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PubMed1963

Studies on the local treatment of rabies-infected wounds.

Local treatment of wounds infected with rabies virus is a valuable adjunct to the use of antiserum, vaccine or both in preventing disease. In the absence of effective chemotherapeutic agents for systemic use, improved treatment awaits a better understanding of the fate of virus at the site of exposure and of the method of spread to the central nervous system.The studies on experimental animals reported in this paper serve further to evaluate methodology in treatment; to evaluate the effectiveness of various substances, including antirabies serum, soap and benzalkonium chloride; and to explore the possible role of blocking agents in preventing rabies. The results obtained provide further evidence of the importance of first-aid procedures. Certain oil-based local anaesthetics, almond oil, benzyl alcohol and benzalkonium chloride, interfere with motor function and exert a marked sparing effect when inoculated intramuscularly above the site of infection; aqueous or saline-based local anaesthetics and saline do not interfere and fail to protect. The role of blocking agents, if any, in preventing rabies in man is unknown.

Ammonium Compounds↗

PubMed1985

Treatment of women who have undergone chemically induced abortions.

The pathophysiology of abortion induced by the transcervical introduction of compounds containing mixtures of soap, cresol and phenol is complex. A plan is necessary for the treatment of such critically ill women. The complex, multisystem damage produced by those compounds requires an extremely sophisticated treatment approach to avoid the many pitfalls that beset those cases.

Abortifacient Agents↗

PubMed1977

Staphylococcal and streptococcal colonization of the newborn infant: effect of antiseptic cord care.

A randomized controlled study was undertaken to compare the effectiveness of three umbilical cord treatment regimens in controlling neonatal bacterial colonization. The three regimens studied included castile soap, triple dye, and silver sulfadiazine. The triple dye and silver sulfadiazine application inhibited bacterial colonization. Staphylococcal colonization was inhibited by both treatment regimens but most effectively by triple dye. Group B streptococcal colonization was inhibited most effectively by silver sulfadiazine while triple dye application to the umbilicus promoted colonization with this microorganism. Silver sulfadiazine was more effective in controlling colonization with Gram-negative microorganisms.

Anti-Infective Agents, Local↗

PubMed2006

Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.

BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of surgical site infection. OBJECTIVES: To review the evidence for preoperative bathing or showering with antiseptics for the prevention of hospital-acquired (nosocomial) surgical site infection. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2005), MEDLINE (January 1966 to December 2005) and reference lists of articles. SELECTION CRITERIA: Randomised controlled trials comparing any antiseptic preparation used for preoperative full-body bathing or showering with non-antiseptic preparations in patients undergoing surgery. DATA COLLECTION AND ANALYSIS: Two authors independently assessed studies for selection, trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS: Six trials involving a total of 10,007 participants were included. Three of the included trials had three comparison groups. The antiseptic used in all trials was 4% chlorhexidine gluconate (Hibiscrub). Three trials involving 7691 participants compared chlorhexidine with a placebo. Bathing with chlorhexidine compared with a placebo did not result in a statistically significant reduction in SSIs; the relative risk of SSI (RR) was 0.91 (95% confidence interval (CI) 0.80 to 1.04). When only trials of high quality were included in this comparison, the RR of SSI was 0.95 (95%CI 0.82 to 0.10). Three trials of 1443 participants compared bar soap with chlorhexidine; when combined there was no difference in the risk of SSIs (RR 1.02, 95% CI 0.57 to 1.84). Two trials of 1092 patients compared bathing with chlorhexidine with no washing. No difference was found in the postoperative SSI rate between patients who washed with chlorhexidine and those who did not wash preoperatively (RR 0.70, 95% CI 0.19 to 2.58). AUTHORS' CONCLUSIONS: This review provides evidence of no benefit for preoperative showering or bathing with chlorhexidine over other wash products, to reduce surgical site infection. Efforts to reduce the incidence of nosocomial surgical site infection should focus on interventions where effect has been demonstrated.

Anti-Infective Agents, Local↗

PubMed2002

Toxicity of biorational insecticides: activity against the green peach aphid, Myzus persicae (Sulzer).

