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PubMed1981

A two-year follow-up study of women sterilized in India.

For large-scale program implementation, it is important to document both early and long-term safety and effectiveness of female sterilization methods. The results of this controlled, prospective, two-year study of 2,053 women who underwent sterilization in Baroda, India, show a marked decline in gynecological abnormalities over time; the incidence of gynecological pathology following sterilization was not significantly higher than what might be expected in the general population. The incidence of post-sterilization gynecological surgery was low. Significantly more women had weight gain than weight loss after sterilization. After sterilization, no change in menstrual cycle parameters was reported for the vast majority of women. Both favorable and unfavorable changes in menstrual cycle parameters were noted. The one-year and two-year pregnancy rates were 0.0 and 0.4 percent, respectively. No ectopic pregnancies were reported.

Body Weight↗
PubMed1993

Female sterilization by the vaginal route: a positive reassessment and comparison of 4 tubal occlusion methods.

Over the last 15 years female sterilization by the vaginal route has been abandoned in favour of the abdominal approach via a laparoscope or a suprapubic incision. This was justified when the vaginal route was used for a fimbriectomy or a Pomeroy type of sterilization. The use of tubal occlusion methods designed for the laparoscope has simplified the technique of vaginal sterilization and lowered the morbidity. Four hundred and ninety consecutive cases over an 18-year period are reviewed. Four hundred and eighty five were completed vaginally. The methods used were Pomeroy with catgut, Falope ring, Hulka and Filshie clips. The Filshie clip was the most satisfactory. Vaginal sterilization is suitable for day care. The readmission rate was 1%. There was no case of pelvic infection in 177 clip cases but 5 in 173 where the Pomeroy technique was used. The pregnancy rate was highest with the Hulka clip. The overall rate was 1%. With clip methods strong analgesics were only required in 6% postoperatively and only 14% took any analgesic after returning home; consequently return to normal activities was rapid. The patient's weight was not related to operative difficulty when clips were used so the vaginal route may prove to be the method of choice in the obese. Filshie clip sterilization via the posterior fornix of the vagina could be the most cost-effective method of sterilization available at present. The vaginal route needs reappraisal using contemporary methods of tubal occlusion.

Adult↗
PubMedDate not supplied

Sterilization approval and follow-through in Brazil.

The purpose of this study was to examine the factors that affect approval for and completion of sterilization in Rio de Janeiro. Of 2,186 new female family planning clients, 1,256 requested sterilization and 925 were approved for surgery. Among the approved women, 639 scheduled surgery and, of these, 595 were sterilized within three months of approval. While approval is dependent mainly on demographic variables, especially age and parity, follow-through by a woman is related to her education and income. The steps that a woman must complete to obtain a sterilization also affect whether she ultimately undergoes surgery. Almost no women were scheduled for sterilization during their initial clinic visit. Women who were not scheduled because they lacked certain documentation were more likely to follow through than women who, in addition to lacking documentation, were asked to switch from an inefficient contraceptive method (or no method) to a more modern one. The lessons to be learned from this study provide useful information to programs in other countries that are concerned about maintaining high standards but do not want to discourage women in their efforts to be sterilized.

Adult↗
PubMed1981

Evaluation of contemporary female sterilization methods.

Different methods of sterilization were evaluated. Laparoscopic techniques were the most satisfactory because they had lower pelvic and incision infection rates and shorter hospitalization and convalescent times than laparotomy lower pelvic infection rates than culdoscopy and culpotomy. Via laparoscopy, sterilization by coagulation and cutting, spring-loaded clips and bands was an effective, safe method. Mechanical problems with the applicator and optics and decreased visibility resulted in more technical failures and difficulties and more misapplication with the clip applicator. Although the total complication rates were similar with all methods, bleeding from the tubes and wound and pelvic infections were more frequent with silastic-band technique. Long-term complications, such as dysmenorrhea and menometrorrhagia and especially those resulting in hysterectomy after laparoscopy, are infrequent. Pregnancy rates are low after laparoscopic sterilization with coagulation and silastic bands as compared to the clip. Rates of complications with sterilization combined with abortion or delivery are only slightly higher than after abortion without sterilization and much less than the combined complications that would be anticipated from abortion and interval sterilization. To make colpotomy, culdoscopy and minilaparotomy easier and potentially safer, mechanical techniques using the spring-loaded clip and silastic band are being evaluated. Simplified techniques that can be administered via the cervix, such as Quinacrine, may be practical in the future.

Abortion, Induced↗
PubMed1983

Public policy and female sterilization in Costa Rica.

