The role of gel application in decreasing pain during speculum examination and its effects on papanicolaou smear results

PURPOSE

This study aimed to investigate the effects of water-based gel application in reducing pain or discomfort associated with speculum examination, and compared the presence of unsatisfactory Papanicolaou smear results between gel-applied and control groups.

METHODS

In this prospective randomized controlled study, a total of 1,580 patients were analyzed. The subjects were randomized to a gel group and a control group. For the collection of the smear sample, water-based gel was used in the gel group and dry speculum was used in the control group. All patients were asked to score their pain on a numeric pain scale at two time points during the procedure (insertion and opening phase of speculum). Cytopathologists who analyzed the smear cytology were blinded to the study. Pain intensity during speculum examination, as well as unsatisfactory smear results, were analyzed between the groups.

RESULTS

The pain scores obtained at two different time points of speculum application were significantly lower in the gel group compared to the control group both in premenopausal and postmenopausal women (p < 0.001). The ratios of unsatisfactory cytopathologic examination results were 1.13 and 1.39% for the gel-applied and control groups, which were not significantly different.

CONCLUSION

Lubrication of the outer superior and inferior blade of the plastic vaginal speculum with a small amount of a water-soluble lubricant gel decreases the pain associated with insertion and opening of the vaginal speculum in both premenopausal and postmenopausal women without affecting the quality of the cytology results during the collection of Papanicolaou test specimens.

Thermo-chemical extraction of fuel oil from waste lubricating grease

This study investigated the recovery of oil from waste grease through the process of thermal degradation in an aqueous solution of potassium hydroxide (KOH) followed by solvent extraction. Waste high temperature metal bearing grease was dissolved in a 15 w/w% KOH solution at 80°C while being agitated at 2000 rpm using a shear action agitator for a period of 15 min. Two distinct layers were observed after 8 min of settling time. The top layer being of dark brown oil and the bottom layer was a heterogeneous mixture. The two layers were separated by decantation. The bottom layer was cooled down to 45°C followed by slow addition of toluene (C7H8) while agitating at 1200 rpm for 15 min to prevent solids settling and minimise rapid volatilisation of the organic compounds in the mixture. Two distinct layers were also formed, the top homogeneous mixture of light brown oil-toluene mixture and the bottom sludge layer. The solvent was recovered from the oil for re-use by fractional distillation of the homogenous mixture. It was observed that 15 w/w% potassium hydroxide solution can chemically degrade the soap matrix in the grease and extract up to 49 w/w% of the fuel oil when subjected to high shear stress at a temperature of 80°C. The 26 w/w% extraction of oil in the remaining sludge was obtained by solvent extraction process with mass ratios of sludge to solvent of 2:1. Solvent recovery of 88% by mass was obtained via fractional distillation method. The combined extraction processes brought an overall oil yield of 75 w/w% from the waste grease. The fuel oil obtained from this process has similar properties to paraffin oil and can be blended with other oils as an alternative energy source.

[Hospital outbreak of urinary tract infections by lubricant gel contaminated with Burkholderia cepacia]

BACKGROUND

Burkholderia cepacia (B. cepacia) has been the causal agent of infectious hospital outbreaks.

METHODS

a case-controls study was conducted to describe an outbreak of urinary tract infection associated to lubricant-gel contaminated with B. cepacia. Patients who developed UTIsc were included in this study. Their clinical data, urine cultures, antiobiograms and the molecular bacterial analysis were analyzed.

RESULTS

the urine culture was positive in 101 (55.8 %); the bacterial strains isolated were: B. cepacia 30.7 %, Escherichia coli 22.7 %, Enterococcus faecalis 9.9 %, Enterococcus spp. 8.9 %. They were 31 patients with B. cepacia isolation that was taken as the cases group and 63 with UTIsc due to another organism as control group. The Charlson comorbidity index was 5.3 ± 1.8 for cases and 4.5 ± 1.2 for controls. The factors associated with death were: heart disease, diabetes, pneumonia, bacteremia and UTIsc B. cepacia.

