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Journal of Pediatric Urology Feb 2020Patients with bladder augmentation (BA) are routinely counseled to irrigate their bladders daily. However, reports of adherence with this regimen are lacking.
BACKGROUND
Patients with bladder augmentation (BA) are routinely counseled to irrigate their bladders daily. However, reports of adherence with this regimen are lacking.
OBJECTIVE
To evaluate adherence to a bladder irrigation protocol and identify risk factors associated with adherence among adults with spina bifida (SB) and BA.
STUDY DESIGN
Adults with SB after BA followed in a multidisciplinary clinic were identified (2017-2019). All patients or caregivers were taught the importance of and the technique for the bladder irrigation protocol prior to and after BA. Patient demographics (age, gender, ambulatory status, and presence of a caregiver in clinics) and surgical details (type of BA, age at surgery, length of follow-up, presence of a catheterizable channel, position of stoma, bladder neck surgery, presence of Malone antegrade colonic enema or ventriculo-peritoneal shunt, and number of stone surgeries) were obtained from the medical record. Patients reported other variables in a standardized clinic questionnaire. Answers were confirmed by health care providers. The variables included who performs clean intermittent catheterization (CIC), size of catheter, frequency of CIC, use of overnight catheterization, difficulties with CIC, number of UTIs, and continence per urethra and per catheterizable channel. Adherence to bladder irrigation was also assessed in the questionnaire. ‛Strict adherence' was defined as bladder irrigation performed ≥6 times/week with ≥120 mL of saline. For statistical analysis, a more lenient definition of ‛higher adherence' was used: bladder irrigation ≥2 times/week with at least 60 mL. ‛Lower adherence' was defined as ≤1 time/week or with less than 60 mL. Factors associated with ‛higher adherence' were assessed with non-parametric tests (Bonferroni-corrected p-value: 0.002).
RESULTS
Adherence was assessed in 87 eligible patients (60.9% females; mean age of 28.8 ± 8.2 years). No patient (0.0%) reported ‛strict adherence', and 62 and 25 patients (71.3% and 28.7%) reported ‛higher' and ‛lower' adherence' to bladder irrigation, respectively. Nine patients (10.3%) in the ‛lower adherence' group did not irrigate at all. No variables were statistically significant on univariate analysis, including previous bladder stone surgery or having a channel (p ≥ 0.01). On exploratory analysis, higher adherence was only associated with self-catheterizations versus those performed by caregivers (76.7% vs 33.3%, p = 0.01).
CONCLUSIONS
Adherence to a bladder irrigation protocol in adults with SB and BA is poor. A history of bladder stones requiring surgery and the presence of a catheterizable channel do not appear to affect adherence. It remains unclear why some patients are more likely than others to irrigate their bladders. Future work will focus on methods to improve adherence.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Intermittent Urethral Catheterization; Male; Patient Compliance; Spinal Dysraphism; Therapeutic Irrigation; Urinary Bladder; Urinary Reservoirs, Continent; Urologic Surgical Procedures; Young Adult
PubMed: 31796294
DOI: 10.1016/j.jpurol.2019.10.029 -
Explore (New York, N.Y.) 2021This report provides a perspective on the relevance of saline water gargling and nasal irrigation to the COVID-19 crisis. While there is limited evidence concerning... (Review)
Review
This report provides a perspective on the relevance of saline water gargling and nasal irrigation to the COVID-19 crisis. While there is limited evidence concerning their curative or preventive role against SARS-CoV-2 infection, previous work on their utility against influenza and recent post-hoc analysis of the Edinburgh and Lothians Viral Intervention Study (ELVIS) provide compelling support to their applicability in the current crisis. Saline water gargling and nasal irrigation represent simple, economical, practically feasible, and globally implementable strategies with therapeutic and prophylactic value. These methods, rooted in the traditional Indian healthcare system, are suitable and reliable in terms of infection control and are relevant examples of harmless interventions. We attempt to derive novel insights into their usefulness, both from theoretical and practical standpoints.
Topics: COVID-19; Humans; Nasal Lavage; Pharynx; SARS-CoV-2; Saline Solution; Saline Solution, Hypertonic; Therapeutic Irrigation
PubMed: 33046408
DOI: 10.1016/j.explore.2020.09.010 -
British Dental Journal Apr 2023
Topics: Sodium Hypochlorite; Dental Pulp Cavity; Root Canal Preparation; Root Canal Irrigants; Therapeutic Irrigation
PubMed: 37059753
DOI: 10.1038/s41415-023-5755-3 -
World Journal of Urology Mar 2022Transurethral endoscopic procedures using bipolar current, or laser energy are nowadays widely accepted and have replaced the traditional monopolar resection. A major... (Review)
Review
PURPOSE
Transurethral endoscopic procedures using bipolar current, or laser energy are nowadays widely accepted and have replaced the traditional monopolar resection. A major advantage of these techniques is the utilization of isotonic saline as irrigation solution, which minimizes side effects such as symptoms associated to classical transurethral resection syndrome (TUR-syndrome). Nonetheless, clinically significant IFA also occurs with saline and is determined by pressure gradients, systemic resistance and by the amount of irrigation fluid. We aimed to investigate the extend of IFA and symptoms due to volume overload during bipolar transurethral resection (bTUR) and laser procedures of the prostate.
