RESUMEN
School context can shape relative intervention response in myriad ways due to factors, such as instructional quality, resource allocation, peer effects, and correlations between the school context and characteristics of enrolled students (e.g., higher-poverty students attending higher-poverty schools). In the current study, we used data from 16,000 Grade 3 students in a community-based supplemental reading intervention program to investigate the degree to which school context factors (percentage eligible for free/reduced-price lunch [FRPL], school-level achievement) relate to the differences in triannual reading fluency growth rates between students actively receiving supplemental intervention (active recipients) and those that formerly received intervention (and therefore only received general class instruction at this time; former recipients). Using Bayesian multilevel modeling, our findings indicate that school-level FRPL eligibility played a more prominent factor in growth rate differences between these two groups than school-level reading achievement. However, school-level reading achievement was much more strongly related to reading fluency differences between active and former intervention recipients at the beginning of the school year (when controlling for FRPL). Implications for investigating school-level heterogeneity in intervention response and sustainability are discussed.
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Longitudinal data can provide inferences at both the between-person and within-person levels of analysis, but only to the extent that the statistical models chosen for data analysis are specified to adequately capture these distinct sources of association. The present work focuses on auto-regressive cross-lagged panel models, which have long been used to examine time-lagged reciprocal relations and mediation among multiple variables measured repeatedly over time. Unfortunately, many common implementations of these models fail to distinguish between-person associations among individual differences in the variables' amounts and changes over time, and thus confound between-person and within-person relations either partially or entirely, leading to inaccurate results. Furthermore, in the increasingly complex model variants that continue to be developed, what is not easily appreciated is how substantial differences in interpretation can be created by what appear to be trivial differences in model specification. In the present work, we aimed to (a) help analysts become better acquainted with the some of the more common model variants that fall under this larger umbrella, and (b) explicate what characteristics of one's data and research questions should be considered in selecting a model. Supplementary Materials include annotated model syntax and output using Mplus, lavaan in R, and sem in Stata to help translate these concepts into practice.
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Relaciones Interpersonales , Modelos Estadísticos , Humanos , IndividualidadRESUMEN
Structural equation models (SEM) are a method of latent variable analysis that offer a high degree of flexibility in terms of modeling methods for applied research questions. Recent advancements associated with longitudinal SEM have unlocked innovative ways to decompose variance and to estimate mean trends over time (e.g., Allison et al., 2017; Berry & Willoughby, 2017; Hamaker et al., 2015; McArdle & Nesselroade, 2014). However, these longitudinal methods are not necessarily readily accessible to scholars seeking to advance theory and practice in school psychology. Importantly, not all longitudinal data are the same and not all longitudinal SEMs are the same; thus, analytic approaches must be appropriately matched to specific research aims to meaningfully inform school psychology theory and practice. The present article highlights recent advances in longitudinal SEMs, clarifies their similarities to other-perhaps more familiar-methods, and matches their applications to specific types of research questions. The intent of this work is to promote careful thinking about the correspondence between estimands, developmental theory, and practical applications to foster specificity in testing quantitative questions in school psychology research and advance a more rigorous evaluation of longitudinal trends relevant to research and practice in the field.
