Wet Swab Research Articles

Evaluation of the histological Inflammation in the intestines of male mice infected with Entamoeba histolytica using immunohistochemistry technology

The current study was conducted during the period between May 1, 2021 and October 30, 2022 for the purpose of diagnosing infection with the Entamoeba histolytica parasite. The clinically infected patients suffered from diarrhea when the samples were examined microscopically using a sample of direct wet swab. In the experimental study, the Entamoeba histolytica was given to laboratory mice and it was observed that tissue damage appeared as a result of infection with the amoeba parasite, represented by necrosis and explosion in the intestinal villi, dissolution of the epithelial layer and the occurrence of a condensation of inflammatory cells in the intestine.

Assessment of chemical contamination by cancer drugs during use of the RIVATM compounding robot: A pilot study.

Many hospitals are now investing in robotic compounding system for the preparation of cytotoxic agents. The objective of the present study was to describe contamination by cytotoxics inside and outside the RIVATM robot (ARxIUM, Winnipeg, Canada). We applied a risk analysis to determine which locations inside and outside the compounding robot should be monitored. Samples were collected by swabbing with a wet swab (using 0.1 mL of sterile water) before the robots was cleaned. Ten cytotoxics compounded with the robot were screened for using LC-MS/MS. We determined the percentage contamination rates inside (CRin) and outside (CRout) the robot and the amounts of each contaminant (in ng/cm²). If a sample was found to be positive, a corrective action was implemented. Our risk analysis highlighted 10 locations inside the robot and 7 outside. Ten sampling campaigns (10 samples per campaign) were performed. The mean CRin (40%) was significantly higher than the mean CRout (2%; p < 10-4). Gemcitabine and cyclophosphamide were the main contaminants. After the implementation of corrective measures (such as daily cleaning with SDS/isopropyl alcohol), the CRin fell from 60% to 10%. The frequency of contamination was lower for robotic compounding than for manual compounding in an isolator. However, robotic compounding tended to generated larger mean amounts of contaminant; this was related to incidents such as splashing when syringes were disposed of after the compounding. The implementation of corrective actions effectively reduced the CRs. Further longer-term studies are required to confirm these results.

A case of small bowel evisceration through the rectum and anus

A 46-year-old man presented with a small bowel prolapsing through the anus after straining on the toilet, which was starting to become ischaemic. He admitted to inserting a plastic object in his rectum about half an hour before straining. The bowel was kept moist by placing an intravenous drip line with saline dripping onto a wet swab. In theatre, the bowel was found to be prolapsing through a hole in the upper rectum and out through the anus. It was reduced back into the abdominal cavity through the same perforation, which was 4 cm long, without needing to extend it. This was sutured with polydioxanone (PDS) 2-0 as there was no contamination with faeces or pus. Due to improvement in the appearance of a small bowel and an extremely bruised mesentery, a re-look was planned in 24 hours. At the re-look the small bowel appeared healthy, therefore no resection was performed. However, a loop colostomy was fashioned to protect the upper rectal perforation repair. This shows that resection is not always required in such cases.

Investigating the Prevalence of the Giardia lamblia Parasite in Children in Salah Al-Din Governorate

The research was conducted from June 2023 until December 2024 to detect the prevalence of infection with the Giardia lamblia parasite among children with diarrhea attending Tikrit Teaching Hospital in Salah al-Din Governorate. The study included collecting 400 stool samples for children whose ages ranged between (1-12) years. Direct wet swab to detect the presence of the parasite. The level of infection with the parasite reached 14.75%. The highest rate of infection was in males at 67.7% and lower in females at a rate of 32.2%. The highest rate of infection was at the age of (1-3) years at a rate of 38.9% and the lowest rate was 11.8% at the age of (9-12) years. The infection rate was 69.4%, high in families with 10 or more members, while in small families (4-5) individuals, the infection rate was 30.5%. The infection rate was highest in children who drank unfiltered river water, at 50.8%, and lowest in children who drank pure water, at 3.3%. The prevalence of this parasite in rural areas was higher than in urban areas, at a rate of 55.9% in all areas of the governorate. It was found that there were varying rates of infection in the different months of the year, reaching 28.8% in the summer, and the lowest infection rate in the winter.

