[Antimicrobial sensitivity of the environmental microbiota in the intensive care units of a peruvian hospital].

Science.gov (United States)

Díaz-Tello, José; Rojas-Jaimes, Jesús; Ibarra-Trujillo, Jimmy; Tárraga-Gonzales, Delza

2017-01-01

The objective was to detect Gram-negative bacilli and Gram-positive cocci isolated from the environmental microbiota of the Intensive Care Unit (ICU) departments of Neonatology, Pediatrics, and Transplants (kidney, liver, and general) in a Lima hospital and determine their antimicrobial sensitivity. Eighty samples were obtained from inanimate surfaces using a wet swab. A total of 61 bacterial strains were identified, including Staphylococcus epidermis (46.0%), Alcaligenes sp. (21.3%), Pseudomonas aeruginosa (16.4%), Acinetobacter sp. (13.1%), Staphylococcus aureus (1.6%), and Staphylococcus haemolyticus (1.6%). Acinetobacter sp. and P. aeruginosa showed a heightened sensitivity to the antibiotics assessed, while Alcaligenes sp. and S. epidermidis presented the highest antimicrobial resistance. It is recommended that sustained asepsis and monitoring methods be used in ICUs.

Standard guidelines for setting up a dermatosurgery theatre

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Rajendran S

2009-08-01

Full Text Available Introduction, definition, rationale and scope: Dermatologists in India are now increasingly performing surgical and cosmetic procedures in their practice. This calls for minimum standards at the national level with the main focus of patient safety and hence the guidelines for setting up a dermatosurgical theatre. Facility: The dermatosurgery theatre can be created in either physician′s clinic, or a hospital depending on the procedure to be performed. The dermatosurgery theatre requires careful planning with regards to - location, dimension, shell design, lighting, electrical requirements, operation table, chair, trolley, surgical instruments, sterilization of devices, asepsis and advanced life support. Apart from physical considerations, other considerations including theatre etiquettes, consent for surgery, safety of dermatosurgeon, theatre staff and lastly biomedical waste management should be looked into. These issues are discussed in detail in the recommendations.

The core competencies of James Marion Sims, MD.

Science.gov (United States)

Straughn, J Michael; Gandy, Roy E; Rodning, Charles B

2012-07-01

The concept of core competencies in graduate medical education was introduced by the Accreditation Council for Graduate Medical Education of the American Medical Association to semiquantitatively assess the professional performance of students, residents, practitioners, and faculty. Many aspects of the career of J. Marion Sims, MD, are exemplary of those core competencies: MEDICAL KNOWLEDGE: Author of the first American textbook related to gynecology. MEDICAL CARE: Innovator of the Sims' Vaginal Speculum, Sims' Position, Sims' Test, and vesico-/rectovaginal fistulorrhaphy; advocated abdominal exploration for penetrating wounds; performed the first cholecystostomy. PROFESSIONALISM: Served as President of the New York Academy of Medicine, the American Medical Association, and the American Gynecologic Society. INTERPERSONAL RELATIONSHIPS/COMMUNICATION: Cared for the indigent, hearthless, indentured, disenfranchised; served as consulting surgeon to the Empress Eugénie (France), the Duchess of Hamilton (Scotland), the Empress of Austria, and other royalty of the aristocratic Houses of Europe; accorded the National Order of the Legion of Honor. PRACTICE-BASED LEARNING: Introduction of silver wire sutures; adoption of the principles of asepsis/antisepsis; adoption of the principles of general anesthesia. SYSTEMS-BASED PRACTICE: Established the Woman's Hospital, New York City, New York, the predecessor of the Memorial Sloan-Kettering Center for the Treatment of Cancer and Allied Diseases; organized the Anglo-American Ambulance Corps under the patronage of Napoleon III. What led him to a life of clinical and humanitarian service? First, he was determined to succeed. His formal medical/surgical education was perhaps the best available to North Americans during that era. Second, he was courageous in experimentation and innovation, applying new developments in operative technique, asepsis/antisepsis, and general anesthesia. Third, his curiosity was not burdened by rigid

[Discoveries and techniques that have contributed to improving the treatment of pancreatic diseases].

Science.gov (United States)

Navarro, Salvador

2015-05-01

Due to its retroperitoneal location, the pancreas has historically been a mysterious organ that is difficult to examine and which complicates treatment. The discovery of anesthesia and asepsis in the mid-19th century allowed laparotomic diagnosis, which was previously only possible at autopsy. The expectations of surgery were improved by the detection of blood groups, vitamin K synthesis, and the development of intensive care units. In addition, high levels of presurgical diagnosis and an unquestionable improvement of its results were enabled by advances in laboratory methods (serum quantification of amylase and lipase, tumoral markers, genetics, and techniques for measuring exocrine pancreatic function), imaging and endoscopic modalities, and fine tuning of surgical techniques. In this article, we review the history of the main milestones that have allowed progress in all these aspects. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

Development and (evidence for) destruction of biofilm with Pseudomonas aeruginosa as architect

Science.gov (United States)

Uzcategui, Valerie N.; Donadeo, John J.; Lombardi, Daniel R.; Costello, Michael J.; Sauer, Richard L.

1991-01-01

Disinfection and maintenance of an acceptable level of asepsis in spacecraft potable water delivery systems is a formidable task. The major area of research for this project has been to monitor the formation and growth of biofilm, and biofilm attached microorganisms, on stainless steel surfaces (specifically coupons), and the use of ozone for the elimination of these species in a closed loop system. A number of different techniques have been utilized during the course of a typical run. Scraping and sonication of coupon surfaces with subsequent plating as well as epifluorescence microscopy have been utilized to enumerate biofilm protected Pseudomonas aeruginosa. In addition, scanning electron microscopy is the method of choice to examine the integrity of the biofilm. For ozone determinations, the indigo decolorization spectrophotometric method seems most reliable. Both high- and low-nutrient cultured P. aeruginosa organisms were the target species for the ozone disinfection experiments.

Basque Museum of the History of Medicine: conservation of heritage, teaching and research.

Science.gov (United States)

Erkoreka, Anton

2009-01-01

The Basque Museum of the History of Medicine was founded in 1982 to preserve the historic memory of medicine in the Basque Country and conserve its scientific heritage. Its permanent exposition comprises approx. 6,000 medical objects of the 19th and 20th centuries arranged, thematically in 24 rooms devoted to different medical specialities: folk medicine, unconventional medicine, pharmacy, weights and measures, asepsis and antisepsis, microscopes, laboratory material, X-rays, obstetrics and gynaecology, surgery, anesthesia, endoscope, odontology, cardiology, ophthalmology, electrotherapy, pathological anatomy and natural sciences. Temporary exhibitions are also held. The Museum is located on the university campus (UPV/EHU) and is important in the training of students in the Faculty of Medicine and the students coming from other faculties. Teaching and research constitute two of the pillars of the Museum that are complemented with publications and the organization of conferences, lectures and other activities.

[From manual workshop to international standard maker: exploration on production standard of acupuncture needle by Chengjiang acupuncture school].

Science.gov (United States)

Cheng, Jie; Cao, Yang; Xia, Youbing

2015-02-01

ABSTRACT The exploration course on production standard of acupuncture needle by Chengjiang acupuncture school is reviewed in this paper. After new China was established, acupuncture needle standard was unified by Mr. CHENG Dan-an, which guided Suzhou Hua Erfang (predecessor of Suzhou Medical Supplies Factory) to make the quality standards and testing methods of acupuncture needle and improved the production process to make the modern acupuncture needle. Based on this, Suzhou Medical Supplies Factory followed the time development pace, ac tively introduced new technology, carried out technological innovation, and constantly improved the level of production technology, as a result, it gradually developed into one of the world's largest acupuncture needle production suppliers. Meanwhile, after establishing China's first national standard on acupuncture needle (GB 2024-1980), the Suzhou Medical Supplies Factory took the lead to draft "ISO) 17218:2014 the disposable use asepsis acupuncture needle", which was officially published as an international standard. The Suzhou Medical Supplies Factory developed from a manual workshop to an international standard maker.

Sternal reconstruction after post-sternotomy mediastinitis

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Pankaj Kaul

2017-11-01

Full Text Available Abstract Background Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text. Methodology and review This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and management of deep sternal wound infections and mediastinitis after cardiac surgery. The role of negative pressure wound therapy and initial and delayed surgical management is discussed with special emphasis on plastic techniques with muscle and omental flaps. Recent advances in reconstructive surgery are presented. Conclusions Deep sternal wound complications no longer spell debilitating morbidity and high mortality. Better understanding of risk factors that predispose to deep sternal wound complications and general improvement in theatre protocols for asepsis have dramatically reduced the incidence of deep sternal wound complications. Negative pressure wound therapy and appropriately timed and staged muscle or omental flap reconstruction have transformed the outcomes once these complications occur.

Diskitis, Osteomyelitis, Spinal Epidural Abscess, Meningitis, and Endocarditis Following Sacroiliac Joint Injection for the Treatment of Low-Back Pain in a Patient on Therapy for Hepatitis C Virus.

Science.gov (United States)

Nagpal, Geeta; Flaherty, John P; Benzon, Honorio T

Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection. The patient was on treatment for hepatitis C virus, and the resulting immunocompromised state likely contributed to the outcome. Immunocompromised patients should be identified prior to treatment, and the small possibility of devastating complications should be thoughtfully weighed against the potential benefit of the procedure. Conservative management should be maximized initially, and if a procedure is done, strict asepsis must be maintained. Prophylaxis for S. aureus should be considered for immunocompromised patients undergoing interventional spine procedures.

MICROBIOLIZATION WITH TRICHODERMA SPP., COMBINED OR NOT WITH POLYMER, ON THE HEALTH, GERMINATION AND VIGOR OF BLACK OATS AND BARLEY SEEDS

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E. R. Baseggio

2017-12-01

Full Text Available The use of bioprotectors in the coating of seeds is increasing, and these become an alternative for the use of chemical fungicides. The aim of this work was to evaluate the use of Trichoderma spp., with or without polymerization, in the control of pathogens associated with black oats (Avena strigosa and barley (Hordeum vulgare seeds of the cultivars 'Comum' (black oats and BRS Cauê (barley, 2014 crop. After asepsis and dried of the seeds, the treatments were applied, using a dose of 5 mL of Trichoderma spp. kg-1 and 10 mL of seed polymer kg-1 of seeds. Sanity tests; germination; germination and emergency rate index; length of seedling (shoot and root; and fresh and dry weight were performed. The coating of oat and barley seeds with Trichoderma spp. was efficient in the control of pathogens, as well as increased the germination and development of the seedlings for both cultures evaluated.

A Study to Assess the Association of Aseptic Practices Being Followed and its Effect on the Overall Outcome of Selected Special Care Newborn Units (SCNUs of Madhya Pradesh at Different Levels.

