Acute myeloid leukemia (AML) is a rare and aggressive malignancy that can present with a broad range of clinical manifestations. Central nervous system (CNS) involvement is rarely documented and may alter the treatment course and overall prognosis. Although several etiologies have been suggested, the exact mechanism of CNS involvement remains unclear. Furthermore, little is known about the impact of surgical stress on the development of AML. Surgeons should be aware of this potential outcome following surgery, particularly if a leukemoid reaction develops post-operatively, as early detection can prevent delays in appropriate treatment. Further data are needed to better understand the pathogenesis and underlying inflammatory cascades following surgical trauma that possibly contribute to the development of AML.
Thermal spread is an unavoidable side-effect of electrocautery, however limiting it is important for minimizing damage to surrounding tissues. LigaSure 5 mm Blunt Tip has been in use since 2009 while Voyant 5 mm Fusion has only been FDA approved since 2018. Our hospital, a rural academic tertiary care center, recently moved to purchasing Voyant because of cost concerns. We aimed to compare the thermal spread of the two tools on raw pork meat at two different cut depths and on both right and left sides. The LigaSure device had significantly less thermal spread than Voyant across all measurements. Based on our data, the LigaSure device should be chosen for use despite the increased cost.
Thermal spread is an unavoidable side-effect of electrocautery, however limiting it is important for minimizing damage to surrounding tissues. LigaSure 5 mm Blunt Tip has been in use since 2009 while Voyant 5 mm Fusion has only been FDA approved since 2018. Our hospital, a rural academic tertiary care center, recently moved to purchasing Voyant because of cost concerns. We aimed to compare the thermal spread of the two tools on raw pork meat at two different cut depths and on both right and left sides. The LigaSure device had significantly less thermal spread than Voyant across all measurements. Based on our data, the LigaSure device should be chosen for use despite the increased cost.
Background: It is well established that stethoscopes harbor pathogenic bacteria species. Within hospital settings, these pathogens can be rapidly transmitted from room to room and can cause harm in vulnerable populations. The current literature demonstrates that disinfecting stethoscopes with isopropanol kills 99% of all bacteria. However, in practice this rarely occurs and disinfection is subject to user error. We assessed the efficacy of ultraviolet germicidal irradiation (UV-C) at decontaminating stethoscopes used at our rural healthcare system along with the cleaning habits of their users. Methods: Stethoscopes were randomly selected from the clinical staff of our hospital’s largest nursing unit. The stethoscopes were each swabbed for culture then exposed to UV-C for 20 seconds and sampled again. Users were asked to complete a survey during this process. Samples were then cultivated on tryptone soya broth (TSB) agar, and all growth was sent for identification via matrix-assisted laser desorption/ionization (MALDI-TOF). Later, the protocol was repeated to assess cleaning efficacy of the isopropanol wipes commonly used in our hospital. We collected pre- and postintervention samples after cleaning vigorously for 3 minutes according to the manufacturer’s guidelines. The samples were classified as follows: “cleaner” if the number of colonies decreased after sanitation, “sterilized” if the number of colonies decreased to zero, “no change” if the number of colonies stayed the same, and “no assessment” if there was no preintervention growth. Several samples “increased” in CFU count after the intervention, likely due to incomplete sampling, contamination, or incomplete penetration of UV-C. The Fisher exact test was used to analyze the effectiveness of the stethoscope sanitation techniques. Results: In total, 60 samples (33 used for analysis) were obtained from stethoscopes cleaned with UV-C (Fig. 1). Moreover, 34 samples (28 used for analysis) were obtained from stethoscopes cleaned with isopropanol (Fig. 2). Both UV-C (93.9% vs 6.1%; P < .01) and isopropanol (100% vs 0%; P < .01) resulted in a significant decrease in bacterial colonization on stethoscopes. UV-C was not more effective at sanitizing stethoscopes than isopropanol (93.9% vs 100%; P = .50). Conclusions: Both UV-C and isopropanol were effective at cleaning hospital stethoscopes. Given that UV-C is not subject to user error and that it takes less time to clean a stethoscope than isopropanol, it may be the superior option in a clinical setting.Funding: NoneDisclosures: None
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