ABSTRACT
OBJECTIVE: The objective of this review is to identify and map literature related to safe injection practices among anesthesia providers in developed nations. The mapped literature will be used to determine if there is sufficient literature available to pose specific questions that can be valuably addressed, through a future systematic review, to reduce the prevalence of unsafe injections. INTRODUCTION: A safe injection is one that does not harm the recipient, does not expose the healthcare worker to avoidable risk, and does not result in waste that is a danger to the community. The literature is replete with examples of disease outbreaks connected to unsafe injections via the misuse of syringes, needles and medications. Many such outbreaks involve unsafe injections by anesthesia providers. INCLUSION CRITERIA: This scoping review will consider any research article or policy document, including unpublished reports, that provides information related to safe injection practices by anesthesia providers in developed nations. METHODS: For studies published in English from 2000, the databases to be searched include Ovid MEDLINE, CINAHL and Google Scholar. The search for unpublished literature will include the websites of anesthesia organizations, the Centers for Disease Control and Prevention, and the National Institutes of Health. Results will be screened by two independent reviewers who will use a standardized tool to independently extract data from each included source. The results of the review will be presented as a map of the data extracted in a tabular form and in a narrative descriptive summary.
Subject(s)
Anesthesia , Health Personnel/standards , Injections/standards , Safety , Syringes/standards , Delivery of Health Care , Developed Countries , Hospitals , Humans , Infection Control/organization & administration , Injections/adverse effectsABSTRACT
While intermittent ureteropelvic junction obstruction is well recognized clinically, intermittent obstruction at the ureterovesical junction has not been previously described. We herein present a case report of intermittent ureterovesical junction obstruction, characterized by intermittent hydroureteronephrosis on ultrasonography and symptoms of flank/abdominal pain, nausea and vomiting.
Subject(s)
Hydronephrosis/etiology , Ureteral Obstruction/complications , Urologic Surgical Procedures/methods , Child , Cystoscopy , Diagnosis, Differential , Follow-Up Studies , Humans , Hydronephrosis/diagnosis , Hydronephrosis/surgery , Male , Recurrence , Tomography, X-Ray Computed , Ureteral Obstruction/diagnosis , Ureteral Obstruction/surgery , UrodynamicsABSTRACT
To determine whether chemically induced miscarriage affects fetomaternal trafficking in a mouse model, we measured the amount of fetal DNA present in various maternal organs by polymerase chain reaction amplification following exposure to lipopolysaccharide (LPS). As the frequency of fetal cells and the number of animals with detectable microchimerism following LPS injection were significantly increased, particularly in lung tissue compared to controls, with no signs of an inflammatory response, we conclude that LPS-induced miscarriage results in increased murine fetomaternal cell trafficking, supporting a relationship between fetal loss and the establishment of fetal cell microchimerism.
Subject(s)
Abortion, Spontaneous/pathology , Cell Movement , Fetus/pathology , Lung/pathology , Maternal-Fetal Exchange , Abortion, Spontaneous/chemically induced , Abortion, Spontaneous/genetics , Animals , Chimerism , Disease Models, Animal , Female , Fetus/metabolism , Gestational Age , Green Fluorescent Proteins/biosynthesis , Green Fluorescent Proteins/genetics , Lipopolysaccharides , Lung/metabolism , Male , Mice , Mice, Inbred C57BL , Mice, Transgenic , Polymerase Chain Reaction , PregnancyABSTRACT
Chimerism in an individual refers to the coexistence of cells arising from two distinct organisms. It can arise iatrogenically via transplant or blood transfusion, and physiologically via twin to twin transfer, or from trafficking between mother and fetus during pregnancy. Many of the diseases associated with microchimerism affect the endocrine system (e.g., autoimmune thyroid disease and diabetes mellitus type 1). Microchimerism is relevant to endocrine pathology because (a) it is associated with pregnancy, a condition of complex endocrine physiology; (b) materno-fetal and feto-maternal cellular migration must involve the placenta, itself an endocrine organ; and (c) in some species, chimerism results in states of intersexuality, a condition intimately involved with endocrine physiology. Studies of feto-maternal microchimerism in the thyroid have documented the presence of fetal cells in association with Hashimoto thyroiditis, Graves' disease, thyroid adenoma, and papillary thyroid carcinoma. Studies of materno-fetal microchimerism have documented the presence of maternal cells in juvenile diabetes and other pediatric conditions. Microchimerism plays a potential role in the repair of diseased thyroid and pancreatic tissues.
