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PubMed1978

[Effects of mode of food sterilization on mineral absorption in germ-free and conventional rats].

Minéral balances of P, Ca, Mg, Na, K, Mn, Fe and Cu were determined for three groups of holoxenic rats (CV) fed a non sterilized (CVN), steamsterilized (CVA) or irradiated (CVI) diet and for two groups of axenic (GF) rats fed a steam-sterilized (GFA) or irradiated (GFI) diet. In the group of CV rats as compared to CVN group of rats, the CVA and CVI rats retained less Cu and more Fe and Mn, their urinary excretion of P and Mg was higher and they retained less Mg. Comparison between CV and GF rats showed that the apparent absorption and retention of Ca, P, Mg, Mn, Cu were higher in GF than in CV rats. On the contrary, the apparent absorption of Na and K was lower in GF than in CV rats. However, the observed differences were modified by the mode of diet sterilization. Thus, with respect to the apparent absorption of Na, K, Mn and urinary excretion of Mg, the differences between CV and GF rats were larger when the diet was irradiated than when it was steam-sterilized. On the contrary, the apparent digestibility and urinary excretion of Mg, the apparent absorption and retention of Fe were more modified when the diet was steam-sterilized than when irradiated. For some parameters of the metabolism of Na, K, Fe, Mn, Mg, and P measured in GF rats, the differences observed between GFA and GFI rats were larger than in CV rats. Accordingly, the mode of sterilization is liable to modify the metabolism of some minerals and the microbial flora of the digestive tract is capable of modifying this action.

Animal Feed↗

PubMed1995

The Otto Aufranc Award. Impact of gamma sterilization on clinical performance of polyethylene in the hip.

Despite studies to determine their causes, significant variations in polyethylene acetabular component wear rates, radial cracking of component rims, and occasional delamination cannot be explained. A subsurface white band frequently occurs in such damaged components. These damaged components often are gamma sterilized. To date, the origin of the band and its effect on polyethylene chemical and mechanical properties, and hence, clinical performance, have not been confirmed, and correlations between radiation sterilization and clinical wear have not been made. By developing techniques for polyethylene retrieval testing and rating, chemical analysis, and mechanical analysis, this research has determined that gamma sterilization in air alters the chemical and mechanical properties of polyethylene over time, resulting in high subsurface oxidation, reduced ductility, and reduced strength. Gamma sterilization-induced oxidation is found to be most severe in the subsurface region of components, and coincides with zones of significantly reduced strength and ductility. This chemical and mechanical property degradation is time dependent and is not typically visible until after 3 years' postirradiation. The presence of the subsurface white band significantly correlates with clinical cracking and delamination observed in retrieved components. Wear of the retrieved components often is observed to have progressed into this heavily oxidized, weakened, and embrittled zone. A method for accelerated aging shows that irradiating in air causes oxidation damage in polyethylene components that is not seen with other sterilization methods. Modifications of gamma sterilization techniques to minimize this damage are discussed.

Biomechanical Phenomena↗

PubMedDate not supplied

Sterilization among currently married men in the United States, 1991.

Data from the 1991 National Survey of Men indicate that about 12% of married men aged 20-39 have had a vasectomy and about 13% are married to a woman who is sterilized. Multivariate analyses indicate that the likelihood of sterilization rises with husband's age, wife's age, duration of marriage and number of children. Black couples are significantly less likely than white couples to rely on sterilization, and interracial couples are less likely than same-race couples to be sterilized. The likelihood of reliance on vasectomy rather than tubal ligation also rises with husband's age, while black men are significantly less likely than white men to elect male over female sterilization. Use of male sterilization is strongly associated with having had a recent contraceptive failure while using a male method.

Adult↗

PubMed1994

The ability of biological indicators to detect sterilization failures.

