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PubMed2000

Replace hand washing with use of a waterless alcohol hand rub?

Hand hygiene is one of the basic components of any infection control program and is frequently considered synonymous with hand washing. However, health care workers frequently do not wash their hands, and compliance rarely exceeds 40%. Hand rubbing with a waterless, alcohol-based rub-in cleanser is commonly used in many European countries instead of hand washing. Scientific evidence and ease of use support employment of a hand rub for routine hand hygiene. It is microbiologically more effective in vitro and in vivo, it saves time, and preliminary data demonstrate better compliance than with hand washing. Therefore, a task force comprising experts from the Centers for Disease Control and Prevention and from professional societies is designing guidelines for the use of a hand rub in the United States. Today, most countries of Northern Europe recommend a hand rub for hand hygiene unless the hands are visibly soiled. Side effects are rare and are mainly related to dryness of the skin. This review evaluates the scientific and clinical evidence that support the use of alcohol-based hand rubs in health care facilities as a new option for hand hygiene.

Alcohols↗

PubMed2004

A prospective, blinded study of quantitative touch-down polymerase chain reaction using oral-wash samples for diagnosis of Pneumocystis pneumonia in HIV-infected patients.

Oral-wash samples obtained during 113 episodes of suspected Pneumocystis pneumonia (PCP) in human immunodeficiency virus-infected patients were tested by use of a quantitative touch-down PCR (QTD PCR) assay. QTD PCR had a sensitivity of 88% and a specificity of 85%. Treatment for PCP prior to oral wash collection had an impact on the sensitivity, and PCR-positive oral-wash samples obtained within < or =1 day of treatment from patients without PCP had significantly fewer copies per tube than did those from patients with PCP; thus, application of a post hoc cut-off value of 50 copies/tube increased the specificity to 100%. QTD PCR of oral-wash samples can be an accurate and noninvasive method for diagnosis of PCP.

AIDS-Related Opportunistic Infections↗

PubMed1981

Evaluation of erythrocyte washing using the Haemonetics Model 102 Cell Washer.

The Haemonetics Model 102 Cell Washer was evaluated for efficiency of leukocyte removal and erythrocyte recovery. Groups of 25 units of blood were washed using five different protocols, including the methods recommended by the manufacturer. Mean erythrocyte recovery ranged from 83% to 91% and median residual leukocytes ranged from 1% to 4% for the five protocols. The mean erythrocyte recovery for units washed with 30 sec of increased pump speed was 95%, while it was 84% for units washed with 90 sec of increased pump speed (P less than 0.001). The median residual leukocytes was 1% for units washed after buffy coat removal and 4% for all other units (P less than 0.001). There was no other significant difference among the different protocols. These findings could not be explained on the basis of age of units, prewash erythrocyte mass, or prewash total leukocytes.

Blood Preservation↗

PubMed1986

A rapid, no-wash technic for immunophenotypic analysis by flow cytometry.

With the advent of fluorochrome-labeled monoclonal antibodies, it has now become possible to eliminate the removal of unbound antibodies during immunophenotypic analysis of lymphoid cells by flow cytometry. Suspensions of mononuclear cells from healthy controls and fluoresceinated monoclonal antibodies may be introduced directly into the flow cytometer. The percentage of nonwashed antibody-positive cells from healthy controls as compared with the conventional technic of cell washing shows a good correlation. However, the correlation is not as good when the lymphocytes from certain classes of diseased patients are analyzed. It appears that excessive washing in fact produces erroneous results for certain markers with cells from diseased patients. The no-wash technic is also applicable to various combinations of dual-fluorescence monoclonal antibody staining. This technic substantially reduces the processing time and, more importantly, eliminates some of the cell losses and artifacts induced during the process of cell washing. The shortened processing time has allowed rapid responsiveness in certain urgent clinical situations.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Comprehensive two-dimensional gas chromatography for fast screening of wash oils.

