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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection control is an important issue in the dental surgery but the potential hazards associated with contaminated dental water have received relatively little attention in recent years. The complex design of the equipment results in stagnation of water within the dental chair and subsequent amplification of contaminating environmental organisms, including pseudomonads and legionellae, to potentially hazardous levels. Immunocompromised patients may be at particular risk of infection. Very poor water quality with total bacterial counts above 10(4) ml-1 is unpleasant for all patients, and the dental chair supply should be of drinking water quality. In addition to these problems, bacteria and viruses may be aspirated from the oral cavity and contaminate the handpiece. Measures to reduce microbial contamination of dental chairs and equipment include flushing water through the chair's equipment at the beginning of each day; continuous or pulsed water chlorination, or application of biocides other than chlorine; provision of sterile bottled water in the system; and autoclaving handpieces between patients. Future dental chair design must attempt to resolve the problems associated with microbial contamination of the water supply and aerosols generated during dental procedures.
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PMID:The microbiological quality of water in dental chair units. 809 91

Forty-three children with malignant diseases who received 48 totally implanted venous accesses (TIVA) were retrospectively analyzed. More than half the patients had acute leukemia. Mean age was 6 years 10 months. Mean duration of use of the TIVA was 473 +/- 50 days (range 28 to 1,285 da; median 424 days). Removal of the TIVA was required because of an adverse event in 33% of cases. Main reasons for removal included infection (22.9%), thrombosis (6.25%), and catheter dysfunction (4.16%). Catheter-related infections were most often due to staphylococci (90%), especially S. epidermidis (63%). Infection rate was 0.48 per 1,000 patient-days. Flushing with a vancomycin-heparin solution can be expected to decrease this rate. Selection of the implantation site is discussed. In children under 6 years of age, the cephalic vein and external jugular vein are often frail or absent and are therefore less appropriate than the internal jugular vein or subclavian vein.
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PMID:[Clinical experience with totally implantable venous access systems in pediatric hematology and oncology]. 835 96

Naturally occurring cryptococcosis in five cats, a dog and a koala is described. Involvement of the nasopharynx was documented in all patients, and nasopharyngeal mass lesions accounted for the major presenting complaints in four. Signs referable to nasopharyngeal disease included snoring, stertor, inspiratory dyspnoea and aerophagia. Diagnoses were made by caudal rhinoscopy using a retroverted flexible endoscope, vigorous orthograde flushing with saline, or at necropsy. Concurrent cryptococcal rhinitis was present in all cases, although involvement appeared limited to the caudal nasal cavity in most cases. Typical signs of nasal cavity disease, such as sneezing and nasal discharge, were often absent. Treatment of nasopharyngeal cryptococcosis should include physical dislodgement or debulking of lesion(s) to provide immediate alleviation of upper airway obstruction, followed by systemic antifungal therapy to eliminate residual infection from the nasal cavity. Infections caused by Cryptococcus neoformans var gattii accounted for a disproportionately large number of these cases.
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PMID:Nasopharyngeal cryptococcosis. 925 19

In 1991, we found that 23 percent of Ohio dentists sterilized handpieces between patients and 67 percent flushed handpieces between patients. In this study, we chose to investigate the changes in handpiece asepsis within Ohio dental offices for the twelve-month period ending August, 1992. Sixty-two percent of the 730 offices polled responded to the questionnaire. Offices reporting sterilization of handpieces between patients in 1992 is 80 percent compared to 23 percent in 1991. Sixty-nine percent of offices in the 1992 survey reported that they have changed infection control protocol to include heat sterilization of handpieces between patients while 24 percent report disinfection between patients. Back order of equipment, inadequate number of handpieces and fear of damage is cited by the offices using disinfection as the reasons for not sterilizing handpieces. Flushing handpieces between patients is reported by 83 percent of the offices. Previously, only 67 percent flushed between patients. Anti-retraction valves are present in 69 percent of the water lines. Breakdown of handpieces attributed to sterilization was reported by 45 percent of the offices. Two-hundred and three offices (45 percent) report questions from patients regarding office infection control policies. Infection control awareness of the general population and implementation of these procedures by dental professionals is increasing in Ohio.
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PMID:Comparison of handpiece asepsis among Ohio dentists: 1991 & 1992. 954 46

Infection is the most common serious complication of intravascular catheters. Most cases of catheter-related infection are caused by staphylococci that originate either from the skin of the patient and migrate along the external surface of the catheter or from a contaminated catheter hub and migrate along the internal surface of the catheter. Major risk factors predisposing to catheter-related infection include prolonged duration of catheter placement, frequent manipulation of the catheter, use of thrombogenic catheter material, location of the catheter, and use of occlusive transparent plastic dressings. A number of measures have been reported in prospective, randomized clinical trials to protect against vascular catheter-related infection. This paper summarizes the clinical efficacy of various preventive measures, such as placement and maintenance of vascular catheters by a skilled infusion therapy team, institution of maximal sterile barriers, use of silver-impregnated subcutaneous cuff, antimicrobial coating of catheters with either antibiotics or antiseptics, use of an antiseptic catheter hub, application of topical disinfectants, and flushing catheters with the combination of antimicrobial and antithrombotic agents.
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PMID:Prevention of vascular catheter-related infections. 1050 65

