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At least 145 records · Page 8Linked to original sources
PubMed2000

Personal respiratory protective devices: efficacy of Millipore and Whatman filters.

A Millipore filter with 0.22 micron pore size and a Whatman grade 1 filter with > 11 microns particle retention were used to capture laser smoke particle mimic atmospheric suspended particulate matter. The experiment was conducted at the Department of Otolaryngology in Ramathibodi Hospital from April 1996 to October 1997. The laser smoke particle evacuator with rotameter created an air flow rate of 15 l/min through the filters. The mean and standard deviation of the laser smoke particle count under high power optical microscope in a 10 Millipore filter and a 10 Whatman filter were 411,327.6 +/- 13,325.0 and 290,453.0 +/- 28,409.8 respectively, 29.4 per cent different. Laser smoke particle size distribution in both filters under eyepiece micrometer was: 1 to 10 microns in Millipore (99.0%) and in Whatman (96.2%), 1 to 5 microns in Millipore (77.1%) and in Whatman (77.6%), no laser smoke particle larger than 17 microns was detected. The Millipore filter ruptured when the air flow rate was greater than 15 l/min. The Whatman filter was suitable for evaluating filtration efficacy of various personal respiratory protective devices in a high air flow rate condition.

Environmental Pollution↗
PubMed1996

Veterinary practice and occupational health. An epidemiological study of several professional groups of Dutch veterinarians. II. Peak expiratory flow variability, dust and endotoxin measurements, use of respiratory protection devices, and time distribution of professional activities.

Dust and endotoxin exposure was measured in the Spring and Autumn in 96 veterinary practitioners, subdivided in four professional groups ((predominantly working with either swine, cattle, poultry, or companion animals). Furthermore, peak expiratory flow (PEF) variability was measured four times a day over a week in Spring and Autumn in order to detect occupation-related respiratory disorders. The participants kept a log book in which they recorded their activities during these periods. Practitioners working with swine, cattle, or poultry had a significantly higher exposure to dust (+/- 5 times) and endotoxin (+/- 10 times) than companion animal practitioners. PEF variability measurements gave no indications for an increased prevalence of bronchial hyperreactivity related to occupational activities. Respiratory protective devices (RPD) were used selectively. Only a small proportion of the practitioners used them at any time when entering a animal confinement building. Swine and cattle practitioners worked for approximately 3.6 hours per day in animal buildings, whereas poultry practitioners worked in the environment of poultry buildings for approximately 2.8 hours per day.

Animals↗
PubMed2005

Release and elimination of soluble vasoactive factors during percutaneous coronary intervention of saphenous vein grafts: analysis using the PercuSurge GuardWire distal protection device.

BACKGROUND: The presence of no-reflow substantially increases the risk of major adverse clinical events (MACE) in percutaneous coronary artery interventions (PCI). Distal protection devices may eliminate both debris and soluble factors that can lead to no-reflow. This study was designed to evaluate the soluble factors released and eliminated by the PercuSurge GuardWire during SVG intervention. METHODS: Twenty-eight consecutive patients underwent PCI on 34 lesions in 31 SVGs using the PercuSurge GuardWire. Blood was taken prior to PCI for baseline measurement of: (1) vasoconstrictive factors: endothelin (ET) and serotonin (5-HT); (2) thrombotic factors: tissue factor (TF), plasminogen activator inhibitor (PAI-1), thrombin/antithrombin III complex (TAT), and prothrombin fragment F1+2 (F1+2); and (3) inflammatory factors: soluble CD40 ligand (sCD40L) and soluble E-selectin. After stenting and before deflating the distal protection balloon, 2 aspiration runs were performed with the PercuSurge Export Catheter and sent for analysis. RESULTS: Clinical follow-up was conducted at an average of 6 +/- 3 months. SVG PCI resulted in a substantial increase in levels of vasoconstrictive factors, including ET (3 x increase; p < 0.001) and 5-HT (9.7 x increase; p = 0.031); thrombotic factors, including TF (4.5 x increase; p = 0.005), TAT (2.4 x increase; p < 0.001), and F1+2 (2.4 x increase; p < 0.001). Pro-inflammatory factors were also released during the procedure. Levels of sCD40L and soluble E-selectin increased 123% (p = 0.003) and 25% (p < 0.001), respectively. CONCLUSIONS: SVG PCI results in an immediate increase in vasoactive factors, including vasoconstrictive, thrombotic and inflammatory factors. The PercuSurge GuardWire effectively removes these soluble factors, which may account for reduction of no-reflow and other complications during SVG interventions.

