Atención domiciliaria en enfermería: estudio de un centro de atención primaria de Salamanca

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Rosales Tejera, Marta

2014-01-01

El objetivo principal de este proyecto es mostrar la importancia que tiene la Atención Domiciliaria y la oportunidad que supone, como medio para mejorar la salud y la calidad de vida de la población

Intervención desde la farmacia comunitaria a pacientes atendidos en los servicios de ayuda domiciliaria municipal

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Gastelurrutia MA

2010-03-01

Full Text Available INTRODUCCIÓN Se describe el programa para la mejora del uso de la medicación en personas atendidas por los servicios de ayuda domiciliaria y se presentan los resultados económicos, clínicos y humanísticos de su aplicación en dos municipios de Gipuzkoa (Donostia-San Sebastián y Legazpi, durante el año 2008. MÉTODO Las farmacias enviaron al Colegio mensualmente los datos para su evaluación. Se calculó tanto el coste de la preparación de los blísteres como el ahorro producido. También se evaluó el incumplimiento midiendo el número de blísteres devueltos que no estaban completamente vacíos y la situación de polimedicación. Se analizó la satisfacción de los usuarios y cuidadores, y de los auxiliares por el personal del Ayuntamiento de Donostia. El Colegio se encargó de evaluar la satisfacción de los farmacéuticos. En todos los casos se utilizaron cuestionarios no validados elaborados ad hoc. RESULTADOS Se han analizado resultados de 13 farmacias con un máximo de 24 pacientes. El 95,6% estaban polimedicados. El 78,8% de los medicamentos prescritos pudieron ser incluidos en blísteres. Se prepararon 1.129 SPD de los que se inutilizaron 31. Además se retornaron 80 blísteres con algún comprimido en su interior. Durante el año de evaluación, se retiraron del sistema un total de 454 recetas que no fueron dispensadas por no ser necesarias. Ello produjo un ahorro global de 6581,73. El tiempo medio de preparación de los blísteres, por paciente y mes fue de 1hora y 36 minutos, lo que supuso un coste de 27,06al mes. La satisfacción en los tres colectivos estudiados fue buena

Aproximación a un servicio de atención domiciliaria (SAD municipal Approach to a local home care service

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Esperanza Ballesteros Pérez

2006-12-01

Full Text Available Introducción: El envejecimiento progresivo de la población española y la importancia demográfica de las personas mayores se concreta en que 17 de cada 100 españoles tiene 65 años o más. El descenso de la tasa de mortalidad y aumento de la esperanza de vida hace que exista un crecimiento considerable de la dependencia, fragilidad y necesidad de cuidados de larga duración de este grupo de población. familia es el principal proveedor de cuidados en un 80% de los casos, pudiéndose considerar como un elemento socio-sanitario de primer orden por su faceta de proveedores de atención y cuidados. literatura revisada destaca la importancia de la complementariedad en la distribución de prestación de cuidados y asistencia entre las redes informales y formales. El Servicio de Atención Domiciliaria (SAD del Ayuntamiento de L'Hospitalet de Llobregat cubre diferentes servicios teleasistencia, acompañamiento en diversas gestiones. Objetivos del estudio: Describir el perfil socio-demográfico y situaciones de dependencia de los usuarios del Servicio de Atención Domiciliaria de L'Hospitalet del Llobregat. Conocer el perfil y la situación de salud del cuidador principal de los usuarios del SAD. Material y métodos: La población de estudio estaba formada por 320 usuarios, la mayor parte del total (358 de los usuarios del SAD. Los factores de inclusión fueron ser usuario del SAD durante la realización del estudio y aceptar voluntariamente la participación en el estudio. Para la valoración de los usuarios se utilizaron los siguientes cuestionarios validados: Barber, Barthel, Pfeiffer y Lawton. Se utilizaron también otros cuestionarios de elaboración propia para conocer otras características: problemas de salud, gestión de la medicación, relación con atención primaria de salud. La información se recogió mediante visitas domiciliarias que realizaron alumnos de Enfermería Enfermería. El análisis estadístico consiste en el an

Costos de medición y redistribución del ingreso en el servicio público de recolección domiciliaria de basuras en Colombia

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Nu00E9stor Rubiano Pu00E1ez

1999-01-01

Full Text Available En atención a que la vivienda y el agua potable, el alcantarillado, la electricidad, el gas combustible, la telefonía y la recolección domiciliaria de basuras son bienes complementarios, la legislación colombiana de Servicios Públicos Domiciliarios entiende por "usuario", y responsable legal por la factura, al propietario o arrendatario del inmueble que recibe los servicios, en tanto que denomina "consumidores" a la totalidad de ocupantes del predio. A diferencia de los restantes servicios, en el de aseo domiciliario a las viviendas no se realizan mediciones cotidianas a los residuos recogidos. La regulación reduce los costos de medición fijando promedios de producción mensual de basura por vivienda, de acuerdo con los cuales se fijan las tarifas. Las empresas han encontrado viviendas informales que albergan a varias familias lo cual conduce a interpretaciones encontradas sobre la correcta facturación del servicio. Este artículo examina las consecuencias de facturar el servicio según promedios, teniendo en cuenta dos fenómenos: el "equilibrio económico contractual" entre empresas y usuarios, y la distribución del ingreso en los seis estratos socioeconómicos establecidos en el Colombia. Concluye que el equilibrio no es alterado por ningún tipo de promedio, mientras que la distribución del ingreso entre estratos sí es afectada por el tipo de promedio utilizado en la facturación, y, en consecuencia, que si los municipios colombianos usaran el mejor promedio, el más adecuado a la estructura del mercado podrían mejorar la distribución del ingreso, sin originar "desequilibrios económicos" para las empresas prestadoras del servicio de aseo.

Modelo integrado de un sistema de biodepuración en origen de aguas residuales domiciliarias. Una propuesta para comunidades periurbanas del Centro Sur de Chile.

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Izaúl Silvestre Parra Piérart

2013-12-01

Full Text Available El crecimiento acelerado de la población mundial y sus impactos ha llevado a buscar nuevas fuentes de abastecimiento hídrico. Las aguas residuales constituyen una  fuente adicional para satisfacer la demanda de este recurso, razón por la cual se han estado diseñando alternativas para mejorar su tratamiento y potenciar su utilización. Este estudio profundiza en la revisión de algunas alternativas de biodepuración y propone el diseño conceptual de un sistema híbrido de biodepuración en origen de aguas residuales domiciliarias basado en el uso de un biofiltro. Este biofiltro se compone de un lombrifiltro y una combinación de humedales artificiales de flujos subsuperficial y libre. Los resultados de este estudio apuntan al diseño de soluciones ecosistémicas en la gestión de los recursos hídricos, aportando además beneficios medioambientales, paisajísticos y educacionales en la generación de alternativas para el manejo sostenible de nuestros recursos naturales.

Comparación de la satisfacción de los usuarios de atención domiciliaria: modelo integrado vs. modelo dispensarizado

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Marta Gorina

2014-06-01

Conclusiones: El grado de satisfacción de los pacientes de atención primaria domiciliaria parece depender de las características propias de cada modelo organizativo, siendo el modelo dispensarizado el que presenta un mayor grado de satisfacción o calidad asistencial percibida. Se debería realizar un mayor número de estudios para generalizar estos resultados a otros centros de atención primaria pertenecientes a otras instituciones.

Gestión logística en la prestación de servicios de hospitalización domiciliaria en el Valle del Cauca: caracterización y diagnóstico

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Elena Valentina Gutiérrez

2014-10-01

Full Text Available Este artículo presenta el primer diagnóstico de la gestión logística de las instituciones habilitadas por el Ministerio de Salud y Protección Social para la prestación de servicios de hospitalización domiciliaria (HHC en el Valle del Cauca, Colombia. El objetivo es caracterizar cómo los proveedores de HHC toman las decisiones logísticas asociadas con el proceso de prestación del servicio, e identificar oportunidades de mejoramiento e investigación. El diagnóstico se construyó mediante la aplicación de una encuesta semiestructurada que evaluó 6 ejes de trabajo y el grado de madurez de los procesos de servicio. Los resultados muestran que se requiere una gestión más integral de las decisiones logísticas, apoyada en el conocimiento del perfil epidemiológico y demográfico de la población atendida.

Infestacion domestica por triatoma infestans y prevalencia de seropositivos al Trypanosoma cruzi en un area rural del nordeste argentino

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M. Esther Bar

1996-12-01

Full Text Available Se llevó a cabo un estúdio epidemiológicopara obtener unpanorama general de la transmisión doméstica del Trypanosoma cruzi en áreas rurales del Departamento San Miguel, Conientes, Argentina. Se investigaron 100 viviendas precarias, 50,0% de las mismas resultó infestado por Triatoma infestans y 1,0% por T. sórdida, citãndose por primera vez para la provinda de Comentes la colonización domiciliaria de esta especie. El 23,1% de T. infestans estaba infectado por T. cruzi. La seroprevalencia de 388 pacientes analizados por hemaglutinacíôn indirecta e inmunofluorescencia indirecta fue 23,4%, destacándose el alto índice (12,9% constatado en menores de 10 anos. Losporcentajes de seropositividad aumentaron con la edad, alcanzándose 50,0% de infectados entre los 31-40 anos. La infestación doméstica por T. infestans, la prevalencia humana de seropositivos al T. cruzi y las condiciones deprecariedad en que se desenvuelve la vida de los pobladores revelan la vigência de la endemia chagãsica en el área estudiada.

Sistema de classificação de pacientes em assistência domiciliária Sistema de classificación de pacientes en atención domiciliaria Patients classification system in home care

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Luiza Watanabe Dal Ben

2006-03-01

Full Text Available OBJETIVOS: O objetivo deste artigo é apresentar os Sistemas de Classificação de Pacientes (SCP existentes nessa área. MÉTODOS: revisão bibliográfica. RESULTADOS: Os instrumentos encontrados foram: de Garrard et al, Home Health Care Classification System4.4 Método Home Health Care Classification System (HHCC, segundo Saba (1991, Escala Katz, as tabelas utilizadas pela Associação Brasileira de Empresas de Medicina de Internação Domiciliar e pelo Núcleo Nacional das Empresas de Assistência Domiciliar, o TISS-Intermediário adaptado por Dal Ben e o catálogo de prestação de serviços da "Fondation des Services d'aide et de Soins à Domicile". Desses instrumentos os dois últimos mensuram a carga de trabalho e os demais apresentam indicadores para obter recursos humanos e financeiros. CONSIDERAÇÕES FINAIS: Quanto ao tempo despendido na assistência ao paciente considera-se como dependência total 24 horas; dependência parcial 12 horas; dependência moderada 6 horas de assistência / dia / paciente.OBJETIVO: el objetivo de este articulo es presentar los sistemas de clasificación de pacientes existentes en esta area. METODOS: revisión bibliográfica. RESULTADOS: Los instrumentos encuentrados fueron: de Garrard et al, Home Health Care Classification System, Escala Katz, las tablas utilizadas por la Asociación Brasileña de Empresas de Medicina de Atencion Domiciliaria y por el Nucleo Nacional de Empresas de Atención Domiciliaria, el TISS-Intermediário adaptado por Dal Ben y el catálogo de la prestación de servicios de la "Fundación de servicios de ayuda y atención domiciliária". De eses instrumentos los dos ultimos miden la carga del trabajo y los demás presentan indicadores para obtener los recursos humanos y financieros. CONSIDERACIONES FINALES: Cuanto al tiempo gasto en la atención del paciente se considera de 24 horas para los que tienen dependencia total, de 12 horas para los que tienen dependencia parcial y de 6

Asegurar el cuidado: Redes, Inmediatez y Autonomía en un Servicio de Teleasistencia Domiciliaria

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Daniel López

2009-11-01

Full Text Available Esta tesis es un estudio etnográfico sobre un servicio de teleasistencia domiciliaria en el que se analiza cómo se organiza el cuidado a distancia e inmediato ante cualquier eventualidad, cómo se corporeiza y práctica la autonomía a través del uso de este servicio, y cómo el hogar y su forma de habitarlo se transforma con el uso de la teleasistencia. Estas tres preguntas tienen como objetivo final dilucidar qué desinstitucionalización se abre con la TAD. Concretamente, la tesis que sostiene el trabajo es que la desinstitucionalización puede interpretarse, a la luz de los resultado de la etnografía, como el paso de un disciplinamiento del cuidado a un aseguramiento del cuidado. 

Hydraulic Model for Drinking Water Networks, Including Household Connections; Modelo hidraulico para redes de agua potable con tomas domiciliarias

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Guerrero Angulo, Jose Oscar [Universidad Autonoma de Sinaloa (Mexico); Arreguin Cortes, Felipe [Instituto Mexicano de Tecnologia del Agua, Jiutepec, Morelos (Mexico)

2002-03-01

This paper presents a hydraulic simulation model for drinking water networks, including elements that are currently not considered household connections, spatially variable flowrate distribution pipelines, and tee secondary network. This model is determined by solving the equations needed for a conventional model following an indirect procedure for the solution of large equations systems. Household connection performance is considered as dependent of water pressure and the way in which users operate the taps of such intakes. This approach allows a better a acquaintance with the drinking water supply networks performance as well as solving problems that demand a more precise hydraulic simulation, such as water quality variations, leaks in networks, and the influence of home water tanks as regulating devices. [Spanish] Se presenta un modelo de simulacion hidraulica para redes de agua potable en el cual se incluyen elementos que no se toman en cuenta actualmente, como las tomas domiciliarias, los tubos de distribucion con gastos espacialmente variado y la red secundaria, resolviendo el numero de ecuaciones que seria necesario plantear en un modelo convencional mediante un procedimiento indirecto para la solucion de grandes sistemas de ecuaciones. En las tomas domiciliarias se considera que su funcionamiento depende de las presiones y la forma en que los usuarios operan las llaves de las mismas. Este planteamiento permite conocer mejor el funcionamiento de las redes de abastecimiento de agua potable y solucionar problemas que requieren de una simulacion hidraulica mas precisa, como el comportamiento de la calidad del agua, las fugas en las redes y la influencia reguladora de los tinacos de las casas.

Percepções e sentimentos do familiar/cuidador expressos diante do ente em internação domiciliar

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Naianny Jonas Fogaça

2015-01-01

Full Text Available Objetivos: analizar percepciones y sentimientos expresados por los familiares en relación al paciente sometido a la atención domiciliaria. Métodos: estudio descriptivo, cualitativo, cuya recolección de datos se realizó a través de entrevistas semi-estructuradas en el hogar, desarrollado con catorce familiares de pacientes atendidos por una empresa de atención domiciliaria. Datos fueron organizados por la técnica de análisis de contenido. Resultados: percepciones y sentimientos expresados fueron: inseguridad, miedo, ansiedad, preocupación, sentimientos de privación de libertad y, al mismo tiempo, gratitud por la atención, comodidad, seguridad y proximidad a controlar cuidadosamente. Prefiriendo ser admitidos en domicilio y evaluaron la atención como satisfactoria. Conclusión: la atención domiciliaria debe ser vista como innovadora modalidad de atención humanizada que tiene como objetivo revertir la lógica del labor de los profesionales de salud, que no se limita sólo a satisfacer las necesidades clínicas de pacientes, sino también proporcionan apoyo necesario a las familias involucradas.

