SEARCH · Search PubMed

Results for “STEAM”

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.

SourceResearch connectionFrom yearThrough year

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

At least 1,099 records · Page 61Linked to original sources

PubMed1996

Mercury release during autoclave sterilization of amalgam.

Natural teeth are an invaluable teaching tool for preclinical instruction in operative dentistry and endodontic techniques. Cavity preparation in teeth containing amalgam restorations is a realistic simulation of an often experienced clinical situation. As various pathogens are contained in saliva, teeth must be disinfected before use by students. The purpose of this study is to indirectly evaluate whether mercury vapor is released from amalgam restorations in such teeth during steam autoclave sterilization. Mercury vapor detection, sample mass changes and x-ray fluorescence data were collected from experimental steam autoclave sterilization of amalgam samples sealed in autoclave bags. All of the data showed evidence of mercury vapor generation coincident to steam autoclave sterilization. Mercury vapor levels within the room where amalgam was exposed to steam autoclave sterilization reached levels that constitute an unnecessary health risk to dental personnel. The volume of amalgam tested simulated that contained in 175 amalgam restored teeth. Initial venting of the autoclave chamber produced mercury vapor concentrations significantly in excess of OSHA vapor concentration ceiling levels. Thus, the use of a steam autoclave for sterilization of amalgam containing teeth for use in preclinical laboratory exercises may be harmful to personnel involved.

Air Pollutants, Occupational↗

PubMed1993

Kinetics of peptide hydrolysis and amino acid decomposition at high temperature.

Dipeptide hydrolysis and amino acid decomposition appear to follow a first-order rate law. The hydrolysis rate increases exponentially with increasing temperature in aqueous solution at both 265 atm and water steam pressures over the temperature range of 100 to 220 degrees C. Dipeptide hydrolysis has a lower apparent activation energy at 265 atm (44.1 KJ/mol) than at water steam pressure (98.9 KJ/mol). At lower temperatures (<200-220 degrees C), the rate of peptide bond hydrolysis is faster at 265 atm than at water steam pressure. At higher temperatures (>200-220 degrees C), however, peptide bond hydrolysis is slower at 265 atm than at water steam pressure. In aqueous solution, amino acid decomposition rates also increase exponentially with increasing temperature. Amino acid decomposition rates are much higher at 265 atm than at water steam pressure over the entire temperature range investigated.

Alanine↗

PubMed2004

Characterization and taste-masking evaluation of acetaminophen granules: comparison between different preparation methods in a high-shear mixer.

The aim of this study was to prepare and to investigate acetaminophen taste-masked granules obtained in a high-shear mixer using three different wet granulation methods (method A: water granulation, method B: granulation with a polyvinylpyrrolidone (PVP) binding solution and method C: steam granulation). The studied formulation was: acetaminophen 15%, alpha-lactose monohydrate 30%, cornstarch 45%, polyvinylpyrrolidone K30 5% and orange flavour 5% (w/w). In vitro dissolution studies, performed at pH 6.8, showed that steam granules enabled the lower dissolution rate in comparison to the water and binding solution granules; these results were then confirmed by their lower surface reactivity (D(R)) during the dissolution process. Moreover, the results of the gustatory sensation test performed by six volunteers confirmed the taste-masking effects of the granules, especially steam granules (P<0.001). Morphological, fractal and porosity analysis were then performed to explain the dissolution profiles and the results of the gustatory sensation test. Scanning electron microscopy (SEM) analysis revealed the smoother and the more regular surface of steam granules with respect to the samples obtained using methods A and B; these results were also confirmed by their lower fractal dimension (D(s)) and porosity values. Finally, differential scanning calorimetry (DSC) results showed a shift of the melting point of the drug, which was due to the simple mixing of the components and not to the granulation processes. In conclusion, the steam granulation technique resulted a suitable method to comply the purpose of this work, without modifying the availability of the drug.

Acetaminophen↗

PubMed1999

Quality assessment of localization technique performance in small volume in vivo 1H MR spectroscopy.

