Low surface tension calcium hydroxide solution is an effective antiseptic

The antimicrobial effects of a saturated calcium hydroxide solution, and in combination with 10% and 20% detergent, were evaluated on Streptococcus faecalis. Strepto-coccus sanguis, Streptococcus mutans, Streptococcus salivarius, Neisseria sp., diphlheroid, Staphylococcus aureus, Lactobacillus sp., Staphylococcus epidermidis, Bacillus suhtilis and Candida albicans. The saturated calcium hydroxide solution was effective against only four of the 11 microorganisms studied over a 60-min exposure time. The calcium hydroxide solutions con-taining detergent killed all 11 test organisms over a 30-min exposure time. This difference was statistically significant (P<0.01). No statistically significant difference in antimicrobial action was found between the 10% and 20% detergent calcium hydroxide solutions (F>0.01). However, the low surface tension (46.5 × 10^?3 Nm^?1) and high pH (10.8) of the calcium hydroxide solution with 20% detergent establish it as the more effective solution.     

超声冲洗功率和时间对清除感染根管内毒素作用的影响

目的 探讨超声冲洗功率、时间对清除感染根管内毒素的作用的影响。方法 选择20颗患慢性根尖周炎的单根管前牙,随机分为根管治疗范围最小功率组和最大功率组,分别于治疗前、常规根管预备后附加超声冲洗1 min和延长超声冲洗1 min后根管内取样,测量内毒素含量的变化。结果 2组根管治疗前的内毒素含量无显著差异(P>0.05),2组经超声冲洗后的内毒素含量也无明显差异(P>0.05)。但每组的治疗前、超声冲洗1 min后、延长超声冲洗1 min后的内毒素含量两两比较均有显著差异(P<0.05)。结论 一定范围内的超声冲洗功率对清除感染根管内毒素作用无明显影响,适当延长超声冲洗时间可加强感染根管内毒素的清除作用。     

The effect of sodium hypochlorite and ethylenediaminetetraacetic acid irrigation, individually and in alternation, on tooth surface strain

Aim  To evaluate the effect of irrigation regimens on tooth surface strain using saline, sodium hypochlorite (3% and 5% NaOCl) and ethylenediaminetetraacetic acid (17% EDTA), individually and in alternating combinations.
Methodology  Single-rooted premolar teeth with single canals prepared to standardized dimensions were grouped by anatomical features and randomly distributed amongst six experimental groups ( n  = 12 each). The six groups were: (1) saline; (2) 5% NaOCl; (3) 3% NaOCl; (4) 17% EDTA; (5) 3% NaOCl and 17% EDTA; (6) 5% NaOCl and 17% EDTA. All groups underwent four (group 1) or five (groups 2, 3, 4, 5, 6) sequential 30-min irrigation periods following each of which the tooth was subjected to a standard regime of cyclic, nondestructive, occlusal loading. Tooth surface strain was measured during each loading cycle using electrical strain gauges mounted cervico-proximally. The data were analysed by Hierarchical anova and post hoc multiple comparisons.
Results  Irrigation with 5% NaOCl alone or alternating with 17% EDTA significantly ( P  < 0.001) increased the peak strain values for each of the irrigation periods compared with that of saline (group 1). The data for the other groups revealed no significant differences compared with those of saline. The strain increase after the fourth irrigation cycle was significantly higher for group 6 than for group 2. The measured canal morphology and dentine thickness parameters did not prove to have a significant effect on tooth surface strain.
Conclusions  Irrigation with 5% NaOCl acting alone or alternated with 17% EDTA (used in 30 min cycles), significantly increased tooth surface strain. The alternated regimen showed significantly greater changes in tooth surface strain than NaOCl alone. Irrigation with 3% NaOCl and 17% EDTA individually or in combination did not significantly alter the tooth surface strain.     

