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PubMed2002

[Hazards of radio frequency magnetic field and their prevention and control].

The paper briefs the sources of radio frequency (RF) electromagnetic field, their hazards to human health and the hygienic standards of RF electro-magnetic field for occupational exposure and for general population exposure. Based on the physical properties of RF electromagnetic field, the author put forward the comprehensive measures for controlling the electromagnetic radiation to meet the hygienic standards. These measures are improvement of the technology to lower the intensity of RF electromagnetic radiation, shielding the RF radiation sources to reduce the radio frequency levels in accessible areas, increasing the distance between the sources and human, and using personal RF protecting devices in area of high radio frequency levels, etc.. In protecting the general population from exposing to RF radiation, measures keeping a safe distance between the sources and the public play very important role, in which good city planning and the effective control of new and existing RF sources are very important. Referring to the RF electromagnetic problems by using electrical devices in the household, different measures based on the above principles for controlling RF hazards are also cited.

Cataract↗
PubMed1999

Carotid stenting with cerebral protection: first clinical experience using the PercuSurge GuardWire system.

PURPOSE: To study the feasibility and safety of carotid angioplasty and stenting using a new cerebral protection device that temporarily occludes the distal internal carotid artery (ICA). METHODS: Forty-eight high-risk patients (39 men, mean age 69.1 +/- 8 years, range 54 to 86) with 53 ICA stenoses underwent percutaneous angioplasty and stenting via the femoral approach under cerebral protection afforded by a 0.014-inch GuardWire balloon occlusion device. Mean stenosis was 82.1% +/- 9.65% (range 70 to 96) and mean lesion length was 16.0 +/- 7.5 mm (range 6 to 50). Thirty-three (62%) lesions were calcified, and 38 (72%) were ulcerated. Thirty-two (60%) of the lesions were asymptomatic. With the occlusion balloon inflated in the distal ICA, the lesion was dilated and stented. The area was cleaned by aspiration and flushed via an aspiration catheter advanced over the wire. Blood samples were collected from the external carotid artery (ECA) and analyzed to measure the size and number of particles collected. Computed tomography and neurological examinations were performed the day after the procedure. RESULTS: Immediate technical success was achieved in all patients with the implantation of 38 Palmaz stents, 8 Expander stents, and 11 Wallstents. Carotid occlusion was well tolerated in all patients but 1 who had multiple, severe carotid lesions and poor collateralization. Mean cerebral flow occlusion time was 346 +/- 153 seconds during predilation and 303 +/- 143 seconds during stent placement. Total mean flow occlusion time was 542 +/- 243 seconds. One immediate neurological complication (transient amaurosis) occurred in a patient who had an anastomosis between the external carotid (EC) and ICA territories. Debris was removed in all patients with a mean 0.8-mm diameter catheter. CONCLUSION: Cerebral protection with the GuardWire device is easy, safe, and effective in protecting the brain from cerebral embolism. Larger studies are warranted.

Aged↗
PubMed1998

Sports medicine and the eye care professional.

BACKGROUND: There are more than 40,000 eye injuries every year in the United States--many of which are sports-related. Sports injuries are a common cause of severe vision loss. Today, contact sports, racket sports, and other high-risk athletic activities are more popular on an organized and informal level. Those engaging in these activities should wear the proper eye and facial protection, so as to minimize the risk of severe injury and potential vision loss. CASE REPORTS: Case studies are used to illustrate examples of sports-related clinical experiences encountered in a primary care practice. A description of protective devices, a discussion of product liability, the standard of care, and the doctor's responsibility to the patient complement the case scenarios. Emphasis is placed on prevention and particular attention should be paid to the patient at high risk and to the one-eyed patient. CONCLUSION: Sports-related eye injuries have a high risk for ocular morbidity and subsequent severe vision loss. Many sports related injuries are preventable and the primary care practitioner can provide important information and education regarding protection and avoidance for those participating in high-risk activities. The provider should promote compliance and be adequately informed as to product liability, standards, manufacturers of the devices, and indications for the use of specific devices.

Adolescent↗
PubMed1998

Leg injuries and shin guards.

