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PubMedDate not supplied

Use of PercuSurge in primary angioplasty.

Thrombus load and its subsequent distal embolization causing slow flow makes primary angioplasty a challenging task. Although data is scanty, these complications may be potentially mitigated by use of distal protection devices. We report 6 cases of PercuSurge distal protection device-assisted primary angioplasty. All lesions were stented with patients achieving brisk TIMI 3 flow; none of the patients had in-hospital major adverse cardiac events. The strategy of PercuSurge Guardwire-assisted primary angioplasty seems encouraging in improving successful outcome in this subset of patients.

Aged↗
PubMed2005

The Zwolle global experience on primary percutaneous coronary intervention.

Timely restoration of antegrade blood flow in the infarct-related artery of patients with ST-segment elevation myocardial infarction (STEMI) results in myocardial salvage and improved survival. We describe the Zwolle approach with regard to prehospital phase, the first 15 min in hospital, initial pharmacological therapy, angiography, angioplasty, risk stratification, rehabilitation and secondary prevention. Confirmation of the diagnosis by 12-lead electrocardiography by either general practitioners or ambulance paramedics allows substantial reduction in the time-delay to first balloon inflation, as the hospital and the catheterization laboratory can be prepared in advance, and the emergency room and the coronary care unit with their unavoidable delays can be skipped on the way to acute angiography. In our setting all patients with STEMI are treated at the time of diagnosis (before or during transportation) with heparin (5000 IU) and aspirin (500 mg) intravenously, with additional oral bolus (300 mg) of clopidogrel and additional 5000 IU heparin at the time of angiography. Our attitude is that an optimal balloon angioplasty result should never be jeopardized just for somewhat lower rate of target vessel revascularization during the first year after the acute event. In particular, attention should be paid to side branches, which may be of more clinical relevance in this setting than with elective angioplasty. Additional mechanical devices, such as distal protection devices and/or thrombosuction, should be mostly used when relevant thrombotic material is visible, with concomitant higher risk of distal embolization, particularly in high-risk patients. Finally, the use of the Zwolle risk score may help to identify low-risk patients who could be safely discharged within 36-48 hours after primary angioplasty, with a significant reduction in the costs of hospitalization.

Angioplasty, Balloon, Coronary↗
PubMed1976

A device to protect indwelling catheters in miniature swine.

A simple, sturdy metal box was designed and utilized to protect indwelling central venous and aortic arch catheters in miniature swine. These catheters were easily maintained for 14 days in unrestrained, free-roaming animals while precise amounts of fluids were infused, serial blood samples were taken, and blood pressure recordings and cardiac output measurements were made.

Animals↗
PubMed1987

Characteristics of farmers who have obtained personal dust respirators.

A postal survey was used to investigate the characteristics of farmers who have acquired dust respirators. In 1979 about a quarter of the farmers were using dust respirators, men more often than women. The more vocational training the farmer had and the larger the area of land under cultivation the more likely he was to own a dust respirator. Grain producers had purchased the protective devices more frequently than other farmers had. Farmers who participated in the occupational health intervention during 1980-82 had acquired dust respirators considerably more often than those in the control group. In the intervention group men under 30 years had most frequently purchased the dust respirators. Participation in the intervention influenced the acquisition of dust respirators more than did occurrence of symptoms of chronic bronchitis or farmer's lung.

Adult↗
PubMed2003

Percutaneous internal carotid artery angioplasty with stenting: early and long-term results.

BACKGROUND: Cerebro-vascular accidents are the third most common cause of death. The most frequent localisation of lesions responsible for stroke are bifurcation of the common carotid artery or the proximal internal carotid artery (ICA). Surgical carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the non-pharmacological methods used to treat carotid artery stenosis. AIM: To assess the efficacy and safety of CAS of ICA. METHODS: CAS was performed in 75 patients (49 males, 26 females) with a mean age of 65.2+/-9.1 years. Twenty (26.7%) patients underwent CAS with the use of the central nervous system (CNS) protective devices. The immediate, mid-term, and long-term results were analysed. RESULTS: In total, 84 stents were implanted to 80 ICA in 73 patients. In two patients stent implantation was not possible. In 7 (9%) patients with a stenosis of both ICA, a bilateral procedure was performed. In two patients concomitant dilatations of the vertebral artery, and in the other two - of subclavian artery, were performed. In 38 patients coronary angiography was performed directly before CAS; one patient underwent coronary angioplasty. In 20 patients protective CNS devices were used. During the procedure four patients developed ischaemic stroke on the side of CAS. In one patient neurological symptoms completely disappeared within 48 hours. The type of technique used during CAS did not influence the frequency of ischaemic complications. Four patients developed hyperperfusion syndrome which disappeared after a few days. There were fire deaths during follow-up: three due to myocardial infarction (MI), one - after urgent CABG, and one due to pulmonary embolism. There were no deaths due to stroke. No new ischaemic changes in CNS nor significant changes in the neurological status, using the UNSS or Barthel scales, were observed. Asymptomatic restenosis was documented in six patients whereas one patient developed symptomatic restenosis due to stent deformation. CONCLUSIONS: Percutaneous angioplasty of an internal carotid artery carries a risk not exceeding that of surgical endarterectomy. In our study, a one-year follow-up revealed a minor risk of ischaemic stroke. Percutaneous angioplasty with the use of protective devices should be tested in larger groups of patients in order to establish the real clinical usefulness and improved safety of this technique.