Aged↗
PubMed2005

FilterWire distal embolic protection device for vein graft stenting: initial single-center experience.

BACKGROUND: Saphenous vein graft (SVG) intervention is associated with a significant incidence of major adverse cardiac events (MACE) related to distal vessel embolization. The FilterWire distal embolic protection device has recently been approved as an adjunct to SVG intervention. We report here our initial experience in a single center in 30 consecutive patients using this device in SVG stenting. HYPOTHESIS: This study examined the outcomes and complications associated with these devices, as well as whether proficiency with the devices increased with greater experience and whether there were measurable outcome differences between devices. METHODS: We retrospectively identified all patients in whom a FilterWire device was placed at our hospital between June 2001 and June 2004. RESULTS: The device was successfully deployed in 29 of 30 patients, and all patients were stented successfully. Overall MACE rate was 6.6%, consistent with reports in larger multicenter clinical trials. Transient decreases in flow were noted while the device was in place in six patients, but improved in five patients with device removal. CONCLUSIONS: This early experience in a single center using FilterWire embolic protection indicates that excellent clinical results can be obtained by the adoption of filter protection for SVG intervention, without evidence for a detrimental learning curve.

Aged↗
PubMed2006

Cerebral protection devices for use during carotid artery angioplasty with stenting: a health technology assessment.

OBJECTIVES: This study sought to examine the safety, efficacy, and economic implications of the use of cerebral protection devices during carotid artery angioplasty and stenting (CAS) in high-risk patients with severe carotid artery disease (CAD). METHODS: A comprehensive search for peer- and non-peer-reviewed studies that compared carotid endarterectomy (CEA) or CAS without cerebral protection to CAS with cerebral protection and appeared in the English language literature between January 1990 and January 2005 was completed. Information from studies identified was extracted using a common data abstraction form and then critically appraised against published quality assessment criteria. RESULTS: Of the eight studies found, six provided information on technical or procedural success rates, with values ranging from 95.6 percent to 100 percent. Three of the four studies comparing groups of patients who received CAS with cerebral protection with those who received only CAS reported a non-statistically significantly higher 30-day incidence of death and stroke (major or minor) in the latter group. None of the three studies comparing CAS with cerebral protection to CEA demonstrated a statistically significant difference in the 30-day incidence of death, major stroke, or myocardial infarction between treatment groups. No economic analyses were found. CONCLUSIONS: In high-risk patients with severe CAD, the evidence suggests that CAS with cerebral protection may offer a safe and efficacious alternative to CEA, reducing the risk of embolic peri-procedural complications associated with CAS to acceptable levels.

Angioplasty↗
PubMed2004

[Distal protection devices in carotid stent].

Endovascular treatment of carotid stenoses is increasingly used. Frequently temporary occlusion balloons or filters are placed distal to the stenosis to gain additional protection against cerebral emboli. There is still a scientific debate about the usefulness of such distal protection devices. The following contribution reviews existing techniques and their clinical results and should allow for a critical discussion and selection of current techniques and materials.

Angioplasty, Balloon↗
PubMed2000

Physiological and practical evaluation of a biological/chemical protective device for infants.

The Chemical Infant Protective System (CHIPS) is a special hood-like system into which a small battery-operated blower delivers filtered air. Because it is a semiclosed system, there is a risk of dangerous CO2 accumulation within the device, which particularly affects infants with acute or chronic respiratory disorders. Eleven infants hospitalized with various respiratory illnesses wore the device for 15 minutes. Inspired O2, inspired CO2, heart rate, respiratory rate, oxygen saturation, and inside temperature and humidity were measured before and during this test period. Inspired O2 and heart rate during the test period were significantly lower than baseline levels (O2, 19.1 vs. 20.1%; heart rate, 133 vs. 142 beats/min). Inspired CO2 and inside temperature during the test period were significantly higher than baseline levels (CO2, 0.23 vs. 0.06%; temperature, 25.0 vs. 23.1 degrees C). Oxygen saturation, respiratory rate, and humidity were not different from baseline levels. A short-term stay within the CHIPS in well-ventilated surroundings did not result in significant clinical and physiological impact for sick infants. Nevertheless, trends were identified that may be worrisome during longer periods and in sealed rooms.