Soccer players have a high risk of soft-tissue injuries to their legs. Fractures of the tibia and fibula represent a serious potential injury; despite this, the incidence of these fractures in soccer players is unknown. Shin guards have become the only protective devices that are required by international and collegiate soccer associations. Nonetheless, the protective ability of shin guards has only been studied to a limited extent. Shin guards are assumed to be most effective at reducing leg abrasions and contusions. The role of shin guards in protecting against fractures has yet to be determined. Further analysis of the clinical effectiveness and biomechanical properties of shin guards is necessary to reduce the rate of leg fractures.

Adolescent↗
PubMed2005

The impact of hearing protection on sound localization and orienting behavior.

The effect of hearing protection devices (HPDs) on sound localization was examined in the context of an auditory-cued visual search task. Participants were required to locate and identify a visual target in a field of 5, 20, or 50 visual distractors randomly distributed on the interior surface of a sphere. Four HPD conditions were examined: earplugs, earmuffs, both earplugs and earmuffs simultaneously (double hearing protection), and no hearing protection. In addition, there was a control condition in which no auditory cue was provided. A repeated measures analysis of variance revealed significant main effects of HPD for both search time and head motion data (p < .05), indicating that the degree to which localization is disrupted by HPDs varies with the type of device worn. When both earplugs and earmuffs are worn simultaneously, search times and head motion are more similar to those found when no auditory cue is provided than when either earplugs or earmuffs alone are worn, suggesting that sound localization cues are so severely disrupted by double hearing protection the listener can recover little or no information regarding the direction of sound source origin. Potential applications of this research include high-noise military, aerospace, and industrial settings in which HPDs are necessary but wearing double protection may compromise safety and/or performance.

Adolescent↗
PubMed1996

Accurate anatomical location of war injuries: analysis of the Lebanon war fatal casualties and the proposition of new principles for the design of military personal armour system.

In this study we present a new approach to the design of the military personal armour system (MPAS). This approach is based on a computerized analysis of the exact anatomical location of 405 penetrating war injuries (290 shrapnel and 115 bullet injuries) in 164 soldiers killed in the Lebanon war. All the penetrating injuries (hits) were plotted on a computerized image of the human body. About 90 per cent of all hits were to the front of the body; 55 per cent of all hits were to the left side. About 45 per cent of all hits were to the torso, which is slightly more than the torso's proportion of total body-surface area (36 per cent). Of all hits to the torso, 64 per cent of the shrapnel hits and 73.3 per cent of the bullet hits were limited to the front mid torso (T4 to T9). The head at the level of the helmet received 9 per cent of all hits, most of which were over the frontal bones (72.4 per cent). The body part with the greatest density of penetrating injuries was the face, with 22.2 per cent of all penetrating wounds, and in particular the mid face, from the level of the lips to the level of the zygomatic bones, was especially vulnerable, sustaining 10 per cent of all the penetrating wounds. These findings suggest several possible modifications in the standard MPAS: an additional protective device over the front mid torso may be incorporated; the face may be protected by a transparent and lightweight face-shield; a horizontal margin added to the standard helmet may protect the upper face from missiles from above; a chin cover may protect the lower face.

Blast Injuries↗
PubMed1989

[Occupational dermatoses: clinical picture, noxious compounds, prevention].

Various occupational substances may cause dermatological lesions. Toxic, toxic-degenerative and allergic eczemas have to be mentioned on the first hand. The prevention of dermatoses ranges among the most important tasks of occupational medicine. The first measure should be a minimization of the direct skin contact with dermatotoxic substances. Here, adequate cleaning products play an important part. --When working with potentially toxic substances, the use of protective devices must be recommended. There are two possibilities: wearing gloves or application of protective ointments. In both instances, numerous disadvantages have to be considered. The main point is the reduced quality of work. Recently, a foam product for external protection has been developed. Clinical experiments and first practical experiences permit the assumption that this foam product which forms a biphasic lattice in the outer layers of the stratum corneum may ameliorate the situation.

Dermatitis, Occupational↗
PubMed1994

[Bone distraction using an external fixator: a new mandibular lengthening technic. A preliminary study apropos of 2 cases of children with mandibular hypoplasia].

