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At least 127 records · Page 7Linked to original sources
PubMed2004

Endovascular treatment of carotid artery stenosis: retrospective study of 79 patients treated with stenting and angioplasty with and without cerebral protection devices.

We evaluate the results of stenting and angioplasty on carotid bifurcation stenotic lesions using protection systems, emphasizing the indications and technical aspects. Seventy-nine patients, mean age 64.5 years were treated from February,1998 to March, 2003. All patients were included in NASCET study criteria. Forty three patients were treated without the protection systems and thirty six were treated with carotid protection filtering system (Angioguard, EPI). Technical success and 6-months carotid Doppler ultrasound follow-up showing stent patency were achieved in all patients. One major stroke and one death due to intracranial reperfusion bleeding occurred in patients treated without cerebral protection devices. Only one patient presenting hyper perfusion syndrome improving after 7 days, was found in the group treated with the cerebral protection filter mechanism, no other neurologic symptom or death occurred in this group. Stenting and angioplasty with protection systems for thromboembolic debris is a safe endovascular method to treat stenotic lesions in the carotid bifurcation with low morbidity and mortality.

Aged↗
PubMed1988

Usage of personal protective devices among Egyptian industrial workers.

A systematic random sample of 405 workers from metal, asbestos cement pipes, textile, and viscose rayon industries were interviewed using a prepared and tested questionnaire. Personal Protective Devices (PPDs), namely goggles, gloves, respirators, and ear defenders, had been distributed to all workers on the payroll and were used by 31.4%. Usage of PPDs was associated with the educational level, duration of occupation, awareness of the work hazards, and knowledge about the purpose of PPDs. Marked association was found between nonusage of PPDs and discomfort, interference with job performance, and the psychological feeling of lowering the person's prestige by the wearing of PPDs. Nonusage was also associated with lack of maintenance of the device and absence of supervision of its usage. Users were more numerous among married workers and workers with urban residence than among unmarried workers and those with rural residence, respectively. No association could be found between the rate of usage and the worker's age except for ear plugs, for which nonusage was proportional to the worker's age. The most important factors were those related to the role of the safety staff and the discomfort of the devices. Recommendations for occupational health authorities on the basis of the above evaluation are suggested.

Cooperative Behavior↗
PubMedDate not supplied

Efficacy of an intervention to promote use of hearing protection devices by firefighters.

Numerous cases of hearing loss consistent with noise-induced damage were noted among firefighters in the city of Columbia, MO. A survey of firefighting vehicles in operation showed that the firefighters were exposed to excessive noise levels and put at risk for noise-induced hearing loss (NIHL). Audiologic evaluation showed that 36 percent of the firefighters had moderate or severe hearing loss (a threshold of 40 decibels (dB) or more at 3,000, 4,000, or 6,000 hertz (Hz) in either ear). An educational program on NIHL was then carried out to increase the use of hearing protection devices (HPDs) by firefighters, followed by an evaluation of the intervention. The educational intervention successfully increased knowledge of NIHL, positive attitudes toward HPDs, and resulted in more frequent use of HPDs. After the intervention, 85 percent of firefighters regularly used HPDs compared with 20 percent before the intervention. Recommendations are made for fire departments to reduce the risk of NIHL.

Audiometry↗
PubMed1999

Respiratory protective devices: rates of medical clearance and causes for work restrictions.

BACKGROUND: There are no published data on the outcomes and benefits of medical evaluations for the use of respiratory protective devices. We, therefore, conducted a retrospective database and chart review to assess the rates of medical clearance and causes for work restrictions at a Department of Energy complex. METHODS: All workers with work restrictions or denied clearance over a one-year period were identified and their medical records abstracted. RESULTS: Of the 5,569 workers who received medical evaluation, only 71 (1.3%) received limitations on respirator use documented in their medical record. Of the 65 workers with sufficient medical records for additional analysis, 9 of the 5,569 workers (0.2%) were denied medical clearance, while 56 workers (1.1%) received work restrictions. Pregnancy was the most common cause for denying medical clearance for respirator use. Lung disease, cardiovascular disease, and claustrophobia were the most common causes for work restrictions. Physical examination and spirometry added little to the detection of relevant medical conditions. CONCLUSIONS: We conclude that few workers fail medical clearance for respirator use or receive work restrictions. Data on adverse events from respirator use are needed to help design appropriate medical evaluations and uniform criteria for work restrictions or denial of medical clearance.

