In vitro research of oral microscope-assisted implant surface decontamination / 华西口腔医学杂志

OBJECTIVES@#To investigate the effect of oral microscope-assisted surface decontamination on implants in vitro.@*METHODS@#Twelve implants that fell off because of severe peri-implantitis were collected, and decontamination was carried out on the surfaces of implants through curetting, ultrasound, titanium brushing, and sandblasting at 1×, 8×, or 12.8× magnifications. The number and sizes of residues on the implants' surfaces after decontamination were determined, and the decontamination effect was analyzed according to the thread spacing in the different parts of the thread.@*RESULTS@#1) The 8× and 12.8× groups scored lower for implant surface residues than the 1× group (P<0.000 1), and the 12.8× group scored lower than the 8× group (P<0.001); 2) no difference in residue score was found between the wide and narrow thread pitch (P>0.05), and the 8× and 12.8× groups had lower scores than the 1× group (P<0.001); 3) the lowest number of contaminants was observed at the tip of the thread, whereas the highest was observed below the thread, and the difference was significant (P<0.001). However, the thread pitch had no effect on the number of contaminants in different areas (P>0.05); 4) the residue scores of the 8× and 12.8× groups were lower than those of the 1× group at the thread tip and above, sag, and below the thread of the implants (P<0.05).@*CONCLUSIONS@#Residues on the surfaces of contaminated implants can be effectively removed by using an oral microscope. After decontamination, the residues of pollutants were mainly concentrated below the thread of the implants, and the thread pitch of the implants had no significant effect on the residues.

Preparation of 4-sulfonylcalix6arene-modified cotton for uranium contamination removal / 中国辐射卫生

Objective To prepare 4-sulfonylcalix[6]arene-modified cotton fibers for adsorption and removal of uranium based on the specific complexation of calix[6]arene with uranium (VI). Methods Chemical grafting was used for the modification of cotton, which reacted with α-bromoisobutyryl bromide, glycidyl methacrylate, and 4-sulfonylcalix[6]arene. Scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and infrared spectroscopy (FTIR) were used to characterize the structure of 4-sulfonylcalix[6]arene-modified cotton (Cotton S-C[6]a). A Franz diffusion cell was used to simulate uranium-contaminated skin. Laser fluorimetry was used to determine the uranium content. Results SEM, XPS, and FTIR showed that cotton fibers were successfully grafted with 4-sulfonylcalix[6]arene. The optimal conditions of Cotton S-C[6]a for the adsorption of uranium (VI) was pH 4.0, duration of 20 min, and 20 mg of adsorbent. The adsorption process fitted well with pseudo-secondary-order kinetics. The uranium removal efficiency of Cotton S-C[6]a was up to 78.46% in aqueous solution and 81.72% on skin. Conclusion The synthesized Cotton S-C[6]a is highly efficient in the removal of uranium (VI) in solution and on contaminated skin.

Discussion on application of control level of radioactive contamination on personnel′s body surface in a nuclear and radiological emergency / 中华放射医学与防护杂志

There are differences and inconsistencies to some degree in the radioactive contamination control level of personnel′s body surface availiable in many national standards, thus puzzling the users. Therefore, it is proposed to compare the applicable scope, conditions and differences between relevant national standards, and combine with similar clinical nuclear medicine standards of radiological protection content to presevent recommendations on the contamination control level that should be correctly applied in an event of nuclear and radiological emergency. Based on the discussion of similar standards, the contaminated personnel with α of 0.04-10 Bq/cm 2 and β of 0.4-100 Bq/cm 2 are advised to be treated in the institutions with higher than secondary medical insititution. Both α econtamination control levels less than 0.04 Bq/cm 2 and β levels less than 0.4 Bq/cm 2 could be achivable, if fully decontaminated.

Characterization of decontamination procedure of beef carcasses at slaughterhouses in the province of Antioquia, Colombia / Caracterización del procedimiento de lavado descontaminación de canales bovinas en las plantas de beneficio animal del departamento de Antioquia, Colombia

Background: Beef slaughterhouses must use a carcass decontamination procedure to control pathogens and thus prevent foodborne diseases transmitted by meat. Objectives: This study aimed to characterize beef carcass decontamination procedures at slaughterhouses located in the province of Antioquia (Colombia). All the slaughterhouses were in service, registered, and approved by Invima (Instituto Nacional de Vigilancia de Medicamentos y Alimentos in Spanish) at the time of the study. Methods: This descriptive study collected information from 23 beef slaughterhouses between July 2019 and April 2021 through documentary reviews and visits to slaughterhouses, using forms and questionnaires. Results: The study allowed the characterization of the procedures used to decontaminate beef carcasses, showing that the chemical disinfection of the carcasses is used to control microorganisms in at least 73.9% of the slaughterhouses analyzed. According to secondary sources, it was found that most of the slaughterhouses are small (slaughter volume <50,000 heads per year); 10 of them use citric acid, lactic acid, peracetic acid, and a mixture of organic acids in concentrations between 900 and 1,200 ppm, 1.5 and 1.7%, 180 and 190 ppm, and 900 and 1,200 ppm, respectively, as carcass disinfectants and according to the technical data sheet of the product. During the visits and through the application of the questionnaire, it was found that the 12 slaughterhouses had implemented chemical disinfection which is not scientifically based, using manual devices as an intervention method to control pathogenic microorganisms. It was found that the type of company, slaughter volume, and the lack of financial resources are the determining factors in the selection of decontamination procedures. The validation of the beef carcass decontamination procedures in the different slaughterhouses in the study was demonstrated. Conclusions:Although it was established that at least one decontamination procedure, such as chemical disinfection, is used in the slaughterhouses of study, this option is not supported by scientific or technical evidence. The findings support the need for improvements in the slaughterhouses of the province of Antioquia, including the improvement of surveillance programs to reduce pathogens in the meat chain effectively.

