戊二醛复方中辅助成分对其性能影响的研究

采用载体定量杀菌试验观察了戊二醛消毒剂复方辅助成分对其性能的影响。结果 ,在 2 0g/L戊二醛溶液中加入 5g/L亚硝酸钠 ,其pH值为 4 .5 6 ,加入 3.0g/L碳酸氢钠和 5 .0g/L亚硝酸钠时 ,其pH值为 7.73。以pH值为7.73的该液作用 4h ,对不锈钢片上枯草杆菌黑色变种芽孢杀灭率为 10 0 % ;对止血钳头上滴染的枯草杆菌黑色变种芽孢达到灭菌。将该消毒剂连续使用 14d后 ,对不锈钢片上的枯草杆菌黑色变种芽孢作用 5h杀灭率为 10 0 %。在室温下存放 7d ,其戊二醛含量下降率 >10 % ,对金属无腐蚀。在 2 0g/L戊二醛溶液中只加入 5g/L亚硝酸钠 (pH4 .5 6 ) ,对不锈钢片上枯草杆菌黑色变种芽孢杀灭率达到 10 0 %需作用 5h ,对止血钳头上滴染的枯草杆菌黑色变种芽孢达到灭菌需要 8h。在室温存放 14d后 ,其戊二醛含量下降率 <10 % ,对铜中度腐蚀。结论 ,加碳酸氢钠的碱性戊二醛杀芽孢效果好 ,但稳定性差 ,腐蚀性小 ;只加亚硝酸钠的酸性戊二醛杀芽孢效果差 ,稳定性好 ,腐蚀性增加。     

强优戊二醛杀菌性能的试验观察

为了解一种11g/L强优戊二醛杀菌性能及腐蚀性,在实验室内进行了载体定量杀菌试验和金属腐蚀性试验。结果,含11g/L强优戊二醛消毒剂对枯草杆菌黑色变种芽孢作用120min,杀灭率达100％;含戊二醛1g/L该消毒剂对金黄色葡萄球菌作用10min,杀灭率达100％。以含11g/L戊二醛的消毒剂对止血钳、镊子、剪刀浸泡灭菌连续使用14d,作用时间120min,对枯草杆菌黑色变种芽孢的杀灭率各次均达100％。经该消毒剂浸泡72h,对碳钢、铜有轻度腐蚀,对铝、不锈钢无腐蚀。结果提示含11g/L戊二醛的该消毒剂对细菌芽孢杀灭效果较好,但对碳钢、铜有轻度腐蚀。     

强化戊二醛消毒剂杀菌效果及理化性能的实验观察

采用载体定量杀菌试验、稳定性试验和金属腐蚀性试验,以观察强化戊二醛的杀菌效果和稳定性及腐蚀性。结果,以含强化戊二醛 500mg/L作用 3min,对金属片上大肠杆菌的杀灭率达 99. 99%,作用 5min,对金黄色葡萄球菌和白色念珠菌的杀灭率均达 100%。戊二醛含量为 20g/L时,作用 2h,对金属片上枯草杆菌黑色变种芽孢的杀灭率为 99. 98%,对医用止血钳齿端上枯草杆菌黑色变种芽孢杀灭率为 99. 99%。该消毒剂于 54℃存放 14d,戊二醛含量下降率为 3. 00%;对金属片基本无腐蚀。     

一元复方戊二醛消毒剂的消毒性能观察

一元复方戊二醛消毒剂使用时不需要活化和另加入缓蚀剂。采用载体定量杀菌试验、理化分析及动物毒性试验方法,对其杀菌效果和消毒相关性能进行了实验室研究。结果,以含3000 mg/L戊二醛该复方消毒剂对细菌繁殖体作用1 m in,杀灭对数值达到3.0以上;以含25 g/L戊二醛该复方消毒剂对龟分枝杆菌作用5 m in,对枯草杆菌黑色变种芽孢作用90 m in,平均杀灭对数值均超过3.0。用该消毒液浸泡止血钳5 h,对污染在止血钳上的枯草杆菌黑色变种芽孢可达到完全杀灭。一元复方戊二醛消毒液对小鼠急性经口毒性LD50大于5000 mg/kg体重,属于无毒类物质;该消毒剂原液产品在37℃下储存90 d,其戊二醛含量下降率小于10%。结论,一元复方戊二醛消毒剂稳定性良好,对细菌繁殖体、分枝杆菌和细菌芽孢杀灭作用较强。     

一种戊二醛消毒剂对医疗器械的灭菌应用效果评价

目的观察一种戊二醛消毒剂对医疗器械的灭菌效果。方法用载体定性灭菌试验方法进行实验室灭菌效果观察。结果用含20 g/L碱性戊二醛消毒液浸泡作用5 h,对载体上枯草杆菌黑色变种芽孢全部杀灭,用连续使用7 d后的戊二醛消毒液浸泡作用5 h,对载体上枯草杆菌黑色变种芽孢全部杀灭。结论该戊二醛消毒剂在碱性条件和常规作用浓度,浸泡作用5 h可完全杀灭医疗器械上污染的细菌芽孢。     