Adult↗
PubMed1994

Respiratory protective devices--NIOSH. Notice of proposed rulemaking.

This proposed rule addresses NIOSH's and the Department of Labor/Mine Safety and Health Administration's (MSHA) certification requirements for respiratory protective devices. Specifically, the proposal would replace existing MSHA regulations with new public health regulations, while also upgrading current testing requirements for particulate filters. This action is the first of a series of modulates which will, over the next several years, upgrade current respirator requirements. This modular approach will allow improvements to be implemented on a priority basis as well as facilitate adaptation to new requirements by the manufacturers and users of respirators. Except for the particulate-filter requirements, most requirements of existing regulations would be incorporated into the new regulations without change. The proposed testing requirements for particulate filters would significantly improve the current approach to evaluating the effectiveness of an air-purifying respirator's filter to remove toxic particulates from the ambient air, updating existing provisions to be consistent with two decades of advances in respiratory protection technology. The certification of air-purifying respirators under these proposed requirements would also enable respirator users to select from a broader range of certified respirators that meet the current performance criteria recommended by CDC for respiratory devices used in health-care settings for protection against Mycobacterium tuberculosis, the infectious agent that causes tuberculosis (TB). This Notice also announces an informal public meeting on the proposed rule, as indicated below. Elsewhere in this issue of the Federal Register, MSHA is publishing a proposal to remove existing regulations at 30 CFR part 11, which would be made obsolete by a final rule resulting from this proposed rule.

Guidelines as Topic↗
PubMed2004

Complication with an embolic protection device during carotid angioplasty.

A case of carotid artery stenting with an AngioGuard cerebral protection device is described in a patient with tight internal carotid stenosis. Deployment of AngioGuard induced sudden severe vasospasm, with subsequent minor stroke. According to our observations, AngioGuard may cause a vasospastic response with adverse neurologic effects.

Aged↗
PubMed2000

Personal respiratory protective devices: efficacy of intranasal stent with filters.

Intranasal, hollow, cylindrical, medical grade and silicone stent with two outer layers face mask filters at both ends was proposed for atmospheric suspended particulate matter prevention. The personal respiratory protective device efficacy was done at the Otolaryngology Department, Ramathibodi Hospital from April 1996 to October 1997. Single pulse mode of carbon dioxide laser smoke particle was the suitable source of atmospheric suspended particulate matter. A laser plume evacuator removed laser smoke particles with 5 Millipore filters of 0.22 um pore size or 5 intranasal stent with filters attached at the inlet end. A Millipore filter got the same laser smoke particle amount that passed through each intranasal stent filter with an air flow rate of 15 l/min controlled by a rotameter. Laser smoke particle deposition in filter materials was counted under a high power optical microscope. Laser smoke particle amount in each layer of a four-layer filter of intranasal stent with 7.5, 15.0 and 30.0 l/min air flow rates is shown. The filtration efficacy of four, three and two layers of intranasal stent with a filter for laser smoke particle retention were compared. An intranasal stent with filter could be applied in a human nasal vestibule with acceptable air flow resistant during public transportation in a traffic congested area.

Environmental Pollution↗
PubMed2004

Safety and feasibility of the use of a distal filter protection device in percutaneous revascularization of small coronary arteries.

The FilterWire EX is one of the filter protection devices developed as alternatives to balloon occlusion system for percutaneous coronary intervention. Its use has been recommended in vessels between 3.5 and 5.5 mm in diameter and no data are available on its use in smaller vessels. We evaluated the safety and feasibility of using FilterWire EX in native coronary arteries smaller than 3.5 mm. We successfully deployed and retrieved the FilterWire EX in 49 coronary arteries with a mean vessel diameter of 2.62 +/- 0.45 mm at device deployment. Reversible vasospasm was observed in 24 (50%) vessels, coronary flow was temporarily reduced in 22 (44.9%), and distal embolization was noted in 2 (4%). There was no vessel dissection induced by the device. These data suggest that it is safe and feasible to use the FilterWire EX in small coronary arteries.

Coronary Angiography↗
PubMed2004

GuardWire emboli protection device is associated with improved myocardial perfusion grade in saphenous vein graft intervention.