Dieta enteral prescrita versus dieta infundida Prescribed enteral diet versus infused diet

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Silvana Aparecida Ribeiro Simões

2017-07-01

Full Text Available Objetivo: Avaliar o volume prescrito de dieta enteral versus o volume infundido, identificando as causas de interrupção da dieta e os gastos gerados por essas interrupções. Métodos: Estudo observacional, com pacientes adultos e idosos, recebendo nutrição enteral em um hospital particular de São Paulo. A coleta de dados foi realizada por meio de prontuário eletrônico. Resultados: O volume infundido foi significantemente menor que o volume prescrito, nos cinco dias de acompanhamento, em toda a amostra. A principal intercorrência na administração da dieta foi a diarreia. Os gastos com a não administração da dieta somam 41,4% do valor despendido para esse serviço. Conclusão: Este estudo contribui para a atuação e desempenho do nutricionista em conjunto com a Equipe Multidisciplinar em Terapia Nutricional visando a melhora do paciente.

CAREGIVERS AND IMPLICATIONS FOR HOME CARE

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Danielli Piatti Carvalho

2015-01-01

Full Text Available : Investigación exploratoria descriptiva de abordaje cualitativo, con el objetivo de aprehender la experiencia de los cuidadores, la práctica de los equipos de atención domiciliaria y la contribución de asistencia domiciliaria a la continuidad de la atención. Los datos fueron colectados por medio de entrevista semiestructurada, aplicada a diez cuidadores. Los testimonios fueran sometidos a un análisis de contenido en la modalidad de análisis temática, acerca de la cual se emergió tres temáticas: decisión para el cuidado, cotidiano de los cuidados y la dimensión social del cuidado en el contexto de la atención domiciliaria. Entre los cuidadores se identificó baja renta y escolaridad, dependencia severa de los sujetos cuidados y dificultades de los equipos de Atención Domiciliaria para suministrar los recursos materiales. Hubo sobrecarga moderada y de moderada a severa en 60% y 40% de los cuidadores, respectivamente, y privación de actividades sociales. Por las condiciones socioeconómicas el cuidado presentó fragilidades y falta de dominios.

O fazer das enfermeiras da estratégia de saúde da família na atenção domiciliária El quehacer de las enfermeras de la estrategia de salud de la familia en la atención domiciliaria The performance of family health nurses in home care

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Cristiane Dantas Laitano Lionello

2012-12-01

Full Text Available Este estudo objetivou conhecer o fazer das enfermeiras da Estratégia de Saúde de Família (ESF na atenção domiciliária. Trata-se de um estudo exploratório, descritivo, com abordagem qualitativa. Foram entrevistadas seis enfermeiras atuantes da ESF de um distrito sanitário de Porto Alegre, Rio Grande do Sul, Brasil. As informações foram submetidas à análise de conteúdo temática, resultando em três categorias: a visita domiciliária (VD na ESF, avaliação das demandas de VD e interação com a equipe de saúde na atenção domiciliária. A visita domiciliária (VD tem oportunizado a identificação das necessidades por meio do conhecimento do contexto de vida dos usuários. Esta tem sido realizada no atendimento de doentes crônicos, acamados e idosos, efetuada a partir das informações trazidas pelos agentes comunitários de saúde. Todas as enfermeiras relataram realizar VD, sendo que gostariam de ter mais tempo para se dedicar a essa atividade.Este estudio objetivó conocer el quehacer de las enfermeras de la Estrategia de Salud de la Familia (ESF en la atención domiciliaria. Se desarrolló un estudio exploratorio descriptivo con abordaje cualitativo. Se entrevistó a seis enfermeras que actúan en la ESF en un distrito sanitario en Porto Alegre, Rio Grande do Sul, Brasil. Las informaciones fueron sometidas al análisis de contenido temático y resutando en tres categorías: visita domiciliaria en la ESF, evaluación de las demandas de la visita domiciliaria e interacción con el equipo en la visita domiciliaria. La visita domiciliaria (VD ha alimentado la identificación de necesidades con conocimiento del contexto de vida de los usuarios. Se la viene realizando en la atención de enfermos crónicos, acamados, ancianos, efectuada a partir de los agentes comunitarios de salud. Todas las enfermeras dicen hacer VD, pero que les gustaría más tiempo para esta actividad.This study aimed at identifying the performance of Family

Diseño y validación de instrumento de evaluación de la satisfacción con los servicios de atención domiciliaria: SATISFAD Design and validation of a home care satisfaction questionnaire: SATISFAD

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José Miguel Morales Asencio

2007-04-01

Full Text Available Objetivos: Construir y validar un instrumento que evalúe la satisfacción con los servicios de atención domiciliaria en versión autoadministrada y telefónica. Método: Estudio observacional transversal en población con atención domiciliaria de los distritos sanitarios de Málaga, Costa del Sol, Almería y Granada. Se diseñó un cuestionario por parte de expertos en la técnica Delphi. Posteriormente, se evaluó la fiabilidad entre las versiones telefónica y autoadministrada y, por último, se comprobó su validez de constructo y la consistencia interna. Resultados: La fiabilidad entre las versiones telefónica y autoadministrada fue alta (coeficiente de correlación intraclase = 0,876; intervalo de confianza del 95%, 0,726-0,941; p = 0,0001. La consistencia interna también fue adecuada (alfa de Cronbach de 0,853 y 0,799 para las distintas versiones, con o sin cuidadora, respectivamente. El análisis factorial explicaba un 66,80 y un 67,81% de la varianza observada para las distintas versiones (con o sin cuidadora. Se aislaron 2 factores que tenían que ver con la relación interpersonal, el rol de la cuidadora y la toma de decisiones. Conclusiones: La evaluación de la satisfacción con los servicios de atención domiciliaria puede realizarse con dimensiones habitualmente utilizadas en los estudios de satisfacción, aunque han de ser evaluadas mediante instrumentos diseñados al efecto. La accesibilidad, la comunicación y las relaciones interpersonales adquieren un alto valor explicativo en la satisfacción de este tipo de población.Objectives: To design and validate an instrument to assess satisfaction with home care services, in both self-administered and telephone versions. Methods: We performed a cross-sectional observational study of the population using home care services in the health districts of Malaga, Costa del Sol, Almeria and Granada (Spain. A questionnaire was designed by an expert panel using a Deplhi technique

Serviços de atenção domiciliar na saúde suplementar e a inserção da enfermagem em Belo Horizonte/MG Servicios de atención domiciliaria en la salud suplementaria y la inserción de la enfermería en Belo Horizonte/MG Supplementary home health care services and the inclusion of nursing in Belo Horizonte/Minas Gerais (Brazil

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Kênia Lara Silva

2012-01-01

Full Text Available OBJETIVO: Analisar modalidades de serviço de atenção domiciliar discutindo a inserção da enfermagem. MÉTODOS: Estudo de caso qualitativo realizado em quatro operadoras de planos de saúde no município de Belo Horizonte/Minas Gerais. Os dados foram obtidos de entrevistas e acompanhamento de casos. RESULTADOS: Os serviços de atenção domiciliar são agrupados em três Modalidades: Cuidados prolongados no domicilio; Atenção provisória no domicilio e Uso intenso de tecnologias e de cuidados. Nas modalidades, a enfermagem assume ações assistenciais e de gestão do cuidado e qualifica a atenção por meio do uso apropriado das tecnologias leves. Há uma tendência à terceirização do serviço de enfermagem na atenção domiciliar. CONCLUSÃO: A inclusão do trabalho do enfermeiro nas modalidades de atenção domiciliar representa ao mesmo tempo um componente de redução de custos e contribui para a transição tecnológica pelo estabelecimento de novas formas de cuidado no domicilio.OBJETIVO: Analizar modalidades de servicio de atención domiciliaria discutiendo la inserción de la enfermería. MÉTODOS: Estudio de caso cualitativo realizado en cuatro operadoras de planes de salud en el municipio de Belo Horizonte/Minas Gerais. Los datos fueron obtenidos de entrevistas y acompañamiento de casos. Resultados: Los servicios de atención domiciliaria son agrupados en tres MODALIDADES: Cuidados prolongados en el domicilio; Atención provisional en el domicilio y Uso intenso de tecnologías y de cuidados. En las modalidades, la enfermería asume acciones asistenciales y de gestión del cuidado y cualifica la atención por medio del uso apropiado de las tecnologías leves. Hay una tendencia a la tercerización del servicio de enfermería en la atención domiciliaria. CONCLUSIÓN: La inclusión del trabajo del enfermero en las modalidades de atención domiciliaria representa al mismo tiempo un componente de reducción de costos y contribuye

ACTUACIÓN DOMICILIARIA EN EL SINDROME DE APNEAS/HIPOPNEAS DURANTE EL SUEÑO (SAHS: DIAGNÓSTICO Y TRATAMIENTO

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Coma del Corral MJ

2006-02-01

Full Text Available RESUMEN:Estudios recientes, relacionan el SAHS con mayor morbimortalidad cardiovascular y por otro lado, sabemos que aún hoy en día, el SAHS sigue estando infradiagnosticado. Este infradiagnóstico supone, por un lado, un déficit o perdida de salud y por otro lado, un aumento de costes, ya que está demostrado que los pacientes con SAHS no diagnosticados ni tratados, son mayores consumidores de los servicios de salud y presentan mayor absentismo laboral, mientras que estos costes se reducen en los pacientes con SAHS tratados con CPAP. Por tanto, nos encontramos ante la necesidad de diagnosticar y tratar adecuadamente al mayor número posible de pacientes que padezcan un SAHS.El método diagnóstico de elección, sigue siendo la PSG nocturna vigilada en el laboratorio de sueño, sin embargo, el futuro del diagnóstico del SAHS pasa indefectiblemente por el empleo de sistemas simplificados con alta sensibilidad y especificidad. En este sentido, la Poligrafía Respiratoria, representa una alternativa útil para el diagnóstico del SAHS, pudiendo ser realizada en el domicilio del paciente, al igual que los sistemas Auto-CPAP. De esta forma, el abordaje actual del SAHS ha cambiado y así, un paciente con alta probabilidad de padecer un SAHS, se le puede realizar una PR domiciliaria que diagnostique el SAHS y posteriormente para ajustar el nivel de presión óptima de CPAP, se le podría hacer un registro domiciliario de Auto-CPAP.Con este nuevo abordaje del SAHS, se podrán disminuir las listas de espera y por tanto disminuir el infradiagnóstico. Todo ello conlleva implícitamente un ahorro de recursos. El lugar del diagnóstico, será fundamentalmente el domicilio, y en este sentido, el desarrollo de aplicaciones telemáticas contribuirá de forma importante a la modificación de las estrategias diagnósticas.El éxito de esta forma de abordaje del SAHS, vendrá marcado por una adecuada selección de los pacientes subsidiarios de diagnóstico y

Determinantes de la gestión clínica en atención médica domiciliaria de personas con secuelas de enfermedad cerebro-vascular

OpenAIRE

Sánchez Cárdenas, Miguel Antonio

2012-01-01

La atención domiciliaria constituye hoy una modalidad de atención que permite solventar las dificultades derivadas de la sobreocupación hospitalaria y la cronicidad, los cuales constituyen un problema de interés en salud pública en los países desarrollados y que pueden ser manejados en el domicilio del paciente como una opción costo-efectiva y segura. Para lo cual es necesario buscar estrategias que permitan su desarrollo, gestión de riesgos y modelos de atención, logrando mejorar las condici...

MEDIDAS DE EXPOSICIÓN A LA MOVILIDAD EN LAS LESIONES GRAVES POR TRÁFICO EN LA COMUNIDAD DE MADRID

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Luis Velázquez Buendía

2015-01-01

Full Text Available Fundamentos: La búsqueda de indicadores apropiados para estimar el riesgo de lesiones por tráfico es actualmente un área de interés relevante. El objetivo de este estudio fue realizar una descripción de la morbilidad hospitalaria y la mortalidad por lesiones por tráfico en la Comunidad de Madrid, según edad y sexo, utilizando y comparando entre sí tasas por población, por personas-km y por personas-horas. Métodos: Estudio descriptivo transversal en la Comunidad de Madrid referido al período 2003-2005. Se estimaron y compararon por edad y sexo tasas de morbilidad y mortalidad por población, por personas-km recorridos y por personas-horas de desplazamiento. Se utilizaron como fuentes de información el Conjunto Mínimo Básico de Datos Hospitalarios de 2003-2005, la Encuesta Domiciliaria de Movilidad de 2004 en la Comunidad de Madrid y el registro de mortalidad del Instituto de Estadística de la Comunidad de Madrid. Resultados: Se identificaron 7.413 altas hospitalarias y 1.046 defunciones. Las tasas poblacionales de morbilidad hospitalaria y mortalidad fueron de 62,24 y 9,20/100.000 habitantes respectivamente en hombres, y de 23,80 y 2,97/100.000 en mujeres, siendo las más elevadas en varones de 16-24 años (119,27 altas y 12,00 fallecidos por 100.000 habitantes. Las tasas por exposición más altas correspondieron a mujeres de 65 y más años: 649,78 altas y 96,72 fallecidas por 109 km, y 13,11 altas y 1,95 fallecidas por 106 horas de desplazamiento. Conclusiones: La morbi-mortalidad fue mayor en hombres en todos los indicadores. Los indicadores basados en la exposición a la movilidad, frente a las tasas poblacionales, reducen la morbi-mortalidad de lesiones por tráfico en hombres y en edades jóvenes y aumentan la misma en edades avanzadas.

Rotavirus morbidity and mortality in children in Brazil Morbilidad y mortalidad por rotavirus en niños en Brasil

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Ana Marli Christovam Sartori

2008-02-01

Full Text Available OBJECTIVE: To study the epidemiology of rotavirus and estimate rotavirus-associated morbidity and mortality in children OBJETIVOS: Analizar la epidemiología del rotavirus y estimar la morbilidad y la mortalidad asociadas con las infecciones por rotavirus en niños < 5 años de edad en Brasil en 2004, antes de incluir la vacuna contra el rotavirus en el Programa Nacional de Inmunizaciones (PNI. MÉTODOS: Para estimar la morbilidad por rotavirus se revisaron los estudios publicados (1999-2006 que abordaban la incidencia de diarrea aguda en niños < 5 años de edad y la frecuencia de las infecciones por rotavirus en niños con diarrea en Brasil. Los casos de diarrea se dividieron en tres categorías de gravedad según el nivel de atención que requirieron: casos leves que solo requirieron atención domiciliaria, casos moderados que requirieron la visita a un servicio ambulatorio de salud y casos graves que requirieron hospitalización. Para estimar la mortalidad por rotavirus se utilizó el número de muertes registradas por diarrea en niños de < 5 años, según el Sistema de Información sobre Mortalidad (SIM del Sistema Único de Salud (SUS de Brasil, y se calculó la proporción de muertes causadas por este virus. RESULTADOS: Se estimó que las infecciones por rotavirus causan anualmente 3 525 053 casos de diarrea, 655 853 visitas a servicios ambulatorios de salud, 92 453 hospitalizaciones y 850 muertes en niños < 5 años de edad en Brasil. CONCLUSIONES: Las infecciones por rotavirus constituyen una importante causa de morbilidad y mortalidad en Brasil.

Visita domiciliaria familiar: estrategia didáctica para la formación integral del personal médico

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Liliana Adela Zuliani-Arango

2015-01-01

Full Text Available La dificultad de abordar el proceso Salud-Enfermedad desde lo biopsicosocial, hapromovido otras estrategias para favorecer la formación integral en el futuro profesional de la salud.En esta investigación buscamos como objetivo comprender la importancia de la visita domiciliariafamiliar como estrategia didáctica para la formación integral de los estudiantes y las estudiantes-años 2006 a 2011-, de pregrado de Medicina de la Universidad de Antioquia, Medellín, Colombia.Es un estudio cualitativo histórico hermenéutico fenomenológico, que implica sistematización decaso y revisión documental con análisis ético, efectuado a 36 participantes entre estudiantes ydocentes, en entrevistas, grupos focales y observaciones participantes. Resultados y conclusiones: lavisita domiciliaria familiar es la estrategia didáctica que facilita la mirada integral en la formacióndel estudiante o la estudiante y mejora la relación médico-paciente, genera compromiso social yresponsabilidad en su quehacer médico-puericultor.

