Impact of Oral Care and Antisepsis on the Prevalence of Ventilator-Associated Pneumonia.

PURPOSE: This study aimed to evaluate the impact of oral care and use of chlorhexidine gluconate on the prevention of ventilator-associated pneumonia (VAP) in patients admitted to an intensive care unit (ICU). MATERIALS AND METHODS: An evaluation was performed on 229 patients admitted to ICU in 2012 (before implementation of oral care protocol) and 329 in 2013 (after the protocol). Oral care was based on the removal of secretions from the oral cavity with 0.12% chlorhexidine solution for brushing and sterile gauze for cleaning before a new aspiration. The cases of VAP were evaluated by observing respiratory signs, radiological changes, and culture and laboratory results. The following data were also analysed: gender, length hospital of stay, mechanical ventilation, use of antibiotics and aetiological agent of infection. RESULTS: There was a tendency towards lower risk of development of VAP after application of oral care protocol (odds ratio = 0.64-95% CI: 0.39-1.04). There was also a reduction in the incidence of early pneumonia (up to 72 h of hospitalisation). With regard to the aetiological agent of infections, although Gram-negative bacteria predominated in the two periods studied, there was a decrease in the cases of Staphylococcus aureus infection. CONCLUSION: Oral care protocol has statistically significantly reduced the risk of developing early VAP in ICU patients, thus demonstrating the importance of multidisciplinary teamwork for hospitalised patients.

Preconcentration and determination of metal ions from fuel ethanol with a new 2,2'-dipyridylamine bonded silica.

A silica surface chemically modified with [3-(2,2'-dipyridylamine) propyl] groups was prepared, characterized, and evaluated for its metal ion preconcentration in fuel ethanol. To our knowledge, we are the first authors who have reported the present modification on silica gel surface. The material was characterized using infrared spectra, scanning electronic microscopy, and (13)C and (29)Si solid-state NMR spectra. Batch and column experiments were conducted to investigate for metal ion removal from fuel ethanol. The results showed that the Langmuir model describes the sorption equilibrium data of the metal ions in a satisfactory way. From the Langmuir isotherms, the following maximum adsorption capacities (in mmol g(-1)) were determined: 1.81 for Fe(III), 1.75 for Cr(III), 1.30 for Cu(II), 1.25 for Co(II), 1.15 for Pb(II), 0.95 for Ni(II), and 0.87 for Zn(II). Thermodynamic functions, the change of free energy (ΔG), enthalpy (ΔH), and entropy (ΔS) showed that the adsorption of metal ions onto Si-Pr-DPA was feasible, spontaneous, and endothermic. The sorption-desorption of the metal ions made possible the development of a preconcentration and quantification method of metal ions in fuel ethanol.

Study on soluble heavy metals with preconcentration by using a new modified oligosilsesquioxane sorbent.

In this work, a new modified oligosilsesquioxane was prepared, characterized and evaluated for its heavy metal adsorption characteristics from aqueous solution. The material was characterized using infrared spectroscopy, X-ray diffractometry, solid-state (29)Si and (13)C nuclear magnetic resonance. Batch and column experiments were conducted to investigate for Fe (III), Cr (III), Cu (II), Cd (II), Pb (II) and Ni (II) removal from dilute aqueous solution by sorption onto modified oligosilsesquioxane. The results obtained in the flow experiments, showed a recovery of ca. 100% of the metal ions adsorbed in a column packed with 2.0 g of nanomaterial, using 3 mL of 1.0 mol L(-1) HCl solution as eluent. The detection limits for Fe, Cr, Cu, Cd, Pb, and Ni were 0.26, 0.33, 0.38, 0.41, 0.47 and 0.55 µg L(-1), respectively. The relative standard deviation values (n=12) were <4.82% for Fe, <4.12% for Cr, <3.79% for Cu, <3.03% for Cd, <4.02% for Pb and <2.65% for Ni. The proposed method was successfully applied to the analysis of environmental samples.