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At least 1,423 records · Page 79Linked to original sources
PubMed1994

Solubilization of keratin debris in conservative treatment of middle ear cholesteatoma: an in vitro study.

A variety of solutions were tested in vitro to find a suitable solvent which could be used in clinical practice for cholesteatoma debris. Though a little weak as a solvent, a liquid soap composed mainly of plant oil did not cause irritation of the middle ear mucosa, and was thought to be a promising solvent with which to rinse away tenacious debris, especially when used in combination with hydrogen peroxide.

Cholesteatoma↗
PubMed1986

Increasing handwashing in an intensive care unit.

The present study provides the first systematic evaluation of strategies for increasing handwashing of hospital staff. Nursing staff on two intensive care units (ICUs) were observed over a 3-month period. After baseline observations, two interventions were implemented on the experimental unit: changing to an emollient handwashing agent, and providing feedback to staff about the frequency of handwashing. Feedback focused on the previous day's handwashing following completed patient contacts, interrupted patient contacts, and critical procedures. No increase in handwashing was observed following introduction of the emollient soap. However, when feedback was provided on the experimental ICU, handwashing following completed patient contacts (the major dependent measure) increased to 92%, and was significantly higher than handwashing on the control unit. Follow-up observations suggested that compliance on the experimental unit appeared to return to baseline levels.

Cross Infection↗
PubMed1987

Evaluation of the skin disinfecting activity and cumulative effect of chlorhexidine and triclosan handwash preparations on hands artificially contaminated with Serratia marcescens.

The initial and cumulative efficacy of two antiseptic handwash preparations in eliminating Serratia marcescens from hands was evaluated on volunteers. Two antiseptics with persistent skin antibacterial activity, 4% chlorhexidine gluconate in detergent and 1.5% triclosan in natural soap, were studied in a new protocol designed according to Food and Drug Administration guidelines. After a single handwash, both preparations exhibited a degerming action statistically superior to the mechanical elimination of the marker organism that was achieved by the nonmedicated controls. Following a further nine hand recontamination sequence with 10(9) colony-forming units (cfu)/mL S marcescens (mean predisinfection baseline, log10 6.6), the efficacy of chlorhexidine and triclosan was significantly augmented: the mean log10 reduction factors were 4.15 and 3.78, respectively. In the absence of internationally accepted testing standards for antiseptic handwash products, the significance of protocol variables is discussed. The advantages to preventative microbiology of antiseptics with persistent skin antibacterial activity are highlighted.

Chlorhexidine↗
PubMed1978

Spin-label and deuterium order parameter discrepancies in bilayers: one possible explanation.

We have simulated electron spin resonance spectra of anisotropically immobilized spin labels of the type seen in lipid and soap-like bilayers using a rigorous formalism which explicitly includes the effects of spin-label motion. In most bilayer systems, spin-label experiments have shown lower order parameters then deuterium-label experiments. In the past this apparent decrease in the order parameters was thought to reflect the distortion of the bilayer by the doxyl ring of the spin probes. We wish to report that this type of discrepancy may be due to the neglect of important motional effects in the time-independent effective Hamiltonian formalisms used in previous interpretations of anisotropically immobilized spin label spectra. That the true order parameters may be the same can be shown by including slow motional corrections in the effective Hamiltonian formalism. The larger volume of the doxyl ring may change the apparent order parameter by increasing the importance of the slow motional effects, as opposed to causing a real decrease in the order parameter, as previously proposed.

Chemical Phenomena↗
PubMed2002

Intra-laboratory reproducibility of the hand hygiene reference procedures of EN 1499 (hygienic handwash) and EN 1500 (hygienic hand disinfection).

The bactericidal efficacy of hand antiseptic products is determined in Europe using two norms--EN1499 (hygienic handwash), and EN 1500 (hygienic hand disinfection) based on reducing the counts of bacteria on artificially contaminated hands. Each requires 12-15 data sets per test and comparison with a reference procedure. Recent research using EN 1500 suggested that most alcohol-based hand gels are significantly less effective than the reference alcohol (2-propanol 60%), whereas liquid alcohol-based rubs are not. However concerns about the accuracy and reproducibility of the norm reference procedures have been raised. We therefore analysed 23 experiments carried out using EN 1500 representing 342 hand disinfection procedures, and 12 experiments using EN 1499 representing 178 handwashes, all performed in the same laboratory for reproducibility of the reference procedures. The reference alcohol gave a mean log(10) reduction factor (RF) of 4.64 +/- 0.93; only one data set gave a significantly higher result (5.14, P = 0.034), and one significantly lower (4.05; P = 0.034). Analysis of all 23 means revealed no significant difference (P = 0.188; ANOVA model). The reference soap gave a mean reduction of 2.82 +/- 0.49. Two data sets were significantly higher than this (3.35,P < 0.001; 3.12, P < 0.001) and two significantly lower (2.55, P = 0.031; 2.47,P = 0.004). Analysis of all the means did reveal a significant difference (P < 0.001, ANOVA model), which is probably explained by the smaller standard deviations of these results. Pre-values (bacteria recovered from fingers before a reference procedure) correlated significantly with RFs for both hand disinfection (correlation coefficient: 0.291;P = 0.01) and handwash (correlation coefficient: 0.372, P = 0.01). Overall both procedures gave accurate and reproducible results.

