scholarly journals Sterile Field Contamination by Elastomeric Respirators Versus Surgical Masks and N95s

2020 ◽  
Author(s):  
Brittany Howard ◽  
Ryan Thorwarth ◽  
Karam Karam ◽  
Sam Snider ◽  
Erica Forzani ◽  
...  

Abstract Background: Elastomeric respirators are reusable and reliable protection from infectious aerosol particles such as SARS-CoV-2. There is a lack of safety data for use in sterile fields limiting application to operating room settings where high-risk aerosol generating procedures are performed. We hypothesized an equivalent reduction in sterile field contamination would be achieved using an elastomeric respirator covered by a surgical mask as compared to a standard surgical mask or N95.Methods: Randomized controlled crossover experiment with repeat measurement comparing microbial and aerosol contamination of operating room surfaces for elastomeric respirators, elastomeric respirators covered by a surgical mask, N95, surgical mask, and no mask. 80 experiments were performed by participants with randomized order and balanced crossover to all masking groups (n=16 per masking group). Participants executed droplet and aerosol generating procedures while wearing: (Group 1) elastomeric respirator with mask, (Group 2) elastomeric respirator only, (Group 3) N95, and (Group 4) surgical mask. Positive control was established with the participant unmasked (Group 5). Contamination was measured by microbial growth on settling plates and optical particle counters (0.2+ and 2 um+ particles).Results: There was a reduction in microbial contamination at the sterile field (p<0.001) for all masks (Groups 1-4) compared to unmasked (Group 5). The mean colony forming units (CFU) at the sterile field was 0 CFUs for elastomeric respirator (+/- mask), N95, and surgical mask versus unmasked growing 1.875 CFUs. Compared to the unmasked control, the elastomeric respirator (+/- mask), N95, and surgical masks all resulted in a -0.75 difference in contamination (95% CI -0.91 to -0.48, p < 0.001). No significant difference in contamination between the elastomeric respirator (+/- mask) and a surgical mask was detected. No significant difference in particle counts (0.2 µm+ and 2.0 µm+) between the elastomeric respirator (+/- mask) and a standard surgical mask.Conclusion and Relevance: Elastomeric respirators with or without mitigation are as effective as a surgical mask and N95 for reducing contamination at the sterile field in an operating room. Consideration should be given to expanding the use of elastomeric respirators to operating rooms during high-risk aerosol generating procedures.

2017 ◽  
Vol 21 (03) ◽  
pp. 189-197 ◽  
Author(s):  
Vlad Dionisie ◽  
Simona Clichici ◽  
Rodica M. Ion ◽  
Oana O. Danila ◽  
Remus Moldovan ◽  
...  

Several studies have shown that some anti-oxidant natural compounds in combination with photodynamic therapy (PDT) can enhance the effectiveness of treatment. The aim of this study is to evaluate the effect of silymarin (SIL) in combination with 5,10,15,20-tetra-sulphonato-phenyl-porphyrin (TSPP) based photodynamic therapy, on experimental tumors. 30 Wistar rats with Walker carcinosarcoma, were divided into 6 groups: group 0 (control) — control, untreated group; group 1 (TSPP) — one dose of TSPP; group 2 (SIL) — silymarin; group 3 (PDT) — TSPP and irradiation 24 h after; group 4 (SIL[Formula: see text]PDT) — silymarin, TSPP and irradiation 24 h after; group 5 (SIL[Formula: see text]IR) and group 6 (IR) — irradiation and in addition, group 5 received SIL. Silymarin administered before photodynamic therapy decreased the lipid peroxidation ([Formula: see text] < 0.05) and modulated the antioxidant defense in tumor treated with PDT and silymarin suggesting that silymarin administration along with photodynamic therapy has an anti-oxidant effect. The caspase — 8 level and -3 activity increased in PDT and PDT [Formula: see text] SIL groups compared to the control; between the two groups there was a significant difference in term of apoptosis in favor to PDT. In conclusion, silymarin administration inhibited the reactive oxygen species generation and reduced the tumoral cells’ apoptosis, suggesting that natural compound administered before photodynamic therapy did not improve the therapy’s effect.


