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PubMed2006

The mechanically stable steam sterilization of bone grafts.

Bone allografts are the standard material used in augmentative bone surgery. However, steam-sterilized bone has a low mechanical stability and limited ossification based on low strain-adapted bone remodelling. Here we describe a new technique which allows the bone to be autoclaved without losing its mechanical stability and osteoconductivity. The compression strength of the new material was compared with steam-sterilized and fresh bone based on mechanical testing using bone cylinders (n=30/group). Allogeneic new material and fresh bone were press-fit implanted into rabbit patellar grooves and examined under fluorescent light and conventional microscopy. Initial healing was assessed after 30 d (n=5/group). Osseous integration and remodelling was studied after 100 d (n=12/group). Steam-sterilized bone showed no mechanical stability, whereas the new material was stiff and had compression curves similar to fresh bone; both groups showed equal degrees of direct ossification after 30 d, advanced bony ingrowth and remodelling after 100 d, and similar ingrowth depths on histomorphometric analysis. The new method preserved the stiffness and osteoconductivity of bone after steam sterilization, and microstructure, mineralization, and composition were conserved. This technique could be useful for bone banking in Third World countries.

Animals↗
PubMed2005

Residual formaldehyde on plastic materials and medical equipment following low-temperature steam and formaldehyde sterilization.

We measured the amount of residual formaldehyde on 16 plastic materials and five medical devices following low-temperature steam and formaldehyde (LTSF) sterilization, based on the European Standard EN14180. The amounts of formaldehyde residue on the plastic materials were compared with that on a filter paper of similar dimensions. The amount of residual formaldehyde on polyamide 6, polyurethane, natural rubber and polyacetal was higher (21.9, 15.2, 3.0 and 2.1 times, respectively) than that on the filter paper. The amount of formaldehyde recovered from a breathing circuit, anaesthesia circuit, oxygen tubing, airway tube and tweezers was 260, 240, 594, 56 and 0 microg, respectively, following LTSF sterilization. Our results emphasize the need to verify the main material composing the medical equipment before LTSF sterilization, as the amount of formaldehyde retrieved following sterilization varies according to the material used for construction.

Cross Infection↗
PubMed2005

The sterility of hospital-prepared Soffban bandages.

An evaluation of the sterility of hospital-prepared Soffban bandages was undertaken. Discs of Bacillus stearothermophilus were inserted into the bandage rolls, prior to sterilization in "porous load" autoclaves. The discs were subsequently removed and placed in culture media, with growth of the organism indicating failure of sterilization. It was demonstrated that Soffban could not be sterilized reliably using standard hospital autoclave techniques.

Bandages↗
PubMedDate not supplied

Prospective analysis of office-based hysteroscopic sterilization.

STUDY OBJECTIVES: To evaluate the efficacy of performing the Essure hysteroscopic sterilization in an office-based setting. DESIGN: Prospective, longitudinal analysis (Canadian Task Force classification II-3). SETTING: University out-patient office. PATIENTS: All patients undergoing permanent sterilization in our outpatient office who opted for hysteroscopic sterilization were included. INTERVENTIONS: Hysteroscopic placement of the Essure device in an office-based setting with only non-steroidal antiinflammatory drugs and paracervical block. MEASUREMENTS AND MAIN RESULTS: Multiple data points were collected on each patient including demographic data, specific procedural information, and 12-week hysterosalpingogram data. Most of our patients were Hispanic and had an average body mass index of 30.3. Average time to perform the procedure was 12.4 minutes, with the steepest improvement in the first 13 cases. Bilateral placement of the device was successful in 98 (96%) of 102 patients. Of these patients 92 have 12-week hysterosalpingography results (6 patients were lost to follow-up), with 90 (98%) showing bilateral tubal occlusion. There were no intraprocedural or postprocedural complications. CONCLUSION: In our institution and in our experience, office-hysteroscopic placement of the Essure device is a feasible and effective approach for permanent sterilization.

Adult↗
PubMed2006

SEM observations and differential scanning calorimetric studies of new and sterilized nickel-titanium rotary endodontic instruments.

Scanning electron microscopy (SEM) and differential scanning calorimetric (DSC) studies were utilized to investigate surface and microstructure of two brands of rotary nickel-titanium (NiTi) endodontic instruments, in the as-received condition and after subjection to 1, 6, and 11 sterilization cycles. A total of 66 ProFile (n = 33) and Flexmaster (n = 33) files were examined. SEM observations indicated the presence of surface imperfections and adherent material in all new and sterilized instruments and an increase in surface roughness of the instruments that underwent multiple sterilizations. DSC measurements showed that the specimens of both brands, in the as-received condition and after 11 sterilizations, were completely austenite in the oral environment temperature, suggesting that they are capable of superelastic behavior in appropriate clinical conditions.

