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Matthew J Smith - One of the best experts on this subject based on the ideXlab platform.
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safety and efficacy of hyperosmolar Irrigation Solution in shoulder arthroscopy
Journal of Shoulder and Elbow Surgery, 2017Co-Authors: Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J SmithAbstract:Background A hyperosmolar Irrigation Solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar Solution were compared with a standard isotonic Solution when used for shoulder arthroscopy. Methods A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) Irrigation Solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores Results Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth ( P P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant ( P > .2). Conclusion A hyperosmolar Irrigation Solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar Irrigation Solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients.
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Safety and efficacy of hyperosmolar Irrigation Solution in shoulder arthroscopy.
Journal of shoulder and elbow surgery, 2017Co-Authors: Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J SmithAbstract:A hyperosmolar Irrigation Solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar Solution were compared with a standard isotonic Solution when used for shoulder arthroscopy. A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) Irrigation Solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores RESULTS: Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth (P < .05), and a significantly lower immediate postoperative visual analog scale pain score (P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant (P > .2). A hyperosmolar Irrigation Solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar Irrigation Solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
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hyperosmolar Irrigation compared with a standard Solution in a canine shoulder arthroscopy model
Journal of Shoulder and Elbow Surgery, 2015Co-Authors: Nicholas M Capito, Matthew J Smith, Aaron M Stoker, Nikki Werner, James L CookAbstract:Background A hyperosmolar Irrigation Solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar Irrigation Solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy Irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P Results The mean percentage change in shoulder girth was higher in the isotonic control group (13.3%) than in the hyperosmolar group (10.4%). Chondrocyte viability and tissue water content for glenoid and humeral head cartilage were well maintained in both treatment groups, and differences were not statistically significant. Conclusions The data from this study suggest that doubling the osmolarity of the standard Irrigation Solution used for arthroscopy was not associated with any detrimental effects on chondrocyte viability or tissue water content after 2 hours of arthroscopic Irrigation. On the basis of potential benefits in conjunction with the safety demonstrated in these data, clinical evaluation of a hyperosmolar Solution for Irrigation during shoulder arthroscopy appears warranted.
James L Cook - One of the best experts on this subject based on the ideXlab platform.
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safety and efficacy of hyperosmolar Irrigation Solution in shoulder arthroscopy
Journal of Shoulder and Elbow Surgery, 2017Co-Authors: Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J SmithAbstract:Background A hyperosmolar Irrigation Solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar Solution were compared with a standard isotonic Solution when used for shoulder arthroscopy. Methods A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) Irrigation Solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores Results Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth ( P P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant ( P > .2). Conclusion A hyperosmolar Irrigation Solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar Irrigation Solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients.
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Safety and efficacy of hyperosmolar Irrigation Solution in shoulder arthroscopy.
Journal of shoulder and elbow surgery, 2017Co-Authors: Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J SmithAbstract:A hyperosmolar Irrigation Solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar Solution were compared with a standard isotonic Solution when used for shoulder arthroscopy. A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) Irrigation Solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores RESULTS: Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth (P < .05), and a significantly lower immediate postoperative visual analog scale pain score (P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant (P > .2). A hyperosmolar Irrigation Solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar Irrigation Solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
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hyperosmolar Irrigation compared with a standard Solution in a canine shoulder arthroscopy model
Journal of Shoulder and Elbow Surgery, 2015Co-Authors: Nicholas M Capito, Matthew J Smith, Aaron M Stoker, Nikki Werner, James L CookAbstract:Background A hyperosmolar Irrigation Solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar Irrigation Solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy Irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P Results The mean percentage change in shoulder girth was higher in the isotonic control group (13.3%) than in the hyperosmolar group (10.4%). Chondrocyte viability and tissue water content for glenoid and humeral head cartilage were well maintained in both treatment groups, and differences were not statistically significant. Conclusions The data from this study suggest that doubling the osmolarity of the standard Irrigation Solution used for arthroscopy was not associated with any detrimental effects on chondrocyte viability or tissue water content after 2 hours of arthroscopic Irrigation. On the basis of potential benefits in conjunction with the safety demonstrated in these data, clinical evaluation of a hyperosmolar Solution for Irrigation during shoulder arthroscopy appears warranted.
