Factores asociados a infección de fracturas abiertas de extremidades por accidentes de tránsito. Bogotá, 2012-2013

Los traumatismos por accidentes de tránsito, constituyen un problema de salud pública, a nivel mundial. Las lesiones más frecuentes son las fracturas de extremidades (84.3%). Las fracturas tienen un elevado riesgo de presentar infecciones, secuelas e incapacidades permanentes. Objetivo : Determinar si los factores asociados con la patología (lugar de fractura, clasificación de fractura, comorbilidades del paciente) y/o los factores relacionados con la atención médica (uso de profilaxis antibiótica diferente al protocolo institucional, tiempo prolongado para remisión, demoras en manejo quirúrgico) se asocian a mayor probabilidad de presentar infección de fracturas abiertas, en población mayor a 15 años, atendidos por accidente de tránsito, en una clínica de Bogotá de tercer nivel especializada en atención de SOAT, durante el período Octubre de 2012 a Octubre de 2013. Metodología: Estudio de casos y controles no apareado, relación 1:3, conformado por 43 casos (fracturas abiertas infectadas) y 129 controles (fracturas abiertas no infectadas). Resultados: La edad media de los casos fue de 39.42 +/- 16.82 años (med=36 años) y la edad media de los controles fue de 33.15 +/- 11.78 años (med=30 años). El 83.7% de los casos y el 78.3% de los controles corresponden al sexo masculino. Predominaron los accidentes en motocicleta en el 81.4% de los casos y el 86% de los controles. En el análisis bivariado se encuentra que la edad mayor a 50 años (p=0.042), una clasificación de la fractura grado IIIB o IIIC (p=0.02), cumplimiento del protocolo antibiótico institucional según el grado de fractura (p=0.014) y un tiempo mayor a 24 horas desde el momento del accidente al centro especializado en trauma (p=0.035) se asociaron significativamente con infección de la fractura abierta. En el análisis multivariado se encuentra únicamente que la clasificación de la fractura grado IIIB o IIIC se asocia con infección de la fractura OR 2.6 IC95% (1.187 – 5.781) (p=0.017). La duración de hospitalización fue mayor en los casos (32.37+/- 22.92 días, med=26 días) que en los controles (8.81 +/- 7.52 días, med=6 días) (p<0.001). El promedio de lavados quirúrgicos fue mayor en los casos (4.85±4.1, med=4.0) que en el grupo control (1.94±1.26, med=2) (p<0.001). Conclusiones: La infección posterior a una fractura abierta, implica costos elevados de atención con hospitalizaciones prolongadas y mayor frecuencia de intervenciones quirúrgicas como se evidencia en el presente estudio. Se debe fortalecer el sistema de remisión y contra remisión para acortar los tiempos de inicio de manejo especializado de los pacientes con fracturas abiertas. Se debe incentivar dentro de las instituciones, el cumplimiento de protocolos de profilaxis antibiótica según el grado de la fractura para disminuir el riesgo de complicación infecciosa.

Feedback dew-point sensor utilising optimally cut plastic optical fibres

A plastic optical fibre reflectance sensor that makes full use of the critical angle of the fibres is implemented to monitor dew formation on a Peltier-cooled reflector surface. The optical configuration permits isolation of optoelectronic components from the sensing head and better light coupling between the reflector and the detecting fibre, giving a better signal of the onset of dew formation on the reflector. Continuous monitoring of the rate of change in reflectance as well as the absolute reflectance signals, the use of a novel polymethyl-methacrylate-coated hydrophobic film reflector on the Peltier element and the application of feedback around the point of dew formation, further reduces the possibility of contamination of the sensor head. Under closed-loop operation, the sensor is capable of cycling around the point of dew formation at a frequency of 2.5 Hz.

Phase separated structures in tethered dPS–PMMA copolymer films revealed using X-ray scattering with a novel contrast enhancement agent

Tethered deuterated polystyrene-block-polymethyl methacrylate films have been examined by X-ray scattering both in their native state and following treatment with ruthenium tetroxide. The use of the stain, while increasing the thickness of the films, does not significantly alter the lateral structure or periodicity of the films and provides contrast between the two blocks. Both the periodicity of the films and the structure normal to the surface have been identified following staining. Experiments were also performed on films treated by a solvent exchange process, and the effects of staining on these films are discussed.