2020 ◽  
Vol 41 (S1) ◽  
pp. s518-s519
Author(s):  
Dayane Costa ◽  
Roel Castillo ◽  
Lillian Kelly Lopes ◽  
Anaclara Tipple ◽  
Honghua Hu ◽  
...  

Objectives: To evaluate the efficacy of double manual cleaning (DMC) with enzymatic followed by alkaline detergent for removing biofilm on hinged surgical instruments compared to automated cleaning by the washer-disinfector. Methods: Biofilm of Staphylococcus aureus (ATCC 25923) was formed in vitro on hemostatic forceps (Fig. 1). Biofilm-covered forceps were rinsed in distilled water and subjected to one of the following cleaning regimes (n = 5 forceps each): Group 1 forceps were soaked in sterile water for 5 minutes. Group 2-DMC forceps were soaked in enzymatic detergent, brushed 5 times on each face, rinsed with filtrated water (0.2 µm), soaked in alkaline detergent, brushed 5 times each face, rinsed with filtrated water (0.2 µm), and dried with sterile cloth. For group 3-DMC plus hinge inner brushing (n = 5), the forceps were soaked in detergents and brushed as in group 2, including hinge inner brushing (2-mm lumen brush) (Fig. 1). In group 4 (automated cleaning in a washer/disinfector), forceps were prewashed, washed once, washed again, rinsed, thermally rinsed, and dried. After the treatments, forceps were evaluated for microbial load (counting of colony-forming units), residual protein (BCA protein assay kit), and biofilm (scanning electron microscopy). Results: There was no statistically significant differences between the microbial load and protein level contaminating the forceps subjected to DMC (group 2) and the positive control group. The DMC with hinge inner brushing group (group 3) and the automated cleaning group (group 4) demonstrated a significantly reduced microbial load: reduction averages of 2.8 log 10 (P = .038) and 7.6 log10 (P ≤ .001), respectively. The protein level remaining on the forceps also significantly decreased: 2.563 μg (P = .016) and 1,453 μg (P = .001), respectively, compared to the positive control group. There was no statistically significant difference between DMC with hinge inner brushing and automated cleaning (groups 3 and 4) for all of the tests performed. None of the cleaning methods completely removed biofilm and/or soil from the forceps hinge internal region (Fig. 1). Conclusions: Automated cleaning had the best efficacy for removing biofilm. However, DMC with hinge inner brushing was an acceptable alternative cleaning method for sterilizing service units with only manual cleaning available, as is the case in most low- and middle-income countries. Neither automated nor any manual cleaning regimes were able to completely remove biofilm and soil from the forceps hinged area, and the amount of protein left after automated and DMC plus hinge brushing was higher than the recommended. Cleaning is the most important step for the reprocessing of reusable medical devices; thus, efforts must be undertaken to improve cleaning in different social and economic realities and scenarios.Funding: This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES.Disclosures: None


2012 ◽  
Vol 3 (2) ◽  
pp. 166-170
Author(s):  
Carla Zogheib ◽  
Etienne Medioni

ABSTRACT Forty-eight extracted maxillary anterior teeth instrumented with ProTaper system to apical preparations 0.25, 0.40 and 0.60 mm (n = 16 each) were divided into six groups for filling as following: Group 1: Apical preparation 25/100 + gutta-percha/AH Plus sealer, group 2: Apical preparation 25/100 + Resilon/Real Seal, group 3: Apical preparation 40/100 + gutta-percha/AH plus sealer, group 4: Apical preparation 40/100 + Resilon/Real Seal, group 5: Apical preparation 60/100 + gutta-percha/AH plus, group 6: Apical preparation 60/100 + Resilon/Real Seal. All teeth were filled using the warm vertical technique. Horizontal sections at 1, 2 and 3 mm from the apex were observed by SEM under 200 × magnification. Sections were digitally photographed under a stereomicroscope and the images were transferred to a compatible PC for image analysis. The surface area of voids were calculated and compared at all levels; using the Kruskal-Wallis test with Sidak correction and Mann-Whitney U test (p > 0.05). Comparisons within each group (gutta-percha/AH plus and Resilon/Real Seal) showed the presence of voids but there was no significant difference between any level of sectioning for apical preparations of 25 and 40 (p > 0.05). The only difference was in the groups prepared to size 60 and filled with Resilon/ Real Seal which showed significantly more voids than the group filled with gutta-percha/AH plus and especially at the 3 mm level. Conclusion The system Resilon/Real Seal did not achieve better results in terms of sealing ability in the apical third when compared to the conventional gutta-percha/AH plus sealing system. How to cite this article Zogheib C, Naaman A, Medioni E. Evaluation of Apical Filling after Warm Vertical Compaction using Two Different Endodontic Materials: Resilon® and Gutta-Percha. World J Dent 2012;3(2):166-170.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4573-4573
Author(s):  
Jordan Nunnelee ◽  
Qiuhong Zhao ◽  
Don M. Benson ◽  
Ashley E. Rosko ◽  
Maria Chaudhry ◽  
...  