The effect of ice-cold water spray following the model for symptom management on postoperative thirst in patients admitted to intensive care unit: A randomized controlled study

BackgroundPostoperative thirst is common in patients admitted to the intensive care unit. Existing methods like wet cotton swabs or oral care prove ineffectual or operationally intricate. Currently, an efficacious postoperative thirst alleviation method remains elusive. Exploring a prompt, safe, and efficacious solution is of paramount importance. ObjectiveTo assess the effect of ice-cold water spray applied following a symptom management model on postoperative thirst and to establish a framework for mitigating thirst in intensive care unit patients. Research designSingle-center randomized controlled study. SettingSurgical intensive care unit in a university-affiliated hospital. Main outcome measures56 intensive care unit patients were selected and equally randomized. The experimental group received ice-cold water spray in conjunction with eight symptom management strategies, while the control group underwent standard care involving wet cotton swabs. Thirst intervention was initiated 0.5 hours after postoperative extubation, followed by subsequent interventions at 2-hour, 4-hour, and 6-hour intervals post-extubation. Thirst intensity, oral comfort, and the duration of relief from thirst were assessed and compared between groups before and 0.5 hours after each thirst intervention. ResultsAcross different interventions, the experimental group exhibited superior scores in thirst intensity and oral comfort compared to the control group. Additionally, the nursing time required to alleviate thirst in the experimental group was significantly shorter than that in the control group (P < 0.01). ConclusionIce-cold water spray following the model for symptom management can effectively mitigate the postoperative thirst intensity in intensive care unit patients, improve oral comfort, and reduce the nursing time for relieving thirst. Implications for clinical practiceClinical nurses can employ ice-cold water spray following the model for symptom management to ameliorate postoperative thirst intensity in ICU patients while enhancing oral comfort. Furthermore, the utilization of ice-cold water spray can reduce the nursing time required for relieving postoperative thirst in intensive care unit patients.

Methicillin Resistant Staphylococcus Aureus Colonization among HIV Patients

Introduction: Methicillin-resistant S. aureus is known to have a significant negative impact on both immunocompetent and immunocompromised individuals (HIV patients). Aim: This study evaluated the antibiotic susceptibility profile of MRSA staphylococcus aureus isolated from HIV patients attending Barau Dikko Teaching Hospital, Kaduna. Methods: Using sterile wet swabs, within the period of 3 months (January– March 2020), a total of 180 samples were collected from the skin, ear, and nasal cavities of 60 HIV patients who gave their consent to be part of the survey, and S. aureus was isolated. Isolation, bacterial characterization, and antimicrobial susceptibility tests were carried out using the methods described by Chesbrough and Kirby-Bauer, respectively. Results: The bacterial isolation rate was 76.7% (138/180) in the samples collected, with 56.5% (78) been Gram positive. The incidences of S. aureus and MRSA were 12.8% and 8.6%, respectively. From the sample sources, the distribution of S. aureus was more in the nostrils, followed by the skin and ear swabs. Resistance was observed against imipenem (86.9%), vancomycin (65.3%), tetracycline (65.3%), and erythromycin (60.9%), while susceptible to ciprofloxacin (60.9%), streptomycin (43.5%), and gentamycin (52.2%). A high percentage (91.3%) of S. aureus were multidrug-resistant and had MARI &gt; 0.2. Conclusion: This study established that high-resistant S. aureus with a possible MRSA gene could be responsible for frequent staphylococcus-associated infections and resistance to treatment among HIV patients in Kaduna, Nigeria. Doi: 10.28991/SciMedJ-2023-05-03-03 Full Text: PDF

Assessing the Bioreceptivity of Biobased Cladding Materials

Materials exposed to the outdoors are prone to various deterioration processes. Architectural coatings are designed to protect surfaces against environmental and biotic degradation and to provide a decorative layer. The objective of this work was to examine the early colonisers on a diverse set of coated and non-coated biobased façade materials. A set of 33 wood-based cladding materials were exposed to four cardinal directions and monitored in outdoor conditions. The surfaces were sampled using a wet swab and plated on DG-18 agar, which prevents the growth of bacteria and limits the growth of fast-growing fungi. Pure cultures were then isolated and identified through PCR amplification and Sanger sequencing of specific DNA regions/genes. The response of cladding materials to weathering and fungal infestation was assessed. The proposed techniques enabled the identification of features that promote/inhibit fungal colonisation and revealed the preference of certain fungi for specific materials. Both the material type and the climate condition at the exposure site influence fungal colonisation. This study is a starting point for more exhaustive assays that aim to develop a novel coating system based on controlled and optimized fungal biofilm formation, and is proposed as a nature-inspired alternative for the protection of architectonic surfaces.