A new phantom and evaluation method for experimental evaluation of 1H-magnetic resonance spectroscopy single volume localization techniques regarding signal contamination (C), defined as the part of the signal originating outside the volume of interest, is presented. The quality assessment method is based on a spherical phantom with an oil/water interface in order to reduce susceptibility effects, and applied for stimulated-echo acquisition method (STEAM) and spin-echo (SE) sequences, echo times of 270, 135, and 10 ms, and cubic volumes of interest (VOI) of 1(3), 1.5(3), 2(3), 2.5(3), and 3(3) cm3. To be able to mimic measurements of the contamination in three dimensions the physical gradients representing the three orthogonal directions for slice selection were shifted in the pulse sequences. Contamination values in one dimension differed between 6.5% and 8.4% in SE sequences, and between 0.7% and 13.8% in STEAM sequences. In STEAM sequences a decrease of C with increasing VOI size was observed while SE sequences showed comparable C values for the different VOI sizes tested. The total contamination in three dimensions were 19% and 18% in SE and STEAM sequences with a TE of 270 ms, and 7% in a STEAM sequence with a TE of 10 ms, respectively. The presented evaluation method is easily applied to the new phantom and showed high reproducibility.

Artifacts↗

PubMed1992

Supercritical carbon dioxide extraction of 2,4-dichlorophenol from food crop tissues.

Supercritical fluid extraction with carbon dioxide has been found to be effective for the isolation of residue levels (0.1-1 ppm) of 2,4-dichlorophenol from selected plant tissues. The 2,4-dichlorophenol residues were incompletely extracted with supercritical CO2 alone, since a substantial fraction of the 2,4-dichlorophenol was covalently attached to the plant matrix. An acid pretreatment procedure was developed to partially hydrolyze the plant tissue prior to extraction, releasing the bound 2,4-dichlorophenol residues. Steam distillation showed higher residue levels for field-treated straw samples. This is attributed to the greater degree of hydrolysis inherent in the steam distillation procedure. Supercritical CO2 extraction of field-treated seed samples showed higher levels of 2,4-dichlorophenol residues than did steam distillation. The supercritical fluid extractant was able to solvate 2,4-dichlorophenol residues in the interior of the seed and transport them to the surface for collection. The aqueous medium used in steam distillation was unable to penetrate the hydrophobic seed matrix to the same degree. While the actual extraction time experienced in supercritical fluid extraction was far less than that of steam distillation (45 min vs 6 h, respectively), the total sample preparation time was similar in both methods.

Carbon Dioxide↗

PubMed2001

Eradication of house dust mite from homes of atopic asthmatic subjects: a double-blind trial.

BACKGROUND: House dust mite (HDM) allergens can accumulate to very high levels in homes. From the observed sensitivity of HDMs to heat and their allergens to steam, a novel treatment of furnishings has been developed. OBJECTIVE: We sought to determine whether combined steam and heat treatment of home furnishings reduced asthmatic patients' bronchial hyperreactivity (BHR) and lowered HDM antigen loads. METHODS: The homes of 30 asthmatic subjects aged 18 to 45 years were randomly allocated into 3 groups. In groups 1 and 2 mattresses and duvets were treated with hot air (110 degrees C), followed by steam and then heat again. All their carpets were steam cleaned. Group 2 also had a special ventilation system installed above each patient's bedroom. The homes of subjects in group 3 were sham treated. Neither patient nor laboratory staff was aware of the types of treatment. Der p 1 and 2 levels in the household dust from the lounge, bedroom carpet, and beds were determined before and after treatment and then at 6 and 12 months. BHR, measured by using histamine PD(20) values, was recorded during the 4-week run-in period and at 3, 6, 9, 12 months after treatment. RESULTS: Active heat-steam treatment of homes caused a sustained reduction of Der p 1 (P =.003) and Der p 2 (P =.001) compared with no change in sham-treated group 3 homes. Patients whose homes were treated showed a 4-fold reduction in BHR at 9 months in group 1 and throughout the posttreatment period in group 2. No change was observed in the asthmatic subjects whose homes were not treated. These improvements were sustained for 12 months in the homes with bedroom ventilation units. CONCLUSIONS: A single treatment of home furnishings reduced mite allergen load to below the risk level for sensitization and improved the asthmatic patients' BHR by 4-fold.

