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Introduction: Female sterilisation is the most common contraceptive method used globally. The use of female sterilisation is disproportionately low in sub-Sahara Africa (SSA) at just 1%. Nonetheless, the prevalence of sterilisation among married women in Malawi is quite high at about 11%. While a few recent studies in SSA have examined the relationship between women's decision-making autonomy and use of long-acting contraceptives, very few have investigated whether different dimensions of decision-making autonomy predict the use of female sterilisation differently. The objective of this study was therefore to examine the relationship between health care and contraceptive decision-making autonomy and the use of female sterilisation in Malawi. Data and methods: The study relied on secondary data from the 2015-16 Malawi Demographic and Health Survey. The sample comprised 9,164 married women in Malawi that were using a modern contraceptive. Multinomial logistic regression analysis was used to examine the association between health care and contraceptive decision-making autonomy and the use of female sterilisation, controlling for key socio-demographic characteristics. Results: The study revealed that the percentage of married women that made health care and contraceptive decisions independently was quite low. The main finding of this study was that contraceptive decision-making autonomy increased the relative likelihood of using female sterilisation while health care autonomy was associated with a lower likelihood of being sterilized. The socio- demographic characteristics that significantly predicted the use of female sterilisation included age, place of residence, household wealth and the number of children a woman had. Conclusion: This study demonstrates that health care and contraceptive decision making have different effects on the use of female sterilisation among married women in Malawi. Specifically, women with autonomy in health care decision making had a relatively lower likelihood of using female sterilisation while those with contraceptive decision-making autonomy had a higher likelihood of using female sterilisation. This suggests that intervention aimed at increasing the uptake of female sterilisation in Malawi need to focus on empowering women in the contraceptive decision-making domain.
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BACKGROUND: The incidence of sterilisation clip migration is reportedly 25%. However, less than 1% of those who experience clip migration will present with pain, an abscess, or spontaneous extrusion. Here we present a rare case of sterilisation clip migration through the entire pelvic floor. CASE PRESENTATION: A 66-year-old female was referred from community to the Surgical Emergency Unit with a possible metallic foreign body under the skin following an attempted routine gluteal cyst excision. The patient first noticed a lump under the skin 2 years ago which gradually became more apparent and tender over the previous 2 months. The patient denied recent trauma, had no co-morbidities and had a sterilisation procedure 24 years prior. Examination revealed a non-mobile solid structure just beneath the skin 5 cm laterally from the anal verge. Inflammatory markers were normal and an ultrasound confirmed a 15 × 7 mm foreign body in the subcutaneous tissues. The foreign body was excised easily under local anaesthesia, revealing a closed Filshie sterilisation clip. The wound was closed primarily, and recovery was uncomplicated. CONCLUSIONS: This was a case of sterilisation clip migration to the subcutaneous gluteal region. A literature review revealed 34 case reports of sterilisation clip migration, mostly to the bladder. Patients with a previous sterilisation procedure and suspected subcutaneous foreign body without trauma should elicit a high index of suspicion for migrated sterilisation clips. These clips can migrate through multiple layers of muscle and fascia, including the pelvic floor.
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INTRODUCTION: The reuse pacemakers is a beneficial technique for patients in countries with a low economic standard of living where health care is almost non-existent. We offered to share the experience of Senegal on the reconditioning of pacemakers. METHODOLOGY: We conducted a retrospective study over a period from January 2015 to December 2020 including all patients who benefited from a reconditioned pacemaker for primary implantation or reimplantation. The criteria for reconditioning pacemakers are the absence of dysfunction or damage and a residual battery life of more than 5 years of the pacemaker. Refurbished pacemakers are acquired either from deceased families or from extraction centers. Sterilization is carried out using phenoxypropanol + benzalkonium chloride solution, 70% ethanol and ethylene oxide. RESULTS: We collected 161 patients during the study period, including 77 men (48%) and 84 women (52%), i.e. a M/F sex ratio of 0.94. The average age of the population was 65 years. Functional symptomatology was dominated by syncope in 54%. Electrocardiographically, 72% of patients were in complete atrioventricular block. A primary implantation was noted in 91.5% of patients. The vascular approach most used during implantation was cephalic in 49.5% of cases. In our series, we noted that 58% of patients had benefited from temporary stimulation before implantation. At implantation, single-chamber stimulation was used in 60% of patients and 46.5% of patients had programming in VVI mode. We had 5.5% major complications with 3% box infection occurring between 3 and 6 months post-implantation and 2.5% pacemaker syndrome. We noted 1 case of death linked to underlying heart disease. CONCLUSION: Reconditioning of cardiac pacemakers is a safe and beneficial therapeutic strategy for patients. In Senegal, reconditioning has shown satisfactory results. In our countries this technique can be an alternative for certain patients.