The authors expose a technical innovation concerning mandibular lengthening without any bone graft, by applying to the mandibular Ilizarov's principles about limb lengthening by osseous distraction. This surgical technique concerns children with mandibular hypoplasia, like the Hanhart's syndrome (aglossia-adactylia, first observation), or Hemifacial Microsomia (second observation). The purpose of this new technique is mandibular lengthening with functional and aesthetic correction of the mandibular growth deficiency, and minimal morbidity. A specialist staff is essential to realize a distraction device with his minimal and appropriate shape for children, as well as a protection device conception. This external distraction device is placed with transmandibular pins. After mandibular corticotomy by endobuccal incision, the distraction is accomplished, at home by the parents, at the rythm of 1 mm p. two days. The distraction goes on about 2 months, depending on the lack of mandibular growth, and a retention device, much more light, is necessary during 8 weeks more to stabilize the osteogenesis. At the term of an eight weeks gradual distraction, the mandibular lengthening is 17.5 mm for the horizontal ramus (first observation), and 13 mm for the vertical ramus (second observation). The functional and aesthetic results, the swift and secure surgical procedure, lead to put forward this mandibular distraction technique in any mandibular or facial defects.

Abnormalities, Multiple↗
PubMed2000

Evaluation of half-mask respirator protection in styrene-exposed workers.

OBJECTIVE: The protection afforded by respirators to styrene (St)-exposed workers varies considerably. Our objective was to study the effective 'in the field' reduction in St exposure obtained by negative-pressure half-mask respirators worn by a group of fiberglass-reinforced plastics (FRP) workers. Protection was evaluated by measuring the reduction in urinary St (StU) excretion. METHODS: Seven FRP workers not using respiratory protection devices were studied for a week. External exposure to St was evaluated by personal passive sampling, and the internal dose by StU measurement. Then workers were asked to use a half-mask respirator for a week for the entire morning half-shift, and St exposure and internal dose were re-assessed. RESULTS: Mean environmental levels of St during the morning half-shift were 230-280 mg/m3, i.e., about three times the current limit proposed by ACGIH; the difference among days was not significant. Using respirators was accompanied by a large inter-individual and also intra-individual variability: the estimated reduction of StU values ranged from 30% to 90% (mean 60%). Mean StU values increased by 50% from Monday to Friday, while environmental St concentrations remained steady. Furthermore, the proportion of workers exceeding the biological equivalent exposure limit (BEEL) was 14% on Monday, double (33%) on Thursday, and triple (43%) on Friday. These data suggest a decrease of protection during the week. CONCLUSIONS: The protection afforded by negative-pressure half-mask respirators varies widely, which stresses the need to assess the effective reduction of exposure whenever these devices are introduced for St-exposed workers. If respirators are to be re-used for several days, their performance must be evaluated during the last shift of use. Measurement of urinary excretion of unmodified St proved a useful tool for the evaluation of respirator effectiveness in exposed workers.

Air Pollutants, Occupational↗
PubMed2006

Antibody responses to several malaria pre-erythrocytic antigens as a marker of malaria exposure among travelers.

Protective devices against vectors are used by travelers in malaria-endemic areas but their efficacy for protection against mosquitoes has rarely been evaluated. The level of exposure to malaria transmission of 205 soldiers deployed in Africa and the efficacy of their anti-vector prophylaxis was evaluated by comparison of their IgM and IgG responses against five pre-erythrocytic Plasmodium falciparum antigens (circumsporozoite protein, sporozoite threonine- and asparagine-rich protein, sporozoite- and liver-stage antigen, liver stage antigen 1, and SR11.1) before and at the end of their deployment, and three months after returning to France for 106 of these soldiers. The immune responses increased significantly during the mission in 35% (95% confidence interval = 28-42%) of the individuals. The permanent use of insecticide-treated bed nets and long-sleeve battle dress at night were associated with protective efficacy. The analysis of these antibody responses was sensitive enough to evaluate exposure to malaria transmission and the efficacy of anti-vector devices in travelers using antimalarial chemoprophylaxis.

Adolescent↗
PubMed1997

National Institute for Occupational Safety and Health; certification of respiratory devices used to protect workers in hazardous environments--NIOSH. Notice of priorities for rulemaking.

In response to public comments received from its May 16, 1996, request (61 FR 24740), NIOSH is announcing the intended priority order for the development of the next proposed rule amendments (modules) to the current NIOSH procedures for certifying respiratory devices used to protect workers in hazardous environments. The priority order is based on the comments and data in the public record. The priority order of the planned modules is provided to help the respirator community plan for potential changes.

Humans↗
PubMed2003

Radiation exposure benefit of a lead cap in invasive cardiology.

