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Objective:To evaluate the efficacy of disposable disinfection cap in preventing catheter-related blood stream infections (CRBSIs).Methods:Literature on the prevention of CRBSIs by disposable disinfection caps were retrieved from CNKI, Wanfang Database, VIP database, Chinese Biomedical Literature Database, PubMed, Cochrane Library, Embase and Web of Science databases. The retrieval period was from the database construction to June 30, 2022. After literature screening, data extraction and quality evaluation were independently carried out by 2 researchers, RevMan5.4 software was used for analysis.Results:A total of 12 articles were included, including 9 832 patients. Meta-analysis results showed that compared with conventional manual disinfection, disposable disinfection cap could reduce the incidence of CRBSIs, and the difference was statistically significant ( RR = 0.58, 95% CI 0.43-0.79, P<0.01). Disposable disinfection cap could reduce the incidence of CRBSIs in adults, but there was no significant difference in the incidence of CRBSIs in children ( P>0.05). It could reduce the incidence of CRBSIs in patients with indwelling vascular catheters in ICU ( RR = 0.58, 95% CI 0.38-0.89, P<0.05), but there was no statistical difference in the incidence of CRBSIs in patients without indwelling vascular catheters in ICU ( P>0.05). In addition, the compliance of the use of disinfection caps by nursing staff was improved by 80% - 90% and the treatment cost was saved by about 282 - 464 dollars. Conclusions:Disposable disinfection caps can reduce the occurrence of CRBSIs, improve the disinfection compliance of nursing staff, and save the hospitalization cost of patients. It is suggested to be popularized in clinical practice.
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The physiologically mobile natural tooth and rigidly fixed dental implant causes different distribution of stress when connected in prosthesis and nonrigid connector compensates this. Understanding of biomechanical behavior is necessary for an adequate choice and construction of this type of rehabilitation. However, there has been insufficient research focusing on different location and type of the nonrigid connector related with the prognosis of both implant and the tooth. Aim of the Study: The purpose of this finite element (FE) analysis was to evaluate the stress distribution around bone, implant, and tooth in tooth implant fixed prosthesis under static load with variations in design and location of nonrigid connectors under simulated functional loads. Materials and Method: Three, 3-dimensional FE models connecting tooth and implant were constructed with different location and type of nonrigid connector. Simulated occlusal load was applied on the restorations and stresses developed in the supporting structures were monitored. Results: The highest stresses were found around the implant in model with nonrigid connector placed between the tooth and implant and model with modified nonrigid connector. On the other hand, less stress was noted around the implant where nonrigid connector was placed between the implant and pontic. Conclusion: It is advisable to place the nonrigid connector between the implant and the pontic to protect the implant from torque effects in a tooth implant fixed prosthesis.
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Objective To evaluate the influence of different types of needleless connector on central venous catheter-related thrombotic occlusions. Methods A detailed search was performed to identify literature about the impact of needleless connector on central venous catheter-related thrombotic occlusions , using the Cochrane Library and the databases of Pubmed,EMbase,CINAHL,CBM,CNKI and WanFang. The meta-analysis or descriptive review were performed after two authors independently searching databases,extracting data and assessing quality of included studies. Results Nine published studies were included for systematic review,which contained three randomized controlled trials,three non-randomized experimental studies and three retrospective observational studies. The results of meta-analysis for five studies showed that the split septum connector was associated with a significantly higher incidence of catheter-related thrombotic occlusions(complete occlusions and partial occlusions) than positive-displacement mechanical valve(RR=0.59,95％CI0.39-0.91,P=0.02). Standard connector and negative- displacement mechanical valve had a higher occlusions rates than positive- displacement mechanical valve ,but the difference did not reach statistical significance after merging the studies( P>0.05). Conclusion It is difficult to decide which needleless connector has the lowest rate of central venous catheter-related thrombotic occlusions because of the insufficient evidence. More large-scale and high-quality randomized controlled trials are required for further confirmation.
