Prostate biopsy sepsis prevention: external validation of an alcohol needle washing protocol.

PURPOSE: Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is associated with a 1-8% risk of post-biopsy sepsis (PBS). A recent study described an isopropyl alcohol needle washing protocol that significantly decreased PBS rates. The current study examined the efficacy of this technique in our clinic population. MATERIALS AND METHODS: Data were reviewed for 1250 consecutive patients undergoing TRUS-Bx at the Charlie Norwood VA Medical Center from January 2017 to January 2023. Needle washing was adopted in February 2021. Complications occurring within 30 days after TRUS-Bx were recorded. RESULTS: There were 912 patients in group 1 (without needle washing) and 338 in group 2 (with needle washing). Groups had equivalent demographic features, and men of African descent comprised 70% of patients. Standard 12 core biopsies were done in 83% and 82% in groups 1 and 2, respectively (p = 0.788). Total complication rates were 4% and 2% in groups 1 and 2, respectively (p = 0.077). There were 13 sepsis events in group 1 (1.4%) and none in group 2 (p = 0.027). Clavien-Dindo Grade I-III complications occurred in 25 (2.7%) and 7 (2.1%) patients in groups 1 and 2, respectively (p = 0.505). Standard antibiotic prophylaxis (PO fluoroquinolone and IM gentamicin) was given in 80% and 86% of patients in groups 1 and 2, respectively (p = 0.030). Subset analysis limited to patients who received standard prophylaxis showed a significant difference in sepsis rates (1.5% vs 0%; p = 0.036). CONCLUSIONS: Adoption of isopropyl alcohol needle washing was associated with a significant decrease in PBS events.

Assessment of Drying Protocol on the Bond Strength and Tag Penetration of Two Different Sealers to the Root Dentin: An In Vitro Study.

Accomplishment of an ideal root canal treatment is attributed to various essential factors such as proper instrumentation, chemomechanical preparation, obturation and post endodontic restoration. The main aim of this study is to test the null hypothesis that is the moisture condition of root dentin would not affect the bond strength and sealer penetration. This is an in vitro study conducted in Department of Conservative Dentistry and Endodontics, M A Rangoonwala Dental College, Pune, India over a period of two years (from 2021 to 2023). One hundred and twenty single-rooted Premolars with fully formed apices and similar root morphology were obtained and stored in 0.1% thymol solution. The specimens were randomly assigned to 3 broad experimental groups (n=40) according to the drying protocol such as Group A- Paper points (P), Group B- diode laser (L) and Group C- isopropyl alcohol (A). For each drying protocol, the specimens were further assigned to 2 subgroups (n=20) with respect to the sealers used: AH Plus (AH) and Apexit Plus sealers (APx). The effect of drying protocol using paper points, isopropyl alcohol and diode-lasers on the bond strength and tag penetration of two different sealers to the root dentin was evaluated. Maximum overall push-out Bond strength was seen in group AH+L and least in group APx+ L. Inter-site push-out bond Strength was highest in the coronal third followed by the middle and least in the apical third of all the groups. Maximum over all depth of penetration was seen in group AH+L and minimum in group APx+L. AH plus sealer showed better bond strength, sealer penetration and adaptation to the dentinal walls compared to Apexit plus sealer, irrespective of the drying protocol followed. All the drying protocols used did not show statistically significant results in the apical thirds of root canals of all the groups.

Numerical analysis and early detection of Plasmodium falciparum using a high performance plasmonic biosensor with an external sensing approach.

The authors propose a surface plasmon resonance (SPR) sensor based on photonic crystal fibers (PCFs) using three hexagonal ring lattices. The sensor can detect biomolecules with maximum wavelength and amplitude sensitivities of 23,000 nm/RIU and 1310.93R I U -1, respectively, in the RI range of 1.32 to 1.42. It can detect infected red blood cells with Plasmodium falciparum for RIs of 1.402, 1.373, 1.395, and 1.383 in various malaria-infected red blood cell stages, including ring phase, trophozoite phase, and schizont phase. Furthermore, the sensor will be able to detect biomolecules such as viruses, proteins, DNA/RNA strands, acetone, ethanol, hexane, isopropanol, hexanol, formic acid, allyl cyanide, and others in its range. With these impressive results and identification capacity, the proposed sensor would benefit the biomaterial field and be appropriate for the early identification of malaria disease.

