Self-administration of medical modalities (SAMM): another method of rehabilitation education.

In order to train patients to carry out home pulmonary care adequately, we developed a hospital-based patient-education program we call Self-Administration of Medical Modalities (SAMM). This teaches patients about their pulmonary disease; about their medications' purposes, side effects and what to do if they occur, possible conflict with other medications, and the medication schedule; about use, care, and cleaning of aerosol inhalation devices and scheduling of aerosol medication treatments; and about chest physical therapy if it is indicated. Nurses, respiratory therapists, and physical therapists in the hospital teach and reinforce these concepts and evaluate the patient's progress in learning. The patient advances through three levels of competency. At Level I he is responsible only for keeping track of his medication and treatment schedules. At Level II the patient initiates requests for medication and treatments on schedule, takes them under supervision, and makes a written record of having done so. At Level III the patient's medications are kept at his bedside, he prepares and takes the medications himself, takes treatments himself, and he keeps written records. At this level the program simulates home conditions as much as possible. Patients have reported that they liked administering their own medications and treatments and that the SAMM Program was helpful in preparing them for self-care at home.

Effect of pH on the antimicrobial activity of some triphenylmethane dyes.

Four common dyes were tested as inhibitors of four types of bacteria over the pH range 5.0-9.0. Inhibition of the gram-negative types, Salmonella anatum and Enterobacter aerogenes, was markedly affected by the pH of the medium. These organisms tolerated concentrations of crystal violet and ethyl violet about 100-fold higher at pH 5.0 than at pH 9.0. Above pH 7.0 brilliant green (BG) and malachite green (MG) were precipitated as their respective carbinols and lost their inhibitory properties with these two organisms. Two gram-positive types, Staphylococcus aureus and Bacillus cereus, were more sensitive to dyes and results were less affected by pH. The carbinol forms of MG and BG were nearly as inhibitory to these organisms as the ionized forms.

Effect of heat on the antimicrobial activity of brillant green dye.

Antimicrobial activity of brilliant green dye in Trypticase soy broth (BBL) is reduced and ultimately destroyed by prolonged autoclaving at 121 C. Loss of antimicrobial activity is accompanied by decolorization of the dye. This is consistent with other evidence that antimicrobial activity of brilliant green resides in the colored dye ion. The dye is not decolorized when heated in distilled water or peptone, but is decolorized by heating in glucose, glycine, or sodium dodecyl sulfate, showing that decolorization results from reaction with components of the medium. To ensure optimal results, it is recommended that bacteriological media be sterilized by heat prior to addition of brilliant green dye.