mL Of Irrigant Research Articles

Can Ethanolic Leaf Extract of Olive or Black Mulberry Substitute Sodium Hypochlorite as a Root Canal Irrigant? An In Vitro Study

This study aimed to evaluate Olea europaea (olive) leaves and Morus nigra (black mulberry) leaves as potential natural alternatives to sodium hypochlorite (NaOCl) endodontic irrigant. Their antimicrobial activity against Enterococcus faecalis (E. faecalis) and their effects on both root dentin microhardness and push-out bond strength of resin sealer/root dentin were assessed. Fifty-four extracted teeth were selected. Samples were grouped according to the irrigant used: group I (control): 2.5% NaOCl, group II: 8% ethanolic extract of Olea europaea, and group III: 2% ethanolic extract of Morus nigra. Antibacterial activity (n = 6) was evaluated after each canal was autoclaved, inoculated with E. faecalis, and incubated. Canals were sampled before and after chemicomechanical canal preparation with 2 mL of irrigant. The colony-forming units (CFUs) were counted at 1/10 and 1/100 broth concentrations. Vickers hardness number (VHN) of root dentin (n = 6) was measured before and after root canal preparation and irrigation. Push-out bond strength testing (n = 9) was carried out following preparation, irrigation, obturation, and thermocycling. Results were considered statistically significant at p ≤0.05. Following irrigation, the CFUs of E. faecalis were significantly reduced with no significant difference in the CFU count between all groups at both broth concentrations. A significant reduction in root dentin microhardness resulted in all groups following irrigation, with Morus nigra resulting in the lowest percentage reduction (26.42 ± 1.12). The lowest significant mean push-out bond strength was revealed in the Olea europaea group (3.372 ± 1.513 MPa). The use of 2% mulberry (Morus nigra) leaf extract and 8% olive (Olea europaea) leaf extract as alternatives to NaOCl provides promising antimicrobial action against E. faecalis. 2% Morus nigra extract may represent a promising natural endodontic irrigant.

The limited effectiveness of bedside positive pressure irrigation on pistol projectile wound contaminant: A biomechanics study

Background Pistol caliber gunshot wounds (PC GSW) are the most common mode of firearm injury treated in the civilian emergency setting, but there is a paucity of data guiding best practice treatment. The goal of this study was to examine the effect of bedside positive pressure irrigation (PPI) on removal of gross debris from PC GSW. Methods Fourteen bovine shanks were prepared with metal impregnated fabric placed in front of the impending impact zones to mimic radio-opaque clothing-like material. They were then shot with a 9 mm bullet from a distance of 3 meters. Specimens were imaged three separate times with standardized computer tomography: immediately after impact, after 250 ml irrigation, and after a total of 750 ml of irrigation. Scanned images were examined for change in radio-opaque contamination at both the entry site and within the wound cavity. Results No samples demonstrated a decrease of debris contamination within the cavity of the wound after 250 ml of irrigation and only one did after 750 ml. Six (42.86%) samples demonstrated a shift of debris without decrease in cavity contamination after 250 ml of irrigation and ten after 750 ml total irrigation. Five samples demonstrated decrease in debris at the entry site of the gunshot projectile wound after 250 ml of irrigation and two showed further superficial decrease with additional irrigations up to 750 ml. No statistically significant differences were found between 250 ml and 750 ml PPI treatments in both superficial and cavity contamination categories. Conclusion Positive pressure irrigation with up to 750 ml of 0.9% normal saline at a rate of 20 ml/sec has limited effect on the removal of gross debris within the cavity of pistol caliber gunshot wounds. The data within this study bring into question the benefits of attempted removal of pistol caliber gunshot wound contaminants utilizing bedside positive pressure irrigation.