Nursing workload predictors in Catalonia (Spain: a home care cohort study Variables predictoras de las cargas de trabajo de enfermería en Cataluña: seguimiento de una cohorte de atención domiciliaria

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Joan Gené Badia

2011-08-01

y situación social (test de Charlson, Barthel, Pfeiffer, Braden y Gijón; sobrecarga del cuidador (Test de Zarit; ingresos hospitalarios y visitas a urgencias; estado subjetivo de salud (SF-12; visitas de los profesionales de salud. Resultados: Los pacientes recibieron 7,2 (DE: 10,4 visitas anuales de su enfermera habitual. Observamos que tienen más riesgo de recibir visitas de enfermería los pacientes varones (IRR=1,42, IC95%: 1,20-1,67, con dependencia para las actividades de la vida diaria (IRR=1,65, IC95%: 1,29-2,13, afectados por úlceras por decúbito (IRR=4,03, IC95%: 2,27-7,14 y que precisaron servicios de atención de urgencia a domicilio (IRR=1,65, IC95%: 1,31-2,07. Por otro lado, los pacientes con deterioro cognitivo importante tienen menos probabilidad de recibir visitas de su enfermera (IRR=0,78, IC95%: 0,63-0,98. Conclusiones: Las características clínicas de los pacientes permiten predecir la carga de trabajo de enfermería. Esta relación positiva de la carga de trabajo con las variables relacionadas con la gravedad de la enfermedad y la relación negativa con el deterioro cognitivo muestra que la enfermería domiciliaria en Cataluña está básicamente orientada a la demanda.

Enteric glia.

Science.gov (United States)

Rühl, A; Nasser, Y; Sharkey, K A

2004-04-01

The enteric nervous system is composed of both enteric neurones and enteric glia. Enteric glial cells were first described by Dogiel and are now known to outnumber neurones approximately 4 : 1. In the past, these cells were assumed to subserve a largely supportive role; however, recent evidence indicates that enteric glial cells may play a more active role in the control of gut function. In transgenic mouse models, where enteric glial cells are selectively ablated, the loss of glia results in intestinal inflammation and disruption of the epithelial barrier. Enteric glia are activated specifically by inflammatory insults and may contribute actively to inflammatory pathology via antigen presentation and cytokine synthesis. Enteric glia also express receptors for neurotransmitters and so may serve as intermediaries in enteric neurotransmission. Thus, enteric glia may serve as a link between the nervous and immune systems of the gut and may also have an important role in maintaining the integrity of the mucosal barrier and in other aspects of intestinal homeostasis.

Visita domiciliária sob o olhar de usuários do programa saúde da família

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Edir Nei Teixeira Mandú

2008-01-01

Full Text Available Por medio de un estudio cualitativo son analizados los significados atribuidos por las familias a la visita domiciliaria realizada por el Programa Salud de la Familia, con el objetivo de reconocer las dificultades y los potenciales relacionados con esta práctica. Entre octubre y diciembre de 2005 fueron hechas treinta entrevistas abiertas con las mujeres y diez con los hombres, todos ellos entre 18 y 79 años, residentes por más de seis meses en una regional de salud de Cuiabá - MT. La categorización de los datos se hizo por medio del análisis del contenido. Se considera la visita como una importante forma de aproximación entre el Programa Salud de la Família y las familias, favoreciendo el acceso a los servicios, la construcción de nuevas relaciones entre los usuarios y el equipo de salud, y, la formación de un vínculo entre ellos. La visita domiciliaria se presenta como una alternativa importante para el acceso a los cuidados clínicos y de vigilancia a la salud, reiterando la práctica de la visita tal como recibida. Al mismo tiempo, se espera que ella promueva respuestas más amplias a las necesidades vividas.

Incremento de la participación de Atención Primaria en la asistencia al virus de la inmunodeficiencia humana: opinan los profesionales de las unidades hospitalarias

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Ángela Ortega López

2014-04-01

Conclusiones: Los facultativos perciben dificultades en el seguimiento del VIH en AP, incluso para usuarios con buen control del VIH. Enfermeras y auxiliares de enfermería se muestran más abiertos a esta posibilidad por la cercanía domiciliaria y la promoción de la salud de AP.

La hospitalización domiciliaria ante los cambios demográficos y nuevos retos de salud

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Rosângela Minardi Mitre Cotta

2002-04-01

Full Text Available Objetivos. En la actualidad, el fenómeno demográfico más importante es el rápido envejecimiento de la población, que tiene un creciente y profundo impacto en todos los ámbitos de la sociedad, aunque su mayor trascendencia es en la sanidad, tanto por su repercusión en todos los niveles asistenciales como por la necesidad de nuevos recursos y estructuras. De ahí que se hayan desarrollado en muchos países diferentes alternativas y programas institucionales, ambulatorios y domiciliarios, encaminados a mejorar la situación sanitaria y a auxiliar en el proceso de establecer prioridades. La hospitalización domiciliaria (HD es una de ellas. El objetivo de este estudio consistió en describir y analizar las características de la población asistida en HD, y en comentar el papel de la HD como mecanismo de integración y coordinación entre niveles, frente al reto de la reorganización de políticas y proyectos de atención sanitaria, especialmente los dirigidos a la población anciana. Métodos. Se realizó un estudio descriptivo, retrospectivo, de una serie de pacientes asistidos en HD en el área sanitaria número 9 de la Comunidad Valenciana, España, con una población de referencia de 321 361 habitantes, de los cuales 60 079 (18,7% son personas de 60 años o más, y 43 044 (13,4%, de 65 años o más. Se realizó un estudio descriptivo de las variables analizadas, calculándose la media y la desviación estándar para las variables cuantitativas, y las frecuencias absoluta y relativa (porcentaje para las variables cualitativas. Resultados. El perfil de los pacientes estudiados corresponde a ancianos (el 78% con 65 años o más; media de 73 años, predominantemente del sexo femenino, con enfermedades crónicas (72% y múltiples enfermedades asociadas (el 67% tenía al menos un diagnóstico secundario asociado. Se constató la existencia de un importante problema de comunicación entre los dos principales niveles de atención (primaria y

Programmed home visits by nursing professionals to older adults: prevention or treatment?

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Caridad Dios-Guerra

2015-06-01

Full Text Available OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad.MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney.RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001. El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001. No existen diferencias significativas en tiempo de vida entre los casos y los controles.CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención.

Programmed home visits by nursing professionals to older adults: prevention or treatment?1

Science.gov (United States)

Dios-Guerra, Caridad; Carmona-Torres, Juan Manuel; Ruíz-Gándara, África; Muñoz-Alonso, Adoración; Rodríguez-Borrego, María-Aurora

2015-01-01

OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad. MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney. RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. PMID:26312638

El hospital ante un brote prolongado de legionelosis The hospital faced with a prolonged Legionella outbreak

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Juan Antonio Fernández

2004-08-01

Full Text Available Objetivo: Describir los recursos asistenciales utilizados en pacientes hospitalizados por neumonía por Legionella durante un brote ocurrido en Alcoy y compararlos con los empleados en otras neumonías. Métodos y resultados: Mediante un protocolo, se analiza y compara a 177 pacientes con neumonía por Legionella con 180 pacientes ingresados por otras neumonías, y se describe su tratamiento y los recursos empleados. La claritromicina fue el antibiótico más utilizado en ambos grupos. La estancia hospitalaria fue similar, pero los requerimientos de ventilación mecánica y cuidados intensivos fueron superiores para Legionella. La hospitalización domiciliaria se utilizó con éxito en un 15,6% de los pacientes con Legionella y en un 11,3% de los demás. El uso de oxigenoterapia domiciliaria al alta fue menor para Legionella (7,8% que para el resto de neumonías (16,7%. Conclusiones: Se destaca la mayor necesidad de ventilación mecánica en la neumonía por Legionella y los buenos resultados de la hospitalización domiciliaria dentro de los nuevos sistemas de gestión.Objective: To describe the health resources used in patients hospitalized with Legionella pneumonia during an outbreak of Legionnaire's disease in Alcoy (Spain, and to compare them with those used in other forms of pneumonia. Methods and results: Using a clinical protocol, 177 Legionella pneumonia patients were compared with 180 patients hospitalized for other types of pneumonia. Data on therapy and the resources used were collected. The most common antibiotic treatment in both groups was clarithromycin, but intensive care and mechanical ventilation requirements were greater in Legionella pneumonia. Home-based hospital care was successfully used in 15.6% of patients with Legionella pneumonia and in 11.3% of those with other types of pneumonia. Home oxygen therapy after discharge was less frequent in the Legionella pneumonia group (7.8% than in the group with non

Effect Of Oligomeric Enteral Nutrition On Symptoms Of Acute Radiation Enteritis

International Nuclear Information System (INIS)

Dubinsky, P.

2008-01-01

Radiotherapy of abdominal and pelvic tumours is frequently associated with acute radiation enteritis. Predominant symptoms include diarrhea, watery stools, abdominal pain, nausea and vomiting. There are very few effective interventions available for this condition. Enteral oligomeric nutrition has been used in bowel diseases with functional failure similar to radiation enteritis. The aim of presented work was to observe occurrence of symptoms of radiation enteritis in patients undergoing abdominal or pelvic radiotherapy. Apart from diet and pharmacological therapy, oral oligomeric enteral nutrition (Peptisorb Powder Nutricia) at the dose of 1000 - 2000 ml per day was administered for minimum of 4 days. Planned period of administration was 14 days and longer. Symptoms of radiation enteritis were evaluated at the beginning and in the end of administration. Prevalence of all evaluated symptoms of radiation enteritis was decreased and difference was statistically significant for diarrhea, watery stools, abdominal pain, nausea and vomiting. The use of evaluated oligomeric nutritional support might, in conjunction with pharmacotherapy and diet, alleviate symptoms of acute radiation enteritis and maintain nutritional status of patients. (author)

Influencia de la consulta de enfermedad renal crónica avanzada en la elección de modalidad de terapia renal sustitutiva

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Carmen Caro Domínguez

Full Text Available Introducción: La enfermedad renal crónica constituye un problema de salud pública por su elevada incidencia y prevalencia, importante morbimortalidad y coste asistencial. Un aspecto fundamental para el paciente es la elección de modalidad de terapia sustitutiva renal. En este sentido, la consulta de enfermedad renal crónica avanzada o prediálisis, puede jugar un papel fundamental. Objetivo: Conocer producción científica sobre la influencia de la consulta de enfermedad renal crónica avanzada en la elección de modalidad de diálisis por parte del paciente. Metodología: Revisión bibliográfica para la que se realizaron búsquedas en las bases de datos de PubMed, Scielo, Science Direct, Proquest y Google Académico. Se analizaron los artículos que trataban la consulta prediálisis, variables que influyeran en la elección de modalidad de diálisis y satisfacción del paciente. Resultados: Se han revisado 25 artículos publicados en los años 2002-2014, de diseño observacional descriptivo y de cohortes. Se ha encontrado relación en la elección de las técnicas domiciliarias con la existencia de un programa de educación prediálisis, la información que ofrece enfermería, la entrada programada en diálisis, menor edad, menor comorbilidad y factores socioeconómicos o estructurales. Conclusion: Los factores que favorecen la elección de las técnicas de diálisis domiciliarias son la existencia de consulta de enfermedad renal crónica avanzada y la referencia oportuna del paciente a dicha consulta, ser joven, menor comorbilidad y la necesidad de contención de costes. Esta elección se ve perjudicada por factores estructurales. Las terapias domiciliarias producen mayor satisfacción en los pacientes.

ESTUDIO COMPARADO DE INFECCIÓN POR SALMONELLA Y CAMPYLOBACTER EN HUESCA. 1996-1999

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Ignacio Pérez Ciordia

2001-01-01

Full Text Available Fundamentos: Los g neros Salmonella y Campylobacter son los principales agentes bacterianos causantes de enteritis en el hombre en los pa ses desarrollados. El objetivo del presente trabajo es estudiar las caracter sticas descriptivas de los casos de infecci n por Salmonella y por Campylobacter y describir su tendencia y variaci n estacional en la provincia de Huesca para el per odo 1996-1999 M todo: Las fuentes de informaci n han sido los Laboratorios Microbiol gicos Hospitalarios (LMH que realizan anal ticas de coprocultivo tanto de enfermos ambulatorios como hospitalarios. Se toma el municipio como unidad de referencia para representar la distribuci n espacial. Para el estudio de la tendencia se utiliza un modelo determinista multiplicativo, agrupando los datos en per odos cuatrisemanales Resultados: Se han recogido un total de 781 casos de infecci n por Salmonella y 654 casos de infecci n por Campylobacter, con unas tasas medias anuales de 95 y 79,5 105 habitantes respectivamente. La enteritis por Campylobacter se presenta mayoritariamente en menores de 5 a os (73,4 %, contra el 35,5 % para la salmonelosis. La situaci n se invierte en el caso de porcentaje de ingreso hospitalario; as , el ingreso por salmonelosis es casi 5 veces superior. Ambos g neros presentan una clara estacionalidad, con un pico pronunciado en el mes de agosto. Conclusiones: Se observa una tendencia ascendente en el n mero de aislamientos positivos para ambos microorganismos y una clara estacionalidad en la poca estival.

La cuidadora domiciliaria de ancianos: de la poca visibilidad de su desempeño laboral The home carer for the elderly people: on the little visibility of their work performance

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Natacha Borgeaud-Garciandía

2012-12-01

Full Text Available Nuestro objetivo es incurrir en el tema de la poca visibilidad social que caracteriza el desempeño del trabajo de la cuidadora domiciliaria de ancianos. Se trata generalmente de trabajadoras mujeres y, particularmente en la Ciudad Autónoma de Buenos Aires (CABA, de trabajadoras migrantes provenientes de países latinoamericanos. En una primera parte retomamos, en base a la literatura existente, datos sobre las migraciones laborales femeninas que han llegado a la Argentina para desempeñarse en empleos domésticos y de cuidados. La idea es ver algunos rasgos socioeconómicos laborales y modificaciones que se dieron en el sector, acompañados por movimientos migratorios laborales feminizados provenientes de países de la región. En una segunda parte, siempre en vistas de reflexionar sobre la invisibilidad laboral de ciertos empleos, incurrimos en las definiciones legales de los trabajadores del sector. Resaltamos brevemente, como aspectos que reflejan percepciones e impactan la realidad, algunos puntos legales particulares, ya sea desde el estatus laboral o de la migración, que jerarquizan los trabajadores y crean vacíos legales que dificultan su reconocimiento. Finalmente, nos aproximaremos en una tercera parte a diferentes elementos propios del empleo de cuidadora domiciliaria para ancianos que convergen hacia la invisibilización social de su labor. Estos elementos se compenetran y refuerzan mutuamente, aunque para mayor claridad en la exposición, los reagrupamos bajo diferentes temáticas, como las poblaciones concernidas, las condiciones de empleo, el espacio de desempeño, las actividades desarrolladas, y finalmente el tipo de relaciones que implica. A modo de conclusión, propondremos una breve reflexión en torno a los esfuerzos de profesionalización del cuidado domiciliario, particularmente tal como se están desarrollando en Francia.Our goal is to engage in the issue regarding the little social visibility that characterizes the

Development and evaluation of a hot-melt coating technique for enteric coating

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Arun Trambak Patil

2012-03-01

Full Text Available Conventional enteric coating requires the use of organic based polymers which are equally hazardous to the environment and operating personnel. Hot-melt coating avoids the use of solvents and is a safer and time-saving process. The present study was designed to assess the efficacy of hot-melt coating (HMC as an enteric coating technique. Pellets prepared by extrusion spheronization were selected as the core formulation for a model of the gastric irritant drug diclofenac sodium (DFS because of their innate advantages over single-unit formulations. Stearic acid (SA and palmitic acid (PA were evaluated as enteric hot-melt coating materials. HMC was carried out in a specially modified coating pan by applying SA and PA in molten state onto preheated pellets to achieve a coating level of 5-15 %w/w. Hot-melt coated pellets were evaluated for disintegration pH and in vitro dissolution in the pH range 1.2 to 6.8, along with basic micromeritics. SEM of coated pellets showed a uniform and smooth coating. These results indicated that HMC of both SA and PA exhibited very good enteric coating ability. The coated pellets showed negligible drug release in acidic pH. As the pellets were subsequently transferred to a higher pH level, a gradual increase in release of the drug from the pellets was observed with increasing pH of the dissolution media. The release was dependent upon coating extent, providing sustained enteric release as opposed to abrupt release with mixed release kinetics.O revestimento entérico convencional requer o uso de polímeros orgânicos os quais são igualmente danosos ao meio ambiente e ao pessoal que o executa. O revestimento por fusão a quente evita o uso de solventes e é processo mais seguro e que consome menos tempo. O presente estudo foi planejado para avaliar a eficácia do revestimento por fusão a quente (RFQ como técnica de revestimento entérico. Os péletes preparados por esferonização por extrusão foram selecionados como

Enteric Duplication.

