Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Protective Devices”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed1998

[Tooth injury during intubation--diagnostic and therapeutic aspects].

This study analysis 16 cases of dental injuries occurring during endotracheal intubation. The overall rate was 1 out of 6000 cases of intubation. As expected, the upper jaw teeth are most often involved. Partial dislocations were the most common lesion, together with dental fractures. A well-documented dental evaluation before delivery of anesthetics and appropriate precautions and protective devices during intubation will prevent most dental trauma related to endotracheal intubation. Also, early use of dental and risk management services often will ensure timely resolution of such problems.

Humans↗
PubMed1985

Experimental superior vena caval placement of the Greenfield filter.

Pulmonary embolism (PE) from sources superior to the right atrium has been documented in several reports, but mechanical device protection has not been advised because of the morbidity associated with occlusion of the superior vena cava (SVC). Mechanical protection must maintain caval patency, protect against recurrent PE, and be safe. Since the Greenfield filter has fulfilled these criteria when placed in the inferior vena cava (IVC), we tested its suitability for use in the SVC in 11 dogs. Thrombus was harvested from phenolized segments of infrarenal vena cava and embolized into filters positioned in the SVC through the jugular or brachiocephalic vein under fluoroscopic guidance. Central venous pressure (CVP) was monitored before and after embolization. The dogs were allowed to recover and were followed up with monthly vena caval contrast studies and CVP measurements. After 3 months the animals were put to death and autopsies performed to determine the size of any residual thrombus and to examine the pulmonary arteries for signs of PE. Ten dogs had correct placement of the filter in the SVC; there were no perforations and no episodes of PE. CVP rose slightly after embolization into the filter but caval patency was maintained in all animals. Resolution of filter-entrapped thrombi occurred in all animals (mean initial weight = 1.02 gm, mean final weights = 0.11 gm, p less than 0.05). In the eleventh animal the filter was discharged high, with one leg perforating the brachiocephalic vein. No hemorrhage or distal embolism occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2001

Current status of carotid bifurcation angioplasty and stenting based on a consensus of opinion leaders.

OBJECTIVE: Carotid bifurcation angioplasty and stenting (CBAS) has generated controversy and widely divergent opinions about its current therapeutic role. To resolve differences and establish a unified view of CBAS' present role, a consensus conference of 17 experts, world opinion leaders from five countries, was held on November 21, 1999. METHODS: These 17 participants had previously answered 18 key questions on current CBAS issues. At the conference these 18 questions and participants' answers were discussed and in some cases modified to determine points of agreement (consensus), near consensus, (prevailing opinion), or divided opinion (disagreement). RESULTS: Conference discussion added two modified questions, placing a total of 20 key questions before the participants, representing four specialties (interventional radiology, seven; vascular surgery, six; interventional cardiology, three; neurosurgery, one). It is interesting that consensus was reached on the answers to 11 (55%) of 20 of the questions, and near consensus was reached on answers to 6 (30%) of 20 of the questions. Only with the answers to three (15%) of the questions was there persisting controversy. Moreover, both these differences and areas of agreement crossed specialty lines. Consensus Conclusions: CBAS should not currently undergo widespread practice, which should await results of randomized trials. CBAS is currently appropriate treatment for patients at high risk in experienced centers. CBAS is not generally appropriate for patients at low risk. Neurorescue skills should be available if CBAS is performed. When cerebral protection devices are available, they should be used for CBAS. Adequate stents and technology for performing CBAS currently exist. There were divergent opinions regarding the proportions of patients presently acceptable for CBAS treatment (<5% to 100%, mean 44%) and best treated by CBAS (<3% to 100%, mean 34%). These and other consensus conclusions will help physicians in all specialties deal with CBAS in a rational way rather than by being guided by unsubstantiated claims.

Angioplasty↗
PubMed2003

Is carotid angioplasty and stenting more cost effective than carotid endarterectomy?