The purpose of this study was to determine if a delay in analyzing biological indicators (BI's) after heat-processing prevents detection of sterilization failures. Sets of various types of BI's were processed through sublethal conditions in a steam, chemical vapor or dry heat sterilizer. Portions of each set of BI's were then analyzed for live spores immediately, after a 7-day delay at 27 degrees C, after a 7-day delay at 37 degrees C and in one instance after a 3-day mail delay. Of the 486 BI's exposed for sublethal times in steam at 250 degrees C, 483 (99.4%) exhibited spore growth (sterilization failure) after the 3-7 day delays before analysis. Of the 200 BI's exposed for sublethal times in the chemical vapor sterilizer, 193 (96.5%) exhibited spore growth after 7-day delays before analysis. All of the 120 (100%) BI's exposed for sublethal times in a static air dry heat sterilizer at 320 degrees F showed growth after 7-day delays before analysis. These results indicate that the delays before BI analysis described in this study do not cause any predictable pattern of preventing detection of sterilization failures.

Bacillus subtilis↗

PubMed1993

Failure of female sterilization at Ramathibodi Hospital: a 20-year review (1969-1988).

The Department of Obstetrics and Gynaecology, Ramathibodi Hospital, has offered female sterilization services since 1969. There were 30,856 cases of sterilization in the last 20 years. Thirty-seven women became pregnant following sterilization (0.12%). The failure rate after laparoscopic and minilaparotomy technique was 0.19 per cent and 0.20 per cent respectively, and the failure rate of postpartum sterilization was only 0.02 per cent. The failure occurred from 3 to 106 months after sterilization. The majority of intrauterine pregnancies occurred within 12 months, while ectopic pregnancy occurred at different periods. Ectopic pregnancies occurred in 18.9 percent of the failure cases. The ectopic pregnancy rate following laparoscopic and minilaparotomy technique was 0.05 and 0.03 per cent respectively. No ectopic pregnancy was found after failure of postpartum sterilization in this series.

Adult↗

PubMed1994

[The efficiency of sterilization methods for different soils].

Three different soil types (two sandy materials and one till soil type) were sterilized with 14 different sterilization methods or variations. The cation-exchange capacity and specific surface of the soil samples were chosen as control parameters of physico-chemical modifications in the soils. Incubation of soil samples in the presence of Na-azide and HgCl2, in addition to tyndallization and fractionated heating of soil lead to a significant reduction of microorganisms. UV radiation and alternating freezing and thawing of soil had no influence on the number of microorganisms. The application of mercury-II-chloride did not lead to the expected sterilization, especially with till. A sterilization of soil is possible by using formaldehyde and ethylene oxide gassing, in addition to autoclaving and gamma radiation. No microorganisms could be detected in the soils after application of these sterilization methods. The cation exchange capacity of the soils was only slightly influenced with these methods. The use of gamma radiation seems to be the best method for sterilization of soils.

Bacteria↗

PubMed1993

Sterilization processes. Meeting the demands of today's health care technology.

Universal Precautions dictate sterilization for all invasive equipment that break the blood barrier; however, current methods of sterilization, such as steam and ethylene oxide gas (ETO), are not compatible with many of the delicate, heat-sensitive surgical instruments used in modern health care. In addition, traditional sterilization methods are often too time consuming for practical use in the operating room. Clearly, new sterilization processes need to be developed. In this article, the criteria modern sterilization processes must meet and how some manufacturers plan to meet this challenge are discussed. In addition, the pros and cons of using peracetic acid (the newest sterilization process currently available) are examined.

Equipment Contamination↗

PubMed1995

[Effects of different sterilization procedures on degree of oxidation of ultra-high molecular weight polyethylene].

We investigated the influence of different sterilization techniques on the degree of oxidation of UHMWPE. Oxidation effects were documented by infrared spectroscopy. The UHMWPE was sterilized with the aid of gamma radiation (2.5 Mrad) in air, gamma radiation in argon, ethylene oxide and autoclaving. Non-sterilized UHMWPE served as control material. The results showed significant differences for the various sterilization techniques employed. The highest degree of oxidation was seen after autoclaving, but gamma radiation was also associated with a significant degree of oxidation. Using gamma radiation in argon, the degree of oxidation was significantly reduced. Following sterilization with ethylene oxide, no oxidation was to be found. In view of these facts, UHMWPE should be sterilized only with ethylene oxide or with gamma radiation in argon.

Humans↗

PubMedDate not supplied

Effect of repeated sterilization and ultrasonic cleaning on curet blades.

