胃镜采用戊二醛和邻苯二甲醛消毒的效果比较

目的探讨胃镜采用戊二醛和邻苯二甲醛消毒的效果。方法以120例胃镜检查术后的胃镜作为研究对象,将其根据消毒剂的不同分为对照组与观察组,每组60例。对照组采用2%碱性戊二醛进行消毒,观察组采用邻苯二甲醛进行消毒,通过现场采样对比分析两组的消毒效果、消毒时间、工作效率等。结果观察组和对照组消毒合格率均为100%,且消毒后均无致病菌生长,两组消毒效果比较,差异无统计学意义(P0.05)。观察组消毒时间、工作效能优于对照组,差异显著(P0.05)。结论 2%碱性戊二醛和邻苯二甲醛用于胃镜消毒均具有良好的消毒效果,其消毒合格率高,但邻苯二甲醛较2%戊二醛的消毒时间短;二者合理使用可显著提高功作效能,缓解内镜供给压力。     

2%碱性戊二醛与邻苯二甲醛对内镜的消毒比较

近年来新型内镜相继问世，如电子内镜、放大胃镜、超声胃镜等，由于内镜均为重复使用，故应作好清洗和消毒工作，以防交叉感染。近几年消毒剂得到迅速发展，常用消毒剂有：洗必泰、84液、餐具净333、酸化电位水、戊二醛、邻苯二甲醛等，为了进一步加强内镜消毒灭菌工作，保障质量和医疗安全，严格预防内镜消毒不佳所导致的医院感染，确保人民生命安全，我们比较了2％碱性戊二醛与0．55％邻苯二甲醛消毒剂对内镜的消毒效果，现报道如下。     

胃镜消毒模拟试验--清洗与消毒时间探讨

目的探讨胃镜清洗与消毒浸泡的有效时间.方法采用1μg/ml乙型肝炎表面抗原(HBsAg)和浓度为3×108/ml的金黄色葡萄球菌、大肠杆菌、绿脓杆菌悬液均匀地涂布在胃镜的镜身、活检孔道、活检钳,对胃镜按常规进行清洗3min后分别在消毒3min、5min、10min,收集清洗前、清洗后及消毒后不同时间段的标本,测其HBsAg和致病菌.结果清洗前能检测出致病菌和HB-sAg,彻底清洗后测不出HBsAg但能检测到致病菌,用适滴(碱性活性戊二醛)浸泡3min后能杀灭致病菌及HBsAg.结论彻底清洗与在2%戊二醛液中浸泡3min能有效杀灭致病菌与HBsAg.     

新型过氧乙酸溶液消毒消化内镜的效果评价

目的 探讨新型过氧乙酸溶液应用于消化内镜消毒的临床价值.方法 选择消化内镜40条分成两组,每组胃镜和肠镜各10条,观察组接受新型过氧乙酸溶液消毒10 min,对照组接受常规2％戊二醛溶液消毒10 min,比较两组消毒合格率,评价新型过氧乙酸溶液消毒的有效性.有效性获得证实后,再选择消化内镜80条分成四组,每组胃镜和肠镜各10条,分别接受新型过氧乙酸溶液消毒2 min、3 min、4 min和5 min,比较消毒合格率,探讨新型过氧乙酸溶液消毒的高效性.结果 对照组胃镜消毒合格率为100％ (10/10),肠镜消毒合格率为90％(9/10),消毒后胃镜和肠镜均能检出菌落;观察组胃镜和肠镜消毒合格率均为100％,且消毒后胃镜和肠镜均不再检出菌落,明显优于对照组.新型过氧乙酸溶液消毒3 min组、4 min组和5 min组胃镜消毒合格率均为100％(10/10),明显高于2 min组的30％ (3/10) (P ＜0.05),但3 min组仍可检出菌落;2 min组肠镜消毒均不合格,4 min组和5 min组肠镜消毒合格率均为100％,明显高于3 min的80％ (8/10) (P ＜0.05),但4 min组仍可检出菌落.结论 新型过氧乙酸溶液可用于临床消化内镜的消毒,较2％戊二醛溶液更符合消化内镜高水平消毒的要求.     