OBJECTIVE: Carotid angioplasty and stenting (CAS) has been advocated as a minimally invasive and inexpensive alternative to carotid endarterectomy (CEA). However, a precise comparative analysis of the immediate and long-term costs associated with these two procedures has not been performed. To accomplish this, a Markov decision analysis model was created to evaluate the relative cost effectiveness of these two interventions. METHODS: Procedural morbidity/mortality rate for CEA and costs (not charges) were derived from a retrospective review of consecutive patients treated at New York Presbyterian Hospital/Cornell (n = 447). Data for CAS were obtained from the literature. We incorporated into this model both the immediate procedural costs and the long-term cost of morbidities, such as stroke (major stroke in the first year = $52,019; in subsequent years = $27,336/y; minor stroke = $9419). We determined long-term survival rate in quality-adjusted life years and lifetime costs for a hypothetic cohort of 70-year-old patients undergoing either CEA or CAS. Our measure of outcome was the cost-effectiveness ratio. RESULTS: The immediate procedural costs of CEA and CAS were $7871 and $10,133 respectively. We assumed major plus minor stroke rates for CEA and CAS of 0.9% and 5%, respectively. We assumed a 30-day mortality rate of 0% for CEA and 1.2% for CAS. In our base case analysis, CEA was cost saving (lifetime savings = $7017/patient; increase in quality-adjusted life years saved = 0.16). Sensitivity analysis revealed major stroke and death rates as the major contributors to this differential in cost effectiveness. Procedural costs were less important, and minor stroke rates were least important. CAS became cost effective only if its major stroke and mortality rates were made equivalent to those of CEA. CONCLUSION: CEA is cost saving compared with CAS. This is related to the higher rate of stroke with CAS and the high cost of stents and protection devices. To be economically competitive, the mortality and major stroke rates of CAS must be at least equivalent if not less than those of CEA.

Aged↗
PubMed2002

Cross-sectional study of the ophthalmological effects of carbon disulfide in Chinese viscose workers.

This article presents cross-sectional investigation results of ophthalmological effects for the occupational exposure to carbon disulfide of workers at a large viscose fibre factory in the middle part of China. The total of 271 exposed subjects (191 males, 80 females) and 133 workers (93 males, 40 females) not exposed to any toxic agent in the working environment underwent ophthalmological examination. The self-administered questionnaire collected data on the medical history and ophthalmological complaints during the past three months. The ophthalmologic examination included routine examination for retinal capillary anomalies and and color vision with the FM 100-Hue test method. Nearly all subjects did not use respirators, smocks or aprons, gloves or other personal protective devices during work time. The average personal CS2 exposure level in the present study was 13.7-20.05 mg/m3. The FM 100-Hue test results showed that the total error scores of the exposed group, whether male or female, were higher than that of the control, the discrimination of the green and blue zones was also impaired significantly. A fundus examination showed no retinal capillary anomalies or other serious ophthalmological symptoms that may be related to effects of CS2. In conclusion, color vision was disturbed in workers exposed to CS2, at levels below the present threshold value. Reduced color discrimination may be attributed to long-term carbon disulfide exposure and suggests that health surveillance of workers exposed to carbon disulfide should include the FM 100-Hue Test as a sensitive and easy method.

Adult↗
PubMed2004

TCD-detected cerebral embolism in carotid endarterectomy versus angioplasty and stenting of the carotid bifurcation.

PURPOSE: In this article we will review some of the issues surrounding the relationship between TCD-detected emboli and brain function and architecture, both during conventional surgical carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS). MATERIAL AND METHODS: In both procedures, the cerebral embolic load was semi quantitatively assessed and associated with clinical outcome during the procedure and after a symptom free interval within 7 days. RESULTS: In CEA, particulate emboli that occurred during the wound closure stage were associated with intraoperative stroke and stroke related death, odds ratios [OR] 2.3 95% CI 1.2-4.4, p = 0.007. In CAS, showers of microemboli that appeared at postdilatation of the stent (OR 3.2, 95% CI 1.5-6.9, p = 0.002), particulate macroembolism (relative risk [RR] 10.2, 95% CI 5.9-17.3, p < 0.001), and massive air embolism (RR 10.2, 95%CI 5.8-17.7, p < 0.001) were associated with new transient and persistent cerebral deficits. CONCLUSION: In both CEA and CAS, recording of cerebral emboli by TCD ultrasonography provides insight in the pathogenesis of procedure related adverse cerebral outcome. In several centres TCD monitoring during CEA is now accepted as a clinically relevant tool that helps the surgeon to make the operation safer. In CAS more research is needed, particularly with respect to the impact of cerebral protection devices.