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Mahore RK

2015-04-01

Full Text Available The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs have been set up at different levels of Health Care Delivery System to provide quality newborn-care services in several hospitals to meet this challenge. Many units are located in the districts where the burden of neonatal deaths is high, and access to special newborn care is poor. The study was conducted to assess the functioning of SCNUs in six centers of India. The evaluation was based on an analysis of secondary data from the six units that had been functioning for at least three year. A cross-sectional survey was also conducted to assess the availability of Quality care and Aseptic practices implemented at different levels of SNCUs. Descriptive statistics were used for analyzing the inputs (Quality care and aseptic practices and outcomes (morbidity and mortality. The rate of mortality among admitted neonates was taken as the key outcome variable to assess the performance of the units. Chi-square test was used for analyzing the trend of case-fatality rate over a period of 3 years considering the first year of operationalization as the base. Correlation coefficients were estimated to understand the possible association of case-fatality rate with factors, such as bed:doctor ratio, bed:nurse ratio, average duration of stay, and bed occupancy rate, and the asepsis score was determined. The rates of admission increased from a median of 16.7 per 100 deliveries in 2012 to 19.5 per 100 deliveries in 2014. The case-fatality rate shows progressive decline in all the units in Last 3 years. Proportional mortality due to sepsis and low birthweight (LBW declined significantly over two years (LBW <2.5 kg. The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. The units had a varying nurse:bed ratio (1:1-1:2.14. The bed occupancy rate ranged from 83% to 121% (median 115%, and the average duration of stay

Alexis Carrel (1873-1944): visionary vascular surgeon and pioneer in organ transplantation.

Science.gov (United States)

Aida, Lai

2014-08-01

Alexis Carrel was a French surgeon in the 20th century. He made significant contributions to many advances in the fields of vascular surgery, cardiothoracic surgery and organ transplantation. He demonstrated that blood vessels can be united end-to-end and pioneered the triangulation suturing technique in vascular anastomosis. The methods he developed are still in use to this day. He insisted on the importance of absolute asepsis in vascular surgery when such practices were almost unheard of. He was also considered the father of solid organ transplantation. He was awarded the Nobel Prize in recognition of his work. Together with Charles Lindbergh, he developed the extracorporeal perfusion pump to keep organs alive outside the human body. His contribution to medicine also extended to tissue culture and wound management. He was one of the most controversial figures of his generation, believing in the idea of genetic superiority and eugenics and he was associated with fascism in the 1930s. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Applications of Midwives and Nurses Working at Pediatrics Clinics to Patients Security

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Fatma Tas Arslan

2014-06-01

RESULT: The research 77.9% of them work as a nurse and %66.1 of them obtain information about patient security. In the applications to the patient security, and ldquo;I give the patients arm band and rdquo; constitutes 54. 1,% and ldquo;I have the concerned doctor sign the oral order form in 24 hours at the latest after it is filled and rdquo; constitutes 73.8%, and ldquo; I evaluate the patients in view of the risk of falling down and rdquo; constitutes 86.1%, and ldquo; I pay attention to asepsis in all invasive attempts and rdquo; constitutes 91% are among the regular ones. It was found out that among the nurses and midwives, 19 out of 103 made medical error during a year. CONCLUSiON: it has been achieved that nurses and midwives have different roles and pay attention to preventing the patients from falling down, providing the communication security, providing the infection security, providing the medicine security. It is thought that they should be supported in respect to identifying and confirming the patients ID [TAF Prev Med Bull 2014; 13(3.000: 209-216

The issue of delivery room infections in the Italian law. A brief comparative study with English and French jurisprudence.

Science.gov (United States)

Zaami, Simona; Montanari Vergallo, Gianluca; Napoletano, Simona; Signore, Fabrizio; Marinelli, Enrico

2018-01-01

Delivery room infections are frequent, and many of them could be avoided through higher standards of care. The authors examine this issue by comparing it to English and French reality. Unlike England, in Italy and France the relationship established between health facility, physician and patient is outlined in a contract. In England, the judges' decisions converge toward a better and higher protection of the patient-the actor-and facilitate the probative task. In case of infections, including those occurring in the delivery room, three issues are evaluated: the hospital's negligent conduct, damages if any and causal nexus. Therefore, the hospital must demonstrate to have taken the appropriate asepsis measures according to current scientific knowledge concerning not only treatment, but also diagnosis, previous activities, surgery and post-surgery. In order to avoid a negative sentence, both physicians and hospital have to demonstrate their correct behavior and that the infection was caused by an unforeseeable event. The authors examine the most significant rulings by the Courts and the Supreme Court. They show that hospitals can avoid being accused of negligence and recklessness only if they can demonstrate to have implemented all the preventive measures provided for in the guidelines or protocols.

History of internal fixation (part 1): early developments with wires and plates before World War II.

Science.gov (United States)

Hernigou, Philippe; Pariat, Jacques

2017-06-01

Though the date at which an orthopaedic implant was first used cannot be ascertained with any certainty, the fixation of bone fracture using an iron wire was reported for the first time in a French manuscript in 1775. The first techniques of operative fracture treatment were developed at the end of the 18th and in the beginning of the 19th centuries. The use of cerclage wires to fix fractures was the most frequent fixation at this time. The French Berenger-Feraud (1832-1900) had written the first book on internal fixation. However internal fixation of fractures could not become a practical method before Lister had ensured the safety of open reduction and internal fixation in the treatment of fractures. Lister is not only the father of asepsis; he also used metal wires to fix even closed fractures. The first internal fixation by means of a plate and screws was described by Carl Hansmann in 1858 in Hamburg. Nevertheless, Arbuthnot Lane (1892) and Albin Lambotte (1905) are considered to be the founders of this method, which was further developed by Sherman in the first part of the 20th century.

Conservação e enraizamento in vitro de infalível (Mandevilla velutina K. Schum., uma planta medicinal do Cerrado In vitro conservation and rooting of "infalível" (Mandevilla velutina K. Schum., a medicinal plant of Cerrado

Directory of Open Access Journals (Sweden)

A.V. Souza

2011-01-01

, dithiothreitol and phloroglucinol. Evaluations were performed at 30 and 60 days as to rooting percentage, and root number and length. For the introduction of genotypes in vitro, nodal segments (1 cm were used as explants; they had an axillary or apical bud and were collected from plants kept in a greenhouse after being subjected to asepsis. Evaluations were carried out for four weeks as to the percentage of explant contamination. Results showed that the presence of phenolic compounds in the culture medium was important to promote in vitro adventitious rooting in M. velutina and that the asepsis methodology for the introduction of in vitro of different genotypes was efficient.

Changing concepts of life-saving procedures in 19th century Polish popular first-aid publications.

Science.gov (United States)

Nieznanowska, Joanna

2006-12-01

Throughout Europe, before the era of health insurance, access to professional medical help in an emergency was limited, for the vast majority of people, especially for those living outside big cities. This did not improve in the nineteenth century, even though the number of physicians grew rapidly. The industrial revolution added a range of previously unknown threats and, with the dramatic rise in population, many more people could not afford medical help. Therefore, the need for popular, easy-to-understand instructions on first aid became urgent. In Poland, such publications were especially needed because of the country's political situation, which resulted in restricted access to university medical education. During the nineteenth century, approximately 50 works on first aid were published in Polish, with almost 90% addressed to non-physicians. Evaluation of the contents of these books and the instructions which they contained gives a good insight into the evolution that first aid concepts underwent in the nineteenth century. These range from changes in the most urgent threats (from epidemic disorders to industrial accidents and combat injuries) and the accelerating development of medical knowledge (especially the asepsis / antisepsis concept), to the changing spectrum of readers (with growing numbers of those who could read but were otherwise poorly educated).

[Outbreak of follicular conjunctivitis caused by adenovirus in a geriatric centre].

Science.gov (United States)

Artieda, Juncal; Montes, Milagrosa; Vicente, Diego; Martínez, Consuelo; Piñeiro, Luis; Mendiola, Josune

2010-12-01

Adenovirus serotype 4a is a respiratory virus that occasionally causes conjunctivitis. This paper describes an outbreak of follicular conjunctivitis that occurred in a geriatric centre. Outbreak description and epidemiological research through a survey. For the microbiological study conjunctival swabs were collected using viral and bacterial transport media. Adenovirus was detected by real-time polymerase chain reaction. The serotype was determined by sequencing of a fragment of the hexon and E1 genes. In autumn 2008 an outbreak of follicular conjunctivitis caused by adenovirus serotype 4a was detected. Twenty three percent 23% (69/300) of residents and 5% (9/180) of workers in a geriatric centre in Gipuzkoa were affected. The clinical symptoms were of prolonged duration (11±5 days). The temporal association of the cases suggested transmission from person to person. The sanitary measures established (asepsis and frequent hand washing, cleaning and disinfection of objects and surfaces) were effective, interrupting the transmission of the disease within a short period of time. Rapid detection, identification of the causative agent and implementing appropriate control measures can significantly reduce the impact on both health and economic costs of these outbreaks. Copyright © 2009 Elsevier España, S.L. All rights reserved.

[Airport security check of medical substances used during patient repatriation].

Science.gov (United States)

Felkai, Péter

2012-09-16

During airport security check of passenger luggage, hazardous items and substances are prohibited to be taken into the restricted safety zone of the airport and the aircraft. Among equipment of the medical staff escorting the patient, there are several devices and materials which are considered hazardous for security reasons. However, medical equipment and substances are indispensable for treating patients during the flight. The aim of the author was to present his experience obtained with the use of an instrument developed for testing liquids, aerosols and gels for security reasons. An instrument based on Raman spectroscopy was used for the identification of medical substances. The results confirmed that the instrument was able to recognize the tested medical substances. The non-destructive testing maintained sample integrity and asepsis. The data indicate that the instrument has a promising utility for the identification of medical substances. It seems important that during repatriation medical substances should be selected not only on the ground of their medical necessity, but their packaging should be also taken into consideration. It is necessary to perform more tests on different medical substances used in emergency care in order to make the database of medical substances stored in the library of instrument more complete.

Menstrual induction in preference to abortion.