Irrigation well water: Essential nutrient contents and other properties

AbstractWater nutrient concentrations and other properties were surveyed by sampling water from 642 irrigation wells in Nebraska. The amount of Ca, Mg, S, and Cl applied in irrigation exceeds removal in 15 Mg ha−1 of corn (Zea mays L.) grain harvest for most wells. Irrigation supply exceeded corn grain harvest removal of K, B, Mn, and Mo for >20% of the wells. The supply of P, Zn, Cu, Fe, and Mo was generally very low but sufficient with some wells to be considered in nutrient management plans. The median level of nitrate N was 4.4 mg kg–1 with 25% of the wells having >10 mg kg–1 NO3–N, which is above the suitability limit for human consumption. The agricultural lime equivalent applied with 1 or 2 Ml of irrigation was enough to neutralize the acidifying effect of 200 kg ha−1 of fertilizer N for 70 or 89% of the wells. Nutrient and lime supply was relatively low for Sandhills wells and relatively high for wells in river valleys of <30.5 m (100 ft) depth. No wells had excessive Na levels but 0.3% of the wells had high salinity levels. A grouping of wells into 11 aquifer–geology–depth categories accounted for >20% of the variation for most water properties but much variation occurred within categories. Sampling of the well water is needed for optimized nutrient and soil management. Information on nutrients supplied through irrigation should be complemented by regular soil testing and the use of recommended nutrient management guidelines.

Effect of intracanal and extracanal heating on pulp dissolution property of continuous chelation irrigant.

Context:Extracanal and intracanal heating of sodium hypochlorite (NaOCl) improve its pulp dissolution, but limited literature is available on its effect as a combined single irrigant with etidronate.Aim:The aim of this study is to compare the effect of temperature on the effectiveness of NaOCl and continuous chelation protocol on the time required for the dissolution of vital and necrotic pulp.Materials and Methods:Dissolution time of 120 standardized bovine (buffalo) pulp fragments, divided into 12 subgroups based on tissue type (vital/necrotic), irrigant (NaOCl/continuous chelation), and temperature (extracanal, intracanal, and nonheated irrigant), was noted. Conical glass tips mimicking the root canal were considered specimen containers. About 0.2 ml of irrigant corresponding to the irrigation protocol was taken in them and then pulp samples were added to it. Samples were observed using loupes under 2.5 X magnification. Dissolution time was recorded using a stopwatch. The study was approved by the Institutional Ethical Committee (SDC/2019/591).Statistical Analysis Used:Two-way analysis of variance; statistical product and service solutions version 25. The level of significance was set at P < 0.05.Results:Time for pulp dissolution by continuous chelation mixture was significantly more as compared to NaOCl alone in all subgroups. Pulp tissue dissolution for both vital and necrotic pulp was improved by the increase in temperature of both irrigants and dissolution time was more for necrotic than vital tissue. Pulp tissue dissolution was significantly better by intracanal heating as compared to extracanal heating.Conclusion:Although intracanal heating of continuous chelation mixture improves its pulp dissolution capacity significantly as compared to extracanal heating and nonheating protocol but pulpal dissolution capacity of nonheated 5% NaOCl still remains significantly better as compared to intracanal and extracanal heated continuous chelation mixture.

Analysis of the ability of XP Clean and easy clean files to remove Calcium Hydroxide paste from simulated internal tooth resorptions

Aim: This study compared the ability of instruments XP Clean and Easy Clean to remove the calcium hydroxide paste from simulated internal root resorptions. Methodology: Thirty freshly extracted human lower incisors were sectioned through the long axis after biomechanical preparation with ProTaper files. On each half, a defect simulating an internal resorption was fabricated on the middle root canal third using a round bur. One week after insertion of calcium hydroxide paste, the teeth were divided into three groups according to the technique employed: G1-Conventional irrigation; G2-XP Clean and G3-Easy Clean. Each instrument was used in three cycles of 20 seconds, followed by renewal with 2 ml of irrigant. Thereafter, the specimens were analyzed on a stereoscopic magnifying glass to analyze the removal of dressing material. Results: Similar performance was observed for both methods employed, even though the rates of absence of removal were higher for the group Easy Clean compared to the group XP Clean. Conclusions: The XP Clean presented better results in removing the calcium hydroxide paste compared to Easy Clean, with statistically significant difference.

Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics . The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). Methods: 40 human lower premolars were contaminated with E. coli (ATCC 25922) for 28 days and E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for E. coli and E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05. Results: All groups were effective in reducing the microbial load of E. coli and E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI. Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over E. faecalis and E. coli and their endotoxins.

Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins.

Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics . The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). Methods: 40 human lower premolars were contaminated with E. coli (ATCC 25922) for 28 days and E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for E. coli and E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05. Results: All groups were effective in reducing the microbial load of E. coli and E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI. Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over E. faecalis and E. coli and their endotoxins.

Comparative Evaluation of Antimicrobial Efficacy, Depth of Penetration into Dentinal Tubules and Effect on Microhardness of Root Dentin by Sodium Hypochlorite, Neem Extract and Gau Ark as Root Canal Irrigants: An In-vitro Study

Introduction: Disinfection of root canals can be done using intracanal irrigants. Sodium hypochlorite or NaOCL is amongst the most commonly used endodontic irrigants. Due to disadvantages of NaOCl, there is a need to identify a more biocompatible irrigant. Aim: To evaluate the antibacterial efficacy, depth of penetration into dentinal tubules and effect on microhardness of root dentin when NaOCl, Neem extract, Gau ark and Normal saline used as an irrigant against Enterococcus faecalis. Materials and Methods: Prepared Neem leaf extract, 3% NaOCl, Gau ark, Normal saline, Brain Heart Infusion (BHI) broth and BHI Agar were used in the present in-vitro study conducted from August-October 2019. Antimicrobial efficacy was measured by agar well diffusion method on 10 petriplates. After access opening and biomechanical preparation, each tooth sample was irrigated with 5 mL of irrigant. Samples were decoronated and roots were split along the longitudinal axis to check penetration depth of irrigants under stereomicroscope for 40 teeth samples. After preparation of 40 teeth sample, 2 mm dentin discs prepared were embedded in acrylic resin. Microhardness was checked under Vickers Microhardness (VHN) tester after samples were irrigated. Statistical Analysis of Variance and Tukey post-hoc test were used. Results: Zones of inhibition were highest with NaOCl (7.66 mm). Irrigants penetration depth into dentinal tubules was significant with NaOCl with average value 0.35 mm. Microhardness of root dentin of saline was 145.90 VHN, followed by Neem 136.59 VHN which was then followed by Gau ark 123.05 VHN hence, Neem has lesser effect on microhardness value as compared to NaOCl and Gau ark. There was statistically significant difference among four groups regarding antimicrobial efficacy, depth of penetration into dentinal tubules and microhardness of root dentin. Conclusion: Neem extract showed significant antimicrobial property as compared to Gau ark and normal saline, good penetration depth and less effect on microhardness of root dentin. Herbal irrigant like Neem extract can be used as a root canal irrigant.

Evolving effective irrigating schedule for potted maize crop

The trial, a 2 x 7 Factorial experiment evaluates two watering regimes: 25 ml of irrigation applied full dose in the Morning (M), or Afternoon (A) or Evening (E), as well as two equal-split applications applied either in the Morning + Afternoon (MA), or Morning + Evening (ME) or Afternoon + Evening (AE), in addition to three equal-split application applied Morning + Afternoon + Evening (MAE). A second irrigation regime was application of 50 ml of irrigation water applied in the same sequence as for 25 ml. A 4-day application schedule was maintained for both watering regimes. Analysis of data reveal that final crop heights were significantly (p≤ 0.05) influenced by irrigation schedule as well as by volume of irrigation applied in both 2017 and 2018 trials. 50 ml of irrigation applied consistently gave better crop heights in both trials. Stem girth however did not respond significantly (p≥ 0.05) to irrigation schedule and to volume of irrigation applied. In 2017 trial leaf number and leaf area were also not significantly (p≥ 0.05) influenced by irrigation schedule investigated as well as the volume of water given. However trials conducted in 2018 indicates significant response of leave area to irrigation schedule as well as rate. Yield parameters responded significantly (p≤ 0.05) to irrigation application, with 50 ml irrigation given better grain yield than 25 ml. Application of water in the Morning gave the best yield responses, thus recommended. The least yield responses were observed when irrigation water was delivered in the Afternoon.

