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Infection prevention and control
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
The HPS (2013) summarises the different types of equipment as follows: Single-use equipment is used once and then discarded and not reused even on the same person. The packaging of these items is marked with a standardised symbol (Figure 12.9). Single person use equipment can be reused but only on the same individual, for example, an oxygen mask.Reusable invasive equipment is used once and then decontaminated, for example, surgical instruments returned to sterile services department for sterilisation.Reusable non-invasive equipment (communal equipment) is reused on more than one individual after disinfection immediately after each use e.g. commodes, drip stands, hoists, blood pressure monitors
Developments of Health Care: A Brief History of Medicine
Published in P. Mereena Luke, K. R. Dhanya, Didier Rouxel, Nandakumar Kalarikkal, Sabu Thomas, Advanced Studies in Experimental and Clinical Medicine, 2021
P. Mereena Luke, K. R. Dhanya, Tomy Muringayil Joseph, Józef T. Haponiuk, Didier Rouxel, S. Thomas
The rise of Egyptian civilization was in about 3000 BC. Sekhet-Eanach was the first doctor known to history. The second doctor was Imhotep (2,600 BC) He seems to have been a successful physician. He started using simple surgery instead of magic [8]. The oldest known medical book is the Ebers Papyrus, written about 1500 BC, covering 200 illnesses, extracting medicine from crops, and pointing out the Egyptian physicians used a wide range of herbal and mineral drugs medicated steam inhalation had used for the treatment of patients with chest problem, and doctors used ointments for healing wounds [9]. According to the Egyptians concept, the human body was full of passages. They considered that it could cause disease if these passages in a human body were blocked, to open the passages; they used laxatives and caused vomiting. However, they believed that spells and magic would help to cure the sickness and they used amulets to prevent the disease. They were, curious about the fundamental and primary sources of illness and they started to search for a physical cause of disease [10]. The Egyptians had some awareness of anatomy from the experience of making mummies. Egyptian surgery was restricted only to the treatment of injuries, fractures, and the treatment of blisters and cysts or abscesses. They had surgical instruments such as probes, saws, forceps, scalpels, and scissors clamps, sutures, and cauterization [11].
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
How is surgical equipment sterilised?The majority of surgical instruments and drapes are sterilised using an autoclave (saturated steam at high pressure), at 134°C, a pressure of 2 atm for a holding time of 3 min. This kills all organisms including viruses and heat-resistant spores. The steam penetration is monitored with the Bowie–Dick test, which should be checked prior to every operation.Dry-heat sterilisation is used for moisture-sensitive instruments and those with fine cutting edges. The tools are heated to 160°C for 1 hour.Ethylene oxide is a highly penetrative gas used to sterilise heat-sensitive equipment (rubber, electrical equipment), and it will kill vegetative bacteria, spores and viruses.Gamma irradiation is used in industry to sterilise large batches of single-use items such as catheters and syringes.
Protective Effect of Calcitriol on Organ Damage Induced by 5-Fluorouracil Treatment
Published in Nutrition and Cancer, 2021
Szu-Chi Chen, Chun-Yen Ke, Yi-Maun Subeq, Wan-Ting Yang, Shyh-Geng Huang, An-Suey Shiao, Ru-Ping Lee
This study protocol was approved by the Institutional Animal Care and Use Committee of Cheng Hsin General Hospital (IACUC Approval No.: CHIACUC 104-23) and was conducted in accordance with the Guide for the Use and Care of Laboratory Animals. Healthy adult Wistar-Kyoto (WKY) rats weighing 280–320 g were purchased from the National Experimental Animal Center (Taipei, Taiwan). The rats were housed in standard cages in a temperature-controlled room (22 °C ± 1 °C), with 40–70% relative humidity and maintained in 12-h light–dark cycles. A catheter was inserted in the femoral artery and femoral vein of the experimental animals in whom anesthesia was induced by inhalation of isoflurane. All surgical instruments were sterilized and disinfected. The surgery was performed in a laminar airflow bench and was completed within 15 min. The surgical wound was maintained within 0.5 × 0.5 cm and was sutured after catheter insertion. The femoral artery catheter was connected to a physiological amplifier (PowerLab, AD Instruments Co., Mountain View, CA, USA) to monitor the arterial blood pressure and for obtaining blood samples; the femoral vein catheter was used as a drug administration route (24). Postoperatively, the animals were placed in a metabolic cage for recovery from the anesthesia.
Efficacy of new emerging surgical approaches for macular hole retinal detachment in myopic patients; a systematic review
Published in Expert Review of Ophthalmology, 2021
Masood Bagheri, Amin Najafi, Amir Eftekhari Milani, Somayyeh Hazeri
It should be noted that it is difficult to compare results in studies that include patients with different severity and don’t define or control enrollment parameters. Surgical success rate is affected by variables such as surgeon’s proficiency, surgical instruments, staining materials, and especially axial length and so on. Also, as mentioned earlier, tangential and anteroposterior retinal traction plays a key role in the pathogenesis of the MHRD in highly myopic eyes. This hypothesis can justify the high rate of proliferative vitreoretinopathy (PVR) in these patients as reported in previous studies [1,5]. However, in most previous reports, patients with significant PVR were excluded from the study, which can lead to a significant bias in the surgical success rate results (both MH closure and retinal reattachment). The most important limitations of this review were the absence of patients matching in terms of axial length, MH size, disease severity (including the presence of PVR) and type of intraocular tamponade.
Negative prognostic implications of splenomegaly in nivolumab-treated advanced or recurrent pancreatic adenocarcinoma
Published in OncoImmunology, 2021
Shih-Hung Yang, Li-Chun Lu, Hsiang-Fong Kao, Bang-Bin Chen, Ting-Chun Kuo, Sung-Hsin Kuo, Yu-Wen Tien, Li-Yuan Bai, Ann-Lii Cheng, Kun-Huei Yeh
Pancreatic cancer is the seventh greatest cause of cancer death worldwide,1 with 70% of patients receiving diagnoses in the advanced stage, without chance of being cured with current standard chemotherapy.2,3 With curative resection, the recurrence rate is >60%, even with intensive adjuvant chemotherapy in carefully selected patients.4 The refinement of surgical instruments and techniques has improved short-term surgical outcomes.5 However, without modifiable factors other than chemotherapy, the original principles of tumor resection and the long-term survival outcomes have changed minimally.6,7 Approximately 80% of patients with pancreatic cancer eventually face the dilemma of choosing between the poor efficacy and high toxicities of the current standard chemotherapy and a fragile body with comorbidities and cancer-associated complications.2,3,8 Median overall survival (OS) of metastatic disease is within 1 year with standard chemotherapy, such as gemcitabine plus nab-paclitaxel or the FOLFIRINOX regimen.2,3