Biological Warfare↗
PubMed1988

Failure of gloves and other protective devices to prevent transmission of hepatitis B virus to oral surgeons.

A survey of 434 oral surgeons was conducted to examine risk factors for hepatitis B virus (HBV) infection. Overall, 112 (26%) of the participants demonstrated serologic evidence of past or current infection with HBV. Seropositivity was significantly associated with age, number of years in practice, and year of graduation from dental school but not with other variables examined, such as the number of patients seen annually or the number of patients seen who were at high risk of HBV infection. The strong correlation between years in practice and seropositivity was unaffected by reported use of gloves, face masks, or eye shields. The use of gloves and other protective devices does not appear to offer substantial protection against HBV exposure in oral surgeons, and all oral surgeons should receive HBV vaccine.

Adult↗
PubMedDate not supplied

[Infection risk and personal protective devices].

The Aa discuss the evidence and recommendations for the use of personal protective equipment by health care practitioners in general care settings; the use of aprons, gowns, gloves, eye protections, face masks is valutated on the basis of an assessment of the risk of transmission of microrganisms to the patient or from the patient to health care practitioners. The primary uses of personal protective equipment are to protect staff and reduce opportunities for transmission of microrganisms in hospitals. A trend to eliminate the unnecessary wearing of aprons, gowns and masks in general care settings has evolved over the past twenty years due to the absence of evidence that they are effective.

Eye Protective Devices↗
PubMed2005

Slow-flow phenomenon during carotid artery intervention with embolic protection devices: predictors and clinical outcome.

OBJECTIVES: The purpose of this research was to define the predictors of the "slow-reflow" phenomenon during carotid artery intervention with filter-type embolic protection devices (EPDs) and to determine its prognostic significance. BACKGROUND: During carotid artery intervention using filter-type EPDs, we have observed cases in which there is angiographic evidence of a significant reduction in antegrade flow in the internal carotid artery proximal to the filter device, termed "slow-flow." The predictors of this phenomenon and its prognostic significance are unknown. METHODS: Using a single-center prospective carotid intervention registry, patients with slow-flow were compared to patients with normal flow during carotid intervention with respect to clinical, procedural, and lesion characteristics, and the 30-day incidence of death and stroke. RESULTS: A total of 414 patients underwent 453 carotid artery interventions using EPDs. Slow-flow occurred in 42 patients (10.1%) undergoing 42 carotid interventions (9.3%), and most commonly occurred after post-stent balloon dilatation (71.4%). Multivariate logistic regression analysis identified the following predictors of slow-flow: recent history (<6 months) of stroke or transient ischemic attack (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.4 to 5.6, p = 0.004), increased stent diameter (OR 1.4, 95% CI 1.02 to 1.94, p = 0.044), and increased patient age (OR 1.05, 95% CI 1.01 to 1.09, p = 0.025). Among patients with slow-flow, the 30-day incidence of stroke or death was 9.5% compared to 2.9% in patients with normal flow (chi-square = 4.73, p = 0.03). This difference was driven by the disparity in the 30-day incidence of stroke (9.5% vs. 1.7%). CONCLUSIONS: Slow-flow during carotid intervention with EPDs is a frequent event that is associated with an excess risk of periprocedural stroke. The association of the phenomenon with clinically symptomatic carotid lesions and use of larger stent diameters suggests that embolization of vulnerable plaque elements may play a pathogenic role.

Aged↗
PubMed1980

[Contact allergy to N-isopropyl N'-phenylparaphenylenediamine (IPPD) in different individual protective devices (author's transl)].

N-isopropyl N'-phenylparaphenylenediamine, a known sensitizer, is searched for in different elastomeric formulations. Systematic chemical analysis as well as clinical investigations have been performed, especially on gloves, boots and respiratory protective devices. Some cases remain unaccounted for: some IPPD-sensitized people do not react to the contact of objects containing IPPD, other react to objects in which even thorough analysis failed to detect this compound. A better knowledge of the allergologic profile of sensitized people and better analytical detection limits might be desirable.

Dermatitis, Atopic↗
PubMed2004

Carotid angioplasty and stent placement: comparison of transcranial Doppler US data and clinical outcome with and without filtering cerebral protection devices in 509 patients.

