| 1. |
- Malmberg, Leona, et al.
(författare)
-
Establishment and maintenance of asepsis in endodontics – a review of the literature
- 2016
-
Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:6, s. 431-435
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract: Objectives: Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance. Materials and methods: A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria. Results: There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study. Conclusions: No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed. © 2016 Acta Odontologica Scandinavica Society.
|
|
| 2. |
- Fletcher-Sandersjoo, Alexander, et al.
(författare)
-
Stockholm score of lesion detection on computed tomography following mild traumatic brain injury (SELECT-TBI) : study protocol for a multicentre, retrospective, observational cohort study
- 2022
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:9
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction Mild traumatic brain injury (mTBI) is one of the most common reasons for emergency department (ED) visits. A portion of patients with mTBI will develop an intracranial lesion that might require medical or surgical intervention. In these patients, swift diagnosis and management is paramount. Several guidelines have been developed to help direct patients with mTBI for head CT scanning, but they lack specificity, do not consider the interactions between risk factors and do not provide an individualised estimate of intracranial lesion risk. The aim of this study is to create a model that estimates individualised intracranial lesion risks in patients with mTBI who present to the ED. Methods and analysis This will be a retrospective cohort study conducted at ED hospitals in Stockholm, Sweden. Eligible patients are adults (>= 15 years) with mTBI who presented to the ED within 24 hours of injury and performed a CT scan. The primary outcome will be a traumatic lesion on head CT. The secondary outcomes will be any clinically significant lesion, defined as an intracranial finding that led to neurosurgical intervention, hospital admission >= 48 hours due to TBI or death due to TBI. Machine-learning models will be applied to create scores predicting the primary and secondary outcomes. An estimated 20 000 patients will be included. Ethics and dissemination The study has been approved by the Swedish Ethical Review Authority (Dnr: 2020-05728). The research findings will be disseminated through peer-reviewed scientific publications and presentations at international conferences.
|
|
| 3. |
- Lytsy, Birgitta, 1968-, et al.
(författare)
-
Evaluating the effect of Novarerus NV800 air purifier units during orthopaedic surgery to reduce bioburden in the air
- 2022
-
Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701 .- 1532-2939. ; 130, s. 108-111
-
Tidskriftsartikel (refereegranskat)abstract
- Background: A locally installed air purifier unit (Novaerus Protect 800) has been shown to reduce the air bioburden in an intensive care unit and the incidence of healthcare-associated infections. Aim: To explore whether this type of air purifying unit could reduce bacterial concentrations in the air of an operating room (OR) during orthopaedic surgery, thereby reducing the risk of surgical site infections. Methods: In this prospective experimental study, undertaken in 2018, three air purifying units were installed in an OR in a Swedish hospital in 2018. The air was actively sampled during 11 operations by a slit-to-slit agar impactor with the air purifying units either switched on or switched off. Air movements were visualized with the aid of smoke in mock-up studies. Findings: No significant difference in bacterial concentrations in air was found between the two conditions (air purifying units switched off or on) (P=0.54). Air movements around and above the surgical wound were disordered and resembled those of dilution mixing air. Conclusion: The three air purifying units installed in the OR did not reduce the airborne bacterial levels in the critical zone during orthopaedic surgery.
|
|
| 4. |
|
|
| 5. |
- Ohlin, Acke, et al.
(författare)
-
Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery
- 2018
-
Ingår i: European Spine Journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 27:10
-
Tidskriftsartikel (refereegranskat)abstract
- © 2018 The Author(s) Purpose: Post-operative infections are relatively common after posterior spine surgery, and there are several observations reflecting different infection complications related to various metals implanted. Here, we selected an array of different bacterial species that are often found in infections associated with orthopaedic implants and tested for inhibition by hydrogen peroxide-treated titanium (Ti-peroxy). Methods: To study the possibility of using Ti-peroxy as an antimicrobial prophylaxis, we developed a protocol for standardized susceptibility testing of bacteria. Results: Importantly, we found that the resulting Ti-peroxy was highly antimicrobial against all aerobic species tested, among others, Staphylococcus aureus and Pseudomonas aeruginosa. Proteus mirabilis was slightly more resistant than, for example, Klebsiella pneumoniae and enterococci. In contrast, anaerobic bacteria Cutibacterium acnes and Parvimonas micra were equally susceptible compared to staphylococci. Conclusions: Our findings suggest that the Ti-peroxy is a promising perioperative antimicrobial strategy that may be highly effective for prevention of post-operative infections. We therefore suggest application of hydrogen peroxide to implants prior to implantation. Graphical abstract: These slides can be retrieved under Electronic supplementary material.[Figure not available: see fulltext.]
