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USE OF SALINE-ENHANCED radiofrequency (RF) technology reduces blood loss in infants under-going liver resection. Radiofrequency systems continuously deliver much higher currents for longer periodAORNs of time than conventional coagulation instruments and thus increase the risk of complications.THREE INFANTS undergoing liver resection with the newer RF technology at one facility experienced electrosurgical unit (ESU) dispersive pad bums. As a result, an experiment was per-formed on animal subjects to determine best ESU dispersive pad placement on infants and to gather data on device impedance.RECOMMENDATIONS to prevent bums include central placement of the ESU dispersive pad and activating warming devices only after resection is complete. [ABSTRACT FROM AUTHOR]

The article focuses on recommended practices for sterilization in the perioperative practice setting developed by the Association of Perioperative Registered Nurses Recommended Practices Committee. These include the following: decontamination of items to be sterilized in a controlled environment; packaging of items to be sterilized according to guidelines established in the organization's "Recommended Practices for Selection and Use of Packaging Systems" and use of saturated steam under pressure method in sterilization.

Background/aims: The susceptibility of adefovir-resistant hepatitis B virus (HBV) mutants is only reduced by 3-10-fold in in vitro studies, suggesting that virologic breakthrough and clinical deterioration are unlikely. The aim of this study was to describe the clinical course of patients with adefovir-resistant HBV infection., Methods: Testing for adefovir-resistant mutations was performed on patients who had a suboptimal response or virologic breakthrough on adefovir. Adefovir-resistant mutations were detected using a line probe assay and direct sequencing of the HBV P-gene., Results: Eight male patients with pre-existing lamivudine resistance or breakthrough (mean age 47+/-13 years) were found to have adefovir-resistant mutations rtA181V/T or rtN236T. Baseline median ALT was 66 IU/L (range, 27-1161) and median HBV DNA 7.9 log10 copies/ml (range, 6-8.3). At the time of adefovir resistance (mean of 20+/-9 months), HBV DNA increased to > or = 5 log10 copies/ml in 7 patients. After detection of adefovir resistance, hepatic decompensation occurred in 2 patients, 1 of whom died. Salvage therapy with lamivudine, entecavir or tenofovir was given to 7 patients and a reduction in HBV DNA by > or = 3 log10 was seen in 3 patients., Conclusions: In conclusion, adefovir resistance can be associated with significant viral rebound and hepatic decompensation which may be fatal.