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PubMed2005

Preparation of highly monodisperse poly(methyl methacrylate) particles incorporating fluorescent rhodamine 6G for colloidal crystals.

Soap-free emulsion polymerization was extended to preparation of monodisperse poly(methyl methacrylate) (PMMA) particles incorporating rhodamine 6G (R6G) fluorescent molecules. The polymerization was conducted in the presence of an anionic monomer, p-styrenesulfonate (NaSS), which improved dispersion stability of the polymer particles. NaSS concentrations was ranged up to 2 mol/m3 H2O in the polymerization at 0.5 kmol/m3 H2O methyl methacrylate (MMA) monomer and 5 mol/m3 H2O potassium persulfate (KPS) initiator for R6G concentrations from 0.1 to 10 mol/m3-polymer. At R6G concentrations lower than 1.0 mol/m3-polymer, PMMA particles were highly monodisperse and incorporated most R6G molecules. The average sizes of PMMA particles were in a rage of 160-300 nm, and decreased with the concentration of NaSS. The high monodispersity of the particles enabled the fabrication of colloidal crystals of the particles with a vertical deposition method.

Journal Article↗
PubMed2006

Maximum withdrawal speed for Langmuir-Blodgett film deposition of arachidic acid.

The maximum withdrawal speed of Langmuir-Blodgett (LB) film deposition of arachidic acid (AA) was investigated. The quality of LB deposited film was determined by the transfer ratio (TR), together with measurements of surface roughness using atomic force microscopy (AFM). A Langmuir mini-trough was used to provide the surface pressure versus molecular area (pi-A) curves and a flow visualization technique was applied to estimate the dynamic contact angles and to observe the fluid motion. The effects of hydrophobic and hydrophilic substrates, pH and the addition of four different ions, i.e., K+, Ba2+, Cd2+, and Al3+, on the withdrawal speed were examined. The "transition point" from liquid to solid states on the pi-A curve provided a clear indication of the maximum withdrawal speed. The lower the transition point, the higher was the maximum withdrawal speed. Stable deposition was possible only if the pH of the solution was maintained in a narrow range. The observation of dynamic contact angles and fluid motion, particularly the movement of air-liquid interface, was consistent with previous findings. Owing to the "soap effect" of the divalent ions Ba2+ and Cd2+, the maximum speed for successful LB film deposition without significant water entrainment could be extended substantially with the addition of divalent ions.

Journal Article↗
PubMed2006

Initial growth process of polystyrene particle investigated by AFM.

We carried out molecular-scale and in situ investigations of the initial growth process of polystyrene particles in soap-free polymerization, where a cationic initiator, V-50, was used to make the formed particles transfer onto the mica plate in sampling, using an atomic force microscope. It was found that the particles coagulated soon after the nucleation process. Such coagulation was estimated from a macroscopic research, however; microscopic evidence was not enough. This study verifies it from a microscopic view.

Journal Article↗
PubMed2004

Synchrotron FT-IR microscopic study of chemical enhancers in transdermal drug delivery: example of fatty acids.

This article illustrates the analysis by synchrotron infrared microscopy of skin treated with penetration enhancers. Pig skin was treated with two fatty acids commonly employed as penetration enhancers, palmitic (C16) and myristic (C14) acids, in propylene glycol (PG). The use of perdeuterated fatty acid chains enabled the penetrating molecules to be perfectly distinguished from the endogenous lipids due to the difference between C-D and C-H stretching modes. Palmitic acid was detected in the stratum corneum (SC), a particularly alkyl-rich region, whereas myristic acid penetrates deeper into the epidermis. Similar experiments with lead and calcium soaps were also performed, but no detectable signal was observed, indicating a much weaker penetration. Additionally, the C-D2 stretching frequency provides information about the conformational order of the penetrating molecules inside the skin. The results indicate that fatty chains are in an ordered state. The improved spatial resolution allows the determination of both chemical composition and distribution in the different layers, from the SC to the dermis.

Adjuvants, Pharmaceutic↗
PubMed2006

Solid olive waste in environmental cleanup: oil recovery and carbon production for water purification.

A potentially-economic three-fold strategy, to use solid olive wastes in water purification, is presented. Firstly, oil remaining in solid waste (higher than 5% of waste) was recovered by the Soxhlet extraction technique, which can be useful for the soap industry. Secondly, the remaining solid was processed to yield relatively high-surface area active carbon (AC). Thirdly, the resulting carbon was employed to reversibly adsorb chromate ions from water, aiming to establish a water purification process with reusable AC. The technique used here enabled oil recovery together with the production of a clean solid, suitable for making AC. This process also has the advantage of low production cost.