Science.gov (United States)

Jeziorczak, Paul M; Warner, Brad W

2018-03-01

Enteric duplications have been described throughout the entire gastrointestinal tract. The usual perinatal presentation is an abdominal mass. Duplications associated with the foregut have associated respiratory symptoms, whereas duplications in the midgut and hindgut can present with obstructive symptoms, perforation, nausea, emesis, hemorrhage, or be asymptomatic, and identified as an incidental finding. These are differentiated from other cystic lesions by the presence of a normal gastrointestinal mucosal epithelium. Enteric duplications are located on the mesenteric side of the native structures and are often singular with tubular or cystic characteristics. Management of enteric duplications often requires operative intervention with preservation of the native blood supply and intestine. These procedures are usually very well tolerated with low morbidity.

Enteral nutrition in surgery

International Nuclear Information System (INIS)

Sucha, R.; Lichvarova, I.; Duchon, R.; Dolnik, J.; Pindak, D.

2011-01-01

Enteral feeding provides physiologic, metabolic, safety, and cost benefits over parenteral nutrition. There are various ways enteral nutritional is administered and scheduled. The method of administration must be individualized to each patient's specific needs. Enteral nutrition is not only the supply of exogenous substrates and to prevent depletion of endogenous sources. Today the enteral nutrition becomes part of a therapeutic strategy to influence the severity of the disease to affect the function of GIT, and to modulate immune responses of the gut and the whole organism. Early enteral nutrition in the postoperative period reduces the risk of infectious complications. (author)

EARLY ENTERAL FEEDING AND DELAYED ENTERAL FEEDING- A COMPARATIVE STUDY

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Alli Muthiah

2017-03-01

Full Text Available BACKGROUND Nutrients form the fuel for the body, which comes in the form of carbohydrates, proteins and lipids. The body is intended to burn fuels in order to perform work. Starvation with malnutrition affects the postoperative patients and patients with acute pancreatitis. There is an increased risk of nosocomial infections and a delay in the wound healing may be noted. They are more prone for respiratory tract infections. Enteral Nutrition (EN delivers nutrition to the body through gastrointestinal tract. This also includes the oral feeding. This study will review the administration, rationale and assess the pros and cons associated with the early initiation of enteral feeding. The aim of this study is to evaluate if early commencement of enteral nutrition compared to traditional management (delayed enteral feeding is associated with fewer complications and improved outcome-  In patients undergoing elective/emergency gastrointestinal surgery.  In patients with acute pancreatitis. It is also used to determine whether a period of starvation (nil by mouth after gastrointestinal surgery or in the early days of acute pancreatitis is beneficial in terms of specific outcomes. MATERIALS AND METHODS A prospective cohort interventional study was conducted using 100 patients from July 2012 to November 2012. Patients satisfying the inclusion and exclusion criteria were included in the study. Patients admitted in my unit for GIT surgeries or acute pancreatitis constituted the test group, while patients admitted in other units for similar disease processes constituted the control group. RESULTS Our study concluded that early enteral feeding resulted in reduced incidence of surgical site infections. When the decreased length of stay, shorter convalescent period and the lesser post-interventional fatigue were taken into account, early enteral feeding has a definite cost benefit.CONCLUSION Early enteral feeding was beneficial associated with fewer

Representações sociais do cuidado de doentes terminais no domicílio: o olhar do cuidador familiar

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Stefanie Griebeler Oliveira

2016-01-01

Full Text Available Objetivo: conocer las representaciones sociales construidas por los cuidadores familiares de pacientes terminales sobre el cuidado en el domicilio. Método: estudio cualitativo con once cuidadores familiares de enfermos terminales, registrados en el servicio de internación domiciliaria de un hospital universitario del sur de Brasil. Realizaron entrevistas narrativas, analizadas por medio del análisis de contenido. Se definieron cuatro categorías: cuidadores hombres y mujeres, una visión diferente; la inversión de roles y los cambios en el cuidado; experiencias como fuente de conocimiento para el cuidado en el hogar; y desafíos del cuidado. Resultados: para los cuidadores hombres, las representaciones difieren de las de las mujeres debido a que el cuidado incluye su entorno. Los hombres no atribuyen la angustia a la sobrecarga, pero sí al temor de perder un ser. Otras representaciones remiten a la imposibilidad de elección para asumir el papel de cuidador y a la inversión de roles, lo que vuelve al paciente sometido al cuidador. Conclusión: esta investigación permitió conocer cómo los cuidadores familiares construyen los significados e interpretan el cuidado que realizan en el domicilio por medio del Programa de Hospitalización Domiciliaria. Se destaca la función de los profesionales de la salud en orientar al cuidador familiar para realizar el cuidado.

Estudo de fibras alimentares em frutas e hortaliças para uso em nutrição enteral ou oral Study of dietary fibre in fruits and vegetables for use in oral or enteral diets

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Edma Maria de Araújo

2010-03-01

Full Text Available Dietas enterais com alimentos convencionais são usadas em nutrição domiciliar para fornecer macronutrientes, obter dietas individualizadas e de menor custo. O objetivo deste trabalho foi estudar frutas e hortaliças (alface, berinjela, cenoura, chicória, goiaba e tamarindo como fontes de fibras alimentares solúveis e insolúveis para serem usadas em nutrição enteral ou suplemento nutricional oral. As hortaliças e frutas foram adicionadas a uma formulação enteral domiciliar e também preparadas em solução com água. Foram determinadas a composição centesimal, as fibras solúveis e insolúveis dos alimentos, a atividade de água e o pH das formulações. Foram realizados testes de gotejamento das formulações com os alimentos experimentais. A melhor proporção de alimento/dieta enteral domiciliar foi de 100 g/2 L para dieta enteral e de 150 g/2 L para suplemento nutricional oral (ingestão por boca. As quantidades de cada alimento adicionadas à formulação enteral equivalem a duas porções (100 g diárias de cada alimento para 2 L e 2000 kcal. A maior contribuição para aumentar a quantidade de fibras foi da goiaba e a menor, da berinjela. Os valores de atividade de água ficaram entre 0,95 e 1,00, indicando que as dietas são susceptíveis à contaminação microbiana. Nessas condições, devem ser consumidas imediatamente após o preparo.Enteral diets based on conventional foods are used in domestic nutritional therapy to provide macronutrients, obtain individualised diets and to lower costs. Eggplant, carrot, chicory, lettuce, guava and tamarind were studied as sources of soluble and insoluble fibers for use in enteral diets or as oral nutritional supplements, added to a domestic enteral formulation and also prepared in aqueous solution. The following physical-chemical characteristics were determined: soluble and insoluble fibers, proximate composition, pH and water activity. Drip tests were carried out with the formulas

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis Nutrição parenteral versus enteral em pacientes com pancreatite aguda grave

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Josiel Paiva Vieira

2010-10-01

: A maioria dos pacientes era Balthazar E, principalmente no grupo enteral, porém sem significado estatístico (p=0,21. Também não houve diferença estatística nos dois grupos em relação ao tempo médio de uso de suporte nutricional, somatostatina e antibiótico. O imipenem foi a droga de escolha para profilaxia da infecção pancreática nos dois grupos. Houve mais complicações gerais no grupo parenteral, sem significado estatístico (p=0,10. As complicações infecciosas do tipo sépsis do cateter e infecção do tecido pancreático foram mais frequentes no grupo parenteral, com significância estatística (p=0,06. Não houve diferença na média de internação nos dois grupos. Houve três óbitos no grupo parenteral e nenhum no enteral. CONCLUSÃO: O suporte nutricional enteral está associado à menor taxa de complicações sépticas do que o parenteral.

Immediate preoperative enteral nutrition (preoperative enteral nutrition

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Lađević Nebojša

2017-01-01

Full Text Available Nutritional support of surgical patients is a necessary part of the treatment. It alone cannot cure the disease but it significantly affects the recovery of patients and supports surgical interventions. Patients in malnutrition have shown to have significantly more postoperative infectious and non-infectious complications. This significantly prolongs treatment time and increases costs. However, there is one fact that cannot be expressed in money, which is the patient's impression of the surgical intervention. Adequate preoperative patient support, based on the intake of liquid nutritive solutions, reduces preoperative stress and deflects the metabolic response. Now, it is recommended for adults and children older than one year to drink clear liquid up to 2 hours before induction in anesthesia. Appropriate enteral nutrition has a significant place in the postoperative recovery of patients. Enteral nutrition is reducing complications, mainly infectious complications because the function of the digestive system as one large immune system is preserved. Perioperative enteral nutrition is a necessary part of the modern treatment of surgical patients. In addition to the significant effect on the occurrence of postoperative complications, it is also important that this type of diet improves the psychological status of patients.

[Modular enteral nutrition in pediatrics].

Science.gov (United States)

Murillo Sanchís, S; Prenafeta Ferré, M T; Sempere Luque, M D

1991-01-01

Modular Enteral Nutrition may be a substitute for Parenteral Nutrition in children with different pathologies. Study of 4 children with different pathologies selected from a group of 40 admitted to the Maternal-Childrens Hospital "Valle de Hebrón" in Barcelona, who received modular enteral nutrition. They were monitored on a daily basis by the Dietician Service. Modular enteral nutrition consists of modules of proteins, peptides, lipids, glucids and mineral salts-vitamins. 1.--Craneo-encephalic traumatisms with loss of consciousness, Feeding with a combination of parenteral nutrition and modular enteral nutrition for 7 days. In view of the tolerance and good results of the modular enteral nutrition, the parenteral nutrition was suspended and modular enteral nutrition alone used up to a total of 43 days. 2.--55% burns with 36 days of hyperproteic modular enteral nutrition together with normal feeding. A more rapid recovery was achieved with an increase in total proteins and albumin. 3.--Persistent diarrhoea with 31 days of modular enteral nutrition, 5 days on parenteral nutrition alone and 8 days on combined parenteral nutrition and modular enteral nutrition. In view of the tolerance and good results of the modular enteral nutrition, the parenteral nutrition was suspended. 4.--Mucoviscidosis with a total of 19 days on modular enteral nutrition, 12 of which were exclusively on modular enteral nutrition and 7 as a night supplement to normal feeding. We administered proteic intakes of up to 20% of the total calorific intake and in concentrations of up to 1.2 calories/ml of the final preparation, always with a good tolerance. Modular enteral nutrition can and should be used as a substitute for parenteral nutrition in children with different pathologies, thus preventing the complications inherent in parenteral nutrition.

Instrumento para a abordagem psicossocial do indivíduo e da família na assistência domiciliar: condições de aplicabilidade Instrumento para el abordaje psicosocial del indivíduo y familia en la asistencia domiciliaria: las condiciones de aplicabilidad Psychosocial instrument to approach person and family in home care: conditions of applicability

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Vilanice Alves de Araújo Püschel

2005-06-01

Full Text Available Na Assistência Domiciliar (AD, o modelo clínico e hospitalar tem sido hegemônico. A abordagem psicossocial mostra-se necessária para os problemas identificados no âmbito domiciliar. Este artigo tem como objetivos: apresentar um instrumento de abordagem psicossocial do indivíduo e da família na assistência domiciliar e mostrar as condições de aplicabilidade do modelo psicossocial no domicílio, a partir da utilização desse instrumento. Esse instrumento foi aplicado pelas participantes de um curso de capacitação para a AD numa abordagem psicossocial, em pessoas doentes e familiares que estavam recebendo o cuidado no domicílio. Verificou-se que este é viável, porém à onipotência própria da clínica se sobrepõe uma impotência quase absoluta de raciocínio clínico-psicossocial. Há necessidade de validação desse instrumento e da composição de um campo de pesquisa significativo para a qualificação do ensino e da prática assistencial na AD.En la asistencia domiciliaria (AD el modelo clínico y hospitalario ha sido hegemónico. El abordaje psicosocial muestra que es necesario para los problemas identificados en el ámbito domiciliario. Este artículo tiene como objetivos: presentar un instrumento de abordaje psicosocial al individuo y a la familia en la asistencia domiciliaria y mostrar las condiciones de aplicabilidad del modelo psicosocial en el domicilio a partir de la utilización de ese instrumento. El instrumento fue aplicado, por las participantes de un curso de capacitación para la AD con abordaje psicosocial, en personas enfermas y familiares que estaban recibiendo el cuidado en el domicilio. Se verificó que éste es viable, sin embargo la omnipotencia propia de la clínica se sobrepone a una impotencia casi absoluta de raciocinio clínico-psicosocial. Hay necesidad de validar el instrumento y de la composición de un campo de investigación significativo para la calificación de la enseñanza y de la pr

Estudio comparado de infección por Salmonella y Campylobacter en Huesca. 1996-1999

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Pérez-Ciordia Ignacio

2001-01-01

Full Text Available Fundamentos: Los géneros Salmonella y Campylobacter son los principales agentes bacterianos causantes de enteritis en el hombre en los países desarrollados. El objetivo del presente trabajo es estudiar las características descriptivas de los casos de infección por Salmonella y por Campylobacter y describir su tendencia y variación estacional en la provincia de Huesca para el período 1996-1999 Método: Las fuentes de información han sido los Laboratorios Microbiológicos Hospitalarios (LMH que realizan analíticas de coprocultivo tanto de enfermos ambulatorios como hospitalarios. Se toma el municipio como unidad de referencia para representar la distribución espacial. Para el estudio de la tendencia se utiliza un modelo determinista multiplicativo, agrupando los datos en períodos cuatrisemanales Resultados: Se han recogido un total de 781 casos de infección por Salmonella y 654 casos de infección por Campylobacter, con unas tasas medias anuales de 95 y 79,5 × 10(5 habitantes respectivamente. La enteritis por Campylobacter se presenta mayoritariamente en menores de 5 años (73,4 %, contra el 35,5 % para la salmonelosis. La situación se invierte en el caso de porcentaje de ingreso hospitalario; así, el ingreso por salmonelosis es casi 5 veces superior. Ambos géneros presentan una clara estacionalidad, con un pico pronunciado en el mes de agosto. Conclusiones: Se observa una tendencia ascendente en el número de aislamientos positivos para ambos microorganismos y una clara estacionalidad en la época estival.

Enterocolite necrosante em recém-nascidos de muito baixo peso: a influência da nutrição enteral

OpenAIRE

KIMAK, Karine Santos

2013-01-01

A enterocolite necrosante é uma importante causa de morbimortalidade neonatal em prematuros, principalmente nos recém-nascidos de muito baixo peso. Apesar de a enterocolite necrosante apresentar etiologia multifatorial, a dieta enteral tem sido implicada como um dos principais fatores associados e não há consenso sobre quando deve ser iniciada, como deve progredir, nem a sua relação com a ocorrência da doença. Assim, este estudo teve por objetivo avaliar se o padrão da nutrição enteral influe...

