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Colonization of bacteria on polyvinyl chloride and Teflon intravascular catheters in hospitalized patients.

During an 8-month period all intravascular catheters were removed by sterile technique upon completion of use and submitted to the hospital microbiology laboratory. All catheters were routinely cultured by the semiquantitative culture technique, with greater than or equal to 15 colonies being defined as a positive result. Of the 687 Teflon catheters cultured, 6.9% were positive by culture, compared with 24.6% of 77 polyvinyl chloride catheters (P less than 0.001). Also, colonization of coagulase-negative staphylococci on polyvinyl chloride was more than on Teflon. These data suggest that polyvinyl chloride catheters are colonized more frequently with organisms than are Teflon catheters; additionally, there is an increased affinity of coagulase-negative staphylococci for polyvinyl chloride as compared with Teflon, substantiating our previous observations with an in vitro system. We conclude that the type of catheter material may be important in determining the incidence of catheter-related infections and in selective colonization by coagulase-negative staphylococci.

Bacterial Infections↗

Evaluation of calcium alginate nasal packing (Algostéril) versus Polyvinyl acetal (Merocel) for nasal packing after inferior turbinate resection.

Nasal packing is commonly used to control postoperative bleeding in patients undergoing endonasal surgical procedures. Bleeding and pain on packing removal are frequently reported. The principal objective of this study was to investigate the efficacy and safety of Algosteril to control post-operative nasal bleeding. The secondary objective was to assess nasal bleeding and pain on packing removal, and to evaluate the endoscopic appearance of nasal mucosa 9 days after the procedure. This open, multicenter, randomized, controlled study was conducted on 50 patients undergoing partial bilateral inferior turbinectomy, packed with Algosteril on one side versus Polyvinyl acetal tampon (Merocel) on the other side following a left/right randomization. Both nasal packs effectively prevented post-operative bleeding. However, bleeding on packing removal was statistically less frequent and less severe with Algosteril than with Polyvinyl acetal (p = 0.016). In addition, pain was statistically lower with Algosteril than with Polyvinyl acetal (p = 0.0001). A trend to a better healing of the wound on day 9 was observed with Algosteril, leading us to further investigations. Algosteril nasal packing is as effective as Polyvinyl acetal in preventing postoperative bleeding following partial inferior turbinate resection. Its removal, however, is less traumatic for the nasal mucosa and less painful for the patient, therefore improving patient's comfort.

Adult↗

Permeability of latex and polyvinyl chloride gloves to carmustine.

Permeability of latex and polyvinyl chloride gloves to the antineoplastic agent carmustine was studied. The latex gloves were of two types: sterile surgical gloves and disposable utility gloves. Polyvinyl chloride gloves of two thicknesses (0.20 mm and 0.35 mm) were tested. Both single and double thicknesses of each material were exposed to carmustine 3.33 mg/ml in a 10% aqueous solution of ethanol, and to the solvent alone, for 5-90 minutes. Permeation of carmustine was tested using a mutagenicity assay and a chemical assay. A time-dependent increase in carmustine permeation was observed for all types of materials (both double and single thicknesses). Mean amounts of carmustine permeating single gloves at 90 minutes ranged from 53 to 86 micrograms for the mutagenicity assay and 49 to 78 micrograms for the chemical assay. Double thicknesses of glove material (especially of the thicker polyvinyl chloride) reduced the amount of drug permeation. These latex and polyvinyl chloride glove materials offer only limited protection against contact exposure to carmustine. Latex surgical gloves may be slightly less permeable than the other types tested.

Carmustine↗

Ocular evaluation of polyvinyl alcohol vehicle in rabbits.

