyzed in a portion of extract by a copper soap method using diphenylcarbazide. The extractant, being less dense than water, is easily separated from an aqueous phase both in the extraction of samples and in the assay of copper soaps. The assay is comparable in accuracy with well-tried titrimetric methods and is quicker and easier to operate.

Autoanalysis↗
PubMed1984

[Verification of the effectiveness of neutralization in the in vivo study of antiseptics].

Well defined controls of the effectiveness of antiseptic neutralizing agents in vitro already exist (Afnor Standards for antiseptics and disinfectants). Conversely, there is currently no standard method for verifying how effectively such agents neutralize antiseptics which have been applied to the skin. We describe a method in which the neutralizing solution is first applied to the antiseptic-treated skin and then filtered to remove skin flora. The effect of the neutralizing agent is then checked using a test organism (Staphylococcus epidermidis ATCC 14990) in parallel with four controls: viability of the test organism (T1), activity of the untreated antiseptic (T2), non-bactericidal effect of the neutralizing agent (T3) and of skin secretions (4). Skin sampling was carried out using Gaschen's bag method for the hands and the Williamson and Kligman method modified by Fleurette for other sites. Twelve soaps and/or antiseptics were studied. In each case, activity of the antiseptic (T2) was confirmed, except when the product under study was a non-bactericidal soap. Bacterial counts obtained in controls T3 and T4 and in the neutralization test itself were always greater than 80% of the control value (T1). Occasionally, the counts in the neutralization test exceeded 100% of the T1 value, probably because of the dispersal effect of the triton X100 present in the neutralizing solution. This method thus offers a means of standardizing the study of antiseptics in vivo. In addition, the test organism, Staphylococcus epidermidis, is more representative of the skin flora than the bacterial strains recommended by Afnor for in vitro studies.

Anti-Infective Agents, Local↗
PubMed1982

Local effects of three standard assault rifle projectiles in live tissue.

A total number of 64 anaesthetized Finnish homebred pigs, weighing 25-30 kg, were wounded in the medial part of one thigh. The shooting range was 30 and 100 m. The weapons were the Finnish M 62, the Russian AKM 47 and the American M 16 A 1, and the projectiles were their standard military ammunition. Simulating typical field conditions the skin of the pigs was covered with a Finnish terrain uniform at 30 m. After trauma the anaesthetized pigs were kept under intensive care for 6 hours before they were debrided on current principles of missile injury operation. The condition of the animals was carefully checked both clinically and in laboratory tests. The pigs showed no signs of shock during the study. The impact and exit velocities were measured, and the respective energies were calculated. At the range of 30 and 100 metres the rate of energy transfer was the same, or 8-9% of the impact energy, with the two 7.62 projectiles. The 5.56 American projectile had a considerably greater energy transfer at the range of 30 m (27.5% of EI) as well as at the range of 100 m (14.4 of EI). With all projectiles the same correlation was observed between debrided tissue per unit length of wound path and rate of energy transfer per unit length of wounds caused by the 5.56 calibre projectile were more injurious than those caused by the 7.62 calibre bullets. The wounds and the tissue damage were estimated by gross appearance, amount of debridement, biopsies and ultrasound studies. The results were comparable with those obtained with soap blocks, except as regards the behaviour of the Russian 7.62 calibre projectile, which was quite different in soap blocks compared to live tissue at both ranges.

Animals↗
PubMed1982

[Study of the mechanism of injuries due to high velocity projectiles].

In the experiments on pigs wounds on the muscle-connective tissues of the thighs were made at 50 meter range by projectiles of military Rifles M 48, M 70, M 16A FAL (the length of the wound canal from 214 to 228 mm), M 91/30 and Dragunov (the length of the wound canal from 160 to 164 mm). The mass of tissue excised at primary surgical debridement was taken as a criterium of the primary devitalization of tissue, the amount of the transferred energy was calculated as well as other parameters of the terminal ballistics. Shooting through the glycerine-soap blocks under the same conditions were parallelly performed. The examinations have shown that the degree of the primary mechanical injury depended on the amount of the transferred energy, which depended not only on the high initial velocity of the bullet but also on the disintegrated, deformed and fragmented bullet after passage through the tissue. The mass of the excised tissue can be a reliable criterium for evaluation of wound severity. There is a good correlation with the volume of the cavity in the soap blocks so that they can be used in experiments as simulant biological media.