BACKGROUND: Occupational head exposure to radiation in cardiologists may cause radiation induced cataracts and an increased risk of brain cancer. OBJECTIVE: To determine the effectiveness of 0.5 mm lead equivalent caps, not previously used in invasive cardiology, in comparison with a 1.0 mm lead equivalent ceiling mounted lead glass screen. DESIGN: An anthropomorphic Alderson-Rando phantom was used to represent the patient. Scatter entrance skin air kerma to the operator position (S-ESAK-O) was measured during fluoroscopy for all standard angulations and the S-ESAK-O per dose-area product (DAP) calculated, as applied to the phantom. RESULTS: Measured mean (SD) left/right anterior oblique angulation ratios of S-ESAK-O without lead devices were 23.1 (10.1), and varied as a function of tube angulation, body height, and angle of incidence. S-ESAK-O/DAP decreased with incremental operator body height by 10 (3)% per 10 cm. A 1.0 mm lead glass shield reduced mean S-ESAK-O/DAP originating from coronary angiography from 1089 (764) to 54 (29) nSv/Gy x cm2. A 0.5 mm lead cap was effective in lowering measured levels to 1.8 (1.1) nSv/Gy x cm2. Both devices together enabled attenuation to 0.5 (0.1) nSv/Gy x cm2. The most advantageous line of vision for protection of the operator's eyes was > or = 60 degrees rightward. CONCLUSIONS: Use of 0.5 mm lead caps proved highly effective, attenuating S-ESAK-O to 2.7 (2.0) x 10(-3) of baseline, and to 1.2 (1.4) x 10(-3) of baseline where there was an additional 1.0 mm lead glass shield. These results could vary according to the x ray systems used, catheterisation protocols, and correct use of radiation protection devices.

Cardiology↗
PubMed2006

Intense vasoconstriction in response to aspirate from stented saphenous vein aortocoronary bypass grafts.

OBJECTIVES: We sought to identify soluble vasoconstrictor substances that are released during stent implantation into saphenous vein aortocoronary bypass grafts. BACKGROUND: Atherosclerotic saphenous vein aortocoronary bypass grafts are particularly vulnerable to plaque rupture. Protection devices prevent particulate debris from being embolized. Additional soluble vasoconstrictor substances possibly also contribute to impaired microvascular perfusion. METHODS: Peripheral venous blood (VB) and aspirate (AS) were obtained from 14 patients with a significant stenosis in a saphenous vein graft during stent implantation under protection with a distal balloon occlusion device. In five additional patients, arterial blood (AB) was also taken distal to the stented lesion before intervention. Vasomotor substances in VB, AB, and AS plasma were identified in a bioassay of rat mesenteric arteries with intact (+E) and denuded endothelium (-E). Vasoconstriction was normalized to that induced by potassium chloride depolarization (100%). RESULTS: Venous blood, AB, and AS plasma induced maximum vasoconstriction within six minutes. The AS plasma induced a vasoconstriction of 138 +/- 13% (-E) and 87 +/- 14% (+E); VB, of 70 +/- 14% (-E) and 23 +/- 4% (+E); and AB plasma obtained before intervention, of 49 +/- 9% (-E) and 36 +/- 8% (+E). The vasoconstrictor potency of AS plasma in endothelium-denuded vessels was related to the severity of anginal symptoms, angiographic stenosis severity, plaque volume, and plaque burden as determined by intravascular ultrasound. The AS plasma-induced vasoconstriction was largely attenuated by combined serotonin/5-hydroxytryptamine (5-HT)(2A/2C)- and 5-HT(1A/1B)-receptor blockade and eliminated by additional thromboxane A2 thromboxane-prostanoid (TP)-receptor blockade. CONCLUSIONS: Stent implantation releases, apart from and in addition to particulate debris, soluble vasoconstrictor substances that possibly contribute to impaired microvascular perfusion.

Animals↗
PubMed2005

Should degenerated saphenous vein grafts routinely be sealed with drug-eluting stents?

The percutaneous treatment of patients with obstructive atherosclerotic disease in degenerated coronary saphenous vein bypass grafts still remains one of the great challenges in interventional cardiology. In this review, we discuss the actual evidence-based knowledge for the percutaneous management of this lesion subset, focusing in particular on the devices that are actually considered the "gold standard" for this treatment: bare metal stents and distal protection devices. We also comment on the negative results of the randomized trials regarding the promising polytetrafluoroethylene-covered stent-grafts. We finally offer insights into the currently available evidence for the use of drug-eluting stents in saphenous vein grafts. These devices are potentially the principal promise for the long-term successful sealing of vein graft disease; however, clear and definitive data coming from controlled trials are requested.