Dielectric Response of Different Alcohols in Water-Rich Binary Mixtures from THz Ellipsometry.

We report a study on the hydrogen bonding mechanisms of three aliphatic alcohols (2-propanol, methanol, and ethanol) and one diol (ethylene glycol) in water solution using a time-domain ellipsometer in the THz region. The dielectric response of the pure liquids is nicely modeled by the generalized Debye-Lorentz equation. For binary mixtures, we analyze the data using a modified effective Debye model, which considers H-bond rupture and reformation dynamics and the motion of the alkyl chains and of the OH groups. We focus on the properties of the water-rich region, finding anomalous behavior in the absorption properties at very low solute molar concentrations. These results, first observed in the THz region, are in line with previous findings from different experiments and can be explained by taking into account the amphiphilic nature of the alcohol molecules.

Enhanced biomethane production from Scenedesmus sp. using polymer harvesting and expired COVID-19 disinfectant for pretreatment.

This study evaluates the repurposing of expired isopropanol (IPA) COVID-19 disinfectant (64% w/w) to pretreat algal biomass for enhancing methane (CH4) yield. The impact of harvesting methods (centrifugation and polymer flocculation) and microwave pretreatment on CH4 production from Scenedesmus sp. microalgal biomass were also investigated. Results show minimal impact of harvesting methods on the CH4 yield, with wet centrifuged and polymer-harvested biomass exhibiting comparable and low CH4 production at 66 and 74 L/kgvolatile solid, respectively. However, microalgae drying significantly increased CH4 yield compared to wet biomass, attributed to cell shrinkage and enhanced digestibility. Consequently, microwave and IPA pretreatment significantly enhanced CH4 production when applied to dried microalgae, yielding a 135% and 212% increase, respectively, compared to non-pretreated wet biomass. These findings underscore the advantage of using dried Scenedesmus sp. over wet biomass and highlight the synergistic effect of combining oven drying with IPA treatment to boost CH4 production whilst reducing COVID-19 waste.

The Many Uses of the Humble Alcohol Swab.

Readily available and comparatively inexpensive, the common alcohol swab can aid dermatologists in everything from diagnosis to preoperative and postoperative care. The 70% isopropyl alcohol swab can aid in the accurate diagnosis of lesions and skin conditions, identification of biopsy sites, and disinfection.

A Randomized Controlled Trial of Povidone-Iodine Versus Chlorhexidine Gluconate With Isopropyl Alcohol for Preoperative Vaginal Antisepsis.

Many surgeons request use of 10% povidone-iodine (PI) for vaginal antisepsis; however, when PI is contraindicated, some surgeons request use of chlorhexidine gluconate (CHG) instead. The purpose of this randomized controlled trial was to determine any significant differences in self-reported symptoms associated with vaginal antisepsis with either 10% PI scrub or 4% CHG with 4% isopropyl alcohol. The control group comprised 62 participants who underwent vaginal antisepsis with the PI product, and the intervention group comprised 58 participants who underwent vaginal antisepsis with the CHG product. Participants completed surveys immediately before surgery, immediately after surgery, and 48 to 72 hours after surgery. No significant differences were found in the reported vaginal symptoms between the two groups for any survey. One participant in the intervention group reported symptoms consistent with an allergic reaction. Additional studies are needed on the use of CHG for vaginal antisepsis.

The impact of skin preparation method on electrocardiogram quality in horses.