Animals↗
PubMedDate not supplied

Importance of Staphylococcus aureus in allergy in a rural environment.

The new scourge represented by allergic diseases should be given prophylaxis of two kinds. In the first place, there should be scientific prevention at the level of industrial production, replacing the products intended for agriculture or rendering them nonsensitizing, together with the chemical radicles with a reducing effect, which are strongly allergizing. In the second place, this prophylaxis should be based on rational body hygiene, in particular, of the hands and feet, using specially studied oxygenating soaps (like Vita Soap) in order to prevent the implantation of micro-organisms and perspiration, and at the same time alkalinization of the skin. The farmer's resistance to allergy, and even that of his animals, should be reinforced by vaccination, by well known antistaphylococcal "Divasta" from Institut Pasteur, thus combating the primary and endemic allergies due to microorganisms and parasites, which pave the way for secondary chemical allergy.

Air Microbiology↗
PubMed1994

Thermodynamics of binding water and solute to powdered long-chain salts of fatty acids.

Hydration of powdered fatty acids and their salts has been studied both in presence and absence of neutral salts, sucrose and urea using the isopiestic vapour pressure technique. Moles of water vapour adsorbed per mole or kg of soaps like sodium palmitate, sodium stearate, sodium myristate and sodium laurate have been measured in presence and absence of salts and compared with that of detergents (SDS, CTAB, DTAB and MTAB). For each case of positive excess adsorption of water vapour and negative excess adsorption of inorganic salts, urea and sucrose to different soaps, the standard free energy change (delta G degrees) per kg of substrate in bringing the bulk mole fraction from zero to unity have been calculated using an appropriate thermodynamic equation and the values so obtained have been compared critically.

Fatty Acids↗
PubMedDate not supplied

Dissolution of cast aluminum in different denture cleansers.

Aluminum is one type of metal base material used as an alternative to acrylic resin. This study evaluated whether commonly used denture cleansers cause leaching of the metal base into the cleaning solution. Seven cleansers (Efferdent, Polident, Clorox, Clorox/Cascade, vinegar, Tartar and Stain Remover, and Ivory soap) and two controls (tap water and distilled water) were evaluated. One hundred thirty-five wax samples (30 x 30 x 1 mm) were cast in 99.4% pure aluminum. The 135 samples were randomly assigned to the nine cleanser groups. Each sample was soaked in a cleanser for 0.5, 1, or 8 hours, and the amount of aluminum present in each cleanser was then analyzed by atomic flame-emission spectrometry. The results indicated that all cleansers leached aluminum into solution in varying amounts. Tartar and Stain Remover and Clorox caused the greatest leaching, whereas Ivory soap and Efferdent leached the least.

Aluminum↗
PubMed1994

Observations on handwashing and defecation practices in a shanty town of Lima, Peru.

Following a two-year cohort study of diarrhoeal diseases in children aged 0-35 months from a shanty town in Lima, 62 families were chosen for detailed observation of hygiene practices. All handwashing and defecation episodes which occurred during a 10-hour observation period (8am-6pm) were recorded. The youngest child in each family was selected as the index child for observation. Handwashing was seen on 483 occasions with 71% of the index children and 80% of mothers observed at least once. The use of clean water, soap and the thoroughness of the handwashing varied according to the purpose, with "better" behaviour observed more frequently when the person was preparing to go out. Forty-five index children (72%) were observed to defecate at least once. Infants defecated in their diapers or clothes; toddlers defecated more indiscriminately around the home area. Handwashing after defecation was rare (11% of occasions) and usually without soap. Faeces were often left accessible to children and animals (42% of occasions), especially when defecation occurred around the home/yard, and the data suggested this occurred more frequently in "higher" diarrhoea households. Stools deposited on the floor were usually just swept aside, covered with earth or eaten by dogs. Those deposited outside the home were frequently left untouched during the observation period or similarly cleared. Soiled clothes were usually left or washed separately, and stools in potties were thrown in latrines. These results suggest hygiene interventions might focus on clearance of stools from home surroundings, increased utilisation of potties and separate washing of soiled clothes.