四步法对污染胃镜的消毒效果

内镜检查与治疗引起的交叉感染时有报道,因此,内镜的有效消毒显得非常重要。我院内镜室用四步消毒法对内镜进行清洗消毒,经验证,消毒效果肯定,现报道如下。 操作方法:先用酒精纱布擦净内镜镜身表面粘液及污迹,放入1:200的84消毒液（青岛产）中,擦洗镜身并持续吸引冲洗内管道,然后取出置于高压自来水多孔冲洗槽中,用自来水反复冲洗镜身,再将内镜放入1:2000的氧氯灵-100（北京产）液中浸泡3 min,并不断送气吸水。最后将胃镜放入无菌蒸馏水中冲洗1～2 min。取出胃镜,垂直吊起,取内管道中流出液体2 ml于无菌试管中。再用无菌盐水纱布环绕镜身反复擦拭（工作刻度以下）,将纱布放入无菌生理盐水中浸泡2 min,将2 ml洗脱液置另一无菌试管中。将2     

戊二醛超声雾化对乙型肝炎病毒污染胃镜的消毒

胃镜在临床中的应用越来越广，但由于其在操作中与患者的体液、组织、血液等密切接触，由此带来的病毒和细菌污染问题也不容忽视，胃镜的消毒问题日益受到重视。我们采用戊二醛超声雾化对胃镜进行消毒，以观察其对乙型肝炎病毒的消毒作用及有效的消毒时间。     

强氧化离子酸性水和戊二醛对胃镜消毒效果的对比观察

现在国内多数医院的情况是:一条内镜在一个单元时间内多次重复使用,如消毒不严格,势必增加经内镜幽门螺杆菌Hp）、乙肝病毒（HBV）等交叉感染机会,并可能成为医源性感染的重要途径。因而,内镜消毒已成为世人瞩目和急待解决的重要课题。强氧化离子酸性水是一种新型的内镜消毒剂,我们将其和现有的内镜消毒剂——戊二醛对比,观察两者对胃镜的消毒效果。 一、材料与方法     

戊二醛三槽法消毒胃镜使用后肝功及HBsAg评析

目的：探讨在基层医院使用戊二醛消毒胃镜的某些方法。方法：总结分析现有226份较为完整的资料，观察使用戊二醛三槽法消毒内镜后，HBsAg阴性患者肝功能复查情况。结果：全部HBsAg阴性患者肝功能复查结果均正常。结论：规范使用戊二醛三槽法消毒内镜后，能最大限度减少乙肝病毒感染机率。     

影响戊二醛消毒内镜的效果观察

1997年以来,我院将 2％戊二醛用于胃镜消毒。由于戊二醛易挥发,易受多种因素的影响,直接影响到消毒效果,现将几种影响因素报告如下。 　　1.一般资料：使用者为各种需作胃镜的患者,（乙肝除外）,包括上消化道肿瘤,消化性溃疡,急慢性胃炎等。 　　2.配制方法： 25％的戊二醛溶液 100ml,加蒸馏水 1 250ml,加 3％碳酸氢钠 3.75g,配制成 2％碱性戊二醛。 　　3.检查方法及分组： (1)取少量 2％戊二醛消毒液 2份作对照,一份密封,一份暴露于空气中。胃镜使用后,用 1： 200 84消毒液及清水冲洗各部件及镜身全部活动旋钮,吸引冲洗 10…     

纤维胃镜消毒与保养方法的探讨

随着纤维胃镜的广泛应用,为避免患者交叉感染,充分发挥仪器的性能,延长仪器的使用期限,胃镜的清洗、消毒保养方法越来越受到重视。现将近年来我院改进的胃镜消毒保养方法报告如下。１．清洗消毒：我们对ＯｌｙｍｐｕｓＧＩＦ－Ｑ２０胃镜的消毒灭菌,采用配有活性剂的２％戊二醛消毒液,另外备有流动水槽２个、无菌纱布数块、无菌碗三个及无菌手套。消毒方法：消毒原则为消毒－清洗－消毒－清洗。胃镜一经从体腔拔出,应立即用卫生纸擦去胃镜插入部表面的粘液。取下送气按钮,更换专用洗涤按钮,送水送气各１０ｓ,以冲出可能逆流到送气…     

EFFICACY OF HIGH‐LEVEL DISINFECTANTS FOR GASTROINTESTINAL ENDOSCOPE DISINFECTION AGAINST STRONGYLOIDES STERCORALIS

Background: Guidelines for high‐level disinfection of gastrointestinal endoscopes have been published in many countries; however, none of them have a statement for disinfection against the parasite Strongyloides stercoralis. To establish a method for gastrointestinal endoscope disinfection against Strongyloides stercoralis, we examined the disinfection efficacy of high‐level disinfectants (3% glutaraldehyde, 0.55% ortho‐phthalaldehyde, and 0.3% peracetic acid) and 70% ethanol by in vitro tests. Methods: Strongyloides stercoralis larval suspension (0.05 mL) was added to 0.95 mL of each disinfectant and disinfection time measured under low magnification microscopy. Results: Among the high‐level disinfectants, peracetic acid was more efficacious for disinfection against Strongyloides stercoralis than glutaraldehyde and ortho‐phthalaldehyde. Ethanol was also efficacious for parasite killing. Conclusion: These results suggested that peracetic acid be recommended for gastrointestinal endoscope disinfection in regions with endemic Strongyloides stercoralis.     