Antecedentes: Las plantas de beneficio animal deben utilizar un procedimiento de descontaminación de canales para el control de patógenos y con ello, prevenir la aparición de enfermedades transmitidas por el consumo de carne. Objetivos: El objetivo de este estudio fue caracterizar el procedimiento de descontaminación de canales bovinas en las plantas de beneficio animal del Departamento de Antioquia, Colombia, que se encontraban en servicio, inscritas y autorizadas por el Invima al momento del estudio. Métodos: Este estudio descriptivo recolectó información de 23 plantas de beneficio animal de la especie bovina, a partir de revisiones documentales y visitas a las plantas, usando formatos y cuestionarios entre julio de 2019 y abril de 2021. Resultados: El estudio permitió caracterizar los procedimientos y técnicas de descontaminación de canales bovinas, revelando que en al menos el 73,9% de las plantas de beneficio estudiadas se realiza la desinfección química de las canales para el control de microorganismos. A partir de fuentes secundarias, se encontró que la mayoría de las plantas de beneficio animal en el Departamento de Antioquia son muy pequeñas, 10 de ellas utilizan productos de desinfección de canales, tales como el ácido cítrico, ácido láctico, ácido peracético y mezcla de ácidos orgánicos en concentraciones entre 900 y 1200 ppm, 1,5 y 1,7%, 180 y 190 ppm y 900 y 1200 ppm, respectivamente; y estos son utilizados de acuerdo con las recomendaciones de la respectiva ficha técnica del producto. Por otro lado, durante la visita a las plantas de beneficio y mediante la aplicación del cuestionario, se constató que las 12 plantas visitadas han implementado la desinfección química como método de intervención para el control de microorganismos patógenos, realizando su aplicación mediante dispositivos manuales, no obstante, estas prácticas no están fundamentadas científicamente. Por otro lado, se estableció que aparentemente el tipo de empresa, volumen de sacrificio y falta de recursos financieros son los factores que determinan la elección del procedimiento de descontaminación de canales. De igual manera, se evidenció la necesidad de realizar estudios para validar la efectividad del procedimiento de descontaminación en las diferentes plantas de beneficio. Conclusiones: Aunque se estableció que en las plantas de beneficio animal visitadas se implementa al menos una técnica de intervención como la desinfección química, esta elección no tiene un sustento con base a fundamentos científicos y técnicos. Estos hallazgos respaldan la necesidad de mejoras en las plantas de beneficio animal del Departamento, incluyendo mejoras al programa de vigilancia de la reducción efectiva de patógenos en la cadena cárnica.

Desinfección y reutilización de respiradores N95 durante pandemia por COVID-19 / Disinfection and reuse of N95 respirators during the COVID-19 pandemic

Introducción: Se está viviendo en un contexto de pandemia por COVID-19, en donde se evidencia la escasez de equipos de protección personal en salud y se prevé que continuará en el corto y mediano plazo. Por lo que considerar la reutilización o el uso prolongado de algunos equipos de protección personal, en especial de los respiradores, podría ser una alternativa a considerar. Objetivo: Revisar y dar a conocer, en base a evidencia científica, distintas formas de desinfección para poder reutilizar de manera segura y asequible los respiradores N95. Comentarios principales: Los respiradores N95 o sus equivalentes son de uso exclusivo del personal de salud para la atención de pacientes con sospecha o confirmación de COVID-19 y en procedimientos con generación de aerosoles. Su eficacia depende en gran medida del estado del respirador, de la capacidad de filtración, del sellado y de su uso adecuado. Son diversos los métodos para desinfectar, como la luz ultravioleta tipo C, el peróxido de hidrógeno, calor seco y húmedo, ozono, irradiación por microondas, etc. Si estos procedimientos no son realizados adecuadamente, podrían no ser efectivos. Comentarios globales: En escenarios de escasez de equipos de protección personal la reutilización es un procedimiento viable, económico, seguro, potencialmente escalable y fácil de realizar. Los respiradores N95 requieren un procedimiento especial de desinfección para preservar su capacidad de filtración y sellado. Existe un limitado número de ciclos de desinfección y reutilización. La estufa en calor seco podría ser el método más asequible en entornos privados(AU)

Introduction: We are living in a context of COVID-19 pandemic, where the shortage of personal protective equipment in health is evident and it is expected that it will continue in the short and medium term. So, considering the reuse or prolonged use of some personal protective equipment, especially respirators, could be an alternative to consider. Objective: To review and disseminate, based on scientific evidence, different forms of disinfection in order to safely and affordably reuse N95 respirators. Main comments: N95 respirators or their equivalents are for the exclusive use of health personnel for the care of patients with suspected or confirmed COVID-19 and in aerosol generation procedures. Its effectiveness depends to a large extent on the condition of the respirator, the filtration capacity, the sealing and its proper use. There are several methods to disinfect, such as ultraviolet light type C, hydrogen peroxide, dry and humid heat, ozone, microwave irradiation, etc. If these procedures are not performed properly, they may not be effective. Global feedback: In personal protective equipment shortage scenarios, reuse is a viable, economical, safe, potentially scalable and easy-to-perform procedure. N95 respirators require a special disinfection procedure to preserve their filtration and sealing capacity. There are a limited number of disinfection and reuse cycles. Dry heat stove might be the most affordable method in private settings(AU)

Physico-chemical and Microbiological Qualities of Abattoir Wastewater in Egbu, Imo State, Nigeria