CONCLUSIONS

the lubricant gel used for urinary catheter placement originated the outbreak. Heart disease, pneumonia, bacteremia and UTIsc B. cepacia were related to patients' death.

Management of vaginal dryness and dyspareunia in estrogen sensitive cancer patients

Cancer patients suffer from vaginal dryness and dyspareunia earlier and longer than the general population, with more severe and distressing symptoms. Life-style advices are the first step and vaginal lubricants can be tried, but they can't completely relieve atrophic symptoms. The most effective therapy is use of vaginal estrogens, but compliance and management are particularly difficult in estrogen sensitive cancer patients because of their systemic absorption. Compliance can be improved if they are begun at a very low dose and gradually increased until the lowest effective dose is reached. Promestriene only possesses an intramucosal effect, it can be used at very low doses in cancer patients suffering from urogenital symptoms.

A call to action for comprehensive HIV services for men who have sex with men

Where surveillance has been done, it has shown that men (MSM) who have sex with men bear a disproportionate burden of HIV. Yet they continue to be excluded, sometimes systematically, from HIV services because of stigma, discrimination, and criminalisation. This situation must change if global control of the HIV epidemic is to be achieved. On both public health and human rights grounds, expansion of HIV prevention, treatment, and care to MSM is an urgent imperative. Effective combination prevention and treatment approaches are feasible, and culturally competent care can be developed, even in rights-challenged environments. Condom and lubricant access for MSM globally is highly cost effective. Antiretroviral-based prevention, and antiretroviral access for MSM globally, would also be cost effective, but would probably require substantial reductions in drug costs in high-income countries to be feasible. To address HIV in MSM will take continued research, political will, structural reform, community engagement, and strategic planning and programming, but it can and must be done.

Analysis of hazardous organic residues from sodium hydrosulfite industry and utilization as raw materials in a novel solid lubricant production

The hazardous organic residual wastes produced by the sodium hydrosulfite industry are demonstrated to be convertible into a novel solid lubricant. Identification and isolation of the organic residues are achieved by Fourier transform infrared (FTIR) spectroscopy, gas chromatography-mass spectrometry (GC-MS), and nuclear magnetic resonance (NMR). FTIR and GC-MS provide important information about the residues and the two main components obtained by column chromatography are further analyzed by NMR. The main organic residues are found to be thiodiglycol and 2,2'-dithiodiethanol which have potential applications in petroleum drilling because of their S-S and/or C-S functional groups. The lubricity of the organic residues is subsequently studied and the influence of different adsorbents on the lubricity is investigated and discussed. This homemade lubricant is observed to have good lubricity and by increasing the concentration of the commercial solid lubricant M, the lubricity diminishes. The process is expected to not only have commercial impact but also help to reduce environmental pollution.

The properties and applications of nanodiamonds

Nanodiamonds have excellent mechanical and optical properties, high surface areas and tunable surface structures. They are also non-toxic, which makes them well suited to biomedical applications. Here we review the synthesis, structure, properties, surface chemistry and phase transformations of individual nanodiamonds and clusters of nanodiamonds. In particular we discuss the rational control of the mechanical, chemical, electronic and optical properties of nanodiamonds through surface doping, interior doping and the introduction of functional groups. These little gems have a wide range of potential applications in tribology, drug delivery, bioimaging and tissue engineering, and also as protein mimics and a filler material for nanocomposites.

Effect of aerosol surface lubricants on the abundance and richness of selected forest insects captured in multiple-funnel and panel traps

