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PubMed2005

Female sterility in hybrids between Anopheles gambiae and A. arabiensis, and the causes of Haldane's rule.

Although F1 female hybrids between Anopheles gambiae and A. arabiensis are fully fertile, sterility is present in backcross females. Here we report the results of a study into the genetic basis of backcross female sterility. Using 23 markers, we performed quantitative trait loci (QTL) mapping analyses to identify chromosomal regions involved in hybrid female sterility. We found that female sterility in backcrosses in both directions is primarily caused by interspecific interactions between a heterozygous X chromosome and recessive autosomal factors. In addition, our data provide support for two theories implicated in Haldane's rule in a single taxon. A comparison with data from a previous study shows that male hybrid sterility QTL are present in higher numbers than female hybrid sterility QTL. Furthermore, autosomal female sterility factors tend to be recessive, supporting the dominance theory for female sterility. Finally, our data indicate a very large effect of the X chromosome from both species on hybrid female sterility, despite the fact that the X chromosome represents less than 9% of the genome. However, this could be the result of a lack of introgression of the X chromosome between A. gambiae and A. arabiensis, rather than a faster evolution of sterility factors on the X chromosome.

Animals↗
PubMed1994

Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion.

OBJECTIVE: In many hospitals, the only sterile precautions used during the insertion of a nontunneled central venous catheter are sterile gloves and small sterile drapes. We investigated whether the use of maximal sterile barrier (consisting of mask, cap, sterile gloves, gown, and large drape) would lower the risk of acquiring catheter-related infections. DESIGN: Prospective randomized trial. SETTING: A 500-bed cancer referral center. METHODS: We randomized patients to have their nontunneled central catheter inserted under maximal sterile barrier precautions or control precautions (sterile gloves and small drape only). All patients were followed for 3 months postinsertion or until the catheter was removed, whichever came first. Catheter-related infections were diagnosed by quantitative catheter cultures and/or simultaneous quantitative blood cultures. RESULTS: The 176 patients whose catheters were inserted by using maximal sterile barrier precautions were comparable to the 167 control patients in underlying disease, degree of immuno-suppression, therapeutic interventions, and catheter risk factors for infections (duration and site of catheterization, number of catheter lumen, catheter insertion difficulty, reason for catheter removal). There were a total of four catheter infections in the test group and 12 in the control group (P = 0.03, chi-square test). The catheter-related septicemia rate was 6.3 times higher in the control group (P = 0.06, Fisher's exact test). Most (67%) of the catheter infections in the control group occurred during the first 2 months after insertion, whereas 25% of the catheter infections in the maximal sterile precautions group occurred during the same period (P < 0.01, Fisher's exact test). Cost-benefit analysis showed the use of such precautions to be highly cost-effective. CONCLUSION: Maximal sterile barrier precautions during the insertion of nontunneled catheters reduce the risk of catheter infection. This practice is cost-effective and is consistent with the practice of universal precautions during an invasive procedure.

Adolescent↗
PubMed1980

Objections to tubal sterilization: what reversibility can and cannot overcome.

In a study of 1074 women, 696 and 338 subjects would not seriously consider permanent and hypothetically reversible sterilization, respectively; they were asked to explain their feelings. The reason accounting for most objections to permanent sterilization (65%) was irreversibility and of the subjects who would not consider reversible sterilization or were unsure, 42.7% attributed their principal objection to unnecessary surgery, a factor at least currently intrinsic to the procedure and not readily overcome by education. Many of the remaining objections to both permanent and reversible sterilization may be amenable to change either through education or financial subsidies. In response to a question concerning female attractiveness subsequent to permanent sterilization, 3% of the sample felt attractiveness would decrease and 17.5% were unsure of the surgery's effect. Unsure responses were largely negative in character. This issue is important because of its relationship to intention to undergo sterilization. Upon consideration of reversible sterilization, negative and unsure responses significantly declined, even on the part of those women whose friends have had a poor experience with currently available procedures. Thus, whereas the option of reversibility cannot overcome objections to surgery, it does overcome those regarding permanency; moreover, the "temporary" character it bestows upon surgical sterilization appears to help certain individuals overcome their fears of losing their physical appeal as a result of such procedures.