Science.gov (United States)

Csapo, A I; Peskin, E G; Sauvage, J P; Pulkkinen, M O; Lampe, L; Godeny, S; Laajoki, V; Kivikoski, A

1980-01-12

In the early 1970s the effort was begun to examine the clinical benefits of "menstrual induction" (MI) at 6 weeks pregnancy (last menstrual period), in the belief that if pregnancy is to be terminated there was no sound medical nor psychological reason to delay the procedure. It was found that the transcervical, intrauterine delivery of a "PG-impact" compromised the conceptus and terminated pregnancy in 95% of the cases, with clinical symptoms of menstruation rather than abortion. The side-effects were acceptable; the prematurity rate did not increase in subsequent pregnancies. Yet, the need for strict asepsis limited the use of this otherwise simple and effective procedure. Recently, this limitation has been overcome by the development of the PGE2 analogue 16-phenoxy-w17,18,19,20 tetranor-PGE2-methyl sulfanylamide ('Sulproston'). Clinical trials have been done in terms of dealing with the questions of efficacy, acceptability, and preference. 90 volunteers have been studied. At 14 days follow-up the success rate (negative pregnancy test) was 96%. The side effects were acceptable -- vomiting 26%, diarrhea 10%, and endometritis 2%. Of the 42 patients interviewed, 90% were satisfied with the procedure. Of those who had previously experienced surgical interruption, 89% preferred this pharmacological method.

Our experience in the management of infantile hydrocephalus: A study on thirty-five regrouped cases in Yaounde, Cameroon

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F F Mouafo Tambo

2011-01-01

Full Text Available Background: Hydrocephalus is a frequent central nervous system disorder in children, and despite its importance, it has not been sufficiently studied in developing countries. Patients and Methods: A prospective and descriptive study on 35 cases of infantile hydrocephalus was carried out in the neurosurgery unit of the Yaounde Central Hospital, from March 2008 to January 2010. Results: The mean age of the patients was 6.69΁1.58 months, and the majority of them were in the 0-6 months age group (71.43%. The most frequent causes were congenital malformations, with stenosis of the aqueduct of Sylvius being the most represented (31.43%. As radiological workup, a CT scan was done in more than half of the cases (57.15%, and ventriculo-peritoneal shunting was the main surgical method of management used (94.29%. Infectious complications were observed in 22.86% of our cases. Conclusion: Hydrocephalus is a frequent disorder in this Cameroonian setting affecting mostly the 0-6months age group. For early diagnosis to be made, the head circumference of neonates should be routinely measured in the labour room and followed-up in all medical visits. To avert complications following surgery, rigorous surgical procedures with effective asepsis and appropriate methods and materials for shunting should be used.

Investigation of Endophytic Bacterial Community in Supposedly Axenic Cultures of Pineapple and Orchids with Evidence on Abundant Intracellular Bacteria.

Science.gov (United States)

Esposito-Polesi, Natalia Pimentel; de Abreu-Tarazi, Monita Fiori; de Almeida, Cristina Vieira; Tsai, Siu Mui; de Almeida, Marcílio

2017-01-01

Asepsis, defined as the absence of microbial contamination, is one of the most important requirements of plant micropropagation. In long-term micropropagated cultures, there may occasionally occur scattered microorganism growth in the culture medium. These microorganisms are common plant components and are known as latent endophytes. Thus, the aim of this research was to investigate the presence of endophytic bacteria in asymptomatic pineapple and orchid microplants, which were cultivated in three laboratories for 1 year. Isolation and characterization of bacterial isolates, PCR-DGGE from total genomic DNA of microplants and ultrastructural analysis of leaves were performed. In the culture-dependent technique, it was only possible to obtain bacterial isolates from pineapple microplants. In this case, the bacteria genera identified in the isolation technique were Bacillus, Acinetobacter, and Methylobacterium. The scanning electron microscopy and transmission electron microscopy (SEM and TEM) analyses revealed the presence of endophytic bacteria in intracellular spaces in the leaves of pineapple and orchid microplants, independent of the laboratory or cultivation protocol. Our results strongly indicate that there are endophytic bacterial communities inhabiting the microplants before initiation of the in vitro culture and that some of these endophytes persist in their latent form and can also grow in the culture medium even after long-term micropropagation, thus discarding the concept of "truly axenic plants."

[The history of flexor tendon surgery].

Science.gov (United States)

Chamay, A

1997-01-01

Flexor tendon injuries were already treated in antiquity by Hippocrates, Galien and Avicenne. Since the Renaissance, other surgeons have attempted to repair flexor tendon injuries, but without success due to problems related to unsuitable materials and ignorance of the basic rules of asepsis and the absence of antiseptics until the second half of the 19th century. The first successful flexor tendon grafts in man were performed by K. Biesalski in 1910, E. Lexer in 1912 and L. Mayer in 1916. These three authors published their series of grafts and described in detail the anatomical, physiological and technical principles to be respected. St. Bunnell, in 1918, developed various pull-out direct suture procedures, but faced with the problems of adhesions, he abandoned this technique and proposed not to repair flexors in the digital tunnels but to graft them. He defined the famous zone which he called No man's land, which subsequently became Claude Verdan's zone II, in 1959. In 1960, C. Verdan published his first series of sutures maintained by 2 pins in zone II with comparable results to those obtained after grafting. In 1967, H. Kleinert, with his mobile suture, became the leader of direct tendon repair in zone II. 2-stage grafts were introduced in 1965 under the impetus of J. Hunter, who revised and popularized the studies conducted by A. Bassett and R.E. Caroll in 1950.

Comparative evaluation of four different sterilization methods on contaminated endodontic files

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Malathi Yenni

2017-01-01

Full Text Available Background: The reuse of instruments in the field of endodontics leads to cross infection due to contamination with microbes as the instruments come into direct contact with saliva, blood, and infected tissues. Since microbes are considered to be the major cause of endodontic failures, sterilization of endodontic instruments is mandatory for maintaining asepsis to prevent cross-contamination from one person to other. Hence, the present study was conducted to compare the effectiveness of four different methods of sterilizing contaminated endodontic files. Materials and Methods: A total of 48 stainless steel K files were divided into four groups based on the sterilization method followed – Group A: Autoclave, Group B: Glass bead sterilization, Group C: Glutaraldehyde, and Group D: Quitanet Plus (aldehyde-free solution. In all the tested groups, half of the files were contaminated with Escherichia coli and remaining with Enterococcus faecalis. Then, presterilization colony counts were recorded, followed by sterilization through respective methods. Later, the sterilized files were rinsed with distilled water and 100 ul of the diluted concentration was transferred and cultured onto the respective agar plates to determine the total microbial reduction. Results: Autoclave showed complete effectiveness in reducing the microbial count followed by Quitanet Plus, glass bead sterilizer, and glutaraldehyde. Conclusion: Autoclave is considered to be the best sterilization technique to prevent cross infection in endodontic therapy.

Understanding the current state of infection preventionists through competency, role, and activity self-assessment.

Science.gov (United States)

Kalp, Ericka L; Marx, James F; Davis, James

2017-06-01

The Association for Professionals in Infection Control and Epidemiology (APIC) MegaSurvey, administered in 2015, was completed by approximately 4,079 APIC members. The survey sought to gain a better understanding the current state of 4 components of infection prevention practice: demographic characteristics, compensation, organizational structure, and practice and competency. The data for this analysis come from the APIC MegaSurvey Practice and Competency domain. Descriptive statistics and χ 2 analyses were conducted to examine differences in infection preventionist (IP) competency, roles, and activity self-assessments. The majority of IPs self-assessed their competency as Proficient compared with Novice or Expert for each of the 8 IP core competency activities. Forty percent of IPs self-rated their competency as Expert in the Preventing/Controlling the Transmission of Infectious Agents/HAIs component. IPs reported Novice competency in Employee/Occupational Health (29%); Cleaning, Sterilization, Disinfection, and Asepsis (23%); and Education and Research categories (22%). Differences in self-rated competency among IPs by discipline type (public health, nurse, and laboratory) were identified. Differences in self-rated competency were identified for each of the 8 IP core competency activities. IPs report using various resource types to gain competency. Future research is needed to identify opportunities to increase competency levels in the weakest-rated competency activities. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Performance Analysis of Exam Gloves Used for Aseptic Rodent Surgery

Science.gov (United States)

LeMoine, Dana M; Bergdall, Valerie K; Freed, Carrie

2015-01-01

Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP–PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham ‘exertion’ activity. According to these criteria, 94% of HP–PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP–PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries. PMID:26045458

A retrospective study of the use of active suction wound drains in dogs and cats.

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Bristow, P C; Halfacree, Z J; Baines, S J

2015-05-01

To report indications for use and complications associated with commonly used closed active suction wound drains in a large number of clinical cases. Retrospective review of medical case records (from 2004 to 2010) for dogs and cats that had a closed active suction drain placed into a wound. Only the four most common drain types were included: Mini Redovac®, Redovac®, Jackson Pratt® and Wound Evac®. Two hundred and fifty-three drains were placed in 33 cats and 195 dogs. Mini Redovac drains were used most frequently in cats (76 · 5%) and Redovac drains in dogs (54 · 3%). The infection rate for clean surgeries in dogs was 15 · 6% (unattainable in cats). Major complications occurred in four dogs; minor complications occurred in 12 drains in cats (35 · 3%), and in 74 drains in dogs (33 · 8%). There was no statistically significant association between the type of drain and complication rate for either species. Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management. © 2015 British Small Animal Veterinary Association.

Performance analysis of exam gloves used for aseptic rodent surgery.

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LeMoine, Dana M; Bergdall, Valerie K; Freed, Carrie

2015-05-01

Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP-PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham 'exertion' activity. According to these criteria, 94% of HP-PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP-PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries.

Role of clamping tube thoracostomy prior to removal in non-cardiac thoracic trauma

International Nuclear Information System (INIS)

Rasheed, M.A.; Majeed, F.A.; Naz, A.

2016-01-01

The frequently encountered thoracic trauma in surgical emergencies is a major cause of mortality and morbidity. Eighty percent of thoracic trauma can be managed by simple insertion of tube thoracostomy. Though guidelines for insertion are comprehensively explained in literature, an ideal algorithm for discontinuation is not available. A standard and safe defined protocol would eliminate hesitancy in confident removal among general surgeons. The objective of this study was to determine role of clamping trial prior to removal in terms of frequency of recurrent pneumothorax. Methods: This study was conducted in department of Surgery Combined military hospital/Military Hospital Rawalpindi from April 2013 to March 2014. Total 180 patients with blunt or penetrating thoracic trauma were included in the study. Chest tube (28-36 Fr) was inserted in Trauma centre under strict asepsis. Tubes were then connected to under water seal for minimum six hours. Patients were randomly divided in two equal groups (90 in each). In Group A, Clamping trial was given before attempting removal while in Group B, tube was removed immediately without clamping trial. Patients of both groups were observed two hourly for development of recurrent pneumothorax. Data was analysed using SPSS-18. Results: The comparison of frequency of recurrent pneumothorax in Group A (9 patients, 10%) and in Group B (4 patients, 4.5%) was not found to be statistically significant. (p-value 2.073). Conclusion: Clamping trial is unnecessary prior to removal of tube thoracostomy in blunt and penetrating non-cardiac thoracic trauma in terms of recurrent pneumothorax. (author)

Reducing bacterial contamination in an Orthopedic Theatre ventilated by natural ventilation, in a Developing Country.