METHODS
We performed a systematic literature search using PubMed, restricted to original English-written articles, including animal, artificial model, and human studies. Search terms were TUR, transurethral, laser, HoLEP, ThuLEP, greenlight, enucleation, fluid absorption, fluid uptake, and TUR-syndrome.
RESULTS
Mean and maximum IFA during bTURP ranges between 133 and 915 ml and 1019 ml and 2166 ml, respectively. Absorption during laser procedures can be significant with maximum values up to 4579 ml and mainly occurs during prostate vaporization techniques. Incidence of moderate to severe symptoms from iso-osmolar volume overload reaches 9%.
CONCLUSIONS
Irrigation fluid absorption during bTUR and laser surgery of the prostate is not negligible. Iso-osmolar overhydration with development of non-classical TUR-syndrome should be identified peri- and postoperatively and surgical teams should be aware of complications. Breath ethanol, venous pH, serum chloride, and bicarbonate could be markers for detecting dangerous events of IFA with saline.
Topics: Humans; Laser Therapy; Lasers; Male; Prostate; Prostatic Hyperplasia; Therapeutic Irrigation; Transurethral Resection of Prostate; Urologic Surgical Procedures
PubMed: 34191108
DOI: 10.1007/s00345-021-03769-4 -
Transanal Irrigation for People With Neurogenic Bowel Dysfunction: An Integrative Literature Review.Gastroenterology Nursing : the Official...Transanal irrigation has been introduced as a complement to standard bowel care for people with neurogenic bowel dysfunction. There is no contemporary integrative review... (Review)
Review
Transanal irrigation has been introduced as a complement to standard bowel care for people with neurogenic bowel dysfunction. There is no contemporary integrative review of the effectiveness and feasibility of transanal irrigation from a holistic nursing perspective, only fragments of evidence to date. The aim was to investigate the effectiveness and feasibility of transanal irrigation for people with neurogenic bowel dysfunction. An integrative literature review was conducted. Nineteen studies were included. According to the results, transanal irrigation can reduce difficulties associated with defecation, episodes of incontinence, and the time needed for evacuation and bowel care. Transanal irrigation can increase general satisfaction with bowel habits and quality of life and decrease level of dependency. However, there are practical problems to overcome and adverse effects to manage. Discontinuation is relatively common. The results support the effectiveness of transanal irrigation, but feasibility is inconclusive. Users, including caregivers, report practical problems, and compliance was not always easy to achieve. It is important that users, including caregivers, are well informed and supported during transanal irrigation treatment, especially during introduction. The quality of the studies found was generally weak; therefore, high-quality quantitative and qualitative studies are needed on the topic.
Topics: Constipation; Fecal Incontinence; Humans; Neurogenic Bowel; Quality of Life; Therapeutic Irrigation
PubMed: 35833736
DOI: 10.1097/SGA.0000000000000645 -
Journal of Cardiovascular... Jan 2020Innovations in radiofrequency (RF) ablation and nonablative techniques have led to significant advances in addressing complex arrhythmogenic substrates for a variety of... (Review)
Review
Innovations in radiofrequency (RF) ablation and nonablative techniques have led to significant advances in addressing complex arrhythmogenic substrates for a variety of cardiac arrhythmias. Anatomical challenges, deep substrate, and mid-myocardial locations may pose difficulties and decrease success rates using routine methods. In this review, we provide an update on novel RF technology and techniques including (a) high-power, low-duration ablation, (b) ablation facilitated by low-ionic irrigant, and (c) bipolar ablation. In addition, we review emerging technologies including electroporation, needle catheter ablation, and ablation with the lattice catheter.
Topics: Arrhythmias, Cardiac; Cardiac Catheterization; Cardiac Catheters; Catheter Ablation; Diffusion of Innovation; Electrodes; Equipment Design; Humans; Risk Factors; Therapeutic Irrigation; Treatment Outcome
PubMed: 31828880
DOI: 10.1111/jce.14317 -
BMC Oral Health Feb 2024Multispecies biofilms located in the anatomical intricacies of the root canal system remain the greatest challenge in root canal disinfection. The efficacy of Er:YAG...
In vitro efficacy of Er:YAG laser-activated irrigation versus passive ultrasonic irrigation and sonic-powered irrigation for treating multispecies biofilms in artificial grooves and dentinal tubules: an SEM and CLSM study.
BACKGROUND
Multispecies biofilms located in the anatomical intricacies of the root canal system remain the greatest challenge in root canal disinfection. The efficacy of Er:YAG laser-activated irrigation techniques for treating multispecies biofilms in these hard-to-reach areas has not been proved. The objective of this laboratory study was to evaluate the effectiveness of two Er:YAG laser-activated irrigation techniques, namely, photon-induced photoacoustic streaming (PIPS) and shock wave-enhanced emission photoacoustic streaming (SWEEPS), in treating multispecies biofilms within apical artificial grooves and dentinal tubules, in comparison with conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and sonic-powered irrigation (EDDY). Two types of multispecies root canal biofilm models were established in combination with two assessment methods using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) with the aim to obtain more meaningful results.