Management of Pediatric Type I Open Fractures in the Emergency Department or Operating Room: A Multicenter Perspective.

The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015. Patients with multiple traumatic injuries, immunocompromised patients, or those without final radiographs indicating healing were excluded. In total, 219 patients met inclusion criteria. A total of 170 fractures were treated operatively (77.6%), 49 fractures were treated nonoperatively (22.4%). There was 1 infection in the nonoperative group (2.0% infection rate), and no infections in the operatively managed group (P=0.062). Cefazolin was the most commonly administered antibiotic (88.1% of patients). Duration of hospital-administered antibiotics was significantly different, with a mean of 10.9 hours in the nonoperative group and 41.6 hours in the operative group (P<0.001). Length of stay averaged 16.3 hours for nonoperative patients and 48.6 hours for the operatively treated patients (P<0.001). In the nonoperative group, 44/49 had documented superficial wound debridement in the ED utilizing, on an average, 1500 mL of irrigant. There were 10 other complications, 9 in the operative group (5.4%) and 2 in the nonoperative group (4.1%, P=0.107), including 2 compartment syndromes and 1 acute carpal tunnel syndrome all requiring immediate surgical release (1.8%) in the operative group. There was no significant difference in infection rate or complication rate in those managed with antibiotics and operative debridement versus those managed with superficial wound debridement and antibiotics in the ED. Consideration should be given to the similar safety profiles for these 2 treatment modalities when managing pediatric patients with type I open fractures. Level III.

Management of contaminated open fractures

Treatment of open fractures demands rapid intervention consisting of intravenous antibiotics, aggressive debridement, fracture immobilization, and soft tissue management including additional debridements and soft tissue coverage. Despite this approach, infection, particularly osteomyelitis, after open fracture continues to be a source of significant morbidity. Recent literature has provided several studies that performed clinical trials in superficial wounds. These investigations compared sterile solutions with tap water for wound decontamination. The results suggest that tap water washouts are cost-effective for these specific wounds. An established protocol using sterile porcine hind limb tibias, as reported by Bhandari et al., was applied with modification. There were then 15 specimens and 5 controls (no irrigation) for each condition. The conditions were potable water and sterile water. A representative bacterium of gram-positive, Staphylococcus aureus, or gram-negative, Escherichia coli, acted as the contaminant. Sectioned, sterile porcine hind limb tibias were inoculated with 1 mL of a known concentration (1 × 10(10)) of bacterium and incubated. Each specimen was then irrigated, with bulb irrigation at a standardized distance of 15 cm, with 500 mL of irrigation. The specimen, along with 0.5 mL of wash (irrigant collected after it was placed over the specimen), was placed in 5 mL of Brain Heart Infusion broth. All specimens were incubated in this broth at 37°C for 2 hours. At 2 hours, a 100-μL supernatant was plated on blood agar plates and incubated for 24 hours. Colony counts for each specimen and controls were then performed. The number of colony forming units (CFUs) for each type of bacterium was different. The average CFUs from bone samples contaminated with E. coli was 5.18 × 10(8) after irrigation with sterile water and 6.24 × 10(8) after irrigation with tap water. The average CFUs from bone samples contaminated with S. aureus was 18 × 10(6) after irrigation with sterile water and 12 × 10(6) after irrigation with tap water. The average CFUs from the irrigation samples from E. coli contamination treated with sterile water was 1.3 × 10(6) and the CFUs from E. coli contamination treated with tap water was 2.2 × 10(6). The average CFUs from the irrigation samples from S. aureus contamination treated with sterile water was 1.57 × 10(6) and the CFUs from S. aureus contamination treated with tap water was 1.56 × 10(6). There was no significant difference between the CFUs for the sterile and potable water (p = 0.201) for each bacterium (p = 0.871).