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Thomas, Stephanie; Palmer, Rish; Phillipo, Edward; Chipungu, Geoffrey

2016-05-31

All surgical procedures have the potential for infection and some of the main sources are contamination from airborne particles, theatre personnel and the theatre environment.  There is strong evidence that the use of ultra-clean air flow systems in orthopedic operating theatres reduces the incidence of deep sepsis after surgery. In the developing world however, this is often an unrealistic solution. The aim of this study was to establish baseline levels of contamination in a working orthopedic theatre, at the Queen Elizabeth Central Hospital, Blantyre, Malawi. To feedback results to the theatre team, promote infection prevention discussion and work with the team to implement workable and realistic goals to improve the intra-operative environment. Samples were collected from theatre equipment available at the time of surgery, from theatre water and theatre air using passive air sampling techniques. Samples were immediately transferred to the Central Microbiology Laboratory for culture on basic culture media. Bacterial contamination of theatre equipment, intra-operative theatre air and water was detected. Results were discussed with the theatre and infection prevention team who were receptive to feedback with regards to infection prevention strategies and keen to develop simple measures which could be put in place to change practice. In this setting, we suggest that implementing workable and realistic goals such as, establishing baseline rates of bacterial contamination and introduction of strict protocols for asepsis and theatre etiquette, may reduce bacterial contamination rates and subsequent intra-operative infection in the absence of expensive engineering solutions.

Factors Affecting Hand Hygiene Adherence at a Private Hospital in Turkey.

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Teker, Bahri; Ogutlu, Aziz; Gozdas, Hasan Tahsin; Ruayercan, Saliha; Hacialioglu, Gulizar; Karabay, Oguz

2015-10-01

Nosocomial infections are the main problems rising morbidity and mortality in health care settings. Hand hygiene is the most effective method for preventing these infections. In this study, we aimed to investigate the factors related with hand hygiene adherence at a private hospital in Turkey. This study was conducted between March and June 2010 at a private hospital in Turkey. During the observation period, employees were informed about training, then posters and images were hanged in specific places of the hospital. After the initial observation, training on nosocomial infections and hand hygiene was provided to the hospital staff in March 2010. Contacts were classified according to occupational groups and whether invasive or not. These observations were evaluated in terms of compatibility with hand hygiene guidelines. Hand hygiene adherence rate of trained doctors was higher than untrained ones before patient contact and after environment contact [48% (35/73) versus 82% (92/113) pHand hygiene adherence rate of trained nurses was higher than untrained ones before patient contact [63% (50/79) versus 76% (37/49) pHand hygiene adherence rate of trained assistant health personnel was higher than untrained ones before asepsis [20% (2/10) versus 73% (16/22) phand antiseptics were used when hand washing was not possible. The increase at the rate of hand washing after training reveals the importance of feedback of the observations, as well as the training. One of the most important ways of preventing nosocomial infections is hand hygiene training that should be continued with feedbacks.

Unblinded randomized control trial on prophylactic antibiotic use in gustilo II open tibia fractures at Kenyatta National Hospital, Kenya.

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Ondari, Joshua Nyaribari; Masika, Moses Muia; Ombachi, Richard Bwana; Ating'a, John Ernest

2016-10-01

To determine the difference in infection rate between 24h versus five days of prophylactic antibiotic use in management of Gustilo II open tibia fractures. Unblinded randomized control trial. Accident and Emergency, orthopedic wards and outpatient clinics at Kenyatta National Hospital (KNH). The study involved patients aged 18-80 years admitted through accident and emergency department with Gustilo II traumatic open tibia fractures. Patients were randomized into either 24hour or five day group and antibiotics started for 24hours or five days after surgical debridement. The wounds were exposed and scored using ASEPSIS wound scoring system for infection after 48h, 5days and at 14days. The main outcomes of interest were presence of infection at days 2, 5 and 14 and effect of duration to antibiotic administration on infection rate. There was no significant difference in infection rates between 24-hour and 5-day groups with infection rates of 23% (9/40) vs. 19% (7/37) respectively (p=0.699). The infection rate was significantly associated with time lapsed before administration of antibiotics (p=0.004). In the use of prophylactic antibiotics for the management of Gustilo II traumatic open tibia fractures, there is no difference in infection rate between 24hours and five days regimen but time to antibiotic administration correlates with infection rate. Antibiotic use for 24hours only has proven adequate prophylaxis against infection. This is underlined in our study which we hope shall inform practice in our setting. A larger, more appropriately controlled study would be useful. Copyright © 2016 Elsevier Ltd. All rights reserved.

Commercial considerations in tissue engineering.

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Mansbridge, Jonathan

2006-10-01

Tissue engineering is a field with immense promise. Using the example of an early tissue-engineered skin implant, Dermagraft, factors involved in the successful commercial development of devices of this type are explored. Tissue engineering has to strike a balance between tissue culture, which is a resource-intensive activity, and business considerations that are concerned with minimizing cost and maximizing customer convenience. Bioreactor design takes place in a highly regulated environment, so factors to be incorporated into the concept include not only tissue culture considerations but also matters related to asepsis, scaleup, automation and ease of use by the final customer. Dermagraft is an allogeneic tissue. Stasis preservation, in this case cryopreservation, is essential in allogeneic tissue engineering, allowing sterility testing, inventory control and, in the case of Dermagraft, a cellular stress that may be important for hormesis following implantation. Although the use of allogeneic cells provides advantages in manufacturing under suitable conditions, it raises the spectre of immunological rejection. Such rejection has not been experienced with Dermagraft. Possible reasons for this and the vision of further application of allogeneic tissues are important considerations in future tissue-engineered cellular devices. This review illustrates approaches that indicate some of the criteria that may provide a basis for further developments. Marketing is a further requirement for success, which entails understanding of the mechanism of action of the procedure, and is illustrated for Dermagraft. The success of a tissue-engineered product is dependent on many interacting operations, some discussed here, each of which must be performed simultaneously and well.

Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report

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Márcio Luiz Benevides

Full Text Available Abstract Background and objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50 kg/m2, who underwent cesarean section under general anesthesia. Case report: Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m2. Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2 min and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day.

Outcome of percutaneous continuous drainage of psoas abscess: A clinically guided technique.

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Dave, Bharat R; Kurupati, Ranganatha Babu; Shah, Dipak; Degulamadi, Devanand; Borgohain, Nitu; Krishnan, Ajay

2014-01-01

Percutaneous aspiration of abscesses under ultrasonography (USG) and computer tomography (CT) scan has been well described. With recurrence rate reported as high as 66%. The open drainage and percutaneous continuous drainage (PCD) has reduced the recurrence rate. The disadvantage of PCD under CT is radiation hazard and problems of asepsis. Hence a technique of clinically guided percutaneous continuous drainage of the psoas abscess without real-time imaging overcomes these problems. We describe clinically guided PCD of psoas abscess and its outcome. Twenty-nine patients with dorsolumbar spondylodiscitis without gross neural deficit with psoas abscess of size >5 cm were selected for PCD. It was done as a day care procedure under local anesthesia. Sequentially, aspiration followed by guide pin-guided trocar and catheter insertion was done without image guidance. Culture sensitivity was done and chemotherapy initiated and catheter kept till the drainage was drainage and ODI (Oswestry Disability Index) score at 2 years. PCD was successful in all cases. Back and radicular pain improved in all cases. Average procedure time was 24.30 minutes, drain output was 234.40 ml, and the drainage duration was 7.90 days. One patient required surgical stabilisation due to progression of the spondylodiscitis resulting in instability inspite of successful drainage of abscess. Problems with the procedure were noticed in six patients. Multiple attempts (n = 2), persistent discharge (n = 1) for 2 weeks, blocked catheter (n = 2) and catheter pull out (n = 1) occurred with no effect on the outcome. The average ODI score improved from 62.47 to 5.51 at 2 years. Clinically guided PCD is an efficient, safe and easy procedure in drainage of psoas abscess.

[The hospital-borne tetanus in the reference service of the Donka National Hospital in Conakry (2001-2011)].

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Traoré, F A; Youla, A S; Sako, F B; Sow, M S; Keita, M; Kpamy, D O; Traoré, M

2013-05-01

Become almost non-existent in the developed countries, the hospital-borne tetanus always stays of current events in our country in spite of the forensic problem which it puts. The objectives of this study were to determine prevalence of this affection, to describe its clinical picture and to determine its lethality. It is about a retrospective study of a duration of 11 years realized in the service of the infectious diseases of Conakry. Among 8649 hospitalizations from 2001 till 2012 we brought together 239 cases of tetanus (2.7%) among which 60 hospital-borne tetanus (0.7%). Men represented 73% of these cases, with a sex-ratio M/F of 2.7. The age bracket of 20-40 years was the most affected with 32 cases (53.3%). A single patient had begun his vaccinal calendar which had remained incomplete. Both national hospitals of the CHU of Conakry and private hospitals were the biggest suppliers of this hospital-borne tetanus with respectively 22 and 27 cases (36.6 and 45%). Tetanus related to IM of quinine represented 26 cases (43.3%) whereas the hernial cure was found in 16 cases (26.6%). The average duration of invasion and incubation was respectively 1.5 days and 6 days for the dead (n = 45.7%) and 2 days and 10.5 days for the survivors. Three-quarters of 60 patients died. The fight against this type of tetanus passes inevitably by an improvement of the working conditions, a strict application of the rules of asepsis and the in-service training of the medical and paramedical staff.

EEG in children, in the laboratory or at the patient's bedside.

