Browsing by Subject "sterility"

Now showing 1 - 3 of 3
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    Decision Making in Fertility Preservation Prior to Pursuing Curative Treatments for Sickle Cell Disease
    (2023-03-24) Collins, Angela J.; Noel, Josey; Abraham, Olivia; Hornberger, Sydney; Rahim, Mahvish Q.; Jacob, Seethal A.; Saraf, Amanda J.
    AUTHORS: Angela Collins, MPH(1), Josey Noel(1), Olivia Abraham(1), Sydney Hornberger(1), Mahvish Rahim MD, MBA, MSCR(1,2), Seethal Jacob MD, MS, FAAP(1,2), Amanda Saraf DO(1,2). AFFILIATIONS: (1) Indiana University School of Medicine, Indianapolis, IN. (2) Department of Pediatrics, Riley Hospital for Children, Indianapolis, IN. ABSTRACT: RELEVANT BACKGROUND: Sickle cell disease (SCD) is one of the most commonly inherited hemoglobinopathies, often well controlled on Hydroxyurea (HU). Curative therapy options exist with stem cell transplant (SCT) and gene therapy. While both the underlying condition and routine therapy such as HU is thought to impact fertility, the chemotherapy used for both SCT and gene therapy can result in permanent sterility. Infertility can have a negative impact on long-term measures of quality of life. As a result, fertility preservation ought to be offered to all patients with SCD planning for curative treatment. Ovarian tissue cryopreservation and mature oocyte or embryo cryopreservation are fertility preservation options available for pre and postpubescent females respectively. Testicular tissue cryopreservation (TTC) is an experimental option for prepubescent males and sperm cryopreservation is utilized for postpubescent males. CASE DESCRIPTION: We present three cases of patients with SCD who pursued fertility preservation prior to receiving curative therapy with a myeloablative preparative regimen. Patient 1 is a prepubescent 8-year-old male with SCD controlled with HU who opted for TTC as fertility preservation prior to receiving a matched sibling SCT. Patient 2 is a 13-year-old male with SCD controlled with HU who opted for TTC following a failed sperm banking attempt prior to haploidentical SCT. Patient 3 is an 18-year-old female with SCD controlled with HU and Voxelator who opted to have eggs harvested prior to gene therapy. CLINICAL SIGNIFICANCE: As highlighted by these cases, continued research on safe and effective fertility preservation as well as counseling about both the impact of the underlying disease on fertility and treatment-related fertility risks is imperative to improve long-term quality of life measures. CONCLUSION: These patients demonstrate a need for further emphasis on fertility risk counseling in this patient population and ensuring that discussions regarding preservation options is standard of practice at every institution.
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    Sterility of Intravenous Catheterization Tubing: Is it Safe to Remove the Sterile Cap for an Extended Period of Time?
    (Office of the Vice Chancellor for Research, 2014-04-11) Nilles, Paige
    This research shows if removing the sterile cap from the intravenous catheterization tubing (following the injection of a saline solution) affects the sterility of the tubing after being exposed to the environment of a nuclear medicine department for up to four hours before use. A total of thirty intravenous catheterization tubes were primed with a saline solution, sterile cap removed, and set on an IV start tray at a local hospital in the nuclear medicine department. The tubes were left exposed to the environment for a total of four hours. The environment included the movement of patients and technologists walking by for various reasons. The end of the tubes where the sterile cap was removed were swabbed using a sterile nasal swab moistened with sterile water at time 0hr, 2hr, and 4hr and wiped on a sheep’s blood agar plate. A different swab was used each time. After 48 hours of incubation at 37 degrees Celsius the samples were evaluated for pathogenic growth, non-pathogenic growth and no growth. None of the samples had any pathogenic growth. 17 out of 90 (18%) samples had non-pathogenic growth; 73 had no growth. Growth was most frequently observed at 0mins. Leaving the sterile cap off of the intravenous catheterization tubing (after injecting it with saline solution) for an extended period of time (four hours) led to no pathogenic growth. Since there were non-pathogenic growths on 17 of the agar plates, the possibility of pathogenic growth is still there.
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    Touching an Aseptic Injection Site Prior to Intravenous Administration: Can microorganisms be introduced to the aseptic area?
    (Office of the Vice Chancellor for Research, 2014-04-11) Ruth, Tina L
    Touching an aseptic injection site to relocate a vein is a common practice when preparing for intravenous catheterization. The purpose of this research was to determine if touching an aseptic injection site prior to intravenous administration with the use of non-sterile gloves could introduce microorganisms. Methods Two different sampling techniques were evaluated. Technique 1 samples were taken from a technologist who donned a pair of non-sterile latex free gloves prior to preparing the materials used for injection and vein palpation. Technique 2 samples were taken from a technologist who donned a pair of non-sterile latex free gloves after preparing the materials used for injection and vein palpation. In both techniques, the injection site was made aseptic with an isopropyl alcohol prep pad. Asepsis was maintained by not touching the injection site to relocate the vein. The procedure was stopped just before the technologist would touch the aseptic site for vein relocation. The gloved tips of digits two, three, and four of the right and left hands were used to inoculate a blood agar petri dish. The petri dishes were incubated for 48 hours at 37° Celsius. A method blank (control) was collected for each sample set collected from Technique 1 and Technique 2. A total of twenty samples were collected, ten from each technique. Results The method blanks and samples both showed observable growth of microorganisms (potential for contamination). 14% (1 out of 7) of the method blanks showed growth. 80% (8 out of 10) of both the right and left hand samples using Technique 1 showed growth. 90% (9 out of 10) of the right hand samples of Technique 2 showed growth, and 60% (6 out of 10) of the left hand samples showed growth. Conclusion Microorganisms could be introduced to the aseptic injection site with commonly used injection techniques.