Combined enteral and parenteral nutrition.

Science.gov (United States)

Wernerman, Jan

2012-03-01

To review and discuss the evidence and arguments to combine enteral nutrition and parenteral nutrition in the ICU, in particular with reference to the Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients (EPaNIC) study. The EPaNIC study shows an advantage in terms of discharges alive from the ICU when parenteral nutrition is delayed to day 8 as compared with combining enteral nutrition and parenteral nutrition from day 3 of ICU stay. The difference between the guidelines from the European Society of Enteral and Parenteral Nutrition in Europe and American Society for Parenteral and Enteral Nutrition/Society of Critical Care Medicine in North America concerning the combination of enteral nutrition and parenteral nutrition during the initial week of ICU stay was reviewed. The EPaNIC study clearly demonstrates that early parenteral nutrition in the ICU is not in the best interests of most patients. Exactly at what time point the combination of enteral nutrition and parenteral nutrition should be considered is still an open question.

The enter-educate approach.

Science.gov (United States)

Piotrow, P T; Coleman, P L

1992-03-01

This article describes how the Population Communication Services (PCS) has seized on the "enter-educate" approach, the blending of popular entertainment with social messages, to change reproductive health behavior. The enter-educate approach spreads its message through songs, soap operas, variety shows, and other types of popular entertainment mediums. Because they entertain, enter-educate projects can capture the attention of an audience -- such as young people -- who would otherwise scorn social messages. And the use of population mediums makes it possible to reach a variety of audiences. Funded by USAID, PCS began its first enter-educate project in response to the increasing number of teenage pregnancies in Latin America. PCS developed 2 songs and videos, which featured popular teenage singers to serve as role models, to urge abstinence. The songs became instant hits. Since then, PCS has mounted more then 80 major projects in some 40 countries. Highlights of programs range from a successful multi-media family planning campaign in Turkey to humorous television ads in Brazil promoting vasectomy. Recently, PCS initiated projects to teach AIDS awareness. At the core of the enter-educate approach is the social learning theory which holds that much behavior is learned through the observation of role-models. Health professionals work alongside entertainers to produce works that have audience appeal and factual social messages. The enter-educate approach works because it is popular, pervasive, personal, persuasive, and profitable. PCS has found that enter-educate programs pay for themselves through cost sharing and cost recovery.

Enteric coating of ibuprofen tablets (200 mg using an aqueous dispersion system

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Rabia Bushra

2010-03-01

Full Text Available Ibuprofen is a propionic acid derivative that belongs to the class NSAIDs. Major adverse reactions associated with Ibuprofen are related to GIT and include peptic and mucosal ulcers, dyspepsia, severe gastric pain and bleeding, that results in excessive treatment failure. The goal of this study was to develop enteric coated ibuprofen tablets in order to avoid gastric mucosal irritation, diffusion of drug across mucosal lining and to let active ingredient be absorbed easily in small intestine. The formulation was developed and manufactured through the direct compression process, the simplest, easiest and most economical method of manufacturing. Enteric coating was done using an Opadry white subcoating and an aqueous coating dispersion of Acryl-Eze. Enteric coated formulation was subjected to disintegration and dissolution tests by placing in 0.1 M hydrochloric acid for 2 h and then 1 h in phosphate buffer with a pH of 6.8. About 0.04% of drug was released in the acidic phase and 99.05% in the basic medium. These results reflect that ibuprofen can be successfully enteric coated in order to prevent its release in the stomach and facilitate rapid release of the drug in the duodenum, due to the presence of superdisintegrant. Formulating this enteric coated tablets could increase patient compliance by decreasing adverse drug reactions (ADR S associated with Ibuprofen therapy.Ibuprofeno é um derivado do ácido propiônico, que pertence à classe dos fármacos não-esteróides (AINES. As principais reações adversas associadas com o ibuprofeno se referem àquelas do trato gastrintestinal (TGI, como úlceras pépticas e da mucosa, dispepsia, dor gástrica grave e sangramento, que resultam em muitas falhas de tratamento. O objetivo do estudo foi desenvolver comprimidos revestidos de ibuprofeno que impeçam a irritação da mucosa gástrica, difusão do fármaco através da mucosa e permitam, facilmente, a absorção do princípio ativo do intestino

Assistência domiciliar a idosos: fatores associados, características do acesso e do cuidado Asistencia domiciliaria a ancianos: factores asociados, características del acceso y del cuidado Home health care for the elderly: associated factors and characteristics of access and health care

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Elaine Thumé

2010-12-01

Full Text Available OBJETIVO: Avaliar fatores associados à assistência domiciliar recebida pela população idosa e suas características, segundo modelos de atenção Estratégia Saúde da Família e modelo tradicional. MÉTODOS: Estudo transversal de base populacional, com amostra representativa de 1.593 indivíduos com 60 anos ou mais, residentes na região urbana de Bagé, RS, em 2008. A amostragem foi realizada em múltiplos estágios. Os dados foram coletados em entrevistas individuais. Foram analisadas as formas de acesso aos serviços, participação dos profissionais, satisfação e situação de saúde dos usuários após o atendimento. Foi utilizado modelo de regressão de Poisson para estimar as razões de prevalência bruta e ajustada, os respectivos intervalos com 95% de confiança e p-valor (teste de Wald. RESULTADOS: Assistência domiciliar foi estatisticamente associada à história prévia de acidente vascular cerebral, à presença de sinais de demência e à incapacidade para as atividades da vida diária. A família foi responsável por 75% das solicitações de cuidado. Nas áreas da atenção tradicional, os médicos responderam pela maior promoção de cuidados, enquanto nas áreas da Estratégia Saúde da Família destacou-se a participação da equipe de enfermagem. Aproximadamente 78% das solicitações foram atendidas em até 24 horas e 95% dos usuários avaliaram positivamente o cuidado recebido. Dois terços dos idosos referiram melhora nas condições de saúde. CONCLUSÕES: As variáveis associadas ao recebimento de assistência domiciliar reiteram os indicadores de fragilidade destacados na Política Nacional de Saúde da Pessoa Idosa e fortalecem a importância da estratégia na promoção da eqüidade no cuidado dos idosos. A avaliação positiva e o impacto na situação de saúde afirmam o domicílio como ambiente terapêutico.OBJETIVO: Evaluar los factores asociados a la asistencia domiciliaria recibida por la poblaci

Meat-based enteral nutrition

Science.gov (United States)

Derevitskay, O. K.; Dydykin, A. S.

2017-09-01

Enteral nutrition is widely used in hospitals as a means of nutritional support and therapy for different diseases. Enteral nutrition must fulfil the energy needs of the body, be balanced by the nutrient composition and meet patient’s nutritional needs. Meat is a source of full-value animal protein, vitamins and minerals. On the basis of this research, recipes and technology for a meat-based enteral nutrition product were developed. The product is a ready-to-eat sterilised mixture in the form of a liquid homogeneous mass, which is of full value in terms of composition and enriched with vitamins and minerals, consists of particles with a size of not more than 0.3 mm and has the modified fat composition and rheological characteristics that are necessary for passage through enteral feeding tubes. The study presents experimental data on the content of the main macro- and micro-nutrients in the developed product. The new product is characterised by a balanced fatty acid composition, which plays an important role in correction of lipid metabolism disorders and protein-energy deficiency, and it is capable of satisfying patients’ daily requirements for vitamins and the main macro- and microelements when consuming 1500-2000 ml. Meat-based enteral nutrition can be used in diets as a standard mixture for effective correction of the energy and anabolic requirements of the body and support of the nutritional status of patients, including those with operated stomach syndrome.

Enteral nutrition - child - managing problems

Science.gov (United States)

... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

Radiation enteritis

International Nuclear Information System (INIS)

Ochsner, S.F.; Head, L.H.

1973-01-01

A comprehensive review of radiation enteritis is presented. Experience in clinical radiation therapy has indicated that the small bowel is the segment of the alimentary tract that is most susceptible to radiation damage. (U.S.)

Enteric Methane Emission from Pigs

DEFF Research Database (Denmark)

Jørgensen, Henry; Theil, Peter Kappel; Knudsen, Knud Erik Bach

2011-01-01

per kg meat produced is increased (Fernández et al. 1983; Lekule et al. 1990). The present chapter will summarise our current knowledge concerning dietary and enteric fermentation that may influence the methane (CH4) emission in pigs. Enteric fermentation is the digestive process by which.......3 % of the worlds pig population. The main number of pigs is in Asia (59.6 %) where the main pig population stay in China (47.8 % of the worlds pig population). The objective of the chapter is therefore: To obtain a general overview of the pigs’ contribution to methane emission. Where is the pigs’ enteric gas...... produced and how is it measured. The variation in methane emission and factors affecting the emission. Possibility for reducing the enteric methane emission and the consequences....

Soporte nutricional enteral en pacientes pediátricos con insuficiencia renal crónica en hemodiálisis Enteral nutritional support in pediatric patients with chronic renal failure on hemodialysis

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Susana Pineda Pérez

2006-03-01

Full Text Available Se realizó un estudio clínico con el objetivo de evaluar la aceptabilidad, tolerancia y efecto en el estado nutricional de la nutrición enteral con Nutricomp® ADN renal de B-BRAUN. Se estudiaron 12 pacientes en edades entre los 10 y 19 años, que presentaban insuficiencia renal crónica y recibían tratamiento de hemodiálisis. Además de su alimentación habitual se indicó ADN renal (90 g, por vía oral, en la sesión de diálisis. Se evaluó cada paciente al inicio y se comparó consigo mismo a los 30 días, según parámetros antropométricos, dietéticos, bioquímicos e inmunológicos. Los datos obtenidos se procesaron con el programa SPSS, versión 8, y se emplearon para el análisis las pruebas t de Student y chi cuadrado. La tolerancia y aceptabilidad de la fórmula enteral fueron buenas. A los 30 días se registró un aumento significativo en las variables antropométricas: peso (p < 0,001, índice de masa corporal (p < 0,001 y área grasa (p < 0,001. En el área de músculo el incremento no fue signficativo (p < 0,259. No hubo modificación significativa de las restantes variables. La recuperación nutricional, expresada por el aumento de peso, el índice de masa corporal, el área de grasa y el área muscular, estuvo presente en todos los pacientes estudiados.

Medium-chain triglyceride-rich enteral nutrition is more effective than low-fat enteral nutrition in rat colitis, but is equal in enteritis.

Science.gov (United States)

Tsujikawa, T; Ohta, N; Nakamura, T; Yasuoka, T; Satoh, J; Fukunaga, T; Itohi, A; Uda, K; Ihara, T; Andoh, A; Sasaki, M; Fujiyama, Y; Bamba, T

2001-10-01

Although enteral nutrition (EN) therapy for Crohn's disease has been confirmed to be as effective as steroid therapy, the precise mechanism responsible for the effects of EN remains unclear, although some of the therapeutic effects of EN are believed to be due to a low dietary fat content. In order to elucidate the influence of fat in EN, it is important to investigate not only the quantity of fat, but also the source of the fat. We compared two enteral nutritional formulae: Elental (Ajinomoto) (elemental diet; ED), which contains only 1.5% fat, provided as long-chain triglycerides (LCT), versus Twinline (Snow Brand Milk Products) (TL), which contains a high percentage of fat (20.4%), provided mainly as medium-chain triglycerides (MCT). These formulae were tested on rat enteritis and rat colitis induced by trinitrobenzene sulfonic acid (TNBS). Both ED and TL reduced the manifestations of enteritis. TL had a stronger anti-inflammatory effect than ED for colitis. TL also had nutritional advantages as compared with ED, as shown by the total serum protein in the TL group being significantly higher than that in the ED group. The results indicate that intraluminal MCT is suitable as a fat energy source during intestinal inflammation in rats. We suggest that Twinline may be more useful to improve nutritional status and to reduce the mucosal inflammation in rat colitis, but that Twinline is equal in effect to Elental for rat enteritis.

Programa interdisciplinar de internação domiciliar de Marília-SP: custos de recursos materiais consumidos Programa interdisciplinar de internación domiciliaria de Marília-SP: costos de los recursos materiales consumidos Interdisciplinary home hospitalization program of Marília-SP: material resource costs

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Sandra Renata Albino Marques Mesquita

2005-08-01

Full Text Available Este estudo estimou o custo médio direto total de alguns fatores produtivos (recursos materiais como material de consumo, dietas, medicamentos e soluções utilizados por dois grupos de pacientes internados no Programa Interdisciplinar de Internação Domiciliar de Marília-SP. A amostra foi constituída de 27 pacientes com acidente vascular cerebral (AVC e 18 com neoplasia. Os dados foram coletados do momento da internação até a saída do Programa. O custo médio direto total foi de R$ 52,72 para cada paciente com AVC e de R$ 65,13 para aqueles com neoplasia. Para ambos os grupos de pacientes, a subcategoria de material - dietas - respondeu, em termos de custos, pelo maior percentual.Este estudio estimó el promedio del costo directo total de algunos factores productivos (recursos materiales, tales como material de consumo, dietas, medicamentos y soluciones usados por dos grupos de pacientes durante el periodo de internación en el Programa Interdisciplinario de Internación Domiciliaria desarrollado en el municipio de Marilia-SP, Brasil. La muestra se constituyó de 27 pacientes con diagnóstico de accidente vascular cerebral (AVC y 18 pacientes con diagnóstico de Neoplasia. Los datos fueron recopilados desde el momento de la internación hasta la salida del Programa. El promedio del costo directo total correspondió a R$ 52,72 para los pacientes con AVC y R$ 65,13 para aquellos con Neoplasia. Para ambos grupos, la subcategoría de material - dieta fue responsable por el mayor porcentual de los costos.This study estimated the mean total direct cost of some production factors (material resources, including consumption materials, diets, medication and solutions used by two patient groups during hospitalization in the Interdisciplinary Home Hospitalization Program (PROIID of Marília-SP, Brazil. The sample consisted of 27 patients with a diagnosis of cerebral vascular accident (CVA and 18 with Neoplasm. Data were collected from the moment of

VISITA DOMICILIÁRIA: TECNOLOGIA DE CUIDADO UTILIZADA PELO ENFERMEIRO NA DEFESA DA SAÚDE DA CRIANÇA

Directory of Open Access Journals (Sweden)

Raquel Dully Andrade

2015-01-01

Full Text Available Este estudio tuvo como objetivo identificar elementos de cuidado favorables a la infancia en la visita domiciliaria, desde las narrativas de enfermeros, en la perspectiva de la atención y de la defensa del derecho a la salud de los niños. Estudio exploratorio con análisis temático cualitativo, basado en aspectos conceptuales del cuidado y derecho a la salud, a través de entrevistas con 14 enfermeros que trabajan en la Estrategia de Salud Familiar. Narrativas muestran las medidas de protección de la salud infantil, organizada por temas: Observación e intervención para el cuidado del niño en el hogar; Incautación de situaciones de violación de derechos; La vulnerabilidad en la infancia con padres usuarios de alcohol y otras drogas. La visita domiciliaria es una herramienta esencial de la práctica clínica en la atención primaria de salud, que constituye un espacio privilegiado para los cuidados de enfermería al niño y al contexto familiar en la defensa de la salud infantil.

Enteral feeding without pancreatic stimulation

DEFF Research Database (Denmark)

Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul

2005-01-01

OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...

Intestinal endocrine cells in radiation enteritis

International Nuclear Information System (INIS)

Pietroletti, R.; Blaauwgeers, J.L.; Taat, C.W.; Simi, M.; Brummelkamp, W.H.; Becker, A.E.

