Broiler Chicken Behavior and Activity Are Affected by Novel Flooring Treatments

The objective was to determine broiler chicken behavioral differences in response to novel flooring treatments. Broilers (n = 182) were housed in 14 pens (a random subset from a larger-scale study including 42 pens), with 13 birds/pen. One of seven flooring treatments were randomly allocated to 14 pens (2 pens per treatment). The flooring treatments (provided from day 1 {1} or day 29 {29}) included regularly replaced shavings (POS), a mat with 1% povidone-iodine solution (MAT), and the iodine mat placed on a partially slatted floor (SLAT). In addition, a negative control treatment was included with birds kept on used litter from day 1 (NEG). Behavior was recorded in weeks 1, 2, 5, and 6. In week 5, treatments affected the behavioral repertoire (p ≤ 0.035). Birds in POS-1 showed more locomoting, preening and activity overall compared to MAT and/or SLAT treatments. Birds in POS-29 showed more drinking, foraging, preening and overall activity than birds in MAT and/or SLAT treatments. In week 6, birds in the POS-1 treatment spent more time foraging compared to birds in all MAT and SLAT treatments (p ≤ 0.030). In addition, birds in the POS-1 treatment spent more time preening than birds in the MAT-1 treatment (p = 0.046). Our results indicate that access to partially slatted flooring and/or disinfectant mats does not benefit broiler chicken welfare in terms of their ability to express highly motivated behaviors. Access to clean, regularly replaced litter is beneficial for broiler chicken welfare in terms of their ability to express their normal behavioral repertoire.

Povidon-iodine applied for the treatment of chylothorax in children

Introduction. The aim of this study is to demonstrate the experience of non-surgical treatment of congenital and acquired chylothorax in children using povidone-iodine.Material and methods. The study presents results of treatment of 10 patients with chylothorax who had chemical pleurodesis with povidone-iodine. The study covered a time period from 2016 to 2020. The congenital character of the disease was registered in 2 patients, the acquired one - in 8 patients. The main indication for surgery was ineffective conservative therapy, including the withdrawal of feeding and the administration of preparation Octreotide. The procedure consisted of intrapleural injection of 4% povidone-iodine solution into the pleural cavity with the calculated dose of 1 ml/kg and solution exposure for 4 hours. Results. The interpleural administration of povidone-iodine was effective in all patients. Complications of chemical pleurodesis were observed in 2 patients and were associated with pulmonary edema on the injection side. Lymph outflow was stopped on average in 4 days. There was one adverse episode which developed because of the lung malformation incompatible with life. Conclusions. Intrapleural administration of povidone-iodine is an effective treatment of chylothorax in children.

Evaluating the Efficacy of Povidone-Iodine Solution Infection Prophylaxis in Immediate Tissue Expander-Based Breast Reconstruction: A Controlled Retrospective Analysis

Background: There is currently no consensus among plastic surgeons regarding the optimal infection prophylaxis for immediate tissue expander placement following mastectomy. The goal of this study was to determine whether irrigation with 1 L of standard triple antibiotic solution (TAS) can achieve similar infection rates compared to a regimen of 180 mL of TAS with povidone-iodine solution (Betadine) painted on the field immediately prior to the placement of the expander. Methods: The 2 regimens were compared via retrospective propensity matching of all patients of the 2 senior authors who underwent bilateral tissue expander placement immediately following mastectomy with one of 3 mastectomy surgeons from January 2013 to December 2019 (n = 281). Groups were controlled for mastectomy surgeon, mastectomy type, mastectomy weight, age, race, body mass index, diabetes, hypertension, smoking, smoking status, prepectoral/subpectoral placement, use of acellular dermal matrix, operating room time, and duration of postoperative antibiotics. Results: Compared to the Betadine cohort (n = 65), the non-Betadine cohort (n = 65) experienced a similar rate of infections (13.8% vs 12.3%, P = 1.00), including major injections requiring intravenous antibiotic treatment (10.8% vs 9.2%, P = 1.00), after propensity matching. Infections in the non-Betadine cohort did not grow different bacteria on culture, require different antibiotic coverage, or result in prolonged duration of average antibiotic therapy (12.0 days vs 19.3 days, P = .19). Rates of subsequent expander washout and exchange ( P = 1.00) and overall complications that required return to the operating room ( P = .826) were similar between groups. Conclusion: The addition of Betadine solution to TAS added no benefit to infection prophylaxis or reduction of surgical complications in immediate tissue expander placement procedures.

