Comparative evaluation of Ziehl Neelsen staining and knowledge, attitudes and practices of laboratory personnel in relation to Ziehl Nielsen / Evaluación comparativa de la tinción de Ziehl Neelsen y los conocimientos, actitudes y prácticas (CAP) del personal de laboratorio en relación con Ziehl Nielsen

OBJECTIVE: To describe laboratory personnel's attitude and practices toward phenol exposure during Ziehl Neelsen (ZN) acid fast staining method and to evaluate the feasibility of an alternate modified Kinyoun cold (MKC) stain. METHOD: A total of 187 sputum samples were collected from suspected tuberculosis cases and stained by the MKC method and ZN stain and were read by an experienced microscopist and a researcher. A crosssectional questionnaire survey of 35 laboratory personnel was also conducted. RESULTS: Modified Kinyoun cold stain gave sensitivity, specificity, positive and negative predictive values of 100%, 99.4%, 94.1% and 100%, respectively. Both stains corresponded with an agreement rate of 99.5%. Almost 94.7%of respondents reported that they worked in a closed area when staining and 57.1% did the staining method without ventilation. Material safety data sheet (MSDS) of phenol was not known to 77.1% of laboratory personnel. All of the participants (100%) in this study welcomed a similar, non heating method for acid-fast bacillus (AFB). There was significant association between those not comfortable with phenol exposure (77.1%) and complaints of irritation (48.6%) and headache (2.9%) [χ² = 10.98, r = 0.55, p = 0.001]. CONCLUSIONS: The MKC is suitable for use as a substitute for the ZN method for the demonstration of AFB in the primary diagnosis and treatment assessment of pulmonary tuberculosis. Focus should be given on educating laboratory staff on the hazards, risks and precautions associated with the phenol/ZN method.

OBJETIVO: Describir las actitudes y prácticas del personal del laboratorio hacia la exposición al fenol durante la aplicación del método de tinción ácido-rápida de Ziehl Neelsen (ZN), y la viabilidad de la alternativa de una tinción de Kinyoun en frío modificada (MKC). MÉTODO: Un total de 187 muestras de esputo fueron recogidas de casos con sospecha de tuberculosis, y teñidas por el método MKC y la tinción de ZN, tras lo cual fueron leídas por un microscopista y un investigador con experiencia. También se realizó una encuesta transversal a manera de cuestionario, entre las 35 personas que conformaban el personal del laboratorio. RESULTADOS: La tinción de Kinyoun en frío modificada arrojó sensibilidad, especificidad, y valores predictivos positivos y negativos de 100%, 99.4%, 94.1% y 100%, respectivamente. Ambas tinciones se correspondieron con una tasa de acuerdo de 99.5%. Casi el 94.7% de los encuestados informó que trabajaban en un área cerrada en el momento de la tinción, y 57.1% tuvo el método de la tinción sin ventilación. La ficha de datos de seguridad (FDS) de fenol era desconocida para el 77.1% del personal de laboratorio. Todos los participantes (100%) en este estudio dieron la bienvenida a un método similar, sin calentamiento, para los bacilos acidoresistentes (BAR). Hubo una asociación significativa entre aquellos para quienes la exposición al fenol les era inconfortable (77.1%) y las quejas de irritación (48.6%) y dolor de cabeza (2.9%) [χ² = 10.98, r = 0.55, p = 0.001]. CONCLUSIONES: El MKC es adecuado para uso como sustituto del método de ZN para la demostración de BAR en el diagnóstico primario y la evaluación del tratamiento de la tuberculosis pulmonar. Debe centrarse la atención en educar al personal de laboratorio en los peligros, los riesgos, y la precaución asociados con el método de fenol/ZN.

Comparative evaluation of phenol and thimerosal as preservatives for a candidate vaccine against American cutaneous leishmaniasis

For decades thimerosal has been used as a preservative in the candidate vaccine for cutaneous leishmaniasis, which was developed by Mayrink et al. The use of thimerosal in humans has been banned due to its mercury content. This study addresses the standardization of phenol as a new candidate vaccine preservative. We have found that the proteolytic activity was abolished when the test was conducted using the candidate vaccine added to merthiolate (MtVac) as well as to phenol (PhVac). The Montenegro's skin test conversion rates induced by MtVac and by PhVac was 68.06 percent and 85.9 percent, respectively, and these values were statistically significant (p < 0.05). The proliferative response of peripheral mononuclear blood cells shows that the stimulation index of mice immunized with both candidate vaccines was higher than the one in control animals (p < 0.05). The ability of the candidate vaccines to induce protection in C57BL/10 mice against a challenge with infective Leishmania amazonensis promastigotes was tested and the mice immunized with PhVac developed smaller lesions than the mice immunized with MtVac. Electrophoresis of phenol-preserved antigen revealed a number of proteins, which were better preserved in PhVac. These results do in fact encourage the use of phenol for preserving the immunogenic and biochemical properties of the candidate vaccine for cutaneous leishmaniasis.