The flow properties and viscosity of the vehicle into which drugs are incorporated can be determining factors in the bioavailability of topically applied ophthalmic drugs. It is shown, in rabbits, that when polyvinyl alcohol and methylcellulose are compared on a viscosity basis, there is essentially no difference in the two vehicles with regard to their influence on ocular drug bioavailability. Moreover, the rate of drainage loss for polyvinyl alcohol solutions, as determined by the radioactive technetium technique, compares favorably to methylcellulose solutions of similar viscosity. The relationship between viscosity and contact time or drainage loss of a drug is not a direct one, but an optimum viscosity range exists for polyvinyl alcohol solutions. This optimum range of 12-15 cps in rabbits is identical to that found for methylcellulose and differs considerably from the commonly employed viscosity in commercial preparations. Based on the methylcellulose-polyvinyl alcohol comparison, it appears that vehicles exhibiting or approximating Newtonian flow properties show comparable effects as ophthalmic vehicles. Finally, a discussion of non-Newtonian vehicles and their expected behavior in the eye is presented.

Animals↗

Compressibility of two polyvinyl siloxane interocclusal record materials and its effect on mounted cast relationships.

STATEMENT OF PROBLEM: Addition silicones (polyvinyl siloxanes) are universally accepted as accurate and stable impression materials. They have also gained popularity as interocclusal record materials. However, it has not been defined if it is possible to work with polyvinyl siloxanes without changing the recorded maxillomandibular relations. PURPOSE: This study examined the compressibility of 2 addition silicones as interocclusal record materials, analyzing the changes of maxillomandibular relations at the condyle region when different compressive forces are used to stabilize articulated casts. MATERIAL AND METHODS: Sixteen interocclusal records, obtained from the same patient (8 of each polyvinyl siloxane, Blu-Mousse, Fast Set), were interposed between the patient casts in a new measuring system obtaining 48 curves of load versus maxillomandibular positional changes in 3 axes (x, y, z). These curves were compared with curves obtained with the casts in maximum intercuspation without interocclusal records (reference curves). Analysis of variance was used to compare maxillomandibular positional changes among the 3 groups (n = 48 each): Blu-Mousse, Fast Set, and control group or maximum intercuspation without interocclusal record. RESULTS: There was no significant change in maxillomandibular relations when forces up to 1 kgf were applied to stabilize the casts related by means of Blu-Mousse and Fast Set addition silicone interocclusal records. CONCLUSION: It is possible to use these polyvinyl siloxanes as interocclusal record materials without changing the recorded maxillomandibular relations.

Analysis of Variance↗

Polyvinyl derivatives as novel interactive polymers for controlled gene delivery to muscle.

PURPOSE: DNA plasmids (pDNA) can be taken up by and expressed in striated muscle after direct intramuscular injection. We have developed interactive polymeric gene delivery systems that increase pDNA bioavailability to muscle cells by both protecting pDNA from nucleases and controlling the dispersion and retention of pDNA in muscle tissue. METHODS: A DNA plasmid, containing a CMV promoter and a galactosidase reporter gene (CMV-beta-gal), was injected either in saline or formulated in polyvinyl pyrrolidone (PVP) and polyvinyl alcohol (PVA) solutions. Interactions between PVP and pDNA were assessed by dynamic dialysis, Isothermal Titration Calorimetry (ITC), and Fourier Transformed Infra Red (FT-IR) spectroscopy. Formulations (50 mu l) were injected into rat tibialis muscles after surgical exposure. Immunohistochemistry for beta-gal was used to visualize the sites of expression in muscle. RESULTS: Beta-gal expression using pDNA in saline reached a plateau while beta-gal expression using PVP formulations increased linearly in the dose range studied (12.5-150 mu g pDNA injected) and resulted in an increase in the number and distribution of cells expressing beta-gal. The interaction between PVP and pDNA was found to be an endothermic process governed largely by hydrogen-bonding and results in protection of pDNA from extracellular nucleases. CONCLUSIONS: Significant enhancement of gene expression using interactive polyvinyl-based delivery systems has been observed. The improved tissue dispersion and cellular uptake of pDNA using polyvinyl-based systems after direct injection into muscle is possibly due to osmotic effects.

Animals↗

Support film in transmission electron microscopy: experiences with polyvinyl butyral Pioloform BM 18.

