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PubMed2006

The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation.

AIM: To determine the influence of volume, irrigant and method of flushing on the removal of artificially-placed dentine debris from the apical part of root canals during passive ultrasonic irrigation. METHODOLOGY: Access cavities were prepared in 15 canine teeth and their root canals instrumented to size 20, 0.10 taper. Each root was split longitudinally, forming two halves. A groove was cut in the canal wall 2-6 mm from the apex in each half which was then filled with dentine debris prior to the roots being reassembled. All canals were ultrasonically irrigated, using a size 15, 0.02 taper smooth wire to a length of 21 mm that was placed in the canal to the apical foramen. In group 1 the canal was flushed with a continuous flow of 50 mL 2% sodium hypochlorite (NaOCl). In group 2 the continuous flow was not used but the canal was flushed with 12 mL 2% NaOCl, at a rate of 2 mL 30 s-1 using a syringe. Group 3 was treated in the same way as group 2 but the canal was flushed with 6 mL 2% NaOCl, at a rate of 2 mL min-1. Group 4 was treated in the same way as group 1 but water was used as the irrigant. Before and after irrigation, images of the grooves were captured and stored. The quantity of dentine debris in the groove was evaluated. The differences in debris scores between the experimental groups were analysed with the Kruskal-Wallis test and the Mann-Whitney U-test. The level of significance was set at P=0.05. RESULTS: The difference between all groups was statistically significant (K-W test P<0.001). Groups 1, 2 and 3 differed significantly from group 4 (P<0.001); there was no significant difference between groups 1, 2 and 3 (P=0.550). CONCLUSIONS: Syringe delivery of 2% NaOCl (6 and 12 mL) was as effective as a continuous flow of 2% NaOCl (50 mL). Water was not effective in removing dentine debris from grooves in the apical portion of root canals.

Cuspid↗

PubMed1994

Characterization of improved renal transplant preservation mechanisms using PB-2 flush solution by HPLC assay.

Renal flush solutions have been found to be beneficial for extending organ viability, but their mechanisms of action are poorly understood. In order to delineate these mechanisms we studied the addition of mannitol and adenosine to a modified simple hypothermic intracellular flush solution (PB-2), and the relationships of renal adenine nucleotide (AN) concentrations with ischemia, reperfusion and viability. A significant (P < 0.05) and progressive decay in AN and increase in total degradation products (DP; hypoxanthine and xanthine) was noted during warm ischemia. Total AN and AMP were significantly higher after 50 h of cold storage in the PB-2 compared to the C-2 control cold flush group. Viability was associated with a significant (P < 0.01) regeneration of AN within 45 min of reperfusion. HPLC assay indicated that PB-2 cold flush solution enhances renal viability by both diminution of reperfusion injury enabling better reflow and primary preservation of AN. The latter process may appreciably contribute to the former process.

Adenine Nucleotides↗

PubMed1981

Cardiovascular responses during the menopausal hot flush.

Circulatory responses during spontaneous and stress induced menopausal flushes were measured by a plethysmographic technique. With the onset of symptoms there was an immediate and marked increase in hand blood flow which was sustained over three to four minutes and then fell to control levels over a further three minutes. Forearm and calf flow increased simultaneously through to a lesser extent and regained control levels within four-and-a-half minutes from the onset of symptoms. Mean pulse rate also increased during the flush but fell to control values at a time when limb flow was still elevated. There was no significant change in blood pressure during or after the flush. The peripheral circulatory exchanges are attributed to altered autonomic activity and may in part reflect a disturbance of thermoregulatory control in the menopause of which the flush is but one manifestation.

Blood Pressure↗

PubMed2006

Survey of Australasian clinicians' prior beliefs concerning lipiodol flushing as a treatment for infertility: a Bayesian study.