For 20 years, female sterilization has been increasing in popularity as a contraceptive method in Costa Rica. However, contraceptive sterilization has never been allowed explicitly under Costa Rican law. In 1976 the Costa Rican National Assembly instituted more stringent guidelines regarding medical sterilizations in order to eliminate contraceptive sterilizations, which had been occurring under relatively loose interpretations of national policy. Data from the 1976 National Fertility Survey and the 1981 Contraceptive Prevalence Survey indicate that the change in policy had only a short-term effect. Period sterilization rates fell substantially after 1976 but rebounded considerably by 1980, and the estimate of the proportion of married women who will ultimately be sterilized was approximately .5 for the periods both before and after 1976.

Adolescent↗
PubMed1995

Laparoscopic sterilization in the supine position using the Ramathibodi uterine manipulator.

OBJECTIVES: To investigate the usefulness of the Ramathibodi uterine manipulator (AMZURA Enterprises, Freeport, NY) in performing laparoscopic sterilization procedures in the supine position under local anesthesia. DESIGN: Descriptive prospective study. SETTING: Ambulatory surgical unit of university-affiliated hospital. PATIENTS: Women presenting for elective sterilization and weighing < 110 kg. INTERVENTION: The Ramathibodi uterine manipulator was used to provide uterine manipulation in 85 cases of laparoscopic sterilization, all performed in the supine position as local anesthesia-sedation sterilization operations. Because such procedures are becoming more common worldwide, we propose the acronym "LASSO" (Local Anesthesia-Sedation Sterilization Operation) for this class of operations. Although commonly used in minilaparotomy procedures, use of this uterine manipulation device in laparoscopic procedures has not been published previously. MAIN OUTCOME MEASURE: Successful tubal occlusion. RESULTS: Among the 85 cases reported here there were no failures to manipulate the uterus successfully, to identify the tubes, and to occlude them. CONCLUSIONS: The simplicity of the Ramathibodi uterine manipulator provided several advantages over other means of uterine manipulation, notably [1] constant easy-to-learn maneuvers, [2] no tenaculum or balloon requirement, [3] the procedure could be performed in the supine position, and [4] there are no working parts, screws, or springs that could be lost or broken by operating room staff. Our experience with this device leads us to recommend it to colleagues as an inexpensive, safe, and effective alternative to currently available instruments for providing uterine elevation during laparoscopic sterilization procedures.

Anesthesia, Local↗
PubMed1987

Involuntary sterilization in the United States: a surgical solution.

Although the eugenics movement in the United States flourished during the first quarter of the 20th Century, its roots lie in concerns over the cost of caring for "defective" persons, concerns that first became manifest in the 19th Century. The history of state-supported programs of involuntary sterilization indicates that this "surgical solution" persisted until the 1950s. A review of the archives of prominent eugenicists, the records of eugenic organizations, important legal cases, and state reports indicates that public support for the involuntary sterilization of insane and retarded persons was broad and sustained. During the early 1930s there was a dramatic increase in the number of sterilizations performed upon mildly retarded young women. This change in policy was a product of the Depression. Institutional officials were concerned that such women might bear children for whom they could not provide adequate parental care, and thus would put more demands on strained social services. There is little evidence to suggest that the excesses of the Nazi sterilization program (initiated in 1934) altered American programs. Data are presented here to show that a number of state-supported eugenic sterilization programs were quite active long after scientists had refuted the eugenic thesis.

Eugenics↗
PubMed2003

Immunochemical characterization of alkaline phosphatase from the fluid of sterile and fertile Echinococcus granulosus cysts.

Alkaline phosphatase (ALP) from hydatid cyst fluid (HCF) was purified and characterized for comparison between fertile and sterile HCF. Samples were obtained from slaughtered sheep and then sterile and fertile cysts were separated. ALP was purified from aspirated cyst fluid and biochemical parameters were determined. Sera from patients with hydatid disease (15 samples) and patients with other parasitic diseases including fascioliasis (2 samples), taeniasis ( Taenia saginata, 5 samples) and also sera from uninfected controls (15 samples), were collected and used in immunoblotting experiments with ALP from sterile and fertile HCF as antigen. Our results showed that ALP activity in fertile HCF [10.75+/-3.78 (SD) U/ml) was significantly more than in sterile HCF (6.25+/-2.43 U/ml). There were also some differences between the kinetic parameters and biochemical characteristics of ALP in fertile and sterile HCF. Immunoreactive bands were clearly observed when sera from hydatid infected patients were tested with ALP from fertile HCF as the antigen. However, this method revealed no cross-reaction between purified ALP from sterile HCF and sheep liver tissue. These findings suggest that there is some variation in the immunochemical characteristics of ALP from fertile and sterile HCF.