Abbattoir waste water is of a complex composition. When discharged without being treated, poses a threat to human health and the environment. This is the practice common in Nigeria, and is worrisome.Objective: The aim of this study was to assess the physico-chemical and microbiological qualities of waste water from Egbu abattoir discharged into ‘Otamiri’ river in Owerri North local government area, Imo State, Nigeria.Methods: The microbial quality of abattoir wastewater was studied. The duration of the study was three months, from June to September, 2019. Sample collection was done in the morning (8-10am) and in the evening (4-6pm). A total of thirty samples (30) were collected from two sampling points, at the place of generation of the wastewater (Effluent source) and at the point of discharge into the river (POE). Standard methods were employed to assess the microbiological and physiochemical quality of the effluent. The microorganisms isolated from the samples included Escherichia coli, Salmonella, Staphylococcus, Aspergillus, Mucor, Listeria, Micrococcus and Candida species. The Total Heterotrophic Count (THC) of effluent samples, at source and POE were 8.51log10 cfu/ml and 6.15log10cfu/ml respectively, Total Coliform Count (TCC) for same samples were 6.77log10 cfu/ml and 4.56log10 cfu/ml respectively. The Total Fungal Count (TFC) of the effluent samples at source and at POE was 5.19log10 cfu/ml and 4.18log10 cfu/ml respectively. Results further revealed that the pH of the effluent at source was 6.58 while that at Point of Entry into the river was 7.30. The temperature of both samples was 25oC. The Total Dissolved Solid values of the effluent collected at source was higher, having a value of 1400mg/L against 1000mg/L at Point of Entry. Also the Biochemical Oxygen Demand (BOD) and Chemical Oxygen Demand (COD) values of the effluent at source were 5.10mg/L and 8.58mg/L respectively, while the BOD and COD of the water at the POE were 4.3mg/L and 7.9mg/L respectively.Conclusion: Abattoir wastes are becoming a major environmental health challenge and being discharged into the Otamiri River indiscriminately is of public health concern. The potential public health implications associated with discharging untreated abattoir wastewater into the environment and thus, the need for adequate treatment to ensure decontamination as well as providing wastewater treatment facility is imperative.

Biofilme em smartphones de profissionais da saúde: padrão de uso e de descontaminação do aparelho / Biofilm on smartphones of healthcare professionals: pattern of device use and decontamination

Objetivo: avaliar a presença de biofilme nas películas de smartphones de profissionais da saúde, investigar o padrão de uso e de descontaminação dos smartphones no ambiente de assistência à saúde em um hospital de médio porte. Métodos: estudo analítico e transversal, realizado com profissionais de saúde que possuíam smartphone. Foram realizadas entrevistas estruturadas e a presença de biofilme nas películas de vidro dos smartphones foi avaliada pela microscopia eletrônica de varredura. Resultados: todas as amostras de películas foram positivas para presença de biofilme, mesmo após descontaminação com álcool a 70%. Dos participantes, 96,4% utilizavam smartphone no ambiente de trabalho, a maioria utilizava o aparelho para fins pessoais e descontaminavam com álcool a 70% com frequência irregular. Conclusões: o smartphone pode servir como fômite, visto que biofilmes foram detectados na superfície das películas. Esses achados apontam para a necessidade de políticas de controle de infecção relacionadas ao uso dos smartphones.

Objective: to evaluate the presence of biofilm on the protective glass films of smartphones of health professionals, to investigate the pattern of use and decontamination of smartphones in the health care environment of a medium-sized hospital. Methods: analytical and cross-sectional study, carried out with health professionals with smartphones. Structured interviews were carried out and the presence of biofilm on the protective glass films of smartphones was evaluated by scanning electron microscopy. Results: all film samples were positive for the presence of biofilm, even after decontamination with alcohol 70%. 96.4% of the participants used a smartphone in the work environment, most used the device for personal purposes and decontaminated it with alcohol 70% with irregular frequency. Conclusion(s): the smartphones can serve as a fomite, considering that biofilms were detected on the surface of the films. These findings point to the need for infection control policies related to the use of smartphones.

Agentes e métodos de descontaminação das escovas dentais - Uma revisão sistemática / Decontamination agents and methods of toothbrushes - A systematic review

Objetivo: Realizar uma revisão sistemática para avaliar os principais agentes e métodos de descontaminação das escovas dentais contra vírus, bactérias e fungos encontrados na literatura. Métodos: Foi realizada uma busca nas bases de dados LILACS® (Literatura científica e técnica da América Latina e Caribe/BVS ­ Biblioteca Virtual em Saúde), MEDLINE® (Medical Literature Analysis and Retrieval System Online / PubMed)®, EMBASE® (Elsevier), em agosto de 2020. Como critério de inclusão, foram selecionados artigos publicados entre os anos de 2010 e 2020, nos idiomas português, inglês e espanhol, estudos de ensaios clínicos controlados randomizados, ensaios clínicos não randomizados e estudos in vitro, que avaliaram diferentes agentes e métodos de descontaminação das escovas dentais. Resultados: Foram recuperados um total de 2523 artigos, sendo qualificados para o estudo um total de 6 artigos "in vivo" e 4 "in vitro". O agente de descontaminação mais estudado e eficaz foi a clorexidina 0,12% (em forma de imersão ou spray), seguida pelo hipoclorito de sódio 1% e 2,5% (imersão), vinagre branco 50% (imersão), solução de cloreto de cetilpiridínio (imersão ou spray), micro-ondas e máquina de lavar-louças. Conclusão: Considerando as evidências de qualidade encontradas, a clorexidina 0,12% constitui o agente mais estudado e eficaz, seguido pelo hipoclorito de sódio 1 % e cloreto de cetilpiridínio, utilizados em forma de spray ou imersão, constituem soluções eficazes, de fácil acesso, que podem ser utilizadas pela população para descontaminação das escovas dentais.