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Modelos Teóricos , Instituciones Académicas , Humanos , Proyectos de InvestigaciónRESUMEN
We examined whether English language proficiency (ELP) related to interim reading and math performance differently when academic assessments were administered to students in either English or Spanish. We also tested these effects with Spanish language proficiency (SLP) as well as jointly with ELP and SLP. Students from a midwestern suburban school district in Grades 2-8 were included (N = 2,327); 763 of these students in Grades 4-8 had SLP and ELP scores. Differences between English and Spanish math scores varied minimally across the majority of the ELP distribution. English-Spanish differences in reading across ELP scores were more pronounced. Language differences in math and reading scores as a function of only SLP were less clear, and reading was also more sensitive to joint changes in ELP and SLP compared to math. We discuss practical implications and limitations for assessment within multitiered systems of support as well as future directions for research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Comunicación , Escolaridad , Lenguaje , Matemática , Lectura , Estudiantes , Humanos , Hispánicos o Latinos , Niño , AdolescenteRESUMEN
Using kindergarten up to fourth-grade data from the Early Childhood Longitudinal Study (2010-2011 cohort), we investigated systematic variability in English language learners' (ELLs; n = 303) mathematics growth as well as relations of kindergarten language growth and working memory (WM) to ELLs' mathematics growth. Using growth mixture modeling, only one class of growth emerged from ELLs' English mathematics growth from first through fourth grades. WM related to ELLs' English mathematics growth from Grades 1 to 4, as did kindergarten growth in English early literacy. We also investigated kindergarten to Grade 4 mathematics growth between ELLs and English proficient students (EPSs; n = 4,711) using latent change score models and whether WM differentially predicted growth patterns. ELLs and EPSs did not exhibit markedly different growth patterns, and WM similarly predicted these patterns. Implications for future research as well as practical implications and limitations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Multilingüismo , Preescolar , Humanos , Lenguaje , Estudios Longitudinales , Matemática , Memoria a Corto PlazoRESUMEN
The purpose of this study was to examine whether seventh-grade positive peer affiliation and conduct problems mediated the relationship between sixth-grade parental monitoring of behavior and eighth-grade school participation and grades among students with elevated behavior ratings (EBR; n = 821) and students with unelevated behavior ratings (UBR; n = 3,779). Conduct problems and peer affiliation mediated the relationship between parental monitoring and school participation as well as grades in the overall sample (n = 4,600). A multiple-group mediation model suggested that these effects did not significantly differ across students with EBR and UBR, though the mediation estimates were smaller in magnitude and not statistically significant among students with EBR. Implications for the role of parental monitoring as an intervention target within a multitiered system of support for social and behavioral skills in middle school, as well as limitations and future directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Conducta del Adolescente , Instituciones Académicas , Adolescente , Humanos , Padres , Grupo Paritario , EstudiantesRESUMEN
Traumatic lesions around the base of the thumb have special features due to the location and structure of the joint and its inherent potential instability. This causes different fracture patterns, which are mostly isolated around the metacarpal base but can also involve just the trapezium or both. Exceptionally, there may be isolated dislocation. Fracture patterns are variable and influence the type of surgery. The most common fracture is Bennett's fracture accounting for 4% of all hand fractures and sometimes associated with trapezium fracture, usually in male subjects. Different fracture mechanisms have been proposed. Apart from intra-articular fractures of the metacarpal base and the trapezium, proximal metaphyseal fractures can exceptionally be treated conservatively by immobilization. All other fractures require open or closed reduction combined with different types of temporary pinning or open reduction and internal fixation with screws or locking plate in case of comminution. Immobilization depends on the type of surgical treatment and can be removable or non-removable. Close follow-up is mandatory to avoid the inconveniences of secondary swelling with non-removable plaster and resin casts. Extra-articular malunion may be tolerated, but articular malunion must be corrected surgically by intra-articular osteotomy to restore the joint. In case of posttraumatic joint degeneration, treatment will focus on a case-by-case basis on the patient's complaints. Arthrodesis or prosthetic surgery can be proposed in case of severe problems caused by osteoarthritis.