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Kaminska, A; Cheliout-Heraut, F; Eisermann, M; Touzery de Villepin, A; Lamblin, M D

2015-03-01

In pediatrics, EEG recordings are performed on patients from the neonatal period up to young adults. This means adapting techniques to many different conditions, concerning not only the patient's age, the need for asepsis and the patient's behavior, but also the environment (e.g. in the laboratory, at the patient's bedside, or in the neonatal intensive care unit [NICU]). Technical requirements depend on age, indication and the type of examination; in infancy, there should be a minimum of 12 EEG electrodes, ECG and respiration recording. In epileptology, surface EMG is also necessary to characterize the type of seizures and refine the diagnosis of epilepsy syndrome, on which physicians will base their treatment choice. The role of the EEG technician is essential because the quality of the recording, its analysis and conclusion will depend on the quality of the technical set-up and the interaction with the child. Sleep is a systematic part of the study up to the age of 5 years for several reasons: sleep EEG yields information on brain maturation; the EEG tracing during wakefulness can contain too many artefacts; and some grapho-elements, key to the diagnosis, only appear during sleep. The time of the examination must be chosen according to the child's usual nap times, possibly after sleep deprivation. Grapho-elements and spatio-temporal organization of the EEG vary with age, and normal variants and unusual aspects are quite wide for any given age; this is why a physician experienced in pediatric EEG should perform the interpretation. This chapter concerns EEG performed in infants, children and adolescents, its technical aspects according to age and indications (general pediatrics, emergency, epilepsy). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Buccal Epithelium in treating Ocular Surface Disorders

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Srinivas KR

2008-11-01

Full Text Available Background - Ocular surface disorders due to limbal stem cell deficiency are an important cause of ocular morbidity and visual loss. Although autologous limbal stem cell transplants have helped in the management of unilateral disease, allografts in those with bilateral disease often fail due to immunological reasons. The use of autologous buccal epithelium cultivated on amniotic membrane has been described as a useful approach in the management of this condition. It is the purpose of this study to explore the feasibility of using a novel thermo-gelatin polymer (TGP as a substrate to culture these cells, and to characterize them using RNA extraction and RT-PCR. Methods - Oral cheek mucosal biopsies were obtained from 5 adult patients undergoing Modified Osteo-Odonto Keratoprosthesis surgery. The specimens were transported to the laboratory in transport medium. The cells were released using enzymatic digestion and seeded in both convention culture medium and TGP. The resulting cellular growth was characterized using RNA extraction and RT-PCR. Results - Cells could be cultured from 4 of the 5 specimens. In one specimen, contamination occurred and this was discarded. In the other specimens, the cheek epithelial cells could be cultured in both the conventional culture medium and TGP, with equal ease. RT-PCR revealed the presence of K3, a marker for epithelial cells, and GAPDH indicating the presence of some adipose tissue as well. Conclusions - It is possible to culture autologous cheek mucosal epithelial cells using TGP, a synthetic scaffold, without the need for other biological substrates. Since the specimens are obtained from the oral cavity, stringent asepsis is required. Further studies are required for histopathological characterization of the cultured cells and to create a model for delivery onto the ocular surface of eyes with bilateral surface disease due to limbal stem cell deficiency.

Hastane Temizlik Hizmetleri Personelinin Tibbi Atiklarin Toplanmasi, Tasinmasi ve Depolanmasi Ile Ilgili Bilgi ve Uygulamalarinin Belirlenmesi

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Esengul Camozu

2011-12-01

Full Text Available Determination of Hospital Cleaning Staff’s Knowledge and Applications About Collecting, Transferring and Stocking of Medical Wastes AIM:This observational descriptive study carried out to identify cleaning staffs’ knowledge and practices about collection, transportation and storage of medical waste, at GATA Education and Research Hospital METHOD: All of 99 staffs were included in the study, Data was collected by questionnaire and observation forms. Observation form consists of 5 chapters and 36 processes created in order to observing staff’s practices and use private preventive equipments during the practices. Participants were observed twice with at least 15-day interval and then a questionnaire was administered. Written consent was obtained from staffs by informing about research before applying questionnaire. The data were analyzed by using SPSS 12 package program. RESULTS: 93 persons had been vaccinated against to HepB and 35 persons had been vaccinated against to tetanus among 99 persons were participated in study. 36 persons stated had been injured at least one time by cutting, or drilling materials. Wearing gloves were the most common private prevention (but about half of them was disposable and other private preventive materials were using less. Observed that most of the participants were carrying waste with their hands and clothes were kept in inconvenient place and washing hands, gloves and container after procedures were leaved out. Also some of participants neglected to put leaky pocket in a substantial one. CONCLUSION: Training of cleaning staffs about collect, transport and storage of medical waste relevance to fundamentals of medical asepsis also using visual stimulants and checking staff’s practices for enhancement of correct applications were suggested. [TAF Prev Med Bull 2011; 10(6.000: 631-640

Direct hair transplantation: A modified follicular unit extraction technique

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Pradeep Sethi

2013-01-01

Full Text Available Background: In hair transplantation, the survival rate of harvested grafts depends upon many factors like maintenance of hydration, cold temperature, reduced mechanical handling and asepsis. All these factors are favourably improved if time out of body is reduced significantly. We have tried a modification called direct hair transplantation in the existing follicular unit extraction technique, in which the follicular unit grafts are implanted as soon as they are harvested. In this article, we have described the detailed methodology and a series of 29 patients who underwent direct hair transplantation. Aim: To evaluate the efficacy and feasibility of direct hair transplantation. Subjects and Methods: The patients willing to undergo hair transplantation by the technique of follicular unit extraction were enrolled for the surgery. After administration of local anaesthesia, the recipient sites were created. Thereafter, the processes of scoring the skin with a motorized punch, graft extraction and implantation were performed simultaneously. These patients were followed up to look for the time period of initiation of hair growth, the growth achieved at the end of 6-8 months and any adverse events. The results of patients with noticeable improvement in the photographs and reduction in baldness grade were taken as ′good′, whereas, in other patients, it was classified as ′poor′. Results: All patients were males with age ranging from 21 to 66 years (median 30 years. Twenty-six patients had androgenetic alopecia, 1 patient had traction alopecia and 2 patients had scarring alopecia. Twenty-seven patients showed ′good′ results, whereas 2 patients showed ′poor′ results. Conclusion: Direct hair transplantation is a simple and feasible modification in the follicular unit extraction technique. It is an efficacious surgical treatment modality for baldness.

Qual seria a fonte de fungos miceliais encontrados em leite humano ordenhado? What is the source of mycelial fungi in expressed human milk?

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Franz Reis Novak

2002-06-01

Full Text Available Caracterizou-se os gêneros de fungos miceliais encontrados em amostras de leite humano ordenhado, recebidas a partir de coleta domiciliar, pelo Banco de Leite Humano do Instituto Fernandes Figueira. Foram analisadas 821 amostras de leite humano ordenhado, obtidas ao acaso, a partir de frascos coletados nos domicílios pelas próprias doadoras, e realizadas pesquisas de bolores e leveduras e microrganismos mesófilos. As análises revelaram a ocorrência de bolores e leveduras em 43 (5,2% das amostras, com contagens atingindo a ordem de 10³UFC/ml, tendo sido isoladas 48 cepas de fungos miceliais, que foram identificadas por técnicas padrão de laboratório, como as seguintes: Aspergillus Grupo Niger (6,3%, Aspergillus sp. (4,2%, Paecilomyces sp. (12,6%, Penicillium sp. (60,4%, Rhizopus sp. (2,0% e Syncephalastrum sp. (14,5%. Discute-se a importância do controle da assepsia das mãos das doadoras, antes da coleta do leite humano.The authors characterized the genera of mycelial fungi found in samples of expressed human milk received through home collection by the Human Milk Bank of the Instituto Fernandes Figueira in Rio de Janeiro. A total of 821 samples of expressed human milk were taken randomly from bottles collected at home by the milk donors themselves and were investigated for molds, yeasts, and mesophilic microorganisms. The analyses showed the occurrence of molds and yeasts in 43 (5.2% of the samples, with counts reaching 103CFU/ml. Some 48 strains of mycelial fungi were identified by standard laboratory techniques, including: Aspergillus Niger group (6.3%, Aspergillus sp. (4.2%, Paecilomyces sp. (12.6%, Penicillium sp. (60.4%, Rhizopus sp. (2.0%, and Syncephalastrum sp. (14.5%. The authors discuss the importance of donor hands' asepsis prior to collecting human milk.

Infections following the application of leeches: two case reports and review of the literature

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Maetz Benjamin

2012-10-01

Full Text Available Abstract Introduction Since the 1980s, leeches have been ingeniously used in the management of venous flap congestion. The presence of anticoagulative substances in their saliva improves the blood drainage. Their digestive tract contains several bacterial species, the main ones being Aeromonas hydrophila and Aeromonas veronii biovar sobria, which contribute to the digestion of ingested blood. These bacteria can be the cause of infections. Case presentation We report two cases of septicemia related to Aeromonas veronii biovar sobria that presented after leeches had been applied to congested transverse rectus abdominis myocutaneous flaps for delayed mammary reconstructions. Patient number 1 was a 55-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the sixth postoperative day she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in the patient’s skin and blood bacteriological samples. Her fever ceased after 4 days of antibiotic treatment. Patient number 2 was a 56-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the seventh postoperative day we noticed that she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in the patient’s blood cultures and local bacteriological samples. An antibiogram showed resistance to amoxicillin/clavulanic acid. Her fever ceased on the eleventh postoperative day after 4 days of antibiotic treatment. Conclusion The rate of infection after application of leeches is not negligible. The concentration of Aeromonas inside the digestive tracts of leeches largely decreases when the patient is under antibiotic therapy. These germs are sensitive to third-generation cephalosporins and fluoroquinolones and resistant to amoxicillin/clavulanic acid. We recommend preventive treatment based on classical measures of asepsis and on oral antibioprophylaxy with a fluoroquinolone

Outcome of percutaneous continuous drainage of psoas abscess: A clinically guided technique

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Bharat R Dave

2014-01-01

Full Text Available Background: Percutaneous aspiration of abscesses under ultrasonography (USG and computer tomography (CT scan has been well described. With recurrence rate reported as high as 66%. The open drainage and percutaneous continuous drainage (PCD has reduced the recurrence rate. The disadvantage of PCD under CT is radiation hazard and problems of asepsis. Hence a technique of clinically guided percutaneous continuous drainage of the psoas abscess without real-time imaging overcomes these problems. We describe clinically guided PCD of psoas abscess and its outcome. Materials and Methods: Twenty-nine patients with dorsolumbar spondylodiscitis without gross neural deficit with psoas abscess of size >5 cm were selected for PCD. It was done as a day care procedure under local anesthesia. Sequentially, aspiration followed by guide pin-guided trocar and catheter insertion was done without image guidance. Culture sensitivity was done and chemotherapy initiated and catheter kept till the drainage was <10 ml for 48 hours. Outcome assessment was done with relief of pain, successful abscess drainage and ODI (Oswestry Disability Index score at 2 years. Results: PCD was successful in all cases. Back and radicular pain improved in all cases. Average procedure time was 24.30 minutes, drain output was 234.40 ml, and the drainage duration was 7.90 days. One patient required surgical stabilisation due to progression of the spondylodiscitis resulting in instability inspite of successful drainage of abscess. Problems with the procedure were noticed in six patients. Multiple attempts ( n = 2, persistent discharge ( n = 1 for 2 weeks, blocked catheter ( n = 2 and catheter pull out ( n = 1 occurred with no effect on the outcome. The average ODI score improved from 62.47 to 5.51 at 2 years. Conclusions: Clinically guided PCD is an efficient, safe and easy procedure in drainage of psoas abscess.

Intestinal transplantation: The anesthesia perspective.