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Objective To evaluate the effects of a self-designed multi-function anti-reflux drainage connector on preventing catheter-associated urinary infection in patients with long-term indwelling catheters.Methods A total of 100 elderly males with indwelling catheters from 10 nursing homes in our city were selected and randomly divided into the control group (n=50) and the experimental group (n=50) from January 2013 to December 2015.The patients in the control group were indwelled with Foley catheters and connected with an ordinary disposable drainage bags;the patients in the experimental group were indwelled the same catheters and connected to disposable drainage bags with an multi-function anti-reflux drainage connector.Patients' urine in catheters and drainage bags from two groups were collected for urine culture on 7th,14th,21st,28th days.The cases of catheter plugging on the 7th,14th,21st,28th days and the cases of catheter encrustation on 28th day in two groups were recorded.Results The cases of bacteriuria on the 7th,14th,21st,28th days in the experimental group were significantly less than those in the control group (P＜0.05),and were also significantly less than those in the drainage bags in the same group (P＜0.05).The cases of catheter plugging on the 7th,14th,21st,28th days were not significantly different between two groups(P＞0.05).The cases of catheter encrustation on the 28th day in the experimental group were significantly less than those in the control group (P＜0.05).Conclusion Multi-function anti-reflux drainage connector can safely and effectively prevent catheter-associated urinary infection,reducing bacteria ascending with reflux of urine as well as catheter encrustation.
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To tackle a large midline diastema and generalized spacing existing before extraction often poses a challenge to the treating prosthodontist. The situation becomes even more complicated if the patient is a teenager, with multiple missing teeth, associated deep bite and where the jaw bone growth has not yet been completed. Possible treatment options would include a removable prosthesis, a fixed partial denture or an implant supported prosthesis. Treating such cases with a simple removable prosthesis cannot be justified if a deep bite existed which would result in posterior disocclusion. Also a conventional fixed partial denture or closure of the diastema with light cure composite (LCC), would result in a seemingly large tooth, which would be unaesthetic in appearance. Implant supported prosthesis is a possibility, if the patient’s jaw bone growth has been completed. Another simple non-invasive solution to this problem would be to fabricate a non-rigid connector using loops. This presentation describes the procedure for fabrication of an interim loop connector for a 16 year old female patient who had lost one of her maxillary central incisors as a result of trauma. Patient also had multiple spacing in the maxillary anterior teeth and an associated deep bite. Her cephalogram revealed that she had a Class III skeletal pattern. A permanent treatment at this stage was not possible due to ontoward mandibular growth pattern as revealed on the cephalogram. Hence to dodge all these problems, a simple and non-invasive treatment using loop connectors was chosen till the growth period was completed.
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Objective To observe the nursing effect of closed needle-free style injection connector in endoscopic nasobiliary drainage (ERCP). Methods From June 2013 to June 2014, 400 patients of the common bile duct stones underwent ERCP technique and placed nasobiliary were divided into two groups according to chronological. Between June 1st, 2013 and December 20th, 200 patients were set as control group, between December 21th, 2013 and June 30, 2014, 200 patients were set as experimental group. For the control group, the nasobiliary duct was directedly connected to the disposable drainage bag. For the experimental group, the nasobiliary duct was connected to closed needle-free style injection connector, and then to the drainage bag. The incidences of the detached connection, the fracture of the connection with the nasobiliary duct, bile leakage from the connection, and post-ERCP infection were compared between two groups. Results The incidence of bile leakage, crack pipes, separation and postoperative infection occurred at the junction nasobiliary rates in the experimental group were 0,0,0,2%(4/200), which were far lower than 35% (70/200),11% (22/200), 6% (12/200), 6%(12/200) of the control group. The difference was statistically significant (χ2=31.75~169.60, P < 0.01). Conclusions The application of closed needle-free style injection connector can effectively avoid the detachment and fracture of the connection, the occurrence of bile leakage, and post-ERCP infection. This will be helpful to decrease the burden of nursing care and increase patients′satisficationdegree.
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Objective To explore the effect of Q-Syte separated membrane sealed without pin connector in children with blood disease. Methods Using random digit table, the children using Q-Syte separation membrane enclosed needle-free connector and heparin cap were divided into the observation group and the control group with 260 children in each group. The two groups were compared in terms of the incidence of using Q-Syte membrane closure cap pin connector and heparin. Results The result showed a significant positive relation between the two groups (P<0.05). The incidence of using Q-Syte separation membrane sealed without pin connector was lower than that of the control group. Conclusion Q-Syte separation membrane sealed without pin connector can reduce the incidence of infusion, which is easy, safe and worth clinical application.