OBJECTIVE: To evaluate clinicians' beliefs concerning the effectiveness of lipiodol flushing as a treatment for unexplained infertility, and to integrate these prior beliefs with evidence from randomised trials. DESIGN: Survey. SETTING: Specialists in Australasian in vitro fertilisation (IVF) clinics in 2001. METHODS: One of two types of structured survey was used to gather information from fertility specialists in Australasian IVF clinics. Prior beliefs were captured graphically and textually from responses. RESULTS: Nineteen specialists returned questionnaires. Eighteen of the 19 specialists believed that lipiodol flushing was more likely to be beneficial than harmful. The most widely held prior belief, reflected in both textual and numerical responses, was that lipiodol was likely to produce a small beneficial response. The credible limits of this belief were compatible with a reasonable fertility benefit, as more than 50% believed that a 1.5-fold increase in pregnancy rate was plausible. The two surveys found that a 1.2-fold or 1.4-fold increase in pregnancy rate was the median expected level of benefit at which clinicians would have been inclined to recommend lipiodol flushing to their patients (combined range 1.1- to 2.3-fold) - new evidence suggests that for women with endometriosis but otherwise unexplained infertility, these levels of benefit are exceeded. CONCLUSIONS: Among Australasian fertility specialists there is variation in prior beliefs concerning the effectiveness of lipiodol flushing as a treatment for unexplained infertility and in the expected level of benefit at which clinicians are inclined to recommend this treatment. Generalisability of these beliefs remains uncertain owing to a low study response rate.

Attitude of Health Personnel↗

PubMed1978

Physiological aspects of menopausal hot flush.

Eighteen hot flushes experimenced by eight menopausal women were studied and compared with the effects of warming in six premenopausal women. The hot flushes were associated with an acute rise in skin temperature, peripheral vasodilatation, a transient increase in heart rate, fluctuations in the electrocardiographic (ECG) baseline, and a pronounced decrease in skin resistence. Although premenopausal women had greater maximum increases in skin temperature and peripheral vasodilatation, they showed a much smaller decrease in skin resistance and no changes in heart rate or ECG baseline. These findings suggest that the onset of the hot flush is associated with a sudden and transient increase in sympathetic drive. Further investigations may lead to the development of a more specific alternative to oestrogen for relieving menopausal hot flushes.

Blood Pressure↗

PubMed1981

Blood concentrations of acetaldehyde during chlorpropamide-alcohol flush.

To test the suggestion that chlorpropamide-alcohol flushing (CPAF) resembles the disulfiram effect and might be mediated by acetaldehyde, the initial metabolite of alcohol, blood concentrations of acetaldehyde were measured after a drink of alcohol in controls and diabetics positive and negative for CPAF. The CPAF-positive diabetics had significantly greater blood acetaldehyde concentrations after alcohol than the CPAF-negative diabetics both with a single dose of chlorpropamide and after two weeks' chlorpropamide treatment. Concentrations in the CPAF-positive group after chlorpropamide were also significantly greater than after a placebo tablet. There was also a clear separation in the increase in facial temperature after two weeks of chlorpropamide between the CPAF-positive and CPAF-negative groups (although there was some overlap after a single tablet). There was no difference in plasma chlorpropamide or alcohol concentrations between CPAF-positive and CPAF-negative diabetics. These findings show that CPAF is distinct from alcohol flushing and that the acetaldehyde concentration in the blood provides an objective measure of CPAF. The difference between flushing and non-flushing diabetics cannot be accounted for by differences in blood concentrations of chlorpropamide or alcohol.

Acetaldehyde↗

PubMed1960

The urinary excretion of 5-hydroxyndoleacetic acid in patients with menopausal flushing.

The 24-hour urinary excretion of 5-hydroxyindoleacetic acid in women with post-menopausal flushing attacks was compared with that of a control group of post-menopausal women without flushing attacks. The results were normal in the women with post-menopausal flushing, and it is concluded that 5-hydroxytryptamine is not a factor in the pathogenesis of post-menopausal flushing.

Female↗

PubMed1996

Effect of heat flushing on the concentrations of Legionella pneumophila and other heterotrophic microbes in hot water systems of apartment buildings.

The decontamination of Legionella pneumophila and other heterotrophic microbes by heat flushing in four legionellae-positive hot water systems was studied. Before the decontamination procedure, the concentration of legionellae varied from 3.0 x 10(3) to 3.5 x 10(5) cfu/L and the hot water temperature from 43.6 to 51.5 degrees C. During the contamination the temperature was raised to 60-70 degrees C. All taps and showers were cleaned from sediments and flushed with hot water twice a day for several minutes. The decontamination lasted for 2-4 weeks. In a few weeks the heat-flushing method reduced the concentration of legionellae below the detection limit (50 cfu/L) in the hot circulating water system just before and after the heat exchanger. The high hot water temperature also decreased the viable counts of heterotrophic bacteria, fungi, and total microbial cells determined by the epifluorescent microscopy. However, the eradication of legionellae failed in a water system where the water temperature remained below 60 degrees C in some parts of the system. After the decontamination, the temperature of hot water was lowered to 55 degrees C. Thereafter, all the studied hot water systems were recolonized by legionellae within a few months, showing that the decontamination by heat flushing was temporary. Also, the contamination of other bacteria increased in a few months to the level before decontamination.