Angioplasty, Balloon, Coronary↗
PubMed1975

Anaerobic specimen transport device.

A device is described and evaluated for the anaerobic transport of clinical specimens. The device limits the amount of oxygen entering with the sample to a maximum of 2%, which is rapidly removed by reacting with hydrogen in the presence of a palladium catalyst. The viability on swabs of 12 species of anaerobes, four strains of facultative anaerobes and a strain of Pseudomonas aeruginosa, was maintained during the length of the tests (24 or 48 h). The results demonstrated that this device protected even the more oxygen-sensitive clinical anaerobes from death due to oxygen exposure. This device can be used for swabs as well as for anaerobic collection and liquid and solid specimens.

Anaerobiosis↗
PubMed1982

[Modern technics of intracavitary curietherapy of cervical carcinoma].

The authors set out the technical innovations which are being used to comply with the three classical aims of endocavitary curietherapy for cervical cancer: the personalization of the irradiation device, protection of staff against exposure risks due to ionizing radiations, planning and control of the irradiation conditions. The personalization of the irradiation device is achieved by preparing a specially shaped vaginal applicator for each patient, and staff protection is ensured by the use of remote-loading techniques and closed circuit television control for in-patients. The planning of the treatments answers to the logic of reproducing the usual curie therapy method with conventional radium-226 sources. In order to control the irradiation conditions, at least the essential part of the treatments must be recognized and expressed: equivalent radium milligrams per hour (MRA h), dose rate (Gy h-1), dimensions of the treated volume and space distribution of the dose.

Brachytherapy↗
PubMed2006

Interventional therapy for carotid artery disease using angioplasty and stenting with embolic protection.

Carotid artery angioplasty with stenting (CAS) has emerged as a viable alternative to endarterectomy for the treatment of occlusive vascular disease. Advances in endovascular techniques and the improvement of specialized stents have served to rapidly close the gap with the traditional gold standard surgery. Furthermore, the development of cerebral embolic protection devices has reduced the occurrence of distal embolization of atheromatous material during such interventions and has reduced periprocedural stroke rates considerably. Continued improvements in distal embolic protection have further improved the risk profile of CAS, and increased operator experience with these interventional procedures has also been shown to reduce periprocedural complication rates. Outcomes may continue to improve as more providers gain experience with the evolving endovascular device technology, and several prospective clinical trials are currently investigating the efficacy of CAS with embolization protection versus endarterectomy in different cohorts. This review will survey the background and current literature covering angioplasty and stenting for occlusive disease in the carotid arteries and discuss the current methods employed to prevent distal emboli during intervention.

Angioplasty, Balloon↗
PubMed1997

A clinical, epidemiological and laboratory study on avoiding the risk of transmitting viral hepatitis during vaccinations with the Dermojet protected by an anticontaminant disposable device.

Jet injectors may transmit blood-borne infections, such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV). To evaluate the safety of an anticontaminant disposable device which protects the jet injector apparatus, 22,714 healthy subjects were intradermally inoculated (38,162 inoculations) with a variety of vaccines. All the subjects were systematically followed-up clinically and epidemiologically for 6-18 months after inoculation; blood samples from 1619 subjects, before and 60-75 days after inoculation, were examined by enzyme-linked immunosorbent assay (ELISA) for HBV, hepatitis C virus (HCV) and HIV. Before vaccination 212 (13.09%) subjects were positive: 204 positive for HBV markers and eight for the HCV marker. None of the subjects were positive for the anti-HIV marker. During the clinico-epidemiological surveillance and the laboratory investigations mentioned above no clinical viral hepatitis B or C case and no seroconversion to positivity for HBV or HCV markers among the susceptible persons in the group were reported. Considering that in similar situations there is a theoretical risk of transmission as high as 1 per 388 to 1 per 3367 injections and that in our case 38,162 inoculations were performed in 22,714 subjects with the same Dermojet protected by the same type of anticontaminant disposable device, no contamination risk being reported, the conclusion can be reached that jet injectors can be safely used in the medical practice if they are protected by the sterile anticontaminant disposable device.

Adolescent↗