Reduction of Hard-tissue Debris Accumulation during Rotary Root Canal Instrumentation by Etidronic Acid in a Sodium Hypochlorite Irrigant

IntroductionHard-tissue debris is accumulated during rotary instrumentation. This study investigated to what extent a calcium-complexing agent that has good short-term compatibility with sodium hypochlorite (NaOCl) could reduce debris accumulation when applied in an all-in-one irrigant during root canal instrumentation. MethodsSixty extracted mandibular molars with isthmuses in the mesial root canal system were selected based on prescans using a micro–computed tomography system. Thirty teeth each were randomly assigned to be instrumented with a rotary system and irrigated with either 2.5% NaOCl or 2.5% NaOCl containing 9% (wt/vol) etidronic acid (HEBP). Using a side-vented irrigating tip, 2 mL of irrigant was applied by 1 blinded investigator to the mesial canals after each instrument. Five milliliters of irrigant was applied per canal as the final rinse. Mesial root canal systems were scanned at high resolution before and after treatment, and accumulated hard-tissue debris was calculated as vol% of the original canal anatomy. Values between groups were compared using the Student's t test (α < .05). ResultsIrrigation with 2.5% NaOCl resulted in 5.5 ± 3.6 vol% accumulated hard-tissue debris compared with 3.8 ± 1.8 vol% when HEBP was contained in the irrigant (P < .05). ConclusionsA hypochlorite-compatible chelator can reduce but not completely prevent hard-tissue debris accumulation during rotary root canal instrumentation.

Bactericidal Activity of Stabilized Chlorine Dioxide as an Endodontic Irrigant in a Polymicrobial Biofilm Tooth Model System

Introduction The purpose of this study was to determine bactericidal efficacy of 0.04% stabilized chlorine dioxide, 3% sodium hypochlorite, 2% chlorhexidine gluconate, and sterile distilled water in a polymicrobial biofilm model. Methods Roots of 35 permanent bovine incisors had pulps extirpated, and their apical size and root length were standardized. Teeth were coated with mucin, inoculated with standardized suspensions of Streptococcus sanguinis, Actinomyces viscosus, Fusobacterium nucleatum, Peptostreptococcus micros, and Prevotella nigrescens and incubated anaerobically. Teeth were randomly divided into four groups and rinsed for 3 minutes with 15 mL of irrigant. Biofilms were harvested and spiral-plated on selective media. Numbers of bacteria in the harvested biofilms was determined via the standard spiral-plating methodology. Treatment groups were evaluated using the nonparametric Kruskal-Wallis procedure. Pair-wise comparisons among the four groups and five organisms were made using the Wilcoxon-Mann-Whitney procedure. Adjustments for multiple comparisons were made using the Holm method with p < 0.05. Results Results provide strong evidence of a significant difference in levels of bactericidal activity associated with the type of irrigant for all five bacterial species tested. Levels of bactericidal activity were significantly higher for the NaOCl group than for the stabilized chlorine dioxide (ClO 2) group for S. sanguinis, A. viscosus, and P. nigrescens. Results for F. nucleatum and P. micros were not significant after the adjustment for multiple comparisons. Conclusions The triple-inoculation bovine tooth model system is a robust, consistent, and reproducible model system to study polymicrobial biofilms. It should be used with the knowledge expansion of biofilm structure and function as well as the development of antimicrobial protocols.

Cleaning ability of chlorhexidine gel and sodium hypochlorite associated or not with EDTA as root canal irrigants: a scanning electron microscopy study

The aim of this study was to evaluate the cleaning efficacy of 2% chlorhexidine gluconate gel (CHX) compared to 2.5% sodium hypochlorite solution (NaOCl) associated or not with 17% EDTA used as irrigants during the biomechanical preparation. Fifty freshly extracted single-rooted human teeth with complete apex formation were randomly divided into five groups: G1 - sterile saline, G2 - 2.5% NaOCl, G3 - 2% CHX, G4 - 2.5% NaOCl + EDTA and G5 - 2% CHX + EDTA. The specimens of G1 were subdivided into two control groups. The teeth were decoronated and the coronal and middle root thirds were prepared with Gates-Glidden burs, and the apical third was reserved to manual instrumentation. All procedures were performed by a single operator. In all groups, 2 mL of irrigant was delivered between each file change. The teeth were sectioned and prepared for analyses under scanning electron microscopy (SEM). SEM micrographs were graded according to a score scale by two examiners. Data were analyzed statistically by Kruskal-Wallis and Dunn tests at 1% significance level. The best results were obtained in the groups in which the irrigant was used followed by the chelating agent. No statistically significant difference was observed among G4, G5 and the positive control group (p<0.01). The groups G2 and G3 were significantly different from the others, presenting the worst cleaning capacity. In conclusion, the use of the chelating agent is necessary to obtain clean canal walls, with open tubules and no heavy debris. The use of 2% chlorhexidine gluconate gel alone is not able to remove the smear layer.