PURPOSE: Instrument cleaning and sterilization are important steps in infection control. This study investigated the effect of repeated ultrasonic cleaning, cycles of autoclave or chemiclave, on the surface and cutting edge of stainless steel and carbon steel curets. METHODS: Eight carbon steel and six stainless steel Columbia #13/14 curets were cleaned or sterilized in a series of treatments by one of the following methods: ultrasonic cleaning, chemiclave sterilization, and autoclave sterilization. In addition, two carbon steel instruments were placed in an anticorrosive dip followed by autoclave. The blades of the curets were examined and photographed with the scanning electron microscope (SEM) at 200 X and 1000 X for baseline and after 2, 4, 8, 16, and 32 treatment cycles. Photographs were evaluated for visible change in surface appearance by four examiners independently. Photographs for each treatment time were compared to the baseline (pretreatment) photographs for the same instrument. They were scored as (1) no visible change; (2) slight change; or (3) moderate to major change. Changes observed were: surface pitting, corrosion products as additions to the surface, edge deterioration, or loss of structure. RESULTS: Stainless steel curets showed slight or no change after the three treatments. Carbon steel curets were affected by all treatments. The chemiclave produced slight change. The autoclave produced slight change after the fourth treatment cycle and moderate to major change after the eighth cycle. Those carbon steel instruments treated by anticorrosive dip followed by the autoclave showed pronounced change after 16 or 32 cycles. The most varied results were from the ultrasonic cleaner; one blade showed moderate to major change after only four cycles, the other showed slight change at that point and major change only after 32 cycles. CONCLUSION: With stainless steel curets, ultrasonic cleanings or sterilization with autoclave or chemiclave can be used without visibly affecting the cutting edge. With carbon steel instruments, chemiclave is the least damaging sterilization method followed by anticorrosive treatment before autoclaving. Use of the autoclave without the anticorrosive pretreatment or use of an ultrasonic cleaner negatively affects the integrity of the surface and cutting edge of these instruments.

Corrosion↗

PubMedDate not supplied

Increased uterine and ovarian vascular resistance following Filshie clip sterilization: preliminary findings obtained with color Doppler ultrasonography.

The effect of Filshie clip sterilization on uterine and ovarian circulation was studied with color Doppler ultrasonography in 16 women before and twice after the operation. As a whole, the vascular resistance was slightly raised in the largest uterine artery and in the fundal parts of the uterine arteries; likewise in the ovarian arteries 2 days after sterilization. The resistance in the uterine arteries approached the presterilization level at 3 months after the operation, although these changes were not statistically significant. Two women had pelvic pain in the first days after the procedure, and they were compared with the symptom-free patients. Two days after sterilization, the patients with pain had significantly higher vascular resistance in all parts of the uterine arteries as compared to the symptom-free patients. After 3 months the difference had decreased in the largest uterine arteries and in the middle parts of the uterine arteries, but in the fundal parts the resistance was still higher than before sterilization. Vascular resistance in the ovarian arteries was increased in both groups, although the elevation was more pronounced in patients with pain. These preliminary findings imply that sterilization may cause an increase in the local vascular resistance, which is measurable by color Doppler sonography.

Adult↗

PubMed1976

The inheritance of radiation induced semi-sterility in Rhodnius prolixus.

Eggs from crosses of 40 adult male R. prolixus irradiated with 6K rad gamma-rays with normal females had a mean fertility of 23.9%, only 2 crosses being completely sterile. The 86 F1 progeny of both sexes, when outcrossed with normal mates, had a mean egg fertility of 12.6;, and 43 of these matings were completely sterile. Twenty-eight "F2" bugs reared from F1 X normal crosses were mated with normal partners and had a mean fertility of 44.6%, 6 of them being fully fertile, a reversal towards normal fertility. Cytogenetic examination of F1, "F2" and "F3" males showed that these changes in fertility correlated well with the degree of chromosomal abnormality found. The very high recovery rate of translocations in F1 generation males can be related to the holocentric chromosomes of these bugs which precludes the formation of dicentric chromosomes which are inviable in monocentric species. In F1 and "F2" males the majority of one bug was found with a ring of IV chromosome association and it is suggested that chromosome morphology, combined with a low chiasma frequency, favours chain association. Most chain multivalents showed linear orientation which may lead to duplication deficiencies and zygotic death. However, "parellel", "indifferent" and the more stable "convergent" modes of chain orientation were also all observed indicating that survival of some translocations in this species may be possible. The survival to the "F2" generation of chromosomal fragments confirmed the holocentric nature of triatomine chromosomes. It is suggested that semi-sterile males would prove more effective than releases of completely sterile males for reducing wild populations of R. prolixus, because of the delayed effects of sterilizing radiation consequent upon the holocentric structure of triatomine chromosomes.