Adsorption↗
PubMed2004

A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization.

Two topical MRSA eradication regimes were compared in hospital patients: a standard treatment included mupirocin 2% nasal ointment, chlorhexidine gluconate 4% soap, silver sulfadiazine 1% cream versus a tea tree oil regimen, which included tea tree 10% cream, tea tree 5% body wash, both given for five days. One hundred and fourteen patients received standard treatment and 56 (49%) were cleared of MRSA carriage. One hundred and ten received tea tree oil regimen and 46 (41%) were cleared. There was no significant difference between treatment regimens (Fisher's exact test; P = 0.0286). Mupirocin was significantly more effective at clearing nasal carriage (78%) than tea tree cream (47%; P = 0.0001) but tea tree treatment was more effective than chlorhexidine or silver sulfadiazine at clearing superficial skin sites and skin lesions. The tea tree preparations were effective, safe and well tolerated and could be considered in regimens for eradication of MRSA carriage.

Administration, Topical↗
PubMed2004

The procedures of hygiene to control hospital-acquired diarrhoea in paediatric wards: a multicentre audit.

An audit was carried out in paediatric wards to study the compliance of healthcare workers (HCWs) to the procedures recommended for the control of hospital-acquired diarrhoea. Thirty-two paediatric wards in the southeast of France participated on a voluntary basis in this prospective observational study after completing a self-administered questionnaire recording measures of hygiene. All the observations were made by the same investigator and focused on preventive procedures: use of single room, handwashing, hand disinfection, overclothing, single-use gloves and masks. Two hundred and seventy patient-HCW contacts were observed, including mainly diapering, temperature measurement, collection of blood sample and catheter care. The isolation of patients in a single room and use of gowns by HCWs were significantly associated with diarrhoea. Whereas handwashing before care was performed by HCWs in more than 95% of all the procedures, the compliance in the use of disposable gloves by HCWs was only of 39.4% for technical procedures (including those with potential exposure to blood) and 20.3% for diapering or temperature measurement. A substantial agreement between reported and observed measures of hygiene was observed for handwashing before contact and hand disinfection with antimicrobial soap before contact. In contrast, this agreement was moderate for use of single room, handwashing after contact, overclothing and wearing disposable gloves after a diaper change. Despite the excellent compliance of HCWs to handwashing, clearer recommendations for the indication and use of disinfectants and disposable gloves are urgently needed.

Child↗
PubMed2004

Metallo-beta-lactamase expressing multi-resistant Acinetobacter baumannii transmitted in the operation area.

Outbreaks of Acinetobacter baumannii demonstrating multiple antibiotic resistance, including meropenem resistance, have been described as severe therapeutic problems. Here we describe a monoclonal outbreak of infection and colonization with multidrug-resistant A. baumannii over a two-month period. Resistance to meropenem was mediated by expression of a metallo-beta-lactamase enzyme. Four of 14 patients showed clinical signs of infection and two died. Contamination of the environment, water, or instruments were excluded as causes of the outbreak. All patients, except one, underwent surgery in a specific operation theatre where surgery of contamination class IV (infected, dirty) was performed. Although individual surgeon error was eliminated, analyses of the patients' histories suggested that bacterial transmission had occurred during surgery. Five patients showed signs of A. baumannii infection and two of these patients suffered from large abdominal wounds infected with a high density of A. baumannii requiring repeated revisions. Presumably, these revisions favoured the transmission of A. baumannii, which is remarkably resistant to various environmental stresses including soaps, disinfectants and dry conditions. No case of meropenem-resistant A. baumannii had been observed in the hospital before the outbreak. Interestingly, the resistant bacteria appear to have been imported by a patient returning from West Africa. This indicates that, similar to MRSA, multiresistant A. baumannii may be introduced by patients from foreign hospitals. The outbreak was stopped in the following months by reinforcing standard procedures and by taking all necessary precautions such as patient isolation, and finally only one new case was detected.

Acinetobacter Infections↗
PubMed2005

Epidemiological investigation of a Serratia liquefaciens outbreak in a neurosurgery department.