Aged↗
PubMed1984

Physiological effects of pressure demand masks during heavy exercise.

Inward leakage in a respiratory protective device may constitute a health hazard. The pressure demand system causes a slightly positive pressure in the facepiece throughout the breathing cycle, so that any insufficient seal in such a system will result in an outward leakage. One question is whether this positive pressure will influence work capacity. Five subjects worked until exhaustion on a bicycle ergometer with four different breathing equipments: two masks with positive pressure (0.5 kPa and 0.8 kPa) and two mouthpieces without positive pressure, one control and one with high resistance. No difference in endurance time was found. Heart rate, oxygen consumption, rated perceived exertion and blood lactate at breaking point did not show any significant changes. The high resistance mouthpiece, -1.1 kPa to +1.3 kPa, at breaking point, did reduce minute ventilation by 21% and end tidal PCO2 was increased by 16% without any influence on work performance.

Adult↗
PubMed1975

Effects of a welding helmet and dust respirators on respiration at rest and during exercise.

The influence of welders' protective devices on respiration at rest and during exercise was studied under laboratory conditions. During exercise the devices caused increased ventilation and increased arterial carbon dioxide tension. In the case of the welding helmet the increase was probably a consequence of increased dead space. It is concluded that the physiological affects on respiration are of minor importance in themselves, but they should be taken into account when the degree of exposure to welding fumes is evaluated.

Adult↗
PubMed1998

Factors associated with ankle injuries. Preventive measures.

A sense of foot position in humans is precise when barefoot, but is distorted by athletic footwear, which accounts for the high frequency of ankle sprains in shod athletes. It is unclear whether taping and rigid and semi-rigid devices protect against ankle sprains, as all of the studies suggesting this are flawed by inadequate controls. If these devices do protect the ankle, it is not through added support but rather through a partial correction of the deceased foot position awareness caused by footwear. Since taping and rigid and semi-rigid devices interfere with normal movement, there is concern that these might actually increase the frequency of injury at the ankle and/or at different locations. In this respect, taping is less of a concern because it interferes least with normal movement. The best solution for reducing ankle sprains in shod athletes is the use of more advanced footwear to retain maximal tactile sensitivity, thereby maintaining an awareness of foot position comparable to that of the barefoot state or perhaps even improving on it.

Ankle Injuries↗
PubMed1983

Influence of physiological noise and the occlusion effect on the measurement of real-ear attenuation at threshold.

The most commonly alleged experimental artifact associated with real-ear attenuation at threshold (REAT) measurements of hearing protection devices (HPDs) was examined: Masking of the protected thresholds due to physiological noise amplified by the occlusion effect. An ear canal mounted subminiature microphone was used to obtain objective measures of physiological noise in occluded and unoccluded test conditions and of the insertion loss (IL) of insert, semi-aural, supra-aural and circumaural HPDs when exposed to broadband noise with a sound pressure level of 93 dB. Measurements spanned 1/3 octave bands from 125 Hz to 2 kHz. Attenuation was also measured via a subjective REAT procedure and the magnitude of the occlusion effect was examined via bone conduction audiometry. The IL data confirmed the accuracy of the REAT results except at the lowest frequencies tested, where the degree to which the REAT values were spuriously inflated was quantified and found to be device related. Furthermore, the magnitude of the error (which never exceeded 5 dB) could be predicted by measuring the physiological noise in the occluded ear and calculating how much this would mask the occluded threshold. It was noted that no evidence was found in the data to suggest a dependency of HPD attenuation on sound level.

Adult↗
PubMed1982

Protecting workers who clean up hazardous waste sites.

On April 21, 1980, an explosion and fire among the 40 000 drums of unlabeled chemical wastes at the former site of Chemical Control Corporation in Elizabeth, New Jersey, attracted national attention and raised serious concern about the health and safety of workers who would be called upon to clean up the disaster site. Evaluation of workers' exposure during clean up operation and an assessment of the level of respiratory protection needed were necessary. NIOSH conducted 8 days of air monitoring. The chemicals of concern were organic vapors, metals, pesticides, polychlorinated biphenyls, cyanide compounds, and dioxins (TCDD). No excessive exposure to chemical substances by inhalation was found. However, continuous use of respiratory protective equipment and other personal protective devices was necessary because of frequent drum ruptures.

Air Pollutants↗
PubMed1996

Hostility and hearing protection behavior: the mediating role of personal beliefs and low frustration tolerance.

The authors examined whether hostility would negatively be associated with occupational health behavior, namely, the use of hearing protection devices (HPDs). Also examined as possible mediators were the protection motivation theory (PMT) components and low frustration tolerance (LFT). Participants were 226 male industrial workers, all exposed to potentially hearing-damaging noise. Hostility was negatively related to HPD use. It moderately correlated with the PMT components: negatively with perceived susceptibility, severity, effectiveness, and self-efficacy and positively with perceived barriers. Hostility correlated highly with LFT. Regression analyses confirmed the mediating role of perceived barriers, low self-efficacy, and LFT in the negative relationship between hostility and the use of HPDs. Thus, intrapsychic characteristics of hostile people may be significant for hearing protection behavior.

Adolescent↗