Beauty↗
PubMed1996

Sterilization.

Sterilization is accepted as a permanent method of contraception by many couples in the world. Female sterilization is more widely used than male sterilization, but the latter is used by many couples in developed countries. The most widely used methods for female sterilization are simple tubal ligation, electrocautery of the fallopian tubes, and occlusion of the tubes by Hulka or Filshie clips or Falope rings. These procedures may be carried out either by minilaparotomy or by laparoscopy, under local anaesthesia. Sterilization may be performed immediately following pregnancy, or as an interval operation. The effectiveness of female sterilization is high, with failure rates of about 1-2 per 1000 procedures. Immediate complications are few and minor, while there appear to be no serious, long-term adverse effects. It is possible that there is a protective effect against ovarian cancer. Potential new technologies for female sterilization include the use of chemicals, such as quinacrine, for transcervical tubal occlusion, and hysteroscopic methods. Male sterilization is more simple and can readily be performed under local anaesthesia. A new technique originating in China, the no-scalpel technique, has made the procedure even more simple and produces fewer complications such as haematoma. It is possible that the direct injection of plug-forming material into the vas may render the procedure more reversible. Concerns about possible adverse effects of vasectomy on cardiovascular diseases and testicular cancer largely have been dispelled, but a possible weak association between vasectomy and prostatic cancer continues to be studied.

Female↗
PubMed1996

Female sterilization in Ramathibodi Hospital: 1987-1993.

A 7 year (1987-1993) restropective review of female sterilization in the Department of Obstetrics and Gynecology, Ramathibodi Hospital was reported. This paper is part of a continuing study of female sterilization in Ramathibodi Hospital. A total of 9,968 cases of female sterilization was done from January 1987 to December 1993. Post partum acceptors accounted for 63 per cent of total female sterilization, the overall postpartum female sterilization rate was 117.4 per 1,000 deliveries. 37 per cent was interval sterilization. The peak of interval sterilization was in March. 69.8 per cent of interval sterilization was performed by minilaparotomy technique, the remainder were by laparoscopy.

Adolescent↗
PubMed2006

Changes in family structure and regret following tubal sterilization.

Tubal sterilization is one of the contraceptive methods whose use has increased the most in Brazil, but a growing number of women have expressed regret after the procedure. A case-control study was conducted at the Centro Integrado de Saúde Amaury de Medeiros (CISAM), Recife, Pernambuco, Brazil, in 1997 to investigate the association between changes in family structure and request for or submittal to surgical reversal of tubal sterilization, comparing 304 sterilized women who had requested or submitted to reversal of tubal sterilization and 304 women who were also sterilized but had not requested, had not submitted to, and who did not wish to submit to reversal. The simple and adjusted odds ratios were estimated using logistic regression. The results of the current study showed that death of children, partners without children prior to the current union, and partner change after tubal sterilization were associated with the request for or submittal to reversal of tubal sterilization. More strict criteria are suggested in the indication of tubal sterilization, including an in-depth profile of the woman requesting tubal sterilization and identification of risk factors for future regret.

Adult↗
PubMed1986

The characteristics, perceptions and personalities of women seeking a reversal of their tubal sterilization.

The characteristics, perceptions and personalities of women who had sought a reversal of a tubal sterilization procedure and those who had not were studied. Women were more likely to request reversal of a tubal sterilization if they were less than 30 years old at the time of the operation or if they had changed their marital status since sterilization. Women who had undergone a tubal sterilization and later sought a reversal stated that at the time of the procedure they did not believe that their family was complete; they had not had sufficient time to consider the implications of undergoing a tubal sterilization; they felt that they had been "pressured" by their partner to be sterilized; and they perceived the potential to have a child as important, even if they did not wish for further children. Women who had had a tubal sterilization performed within a few days of childbirth for "health or medical reasons" and sought a reversal no longer believed that the reasons were valid. In spite of the inclusion of women who had changed their minds about tubal sterilization, no differences were detected in psychometric measures of personality and mental health between our groups. The findings of the survey confirm that a woman should make up her own mind whether or not to undergo a tubal sterilization, and the operation should not be available "on demand". Ways of overcoming the problem are suggested.