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Fracturas Óseas , Luxaciones Articulares , Huesos del Metacarpo , Traumatismos de la Muñeca , Fijación Interna de Fracturas/efectos adversos , Fracturas Óseas/cirugía , Humanos , Luxaciones Articulares/etiología , Luxaciones Articulares/cirugía , Masculino , Huesos del Metacarpo/cirugía , Pulgar/cirugía , Traumatismos de la Muñeca/complicacionesRESUMEN
Several surgical and anesthesia techniques are used in carpal tunnel surgery. The practices of members of the American Society for Surgery of the Hand and the Canadian Society of Plastic Surgery were recently published and compared. Because of the great difference in these practices, we investigated the practices of the members of the French Society for Surgery of the Hand and how they would change. An online survey including 14 systematic and 12 conditional questions was sent by email to all 685 surgeons who were members of the French Society for Surgery of the Hand in July 2019. Data were analyzed using descriptive statistics. The survey was completed by 129 members (19%). The open approach was used by 56% of the surgeons (8% by traditional open technique, 48% by minimally invasive open technique), endoscopic techniques by 40% and ultrasound-guided techniques by 4%. Most surgeons used regional anesthesia (69%) or local anesthesia (25%). Half of the surgeons (50%) would consider changing their surgical technique. Sixty-one percent were interested in ultrasound-guided techniques and 34% in endoscopic techniques. Almost half the surgeons (48%) would consider changing their anesthesia technique and 97% were interested in local anesthesia. Our study showed that the open approach and regional anesthesia were the most frequently used techniques but that an increase in endoscopic and ultrasound-guided techniques as well as local anesthesia techniques was likely. LEVEL OF EVIDENCE: Economic and decision analysis V.
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Síndrome del Túnel Carpiano , Anestesia Local , Canadá , Síndrome del Túnel Carpiano/cirugía , Mano , Humanos , Estados Unidos , MuñecaRESUMEN
Scaphotrapeziotrapezoid osteoarthritis (STT OA) is common and often associated with thumb basal joint arthritis. Pain at the base of the thumb on the volar aspect and during resisted extension is characteristic of symptomatic STT OA. If conservative treatment fails, surgical treatment may be offered. In case of STT OA, treatment may range from arthrodesis to trapeziectomy (isolated or associated with ligament reconstruction and/or interposition). Any preoperative intracarpal instability (DISI) can be exacerbated by resecting more than 3 or 4 mm of the distal pole of scaphoid. For peritrapezial osteoarthritis, trapeziectomy is the logical solution, but it exposes the patient to known complications: loss of strength, long recovery, trapeziometacarpal impingement. Initial treatment of thumb basal joint arthritis by arthroplasty is also an option. Treatment of both sites is also possible by interposition of pyrocarbon implants. In all cases (isolated or associated STT OA) and no matter the technique chosen, maintaining the scaphoid height (arthrodesis, resection < 3 mm and/or associated interposition) and performing oblique trapezoidal osteotomy (to prevent scaphoid-metacarpal impingement) are the two crucial elements of surgical treatment.
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Huesos del Metacarpo , Osteoartritis , Hueso Escafoides , Hueso Trapecio , Humanos , Osteoartritis/diagnóstico por imagen , Osteoartritis/cirugía , Hueso Escafoides/diagnóstico por imagen , Hueso Escafoides/cirugía , Pulgar , Hueso Trapecio/diagnóstico por imagen , Hueso Trapecio/cirugíaRESUMEN
Exertional compartment syndrome of the forearm is a rare pathology, occurring almost exclusively in motorcycle racers. The results of endoscopic techniques are similar to those of open fasciotomies, but they are less invasive and leave smaller scars. The aim of our study was to present a new endoscopic technique for superficial fasciotomy using the Agee® system and to describe the results. This was a single-center, retrospective descriptive study of 21 patients (36 forearms) operated on between 2006 and 2016. All patients but one were competitive motorcycle racers. The mean operating time was 38.2min (standard deviation (SD), 10.5min). The QuickDASH score was 23.3±10.2% preoperatively versus 1±2% postoperatively (mean±SD). Among the 18 patients who came back for a follow-up visit after 4.9±2.7 years, 17 (94%) were satisfied or very satisfied. The mean time before returning to sport was 4.3 weeks (SD, 1.8 weeks), 9 patients (50%) at the same level as before surgery, 8 (44%) at a higher level, and one at a lower level. There were a few minor complications (superficial vascular lesions, hematoma, transitory hypoesthesia) and symptoms recurred in two patients. Our technique yields outcomes similar to those of other published endoscopic procedures and allows early return to sport. It has the advantage of being based on the Agee endoscope, which is commonly used to treat carpal tunnel syndrome, making the procedure easy to master.