Objective: Several skin preparation techniques are used in electrocardiogram (ECG) monitoring of horses. The objective of this study was to determine which methods produce the greatest signal quality using textile electrodes and standard silver/silver chloride (Ag/AgCl) electrodes. Animals and samples: Electrocardiogram data were collected using textile and Ag/AgCl electrodes simultaneously for 4 skin preparation techniques in 6 horses. Procedure: The effects of skin preparation (cleansing with isopropyl alcohol, with or without shaving the hair) and the effects of the application of a conductive gel were assessed using metrics of signal quality. Results: Shaving and cleansing with alcohol had no effect on signal quality for either electrode type. The Ag/AgCl electrodes contain a solid gel, and the application of additional gel did not affect signal quality. Data quality was significantly improved when gel was applied to textile electrodes. Furthermore, there was no difference in signal quality between electrode types when gel was used. Conclusion and clinical relevance: This study suggests that skin preparation by cleansing and/or shaving does not have a significant effect on equine ECG signal quality. When gel is used, textile electrodes are a practical alternative for Ag/AgCl electrodes, as they produce ECG recordings of the same quality.

Impact de la méthode de préparation de la peau sur la qualité de l'électrocardiogramme chez le cheval. Objectif: Plusieurs techniques de préparation de la peau sont utilisées lors de la surveillance électrocardiographique (ECG) des chevaux. L'objectif de cette étude était de déterminer quelles méthodes produisent la meilleure qualité de signal en utilisant des électrodes textiles et des électrodes standard argent/chlorure d'argent (Ag/AgCl). Animaux et échantillons: Les données d'électrocardiogramme ont été obtenues simultanément à l'aide d'électrodes textiles et d'électrodes Ag/AgCl pour 4 techniques de préparation cutanée chez 6 chevaux. Procédure: Les effets de la préparation de la peau (nettoyage à l'alcool isopropylique, avec ou sans rasage des cheveux) et les effets de l'application d'un gel conducteur ont été évalués à l'aide de métriques de qualité du signal. Résultats: Le rasage et le nettoyage à l'alcool n'ont eu aucun effet sur la qualité du signal pour les deux types d'électrodes. Les électrodes Ag/AgCl contiennent un gel solide et l'application de gel supplémentaire n'a pas affecté la qualité du signal. La qualité des données a été considérablement améliorée lorsque le gel a été appliqué sur des électrodes textiles. De plus, il n'y avait aucune différence dans la qualité du signal entre les types d'électrodes lorsque du gel était utilisé. Conclusion et pertinence clinique: Cette étude suggère que la préparation de la peau par nettoyage et/ou rasage n'a pas d'effet significatif sur la qualité du signal ECG équin. Lorsque du gel est utilisé, les électrodes textiles constituent une alternative pratique aux électrodes Ag/AgCl, car elles produisent des enregistrements ECG de même qualité.(Traduit par Dr Serge Messier).

Characterization and electrochemical properties of TiO2-rNTs/SnO2-Sb/PbO2 electrodes for the mineralization of persistent organic pollutants using anodic oxidation coupled Electro-Fenton treatment: Effect of precursor selection.

The present study compares the effect of using different solvents on the electrochemical properties of the reduced TiO2 nanotubes (TiO2-rNTs) layered Ti/TiO2-rNTs/SnO2-Sb/PbO2 anodes. The electrodes are prepared using three different solvent-based precursors: (i) isopropanol, (ii) ethylene glycol and citric acid (Pechini method), and (iii) 2-hydroxyethylammonium acetate (2HEAA) ionic liquid (IL) via the thermal decomposition route. The decomposition mechanism of precursor solutions was explored using the thermogravimetric (TGA) analysis. Further, the physicochemical properties of the electrodes are examined using Field emission Scanning Electron microscopy (FE-SEM), X-ray diffraction spectroscopy (XRD), and X-ray photoelectron emission spectroscopy (XPS). The results revealed that solvents with higher viscosity and slower decomposition rates support better film uniformity and higher stability of the electrode. The TiO2 -rNTs bottom layer and PbO2 top layer helped obtain higher film stability, increased working potential window (2.2 V vs. SHE) of the electrode, and the repeatability of the results. The performance of different electrodes based on the precursor solution is found as IL â‰« Pechini > Isopropanol. 4-chlorophenol (4-CP) is used as a model pollutant to test the performance of IL-Ti/TiO2-rNTs/SnO2-Sb/PbO2 anode in an anodic oxidation (AO) coupled electro-Fenton (EF) treatment. Further, the reliability of the electrode is evaluated by mineralizing other persistent organic pollutants (POPs) like tetracyclin, phenol, 2-chlorophenol (2-CP), and 2,4-dichlorophenol (2,4-DCP). Under the optimized conditions, the proposed system was able to mineralize the tetracyclin, phenol, 2-CP, 2,4-DCP, and 4-CP up to 78.91, 82.07, 74.96, 78.78, and 69.3 %, respectively. Moreover, the degradation mechanism of chlorophenols is proposed.