ATR-FTIR Spectroscopy with Chemometrics for Analysis of Saliva Samples Obtained in a Lung-Cancer-Screening Programme: Application of Swabs as a Paradigm for High Throughput in a Clinical Setting.

There is an increasing need for inexpensive and rapid screening tests in point-of-care clinical oncology settings. Herein, we develop a swab "dip" test in saliva obtained from consenting patients participating in a lung-cancer-screening programme being undertaken in North West England. In a pilot study, a total of 211 saliva samples (n = 170 benign, 41 designated cancer-positive) were randomly taken during the course of this prospective lung-cancer-screening programme. The samples (sterile Copan blue rayon swabs dipped in saliva) were analysed using attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy. An exploratory analysis using principal component analysis (PCA,) with or without linear discriminant analysis (LDA), was then undertaken. Three pairwise comparisons were undertaken including: (1) benign vs. cancer following swab analysis; (2) benign vs. cancer following swab analysis with the subtraction of dry swab spectra; and (3) benign vs. cancer following swab analysis with the subtraction of wet swab spectra. Consistent and remarkably similar patterns of clustering for the benign control vs. cancer categories, irrespective of whether the swab plus saliva sample was analysed or whether there was a subtraction of wet or dry swab spectra, was observed. In each case, MANOVA demonstrated that this segregation of categories is highly significant. A k-NN (using three nearest neighbours) machine-learning algorithm also showed that the specificity (90%) and sensitivity (75%) are consistent for each pairwise comparison. In detailed analyses, the swab as a substrate did not alter the level of spectral discrimination between benign control vs. cancer saliva samples. These results demonstrate a novel swab "dip" test using saliva as a biofluid that is highly applicable to be rolled out into a larger lung-cancer-screening programme.

EVALUATION OF PERCEPTION OF EXTEROCEPTIVE SENSATIONS IN PRETERM NEONATES-A PILOT STUDY

Aim: Preterm infant is deprived of various in-utero sensory experiences which have been documented as risk factor for prevalence of broad range of neurodevelopmental impairment in preterm infants. The present study evaluates the pain processing pattern in preterm neonates with and without known abnormalities using the Premature Infant Pain Profile (PIPP)-a 7 indicator pain measure that include three behavioural (facial actions: brow bulge, eye squeeze and nasolabial furrow), two physiological (heart rate and oxygen saturation), and two contextual (gestational age and behavioural state). Method: Neonates were randomly observed for receiving one of the following procedures: Dry cotton swab for simple touch (T), Cold and warm water wet cotton swabs for recording temperature perceptions (Tp), venous puncture in the back of the hand (P), considered as a painful stimulus; or alcohol swab friction on the back of the hand (F), considered as a distressing but not painful stimulus. A neonatologist evaluated physiologic and behavioral pain parameters. The evaluation of the perception includes utilizing Neonatal Infant Pain Scale (NIPS) and PIPP. Results: The mean pain score is 8.04 which is considered as moderate as per PIPP table. The standard deviation is 3.517. The probability distribution of pain is normal. Conclusion: The pain perception according to the recorded score is moderate in the premature neonates and the perception score is comparatively high in preterm neonates with known abnormalities. The infants born at 29-31 weeks of gestational age group showed greatest changes in the hemodynamic patterns during exteroceptive painful stimulation. KEY WORDS: premature, neonates, Premature Infant Pain Profile, PIPP, Neonatal Infant Pain Scale, NIPS, preterm birth