Fast screening of wash oils is demonstrated using comprehensive two-dimensional gas chromatography (GCxGC). Wash oils are used in ethylene production plants to minimize compressor fouling. The composition of a wash oil determines its effectiveness in solubilizing heavy hydrocarbons. In particular, the relative amount of 1- and 2-ring aromatics is important. The presence of oxygenates is undesirable because of adverse effects to the process. It is shown that GCxGC is well suited for this application. Species in wash oils are separated and grouped into three bands: a nonpolar aliphatics band, 1- and 2-ring aromatics band, and polyaromatics band. For a given polar secondary column, the spacing between bands in the second dimension can be adjusted in a broad range by selecting a primary column and an oven-temperature-programming rate. Integration of GCxGC peaks is evaluated using a standard GC integration program and a new GCxGC integration program. Consistent results are obtained using both programs for well-separated GCxGC peaks with relative differences for individual peak ranging from 0.04% to 1.6%. Peak responses are integrated by the GCxGC software, and the relative amounts of aromatics content and aliphatics content are estimated by peak response percent with relative standard deviations ranging from 0.15% to 2.8% (n = 3).

Journal Article↗

PubMed2002

Quantitative detection of disseminated free cancer cells in peritoneal washes with real-time reverse transcriptase-polymerase chain reaction: a sensitive predictor of outcome for patients with gastric carcinoma.

OBJECTIVE: To evaluate the feasibility of real-time reverse transcriptase-polymerase chain reaction (RT-PCR) detection of free cancer cells in the peritoneal washes as a prognostic indicator for patients with gastric carcinoma. SUMMARY BACKGROUND DATA: Peritoneal lavage cytology (CY) is an excellent prognostic determinant but lacks sensitivity. This can be improved by using RT-PCR to quantitate carcinoembryonic antigen (CEA) mRNA in peritoneal washes. METHODS: Peritoneal washes were obtained from 189 patients with gastric carcinoma during laparotomy. CEA mRNA levels and CEA/GAPDH mRNA ratios were quantified using a real-time PCR system with fluorescent hybridization probes. Receiver-operating characteristic plots were used to determine which of these parameters should be used as a marker for the intraperitoneal cancer cells. The prognostic significance of its positivity was then evaluated by Kaplan-Meier curves, and its value as an independent prognostic factor was evaluated by multivariate analysis. RESULTS: The sensitivity and specificity of real-time RT-PCR with an optimal cutoff value were 80% and 94%; those for conventional cytology were 56% and 91%. The survival of 16 patients who were CY-PCR+ was poor and approached that of 35 CY+ patients. Recurrence as peritoneal carcinomatosis was frequent among PCR+ patients but rare for their PCR- counterparts. PCR+ was a significant independent prognostic factor, along with the presence of node metastasis and serosal invasion, but CY+ was not. CONCLUSIONS: Quantitative RT-PCR of peritoneal washes can replace cytologic examination as a tool for the sensitive evaluation of the risk of intraperitoneal recurrence in patients with gastric carcinoma.

Adenocarcinoma↗

PubMed1997

Peritoneal washing cytology combined with immunocytochemical staining and detecting mutant K-ras in pancreatic cancer: comparison of the sensitivity and availability of various methods.

Peritoneal metastases are the second most common site of involvement, following the liver, in pancreatic cancer. Thus, we performed peritoneal washing cytology at laparotomy to diagnose accurately the intraperitoneal spread of carcinoma cells to determine the appropriate therapy. Peritoneal washings were collected at laparotomy from 20 Japanese pancreatic carcinoma patients at Nagoya University Hospital between April 1993 and December 1994. From centrifuged deposits, we examined the cytology by three methods as follows. The first method was conventional cytology, including May-Grünwald and Giemsa, Papanicolaou, periodic acid-Schiff, and Alcian blue. The second method was immunocytochemical staining, using antibodies to carbohydrate antigen (CA19-9) and carcinoembryonic antigen. After extracting DNA from the remaining pellet, we studied the last method, detecting K-ras point mutation, by two-step polymerase chain reaction and restriction fragment length polymorphism analysis. In two cases, peritoneal metastases were macroscopically recognized, and the results of all three methods were positive. In the two other cases, where peritoneal dissemination was not macroscopically recognized, the judgments of conventional cytological study and detecting K-ras point mutation were negative. However, a few malignant cells were found by the immunocytochemical staining method. Judging from their clinical course, the positively stained cells were suggestive of malignancy. At present, the immunocytochemical staining method is the most sensitive of these three methods in peritoneal washing cytology. However, preserving DNA is suitable for repeated examination, and a modified method can be applied. If the sensitivity increases, the method of detecting K-ras has the potential to become the standard for peritoneal washing cytology in pancreatic cancer.