Child, Preschool↗
PubMed1994

[Model tests for effectiveness assay of disinfectants on surfaces. III. Dependence of test results on the type of substances and the test microbes (Staphylococcus aureus, Mycobacterium terrae)].

A new test method for surface disinfectants was applied to investigate the efficacy of the most important active components of disinfectants to Staphylococcus aureus and Mycobacterium terrae. The test germs were embedded in coagulated blood. Frosted glass served as test surface. The disinfection was performed by applying a fixed amount of the disinfectant and mixing it with the contamination by rubbing. The number of surviving germs was determined quantitatively. Generally, the two test germs showed a distinctly different behaviour towards the active substances applied. Mycobacteria proved to be clearly more resistant than staphylococci, except with formaldehyde and the cresol-soap solution. The formaldehyde, the mycobacteria were only a little more resistant, while to cresol-soap solution they were even a little more sensitive than were staphylococci. Compounds containing active chloride showed a sufficient effect on mycobacteria only if the consumption of the active component by blood was nearly excluded. The quaternary ammonium compound and glyoxal, even the high concentrations, showed a totally insufficient efficacy to mycobacteria. The results shall provide the basis for a new guideline to be established by the Federal Health Office concerning the efficacy testing of surface disinfectants effective against mycobacteria, especially tuberculosis bacteria.

Chlorine↗
PubMed1994

[Nursing process and problem-oriented documentation. The development of a measuring tool].

This paper reports on an investigation about application of the nursing process in psychiatric nursing. The main focus was the development of an instrument for measuring the nursing process. This instrument was developed on the principle of the SOAP-system. The goal of developing such an instrument was to give nurses the possibility of following the process of implementation of the nursing process on their wards. After selecting the items of the instrument, content validity and interrater reliability were determined. Analysis revealed adequate validity and reliability of the instrument. Therefore the instrument can be used in psychiatric hospitals applying the nursing process on the principle of the SOAP-system.

Documentation↗
PubMed1993

[The benefits of auditing clinical histories. Our experience over 5 years].

OBJECTIVE: To evaluate how our clinical records (CR) are filled in and to observe the impact of measures taken to correct faults found over a five-year follow-up period. DESIGN: Three descriptive studies (auditing methodologies) on representative samples of CR selected at random. Four quality indicators were fixed: internal communication (i.e. legibility and comprehensibility), external communication, manageability and the quality of the activity at attendances measured by the SOAP. The optimum standards (OS) were agreed by the team (technique of nominal group). SETTING: "Florida" Health Centre, Alicante. PATIENTS AND OTHERS PARTICIPANTS: Periodic team meetings to analyse results and agree activities. In 1986, N of CR = 367; in 1988, 370; and in 1990, 372. MAIN MEASUREMENTS AND RESULTS: During the follow-up period, the filling-in of all the variables, except the address, the test carried out and blood pressure, improved. But the following did not reach the OS: code, affiliation, origin, instruction, habits, allergies, working activity, socio-economic data, age and gender, family/personal background, test carried out, blood pressure and analytical data. The following all reached the OS: legibility, which went up from 88% to 96.5%, comprehensibility from 62 to 75.3%, external communication from 81 to 88.9%, manageability from 53 to 79.6% and SOAP from 62 to 82.5%. CONCLUSIONS: Auditing allows the level of the filling-in of the CR to be measured. Deficiencies which appear to be due to the design of the record itself can be detected. The efficacy of corrective measures to improve records can also be assessed.