Alkaline Phosphatase↗
PubMed1995

Disinfection and sterilization practices in Mexico.

We evaluated antisepsis, disinfection, and sterilization procedures at 22 hospitals in the state of Yucatan, Mexico, which provide services for approximately 80% of the population. The percentage of hospitals that followed standard recommendations for diverse antisepsis procedures were as follows: surgical scrub, 41%; surgical site preparation, 68%; central intravenous (iv) catheters, 61%; peripheral iv catheters, 86%; urinary catheters, 41%, and umbilical cord care, 5%. Inappropriate procedures typically involved the use of benzalkonium chloride and mercury compounds. Adequate sterilization procedures were observed for sharp surgical instruments in 9%, for blunt surgical instruments in 81%; for linen in 90%; for surgical brushes in 9%; for metal prostheses in 100%; for plastic prostheses in 57%; and for disinfection of endoscopes in 30%. The most common errors were the use of too short an exposure time in steam sterilizers or dry heat sterilizers, and the use of benzalkonium chloride as a sterilizing agent. Only 14% of hospitals used commercial spore preparations for autoclave monitoring. For the reuse of disposables, 50-94% of hospitals employed inappropriate sterilization or low-level disinfection procedures. Similar conditions are likely to exist in hospitals throughout the country. The establishment of strict regulations and hospital training programmes for disinfection and sterilization procedures, and the reuse of disposable devices is urgently needed in Mexico.

Cross Infection↗
PubMed1991

Rapid control of purity for the cytoplasm of male-sterile seed stocks by means of a dot hybridization assay.

To produce hybrids, one member of the parental line is genetically made male-sterile. This male-sterile trait is encoded by mitochondria so that it is maternally inherited. Consequently, the progeny of a male-sterile plant is fully sterile. Nevertheless, during the handling of cytoplasmic male-sterile seed stocks, some mixture with seeds of the maintainer lines can occur. Up to the present time, the only way to check the homogeneity of the cytoplasmic male-sterile seed stock was to grow the plants until flowering time. We have developed a method which can be used immediately after the harvest, allowing us to check samples from both sunflower and sugar beet. We used the mitochondrial plasmid, present only in the maintainer lines, as a probe for the total nucleic acids prepared from the cytoplasmic male-sterile seed stocks which might be contaminated. The signals compared to those of samples artificially contaminated allow us to measure as few as one male-fertile seed in 1000 seeds in a rapid and accurate manner.

Blotting, Northern↗
PubMed2004

Using maximal sterile barriers to prevent central venous catheter-related infection: a systematic evidence-based review.

BACKGROUND: Catheter-related infections cause increased morbidity, mortality, and health care costs. Infection control experts advocate using maximal sterile barriers to reduce the incidence of these infections. Low compliance rates suggest that clinicians are not convinced or are not aware that available data support adopting this more cumbersome, time-consuming, and relatively more expensive technique. Accordingly, we conducted a systematic, evidence-based review of the medical literature to determine the value of maximal sterile barriers. DATA SOURCES: We used multiple computerized databases, reference lists of identified articles, and queries of prominent investigators. STUDY SELECTION: We selected studies comparing infectious outcomes using maximal sterile barriers versus using less stringent sterile barrier techniques during central venous catheter insertion. DATA SYNTHESIS: We found only 3 primary research studies. Although each study suggests maximal sterile barriers may reduce infectious complications, the evidence supporting this conclusion is incomplete. The only randomized controlled trial limited enrollment to ambulatory oncology patients. These 3 studies differed notably in their patient populations, research designs, and health care settings. CONCLUSION: The medical literature suggests maximal sterile barriers are advantageous in at least one setting and may be useful in others. While we believe the available evidence does support the use of maximal sterile barriers during routine insertion of central venous catheters, prospective studies and economic analyses would better clarify its value.

Bacteremia↗
PubMed1996

Use of sterile compared with tap water in gastrointestinal endoscopic procedures.