Investigation of a one-time phenol application for pilonidal disease

To investigate wound healing rates and postoperative recovery of patients after a one-time phenol application for pilonidal disease. A total 30 consecutive patients with chronic pilonidal disease ranging from midline to complex sinuses were enrolled in the study. No preoperative laboratory examinations or bowel preparation were required. No antibiotic prophylaxis or sedation was used. A small incision was made on the midline and hair/ debris in the sinuses was removed. A cotton swab with saturated phenol was moved into the cavity and the phenol was left for 2 min. No special dressing was necessary and patients left the hospital immediately afterwards. Patients filled out a daily questionnaire for 7 days. We did not intervene in the wounds with a second phenol application or curettage during the observation period. Wounds were inspected at weekly intervals for 2 months. At the end of the third day, 97% of the patients were pain-free and 100% of the patients were free from analgesics. Time off work was 2 days for most patients [93.3%]. Twenty-eight [93.3%] patients were satisfied with the procedure, they found it easy and painless and suggested the procedure to other patients. Twenty-five [83%] patients were asymptomatic at the end of 2 months' observation and the remaining 5 patients had un-healed sinuses. Mean time for wound healing was 25 days [range 10-63 days]. There were 4 recurrences after a mean of 14 months' follow-up and the overall success rate was 70%. A one-time phenol application was an effective treatment for pilonidal disease with acceptable wound healing rates, less postoperative pain and less time off work. Hence it can be an alternative treatment modality

Bloqueios com fenol para tratamento de espasticidade / Phenol block for spasticity management

No tratamento da espasticidade focal, os bloqueios periféricos com toxina botulínica (TB) e com fenol são os preferidos. Os bloqueioscom fenol são os assuntos de interesse desta revisão, que mostra alguns aspectos históricos, princípios de ação, principais indicações e aaplicabilidade clínica desta substância. Ela tem o propósito de relembrar que o fenol, quando respeitada suas indicações, tem mostradoboa relação entre eficácia e segurança. Desde que é uma droga de baixíssimo custo, deveria ser considerada como agente ideal para usoem larga escala nos serviços de reabilitação carentes de recursos econômicos.

Ceratoacantoma após peeling profundo com fenol / Keratoacanthoma development after deep phenol peeling

O peeling químico profundo com fenol é uma técnica utilizada para intensa esfoliação cutânea para posterior renovação celular. Está indicado nos tratamentos de rugas faciais e para homogeneização da pigmentação da pele. Relata-se um caso em que a paciente, em tratamento com fenol, desenvolveu ceratoacantoma de face.

The deep phenol peeling consists in a technique used to cause an intense facial exfoliation and further cellular regeneration. It is indicated to treat of facial wrinkles and to make homogeneous the skin pigmentation. A case in which a patient submitted to fenol treatment developed a facial keratoacanthoma is decribed.

Rejuvenescimento facial: peeling de fenol atenuado / Face anti-ageing: profound phenolmethod

O objetivo do presente estudo é descrever a técnica de peeling de fenol pré-oxidado, os principais cuidados pré e pós-operatórios e a avaliação dos resultados obtidos em quatro pacientes submetidos ao método, breve comparação com o método de fenol profundo tradicional de Backer e Gordon.Apresenta-se, ainda.Ao final, conclui-se que o método de peeling de fenol pré-oxidado, sem a necessidade de máscaras oclusivas, é seguro, reprodutível e demonstra um alto grau de aceitação no grupo submetido ao tratamento.

The objective of the present work is to describe the techniques of phenol peeling, the main pre-peeling and post-peeling care and the evaluation from this method of the results obtained by four patients. Comparison with Backer and Gordon traditional profound phenol method. Finally, the conclusion is that the profound phenol peeling method which doesn't use occlusive mascara is secure, reproducible and shows a real acceptance in the group submitted to the treatment.

Problemas asociados con polyfendes cuando selecciona extractos de algas pardas para la actividad biológica / Problems associative with polyphenols when screening extracts of brown algae for biological activity

High levels of activity were detected when extracts of certain brown algae were tested for the presence of enzyme inhibitiors, lectins and DNA- cleaving compounds. Partial purification of these extacts by dialysis against water revealed that the compounds active in all three test were high molecular weight polyphenols. The active species included ascophyllum nodosum, Fucus serratus and F.versiculosus