Communication↗
PubMed1998

Modelling the process of encounter between general practitioner and patient as a method for the detection of psychosocial problems.

In the Netherlands all patient on the list of a GP can present with all health problems in all their stages of development at any time, and more than 80% of all complaints presented to a GP are resolved by him or her. Many of these problems have psychosocial aspects. GPs need a structured consultation model for the doctor-patient encounter and, at the same time, need an open consultation style. The model must be seen as an aid in the doctor-patient communication and in medical education. In this article such a model, based on the SOAP system, a system for medical recording is described. Furthermore, a broader protocol of the SOAP, called the BATHE, is introduced. In addition, a description is given of how students at the medical school of Maastricht University are trained to use this model, especially in the clerkship in general practice.

Clinical Clerkship↗
PubMed1998

Multistate surveillance for food-handling, preparation, and consumption behaviors associated with foodborne diseases: 1995 and 1996 BRFSS food-safety questions.

PROBLEM/CONDITION: In 1995, CDC, the Food and Drug Administration (FDA), and several state health departments collaboratively developed questions regarding food safety. This set of questions was used to collect data about food-handling, preparation, and consumption behaviors that have been associated with foodborne diseases in adults. These data will help characterize persons at high risk for foodborne illness and assist in developing food-safety education strategies for consumers and foodhandlers that are intended to reduce foodborne illness. REPORTING PERIOD COVERED: January 1995-December 1996. DESCRIPTION OF SYSTEM: Data were collected by using the 12 food-safety questions, which were administered with the 1995 Behavioral Risk Factor Surveillance Systems (BRFSS) in Colorado, Florida, Missouri, New York, and Tennessee, and the 1996 BRFSS in Indiana and New Jersey. In addition, data were collected in South Dakota from two of the standardized questions that deal with consumption of undercooked eggs and pink hamburgers. The BRFSS is a state-based system that surveys noninstitutionalized adults by telephone about their health behaviors and practices. RESULTS: This study included 19,356 completed questionnaires (2,461 in Colorado; 3,335 in Florida; 2,212 in Indiana; 1,572 in Missouri; 3,149 in New Jersey; 2,477 in New York; 2,110 in South Dakota; and 2,040 in Tennessee). During the previous 12 months, 50.2% of respondents reported eating undercooked eggs (95% confidence interval [CI] = 49.2-51.2); 23.8% reported eating home-canned vegetables (95% CI = 22.5-24.5); 19.7% reported eating pink hamburgers (95% CI = 18.9-20.5); 8.0% reported eating raw oysters (95% CI = 7.5-8.5); and 1.4% reported drinking raw milk (95% CI = 1.2-1.6). The prevalence of not washing hands with soap after handling raw meat or chicken and not washing a cutting board with soap or bleach after using it for cutting raw meat or chicken were 18.6% (95% CI = 17.8-19.4) and 19.5% (95% CI = 18.6-20.4), respectively. Less than half of respondents (45.4%, 95% CI = 44.2-46.6) reported seeing safe food-handling label information on raw meat products. In addition, among those persons who reported they remembered seeing the label information, 77.2% (95% CI = 76.0-78.4) remembered reading the label information, and 36.7% reported changing their meat and poultry preparation habits because of the labels (95% CI = 35.2-38.2). When population characteristics were considered in the analysis, all high-risk food-handling, preparation, and consumption behaviors were more prevalent in men than in women. Eating pink hamburgers during the previous 12 months was more commonly reported by whites (22.3%) than by blacks (6.5%). The prevalence of reported consumption of pink hamburgers during the previous. 12 months decreased with age (18-29 years: 21.8%, 30-59 years: 21.9%, and 60-99 years: 13.2%); increased with education (less than grade 12: 12.0%, high school graduate: 16.5%, and any college education: 24.0%); and increased with income (< $15,000: 11.8%, $15,000-$34,999: 17.6%, $35,000-$49,999: 22.0%, and > or = $50,000: 28.6%). INTERPRETATION: During 1995-1996, several high-risk food-handling, preparation, and consumption behaviors were common, and some were particular to specific population groups. Based on this analysis, interventions are needed to reduce the prevalence of these risky behaviors. All consumers and foodhandlers could benefit from food-safety education. ACTIONS TAKEN: Behavioral surveillance systems can provide data that identify persons or groups in which behaviors associated with foodborne diseases are more common and who are at higher risk for foodborne illness. State-specific data can assist in developing food-safety education programs and, if collected periodically, can be used to evaluate program effectiveness.