Adult↗
PubMed1987

Profile of Danish women undergoing reversal of sterilization, 1978-1983.

To help identify those women who might regret undergoing sterilization, the Danish women refertilized from 1978 to 1983 were contacted by mailed questionnaire. Eighty-three percent (120/144) responded. These women were younger at the time of sterilization than Danish women sterilized in the same period (mean age 29 years versus 34 years). Furthermore, they had more children at the time of sterilization and had their first and last child at a younger age than Danish women generally, in the same age group. Their social and educational status was lower than the background population and fewer were in gainful employment. At sterilization, most of the women were in an emotionally stressful situation (e.g., marital disharmony (78% of the married women), single parenthood (28%), unwanted pregnancy (27%], or had chronic health problems in the family. Alternative contraceptive methods had not been fully explored. Thirty-eight percent complained of late secondary effects attributable to the sterilization, but the main reason for wanting reversal of sterilization was a new partner (75%). The study suggests that the psycho-social situation and contraceptive alternatives should be carefully evaluated in women requesting sterilization, especially in those below the age of 30.

Adult↗
PubMed2002

Feasibility study using a natural compound (reuterin) produced by Lactobacillus reuteri in sterilizing and crosslinking biological tissues.

Bioprostheses derived from biological tissues have to be fixed and subsequently sterilized before they can be implanted in humans. Currently available crosslinking agents and sterilants used in the fixation or sterilization of biological tissues such as glutaraldehyde and formaldehyde are all highly cytotoxic, which may impair the biocompatibility of bioprostheses. Therefore, it is desirable to provide an agent suitable for use in biomedical applications that is of low cytotoxicity and may form sterile and biocompatible crosslinked products. To achieve this goal, a natural compound (reuterin), produced by Lactobacillus reuteri in the presence of glycerol, was used by our group. It is known that reuterin has antibacterial, antimycotic, and antiprotozoal activities. Additionally, as in the case with formaldehyde, reuterin may react with the free amino groups in biological tissues by using its aldehyde functional group. Therefore, it was speculated that reuterin could be used as a crosslinking agent and a sterilant for biological tissues in the same way as glutaraldehyde and formaldehyde. In the study, the production of reuterin, produced by Lactobacillus reuteri under control conditions, was reported. Preparative chromatography was used to purify reuterin. Also, the minimal inhibitory concentration and minimal bactericidal concentration of reuterin and its antimicrobial activity on a contaminated tissue were investigated. In addition, the cytotoxicity of reuterin was evaluated. Glutaraldehyde, the most commonly used sterilant in the sterilization of biological tissues, was employed as a control. Furthermore, the feasibility of using reuterin as a crosslinking agent in fixing biological tissues was studied. Fresh and the glutaraldehyde-fixed tissues were used as controls. The results obtained in the minimal inhibitory concentration and minimal bactericidal concentration studies and in the sterilization study of a contaminated tissue indicated that the antimicrobial activity of reuterin is significantly superior to its glutaraldehyde counterpart. In addition, the results obtained in the 3-(4,5-dimethylthiazol-yl)-2,5-diphenyltetrazolium bromide assay showed that reuterin is significantly less cytotoxic than glutaraldehyde. Additionally, it was found that reuterin is an effective crosslinking agent for biological tissue fixation. The reuterin-fixed tissue had comparable free amino group content, denaturation temperature, and resistance against enzymatic degradation as the glutaraldehyde-fixed tissue. In conclusion, the results obtained in this study indicate that reuterin is an effective agent in the sterilization and fixation of biological tissues.