Adult↗

PubMed2002

Removing pesticides from the hands with a simple washing procedure using soap and water.

Crop activities lead to dermal exposure of workers to pesticides. The efficacy of hand washing as a control measure is unknown. The efficacy of water and soap was studied for some pesticides and exposure situations. Pre-washing contamination levels in field studies were calculated from foliar residues by models using transfer factors. Between 24.5% and 50.7% of the calculated prewashing contamination was removed in two field studies with three pesticides, with coefficients of variation between 43% and 72%. In a human volunteer study, on average 45.8% and 85.7% was removed for two pesticides (coefficients of variation 6% and 7%). No influence of 'washing vigour' was found and efficacy did not depend on pre-washing contamination levels. The combination of field studies and laboratory experiments was successful, partly compensating for weaknesses in both approaches.

Adult↗

PubMed1979

Comparison of the responses of corn root tissue to fusicoccin and washing.

A comparison has been made of the effects of fusicoccin with those of washing on segments of corn (Zea mays L.) root tissue. Both fusicoccin and washing caused increases in K(+)((86)Rb) influx, net H(+) efflux, and electrogenic cell membrane potential, but with no effect on respiration rate. The similarity was most evident with fresh tissue during the initial phases of washing, prior to the developmental changes which augment the anion and general solute transport rates of the tissue. After the development of enhanced transport capacity the proportional response to fusicoccin was much diminished. It is suggested that the fusicoccin-like response to washing may be a manifestation of recovery from injury.

Journal Article↗

PubMed1976

A plasmocytoma ribosome-associated protein kinase which phosphorylates a specific protein of the ribosomal KCl wash.

One ribosomal protein kinase activity and 3 soluble protein kinase activities have been identified in plasma cell tumors by DEAE-cellulose chromatography. We have shown phosphorylation in vivo and in vitro of a protein fraction from the ribosomal KCl wash which we have termed 'PPx fraction'. Phosphorylation of this protein fraction has been obtained in vitro with the ribosome-associated protein kinase. We have determined for the ribosomal protein kinase the following characteristics. 1. It is an Mg2+-dependent enzyme that transfers the gamma-phosphate from ATP into phosphoseryl and phosphothreonyl residues of the substrate. 2. It has a wide substrate specificity. Like the soluble protein kinases it catalyses the phosphorylation of several proteins like histone, phosvitin, casein and ribosomal proteins but it differs from the main soluble kinases (I, II) by the fact that it catalyses specifically the phosphorylation at least of one of the ribosomal KCl wash proteins. On dodecylsulfate-polyacrylamide gels this protein has a molecular weight of approximately 90000 and it is released from ribosomes under conditions commonly employed for extraction of initiation factors. 3. The ribosome-associated protein kinase is not stimulated by the addition of cyclic adenosine 3':5'-monophosphate. 4. KCl has no effect, NaCl has a weak effect on the phosphorylation, Mn2+ and Ca2+ are inhibitors. 5. ADP has been found to be a competitive inhibitor. 6. The maximum velocity of the ribosomal protein-kinase-catalysed reaction is 0.65 nmol of 32P incorporated in the KCl wash protein per min and per mg protein. 7. The apparent Km for the ribosomal KCl wash protein as substrate is 0.71 mg/ml and the Km for ATP is 94 muM. 8. The molecular weight of the ribosomal protein kinase, estimated by electrophoresis in polyacrylamide-dodecylsulfate gels, is 60000 and corresponds probably to a catalytic subunit.

Adenosine Diphosphate↗

PubMedDate not supplied

Evidence for the reconstitution of motility by epididymal plasma-protein factor(s) in immotile washed spermatozoa from goat cauda epididymis.