Phase separation in thin films of end-grafted block copolymers

An atomic force microscopy investigation was carried out on various thick (30–120 nm) polymethyl methacrylate-bpolystyrene and poly(2-(dimethyl amino)ethyl methacrylate)-b-polystyrene films prepared via a grafting-from method. The structure of the films was examined with both topographic and phase imaging. Several different morphologies were observed including a perforated lamellar phase with irregular perforations. In addition, complementary small-angle X-ray scattering and reflectometry results measurements on a non-grafted polymer are presented.

Simple solution for a complex problem: Proanthocyanidins, galloyl glucoses and ellagitannins fit on a single calibration curve in high performance-gel permeation chromatography

This study was undertaken to explore gel permeation chromatography (GPC) for estimating molecular weights of proanthocyanidin fractions isolated from sainfoin (Onobrychis viciifolia). The results were compared with data obtained by thiolytic degradation of the same fractions. Polystyrene, polyethylene glycol and polymethyl methacrylate standards were not suitable for estimating the molecular weights of underivatized proanthocyanidins. Therefore, a novel HPLC-GPC method was developed based on two serially connected PolarGel-L columns using DMF that contained 5% water, 1% acetic acid and 0.15 M LiBr at 0.7 ml/min and 50 degrees C. This yielded a single calibration curve for galloyl glucoses (trigalloyl glucose, pentagalloyl glucose), ellagitannins (pedunculagin, vescalagin, punicalagin, oenothein B, gemin A), proanthocyanidins (procyanidin B2, cinnamtannin B1), and several other polyphenols (catechin, epicatechin gallate, epicallocatechin gallate, amentoflavone). These GPC predicted molecular weights represented a considerable advance over previously reported HPLC-GPC methods for underivatized proanthocyanidins. (C) 2011 Elsevier B.V. All rights reserved.

Measuring colour and photostability of small fleece wool samples

A convenient method for measuring the clean colour (Y and Y-Z) and photostability Δ(Y-Z) of small samples of fleece wool (0.5 g) is described. Scoured wool samples are compressed to a constant density in disposable polymethyl methacrylate spectrophotometer cells and the wool colour is measured using a standard textile laboratory reflectance spectrophotometer. Packing scoured wool into cells ensures that the irradiated fibre surface is robust and individual fibres are unable to move relative to one another during irradiation and measurement. A UVB (280–320 nm) source was used to ensure all samples regardless of initial yellowness were yellowed following exposure and photobleaching was avoided. An apparatus capable of irradiating up to 48 scoured wool samples in one batch is described. The precision of photostability measurements was assessed and the relative error in Δ(Y-Z) was 5.7%. An initial study on 75 fleece wool samples with a high range of initial yellowness showed a moderate linear correlation (R² = 0.68) between initial yellowness and Δ(Y-Z).

A protocol for improving fabrication yield of thin SU-8 microcantilevers for use in an aptasensor

SU-8 negative photoresist has been extensively employed in the fabrication of microfluidics and microelectromechanical systems. This is due to its advantages including ease of fabrication using limited equipment, biocompatibility, excellent chemical resistance, and compatibility with silicon processing. In addition, its low Young’s modulus compared to silicon has made it an excellent choice for microcantilever structure development especially for sensing applications. This paper presents a fabrication protocol for the development of thin SU-8 microcantilevers. Factors such as baking temperatures and release methods that influence the fabrication yield of SU-8 microcantilevers are considered. The influence of the baking temperature on the deformation of the SU-8 structure is investigated using the finite element method and verified experimentally. Three release methods are studied including a dry release method using fluorocarbon film, and two wet release methods using OmniCoat sacrificial layer and polymethyl methacrylate (PMMA) sacrificial layer. The wet release method using PMMA sacrificial layer produced the highest yield. An aptasensor is formed using the SU-8 microcantilever, and its deflection measured for thrombin detection.