Rational development of topical climbazole formulations.

Dandruff, or pityriasis capitis simplex, is a common scalp condition associated with excessive flaking and scaling of the epidermal tissue. Other features include irregular corneocyte turnover, irritation, itching and an impaired skin barrier function. Previously we reported the characterization of climbazole (CBZ), an antifungal agent used in the management of dandruff. Skin permeation of CBZ from neat solvents was also investigated. In the present work we evaluated CBZ permeation in human skin in vitro from more complex formulations that better represent products used by consumers. The various systems studied were composed of propylene glycol (PG), Transcutol®P (TC), octyl salicylate (OSal) and isopropyl alcohol (IPA). As well as measurement of skin uptake and penetration of CBZ, where possible, the skin retention and permeation of the various solvents was also determined. All vehicles promoted skin permeation of CBZ but no significant differences in amount permeated were evident between the binary vehicles (PG:TC, TC:OSal) and the ternary vehicle studied (PG:IPA:OSal). The binary vehicles generally promoted more skin uptake of CBZ compared with the neat solvents (PG, TC, OSal) studied previously. Permeation and skin extraction of CBZ from the PG:TC vehicles increased with increasing PG content; a similar trend was evident for the PG:IPA:OSal systems. New methods were developed and validated for measurement of PG, TC and OSal. Analysis of the individual solvents indicated that PG permeation was also independent of the amounts of other solvents in the binary or ternary systems. Consistent with previous findings higher proportions of TC permeated compared with PG for the PG:TC binary systems; TC also permeated the skin more rapidly than PG from these vehicles. For OSal, skin extraction was generally higher for TC:OSal compared with the PG:IPA:OSal vehicle. However, increasing the content of OSal did not appear to influence CBZ skin uptake nor permeation. Interestingly, the effects of the various PG:TC vehicles on CBZ skin delivery contrast with results we previous reported for the same systems for a different active. This confirms that with reference to skin permeation, formulation effects and/or skin penetration enhancement should be expected to vary and may not be predicted for specific vehicles.

Cell counting to monitor swab efficiency.

Plastic bags, such as ziplock bags, have been used to transport illicit materials worldwide; however, very few studies have tried to optimize the recovery of DNA from these items. This study reports on the best combination of swabs and moistening solution for the greatest recovery of cellular material from ziplock bags. Five swabs, two different variations of Copan Diagnostics nylon 4N6FLOQSwabs, one Medical Wire rayon DRYSWAB, one IsoHelix rayon swab, and one Livingstone cotton swab, were evaluated with two moistening solutions, Triton X-100 in either distilled water or isopropanol. Fingermarks were deposited on ziplock bags and stained with Diamond™ Nucleic Acid Dye to allow visualization of the cells pre- and post-swabbing to determine the number of cells recovered. Based on cell counting data, swabs moistened with Triton X-100 in distilled water performed better than those moistened with isopropanol. Livingstone cotton swabs had the worst recovery of cellular material, while the other swabs tested had no significant difference in their respective solutions. A comparison of the best three swabs for cellular recovery yielded no differences in the DNA concentration extracted. A linear relationship was observed between the log number of cells recovered by swabbing and the DNA concentration following extraction and quantification. The process of monitoring cell collection using fluorescence microscopy on ziplock bags allowed evaluation of swabbing efficacy. Additionally, this study highlights the ability to evaluate cellular recovery independently of traditional extraction, quantification, or profiling techniques which may unequally affect samples.