3T3 Cells↗
PubMed2004

Effects of various sterilization methods on the setting and mechanical properties of apatite cement.

Sterilization capability is a necessary requirement for any material that is to be used in a medical application. Therefore, it is necessary for apatite cement (AC) to be sterilized. Because there is little information on the sterilization methods of AC, the aims of this investigation were to evaluate the effects of various sterilization methods, including steam, dry heat, ethylene oxide (EtO) gas, and gamma irradiation sterilizations, on the setting and mechanical properties of AC. In the case of steam sterilization, because AC powder aggregated before setting-time measurements, the setting time could not be measured. When the powder was sterilized by dry heat or EtO gas, the setting time was prolonged significantly and the wet diametral tensile strength (DTS) value decreased significantly. Therefore, sterilizations with steam, dry heat, or EtO gas were suggested to be inappropriate methods for AC. Accordingly, the following experiments focused on gamma sterilization. The setting time of AC was retarded with an increase in gamma irradiation dose. The wet DTS value decreased with the increase in gamma irradiation dose. There was no compositional change due to the gamma irradiation. The following tests were carried out in order to examine the effect of the gamma irradiation on the setting reaction of AC in detail. Tetracalcium phosphate [TTCP: Ca(4)(PO(4))(2)O] and dicalcium phosphate anhydrous (DCPA: CaHPO(4)) were separately irradiated, and the cements were produced with the use of irradiated powder and nonirradiated powder. Although the wet DTS value of AC produced from irradiated TTCP and nonirradiated DCPA decreased with increasing gamma irradiation dose, there was no significant difference. In contrast, the wet DTS value of AC produced from irradiated DCPA and nonirradiated TTCP significantly decreased with the increase in gamma irradiation dose. In conclusion, although the detailed mechanism of the delayed setting time and decreased DTS value was not clarified by the present study, it was found that gamma irradiation affected DCPA more than TTCP.

Adhesives↗
PubMed1998

[Comparison between steam and gas sterilized optics. Costs, availability, maintenance].

METHODS: In a 300-bed acute-care hospital we compared optical instruments employed, for orthopedic, urological and gynecological operations during their use in practice. The comparison between 33 ethylene oxide(EO)-sterilized optical instruments and 14 steam-sterilized optical instruments took into account the following criteria: frequency of use; availability; sterilization cycles; kind, cost and number of repairs. RESULTS: The 33 EO-sterilized optical instruments were handled 1043 times and were repaired 10 times (at a cost of up to 2000 SFR). The 14 steam-sterilized optical instruments were treated 1101 times and were repaired 8 times (2000 SFR). The total costs were 77,000 SFR for the 14 steam-sterilized instruments and 132,000 SFR for the 33 EO-sterilized instruments. INTERPRETATION: Steam-sterilization is a reasonable, safe and fast method of sterilizing optical instruments. We prefer this method, given its advantages (less toxicity, personal care and pollution control).

Cost-Benefit Analysis↗
PubMed1995

Cytotoxicity of medical materials sterilized with vapour-phase hydrogen peroxide.

A new sterilization system using vapour-phase hydrogen peroxide (VPHP) was recently developed. The cytotoxicity of various medical materials sterilized by the VPHP sterilization system was investigated. After VPHP sterilization, polystyrene, polyurethane (PU8), blend material of silicone and polyurethane (Sil/PU6), poly(methyl methacrylate) (PMMA), fluorosilicone acrylate and poly(2-hydroxyethyl methacrylate) (HEMA) showed strong cytotoxicity, whereas polyethylene and polypropylene did not. Although the cytotoxic potential of most materials is reduced by extension of the aeration time, HEMA and PMMA still retained strong cytotoxicity after 12 h aeration. Addition of catalase to the cell culture eliminated the cytotoxicity of sterilized polystyrene and PU8. Hydrogen peroxide (H2O2) residues remaining in the sterilized materials were determined. Large amounts of H2O2 (5.1-186 micrograms) were detected in HEMA, PU8, Sil/PU6 and PMMA. In contrast, silicone and polyethylene contained low levels of H2O2. The amounts of residual H2O2 in the materials decreased with increasing aeration time, but the elimination rate of H2O2 differed among the test materials. The cytotoxic potential of the VPHP-sterilized materials correlated with the amounts of residual H2O2 present. These results indicated that the cytotoxicity of VPHP-sterilized materials was caused by the residual H2O2. To generalize the developed VPHP sterilization system for various medical devices, it is important to validate the aeration of materials for removal of cytotoxic residuals.