Animals↗

PubMed1980

Technical failures in tubal ring sterilization: Incidence, perceived reasons, outcome, and risk factors.

Six centers participated in comparative studies of female sterilization conducted by the international Fertility Research Program. The incidence of technical failures (or failed attempts) was compared between patients sterilized with the tubal ring and those sterilized with other tubal occlusion techniques. The tubal ring was associated with a higher failure rate than electrocoagulation, the Rocket clip, or the modified Pomeroy technique. Of 1,035 tubal ring sterilizations, there were 38 technical failures. Reasons given by the operators for the failures, by frequency of occurrence, were surgical complications, conditions preexisting in the patients, and problems with the instruments. Most of these failures were remedied by changing to other techniques. In two patients, the procedure was completed by changing the approach from laparoscopy to laparotomy. In five others, sterilization was not completed. Case-control analysis was performed and three risk factors were delineated: obesity, prior use of an intrauterine contraceptive device and previous abdominal operations.

Abdomen↗

PubMedDate not supplied

Sexual adjustment to tubal sterilization.

Sexual adjustment after laparoscopic sterilization has been investigated in a Danish population. The study comprises 659 patients who underwent laparoscopic sterilization during the 4-year period 1980-1983. The study focused on libido, coital frequency, coital enjoyment, lack of excitement, sexual life and feelings of femininity after sterilization in one group of patients satisfied with the sterilization and in another group dissatisfied with the decision to undergo tubal sterilization. There was no difference in libido, coital frequency and sexual satisfaction between the two groups. However, a significant difference was seen between the two groups concerning lack of excitement in sexual life, perception of a more relaxed sexual life, and, finally, perception of changed femininity.

Coitus↗

PubMed1985

Safety of abortion and tubal sterilization performed separately versus concurrently.

Concurrent abortion and sterilization are preferred by many women to avoid a second hospitalization, operation, and, in some instances, general anesthesia. Several authors have shown concern, however, that the two procedures carry a higher risk of morbidity when performed concurrently versus separately. To determine whether the concurrent performance of sterilization and induced abortion is as safe as the two procedures performed separately, we selected women undergoing these procedures from two separate multicenter, prospective, national United States studies: the Joint Program for the Study of Abortion and the Collaborative Review of Sterilization. Using standard definitions of major morbidity, we calculated the crude rate of one or more major complications to be 0.9% for the abortion-only group, 1.7% for the group concurrent abortion and tubal sterilization. Thus our data suggest that performing concurrent abortion and sterilization is as safe as performing those procedures separately.

Abortion, Induced↗

PubMed1985

Long-term risk of menstrual disturbances after tubal sterilization.

We analyzed data from the Walnut Creek Contraceptive Drug Study to compare the menstrual characteristics of 719 women who had tubal sterilizations and 1083 women whose partners had undergone a vasectomy. Study participants were enrolled from 1968 to 1972 and followed up through 1976. The tubal sterilization group had slightly increased, though in most instances not statistically significant, risks of moderate to severe menstrual cramps and adverse menstrual bleeding. At follow-up intervals longer than 2 years, the tubal sterilization group had significantly increased risks of abnormal menstrual cycles and combinations of two or more adverse menstrual outcomes. Tubal sterilization was not associated with an increased risk of premenstrual symptoms. These findings suggest that the types of tubal sterilization procedures which were performed during the early 1970s possibly carry some increased risk of menstrual disturbances, particularly abnormal cycles, and that it may take more than 2 years for the increased risk to become apparent.