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Síndrome Compartimental Crónico de Esfuerzo , Síndromes Compartimentales , Síndromes Compartimentales/diagnóstico , Síndromes Compartimentales/cirugía , Fasciotomía/efectos adversos , Antebrazo/cirugía , Humanos , Estudios RetrospectivosRESUMEN
Stability and turning performance are two key metrics of locomotor performance in animals, and performance in both of these metrics can be improved through a variety of morphological structures. Aquatic vehicles are often designed with keels and rudders to improve their stability and turning performance, but how keels and rudders function in rigid-bodied animals is less understood. Aquatic turtles are a lineage of rigid-bodied animals that have the potential to function similarly to engineered vehicles, and also might make use of keels and rudders to improve their stability and turning performance. To test these possibilities, we trained turtles to follow a mechanically controlled prey stimulus under three sets of conditions: with no structural modifications, with different sized and shaped keels, and with restricted tail use. We predicted that keels in turtles would function similarly to those in aquatic vehicles to reduce oscillations, and that turtles would use the tail like a rudder to reduce oscillations and improve turning performance. We found that the keel designs we tested did not reduce oscillations in turtles, but that the tail was used similarly to a rudder, with benefits to both the magnitude of oscillations they experienced and turning performance. These data show how variation in the accessory structures of rigid-bodied animals can impact swimming performance, and suggest that such variation among turtles could serve as a biomimetic model in designing aquatic vehicles that are stable as well as maneuverable and agile.
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Biomimética/métodos , Locomoción/fisiología , Natación/fisiología , Animales , Fenómenos Biomecánicos/fisiología , TortugasRESUMEN
INTRODUCTION: Blood reflux is caused by changes in pressure within intravascular catheters upon connection or disconnection of a syringe or intravenous tubing from a needle-free connector (NFC). Changes in pressure, differing with each brand of NFC, may result in fluid movement and blood reflux that can contribute to intraluminal catheter occlusions and increase the potential for central-line associated bloodstream infections (CLABSI). METHODS: In this study, 14 NFC brands representing each of the four market-categories of NFCs were selected for evaluation of fluid movement occurring during connection and disconnection of a syringe. Study objectives were to 1) theoretically estimate amount of blood reflux volume in microliters (µL) permitted by each NFC based on exact component measurements, and 2) experimentally measure NFC volume of fluid movement for disconnection reflux of negative, neutral and anti-reflux NFC and fluid movement for connection reflux of positive displacement NFC. RESULTS: The results demonstrated fluid movement/reflux volumes of 9.73 µL to 50.34 µL for negative displacement, 3.60 µL to 10.80 µL for neutral displacement, and 0.02 µL to 1.73 µL for pressure-activated anti-reflux NFC. Separate experiment was performed measuring connection reflux of 18.23 µL to 38.83 µL for positive displacement NFC connectors. CONCLUSIONS: This study revealed significant differences in reflux volumes for fluid displacement based on NFC design. While more research is needed on effects of blood reflux in catheters and NFCs, results highlight the need to consider NFCs based on performance of individual connector designs, rather than manufacturer designation of positive, negative and neutral marketing categories for NFCs without anti-reflux mechanisms.
