Essential tips for nurses.

A useful book for teachers of nurses as well as for their pupils was reviewed in the BJN 100 years ago. It was called, 'A Quiz Book of Nursing,' by Miss Amy Elizabeth Pope, with regard to the restraint of patients, it is suggested that the following points should be emphasized by the instructor:

A letter from Alexis Carrel concerning the preantibiotic treatment of war wounds: The Carrel-Dakin solution.

The morbidity and mortality of soldiers injured during the First World War stemmed in large part from infections of battle wounds. Preventing and treating such infections was a major challenge for the medical corps. Alexis Carrel, a French-American surgeon, advocated irrigating open wounds with a hypochlorite solution (the Carrel-Dakin solution) to prevent the growth of bacteria contaminating them. His method of treatment was complicated and time consuming and was not well followed by surgeons who doubted the necessity of such an exacting protocol. In 1917, Carrel wrote a letter to an American colonel overseeing U.S. medical personnel soliciting his support in training American medical personnel in the proper use of the Carrel-Dakin solution. This letter was the stimulus for recalling here the opposition encountered by both Carrel and Joseph Lister, his predecessor in the aseptic-antiseptic treatment of open wounds, and for noting the conflicting views of contemporary surgeons over surgical sepsis.

The history of ultraviolet germicidal irradiation for air disinfection.

Public health concerns such as multi- and extensive drug-resistant tuberculosis, bioterrorism, pandemic influenza, and severe acute respiratory syndrome have intensified efforts to prevent transmission of infections that are completely or partially airborne using environmental controls. One such control, ultraviolet germicidal irradiation (UVGI), has received renewed interest after decades of underutilization and neglect. With renewed interest, however, come renewed questions, especially regarding efficacy and safety. There is a long history of investigations concluding that, if used properly, UVGI can be safe and highly effective in disinfecting the air, thereby preventing transmission of a variety of airborne infections. Despite this long history, many infection control professionals are not familiar with the history of UVGI and how it has, and has not, been used safely and effectively. This article reviews that history of UVGI for air disinfection, starting with its biological basis, moving to its application in the real world, and ending with its current status.

[Brief history of the syringe]. / Une brève histoire de la seringue.

Since the Greek Antiquity, the syringe was used to introduce some liquids through natural orifices; the invention of the hollow needle by Pravaz allowed the injection to be used through the skin or the blood vessels. Between 1841 and 1853, with the aid of the cutler Charrière, he succeeded in manufacturing a prototype of his syringe which is displayed in the museum of Lyons.

Five millennia of wound care products--what is new? A literature review.

The first wound an wound treatments were described five millennia ago. Since then, various principles of wound care have been passed on from generation to generation. In contrast to large numbers of general technological inventions over the last 100 years, progress beyond ancient wound care practices is a recent phenomenon. It is essential to know the historical aspects of wound treatment (both successes and failures) in order to continue this progress and provide future direction. A survey of the literature shows that concepts such as "laudable pus" persisted for hundreds of years and that lasting discoveries and meaningful progress did not occur until grand-scale manufacturing and marketing started. Landmarks such as understanding the principles of asepsis/antisepsis, fundamental cellular research findings, knowledge about antibiotics/antimicrobials, moist wound healing, and the chemical and physical processes of wound healing have provided the foundation to guide major developments in wound management, including available evidence-based guidelines. Although research regarding interaction of basic wound management principles remains limited, the combined efforts of global research and clinical groups predict a bright future for improved wound management.

Early attempts at sterilization: BJN 100 years ago.

The cleanliness of the skin for operations was a big issue 100 years ago, and it is fascinating to read different accounts of how surgeons tackled the problem and came up with their solutions. Mr Stretton, a senior surgeon to the Kidderminster Infirmary and Children's Hospital, writing in the BJN at the time, said:

[A predicted epidemic. The appearance of cholera in 1832 in southwest France]. / Une épidémie annoncée. L'apparition du choléra en 1832 dans le sud-ouest de la France.