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OBJECTIVE: A groove technique for securing an electrode connector was described as an alternative surgical technique in deep brain stimulation (DBS) surgery to avoid electrode connector-related complications, such as skin erosion, infection, and migration. METHODS: We retrospectively reviewed 109 patients undergoing one of two techniques; the standard technique (52 patients using 104 electrodes) and the groove technique (57 patients using 109 electrodes) for securing the electrode connector in DBS surgery, regardless of patient disease. In the standard percutaneous tunneling technique, the connector was placed on the vertex of the cranial surface. The other technique, so called the groove technique, created a groove (about 4 cm long, 8 mm wide) in the cranial bone at the posterior parietal area. Wound erosion and migration related to the connectors were compared between the two techniques. RESULTS: The mean follow-up period was 73 months for the standard method and 46 months for the groove technique. Connector-related complications were observed in three patients with the groove technique and in seven patients with the standard technique. Wound erosion at the connector sites per electrode was one (0.9%) with the groove technique and six (5.8%) with the standard technique. This difference was statistically significant. The electrode connector was migrated in two patients with the groove technique and in one patient with the standard technique. CONCLUSIONS: The groove technique, which involves securing an electrode using a groove in the cranial bone at the posterior parietal area, offers an effective and safe method to avoid electrode connector-related complications during DBS surgery.
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Humanos , Estimulación Encefálica Profunda , Electrodos , Estudios de Seguimiento , Rabeprazol , Estudios Retrospectivos , Piel , Heridas y LesionesRESUMEN
Objectives: The goal of every prosthetic management is to simulate nature and be in harmony with nature within the physiological limits. The occlusal forces on a fixed dental prosthesis are transmitted to the surrounding structures through pontics, connectors and retainers and more stresses are seen at the connector region. To analyze the stress patterns in cast and soldered connectors between the two pontics and between the retainer and pontic of a four unit fixed dental prosthesis on axial and non axial loading and also to observe and ascertain the need to modify the design of the rigid connectors. Materials and Methods: Subsequently four models each of cast and soldered connectors with cylindrical and triangular design, of dimension 3 × 4 mm and thickness 0.5 mm was designed for the study. The first premolar and second molar were considered as the abutments and 2 nd premolar and 1 st molar as the pontics. The analysis was done using ANSYS version 8.0 software and by placing axial and non-axial load of 40 Newtons each. Results: Von Misses stresses were observed at the connector region between the two pontics, especially in the cervical region. Conclusion: The cylindrical cast connectors showed less stress in comparison to triangular design and the difference in the stress distribution of cast and soldered connectors were marginal. Clinical Significance: The occlusal forces on a fixed dental prosthesis are transmitted to the surrounding structures through pontics, connectors and retainers with maximum stresses concentrated at the connectors. Hence this three-dimensional finite element analysis study investigated stress distribution in a four unit posterior fixed dental prosthesis, having cylindrical and triangular connector designs.
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Objective To discuss the advantages of combined use of intravenous indwelling needle and infusion connector joint.Methods 120 cases of children in our hospital receiving chemotherapy through intravenous infusion were randomized into the control group and the experimental group with 60 cases in each group.The control group used heparin cap,after each infusion was completed,with 12.SU/ml 3～5ml of heparin saline pulse-type sealing.The experimental group adopted infusion connector joint,after the infusion completed,3～5 ml normal saline was injected into the joint to flush the blessing sealed tube.The complications rate was calculated in two groups.Results The experimental group and the control group showed differences in the incidence of complications and the patients' approval to nurses.Conclusions Combination of intravenous indwelling needle and infusion connector joint can reduce the complications significantly,and improve patients' approval to nurses.