三种消毒剂的杀灭细菌芽孢效果和稳定性观察

目的 比较含氯消毒剂、一元包装过氧乙酸、戊二醛三种高效消毒剂杀灭细菌芽孢的效果和稳定性.方法 杀菌试验采用悬液定量法,稳定性试验采用化学加速法试验.结果 浓度为2 000 mg/L的含氯消毒剂作用20 min,2 000 mg/L的过氧乙酸消毒液作用20 min,21.85 g/L的戊二醛消毒液原液作用60 min,对枯草杆菌黑色变种芽孢的平均杀灭对数值均可达到5.00以上;将三种消毒剂密封避光保存于25℃恒温箱中30 d,含氯消毒剂、过氧乙酸、戊二醛含量分别下降3.22%,16.7%和1.87%.结论 含氯消毒剂和过氧乙酸杀灭芽孢作用快速.过氧乙酸稳定性最差,戊二醛稳定性最好.     

复方强化戊二醛消毒液对细菌芽孢的杀菌效果观察

为了解复方强化戊二醛消毒液对细菌芽孢杀灭效果,采用载体定量和定性杀菌试验进行了实验室观察和现场试验。结果,以含22.4 g/L戊二醛的复方强化戊二醛消毒液对载体上枯草杆菌黑色变种芽孢作用1 h,杀灭率>99.9%;作用3 h达到完全杀灭。能量试验对大肠杆菌最低有效浓度为1000 mg/L戊二醛。经模拟现场试验用含22.4 g/L戊二醛消毒液对污染在止血钳上的枯草杆菌黑色变种芽孢作用3 h达到完全杀灭。连续使用稳定性杀菌试验,14 d后达到完全杀灭细菌芽孢的效果需要作用5 h。结论,复方强化戊二醛消毒液对细菌芽孢杀灭效果较好,性能稳定。     

过氧化氢银离子复方消毒剂杀菌效果试验观察

目的了解过氧化氢银离子复方消毒剂消毒相关性能。方法采用载体定性灭菌试验法,对该过氧化氢银离子复方消毒剂杀菌效果及稳定性进行了观察。结果以含100 g/L过氧化氢与109 mg/L的银离子复方消毒剂,对载体上枯草杆菌黑色变种芽孢作用90 min,或对污染在止血钳齿端上的枯草杆菌黑色变种芽孢作用90 min,均可达到完全杀灭。将该复方消毒剂原液密封保存于37℃恒温箱中3个月,其过氧化氢及银离子含量平均下降率分别为4.98%和3.43%。结论过氧化氢银离子复方消毒剂对细菌芽孢均具有较强的杀灭效果,性能稳定。     

一种过氧化氢银离子复方消毒剂对医疗器械的消毒效果及其腐蚀性研究

目的研究一种过氧化氢银离子复方消毒剂对医疗器械的消毒与灭菌效果及其腐蚀性。方法采用载体浸泡杀菌试验和腐蚀性试验方法,对某过氧化氢银离子复方消毒剂杀菌效果及其腐蚀性进行观察。结果以浓度为65 g/L过氧化氢与84 mg/L银离子的复方消毒剂浸泡30 min,对载体上的枯草杆菌黑色变种芽孢杀灭对数值均3.0,作用1 h无菌生长。在上述条件下,对污染于医疗器械的枯草杆菌黑色变种芽孢作用30 min、1 h,能分别达到消毒、灭菌合格要求,在反复取放浸泡医疗器械条件下,消毒作用1 h,可连续使用14 d达到消毒与灭菌要求。该消毒剂对不锈钢基本无腐蚀,对碳钢、铝、铜有不同程度腐蚀。结论该过氧化氢银离子复方消毒剂具有良好的杀灭细菌芽孢的效果,对不锈钢类医疗器械基本无腐蚀性。     

一种新型过氧化氢复方消毒剂的杀菌效果及相关性能的实验观察

目的研究复方过氧化氢消毒剂消毒性能。方法采用悬液定量和载体定量试验法,对该复方消毒剂杀菌效果及稳定性进行了观察。结果以含4580mg/L过氧化氢的复方消毒液作用5min,对悬液内金黄色葡萄球菌和大肠杆菌的杀灭对数值均>5.00。以含过氧化氢47.6g/L的复方消毒液,载体上枯草杆菌黑色变种芽孢作用90min,或对污染在止血钳齿端上的枯草杆菌黑色变种芽孢作用120min,均可达到完全杀灭。将该复方消毒剂原液密封保存在54℃14d或在室温下存放1年后,其过氧化氢含量平均下降率分别为5.78%和16.38%。该过氧化氢复方消毒剂原液对不锈钢基本无腐蚀,对碳钢、铜和铝等金属均有不同程度的腐蚀性。体积分数50%小牛血清对该过氧化氢复方消毒剂的杀菌效果基本无干扰。结论过氧化氢复方消毒剂对细菌繁殖体和细菌芽孢均具有较强的杀灭效果,对普通金属存在腐蚀性。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.