Evaluierung von OP-Textilien nach hygienischen, ökonomischen und ökologischen Kriterien: Methodische Herangehensweise bei der Evaluierung unter realen praktischen Bedingungen

Der zielgerichtete Einsatz innovativer Operationstextilien ist eine wichtige Maßnahme zur perioperativen Infektionsprophylaxe. Operationsmäntel und -abdecktücher sind den Bereichen Mehrweg- und Einwegprodukte zuzuordnen, mit deren Nutzung ein entsprechender Ressourcenverbrauch sowie Schadstoffbelastung verbunden sind. Den Anwendern ist die Auswahl kostengünstiger und umweltfreundlicher Produkte, gleiche Funktionalität vorausgesetzt, zurzeit nicht möglich, da Operationstextilien bislang in dieser Ganzheitlichkeit noch nicht betrachtet und untersucht worden sind. Das interdisziplinäre Verbundvorhaben befasst sich deshalb mit der ganzheitlichen Evaluierung innovativer Operationstextilien unter realen Praxisbedingungen nach funktionalen, hygienischen sowie ökologisch und ökonomischen Aspekten im Verlaufe ihres Lebenszyklus. Das Verbundvorhaben wird in 4 Teilprojekten mit folgenden wissenschaftlichen Zielstellungen bearbeitet: - Entwicklung einer Methode zur ganzheitlichen Evaluierung von OP-Textilien - Bewertung der Barrierewirkung von OP-Textilien hinsichtlich ihrer Struktur-Eigenschafts-Beziehungen in Abhängigkeit von den Nutzungszyklen - Bewertung der Barrierewirkung von OP-Textilien hinsichtlich ihrer Qualität und Konformität in Abhängigkeit von den Nutzungszyklen - Mikrobiologische und physikalische Untersuchungen zum Einfluss der Struktur von Operationstextilien auf deren Dampfsterilisation unter Praxisbedingungen - Ökonomische und ökologische Aspekte beim Erhalt der Barrierewirkung - Verknüpfung der funktionalen, ökonomischen und ökologischen Bewertungen zur Erstellung von Entscheidungsinstrumenten für den indikationsgerechten Einsatz von OP-Textilien.The specific use of innovative O.R. textiles is an important measure for the perioperative infection prophylaxis. Surgical gowns and drapes are available as single-use and re-usable products. Their use is connected with the corresponding consumption of resources and environmental pollution. At present, the selection of cost-saving and environmental-friendly products with a high level of protection is not possible, because O.R. textiles have not been integral investigated up to now. Hence, the interdisciplinary project is dealing with the holistic evaluation of O.R. textiles according to hygienic, ecological and economic criteria during their life cycle influenced by real conditions in practice. The integrated project consists of 4 sub projects with the following scientific objectives: - developing of a method for the holistic evaluation of O.R. textiles - assessment of the barrier effect of the O.R. textiles in reference to the structure-properties-relations depending on the use cycles - assessment of the barrier effect of the O.R. textiles in reference to the quality and conformity depending on the use cycle - microbiological and physical investigations regarding to the influence of the structure of the O.R. textiles on the steam sterilisation in practice - ecological and economic assessment of reprocessing and preservation of the barrier function depending on the use cycles

Evaluierung von OP-Textilien nach hygienischen, ökonomischen und ökologischen Kriterien: Methodische Herangehensweise bei der Evaluierung unter realen praktischen Bedingungen

Der zielgerichtete Einsatz innovativer Operationstextilien ist eine wichtige Maßnahme zur perioperativen Infektionsprophylaxe. Operationsmäntel und -abdecktücher sind den Bereichen Mehrweg- und Einwegprodukte zuzuordnen, mit deren Nutzung ein entsprechender Ressourcenverbrauch sowie Schadstoffbelastung verbunden sind. Den Anwendern ist die Auswahl kostengünstiger und umweltfreundlicher Produkte, gleiche Funktionalität vorausgesetzt, zurzeit nicht möglich, da Operationstextilien bislang in dieser Ganzheitlichkeit noch nicht betrachtet und untersucht worden sind. Das interdisziplinäre Verbundvorhaben befasst sich deshalb mit der ganzheitlichen Evaluierung innovativer Operationstextilien unter realen Praxisbedingungen nach funktionalen, hygienischen sowie ökologisch und ökonomischen Aspekten im Verlaufe ihres Lebenszyklus. Das Verbundvorhaben wird in 4 Teilprojekten mit folgenden wissenschaftlichen Zielstellungen bearbeitet: - Entwicklung einer Methode zur ganzheitlichen Evaluierung von OP-Textilien - Bewertung der Barrierewirkung von OP-Textilien hinsichtlich ihrer Struktur-Eigenschafts-Beziehungen in Abhängigkeit von den Nutzungszyklen - Bewertung der Barrierewirkung von OP-Textilien hinsichtlich ihrer Qualität und Konformität in Abhängigkeit von den Nutzungszyklen - Mikrobiologische und physikalische Untersuchungen zum Einfluss der Struktur von Operationstextilien auf deren Dampfsterilisation unter Praxisbedingungen - Ökonomische und ökologische Aspekte beim Erhalt der Barrierewirkung - Verknüpfung der funktionalen, ökonomischen und ökologischen Bewertungen zur Erstellung von Entscheidungsinstrumenten für den indikationsgerechten Einsatz von OP-Textilien.The specific use of innovative O.R. textiles is an important measure for the perioperative infection prophylaxis. Surgical gowns and drapes are available as single-use and re-usable products. Their use is connected with the corresponding consumption of resources and environmental pollution. At present, the selection of cost-saving and environmental-friendly products with a high level of protection is not possible, because O.R. textiles have not been integral investigated up to now. Hence, the interdisciplinary project is dealing with the holistic evaluation of O.R. textiles according to hygienic, ecological and economic criteria during their life cycle influenced by real conditions in practice. The integrated project consists of 4 sub projects with the following scientific objectives: - developing of a method for the holistic evaluation of O.R. textiles - assessment of the barrier effect of the O.R. textiles in reference to the structure-properties-relations depending on the use cycles - assessment of the barrier effect of the O.R. textiles in reference to the quality and conformity depending on the use cycle - microbiological and physical investigations regarding to the influence of the structure of the O.R. textiles on the steam sterilisation in practice - ecological and economic assessment of reprocessing and preservation of the barrier function depending on the use cycles