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Cateterismo Venoso Central/instrumentación , Cateterismo Periférico/instrumentación , Catéteres de Permanencia , Catéteres Venosos Centrales , Dispositivos de Acceso Vascular , Obstrucción del Catéter/etiología , Infecciones Relacionadas con Catéteres/etiología , Cateterismo Venoso Central/efectos adversos , Cateterismo Periférico/efectos adversos , Diseño de Equipo , Ensayo de Materiales , Jeringas , Presión VenosaRESUMEN
In posterior shoulder instability (recurrent dislocation, involuntary posterior subluxation or voluntary subluxation that has become involuntary), surgery may be considered in case of failure of functional treatment if there are no psychological contraindications. Acromial bone-block with pediculated deltoid flap, as described by Kouvalchouk, is an alternative to iliac bone-block, enabling triple shoulder locking by the blocking effect, the retention hammock provided by the deltoid flap and posterior capsule repair. Arthroscopy allows shoulder joint exploration and diagnosis of associated lesions, with opening and conservation of the posterior capsule; it greatly facilitates bone-block positioning and capsule reinsertion. The present report describes the procedure in detail. LEVEL OF EVIDENCE: Technical note.
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Artroscopía/métodos , Inestabilidad de la Articulación/cirugía , Luxación del Hombro/cirugía , Articulación del Hombro/cirugía , Hombro/cirugía , Acromion/trasplante , Músculo Deltoides/cirugía , Humanos , Cápsula Articular/cirugía , Colgajos QuirúrgicosRESUMEN
BACKGROUND: Painful posterior shoulder instability (PPSI) is the least common of the three clinical patterns of posterior shoulder instability. PPSI is defined as pain combined with anatomical evidence of posterior instability but no instability events. MATERIAL AND METHOD: We studied a multicentre cohort of 25 patients with PPSI; 23 were identified retrospectively and had a follow-up of at least 2 years and 2 patients were included prospectively. Most patients engaged in sports. RESULTS: All 25 patients underwent surgery, which usually consisted in arthroscopic capsulo-labral reconstruction. The outcome was excellent in 43% of patients; another 43% had improvements but reported persistent pain. The pain remained unchanged or worsened in the remaining 14% of patients. Causes of failure consisted of a missed diagnosis of shoulder osteoarthritis with posterior subluxation, technical errors, and postoperative complications. The main cause of incomplete improvement with persistent pain was presence of cartilage damage. CONCLUSION: Outcomes were excellent in patients who were free of cartilage damage, bony abnormalities associated with posterior instability (reverse Hill-Sachs lesion, erosion or fracture of the posterior glenoid), technical errors, and postoperative complications.
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Inestabilidad de la Articulación/cirugía , Articulación del Hombro/cirugía , Dolor de Hombro/cirugía , Adolescente , Adulto , Artroscopía/efectos adversos , Artroscopía/métodos , Cartílago Articular/lesiones , Errores Diagnósticos , Femenino , Humanos , Inestabilidad de la Articulación/complicaciones , Masculino , Persona de Mediana Edad , Osteoartritis/complicaciones , Osteoartritis/diagnóstico , Estudios Prospectivos , Estudios Retrospectivos , Dolor de Hombro/etiología , Insuficiencia del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: The posterior bone block procedure is a well-known treatment option for posterior shoulder instability. The goal of this retrospective multicenter study was to evaluate the clinical and radiological outcomes of this procedure. MATERIAL AND METHODS: The study cohort consisted of 66 patients (55 men, 11 women) with an average age of 27.8 years who were evaluated clinically and radiologically using a standardized questionnaire after posterior bone block surgery. RESULTS: The Constant score significantly improved postoperatively (P<0.0001). The postoperative Walch-Duplay score was 81.5. The Rowe score was 86.5 points. The pain level (VAS) was significantly reduced after this procedure (P<0.0001). Eighty-five percent of patients were satisfied or very satisfied with the outcome. CONCLUSION: This multicenter study of 66 patients shows that the posterior bone block procedure is an effective technique with good subjective and objective outcomes; however, the possibility of complications cannot be ignored. CLINICAL STUDY: Level of evidence IV.