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Background: The U-shaped maxillary major connector is considered to be the least-desirable design by many prosthodontists as it lacks rigidity, which is a primary requisite for a major connector. Aims and Objectives: Design modifications in the U-shaped palatal major connector are desired because it lacks rigidity. The study also aimed to determine the best design when a U-shaped palatal major connector is indicated for clinical use. Materials and Methods: The normal design and the design-modified models (modification 1, 2, 3, 4) were loaded at the functional cusps of the premolars and the molars with a magnitude of 200 N, 250 N and 300 N at angulations of 60 o and 90 o on both sides of the maxillary arch. Results for each loading were obtained as stress distribution colored images and numerical values were recorded. A three-dimensional finite element analysis study of the design-modified models was performed using two finite element softwares, namely PRO-E and IDEAS. Results: The least stress value of 7.86 Megapascals (MPa) at 200 N, 60 o was recorded for the double-thickness design, followed by design 1, which was 8.03 MPa. The least stress value for the palatal mucosa and ligament was provided by design modification 1 (0.5 mm-thick U-shaped connector, 9 mm anteroposteiorly, 14.6 mm laterally), which was 9.78 MPa and 2.98 MPa, respectively. Conclusion: The double-thickness group exhibited the least internal stress for the U-shaped major connector. However, it delivered the greatest stress to the palatal mucosa and the periodontal ligaments.
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Proceso Alveolar/fisiología , Diente Premolar/fisiología , Fenómenos Biomecánicos , Aleaciones de Cromo/química , Arco Dental/fisiología , Diseño de Dentadura , Dentadura Parcial Removible , Módulo de Elasticidad , Análisis de Elementos Finitos , Humanos , Imagenología Tridimensional/métodos , Ensayo de Materiales , Maxilar/fisiología , Diente Molar/fisiología , Mucosa Bucal/fisiología , Hueso Paladar/fisiología , Paladar Duro/fisiología , Ligamento Periodontal/fisiología , Docilidad , Estrés MecánicoRESUMEN
Cardiopulmonary bypass (CPB) is widely used for cardiac surgery by virtue of its proven safety over the course of its use during the past half century. Even though perfusion is safer, incidents still occur. During the repair of a ventricular-septal defect in an 11-month-old infant, we experienced a critical incident related to the potential hazardous effect of volatile anesthetics on the polycarbonate connector of extra-corporeal circuit. The damage to the polycarbonate connector had occurred after spillage of isoflurane during the filling of the vaporizer, causing it to crack and leak. The incident was managed by replacement of the cracked connector during a temporary circulatory arrest. The patient was hypothermic and the time off bypass was less than 1.5 min. There were no neurologic sequelae, the patient made an uneventful recovery. In conclusion, the spillage of volatile anesthetics can cause cracks in the polycarbonate connector of the extra-corporeal circuit, leading to potentially interruption of CPB.
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Humanos , Lactante , Anestésicos , Puente Cardiopulmonar , Isoflurano , Nebulizadores y Vaporizadores , Perfusión , Cemento de Policarboxilato , Cirugía Torácica , VirtudesRESUMEN
The aortic connector system may reduce stroke during proximal venous anastomosis. However, the overall anastomotic patency rate has been generally reported to be low. From October 2002 to March 2004, 68 patients who received proximal anastomosis using the St. Jude Aortic Connector System were included in the study. There were 47 men and 21 women and their mean age was 65.68+/-6.68 yr old (52 to 85 yr). Grafts were evaluated by coronary angiography or multi-slice 16 channel 3-D CT at 6 days and at 6 months postoperatively. In the immediate postoperative period, no stenosis was observed by either angiography (n=22) or 3D CT (n=46). At 6-month postoperatively, we performed either angiography (n=7) or 3-D CT (n=52). Of these patients, 5 patients showed graft stenosis in the midportion, and 3 in the ostium. There were no stroke. Simple, and effective proximal anastomosis with good protection from cerebrovascular accident was achieved especially when calcification or atheromatous plaque was observed at the ascending aorta in the operation room. However, our mid term patency results raise concerns related to venous graft stenosis in the midportion. Therefore, longer follow up is recommended.