PURPOSE: To prospectively evaluate emboli detected at transcranial Doppler ultrasonography (US) and outcome of carotid angioplasty and stent placement and compare these findings in patients treated with the use of filtering cerebral protection devices (CPDs) with the findings in patients treated without the use of filtering CPDs. MATERIALS AND METHODS: This study was approved by the institutional human research committee. Written informed consent was obtained for all patients. Patients were divided into three groups: 161 patients treated before filtering CPDs had become available (group 1), 151 patients treated with filtering CPDs (group 2), and 197 patients treated without CPDs after CPDs had become available (group 3). Clinical end points were cerebral ischemic events and death. Transcranial Doppler US end points included isolated microemboli, microembolic showers, macroemboli, and distal thrombus. The procedure was divided into five phases: wiring, predilation, stent deployment, postdilation, and CPD handling. Data not distributed normally were analyzed with the Mann-Whitney U statistic. For binomial data, the chi(2) test was used. P < .05 indicated statistical significance. RESULTS: For each phase, median and interquartile range (IQR) for isolated microemboli in group 2 versus group 3 were as follows: wiring, 51 (IQR, 31-69) versus 27 (IQR, 15-48); predilation, 19 (IQR, 13-33) versus 13 (IQR, 8-19); stent deployment, 64 (IQR, 46-82) versus 48.5 (IQR, 33.25-66); and postdilation, 24 (IQR, 14-39) versus 16 (IQR, 11-27.5) (P < .001 for each phase). Median and IQR for microembolic showers were as follows: wiring, 0 (IQR, 0-3) versus 0 (IQR, 0-0); predilation, 1.5 (IQR, 0-4) versus 0 (IQR, 0-2); stent deployment, 22 (IQR, 11-36) versus 11 (IQR, 6-17); postdilation, three (IQR, 0-9) versus one (IQR, 0-4); (postdilation phase, P = .001; all other phases, P < .001). Median for isolated microemboli in group 1 versus groups 2 and 3 combined were as follows: predilation, 10 (IQR, 5-22.75) versus 16 (IQR, 9-25) (P = .001); stent deployment, 32 (IQR, 15-58) versus 54 (IQR, 40.5-74) (P < .001); and postdilation, 11 (IQR, 6-19) versus 18 (IQR, 12-33) (P < .001). Median for microembolic showers during stent deployment were six (IQR, 1-14) versus 13 (IQR, 7-26) (P < .001). Five patients died, and five major strokes and 14 minor strokes occurred. Eight macroemboli occurred in unprotected procedures; six distal thrombi occurred in protected procedures. CONCLUSION: Carotid angioplasty and stent placement yielded more microemboli in patients treated with filtering CPDs than in unprotected procedures. The infrequent occurrence of cerebral sequelae did not allow comprehensive statistical comparison between groups.

Aged↗
PubMed2004

Effects of a distal protection device during primary stenting in patients with acute anterior myocardial infarction.

BACKGROUND: The angiographic no-reflow phenomenon is an adverse prognostic factor in patients with acute myocardial infarction (AMI). The aim of the present study was to evaluate the effects of an occlusive balloon type distal protection device (PercuSurge GuardWire: GW) during primary stenting in patients with anterior AMI. METHODS AND RESULTS: The GW group included 42 patients treated by primary stenting with GW protection and the control group included 30 patients treated by primary stenting after thrombectomy without distal protection. Left ventricular (LV) function was measured and compared by left ventriculography obtained soon after percutaneous coronary intervention (PCI) and 3 weeks after onset. The corrected TIMI frame count values were lower in the GW group than in the control group (27.5+/-2.3 vs 35.1 +/-2.5, p=0.030). The number of patients with myocardial blush grade 3 after PCI was higher in the GW group than in the control group (45.7 vs 20.0%, p=0.029). Peak concentration of creatine kinase myocardial fraction was lower in the GW group than in the control group (326.6+/-41.5 vs 454.9+/-46.2 mg/dl, p=0.043). GW patients showed greater improvement at 3 weeks after PCI in terms of LV ejection fraction (+4.6+/-1.2 vs -1.1+/-1.5, p=0.004), LV end-systolic volume index (+0.5+/-2.4 vs +9.0+/-2.7, p=0.023), and regional wall motion abnormalities (-2.03+/-0.14 vs -2.51+/-0.14, p=0.018). CONCLUSION: Primary stenting with GW protection can restore epicardial coronary flow and myocardial perfusion, and also preserve LV function in anterior AMI.

Blood Flow Velocity↗