Microscopic work with single-slot grids requires high-quality support films to span the relatively large gap. The imminent unavailability of the polyvinyl formal Pioloform FN 65, which to date has been used as the standard polyvinyl formal for the generation of support films in transmission electron microscopy (TEM), has necessitated the finding of a substitute material to produce such films. Therefore, we compared the polyvinyl butyral Pioloform BM 18 with the polyvinyl formal Pioloform FN 65 for the production of TEM support films, using operational criteria for assessment. Pioloform BM 18 with the solvent chloroform resulted in support films of unacceptable quality compared with Pioloform FN 65. Adding the softener dibutyl phthalate to the chloroform solvent for Pioloform BM 18 markedly improved the film quality, resulting in support films with high transparency and flexibility, and even greater stability in the electron beam when compared with films of Pioloform FN 65. Pioloform FN 65 also had the disadvantage of requiring highly toxic 1,2-dichloroethane as a solvent, whereas Pioloform BM 18 can be used with chloroform.

Collagen Type IV↗

Neutron attenuation characteristics of polyethylene, polyvinyl chloride, and heavy aggregate concrete and mortars.

Polyethylene and polyvinyl chloride pellets were introduced into concrete to improve its neutron attenuation characteristics while several types of heavy coarse aggregates were used to improve its gamma ray attenuation properties. Neutron and gamma ray attenuation were studied in concrete samples containing coarse aggregates of barite, pyrite, basalt, hematite, and marble as well as polyethylene and polyvinyl chloride pellets in narrow-beam geometry. The highest neutron attenuation was shown by polyethylene mortar, followed by polyvinyl chloride mortar; barite and pyrite concrete showed higher gamma ray attenuation than ordinary concrete. Broad-beam and continuous (infinite) medium geometries were used to study the neutron attenuation of samples containing polymers at different concentrations with and without heavy aggregates, the fitting equations were established, and from these the neutron removal coefficients were deduced. In a radiation field of neutrons and gamma rays, the appropriate concentration of polymer and heavy aggregate can be selected to give the optimum total dose attenuation depending on the relative intensities of each type of radiation. This would give much better design flexibility over ordinary concrete. The compressive strength tests performed on mortar and concrete samples showed that their value, in general, decreases as polymer concentration increases and that the polyvinyl chloride mortar showed higher values than the polyethylene mortar. For general construction purposes, the compression strength was considered acceptable in these samples.

Construction Materials↗

Vitamin A sorption to polyvinyl and polyolefin intravenous tubing.

The loss of vitamin A to plastic infusion tubing from a total parenteral nutrition solution was studied using an in vitro infusion system and HPLC quantification of vitamin A. Polyolefin tubing was compared to polyvinyl chloride at varied vitamin A concentration, infusion temperature, and flow rate. Significantly enhanced recovery of vitamin A was found with the polyolefin tubing compared to that of the polyvinyl chloride under all conditions tested. After 24 hours under the varied conditions of the study, vitamin A availability ranged from 47 to 87% with polyolefin and 19 to 74% with polyvinyl chloride. These differences may be expected to result in significantly greater vitamin A delivery from polyolefin compared to polyvinyl chloride tubing to patients treated in neonatal intensive care units.

Infusions, Intravenous↗

[A comparative study of 0.15% sodium hyaluronate versus polyvinyl alcohol in the treatment of dry eyes].

PURPOSE: To evaluate the efficacy of two artificial tears for the treatment of dry eyes: 0.15% sodium hyaluronate and polyvinyl alcohol. METHODS: The study included 60 dry eyes in 30 patients. Fifteen of the patients were treated with 0.15% sodium hyaluronate and 15 with polyvinyl alcohol. Five drops a day for one month was given in both groups. Visual acuity, Schirmer's test, tear clearance, dry eye symptoms questionnaire, fluorescein and rose bengal staining, corneal sensibility, bulbar hyperemia, tear detritus, meibomian gland plug, palpebral erythema and edema before and after treatment were evaluated. RESULTS: Symptoms as judged by the dry eye questionnaire, as well as both fluorescein and rose bengal staining, were significantly improved by 0.15% sodium hyaluronate. The polyvinyl alcohol treated patients did not show a significant improvement in any parameter. CONCLUSION: Sodium hyaluronate was more effective than polyvinyl alcohol in the treatment of patients with dry eyes (Arch Soc Esp Oftalmol 2005; 80: 387-394).