刷牙冲洗法用于经口气管插管患者口腔护理的效果

目的 观察刷牙冲洗法用于口腔护理的效果,为经口气管插管的患者提供更好的护理措施.方法 将100例经口气管插管的患者分为两组,对照组采用传统口腔护理方法,实验组采用儿童软毛牙刷蘸牙膏刷牙,然后用生理盐水冲洗的方法进行口腔护理.结果 患者口臭、真菌感染率及呼吸机相关性肺炎的发生率均下降,细菌培养菌株数减少(P＜0.01...     

慢性硬膜下血肿术后复发的危险因素分析

目的探讨多种潜在的高危因素对慢性硬膜下血肿术后复发的影响。方法回顾性分析我院采用钻孔血肿冲洗术治疗的115例慢性硬膜下血肿患者的临床资料,对可能影响慢性硬膜下血肿的因素进行分析,如年龄、性别、术前GCS评分、血小板、高血压、糖尿病、术后是否进行闭式引流、术中冲洗液所见。对以上因素与慢性硬膜下血肿的复发进行多因素分析。结果 11例患者术后复发,复发率为9.6%。血肿腔冲洗液中有血凝块及絮状物和糖尿病是慢性硬膜下血肿术后复发的危险因素(P<0.05),而年龄、性别、术前GCS评分、血小板、高血压等没有明确的证据显示其与血肿的术后复发相关。结论血肿腔冲洗液中有血凝块及絮状物是慢性硬膜下血肿复发的危险因素,而是否有糖尿病也与慢性硬膜下血肿术后的复发相关。     

What Should Be Considered to Cause the Early Post-Craniotomy Seizure: Antibiotics (Cefazolin) Irrigation

Objective

Post-craniotomy seizure (PCS) is reported only rarely. However, our department noted a 433% increase in PCS for a year beginning September 2010, especially after cerebrovascular surgery. Our goal was to identify the cause of our unusual outbreak of PCS.

Methods

For almost one year after September 2010, cases of PCS increased significantly in our department. We analyzed 973 patients who had received a major craniotomy between January 2009 and November 2011. We included seizures that occurred only in the first 24 postoperative hours, which we defined as early PCS. After verifying the presence of PCS, we analyzed multiple seizure-provoking factors and their relation to the duration and character of seizure activity.

Results

Overall PCS incidence was 7.2% (70/973). Cefazolin (2 g/L saline) was the antibiotic drug used for intraoperative irrigation in 88.4% of the operations, and no PCS occurred without intraoperative cefazolin irrigation. When analyzed by operation type, clipping surgery for unruptured aneurysms was the most frequently associated with PCS (80%). Using logistic regression, only 2 g cefazolin intraoperative irrigation (p=0.024) and unruptured aneurysm clipping surgery (p<0.001) were associated with early PCS. The seizure rate of unruptured aneurysm clipping surgery using 2 g cefazolin intraoperative irrigation was 32.9%.

Conclusion

Intraoperative cefazolin irrigation must be avoided in patients undergoing craniotomy, especially for clipping of unruptured aneurysms, because of the increased risk of early PCS.     

Clinical investigation of a population recently infected with Schistosoma mansoni (Richard-Toll, Senegal)

Following the introduction of large-scale irrigation, an exceptional epidemic of intestinal schistosomiasis occurred in northern Senegal when a non-immune population was exposed to massive infection. Subjects infected with Schistosoma mansoni were followed up parasitologically and clinically from the onset of the epidemic. After the initial evaluation, patients received a health education session and were treated with praziquantel in a dose of 30 mg/kg. One year after this treatment, S. mansoni eggs were found in the stools of 227/301 subjects (75%). Twenty-three per cent of subjects excreted >400 eggs per gram (e.p.g.) and 11% excreted >1000 e.p.g. of faeces. Overall, the geometric mean was 191 e.p.g. of faeces in infected individuals. The prevalence of diarrhoea was reduced from 55 to 29%, the prevalence of bloody diarrhoea from 44 to 11% and the prevalence of abdominal discomfort from 66 to 41%. No hepatomegaly was found in these patients either before or one year after treatment. Splenomegaly was reduced from 30% (measured by ultrasound) to 3% (on clinical examination). Morbidity associated with S. mansoni infection was considerably reduced one year after treatment with praziquantel (30 mg/kg).