The relationship between dose for each of four biorational insecticides (pyrethrins, neem extract, capsiacin extract, insecticidal soap) and mortality of the green peach aphid (Myzus persicae) was determined using a laboratory bioassay. These insecticides were toxic to aphids and paired mixtures of the insecticides provided synergistic activity as measured by aphid mortality under the laboratory bioassay conditions. Capsiacin extracts were found to provide low levels of mortality alone but acted synergistically in mixtures with the other insecticides and provided higher than expected levels of mortality. Activity as determined in the laboratory for each insecticide was not evident under field-use conditions in five separate experiments. Under field conditions and using common application methods, these insecticides did not provide significant levels of control of aphids.

Agriculture↗

PubMed2004

The contact toxicity of indoxacarb and five other insecticides to Orius insidiosus (Hemiptera: Anthocoridae) and Aphidius colemani (Hymenoptera: Braconidae), beneficials used in the greenhouse industry.

The contact toxicity of indoxacarb, abamectin, endosulfan, insecticide soap, S-kinoprene and dimethoate to Orius insidiosus (Say) and Aphidius colemani Viereck were studied in the laboratory. These beneficials are often used in the greenhouses to manage various insect pests. Indoxacarb is slow acting and therefore, to estimate lethal dosages, observations should be continued for several days until data stabilize. Seven days after treatment, the LC50 was 0.119 g AI litre(-1) for O insidiosus adults and 0.019 g AI litre(-1) for A colemani. At that time, the recommended field concentration was 0.479 times the LC50 for O insidiosus adults and three times the LC50 for A colemani. In contrast, indoxacarb had no adverse effect on the reproductive capacity of wasps surviving a treatment or the developing wasps in the aphid mummy. Among the other insecticides S-kinoprene was the most innocuous while dimethoate was the most toxic to the two beneficials. The other insecticides had overlapping toxicities.

Animals↗

PubMed2002

Skin cleansing in neonates and infants--basics of cleansers.

OBJECTIVE: Using a proper cleanser for bathing neonatal and infant skin is of prime importance considering the anatomical differences with regard to adult skin. Choosing the right cleanser requires knowledge of the composition of a cleanser as well as the properties of the individual ingredients. METHODS: The article discusses the guidelines for cleansing the skin of neonates and infants. The characteristics of an ideal cleanser for pediatric skin have also been enumerated. RESULTS: In India, majority of cleansers recommended for babies do not mention their active ingredients. Their claims of "mildness" have not been substantiated with clinical studies. Cetaphil, a non-soap, lipid-free liquid cleanser, has been clinically proven to be non-irritating by the Chamber Scarification Test. Moreover, Cetaphil also has a pH of less than 7, which does not alter the physiological pH of skin. CONCLUSION: Hence, Cetaphil should definitely be considered while choosing a cleanser for neonates and infants.

Dermatologic Agents↗

PubMed2002

Role of friction and tangential force variation in the subjective scaling of tactile roughness.

The present study examined the contribution of normal (Fz) and tangential (Fx) forces, and their ratio, kinetic friction (Fx/Fz), to the subjective magnitude estimations of roughness. The results suggested that the rate of variation in tangential stroking force is a significant determinant of roughness perception. In the first experiment, six volunteer subjects scaled the roughness of eight surfaces explored with a single, active scan of the middle finger. The surfaces were 7.5x2.4-cm polymer strips embossed with truncated cones 1.8 mm high with a spatial period of 2.0 mm in the transverse direction and 1.5-8.5 mm in the longitudinal, scanning direction. The surfaces were mounted on a six-axis force and torque sensor that measured the perpendicular, contact force (normal to the skin surface) and the tangential force along the axis of stroking. The results confirmed the findings of an earlier study that magnitude estimates of perceived roughness increase approximately linearly up to a longitudinal spatial period of 8.5 mm. Across subjects, no consistent correlations were found between perceived roughness and either the mean normal or tangential force alone. Although significant positive correlations were found between roughness and mean kinetic friction for all subjects, they were not as consistently robust as one might have expected. Furthermore, instantaneous kinetic friction varied widely over the course of a single stroke because of within trial oscillations in the tangential force. The amplitude of these oscillations increased with the longitudinal spatial period and their frequency was determined by a combination of the spatial period and the stroking velocity. These oscillations were even more conspicuous in the first derivative or rate of change of the tangential force (dFx/d t), which was quantified as the root mean square (RMS) of the tangential force rate. The mean normalized RMS proved to be strongly correlated with subjective roughness, averaging 0.88 for all subjects. In order to dissociate the fluctuations in tangential force from both the surface structure and the mean kinetic friction, a second experiment was performed on six additional subjects who estimated the roughness of identical lubricated and unlubricated (dry) surfaces. Lubrication with liquid soap reduced the mean kinetic friction by approximately 40%, the RMS of the tangential force rate by slightly more than 21% and the subjective estimates of roughness by 16.4%. Taken together, the results suggest that in tactile exploration, the RMS of the tangential force rate may be an important determinant of subjective roughness.