Efficacy of electrolyzed acid water in reprocessing patient-used flexible upper endoscopes: Comparison with 2% alkaline glutaraldehyde

BACKGROUND AND AIM: Two percent glutaraldehyde, the most widely used liquid chemical germicide (LCG), may be hazardous to patients and medical personnel. Alternatives to glutaraldehyde, such as electrolyzed acid water (EAW), are being developed, but data from well-controlled studies with patient-used endoscopes are rare. The purpose of the present paper was to evaluate the high-level disinfection capability of EAW and compare it with glutaraldehyde. METHODS: A random sample of 125 endoscopes was collected immediately after upper endoscopic examination. After careful manual cleaning, endoscopes were divided into a glutaraldehyde and EAW group. After the disinfection procedure, samples from working channel (S-1), insertion tube (S-2), umbilical cord (S-3), and angulation knob (S-4) were taken and cultured. Another twenty endoscopes were experimentally contaminated with hepatitis B virus (HBV) and samples were collected after contamination (T-1), after manual cleaning (T-2), and after final disinfection (T-3). Polymerase chain reaction (PCR) for HBV-DNA was performed. RESULTS: In the EAW group, culture-positive rates were 3.2% in S-1, 9.5% in S-2, 3.2% in S-3, and 27.0% in the S-4 samples. There was no significant difference between the EAW and glutaraldehyde groups for all sampling sites. However, in both groups, disinfection of the angulation knobs (S-4) was less efficient than the others. For the T-1 site, HBV-DNA was detected from all of them, and in 95% (19/20) of T-2. However, HBV-DNA was not detected from T-3 samples. CONCLUSIONS: Electrolyzed acid water is as efficient as glutaraldehyde in eliminating bacteria from patient-used endoscopes. After disinfection procedures using both methods, HBV-DNA was not detected from any endoscopes experimentally contaminated with HBV-positive mixed sera. However, some bacteria may remain on the surface of the endoscopes. Therefore, more careful precleaning of the endoscopes may help achieve high-level disinfection in the clinical setting.     

Evaluation of the Cathetron system for recycling angioplasty catheters

The Cathetron (Minntech Corporation, Minneapolis, MN) peracetic acid-based reprocessing method for percutaneous transluminal coronary angioplasty (PTCA) catheters was evaluated for ability to sterilize and maintain catheter integrity. The balloons and lumens of 42 catheters (140 reprocessing cycles) were inoculated with suspensions of Staphylococcus epidermidis, S. aureus, Pseudomonas aeruginosa, and Bacillus circulans. Five catheters failed the initial evaluation of mechanical integrity and were discarded. Cultures from 37 catheter lumens, balloons, and hubs (n = 349) were negative following reprocessing. The Cathetron system reliably sterilized PTCA catheter; however, further studies using different brands of catheters and evaluating catheter sterility over time under storage conditions are required. Cathet. Cardiovasc. Diagn. 41:132–135, 1997. © 1997 Wiley-Liss, Inc.     

Strongly acidic electrolyzed water: valuable disinfectant of endoscopes

Background: Glutaraldehyde (GA) is currently considered to be the best disinfectant for endoscope disinfection. However, GA poses high risks for medical staff involved in the process and also to the environment. Strongly acidic electrolyzed water (SAEW) has been recently re‐evaluated for its potent bactericidal effect and environmental safety. Methods: Through the aspiration channel of the scopes, upper GI endoscopes and colonoscopes were experimentally contaminated with Pseudomonas aeruginosa, Mycobacterium avium and hepatitis B surface antigen positive blood. Four disinfection methods were tested: manual washing only, soaking in 3% GA for 5 and 10 min, and a 10‐s soak in SAEW with 50 or 100 mL of aspiration. Results: Direct plating culture was positive for Pseudomononas contamination after manual washing only (1/5) and after a 5‐min soak in 3% GA. Complete disinfection, confirmed by enrichment culture and polymerase chain reaction (PCR) of Pseudomonas and hepatitis B surface antigen positive blood on the contaminated upper GI endoscope was obtained after a 10‐min soak in GA and after using SAEW (0/5). Mycobacterum avium are rather resistant against SAEW as determined by broth culture and PCR (1/5). Conclusion: Strongly acidic electrolyzed water is a valuable disinfectant for endoscopes.     

