THE COMPOSITION OF SURGICAL SMOKE AND AEROSOL The generation of surgical smoke by electrocautery and laser systems occur from the thermal action on the tissue and even though the energy source can differ the qualities of the smoke produced by these two methods are very similar (Alp et al., 2006). When a “hot” tool, such as a laser or electrosurgery device, is used to vaporize, cut, ablate, excise, or coagulate tissue surgical smoke is produced.(Baggish et al., 1988) This smoke contains three primary components. The first is particulate matter which consists of the carbonised tissue, blood, and potentially infectious viruses and bacteria. The second is steam, this accounts for 95% of the smoke. The third component is the various toxins or potentially hazardous chemicals, these can include irritant, carcinogenic and neurotoxic compounds (Al Sahaf et al., 2007) Studies carried out by (Ott, 1993) identified the following toxic chemical by products in surgical smoke: acrolein, isobutene, acetonitrile, methane, acrylonitrile, phenol, acetylene, polycyclic aromatic hydrocarbons, alkyl benzenes, propene, benzene, propylene, butadiene, pyridine, butane, pyrrole, carbon monoxide, styrene, creosols, toluene, ethane, xylene, ethylene, formaldehyde, free radicals and hydrogen cyanide. Al Sahaf et al. (2006) concurred with these findings and found that the smoke created with laser and electrocautery contains mainly hydrocarbons, nitriles, fatty acids and phenols. Of these they found formaldehyde, acrolein, mixtures of benzene, toluene, ethylbenzene, xylene and polyaromatic hydrocarbons to be of most concern. The presence of chemical toxins may result in pulmonary irritation and inflammation of the respiratory tract (Wenig et al., 1993) In ... ... middle of paper ... ... and colleagues concurred with the earlier findings of Garden et al. They identified human papilloma virus in the plume generated during loop electrosurgical procedure of the cervix. However, it remains unknown whether this DNA is in a viable form or not and this study recommended that future studies should focus on assessing the viability of the cells and the DNA in the plume generated by LEEP and also advocated the long term follow up of gynaecological surgeons involved with LEEP to help establish the consequences of exposure to this plume. However, in view of the presence of DNA in the plume they felt it would prudent to use smoke evacuation during these procedures (Sood et al. 1994). Sawchuck et al. 1989 also determined that viral DNA was present in the smoke produced when treating infectious papillomavirus. However they did not determine if it was infectious.
Type 1 diabetes mellitus is an autoimmune disease that results in insulin dependence due to failure of secretion of the hormone insulin by beta cells in the pancreas. Type 1 diabetes usually manifests in childhood, < 20 years of age – the reason for which it was formerly termed juvenile diabetes, and is more prevalent in Caucasians then in any other ethnicity (Diabetes Basics, n.d.). The key to proper management is early detection, patient education, and most importantly patient compliance. The patient
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The triple screen finds abnormalities caused by aneuploidy by testing for human chorionic gonadotropin, unconjugated estriol and alpha-fetoprotein, three chemicals found in the maternal serum. The quadruple screen tests for the same chemicals with the addition of inhibin A (Farrell). These tests are examples of maternal serum alpha-fetoprotein screening that can be done on “all pregnant women, regardless of their risk of having a baby with Down syndrome or neural tube defects, serious malformations
physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit. Pt. is able to do all his ADL's with limited assistance. He wants to get better and leave the HSP. Pt. Stated' 90 days is to long to be