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Reutilização de Equipamento , Hospitais Universitários , Marca-Passo Artificial , Humanos , Masculino , Feminino , Estudos Retrospectivos , Senegal , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , AdultoRESUMO
Fresh sea urchin (Paracentrotus lividus) gonads are a delicacy with short seasonal availability, very often heterogeneous in size and intrinsic characteristics. This study aimed to valorise this resource through the preparation of canned products (with/without Porphyra spp.) and evaluate their physicochemical and sensory quality (3-12 months). Canning contributed to a decrease in protein, K and most carotenoids contents; and a concentration of lipids, ash, Na and Se levels. A simulated 12-month ageing led to decrease the protein and ß-carotene contents; and the Na and lutein levels concentration. The macroalgae addition resulted in an orange, darker and less soft product, with higher carbohydrates, Na, Se and carotenoids contents. A 25 g-dose contributes to significant daily intakes of protein (8-9%), EPA+DHA (47-53%), I (35-62%) and Se (30-47%). The products were commercially stable/sterile and had good sensory acceptance. Overall, canning constitutes a strategy to provide a nutritionally balanced product available all year-round.
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Gônadas , Paracentrotus , Animais , Gônadas/química , Gônadas/metabolismo , Paracentrotus/química , Humanos , Conservação de Alimentos/métodos , Carotenoides/análise , Carotenoides/química , Ouriços-do-Mar/química , Valor NutritivoRESUMO
OBJECTIVES: In order to share their knowledge, sterilization unit managers publish the results of their work in journals or at scientific conferences. The aim of Enthalpies is to list all such work in a single database. The work presented describes the construction of this database and the assessment of its feasibility for the washing step. METHODS: The first step was to carry out a literature review. Only articles published over 10years (2013-2023) in connection with the ten-year washing stage were included. Then, each publication was categorized, coded, graded and summarized by a pharmacist-internal pair. All this data was collated in an Excel® spreadsheet, and from the data categorization a tree structure was created, enabling the interface between the user and the platform hosting Enthalpies to be understood. RESULTS: Eighty-one publications were identified. These were categorized into 6 themes and 27 sub-themes. A reading grid was drawn up for each publication. Genially®, an online platform, was chosen to host our database. CONCLUSION: Enthalpies was not designed to issue recommendations for best practice. However, by collating published scientific data, this tool can be used to assist decision-making. It represents an innovative solution for providing a literature review in the field of hospital sterilization.
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OBJECTIVES: The standard process of central sterilization is crucial for the optimal functioning of the operating room. The outcome of this process is closely linked to the steps preceding the steps prior to the sterilization step itself. These steps include pre-disinfection carried out in the operating rooms and other stages, namely washing, drying and packaging, which must be performed in the central sterilization unit. In this context, this study aimed to describe the knowledge of the staff in the operating rooms and the central sterilization unit at Sahloul University Hospital in Sousse (Tunisia) in 2022, regarding the steps prior to the sterilization of reusable thermoresistant medical devices and to describe their practices in terms of compliance with these steps. METHOD: A descriptive study was conducted from January 2022 to June 2022 with the aforementioned staff, using a self-administered questionnaire to assess their knowledge of the pre-sterilization steps and a direct observation audit of their practices with regard to these steps. Both measurement instruments were pre-tested. RESULTS: Out of 102 self-administered questionnaires (knowledge assessment) distributed to the staff concerned, only 80 were returned and correctly filled out, giving a response rate of 78.4%. Participants' responses regarding the order of steps prior to the sterilization were incorrect in 64% of cases. With regard to the evaluation of professional practices, 224 observations were made in the study area (practice audit). In 82% of these observations, the pre-disinfection step was confused with the washing step. The use of Betadine brushes and scrubbing pads for device washing was noted in 89.3%, along with the absence of swabbing of the canals and hollow parts in 9.4% of cases and the absence of drying of the canals with compressed air. CONCLUSION: Mastery of the steps prior to sterilisation of reusable thermoresistant medical devices was insufficient in our institution, suggesting the importance of reinforcing the implementation of the procedure through a continuous training program followed by action plans.