Aim: To carry out a systematic review of articles found in the literature in order to evaluate the main agents and methods for decontaminating toothbrushes against viruses, bacteria, and fungi. Methods: A search was performed in LILACS® (Scientific and Technical Literature of Latin America and the Caribbean/VHL ­ Virtual Health Library), MEDLINE® (Medical Literature Analysis and Retrieval System Online /PubMed)®, and EMBASE® databases (Elsevier), in August 2020. As inclusion criteria, articles published between 2010 and 2020, in Portuguese, English, and Spanish, studies of randomized controlled clinical trials, non-randomized clinical trials, and in vitro studies were selected, which evaluated different agents and methods for decontaminating toothbrushes. Results: A total of 2,523 articles were retrieved, with a total of 6 in vivo and 4 in vitro articles deemed to be eligible for the study. The most studied and effective decontamination agent was 0.12% chlorhexidine (in immersion or spray form), followed by 1% and 2.5% sodium hypochlorite (immersion), 50% white vinegar (immersion), solution of cetylpyridinium chloride (dip or spray), microwave, and dishwasher. Conclusion: Considering the quality evidence found, 0.12% chlorhexidine is the most studied and effective agent, followed by 1% sodium hypochlorite and cetylpyridinium chloride, used in spray or immersion form; these are effective, easily accessible solutions that can be used by the population to decontaminate toothbrushes.

Knowledge and Attitude towards Dental Unit Waterline System Decontamination among Undergraduate and Postgraduate Dental Students in Universiti Sains Malaysia

@#Introduction: Dental unit waterline system (DUWLS) decontamination is an important infection control in dental practice. This study aimed to determine knowledge and attitude towards DUWLS decontamination and its associated factors among undergraduate and postgraduate dental students in Universiti Sains Malaysia. Methods: A cross-sectional study was conducted using a validated questionnaire administered online using Google Forms to assess the knowledge and attitude of dental students towards DUWLS decontamination. Descriptive and inferential statistics using independent t-test, Pearson, and Spearman correlation were carried out using SPSS version 24.0. Results: A total of 169 dental students participated in the study, and the majority were female (71.6%) and Malay (59.2%). The mean (SD) age was 23.2 (0.93) and 34.4 (2.65), for the undergraduates and postgraduates, respectively. The mean (SD) knowledge scores for the undergraduates and postgraduates were 11.6 (4.23) and 18.0 (2.82), respectively, whereas the mean attitude scores were 51.3 (7.86) and 54.6 (4.74), respectively. The postgraduates had significantly higher mean knowledge and attitude scores than the undergraduates (p<0.001). The significant factors associated with the undergraduates’ knowledge were received information and guidance and their personal experience in managing DUWLS (p<0.05). However, only received information on DUWLS was significantly associated with the postgraduate’s knowledge score (p=0.011). Age factor had a significant association with the attitude score among the postgraduates (p=0.014). Conclusion: The knowledge regarding DUWLS decontamination was relatively moderate in both groups. However, both groups showed a favourable attitude towards DUWLS decontamination. Significantly higher knowledge and attitude scores were presented among the postgraduates than the undergraduates.

Diagnosis and treatment strategy of intestinal flora imbalance after liver transplantation / 器官移植

Multiple short-term and long-term complications might occur after liver transplantation. In the early stage after liver transplantation, the incidence of multidrug-resistant bacteria is likely to cause different types of infection, one of which is intestinal flora imbalance. In the recent decade, a series of studies have demonstrated that intestinal flora plays an important role in maintaining intestinal homeostasis. Intestinal flora may interact with other organs via multiple patterns. Among which, gut-liver axis is one of the most critical channels for regulating microenvironment of the host. Changes in the quantity and composition of intestinal flora could lead to intestinal flora imbalance. In both local and systemic systems, extensive interaction exists between intestinal flora and immune system. In this article, the risk factors of intestinal flora imbalance after liver transplantation, influence of intestinal flora imbalance on liver transplant recipients and relevant treatment strategies were reviewed.

Role of decontamination treatment for implant surface in the treatment of peri-implantitis / 中南大学学报(医学版)

Peri-implantitis, characterized by inflammation of tissues around implants and gradual loss of supporting bone tissue, has become one of the main causes for implant failure. Thoroughly removing the plaque biofilm on the implant surface is the first principle in the treatment of peri-implantitis. For this reason, various decontamination methods have been proposed, which can be divided into 2 categories: Removing biofilm and killing microorganisms according to the effect of plaque biofilm on the implant surface. However, at present, there is no decontamination method that can completely remove the plaque biofilm on the implant surface, and it lacks of clinical recommended guidelines. To understand the advantages and disadvantages, effectiveness and safety for different implant surface decontamination methods is of great significance to guide the clinical selection for peri-implantitis treatment.

Intoxicación aguda por acetaminofén en atención primaria / Acute Acetaminophen Intoxication in Primary Care / Intoxicação aguda por acetaminofeno na atenção primária

Resumen: El acetaminofén es un medicamento analgésico y antipirético considerado como seguro y eficaz. Debido a esto, en Colombia es de venta libre y ampliamente utilizado tanto en niños como en adultos. Por su fácil acceso, la intoxicación por acetaminofén es un evento frecuente, por lo que los médicos de atención primaria deben tener conocimiento acerca de su diagnóstico y manejo, además de los factores de riesgo para el desarrollo de falla hepática y las indicaciones para remitir a los pacientes a los servicios especializados. El objeto de este artículo es orientar al personal de atención primaria en salud acerca de la fisiopatología, el diagnóstico y el tratamiento de esta intoxicación.