|
|
| 6. |
- Pihl, Maria, 1978, et al.
(författare)
-
Osseointegration and antibacterial effect of an antimicrobial peptide releasing mesoporous titania implant
- 2021
-
Ingår i: Journal of Biomedical Materials Research - Part B Applied Biomaterials. - : Wiley. - 1552-4981 .- 1552-4973. ; 109:11, s. 1787-1795
-
Tidskriftsartikel (refereegranskat)abstract
- Medical devices such as orthopedic and dental implants may get infected by bacteria, which results in treatment using antibiotics. Since antibiotic resistance is increasing in society there is a need of finding alternative strategies for infection control. One potential strategy is the use of antimicrobial peptides, AMPs. In this study, we investigated the antibiofilm effect of the AMP, RRP9W4N, using a local drug-delivery system based on mesoporous titania covered titanium implants. Biofilm formation was studied in vitro using a safranine biofilm assay and LIVE/DEAD staining. Moreover, we investigated what effect the AMP had on osseointegration of commercially available titanium implants in vivo, using a rabbit tibia model. The results showed a sustained release of AMP with equal or even better antibiofilm properties than the traditionally used antibiotic Cloxacillin. In addition, no negative effects on osseointegration in vivo was observed. These combined results demonstrate the potential of using mesoporous titania as an AMP delivery system and the potential use of the AMP RRP9W4N for infection control of osseointegrating implants.
|
|
| 7. |
- Ranisch, Robert, et al.
(författare)
-
Ethics of digital contact tracing apps for the Covid-19 pandemic response
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- There is a growing interest in contact tracing apps (CT apps) for pandemic man- agement. These apps raise significant moral concerns. It is therefore crucial to consider ethical requirements before and while implementing such apps. Public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely under- mine public trust, and as such, risk impeding general effectiveness. In response to these demands, to meet ethical requirements and find a basis for justified trust, this background introduces an ethical framework for a responsible design and implementation of CT apps. However, even prudently chosen measures of digital contact tracing carry moral costs, which makes it necessary address different trade-offs. This background paper aims to inform developers, researchers and decision-makers be- fore and throughout the process of implementing contact tracing apps.
|
|
| 8. |
- Aganovic, A., et al.
(författare)
-
Ventilation design conditions associated with airborne bacteria levels within the wound area during surgical procedures: a systematic review
- 2021
-
Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701 .- 1532-2939. ; 113, s. 85-95
-
Forskningsöversikt (refereegranskat)abstract
- Background: Without confirmation of the ventilation design conditions (typology and airflow rate), the common practice of identifying unidirectional airflow (UDAF) systems as equivalent to ultra-clean air ventilation systems may be misleading, but also any claims about the ineffectiveness of UDAF systems should be doubted. The aim of this review was to assess and compare ventilation system design conditions for which ultra-clean air (mean <10 cfu/m ) within 50 cm from the wound has been reported. Six medical databases were systematically searched to identify and select studies reporting intraoperative airborne levels expressed as cfu/m close to the wound site, and ventilation system design conditions. Available data on confounding factors such as the number of persons present in the operating room, number of door openings, and clothing material were also included. Predictors for achieving mean airborne bacteria levels within <10 cfu/m were identified using a penalized multivariate logistic regression model. Twelve studies met the eligibility criteria and were included for analysis. UDAF systems considered had significantly higher air volume flows compared with turbulent ventilation (TV) systems considered. Ultra-clean environments were reported in all UDAF-ventilated (N = 7) rooms compared with four of 11 operating rooms equipped with TV. On multivariate analysis, the total number of air exchange rates (P=0.019; odds ratio (OR) 95% confidence interval (CI): 0.66–0.96) and type of clothing material (P=0.031; OR 95% CI: 0.01–0.71) were significantly associated with achieving mean levels of airborne bacteria <10 cfu/m . High-volume UDAF systems complying with DIN 1946-4:2008 standards for the airflow rate and ceiling diffuser size unconditionally achieve ultra-clean air close to the wound site. In conclusion, the studied articles demonstrate that high-volume UDAF systems perform as ultra-clean air systems and are superior to TV systems in reducing airborne bacteria levels close to the wound site. 3 3 3 3
|
|
| 9. |
- Lytsy, Birgitta, 1968-, et al.