Approx. 90% of the highly motile goat cauda-epididymal spermatozoa lose motility completely due to removal of the surrounding epididymal plasma (EP) by washing with a modified Ringer's solution. Motility can however, be reconstituted in approx. 80% of these washed cells that lost motility during washing, with the addition of goat cauda-EP. The activity of the EP-factor(s) that cause reconstitution of motility in the washed immotile spermatozoa, is nondialysable and sensitive to the action of trypsin. The activity of the factor(s) is not dependent on exogenous Ca2+ (1 mM), Mg2+ (1.2 mM), cyclic AMP (5 mM) or dibutyryl cyclic AMP (5 mM). The novel system may thus serve as an excellent analytical tool to yield an insight into the molecular basis of the regulation of spermatozoal motility.

Animals↗

PubMed1987

Effect of washing on sperm surface autoantibodies.

This study tested the hypothesis that immediate washing "removes" sperm surface antibodies. Nine ejaculates with antisperm antibodies were studied. Separate portions of each ejaculate were washed by centrifugation (Shulman's method) as soon as possible after production (0-h) and 2 h later (2-h). In four samples, portions were also washed by a simple swim-up migration started at 0-h. Washed sperm were tested for surface antibodies using the immunobead binding test. The number of sperm with bound IgG antibodies at 0-h was significantly less than that at 2-h (P less than 0.001) but no significant difference was found in respect of IgA antibodies. Swim-up migration yielded results similar to those of centrifugation and had the advantage of selecting highly motile sperm. The potential application and implication of these findings are discussed.

Autoantibodies↗

PubMed2006

'Hair wash' or 'head bath' triggering migraine - observations in 94 Indian patients.

Identification of trigger factors is helpful in the diagnosis and management of migraine. Common triggers of migraine are well established but 'hair wash or head bath' as a trigger for migraine has so far not been reported. This prospective study analysed this unusual trigger link in 94 out of 1500 Indian patients who fulfilled the International Headache Society criteria for migraine. In 11 patients, hair wash was the only trigger; in 45 patients hair wash was one of the triggers and in 38 patients hair wash was a trigger concurrently and in combination with another common trigger. The effect of episodic and long-term prophylaxis in preventing this trigger-like headache has been analysed. The underlying pathophysiological basis is not established but it is important for this unusual regional trigger to be identified and incorporated in the management strategy.

Adult↗

PubMed1995

Irritant effects of a detergent in wash and chamber tests.

Irritant properties of detergents can be tested by using patch and chamber tests and various kinds of use tests. The aim of the present study was to compare the results of use and 12 mm Finn Chamber tests. Study subjects (10 atopic and 11 non-atopic medical students) washed the outer aspect of 1 upper arm with liquid detergent for 1 minute 2 x daily for 1 week. 48-h chamber test with 5 concentrations of the same detergent in water were concurrently applied to upper back skin. Transepidermal water loss (TEWL), electrical capacitance and skin blood flow were measured to quantify reactions on days 0, 2, 5 and 7. Irritant contact dermatitis developed equally in atopics and non-atopics in the wash test, whereas in the chamber test with a 10% aq. solution of the detergent, increase in TEWL was significantly higher in atopics than in non-atopics. The chamber test results thus predicted poorly the result of the wash test. This might indicate that the wash test and the chamber test measure different aspects of skin barrier function.

Adult↗

PubMed1993

[Pleural washing with povidone-iodine for treatment of empyema].

In this paper, we report two successful cases of empyema treated by pleural washing with povidone-iodine solution. In these two cases, empyema was caused by secondary infection of multi-drug resistant Pseudomonas aeruginosa. First, we replaced intrathoracic drainage tube and washed intrathoracic space with 500-1000 ml saline containing antibiotics (tobramycin, aztreonam) every 8 hours for 10-14 days. But, cultural studies of pleural effusion were positive even after this treatment. So, we tried pleural washing with warm povidone-iodine solution 1:20 diluted with saline every 8 hours. Surprisingly, after 3 days treatment, cultural studies of the pleural effusion became negative. This pleural washing method with povidone-iodine was very effective for treatment of empyema patients.

Aged↗

PubMed1993

Comparative in vivo efficiencies of hand-washing agents against hepatitis A virus (HM-175) and poliovirus type 1 (Sabin).