Adjuvants, Immunologic↗

Effect of mixing technique on shrinkage rate of one polyether and two polyvinyl siloxane impression materials.

PURPOSE: Different mixing techniques may affect the quality of set impression materials. Therefore, dimensional accuracy is the most important factor when constructing a passive and accurate prosthesis. In this study, observation of the shrinkage rate of one polyether and two polyvinyl siloxane impression materials, which are both commercially available for cartridge- and hand-mix techniques, was used for comparative analysis. The hypothesis was that the cartridgemix technique would produce a more precise impression. The authors also sought to confirm the hypothesis that the studied materials would remain stable after setting. MATERIALS AND METHODS: The low-viscosity polyether material was Permadyne Garant 2:1, type 3 (ESPE). The polyvinyl siloxane materials were: (1) medium-viscosity Provil Novo Medium, cartridge- and hand-mix type 2 (Heraeus Kulzer); and (2) low-viscosity President, hand- and cartridge-mix type 3 (Coltène). Measurements were made according to American Dental Association specification No. 19. Ten specimens were made of each impression material; the same examiner measured each specimen 10 times. Shrinkage rates of the same materials mixed using different techniques were compared 30 minutes, 24 hours, and 72 hours after mixing. Dimensional changes at the different measuring times were also compared. The results were statistically analyzed and compared with the SPSS for Windows program package, version 11.0 (SPSS); a two-sample t test was applied to compare the mixing techniques at every measuring time; and a Friedman test was used to analyze the changes in shrinkage rate during the evaluation period (P > .05). RESULTS: Figure 1 shows the shrinkage rate data for all materials. Statistical analysis showed no significant difference at any measuring point when the mixing techniques of the polyvinyl siloxane materials were compared. However, analysis showed significant differences for both hand- and cartridge-mixed materials when measurements at 30 minutes, 24 hours, and 72 hours were compared; the shrinkage rate increased significantly as time passed. Statistical analysis of the results of the polyether material showed no significant difference at 30 minutes, but at 24 and 72 hours, the cartridge-mixed material produced a statistically higher shrinkage rate. Analysis also showed significant differences for both hand- and cartridge-mixed materials when measurements at 30 minutes, 24 hours, and 72 hours were compared; shrinkage rate also increased significantly as time passed. CONCLUSION: We could not detect significant differences in dimensional changes when hand- and cartridge-mix techniques were compared at the same measuring time for the tested polyvinyl siloxane materials. The cartridge-mix technique for the polyether material showed significantly higher shrinkage at 24 and 72 hours, while the mean shrinkage rate of all six materials showed a significant time-dependent increase.

Dental Impression Materials↗

Selected characteristics of a new polyvinyl siloxane impression material--a randomized clinical trial.

OBJECTIVES: This study evaluated the ability of a new polyvinyl siloxane impression material (Affinis, Coltène/Whaledent, material A) to obtain final impressions free of bubbles and voids for indirect fixed cuspal-coverage restorations. The results were compared to a control polyvinyl siloxane impression material (material B). Both materials were handled by inexperienced clinicians (undergraduate dental students) in student clinics. METHOD AND MATERIALS: One-hundred and thirty patients who were treated in the Louisiana State University School of Dentistry Junior Student Clinic for indirect fixed cuspal-coverage restorations and who met the inclusion criteria were randomly assigned to either one of two treatment groups, group A (n = 65) or group B (n = 65). Two calibrated examiners evaluated the first impression of prepared posterior teeth at a magnification of 10x for acceptability (no voids or bubbles). Position of tooth, type of preparation, preparation finish line (Class I-V), and gingival bleeding scores were recorded. All statistical tests were performed with the level of significance set at .05. RESULTS: The Fisher-Freeman-Halton test did not reveal significant associations between material and gingival bleeding score (P = .492). Significant differences in the location of the preparation finish line between materials were observed (P = .0096); material A was more frequently used in cases where the preparation finish line was located at least 2 mm subgingivally. Logistic regression was used to assess the effect of the material on the success of the impression (acceptable/ unacceptable). Material was highly significant in the logistic model (P < .001) with an odds in favor of an acceptable impression being eight times higher with material A than with material B (odds ratio = 8.00; 95% confidence index for odds ratio: 2.832, 22.601). The 60/65 (92.3%) impressions made with material A and 39/65 (60%) impressions made with material B were rated "acceptable." CONCLUSION: The new polyvinyl siloxane impression material provided a significantly higher proportion of impressions free of bubbles and voids than the control polyvinyl siloxane material.