Analysis of Variance↗
PubMed1984

[Iodine resorption from PVP-iodine preparations after their use in humans].

The absorption of iodine from iodine-containing PVP preparations and the possibility of iodide being split off from the organic compound were tested in subjects with normal thyroid function after they had used PVP-iodine as mouth-antiseptic (15 subjects), vaginal gel (20 subjects) or liquid soap (20 subjects). Serum I-, T3, T4, TSH and urinary iodide excretion were measured, as an index of thyroid function, before and after the PVP application. Increase in iodine supply was up to 2 mg daily in the test subjects. The overwhelming proportion of the absorbed iodine (greater than 75%) was as organically bound iodine. In none of the subjects was there evidence of developing hyper- or hypothyroidism as a result of the additional iodine supply. Approximate values for the biological half-life and the distribution volume of total iodine in the body were also obtained.

Absorption↗
PubMed2001

Pruritus vulvae in prepubertal children.

BACKGROUND: Vulvar pruritus is a common complaint in females of all ages. However, little has been published on pruritus vulvae in children as a primary symptom. OBJECTIVE: Our purpose is to review the causes and treatments of vulvar pruritus in prepubertal girls and to retrospectively evaluate the causes and outcomes of the premenarchal children we studied. METHODS: The records of 44 premenarchal girls with vulvar pruritus were reviewed, and follow-up interviews were performed by telephone. RESULTS: Thirty-three patients (75%) had nonspecific pruritus. Lichen sclerosus, bacterial infections, yeast infection, and pinworm infestation were seen in a minority of patients. At follow-up, pruritus had cleared in 15 patients, been alleviated in 13, and remained the same in 4. CONCLUSION: Most of our patients had nonspecific pruritus, which was alleviated by or cleared with better hygiene and avoidance of irritants. In prepubertal girls, poor hygiene and irritants such as soap are major contributors to pruritus vulvae. All patients may benefit from following hygienic measures and irritant precautions in addition to specific therapy directed at underlying causes.

Adolescent↗
PubMed1990

Personal hygiene in external genitalia of healthy and hospitalized elderly women.

A comparative study of the personal hygiene of two groups of elderly women was carried out in Orebro, Sweden. The investigation group consisted of 28 women who were hospitalized in long-term care wards and the comparison group consisted of 35 healthy women. The results show that a remainder of soap in the genitalia may be one factor contributing to elderly hospitalized women's discomfort. Caregivers should be educated in how to assist elderly hospitalized women with their personal hygiene.

Aged↗
PubMed1990

Percutaneous absorption and skin decontamination of PCBs: in vitro studies with human skin and in vivo studies in the rhesus monkey.

Knowledge of the entry of polychlorinated biphenyls through the skin into the body and subsequent disposition aids estimation of potential for human health hazard. [14C]Aroclor 1242 and [14C]Aroclor 1254 were separately administered intravenously and topically to rhesus monkeys. Following iv administration, 30-d excretion was 39.4 +/- 5.9% urine and 16.1 +/- 0.8% feces (total 55.5 +/- 5.1%) for Aroclor 1242, and 7.0 +/- 2.2% urine and 19.7 +/- 5.8% feces (total 26.7 +/- 7.5%) for Aroclor 1254. Mineral oil and trichlorobenzene are common PCB cosolvents in transformers. Skin absorption of Aroclor 1242 was 20.4 +/- 8.5% formulated in mineral oil and 18.0 +/- 3.8% in trichlorobenzene (p greater than .05). Absorption of Aroclor 1254 was 20.8 +/- 8.3% in mineral oil and 14.6 +/- 3.6% in trichlorobenzene (p greater than .05). PCBs are thus absorbed through skin, and excretion from the body is slow. Vehicle (trichlorobenzene or mineral oil) did not affect percutaneous absorption. In vitro skin absorption in human cadaver skin did not correlate with in vivo findings. This was due to lack of PCB partition from skin into the water receptor fluid, even with addition of 6% Oleth 20 (Volpo 20) solubilizer. Skin decontamination of PCBs showed soap and water to be as effective as or better than the solvent ethanol, mineral oil, and trichlorobenzene in removing PCBs from skin. There is a dynamic time lapse for PCBs between initial skin contact and skin absorption (irreversible removal). Thus initially most PCBs could be removed from skin, but this ability decreased with time to the point where at 24 h only about 25% of the initial PCB skin dose could be recovered with skin washing.