Acrylates↗
PubMed1986

Glass bead sterilization of orthodontic bands.

The purpose of this study was threefold: to determine if bead sterilization is capable of sterilizing orthodontic bands, if so, to establish a minimal time for sterilization when bands are inoculated with bacteria and spores, and to compare bead sterilization to other methods of cleansing and disinfecting orthodontic bands used in the office setting. Ten bands per time trial inoculated with either Bacillus subtilis spores or Staphylococcus albus bacteria were used along with ten controls (inoculated but not placed in the bead sterilizer). The bands were placed one at a time into a 226 degrees C bead sterilizer for 15, 30, 45, and 60 seconds, transferred to a test tube with BHI broth, and incubated at 37 degrees C for 3 days. The results indicated that 15 seconds is required to sterilize bacteria and 45 seconds required for spores. If five bands were placed in the bead sterilizer simultaneously, twice the time was required for sterilization. Other techniques for disinfecting bands, such as a 5-second tap water rinse, 10-second soap scrub, 30-minute immersion in alcohol, and alcohol flame, were ineffective in killing bacteria or spores with one exception--the alcohol flame was capable of preventing growth on bands inoculated with Staphylococcus albus.

Bacillus subtilis↗
PubMed2003

Frustrated demand for postpartum female sterilization in Brazil.

During the last three decades, Brazilians have relied almost exclusively on two contraceptive methods, the pill and female sterilization, with sterilization use increasing over time. Until a new law was passed in 1997, sterilization was virtually illegal and not covered by either public or private health insurance. It was, however, frequently provided in public and private hospitals in conjunction with a cesarean section. The new law regulating sterilization provided for reimbursement for interval sterilizations by public health insurance, but placed restrictions on availability intended to reduce the use of cesareans. These restrictions included the prohibition of postpartum sterilizations. This paper focuses on women's sterilization intentions during pregnancy and their experiences postpartum. In a prospective study of 1612 pregnant women carried out in four Brazilian cities, there was substantial demand for postpartum sterilization in both the private and public sectors among women who wanted no more children. However, public patients were much less likely to be sterilized than private patients. Thus, the new law may not have reduced inequities in access or, paradoxically, the incentive for unnecessary cesarean sections.

Adolescent↗
PubMed1998

Effect of sterilization on cyclic fatigue of rotary nickel-titanium endodontic instruments.

The ability of heat treatment as a result of autoclave sterilization to extend the life of nickel-titanium rotary endodontic instruments by reducing the effect of cyclic fatigue was evaluated using 280 size 40 Lightspeed instruments. Instruments were cycled in artificial canals with angles of curvature of 30 degrees and either 2 or 5 mm radii of curvature. In a pilot study, instruments were sterilized or not sterilized and cycled to failure to obtain mean cycles-to-failure values for each group. In the first experimental protocol, instruments were cycled to either 25%, 50%, or 75% of the mean cycles-to-failure limit determined in the pilot study, then sterilized or not sterilized before being cycled to failure. In the second experimental protocol, instruments were cycled to 25% of the mean cycles-to-failure determined in the pilot study, and sterilized or not sterilized. The sequence of cycling to 25% of the predetermined cycles-to-failure limit followed by sterilization was repeated until the instruments failed. No significant increases in cycles to failure were observed between groups for either experimental protocol when instruments were evaluated at a similar radius. Significant differences in cycles to failure were only observed when instruments cycled to failure in the artificial canal with 2 mm radius were compared with instruments cycled to failure in the artificial canal of 5 mm radius. Scanning electron microscopic photos showed crack initiation and propagation in all instruments that were cycled to a percentage of the predetermined cycles-to-failure limit. It is concluded that heat treatment as a result of autoclave sterilization does not extend the useful life of nickel-titanium instruments.