Aged↗
PubMedDate not supplied

Protected carotid artery stenting (PCAS): a short medical technology assessment.

After a period of experimenting with angioplasty and stenting, carotid artery stenting under embolic protection (PCAS) is becoming a viable alternative for carotid endarterectomy (CEA). A standard literature review showed that, at January 2005, there was no evidence that PCAS is more effective than CEA. The high costs of stent and protection device makes PCAS then inferior to CEA. PCAS may be the sole possible option in patients with symptomatic carotid artery stenosis unfit for surgery, where the high risk of stroke overrides uncertainty about health effects and overrides cost-effectiveness. These are a few patients per year in Belgium. Several randomised controlled trials comparing PCAS and CEA are now recruiting patients. To have answers on key questions of cost-effectiveness, it is of paramount importance that these trials recruit and publish rapidly. The KCE (Belgian HealthCare Knowledge Center/Centre Fédéral d'Expertise des Soins de Santé/Federaal Kenniscentrum voor de Gezondheidszorg) therefore advises cooperation with these trials. Outside these trials and compassionate use in the few symptomatic patients unfit for CEA, the use of PCAS raises serious ethical questions.

Cardiovascular Surgical Procedures↗
PubMedDate not supplied

Timing of complications during carotid artery stenting. How can they be predicted?

Carotid artery stenting (CAS) is becoming increasingly common for the treatment of carotid stenosis. Accumulating data, but not randomised data, suggest that CAS has promising efficacy in preventing stroke with an acceptable rate of procedure-related complications when compared to carotid endarterectomy (CEA). However, CAS procedures can carry a risk of non-negligible complications such as cerebral embolization, cerebral hemorrhage, severe hypotension and bradycardia. These may occur after the first 24 hours. Lessons may be learned from the timing of occurrence of CAS adverse events. The most severe neurological complications are generally due to embolism and occur intraprocedurally especially during catheter, wire or sheath manipulation in the aortic arch and common carotid. These strokes, obviously, cannot be prevented by using cerebral protection devices and enhance the importance of an appropriate learning curve that includes proper material choice, patient selection, good technique and the skill of "know when to quit".

Bradycardia↗
PubMedDate not supplied

Prevalence of antibodies to Legionella pneumophila among workers exposed to a contaminated cooling tower.

A serosurvey for antibodies to Legionella pneumophila was conducted among 206 employees of a power-generating plant. L. pneumophila serotype 6 and a non-typable L. pneumophila organism were isolated from cooling-tower water specimens at the plant, and antibody titers in workers were measured using homologous antigens prepared from these isolates. For the serotype 6 water isolate, none of workers with low cooling tower exposure, 4.6% with intermediate exposure, and 7.6% with high exposure levels had titers equal to or greater than 1:128 (P less than .05, Kruskal-Wallis test). For the non-typable L. pneumophila isolate, a similar trend was observed, but differences among workers in the three exposure groups were not statistically significant. No association was observed between antibodies to L. pneumophila serotypes isolated from cooling water and workers' age, race, smoking status, or duration of job assignment. None of the study employees had findings suggesting the occurrence of L. pneumophila pneumonia since the plant had been in operation. Use of respiratory protection devices by workers exposed to aerosols from cooling towers was not recommended.

Adult↗
PubMed2001

Pattern recognition for road traffic accident severity in Korea.

An increasing number of road traffic accidents (RTA) in Korea has emerged as being harmful both for the economy and for safety. An accurately estimated classification model for several severity types of RTA as a function of related factors provides crucial information for the prevention of potential accidents. Here, three data-mining techniques (neural network, logistic regression, decision tree) are used to select a set of influential factors and to build up classification models for accident severity. The three approaches are then compared in terms of classification accuracy. The finding is that accuracy does not differ significantly for each model and that the protective device is the most important factor in the accident severity variation.

Accidents, Traffic↗
PubMed2006

Bedside safety rails: assessment of strength requirements and the appropriateness of current designs.