Adolescent↗

PubMed2003

Effects of heat treatment on the nutritional value of raw soybean selected for low trypsin inhibitor activity.

1. Two broiler experimentss and a layer experiments were conducted on Kunitz trypsin inhibitor (Kti) soybeans (SB) of low trypsin inhibitor (TI) activity to determine their nutritive value when included as mash in least-cost poultry diets. 2. Experiment 1 compared chick performance on the Kti or raw SB using a commercial full-fat SB meal (FFSBM) and a solvent extracted SB meal (SBM) as controls during a 20 d experimental period. Broiler experiment 2 compared Kti and raw SB, non-steamed, or steam-pelleted with and without DL-methionine supplementation added to every treatment containing 170 g SB/kg. For each broiler experiment the levels of each SB were 70, 120 and 170 g/kg with the control birds fed only 170 g SB/kg. 3. The layer experiment, compared steam-pelleted Kti and raw SB against a non-steamed Kti and raw SB each fed at two levels (70 and 110 g/kg) x 30 replicates from 29 weeks of age for 19 weeks in a completely randomised design. Production parameters were measured when diets were formulated to contain minimum required specifications and calculated apparent metabolisable energy (AME). At the completion of each trial, 2 broiler birds from each cage and 5 layer birds per treatment were killed, weighed, and their liver and pancreas weighed. 4. Both broiler experiments indicated that production parameters on the Kti SB treatments were significantly lower (P<0.05) than on the two commercial control SB treatments. However, the Kti treatments were superior to the raw SB treatments. 5. Pancreas weight increased with increasing inclusion of both raw and Kti SB, suggesting that a TI was causing the depression in performance. The AME of the Kti SB was similar to that of commercial FFSB meal. After steam conditioning, the raw SB meal AME value of 9.5 MJ/kg dry matter (DM) was improved to 14.1 MJ/kg DM by reduced TI activity, but this AME improvement with TI activity reduction, plus the supplementation with DL-methionine on birds fed the raw SB had no effect (P>0.05) on any parameter evaluated in experiment 2. 6. The layer experiment showed that hens on the Kti SB treatments had significantly greater live weight gain (LWG), egg weight and daily egg mass than birds given raw SB. A reduced food intake (FI) was observed in the Kti treatments but egg mass was generally similar to that on the FFSB control diet, indicating that Kti SB supported excellent egg production at an inclusion of 110 g/kg. The depressed performance observed for broiler chicks suggest that younger birds are more susceptible to the effects of SB TI.

Analysis of Variance↗

PubMed2006

Changes in the content of health-promoting compounds and antioxidant activity of broccoli after domestic processing.

The effect of water- and steam-cooking on the content of vitamin C, polyphenols, carotenoids, tocopherols and glucosinolates, as well as on the antioxidant activity of broccoli, are reported. Flavonoids, phenolic acids, vitamins C and E, beta-carotene, lutein, and glucosinolates in domestically processed broccoli were quantified using high-performance liquid chromatography (HPLC) methods; total polyphenols were determined with Folin-Ciocalteu reagent. The antioxidant capacities of broccoli extracts were evaluated using the Trolox equivalent antioxidant capacity (TEAC) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) methods. The results indicated that steam-cooking of broccoli results in an increase in polyphenols, as well as the main glucosinolates and their total content as compared with fresh broccoli, whereas cooking in water has the opposite effect. Steam-cooking of broccoli has no influence on vitamin C, whereas cooking in water significantly lowers its content. Both, water- and steam-cooking of broccoli results in an increase in beta-carotene, lutein, and alpha- and gamma-tocopherols as compared with fresh broccoli. Similar effects of steaming and water-cooking of broccoli on their antioxidant activity were observed.

Antioxidants↗

PubMed2002

Thermal regeneration of granular activated carbons using inert atmospheric conditions.