1989-01-01

In this study, the intestinal endocrine cells were investigated in 13 surgical specimens affected by radiation enteritis. Endocrine cells were studied by means of Grimelius' silver staining and immunostaining for chromogranin, a general marker of endocrine cells. Positively stained cells were quantified by counting their number per unit length of muscularis mucosa. Results in radiation enteritis were compared with matched control specimens by using Student's t test. Chromogranin immunostaining showed a statistically significant increase of endocrine cells in radiation enteritis specimens compared with controls both in small and large intestine (ileum, 67.5 +/- 23.5 cells per unit length of muscularis mucosa in radiation enteritis versus 17.0 +/- 6.1 in controls; colon, 40.9 +/- 13.7 cells per unit length of muscularis mucosa in radiation enteritis versus 9.5 +/- 4.1 in controls--p less than 0.005 in both instances). Increase of endocrine cells was demonstrated also by Grimelius' staining; however, without reaching statistical significance. It is not clear whether or not the increase of endocrine cells in radiation enteritis reported in this study is caused by a hyperplastic response or by a sparing phenomenon. We should consider that increased endocrine cells, when abnormally secreting their products, may be involved in some of the clinical features of radiation enteropathy. In addition, as intestinal endocrine cells produce trophic substances to the intestine, their increase could be responsible for the raised risk of developing carcinoma of the intestine in long standing radiation enteritis

Proposta de modelo para dimensionamento do pessoal de enfermagem em assistência domiciliária Propuesta de modelo para la provisión de personal de enfermería en asistencia domiciliaria Proposal for a model for calculating the size of nursing staff in home care

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Luiza Watanabe Dal Ben

2007-03-01

Full Text Available A assistência domiciliária (AD suscita questionamentos sobre a necessidade do número de horas diárias e dos dias de assistência de enfermagem por parte dos compradores da prestação de serviços à saúde em domicílio. Identificar os critérios adotados por gerentes e enfermeiras para o dimensionamento do pessoal de enfermagem. Os dados foram coletados por meio de entrevista semi-estruturada e analisados segundo o método de análise de conteúdo. Identificaram-se três categorias: elegibilidade do paciente; tempo despendido na assistência e perfil de competência do profissional. As etapas consideradas foram: identificação da carga média diária de trabalho; determinação da proporção das categorias profissionais; jornada de trabalho dos profissionais de enfermagem e identificação do índice de segurança técnica para cobertura de ausências previstas e de não previstas. Com base nessas variáveis, propusemos um modelo para calcular o quadro de profissionais de enfermagem em AD, agilizando o processo de tomada de decisão.La asistencia domiciliaria (AD suscita interrogantes sobre la necesidad del número de horas diarias y de los días de asistencia de enfermería por parte de los compradores de prestación de servicios a la salud en domicilio. Tuvo por objetivo identificar los criterios adoptados por gerentes y enfermeras para el cálculo del personal de enfermería. Los datos fueron recolectados por medio de una entrevista semi-estructurada y analizados según el método de análisis de contenido. Se identificaron tres categorías: elegibilidad del paciente, tiempo invertido en la asistencia y perfil de competencia del profesional. Las etapas consideradas fueron: identificación de la carga promedio diario de trabajo; determinación de la proporción de las categorías profesionales; jornada de trabajo de los profesionales de enfermería e identificación del índice de seguridad técnica para la cobertura de ausencias

Aspectos básicos de la nutrición enteral en el paciente quemado

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Carlos Manuel Collado Hernández

Full Text Available El tratamiento nutricional es un elemento importante en la terapia combinada de las lesiones por quemaduras severas, permitiendo un control del catabolismo en el paciente. En los pacientes quemados el hipermetabolismo estimula el aumento de las necesidades proteico calóricas, la influencia del inicio precoz de la nutrición apoya la estabilidad hemodinámica. El objetivo de esta revisión es describir los aspectos esenciales y actuales de la nutrición enteral en el paciente gran quemado como su concepto, vías de administración, importancia de su aplicación, fórmulas principales para el cálculo proteico energético, tratamiento con macronutrientes y micronutrientes para garantizar una nutrición adecuada y acorde a las necesidades. La nutrición enteral continua siendo la vía más importante y segura en el paciente gran quemado para la administración de macronutrientes y micronutrientes necesarios en los procesos metabólicos que garantizan la cicatrización y curación de los mismos.

Diarrhea in enterally fed patients: blame the diet?

Science.gov (United States)

Chang, Sue-Joan; Huang, Hsiu-Hua

2013-09-01

Diarrhea has great impact on enteral nutrition. The purpose of this review is to identify the factors leading to diarrhea during enteral nutrition and to provide the published updates on diarrhea prevention through nutritional intervention. Diarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. Diet management can alleviate diarrhea in enteral feeding. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Fiber-enriched formula can reduce the incidence of diarrhea and produce short-chain fatty acids for colonocytes. Ingesting prebiotics, nonviable probiotics or probiotic derivatives, and human lactoferrin may provide alternatives for reducing/preventing diarrhea. Enteral feeding is not generally considered the primary cause of diarrhea, which is frequently linked to prescribed medications. When diarrhea is apparent, healthcare members should evaluate the possible risk factors and systematically attempt to eliminate the underlying causes of diarrhea before reducing or suspending enteral feeding. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea.

Do enteric neurons make hypocretin? ☆

Science.gov (United States)

Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.

2008-01-01

Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, sectioned tissue, pre-treatment of mice with colchicine, and the use of various primary antisera), we could not identify hypocretin-producing cells in enteric nervous tissue collected from mice or normal human subjects. These results raise doubts about whether enteric neurons produce hypocretin. PMID:18191238

Effects of continuous versus bolus infusion of enteral nutrition in critical patients Efeitos da administração contínua versus intermitente da nutrição enteral em pacientes críticos

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Letícia Faria Serpa

2003-01-01

, without statistical differences, probably because of meticulous technique, careful monitoring, strict patient matching, and conservative amounts of diet employed in both situations. Further studies with additional populations, diagnostic groups, and dietetic prescriptions should be performed in order to elucidate the differences between these commonly used feeding modalities.ANTECEDENTES: A alimentação enteral é a modalidade preferida de suporte em pacientes graves com função digestiva aceitável porém incapazes de se alimentar por via oral, entretanto as vantagens da oferta contínua em contraste com a intermitente são rodeadas de controvérsias. Tendo como objetivo identificar os benefícios e as complicações destas técnicas, realizou-se um estudo prospectivo e controlado com casos pareados. PACIENTES E MÉTODOS: Vinte e oito pacientes consecutivos candidatos a alimentação enteral foram divididos em dois Grupos (n= 14, pareados segundo diagnóstico e índice APACHE II.Uma dieta polimérica comercial imuno-estimulante foi administrada por sonda nasogástrica e bomba de infusão na proporção de 25 kcal/kg/dia, em forma de bolo por uma hora a cada três horas (Grupo I, ou continuamente nas 24 horas (Grupo II, durante três dias. Os métodos incluiram antropometria, dosagens bioquímicas, registro de uso de drogas e outras terapêuticas, RX de tórax, circunferência abdominal, resíduo gástrico, e avaliação clínica e nutricional, efetuada no mínimo uma vez por dia. Os principais desfechos colimados neste estudo foram frequência de distensão abdominal e aspiração pulmonar, e capacidade de atingir a meta calórica pretendida. RESULTADOS: Quase metade da população total (46,4% apresentou resíduos gástricos elevados em pelo menos uma ocasião, porém somente foi registrado um episódio confirmado de aspiração pulmonar (3,6%. Ambos os grupos padeceram de um número moderado de complicações, sem diferenças. O ganho de dieta no Grupo II foi maior

Enteral nutrition in inflammatory bowel disease.

Science.gov (United States)

Gassull, M A; Abad, A; Cabré, E; González-Huix, F; Giné, J J; Dolz, C

1986-01-01

To assess the effect of the addition of enteral tube feeding with polymeric diets to the standard treatment of acute attacks of inflammatory bowel disease a total of 43 patients admitted to hospital (23 with Crohn's disease and 20 with ulcerative colitis) were studied retrospectively. Total enteral nutrition was given to 26 as the sole nutritional supply and to 17 in conjunction with a normal ward diet, when appropriate, according to the severity of attack (control group). Nutritional state was assessed and classified in all patients at admission and at the end of the study, by measuring the triceps skinfold thickness, mid arm muscle circumference, and serum albumin concentration as representative of body fat, muscle protein, and visceral protein, respectively. At admission the three nutritional variables were not statistically different between the groups. There was a significantly positive effect on mid arm muscle circumference in patients on total enteral nutrition compared with the control group, but there was no effect on either triceps skinfold thickness or serum albumin concentration. The percentage of subjects requiring intravenous albumin infusion, however, was significantly less in the group fed enterally than in the control group. In addition, fewer patients in the group fed enterally required surgical treatment compared with the control group, despite the fact that one of the criteria for starting enteral nutritional support was the expectancy that surgery would be needed. Total enteral nutrition was well tolerated and no major side effects arose during its use in patients with acute exacerbations of inflammatory bowel disease. PMID:3098646

[Enteral nutrition in burn patients].

Science.gov (United States)

Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P

1992-01-01

Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

Mejoramiento de Vivienda como Estrategia de Control de la Enfermedad de Chagas.

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Victor Manuel Ángulo

2000-08-01

Full Text Available

El Proceso en Colombia.

La Constitución Política de 1991 en el artículo 51 estableció que todos los colombianos tienen derecho a una vivienda digna. Para dar cum-plimiento a este mandato se instituyó la ley 3 de 1991 que creó el subsidio de vivienda y el sistema SISBEN. El desarrollo estatutario de esta ley dejó en manos de la Red de Solidaridad Social (RSS y la Caja Agraria (CA la metodología para que las comunidades de los diferentes entes territoriales puedan acceder a los recursos del subsidio. Esta metodología permite a la colectividad formular los proyectos destinados a la consecución de recursos para los departamentos o regiones y concertar en una mesa colegiada de alcaldes, la focalización de éstos.

Por otro lado, en 1994 se comenzó a diseñar el plan para la elaboración del Programa Nacional de Promoción, Prevención y Control de la Enfermedad de Chagas, al tiempo que en el departamento de Santander a través del CINTROP-UIS y la Secretaría de Salud, se realizaban estudios sobre la situación de infestación domiciliaria por triatominos y las características físicas de las viviendas en las comunidades rurales, con el fin de ejecutar un proyecto que le permitiera evaluar las estrategias de control del vector.

Estos estudios mostraron la alta prevalencia de infestación domiciliaria por triatominos que aún existe en amplias zonas rurales. De igual manera, se pudo conocer la influencia que tiene la calidad de la vivienda como factor de riesgo para la domiciliación de triatominos. El desarrollo de la ley de descentralización municipal y el enfoque intersectorial e interinstitucional permitieron incluir dentro de la evaluación de estrate-gias para el control de triatominos, el mejoramiento de vivienda y dentro de los proyectos de mejoramiento de vivienda el concepto de salud: vivienda buena, salud para la familia.

Los alcaldes como responsables de la focali-zación de los

Two Contrasting Failure Modes of Enteric Coated Beads.

Science.gov (United States)

Shi, Galen H; Dong, Xia; Lytle, Michelle; Kemp, Craig A J; Behme, Robert J; Hinds, Jeremy; Xiao, Zhicheng

2018-04-09

This study aimed to elucidate the mechanisms and kinetics of coating failure for enteric coated beads exposed to high-humidity conditions at different storage temperatures. Enteric coated beads were placed on high-humidity conditions (75 to 98% relative humidity (RH)) in the temperature range of 5 to 40°C. These stability samples of beads were tested for acid dissolution and water activity and also analyzed with SEM, X-ray CT, and DMA. Exposure of enteric coated beads to high humidity led to increased gastric release of drug which eventually failed the dissolution specification. SEM showed visible cracks on the surface of beads exposed to 5°C/high humidity and fusion of enteric beads into agglomerates at 40°C/high humidity. In a non-destructive time elapse study, X-ray CT demonstrated swelling of microcrystalline cellulose cores, crack initiation, and propagation through the API layer within days under 5°C/98% RH storage conditions and ultimately fracture through the enteric coating. DMA data showed a marked reduction in T g of the enteric coating materials after exposure to humidity. At 5°C/high humidity, the hygroscopic microcrystalline cellulose core absorbed moisture leading to core swelling and consequent fracture through the brittle API and enteric layers. At 40°C (high humidity) which is above the T g of the enteric polymer, enteric coated beads coalesced into agglomerates due to melt flow of the enteric coating. We believe it is the first report on two distinct failure models of enteric coated dosage forms.

Thermal inactivation of enteric viruses and bioaccumulation of enteric foodborne viruses in live oysters (Crassostrea virginica)

Science.gov (United States)

Human enteric viruses are one of the main causative agents of shellfish associated outbreaks. In this study, the kinetics of viral bioaccumulation in live oysters and the heat stability of the most predominant enteric viruses were determined in both tissue culture and in oyster tissues. A human nor...

Advantages of enteral nutrition over parenteral nutrition

OpenAIRE

Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra

2013-01-01

It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

Laboratory Screening for Children Entering Foster Care.

Science.gov (United States)

Greiner, Mary V; Beal, Sarah J; Nause, Katie; Staat, Mary Allen; Dexheimer, Judith W; Scribano, Philip V

2017-12-01

To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic. The prevalence of hepatitis B, hepatitis C, syphilis, and tuberculosis were all found to be <1%. There were no cases of HIV. Seven percent of teenagers entering foster care tested positive for Chlamydia . A secondary finding was that 54% of subjects were hepatitis B surface antibody-negative, indicating an absence of detected immunity to the hepatitis B virus. Routine laboratory screening for children entering foster care resulted in a low yield. Targeted, rather than routine, laboratory screening may be a more clinically meaningful approach for children entering foster care. Copyright © 2017 by the American Academy of Pediatrics.

Valoración de enfermería a una persona mayor atendida en atención domiciliaria Nursing assessment for an elder person served in the Program Primary Care

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Montserrat Puig Llobet

2011-09-01

Full Text Available El programa de Atención Domiciliaria (ATDOM es el elegido en nuestro caso para identificar la función que tienen los profesionales de enfermería en la detección de las necesidades de las personas mayores dependientes. El objetivo es presentar la situación de una persona mayor dependiente que recibe cuidados domiciliarios del servicio ATDOM del Centro de Atención Primaria de Vilafranca del Penedès. La paciente presenta HTA, diabetes no insulinodependiente y artrosis. Tiene una dependencia moderada en las actividades básicas y en las actividades instrumentales de la vida diaria. Según los patrones de Gordon, se han encontrado alterados cinco patrones y según la taxonomía NANDA se han identificado ocho diagnósticos de enfermería.Home care program is chosen in our case to identify the role that nurses in the detection of the needs of elderly dependents. The pourpose to present the status of a dependent elderly receiving home care service of the Center for Primary Care Vilafranca del Penedès. The patient has hypertension, noninsulin-dependent diabetes and arthritis. It has a moderate dependence in basic activities and instrumental activities of daily living. According to Gordon patterns have been found five patterns and altered according to the NANDA taxonomy has identified eight diagnoses.

Enteral feeding pumps: efficacy, safety, and patient acceptability

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White H

2014-08-01

Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience

Coronavirus–associated enteritis in a quail farm

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Antonio Camarda

2010-01-01

Full Text Available An enteric syndrome observed in semi-intensively reared quails is described. The affected birds showed depression, severe diarrhoea and dehydration. The mortality occurred particularly in young birds. At necropsy, the prominent lesion was catarrhal enteritis. Laboratory investigations demonstrated the presence of coronavirus in the gut of dead animals. No additional pathogens were detected. To our knowledge, this is the first evidence for the presence of CoVs in quail with enteritis.