BACKGROUND: Because of the concern for infection risk, use of sterile water has been recommended in the water bottle for endoscopic equipment, although studies evaluating prevalence of contamination of the water bottle with clinical outcomes have not been performed. METHODS: Over a 12-week period in three endoscopy rooms at a university teaching hospital, the water bottles were filled on a weekly schedule with either sterile (one room) or tap water. The water bottles were sterilized on a weekly basis with an automated endoscope washer. At the end of each week, an aliquot of the remaining water was transferred to a sterile container, and quantitative cultures for aerobic and facultative anaerobic bacteria were performed by use of a 0.01 ml calibrated loop according to standard protocols. Cultures were performed in a blinded fashion without knowledge of the water source. Follow-up was performed on all patients within 2 weeks of the procedure to determine any potential infectious complications. RESULTS: During the study period, 437 procedures were performed (203 endoscopy, 68 colonoscopy, 38 sigmoidoscopy, 128 endoscopic retrograde cholangiopancreatography). Of a total of 36 cultures (12 sterile), the results of nine (25%) were positive, including three bottles where sterile water was used. Bacterial isolates included five Flavobacterium sp., four Acinetobacter sp., two Pseudomonas sp., and one Stenotrophomonas maltophilia. Colony counts ranged from 900 to more than 10,000 per ml. On follow-up no patient had development of a clinical infection from any of these organisms. CONCLUSIONS: Bacterial growth in the water bottle was infrequent, consisted predominantly of nonpathogenic organisms, and was not associated with clinical complications. Our pilot study suggests that the use of tap water as compared with sterile water may be practical as well as provide cost savings.

Bacteria↗
PubMed2000

Chemical transformation of some biologically relevant calcium phosphates in aqueous media during a steam sterilization.

The purpose of this study was to investigate the effect of steam sterilization on some biologically relevant calcium phosphates: CaHPO4 . 2H2O (DCPD), calcium deficient apatite (CDA) and biphasic calcium phosphate (BCP). Suspensions of 0.2 g of each calcium phosphate compound with 5.0 ml of deionized water were prepared and steam sterilized in an autoclave (20 min at 121 degrees C). After sterilization the suspensions were filtered and the dried solids characterized with scanning electron microscopy, IR-spectroscopy and X-ray diffraction. The pH and calcium concentrations of the filtrates were determined with ion selective electrodes. Similar measurements were made with the same samples which were not sterilized. The sterilization procedure was found to result in the dehydration of DCPD and hydration of calcium oxide incorporated into the BCP. Solution pH was observed to change from 7.3 to 5.5 for the solutions in equilibrium with DCPD and from 8.5 to 10.6 for those in equilibrium with BCP. Minor changes both with the solid and liquid phases were found to occur during the steam sterilization of CDA. These results indicate that steam sterilization may have different effects on different calcium phosphate suspensions: it can result in dehydration of DCPD, fast hydration for CaO in BCP, but no significant effect on CDA.

Journal Article↗
PubMed2006

Male sterility in triploid dandelions: asexual females vs. asexual hermaphrodites.

Male reproductive output, pollen in plants and sperm in animals has been shown to constitute a substantial cost for many organisms. In parthenogenetic hermaphrodites, selection is therefore expected to reduce the allocation of resources to male reproductive output. However, sustained production of pollen or sperm has been observed in numerous asexual hermaphrodites. We studied the widespread production of pollen by triploid asexual dandelions, Taraxacum sect. Ruderalia, comparing rare male sterile individuals with pollen producing asexuals. We found that individuals can show plasticity in the production of pollen, but that it is nevertheless possible to distinguish between (facultatively) male sterile asexuals and male fertile asexuals. Based on evidence from genetic markers and crosses, we conclude that the male sterility in asexual dandelions is caused by nuclear genes, in contrast to the cytoplasmically inherited male sterility previously found in sexual dandelions. Male sterile lineages did not produce more seeds per flower head, heavier seeds or seeds that were more viable. However, male sterile plants did produce more seed heads and hence more seeds than pollen producing ones, indicating that they were able to reallocate resources toward seed production. Considering the difference in seed production, it remains puzzling that not more asexual dandelions are male sterile.

Genetic Markers↗
PubMed2005

Mutations in Serac1 or Synj2 cause proximal t haplotype-mediated male mouse sterility but not transmission ratio distortion.