Bedside safety rails are used extensively throughout hospitals and residential care environments as a safety device to protect people against the risk of falling out of bed. However, several adverse incidents involving body entrapment have been linked to their use, which have resulted in serious injury to the bed occupants and, in more extreme cases, fatalities. Internationally agreed standards (i.e. European Committee for Standardisation (CEN) standards) for the design and testing of bed rails have recently been developed and are targeted at improved safety requirements (European Committee for Standardisation 19972000). The purpose of the present study was to: 1) determine whether the CEN test procedure for assessing bed rail strength and rigidity requirements is consistent with human force exertions to which bed rails may be exposed; 2) carry out loading tests on bed rails currently in use throughout the UK to determine whether they comply with the current safety recommendations proposed by the CEN standards.A laboratory study was conducted to determine the force exertions of 20 participants performing seven tasks (including activities of both bed occupants and care providers), which were considered representative of the forces to which bed rails could be exposed during normal use. Forces exerted by participants were measured using a force platform and distortions of the bed rails leading to potential entrapment zones were measured using linear displacement transducers. Static load tests were then conducted, in which incremental point loading was applied at the most adverse points on each of nine different bed rails (commonly used in UK nursing and residential care homes) in accordance with the test procedure detailed in the current CEN standards. Maximum static forces exerted by participants were found to range between 250 N and 350 N, which were within the 500 N force tolerance requirements set by the standards. Dynamic tasks involving 'rolling aggressively' against the bed rail produced the highest peak force of 722 N. None of the bed rails included in this study met the requirements of the CEN test procedures, principally due to horizontal lateral displacements being in excess of 50 mm for a 500 N applied force and/or the bed rails' inability to withstand inward horizontal forces of 500 N. Bed rails used with divan beds were often unable to withstand forces greater than 300 N due to turning moments exceeding the bed rail's restraining mechanism. Current CEN standards for assessing the strength and rigidity of bedside safety rails appear to be consistent with the human forces that might arise as a consequence of the normal movement and activities of a bed occupant or care provider. Although compliance with existing standards is not compulsory, findings from the tests carried out on the selection of bed rails in current use throughout the UK highlight the need for improvements in the design and manufacture of bed rails.

Accidental Falls↗
PubMed2001

Age and noise-induced hearing loss.

The purpose of the study was to evaluate the effect of noise, age and confounders in noise-induced hearing loss (NIHL). Information about work exposure, the use of hearing protective devices, audiogram, environmental and biological factors was collected from 406 paper mill workers exposed to noise levels of 91-94 dB(A), 124 forest workers exposed to noise levels of 96-99 dB(A) and 176 shipyard workers exposed to noise levels 95-97 dB(A). In addition to noise exposure, we collected the following confounders: smoking habits, serum cholesterol, systolic or diastolic blood pressure and use of analgesics. Subjects were classified based on median values, into high- and low-risk groups. The confounders were a significant source of hearing loss (HL) in younger and elderly groups of subjects, serum cholesterol level being the most important. In risk analysis the confounders partly masked the effects of noise in the development of HL. For subjects with less than two confounders, occupational noise exposure determined the development of NIHL. As the number of confounders increased, the noise exposure was overruled by these factors in the development of HL. In analysis where the subjects were matched with pairs by age, exposure, blood pressure and serum cholesterol level, the elderly subjects were more susceptible to NIHL than younger subjects. Factors independently but causally related to age were important in the development of NIHL among workers exposed to noise levels below 98 dB(A).

Adult↗
PubMed2001

Post-stroke violent adventitial movement responsive to levo-dopa/carbi-dopa therapy.

Previous reports in the literature concerning cerebrovascular accident have illustrated cases of post-stroke tremor. Treatments of these studies have varied. Trials of levo-dopa have been reported in two such cases. This case study reports on a case of a patient with a left thalamic, left superior cerebellar artery infarction with a lacunar infarction in the basal ganglia. The patient developed a violent tremor/movement disorder which was unresponsive to haloperidol. With this failure, and with the evidence of a basal ganglion lesion, levo-dopa/carbi-dopa was introduced as an intervention. The amplitude of the tremor was dramatically reduced, with protective devices removed, and with complete cessation of the tremor at rest. The medication was withdrawn and reintroduced with a reduction and subsequent resolution of the symptoms. A discussion of the previous studies of movement disorder with cerebrovascular accident is included.

Aged↗
PubMed2006

Lung function in Pakistani wood workers.