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Inestabilidad de la Articulación/cirugía , Articulación del Hombro/cirugía , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Inestabilidad de la Articulación/diagnóstico por imagen , Inestabilidad de la Articulación/fisiopatología , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Periodo Posoperatorio , Radiografía , Estudios Retrospectivos , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/fisiopatología , Dolor de Hombro/etiología , Dolor de Hombro/cirugía , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Open reduction and internal fixation of complex proximal humeral fracture represents a surgical challenge. The main objective of this procedure is to anatomically reduce the tuberosities. We propose a standardized and reproducible technique that we apply to all complex displaced 3- and 4-part fractures of patients under 50 years. We use an antero-lateral trans-deltoid approach; the humeral head and the tuberosities are reduced under fluoroscopic control. The tuberosities are stabilized with an inter-tuberosity osteosuture, and we then introduce a thin and straight intra-medullary nail (Telegraph IV FH Orthopedics) at the hinge point of the humeral head. The osteosynthesis of the tuberosities is completed by 3- or 4-self-stable divergent screws in the nail. A dynamic distal locking stabilizes the humeral shaft in rotation and facilitates consolidation thanks to micro movements. The removal of the nail with an arthroscopic shoulder arthrolysis in case of stiffness is possible secondarily.
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Clavos Ortopédicos , Fijación Interna de Fracturas/métodos , Fracturas del Hombro/cirugía , Técnicas de Sutura , Tornillos Óseos , Fijación Interna de Fracturas/efectos adversos , Fijación Interna de Fracturas/instrumentación , Humanos , Imagenología Tridimensional , Reducción Abierta/métodos , Selección de Paciente , Cuidados Posoperatorios , Rango del Movimiento Articular , Reoperación , Fracturas del Hombro/complicaciones , Fracturas del Hombro/diagnóstico por imagen , Fracturas del Hombro/fisiopatología , Adherencias Tisulares/etiología , Adherencias Tisulares/cirugía , Tomografía Computarizada por Rayos XRESUMEN
This paper is the first in a series of two publications relating to the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the diagnosis and management of Crohn's disease and concerns the methodology of the consensus process, and the classification, diagnosis and medical management of active and quiescent Crohn's disease. Surgical management as well as special situations including management of perianal Crohn's disease of this ECCO Consensus are covered in a subsequent second paper [Gionchetti et al JCC 2016].
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Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/diagnóstico por imagen , Enfermedad de Crohn/patología , Enfermedad de Crohn/terapia , Endoscopía Gastrointestinal , Medicina Basada en la Evidencia , Humanos , Intestinos/diagnóstico por imagen , Intestinos/patología , Imagen por Resonancia Magnética , Recurrencia , Inducción de Remisión , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Currently there is no guideline for the treatment of patients with Crohn's disease and high perianal fistulas. Most patients receive anti-TNF medication, but no long-term results of this expensive medication have been described, nor has its efficiency been compared to surgical strategies. With this study, we hope to provide treatment consensus for daily clinical practice with reduction in costs. METHODS/DESIGN: This is a multicentre, randomized controlled trial. Patients with Crohn's disease who are over 18 years of age, with newly diagnosed or recurrent active high perianal fistulas, with one internal opening and no anti-TNF usage in the past three months will be considered. Patients with proctitis, recto-vaginal fistulas or anal stenosis will be excluded. Prior to randomisation, an MRI and ileocolonoscopy are required. All treatment will start with seton placement and a course of antibiotics. Patients will then be randomised to: (1) chronic seton drainage (with oral 6-mercaptopurine (6MP)) for one year, (2) anti-TNF medication (with 6MP) for one year (seton removal after six weeks) or (3) advancement plasty after eight weeks of seton drainage (under four months anti-TNF and 6MP for one year). The primary outcome parameter is the number of patients needing fistula-related re-intervention(s). Secondary outcomes are the number of patients with closed fistulas (based on an evaluated MRI score) after 18 months, disease activity, quality of life and costs. DISCUSSION: The PISA trial is a multicentre, randomised controlled trial of patients with Crohn's disease and high perianal fistulas. With the comparison of three generally accepted treatment strategies, we will be able to comment on the efficiency of the various treatment strategies, with respect to several long-term outcome parameters. TRIAL REGISTRATION: Nederlands Trial Register identifier: NTR4137 (registered on 23 August 2013).