Chi-Square Distribution↗

Preoperative embolization of cerebral arteriovenous malformations with polyvinyl alcohol particles: experience in 51 adults.

In order to determine possible risk factors and to assess the value of platinum microcoils added to polyvinyl alcohol particles in preoperative embolization of cerebral arteriovenous malformations in adults, we reviewed our experience with this procedure. Between September 1985 and June 1989, we performed embolizations in 54 patients with cerebral arteriovenous malformations. Of these, procedures in 51 adults involved the use of polyvinyl alcohol particles, either alone (n = 29) or in combination with platinum microcoils (n = 21). A complication during catheterization precluded embolization in another patient. Beginning as flow-directed embolizations via carotid artery catheterizations (n = 12), newer catheters allowed progression to superselective intracerebral catheterizations (n = 38). Embolization has led to shorter surgical procedures, more clearly defined operative margins, and less bloody operative fields. We have not found recanalization to significantly hinder embolization results with polyvinyl alcohol when resection is undertaken within 1-4 weeks of embolization. Its relative safety and ease of manipulation at surgery argue for its use. We found no significant increase in complications based on patient age, venous drainage of the arteriovenous malformation, or the circulation embolized. Embolization results in cerebral arteriovenous malformations were improved with superselective catheterization and most improved with the combined use of polyvinyl alcohol for nidus embolization followed by occlusion of the feeding vessel with microcoils.

Adolescent↗

Laryngeal changes following long-term stenting with polyvinyl chloride tubes.

BACKGROUND: To treat tracheal stenosis and permit wound healing to occur an inert stent is required which resists the contraction process and prevents re-stenosis. The newer stents of polyvinyl chloride are not readily available in India and endotracheal tubes are used in many centres. In our centre polyvinyl chloride tubes are used nasotracheally for prolonged periods. We prospectively studied the pattern of laryngeal changes that occur because of prolonged nasotracheal stenting with polyvinyl chloride tubes. METHODS: The incidence and pattern of laryngeal changes due to stents was prospectively studied at the time of removal of stents, using an operating microscope. Twenty-nine patients underwent tracheal reconstructive surgery for tracheal stenosis (post-intubation or post-tracheostomy) and tracheal injuries. RESULTS: Twelve different lesions were noted and their pattern was related to the period of stenting. Fibrosis, fibrous band formation and webs were noted after four weeks. A high incidence of laryngeal changes was seen in all age groups with an overall incidence of 79% (males 79%; females 88%; adults 82%, children 75%). The mean (SD) duration of stenting was 50 (33) days. Patients with laryngeal changes had a significantly (p < 0.05) longer duration of stenting [56 (34) days] compared to those without any lesion [29 (15) days]. CONCLUSIONS: After four weeks of stenting the severity and incidence of laryngeal changes increase. We recommend restriction of the use of polyvinyl chloride stents to less than four weeks to prevent permanent laryngeal damage.

Adolescent↗

Polyvinyl pyrrolidone-iodine liposome hydrogel improves epithelialization by combining moisture and antisepis. A new concept in wound therapy.

