Streptokinase versus alteplase and other treatments for acute and delayed thrombolysis of blood stains in clothing.
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OBJECTIVE: To assess the usefulness of heparin, alteplase, and streptokinase in removing blood stains. DESIGN: Randomised controlled trial. SETTING: Hospital laundry. INTERVENTIONS: Blood stains were allocated to treatment with alteplase, streptokinase, heparin, a commercial enzymatic stain remover, or no treatment at all after three or seven hours and then washed in hot or cold water two hours later. RESULTS: Both hot water and early treatment were strongly associated with improved stain removal. All four treatments were associated with a worse outcome than no treatment at all, although for streptokinase this trend did not reach significance. The commercial stain remover gave the worst results of all treatments tested. CONCLUSIONS: Contrary to popular wisdom, hot water is much more effective than cold in removing blood stains. Methodologically rigorous research and evidence based principles are needed within the laundry industry, and the role of thrombolytic drugs should be assessed further. (+info)
Reflections on errors in neonatology: II. The "Heroic" years, 1950 to 1970.
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This series errors in neonatology since the 1920s. Three historical periods are defined: the "Hands-Off" years from 1920 to 1950, the "Heroic" years from 1950 to 1970, and the "Experienced" years from 1970 on. In this article, the "Heroic" years, we discuss the Blossom air lock, sulfisoxazole, chloramphenicol, novobiocin, hexachlorophene, Epsom salts enemas, feeding gastrostomy, diaper laundering, and equipment cleaning. (+info)
Hospital textiles, are they a possible vehicle for healthcare-associated infections?
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Bacteriological quality of fabrics washed at lower-than-standard temperatures in a hospital laundry facility.
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We determined whether the bacteriological quality of fabrics cleaned in a hospital laundry could be maintained at wash temperatures lower than 75 degrees C by the use of economically reasonable formulas and wash conditions. Three groups of bacteria were examined to determine bacteriological quality: aerobic, nonexacting chemoorganotrophs, staphylococci, and total coliforms. The distribution of bacteria on soiled fabric was patchy, with staphylococci and total coliforms ranging from less than 0.1 to greater than 4 X 10(3) CFU/cm2 and chemoorganotrophs ranging from less than 0.1 to greater than 5 X 10(5) CFU/cm2. The washing process routinely produced fabric containing less than 1 CFU/cm2. Low-temperature (47.8 to 60.0 degrees C) wash procedures eliminated all bacterial groups at least as effectively as did high-temperature procedures. The effectiveness of bacterial density reduction at low temperature was augmented by increased concentrations of bleach. Successful low-temperature washing such as that shown here may save both energy and money for hospitals. (+info)
Is a bed centre in a hospital a hygienic hazard?
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The contamination of linen and air in a bed centre, supply station and ward were compared, as well as the contamination of gowns used by the staff working in the 'clean' and the 'dirty' rooms of the bed-centre. The contamination of linen and air was low and there was no significant difference between the tested areas. The contamination on gowns used by the staff working in the 'dirty' room was significantly higher than that on gowns used by the staff working in the 'clean' room. This stresses the importance of dividing a bed centre into 'clean' and 'dirty' rooms. So organized, a bed centre does not seem to be a hygienic hazard. (+info)
Contamination of hospital linen by Bacillus cereus.
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An investigation into two cases of post-operative Bacillus cereus meningitis revealed that hospital linen laundered by a batch continuous washing machine was heavily contaminated by B. cereus spores. The washing machine, detergents, other chemical additives and the water supply were eliminated as the source of contamination. It was found that the linen introduced into the washing machine had a high B. cereus spore content and that this was still present after the wash process. The spores were not killed by either the heat disinfection stage of the wash or the addition of chemical disinfectants and were not removed by the dilution in the process. The multiplication of B. cereus was thought to have occurred on used, damp linen stored in plastic bags, particularly when ambient temperatures were high. An increase in the water flow through the washing machine was the only measure associated with a decrease in B. cereus on laundered linen. (+info)
Uses of inorganic hypochlorite (bleach) in health-care facilities.
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Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. (+info)