Adult↗
PubMed1998

Concentrated cresol intoxication.

Cresol, a commonly used disinfectant, may cause gastrointestinal corrosive injury, central nervous system and cardiovascular disturbances, and renal and hepatic injury following intoxication. We report a case of acute severe cresol poisoning after a suicide attempt with ingestion of a cresol-soap solution used as a toilet disinfectant. A 44-y-old male was found unconscious after ingesting 300 ml of 50% cresol-soap solution. Endotracheal intubation, gastric lavage and activated charcoal were given immediately which reversed his conscious. He had dermal burns, esophageal and gastric erosion, pneumonia, mixed metabolic acidosis and respiratory aklalosis, renal and liver function impairment, leucocytosis and dark urine. Acute renal failure and hemolysis developed, but he recovered after hemodialysis and intensive supportive care. Urine levels of p-cresol, m-cresol, o-cresol and phenol were respectively 2083, 2059, 125 and 68 mg/g creatinine at 7 h post-ingestion. Though the amount cresol claimed ingested by the patient (150 g) far exceeded the reported lethal dose (30-60 g), and multiple complications developed after massive ingestion, this patient recovered. The renal, pulmonary and hematological effects in this patient might have resulted from the direct toxicity of cresol and its metabolites.

Adult↗
PubMed1998

Problem focused knowledge navigation: implementing the problem focused medical record and the O-HEAP note.

The current organization of most Computerized Medical Records (CMR) is based on the Problem Oriented Medical Record (POMR) and the SOAP (Subjective, Objective, Assessment and Plan) note. The organizational structure of the POMR and especially the SOAP note, does not allow for optimal use of computer capabilities in the follow up note. Since follow up visits are the most common office visit by far, this is a major flaw in the CMR. The authors propose a Problem Focused Medical Record and the OHEAP (Orientation, History, Exam, Assessment and Plan) note to resolve this problem. OHEAP starts with a powerful orientation structure that brings forward the timeline, last Assessment and Plan, and Plan Results for each problem along with the patient's historical tables as the starting point of every follow up visit. The Assessment and Plan portion brings problem specific differential diagnoses and their workups along with other relevant tables such as expert systems, treatments, instructions, medical literature or pathways. This leads to Problem Focused Knowledge Navigation that brings powerful efficiencies to the CMR. By recognizing the true workflow in the longitudinal diagnosis and management of any medical problem, the efficiency of the CMR is maximized. OHEAP allows for optimal use of both personal and external data elements in the medical record. Its powerful orientation attributes minimize the time spent in analyzing the current status of the problem while its connections to problem specific databases help resolve the problem.

Decision Making, Computer-Assisted↗
PubMed1975

Management of septic chemical abortion with renal failure. Use of a conservative regimen.

The concept that hysterectomy is of value in the management of septic abortion induced by instillation of soap or phenolic antiseptics into the uterus is challenged. Nineteen out of 20 such cases with renal failure were managed with intensive antibiotic therapy, peritoneal dialysis and an absolute minimun of surgical intervention. Seventeen patients recovered, with normal renal function. Of the 11 known to be subsequently exposed to conception seven have achieved normal pregnancies.

Abortifacient Agents↗