Variability in catheter microwave sterilization techniques in a single clinic population

PURPOSE: We designed a survey to assess the microwave sterilization technique practiced by patients at our clinic who perform clean intermittent catheterization. MATERIALS AND METHODS: A 23-question survey addressing urinary catheter use and home sterilization techniques was mailed to 129 patients. A followup survey was mailed to 47 respondents who reported using a microwave oven to sterilize the catheters to assess the microwave technique further. RESULTS: Of the 129 initial surveys 84 (64%) were returned, while 40 (85%) of the 47 followup questionnaires on microwave sterilization were returned. All patients surveyed have used clean intermittent catheterization for at least 1 year and 75% have used it more than 5 years. Of the respondents 80% perform clean intermittent catheterization 4 to 5 times daily, although sterilization frequency varies from daily to less than once weekly. Of the respondents 71% reported no difficulty with microwave sterilization, although 31 (63%) reported a history of catheter melting during microwaving. Of the respondents 35% reported using a rotation table, all used a heat sink containing 1/2 to 4 cups of water, 39% used 500 to 1,000 W., 37% used greater than 1,000 W., 73% set the microwave for 6 minutes, others set it for 3 to 30 minutes and 98% used a power setting described as high, full, 10 or 100%. CONCLUSIONS: Significant variation exists in the cleaning and sterilizing techniques used by our patients, although they were given uniform written and verbal instructions. It is unclear from the data in the literature how this variation affects sterilization.     

Increased familial risk of the psychotic phenotype of Alzheimer disease

BACKGROUND: Psychotic symptoms in patients with AD (AD with psychosis [AD+P]) define a phenotype characterized by more rapid cognitive and functional decline and a liability to aggressive behaviors. OBJECTIVE: To determine if AD+P aggregates within families. METHODS: Case-control study of AD+P frequency in 461 siblings of 371 probands diagnosed with AD. All siblings were ascertained as part of a genetic investigation and also were diagnosed with AD. Statistical analysis used Generalized Estimating Equations to adjust for clustering within families. RESULTS: AD+P in probands was associated with a significantly increased risk for AD+P in family members (OR, 2.41; 95% CI 1.46-4.0; p = 0.0006). The correlation among siblings for AD+P status was modest: 0.16. CONCLUSION: AD+P demonstrates familial aggregation. Further studies are required to investigate a possible genetic basis of AD+P.     

Linkage analysis of Alzheimer disease with psychosis

Although a portion of risk for late-onset AD (LOAD) is attributable to APOE, the search for other loci is ongoing. The authors hypothesize that psychotic symptoms with LOAD (LOAD+P) identify a potentially more etiologically homogeneous form of AD. Linkage analysis of families with LOAD+P identified one significant and several suggestive novel linkage signals, which bolsters the conjecture of greater etiologic homogeneity.     

Bonding characteristics of a phosphonated anaerobic adhesive to amalgam.

The shear bond strength of a phosphonated anaerobic resin dental adhesive (Panavia-Ex) to amalgam was determined and clinically important parameters affecting the bond strength: amalgam type, surface finish and corrosion, were investigated. It is possible to bond to high copper set amalgam using this adhesive with a clinically useful shear bond strength. Three copper-enriched, single composition alloys were studied. One was a spherical alloy and two were lathe cut. The bond strength to one of the lathe-cut alloys was significantly lower than to the other two alloys. A significantly higher bond strength to aged lathe-cut amalgam than to fresh amalgam was found. However, Weibull analysis indicated that these latter changes were less consistent and indicated patchy, localized changes in the amalgam surface. The bond strength to the spherical alloy was significantly reduced by polishing with a finishing bur or Prophy-Jet. Therefore when bonding to a large amalgam restoration with such a phosphonated anaerobic adhesive, no polishing of the amalgam should be undertaken.     

Temporary loop ileostomy.

A refinement of the technique for constructing the temporary loop ileostomy using a subcutaneous absorbable bridge is described. This leaves the skin surface uncluttered and allows immediate fitting of a watertight appliance. Clinical experience in 22 patients confirms that this is a safe, simple defunctioning stoma with few complications and in our practice has also replaced the loop colostomy as the covering stoma for difficult colorectal anastomoses.