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Dalal, Aparna

2016-04-01

Intestinal transplantation is a complex and challenging surgery. It is very effective for treating intestinal failure, especially for those patients who cannot tolerate parenteral nutrition nor have extensive abdominal disease. Chronic parental nutrition can induce intestinal failure associated liver disease (IFALD). According to United Network for Organ Sharing (UNOS) data, children with intestinal failure affected by liver disease secondary to parenteral nutrition have the highest mortality on a waiting list when compared with all candidates for solid organ transplantation. Intestinal transplant grafts can be isolated or combined with the liver/duodenum/pancreas. Organ Procurement and Transplantation Network (OPTN) has defined intestinal donor criteria. Living donor intestinal transplant (LDIT) has the advantages of optimal timing, short ischemia time and good human leukocyte antigen matching contributing to lower postoperative complications in the recipient. Thoracic epidurals provide excellent analgesia for the donors, as well as recipients. Recipient management can be challenging. Thrombosis and obstruction of venous access maybe common due to prolonged parenteral nutrition and/or hypercoaguability. Thromboelastography (TEG) is helpful for managing intraoperative product therapy or thrombosis. Large fluid shifts and electrolyte disturbances may occur due to massive blood loss, dehydration, third spacing etc. Intestinal grafts are susceptible to warm and cold ischemia and ischemia-reperfusion injury (IRI). Post-reperfusion syndrome is common. Cardiac or pulmonary clots can be monitored with transesophageal echocardiography (TEE) and treated with recombinant tissue plasminogen activator. Vasopressors maybe used to ensure stable hemodynamics. Post-intestinal transplant patients may need anesthesia for procedures such as biopsies for surveillance of rejection, bronchoscopy, endoscopy, postoperative hemorrhage, anastomotic leaks, thrombosis of grafts etc. Asepsis

A Histologic Evaluation on Tissue Reaction to Three Implanted Materials (MTA, Root MTA and Portland Cement Type I in the Mandible of Cats

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F. Sasani

2004-09-01

Full Text Available Statement of Problem: Nowadays Mineral Trioxide aggregate (MTA is widely used for root end fillings, pulp capping, perforation repair and other endodontic treatments.Investigations have shown similar physical and chemical properties for Portland cement and Root MTA with those described for MTA.Purpose: The aim of this in vitro study was to evaluate the tissue reaction to implanted MTA, Portland cement and Root MTA in the mandible of cats.Materials and Methods: Under asepsis condition and general anesthesia, a mucoperiosteal flap, following the application of local anesthesia, was elevated to expose mandibular symphysis. Two small holes in both sides of mandible were drilled. MTA, Portland cement and Root MTA were mixed according to the manufacturers, recommendation and placed in bony cavities. In positive control group, the test material was Zinc oxide powder plus tricresoformalin. In negative control group, the bony cavities were left untreated. After 3,6 and 12 weeks, the animals were sacrificed and the mandibular sections were prepared for histologic examination under light microscope. The presence and thickness of inflammation, presence of fibrosis capsule, the severity of fibrosis and bone formation were investigated. The data were submitted to Exact Fisher test, chi square test and Kruskal-Wallis test for statistical analysis.Results: No statistically significant differences were found in the degree of inflammation,presence of fibrotic capsule, severity of fibrosis and inflammation thickness between Root MTA, Portland cement and MTA (P>0.05. There was no statistical difference in boneformation between MTA and Portland cement (P>0.05. However, bone formation was not found in any of the Root MTA specimens and the observed tissue was exclusively of fibrosis type.Conclusion: The physical and histological results observed with MTA are similar to those of Root MTA and Portland cement. Additionally, all of these three materials are biocompatible

Fototerapia (LEDs 660/890nm no tratamento de úlceras de perna em pacientes diabéticos: estudo de caso Phototherapy (LEDs 660/890nm in the treatment of leg ulcers in diabetic patients: case study

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Débora Garbin Minatel

2009-07-01

Full Text Available Avaliou-se a fototerapia na cicatrização de úlceras de perna (UP mistas em dois pacientes diabéticos (tipo 2, hipertensos. O aparelho apresentava sonda 1 (S1 (1 LED de 660nm, 5mW aplicado em 3 UP e sonda 2 (S2 (32 LEDs de 890nm e 4 LEDs de 660nm, 500mW em 6 UP. Após antissepsia,úlceras foram tratadas com sondas a 3J/cm2, 30seg, 2x/semana seguido pelo curativo diário com sulfadiazina de prata a 1% por 12 semanas. Pela análise com software Image J®, as UP com S2 tiveram índices de cicatrização médios de 0,6; 0,7 e 0,9 enquanto S1 foi de 0,2; 0,4 e 0,6 no 30º, 60º e 90º dias, respectivamente. A fototerapia acelerou a cicatrização das úlceras de perna em pacientes diabéticos.This study evaluated the use of phototherapy in the healing of mixed leg ulcers in two diabetic patients (type 2 with arterial hypertension. The device had probe 1 (one 660nm LED, 5mW applied in 3 ulcers and probe 2 (32 890nm LEDs associated with 4 660nm LEDs, 500mW in 6 ulcers. After asepsis, ulcers were treated with probes to 3 J/cm2, 30sec per point, twice a week, followed by topical daily dressing with 1% silver sulphadiazine during 12 weeks. The following analyses of ulcers with software Image J showed that probe 2 presented mean healing rates of 0.6; 0.7 and 0.9, whereas probe 1 had 0.2;0.4 and 0.6 at 30, 60 and 90 days, espectively. Phototherapy accelerated wound healing of leg ulcers in diabetic patients.

Biological research in the evolution of cancer surgery: a personal perspective.

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Fisher, Bernard

2008-12-15

During the 19th, and for most of the 20th century, malignant tumors were removed by mutilating radical anatomic dissection. Advances such as anesthesia, asepsis, and blood transfusion made possible increasingly more radical operations. There was no scientific rationale for the operations being performed. Surgery in the 20th century was dominated by the principles of William S. Halsted, who contended that the bloodstream was of little significance as a route of tumor cell dissemination; a tumor was autonomous of its host; and cancer was a local-regional disease that spread in an orderly fashion based on mechanical considerations. Halsted believed that both the extent and nuances of an operation influenced patient outcome and that inadequate surgical skill was responsible for the failure to cure. A new surgical era arose in 1957, when cancer surgery began to be influenced by laboratory and clinical research, with results contrary to Halstedian principles. A new hypothesis resulted in a scientific basis for cancer surgery. Clinical trials supported the thesis that operable cancer is a systemic disease and that variations in local-regional therapy are unlikely to substantially affect survival. Complex host-tumor relationships were shown to affect every aspect of cancer and, contrary to Halsted's thesis, the bloodstream is of considerable importance in tumor dissemination. Clinical trials also have shown that less radical surgery is justified. Studies have shown that improved survival can be achieved with systemic therapy after surgery. Such therapy can reduce both the incidence of distant disease and the tumor recurrence at the tumor site after minimal surgery. The use of systemic therapy in patients who have no identifiable metastatic disease is a drastic departure from previous strategies. New technological innovations resulting from engineering research have improved the quality of life of patients by eliminating the need for some surgical procedures. Because cancer

[Sciatica. From stretch rack to microdiscectomy].

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Gruber, P; Böni, T

2015-12-01

In ancient times as well as in the Middle Ages treatment options for discogenic nerve compression syndrome were limited and usually not very specific because of low anatomical and pathophysiological knowledge. The stretch rack (scamnum Hippocratis) was particularly prominent but was widely used as a therapeutic device for very different spinal disorders. Since the beginning of the nineteenth century anatomical knowledge increased and the advances in the fields of asepsis, anesthesia and surgery resulted in an increase in surgical interventions on the spine. In 1908 the first successful lumbar discectomy was initiated and performed by the German neurologist Heinrich O. Oppenheim (1858-1919) and the surgeon Fedor Krause (1857-1937); however, neither recognized the true pathological condition of discogenic nerve compression syndrome. With the landmark report in the New England Journal of Medicine in 1934, the two American surgeons William Jason Mixter (1880-1958) and Joseph Seaton Barr (1901-1963) finally clarified the pathomechanism of lumbar disc herniation and furthermore, propagated discectomy as the standard therapy. Since then interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. The surgical procedures changed over time and were continuously being refined. In the late 1960s the surgical microscope was introduced for spinal surgery by the work of the famous neurosurgeon Mahmut Gazi Yasargil and his colleague Wolfhard Caspar and so-called microdiscectomy was introduced. Besides open discectomy other interventional techniques were developed to overcome the side effects of surgical procedures. In 1964 the American orthopedic surgeon Lyman Smith (1912-1991) introduced chemonucleolysis, a minimally invasive technique consisting only of a cannula and the proteolytic enzyme chymopapain, which is injected into the disc compartment to dissolve the displaced disc material. In 1975 the Japanese orthopedic

Microbiological analysis of critical points in the chicken industry

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Rogério Luis Cansian

2005-05-01

Full Text Available This work is focused on identifying microbial contamination in the scalding asepsis and cooling processes as well as in fresh sausages obtained. Salmonella was identified in two scald water samples but was absent in the water from chiller and in the final product, which might be explained in terms of chlorine addition and temperature reduction. The analysis revealed that MPN of Escherichia coli was in the range of O objetivo deste trabalho foi identificar a contaminação microbiana no processo de escaldagem, assepsia e resfriamento do frango (chiller, e em linguiças de frango produzidas a partir destes. As amostras foram coletadas em um frigorífico de aves, em sete datas e analisadas em triplicata. A presença de Salmonella foi detectada em duas amostras da água de escaldagem não estando mais presente na água do chiller e nem no produto final. Isto se deve à redução de temperatura da água e adição de cloro. O NMP de coliformes fecais variou entre < 1 a 11/ml na água de escaldagem e < 1 a 64/ml na água do chiller, que embora em padrões aceitáveis, mostram tendência de acréscimo no chiller, devido principalmente ao processo de evisceração. As contagens de Aeromonas variaram de 5 a 3,5x10¹UFC/ml na água de escaldagem e 9 a 3,7x10²UFC/ml na água do chiller. Este acréscimo se deve, provavelmente, por Aeromonas ser psicrófila e também devido a retirada das víceras. As análises de linguiça de frango mostraram acréscimo nas contagens de Aeromonas, apresentando até 2,5x10³UFC/g. Esta tendência de aumento de crescimento no produto final, aliado a capacidade de causar infecções de Aeromonas demonstram a necessidade de incluir a análise destas nas avaliações microbiológicas de alimentos.

Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India.