The lung function impairment is the most common respiratory problem in industrial plants and their vicinity. Therefore, the purpose was to study the affects of wood dust and its duration of exposure on lung function. This was a matched cross-sectional study of Spirometry in 46 non-smoking wood workers with age range 20 - 60 years, who worked without the benefit of wood dust control ventilation or respiratory protective devices. Pulmonary function test was performed by using an electronic Spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and Maximum Voluntary Ventilation (MVV) in wood workers relative to their matched controls. This impairment was increased with the duration of exposure to wood industries. It is concluded that lung function in wood workers is impaired and stratification of results shows a dose-response effect of years of wood dust exposure on lung function.

Air Pollutants, Occupational↗
PubMed2006

Determination of elastomeric foam parameters for simulations of complex loading.

BACKGROUND: Finite element (FE) analysis has shown promise for the evaluation of elastomeric foam personal protection devices. Although appropriate representation of foam materials is necessary in order to obtain realistic simulation results, material definitions used in the literature vary widely and often fail to account for the multi-mode loading experienced by these devices. This study aims to provide a library of elastomeric foam material parameters that can be used in FE simulations of complex loading scenarios. METHOD OF APPROACH: Twelve foam materials used in footwear were tested in uni-axial compression, simple shear and volumetric compression. For each material, parameters for a common compressible hyperelastic material model used in FE analysis were determined using: (a) compression; (b) compression and shear data; and (c) data from all three tests. RESULTS: Material parameters and Drucker stability limits for the best fits are provided with their associated errors. The material model was able to reproduce deformation modes for which data was provided during parameter determination but was unable to predict behavior in other deformation modes. CONCLUSIONS: Simulation results were found to be highly dependent on the extent of the test data used to determine the parameters in the material definition. This finding calls into question the many published results of simulations of complex loading that use foam material parameters obtained from a single mode of testing. The library of foam parameters developed here presents associated errors in three deformation modes that should provide for a more informed selection of material parameters.

Cellulose↗
PubMed2006

Design of optimal noise hazard control strategy with budget constraint.

An analytical design procedure to determine optimal noise hazard control strategies for industrial facilities is presented. Its objective is to determine a set of appropriate noise controls to eliminate or reduce noise levels so that workers' daily noise exposure does not exceed a permissible level. From a given noise control budget, engineering controls will be firstly implemented, followed by administrative controls, and then the use of hearing protection devices. Six optimization models are developed and sequentially applied to select appropriate noise controls without exceeding the budget. Numerical examples are presented to demonstrate the application of the proposed design procedure.

Hearing Loss, Noise-Induced↗
PubMed2001

Percutaneous intervention of old degenerated saphenous vein grafts.

The treatment of failing bypass grafts is difficult because repeat surgery carries a higher mortality rate than a first operation. Percutaneous intervention is more difficult because mechanical manipulation of these soft, friable atherosclerotic plaques have been associated with a significant rate of distal embolization, myocardial infarction, late restenosis and death. Balloon angioplasty alone has proven to have serious limitations in the treatment of older degenerated saphenous vein grafts (SVG). Although directional atherectomy yielded a higher angiographic success in a randomized trial, the restenosis rate was similar, and the procedural complications higher. The transluminal extraction catheter (TEC) has also shown significant limitations for the treatment of degenerated or thrombotic vein grafts with a significant procedural complication rate. A randomized trial comparing stenting versus balloon angioplasty in focal SVG lesions showed a higher freedom from major adverse cardiovascular events in the stent group, but there was no significant difference in the angiographic restenosis rates. More recently, rheolytic thrombectomy and mechanical thrombolysis have proven useful in treating thrombotic lesions in SVG. In addition, the recent development of distal protection devices appears very promising and will probably contribute to decreased distal embolization during percutaneous revascularization of these conduits.

Journal Article↗
PubMed1980

Air contaminants encountered by firefighters.

The concentrations of eight air contaminants suspected of causing acute and chronic health problems for firefighters were measured in over 200 fires in the City of Boston using a personal air sampler. Threatening concentrations of both carbon monoxide and acrolein were found in a small proportion of the fires. Less hazardous levels of hydrogen chloride, hydrogen cyanide, nitrogen dioxide and carbon dioxide were also noted. Benzene was found in most fires, but at concentrations well below those expected to cause acute injury. The air sampling data have application in treatment of smoke inhalation victims, development of firefighting strategies and selection of respiratory protection devices.

Air Pollutants↗