Adolescent↗

PubMed1991

Acute pelvic inflammatory disease after surgical sterilization.

STUDY OBJECTIVE: Physicians are very cognizant of the possibility of pregnancy after surgical sterilization, but the potential for acute pelvic inflammatory disease (PID) is thought to be rare. This study was undertaken to determine if upper tract PID occurred more frequently than previously reported in patients remote from surgical sterilization. DESIGN: Retrospective review of hospitalized patients with the primary discharge diagnosis of PID. SETTING: Urban, university hospital. PARTICIPANTS: Three hundred sixty-four hospitalized patients with the primary discharge diagnosis of PID over a six-year study period. MEASUREMENTS AND MAIN RESULTS: Patients' age; gynecologic histories and diagnoses; and laboratory, clinical, and surgical findings were noted. Twenty-three cases of acute PID were identified in 21 patients previously sterilized (6%). Nine of the 23 cases had systemic toxicity warranting surgical evaluation; 18 of the 23 cases were admitted from the emergency department. Mean statistical characteristics of the study group were age, 27.3 +/- 0.8 (SE) years; time interval from sterilization, 49.8 +/- 7.4 months; WBC 15,000 +/- 1,200; and temperature, 38.0 +/- 0.2 C. CONCLUSION: We conclude that acute PID may occur more frequently than previously reported in patients with prior surgical sterilization. An increased awareness of this entity is warranted.

Acute Disease↗

PubMed1991

Tubal sterilization, hysterectomy, and the subsequent occurrence of epithelial ovarian cancer.

Several hypotheses predict that tubal sterilization and hysterectomy may influence a woman's risk of developing ovarian cancer. To examine the relation between these surgeries and epithelial ovarian cancer, the authors analyzed data from the Cancer and Steroid Hormone Study, a case-control study of women aged 20-54 years. Eight population-based cancer registries in the United States identified women with newly diagnosed epithelial ovarian cancer during 1980-1982 (n = 494). A comparison sample of female residents of these eight areas (n = 4,238) was identified through random digit dialing. Women who had had tubal sterilization (relative risk (RR) = 0.69, 95% confidence interval (Cl) 0.50-0.95), a hysterectomy only (RR = 0.55, 95% Cl 0.38-0.81), or a hysterectomy with unilateral oophorectomy (RR = 0.60, 95% Cl 0.31-1.17) had lower risks of ovarian cancer than did women who had never had any sterilization surgery. However, the negative associations with tubal sterilization and hysterectomy only appeared to wane after two decades. These findings may be partly explained by the screening for occult ovarian pathology that often accompanies pelvic surgery: Women whose ovaries screen as "negative" may be temporarily at low risk of being diagnosed with ovarian cancer. However, because the decreased risks persisted for so long, it is conceivable that hormonal, mechanical, or circulatory sequelae of these sterilization procedures may act to lower ovarian cancer risk.

Adult↗

PubMed1993

Long-term risk of hysterectomy among 80,007 sterilized and comparison women at Kaiser Permanente, 1971-1987.

To study the long-term risk of hysterectomy after tubal sterilization, the authors analyzed historical hospital discharge data on 39,502 parous women sterilized during 1971-1984 and 40,505 comparison women matched on age, race, parity, and interval since last birth. Sterilized women were significantly more likely than were comparison women to undergo hysterectomy (relative risk (RR) = 1.35, 95% confidence interval (CI) 1.26-1.44), especially for diagnoses of menstrual dysfunction and pelvic pain (RR = 1.88, 95% CI 1.65-2.13). Higher relative risks were not associated with greater tissue-destructive methods of tubal occlusion. Relative risks were highest for women who were young on the reference date (RR = 2.45, 95% CI 1.79-3.36 for women aged 20-24 years), but declined steadily as age increased (RR = 0.96, 95% CI 0.72-1.28 for women aged 40-49 years). In all age groups, relative risks were significantly above 1.00 after 7 years of follow-up. Reasons for elevated risks may be related to a greater willingness of sterilized women to forgo their uteruses. The emergence of greater risk in all age groups, however, prevents the authors from ruling out a possible latent biologic effect of tubal sterilization.

Adult↗