METHODS
Ninety extracted human single-rooted premolars were chosen for two multispecies biofilm models. Each tooth was longitudinally split into two halves. In the first model, a deep narrow groove was created in the apical segment of the canal wall. After cultivating a mixed bacterial biofilm for 4 weeks, the split halves were reassembled and subjected to five irrigation techniques: CNI, PUI, EDD, PIPS, and SWEEPS. The residual biofilms inside and outside the groove in Model 1 were analyzed using SEM. For Model 2, the specimens were split longitudinally once more to evaluate the percentage of killed bacteria in the dentinal tubules across different canal sections (apical, middle, and coronal thirds) using CLSM. One-way analysis of variance and post hoc multiple comparisons were used to assess the antibiofilm efficacy of the 5 irrigation techniques.
RESULTS
Robust biofilm growth was observed in all negative controls after 4 weeks. In Model 1, within each group, significantly fewer bacteria remained outside the groove than inside the groove (P < 0.05). SWEEPS, PIPS and EDDY had significantly greater biofilm removal efficacy than CNI and PUI, both from the outside and inside the groove (P < 0.05). Although SWEEPS was more effective than both PIPS and EDDY at removing biofilms inside the groove (P < 0.05), there were no significant differences among these methods outside the groove (P > 0.05). In Model 2, SWEEPS and EDDY exhibited superior bacterial killing efficacy within the dentinal tubules, followed by PIPS, PUI, and CNI (P < 0.05).
CONCLUSION
Er:YAG laser-activated irrigation techniques, along with EDDY, demonstrated significant antibiofilm efficacy in apical artificial grooves and dentinal tubules, areas that are typically challenging to access.
Topics: Humans; Ultrasonics; Lasers, Solid-State; Microscopy, Electron, Scanning; Microscopy, Confocal; Biofilms; Root Canal Irrigants; Root Canal Preparation; Dental Pulp Cavity; Therapeutic Irrigation; Sodium Hypochlorite
PubMed: 38389109
DOI: 10.1186/s12903-024-04042-x -
Asian Journal of Surgery Feb 2022
Topics: Humans; Therapeutic Irrigation
PubMed: 34969571
DOI: 10.1016/j.asjsur.2021.12.019 -
Journal of Endodontics Nov 2023To compare the biofilm-mimicking hydrogel removal efficiency of laser-activated irrigation (LAI) with five other irrigation techniques in simulated curved root canals... (Comparative Study)
Comparative Study
INTRODUCTION
To compare the biofilm-mimicking hydrogel removal efficiency of laser-activated irrigation (LAI) with five other irrigation techniques in simulated curved root canals with lateral canals.
METHODS
Three-dimensional-printed root canal models (60°-curvature, radius 5 mm; dimension 25/.06) with a total length of 20 mm and lateral canals in all directions at 2, 5, and 8 mm (diameter 0.2 mm) from the apex were filled with a colored biofilm-mimicking hydrogel. The following protocols (each 3 × 20 seconds continuous irrigation with distilled water 3 ml/20 seconds; n = 20) were carried out: conventional needle irrigation; manual agitation ([MA], gutta-percha point 25/.06); EndoActivator (=sonically-activated irrigation EndoActivator, 25/.04); EDDY (=sonically-activated irrigation EDDY [SAI-E]; 25/.04); ultrasonically-activated irrigation and LAI (Erbium-doped Yttrium Aluminum Garnet laser; P400FL tip at canal entrance; 25 pps, 50 mJ, 300 μs). Standardized photos were taken with a microscope and the removal of the hydrogel was determined as a percentage for the entire system, the main canal and the lateral canals. Statistical analysis was performed using analysis of variance and Scheffé test (P = .05).
RESULTS
LAI (89.3% ± 5.9%) showed the greatest hydrogel removal followed by SAI-E (65.5% ± 3.3%) and ultrasonically-activated irrigation (59.1% ± 4.7%), with significant differences between these groups (P < .05). Needle irrigation, MA, and sonically-activated irrigation EndoActivator performed equally (P > .05) and obtained the significantly lowest values (P < .05). LAI and SAI-E showed the significantly best hydrogel removal from the main canal (P < .05). At all three levels, LAI removed significantly more hydrogel from the lateral canals than all other techniques (P < .05).
CONCLUSIONS
LAI was superior to other techniques in both the entire system and the lateral canals in removing the hydrogel. SAI-E achieved comparable results in the main canal.
Topics: Dental Pulp Cavity; Therapeutic Irrigation; Root Canal Preparation; Humans; Root Canal Irrigants; Printing, Three-Dimensional; Biofilms; Hydrogels
PubMed: 37586645
DOI: 10.1016/j.joen.2023.08.006 -
Expert Review of Anti-infective Therapy Mar 2021
Topics: Administration, Intravaginal; Deodorants; Detergents; Female; Humans; Nonprescription Drugs; Vaginal Douching
PubMed: 32909859
DOI: 10.1080/14787210.2020.1822166