(författare)
-
Source strength as a measurement to define the ability of clean air suits to reduce airborne contamination in operating rooms
- 2022
-
Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701 .- 1532-2939. ; 119, s. 9-15
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Surgical site infections after total hip and knee replacement are linked to the quality of the operating room (OR) air. Applying tight occlusive clothing, effective ventilation and correct working methods are key concepts to obtain low bacterial concentrations in the OR air. The dry penetration test referred to in European standard EN 13795-2:2019 is a screening method for materials used in surgical clothing. Source strength, defined as the dispersal of bacteria-carrying particles from persons during activity, is a functional test of clothing systems and has been calculated in a dispersal chamber and in ORs. Results from both tests can be used when comparing surgical clothing systems. Aim: This study relates results of dry penetration tests to source strength values for five surgical clothing systems available on the Swedish market. Methods: Experimental data are reported on the function of these products, expressed as source strength calculated from results in a dispersal chamber and in ORs during orthopaedic operations. Findings: All materials tested with dry penetration ≤50 colony-forming units (cfu) had source strength values <3 cfu/s for one person in the dispersal chamber, whereas the material of one product when laundered >50 times had source strength in the dispersal chamber of up to 8 cfu/s. Conclusion: The dry penetration test could predict the performance of clean air suits of the same design, but more studies are needed to obtain a more valid correlation. Requirements of source strength should be included in standards.
|
|
| 10. |
- Atefyekta, Saba, 1987
(författare)
-
Antibacterial Surfaces for Biomedical Applications
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Medical devices such as orthopedic implants are intended to serve for improved quality of life. However, clinical success cannot be taken for granted and the most common reason for failure is due to biomaterials associated infection (BAI). An implantation surgical site is a susceptible environment for bacterial colonization, which in combination with compromised immune system, results in that bacteria can develop biofilms on the implant surface or in adjacent tissue. Once such a biofilm has established, it may lead to an infection that cannot be eradicated by means of traditional antibiotics, often resulting in revision surgery. Wounds after post implantation surgery is another risk for bacterial colonization into underlying tissue and increases further the susceptibility to infection. These and other bacteria related complications are today becoming more serious due to the rapid increase of antibiotic resistance worldwide. This has resulted in that many available antibiotics are losing their potency against bacteria and consequently, treating an infection with antibiotics is not working as effectively as in the past. The objective of this thesis was to find new solutions to address the complications associated with bacterial colonization through applying preventive measures by designing antibacterial surfaces for inhibition of early biomaterials associated and wound infection. For this purpose, two types of antibacterial surfaces were designed and evaluated. In the first type, a local drug-delivery system based on mesoporous Titania thin films were developed. These films were to serve as implant coatings where antibiotics are released locally at the implantation site to prevent biofilm formation and subsequent tissue colonization. In the second approach, antibacterial surfaces were developed through covalent immobilization of a cationic antimicrobial peptide (AMP), thus creating surfaces that kill bacteria upon contact. The overall results in this thesis, which are presented as four papers, suggest that the developed antibacterial surfaces are promising to use in future biomedical applications.
|
|