Introduction-Multiple myeloma (MM) represents 1.8% of all new cancer cases in the U.S., with an estimated 32,110 new cases in 2019. While not curable, advances in treatment, including autologous stem cell transplant (ASCT) and maintenance therapy, have dramatically improved progression free survival (PFS) and overall survival (OS). The Ohio State University bone marrow transplant program began utilizing ASCT for newly diagnosed MM (NDMM) patients in 1992. With the introduction of new and more effective drugs used before and after ASCT, we performed survival analysis in NDMM patients from 1992-2016 receiving ASCT to examine our institutional progress. Method-We performed a retrospective analysis of 1002 consecutive transplant eligible NDMM patients. Patients were split into five groups based on historic changes in novel agents for treatment of MM: 1992-1998 (vincristine/doxorubicin/dexamethasone-group 1), 1999-2002 (thalidomide/dexamethasone-group 2), 2003-2008 (bortezomib/lenalidomide/dexamethasone-group 3), 2009-2013 (carfilzomib/pomalidomide/dexamethasone, and maintenance therapy-group 4), and 2014-2016 (agents used for relapsed MM, including daratumumab/elotuzumab/ixazomib/dexamethasone, and maintenance therapy-group 5). Pre-ASCT conditioning regimen was melphalan 140-200 mg/m2 in 94.4% of patients. Data were consistently obtained since 2003 for both standard and high-risk patients at diagnosis. High-risk patients had del17, t(4:14), t(14:16), hypodiploidy and/or 1q abnormality. Primary endpoints were PFS and OS. PFS was defined as time to progressive disease or death from any cause from the date of transplantation. OS was defined as time from transplantation to death from any cause, censoring those who were still alive at the last follow up. Kaplan Meier curves were used to calculate PFS and OS. Results-The median age of all patients at transplant was 58 years (range: 18-81 years) and 58.5% were male. The median patient age increased significantly, from 54 to 60 years, over 1992-2016 (p<0.001). The majority of patients (53.6%) had IgG myeloma and 19.3% had light chain disease. 30% of patients with known cytogenetic data were high-risk. Melphalan 200 mg/m2 was used in 80.5% of patients. It was noted that across the years (1992-2016), there was a statistically significant improvement in both PFS (p<0.01) and OS (p<0.01). Median PFS and OS of all patients was 1.3 and 2.0 years in group 1 (1992-1998); 1.0 and 3.2 years in group 2 (1999-2002); and 2.0 and 5.8 years in group 3 (2003-2008), respectively. This response was further improved to PFS and OS of 4.1 years and not reached (NR) in group 4 (2009-2013), and 3.8 years and NR in group 5 (2014-2016), respectively (Figure 1). The 3 year PFS of groups 1 through 5 was 26%, 25%, 35%, 57% and 58%, respectively. The 3 year OS of groups 1 through 5 was 45%, 54%, 74%, 82% and 80%, respectively. On subset analysis, across years, significant increases in PFS (p<0.01) and OS (p<0.01) were seen in patients ≤65 years of age. For patients >65 years old, there was a statistically significant improvement in PFS (p<0.01) but not in OS (p=0.054). For both standard and high-risk disease, there was significant improvement in PFS (p<0.01 and p<0.01), and OS (p=0.02 and p=0.02), respectively. The rate of response both pre- and post-transplant showed statistically significant improvement across the years (p<0.01). The pre-transplant rate of very good partial response (VGPR), or better, increased from 5.3% in early 1990's (group 1), 15.3% (group 2), 39.8% (group 3) to 51.2% (group 4) and 54% (group 5). The post-transplant rate of response (VGPR or better) also increased from 31.5% (group 1), 28.8% (group 2), 65.6% (group 3), to 79.6% (group 4) and 76.3 % (group 5). Conclusion-Our data show that NDMM patients' survival and response to standard of care treatment have improved dramatically since 1992, primarily due to inclusion of novel therapies and maintenance. For NDMM patients receiving ASCT, the 3 year overall survival rate has significantly improved from 45% in 1992-1998 to 80% in 2014-2016, which is similar to the post-ASCT OS shown in the 2012 study by McCarthy et al. The significantly increasing age of NDMM patients receiving ASCT over time suggests improving supportive care and expansion of standard of care therapies to more of the population, improving survival and quality of life. Disclosures Rosko: Vyxeos: Other: Travel support. Efebera:Takeda: Honoraria; Akcea: Other: Advisory board, Speakers Bureau; Janssen: Speakers Bureau.