A New Sodium Phosphate Tablet Bowel Purgative Requires Less Irrigation during Colonoscopy Than 2 L Polyethylene Glycol Electrolyte Lavage Solution Plus Bisacodyl Tablets

Purpose: The time involved in irrigating the colon to adequately visualize the mucosal lining can greatly affect the efficiency of colonoscopy. This study compared the irrigation requirements during colonoscopy of a new sodium phosphate (NaP) tablet bowel purgative (OsmoPrep™; Salix Pharmaceuticals, Inc) with a bowel preparation kit consisting of 2 L polyethylene glycol electrolyte lavage solution (PEG) and bisacodyl tablets (HalfLytely®; Braintree Laboratories, Inc). Methods: Patients (pts) ≥18 y enrolled in a multicenter, investigator-blinded study were randomized to receive 32 (48 g) NaP tablets or 2 L PEG + 4 (20 mg) bisacodyl tablets. NaP tablets were administered as 4 tablets with 8 oz clear liquid every 15 min the evening before (n = 20) and 3 to 5 h prior to (n = 12) colonoscopy. 2 L PEG + bisacodyl tablets were taken the day prior to colonoscopy as directed in US prescribing information. Irrigation requirements during colonoscopy were scored by investigator from 0 to 3 (0 = none; 1 = <50 mL; 2 = 50–100 mL; 3 = >100 mL). Results: 205 pts taking NaP tablets and 206 pts taking 2 L PEG + bisacodyl who took ≥1 tablet or sip of study medication and underwent colonoscopy were evaluated. Mean irrigation scores were significantly lower in pts taking NaP tablets compared with 2 L PEG + bisacodyl (0.80 ± 1.12 vs 1.28 ± 1.25; P < 0.0001) and remained significant for the following subgroups: males (0.78 ± 1.13 vs 1.31 ± 1.24; P= 0.0033); females (0.82 ± 1.12 vs 1.26 ± 1.26; P= 0.0050); pts ≤64 y (0.75 ± 1.13 vs 1.21 ± 1.22; P= 0.0007); and pts >64 y (0.96 ± 1.10 vs 1.52 ± 1.33; P= 0.0244). Significantly fewer pts in the NaP tablet group required any irrigation during colonoscopy compared with the 2 L PEG + bisacodyl group (39% vs 58%, P < 0.0001). Additionally, fewer pts required >100 mL of irrigation with NaP tablets compared with 2 L PEG + bisacodyl (13% vs 26%; P= 0.0017). The distribution of irrigation scores was significantly different between treatment groups and favored NaP tablets (P= 0.0004). This significant difference in favor of the NaP tablet group was consistent for the following subgroup analyses: males (P= 0.0054); females (P= 0.0488); pts ≤64 y (P= 0.0026); and pts >64 y (P= 0.0067). Conclusions: Significantly less irrigation during colonoscopy is necessary for NaP tablets compared with 2 L PEG + bisacodyl. Given the lower irrigation requirement and previously established efficacy, NaP tablets may improve the efficiency of colonoscopy.

Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real‐time imaging in vitro

To test the hypothesis that the mechanical efficacy of irrigation in reducing bacteria in the root canal is dependent on depth of placement of the irrigation needle. The root canals of 30 permanent cuspids were instrumented to apical size 60 using a crown-down technique. A suspension of the bioluminescent reporter strain Pseudomonas fluorescens 5RL was inoculated into each canal of sterilized teeth. Emission of bioluminescence (photons s(-1)) from each tooth was quantified on four sequential occasions using luminometry and bioluminescence imaging: (i) background, (ii) after inoculation, (iii) after irrigating the inoculated teeth with 3 mL of a nonantimicrobial irrigant delivered either 1 mm (group 1, n = 15) or 5 mm (group 2, n = 15) from working length (WL) using a 28G safety-ended irrigating needle, (iv) after an additional 3 mL irrigation (total 6 mL). Intragroup and intergroup comparisons were made using Wilcoxon matched pairs and Mann-Whitney tests, respectively. In group 1, there was a mean log10 decrease in bacteria of 0.68 +/- 0.26 after 3 mL of irrigant compared with 1.19 +/- 0.48 after 6 mL (P < 0.001); in group 2 the mean log10 decrease was 0.58 +/- 0.28 after 3 mL of irrigant compared with 0.69 +/- 0.35 after 6 mL (P < 0.02) (Wilcoxon matched pairs). Using 3 mL of irrigant, needle depth did not have a significant effect on reduction of intracanal bacteria (P = 0.407), but the effect became significant when 6 mL of irrigant was used (P < 0.002) (Mann-Whitney tests). The mechanical efficacy of 6 mL of irrigant in reducing intracanal bacteria was significantly greater when delivered 1 mm compared with 5 mm from WL.

Efficacy of Irrigation with Rotary Instrumentation

The purpose of this study was to evaluate the efficacy of a handpiece-mounted irrigation device and compare it to irrigation with a syringe and needle in the apical 5 mm of the root canal system. Twenty matched pairs of extracted teeth were used. The only variable within each matched pair was the method of irrigation. A syringe and needle were used in group A and the handpiece-mounted system in group B. Sections 1, 3, and 5 mm from the working length were examined microscopically, and images of the slides were digitized. The percentage of canal space occupied by pulpal and dentinal debris was calculated to be 6% +/- 12.7% in group A, versus 3.8% +/- 7% in group B (p = 0.264). The percentages at each level were as follows: 1 mm from the working length, 14.1% +/- 19% for group A and 5% +/- 7.5% for group B; 3 mm from working length, 1.8% +/- 5.4% for group A and 3.9% +/- 6.9% for group B; and 5 mm from working length, 3.1% +/- 7.7% for group A and 2.6% +/- 7.3% for group B. In group A, there was significantly more debris in the 1-mm section than in the 3- or 5-mm sections. In group B, the differences between levels were not significant. There was no significant difference in the amount of debris remaining in the apical 5 mm of canals when comparing the handpiece-mounted irrigation device to irrigation with a syringe and needle. The average times for instrumentation in group A (needle irrigation) and group B (Quantec-E irrigation system) were 8.7 +/- 2.7 min and 6.5 +/- 1.9 min, respectively. Group B was associated with statistically significant shorter instrumentation time (p < 0.0005). An average of 12.5 +/- 4.9 ml of irrigant was used in group A and 17.3 +/- 4.8 ml in group B. The difference was statistically significant (p < 0.0005).

Does intraprostatic vasopressin prevent the transurethral resection syndrome?