Thermal regeneration is increasingly being used for the recovery of field-spent granular activated carbons (GAC) generated by the water treatment industry. Despite its commercial success, conventional methods using oxidising conditions (usually steam) are known to damage the porosity of the regenerated carbons, thus reducing their adsorption capacity and economic value. This paper presents a comparative investigation into the benefits of using inert conditions for the regeneration of field-spent GAC. For the purpose of this work, a sample of spent carbon was regenerated in nitrogen and in steam to different degrees of burn off. The resulting samples were analysed for their porosity and surface area characteristics using nitrogen gas adsorption, and for their aqueous adsorption capacities using phenol and methylene blue. Experimental results showed that steam was sightly more effective than nitrogen at regenerating the total micropore volume and BET surface area of the carbons. However, these benefits were largely counteracted by greater losses in the carbon yield and damage to the narrow microporosity. Carbons regenerated in nitrogen exhibited greater adsorption capacities for the adsorption of small molecular size compounds (phenol) from solution, while carbons regenerated in steam adsorbed larger molecular size compounds (methylene blue) more effectively. However, when product yields were taken into consideration, inert regeneration was found to produce significantly better results than steam regeneration. An optimum process temperature was determined to be 950 degrees C.

Adsorption↗

PubMed1997

Cerebral metabolic alterations in human immunodeficiency virus-related encephalopathy detected by proton magnetic resonance spectroscopy. Comparison between sequences using short and long echo times.

RATIONALE AND OBJECTIVES: The aim of this study is to evaluate comparatively the metabolic information afforded by proton magnetic resonance (MR) spectroscopy with stimulated-echo acquisition mode (STEAM) (echo time [TE], 20 mseconds) and point-resolved spectroscopy sequence (PRESS) (TE, 135 mseconds) spectra in HIV-related encephalopathy. METHODS: Sixty-three human immunodeficiency virus (HIV) patients and 8 controls were examined by single-voxel proton MR spectroscopy at 1.5 tesla, using both PRESS (TE, 135 mseconds) and STEAM (TE, 20 mseconds) sequences performed during the same MR examination, in the same volume of interest. Cerebral atrophy was quantitated using bicaudate ratio (BCR) and bifrontal ratio (BFR). RESULTS: With the STEAM (TE, 20 mseconds) spectra, mean N-acetylaspartate (NAA)/choline (Cho) and NAA/creatine and phosphocreatine (Cr-PCr) ratios are reduced in acquired immunodeficiency syndrome (AIDS) dementia complex (ADC) patients but not in neuroasymptomatics. The proportion of inositol signal is increased, that of NAA decreased in ADC patients. NAA/Cho and NAA/ Cr-PCr mean values measured with PRESS (TE, 135 mseconds) spectra are significantly reduced in ADC and neuroasymptomatic patients. Bifrontal ratio only correlates with NAA/Cr-PCr and NAA/Cho measured on the PRESS spectrum. PRESS (TE, 135 mseconds) spectra allow a definition of different metabolic patterns in HIV-related encephalopathy. At last, no correlation has been found between the NAA raw signals measured on the PRESS (TE, 135 mseconds) and STEAM (TE, 20 mseconds) spectra obtained in the same MR examination. CONCLUSIONS: STEAM (TE, 20 mseconds) spectra provide more metabolic information-namely an evaluation of glial-neuronal status-than PRESS (TE, 135 mseconds) spectra, which afford a metabolic classification of the HIV-related encephalopathy. Because both sequences afford a similar diagnostic gain, MR spectroscopy examination probably requires spectrum acquisition with both sequences.

AIDS Dementia Complex↗

PubMed1992

Systemic levels of tumor necrosis factor alpha during hemodialysis with cellulosic membranes: no effect of the sterilization procedure.