In 1832 the epidemic cholera provoked the fear of a new plague on the banks of the Garonne and the administrative measures to struggle against the illness as the sprawling epidemic could be delimited in three departments. The author describes the clinical pictures of the illness and underlines the prophylactic measures which followed from epidemics of previous centuries and lasted until pasteurism, the increasing hygiene and the apparition of chemical treatments.

[Changes in the therapy of pulpal diseases and periapical lesions according to the articles published in the journal Fogorvosi Szemle during the past 100 years (1908-2008)]. / A fogbélbetegségek és a fogbél következményes betegségeinek terápiájában (gyökérkezelés) bekövetkezett változások 100 éve a Fogorvosi Szemle közlemenyeinek tükrében (1908-2008).

Present review makes an attempt to summarize the Hungarian endodontic literature of pulpal and periodontal diseases, published during the past 100 years. The experimental examinations and clinical studies make it possible to follow the changes in the methods and in the medicines, used in the field of pulpal treatment. The overview gives us information about the problem of disinfection, shaping, measuring, and obturation of root canal.

[Ilha Grande Lazaretto: isolation, imprisonment, and surveillance in the fields of health care and politics (1884-1942)]. / Lazareto da Ilha Grande: isolamento, aprisionamento e vigilância nas áreas de saúde e política (1884-1942).

The Ilha Grande pest house, located on the coast of Rio de Janeiro state, was built in 1884 to control the spread of epidemics via Brazilian ports. Separated from the continent, the buildings that housed patients could be kept under constant surveillance. Isolation regimens differed in accordance with the class on which passengers had traveled. The complex was used at different times as a military prison and eventually deactivated. In 1942, it was restored and became the Cândido Mendes Penal Colony.

John Wesley (1708-91).

John Wesley was a competent physician, quite capable of the diagnosis and care of patients. His Primitive Physic provides a picture of therapy in the eighteenth century but he rejected the bleeding and purging which were common at that time. He was ahead of his time in his emphasis on hygiene, cleanliness and simple living. In this he has been regarded as a pioneer of preventive medicine. He was in the forefront of the philanthropic movement in his provision of Dispensaries for the poor and his care of the sick and elderly. In spite of this he does not seem to have had a direct influence on the physicians of the day. Loudon does not mention him in his Origins and Growth of the Dispensary Movement in England and Clarke only gives him a passing reference in his History of The Royal College of Physicians. He experimented with electrotherapy and it seems likely he was one of those who saw that electricity could be the 'greatest step forward' in medicine as a whole.

Disinfection in the laboratory: theory and practice in disinfection policy in late C19th and early C20th England.

This article examines the relationship between theory and practice in nineteenth century English public health disinfection practice. Disinfection undertaken by local authorities and practised on objects, spaces and people became an increasingly common public health practice in the last quarter of the nineteenth century, and was part of a newly developed public health system of 'stamping out' disease as described by Hardy. Despite disinfection's key role in public health policy, it has thus far not received significant investigation or historiographical attending. This article explores the development of disinfection policy at local level, highlighting that despite commentators assumptions that increasingly exacting standards of disinfection required professional oversight rather than that of the 'amateur' public, there was a significant gap between laboratory based knowledge and evidence derived from practical experience. Laboratory conditions could not replicate those found in day-to-day disinfection, and there were myriad debates about how to create a mutually understandable scientific standard for testing. Despite increasing efforts to bring local disinfection in line with new ideas promulgated by central government and disinfection researchers, the mismatches between the two meant that there was greater divergence. This tension lay at the heart of the changes in disinfection theory and practice in the second half of the nineteenth century, and illustrate the complexities of the impact of germ theory on public health policy.

Water disinfection: microbes versus molecules--an introduction of issues.

"Water is, apart from the air one breathes, the only nutrient which is, as a matter of necessity, consumed by every human being from the first day to the last day of his existence, and it is consumed in considerably larger quantities than any other nutritional substance."(1)

Role of disinfection in suppressing the spread of pathogens with drinking water: possibilities and limitations.