Transmission ratio distortion (TRD) and sterility are male-specific quantitative trait phenomena associated with the mouse t haplotype. TRD occurs in t haplotype-heterozygous males and is caused by the deleterious action of distorter products on sperm bearing a wild-type responder locus. It has been proposed that t-mediated male sterility is a severe manifestation of TRD caused by homozygosity for distorter loci; thus, the distorter and sterility loci would be identical. In this, study a transgenic approach was used to identify the proximal sterility locus, tcs1 (S1), and test its role in TRD. Mice transgenic for a wild-type bacterial artificial chromosome (BAC) derived from the S1-critical region were bred onto t haplotype backgrounds. Mating results conclusively showed that the BAC is sufficient to restore fertility in otherwise sterile males. Multiple mutations were identified in the t alleles of Synj2 and Serac1, two genes in the BAC; thus, they are candidates for S1. In addition, whereas the BAC transgene rescued sterility, it had no effect on TRD. These results uncouple the proximal t haplotype sterility locus, S1, from TRD, demonstrating that S1 and the proximal distorter locus, D1, are not the same gene.

Animals↗
PubMed1979

Hybrid dysgenesis in Drosophila melanogaster: the biology of female and male sterility.

High levels of female and male sterility were observed among the hybrids from one of the two reciprocal crosses between a wild strain of D. melanogaster known as pi2 and laboratory strains. The sterility, which is part of a common syndrome called hybrid dysgenesis, was found to be associated with the rudimentary condition of one or both of the ovaries or testes. All other tissues, including those of the reproductive system were normal, as were longevity and mating behavior. The morphological details of the sterility closely mimic the agametic condition occurring when germ cells are destroyed by irradiation or by the maternal-effect mutation, grandchildless. We suggest that sterility in hybrid dysgenesis is also caused by failure in the early development of germ cells. There is a thermo-sensitive period beginning at approximately the time of initiation of mitosis among primordial germ cells a few hours before the egg hatches and ending during the early larval stages. Our results suggest that hybrid dysgenesis, which also includes male recombination, mutation and other traits, may be limited to the germ line, and that each of the primordial germ cells develops, or fails to develop, independently of the others. This hypothesis is consistent with the observed frequencies of unilateral and bilateral sterility, with the shape of the thermosensitivity curves and with the fact that males are less often sterile than females. The features of this intraspecific hybrid sterility are found to resemble those seen in some interspecific Drosophila hybrids, especially those from the cross D. melanogaster X D. simulans.

Animals↗
PubMed1989

Delayed cerebrospinal fluid sterilization in infants with Hemophilus influenzae type b meningitis.

Cerebrospinal fluid (CSF) sterilization after greater than 24 h of intravenous antibiotic therapy (delayed CSF sterilization) was noted in two infants treated with ceftizoxime and ceftazidime for bacterial meningitis. A case-control study was conducted of children between 6 w and 6 y of age treated between 1975 and 1985 at one institution for bacterial meningitis to determine risk factors for delayed CSF sterilization. Hemophilus influenzae type b was isolated from all children (n = 5) with delayed CSF sterilization, compared with only 78% of all children in the study (n = 83). In children with H. influenzae type b disease, children less than 6 mo of age were at higher risk than older children for delayed CSF sterilization (odds ratio = 7.5, 95% confidence limits = 1.4, 40.0). Factors not associated with delayed CSF sterilization included time of follow-up lumbar puncture, CSF total or differential white blood cell count, and CSF protein and glucose concentrations. Despite the in vitro antimicrobial susceptibility of H. influenzae type b to ceftizoxime and ceftazidime, delayed CSF sterilization may occur in infants receiving these antibiotics for bacterial meningitis.

Age Factors↗
PubMed2004

Irradiation of Anastrepha obliqua (Diptera: Tephritidae) revisited: optimizing sterility induction.

The effects of irradiation doses increasing from 0 to 100 Gy (1 Gy is energy absorbed in J kg(-1) of irradiated material) on fertility, flight ability, survival, and sterile male mating performance were evaluated for mass-reared Anastrepha obliqua (Macquart). High sterility values (> 98.2%) for irradiated males were obtained for doses as low as 25 Gy. Egg hatch was inhibited for irradiated males crossed with irradiated females at a low dose of 20 Gy. However, we estimated that to achieve 99.9% sterility (standard goal of many sterile insect technique programs), irradiation doses had to be increased to a dose between 50 and 75 Gy. At doses of 25 Gy and greater, we observed a decreasing trend in adult flight ability and an increasing trend in adult mortality. Such differences were greater for pupae irradiated at a young age compared those irradiated 24 h before emergence. Our single most relevant finding was that sterility induction (i.e., oviposition of nonfertilized eggs) was two times greater for males irradiated at low doses (40 Gy) than for males irradiated at high doses (80 Gy) when used at a 3:1:1 sterilized male to fertile male to fertile female ratio. Males irradiated at high doses may have been outcompeted by unirradiated males when courting unirradiated females. Implications of our findings for sterile insect technique programs are discussed.

Animals↗