Survey and detection programs for native and exotic forest insects frequently rely on traps baited with odorants, which mediate the orientation of target taxa (e.g., the southern pine beetle, Dendroctonusfrontalis Zimmermann) toward a resource (e.g., host material, mates). The influence of trap design on the capture efficiency of baited traps has received far less empirical attention than odorants, despite concerns that intercept traps currently used operationally have poor capture efficiencies for some target taxa (e.g., large woodborers). Several studies have recently demonstrated that treating traps with a surface lubricant to make them "slippery" can increase their capture efficiency; however, previously tested products can be expensive and their application time-consuming. The purpose of this study was to evaluate the effect of alternate, easier to apply aerosol lubricants on trap capture efficiency of selected forest insects. Aerosol formulations of Teflon and silicone lubricants increased both panel and multiple-funnel trap capture efficiencies. Multiple-funnel traps treated with either aerosol lubricant captured significantly more Monochamus spp. and Acanthocinus obsoletus (Olivier) than untreated traps. Similarly, treated panel traps captured significantly more Xylotrechus sagittatus (Germar), Ips calligraphus (Germar), Pissodes nemorensis (Germar), Monochamus spp., A. obsoletus, Thanasimus dubius (F.), and Ibalia leucospoides (Hochenwarth) than untreated traps. This study demonstrates that treating multiple-funnel and panel traps with an aerosol dry film lubricant can increase their capture efficiencies for large woodborers (e.g., Cerambycidae) as well as bark beetles, a weevil, a woodwasp parasitoid and a bark beetle natural enemy (Coleoptera: Cleridae).

Evaluation and selection of regeneration of waste lubricating oil technology

Lubricant is one of the important resources that cannot be disposed of randomly due to the presence of pollutants. In response to economic efficiency and environmental protection, there is a growing trend of regeneration and reuse of waste lubricant. However, the technologies shall be compared to provide a useful reference for the use of waste lubricant. The major aim of this paper is to use analytic hierarchy process to select, analyze, and compare the regenerative technologies, thus laying a basis for the governmental bodies in policy making of lubricant recovery as well as for industrial operators in deciding the recovery methods.

The Use of Laminar Lubricants in Compaction Processes

A punch penetration shear test has been used to support the theory of orientation of layers within the crystal lattice as the lubricating mechanism of laminar solids. Under high applied loads, this orientation is prevented, thereby causing a high value of the shear strength. The increased shear strength is manifest in an increased coefficient of friction under high loads, as found experimentally in the die pressing of solid plugs of talc and graphite. The use of these solids as lubricants in compaction processes cannot be justified at high constraining loads, where the relative density of the compact is high.

Orally disintegrating mini-tablets (ODMTs)--a novel solid oral dosage form for paediatric use

The new European regulations on paediatric medicines and recent WHO recommendations have induced an increased need for research into novel child-appropriate dosage forms. The aim of this study was the development of orally disintegrating mini-tablets (ODMTs) as a suitable dosage form for paediatric patients. The suitability of five commercially available ready-to-use tableting excipients, Ludiflash, Parteck ODT, Pearlitol Flash, Pharmaburst 500 and Prosolv ODT, to be directly compressed into mini-tablets, with 2 mm in diameter, was examined. All of the excipients are based on co-processed mannitol. Drug-free ODMTs and ODMTs with a child-appropriate dose of hydrochlorothiazide were investigated. ODMTs could be produced with all investigated excipients. ODMTs with a sufficient crushing strength >7 N and a low friability <1% could be obtained, as well as ODMTs with a short simulated wetting test-time <5 s. ODMTs made of Ludiflash showed the best results with crushing strengths from 7.8 N up to 11.8 N and excellent simulated wetting test-times from 3.1 s to 5.0 s. For each excipient, ODMTs with accordance to the pharmacopoeial specification content uniformity could be obtained. The promising results indicate that orally disintegrating mini-tablets may serve as a novel platform technology for paediatrics in future.

Treatment options for female sexual arousal disorder: part II

Female sexual arousal disorder (FSAD) occurs when a woman experiences distress due to the inability to attain or maintain adequate vaginal lubrication. Many treatments are still under investigation, and at this time, there are no FDA-approved medications available for the treatment of FSAD. Treatment options include "off-label" medications, vaginal estrogen, compounded preparations, and over-the-counter products.