Topical Film Forming Clotrimazole Emulgel

Abstract: Introduction: Clotrimazole is a weak base and is practically insoluble in water. To enhance drug loading of hydrophobic Clotrimazole in the formulation and, to circumvent greasiness, poor retention time and easy wipe off associated with conventional topicals, it was formulated as a Film Forming Emulgel. Materials and Methods: Preformulation studies were performed to evaluate solubility and emulsification of drug in oils and surfactants, and screening of gelling and film forming agents. Capryol 90 and Tween 80 were selected as the oil and surfactant, respectively. Sepineo P 600 and HPMC E4M were selected as the gelling agent and film forming agent respectively. The films were evaluated for peelability, tackiness, folding endurance, swelling index and cosmetic attractiveness. Results: The optimized formulation formed clear, uniform and adhesive films and exhibited similar in vitro and ex vivo release profiles, to that of the marketed product (α = 0.05, p=0.605 for in vitro diffusion). Dry and wet swab studies performed on the optimized formulation presented that the film formed exhibits good adhesion, lowered drug loss associated with wipe off and enhanced retention. In vivo dermal irritation test on Sprague-Dawley rats was also carried out. Release profiles were compared using multiple models with first order release being the best suited model for the optimized formulation (R2= 0.9932) and marketed product (R2=0.9859). Stability studies performed helped conclude the optimized formulation was stable. Conclusion: The developed formulation is an excellent alternative to emulgel and patches, overcoming the drawbacks of each by giving longer retention on the skin for prolonged therapy. Keywords: Adhesive film, Wipe-off resistant, Longer retention, Long term therapy, Antifungal.

Design and synthesis of vertical gradient of expansion structure based on polyimide humidity sensing layer with ultra-fast response, high sensitivity, and large deformation driven by humidity

The design of humidity actuators with fast reaction sensitivity (particularly actuation time) while retaining desirable mechanical qualities is critical for advanced smart manufacturing such as soft robots and smart devices, yet it remains a challenge. Here, we fabricated film-based humidity-responsive materials from hydrogenated pyromellitic dianhydrides (HPMDAs) via a simple two-step chemical imidization. The bending of the film is highly sensitive to humidity, and even a small amount of humidity based on a wet cotton swab can be observed from a distance of a few millimeters to bend the film. HPMDAs-based PI (PIs-HPMDAs) not only possess facile fabrication features and excellent properties, such as thermal stability, mechanical properties, and optical properties, but also deliver excellent deformation, including a fast response/recovery (0.02/0.94 s), large deformation (220°), and sufficient bending stability (no detectable degradation after 1200 times). Taking advantage of these benefits, the relative humidity can be converted into a deformation signal of moving object, and it can be further turned into electric signals. Compared with conventional humidity sensors, such the polyimide-based humidity sensor is expected to be used in ambient electrical sensors and relays due to their simple fabrication, rapid response, and high stability. Our strategy of generating and exploiting internal stress in responsive polymers provides a promising platform for humidity actuators.

Application of RapidHIT™ ID for cell authentication by fast and convenient STR profiling.

As cell therapies are injected directly into the body, cell authentication is essential. Short tandem repeat (STR) profiling is used for human identification in forensics as well as for cell authentication. The standard methodology (DNA extraction, quantification, polymerase chain reaction, and capillary electrophoresis) takes at least 6h and requires several instruments to obtain an STR profile. RapidHIT™ ID is a single automated instrument that provides an STR profile in 90 min. In this study, we aimed to propose a method to use RapidHIT™ ID for cell authentication. Four types of cells which are used for cell therapy or in the production process were used. The sensitivity of STR profiling was compared by the cell type and cell count using RapidHIT™ ID. Moreover, the effect of preservation solutions, pre-treatment with cell lysis solution, proteinase K, Flinders Technology Associates (FTA) cards, and dried or wet cotton swabs (with a single cell type or a mixture of two) were examined. The results were compared to those obtained by the standard methodology using genetic analyzer ThermoFisher SeqStudio. We accomplished a high sensitivity through our proposed method that can benefit cytology laboratories. Although the pre-treatment process affected the quality of the STR profile, other variables did not significantly affect STR profiling. As a result of the experiment, RapidHIT™ ID can be used as a faster and simpler instrument for cell authentication.

Synergistic attraction of Western black-legged ticks, Ixodes pacificus, to CO2 and odorant emissions from deer-associated microbes.