Wettability investigation of UV/oand acid functionalized MWCNT and MWCNT/PMMA nanocomposites by contact angle measurement

The dispersion state of individual MWCNT in the polymer matrix influences the mechanical, thermal, and electrical properties of the resulting composite. One method of obtaining a good dispersion state of MWCNT in a polymer matrix is to functionalize the surface of MWCNT using various treatments to enhance the surface energy and increase the dispersibility of MWCNT. In this study, wettability and surface energy of UV/Oand acid-treated multiwall carbon nanotubes (MWCNTs) and its polymethyl methacrylate (PMMA) polymer nanocomposites were measured using contact angle analysis in various solvent media. Contact angle analysis was based on ethylene glycol-water-glycerol probe liquid set and data was further fitted into geometric mean (Fowkes), van Oss-Chaudhury-Good (GvOC), and Chang-Qing-Chen (CQC) models to determine both nonpolar and acid base surface energy components. Analysis was conducted on MWCNT thin films subjected to different levels of UV/Oand acid treatments as well as their resulting MWCNT/PMMA nanocomposites. Contact angle analysis of thin films and nanocomposites revealed that the total surface energy of all samples was well fitted with each other. In addition, CQC model was able to determine the surface nature and polarity of MWCNT and its nanocomposites. Results indicated that the wettability changes in the thin film and its nanocomposites are due to the change in surface chemistry. Finally, electrical properties of nanocomposites were measured to investigate the effect of surface functionality (acid or basic) on the MWCNT surfaces.

Bond strength between acrylic resin and maxillofacial silicone

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Measurement of Interfacial Porosity at the Acrylic Resin/Denture Tooth Interface

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of water storage and heat treatment on the cytotoxicity of soft liners

Objective: To evaluate the effect of water storage time on the cytotoxicity of soft liners.Methods: Sample discs of soft liners Dentusoft, Dentuflex, Trusoft, Ufi-Gel-P and denture base acrylic resin Lucitone-550 were prepared and divided into four groups: GN: No treatment, G24: Stored in water at 37 degrees C for 24 h; G48: Stored in water at 37 degrees C for 48 h, GHW: Immersed in water at 55 degrees C for 10 min. To analyse the cytotoxic effect, three samples of each group were placed in tubes with Dubelcco's Modified Eagle Mediums and incubated at 37 degrees C for 24 h. During this period, the toxic substances were leached to the culture medium. The cytotoxicity was analysed quantitatively by the incorporation of radioactivity H-3-thymidine checking the number of viable cells (synthesis of DNA). The data were statistically analysed using two-way ANOVA and Tukey's honestly significant difference tests (alpha = 0.05).Results: Treatments did not reduce the cytotoxicity effect of the soft liners (p > 0.05). It was found that Ufi-Gel-P had a non-cytotoxic effect, Trusoft had a slightly cytotoxic effect, Dentuflex had a moderated cytotoxic effect, Dentusoft alternated between slightly and non-cytotoxic effect, and Lucitone-550 had non-cytotoxic effect when stored in water for 48 h.Conclusion: The effect of water storage and the heat treatment did not reduce the cytotoxicity of the soft liners.

Comparison of accuracy between compression- and injection-molded complete dentures

Statement of problem. A clinically significant incisal pin opening may occur after processing complete dentures if a compression molding technique is used. To recover the proper vertical dimension of occlusion, a time-consuming occlusal adjustment is necessary that often destroys the anatomy of the artificial teeth. A new injection molding process claims to produce dentures that require few, if any, occlusal adjustments in the laboratory after processing.Purpose. This laboratory study compared incisal pin opening, dimensional accuracy, and laboratory working time for dentures fabricated by this new injection system with dentures constructed by the conventional compression molding technique.Material and methods. Two groups of 6 maxillary and 6 mandibular dentures were evaluated as follows: group 1 (control), Lucitone 199, compression molded with a long cure cycle; and group 2, Lucitone 199, injection molded with a long cure. Incisal pin opening was measured with a micrometer immediately after deflasking. A computerized coordinate measuring machine was used to measure dimensional accuracy of 3-dimensional variations in selected positions of artificial teeth in 4 stages of denture fabrication. Analysis of variance (ANOVA) and t tests were performed to compare the groups.Results. A significant difference was found in pin opening between groups (t test). Horizontal dimensional changes evaluated with repeated measures ANOVA revealed no significant differences between groups. However, analysis of vertical dimensional changes disclosed significant differences between the groups. There was no appreciable difference in laboratory working time for flasking and molding denture bases between the injection and compression molding techniques when polymethyl methacrylate resin was used.Conclusion. The injection molding method produced a significantly smaller incisal pin opening over the standard compression molding technique. The injection molding technique, using polymethyl methacrylate, was a more accurate method for processing dentures. There were no appreciable differences in laboratory working time between the injection and compression molding techniques.