Between February 2001 and March 2003, 17 patients from the neurosurgery department of the University Hospital of Rangueil (Toulouse, Southern France) developed Serratia liquefaciens infections. Due to the atypical antibiotype displayed by the clinical isolates (i.e. gentamicin resistance), an outbreak was suspected. Molecular analysis carried out by pulsed-field gel electrophoresis demonstrated a genetic link for all patients. Furthermore, the patient who introduced the epidemic Serratia strain was also identified and shown to be related to the two epidemic peaks observed during the outbreak period. Investigation failed to reveal a reservoir among the antiseptics and soaps, or among the mechanical ventilators used. However, when the colonization of patients was investigated, positive carriage was observed and could be considered as a potential risk for the spread of the epidemic strain. Due to the delay between antibiotherapy and S. liquefaciens colonization, a selection effect had to be considered. Finally, implementation of hygiene measures was accompanied by control of the outbreak.

Anti-Infective Agents, Local↗
PubMed2005

Needlestick injuries in a tertiary care centre in Mumbai, India.

Accidental exposure from blood/body fluid of patients is a risk to healthcare workers (HCWs). Percutaneous injury is the most common method of exposure to blood-borne pathogens. A policy was formulated at our institute, a tertiary care centre in central Mumbai, and we report a six-year (1998--2003) ongoing surveillance of needlestick injuries. Of the 380 HCWs who reported needlestick injuries, 45% were nurses, 33% were attendants, 11% were doctors and 11% were technicians. On source analysis, 23, 15 and 12 were positive for Hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV) and hepatitis C virus (HCV), respectively. Immediate action following potential exposure included washing the wound with soap and water, encouraging bleeding and reporting the incident to the emergency room. Analysis of the source of injuries revealed that known sources accounted for 254 injuries, and unknown sources from garbage bags and Operating Theatre instruments accounted for 126 injuries. Most needlestick injuries occurred during intravenous line insertion (N=112), followed by blood collection (N=69), surgical blade injury (N=36) and recapping needles (N=36). Immediate postexposure prophylaxis (PEP) for HCWs who sustained injuries with hepatitis-B-virus-positive patients included booster hepatitis B immunization for those positive for antiHBs. A full course of immunization with hepatitis B immunoglobulin was given to those who were antiHBs negative. All staff who sustained injury with HIV were given immediate antiretroviral therapy (AZT 600 mg/day) for six weeks. Subsequent six-month follow-up showed zero seroconversion.

Accidents, Occupational↗
PubMed2006

Physician handwashing: what do parents want?

Transmission of micro-organisms from the hands of healthcare workers to patients is a major cause of healthcare-acquired infections. In 2002, the US Centers for Disease Control and Prevention (CDC) published guidelines for healthcare workers that included the recommendation for alcohol-based hand rub for hand hygiene during patient visits. In this prospective study we surveyed parental and healthcare workers' preferences for the hand hygiene practices of emergency physicians. The study comprised 99 parents of ill or injured children presenting to our emergency department and 100 healthcare providers (64 nurses, 29 physicians and seven nurse practitioners) within the department. There was a clear and similar preference by parents and healthcare workers for hand hygiene using soap and water over alcohol cleansing rubs. Furthermore, both groups preferred hand hygiene before and after the examination and wanted to observe the physician perform this procedure. In conclusion, families and healthcare worker preferences for hand hygiene are not in keeping with recommendations published by the CDC. Educational interventions are needed to disseminate the CDC's guidelines and to promote compliance with evidence-based recommendations for hand hygiene.

Adult↗
PubMed2004

Quantitative analysis of cresol and its metabolites in biological materials and distribution in rats after oral administration.

We investigated kinetics of p-cresol, m-cresol, and their glucuronide and sulfate metabolites in blood and organs of rats. We established a quantitative analysis method for the measurement of the concentrations of cresols. Endogenous beta-glucuronidase, an enzyme which hydrolyses the glucuronide, existed in rat organs, and it influenced the procedures for cresol hydrolysis of sulfatase. It was necessary for the quantitative analysis of cresol sulfate in organs to add the saccharolactone (d-saccharic acid 1,4-lactone) as an inhibitor for beta-glucuronidase. On the other hand, endogenous sulfatase did not interfere in the quantitative analysis of the glucuronide. It was found that cresol administered via the stomach tube diffuses directly through gastric and small intestinal walls because the unconjugate cresol concentrations were extremely high not only in the liver, but also in the spleen. The unconjugates of cresol in the liver, spleen and kidney were detected in high concentrations even when the unconjugates were not detected in the blood. m-Cresol was easily metabolized to sulfate, and the p-cresol to glucuronide in rats. The concentration ratios of m-cresol to p-cresol in blood and organs were different from the rate of the cresol soap solution that was administered. The pharmacokinetics was different between p-cresol and m-cresol in rats.