1987 ◽  
Vol 253 (5) ◽  
pp. E503-E507 ◽  
Author(s):  
T. Matsumoto ◽  
K. Ikeda ◽  
K. Morita ◽  
S. Fukumoto ◽  
H. Takahashi ◽  
...  

To clarify whether extracellular Ca2+ modulates renal 25-hydroxyvitamin D3 [25(OH)D3]-1 alpha-hydroxylase, thyroparathyroidectomized rats were infused with 15 mM CaCl2, 20 mM EGTA, and/or 2.5 U/h parathyroid hormone (PTH), and blood Ca2+, serum 1,25-dihydroxyvitamin D [1,25(OH)2D], and renal 1 alpha-hydroxylase activity were determined. Rats with CaCl2, EGTA, or PTH infusion (group 1) exhibited low blood Ca2+, serum 1,25(OH)2D, and 1 alpha-hydroxylase activities. Infusion of CaCl2 alone (group 2) caused a significant increase in blood Ca2+ and a reduction in serum 1,25(OH)2D and 1 alpha-hydroxylase compared with group 1. Administration of PTH alone (group 3) markedly elevated blood Ca2+, serum 1,25(OH)2D, and 1 alpha-hydroxylase activity. When EGTA was infused along with PTH (group 4), blood Ca2+ was significantly reduced compared with group 3, and serum 1,25(OH)2D and renal 1 alpha-hydroxylase were further elevated. In contrast, when CaCl2 was infused with PTH (group 5), blood Ca2+ was higher than that in group 3, and serum 1,25(OH)2D and 1 alpha-hydroxylase activities were significantly reduced compared with group 3. No significant difference in serum inorganic phosphate or urinary cAMP excretion was observed by CaCl2 or EGTA infusion in both PTH-treated and nontreated rats. These results demonstrate that extracellular Ca2+ modulates the responsiveness of renal 1 alpha-hydroxylase to PTH as well as the base-line activity of the enzyme in the absence of PTH. These effects of extracellular Ca2+ on renal 1 alpha-hydroxylase may serve to offer an efficient way of regulating 1,25(OH)2D production and serum 1,25(OH)2D concentration by altering the responsiveness of 1 alpha-hydroxylase to PTH and possibly other stimulations depending on the demand for Ca2+.(ABSTRACT TRUNCATED AT 250 WORDS)


2015 ◽  
Vol 45 (9) ◽  
pp. 1634-1640 ◽  
Author(s):  
Carlos Alberto Oliveira Júnior ◽  
Gabriela Riet-Correa ◽  
Everton Lima ◽  
Danilo Maia Leite ◽  
James A. Pfister ◽  
...  