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Biomaterials that can improve the healing of articular cartilage lesions are needed. To address this unmet need, we developed novel 3D printed silica/poly(tetrahydrofuran)/poly(ε-caprolactone) (SiO2/PTHF/PCL-diCOOH) hybrid scaffolds. Our aim was to carry out essential studies to advance this medical device towards functional validation in pre-clinical trials. First, we show that the chemical composition, microarchitecture and mechanical properties of these scaffolds were not affected by sterilisation with gamma irradiation. To evaluate the systemic and local immunogenic reactivity of the sterilised 3D printed hybrid scaffolds, they were implanted subcutaneously into Balb/c mice. The scaffolds did not trigger a systemic inflammatory response over one week of implantation. The interaction between the host immune system and the implanted scaffold elicited a local physiological reaction with infiltration of mononuclear cells without any signs of a chronic inflammatory response. Then, we investigated how these 3D printed hybrid scaffolds direct chondrogenesis in vitro. Human bone marrow-derived mesenchymal stem/stromal cells (hBM-MSCs) seeded within the 3D printed hybrid scaffolds were cultured under normoxic or hypoxic conditions, with or without chondrogenic supplements. Chondrogenic differentiation assessed by both gene expression and protein production analyses showed that 3D printed hybrid scaffolds support hBM-MSC chondrogenesis. Articular cartilage-specific extracellular matrix deposition within these scaffolds was enhanced under hypoxic conditions (1.7 or 3.7 fold increase in the median of aggrecan production in basal or chondrogenic differentiation media). Our findings show that 3D printed SiO2/PTHF/PCL-diCOOH hybrid scaffolds have the potential to support the regeneration of cartilage tissue.
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The volatile organic compounds (VOCs) of Rhizoma Acori Tatarinowii were extracted via steam distillation and then irradiated with 60Co-γ rays, in which doses of 60Co-γ 0, 5, and 10 kGy were selected to irradiate the VOCs. Finally, gas chromatography-ion mobility spectrometry (GC-IMS) was used to compare the differences between the VOCs, and then qualitatively analyse the components and contents of each part of the VOCs The results showed that under the three irradiation doses of 60Co-γ 0, 5 and 10 kGy, the VOCs of unirradiated and 5 kGy-irradiated samples were closer, and the samples irradiated at a 10 kGy dose were quite different from the other two components, meaning that when the calamus medicinal materials were sterilised by means of 60Co irradiation, the dose of 5 kGy was closer to the original compound content of the medicinal materials.
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INTRODUCTION: This study observed the effects of oxygen supplementation, via an oxygen concentrator, on peripheral arterial blood oxygenation (SpO2) measured by pulse oximetry in anaesthetised cats undergoing spay in three different surgical positions. A total of 192 female feral cats were investigated for a large-scale trap-neuter-release program. Cats were anaesthetised with an intramuscular combination of butorphanol (0,4 mg / kg), ketamine (7-10 mg / kg) and medetomidine (0,03-0,05 mg / kg). Cats were randomly allocated to undergo spay in either Trendelenburg (TR) (70° downward head tilt), lateral (LR) or dorsal (DR) recumbency. Cats were breathing spontaneously either room air or 2 L/minute oxygen via a tight-fitting face mask. Pulse rate (in beats per minute), respiratory rate (in breaths per minute) and SpO2 (in percentage) were measured at baseline in left lateral recumbency and afterwards continuously after being positioned in allocated surgical position. At the end of surgery, cats were placed again in left recumbency, and all parameters were re-evaluated after five minutes. Overall, 33 % of cats showed severe arterial oxygen desaturation (SpO2 < 90 %) at baseline when breathing room air. When oxygen was supplemented during the procedure, arterial oxygen desaturation resolved in all cats. At the end of the procedure, 29 % of cats were hypoxaemic when oxygen was not supplemented, with an overall higher percentage of hypoxaemic cats in TR as compared to DR and LR recumbencies. All cats recovered well from surgery and were released within 24 hours post-anaesthesia. Arterial oxygen desaturation is frequent in cats anaesthetised with injectable anaesthesia for spay under field conditions. Oxygen supplementation administered via a tight-fitting mask resolved arterial oxygen desaturation in this feral cat population regardless of the surgical position and therefore oxygen supplementation is recommended in any case.