Isopropanol production using engineered Corynebacterium glutamicum from waste rice straw biomass.

Isopropanol, a well-known biofuel, is a widely used precursor for chemical products that can replace nonrenewable petroleum energy. Here, engineered Corynebacterium glutamicum that can effectively utilize all xylose and glucose in agricultural waste rice straw to produce isopropanol was described. First, codon mutations were introduced into transporters and glycolytic-related genes to decrease the glucose preference of C. glutamicum. A more energetically favorable xylose oxidative pathway was constructed that replaced traditional xylose isomerization pathways, saving twice the number of enzymatic steps. A succinate auxiliary module was incorporated into the tricarboxylic acid cycle (TCA), connecting the xylose-utilized pathway with the isopropanol pathway to maximize xylose orientation towards the product. The final engineered strain successfully consumed 100 % of the xylose from NaOH-pretreated, enzyme-hydrolyzed rice straw and effectively synthesized 4.91 g/L isopropanol. This study showcases the successful conversion of agricultural waste into renewable energy, unveiling new possibilities for advancing biological fermentation technology.

IgG glycopeptide enrichment using hydrophilic interaction chromatography-based solid-phase extraction on an aminopropyl column.

The sample preparation step is pivotal in glycoproteomic analysis. An effective approach in glycoprotein sample preparation involves enriching glycopeptides by solid-phase extraction (SPE) using polar stationary phases in hydrophilic interaction liquid chromatography (HILIC) mode. The aim of this work is to show how different experimental conditions influence the enrichment efficiency of glycopeptides from human immunoglobulin G (IgG) on an aminopropyl-modified SPE column. Different compositions of the elution solvent (acetonitrile, methanol, and isopropanol), along with varying concentrations of elution solvent acidifiers (formic and acetic acid), and different concentrations of acetonitrile for the conditioning and washing solvents (65%, 75%, and 85% acetonitrile) were tested to observe their effects on the glycopeptide enrichment process. Isopropanol proved less effective in enriching glycopeptides, while acetonitrile was the most efficient, with methanol in between. Higher formic acid concentrations in the elution solvent weakened the ionic interactions, particularly with sialylated glycopeptides. Substituting formic acid with acetic acid led to earlier elution of more glycopeptides. The acetonitrile concentration in conditioning and washing solutions played a key role; at 65% acetonitrile, glycopeptides were not retained on the SPE column and were detected in the flow-through fraction. Ultimately, it was proven that the enrichment method was applicable to human plasma samples, resulting in a significant decrease in the abundances of non-glycosylated peptides. To the best of our knowledge, this study represents the first systematic investigation into the impact of the mobile phase on glycopeptide enrichment using an aminopropyl-modified SPE column in HILIC mode. This study demonstrates the substantial impact of even minor variations in experimental conditions, which have not yet been considered in the literature, on SPE-HILIC glycopeptide enrichment. Consequently, meticulous optimization of these conditions is imperative to enhance the specificity and selectivity of glycoproteomic analysis, ensuring accurate and reliable quantification.

Evaluation of stability of (1R,2 S)-(-)-2-methylamino-1-phenyl-1-propanol hydrochloride in plasma and urine samples-inoculated with Escherichia coli using high-performance liquid chromatography (HPLC).