Vaginal preparation with povidone iodine solution before caesarean section and its impact on the post-operative infectious morbidity

Background: A prospective randomized control trial (RCT) was conducted in the department of obstetrics and gynecology. The aim of the study was to evaluate the effect of pre-operative vaginal preparation with 1% povidone iodine solution on the post-operative caesarean infectious morbidity.Methods: 72 women were enrolled in the experimental group who received 1% povidone iodine vaginal wash and 72 in the control group who did not receive any vaginal wash. The investigators were blinded to the computer-generated random number table and to the allocation group. The clinical data was recorded and after its completion, the allocation group was revealed to the investigator. The data was tabulated and statistically analyzed using SPSS 21.Results: Age, parity, BMI, gestational age, blood loss, and operative time between the two groups was comparable. Pre-operative povidone iodine vaginal wash was more effective when membranes were intact versus ruptured. With intact membranes, statistical significance was reached for postoperative fever, seroma, endometritis, gaped incisional site, and foul discharge with p value 0.012, 0.012, 0.013, 0.027 and 0.012 respectively, between group A and B. The overall infectious morbidity in the 144 subjects showed statistical significance for endometritis, and foul-smelling lochia with p value 0.049 and 0.024 respectively; urinary tract infection, hospital stay duration, and incisional wound dehiscence were higher in group B versus group A, the difference in these parameters did not reach statistical significance.Conclusions: Pre-operative vaginal cleansing with 1% povidone iodine reduced post-operative infectious morbidity more effectively in those with intact membranes than ruptured membranes.

Comparison of the Sterilization Efficiency of 3 Disinfectants for Dropped Anterior Cruciate Ligament Grafts: A Systematic Review and Meta-analysis

Background: The inadvertent contamination of anterior cruciate ligament (ACL) grafts can occur if they are accidentally dropped on the floor during ACL reconstruction. There has been no meta-analysis conducted to compare the sterilization efficiency of the different disinfectants used on dropped ACL grafts. Purpose: To compare the sterilization efficiency of 3 disinfectants to decontaminate ACL grafts as necessary. Study Design: Systematic review. Methods: A systematic literature review was performed using the MEDLINE, Embase, and Cochrane Library databases. All studies reporting the management of dropped or contaminated grafts were considered for this meta-analysis. Results: A total of 7 studies meeting inclusion criteria were identified from a literature search. The pooled results of this meta-analysis indicated that the rate of positive cultures of ACL grafts dropped on the operating room floor was 44.9% and that the commonly contaminated microbes were staphylococci and bacilli. The meta-analysis results indicated that the sterilization efficiency of a 4% chlorhexidine solution was superior to an antibiotic solution (odds ratio [OR], 0.17 [95% CI, 0.05-0.57]; P = .004) and a 10% povidone-iodine solution (OR, 0.04 [95% CI, 0.01-0.20]; P < .0001). Further, the antibiotic solution was superior to the 10% povidone-iodine solution (OR, 0.20 [95% CI, 0.07-0.55]; P = .002). Conclusion: The results of our meta-analysis demonstrated that staphylococci and bacilli were the most common contaminants on dropped ACL grafts and that decontamination using a 4% chlorhexidine solution more reliably disinfected ACL grafts. This information can help to guide surgeons as regards appropriate remedial measures.