INTRODUCTION: Cette étude a observé les effets d'une supplémentation en oxygène, via un concentrateur d'oxygène, sur l'oxygénation du sang artériel périphérique (SpO2) mesurée par oxymétrie de pouls chez des chats anesthésiés subissant une stérilisation dans trois positions chirurgicales différentes. Au total, 192 chats sauvages femelles ont été examinés dans le cadre d'un programme de piégeage, de stérilisation et de remise en liberté à grande échelle. Les chats ont été anesthésiés avec une combinaison de butorphanol (0,4 mg / kg), de kétamine (710 mg / kg) et de médétomidine (0,030,05 mg / kg) appliquée par voie intramusculaire. Les chats ont été répartis au hasard pour subir une stérilisation en position de Trendelenburg (TR) (inclinaison de la tête de 70° vers le bas), en décubitus latéral (LR) ou en décubitus dorsal (DR). Les chats respiraient spontanément soit de l'air ambiant, soit de l'oxygène à raison de 2 L/minute par l'intermédiaire d'un masque facial bien ajusté. Le pouls (en battements par minute), la fréquence respiratoire (en respirations par minute) et la SpO2 (en pourcentage) ont été mesurés au départ en décubitus latéral gauche, puis en continu après avoir été placés dans la position chirurgicale attribuée. À la fin de l'opération, les chats ont été replacés en décubitus latéral gauche et tous les paramètres ont été réévalués au bout de cinq minutes. Dans l'ensemble, 33 % des chats présentaient une désaturation sévère en oxygène artériel (SpO2 < 90 %) au départ lorsqu'ils respiraient de l'air ambiant. Lorsque de l'oxygène a été ajouté pendant la procédure, la désaturation en oxygène artériel s'est résorbée chez tous les chats. À la fin de l'intervention, 29 % des chats étaient hypoxémiques lorsque l'oxygène n'était pas administré, avec un pourcentage global plus élevé de chats hypoxémiques en décubitus dorsal qu'en décubitus latéral. Tous les chats se sont bien remis de l'opération et ont été libérés dans les 24 heures suivant l'anesthésie. La désaturation en oxygène artériel est fréquente chez les chats anesthésiés par injection pour la stérilisation dans des conditions de terrain. La supplémentation en oxygène administrée via un masque étanche a résolu la désaturation en oxygène artériel dans cette population de chats sauvages, quelle que soit la position chirurgicale et la supplémentation en oxygène est donc recommandée dans tous les cas.
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Anestesia , Gatos/cirurgia , Animais , Feminino , Anestesia/veterinária , Animais Selvagens , Respiração , Oxigênio , Oxigenoterapia/veterináriaRESUMO
The quality of sterilisation and disinfection in a central sterile supply department is directly related to the quality of the hospital services and the patients' safety. Wet packs occasionally occur following the process of pressure steam sterilisation; reducing this occurrence is an important issue. Therefore, the causes of wet pack following sterilisation were analysed to identify the influencing factors and suggest improvements to prevent its occurrence. Understanding the sterilisation process and possible causes of exposure helps with risk assessment and identifying necessary corrective measures.
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Vapor , Esterilização , Humanos , Vácuo , Pressão Sanguínea , DesinfecçãoRESUMO
BACKGROUND: Intraperitoneal antibiotics may be required daily for up to three weeks to treat peritoneal dialysis (PD)-related peritonitis. In some jurisdictions, antibiotic-admixed PD solutions are required to be used within 24 h due to concerns regarding microbial contamination and growth. This requires patients to attend the PD unit daily or alternatively for staff to perform home delivery with associated transport, staffing and cost implications. OBJECTIVE: The aim of this study was to determine if significant microbial growth occurs in PD solutions following their injection with antibiotic or sterile water. METHODS: Twelve PD solution bags were admixed with cefazolin sodium 1 g, diluted in 10 mL sterile water, while a further 12 PD solution bags were admixed with 10 mL sterile water using aseptic technique (AT) under supervision. All bags were stored at room temperature. Three bags from each experimental group were sampled for microbiologic culture at 0-, 24-, 48- and 72-h intervals. RESULTS: One sterile water admixed bag sampled at 24 h yielded a Corynebacterium spp. after microbiologic culture. A repeat specimen from the same bag at day nine returned a negative culture result. All other sterile water and cefazolin admixed bags returned negative culture results at all time points. CONCLUSIONS: Antibiotic-admixed PD solutions prepared using AT and stored at room temperature remained sterile for up to 72 h. This suggests that patients can be safely issued with a supply of antibiotic-admixed PD bags for up to three days at a time.