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Antiinflamatorios/uso terapéutico , Enfermedad de Crohn/terapia , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Drenaje/métodos , Fármacos Gastrointestinales/uso terapéutico , Fístula Rectal/terapia , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Antiinflamatorios/efectos adversos , Antiinflamatorios/economía , Terapia Combinada , Análisis Costo-Beneficio , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/economía , Enfermedad de Crohn/inmunología , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Procedimientos Quirúrgicos del Sistema Digestivo/economía , Drenaje/efectos adversos , Drenaje/economía , Quimioterapia Combinada , Europa (Continente) , Fármacos Gastrointestinales/efectos adversos , Fármacos Gastrointestinales/economía , Costos de la Atención en Salud , Humanos , Imagen por Resonancia Magnética , Mercaptopurina/uso terapéutico , Calidad de Vida , Fístula Rectal/diagnóstico , Fístula Rectal/economía , Fístula Rectal/inmunología , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/inmunologíaRESUMEN
BACKGROUND: The Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) report published in 2009 shows that there were about 16,000 cases of surgical site infection (SSI) following ~ 850,000 operative procedures making SSI one of the most predominant infection amongst nosocomial infections. Preoperative skin preparation is a standard procedure utilized to prevent SSIs thereby improving patient outcomes and controlling associated healthcare costs. Multiple techniques/ products have been used for pre-operative skin preparation, like 2 step scrubbing and painting, 2 step scrubbing and drying, and 1 step painting with a drying time. However, currently used products require strict, time consuming and labor-intensive protocols that involve repeated mechanical scrubbing. It can be speculated that a product requiring a more facile protocol will increase compliance, thus promoting a reduction in SSIs. Hence, the antimicrobial efficacy of a spray-on foaming formulation containing Betadine (povidone-iodine aerosol foam) that can be administered with minimum effort is compared to that of an existing formulation/technique (Wet Skin Scrub). METHODS: In vitro antimicrobial activities of (a) 5% Betadine delivered in aerosolized foam, (b) Wet Skin Scrub Prep Tray and (c) liquid Betadine are tested against three clinically representative microorganisms (S. aureus, S. epidermidis and P. aeruginosa,) on two surfaces (agar-gel on petri-dish and porcine skin). The log reduction/growth of the bacteria in each case is noted and ANOVA statistical analysis is used to establish the effectiveness of the antimicrobial agents, and compare their relative efficacies. RESULTS: With agar gel as the substrate, no growth of bacteria is observed for all the three formulations. With porcine skin as the substrate, the spray-on foam's performance was not statistically different from that of the Wet Skin Scrub Prep technique for the microorganisms tested. CONCLUSIONS: The povidone-iodine aerosolized foam could potentially serve as a non-labor intensive antimicrobial agent for surgical site preparation.
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Infección Hospitalaria/prevención & control , Desinfectantes/farmacología , Desinfección/métodos , Povidona Yodada/farmacología , Cuidados Preoperatorios/métodos , Infección de la Herida Quirúrgica/prevención & control , Animales , Infección Hospitalaria/microbiología , Desinfección/instrumentación , Humanos , Povidona Yodada/química , Cuidados Preoperatorios/instrumentación , Pseudomonas aeruginosa/efectos de los fármacos , Piel/efectos de los fármacos , Piel/microbiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus epidermidis/efectos de los fármacos , Infección de la Herida Quirúrgica/microbiología , PorcinosRESUMEN
We present a straightforward, environmentally-benign, one-pot photochemical route to generate alloyed AgAu bimetallic nanoparticle decorated aminoclays in water at room temperature. The protocol uses no reducing agent (e.g., NaBH4) nor is photocatalyst required. These hybrid materials show excellent promise as dual catalysts/antibacterial agents.