J. T. Marais - One of the best experts on this subject based on the ideXlab platform.
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Antimicrobial effectiveness of electro‐chemically activated water as an endodontic Irrigation Solution
International Endodontic Journal, 2001Co-Authors: J. T. Marais, W P WilliamsAbstract:Marais JT, Williams WP. Antimicrobial effectiveness of electro-chemically activated water as an endodontic Irrigation Solution. International Endodontic Journal , 34 , 237‐243, 2001. Aim The aim of this in vitro study was to evaluate the antimicrobial effectiveness of electro-chemically activated water (ECA) as an endodontic Irrigation Solution. Methodology The root canals of 60 caries-free, single-rooted, adult, maxillary, anterior human teeth were instrumented and irrigated in a similar method to that used for in vivo root canal treatment. The external root surface of each tooth was sealed, maintaining the access cavities patent and the root canals were inoculated with a suspension containing four bacteria. The teeth were randomly divided into four groups ( n = 15). Each group was irrigated ultrasonically with one of the following Solutions: distilled water (control), NaOCl (3.5%), and ECA, the latter at pHs 7.0 and 9.0. Antimicrobial effectiveness was established directly after Irrigation and again 7 days later, by counting colonyforming units on blood agar plates and by spectrophotometric analysis. Results Large numbers of bacteria were present in the canals of teeth irrigated with distilled water. No bacteria were observed following Irrigation with NaOCl. Neither of the ECA Solutions were found to be effective against all the bacteria. Although some reduction in the number of bacteria was evident in the ECA groups, this was not statistically significant ( P > 0.05) when compared to sodium hypochlorite. Conclusion Within the confines of this study ECA did not demonstrate antimicrobial effectiveness.
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antimicrobial effectiveness of electro chemically activated water as an endodontic Irrigation Solution
International Endodontic Journal, 2001Co-Authors: J. T. Marais, W P WilliamsAbstract:Marais JT, Williams WP. Antimicrobial effectiveness of electro-chemically activated water as an endodontic Irrigation Solution. International Endodontic Journal , 34 , 237‐243, 2001. Aim The aim of this in vitro study was to evaluate the antimicrobial effectiveness of electro-chemically activated water (ECA) as an endodontic Irrigation Solution. Methodology The root canals of 60 caries-free, single-rooted, adult, maxillary, anterior human teeth were instrumented and irrigated in a similar method to that used for in vivo root canal treatment. The external root surface of each tooth was sealed, maintaining the access cavities patent and the root canals were inoculated with a suspension containing four bacteria. The teeth were randomly divided into four groups ( n = 15). Each group was irrigated ultrasonically with one of the following Solutions: distilled water (control), NaOCl (3.5%), and ECA, the latter at pHs 7.0 and 9.0. Antimicrobial effectiveness was established directly after Irrigation and again 7 days later, by counting colonyforming units on blood agar plates and by spectrophotometric analysis. Results Large numbers of bacteria were present in the canals of teeth irrigated with distilled water. No bacteria were observed following Irrigation with NaOCl. Neither of the ECA Solutions were found to be effective against all the bacteria. Although some reduction in the number of bacteria was evident in the ECA groups, this was not statistically significant ( P > 0.05) when compared to sodium hypochlorite. Conclusion Within the confines of this study ECA did not demonstrate antimicrobial effectiveness.
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cleaning efficacy of a new root canal Irrigation Solution a preliminary evaluation
International Endodontic Journal, 2000Co-Authors: J. T. MaraisAbstract:Marais JT. Cleaning efficacy of a new root canal Irrigation Solution: a preliminary evaluation. International Endodontic Journal , 33 , 320‐325, 2000. Aim A new product, electro-chemically activated water, was compared to NaOCl for its cleaning effect on root canal walls. Methodology Root canal treatment was carried out on two groups of extracted teeth with one of the irrigants being used in each group. The control group received no treatment. All teeth were split and the canal walls viewed in a scanning electron microscope. Results The canal walls of the control group were covered by debris and bacteria. Sodium hypochlorite produced clean surfaces with the dentinal tubules open in some areas and occluded by the smear layer in other areas; in some areas bacteria were visible inside or under the smear layer. Electro-chemically activated water produced markedly cleaner surfaces, removing the smear layer in large areas. Conclusions The cleaning efficacy of electrochemically activated water in root canals was considered to be superior to NaOCl.
Nicholas M Capito - One of the best experts on this subject based on the ideXlab platform.
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safety and efficacy of hyperosmolar Irrigation Solution in shoulder arthroscopy
Journal of Shoulder and Elbow Surgery, 2017Co-Authors: Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J SmithAbstract:Background A hyperosmolar Irrigation Solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar Solution were compared with a standard isotonic Solution when used for shoulder arthroscopy. Methods A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) Irrigation Solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores Results Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth ( P P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant ( P > .2). Conclusion A hyperosmolar Irrigation Solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar Irrigation Solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients.
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Safety and efficacy of hyperosmolar Irrigation Solution in shoulder arthroscopy.