Effect of cold plasma treatment on mechanical properties of PET/PMMA composites

Mechanical strength of polyethylene terephthalate (PET) fibres and polymethyl methacrylate (PMMA) matrix composites were studied with particular interest on the effects of oxygen and argon plasma treated fibres. PET. fibres were treated in a radio frequency plasma reactor using argon or oxygen for different treatment times to increase the interface adhesion. Fibre volume fraction was measured through digital image analysis. Elastic moduli resulted between 3 GPa for untreated to 6 GPa for treated composites. Tensile tests on PET fibres showed that plasma treatment caused a decrease in average tensile strength compared to untreated fibres. Fracture analysis confirmed the increase in interfacial adhesion due to plasma treatment. (c) 2004 Elsevier Ltd. All rights reserved.

Ceramic Primer Heat-Treatment Effect on Resin Cement/Y-TZP Bond Strength

The purpose of this study was to evaluate the effect of different heat-treatment strategies for a ceramic primer on the shear bond strength of a 10-methacryloyloxydecyl-dihydrogen-phosphate (MDP)-based resin cement to a yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. Specimens measuring 4.5 x 3.5 x 4.5 mm(3) were produced from Y-TZP presintered cubes and embedded in polymethyl methacrylate (PMMA). Following finishing, the specimens were cleaned using an ultrasound device and distilled water and randomly divided into 10 experimental groups (n=14) according to the heat treatment of the ceramic primer and aging condition. The strategies used for the experimental groups were: GC (control), without primer; G20, primer application at ambient temperature (20 degrees C); G45, primer application + heat treatment at 45 degrees C; G79, primer application + heat treatment at 79 degrees C; and G100, primer application + heat treatment at 100 degrees C. The specimens from the aging groups were submitted to thermal cycling (6000 cycles, 5 degrees C/55 degrees C, 30 seconds per bath) after 24 hours. A cylinder of MDP-based resin cement (2.4 mm in diameter) was constructed on the ceramic surface of the specimens of each experimental group and stored for 24 hours at 37 degrees C. The specimens were submitted to a shear bond strength test (n=14). Thermal gravimetric analysis was performed on the ceramic primer. The data obtained were statistically analyzed by two-way analysis of variance and the Tukey test (alpha=0.05). The experimental group G79 without aging (7.23 +/- 2.87 MPa) presented a significantly higher mean than the other experimental groups without aging (GC: 2.81 +/- 1.5 MPa; G20: 3.38 +/- 2.21 MPa; G100: 3.96 +/- 1.57 MPa), showing no difference from G45 only (G45: 6 +/- 3.63 MPa). All specimens of the aging groups debonded during thermocycling and were considered to present zero bond strength for the statistical analyses. In conclusion, heat treatment of the metal/zirconia primer improved bond strength under the initial condition but did not promote stable bonding under the aging condition.

Effectiveness of microwave irradiation on the disinfection of complete dentures

Purpose: The purpose of this study was to evaluate the effectiveness of microwave irradiation on the disinfection of simulated complete dentures. Materials and Methods: Eighty dentures were fabricated in a standardized procedure and subjected to ethylene oxide sterilization. The dentures were individually inoculated (10 7 cfu/mL) with tryptic soy broth (TSB) media containing one of the tested microorganisms (Candida albicans, Streptoccus aureus, Bacillus subtilis, and Pseudomonas aeruginosa). After 48 hours of incubation at 37°C, 40 dentures were individually immersed in 200 mL of water and submitted to microwave irradiation at 650 W for 6 minutes. Forty nonirradiated dentures were used as positive controls. Replicate aliquots (25 μL) of suspensions were plated at dilutions of 10 -3 to 10 -6 on plates of selective media appropriate for each organism. All plates were incubated at 37°C for 48 hours. TSB beakers with the microwaved dentures were incubated at 37°C for 7 more days. After incubation, the number of colony-forming units was counted and the data were statistically analyzed by Kruskal-Wallis test (α = .05). Results: No evidence of growth was observed at 48 hours for S aureus, B subtilis, and C albicans. Dentures contaminated with P aeruginosa showed small growth on 2 plates. After 7 days incubation at 37°C, no growth was visible in the TSB beakers of S aureus and C albicans. Turbidity was observed in 3 broth beakers, 2 from P aeruginosa and 1 from B subtilis. Conclusion: Microwave irradiation for 6 minutes at 650 W produced sterilization of complete dentures contaminated with S aureus and C albicans and disinfection of those contaminated with P aeruginosa and B subtilis.