Analysis of Variance↗
PubMed2006

The rapid sterilization of gutta-percha cones with sodium hypochlorite and glutaraldehyde.

The purpose of this in vitro study was to evaluate the effectiveness of sodium hypochlorite and glutaraldehyde for rapid sterilization of gutta-percha cones contaminated with Bacillus subtilis ATCC 6633. Cones were treated with either 2% glutaraldehyde or 2.5% sodium hypochlorite. The gutta-percha cones were sterilized with a 2.5% sodium hypochlorite solution throughout the test. Glutaraldehyde did not decontaminate the gutta-percha cones even after 15 minutes of contact. All positive controls showed positive results during the first 24 hours. Negative controls were followed up for 24 and 48 hours and demonstrated the efficiency of previous sterilization. No microbial growth was observed in the groups tested. Even though gutta-percha cones are usually sterile during storage, they can be easily contaminated if incorrectly manipulated. NaOCl at 2.5% concentration is an effective agent for decontamination of gutta-percha cones at no additional cost.

Anti-Infective Agents, Local↗
PubMed2005

Are sterile gloves necessary in nonsurgical dental extractions?

PURPOSE: The aim of the study was to compare the incidence of healing complications of extraction socket with the use of sterile or clean nonsterile gloves during nonsurgical dental extractions. MATERIAL AND METHODS: This was a randomized prospective study conducted at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (Nigeria), between October 2002 and January 2003. Patients who were referred for nonsurgical extractions of permanent teeth and who satisfied the inclusion criteria into the study were randomly allocated into 2 groups. One group had their extractions performed with the surgeon wearing a pair of sterile gloves and the second group had their extractions performed with the surgeon wearing a pair of clean nonsterile gloves. Two hundred sixty-nine patients who had 301 teeth extracted and satisfied the inclusion criteria for socket healing assessment were assessed for postoperative socket healing. RESULTS: Three different types of socket healing complications were identified (dry socket, acutely inflamed socket, and acutely infected socket). A total of 32 patients (11.9%) developed socket healing complications. Nineteen of 122 patients in the sterile glove group and 13 of 147 patients in the clean nonsterile glove group developed socket healing complications (P = .09). CONCLUSION: The study confirmed that the use of sterile surgical gloves offers no advantage over clean nonsterile gloves in minimizing extraction socket healing complications following dental extraction. Therefore, nonsurgical dental extraction can be safely performed with the surgeon wearing clean nonsterile gloves.

Adolescent↗
PubMed2006

Effect of sterilization process on the formation of mono(2-ethylhexyl)phthalate from di(2-ethylhexyl)phthalate.

The risk assessment of di(2-ethylhexyl)phthalate (DEHP) migrating from polyvinyl chloride (PVC) medical devices is an important issue. Many studies have been conducted to determine the level of DEHP migration. A recent report has indicated that DEHP in blood bags is hydrolyzed by esterase into mono(2-ethylhexyl)phthalate (MEHP). However, MEHP is thought to be even more toxic than the parent compound. Therefore, a method for the simultaneous determination of DEHP and MEHP was developed. The limits of quantification (LOQs) of DEHP and MEHP were 2.5 and 0.75 ng/ml, respectively. In this study, the effect of sterilization process on the levels of DEHP and MEHP migration was investigated. The level of migration of DEHP from gamma(gamma)-ray sterilized PVC sheet was low compared with that of the unsterilized control. By contrast, the level of MEHP migration from the gamma-ray sterilized PVC sheet was high compared with that of the unsterilized control. In addition, a high content of MEHP was found in the gamma-ray sterilized PVC sheet.

Chromatography, Liquid↗
PubMed2004

Hysteroscopic tubal sterilization.

This article provides an overview of the history of hysteroscopic sterilization including the current state of the art and future ideals. Unlike laparoscopic techniques, sterilization by hysteroscopy can be performed in an outpatient setting without general anesthesia. Many attempts have been made to develop a safe and effective method, but until recently, without success. The Essure system is the first one that seems to be a realistic alternative to laparoscopic sterilization, but is irreversible. The search is still on for the optimum method of hysteroscopic sterilization.

Female↗
PubMed2006

Non-surgical methods of contraception and sterilization.