The preservation of drug stability in biological evidence during the processes of collection and storage poses a substantial obstacle to the progress of forensic investigations. In conjunction with other constituents, the microorganisms present in the samples play a vital role in this investigation. The present investigation employed the high-performance liquid chromatography (HPLC) technique to assess the stability of (1R,2 S)-(-)-2-methylamino-1-phenyl-1-propanol hydrochloride in plasma and urine samples that were inoculated with Escherichia coli. These samples were subjected to storage conditions of 37 °C for 48 h and - 20 °C for a duration of 6 months. Minimal inhibitory concentration (MIC) and Minimal bactericidal concentration (MBC) of MPPH against E. coli were determined using microdilution method. The stability of MPPH in plasma and urine samples inoculated with E. coli was investigated using HPLC method. The results showed the MIC and MBC of MPPH were 87.5 ± 25 ppm and 175 ± 50 ppm, respectively. While MPPH remained stable in plasma for 48 h at 37 °C, it showed a notable decrease of about 11% in stability when stored in urine for the same period and temperature. From the beginning of the first month, a decrease in the stability of the compound appeared in all samples that were stored at - 20 °C, and the decrease reached 7% for plasma samples and about 11% for urine samples. The decrease in the stability reached its peak in the sixth month, reaching more than 30% and 70% of plasma and urine samples preserved at - 20 °C. This work concluded that E. coli can negatively affect the stability of MPPH in plasma and urine samples. This may lead to incorrect conclusions regarding the analysis of biological samples in criminal cases.

Optimal antiseptic skin preparation agents for minimizing surgical site infection following surgery: cost and cost-effectiveness analysis.

BACKGROUND: The application of antiseptic skin agents prior to incision minimizes the rate of surgical site infection. Despite their ubiquity, the optimal skin preparation agent remains uncertain. A retrospective economic analysis was conducted to complement the results from the NEWSkin Prep trial which prospectively compared three preparation agents. METHODS: A cost and cost-effectiveness analysis was performed from a healthcare service perspective to compare chlorhexidine with 70% ethanol, and aqueous povidone-iodine, against povidone-iodine with 70% ethanol. Resource use estimates accounted for hospital admissions, readmissions associated with surgical site infection, outpatient and general practitioner attendances, visits from community nurses and therapeutic consumables. The measure of effectiveness comprised the net difference in number of patients with surgical site infections per 1000 patients. Costs were compared using a two-sample Welch's t-test. Deterministic and probabilistic sensitivity analyses were performed to evaluate the incremental cost-effectiveness ratio. RESULTS: The null hypothesis that the mean costs for the trial arms were significantly different was not rejected (Welch's t-test P value: 0.771 for chlorhexidine with 70% ethanol against povidone-iodine with 70% ethanol; and 0.955 for aqueous povidone-iodine against povidone-iodine with 70% ethanol). Based on bootstrap averages, the chlorhexidine with 70% ethanol intervention generated 8.0 fewer surgical site infections per 1000 patients and net cost savings of €151,698 (Euros) per 1000 patients compared with povidone-iodine with 70% ethanol, and aqueous povidone-iodine produced a net cost saving of €37,494 per 1000 patients but generated an additional 11.6 surgical site infections per 1000 patients compared with povidone-iodine with 70% ethanol. The comparison of chlorhexidine with 70% ethanol to povidone-iodine with 70% ethanol was sensitive to the inclusion of cost outliers, while the comparison of aqueous povidone-iodine to povidone-iodine with 70% ethanol was sensitive to the estimated cost per surgical site infection. CONCLUSION: Based on the outcomes from the NEWSkin Prep study, this economic analysis found no definitive evidence in favour of any one of the study comparators. Future model-based economic analyses of alternative skin preparations should critically address the quality of evidence and integrate the results from the NEWSkin Prep study.

Prevalent occupational exposures and risk of lung cancer among women: Results from the application of the Canadian Job-Exposure Matrix (CANJEM) to a combined set of ten case-control studies.