Adult↗

PubMed2001

Prospective randomized comparison of two preoperative skin preparation techniques in a developing world country.

Povidone-iodine (PI) is a scarce and expensive item for some hospitals in developing countries. This prospective, randomized study was performed at Baptist Medical Centre (BMCO) in Ogbomoso, Nigeria to determine if the use of PI for preoperative skin preparation would result in a lower postoperative wound infection rate and to identify other factors influencing the infection rate. Two hundred patients undergoing inguinal hernia repair were randomized to receive skin preparation with either: (1) locally available, inexpensive market soap and methylated spirit or (2) imported PI. The two groups were equally stratified. The overall postoperative wound infection rate was 5.5%, and there was no significant difference between the groups (5.1% vs. 5.9%). Factors that did not affect the infection rate included gender, age, type of anesthesia, type or duration of the operative procedure, and number of breaks in optimal technique. There were eight abscesses and three cases of cellulitis without suppuration diagnosed an average of 10 days postoperatively. Staphylococcus was the only bacterium identified on Gram stain or culture. The expense of procuring PI is not justified at BMCO. Available funds may better be used for preoperative antibiotics or for improvement in hospital infrastructure, which should result in fewer breaks in optimal operating room technique.

Adolescent↗

PubMed2002

[Diffuse lamellar keratitis. Postoperative prophylactic treatment with corticosteroids in an experimental animal study].

PURPOSE: The aim of this experimental ani-mal study was to induce diffuse lamellar keratitis (DLK), and investigate a prophylactic treatment with corticosteroids. MATERIALS AND METHODS: A corneal flap was cut in 40 eyes from 20 Dutch-belted rabbits and the interface inoculated with either Pseudomonas aeruginosa lipopolysaccharide (LPS) endotoxin ( n=21) or Palmolive Ultra soap ( n=19). Half of the eyes were treated with topical corticosteroids and the other half remained untreated. Slitlamp examinations were performed 1, 3, 5 and 7 days postoperatively and DLK was graded from I-IV. RESULTS: At the end of the study 33 eyes were available for evaluation and 94% of the non-treated eyes developed DLK. Out of those eyes treated with steroids 19% developed DLK during the 1 week follow-up period. This was statistically significantly lower ( P=0.018) when compared to the untreated group. CONCLUSION: Pseudomonas aeruginosa LPS endotoxin as well as Palmolive((R)) Ultra caused a very high rate of DLK in rabbit eyes. The postoperative prophylactic treatment with corticosteroids showed a statistically significant lower DLK rate in this rabbit eye model.

Adrenal Cortex Hormones↗

PubMed1981

Prevention of catheter-associated urinary tract infections. Efficacy of daily meatal care regimens.