Foraging ticks reportedly exploit diverse cues to locate their hosts. Here, we tested the hypothesis that host-seeking Western black-legged ticks, Ixodes pacificus, and black-legged ticks, I. scapularis, respond to microbes dwelling in sebaceous gland secretions of white-tailed deer, Odocoileus virginianus, the ticks' preferred host. Using sterile wet cotton swabs, microbes were collected from the pelage of a sedated deer near forehead, preorbital, tarsal, metatarsal and interdigital glands. Swabs were plated on agar, and isolated microbes were identified by 16S rRNA amplicon sequencing. Of 31 microbial isolates tested in still-air olfactometers, 10 microbes induced positive arrestment responses by ticks, whereas 10 others were deterrent. Of the 10 microbes prompting arrestment by ticks, four microbes-including Bacillus aryabhattai (isolates A4)-also attracted ticks in moving-air Y-tube olfactometers. All four of these microbes emitted carbon dioxide and ammonia as well as volatile blends with overlapping blend constituents. The headspace volatile extract (HVE) of B. aryabhattai (HVE-A4) synergistically enhanced the attraction of I. pacificus to CO2. A synthetic blend of HVE-A4 headspace volatiles in combination with CO2 synergistically attracted more ticks than CO2 alone. Future research should aim to develop a least complex host volatile blend that is attractive to diverse tick taxa.

Effect of swabbing technique and duration on forensic DNA recovery

Various factors have been shown to affect performance of the conventional wet-dry double and single wet swabbing techniques to recover DNA, such as pressure and angle of application, volume and type of wetting agent, and swab type. However, casework laboratories in some jurisdictions have recently adopted different swabbing techniques that include wet-moist double swabbing and moist-dry single swabbing. Factors affecting the effectiveness of these recent techniques in maximising DNA recovery therefore need to be investigated. Here, the performance of traditional and recent swabbing techniques was compared and the impact of swabbing duration on DNA recovery was investigated. Ten µl aliquots of a known concentration of DNA extracted from human blood were deposited on pre-cleaned DNA-free cotton swatches (porous) and porcelain tiles (non-porous). Five swabbing techniques were used, of which three were double swabbing techniques: wet-moist, wet-wet and wet-dry, and two were single swabbing techniques: wet and moist-dry. For a ‘wet’ or ‘moist’ swab, 100 or 50 µL water was added, respectively. For a moist-dry swab, water was applied to one side of the swab, leaving the other side drier. Each swabbing technique was applied for two durations, 15 and 30 s per swab, with 5 reps of each combination (n = 100 plus controls). All samples were extracted and quantified, and a sub-set was profiled. The results showed that the wet-moist double swabbing technique with a swabbing duration of 30 s maximised DNA recovery from cotton. From tile, a single wet or moist-dry swab maximised DNA recovery, but increasing swabbing duration from 15 to 30 s had no impact. These data can be used to inform standardisation of DNA collection protocols across casework laboratories.

Sensitive detection of chronic wasting disease prions recovered from environmentally relevant surfaces.

Chronic wasting disease (CWD) has been identified in 30 states in the United States, four provinces in Canada, and recently emerged in Scandinavia. The association of CWD prions with environmental materials such as soil, plants, and surfaces may enhance the persistence of CWD prion infectivity in the environment exacerbating disease transmission. Identifying and quantifying CWD prions in the environment is significant for prion monitoring and disease transmission control. A systematic method for CWD prion quantification from associated environmental materials, however, does not exist. In this study, we developed an innovative method for extracting prions from swabs and recovering CWD prions swabbed from different types of surfaces including glass, stainless steel, and wood. We found that samples dried on swabs were unfavorable for prion extraction, with the greatest prion recovery from wet swabs. Using this swabbing technique, the recovery of CWD prions dried to glass or stainless steel was approximately 30% in most cases, whereas that from wood was undetectable by conventional prion immunodetection techniques. Real-time quake-induced conversion (RT-QuIC) analysis of these same samples resulted in an increase of the detection limit of CWD prions from stainless steel by 4 orders of magnitude. More importantly, the RT-QuIC detection of CWD prions recovered from stainless steel surfaces using this method was similar to the original CWD prion load applied to the surface. This combined surface swabbing and RT-QuIC detection method provides an ultrasensitive means for prion detection across many settings and applications.