Journal of shoulder and elbow surgery, 2017Co-Authors: Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J SmithAbstract:A hyperosmolar Irrigation Solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar Solution were compared with a standard isotonic Solution when used for shoulder arthroscopy. A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) Irrigation Solutions used for arthroscopic rotator cuff repair. Primary outcomes focused on the amount of periarticular fluid retention based on net weight gain, change in shoulder girth, and pain. All patients were tracked through standard postsurgical follow-up to ensure no additional complications arose. Patients were contacted at 1 year to assess American Shoulder and Elbow Surgeon score, visual analog scale pain score, and the Single Assessment Numeric Evaluation shoulder scores RESULTS: Fifty patients (n = 25/group) were enrolled and completed the study. No statistically significant differences were noted between cohorts in demographics or surgical variables. The hyperosmolar group experienced significantly less mean weight gain (1.6 ± 0.82 kg vs. 2.25 ± 0.77 kg; P = .005), significantly less change in shoulder girth (P < .05), and a significantly lower immediate postoperative visual analog scale pain score (P = .036). At 1 year postoperatively, the differences between groups for American Shoulder and Elbow Surgeons, visual analog scale pain, and Single Assessment Numeric Evaluation were not significant (P > .2). A hyperosmolar Irrigation Solution provides a safe and effective way to decrease periarticular fluid retention associated with arthroscopic rotator cuff surgery without any adverse long-term effects. Use of a hyperosmolar Irrigation Solution for shoulder arthroscopy has potential clinical benefits to surgeons and patients. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
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hyperosmolar Irrigation compared with a standard Solution in a canine shoulder arthroscopy model
Journal of Shoulder and Elbow Surgery, 2015Co-Authors: Nicholas M Capito, Matthew J Smith, Aaron M Stoker, Nikki Werner, James L CookAbstract:Background A hyperosmolar Irrigation Solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar Irrigation Solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy Irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P Results The mean percentage change in shoulder girth was higher in the isotonic control group (13.3%) than in the hyperosmolar group (10.4%). Chondrocyte viability and tissue water content for glenoid and humeral head cartilage were well maintained in both treatment groups, and differences were not statistically significant. Conclusions The data from this study suggest that doubling the osmolarity of the standard Irrigation Solution used for arthroscopy was not associated with any detrimental effects on chondrocyte viability or tissue water content after 2 hours of arthroscopic Irrigation. On the basis of potential benefits in conjunction with the safety demonstrated in these data, clinical evaluation of a hyperosmolar Solution for Irrigation during shoulder arthroscopy appears warranted.
W P Williams - One of the best experts on this subject based on the ideXlab platform.
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Antimicrobial effectiveness of electro‐chemically activated water as an endodontic Irrigation Solution
International Endodontic Journal, 2001Co-Authors: J. T. Marais, W P WilliamsAbstract:Marais JT, Williams WP. Antimicrobial effectiveness of electro-chemically activated water as an endodontic Irrigation Solution. International Endodontic Journal , 34 , 237‐243, 2001. Aim The aim of this in vitro study was to evaluate the antimicrobial effectiveness of electro-chemically activated water (ECA) as an endodontic Irrigation Solution. Methodology The root canals of 60 caries-free, single-rooted, adult, maxillary, anterior human teeth were instrumented and irrigated in a similar method to that used for in vivo root canal treatment. The external root surface of each tooth was sealed, maintaining the access cavities patent and the root canals were inoculated with a suspension containing four bacteria. The teeth were randomly divided into four groups ( n = 15). Each group was irrigated ultrasonically with one of the following Solutions: distilled water (control), NaOCl (3.5%), and ECA, the latter at pHs 7.0 and 9.0. Antimicrobial effectiveness was established directly after Irrigation and again 7 days later, by counting colonyforming units on blood agar plates and by spectrophotometric analysis. Results Large numbers of bacteria were present in the canals of teeth irrigated with distilled water. No bacteria were observed following Irrigation with NaOCl. Neither of the ECA Solutions were found to be effective against all the bacteria. Although some reduction in the number of bacteria was evident in the ECA groups, this was not statistically significant ( P > 0.05) when compared to sodium hypochlorite. Conclusion Within the confines of this study ECA did not demonstrate antimicrobial effectiveness.
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antimicrobial effectiveness of electro chemically activated water as an endodontic Irrigation Solution
International Endodontic Journal, 2001Co-Authors: J. T. Marais, W P WilliamsAbstract:Marais JT, Williams WP. Antimicrobial effectiveness of electro-chemically activated water as an endodontic Irrigation Solution. International Endodontic Journal , 34 , 237‐243, 2001. Aim The aim of this in vitro study was to evaluate the antimicrobial effectiveness of electro-chemically activated water (ECA) as an endodontic Irrigation Solution. Methodology The root canals of 60 caries-free, single-rooted, adult, maxillary, anterior human teeth were instrumented and irrigated in a similar method to that used for in vivo root canal treatment. The external root surface of each tooth was sealed, maintaining the access cavities patent and the root canals were inoculated with a suspension containing four bacteria. The teeth were randomly divided into four groups ( n = 15). Each group was irrigated ultrasonically with one of the following Solutions: distilled water (control), NaOCl (3.5%), and ECA, the latter at pHs 7.0 and 9.0. Antimicrobial effectiveness was established directly after Irrigation and again 7 days later, by counting colonyforming units on blood agar plates and by spectrophotometric analysis. Results Large numbers of bacteria were present in the canals of teeth irrigated with distilled water. No bacteria were observed following Irrigation with NaOCl. Neither of the ECA Solutions were found to be effective against all the bacteria. Although some reduction in the number of bacteria was evident in the ECA groups, this was not statistically significant ( P > 0.05) when compared to sodium hypochlorite. Conclusion Within the confines of this study ECA did not demonstrate antimicrobial effectiveness.