Abstract: Acetaminophen is an analgesic and antipyretic medication considered safe and effective. Because of this, in Colombia it is freely available and widely used in both children and adults. Due to its easy access, acetaminophen intoxication is a frequent event, so primary care physicians must be knowledgeable about its diagnosis and management. In addition to the risk factors for the development of liver failure and the indications for referring patients to specialized services. The purpose of this article is to guide primary health care personnel about the pathophysiology, diagnosis and treatment of this intoxication.

Resumo: O acetaminofeno é um medicamento analgésico e antipirético considerado seguro e eficaz. Por isso, na Colômbia é over-the-counter e amplamente utilizado em crianças e adultos. Por seu fácil acesso, a intoxicação por acetaminofeno é um evento frequente, é por isso que os médicos da atenção primária devem estar cientes de seu diagnóstico e manejo. Além dos fatores de risco para o desenvolvimento de insuficiência hepática e indicações de encaminhamento aos pacientes para serviços especializados. O objeto deste artigo é guiar á equipe da atenção primária á saúde sobre a fisiopatologia, diagnóstico e tratamento dessa intoxicação.

Quemadura con cloroformiato de etilo en ocasión de la respuesta a una emergencia química. A propósito de un caso / Burning by Ethyl chloroformate in response to a chemical emergency. A case report

Resumen Se describe un caso de quemadura causada por cloroformiato de etilo en ocasión de la respuesta a un incidente que requirió el trasvase del producto desde contenedores defectuosos a otros seguros. La investigación del evento puso en evidenciala necesidad de mantener un protocolo de registro de materiales que ingresan a la zona caliente, que debe ser tenido en cuentaal momento del retiro de los mismos, procediendo a su correcta descontaminación bajo la fiscalización del oficial de seguridad.

Abstract A burn by Ethyl chloroformate in occasion of response to a chemical emergency which required to transfer products from defective containers to safe containers is described. The investigation of the event highlighted the need to maintain aprotocol for the registration of materials to be entered in the hot zone, which must be considered al the moment of remove andproceeding to the proper decontamination under the supervision of the security officer.

Reuse of hospital bedpans / Reutilización de chatas higiénicas / Reutilização de comadres hospitalares

ABSTRACT Objectives: to evaluate the results of two methods of hospital bedpan reprocessing. Methods: cross-sectional study. Hospital bedpans containing a biological material contamination simulator or organic matter were submitted to manual cleaning followed by disinfection with 70% alcohol solution or thermodisinfection. Permanence of simulated contamination was evaluated by using the fluorescence technique and presence of organic matter was verified by carrying out the protein detection test. Results: the contamination simulator was found in bedpans submitted to both processes. The seat was dirtier after manual cleaning (p=0.044) in comparison with the result obtained with thermodisinfection. Automatized decontamination led to worse results when compared to the manual procedure for the scoop and external bottom (p=0.000). The protein detection test was positive in two items after thermodisinfection. Conclusions: manual cleaning followed by rubbing with 70% alcohol solution proved more effective than automatized cleaning in the reprocessing of hospital bedpans. There are relevant issues regarding reuse of hospital bedpans.

RESUMEN Objetivos: evaluar los resultados de dos métodos de reprocesamiento de chatas higiénicas. Métodos: estudio transversal. Chatas higiénicas conteniendo simulador de contaminación por material biológico o materia orgánica fueron sometidas a lavado manual/desinfección con alcohol al 70% o termodesinfección. La permanencia de contaminación simulada se evaluó por fluorescencia; la presencia de material orgánico, por prueba de detección de proteínas. Resultados: se constató presencia de simulador de contaminación en chatas sometidas a ambos procesos. El asiento resultó más contaminado luego de la limpieza manual (p=0,044. En la pala y el fondo externo, la descontaminación automatizada tuvo peor resultado comparada con la manual (p=0,000). La prueba de detección de proteínas fue positiva en dos chatas luego de la termodesinfección. Conclusiones: para reprocesar chatas higiénicas, la limpieza manual seguida por fricción con alcohol al 70% resultó más eficaz que la limpieza automatizada. Se plantean interrogantes respecto de reutilizar chatas higiénicas.

RESUMO Objetivos: avaliar os resultados de dois métodos de reprocessamento de comadres hospitalares. Métodos: estudo transversal. Comadres hospitalares contendo simulador de contaminação por material biológico ou matéria orgânica foram submetidas a limpeza manual/desinfecção com álcool a 70% ou termodesinfecção. A permanência de contaminação simulada foi avaliada por fluorescência e a presença de matéria orgânica pelo teste de detecção de proteína. Resultados: constatou-se a presença de simulador de contaminação nas comadres submetidas a ambos os processos. O assento se mostrou mais sujo após a limpeza manual (p=0,044). Nas áreas da pá e fundo externo, a descontaminação automatizada teve pior resultado quando comparada à manual (p=0,000). O teste de detecção de proteínas foi positivo em dois utensílios após a termodesinfecção. Conclusões: no reprocessamento de comadres hospitalares, a limpeza manual seguida de fricção com álcool a 70% mostrou-se mais eficaz que a limpeza automatizada. Há fragilidades relativas à reutilização de comadres hospitalares.