Adherencia de planes caseros de terapia respiratoria en pacientes con enfermedades crónicas del programa de atención domiciliaria, Cali, 2014 / Adherence to home respiratory therapy plans among patients with chronic diseases from the home care program, Cali, 2014

Directory of Open Access Journals (Sweden)

Anisbed Naranjo-Rojas

2016-05-01

Full Text Available Resumen Objetivo: Determinar la adherencia de los planes caseros de terapia respiratoria en pacientes con enfermedades crónicas de un programa de atención domiciliaria, cuyos tratamientos incluyen prácticas de terapias respiratorias en la ciudad de Santiago de Cali – Colombia. Metodología: Se realizó un estudio observacional, descriptivo y de corte transversal. La población de estudio correspondió a 83 adultos entre 45 y 85 años con patologías crónicas, no alterara las funciones cognitivas, pertenecientes al programa de terapia respiratoria de la ips sisanar. Se diseñó una encuesta dirigida al paciente y cuidadores primarios. Resultados: El comportamiento entre las variables analizadas no fue paralelo, en ambas variables bien sea por factores como el tipo de afiliación, caso que correspondería al Plan casero Vs sgsss, mientras que el segundo de ellos presenta un comportamiento que refleja una diferencia en el número de sesiones realizadas por mes y las actividades registradas en el plan casero. Discusión: Este estudio encontró que los planes caseros muestran que la adherencia es efectiva pero depende del alto grado del manejo que se dé inicialmente desde los Sistemas de Seguridad Social al que pertenezcan los pacientes y al cumplimiento de las actividades. / Abstract Objective: to assess the adherence to home respiratory therapy plans in patients with chronic diseases from a home care program whose treatments include respiratory therapy practice in the city of Santiago de Cali, Colombia. This study focused mainly on the patients affiliated to the home care program of the SISANAR health care providing institution. Methodology: an observational, descriptive and cross-sectional study was conducted. The studied population consisted of 83 adults aged 45 to 85 with chronic pathologies which did not alter cognitive functions. These patients were part of the respiratory therapy program of the SISANAR health care providing institution

[Not Available].

Science.gov (United States)

Germán Díaz, Marta; Moreno Villares, José Manuel; Gomis Muñoz, Pilar

2016-07-19

Introducción: la nutrición parenteral domiciliaria se ha convertido en un punto clave en el tratamiento de pacientes con fracaso intestinal crónico. A pesar de los importantes avances que se han producido en las últimas décadas, tanto en los accesos vasculares, como en las soluciones empleadas, las infecciones asociadas a catéter venoso central siguen constituyendo una de las complicaciones más importantes. Dentro de las estrategias para la prevención o el tratamiento de estas infecciones se encuentra el empleo de sellados con antisépticos, como el etanol o la taurolidina, o de antibióticos.Objetivo: el objetivo de este artículo es revisar la evidencia disponible sobre el empleo de sellados con antisépticos o antibióticos en el manejo de pacientes pediátricos con nutrición parenteral domiciliaria.Material y métodos: el uso de sellados con etanol o taurolidina para prevenir el desarrollo de infecciones asociadas a catéter central estaría indicado en pacientes con nutrición parenteral domiciliaria que hayan tenido más de una infección en el año anterior o que se consideren pacientes de riesgo. Los sellados con antibióticos están indicados en el tratamiento de bacteriemias asociadas a catéter central producidas por S. coagulasa-negativo o gramnegativos, asociados a un tratamiento sistémico, siempre que sea posible, con el fin de salvar el catéter. Se debería llevar a cabo la retirada del mismo cuando existan signos de infección del punto de entrada o del trayecto subcutáneo, o cuando el germen responsable de la infección sea S. aureus o Cándida.Conclusión: a pesar de que la fuerza de la evidencia sobre la eficacia del sellado en la prevención o el tratamiento de infecciones asociadas al catéter es limitada, tanto en el niño como en el adulto, cada vez existen más datos a usar esta alternativa en pacientes con nutrición parenteral domiciliaria en los que la atención y salvaguarda de los catéteres es primordial.

Comparison of the EntericBio multiplex PCR system with routine culture for detection of bacterial enteric pathogens.

LENUS (Irish Health Repository)

O'Leary, James

2009-11-01

The EntericBio system uses a multiplex PCR assay for the simultaneous detection of Campylobacter spp., Salmonella enterica, Shigella spp., and Escherichia coli O157 from feces. It combines overnight broth enrichment with PCR amplification and detection by hybridization. An evaluation of this system was conducted by comparing the results obtained with the system with those obtained by routine culture, supplemented with alternative PCR detection methods. In a study of 773 samples, routine culture and the EntericBio system yielded 94.6 and 92.4% negative results, respectively. Forty-two samples had positive results by culture, and all of these were positive with the EntericBio system. This system detected an additional 17 positive samples (Campylobacter spp., n = 12; Shigella spp., n = 1; E. coli O157, n = 4), but the results for 5 samples (Campylobacter spp., n = 2; Shigella spp., n = 1; E. coli O157, n = 2) could not be confirmed. The target for Shigella spp. detected by the EntericBio system is the ipaH gene, and the molecular indication of the presence of Shigella spp. was investigated by sequence analysis, which confirmed that the ipaH gene was present in a Klebsiella pneumoniae isolate from the patient. The sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 99.3%, 91.5%, and 100%, respectively. Turnaround times were significantly reduced with the EntericBio system, and a result was available between 24 and 32 h after receipt of the sample in the laboratory. In addition, the amount of laboratory waste was significantly reduced by use of this system. In summary, the EntericBio system proved convenient to use, more sensitive than the conventional culture used in this study, and highly specific; and it generated results significantly faster than routine culture for the pathogens tested.

Modelo de previsión del tráfico en Santander: Año 2020

OpenAIRE

Campollo Canduela, Alfonso

2015-01-01

El presente trabajo consiste en un análisis de la previsión de la demanda de tráfico en transporte privado de viajeros en la ciudad de Santander (Cantabria, España) para el año 2020, entre las 8 y las 9 de la mañana de un día laborable, a partir de los datos procedentes de una encuesta domiciliaria, realizada por el Grupo de Investigación de Sistemas de Transporte (GIST) de la Universidad de Cantabria para un estudio previo, y el modelo de ordenación que el Plan General de Ordenación Urbana v...

Enteral Nutrition and Acute Pancreatitis: A Review

NARCIS (Netherlands)

Spanier, B. W. M.; Bruno, M. J.; Mathus-Vliegen, E. M. H.

2011-01-01

Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English

Understanding and controlling the enteric nervous system

NARCIS (Netherlands)

Boeckxstaens, G. E.

2002-01-01

The enteric nervous system or the `Little Brain' of the gut controls gastrointestinal motility and secretion, and is involved in visceral sensation. In this chapter, new developments in understanding the function of the enteric nervous system are described. In particular, the interaction of this

Do enteric neurons make hypocretin? ☆

OpenAIRE

Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.

2007-01-01

Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, s...

Enteric virus with segmented double-stranded RNA genome in broiler chicken: Rotavirus, Reovirus and Picobirnavirus / Virus entéricos RNA fita dupla, segmentado, em aves: Rotavírus, Reovírus e Picobirnavírus

Directory of Open Access Journals (Sweden)

Amauri Alcindo Alfieri

2000-04-01

Full Text Available Enteric infections account for considerable economic losses to the poultry industry through weight loss, low food conversion, direct and indirect expenses with treatments and increased death rates. Poultry intestinal pathologies, either with local or general manifestations, can be caused by bacteria, protozoa or virus, acting alone or in association. Regarding viral etiology, several genera have been isolated from poultry with enteric disease. However, two genera from the Reoviridae family, the rotavirus and the reovirus are found more frequently in broiler chicken and/or laying hen feces. These viruses have been associated with clinical signs of enteritis in most epidemiological research. This revision aims to present some topics on the etiological agents (rotavirus, reovirus and picobirnavirus, the clinical disease and the diagnostic and control methods and prophylaxis of the infection.As infecções entéricas são responsáveis por consideráveis prejuízos econômicos à indústria avícola representados por perda de peso, baixa conversão alimentar, custos diretos e indiretos com tratamentos e por aumento na taxa de mortalidade. As patologias intestinais em aves, tanto com manifestação local quanto geral, podem ser determinadas por bactérias, protozoários e vírus, atuando de forma isolada ou em associação. Com relação a etiologia virai, vários gêneros têm sido isolados a partir de aves com enteropatias. Porém, dois gêneros na família Reoviridae, o rotavírus e o reovírus são encontrados com maior freqüência em fezes de frangos de corte e/ou galinhas poedeiras. Na maioria dos inquéritos epidemiológicos esses vírus estão associados a sinais clínicos de enterite. Esta revisão tem por objetivo apresentar alguns tópicos relativos aos agentes etiológicos (Rotavírus, Reovírus e Picobirnavírus, à doença clínica e aos métodos de diagnóstico, controle e profilaxia da infecção.

9 CFR 113.204 - Mink Enteritis Vaccine, Killed Virus.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Mink Enteritis Vaccine, Killed Virus..., DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.204 Mink Enteritis Vaccine, Killed Virus. Mink Enteritis Vaccine...

Noncommunicating Isolated Enteric Duplication Cyst in the ...

African Journals Online (AJOL)

Noncommunicating isolated enteric duplications in the abdomen are an extremely rare variant of enteric duplications with their own blood supply. We report a case of a noncommunicating isolated ileal duplication in a 10-month-old boy. He was admitted because of severe abdominal distension and developed irritability ...

Science.gov (United States)

Wanden-Berghe Lozano, Carmina; Campos Martín, Cristina; Cuerda Compes, Cristina; Gómez Candela, Carmen; Burgos Peláez, Rosa; Moreno Villares, José Manuel; Pereira Cunill, José Luis; Pérez de la Cruz, Antonio; Virgili Casas, Nuria; Martinez Faedo, Ceferino; Álvarez Hernández, Julia; Garde Orbaiz, Carmen; Penacho Lázaro, Mª Ángeles; Sánchez Martos, Eva Ángeles; Sanz Paris, Alejandro; Gonzalo Marín, Montserrat; Zugasti Murillo, Ana; Matía Martín, Pilar; Martín Folgueras, Tomás; Carabaña Pérez, Fátima; Díaz Guardiola, Patricia; Tejera Pérez, Cristina; De Luis Román, Daniel; Luengo Pérez, Luis Miguel; Santacruz Carmona, Nieves; Apezetxea Celaya, Antxón; Ponce González, Miguel Ángel; Urgeles Planella, Juan Ramón; Laborda González, Lucía; Martinez Olmos, Miguel Ángel; Sánchez-Vilar Burdiel, Olga; Joaquín Ortiz, Clara; Martínez Costa, Cecilia; Suárez Llanos, José Pablo; Calleja Fernández, Alicia; Leyes García, Pere; Gil Martinez, Mª Carmen; Mauri Roca, Silvia; García Zafra, Maria Victoria; Carrera Santaliestra, María José; Nadya-Senpe, Grupo

2016-11-29

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE del años 2015.Material y métodos: Recopilación de los datos de NPD del registro "on-line" del grupo de Nutrición Artificial Domiciliaria y Ambulatoria (NADYA) desde el 1 de enero de 2015 al 31 de diciembre de 2015.Resultados: Se registraron 236 pacientes, con 243 episodios de NPD procedentes de 40 hospitales. Lo que representa una tasa de 5,08 pacientes/millón de habitantes/ año 2015. La patología más frecuente en los adultos fue "otros" (26,3%) seguido por "oncológico paliativo" (21,6%).  La complicación más frecuente fue la séptica relacionada con el catéter que presentó una tasa de 0,53 infecciones/1000 días de NPD. Finalizaron 64 episodios, la principal causa fue el fallecimiento (43,7%) y el 'paso a la vía oral' (32,8%).Conclusiones: constatamos el aumento de los centros y profesionales colaboradores, dando respuesta a la cantidad progresivamente mayor de pacientes con soporte nutricional parenteral en domicilio. Se mantienen estables las principales indicaciones para el establecimiento de NPD y las causas de finalización del tratamiento.

Genetics of enteric neuropathies

NARCIS (Netherlands)

Brosens, Erwin; Burns, Alan J.; Brooks, Alice S.; Matera, Ivana; Borrego, Salud; Ceccherini, Isabella; Tam, Paul K.; García-Barceló, Maria-Mercè; Thapar, Nikhil; Benninga, Marc A.; Hofstra, Robert M. W.; Alves, Maria M.

2016-01-01

Abnormal development or disturbed functioning of the enteric nervous system (ENS), the intrinsic innervation of the gastrointestinal tract, is associated with the development of neuropathic gastrointestinal motility disorders. Here, we review the underlying molecular basis of these disorders and

30 CFR 77.1502 - Auger holes; restriction against entering.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Auger holes; restriction against entering. 77... UNDERGROUND COAL MINES Auger Mining § 77.1502 Auger holes; restriction against entering. No person shall be permitted to enter an auger hole except with the approval of the MSHA Coal Mine Safety and Health District...

Cellular changes in the enteric nervous system during ageing.

Science.gov (United States)

Saffrey, M Jill

2013-10-01

The intrinsic neurons of the gut, enteric neurons, have an essential role in gastrointestinal functions. The enteric nervous system is plastic and continues to undergo changes throughout life, as the gut grows and responds to dietary and other environmental changes. Detailed analysis of changes in the ENS during ageing suggests that enteric neurons are more vulnerable to age-related degeneration and cell death than neurons in other parts of the nervous system, although there is considerable variation in the extent and time course of age-related enteric neuronal loss reported in different studies. Specific neuronal subpopulations, particularly cholinergic myenteric neurons, may be more vulnerable than others to age-associated loss or damage. Enteric degeneration and other age-related neuronal changes may contribute to gastrointestinal dysfunction that is common in the elderly population. Evidence suggests that caloric restriction protects against age-associated loss of enteric neurons, but recent advances in the understanding of the effects of the microbiota and the complex interactions between enteric ganglion cells, mucosal immune system and intestinal epithelium indicate that other factors may well influence ageing of enteric neurons. Much remains to be understood about the mechanisms of neuronal loss and damage in the gut, although there is evidence that reactive oxygen species, neurotrophic factor dysregulation and/or activation of a senescence associated phenotype may be involved. To date, there is no evidence for ongoing neurogenesis that might replace dying neurons in the ageing gut, although small local sites of neurogenesis would be difficult to detect. Finally, despite the considerable evidence for enteric neurodegeneration during ageing, and evidence for some physiological changes in animal models, the ageing gut appears to maintain its function remarkably well in animals that exhibit major neuronal loss, indicating that the ENS has considerable

La provisión de agua potable en la periferia del AMBA, Argentina

Directory of Open Access Journals (Sweden)

Veronica Caceres

2013-12-01

Full Text Available El artículo analiza la problemática de la provisión de agua potable domiciliaria en territorios con escasa cobertura de las redes, en el principal aglomerado urbano de la Argentina denominado Área Metropolitana de Buenos Aires. Se recuperan los aportes de una investigación exploratoria que recurrió al estudio de caso y el análisis de fuentes primarias y secundarias. Principalmente centra la atención en la caracterización de los circuitos mercantiles que emergen ante la ausencia de las redes, comprendidos por la presencia de empresas formales e informales que realizan perforaciones e instalan equipos para la explotación individual de los acuíferos por parte de hogares que no acceden a las redes de agua. También se analiza la exigua regulación, control y fiscalización estatal.  

Hypophosphatemia associated with enteral alimentation in cats.