<p><bold>Ipomoea carnea</bold> is a toxic plant that grazing goats and cattle may learn to ingest with repeated exposure. The objective of this study was to evaluate the feeding preferences of experienced and non-experienced (naïve) goats and sheep for<bold> I. carnea.</bold>The study used 3 groups of 5 goats (Group 1, experienced that were previously poisoned by the plant; group 2, naïve; Group 3, experienced eaters, composed of animals adapted to eat the fresh plant) and 2 groups of sheep (group 4, experienced that were previously poisoned by the plant; and group 5, naïve). For the test, the animals were placed daily for 10 minutes and 4 days in a rectangular stall (5x7m) with 4 feeders, each with 200g of a different food (<bold>Ipomoea carnea</bold>, commercial concentrate food, recently harvested green grass (mainly <bold>Brachiaria</bold> spp.), and <bold>Cynodon dactylon</bold>hay. The intake of concentrate food was significantly higher (P<0.05) than the consumption of green grass, hay and <bold>I. carnea</bold>. In a second 4 day trial, in which the commercial concentrate food was replaced by freshly harvested <bold>Amorimia septentrionalis</bold>, the ingestion of green grass (<bold>Brachiaria</bold> spp.) was significantly higher (P<0.05) than the consumption of other foods. In both trials there was no significant difference in food consumption between eaters and naïve animals. The results suggest that experienced or naïve sheep and goats do not prefer <bold>I. carnea</bold> when it is offered with other foods or forages, suggesting that animals will avoid the plant and not become poisoned if other food options are available.</p>


2007 ◽  
Vol 8 (7) ◽  
pp. 62-69 ◽  
Author(s):  
Emre Ozel ◽  
Idil Dikbas ◽  
Jale Tanalp ◽  
Temel Koksal ◽  
Mustafa Ersoy

Abstract Aim The purpose of this study was to evaluate the fracture resistance of endodontically treated maxillary central incisors restored with quartz fiber posts, composite cores, and crowns when different types of ferrule designs were incorporated. Methods and Materials Sixty maxillary incisors were divided into six groups: Group 1 (control): teeth with root canal treatments having a full crown prosthesis; Group 2: teeth with a 2 mm circumferential ferrule; Group 3: teeth with a 2 mm ferrule only in the vestibular region; Group 4: teeth with a 2 mm ferrule only in the palatal region; Group 5: teeth with a 2 mm ferrule in the vestibular and palatal region, having cavities in both proximal areas; and Group 6: teeth with no ferrule. The teeth in the experimental groups were restored with quartz fiber posts-composite cores and full metallic crowns. All experimental teeth were subjected to an increasing compressive force with a crosshead speed of 1 mm/min, until fracture occurred. Results The median fracture values of groups were as follows: Group 1: 574.4 N, Group 2: 472.4 N, Group 3: 474.3 N, Group 4: 480.7 N, Group 5: 463.1 N, and Group 6: 297.9 N. A statistically significant difference was found between Group 1 and Group 6 (p< 0.01). Conclusion It was concluded different ferrule designs did not have any influence on the fracture resistance of teeth with fiber posts. The results of this study indicate fiber posts can safely be used for their reinforcing properties. Furthermore, there is no significant change in the resistance of teeth with fiber posts regardless of which ferrule design is incorporated. The property of these types of posts is an additional advantage in clinical practice. Citation Dikbas I, Tanalp J, Ozel E, Koksal T, Ersoy M. Evaluation of the Effect of Different Ferrule Designs on the Fracture Resistance of Endodontically Treated Maxillary Central Incisors Incorporating Fiber Posts, Composite Cores and Crown Restorations. J Contemp Dent Pract 2007 November; (8)7:062-069.


2002 ◽  
Vol 126 (3) ◽  
pp. 290-295 ◽  
Author(s):  
Binoy Chandy ◽  
Fleurette Abreo ◽  
Raja Nassar ◽  
Fred J. Stucker ◽  
Cherie-Ann Nathan

OBJECTIVE: eIF4E (4E) is elevated in 100% of head and neck squamous cell carcinoma (HNSCC) and in premalignant lesions of the larynx. However, it is not elevated in normal mucosa. In this study, we hypothesize that 4E is not significantly elevated in inflammation unlike its expression in premalignant lesions of the oral cavity. STUDY DESIGN: Biopsies from the oral cavity were divided into 5 groups: (1) normal mucosa, (2) chronic inflammation, (3) mild dysplasia from leukoplakic lesions, (4) mild dysplasia in surgical margins of patients with HNSCC, and (5) HNSCC. Immunohistochemical qualitative analysis was then performed. RESULTS: None of the 15 specimens in group 1 and 100% of the 15 specimens in group 5 expressed 4E. Of the 29 specimens in group 2 only 4/29 (13%) overexpressed 4E compared with 10/31 (32%) in group 3 and 9/21 (42%) in group 4. There was a significant difference between groups 2 and 3 and groups 2 and 4 ( P < 0.0001 and P < 0.003 respectively) but no significant difference between groups 1 and 2 ( P = 0.13) and between groups 3 and 4 ( P = 0.30). CONCLUSION: 4E is not significantly elevated in inflammation of the oral cavity thus fulfilling one of the criteria that biomarkers require to be useful in a clinical setting.