To evaluate the efficacy of daily cleansing of the urethral meatus-catheter junction in preventing bacteriuria during closed urinary drainage, randomized, controlled trials of two widely recommended regimens for meatal care were completed. In 32 (16.0 percent) of 200 patients given twice daily applications of a povidone-iodine solution and ointment bacteriuria was acquired, as compared with 24 (12.4 percent) of 194 patients not given this treatment. In 28 (12.2 percent) of 229 patients given once daily meatal cleansing with a nonantiseptic solution of green soap and water bacteriuria was acquired, as compared with 18 (8.1 percent) of 23 patients not given special meatal care. There was no evidence in either trial of a beneficial effect of meatal care. Moreover, each of four different statistical methods indicated that the rates of bacteriuria were higher in the treated groups than in the untreated groups. In subsets of female patients at high risk in both studies significantly higher rates of bacteriuria were noted in the treated groups than in the untreated groups. Current methods of meatal care appear to be hazardous, as well as expensive, and cannot be recommended as measures to control infection.

Administration, Topical↗

PubMed1983

Vaginal absorption of hexachlorophene during labor.

Surgical soap that contains hexachlorophene is used as an antiseptic lubricant for vaginal examinations during labor in some centers. Theoretically, hexachlorophene can be absorbed from the vaginal mucosa and be potentially toxic to the fetus and neonate. To evaluate vaginal absorption and placental transfer of hexachlorophene, we measured levels in mixed arterial/venous cord serum and postpartum maternal serum in 28 women whose vaginal examinations were lubricated with pHisoHex during labor. The serum of 12 women had detectable levels of hexachlorophene, with a high level of 942 ng/ml. Cord serum had detectable levels in nine neonates, with a high level of 617 ng/ml. The conclusion is that hexachlorophene from vaginal lubricants is variably absorbed from the vaginal mucosa, and appreciable amounts can be detected in maternal and cord serum. Because of the potential for neonatal hexachlorophene toxicity, we recommend the use of alternative lubricants for pelvic examinations during labor.

Absorption↗

PubMed1984

Determination of trace levels of fatty acid metal salts by high-performance liquid chromatography with fluorescence prelabeling.

A simple method is described for picomole determinations of fatty acid metal salts. Fatty acid salts are directly labeled with 4-bromomethyl-7-methoxycoumarin in the presence of excess ethylenediaminetetraacetic acid tripotassium salt without any solvent extractions. The fluorescence derivatives of fatty acids are separated by reverse-phase high-performance liquid chromatography followed by fluorometric detection. The response of each fatty acid (C8-C18) calcium salt is linear from 1 to 50 micrograms/ml of samples. The detection limit is about 7 pmol. Good recoveries are obtained for the calcium salts of myrystic acid and soap (C8-C18, C18:1,2). The new method is successfully applied to the study on biodegradation of fatty acids in river water.

Biodegradation, Environmental↗

PubMed1993

Effect of heat-curing cycle and gypsum contamination on the bond strengths of composite bonded to a silane-treated alloy.

Silane-coated alloy specimens bonded to composite resin were tested for shear bond strengths and compared with an identical specimen group exposed to gypsum invested heat-processing conditions. The results indicate that the bond of composite resin to silane-coated alloy is not impaired by investing, boil-out, cleaning, packing, and curing during the process of securing artificial teeth to a partial denture framework. In a second part of this study, the alloy specimens were silane-coated and exposed to the gypsum invested heat-processing procedure before the composite resin was bonded to them. In addition, the specimens were exposed to one of three different cleaning agents (ethyl acetate, ethyl alcohol, and soap and water). Results in the second part of the study indicate that ethyl acetate is an effective cleaning agent to use when a silane-coated alloy surface previously exposed to gypsum processing is to be bonded to composite resin.

Acetates↗

PubMed1988

A laboratory model for testing agents for hygienic hand disinfection: handwashing and chlorhexidine for the removal of klebsiella.

A model for the laboratory assessment of hygienic hand disinfection is described which closely reproduces handwashing in a ward setting. The model uses a clinically relevant test organism and takes into account the natural antibacterial action of the skin. It also provides a means of measuring any residual antibacterial action after hand disinfection. Using an epidemic multiply-resistant strain of Klebsiella aerogenes K21, 0.5% chlorhexidine in iso-propyl alcohol yielded sterile post-disinfection finger washings more often than 4% chlorhexidine digluconate. Both preparations were more effective than soap and water, and with each residual action was demonstrable. The model is applicable to the laboratory evaluation of hygienic hand procedures and for agents of potential use in defined clinical settings.