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Installation of technologies to remove or deactivate respiratory pathogens from indoor air is a plausible non-pharmaceutical infectious disease control strategy. OBJECTIVE: We undertook a systematic review of worldwide observational and experimental studies, published 1970-2022, to synthesise evidence about the effectiveness of suitable indoor air treatment technologies to prevent respiratory or gastrointestinal infections. METHODS: We searched for data about infection and symptom outcomes for persons who spent minimum 20 h/week in shared indoor spaces subjected to air treatment strategies hypothesised to change risk of respiratory or gastrointestinal infections or symptoms. RESULTS: Pooled data from 32 included studies suggested no net benefits of air treatment technologies for symptom severity or symptom presence, in absence of confirmed infection. Infection incidence was lower in three cohort studies for persons exposed to high efficiency particulate air filtration (RR 0.4, 95%CI 0.28-0.58, p < 0.001) and in one cohort study that combined ionisers with electrostatic nano filtration (RR 0.08, 95%CI 0.01-0.60, p = 0.01); other types of air treatment technologies and air treatment in other study designs were not strongly linked to fewer infections. The infection outcome data exhibited strong publication bias. CONCLUSIONS: Although environmental and surface samples are reduced after air treatment by several air treatment strategies, especially germicidal lights and high efficiency particulate air filtration, robust evidence has yet to emerge that these technologies are effective at reducing respiratory or gastrointestinal infections in real world settings. Data from several randomised trials have yet to report and will be welcome to the evidence base.
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Infecções Respiratórias , Humanos , Estudos de Coortes , Infecções Respiratórias/prevenção & controleRESUMO
INTRODUCTION: Intraperitoneal administration of local anaesthetics may reduce postoperative pain after ovariohysterectomy in dogs. The aim of this prospective, randomised, blinded, placebo-controlled clinical trial was to compare postoperative analgesia and opioid requirements after intraperitoneal and incisional administration of ropivacaine versus 0,9 % NaCl (saline). Forty-three client-owned dogs were enrolled in the study and anaesthetised using a standardized protocol that included premedication with acepromazine (0,03-0,05 mg/kg) and dexmedetomidine (0,01 mg/kg) intramuscularly. Anaesthesia was induced with propofol titrated to effect and ketamine (1 mg/kg) intravenously and maintained with isoflurane in oxygen. The analgesic regimen included carprofen (4 mg/kg) subcutaneously and morphine (0,2 mg/kg) intravenously. Depending on group assignment, each dog received either an intraperitoneal and incisional splash with ropivacaine (2 mg/kg and 1 mg/kg, respectively) (group R), or an equal volume of saline (group S). Buprenorphine (0,02 mg/kg) was administered intramuscularly once the uterus was removed. Sedation and pain were assessed 0,5, 1, 2, 4, 6 and 8 hours after extubation using a sedation scale, the short form of the Glasgow Composite Pain Scale (CMPS-SF) and a dynamic interactive visual analogue scale (DIVAS). Postoperatively, buprenorphine (0,01 mg/kg) was administered intravenously if dogs scored 6/24 on CMPS-SF. The ordinal mixed model showed no difference in pain scores between groups. Fisher's exact test showed no significant difference in postoperative buprenorphine requirements between group S (3/22 dogs) and group R (1/21 dogs) at the doses used. In addition, lower sedation scores were associated with higher DIVAS scores. In this multimodal analgesic protocol, ropivacaine could not improve analgesia compared to saline.