Techniques for inactivating Toxoplasma gondii oocysts: a systematic review / Técnicas para inativar oocistos de Toxoplasma gondii: uma revisão sistemática

Abstract The oocyst, a resistant form of Toxoplasma gondii, plays an important role in the transmission of this protozoan. The objective of this review was to report the methods capable of inactivating oocysts through a systematic review of the literature carried out in the Scientific Electronic Library Online, Web of Science, Science Direct, PubMed and Scopus databases. The keywords searched were (((effects OR infectivity OR resistance) AND Toxoplasma) AND oocyst). We selected 16 articles that described 309 different treatments. Among all the protocols evaluated, 35.60% (110/309) were effective in inactivating oocysts. Physical methods were more effective than other methods (p <0.05). Sporulated oocysts and the T. gondii VEG strain were more resistant (p <0.05) to treatments. Although it is effective against viruses and bacteria, the use of disinfectants in water has little or no effect on T. gondii oocysts. The use of radiation and pressure were effective in inactivating oocysts, as these treatments do not include changes in temperature, they can be used in foods for raw consumption, such as vegetables, as it will not cause substantially changes in their physical and chemical characteristics. Therefore, these methods can be viable alternatives for the control of T. gondii.

Resumo O oocisto, forma resistente do Toxoplasma gondii, desempenha um papel importante na transmissão desse protozoário. O objetivo desta revisão foi relatar os métodos capazes de inativar oocistos por meio de uma revisão sistemática da literatura realizada nas bases de dados Scientific Electronic Library Online, Web of Science, Science Direct, PubMed e Scopus. As palavras-chave pesquisadas foram (((efeitos OR infectividade OR resistência) AND Toxoplasma) AND oocyst). Foram selecionados 16 artigos que descreveram 309 tratamentos diferentes. Dentre todos os protocolos avaliados, 35,60% (110/309) foram eficazes na inativação de oocistos. Os métodos físicos foram mais eficazes do que outros métodos (p <0,05). Oocistos esporulados e a cepa VEG de T. gondii foram mais resistentes (p <0,05) aos tratamentos. Embora seja eficaz contra vírus e bactérias, o uso de desinfetantes na água tem pouco ou nenhum efeito sobre os oocistos de T. gondii. O uso de radiação e pressão foram eficazes na inativação de oocistos. Como esses tratamentos não incluem mudança de temperatura, podem ser utilizados em alimentos de consumo cru, tais como vegetais, pois não acarretarão substancialmente alterações nas suas características físico-químicas. Portanto, esses métodos podem ser alternativas viáveis ​​para o controle de T. gondii.

Decontamination of stainless-steel bowls with 80% (w/v) alcohol for 30 s and 60 s: randomized experimental study / Descontaminação de bacias inoxidáveis com álcool 80% (p/v) por 30 s e 60 s: estudo experimental randomizado / Descontaminación de palanganas de acero inoxidable con alcohol al 80% (p/v) durante 30 s y 60 s: estudio experimental aleatorizado

Objective: to compare the efficacy of 80% (w/v) alcohol, rubbed for 30 and 60 seconds, in the manual processing of stainless-steel wash bowls, after cleaning with running water and neutral detergent. Method: experimental study conducted in a hospital in the state of São Paulo, Brazil, on 50 bowls randomly divided into two groups of 25 bowls each for interventions of 30 and 60 seconds of rubbing with 80% (w/v) alcohol. Results: based on the microbiological analyses collected, before and after the interventions for both groups, partial efficacy of the disinfectant was observed even when extending rubbing time. In both groups, there was a higher prevalence of survival of Pseudomonas aeruginosa, with 14 strains that were resistant to carbapenems, being, specifically, 11 to imipenem and three to meropenem. Conclusion: stainless-steel bed wash bowls decontaminated for reuse by 80% (w/v) alcohol, after cleaning with running water and neutral detergent, showed to be reservoirs of hospital pathogens. The use of bed wash bowls for patients with intact skin would not have worrying consequences, but considering those with non-intact skin and the contamination of professionals' hands, the results in this study justify the search for other decontamination methods or the adoption of disposable bed baths.

Objetivo: comparar a eficácia do álcool 80% (p/v), friccionado por 30 e 60 segundos, no processamento manual de bacias de banho em aço inoxidável, após limpeza com água corrente e detergente neutro. Método: estudo experimental realizado em hospital do estado de São Paulo, Brasil, com 50 bacias randomicamente distribuídas em dois grupos de 25, para as intervenções de 30 e 60 segundos de fricção com álcool 80% (p/v). Resultados: das análises microbiológicas coletadas, antes e após as intervenções para os dois grupos, verificou-se eficácia parcial do desinfetante, mesmo ampliando o tempo de fricção. Em ambos os grupos, observou-se maior prevalência de sobrevida de Pseudomonas aeruginosa, 14 cepas resistentes a carbapenens, especificamente, 11 ao imipenen e três ao meropenen. Conclusão: bacias de banho no leito em aço inoxidável, descontaminadas para reuso com álcool 80% (p/v), após limpeza com água corrente e detergente neutro, apresentam-se como reservatórios de patógenos hospitalares. O uso das bacias de banho no leito para pacientes com pele íntegra não teria consequências preocupantes, mas para aqueles com pele não íntegra e pensando na contaminação das mãos dos profissionais, os resultados dessa pesquisa justificam a busca de outros métodos de descontaminação ou a adoção de banho de leito descartável.