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Persona de Mediana Edad , Masculino , Humanos , Femenino , Anciano de 80 o más Años , Anciano , Vena Safena/trasplante , Estudios de Seguimiento , Puente de Arteria Coronaria/instrumentación , Aorta/cirugía , Anastomosis Quirúrgica/instrumentaciónRESUMEN
Statements of problem: Zirconia core is used for posterior fixed partial dentures because it's good mechanical properties. Stress is concentrated on connectors in fixed partial dentures, so the proper design of connector areas is needed for adequate mechanical long-term properties of any prosthesis. The area of connector is critical, but tooth size and surrounding soft tissue limit the connector design. PURPOSE: The purpose of this study is to compare fracture strengths between different connector designs of zirconia core for posterior fixed partial dentures manufactured with CAD/CAM system and determining the optimal connector design satisfying strength and hygiene. MATERIAL AND METHOD: The following four groups of 40 posterior fixed partial denture specimens(each group 10) were fabricated as followed; group 1, vertical height of connector is 3mm(control group, all groups have the same condition); group 2, lingual vertical 1mm reinforcement on connector; group 3, lingual vertical 2mm reinforcing on connector and group 4, lingual vertical 3mm reinforcing on connector. Specimens were subjected to compressive loading on the central fossa of pontic by instron. SEM was used to identify the initial crack and characterize the fracture mode. RESULTS: The results were as follows: 1. The mean fracture load of the non-lingual reinforcing group was 1212N and the lingual vertical 1mm reinforcing group was 1510N, the lingual vertical 2mm reinforcing group was 1882N, the lingual vertical 3mm reinforcing group was 1980N. 2. The reinforcing groups were statistically significant compared to non-reinforcing groups(P0.05) 4. Fractures were initiated in gingival embrasures of connectors and processed to the loading site. CONCLUSION: In this study, lingual reinforcement of connector for improved strength of zirconia based fixed partial denture is nessasary. And long-term study for clinical application is required.
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Dentadura Parcial Fija , Higiene , Prótesis e Implantes , DienteRESUMEN
Statements of problem: Zirconia core is used for posterior fixed partial dentures because it's good mechanical properties. Stress is concentrated on connectors in fixed partial dentures, so the proper design of connector areas is needed for adequate mechanical long-term properties of any prosthesis. The area of connector is critical, but tooth size and surrounding soft tissue limit the connector design. PURPOSE: The purpose of this study is to compare fracture strengths between different connector designs of zirconia core for posterior fixed partial dentures manufactured with CAD/CAM system and determining the optimal connector design satisfying strength and hygiene. MATERIAL AND METHOD: The following four groups of 40 posterior fixed partial denture specimens(each group 10) were fabricated as followed; group 1, vertical height of connector is 3mm(control group, all groups have the same condition); group 2, lingual vertical 1mm reinforcement on connector; group 3, lingual vertical 2mm reinforcing on connector and group 4, lingual vertical 3mm reinforcing on connector. Specimens were subjected to compressive loading on the central fossa of pontic by instron. SEM was used to identify the initial crack and characterize the fracture mode. RESULTS: The results were as follows: 1. The mean fracture load of the non-lingual reinforcing group was 1212N and the lingual vertical 1mm reinforcing group was 1510N, the lingual vertical 2mm reinforcing group was 1882N, the lingual vertical 3mm reinforcing group was 1980N. 2. The reinforcing groups were statistically significant compared to non-reinforcing groups(P0.05) 4. Fractures were initiated in gingival embrasures of connectors and processed to the loading site. CONCLUSION: In this study, lingual reinforcement of connector for improved strength of zirconia based fixed partial denture is nessasary. And long-term study for clinical application is required.
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Dentadura Parcial Fija , Higiene , Prótesis e Implantes , DienteRESUMEN
OBJECTIVE To investigate the appropriate time of changing Ke Lai Fu infusion connector of central venous infusion catheter.METHODS The patients were selected from Internal Oncology Dept in our hospital based on certain criteria,and divided these patients with central venous infusion catheter into 4 groups.The new infusion connector of their central venous catheter was changed every 7 days,10days,15 days and 30 days etc.The replaced infusion connectors were rinsed by normal saline and their residual flush liquids were sent for bacterial culture.The group that their bacterial culture of residual flush liquids was negative was determined as the best changing days of infusion connectors.RESULTS The bacterial culture positive rates of Ke Lai Fu infusion connectors which were renewed every 7 days,10 days,15 days and 30 days,were 0,8.1%,10.3%and 29.7%,respectively.The best renewing days of connector was 7 days.CONCLUSIONS This result of the study provides a valuable guidance for the proper application of infusion connectors and effectively prolonging the indwelling days of central venous infusion catheter;therefore it can decrease hospital infection rate.