The abilities of 10 hygienic hand-washing agents and tap water (containing approximately 0.5 ppm of free chlorine) to eliminate strain HM-175 of hepatitis A virus (HAV) and poliovirus (PV) type 1 (Sabin) were compared by using finger pad and whole-hand protocols with three adult volunteers. A mixture of the two viruses was prepared in a 10% suspension of feces, and 10 microliters of the mixture was placed on each finger pad. The inoculum was allowed to dry for 20 min, and the contaminated area was exposed to a hand-washing agent for 10 s, rinsed in tap water, and dried with a paper towel. In the whole-hand protocol, the hands were contaminated with 0.5 ml of the virus mixture, exposed for 10 s to a hand-washing agent, washed, and dried as described above. Tryptose phosphate broth was used to elute any virus remaining on the finger pads or hands. One part of the eluate was assayed directly for PV with FRhK-4 cells, while the other part was first treated with a PV-neutralizing serum and then assayed for HAV with the same cell line. The results are reported as mean percentages of reduction in PFU compared with the amount of infectious virus detectable after initial drying.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2000

Effects of acid adaptation of Escherichia coli O157:H7 on efficacy of acetic acid spray washes to decontaminate beef carcass tissue.

Exposure to low pH and organic acids in the bovine gastrointestinal tract may result in the induced acid resistance of Escherichia coli O157:H7 and other pathogens that may subsequently contaminate beef carcasses. The effect of acid adaptation of E. coli O157:H7 on the ability of acetic acid spray washing to reduce populations of this organism on beef carcass tissue was examined. Stationary-phase acid resistance and the ability to induce acid tolerance were determined for a collection of E. coli O157:H7 strains by testing the survival of acid-adapted and unadapted cells in HCl-acidified tryptic soy broth (pH 2.5). Three E. coli O157:H7 strains that were categorized as acid resistant (ATCC 43895) or acid sensitive (ATCC 43890) or that demonstrated inducible acid tolerance (ATCC 43889) were used in spray wash studies. Prerigor beef carcass surface tissue was inoculated with bovine feces containing either acid-adapted or unadapted E. coli O157:H7. The beef tissue was subjected to spray washing treatments with water or 2% acetic acid or left untreated. For strains ATCC 43895 and 43889, larger populations of acid-adapted cells than of unadapted cells remained on beef tissue following 2% acetic acid treatments and these differences remained throughout 14 days of 4 degrees C storage. For both strains, numbers of acid-adapted cells remaining on tissue following 2% acetic acid treatments were similar to numbers of both acid-adapted and unadapted cells remaining on tissue following water treatments. For strain ATCC 43890, there was no difference between populations of acid-adapted and unadapted cells remaining on beef tissue immediately following 2% acetic acid treatments. These data indicate that adaptation to acidic conditions by E. coli O157:H7 can negatively influence the effectiveness of 2% acetic acid spray washing in reducing the numbers of this organism on carcasses.

Abattoirs↗

PubMed1977

Factors influencing the appearance of antibody in tracheal washes and serum of young chickens after exposure to Newcastle disease virus.

The development of plaque-neutralizing antibody in tracheal washes and hemagglutination inhibition antibody in serum was followed after intratracheal and intranasal or intramuscular inoculation of 1-, 14-, or 28-day-old chicks with a lentogenic strain of Newcastle disease virus (NDV). Serum antibody could be detected between 7 and 10 days after intratracheal and intranasal vaccination in birds either with or without maternal antibody to NDV. However, among the 1-day-old group only birds without maternal antibody showed an antibody response after intramuscular inoculation. All birds possessing either actively or passively acquired serum antibody showed a sharp rise and subsequent decline of anti-NDV activity in tracheal washes between 4 and 10 days after intratracheal or intranasal vaccination. Using radiolabeled chicken immunoglobulin injected intravenously as a tracer, it was shown that this initial peak of anti-NDV activity in tracheal washes could be accounted for by enhanced transudation of serum antibody. The transudation of serum antibody coincided with the course of viral pathology observed in the tracheae of infected birds. Neutralizing antibody in tracheal washes beyond 10 to 14 days postvaccination was, most likely, porduced locally, in the respiratory tract.

Administration, Intranasal↗