Administration, Topical↗
PubMed2003

Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital.

We determined risk factors for hand contamination and compared the efficacy of 3 randomly allocated hand hygiene agents in a group of surgical intensive care unit nurses. We cultured samples of one of the subjects' hands before and samples of the other hand after hand hygiene was performed. Ring wearing was associated with 10-fold higher median skin organism counts; contamination with Staphylococcus aureus, gram-negative bacilli, or Candida species; and a stepwise increased risk of contamination with any transient organism as the number of rings worn increased (odds ratio [OR] for 1 ring worn, 2.6; OR for >1 ring worn, 4.6). Compared with use of plain soap and water, hand contamination with any transient organism was significantly less likely after use of an alcohol-based hand rub (OR, 0.3; 95% confidence interval [CI], 0.1-0.8) but not after use of a medicated hand wipe (OR, 0.9; 95% CI, 0.5-1.6). Ring wearing increased the frequency of hand contamination with potential nosocomial pathogens. Use of an alcohol-based hand rub resulted in significantly less frequent hand contamination.

Alcohols↗
PubMed1999

Bacterial contamination of hospital physicians' stethoscopes.

Because stethoscopes might be potential vectors of nosocomial infections, this study, conducted in a 450-bed general hospital, was devised to evaluate the bacterial contamination of stethoscopes; bacterial survival on stethoscope membranes; the kinetics of the bacterial load on stethoscope membranes during clinical use; and the efficacy of 70% alcohol or liquid soap for membrane disinfection. Among the 355 stethoscopes tested, 234 carried > or =2 different bacterial species; 31 carried potentially pathogenic bacteria. Although some bacteria deposited onto membranes could survive 6 to 18 hours, none survived after disinfection.

Bacteria↗
PubMed2007

Multicenter intervention program to increase adherence to hand hygiene recommendations and glove use and to reduce the incidence of antimicrobial resistance.

OBJECTIVE: To determine whether a multimodal intervention could improve adherence to hand hygiene and glove use recommendations and decrease the incidence of antimicrobial resistance in different types of healthcare facilities. DESIGN: Prospective, observational study performed from October 1, 1999, through December 31, 2002. We monitored adherence to hand hygiene and glove use recommendations and the incidence of antimicrobial-resistant bacteria among isolates from clinical cultures. We evaluated trends in and predictors for adherence and preferential use of alcohol-based hand rubs, using multivariable analyses. SETTING: Three intervention hospitals (a 660-bed acute and long-term care hospital, a 120-bed community hospital, and a 600-bed public teaching hospital) and a control hospital (a 700-bed university teaching hospital).Intervention. At the intervention hospitals, we introduced or increased the availability of alcohol-based hand rub, initiated an interactive education program, and developed a poster campaign; at the control hospital, we only increased the availability of alcohol-based hand rub. RESULTS: We observed 6,948 hand hygiene opportunities. The frequency of hand hygiene performance or glove use significantly increased during the study period at the intervention hospitals but not at the control hospital; the maximum quarterly frequency of hand hygiene performance or glove use at intervention hospitals (74%, 80%, and 77%) was higher than that at the control hospital (59%). By multivariable analysis, preferential use of alcohol-based hand rubs rather than soap and water for hand hygiene was more likely among workers at intervention hospitals compared with nonintervention hospitals (adjusted odds ratio, 4.6 [95% confidence interval, 3.3-6.4]) and more likely among physicians (adjusted odds ratio, 1.4 [95% confidence interval, 1.2-1.8]) than among nurses at intervention hospitals. A significantly reduced incidence of antimicrobial-resistant bacteria among isolates from clinical culture was found at a single intervention hospital, which had the greatest increase in the frequency of hand hygiene performance. CONCLUSIONS: During a 3-year period, a multimodal intervention program increased adherence to hand hygiene recommendations, especially to the use of alcohol-based hand rubs. In one hospital, a concomitant reduction was found in the incidence of antimicrobial-resistant bacteria among isolates from clinical cultures.