INTRODUCTION: L'administration intrapéritonéale d'anesthésiques locaux peut réduire la douleur postopératoire après une ovariohystérectomie chez la chienne. L'objectif de cet essai clinique prospectif, randomisé, en aveugle et contrôlé par placebo était de comparer l'analgésie postopératoire et les besoins en opioïdes après l'administration intrapéritonéale et incisionnelle de ropivacaïne par rapport à du NaCl 0,9 % (sérum physiologique). Quarante-trois chiennes appartenant à des clients ont été enrôlés dans l'étude et anesthésiés selon un protocole standardisé comprenant une prémédication par acépromazine (0,03 - 0,05 mg/kg) et dexmedetomidine (0,01 mg/kg) par voie intramusculaire. L'anesthésie a été induite avec du propofol dosé à l'effet et de la kétamine (1 mg/kg) par voie intraveineuse et maintenue avec de l'isoflurane dans de l'oxygène. Le traitement analgésique comprenait du carprofène (4 mg/kg) par voie sous-cutanée et de la morphine (0,2 mg/kg) par voie intraveineuse. En fonction de son affectation à un groupe, chaque chien a reçu soit une injection intrapéritonéale et incisionnelle de ropivacaïne (2 mg/kg et 1 mg/kg, respectivement) (groupe R), soit un volume égal de solution saline (groupe S). La buprénorphine (0,02 mg/kg) a été administrée par voie intramusculaire après l'ablation de l'utérus. La sédation et la douleur ont été évaluées 0,5, 1, 2, 4, 6 et 8 heures après l'extubation à l'aide d'une échelle de sédation, de la forme courte de l'échelle composite de douleur de Glasgow (CMPS-SF) et d'une échelle visuelle analogique interactive dynamique (DIVAS). En postopératoire, de la buprénorphine (0,01 mg/kg) a été administrée par voie intraveineuse si les chiens obtenaient un score de 6/24 sur l'échelle CMPS-SF. Le modèle mixte ordinal n'a montré aucune différence dans les scores de douleur entre les groupes. Le test exact de Fisher n'a pas montré de différence significative dans les besoins postopératoires en buprénorphine entre le groupe S (3/22 chiens) et le groupe R (1/21 chiens) aux doses utilisées. De plus, des scores de sédation plus faibles étaient associés à des scores DIVAS plus élevés. Dans ce protocole d'analgésie multimodale, la ropivacaïne n'a pas permis d'améliorer l'analgésie par rapport au sérum physiologique.
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Analgesia , Anestesia , Buprenorfina , Doenças do Cão , Dor Pós-Operatória , Animais , Cães , Feminino , Analgesia/veterinária , Analgesia/métodos , Analgésicos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Anestesia/veterinária , Buprenorfina/uso terapêutico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/prevenção & controle , Histerectomia/veterinária , Ovariectomia/veterinária , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/veterinária , Estudos Prospectivos , Ropivacaina/uso terapêuticoRESUMO
BACKGROUND: Low-cost meshes (LCM) have been successfully used in low-income countries (LIC) over the past decades, demonstrating comparable surgical outcomes to commercial meshes at a fraction of the cost. However, LIC sterilisation standards (autoclave sterilisation at 121 °C) do not meet UK regulations for medical devices, which require either ethylene oxide (EO) sterilisation or steam sterilisation at 134 °C. Therefore, the aim of this study was to sterilise UK LCM and characterise their mechanical properties and in vitro biocompatibility to verify whether EO sterilisation causes changes in the mechanical properties and biocompatibility of LCM. METHODS: EO sterilised LCM were used. Uniaxial tensile tests were performed to measure mechanical properties. Biocompatibility was measured through viability and morphology of Human Dermal Fibroblasts (HDFs) cultured in mesh-conditioned media, and by calculating the metabolic activity and proliferation of HDFs attached on the meshes, with alamarBlue assay. RESULTS: Break stress of LCM1 was significantly higher than LCM2 (p < 0.0001), while Young's modulus of LCM1 was significantly lower than LCM2 (p < 0.05) and there was no significant difference in break strain. Viability and morphology showed no significant difference between LCM and control. Attachment and proliferation of HDFs on LCM showed a better proliferation on LCM2 than LCM1, with values similar to the control at the final time point. CONCLUSIONS: We demonstrated that EO sterilisation affects LCM mechanical properties, but they still have values closer to the native tissues than the commercially available ones. We also showed that in vitro biocompatibility of LCM2 is not affected by EO sterilisation, as HDFs attached and proliferated on the mesh, while EO affected attachment on LCM1. A more detailed cost analysis of the potential savings for healthcare systems around the world needs to be performed to strengthen the cost-effectiveness of this frugal innovation.