Administration, Oral↗
PubMed2004

Does aqueous or sucralfate cream affect the severity of erythematous radiation skin reactions? A randomised controlled trial.

BACKGROUND AND PURPOSE: Evidence on which to base decisions about the management of radiation skin reactions is lacking. The purpose of this study was to investigate whether sucralfate or aqueous cream reduced acute skin toxicity during radiotherapy to the head and neck, breast or anorectal area (phase A), and to evaluate the effect of hydrogels and dry dressings on moist desquamation (phase B). This paper presents the results of phase A. PATIENTS AND METHODS: Three hundred and fifty seven patients were randomised to apply aqueous cream, sucralfate cream or no cream to the irradiated area from day one of radical radiotherapy treatment. All patients were instructed to wash using unperfumed soap. Acute skin toxicity was measured using a modified radiation therapy oncology group (RTOG) score, reflectance spectrophotometry, patient diary card and dermatology life quality index (DLQI). A cost minimisation approach was used to compare the costs of each skin care approach. RESULTS: No consistent differences were found in the severity of skin reactions or levels of discomfort suffered by patients in each of the randomised groups. Patients with a higher body mass index, who smoked, received concomitant chemotherapy, boost or bolus during treatment were more likely to develop skin reactions. CONCLUSIONS: There is no evidence to support the prophylactic application of either of the creams tested for the prevention of radiation skin reactions. Our results show that it is possible to predict which patients are at greatest risk of skin reactions. We suggest that known risk factors should be incorporated into future study protocols.

Administration, Topical↗
PubMed2005

The association between lead contamination on the hand and blood lead concentration: a workplace application of the sodium sulphide (Na2S) test.

OBJECTIVES: Lead is one of the major causes of workplace poisoning and lead contamination on skin is a possible route of lead absorption. Using a colourimetric method with sodium sulphide (Na2S), we examined whether the lead on skin represents longer-term lead exposure. METHODS: This cross-sectional study of 119 lead-handling workers in a battery recycling plant in Japan was conducted in July 2004. The main outcome measure was skin-colour darkening on the workers' hands, visualised by wetting the seemingly clean hands of the workers with 1% Na2S solution (128 mmol/L): the Na2S test. This study then examined the relationships between the Na2S test results and workers' blood lead concentration (BLC) and hygiene activities. RESULTS: The Na2S test produced skin-colour darkening of the hands of 92 (77%) of the lead workers, although 88 of them had washed their hands with soap and 50 had bathed before taking the test. In the bivariate analyses, a positive result in the Na2S test was associated with not washing hands (p=0.009), not bathing (p=0.061), and a higher BLC (p=0.008). The association between the results of the Na2S test and BLC was still significant in the multivariate linear regression analysis adjusted for age and hand washing (p<0.001). CONCLUSIONS: Lead contamination on workers' hands, otherwise unapparent, was clearly demonstrated by the Na2S test. The result of this test was associated with BLC in addition to the hygiene activities after the last work with lead. As the lead contamination on the hand is persistent, simply encouraging hand washing may not be sufficient to reduce lead intake into body.

Cross-Sectional Studies↗
PubMed2006

Triclosan in plasma and milk from Swedish nursing mothers and their exposure via personal care products.

The bactericide triclosan is commonly used in e.g. plastics, textiles and health care products. In vitro studies on rat and human biological systems indicate that triclosan might exert adverse effects in humans. Triclosan has previously been found in human plasma and milk, but neither the primary source of human exposure nor the efficiency of triclosan transfer to human milk is known. In this study, plasma and milk were sampled from 36 mothers and analyzed for triclosan. Scrutinization of the women's personal care products revealed that nine of the mothers used toothpaste, deodorant or soap containing triclosan. Triclosan and/or its metabolites were omnipresent in the analyzed plasma and milk. The concentrations were higher in both plasma and milk from the mothers who used personal care products containing triclosan than in the mothers who did not. This demonstrated that personal care products containing triclosan were the dominant, but not the only, source of systemic exposure to triclosan. The concentrations were significantly higher in plasma than in milk, indicating that infant exposure to triclosan via breast milk is much less than the dose in the mother.

Anti-Infective Agents, Local↗
PubMed2005

Effect of triclosan (TRN) on energy-linked functions of rat liver mitochondria.