DNA chip-based diagnosis of onychomycosis and tinea pedis.

Onychomycosis (OM) and tinea pedis (TP) are common fungal infections. Currently, diagnosis is based on direct microscopy and culture that have a low to moderate sensitivity and/or require up to 3-4 weeks until results are obtained. PCR techniques have emerged for the diagnosis of fungal infections, but little is known about their sensitivity and specificity in diagnosing. Here, we compared the diagnostic value of a DNA-chip technology, that detects 56 fungal pathogens, in a single-center prospective diagnostic study with microscopy and culture in suspected OM/TP. Microscopy, culture and DNA microarray assays were performed on scraping material from patients with suspected OM (n = 67) or TP (n = 73). To test whether swabs can be used as an alternative for scraping, PCR yields were compared in a further 13 patients with OM and 11 patients with TP. DNA microarrays had the highest sensitivity. Combination of DNA-chip technology with microscopy further increased the sensitivity, and results from this combined laboratory diagnosis can be obtained within 24 hours. Comparison of sampling techniques (scraping, dry or wet swab) for DNA-chip assays showed similar results in suspected OM or TP. DNA-chip technologyshows high sensitivity for OM and TP diagnosis, especially when combined with microscopy.

Extraction of the DNA of Giardia lamblia isolated from vegetables and fruits in a simplified way and its diagnosis using Nested-PCR.

Giardiasis is one of the main diseases transmitted by food contaminated with infectious stages. It was usually spread through freshly eaten food. In this study, this parasite was diagnosed based on microscopic diagnosis of isolated samples of vegetables and fruits, as well as molecular diagnosis. The possibility of isolating parasites from vegetables and fruits and extract DNA to be used in most laboratories were verified in this study .The prevalence of Giardia lamblia were estimated on vegetables and fruits without the need to purchase a special extraction kit. .The prevalence of Giardia on fresh vegetables was estimated by using wet direct swab with Lugol's iodine dye in microscopic examination, at a rate of 4 positive samples out of 230 of all studied species, or 1.7%. DNA extraction was carried out for all samples, and 102 DNA samples were extracted from all samples, with a percentage of 44.3%. Moreover, the shown results of the nested PCR test for the 16S rRNA gene on the obtained DNA the prevalence of Giardia lamblia at a rate of 5.9% from DNA samples isolated from vegetables and fruits.

Detection of Antimicrobial Resistance, Pathogenicity, and Virulence Potentials of Non-Typhoidal Salmonella Isolates at the Yaounde Abattoir Using Whole-Genome Sequencing Technique.

One of the crucial public health problems today is the emerging and re-emerging of multidrug-resistant (MDR) bacteria coupled with a decline in the development of new antimicrobials. Non-typhoidal Salmonella (NTS) is classified among the MDR pathogens of international concern. To predict their MDR potentials, 23 assembled genomes of NTS from live cattle (n = 1), beef carcass (n = 19), butchers’ hands (n = 1) and beef processing environments (n = 2) isolated from 830 wet swabs at the Yaounde abattoir between December 2014 and November 2015 were explored using whole-genome sequencing. Phenotypically, while 22% (n = 5) of Salmonella isolates were streptomycin-resistant, 13% (n = 3) were MDR. Genotypically, all the Salmonella isolates possessed high MDR potentials against several classes of antibiotics including critically important drugs (carbapenems, third-generation cephalosporin and fluoroquinolone). Moreover, >31% of NTS exhibited resistance potentials to polymyxin, considered as the last resort drug. Additionally, ≤80% of isolates harbored “silent resistant genes” as a potential reservoir of drug resistance. Our isolates showed a high degree of pathogenicity and possessed key virulence factors to establish infection even in humans. Whole-genome sequencing unveiled both broader antimicrobial resistance (AMR) profiles and inference of pathogen characteristics. This study calls for the prudent use of antibiotics and constant monitoring of AMR of NTS.

A novel swab storage gel is superior to dry swab DNA collection, and enables long-range high resolution next generation sequencing HLA typing from buccal cell samples.