Objetivo: comparar la eficacia del alcohol al 80% (p/v), frotado durante 30 y 60 segundos, en el proceso de descontaminación manual de palanganas de baño de acero inoxidable, después de lavarlas con agua corriente y detergente neutro. Método: estudio experimental realizado en un hospital del estado de São Paulo, Brasil, con 50 palanganas divididas aleatoriamente en dos grupos de 25, para intervenciones de 30 y 60 segundos de frotamiento con alcohol al 80% (p/v). Resultados: los análisis microbiológicos recolectados, antes y después de las intervenciones para ambos grupos, demostraron efectividad parcial del desinfectante, incluso cuando se extendió el tiempo de fricción. En ambos grupos, se observó una mayor prevalencia de supervivencia de Pseudomonas aeruginosa, 14 cepas resistentes a carbapenemas, específicamente 11 a imipenem y tres a meropenem. Conclusión: las palanganas de baño de cama de acero inoxidable, descontaminadas para su reutilización con alcohol al 80% (p/v), después del lavado con agua corriente y detergente neutro, actúan como reservorios de patógenos hospitalarios. El uso de las palanganas de baño de cama no tendría consecuencias preocupantes para pacientes con la piel íntegra, pero para aquellos cuya piel no conserva su integridad y pensando en la contaminación de las manos de los profesionales, los resultados de esta investigación justifican la búsqueda de otros métodos de descontaminación o la adopción del baño de cama desechable.

Infection Control in the Dental Practice with Emphasis on Intraoral Scanners and Semi-Critical Complex Instruments / Control de Infecciones en la Práctica Dental Con Énfasis en Escáneres Intraorales e Instrumentos Complejos Semicríticos

ABSTRACT: We present an integrative review of the literature conducted to find and analyse specific measures for disinfection and/or sterilization of intraoral complex instruments, applicable to intraoral scanners. We performed a two-stage search in the PubMed/MEDLINE, SciELO, REDALYCS, and LILACS databases, and the Google Scholar website, which included full articles in Spanish, Portuguese, and English. The strategy associated the terms 'disinfection', 'biosecurity', 'decontamination', and (a) 'intraoral scanners', and (b) other 'semi-critical' intraoral complex instruments, according to the American Dental Association definition (e.g., 'turbine', etc). Strategy (a) produced just one outcome, whereas (b) produced nine articles, which only suggested low-level disinfectants.The lack of empirically based protocols that allow effective microbiological control makes it necessary to create a new categorization for these instruments when trying to comply with American Dental Association recommendations for dental practice.

RESUMEN: Presentamos una revisión integradora de la literatura realizada para encontrar y analizar medidas específicas de desinfección y / o esterilización de instrumentos complejos intraorales, aplicables a los escáneres intraorales. Realizamos una búsqueda en dos etapas en las bases de datos PubMed / MEDLINE, SciELO, REDALYCS y LILACS, y en el sitio web Google Scholar, que incluía artículos completos en español, portugués e inglés. La estrategia asoció los términos 'desinfección', 'bioseguridad', 'descontaminación' y (a) 'escáneres intraorales', y (b) otros instrumentos complejos intraorales 'semicríticos', según la definición de la Asociación Dental Ameri- cana (p. Ej., 'turbina', etc.). La estrategia (a) produjo un solo resultado, mientras que (b) produjo nueve artículos, que solo sugirieron desinfectantes de bajo nivel. La falta de protocolos de base empírica que permitan un control microbiológico efectivo hace necesario crear una nueva categorización para estos instrumentos, cuando se trata de cumplir con las recomendaciones de la Asociación Dental Americana para la práctica dental.

Intraoperative graft decontamination during ACL reconstruction surgery / Descontaminação transoperatória de enxerto durante cirurgia de reconstrução do LCA

Abstract Objective To evaluate different decontaminants for tendon grafts, proposing an antiseptic protocol for contaminated grafts. Methods A total of 25 patients were tissue donors for the study. Each participant donated a 2.5-cm tendon sample, which was divided into 5 fragments with 5 mm each during anterior cruciate ligament (ACL) reconstruction surgery. The collected material was divided into 5 groups, totaling 125 samples. In total, four fragments of each patient were placed on the operating room floor for one minute for contamination, simulating the fall of the graft on the floor during surgery. The other fragment was immediately placed in a sterile container (group 1). One of the contaminated fragments was placed in the sterile container without being previously immersed in decontaminating solution (group 2). The remaining fragments were immersed for ten minutes in decontaminating solution: 0.5% chlorhexidine (group 3), 0.9% saline (group 4) and 0.55% ortho-phthalaldehyde (group 5), and, after this time, they were individually placed in a sterile container. The samples from the 5 groups were submitted to microbiological examination. Results Bacteria were detected in 26% of the total samples in the microbiological tests, and in group 1 there was no growth of microorganisms. In group 2, bacterial growth was observed in 16 samples. Considering the evaluation of test groups 3, 4 and 5, the percentage of decontamination was higher than the growth of microorganisms in the respective cultures. Conclusion The protocol suggested by the study showed that intraoperative graft decontamination is possible.

Resumo Objetivo Avaliar diferentes descontaminantes para enxertos de tendões, propondo um protocolo de antissepsia para o enxerto contaminado. Métodos Um total de 25 pacientes foram doadores de tecido para o estudo. Cada participante doou uma amostra de 2,5 cm de tendão, a qual foi dividida em 5 fragmentos de 5 mm durante cirurgia de reconstrução do ligamento cruzado anterior (LCA). O material coletado foi dividido em 5 grupos, totalizando 125 amostras. Ao todo, quatro fragmentos de cada paciente foram colocados sobre o piso da sala cirúrgica, durante um minuto, para contaminação, simulando a queda do enxerto no chão durante o ato operatório. O outro fragmento foi, imediatamente, colocado em um recipiente esterilizado (grupo 1). Um dos fragmentos contaminados foi colocado no recipiente esterilizado sem ser previamente imerso em solução descontaminante (grupo 2). Os demais fragmentos foram imersos, por dez minutos, em solução descontaminante: clorexidina 0,5% (grupo 3), soro fisiológico 0,9% (grupo 4) e ortoftaldeído 0,55% (grupo 5), e, após esse tempo, foram colocados individualmente em um recipiente esterilizado. As amostras dos 5 grupos foram submetidas a exame microbiológico. Resultados Houve detecção de bactérias em 26% do total de amostras nos testes microbiológicos, sendo que no grupo 1 não houve crescimento de micro-organismos. No grupo 2, observou-se crescimento bacteriano em 16 amostras. Avaliando-se os grupos de teste 3, 4 e 5, o percentual de descontaminação foi superior ao crescimento de micro-organismos nas respectivas culturas. Conclusão O protocolo sugerido pelo estudo mostrou que é possível a descontaminação transoperatória do enxerto.