Extractable constituents of dialyzer membranes (e.g., monomers and beta-glucans) may induce the production of cytokines in vitro. We therefore studied circulating tumor necrosis factor alpha (TNF alpha) levels in 23 stable hemodialysis patients during treatment with dry Cuprophan membranes (ETO-sterilized n = 10, steam-sterilized n = 13) longitudinally over a period of 4 weeks. After 4 weeks, those 5 patients of each group showing the highest TNF alpha levels were switched to steam-sterilized, wet Cuprophan membranes. No significant increase in plasma TNF alpha was observed during hemodialysis with either ETO- or steam-sterilized dry Cuprophan membranes. A substantial TNF alpha increase (> or = 100% compared to pre-HD values), however, was observed during 14 of 84 treatment sessions. In 5 selected patients with ETO-sterilized, dry Cuprophan dialyzers, TNF alpha rose from (mean +/- SEM) 17.2 +/- 3.0 (pre-HD) to 20.9 +/- 6.2 (120 min) and 21.9 +/- 4.5 pg/ml (240 min). Corresponding levels in patients with steam-sterilized, dry Cuprophan were 16.2 +/- 5.4 (pre-HD), 21.9 +/- 6.8 (120 min), and 16.0 +/- 3.7 pg/ml (240 min), respectively. There was no difference between ETO- and steam-sterilized dialyzers. No significant reduction in mean TNF alpha plasma levels or in frequency of elevated peak levels was achieved when these patients were switched to wet Cuprophan dialyzers for another 4 weeks. It is suggested that an induction of elevated TNF alpha levels during hemodialysis is possible but is not observed regularly during treatment with Cuprophan membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellulose↗

PubMed2002

Effect of corn processing on degradable intake protein requirement of finishing cattle.

Three finishing trials were conducted to determine effect of corn processing on degradable intake protein requirement (DIP) of feedlot cattle. In Trial 1, 252 steers were fed 90% concentrate, high-moisture corn-based diets that contained 0, 0.4, 0.8, or 1.2% urea (DM basis) to provide dietary DIP values of 7.0, 8.2, 9.3, and 10.5% of DM, respectively. Nonlinear analysis predicted maximal feed efficiency at 10.2% dietary DIP (95% confidence interval was 9.9 to 13.3%). In Trial 2, 264 steers were fed 90% concentrate, steam-flaked corn-based diets that contained 0, 0.4, 0.8, 1.2, 1.6, or 2.0% urea (DM basis) to provide dietary DIP values of 4.7, 5.8, 7.0, 8.2, 9.3, and 10.5% of DM, respectively. Nonlinear analysis predicted maximal feed efficiency at 7.1% dietary DIP (95% confidence interval was 7.0 to 7.2%). In Trial 3, 90 individually-fed steers were fed 90% concentrate, dry-rolled, high-moisture, or steam-flaked corn-based diets. Urea was factored across diets at 0, 0.5, 1.0, or 2.0% of DM to provide dietary DIP values of 4.8. 6.3, 7.8, 9.2, and 10.7% for dry-rolled, 6.7,8.1,9.6, 11.1, and 12.5% for high-moisture, and 4.7, 6.1, 7.6, 9.0, and 10.5% for steam-flaked corn-based diets, respectively. For the dry-rolled corn-based diet, nonlinear analysis could not predict a requirement because feed efficiency was not improved beyond the first increment of dietary DIP, suggesting that the DIP requirement was met at 6.3% of DM. For the high-moisture corn-based diet, nonlinear analysis predicted maximal feed efficiency at 10.0% dietary DIP (95% confidence interval was 9.2 to 11.3%). For the steam-flaked corn based diet, nonlinear analysis predicted maximal feed efficiency at 9.5% dietary DIP (95% confidence interval was 9.2 to 9.5%). Our estimate of the DIP requirement for dry-rolled corn-based diets (6.3%) agrees well with past research and predicted values. Our estimate of the DIP requirement for high-moisture corn-based diets (10.1%) was very consistent between trials and higher than predicted. Our estimates of the DIP requirement for steam-flaked corn-based diets varied from 7.1 to 9.5%, with an average of 8.3% of dietary DM.

Animal Feed↗

PubMed1998

Determining the capability of a drug product to be terminally sterilized: a case study involving a heat-sensitive, oxygen-sensitive drug product.