多不饱和脂肪酸对高碘所致胚胎损害的拮抗作用

目的：观察多不饱和脂肪酸对高碘所致胚胎损害的拮抗作用。方法：将小鼠随机分为适碘组,高碘组,高碘十多不饱和脂肪酸组（DHA,EPA）,分别饮含碘50,3000ug/L的去离子水,喂养3个月,令雌雄同笼,观察胚胎生长发育情况,结果：加多不饱和脂肪酸组甲状腺绝对重量和相对重量,畸胎率和颈椎异常均低于高碘组（P＜0．05）,而窝平均体重和窝平均胎盘重均高于高碘组（P＜0．005）,多不饱和脂肪酸组与适碘组相比,窝平均胎盘增加,结论：多不饱和脂肪酸对高碘所致胎胎损害有一定的秸抗作用。     

MODIFIED ENDOSCOPIC CONGO RED TEST: A RAPID METHOD TO VISUALIZE GASTRIC ACID SECRETION

Background: The conventional endoscopic Congo red test (CRT) permits visualization of acid‐producing mucosa. However, the CRT has not been disseminated into clinical endoscopy, which is partly due to the substantial prolongation of the gastroscopic examination. Methods: Five healthy volunteers and 551 patients were included in a study designed to develop a more rapid approach based on the CRT. In this modified endoscopic Congo red test (MCRT), 0.2 µg/kg of pentagastrin was given intravenously to stimulate gastric acid production. The technical feasibility, tolerability, reproducibility, and inter‐ and intra‐observer reliability of the MCRT were evaluated. Results: The MCRT was as effective as the CRT (i.e. 6 µg/kg of pentagastrin was administered intramuscularly) in visualizing the extent of acid‐producing gastric mucosa. Moreover, the MCRT significantly reduced the duration of examination by 63% (almost 8 min), compared to the CRT. Conclusions: This MCRT is a simple, inexpensive, well‐tolerated and reproducible method with low inter‐ and intra‐observer variability and is well suited for endoscopy units with high workloads.     

Analysis of omega-3 fatty acid content of South African fish oil supplements

Introduction

Substantial evidence describes the protective effects of marine-derived omega-3 (n-3) polyunsaturated fatty acids (PUFA) on cardiovascular diseases as well as many other conditions. Numerous fatty acid preparations are marketed for supplementing the Western diet, which is low in n-3 fats. Since these preparations may vary in their n-3 PUFA content, we tested 45 commercially available products on the South African market for their fatty acid composition.

Method

Forty-five commercially available n-3 fatty acid supplements were analysed using gas–liquid chromatography to determine their fatty acid content.

Results

More than half of the n-3 supplements available on the South African market contained ≤ 89% of the claimed content of EPA and/or DHA as stated on the product labels. To meet ISSFAL’s recommendation of 500 mg EPA + DHA/day can cost consumers between R2 and R5 per person per day (R60 to R150 p/p/month). Regarding rancidity, the majority of capsules contained conjugated diene (CD) levels higher than that of vegetable oil obtained from opened containers (three months) used for domestic cooking purposes, despite the addition of vitamin E as antioxidant.

Conclusion

Since no formal regulatory structure for dietary supplements currently exists in South Africa, consumers depend on self-regulation within the nutraceutical industry for assurance of product quality, consistency, potency and purity. Our results indicate that more than half of the n-3 fatty acid supplements on the South African market do not contain the claimed EPA and/or DHA contents as stated on product labels, and they contained CD levels higher than that in unused vegetable oils obtained from opened containers used for domestic cooking purposes.     

Use of a latex cover sheath for transesophageal echocardiography (TEE) instead of regular disinfection of the echoscope?

Better visualization of cardiac structures is an advantage of transesophageal echocardiography (TEE). Because of this, the transesophageal approach is an essential window in the assessment of various cardiovascular disorders. Quick consecutive access to this instrument should not be delayed by time-consuming cleansing procedures of the probe. In this study we used a sterile latex condom in routine TEE examinations as a barrier to contamination of the echoscope, observing practical use and the incidence of perforations. Defects were detected after the procedure by visual inspection and by an airtightness test. Maneuvers or situations associated with an increased likelihood of injury were checked for. In 180 studies a total of 168 patients were consecutively examined; insertion was feasible in all but one case (99.5%). We found 8 of 181 (4.4%) sheaths defective following the procedure. Visual inspection was less sensitive (only 3 of 8) for finding defects than an airtight-ness test (8 times). Teeth in situ and/or a bite guard are the only sharp edges during insertion and removing the probe; these seem to be the main risk factors in latex perforation. Application of a cover sheath for each examination saves approximately two-thirds of the time otherwise necessary for a cleansing bath, and easy handling of cover sheaths for TEE make them an alternative to regular disinfection in general. For reasons of safety we recommend checking each used cover sheath after examination for holes so as not to jeopardize the following patient by the possible spread of germs from contaminated probes. Not only visual inspection but also a second method, for example, an airtightness test, is mandatory.