The Humane Society of the United States estimates that each year between 8 and 10 million dogs and cats enter shelters and 4-5 million of these animals are euthanized due to lack of homes. Many veterinarians within the United States recommend surgical sterilization for population control in dogs and cats. However, there are non-surgical methods to control reproduction. Pharmacologic methods of contraception and sterilization can be safe, reliable and reversible. Hormonal treatments using progestins, androgens, or gonadotropin releasing hormone (GnRH) analogs act to either directly block reproductive hormone receptor-mediated events, or indirectly block conception via negative feedback mechanisms. Immunocontraception, via vaccination against GnRH, the luteinizing hormone receptor or zona pellucida proteins, is also possible. Intratesticular or intraepididymal injections provide a method for non-surgical sterilization of the male dog and cat. Additional methods have been employed for mechanical disruption of fertility including intravaginal and intrauterine devices and ultrasound testicular ablation. Alternative approaches to surgical sterilization will be reviewed.

Animals↗
PubMed2002

A long-term follow-up study of women with asymptomatic endometriosis diagnosed incidentally at sterilization.

OBJECTIVE: To evaluate whether asymptomatic endometriosis diagnosed in connection with tubal sterilization is likely to cause symptoms later in the woman's life. DESIGN: Controlled, clinical follow-up study of women who were examined for endometriosis in connection with tubal sterilization performed between 1986 and 1989. SETTING: University hospital. PATIENT(S): Thirty-nine women with mostly minimal endometriosis discovered at sterilization and 157 control women with no endometriosis discovered at sterilization. INTERVENTION(S): Interview in 2001 by a posted questionnaire. MAIN OUTCOME MEASURE(S): Report on pain, pelvic operations, menopausal status, and use of hormone replacement therapy. RESULT(S): Pelvic pain was more frequently reported by controls than by women with endometriosis (28% vs. 6%). There was no significant difference between the groups concerning dysmenorrhea, premenstrual pain, or dyspareunia, nor was there any significant difference in the hysterectomy rate. CONCLUSION(S): There is little risk that asymptomatic, minimal endometriosis found incidentally will become symptomatic.

Dysmenorrhea↗
PubMed1977

Contraceptive and sterilization practices and extrauterine pregnancy: a realistic perspective.

Comparative data on the incidence of ectopic pregnancy among accidental pregnancies associated with failure of a contraceptive or sterilization procedure are shown in Table 16. The practical clinical significance of the data in this review is predicated upon a number of related factors. One of the most important of these is the realistic failure rate (or success rate) of each contraceptive or sterilization method. The reported efficacy of various contraceptive methods has such a wide range that we have not attempted to calculate the likelihood that a woman may experience an ectopic pregnancy within a particular time period while using a specific method. The success or failure rate of each method is influenced by such variables as (1) the conscientiousness and ability of the patient to follow instructions, (2) the true failure rate of the method itself, (3) the experience of the clinician prescribing a method or performing a surgical procedure, and (4) other factors less clearly defined. Because of these many variables, the data shown in Table 16 were calculated on the basis of the number of reported accidental pregnancies which occurred coincidentally with, or subsequent to, a specific contraceptive or sterilization modality. (formula: see text). These data do not reflect the actual rate of occurrence of ectopic pregnancy with respect to woman-months of experience. We recognize the significant influence that age, race, gravidity, and socioeconomic factors have upon the incidence of ectopic pregnancy, but were unable to control for these factors in the data presented in this review. These data reprresent only what has occurred under specific circumstances and cannot logically be extrapolated to any specific future case or study series. It is important to emphasize the necessity of constant awareness by the medical and paraprofessional personnel of the potentially increased risk to the patient of an extrauterine pregnancy should one or another of these contraceptive or sterilization procedures fail. Complacency or a false sense of security on the part of responsible medical personnel concerning women who are "protected against conception" can quickly lead to a life-threatening situation in case of an ectopic pregnancy. Prompt diagnosis and definitive treatment of the extrauterine pregnancy is vital for the successful management of this serious complication of conception.

Contraceptive Agents, Female↗
PubMed1978

Profile of women requesting reversal of sterilization.

One hundred consecutive patients requesting reversal of sterilization have been analyzed. At the time of sterilization 52% were 25 years old or under and 89% were 30 years old or under. Fifty-three patients were not in a stable marital relationship. The mean number of children per patient was 2.39. Two-thirds of the 47 patients who underwent pueperal sterilization regretted their decision within the 1st year. Twenty-six percent of the patients felt psychologically adversely affected by the procedure. The reason for requesting reversal of sterilization in the majority (63%) was a change in marital status. Other reasons were crib death (17%), desire for more children (10%), psychologic factors (6%) accidental tragedies (4%).