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Jaggi, Namita; Sissodia, Pushpa

2012-10-01

Catheter Associated Urinary Tract Infections (CAUTI) contribute 30%-40% of all the nosocomial infections and they are associated with substantially increased institutional death rates. A multimodal supervision program which incorporates training of the staff with respect to infection control measures can be effective in reducing the CAUTIs in hospitals. To assess the impact of a multimodal UTI supervision program on the CAUTI rates over a year, from January 2009 to December 2009, in a tertiary care hospital in India. A 215 bedded tertiary care private hospital. The CAUTI rates were analyzed for the first 6 months (January 2009-June 2009). A UTI supervision program was instituted in the month of July 2009, which included training with respect to the standard protocols for the sample collection and diagnosis, the bundle components of the urinary catheter checklist and hand hygiene practices. The impact was assessed as per the CAUTI rates in the subsequent months. The average CAUTI rate was reduced by 47.1% (from 10.6 to 5.6) after the introduction of the supervision program. This study presented the mean age of the patients with CAUTIs as 54.5 years and it showed an approximately equal contribution of both the sexes (52.94% in males and 47.05% in females). The impact analysis of the supervision program showed a reduction of 8.7% (from 23 days to 21 days) during the average duration of the catheterization. The adherence to the components of the urinary catheter check list was increased by 44.4% (p=0.069) and the hand hygiene compliance was increased by 56.4% (p=0.004) respectively after the interventions. Components like bladder irrigation and practising perineal cleaning were found to show no effect on the CAUTI rates. The most common labour and cost effective infection control measures as revealed by the supervision programme were adherence to the urinary catheter checklist components (indication for catheter insertion and change, asepsis maintenance during and

Place and role of multifield hospital in teaching program on surgery for students

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A. V. Kapshytar

2013-08-01

Full Text Available Present time is characterized by increase of dynamics of world and social development, introduction of ECTS (European Credit Transfer System [Andrushchenko V. P. at al. 2007; Pertseva T. O. at al. 2008]. Features of new information technologies and forms of educational process dictate need of active introduction of the principles of evidential medicine [Pidayev A. Century at al. 2004; Pishak at al. 2005; Bereznitsky Y. S. at al. 2006]. Thus the main postulate of the Bologna declaration is providing adequate material level of educational base where the training program is implemented in the hospital [Desyaterik V.I. 2008]. Research objective: to determine place and role of multifield clinical base in student’s teaching “General surgery”. Material and research methods. The chair of the general surgery with care of the patients, located in the Community organization “City clinical hospital urgent and an emergency medical service” based in 3 abdominal surgical departments. The hospital has totally 10 surgical departments of a various profile which are the specialized centers and bases of chairs of urology and medicine of accidents, military medicine, anesthesiology and resuscitation. Results of research. Students under the supervision of the teacher visit departments in the hospital and achieve practical skills according to subject goals, make the acquaintance of structure of surgical departments, desmurgy, an asepsis and antiseptics, anesthesia, participate in primary surgical processing of wounds, a bleeding stop, reposition of changes and dislocations, imposing of plaster bandages, imposing or removal of spoke and rod devices, performance of drainage. Big importance has studying of nosological forms is purulent - septic diseases of skin and hypoderma, chronic specific and nonspecific surgical infection, an necrosis, sepsis, tumors and anomalies of development, etc. Wreath of an educational program, the General surgery is writing of the

Ionic implantation by plasma in titanium and stainless steels used in prosthesis and medical instruments

International Nuclear Information System (INIS)

Munoz C, A. E.

2008-01-01

A study of a process known as plasma immersion ion implantation (PIII) of nitrogen at low voltages (< 4 kV) into three kind of samples: 1) austenitic stainless AISI 316-L steel plates, 2) ferritic stainless AISI 434 steel-based dentistry drills and 3) commercially pure titanium (CPTi) disks. On the case of CPTi the study was conducted in nitrogen- oxygen calibrated mixtures: 90% N-10% O, 80% N-20% O, 70% N-30% O and in 99.5% pure oxygen and 99.9% pure nitrogen. The PIII process was carried out by using a direct current plasma source controlled both in voltage and current, a negative voltage pulse modulator, a stainless AISI 304 steel vacuum chamber and a rod of the same material, horizontally located in the upper region of the chamber, which plays the role of anode in the plasma discharge. The purpose of the nitriding is forming a relatively thick layer on the surface of the steel specimens in order to enhance their both microhardness and general corrosion performances, desirable in medical applications. This layer contains interstitial nitrogen atoms (∼24% at.) which gives place to a deformed lattice (expanded phase) of the steel. Vickers microhardness and potentiodynamic tests (the latter in agreement to the norm ASTM G-61-89) confirm an increase of microhardness up to three times and a decrease of general corrosion rate in one order of magnitude. The nitriding of de dentistry drills is aimed at inhibiting the pitting corrosion produced by the asepsis process which results in pit nucleations, their propagation and consequent fractures when being under cyclic stress (fatigue). Scanning electron microscope micrographs reveal the risks involved in surpassing the critical treatment simple temperature of 450 C as the PIII process itself induces pitting. On its part, cyclic (ASTM G-61) potentiodynamic tests indicate an excellent pitting corrosion resistance of the samples treated under 450 C. In turn, the treatment of CPTi was meant to develop oxidized and

Ionic implantation by plasma in titanium and stainless steels used in prosthesis and medical instruments; Implantacion ionica por plasma en titanio y aceros inoxidables usados en protesis e instrumental medico

Energy Technology Data Exchange (ETDEWEB)

Munoz C, A. E. [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)

2008-07-01

A study of a process known as plasma immersion ion implantation (PIII) of nitrogen at low voltages (< 4 kV) into three kind of samples: 1) austenitic stainless AISI 316-L steel plates, 2) ferritic stainless AISI 434 steel-based dentistry drills and 3) commercially pure titanium (CPTi) disks. On the case of CPTi the study was conducted in nitrogen- oxygen calibrated mixtures: 90% N-10% O, 80% N-20% O, 70% N-30% O and in 99.5% pure oxygen and 99.9% pure nitrogen. The PIII process was carried out by using a direct current plasma source controlled both in voltage and current, a negative voltage pulse modulator, a stainless AISI 304 steel vacuum chamber and a rod of the same material, horizontally located in the upper region of the chamber, which plays the role of anode in the plasma discharge. The purpose of the nitriding is forming a relatively thick layer on the surface of the steel specimens in order to enhance their both microhardness and general corrosion performances, desirable in medical applications. This layer contains interstitial nitrogen atoms ({approx}24% at.) which gives place to a deformed lattice (expanded phase) of the steel. Vickers microhardness and potentiodynamic tests (the latter in agreement to the norm ASTM G-61-89) confirm an increase of microhardness up to three times and a decrease of general corrosion rate in one order of magnitude. The nitriding of de dentistry drills is aimed at inhibiting the pitting corrosion produced by the asepsis process which results in pit nucleations, their propagation and consequent fractures when being under cyclic stress (fatigue). Scanning electron microscope micrographs reveal the risks involved in surpassing the critical treatment simple temperature of 450 C as the PIII process itself induces pitting. On its part, cyclic (ASTM G-61) potentiodynamic tests indicate an excellent pitting corrosion resistance of the samples treated under 450 C. In turn, the treatment of CPTi was meant to develop oxidized and

EL SURGIMIENTO DE LO TRÁGICO Y NUEVAS FORMAS DE INSURRECCIÓN SOCIAL SURGIMENTO DA COISA TRÁGICA: AS NOVOS FORMAS DA EXPRESSÃO SOCIAL TRAGIC UPRISING AND NEW FORMS OF SOCIAL INSURRECTION

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Michel Maffesoli

2002-01-01

towards the prevailing social networks and societal relationships currently in force. It is therefore necessary to reflect upon the unthinkable, over that which we have considered unthinkable since the non-rational: to think that the non-rational is far from being irrational. The spirit of this great social asepsis has sought to expel the darkness, which corrodes both the body of the individual and society as a whole. Analysis, in terms of social contract, citizenship, and a democratic ideal has been incapable of explaining the aforementioned detonation of tribal passion and emotion. The question that we now face is how must we confront this flammable reality within the bounds of normative ethics and morality

Effects of quorum sensing system lasR/rhlR gene on the expression of Foxp3, TGF-β1 and IL-10 of lung tissue in tracheal intubation model rat with Pseudomonas aeruginosa biofilm infection

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Qing-qing XIANG

2016-03-01

Full Text Available Objective 　To investigate the effects of lasR/rhlR gene on Foxp3, TGF-β1 and IL-10 of lung tissue in rat tracheal intubation model with biofilm infection of Pseudomonas aeruginosa (Ps. aer wild strain (PAO1 and quorum sensing (QS deficient strain (ΔlasRΔrhlR. Methods 　Twenty-one SD rats were randomly assigned into 3 groups (7 each: ΔlasRΔrhlR-treated group, PAO1-treated group and sterile control group. Biofilms (BF were cultured in vitro, and the BF coated tube (infected respectively with Ps. aer PAO1 strain, ΔlasRΔrhlR strain, or with asepsis was inserted into the trachea to establish the rat model. The rats were sacrificed on the 7th day after intubation. Colony count of lung tissue homogenate (cfu and lung HE staining were performed, and IL-10 content in bronchoalveolar lavage fluid (BALF, TGF-β1 in lung tissue, and the expression of Foxp3 mRNA in lung cells were determined. Results 　The bacterial counts were significantly higher in PAO1 and ΔlasRΔrhlR groups than that in sterile control group, and the counts were obviously higher in PAO1 group (10 400.00±6313.70/g lung tissue than that in ΔlasRΔrhlR group (975.00±559.97/g lung tissue, P<0.05. There was no significant pathological changes in lung tissue in sterile control group, while the bronchi and blood vessels in PAO1 group were infiltrated by a large number of inflammatory cells and complicated with alveolar septum thickening and local abscess and necrosis. The pathological changes were milder in ΔlasRΔrhlR group than in PAO1 group; the expression of Foxp3 mRNA was higher in the two Ps. aer infected groups than that in sterile control group (0.65±0.32, and it was significantly higher in PAO1 group (4.62±1.07 than in ΔlasRΔrhlR group (2.15±1.43, P<0.05. The accumulated optical density value of TGF-β1 was significantly higher in the two Ps. aer infected groups than in sterile control group (3721.66±1412.95, and significantly higher in PAO1 group (65 090.56±33

Estabelecimento, multiplicação e alongamento in vitro de Eucalyptus benthamii Maiden & Cambage x Eucalyptus dunnii Maiden Establishment, multiplication and elongation in vitro of Eucalyptus benthamii Maiden & Cambage x Eucalyptus dunnii Maiden