BACKGROUND: Worldwide, lung cancer is the second leading cause of cancer death in women. The present study explored associations between occupational exposures that are prevalent among women, and lung cancer. METHODS: Data from 10 case-control studies of lung cancer from Europe, Canada, and New Zealand conducted between 1988 and 2008 were combined. Lifetime occupational history and information on nonoccupational factors including smoking were available for 3040 incident lung cancer cases and 4187 controls. We linked each reported job to the Canadian Job-Exposure Matrix (CANJEM), which provided estimates of probability, intensity, and frequency of exposure to each selected agent in each job. For this analysis, we selected 15 agents (cleaning agents, biocides, cotton dust, synthetic fibers, formaldehyde, cooking fumes, organic solvents, cellulose, polycyclic aromatic hydrocarbons from petroleum, ammonia, metallic dust, alkanes C18+, iron compounds, isopropanol, and calcium carbonate) that had lifetime exposure prevalence of at least 5% in the combined study population. For each agent, we estimated lung cancer risk in each study center for ever-exposure, by duration of exposure, and by cumulative exposure, using separate logistic regression models adjusted for smoking and other covariates. We then estimated the meta-odds ratios using random-effects meta-analysis. RESULTS AND CONCLUSIONS: None of the agents assessed showed consistent and compelling associations with lung cancer among women. The following agents showed elevated odds ratio in some analyses: metallic dust, iron compounds, isopropanol, and organic solvents. Future research into occupational lung cancer risk factors among women should prioritize these agents.

Bond Strength to Lithium-Disilicate Ceramic after Different Surface Cleaning Approaches.

PURPOSE: To evaluate the effect of different lithium-disilicate (LiSi) glass-ceramic surface decontamination procedures on the shear bond strength (SBS) to resin cement. MATERIALS AND METHODS: Seventy CAD/CAM LiSi ceramic specimens (IPS e.max CAD, Ivoclar) were cut and sintered. Fifty specimens were treated with 5% hydrofluoric acid (HF) for 20 s, while 20 were left untreated. All 70 specimens were then contaminated with human saliva and try-in silicone paste. The following surface cleaning methods were investigated (n = 10): C: water rinsing (control); PA: 37% H3PO4 etching for 20 s; E: 70% ethanol applied for 20 s; CP: cleaning paste (Ivoclean, Ivoclar) brushed for 20 s; HFSEP: self-etching ceramic primer (Monobond Etch&Prime, Ivoclar) rubbed for 20 s; HF: 5% HF applied for 20 s or no HF etching prior to contamination; SEP: self-etching ceramic primer rubbed for 20 s and no HF etching prior to contamination. Composite cylinders were created and luted with an adhesive resin cement to the decontaminated surfaces. After storage for 24 h at 37°C, the SBS test was conducted. Two fractured specimens per group were observed under SEM to perform fractographic analysis. The data were statistically analyzed with p set at <0.05. RESULTS: The type of surface cleaning approach influenced bond strength (p < 0.001). HFSEP, SEP, and HF attained higher SBS (p < 0.001) compared to other groups. None of the approaches were able to completely remove contaminants from the ceramic surfaces. SEM images showed residual traces of contaminants on CP-treated surfaces. CONCLUSIONS: The self-etching ceramic primer enhanced bond strength to contaminated LiSi ceramic surfaces, irrespective of previous treatment with hydrofluoric acid.

In vitro assessment of isopropanol leakage from antiseptic barrier caps into commonly used needleless connectors.

BACKGROUND: Needleless connectors (NCs) can be disinfected using antiseptic barrier caps (ABCs) to reduce the risk of catheter-related bloodstream infections. However, recent evidence suggests that isopropanol can leak from the ABC into the NC, posing concern about their safe use. We sought to determine in vitro which ABC and NC parameters influence the leakage of isopropanol through the infusion circuit. METHODS: We assessed 13 NCs and 4 ABCs available in the European market. In vitro circuits consisting of an isopropanol cap, a NC, and an 11-cm catheter line were created. The circuits were left in place for 1 to 7 days at room temperature to assess the kinetics of isopropanol leakage. Isopropanol content in ABC and in circuit flushing solutions (5 mL NaCl 0.9%) after exposure to the cap were measured using gas chromatography with a flame ionization detector. RESULTS: The leakage of isopropanol from the cap to the NC was dependent on the NC, but not the cap. The NC mechanism did not predict the leakage of isopropanol. The Q-Syte NC exhibited the most isopropanol leakage (7.01±1.03 mg and 28.32±2.62 mg at 24 hours and 7 days, respectively), whereas the Caresite NC had the lowest isopropanol leakage at 7 days (1.69±0.01 mg). CONCLUSION: The use of isopropanol ABCs can cause isopropanol leakage into the catheter circuit according to NC parameters. Caution should be exercised when using these devices, especially in the pediatric and neonatal population.