Analysis of Variance↗
PubMed2006

Labeling solutions and medications in sterile procedural settings.

BACKGROUND: Confusion resulting from unlabeled solutions and medications during sterile procedures can result in serious medication errors. CASE STUDY: During elective surgery; a seven-year-old boy was mistakenly injected with 100 times the intended dose of epinephrine. Cardiac arrest ensued, and the child died the next day. HOW ONE HOSPITAL MET THE CHALLENGE: At Marion General Hospital (Marion, Ohio), sterile procedures are performed in the surgery department, the cardiac catheterization lab, the labor and delivery area, intensive care unit rooms, and the emergency department. MGH's surgical services management team developed a policy and protocol for medication safety that refers to labeling of medications in sterile procedural settings. DISCUSSION: Sterile procedures often require medications or solutions to be placed in syringes or sterile basins. Facilities can eliminate the need for some solutions by using commercially available applicators or swabs, and can purchase some medications in sterile, labeled syringes. Sterile marking pens and blank sterile labels are available, as are preprinted sterile labels. The Association of periOperative Registered Nurses has helpful guidance statements and a medication safety toolkit. CONCLUSION: This requirement can be challenging to meet, but good resources are available.

Child↗
PubMed1998

Improved injection practices after the introduction of treatment and sterility guidelines in Tanzania.

OBJECTIVE: To evaluate the effect of introduction of treatment and sterilization guidelines on the number of avoidable injections and on the sterility of needles and syringes. METHODS: In 1991, 66 randomly selected health units in Mwanza Region, Tanzania, were visited and factors were determined that might contribute to HIV transmission by injections. In a workshop with all senior health workers from the region, findings were presented and treatment and sterilization guidelines developed. Thereafter, seminars were held at each health centre of the region. Four months after the intervention, data were collected at the same health facilities in order to assess changes in prescribing practices, sterilization procedures, and sterility of needles and syringes. RESULTS: The knowledge on indications for injections improved markedly for paramedical staff. The proportion of outpatients receiving an injection dropped from 23% to 10% and the proportion of patients receiving an avoidable injection dropped from 16% to 6%. Procedures for sterilization, keeping sterilized equipment, and administration of injections improved. A smaller proportion of sterilized needles and syringes tended to be contaminated in dispensaries, but this reduction from 44% to 22% was not significant. CONCLUSION: Considerable improvement in knowledge, prescription practices and sterility procedures was observed at dispensary level after carrying out a training programme.

Allied Health Personnel↗
PubMed1999

Sterilization and disinfection in general practice in Northern Ireland.

In view of the recent trend towards more minor surgery being carried out in general practice we decided to conduct a postal survey to assess the level of knowledge of sterilization and disinfection and the use of benchtop sterilizers in general practice in Northern Ireland. The survey, of all 366 practices in the Province, was carried out in January/March 1998. One hundred and eleven (30%) completed questionnaires were returned. All practices performed at least one of a range of procedures requiring sterilization or disinfection, e.g., minor surgery 95%, cervical smear taking 98%, syringing of ears 98%. Only 76% of practices had a benchtop sterilizer and 39% did not have access to a sterile supply department (SSD); 32% of the latter had no desire to utilize such a service. Only 25% and 34% correctly identified the Medical Devices Agency (MDA) definitions of sterilization and disinfection respectively. The MDA Device Bulletin on benchtop sterilizers had been read by only 26% of respondents. There was an 86% interest in attending a workshop on sterilization and disinfection. The concepts and practice of sterilization and disinfection appear not to be clearly understood. We conclude that resources must be identified to provide appropriate education in this important area for primary care staff.

Ambulatory Surgical Procedures↗