Correction of the Maximum Permissible Values of the Oil Acidity by the Minimum Risk Method

Materials and Methods. Published articles on the opioid abuse and methods of opioid detoxification were identified by searching medical databases, using corresponding literature and were also searched manually for applicable papers. The search was limited to articles published from 1985 through 2014. Results. Opioid dependence determine pathophysiologic changes in the dopaminergic pathways of the organism, as well as the alterations in the stress-responsive hypothalamic-pituitary-adrenal axis. The usage of opioid antagonists in the early stages of withdrawal, can lead the effectiveness of opioid detoxification to 100%. Rapid opioid detoxification do not remove all the symptoms of abstinence. Negative aspects, concerning the procedure, while using prevention, can be reduced to the minimum risk. Rapid opioid detoxification, comparing it with Ultrarapid opioid detoxification procedure, diverges as less financial resources and a lower risk containing technique. Conclusions. Use of antagonists may reduce the duration of withdrawal, thus reducing the overall severity of withdrawal and increasing the chances of successful completion. This technique facilitates commencement of naltrexone treatment. Dosing regimens used in clinical trials vary. Subsequent results do not correlate with the methods of detoxification.

Download Full-text

Nonionic Low-Osmolar Monomeric Iodinated Contrast Material: Some Aspects of use for Computed Tomography in Children

Medical Visualization ◽

10.24835/1607-0763-2017-6-118-129 ◽

2017 ◽

pp. 118-129

Author(s):

I. A. Kondrashov ◽

V. Mandal

Keyword(s):

Computed Tomography ◽

Contrast Agents ◽

Adverse Reactions ◽

Contrast Material ◽

Iodine Content ◽

Diagnostic Procedures ◽

Diagnostic Efficacy ◽

Minimum Risk ◽

Electrical Neutrality ◽

Iodinated Contrast

Iodine containing contrast media are used much frequently now-a-days for computed tomography examinations in children. The group of non-ionic monomers occupies a special place among modern contrast agents. Low osmolarity and viscosity, electrical neutrality and the highest iodine content of these contrast materials provide the best diagnostic efficacy with minimum risk of adverse reactions. However, characteristic anatomic and physiological aspects of a growing child’s body require additional attention and care during diagnostic procedures with use of such contrast agents. This article presents concise literature review of recent years highlighting practical aspects of nonionic lowosmolar iodinated contrast material use for computed tomography assisted diagnostic examinations in child population.

Download Full-text

Risk evaluation of duodenoscope-associated infections in the Netherlands calls for a heightened awareness of device-related infections: a systematic review

Endoscopy ◽

10.1055/a-1467-6294 ◽

2021 ◽

Author(s):

Judith A. Kwakman ◽

Nicole S. Erler ◽

Margreet C. Vos ◽

Marco J. Bruno

Keyword(s):

The Netherlands ◽

Multidrug Resistant ◽

Healthcare Personnel ◽

Endoscopic Retrograde ◽

Minimum Risk ◽

Actual Risk ◽

Molecular Matching ◽

Estimated Risk ◽

Technical Solutions ◽

Risk Ratios

Abstract Background The risk of exogenous infections from endoscopic procedures is often cited as almost negligible (1 infection in 1.8 million procedures); however, this risk is based on older literature and does not seem to match the number of infectious outbreaks due to contaminated duodenoscopes reported after endoscopic retrograde cholangiopancreatography (ERCP). Using Dutch data, we aimed to estimate the minimum risk of duodenoscope-associated infection (DAI) and colonization (DAC) in patients undergoing ERCP. Methods A systematic literature search identified all DAI outbreaks in the Netherlands reported between 2008 and 2019. Included cases were confirmed by molecular matching of patient and duodenoscope cultures. Risk ratios were calculated based on the total number of ERCPs performed during the study period. Results Three outbreaks were reported and published between 2008 and 2018, including 21 confirmed DAI cases and 52 confirmed DAC cases. The estimated number of ERCPs performed during the same period was 181 209–227 006. The calculated minimum estimated DAI risk was approximately 0.01 % and the minimum estimated DAC risk was 0.023 %–0.029 %. Conclusions The estimated risk of DAI in Dutch ERCP practice was at least 180 times higher than previously published risk estimates. The actual risk is likely to be (much) higher due to underreporting of infections caused by multidrug-resistant organisms and sensitive bacteria. Greater awareness by healthcare personnel involved in endoscopy and endoscope cleaning is required, as well as innovative technical solutions to contain and ultimately eliminate DAIs.

Download Full-text

Risk Estimate of Duodenoscope-Associated Infections in The Netherlands

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1102 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s436-s437

Author(s):

M. Vos ◽

Judith Kwakman ◽

Marco Bruno

Keyword(s):

