Disinfection of corrugated tubing by ozone and ultrasound in mechanically ventilated tracheostomized patients

BACKGROUND

Medical equipment coming into contact with non-intact skin or mucous membranes is classified as semi-critical material. This equipment requires at least high-level disinfection, as the major risk in all invasive procedures is the introduction of pathogenic microbes causing hospital-associated infections.

AIM

To evaluate the capacity of ozone gas and ultrasound to disinfect semi-critical, thermally sensitive material.

METHODS

Used corrugated tubing from mechanically ventilated tracheostomized patients in the intensive care unit was obtained. Enzymatic detergent was applied for 15min before different disinfection techniques were evaluated as follows: Group A (0.2% peracetic acid); Group B (ultrasound for 60min); Group C (application of ozone gas at a concentration of 33mg/L for 15min); Group D (ultrasound for 30min and ozone for 15min); Group E (ultrasound for 60min and ozone for 15min).

FINDINGS

Application of ultrasound for 60min reduced the level of microbial contamination by 4 log10, whereas ozone alone and the other two combined techniques (ultrasound and ozone) and the peracetic acid reduced the level of microbial contamination by 5 log10.

CONCLUSION

Ozone was the most advantageous technique taking into consideration processing time, ease of use, effectiveness, and cost. The use of ozone gas to disinfect semi-critical material proved to be technically feasible and extremely promising.

Postprandial insulin resistance in Zucker diabetic fatty rats is associated with parasympathetic-nitric oxide axis deficiencies

The Zucker diabetic fatty (ZDF) rat is an obesity and type 2 diabetes model. Progression to diabetes is well characterised in ZDF rats, but only in the fasted state. We evaluated the mechanisms underlying postprandial insulin resistance in young ZDF rats. We tested the hypothesis that the overall postprandial action of insulin is affected in ZDF rats as a result of impairment of the hepatic parasympathetic-nitric oxide (PSN-NO) axis and/or glutathione (GSH), resulting in decreased indirect (PSN-NO axis) and direct actions of insulin. Nine-week-old male ZDF rats and lean Zucker rats (LZR, controls) were used. The action of insulin was assessed in the fed state before and after parasympathetic antagonism atropine. Basal hepatic NO and GSH were measured, as well as NO synthase (NOS) and γ-glutamyl-cysteine synthethase (GCS) activity and expression. ZDF rats presented postprandial hyperglycaemia (ZDF, 201.4 ± 12.9 mg/dl; LZR, 107.7 ± 4.3 mg/dl), but not insulinopaenia (ZDF, 5.9 ± 0.8 ng/ml; LZR, 1.5 ± 0.3 ng/ml). Total postprandial insulin resistance was observed (ZDF, 78.6 ± 7.5 mg glucose/kg; LZR, 289.2 ± 24.7 mg glucose/kg), with a decrease in both the direct action of insulin (ZDF, 54.8 ± 7.0 mg glucose/kg; LZR, 173.3 ± 20.5 mg glucose/kg) and the PSN-NO axis (ZDF, 24.5 ± 3.9 mg glucose/kg; LZR, 115.9 ± 19.4 mg glucose/kg). Hepatic NO (ZDF, 117.2 ± 11.4 μmol/g tissue; LZR, 164.6 ± 4.9 μmol/g tissue) and GSH (ZDF, 4.9 ± 0.3 μmol/g; LZR, 5.9 ± 0.2 μmol/g) were also compromised as a result of decreased NOS and GCS activity, respectively. These results suggest a compromise of the mechanism responsible for potentiating insulin action after a meal in ZDF rats. We show that defective PSN-NO axis and GSH synthesis, together with an impaired direct action of insulin, appears to contribute to postprandial insulin resistance in this model.

Understanding postprandial glucose clearance by peripheral organs: the role of the hepatic parasympathetic system

The hepatic parasympathetic system is one of the major contributors for preserving insulin sensitivity in the postprandial state. Postprandial hepatic vagal control of whole-body glucose clearance and its effect on specific organs remains unknown. Our hypothesis is that, in the postprandial state, the hepatic parasympathetic nerves (HPN) are responsible for a considerable part of extra-hepatic tissue glucose clearance. Two groups of 9-week-old Sprague-Dawley rats were studied, comparing sham-operated versus hepatic parasympathetic denervated animals. Insulin sensitivity was evaluated in the postprandial state by the rapid insulin sensitivity test (RIST). [(3) H]2-deoxy-d-glucose was administered during the RIST. Plasma glucose rate of the disappearance and clearance by skeletal muscle, adipose tissue, liver, pancreas, heart and kidney of this radioisotope was measured. The postprandial denervated group showed a decrease insulin sensitivity of 41.4 ± 5.2%. This group of animals showed a decrease in the rate of plasma [(3) H]2-deoxy-d-glucose disappearance and skeletal muscle, heart and kidney glucose clearance by 45%, 35% and 67%, respectively. These studies show that the major contributor of postprandial whole-body glucose clearance was skeletal muscle; in the range 69-38%, depending on HPN integrity. The results obtained in the present study indicate that HPN are crucial for postprandial action of insulin through a mechanism that is essential for maintenance of skeletal muscle, heart and kidney glucose clearance. These results suggest that hepatic parasympathetic dysfunction could lie at the genesis of type 2 diabetes complications, namely insulin resistance, nephropathy and cardiomyopathy.

[Relationship between companion animals and intestinal parasites in children at municipality of Seropédica, RJ]

Several parasitic zoonoses are associated to the human and companion animals, mainly dogs and cats. The present work aimed to analyze the relationship of parasites in children at the Center of Integral Attention to the Child Paulo Dacorso Filho and their companion animals where to verify the relationship of positive children for some parasites, which got in contact with infected animals. In a total of 64 fecal samples, they were consisted by 46 childrens fecal samples and 21 of their companion animals, being 18 from dogs and 3 from cats. Those were analyzed by using the techniques of centrifugal-flotation in brilliant field and staining by modified Ziehl-Neelsen to determine Cryptosporidium spp. oocysts. Of the childrens samples, 91% were positive for the genus Cryptosporidium, of those 13 samples; they were also in association to Giardia intestinallis, two to Ascaris lumbricoides, two to Trichuris trichiura and one to Endolimax nana only. Of the dogs samples, 94.44% were positive where Cryptosporidium spp. was observed in 94.44% of them, Ancylostoma spp. In 50%, Cystoisospora canis in 5.55% and Toxocara canis in 11.11%. The parasite that was common among children and animals belongs to genus Cryptoporidium. However, most of the positive children for Cryptosporidium spp., did not get in contact with animals.