Alcohols↗
PubMed1997

No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance?

Handwashing is the most important and least expensive measure to prevent transmission of nosocomial infections. However, compliance rarely exceeds 40% under study conditions. Alcoholic hand disinfection (AHD) generally is used in Europe. In contrast, handwashing with medicated soap is practiced most frequently in the United States. Healthcare workers often explain the failure to comply with handwashing or AHD as due to the limited time available for this practice. We calculated a time consumption for handwashing and AHD in a representative model intensive-care unit with 12 healthcare workers, based on different compliance levels (40%, 60%, and 100%), duration of handwashing (40-80 seconds), and AHD (20 seconds). Comparing the extremes of our model, given 100% compliance, handwashing consumes 16 hours of nursing time per day shift, whereas AHD from a bedside dispenser requires only 3 hours (P = .01). We conclude that 100% compliance with handwashing may interfere with patient care and parltly explains the low compliance. In contrast, AHD, with its rapid activity, superior efficacy, and minimal time commitment, allows 100% healthcare-worker compliance without interfering with the quality of patient care.

Alcohols↗
PubMed1986

Colitis after Hibiclens enema.

Acute colitis occurred after a Hibiclens cleanser enema. Endoscopic and histologic features were not helpful in distinguishing this colitis from an infectious or idiopathic colitis, and a careful history proved invaluable. We review the complications of using soapsuds and various chemical-containing enemas; these complications range from mild colitis to death. Because soap and other chemicals are damaging to colonic mucosa, these enemas should be included as a cause of acute colitis.

Biopsy↗
PubMed1988

Terminal behaviour of deforming bullets.

Some types of deforming bullets, including soft-point hunting ammunition and so-called shotgun slugs, were fired against blocks of soft soap and against the muscular parts of the hind legs of live, anesthetised pigs. The deformation, breakup, and retardation of the bullets within the targets were recorded by means of a multi-flash X-ray setup. The extent of the soft-tissue damage was evaluated by means of debridement performed by a highly skilled surgeon. The excised tissue was then accurately weighed. The potential to transfer energy of these bullets was, as could be anticipated, extremely high, and the injuries caused were very large. The relations between bullet velocity, construction, deformation, breakup, and the resulting injuries are discussed.

Animals↗
PubMed1988

Wound ballistics of Swedish 5.56-mm assault rifle AK 5.

The recently adopted Swedish standard 5.56-mm assault rifle Ak 5, with ammunition 5.56-mm sk ptr 5 stkprj, closely similar to the Belgian weapon FNC, with corresponding ammunition SS 109, was fired against blocks of soft soap and against the muscular parts of the hind legs of live, anesthetised pigs. The behaviour and retardation of the bullets within the targets were recorded by means of a stereo, multiflash X-ray setup. The extent of the soft-tissue damage was evaluated in sections by means of debridement performed by a highly skilled surgeon. The excised tissue was then accurately weighed. The energy transfer characteristics and the wounding potential of the weapon are discussed.

Animals↗
PubMed1988

Some observations relating to behind-body armour blunt trauma effects caused by ballistic impact.

Live, anesthetised pigs were used to assess behind-armour blunt trauma effects. The thoraco-abdominal body region was covered with varying thicknesses of Kevlar fabric packets. This soft body armour was applied, either in direct contact with the thoracic wall of the animals, or with different plastic foam sheets, so-called trauma packs, between the armour and the skin. The live animals were surgically evaluated, and then sacrificed. Blocks of soft soap were subjected to equal tests and the behind-armour indentations were measured. The results indicate that serious injury to the body armour-protected chest may be caused by the impact of nonpenetrating bullets and shotgun pellets. Severe pulmonary contusions and lacerations were found when the energy transferred through the body armour was estimated to be high.

Abdominal Injuries↗
PubMed1980

Skin decontamination of commonly used medical radionuclides.

The increasing use of radionuclides in medical diagnosis raises the possibility of accidental spills and skin contamination. This study was performed to evaluate the effectiveness of several decontaminating agents. Most nuclides were easily removed to levels of less than 5% of their original activity. Sodium pertechnetate (Tc-99m) was the most difficult compound to remove. Little difference was found between the effectiveness of tap water, soap and water, and two commercially available decontaminating agents.

Decontamination↗