Bisphenols are a class of compounds that exhibit a broad spectrum of antimicrobial activity. One of the most widely used member of this group is triclosan (TRN). TRN is a synthetic, non-ionic, broad-spectrum antimicrobial agent, which is incorporated into several products, including hand soaps and detergents and those of skin care and oral hygiene. The effects of TRN on mitochondrial respiratory parameters and the inner mitochondrial membrane potential (DeltaPsi) are described. That of TRN (up to 60 nmol mg(-1) protein) on isolated liver mitochondria decreased oxygen consumption of state 3 respiration, as well as DeltaPsi, but increased oxygen consumption of state 4 respiration, characteristic of an uncoupler effect. Analysis of segments of the respiratory chain suggested that the TRN inhibition site is located between complexes II and III. Mitochondrial swelling, energized or driven by the K+ diffusion potential using valinomycin, was also inhibited by TRN, the former being completely inhibited at concentrations greater than 10 nmol TRN mg(-1) protein, suggesting that it is also able to interfere with fluidity of the inner mitochondrial membrane. These results suggest that, besides its antibacterial effect, TRN can also impair the mitochondrial function of animal cells.

Animals↗
PubMed2005

Contamination of the nebulization systems used in the prophylaxis with amphotericin B nebulized in lung transplantation.

The contamination of nebulizer may be the origin of respiratory infections. The aim of this study was to determine the incidence of contamination in nebulizers used to nebulize amphotericin B in lung transplant (LT) patients and the relationship with bacterial isolation in sputum culture. A prospective, cross-sectional study was conducted with 41 LT patients who were administered amphotericin B with a jet nebulizer. Samples were taken from the nebulizers (prior to nebulization). Sputum culture was carried out and patients were asked whether or not they followed a cleaning and disinfection protocol (washing and brushing with soap and water followed by subsequent disinfection with the Milton method after each nebulization). Contamination was defined as such when potentially pathogenic bacteria were isolated in the nebulizer. Seventeen of the 41 nebulizers (41.4%) were contaminated. In 7 of the 17 cases (41.1%) contamination was polymicrobial. The most common microorganism was Pseudomonas aeruginosa. Fourteen of the 41 patients (34.1%) presented positive sputum cultures, most common was P aeruginosa. In 10 patients (24.3%) pathogenic bacteria was isolated both in the nebulizer and in the sputum. In four of these patients (9.7%) the species was the same. The cleaning and disinfection protocol was carried out by 16 of the 41 patients (39.0%). In 2 of the 16 patients (12.5%) who were following the protocol the nebulizer was contaminated, compared to 15 of 25 patients (60.0%) whose nebulizer was not contaminated (P < .05). Two of the 16 patients (12.%) who were following the protocol presented positive sputum culture compared to 12 of 25 (48.0%) who did not (P < .05). In conclusion, the contamination of the nebulizing systems is frequent when no strict cleaning and disinfection protocol is followed. Patients who did not follow the protocol presented a greater isolation of pathogenic bacteria in the sputum.

Amphotericin B↗
PubMed2005

Campylobacter species and drug resistance in a north Indian rural community.

Campylobacter species are known as agents of enteritis worldwide. However, rural community-based studies on Campylobacter infections are lacking. We carried out a prospective case-control study from July to December 2002 to investigate the prevalence and socio-epidemiological determinants of Campylobacter infection in a rural community in north India and the drug resistance of Campylobacter strains isolated from the community. Stool specimens from 348 subjects with diarrhoea and 351 age- and gender-matched asymptomatic controls were cultured for Campylobacter, Salmonella and Shigella. All Campylobacter strains were identified and tested for antibiotic susceptibility. Campylobacter species were isolated from 47 (13.5%) subjects with diarrhoea and 2 (0.6%) asymptomatic controls respectively (P<0.001). Campylobacter infection was significantly higher in children aged less than 5 years, families engaged in agriculture and persons who did not wash their hands with soap after peri-anal washing following defaecation. Campylobacter infections were more frequent than combined Salmonella and Shigella infections (47/348 vs. 15/351; P<0.001) in subjects with diarrhoea. Only two Campylobacter-infected individuals with diarrhoea had bloody stools. Antibiotic resistance of Campylobacter species was as follows: ampicillin 81.6%, ciprofloxacin 71.4%, tetracycline 26.5%, furazolidine 14.3%, gentamicin 10.2% and erythromycin 6.1%; 30.6% of strains were multidrug resistant. Increased quinolone resistance and multidrug resistance pose major risks for treatment failure.

Adolescent↗