To determine the prevalence of Helicobacter pylori antigen carriage in stool in the Penan ethnic minority in Malaysian Borneo, we studied 295 Penans 0.6-89.0 years of age from 1) the remote Limbang Division, 2) Mulu regional center, and 3) Belaga village. Overall, 37.7% of the subjects tested positive. Peak prevalence was reached by 10 years of age. There were no differences in age, sex, body mass index, and socioeconomic/domestic variables between antigen-positive and antigen-negative subjects. In a logistic regression analysis, subjects from Limbang were least likely to be antigen-positive (odds ratio [OR] = 0.23, 95% confidence interval [CI] = 0.12-0.44 versus other sites, P < 0.001). Availability of a flushing toilet was protective against H. pylori carriage (OR = 0.51, 95% CI = 0.27-0.95, P = 0.031). Infection with H. pylori among the Penan was less than reported in other low socioeconomic groups. The lowest prevalence in the most remote setting suggests that the infection has been a recent arrival in previously isolated communities.
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PMID:Prevalence and predictors of Helicobacter pylori infection in children and adults from the Penan ethnic minority of Malaysian Borneo. 1551 41

Guidelines for reprocessing flexible endoscopes have been published in many countries. The present survey investigated compliance with German guidelines in all hospitals and private practices in Frankfurt/Main, Germany. In 2003, all endoscopic units in Frankfurt/Main [15 hospitals and 23 private practices (10 large practices performing >1,000 endoscopies/year and 13 small practices performing <1,000 endoscopies/year)] were visited by members of the Public Health Service and assessed using a checklist based on the recommendations of the German guidelines. In 2004, a re-evaluation took place, either by analysing the written reports of the institutions or by visiting them again. Meanwhile, one hospital had closed and three small practices had ceased performing endoscopy, so the re-evaluation encompassed 14 hospitals and 20 private practices. In 2003, hospital compliance with the guidelines was satisfactory but many problems were identified in private practices. Between 2003 and 2004, great improvements were made. By the end of 2004, 90% of private practices had adequate storage facilities for reprocessed endoscopes, and were performing reprocessing of bottles and tubes for air-/water-channel flushing correctly (2003: adequate storage 52%; correct reprocessing 74%). Sterilization of endoscopic accessories was satisfactory, and routine testing of endoscopes after reprocessing was performed in all private practices at the end of 2004 (2003: sterilization of accessories 57%; microbiological control tests 56%). In 2003, although hospital compliance with the guidelines was satisfactory, mandatory improvements were required in private practices, notably in smaller units. Infection control advice and the control of public health regulations resulted in the correction of most processing faults between 2003 and 2004.
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PMID:German guidelines for reprocessing endoscopes and endoscopic accessories: guideline compliance in Frankfurt/Main, Germany. 1682 Feb 48

This article aims to provide guidance for practitioners on intravenous therapy devices, their management and care. It explains the indications for their use and considerations when selecting devices for intravenous therapy and treatment. Both PVADs and CVADs are discussed in detail to provide the practitioner with a clear understanding for each. Infection control and how to reduce infection risks are also addressed with recommendations for best practice guidance on flushing devices, minimising complications and documentation. This article addresses the importance of safe practice and aims to help practitioners to improve their knowledge and clinical decision-making for patients undergoing intravenous therapy.
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PMID:Intravenous therapy: guidance on devices, management and care. 2312 74

Introduction. P. aeruginosa is the primary cause for pulmonary destruction and premature death in cystic fibrosis (CF). Therefore, prevention of airway colonization with the pathogen, ubiquitously present in water, is essential. Infection of CF patients with P. aeruginosa after dentist treatment was proven and dental unit waterlines were identified as source, suggesting prophylactic measures. For their almost regular sinonasal involvement, CF patients often require otorhinolaryngological (ORL) attendance. Despite some fields around ORL-procedures with comparable risk for acquisition of P. aeruginosa, such CF cases have not yet been reported. We present four CF patients, who primarily acquired P. aeruginosa around ORL surgery, and one around dentist treatment. Additionally, we discuss risks and preventive strategies for CF patients undergoing ORL-treatment. Perils include contact to pathogen-carriers in waiting rooms, instrumentation, suction, drilling, and flushing fluid, when droplets containing pathogens can be nebulized. Postsurgery mucosal damage and debridement impair sinonasal mucociliary clearance, facilitating pathogen proliferation and infestation. Therefore, sinonasal surgery and dentist treatment of CF patients without chronic P. aeruginosa colonization must be linked to repeated microbiological assessment. Further studies must elaborate whether all CF patients undergoing ORL-surgery require antipseudomonal prophylaxis, including nasal lavages containing antibiotics. Altogether, this underestimated risk requires structured prevention protocols.
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PMID:Pseudomonas aeruginosa Acquisition in Cystic Fibrosis Patients in Context of Otorhinolaryngological Surgery or Dentist Attendance: Case Series and Discussion of Preventive Concepts. 2586 86

The protistan parasite Ichthyophonus sp. occurs in coastal populations of Pacific Herring Clupea pallasii throughout the northeast Pacific region, but the route(s) by which these planktivorous fish become infected is unknown. Several methods for establishing Ichthyophonus infections in laboratory challenges were examined. Infections were most effectively established after intraperitoneal (IP) injections with suspended parasite isolates from culture or after repeated feedings with infected fish tissues. Among groups that were offered the infected tissues, infection prevalence was greater after multiple feedings (65%) than after a single feeding (5%). Additionally, among groups that were exposed to parasite suspensions prepared from culture isolates, infection prevalence was greater after exposure by IP injection (74%) than after exposure via gastric intubation (12%); the flushing of parasite suspensions over the gills did not lead to infections in any of the experimental fish. Although the consumption of infected fish tissues is unlikely to be the primary route of Ichthyophonus sp. transmission in wild populations of Pacific Herring, this route may contribute to abnormally high infection prevalence in areas where juveniles have access to infected offal.
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PMID:Infecting Pacific Herring with Ichthyophonus sp. in the Laboratory. 2665 Dec 22


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