Moist treatment of wounds has been shown to improve epithelialization, however at an increased risk of bacterial infection. In this monocentric, randomized, open, phase II pilot study of polyvinyl pyrrolidone-iodine, a well-established topical antiseptic was tested in a new liposomal complexed form in patients receiving meshed skin grafts after burns or reconstructive procedures. Mesh skin graft sites of 36 patients were dressed either with the new polyvinyl-pyrrolidone-iodine liposome hydrogel formulation (Betasom hydrogel) (n = 21), or chlorhexidine-gauze (n = 15). After the first dressing change, wounds were assessed daily and documented every other day until they were healed. Methods of analysis included clinical assessment, photoplanimetry (rate of epithelialization), impedance measurement (moisture of surface and wound healing quality), patient's assessment of pain and other sensations, and thyroid hormones (T3, T4, and TSH). The rate of epithelialization was improved with Betasom hydrogel compared to chlorhexidine-gauze on day 11 (96.3% vs. 75.9% p = 0.056) and significantly on day 13 (100% vs. 82.3% p = 0.005), respectively. Impedance measurements showed an earlier return to normal values (day 9) in Betasom-hydrogel-treated wounds as opposed to chlorhexidine treatment (day 11). Clinical assessment indicated significantly better antiseptic efficacy (p = 0.002) and wound healing quality (p = 0.004) of Betasom hydrogel. Graft loss occurred at a significantly lower rate in Betasom treatment (n = 1; 5%), than in chlorhexidine treatment (n = 5; 35.7%) (p = 0.001). No relevant adverse events or clinically relevant changes of thyroid hormones were observed with Betasom hydrogel. The rationale of this new polyvinyl pyrrolidone-iodine liposomal formulation was based on the properties of liposomes that provide higher moisture to the wound surface, release PVP-iodine at a low rate, and target the substance more exactly by interaction with the cell surface. These initial clinical results show earlier epithelialization and better healing in wounds treated with polyvinyl pyrrolidone-iodine liposome hydrogel, which combines moisture and antisepsis, compared to wounds treated with a conventional antiseptic chlorhexidine-gauze.

Adult↗

Urinary excretion of 5-hydroxyindolacetic acid in occupational exposure to polyvinyl chloride and polyurethane foams.

The effect of plastics as polyurethane foams and polyvinyl chloride on the metabolism of tryptophan was investigated by determining the concentration of 5-hydroxyindoleacetic acid (5-HIAA) as its metabolic end product excreted in the urine. Investigation of persons occupationally exposed to polyurethane and polyvinyl chloride showed that these plastics inhibit the metabolism of tryptophan, causing increased excretion of its easily measurable metabolite 5-HIAA. This fact points to the possibility of practical use of this laboratory test which, together with other biological parameters, could improve methods for early detection of occupational exposure to polyurethanes and polyvinyl chloride.

Environmental Exposure↗

Endothelial cell response to polyvinyl chloride-packaged GORETEX: effect of surface contamination.

A Fourier transform infrared spectroscopic study of polyvinyl chloride packaged GORETEX vascular prostheses indicated that their internal and external surfaces were coated with an additive layer presumed to be derived from the polyvinyl chloride packaging. This layer was not removed by washing in phosphate buffered saline but was soluble in trimethyl pentane and hexane. Some other treatments of GORETEX and the packaging were shown to remove the contaminant from the surface and this correlated with an inferior in vitro aortic endothelial cell response. Analyses of materials extracted from both the polyvinyl chloride and the GORETEX surface indicated that the major surface component was a long chain aliphatic ester, either a plasticizer or a lubricant constituent.

Animals↗

Inhibition of polymerization of polyvinyl siloxanes by medicaments used on gingival retraction cords.

Inhibition of polymerization of polyvinyl siloxane materials by latex products is well documented. It is thought to be caused by contamination of the chloroplatinic acid catalyst by sulfur compounds. Many medicaments, such as aluminum sulfate and ferric sulfate, used on gingival retraction cords have been accused of causing inhibition of set of polyvinyl siloxane materials. Several of these medicaments were tested with two polyvinyl siloxanes and found not to cause any inhibition of set.

Alum Compounds↗