A decision scheme for determining the capability of a finished product dosage form to be terminally sterilized was presented and followed for a heat-sensitive, oxygen-sensitive drug product (DP). Studies were conducted first in a laboratory steam sterilizer and then in a production unit. When a nonheat-sensitive steam sterilization cycle produced unfavorable loss of potency and increases in the amount of impurities, a new heat-sensitive steam sterilization cycle was investigated. An acceptable product was produced by reducing the headspace oxygen level and reducing the heat delivered to the product during terminal sterilization. The amount of sterilizing steam heat delivered to the product was reduced by reducing the allowable temperature range from set-point of the terminal steam sterilizer, and by developing a new heat-sensitive cycle. The heat-sensitive cycle, with a model based upon a known relationship of the biological indicator, product D value, and the environmental bioburden, can achieve a 10(-6) sterility assurance level when it delivers an F0 > or = 4 min. When the standard terminal sterilization model and cycle produced unacceptable levels of degradation, formulation/production changes, and terminal sterilization model and cycle modifications were explored, before the DP was directed to aseptic filling. Acceptable moist heat terminal sterilization the DP was then achieved.

Drug Stability↗

PubMed2004

Thermal resistance of Listeria monocytogenes, Salmonella Heidelberg, and Escherichia coli O157:H7 at elevated temperatures.

A continuous-flow apparatus was developed to measure thermal resistance (D- and z-values) of microorganisms at temperatures above 65 degrees C. This apparatus was designed to test whether vegetative microorganisms exhibited unusually high thermal resistance that prevented them from being completely eliminated at temperatures applicable to vacuum-steam-vacuum processes (116 to 157 degrees C). The apparatus was composed of a high-pressure liquid chromatography pump, a heating unit, and a cooling unit. It was designed to measure small D-values (<1 s). Three randomly selected organisms, Listeria monocytogenes, Salmonella Heidelberg, and Escherichia coli O157:H7 suspended in deionized water were tested in the continuous-flow apparatus at temperatures ranging from 60 to 80 degrees C. Studies showed that the D-values of these organisms ranged from 0.05 to 20 s. Heating at 80 degrees C was found to be basically the physical limit of the system. Experimental results showed that L. monocytogenes, Salmonella Heidelberg, and E. coli O157:H7 did not exhibit unusual heat resistance. The conditions used in the vacuum-steam-vacuum processes should have completely inactivated organisms such as L. monocytogenes, Salmonella Heidelberg, and E. coli O157:H7 if present on food surfaces. The complete destruction of bacteria during vacuum-steam-vacuum processes might not occur because the surface temperatures never reached those of the steam temperatures and because bacteria might be hidden beneath the surface and was thus never exposed to the destructive effects of the steam.

Chromatography, High Pressure Liquid↗

PubMed2006

Survival and growth of foodborne pathogens during cooking and storage of oriental-style rice cakes.

Fresh cooked rice cakes for retail sale are typically held at room temperature because refrigeration dramatically reduces their quality. Room temperature, high water activity, and a pH of > 4.6 provided an environment conducive to pathogen growth. To date, no studies have been published regarding survival and growth of foodborne pathogens in fresh cooked rice cakes. This study was undertaken to investigate the effect of steam cooking on foodborne pathogens and their subsequent growth in five varieties of rice cakes made from flours of regular rice, sweet rice, white rice, tapioca, and mung bean. Bacillus cereus spores were detected in white rice, tapioca, and mung bean samples. The rice cake flours were inoculated with non-spore-forming foodborne pathogens (Escherichia coli O157:H7, Salmonella enterica serovar Typhimurium, Listeria monocytogenes, and Staphylococcus aureus) or spore-forming bacteria (Bacillus cereus) and steam cooked (100 degrees C) for 30 min. Steam cooking significantly reduced (> 6 log CFU/g) non-spore-forming foodborne pathogens in all samples and inactivated spores of B. cereus by 1 to 2 log CFU/g. Although spores of B. cereus survived steam cooking and germinated during 3 days of storage at room temperature, populations in most rice cakes remained below 106 CFU/g, which is the threshold for producing toxin. Rice cakes made from mung bean flour supported growth and germination of B. cereus spores above that critical level. In mung bean rice cakes, enterotoxin production was detected by the second day, when B cereus cell populations reached about 6.9 log CFU/g. The toxin concentration increased with storage time. However, our results suggest that rapid growth of total mesophilic microorganisms by more than 7 to 8 log CFU/ml during the first day of storage produced off flavors and spoilage before B. cereus was able to grow enough to produce toxins. Therefore, steam-cooked rice cakes made from a variety of flours including mung bean flour are safe for sale for up to 1 day after storage at room temperature and are free of B. cereus toxins.