BACKGROUND: Use of emboli protection devices (EPD) during saphenous vein graft percutaneous coronary intervention (SVG-PCI) has been proven to reduce major adverse cardiac events (MACE). However, the impact of EPD on the microcirculation using Thrombolysis in Myocardial Infarction myocardial perfusion grade (TMP) has not been fully characterized. We sought to analyze TMP after SVG-PCI with and without EPD and determine its impact on inhospital MACE. METHODS: From August 2001 to December 2002, 305 patients had SVG-PCI suitable for EPD; 210 (69%) had an angiogram appropriate for TMP evaluation. Of those, 46 (22%) had an EPD (GuardWire, Medtronic, Minneapolis, Minn) deployed during the coronary intervention. Both groups were similar with regard to most demographic and clinical features. RESULTS: A TMP score of 2.5 or 3 was obtained in 98% of the EPD group versus 85% of the unprotected SVG-PCI (P = .01). There was a trend towards reduction in MACE when using EPD (15% vs 27%, respectively, P = .07). Peak postprocedural creatine kinase-MB was somewhat lower in the EPD group (6.03 +/- 7.8 ng/mL vs 14.87 +/- 42 ng/mL, P = .17) Patients with a TMP grade of 2.5 or 3 had a statistically significant reduction in MACE (OR 0.36, 95% CI 0.14-0.87, P = .02). CONCLUSIONS: Compared with SVG-PCI without emboli protection, EPD significantly improved TMP and trended towards a reduction in MACE.

Aged↗
PubMed2005

Influence of vessel diameter on the efficacy of distal protection devices during saphenous vein graft intervention.

We sought to determine the influence of vessel diameter on the efficacy of distal protection devices during saphenous vein graft intervention. From the Filterwire EX Randomized Evaluation trial, in which patients who underwent saphenous vein graft stenting were randomized to distal protection with the GuardWire or FilterWire EX, outcomes in 572 patients were examined in vessel size tertiles. The 30-day composite incidence of major adverse cardiac events (MACEs) increased with vessel size and was 6.9%, 9.7%, and 14.9% in the smallest, middle, and largest tertiles, respectively (p = 0.04). MACE rates were relatively vessel size independent for the GuardWire but increased steadily with vessel size with the FilterWire EX. In the smallest tertile, MACEs were reduced by 71% with the FilterWire EX compared with the GuardWire (p = 0.05), with the devices showing similar event rates in the other tertiles.

Aged↗
PubMedDate not supplied

A comparative user evaluation of three needle-protective devices.

Needlestick injuries (NSI) can result in healthcare workers being exposed to blood-borne viruses. Between 1997 and 2002, three healthcare workers in the UK have seroconverted to hepatitis C and one to human immunodeficiency virus (Public Health Laboratory Service (PHLS), 2003). Experience both in the UK and the USA suggests that even robust educational strategies may be insufficient to reduce the number of occupationally acquired NSI (Jagger et al, 1988). Needle-protective devices have now become more widely available and several studies have demonstrated an associated reduced risk of NSK. It is, however, essential that the devices are appropriately evaluated before introduction to ensure that they meet user requirements, do not interfere with function and reduce NSI risk. This article describes an evaluation programme carried out at the University Hospital Birmingham, UK. The programme focused on three key areas: safety, usability and compatibility. Results demonstrated that nurses rapidly adapt their practices to use the new safety devices and the study highlighted key education requirements that would be required before implementation. In addition, without this evaluation, it would not have been identified that attachment of the safety needles to the syringes requires a push-and-twist method or the use of LuerLok syringes to prevent detachment on activation of the safety procedure

Humans↗
PubMed2003

The use of a distal occlusion balloon protection device in acute coronary syndrome.

We report our early experience in using the PercuSurge GuardWire Plus system as a distal protection device in patients with acute coronary syndrome and acute myocardial infarction. Forty-three patients received percutaneous coronary intervention with the GuardWire Plus system. Thirteen had unstable angina, five had non-Q myocardial infarction and 25 had ST segment elevation myocardial infarction. Forty-one target lesions were in native coronary vessels and two were in saphenous vein grafts. Total occlusion occurred in 18 patients. The mean occlusion time by the distal protective balloon was 262.8 +/- 114.1 s. Preoperatively, TIMI 0 flow was present in 18, TIMI II flow in two and TIMI III flow in 23 patients. Post-operatively, TIMI II and TIMI III flow were established in two and 41 patients, respectively. All procedures were successful and the GuardWire Plus system was successfully deployed in all but two patients. There was no procedure-related major adverse clinical event. There was no major adverse clinical event at 30 days. There was no device-related complication. We believe that the GuardWire Plus system is safe and feasible in patients with acute coronary syndrome and acute myocardial infarction.

Angina, Unstable↗