1-Propanol↗

PubMed1990

Hygienic hand disinfection tests in three laboratories.

A comparative study was made in three laboratories of a test for hygienic hand disinfection. Staphylococcus aureus was applied to the fingertips of a total of 74 volunteers (49 female and 25 male) and the effect of washing with three chlorhexidine preparations and one non-medicated soap was assessed after one and five applications. Fingertip inoculation is convenient and is a realistic representation of the in-use situation. Although significant differences were obtained between log10 reductions in test organisms using the same formulation in different centres, and different periods in the same centre, the maximum differences after a single application of a preparation were small, e.g. between centres 0.39 and between periods in the same centre 0.55, and after multiple applications the maximum difference between centres was 0.42 and between periods in the same centre it was 0.51. The differences between preparations were similar in all centres. This test compares well with other similar tests and products can be placed in rank order of effectiveness. It is concluded that this test, if carried out under the controlled conditions described, is sufficiently reproducible between laboratories and repeatable within laboratories to be used as a standard test.

Chlorhexidine↗

PubMed1991

Investigations into the efficacy of different procedures for surgical hand disinfection between consecutive operations.

In order to examine whether thorough surgical hand disinfection (handwashing plus hand disinfection) between consecutive operations is necessary, tests were carried out simulating normal clinical conditions. The tests were performed according to the guidelines for the evaluation of disinfection procedures of the German Society for Hygiene and Microbiology. Surgical hand disinfection was as follows: handwashing with soap without antimicrobial additives and subsequent 5-min disinfection with 60% n-propanol. This was followed by simulated operations of 30 or 120 min duration with a 30-min break between operations, during which half of the test group kept on the surgical gloves, while the other half removed them. The second surgical hand disinfection was done without prior handwashing by 50% of the test group. The disinfection time was reduced from 5 to 1 min by 50% of the test group. The results were evaluated by means of explorative data analysis and inductive statistical methods. Removing the surgical gloves during the interoperative break did not result in significantly higher numbers of colony forming units (cfu) compared with retaining the gloves. This was also the case after a subsequent handwashing. At the second surgical hand disinfection, after a simulated operation of 60 min duration (including break), there was no significant difference in the numbers of cfus between the test group who had washed their hands and those who had not. Reducing the disinfection time from 5 min to 1 min was not associated with a significant increase in the number of cfus. However, after a simulated operating time of 150 min (including the break), the second surgical hand disinfection with handwashing resulted in a significantly lower number of microorganisms than disinfection alone. In half the tests, the numbers of cfu were significantly lower when the test group disinfected their hands for 5 min rather than 1 min.

1-Propanol↗

PubMed1991

A test procedure for evaluating surgical hand disinfection.

A technique for assessing the immediate and prolonged efficacy of surgical scrubs and alcoholic hand rubs is described. A mean baseline count is obtained from all volunteers and logarithmic reductions in resident skin flora immediately after one or more applications, and after wearing gloves for 3 h, are measured. Loose-fitting surgical gloves are used for sampling resident flora. Preparations were applied using a standard technique for 2 min, apart from one test with 70% isopropanol (IPA) in which the application time was 30 s. Two studies are described, one of which compared four chlorhexidine scrubs, and the second 70% IPA, 7.5% povidone-iodine scrub, 2% triclosan cleanser and unmedicated bar soap. In spite of their constituent similarity, the four chlorhexidine scrubs varied considerably in efficacy and user acceptability. A 2 min application of 70% IPA was the most effective treatment, and gave log10 reductions of 1.65 for immediate and 1.58 for prolonged effect. This was marginally more effective than a 30 s application, but the difference was not significant. 'Hibiscrub' was the most effective aqueous formulation and gave reductions of 1.01 for immediate effect and 1.16 for prolonged effect. The test described could be used by reference centres and manufacturers to assess the efficacy of new and existing surgical hand disinfection formulations.

Adolescent↗