Animals↗

PubMed2006

[Superheat-and-flush effect on the control of hospital-acquired Legionella infection].

BACKGROUND AND OBJECTIVE: Superheat-and-flush is one of the methods of disinfection used against Legionella in hospital water distribution systems. An outbreak of nosocomial legionellosis (NL) was detected in the hospital Germans Trias i Pujol in January 1996. The aim of this study was to evaluate the impact of this disinfection technique at an environmental and clinical level. MATERIAL AND METHOD: Water samples were collected daily from central and tap water points 3 days prior to 15 days after superheating and flushing. Clinical surveillance of NL was performed 30 consecutive days following disinfection. RESULTS: After superheat-and-flush, the inoculum of Legionella pneumophila decreased in the central points but increased after day 11, achieving maximum values at 15 days. On the other hand, L. pneumophila was not detected in tap water points after 4 days but recolonization was observed after day 7, achieving 66% at day 9. No clinical cases of NL were detected during the study period. CONCLUSIONS: Superheat-and-flush is an effective albeit transitory method of rapid disinfection in outbreaks of NL.

Cross Infection↗

PubMed2000

Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: A randomized, multicenter, double-blind trial.

PURPOSE: To determine whether an antibiotic flush solution containing vancomycin, heparin, and ciprofloxacin (VHC) can prevent the majority of line infections. PATIENTS AND METHODS: A prospective double-blind study was performed comparing VHC to vancomycin and heparin (VH) to heparin alone in 126 pediatric oncology patients. RESULTS: The 153 assessable lines resulted in 36,944 line days studied. There were 58 blood stream infections (43 gram-positive, 14 gram-negative, and one fungal). Forty were defined as line infections (31 heparin, three VH, six VHC). The time to develop a line infection was significantly increased using either antibiotic flush (VH, P =.011; VHC, P =.036). The rate of total line infections (VH, P =.004; VHC, P =.005), gram-positive line infections (VH, P =. 028; VHC, P =.022), and gram-negative line infections (VH, P =.006; VHC, P =.003) was significantly reduced by either VH or VHC. Sixty-two (41%) of the lines developed 119 occlusion episodes (heparin, 3.99 per 1,000 line days; VHC, 1.75 per 1,000 line days; P =.0005). Neither antibiotic could be detected after flushing, and no adverse events were detected, including increased incidence of vancomycin-resistant Enterococcus colonization or disease. CONCLUSION: The use of either VH or VHC flush solution significantly decreased the complications associated with the use of tunneled central venous lines in immunocompromised children and would save significant health care resources.

Anti-Infective Agents↗

PubMed1984

A primate model of human postmenopausal hot flushes.

The hot flush is the only symptom specifically attributable to the menopause. Hot flushes appear to represent an episodic derangement of thermoregulation as a result of estrogen deficiency but the underlying physiological mechanisms are unknown. We have developed an animal model for the study of hot flushes. Two female monkeys (Macaca arctoides) were trained to accept monitoring of scalp cutaneous temperatures. After baseline temperature recordings were obtained both monkeys were ovariectomized. A few days after operation the previously stable scalp temperature changed to an undulating pattern with cycles lasting approximately 40-50 min. Ethinyl estradiol (20 micrograms orally or im) and (7 alpha,17 alpha)-17-hydroxy-7-methyl-19-nor-pregn-5(10)-en-20-yn-3-one (2.5 mg orally), a steroid with weak estrogenic, progestogenic, and androgenic properties, suppressed the characteristic undulating temperature pattern; this returned after withdrawal of replacement therapy. Clonidine (0.15 mg twice a day) suppressed the cyclic changes for 2 to 3 h. Domperidone and naloxone had no significant effect. This animal model may be useful for the investigation of alternative therapy for the management of menopausal flushes.