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A 76-year-old man who had undergone primary coronary operation through a median sternotomy 9 years previously presented with recurrent angina. Preoperative angiography revealed 90% stenosis of the circumflex coronary artery and left subclavian artery. Two saphenous vein grafts (SVG) placed in the previous operation were patent. Redo off-pump CABG was performed through a left thoracotomy approach. The proximal end of the new SVG was connected to the descending thoracic aorta using the St. Jude Medical aortic connector system. The distal anastomosis to the obtuse marginal branch was performed on a beating heart. The postoperative course was uneventful. This case suggested that, in cases requiring the proximal graft anastomosis on the descending aorta, the application of the aortic connector system can be a useful strategy, helping to facilitate the proximal anastomosis and avoid complications associated with the aortic partial-clamping on the descending aorta.
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STATEMENTS OF PROBLEM: All ceramic fixed partial denture cores can be made by the slip casting method and the advanced alumina tape method. The fracture resistance of these core connector areas is relatively low. PURPOSE: The purpose of this study is to standardize the appropriate volumetric figure and location of the connectors in the alumina core fabricated in alumina tape to be used in fixed partial dentures by way of topology optimization. MATERIAL AND METHOD: A maxillary anterior three-unit bridge alumina core with teeth form and surrounding periodontal apparatus model was used to ultimately design the most structurally rigid form of the connector. Loadings from a 0 degree, 45 degrees and 60 degrees to the axis of each tooth were applied and analyzed with the 3-D finite element analysis method. Using the results from these experiments, the topology optimization was applied and the optimal reinforcement layout of connector was obtained and the detail shape in the fixed partial denture core was designed. RESULTS: The modified prosthesis with the form of a bulk in the lower lingual surface of the connector in the event, reduced the stress concentration up to 20% in the 3-D FEA. CONCLUSION: The formation of a bulk in the lower lingual connector area of an alumina core for a fixed partial denture decreases the stress to a clinically favorable measure but does not harm the esthetic point of view. This result illustrates the possibility of clinical application of the modified form designed by the topology optimization method.
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Óxido de Aluminio , Vértebra Cervical Axis , Cerámica , Dentadura Parcial Fija , Análisis de Elementos Finitos , Prótesis e Implantes , DienteRESUMEN
Ventilation impairment sometimes developes in patients with a double-lumen tube (DLT) during thoracic anesthesia. A 27-year old man who suffered from a left pneumothorax showed ventilation impairment with right lung obstruction after the induction of anesthesia. We checked breathing sounds before and after clamping each lumen. Correct positioning was confirmed by direct visualization using a flexible fiberoptic bronchoscope and by chest X-ray. The DLT was removed and replaced by a single lumen endotracheal tube because of severe ventilation impairment. On careful examination of the DLT, manufacturing defects in a bifurcated connector were noted, and its openings were occluded with a thin plastic membrane. After replacing the DLT, the ventilation impairment was improved. It is important to test DLT prior to use, and to maintain an awareness that airway obstruction can occur due to structural defects.
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Adulto , Humanos , Obstrucción de las Vías Aéreas , Anestesia , Broncoscopios , Constricción , Pulmón , Membranas , Plásticos , Neumotórax , Ruidos Respiratorios , Tórax , VentilaciónRESUMEN
Objective To develop a connector between anesthetic machine and oxygen provider for continual oxygen supply to anesthetic machine during field operation.Method According to the principle of three-way block and one-way qas wave,the new connector with two-routes but one-way for the anesthetic machine was made.Result This setting enable the anesthetic machine to connect two oxygen providers at one time.Conclusion With low cost and being easy to install and dissemble,it can be connected to all kinds of anesthetic machine,thus ensuring the persistence work of the anesthetic machine when changing oxygen provider.