Bacillus cereus↗

PubMed2005

A burn mass casualty event due to boiler room explosion on a cruise ship: preparedness and outcomes.

The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship. Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees were brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory distress or airway protection. Six patients had >80 per cent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m2-27,000 ml/m2 body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13-20 per cent bums and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event; having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus, adequate support personnel were instantaneously to hand. Our mass casualty preparation proved useful in managing this event. Most of the patients who survived showed signs of post-traumatic stress syndrome, which was diagnosed and treated by the burn center psychology team. Despite our efforts at treating large burns (>80%) with steam inhalation, mortality was 100 per cent. Fluid requirements far exceeded those predicted by the Parkland (Baxter) formula. Abdominal compartment syndrome proved to be a significant complication of this fluid resuscitation. A coordinated effort by the facility and preparation for mass casualty events are needed to respond to such events.

Body Surface Area↗

PubMed1997

Sterilization of slide sheath anesthetic injection systems placed within sharps containers.

The purpose of this study was to evaluate the effect that two steam autoclaves and an unsaturated chemical vapor sterilizer had on killing bacterial endospores present on commercial spore strips or applied to sterile anesthetic injection systems placed within sharps containers. Three types of sterilizers were used: a gravity steam autoclave, a high vacuum steam autoclave and an unsaturated chemical vapor sterilizer. The microbial challenge for the sterilizers were Bacillus stearothermophilus spores present on commercial spore strips or drawn into and applied onto sliding sheath anesthetic injection systems with anesthetic carpules attached. Spore-soiled items were placed into the middle of sharps containers three-quarters-filled with representative clinical waste and sterilized. If, after culturing, sterilization of all test items in a group was not achieved, additional sterilization time was applied. Spore strips were killed within a single cycle of each sterilizer. Spore-soiled injection systems and carpules could not be routinely sterilized in the gravity steam autoclave or unsaturated chemical vapor sterilizers, even after three consecutive sterilization cycles. These items, however, were sterilized by exposure to a single-treatment cycle in a high-vacuum steam autoclave. Results indicate that routine sterilization of spore contaminated anesthetic carpules or injection systems could not be accomplished in a reasonable amount of time using sterilizers commonly found in dental offices.

Anesthesia, Dental↗

PubMed2006

Heated, humidified air for the common cold.

BACKGROUND: Heated, humidified air has long been used by common cold sufferers. The theoretical basis is that steam may help congested mucus drain better and heat may destroy cold virus as it does in vitro. OBJECTIVES: To assess the effects of inhaling heated water vapour (steam), in the treatment of the common cold by comparing symptoms, viral shedding and nasal resistance. SEARCH STRATEGY: In this updated review we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2005); MEDLINE (2003 to December Week 2 2005); EMBASE (July 2003 to September 2005); and Current Contents (current five years). SELECTION CRITERIA: Randomized controlled trials (RCTs) using heated water vapor in patients with the common cold or volunteers with experimentally induced common cold. DATA COLLECTION AND ANALYSIS: All the articles retrieved were initially subjected to a review for inclusion or exclusion criteria. Review articles, editorials and abstracts with inadequate outcome descriptions were excluded. Studies selected for inclusion were subjected to a methodological assessment. MAIN RESULTS: Six trials were included. Three found benefits of steam for symptom relief with the common cold (odds ratio (OR) 95% confidence interval (CI) 0.31; 0.16 to 0.60; relative risk (RR) 0.56; 95% CI 0.4 to 0.79). Results on symptom indices were equivocal. No studies demonstrated an exacerbation of clinical symptom scores. One USA study demonstrated worsened nasal resistance, while an earlier Israeli one showed improvement. One study examined viral shedding and antibody titres in nasal washings: there was no change of either between treatment and placebo groups. Minor side effects (including discomfort or irritation of the nose) were reported in some studies. AUTHORS' CONCLUSIONS: Steam inhalation are not recommended in the routine treatment of common cold symptoms until more double-blind RCT trials are conducted.

Air↗