Pragmatic randomized trial evaluating pre-operative aqueous antiseptic skin solution in open fractures (Aqueous-PREP): the feasibility of a cluster randomized crossover study

Background Preoperative antiseptic skin solutions are used prior to most surgical procedures; however, there is no definitive research comparing infection-related outcomes following use of the various solutions available to orthopedic trauma surgeons. The objective of this pilot study was to test the feasibility of a cluster randomized crossover trial that assesses the comparative effectiveness of a 10% povidone-iodine solution versus a 4% chlorhexidine gluconate solution for the management of open fractures. Methods Two orthopedic trauma centers participated in this pilot study. Each of these clinical sites was randomized to a starting solution (povidone-iodine solution or chlorhexidine gluconate) then subsequently crossed over to the other treatment after 2 months. During the 4-month enrollment phase, we assessed compliance, enrollment rates, participant follow-up, and accurate documentation of the primary clinical outcome. Feasibility outcomes included (1) the implementation of the interventions during a run-in period; (2) enrollment of participants during two 2-month enrollment phases; (3) application of the trial interventions as per the cluster randomization crossover scheme; (4) participant follow-up; and (5) accurate documentation of the primary outcome (surgical site infection). Feasibility outcomes were summarized using descriptive statistics reported as means (standard deviation) or medians (first quartile, third quartile) for continuous variables depending on their distribution and counts (percentage) for categorical variables. Corresponding 95% confidence intervals (CIs) were also reported. Results All five of the criteria for feasibility were met. During the run-in phase, all 18 of the eligible patients identified at the two clinical sites received the correct cluster-assigned treatment. A total of 135 patients were enrolled across both sites during the 4-month recruitment phase, which equates to 92% (95% CI 85.9 to 96.4%) of eligible patients being enrolled. Compliance with the assigned treatment in the pilot study was 98% (95% CI 93.5 to 99.8%). Ninety-eight percent (95% CI 93.5 to 99.8%) of participants completed the 90-day post-surgery follow-up and the primary outcome (SSI) was accurately documented for 100% (95% CI 96.6 to 100.0%) of the participants. Conclusions These results confirm the feasibility of a definitive study comparing antiseptic solutions using a cluster randomized crossover trial design. Building upon the infrastructure established during the pilot phase, a definitive study has been successfully initiated. Trial registration ClincialTrials.gov, number NCT03385304. Registered December 28, 2017.

TOLERABILITY OF HALODINE ORAL AND NASAL ANTISEPTICS AS PART OF A SARS-COV-2 TRANSMISSION REDUCTION STRATEGY

Background: ® Halodine oral and nasal antiseptics (Halodine LLC, Miami, FL USA) have been employed for routine oral and nasal decontamination as part of SARS-CoV-2 transmission reduction protocols.These preparations designed for the mouth and nose have been developed as oral sprays (1.25% povidone-iodine solution), oral rinses (1.75% povidoneiodine solution), nasal swabsticks (2.5% povidone-iodine solution), and nasal irrigation solutions (1.25% povidoneiodine solution). Methods: In a cross-sectional survey study, individuals who used any of the Halodine nasal or oral antiseptic products as part of a SARS-CoV-2 transmission reduction protocol were consented and invited to voluntarily complete a written questionnaire based on their practice and usage. Questions were derived from the Sino-Nasal Outcome Test (SNOT-22) to capture overall comfort and nasal symptomology.Results: There were 133 individuals ages 2-86 years who used Halodine in the forms of oral sprays,oral rinse,nasal swab-sticks,and nasal irrigation solutions for oral and nasal decontamination and volunteered to complete a satisfaction survey to assess tolerability. Decontamination was well tolerated; 99.2% of respondents reported no pain and 88.0% reported no nasal symptoms. Loss of taste, loss of smell, dizziness or blocked sinuses were not reported in any individuals. Three percent of respondents reported clearing of their sinuses.Halodine oral and/or nasal antiseptics were used two or more times per day in 94.7% of respondents.Discussion: Halodine for oral and nasal decontamination appears to be well tolerated for repeated daily use, even in individuals reporting 4 months or more of use. No individuals reported severe symptoms such as loss of taste, loss of smell, or dizziness. No pain was reported in 99.2% of individuals,while the remaining <1% reported very mild/minimal discomfort. Conclusion: These findings point to high tolerability of Halodine for repeated oral and nasal decontamination.