Anabolic Agents↗

PubMed2000

The effect of human organ preservation and albumin flush solution on in vitro cell metabolic activity.

In liver transplantation, the organ during the recipient's operation is traditionally flushed with 4.5% of human albumin solution to wash away the potassium-rich University of Wisconsin (UW) solution. It has been argued whether albumin could be useful at this stage. We used a new simple non-toxic assay to determine cell viability in vitro. Alamar Blue incorporates a redox indicator which changes colour from blue (oxidised form) to magenta (reduced form) in response to metabolic activity. Cultured human hepatocyte and HUVEC cell lines were exposed for 3, 6, 12 or 24 hours to plain medium, UW solution, human albumin 4.5% solution, UW-containing effluents before and after preservation as well as albumin flushes from different transplantation cases. After addition of Alamar Blue the optical density was measured at 570 nm and the background measured at 600 nm was subtracted. The studies showed a significantly lower metabolic rate of the cells exposed to albumin and albumin-containing flushes at all time periods, even after a short exposure such as 3 hours (p < 0.001). On the other hand, there was no significant difference of growth and metabolic activity rate between cells exposed to UW solution, different UW-containing flushes and medium for up to 12 hours. In conclusion, human albumin is a very poor solution for cell maintenance. In contrast, UW solution has comparable results with the full growth medium for up to 12 hours of exposure.

Albumins↗

PubMed1995

Determinants of treatment choice for menopausal hot flushes: hormonal versus psychological versus no treatment.

Sixty-one women, reporting hot flushes once a week or more frequently, completed questionnaires eliciting information about demographic details, health, mood and health beliefs. They were interviewed and asked to choose between no treatment, hormone treatment (HRT), psychological treatment (cognitive-relaxation therapy (CRT) and no preference for either CRT or HRT. Seventy-five per cent wanted treatment, with approximately 40% of these women preferring HRT and 60% CRT. Women who wanted treatment for hot flushes were significantly more anxious, coped less well with stress, had lower internal locus of control scores and lower self-esteem, compared with those not seeking treatment. Hot flush frequency was the same for both groups, but those wanting treatment viewed flushes as being more problematic. Few differences emerged between those preferring hormonal or psychological treatment. However, particular reasons were given based upon past experience, views about medication and practical considerations. This study highlights the need for the development of alternative treatment regimens for women seeking help for menopausal problems.

Adaptation, Psychological↗

PubMed1987

Profiles of uterine protein in flushings and progesterone in plasma of normal and repeat-breeding dairy cattle.

Uterine secretions were collected nonsurgically from 15 normal and 9 repeat-breeder Holstein and Jersey cows on d 0 and 5, 10, or 15 of an estrous cycle. Uterine flushings presented 19 protein bands in one-dimensional PAGE, but only 16 bands were found in gels of plasma samples of normal and repeat-breeder cows. Red blood cell contamination of uterine flushings ranged from 50,400 to 4,940,000 cells/ml of flush recovered for visibly clear samples to over 17 x 10(6) cells/ml in obviously red samples. A prealbumin (electrophoretic mobility relative to albumin; Ra 1.28) and a pretransferrin (Ra .72) were found in uterine flushings. A possible uterine protein (Ra .35) was probably a hemoglobin-like contaminant. Data suggest that differences in peripheral plasma progesterone concentrations during the estrous cycle in repeat-breeder cattle may provide the basis for altered synthesis or secretion of uterine proteins needed for development by early embryos.

Animals↗

PubMed2001

Oral estrogen replacement therapy versus placebo for hot flushes: a systematic review.