The Netherlands ◽

Multidrug Resistant ◽

National Database ◽

Clinical Infection ◽

Minimum Risk ◽

Medical Practitioners ◽

Healthcare Facilities ◽

Calculated Risk ◽

Original Calculation ◽

Bare Minimum

Background: The likelihood of endoscopy-associated infections (EAIs) is often referenced from a paper published in 1993 by Kimmery et al1 in which a risk of 1 exogenous infection for every 1.8 million endoscopies (0.00006%) is proclaimed. Even though Ofstead et al2 pointed out in 2013 that this was at least an underestimation by 6-fold because of erroneous assumptions and mathematical errors, the original calculation is still often referred to. In the past decade, multiple outbreaks of multidrug-resistant microorganisms (MDROs) related to contaminated duodenoscopes have been reported worldwide. This leads to the assumption that the former risk calculation is indeed incorrect. Objective: We calculated the duodenoscope-associated infection (DAI) risk for the Dutch ERCP practice. Methods: We searched and consolidated all Dutch patients reported in the literature to have suffered from a clinical infection linked to a contaminated duodenoscope between 2008 and 2018. From a national database, the number of ERCPs performed per year in The Netherlands were retrieved. Actual numbers were available from 2012 to 2018. Numbers from 2008 to 2011 were estimated and assumed to be equal to 2012. Results: In 2008–2018, 3 MDRO outbreaks in Dutch hospitals were reported in the literature, with 21 patients suffering from a clinical infection based on a microorganism proven to be transmitted by a duodenoscope. In that period, ∼203,500 ERCP procedures were performed. Hence, for every 9,690 procedures, 1 patient developed a clinically relevant infection (DAI risk, 0.010%). Conclusions: The risk of developing a DAI is at least 30–180 times higher than the risks that were previously reported for all types of endoscopy-associated infections. Importantly, the current calculated risk of 0.010% constitutes a bare minimum risk of DAI because endoscope-related infections are underreported. Apart from DAI risk, a patient is also at risk of becoming colonized with a microorganism through contaminated endoscopes but without developing symptoms of clinical infection. These data call for consorted action of medical practitioners, industry, and government agencies to minimize and ultimately eliminate the risk of exogenous endoscope-associated infections and contamination. As a first step, the FDA recently recommended that healthcare facilities and manufacturers begin transitioning to duodenoscopes with disposable components.3Funding: NoneDisclosures: None

Download Full-text

A Fast Algorithm for CU Depth Decision Based on the Minimum Risk Bayesian Criterion

2021 IEEE Asia Conference on Information Engineering (ACIE) ◽

10.1109/acie51979.2021.9381078 ◽

2021 ◽

Author(s):

Jianlong Guo ◽

Jiang Xue ◽

Manhua Wen

Keyword(s):

Fast Algorithm ◽

Minimum Risk ◽

Bayesian Criterion

Download Full-text

Neurological morbidity in vaccine-associated paralytic poliomyelitis in Brazil from 1989 up to 1995

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2004000300008 ◽

2004 ◽

Vol 62 (2b) ◽

pp. 414-420 ◽

Cited By ~ 2

Author(s):

Elza Dias-Tosta ◽

Carlos Santos Kückelhaus

Keyword(s):

Virus Infection ◽

Neurological Deficit ◽

Strong Relationship ◽

Vaccine Virus ◽

Paralytic Poliomyelitis ◽

Ministry Of Health ◽

Minimum Risk ◽

Clinical Pattern ◽

Neurological Morbidity ◽

Permanent Neurological Deficit

We collected 30 cases of vaccine associated paralytic poliomyelitis (VAPP) from 4081 cases of acute flaccid palsies cases notified from 1989 to 1995 to the Brazilian Ministry of Health. There were 30 VAPP cases with 56% of children younger than 1 year old, 56.7% of female. 46% of cases were reported in the Northeast. Ten P2 vaccine virus, 8 P3 and 2 P1 and associations amongst them were isolated. The clinical pattern in 60 days was: monoplegia (16), paraplegia (6), tetraplegia (5), hemiplegia (2) and triplegia (1). There was no strong relationship between fever, before or after the prodrome period, or the use of intramuscular medication to morbidity. CONCLUSION: if the anti-poliomyelitis strategy adopted in Brazil has lead to the eradication of the poliomyelitis with wild virus infection, the existence of a minimum risk of vaccine-associated poliomyelitis is a matter of concern because there will be a permanent neurological deficit.

Download Full-text

The development of the program of voluntary blood donation promotion in students population of the University of Belgrade

Vojnosanitetski pregled ◽

10.2298/vsp1506489j ◽

2015 ◽

Vol 72 (6) ◽

pp. 489-494 ◽

Cited By ~ 4

Author(s):

Snezana Jovanovic-Srzentic ◽

Ivana Rodic ◽

Mirjana Knezevic

Keyword(s):

Blood Donors ◽

Blood Donation ◽

Population Group ◽

Minimum Risk ◽

Blood Donations ◽

The Public ◽

The Media ◽

Donated Blood ◽

The University ◽

Academic Year

Background/Aim. Given that in each country students represent the most progressive population group, as of 2001, the Blood Transfusion Institute of Serbia (BTIS) has been carrying the program of voluntary blood donation promotion and education of volunteers at the University of Belgrade (UB). In 2011, the BTIS intensified all activities at the UB. The aim of this study was to present activities performed from 2001 at the Blood Donors` Motivation Department (DMD) of the BTIS related with increasing the level of awareness on voluntary blood donation in the Belgrade students` population, enhancing their motivation to become voluntary blood donors (VBDs), increasing the number of blood donations at faculties of the UB, and increasing the number of blood donations in the UB students population compared with the total number of blood units collected by BTIS in Belgrade, with the emphasis on the year 2013. Methods. Initially, the applied methodology was based on encouraging students to donate blood through discussions and preparatory lectures, followed by organized blood drives. Appropriate selection of volunteers at each faculty was crucial. Besides their recognisable identity, they had to have remarkable communication skills and ability to positivly affect persons in their environment. The applied principle was based on retention of volunteers all through the final academic year, with the inclusion of new volunteers each year and 1,000 preparatory lectures on the annual basis. The activities were realized using two Facebook profiles, SMS messages and continuous notification of the public through the media. Results. There was an increase in the average number of students in blood drives at the faculties from 2011, when the average number of the students per blood drive was 39, followed by 43 in 2012 and 46 in 2013. The number of students who donated blood in 2013 increased by 21.3% compared with 2012 data. Conclusion. The applied concept highly contributed to generation and retention of future VBDs willing to regularly donate blood in the coming years, with a minimum risk of transmission of transfusion transmissible diseases markers.

Download Full-text