Effects of lubricants on binary direct compression mixtures

The objective of this study was to investigate the effects of conventional lubricants including a new candidate lubricant on binary direct compression mixtures. Magnesium stearate (MGST), stearic acid (STAC), glyceryl behenate (COMP) and hexagonal boron nitride (HBN) were tested. The binary mixtures were 1:1 combinations of spray dried lactose (FlowLac 100), dicalcium phosphate dihydrate (Emcompress), and modified starch (Starch 1500) with microcrystalline cellulose (Avicel PH 102). Tablets were manufactured on a single-station instrumented tablet press with and without lubricants. In the case of unlubricated granules, the modified starch-microcrystalline cellulose mixture provided the highest percent compressibility value at 8.25%, spray dried lactose-microcrystalline cellulose mixture was 7.33%, and the dialcium phosphate dihydrate-microcrystalline cellulose mixture was 5.79%. Their corresponding tablet crushing strength values were: 104 N, 117 N, and 61 N, respectively. The lubricant concentrations studied were 0.5, 1, 2, and 4%. Effects of lubricant type and lubricant concentration on crushing strength were analyzed using a factorial ANOVA model. It was found that the Avicel PH 102-Starch 1500 mixture showed the highest lubricant sensitivity (110 N vs. 9 N), the least affected formulation was FlowLac-Avicel PH 102 mixture (118 N vs. 62 N). The crushing strength vs. concentration curve for MGST showed a typical biphasic profile, a fast drop up to 1% and a slower decline between 1 and 4%. The STAC, COMP, and HBN for all formulations showed a shallow linear decline of tablet crushing strength with increasing lubricant concentration. The HBN was as effective as MGST as a lubricant, and did not show a significant negative effect on the crushing strength of the tablets. The COMP and STAC also did not interfere with the crushing strength, however, they were not as effective lubricants as MGST or HBN.

Electrokinetic remediation of contaminated soil with waste-lubricant oils and zinc

The feasibility of electrokinetic technology on the remediation of mixed-waste-contaminated railroad soil, contaminated by lubricant oil and zinc, was investigated. To enhance the removal efficiency, catholyte purging with 0.1M HNO(3) and a supply of non-ionic surfactant, secondary alcohol ethoxylate, was applied to the anode to remove Zn and to solubilize the lubricant oil. The catholyte purging maintained the soil pH as acidic and enhanced desorption of zinc from the soil, where the zeta potential of the acidic soil became positive. Thereafter, the direction of electro-osmotic flow was changed from the cathode to anode and the flow rate was reduced. The lesser in magnitude reverse electro-osmotic flow inhibited the migration of zinc and the lubricant oil was removed by the electro-osmotic flow. The removal of zinc and lubricant oil was enhanced with an increase in voltage gradient; however, a higher voltage gradient resulted in higher energy expenditure. After electrokinetic operation over 17 days, the removal efficiency of zinc was 22.1-24.3%, and that of lubricant oil was 45.1-55.0%. Although the removal of lubricant oil was quite high, the residual concentration did not meet Korean regulation levels.

Sexual risk reduction among Zambian couples

Zambia has over 1 million HIV infections nationwide and an urban prevalence rate of 23%. This study compared the impact of male involvement in multiple and single session risk reduction interventions among inconsistent condom users in Zambia and the role of serostatus among HIV-seropositive and serodiscordant couples. Couples (N=392) were randomised into intervention arms. Among inconsistent condom users at baseline (N=83), condom use increased in both conditions and this increase was maintained over a 12- month period. At 12 months, seronegative men in the multiple session condition increased sexual barrier (male and female condoms) use in comparison with those in the single session condition (F=16.13, =0.001) while seropositive individuals increased sexual barrier use regardless of condition. Results illustrate the importance of both single and multiple session risk reduction counseling among seronegative men in serodiscordant couples in Zambia, and highlight the differing perception of risk between seropositive and serodiscordant persons.

A simple atomic force microscopy calibration method for direct measurement of surface energy on nanostructured surfaces covered with molecularly thin liquid films

A simple calibration method is described for the determination of surface energy by atomic force microscopy (AFM) pull-off force measurements on nanostructured surfaces covered with molecularly thin liquid films. The method is based on correlating pull-off forces measured in arbitrary units on a nanostructured surface with pull-off forces measured on macroscopically smooth dip-coated gauge surfaces with known surface energy. The method avoids the need for complex calibration of the AFM cantilever stiffness and the determination of the radius of curvature of the AFM tip. Both of the latter measurements are associated with indirect and less accurate measurements of surface energy based on various contact mechanics adhesion models.