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Óxido de Etileno , Telas Cirúrgicas , Humanos , Teste de Materiais , Hérnia , Reino UnidoRESUMO
Cats are popular companion animals globally. While the general academic definition of responsible cat ownership is agreed upon, committing to responsible cat ownership is multifaceted, often reflecting regional priorities and values. Utilising a virtual private network (VPN), an English-language online search for 'responsible cat ownership' was applied from major cities in 10 different nations, accounting for five different geographic regions and nine different geographic sub-regions. Data were extracted from the first 20 webpages of each search and included author affiliation, country of webpage origin, and all recommendations towards responsible cat ownership. Searches identified 58 different webpages, 142 duplicate results, and 16 different recommendations. Both before (60.5%) and after (58.6%) duplicate exclusion, irrespective of region, most webpages originated from Australia, so recommendations may lack local nuance in other countries. Similarly, local government webpages were the most common author affiliation both before (35.5%) and after (37.9%) duplicate exclusion-moreover, most Australian webpages were authored by local government (55.9%). More than half of all webpages recommended registration and microchipping (65.5%), desexing (65.5%), and containment (60.3%), probably due to the predominance of local government and Australian webpages online-reflecting Australia's strong legislative stance. Both Australia and New Zealand showed majority recommendations for containment but not for environmental and behavioural enrichment in households. This may be partially explained by the significantly higher agreement in Australia and New Zealand that cats threaten valued wildlife in cities, towns, and rural areas. Unlike the Oceanian nations, other countries clearly recommended improved understanding and provision for cat needs, but with little evidence of support for containment. Thus, divergent welfare considerations inform major webpages associated with attitudes towards cat ownership internationally. Encouraging containment, a responsible cat ownership practice with benefits for cats and wildlife, may be more likely to succeed outside Oceania if cat welfare is emphasised instead of wildlife protection. Within Oceania, more attention could be given to enhancing the well-being of contained cats.
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The cornea is the major contributor to the refractive power of the eye, and corneal diseases are a leading cause of reversible blindness. The main treatment for advanced corneal disease is keratoplasty: allograft transplantation of the cornea. Examples include lenticule implantation to treat corneal disorders (e.g. keratoconus) or correct refractive errors. These procedures are limited by the shelf-life of the corneal tissue, which must be discarded within 2-4 weeks. Electron-beam irradiation is an emerging sterilisation technique, which extends this shelf life to 2 years. Here, we produced lenticules from fresh and electron-beam (E-beam) irradiated corneas to establish a new source of tissue for lenticule implantation. In vitro, in vivo, and ex vivo experiments were conducted to compare fresh and E-beam-irradiated lenticules. Results were similar in terms of cutting accuracy, ultrastructure, optical transparency, ease of extraction and transplantation, resilience to mechanical handling, biocompatibility, and post-transplant wound healing process. Two main differences were noted. First, â¼59% reduction of glycosaminoglycans resulted in greater compression of E-beam-irradiated lenticules post-transplant, likely due to reduced corneal hydration-this appeared to affect keratometry after implantation. Cutting a thicker lenticule would be required to ameliorate the difference in refraction. Second, E-beam-sterilised lenticules exhibited lower Young's modulus which may indicate greater care with handling, although no damage or perforation was caused in our procedures. In summary, E-beam-irradiated corneas are a viable source of tissue for stromal lenticules, and may facilitate on-demand lenticule implantation to treat a wide range of corneal diseases. Our study suggested that its applications in human patients are warranted. STATEMENT OF SIGNIFICANCE: Corneal blindness affects over six million patients worldwide. For patients requiring corneal transplantation, current cadaver-based procedures are limited by the short shelf-life of donor tissue. Electron-beam (E-beam) sterilisation extends this shelf-life from weeks to years but there are few published studies of its use. We demonstrated that E-beam-irradiated corneas are a viable source of lenticules for implantation. We conducted in vitro, in vivo, and ex vivo comparisons of E-beam and fresh corneal lenticules. The only differences exhibited by E-beam-treated lenticules were reduced expression of glycosaminoglycans, resulting in greater tissue compression and lower refraction suggesting that a thicker cut is required to achieve the same optical and refractive outcome; and lower Young's modulus indicating extra care with handling.