Adult↗
PubMed1979

Menstrual patterns and women's attitudes following sterilization by Falope rings.

Follow-up data on 147 women sterilized by laparoscopic Falope ring application were analyzed for changes in menstrual patterns, postoperative complications, patient feelings about surgery, and incidence of regret. Twelve to twenty-eight months after surgery, there were no consistent changes in interval, length, or amount of menstrual flow, and only 4% of women developed transient episodes of dysfunctional uterine bleeding. Analysis of feelings after sterilization showed that 90% of women were satisfied with the sterilization, 3% were unhappy, and 7% were ambivalent. Feelings of regret were not associated with postoperative complications and appeared to be related to the reasons for sterilization. Individual counseling not only helped to identify the population at risk for regret but also served to reduce the incidence of poststerilization ambivalent feelings.

Adult↗
PubMed2003

The acceptability, efficacy and safety of quinacrine non-surgical sterilization (QS), tubectomy and vasectomy in 5 provinces in the Red River Delta, Vietnam: a follow-up of 15,190 cases.

OBJECTIVES: To compare the safety, efficacy and acceptability of quinacrine sterilization (QS), tubectomy and vasectomy in Vietnam. METHODS: This study was initiated in January 1998 and completed in February 2000. A sample of 9 districts in 5 provinces, where the prevalence of QS was known to be high, was selected. Every person sterilized in these 9 districts between January 1, 1988 and March 31, 1998 was identified and systematically interviewed by family planning clinicians who had received special training for this project. RESULTS: A total of 15,982 sterilization users were identified and 15,190 were interviewed and examined, including a gynecologic exam, if needed: a follow-up rate of 95%. Of those interviewed, 9,753 used tubectomy, 3,734 used QS and 1,703 used vasectomy. All three methods were found to be safe, although morbidity associated with tubectomy was more serious than with QS or vasectomy. No deaths were reported. After more than 5 years of follow-up, tubectomy had the lowest failure rate: 1.0%, followed by 4.1% with vasectomy. A pregnancy rate of 13.2% was reported with quinacrine, although only a small fraction of these failures were confirmed. A strong preference for QS was found. CONCLUSION: QS has an important role to play in sterilization services in Vietnam.

Female↗
PubMed2003

Female sterilization with quinacrine using hysterosalpingography (HSG) as an endpoint after a single-insertion protocol in Caracas, Venezuela.

OBJECTIVE: To evaluate the intrauterine insertion of quinacrine as an alternative nonsurgical female sterilization method by confirming bilateral occlusion of the fallopian tubes using HSG in a group of women who desire permanent sterilization. METHODS: After doing hysterosalpingography to confirm patency of both fallopian tubes, 324 mg of quinacrine were introduced with a modified IUD inserter in 30 patients who came to Concepción Palacios Maternity Hospital seeking permanent sterilization, between June 2000 and September 2001. Follow-up with HSG was done 3 months later to verify occlusion of the fallopian tubes. RESULTS: 26 of 30 patients (86%) had bilateral tubal occlusion as determined by HSG. There were minor side effects such as: pain (66.7%), yellow discharge (100%) and menstrual abnormalities (13.3%). One woman became pregnant after HSG showed bilateral occlusion. HSG may interfere with the action of the quinacrine. CONCLUSION: QS is a simple and safe alternative to surgical sterilization with few side effects.

Adult↗
PubMed1982

Irrigation during vasectomy: a comparison between sterile water and the spermicide euflavine.

In a randomized, double-blind investigation 36 men undergoing sterilization had irrigation of the vas deferens with either sterile water or the spermicide, euflavine, to reduce the lag to sterility. Semen samples were vital stained by the patients shortly after ejaculation and the smears were mailed to the laboratory. Irrigation with the spermicide was significantly more effective than sterile water. However, even in the group irrigated with euflavine 6 to 35 days elapsed before the semen samples were without potentially fertile spermatozoa.

Acriflavine↗
PubMed1997

Cleaning of endodontic files, Part I: The effect of bioburden on the sterilization of endodontic files.

Ninety-two new endodontic files were randomly assigned to five groups with varying parameters of contamination, cleaning method, and sterilization (steam or chemical). Files were instrumented in bovine teeth to accumulate debris and a known contaminant, Bacillus stearothermophilus. Positive controls produced growth on both T-soy agar plates and in T-soy broth. Negative controls and experimental files (some with heavy debris) failed to produce growth. The results showed that there was no significant difference between contaminated files that were not cleaned before sterilization and contaminated files that were cleaned before sterilization. Bioburden present on endodontic files does not appear to affect the sterilization process.

Animals↗