Acceptability and use of sexual barrier products and lubricants among HIV-seropositive Zambian men

This study assessed the acceptability and preference for sexual barrier and lubricant products among men in Zambia following trial and long-term use. It also examined the role of men's preferences as facilitators or impediments to product use for HIV transmission reduction within the Zambian context. HIV-seropositive and -serodiscordant couples were recruited from HIV voluntary counseling and testing centers in Lusaka between 2003 and 2006; 66% of those approached agreed to participate. HIV seropositive male participants participated in a product exposure group intervention (n = 155). Participants were provided with male and female condoms and vaginal lubricants (Astroglide [BioFilm, Inc., Vista, CA] & KY gels [Johnson & Johnson, Langhorne, PA], Lubrin suppositories [Kendwood Therapuetics, Fairfield, NJ]) over three sessions; assessments were conducted at baseline, monthly over 6 months and at 12 months. At baseline, the majority of men reported no previous exposure to lubricant products or female condoms and high (79%) levels of consistent male condom use in the last 7 days. Female condom use increased during the intervention, and male condom use increased at 6 months and was maintained over 12 months. The basis for decisions regarding lubricant use following product exposure was most influenced by a preference for communicating with partners; participant preference for lubricant products was distributed between all three products. Results illustrate the importance of development of a variety of products for prevention of HIV transmission and of inclusion of male partners in interventions to increase sexual barrier product use to facilitate barrier acceptability and use in Zambia.

Effects of a zeolite-selective catalytic reduction system on comprehensive emissions from a heavy-duty diesel engine

The effects of a zeolite urea-selective catalytic reduction (SCR) aftertreatment system on a comprehensive spectrum of chemical species from diesel engine emissions were investigated in this study. Representative samples were collected with a newly developed source dilution sampling system after an aging process designed to simulate atmospheric dilution and cooling conditions. Samples were analyzed with established procedures and compared between the measurements taken from a baseline heavy-duty diesel engine and also from the same engine equipped with the exhaust aftertreatment system. The results have shown significant reductions for nitrogen oxides (NOx), carbon monoxide, total hydrocarbons, polycyclic aromatic hydrocarbons (PAHs), and organic carbon (OC) emissions. Additionally, less significant yet notable reductions were observed for particulate matter mass and metals emissions. Furthermore, the production of new species was not observed with the addition of the zeolite urea-SCR system joined with a downstream oxidation catalyst.

A study of the properties of tablets made of directly compressible maltose

The paper deals with the study of the strength and disintegration time of tablets made of directly compressible maltose Advantose 100. It studies the differences of the effects of two types of lubricants, magnesium stearate and sodium stearylfumarate, on the above-mentioned properties, and it also tests the mixtures of the substance with microcrystalline cellulose Vivapur 102 in a ratio of 1:1 and with ascorbic and acetylsalicylic acids. The compacts are obtained by using three compression forces, excepting mixtures with active ingredients, where one compression force is used. In the compression forces of 6 and 8 kN, no statistically significant difference was found in the intervention of the lubricants into the strength of the compacts made of Advantose 100, only in the compression force of 10 kN Pruv decreased the strength more than stearate. The mixture of Advantose 100 and Vivapur 102 yielded the strongest tablets, an addition of Pruv to it decreased the strength of compacts more than stearate. The periods of disintegration time of Advantose compacts as well as those of the mixture of dry binders were longer with an addition of Pruv. The compacts with acetylsalicylic acid possessed higher strength and a longer period of disintegration than those with ascorbic acid. There was no statistically significant difference within the type of the lubricant employed, both in the case of Advantose 100 and its mixture with Vivapur 102, between the values of strength of the compacts with acetylsalicylic acid.