Decontamination of Gutta-percha Cones employed in Endodontics / Descontaminação de cones de guta-percha empregados em endodontia

ABSTRACT The guttapercha cones used in endodontic treatment are produced in aseptic conditions and their composition includes zinc oxide, which is responsible for antibacterial activity. However, there is the possibility of microbial contamination by manipulation, aerosol or during storage. Although several chemical agents have been tested for their decontamination, there is no consensus on the best disinfection protocol to be used. The aim of this study was to evaluate the decontamination of guttapercha cones contaminated with the bacteria Enterococcus faecalis, by using chlorhexidine digluconate (CHX) and sodium hypochlorite (NaClO) at different concentrations for short exposure times. For this purpose, guttapercha cones (size 40) were selected at random from a sealed box and immersed for 1 min in a microbial suspension. Then they were immersed in specific Petri dishes for different groups containing: CHX 2%, NaClO 1% or NaClO 2.5% for 30 s or 1 min, and subsequently placed in tubes containing BHI broth. After incubating the tubes for 48 h, it was observed that 1% and 2.5% NaClO and 2% CHX were effective for decontaminating the cones at those exposure time intervals. Microbial growth was detected in one of the replicates of the group with CHX applied for 30 s. To prevent the possibility of failures at this stage, the exposure time of guttapercha cones to the decontaminating agent should not be reduced.

RESUMO Os cones de gutapercha utilizados no tratamento endodôntico são produzidos em condições assépticas e possuem óxido de zinco em sua composição, responsável pela atividade antibac te riana. No entanto, existe a possibilidade de contaminação microbiana por manipulação, aerossol ou seu armazenamento. Embora vários agentes químicos já tenham sido testados para sua descontaminação, não há consenso sobre o melhor proto colo de desinfecção a ser usado. Nosso objetivo foi avaliar a descontaminação de cones de gutapercha contaminados com a bactéria Enterococcus faecalis, utilizando digluconato de clorexidina (CHX) e hipoclorito de sódio (NaClO) em diferentes concentrações e tempos de exposição curtos. Para esse fim, 40 cones de gutapercha foram selecionados aleatoriamente, de uma caixa selada e imersos por 1 min em uma suspensão microbiana. Em seguida, foram imersos em placas de Petri específicas para diferentes grupos contendo: CHX 2%, NaClO 1% ou 2,5%, nos tempos de exposição de 30s e 1min e subseqüentemente imersos em tubos contendo caldo BHI. Após incubação dos tubos por 48 h, observouse que NaClO 1% e 2,5% e CHX 2% foram eficazes para a descontaminação dos cones nesses intervalos de tempo de exposição. Em uma das réplicas do grupo com CHX aplicado por 30s foi detectado crescimento microbiano. O tempo de exposição dos cones de gutapercha ao agente de desconta minação não deve ser reduzido para evitar a possibilidade de falhas nesse estágio.

Reutilización de respiradores N95: estrategias de descontaminación aplicables en la pandemia de COVID 19 en Perú / Reusing N95 Respirators: decontamination strategies applicable in COVID-19 pandemics in Peru

RESUMEN El virus SARS-CoV-2 o virus del COVID-19, considerado como emergencia internacional de salud pública, fue declarada posteriormente como una pandemia. Debido a la alta propagación del virus del COVID-19 por medio de droplets, la demanda de los equipos de protección personal (EPP) para el personal de salud ha sido notable, en especial el de los respiradores. Por ende, se hace importante conocer los métodos de descontaminación considerados para su aplicación en nuestro medio; teniendo en cuenta el uso adecuado de medidas de asepsia y antisepsia, garantizando a su vez la integridad del respirador (correas, puente nasal y material de espuma nasal) y contando con el proceso natural de degradación. Los métodos adecuados de desinfección en respiradores descritos son: el uso de hornos esterilizadores (calor seco), autoclave (vapor), radiación ultravioleta (UV) y vaporizadores caseros (olla arrocera con vaporizador). Estos métodos deben ser empleados acordes a las necesidades del personal de salud.

ABSTRACT The SARS-CoV-2 virus, also called COVID-19, was initially considered as an international public health emergency, and later it was declared as a pandemic. Due to the high spread of COVID-19 through droplets, the demand for personal protective equipment (PPE) for healthcare professionals has been remarkable, particularly filtering face-piece particulate respirators. Therefore, it is important to know the decontamination methods proposed for their application in our environment, considering the proper asepsis and antisepsis measures to be used, and also on how to preserve the integrity of the device (straps, nasal bridge and nasal foam material) and counting on its natural degradation process. Adequate methods for disinfecting these devices are as follows: using sterilizing ovens (dry heat), autoclave (steam), ultraviolet radiation (UV) and homemade vaporizers, which should be used according to the needs of the healthcare professionals.