Effect of high tibial osteotomy on joint loading in symptomatic patients with varus aligned knees: a study using SPECT/CT

Purpose: The purpose was to prospectively evaluate the outcome, in particular the SPECT/CT bone tracer uptake (BTU) after high tibial osteotomy (HTO) due to symptomatic varus malalignment. It was the hypothesis that the BTU after HTO decreases in the medial compartment, clinical outcome and the degree of correction correlates with BTU and asymptomatic patients after HTO reveals a significantly decreased BTU in the medial subchondral areas. Methods: Twenty-two consecutive patients with 23 knees undergoing medial opening-wedge HTO for medial compartment overloading were assessed pre- and postoperatively (12 and/or 24months) using Tc-99m-HDP-SPECT/CT including our 4D-SPECT/CT protocol. BTU was quantified and localized to specific biomechanically relevant joint areas. Maximum absolute and relative values (mean±standard deviation, median and range) for each area were recorded. Pre- and postoperative mechanical alignment was measured. At 24months after HTO, the WOMAC score was used. Results: A significant decrease of BTU in the medial subchondral zones after HTO was found (preoperatively to 12 and 24months postoperatively, p<0.01). BTU normalized in all asymptomatic patients within 24months. This decrease was partly seen in the lateral compartments, but significantly higher in the medial compartments (p<0.0001). A significant increase of the BTU was noted in zones directly adjacent to the plate or within the osteotomy zone (p<0.01). Decreased BTU was observed in osteotomy zones at 24months postoperatively following higher uptake values at 12months postoperatively. The average valgus correction of the tibiofemoral angle was 5.9°±2.8°. Less stiffness correlated significantly with a higher decrease in BTU (p<0.05). Higher postoperative BTU significantly correlated with more pain (p<0.05). No statistical significant associations between BTU and alignment correction were found. Conclusion: In patients with medial compartment, overloading due to varus malalignment HTO led to a significant decrease in BTU in the medial joint compartments. SPECT/CT BTU patterns and intensity in these patients pre- to 12 and 24months postoperatively were seen. These correlated significantly with pain and stiffness. Hence, SPECT/CT could be used for assessment of adequate correction and healing after HTO. SPECT/CT could be further used to identify the optimal individualized correction for each patient and clinical scenario. Clinical evidence: Diagnostic prospective study, Level II

Stability and Structure of Mixed-Ligand Metal Ion Complexes That Contain Ni(2+), Cu(2+), or Zn(2+), and Histamine, as well as Adenosine 5 `-Triphosphate (ATP(4-)) or Uridine 5 `-Triphosphate (UTP(4-)): An Intricate Network of Equilibria

With a view on protein-nucleic acid interactions in the presence of metal ions we studied the ``simple'' mixed-ligand model systems containing histamine (Ha), the metal ions Ni(2+), Cu(2+), or Zn(2+) (M(2+)), and the nucleotides adenosine 5'-triphosphate (ATP(4-)) or uridine 5'-triphosphate (UTP(4-)), which will both be referred to as nucleoside 5'-triphosphate (NTP(4-)). The stability constants of the ternary M(NTP)(Ha)(2-) complexes were determined in aqueous solution by potentiometric pH titrations. We show for both ternary-complex types, M(ATP)(Ha)(2-) and M(UTP)(Ha)(2-), that intramolecular stacking between the nucleobase and the imidazole residue occurs and that the stacking intensity is approximately the same for a given M2+ in both types of complexes: The formation degree of the intramolecular stacks is estimated to be 20 to 50%. Consequently, in protein-nucleic acid interactions imidazole-nucleobase stacks may well be of relevance. Furthermore, the well-known formation of macrochelates in binary M(2+) complexes of purine nucleotides, that is, the phosphate-coordinated M(2+) interacts with N7, is confirmed for the M(ATP)(2-) complexes. It is concluded that upon formation of the mixed-ligand complexes the M(2+)-N7 bond is broken and the energy needed for this process corresponds to the stability differences determined for the M-(UTP)(Ha)(2-) and M(ATP)(Ha)(2-) complexes. It is, therefore, possible to calculate from these stability differences of the ternary complexes the formation degrees of the binary macrochelates: The closed forms amount to (65 +/- 10)%, (75 +/- 8)%, and (31 +/- 14)% for Ni(ATP)(2-), Cu(ATP)(2-), and Zn(ATP)(2-), respectively, and these percentages agree excellently with previous results obtained by different methods, confirming thus the internal validity of the data and the arguments used in the evaluation processes. Based on the overall results it is suggested that M(ATP)(2-) species, when bound to an enzyme, may exist in a closed macrochelated form only, if no enzyme groups coordinate directly to the metal ion