Transmission of pathogens with drinking water is a widespread problem, which affects not only the countries with low hygienic standards but the industrialized countries as well. The pathogens are excreted by man or animals and are picked up orally. Chlorination of drinking water has been introduced to the water supply in the beginning of the 19th century in order to stop the spreading of pathogens especially typhoid fever by drinking water. Despite the worldwide use of chlorine for disinfection of drinking water, water-mediated disease outbreaks occur again and again. Disinfection of drinking water with chlorine has undoubtedly contributed to the reduction of typhoid fever mortality. However, it must be clear that other factors play an important role in the mortality drop. Filtration of water is a long-known and very effective process for eliminating pathogens from the drinking water. Pathogens in particles cannot be killed sufficiently by a chemical disinfectant. Even small fecal particles have to be eliminated reliably from the water by filtration. Disinfection of drinking water cannot replace filtration. The disinfection should be used to minimize the residual risk due to the presence of pathogens in the water but cannot be used for bringing fecally contaminated water into a hygienically sound condition.

History of disinfection from early times until the end of the 18th century.

The author describes and analyses the methods of disinfection in use until the end of the 18th century, i.e. before the scientific demonstration of the role of pathogenic microorganisms. These methods are classified into three categories: chemical (by derivatives of sulphur, mercury, copper, and also by alkalis and acids), physical (heating, fumigation, filtration, etc.) and biological (burial). The author concludes that, despite their empiricism, these methods were of great value to those responsible for controlling diseases of animals, as in some cases they were able to eradicate diseases while still ignorant of the causal mechanisms.

History and future perspectives of the use of disinfectants in animal health.

Programmes for the prevention, control and eradication of animal diseases are closely interlinked in many ways. In the field of animal health over the last 100 years, surveillance, diagnostics, rapid response, regulatory and legal authorities, epidemiological investigations, together with guidelines for dealing with diseased animals and contaminated premises and materials, have proved to be the critical links in the chain of actions needed to prevent, control and eradicate diseases. Disinfection, as an integral part of the protection of animal health, has become more sophisticated and more effective over this period. The historical trends suggest that disinfection will be even more important in the future, and that disinfectants and procedures must be further developed to keep pace with new scientific findings, changing agricultural structures and contemporary social concerns.

Milk pasteurisation and safety: a brief history and update.

A brief history of the development of milk pasteurisation is presented and updated. Concerns about the margin of safety provided by current pasteurisation standards in terms of milk-borne pathogens such as mycobacteria (in particular Mycobacterium paratuberculosis) and other emerging pathogens such as Listeria monocytogenes and Escherichia coli O157:H7 are discussed. With the exception of the endospores of Bacillus cereus, current standards appear to be adequate for public health assurance of milk safety provided good manufacturing practices are followed.

[Surgical hand disinfection using alcoholic rubbing disinfectants]. / Chirurgische Händedesinfektion mit alkoholischen Einreibepräparaten. Eine Standortbestimmung.

Since 1965, besides the use of scrubbing disinfectants, a number of alcoholic handrub methods are employed in the surgical skin disinfection of the hands. These contain, in addition to the alcohols, substances such as phenols and among others, cation-active substances. The efficacy of the substances is examined by means of in vitro-tests and through investigations conducted under conditions approximating those in the practice in accordance with the guidelines set down by the German Society of Hygiene and Microbiology. The comparison between the alcohol-containing handrub disinfectants and the scrubbing methods indicates clearly that the latter achieve only a low germ-reduction effect. The investigation on 4 alcoholic handrub disinfectants showed an initial potent germ-reducing and a good long-term effect. When mechanical scrubbing of the hands is carried out in a timely relationship to the application of the handrub -method, it is found to be able to produce extensive dermal damages. The reduction in the transient microbial flora by means of the mechanical hand scrubbing is minimal. The study on the germ-reduction after surgical disinfection of the hands using alcoholic handrub disinfectants in combination with and without initial soap-scrubbing demonstrated no differences, neither in the number of sterile hands nor in the averages of germ-reduction. The investigations conducted confirmed the excellent efficacy of the alcoholic handrub disinfectants and pointed out that it is unnecessary to combine mechanical hand scrubbing and the employment of alcoholic disinfectants in the same process.