2020 ◽  
Author(s):  
Jialong Chen ◽  
Jing Lin ◽  
Dansen Wu ◽  
XiaoLan Guo ◽  
XiuHua Li ◽  
...  

Abstract Objective: Pulmonary embolism is a terrible cardiovascular condition with considerable morbidity and mortality. Previous studies have investigated systolic blood pressure (systolic BP) and diastolic blood pressure (diastolic BP) as being related to 30-day and in-hospital mortality. We aimed to determine whether the average mean arterial pressure (aMAP) in the first 24 hours of hospital admission is useful in predicting short-term outcomes of intermediate-risk and high-risk PE patients. Method: We conducted a single-center retrospective study. From May 2012 to April 2019, 122 intermediate-risk and high-risk PE patients were included. The primary outcome was in-hospital mortality. The secondary outcome was adverse events. ROC curves and cut-off values for aMAP predicting in-hospital death were computed. According to cut-off values, we categorized five groups defined as follows: group 1: aMAP<70 mmHg; group 2: 70 mmHg≤aMAP<80 mmHg; group 3: 80 mmHg≤aMAP<90 mmHg; group 4: 90 mmHg≤aMAP<100 mmHg; and group 5: aMAP≥100 mmHg. Cox regression models were calculated to investigate associations between aMAP and in-hospital death. Results: In the study group of 122 patients, 15 patients (12.30%) died in the hospital due to PE. ROC analysis for MAP predicting in-hospital death revealed an AUC of 0.729 with a cut-off value of 79.4 mmHg. Cox regression models showed a significant association between in-hospital death and aMAP group 1 (ref), aMAP group 2 (OR 1.680, 95% CI 0.020-140.335), aMAP group 3 (OR 0.003, 95% CI 0.0001-0.343), aMAP group 4 (OR 0.006, 95% CI 0.0001-1.671), and aMAP group 5 (OR 0.003, 95% CI 0.0001-9.744). In particular, those with an aMAP of 80-90 mmHg suffer from minimum adverse events. Conclusion: The prognostic role of MAP during the first 24 hours of hospital admission should be emphasized in patients with PE. The optimal range of MAP for intermediate-risk and high-risk PE patients may be 80 to 90 mmHg.


Author(s):  
Michele Méndez Velázquez

Aim: Sodium hypochlorite is the most common solution in the Endodontics field, however, NaOCl concentrations of commercial brands which are prepared for this purpose differ from their actual concentration. The aim of this study was to compare the physicochemical properties of dental and household hypochlorites. Materials and Methods: The solutions were divided in the following groups: Control: Clorarex 6%, Group 1: Viarzoni-T 5.25%, Group 2: Endo Chlord 3%, Group 3: Chlor- XTRA 6%, Group 4: Viarzoni-T (diluted from 5.25%), Group 5: Cloralex (diluted from 6%), Group 6: Chlor- Xtra (diluted from 6%). pH and temperature were measured by means of potentiometer, dilution test was performed using bovine tissue and exposed to each solution. For cytotoxicity assay, erythrocytes were exposed to each solution and stained with Sternheimer-Malbin solution. Results: Dissolution times showed a significant difference since the shortest time was Cloralex (6.6 ± 2.09). The solution with the highest alkalinity in the original concentration was Endo Chlord for dental use (11.7 ± 2.2). The solution with the highest alkalinity in the original concentration was Endo Chlord for dental use (11.7 ± 2.2) but it also was the solution with less cytotoxicity. Conclusion: Viarzoni-T was the only solution without any dissolving capacity, Cloralex, ChorlXtra and EndoChlord were capable of dissolving bovine pulp tissue effectively, reducing their concentration of Cloralex and ChlorXtra did not reduce the pH, but all solutions showed a cytotoxic effect on erythrocites.


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