Hyperbaric oxygen therapy and osteoradionecrosis.

Osteoradionecrosis of the mandible is a potentially devastating complication of head and neck radiation. Radiation causes progressive vascular occlusion with tissue hypoxia, tissue death, and failure of healing. Hyperbaric oxygen therapy is an accepted treatment for osteoradionecrosis. This article reviews the history of hyperbaric oxygen therapy, its physiologic mechanisms, its use in the management of osteoradionecrosis, and its complications and contraindications.

Reduced intravascular catheter-related infection by routine use of antibiotic-bonded catheters in a surgical intensive care unit.

We report a comparative analysis of intravascular catheter-related infection before and after routine use of antibiotic-bonded catheters in an intensive care unit. Cefazolin-bonded catheters were placed in patients requiring catheterization for at least 3 days, or with remote infection, standard catheters at other times. One thousand forty-five catheters (259 patients) over 6 months were compared with 801 (236 antibiotic-bonded, 565 standard) catheters (239 patients) the next 6 months. After use of antibiotic-bonded catheters, we found: 1.7% catheters infected versus 3.7% (p = 0.01); catheter-associated bacteremia 0.1% versus 1.3% (p < 0.005); catheter-related infection rate 4.39 versus 10.73 per 1000 patient days (p < 0.005), and 5.06 versus 11.47 per 1000 catheter days (p < 0.01); and cumulative risk of infection decreased (p < 0.005). Antibiotic-bonded catheters were used with more remote infections (52% versus 27%, p < 0.001), had longer indwelling time (4.4 versus 3.1 days, p = 0.0001), and more were inserted over a guide wire (66% vs. 28%, p < 0.001). In conclusion routine use of antibiotic-bonded catheters was associated with a significant reduction in infectious complications.

Ultrasonic nonlinear parameters and sound speed of alcohol-water mixtures.

Changes in the nonlinear parameter B/A caused by the addition of monohydric alcohols to water have been investigated. The measurements, made by using an aqueous solution of n-propanol, isopropanol, and t-butanol, show that as the alcohol concentration is increased, B/A decreases to a minimum at approximately 10% concentration (by volume). Further increase in alcohol concentration raises B/A rapidly to a maximum at about 80% by volume. This complex variation in B/A is attributed to solute-solvent interaction which is believed to be due to an enhancement of water structure in the water-rich region. These results suggest that the magnitude of B/A may be closely related to the quasilattice structure of water, which to a first approximation can be expressed by relative amounts of bound and unbound water.