Skin Antisepsis before Surgical Fixation of Extremity Fractures.

BACKGROUND: Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery to repair a fractured limb (i.e., an extremity fracture). METHODS: In a cluster-randomized, crossover trial at 25 hospitals in the United States and Canada, we randomly assigned hospitals to use a solution of 0.7% iodine povacrylex in 74% isopropyl alcohol (iodine group) or 2% chlorhexidine gluconate in 70% isopropyl alcohol (chlorhexidine group) as preoperative antisepsis for surgical procedures to repair extremity fractures. Every 2 months, the hospitals alternated interventions. Separate populations of patients with either open or closed fractures were enrolled and included in the analysis. The primary outcome was surgical-site infection, which included superficial incisional infection within 30 days or deep incisional or organ-space infection within 90 days. The secondary outcome was unplanned reoperation for fracture-healing complications. RESULTS: A total of 6785 patients with a closed fracture and 1700 patients with an open fracture were included in the trial. In the closed-fracture population, surgical-site infection occurred in 77 patients (2.4%) in the iodine group and in 108 patients (3.3%) in the chlorhexidine group (odds ratio, 0.74; 95% confidence interval [CI], 0.55 to 1.00; P = 0.049). In the open-fracture population, surgical-site infection occurred in 54 patients (6.5%) in the iodine group and in 60 patients (7.3%) in the chlorhexidine group (odd ratio, 0.86; 95% CI, 0.58 to 1.27; P = 0.45). The frequencies of unplanned reoperation, 1-year outcomes, and serious adverse events were similar in the two groups. CONCLUSIONS: Among patients with closed extremity fractures, skin antisepsis with iodine povacrylex in alcohol resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in alcohol. In patients with open fractures, the results were similar in the two groups. (Funded by the Patient-Centered Outcomes Research Institute and the Canadian Institutes of Health Research; PREPARE ClinicalTrials.gov number, NCT03523962.).

High-performance liquid chromatographic enantioseparation of azole analogs of monoterpene lactones and amides focusing on the separation characteristics of polysaccharide-based chiral stationary phases.

High-performance liquid chromatography-based enantioseparation of newly prepared azole analogs of monoterpene lactones and amides was studied. Effects of additives and mobile phase composition were evaluated both in normal and polar organic modes. Applying amylose tris-(3,5-dimethylphenylcarbamate) selector in normal and polar organic modes acid and base additives were found to affect the peak profiles, without significantly influencing the enantiorecognition ability of the studied selector. In most cases, differences observed in retention times and enantioselectivities were lower than 10 and 20 % under normal phase and polar organic conditions, respectively. Under normal phase conditions decreased retention was observed for all the studied analytes with increased eluent polarity. Interestingly, enantioselectivity was only slightly (<10 %) influenced by the variation in the n-hexane/2-propanol ratio between 80/20 and 20/80 v/v. In polar organic mode, five different neat solvents (acetonitrile, methanol, ethanol, 1-propanol, and 2-propanol) were tested, and the best results were obtained with acetonitrile and ethanol in the case of Lux Amylose-1 column with enantioresolutions most often above 2. Based on results obtained with amylose and cellulose-based columns the amylose tris-(3,5-dimethylphenylcarbamate) selector is found to offer a superior performance both in normal and polar organic modes. When evaluating the possible effects of the selector immobilization, no striking differences were found in the normal phase. Usually, enantioselectivities and resolutions were higher (10-20 %), while retention factors of the first peaks were lower (20-30 %), on the coated-type column. In contrast, in polar organic mode, the retention characteristics and enantiorecognition ability of the coated and immobilized selectors were heavily affected by the nature of the polar solvent. Special attention has been paid to the history-dependent behavior of polysaccharide-based selectors. A confidence interval-based evaluation is suggested to help comparison of the histereticity observed in different systems. Several examples are shown to confirm that the recently discovered hysteresis is a common characteristic of polysaccharide-based selectors.