HLA sequence-based DNA typing (SBT) by long-range PCR amplification (LR PCR) and next-generation sequencing (NGS) is a high-throughput DNA sequencing method (LR-NGS-SBT) for the efficient and sensitive detection of novel and null HLA alleles to the field-4 level of allelic resolution without phase ambiguity. However, the accuracy and reliability of the HLA typing results using buccal cells (BCs) and saliva as genetic source materials for the LR-NGS-SBT method are dependent largely on the quality of the extracted genomic DNA (gDNA) because a large degree of gDNA fragmentation can result in insufficient PCR amplification with the incorrect assignment of HLA alleles because of allele dropouts. In this study, we developed a new cost-efficient swab storage gel (SSG) for wet swab collection of BCs (BC-SSG) and evaluated its usefulness by performing different DNA analytical parameters including LR-NGS-SBT to compare the quality and quantity of gDNA extracted from BCs (in SSG or air dried), blood and saliva of 30 subjects. The BC-SSG samples after 5 days of storage revealed qualitative and quantitative DNA values equivalent to that of blood and/or saliva and better than swabs that were only air-dried (BC-nSSG). Moreover, all the gDNA extracted from blood, saliva and BC-SSG samples were HLA-typed successfully to an equivalent total of 408 alleles for each sample type. Therefore, the application of BC-SSG collection media for LR-NGS-SBT has benefits over BC dried samples (dry swabs) such as reducing retesting and the number of untestable BC samples because of insufficient DNA amplification.

Effects of a spray-based oropharyngeal moisturising programme for patients following endotracheal extubation after cardiac surgery: A randomised, controlled three-arm trial

BackgroundWhen a patient emerges from cardiac surgery, they may experience intense thirst and discomfort or even impaired swallowing after endotracheal extubation. This may lead to feelings of suffocation, desperation, fear, and anxiety. Although thirst relief and dysphagia prevention share similar mechanisms, there is limited evidence for a combined intervention to alleviate thirst and prevent dysphagia. Furthermore, no studies to date have targeted postoperative cardiac patients. ObjectiveTo evaluate the safety, feasibility, and effects of a spray-based oropharyngeal moisturising programme for cardiac surgery patients following endotracheal extubation. DesignA randomised, controlled three-arm trial was conducted from October 2017 to December 2019. SettingTertiary medical centre cardiac care unit. ParticipantsParticipants (N = 145) were patients who underwent cardiac surgery and received mechanical ventilation. MethodsParticipants were randomly assigned to one of three groups: a four-part programme offering spray-based therapy with either a constant low-temperature cold spray (programme A; n = 47) or low-to-normal temperature spray (programme B; n = 49), or those that received usual care (control group; n = 49). Control group patients who complained of thirst were given wet cotton swabs to moisten their mouths. The primary outcomes included discomfort and various levels of thirst intensity; secondary outcomes included dysphagia and adverse events. Outcomes were evaluated at Time 0 (baseline), Time 1 (3 h), Time 2 (6 h) and Time 3 (96 h) post intervention. Repeated-measures analyses was performed using generalised estimating equations. ResultsThe baseline evaluation indicated no significant differences between the groups. Participants (average age: 55 years; 53.8% men) underwent cardiac surgery for; valvular heart disease (64.8%), coronary atherosclerotic heart disease (25.5%), or aortic dissection (9.7%). Baseline scores indicated moderately severe thirst (6.24±1.57) and discomfort (9.88±2.23). Post intervention, the thirst intensity in the intervention groups was significantly lower than that of the control group (p<0.001). The generalised estimating equation analysis showed no significant difference in reduced thirst intensity between programmes A and B (adjusted β=0.08, 95% CI: −0.59–0.76, p = 0.810) when controlling for intervention condition and time. Comparable results were found for reduced thirst discomfort (adjusted β=0.36, 95% CI: −0.66–1.38, p = 0.493). The three groups showed no significant differences for dysphagia frequency. No observable adverse events were reported during the intervention period. ConclusionsA spray-based oropharyngeal moisturising programme is a practical and effective intervention to alleviate patient thirst after cardiac surgery and tracheal intubation that could be integrated into comfort care for post-surgical patients’ critical care management.Tweetable abstract: A spray-based oropharyngeal moisturising programme for cardiac surgery recipients following endotracheal extubation may alleviate thirst.