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Gilvano Ebling Brondani

2009-02-01

Full Text Available Neste trabalho foram testadas diferentes concentrações de cloro ativo (NaOCl na assepsia de explantes para o estabelecimento in vitro, bem como benzilaminopurina (BAP e ácido naftalenoacético (ANA para a multiplicação e alongamento de Eucalyptus benthamii x Eucalyptus dunnii. As minicepas fornecedoras de propágulos para introdução in vitro foram conduzidas em minijardim clonal sob sistema semi-hidropônico. Segmentos nodais dos clones H12, H19 e H20 foram desinfestados com 0,5; 1,0; 1,5; e 2,0% (v/v de cloro ativo durante 10 min e inoculados em meio de cultura MS. Na obtenção de brotações múltiplas, utilizou-se o meio de cultura ½MS suplementado com 0; 0,25; 0,50; 0,75; e 1,0 mg L-1 de BAP. Na fase de alongamento, utilizou-se o meio de cultura ½MS com 0; 0,25; 0,50; 0,75; e 1,0 mg L-1 de ANA. Não houve interação entre os fatores estudados, obtendo-se 45%, 46% e 66% de estabelecimento do clone H12, H19 e H20, respectivamente. A concentração de BAP que resultou na maior proliferação de gemas axilares para o clone H12 aos 60 dias foi estimada na faixa de 0,25 e 0,30 mg L-1. Aos 60 dias, a faixa entre 0,25 e 0,75 mg L-1 de ANA promoveu o maior número de brotações alongadas do clone H12.This work aimed to evaluate different concentrations of active chlorine (NaOCl in explant asepsis for the establishment in vitro as well as of benzylaminopurine (BAP and naphthalene acetic acid (NAA in the multiplication and elongation of Eucalyptus benthamii x Eucalyptus dunnii. Ministumps, which supply shoots for introduction in vitro, were cultivated in a clonal mini garden under semi-hydroponic system. Nodal segments of clones H12, H19 and H20 were disinfested with 0.5, 1.0, 1.5 and 2.0% (v/v of active chlorine during 10 minutes and inoculated in MS medium. In the multiplication phase, culture ½MS medium supplemented with 0, 0.25, 0.50, 0.75 and 1.0 mg L-1 of BAP was used. In the elongation phase, ½MS medium supplemented with 0, 0.25, 0

Micropropagation of an Eucalyptus hybrid (Eucalyptus benthamii x Eucalyptus dunnii=Micropropagação de um híbrido de Eucalyptus (Eucalyptus benthamii x Eucalyptus dunnii.

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Fabricio Augusto Hansel

2011-10-01

Full Text Available This study was designed to micropropagate E. benthamii x E. dunnii, by testing chlorine concentrations for explant asepsis, the optimal concentrations of benzylaminopurine (BAP and naphthaleneacetic acid (NAA for bud proliferation, and the ratio between BAP and gibberellic acid (GA3 in two nutrient media for shoot elongation. Nodal segments from H12, H19 and H20 clones were disinfected with 0.5, 1.0, 1.5 and 2.0% (v v-1 of chlorine. Explants were grown on ½MS medium supplemented with BAP (0, 0.25, 0.50, 0.75 and 1.00 mg L-1 and NAA (0, 0.025, 0.050, 0.075 and 0.100 mg L-1 for bud production. They were elongated on MS and ½MS media supplemented with BAP (0, 0.05 and 0.10 mg L-1 and GA3 (0, 0.1, 0.2 and0.3 mg L-1. The 0.50 mg L-1 BAP and 0.050 mg L-1 NAA combination was optimal for bud proliferation for H12 and H20. GA3 concentrations of 0.10 and 0.20 mg L-1 combined with 0.10 mg L-1 BAP on ½MS resulted in the longest shoots, for H12 and H20, respectively. Regardless of clone, the rooting rate was low, with an average of 12.0% and 14.4% of plants having roots for in vitro and ex vitro conditions, respectively.Objetivou-se micropropagar E. benthamii x E. dunnii, testando concentrações de cloro para a assepsia de explantes, a concentração ótima de benzilaminopurina (BAP e ácido naftalenoacético (ANA para a proliferação de gemas e a relação entre BAP e ácido giberélico (GA3 em dois meios de cultura para o alongamento de brotações. Segmentos nodais dos genótipos H12, H19 e H20 foram desinfetados com 0,5; 1,0; 1,5 e 2,0% (v v-1 de cloro. Os explantes foram multiplicados em meio ½MS suplementado com BAP (0; 0,25; 0,50; 0,75 e 1,00 mg L-1 e ANA (0; 0,025; 0,050; 0,075 e 0,100 mg L-1 para produção de gemas, e alongados nos meios MS e ½MS suplementados com BAP (0; 0,05 e 0,10 mg L-1 e GA3 (0; 0,1; 0,2 e 0,3 mg L-1. A combinação de 0,50 mg L-1 de BAP e 0,050 mg L-1 de ANA proporcionou melhor proliferação de gemas para os gen

Germinação in vitro de sementes de alcachofra In vitro artichoke seed germination

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Cassieli F de Moraes

2010-03-01

elimination; lighting conditions (light or dark; and two cultivation media [MS medium, with salts concentration reduced by half (M1 and MS medium, full strenger (M2] have been tested. In both cases, 30 g L-1 sucrose and 7 g L-1 agar were added, with pH adjusted to 5.6 with NaOH. Cultivation took place in a growth chamber. It is viable to obtain healthy artichoke plantlets in short time (seven days, to be used as a source of explants from in vitro seed germination without the tegument (77,5% of germination, using the M1 or M2 culture medium and growth chamber without light. In these conditions, the asepsis of seeds can be done with alcohol 70% during 30 minutes and the subsequent immersion in solution of 2% of active chlorine during 10 minutes, before the removal of the tegument.

Legal, ethical, and procedural bases for the use of aseptic techniques to implant electronic devices

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Mulcahy, Daniel M.

2013-01-01

animals often mask the signs of infection to avoid attracting predators (Wobeser 2006). Guidance specific to sterilization of electronic devices for implantation is limited in the wildlife record (Burger et al. 1994; Mulcahy 2003). Few biologists have been formally trained in aseptic technique, but most biologists know that electronic devices should be treated in some way to reduce the chance for infection of the host animal by bacteria, viruses, parasites, and fungi. Most biologists (73%) who implant devices into fishes believe aseptic techniques are important (Wagner and Cooke 2005). However, I maintain that many biologists find it difficult to place the concept of asepsis into practice in their work because of confusion about what constitutes aseptic technique, a lack of surgical knowledge and training, the perception of increased costs, or the belief that aseptic surgeries are impractical or unnecessary for their application. Some have even argued that, while compromising surgical techniques in the field might result in complications or mortalities, the money saved would allow for a compensatory increase in sample size (Anderson and Talcott 2006). In this paper I define aseptic surgical techniques, document the legal and professional guidance for performing aseptic surgeries on wild animals, and present options for sterilizing electronic devices and surgical instruments for field use.

Elimination of intracanal infection in dogs' teeth with induced periapical lesions after rotary instrumentation: influence of different calcium hydroxide pastes Eliminação da infecção intracanal em dentes de cães com lesões periapicais induzidas após instrumentação automatizada: influência de diferentes pastas de hidróxido de cálcio

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Janir Alves Soares

2006-06-01

Full Text Available The aim of this study was to evaluate the antiseptic efficacy of rotary instrumentation associated with calcium hydroxide-based pastes prepared with different vehicles and antiseptics. Chronic periapical lesions were experimentally induced in 72 premolar root canals of four dogs. Under controlled asepsis, after initial microbiological sampling (A1, the root canals were instrumented using the ProFile system in conjunction with 5.25% sodium hypochlorite and the intracanal medication was placed. Four experimental groups were formed according to the pastes used: group 1- Calen (n=18, group 2- Calen+CPMC (n=20, group 3- Ca(OH2 p.a.+ anaesthetic solution (n=16 and group 4- Ca(OH2 p.a.+ 2% chlorhexidine digluconate (n=18. After 21 days, the pastes were removed; the canals were emptied and 96 hours later a second microbiological sample was obtained (A2. The incidence of positive microbiological cultures and the number of cfus in stages A1 and A2 were compared statistically by the Wilcoxon test while the influence of the different treatments in intracanal infection was evaluated by Kruskal-Wallis test at 5% significance level (pO objetivo deste estudo foi avaliar a eficácia anti-séptica da instrumentação rotatória associada às pastas à base de hidróxido de cálcio [Ca(OH2] contendo diferentes veículos e anti-sépticos. Lesões periapicais crônicas foram experimentalmente induzidas em 72 canais radiculares de pré-molares de 4 cães. Sob controlada assepsia, após amostras microbiológicas iniciais (A1, fez-se a instrumentação com o sistema ProFile coadjuvado pela solução de hipoclorito de sódio a 5,25%, seguido de medicação intracanal. Em função das pastas utilizadas obtiveram-se 4 grupos: grupo 1- Calen (n=18, grupo 2- Calen+PMCC (n=20, grupo 3- Ca(OH2 p.a.+ solução anestésica (n=16 e grupo 4- Ca(OH2 p.a.+ solução de digluconato de clorexidina a 2% (n=18. Transcorridos 21 dias, removeram-se as pastas, deixando os canais

Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia – case report

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Márcio Luiz Benevides

2016-07-01

Full Text Available Background and objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50 kg/m2, who underwent cesarean section under general anesthesia. Case report: Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m2. Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2 min and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day. Resumo: Justificativa e objetivos: O aumento na prevalência da obesidade na população geral se estende para mulheres na idade reprodutiva. O objetivo deste estudo é relatar o controle perioperatório de uma gestante obesa mórbida com índice de massa corporal >50 Kg/m2, submetida a parto cesariano sob anestesia geral. Relato do caso: Gestante de 35 anos com índice de massa corporal

Improvement of nursing students' learning outcomes through scenario-based skills training.

Science.gov (United States)

Uysal, Nurcan

2016-08-08

this study analyzed the influence of scenario-based skills training on students' learning skills. the author evaluated the nursing skills laboratory exam papers of 605 sophomores in nursing programs for seven years. The study determined the common mistakes of students and the laboratory work was designed in a scenario-based format. The effectiveness of this method was evaluated by assessing the number of errors the students committed and their achievement scores in laboratory examinations. This study presents the students' common mistakes in intramuscular and subcutaneous injection and their development of intravenous access skills, included in the nursing skills laboratory examination. an analysis of the students' most common mistakes revealed that the most common was not following the principles of asepsis for all three skills (intramuscular, subcutaneous injection, intravenous access) in the first year of the scenario-based training. The students' exam achievement scores increased gradually, except in the fall semester of the academic year 2009-2010. The study found that the scenario-based skills training reduced students' common mistakes in examinations and enhanced their performance on exams. this method received a positive response from both students and instructors. The scenario-based training is available for use in addition to other skills training methods. en este estudio fue analizada la influencia de la capacitación basada en escenarios en las capacidades de aprendizaje de los alumnos. el autor evaluó los textos de exámenes de laboratorio de habilidades de enfermería producidos por 605 alumnos de segundo año en cursos de enfermería durante siete años. El estudio determinó los errores comunes de los alumnos y el trabajo en laboratorio adoptó el formato basado en escenarios. La eficacia de ese método fue evaluada mediante la cantidad de errores que los alumnos cometieron y sus notas de desempeño en exámenes de laboratorio. Este estudio