OBJECTIVE: To examine the effectiveness of oral hormone replacement therapy (HRT) with regard to hot flushes and night sweats, which are vasomotor symptoms commonly experienced by menopausal women. METHODS: Double-blind, randomized, placebo-controlled trials of oral HRT for at least 3 months' duration and reporting vasomotor outcomes were identified using a search strategy developed by the Menstrual Disorders Group and Subfertility Group of the Cochrane Collaboration. Twenty-one trials meeting the selection criteria were included in the review. Study participants totalled 2511. Trial duration ranged from 3 months to 3 years. RESULTS: There was a significant reduction in the weekly hot flush frequency for HRT compared with placebo (weighted mean difference -17.46, 95% confidence interval (CI) -24.72 to -10.21). This was equivalent to a 77% reduction in frequency (95% CI 58.2-87.5) for HRT relative to placebo. Symptom severity was also significantly reduced compared with placebo (odds ratio (OR) 0.13, 95% CI 0.08-0.22). Withdrawal for lack of efficacy occurred significantly more often with placebo therapy (OR 17.25, 95% CI 8.23-36.15). Withdrawal for adverse events, commonly breast tenderness, edema, joint pain and psychological symptoms, was not significantly increased for HRT (OR 1.38, 95% CI 0.87-2.21). In women who were randomized to placebo treatment, a 50.8% (95% CI 41.7-58.5) reduction in hot flushes was observed between baseline and the end of the study. CONCLUSIONS: Oral HRT is highly effective in alleviating hot flushes and night sweats. Owing to the marked effect seen with placebo treatment, it is important to compare therapies purported to alleviate vasomotor symptoms with a placebo or an established therapy.

Administration, Oral↗

PubMed2001

Urinary excretion of calcitonin gene-related peptide in males with hot flushes after castration for carcinoma of the prostate.

OBJECTIVE: The majority of men who undergo surgical or medical castration due to prostatic carcinoma develop vasomotor symptoms with hot flushes. The mechanisms behind these symptoms are poorly understood. One possible explanation is a release of the vasodilatory peptide calcitonin gene-related peptide (CGRP) from perivascular nerves, which seem to be involved in the mechanisms behind vasomotion and sweating in postmenopausal women. The aim of this report was to investigate whether CGRP is involved in vasomotion in men after castration therapy. MATERIAL AND METHODS: Twenty-four hour urine excretion of CGRP was analysed in 15 men with prostatic carcinoma, using radioimmunoassay before and 3 months after surgical or medical castration. RESULTS: Eleven of the 15 men developed hot flushes during the observation period of 3 months. Twenty-four hour urine excretion of CGRP did not change significantly after castration, either in the group as a whole or in those 11 men who developed hot flushes. CONCLUSIONS: Even though we did not observe any significant changes in 24-h urine excretion of the potent vasodilator CGRP after castration it is possible that serum levels of CGRP increase during hot flushes, without having an effect on the 24-h urine excretion of the peptide.

Aged↗

PubMed2003

Removal of the organic surface layer in combined sewer sediment using a flushing gate.

Recent research identified the different sources of pollution of wet weather Combined Sewers Overflows (CSOs): it appeared that the deposits in sewers, and especially an organic layer situated at the water-sediment interface, may contribute 40-70% to the total pollution load of CSOs. Using the cyclic flush Hydrass gate, we generated increased water flows during dry weather. The effects of flushing the deposits have been analysed: the eroded particles sampled during the first flush wave show pollutant characteristics similar to characteristics measured in the organic layer. The organic layer that has formed on the surface of deposits can thus be washed off before rainstorms occur using the cyclic flushing technique.

Organic Chemicals↗

PubMedDate not supplied

Effects of allopurinol pretreatment with pulmonary flush on lung preservation.

This study was designed to test whether use of allopurinol could improve lung preservation after 6 hours of cold storage. Thirty-two rabbits were divided into four groups (n = 8 each group): (1) the control group received no flush or storage, (2) the EC group received Euro-Collins (EC) solution for both flush and storage, (3) the Allo-F group received Euro-Collins solution with allopurinol (1 mmol/L) for both flush and storage, and (4) the Allo-R group received Euro-Collins solution to which allopurinol (1 mmol/L) was added only to the reperfused blood. For groups 2 through 4, the lungs were flushed (40 ml/kg) in situ, excised, and then stored at 4 degrees C. After storage, the lungs were reperfused for 1 hour with an in vitro blood-perfused ventilated model. Lung function was measured during reperfusion with mean pulmonary arterial pressure, end-inspiratory airway pressure, and blood gas data. The lung wet/dry weight ratio was used to measure lung edema. The lungs in the EC group had a significant increase in mean pulmonary arterial pressure, airway pressure, and wet/dry weight ratio when compared with the control group. The mean pulmonary arterial pressure in either of the groups receiving allopurinol was consistently lower than that in the EC group. The airway pressure in the Allo-R group also significantly decreased compared with the EC group.(ABSTRACT TRUNCATED AT 250 WORDS)

Allopurinol↗