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Cirurgia da Córnea a Laser , Ceratocone , Erros de Refração , Humanos , Substância Própria/transplante , Elétrons , Cirurgia da Córnea a Laser/métodos , Córnea/cirurgia , Ceratocone/cirurgia , GlicosaminoglicanosRESUMO
The novelty of this study is the investigation of the effect of different heat treatments and, simultaneously, the effect of different fat levels on the quality of pork liver pâtés. Hence, this study aimed to evaluate the effect of heat treatment and fat content on selected properties of pork liver pâté. For this purpose, four batches of pâtés with two different fat contents (30 and 40% (w/w)) and two different heat treatments (pasteurisation: target temperature 70 °C, holding time of 10 min; sterilisation: target temperature 122 °C, holding time of 10 min) were manufactured. Chemical (pH, dry matter, crude protein, total lipid, ammonia, and thiobarbituric acid reactive substances (TBARS)), microbiological, colour, textural, rheological, and sensory analyses were performed. Both different heat treatment and fat content affected most of the parameters observed. Sterilisation ensured the commercial sterility of the manufactured pâtés, resulting in elevated TBARS values, hardness, cohesiveness, gumminess and springiness, and increased rheological parameters (G', Gâ³, G*, and η*), as well as colour changes (decrease in L* and increase in a*, b*, and C* values) and deterioration of appearance, consistency, and flavour also being detected (p < 0.05). Higher fat content caused similar variations in the textural and viscoelastic properties, i.e., the increase in hardness, cohesiveness, gumminess and springiness, and also in G', Gâ³, G*, and η* (p < 0.05). However, the colour and sensorial parameters changed in different ways compared to the changes induced by the sterilisation effect. Overall, the observed changes might not be desirable for some consumers and further research would be appropriate to improve especially the sensorial attributes of sterilised pork liver pâtés.
RESUMO
BACKGROUND: Female sterilisation remains a common contraceptive method in many countries. AIMS: The aim is to analyse the recent changes in the incidence of female sterilisation in New South Wales (NSW). METHODS: Data were obtained from the NSW Admitted Patients Data Collection for all female patients who had undergone one of the five sterilisation procedures in a public or private hospitals in NSW during 2010 and 2019. Denominators for calculating sterilisation rates were estimated using census and other population data. RESULTS: The number of sterilisation cases dropped from 3407 in 2010 to 2561 in 2019, and the sterilisation rate declined from 22.6 per 10 000 females aged 20-49 in 2010 to 15.4 in 2019. Incidence was at its peak in the 35-39 age group in both years. Indigenous females had higher sterilisation rates than non-Indigenous females born in Australia or overseas. While some foreign-born females had higher sterilisation rates than for those who were in Australia or overseas on average their rates were lower than those who were born in Australia or overseas. There was a clear socio-economic gradient such that females living in the most disadvantaged areas had much higher sterilisation rates than those living in the least disadvantaged areas. The Indigenous, ethnic and socio-economic differences in sterilisation rates persisted in both years of this study. CONCLUSION: Although fertility rates in NSW changed little over the 10-year interval a steady decline in sterilisation occurred, consistent with other forms of contraception (particularly long-acting reversible types) increasing concurrently in popularity.
Assuntos
Anticoncepção , Esterilização Reprodutiva , Humanos , Feminino , Adulto , New South Wales/epidemiologia , Austrália , Coleta de DadosRESUMO
In order to implement individual instrument traceability, the evolution of laser and micropercussion markings was evaluated over 250 sterilisation cycles. A datamatrix associated with its alphanumeric code was applied on three types of instruments by laser or micropercussion. All instruments had a unique identifier affixed by the manufacturer. The sterilisation cycles corresponded to the usual cycles performed in our sterilisation unit. The laser markings had very good visibility but were quickly affected by corrosion: 12% of the markings were corroded after the 5th sterilisation cycle. Similar results were observed for unique identifiers applied by the manufacturer but with visibility attenuated by sterilisation cycles: 33% of identifiers were poorly visible after the 125th sterilisation cycle. Finally, micropercussion markings were less susceptible to corrosion but initially showed poorer contrast.