To determine whether intraprostatic vasopressin (IPVP) prevents the transurethral resection (TUR) syndrome during prostatectomy. The study comprised 36 consecutive patients (mean age 68 years) with prostates clinically assessed as >/= 20 g who underwent standard transurethral prostatectomy (TURP). Ten units of vasopressin in 0.5 mL were diluted with 9.5 mL isotonic saline and injected into the prostate transrectally before TURP. Blood samples were taken before and immediately after TURP to measure serum sodium concentration and free haemoglobin levels. The TURP irrigant used was cooled, boiled water maintained at 70-80 cmH2O pressure during resection. Twenty patients had alcohol added to the irrigant and their breath alcohol assessed at 10-min intervals during TURP. All patients had their pulse rate, blood pressure and sensorium monitored continuously. Extreme care was taken to avoid and/or identify capsular damage during resection. The mean weight of tissue resected was 36 g and the mean resection time 24 min. There was no significant change in clinical variables during TURP. In 19 patients the breath alcohol changes were insignificant. Changes in free haemoglobin were not significant, but the levels decreased after TURP in four patients, caused by the dilution consequent on the infusion of 800-1000 mL isotonic saline during surgery. Serum sodium concentrations showed only insignificant decreases, except in one patient whose breath alcohol suggested the absorption of 500 mL of irrigant. This patient's serum sodium concentration decreased by 9 mmol/L; 1 L of 5% dextrose was infused during the procedure and capsular damage was recognized early during TURP. Insignificant volumes of irrigant entered the circulation of the patients during TURP with water irrigation and IPVP. The greatest risk factor for fluid entry during TURP is capsular damage. IPVP decreases bleeding and therefore improves visibility, so allowing the early identification of capsular damage. IPVP seems therefore to be of help during TURP by decreasing bleeding and allowing insignificant volumes of irrigant to enter the vasoconstricted vessels; it appears to prevent the TUR syndrome.

Effects of Fertilizer Additions on Growth of Cotoneaster dammeri and Rudbeckia fulgida in Composted Turkey Litteramended Pine Bark Substrates

An experiment with a factorial treatment combination in a split plot design with five single plant replications was conducted to evaluate the effects of five rates of fertilizer addition and two irrigation volumes on plant growth in a composted turkey-litter-amended pine bark substrate. Main plots were daily applications of 600 or 900 ml/3.8-L container. Subplots were either 0, 1.0, 2.0, 3.0, or 4.0 g N additions (Osmocote High H 24N–1.7P–5.8K) per container topdressed on a substrate composed of pine bark amended with 8% (by volume) composted turkey litter. No additional amendments were made to the compost amended substrates. An additional “industry control” treatment consisted of an 8 pine bark: 1 sand (by volume) substrate amended with 3.0 kg/m3 dolomitic limestone and 0.9 kg/m3 Micromax and topdressed with 3.5 g N (Osmocote High N) per container. After 134 days, Cotoneaster dammeri `Skogholm' and Rudbeckia fulgida `Goldsturm' plants were harvested and shoot and root (cotoneaster only) dry weights were determined. Cotoneaster shoot and root dry weights and rudbeckia shoot dry weight increased linearly as N rate increased from 0 to 4.0 g N. Irrigation volume did not affect cotoneaster shoot or root dry weights. Rudbeckia shoot dry weight was 18% greater with 900 ml than with 600 ml of irrigation. Rudbeckia growth in compost amended substrate was greater than in the industry control when topdressed with ≥1.0 g N. Shoot growth of cotoneaster in the industry control substrate and compost amended substrate with ≥ 3.0 g N applied was similar.

Control of Fungus Gnats in Greenhouse Grown Plants, 1995

Bachelor buttons grown in 6 inch clay pots at the Pesticide Research Center greenhouses on the MSU campus were used for this test. Each treatment was replicated 6 times with each replication consisting of a single plant. Marathon and Oxamyl were applied with a hand-held shaker according to the rate per pot on the label. Each pot received 100 ml of irrigation after treatment. The Dycarb was applied as a drench; 250 ml of solution to each pot. All other treatments were applied at a rate of 200 gal of spray solution per acre. Each pot received 3.5 ml of finished spray to the soil surface, followed with 100 ml of irrigation. All of the above treatments were applied on 16 Jun. Precounts were taken on 14 Jun and post spray evaluations were made on 23 Jun and 30 Jun. To monitor the larvae two 1/2 inch-diameter, 3/4 inch-long slices of potato were cut using a large cork borer and placed into the pots 1/2 inch deep in the soil. After 2 days the potato slices were removed along with about 0.7-1.0 g (1 ml) of soil from beneath the potato. The soil and potato slices were placed in a 2 oz plastic cup and brought back to the lab where 20% ethanol extractions were performed using a Buchner funnel. Live larvae were counted under a dissecting microscope, both from the potato and the soil.