Science.gov (United States)

Justin, R B; Hohenhaus, A E

1995-01-01

Hypophosphatemia is uncommon in cats, but it has been reported in association with diabetes mellitus and hepatic lipidosis, where it can cause hemolysis, rhabdomyopathy, depression, seizures, and coma. The purpose of this article is to describe 9 cats that developed low serum phosphorus concentrations (alimentation. Serum biochemical analyses from more than 6,000 cats were reviewed. The medical records of all cats with hypophosphatemia were examined for history of enteral alimentation; diabetic cats were excluded from the study. Nine cats, ranging in age from 3 to 17 years, were identified. All cats had normal serum phosphorus concentrations before tube feeding began. Onset of hypophosphatemia occurred 12 to 72 hours after initiation of enteral alimentation, and the nadir for phosphorus concentrations ranged from 0.4 to 2.4 mg/dL. Hemolysis occurred in 6 of the 9 cats. Hypophosphatemia secondary to enteral alimentation is an uncommon clinical finding in cats. Cats with high alanine aminotransferase activity, hyperbilirubinemia, and weight loss should be closely monitored for hypophosphatemia during the first 72 hours of enteral alimentation.

[Indications and practice of enteral nutrition].

Science.gov (United States)

Hallay, Judit; Nagy, Dániel; Fülesdi, Béla

2014-12-21

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient's condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy.

Nutrición enteral

OpenAIRE

Barrachina Bellés, Lidón; García Hernández, Misericordia; Oto Cavero, Isabel

1984-01-01

Este trabajo nos introduce en la administración de la nutrición enteral, haciendo una revisión de los aspectos a tener en cuenta tanto en sus indicaciones, vias, tipos, métodos, cuidados y complicaciones más importantes.

Suprimento de micronutrientes, adequação energética e progressão da dieta enteral em adultos hospitalizados Adequacy of energy and micronutrient supply and progression of enteral diet in hospitalized adult patients

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Vivian Cristine Luft

2008-10-01

Full Text Available OBJETIVO: Avaliar a adequação da dieta enteral, em termos de micronutrientes e energia e identificar fatores interferentes na progressão da dieta enteral prescrita a adultos hospitalizados em um hospital geral de alta complexidade. MÉTODOS: Entre junho de 2004 e maio de 2005, adultos internados em um hospital de alta complexidade do sul do Brasil foram avaliados quanto às suas características clínicas e da prescrição da nutrição enteral. As características da nutrição enteral foram avaliadas e comparadas às recomendações diárias de ingestão, obtendo-se o percentual de adequação de nutrientes prescritos na dieta enteral em relação aos valores de recomendação para cada paciente. Os fatores associados à prescrição de energia foram identificados por meio de Regressão Linear Múltipla. RESULTADOS: Foram acompanhados 230 pacientes em uso de nutrição enteral. As recomendações diárias foram alcançadas satisfatoriamente para vitaminas hidrossolúveis (exceto ácido fólico, lipossolúveis (exceto vitamina D e minerais (exceto cálcio. Em média, as prescrições iniciais de nutrição enteral ofereceram 24,0kcal/kg/dia (desvio-padrão=10,8, e valores mínimo e máximo de 4,3 a 69,2, e progrediram até 28,4kcal/kg/dia (desvio-padrão=11,8, valores mínimo e máximo de 1,4 a 69,2. A recomendação de 25 a 35kcal/kg/dia foi prescrita para 32,6% dos pacientes. Para 15,7% dos pacientes foram prescritas acima de 40kcal/kg/dia. Somente o índice de massa corporal e o número de dias de hospitalização, ajustados para a quantidade de energia já inicialmente prescrita, associaram-se de forma independente à prescrição energética final. CONCLUSÃO: Pequena proporção das prescrições esteve adequada em relação à quantidade de energia, e a progressão da dieta enteral ocorreu independentemente das características clínicas dos pacientes.OBJECTIVE: To asses the adequacy of enteral diet, in terms of micronutrients and

Impacto de un programa de atención domiciliaria al enfermo crónico en ancianos: calidad de vida y reingresos hospitalarios Impact of the program home care for the chronically ill for elderly: quality of life and hospital readmissions

Directory of Open Access Journals (Sweden)

María Claudia Espinel-Bermúdez

2011-02-01

Full Text Available OBJETIVO: Evaluar el impacto del programa Atención Domiciliaria al Enfermo Crónico (ADEC comparado con la atención habitual (AH a ancianos con dependencia funcional, derechohabientes del Instituto Mexicano del Seguro Social (IMSS. MATERIAL Y MÉTODOS: Cohorte prospectiva a tres meses a partir del egreso hospitalario en dos hospitales de la Ciudad de México. Se ingresaron 130 ancianos con dependencia funcional, 70 insertados al programa ADEC y 60 con atención habitual. Se midió impacto en reingresos hospitalarios y calidad de vida a partir de la escala Perfil de Impacto de la Enfermedad (SIP, por sus siglas en inglés. RESULTADOS: La edad promedio de los ancianos fue de 74 años (61/103 y 60% fueron mujeres. El principal diagnóstico fue enfermedad vascular cerebral (EVC (30.77%. El grupo de ADEC mejoró la calidad de vida en la dimensión psicosocial [46.26 (±13.85 comparado con 29.45 (±16.48 vs. 47.03 (±16.47 a 42.36 (±16.35 p0.05. CONCLUSIONES: El programa mejoró la dimensión psicosocial de calidad de vida.OBJECTIVE: To evaluate the impact of the ADEC program (acronym in Spanish as compared with the typical care provided to disabled elderly affiliated with the Mexican Institute of Social Security (IMSS. MATERIAL AND METHODS: Prospective cohort at three months after discharge from two general hospitals in Mexico City. A total of 130 patients with functional dependency were studied, 70 in the ADEC program and 60 with typical care. Impact was measured using hospital readmissions and quality of life based on the Sickness Impact Profile (SIP. RESULTS: Average age was 74 (61/103 years and 60% were women. The main diagnosis was cerebrovascular disease (30.77%. The quality of life in the psychosocial dimension improved for the ADEC group (from 46.26 (±13.85 to 29.45(±16.48 as compared with 47.03 (±16.47 to 42.36 (±16.35 for those receiving typical care (p0.05. CONCLUSIONS: HC program improved the psychosocial dimension of quality of

Formulações com alimentos convencionais para nutrição enteral ou oral Formulations for enteral or oral nutrition using conventional foods

Directory of Open Access Journals (Sweden)

Edma M. Araújo

2006-09-01

Full Text Available A nutrição enteral domiciliar é um tratamento econômico e seguro usado na prevenção da desnutrição e manutenção da qualidade de vida. Nesse estudo, foi analisada a formulação FCM (CARVALHO et al. 1992 e foram desenvolvidas formulações (F1 e F2 para obter quantidades e qualidade dos componentes conforme literatura. As fórmulas foram desenvolvidas com alimentos convencionais de baixo custo, factíveis de preparo em domicílio, disponíveis em regiões menos desenvolvidas, onde as dietas industrializadas não são comercializadas. Foram determinadas propriedades como viscosidade, osmolalidade, gotejamento e valor nutricional. As fórmulas F1 e F2 apresentaram menor viscosidade e distribuição calórica (proteína 14%, gordura 33%, carboidrato 53%, fibra alimentar (8,16 g/2 L e densidade calórica (1 kcal/mL melhores que FCM (proteína 19%, gordura 33%, carboidrato 48%, fibra alimentar 4,68 g/2 L e densidade calórica 0,87 kcal. As fórmulas F1 e F2 apresentaram soluções mais fluidas que FCM, gotejamento de 60 80 gotas/minuto. As osmolalidades ficaram isotônicas. A adição de fubá de milho, Soymilk® e Nidex® melhoraram o valor nutritivo e a fluidez de F1 e F2, viabilizando a administração de maior quantidade em menor tempo. As formulações F1 e F2 são opções para uma individualização de dieta enteral normal por gastrostomia em terapia domiciliar.Home enteral nutrition is a safe, economic treatment used in the prevention of malnutrition and in the maintenance of life quality. In this study the formulation FCM (CARVALHO et al., 1992 was analysed, and the formulations F1 and F2 developed, aiming at obtaining the component quantities and qualities cited in the literature. The formulations were developed using low cost conventional foods, easy to prepare domestically and available in less developed regions where industrialised diets are not commercialised. The viscosity, osmolality, dripping properties and nutritive value

Portable exhausters POR-004 SKID B, POR-005 SKID C, POR-006 SKID D storage plan

International Nuclear Information System (INIS)

Nelson, O.D.; Keller, G.M.

1997-01-01

This document provides a storage plan for portable exhausters POR-004 SKID B, POR-005 SKID C, AND POR-006 SKID D. The exhausters will be stored until they are needed by the TWRS (Tank Waste Remediation Systems) Saltwell Pumping Program. The storage plan provides criteria for portable exhauster storage, periodic inspections during storage, and retrieval from storage

Epigenetic regulation of enteric neurotransmission by gut bacteria.

Directory of Open Access Journals (Sweden)

Tor eSavidge

2016-01-01

Full Text Available The Human Microbiome Project defined microbial community interactions with the human host, and provided important molecular insight into how epigenetic factors can influence intestinal ecosystems. Given physiological context, changes in gut microbial community structure are increasingly found to associate with alterations in enteric neurotransmission and disease. At present, it is not known whether shifts in microbial community dynamics represent cause or consequence of disease pathogenesis. The discovery of bacterial-derived neurotransmitters suggests further studies are needed to establish their role in enteric neuropathy. This mini-review highlights recent advances in bacterial communications to the autonomic nervous system and discusses emerging epigenetic data showing that diet, probiotic and antibiotic use may regulate enteric neurotransmission through modulation of microbial communities. Because of its limited scope, a particular emphasis is placed on bacterial regulation of enteric nervous system function in the intestine.

Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

Directory of Open Access Journals (Sweden)

Gilberto Simeone HENRIQUES

Full Text Available Abstract Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent, and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.

Surgical treatment of radiation enteritis

Energy Technology Data Exchange (ETDEWEB)

Cross, M.J.; Frazee, R.C. (Department of General Surgery, Scott and White Memorial Hospital, Temple TX (United States))

1992-02-01

Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting.

Surgical treatment of radiation enteritis

International Nuclear Information System (INIS)

Cross, M.J.; Frazee, R.C.

1992-01-01

Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting

Enteral alimentation and gastrointestinal bleeding in mechanically ventilated patients.

Science.gov (United States)

Pingleton, S K; Hadzima, S K

1983-01-01

The incidence of upper gastrointestinal (GI) bleeding in mechanically ventilated ICU patients receiving enteral alimentation was reviewed and compared to bleeding occurring in ventilated patients receiving prophylactic antacids or cimetidine. Of 250 patients admitted to our ICU during a 1-yr time period, 43 ventilated patients were studied. Patients in each group were comparable with respect to age, respiratory diagnosis, number of GI hemorrhage risk factors, and number of ventilator, ICU, and hospital days. Twenty-one patients had evidence of GI bleeding. Fourteen of 20 patients receiving antacids and 7 of 9 patients receiving cimetidine had evidence of GI bleeding. No bleeding occurred in 14 patients receiving enteral alimentation. Complications of enteral alimentation were few and none required discontinuation of enteral alimentation. Our preliminary data suggest the role of enteral alimentation in critically ill patients may include not only protection against malnutrition but also protection against GI bleeding.

9 CFR 302.3 - Livestock and products entering official establishments.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Livestock and products entering official establishments. 302.3 Section 302.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... Livestock and products entering official establishments. All livestock and all products entering any...

Enteric nervous system specific deletion of Foxd3 disrupts glial cell differentiation and activates compensatory enteric progenitors.

Science.gov (United States)

Mundell, Nathan A; Plank, Jennifer L; LeGrone, Alison W; Frist, Audrey Y; Zhu, Lei; Shin, Myung K; Southard-Smith, E Michelle; Labosky, Patricia A

2012-03-15

The enteric nervous system (ENS) arises from the coordinated migration, expansion and differentiation of vagal and sacral neural crest progenitor cells. During development, vagal neural crest cells enter the foregut and migrate in a rostro-to-caudal direction, colonizing the entire gastrointestinal tract and generating the majority of the ENS. Sacral neural crest contributes to a subset of enteric ganglia in the hindgut, colonizing the colon in a caudal-to-rostral wave. During this process, enteric neural crest-derived progenitors (ENPs) self-renew and begin expressing markers of neural and glial lineages as they populate the intestine. Our earlier work demonstrated that the transcription factor Foxd3 is required early in neural crest-derived progenitors for self-renewal, multipotency and establishment of multiple neural crest-derived cells and structures including the ENS. Here, we describe Foxd3 expression within the fetal and postnatal intestine: Foxd3 was strongly expressed in ENPs as they colonize the gastrointestinal tract and was progressively restricted to enteric glial cells. Using a novel Ednrb-iCre transgene to delete Foxd3 after vagal neural crest cells migrate into the midgut, we demonstrated a late temporal requirement for Foxd3 during ENS development. Lineage labeling of Ednrb-iCre expressing cells in Foxd3 mutant embryos revealed a reduction of ENPs throughout the gut and loss of Ednrb-iCre lineage cells in the distal colon. Although mutant mice were viable, defects in patterning and distribution of ENPs were associated with reduced proliferation and severe reduction of glial cells derived from the Ednrb-iCre lineage. Analyses of ENS-lineage and differentiation in mutant embryos suggested activation of a compensatory population of Foxd3-positive ENPs that did not express the Ednrb-iCre transgene. Our findings highlight the crucial roles played by Foxd3 during ENS development including progenitor proliferation, neural patterning, and glial

Science.gov (United States)

Ferrer Gómez, Mercedes; García Zafra, María Victoria; Cuenca Sánchez, Juan Ramón; Sánchez Romera, Juan Francisco; Aranda García, Ana; Rausell Rausell, Víctor José; Hernández Martínez, Antonio Miguel

2016-09-20

Introducción: en Murcia, y hasta 2010, la administración de la nutrición enteral domiciliaria (NED) dictaba cumplir la regulación marcada en cuanto a los facultativos con competencias para su prescripción.Objetivos: examinar aspectos esenciales de este recurso en el periodo 2007-2010, características de la muestra y evolución del coste, así como perspectivas de futuro.Métodos: estudio del perfil de la población NED en un área de salud específica. Selección de recetas facturadas de productos NED en el conjunto de la Región, clasificación por tipos y análisis de la evolución en importe y en envases para el periodo 2007-2010.Resultados: respecto al perfil de la muestra del Área I de Salud de la Región, la patología, vía de administración y tipo de nutrición más frecuentes resultaron, respectivamente, la enfermedad neurológica, la vía oral y la nutrición no específica. Por otro lado, el gasto sanitario en productos dietoterápicos, en el Servicio Murciano de Salud, aumentó alrededor del 50% entre los años 2007 y 2010. Tanto en envases como en importe, Murcia se sitúa por encima de la media nacional.Conclusiones: el perfil de la muestra no coincide con trabajos publicados en otras regiones. Este dato, junto a la posición de Murcia en gasto dietoterápico, y su evidente tendencia al alza en los años analizados, hace evidente la necesidad de medidas que mejoren la calidad de la NED en la Región de Murcia y, en caso de ser posible, conseguir alcanzar valores nacionales en relación con el consumo medio y el gasto.

Enteric pathogen modification by anaecic earthworm, Lampito Mauritii

African Journals Online (AJOL)

The biosolids from municipal wastewater treatment plant contains several enteric microbial pathogens, predominantly Salmonella and Escherichia species in the range of 15-18 x 104 CFU/g and 11-12 x 104 CFU/g respectively. The present study investigates the influence of earthworm, Lampito mauritii on enteric pathogen ...

Comparison of neutral and positive enteral contrast media for MDCT enteroclysis

International Nuclear Information System (INIS)

Aiyappan, Senthil Kumar; Kalra, Naveen; Sandhu, Manavjit Singh; Kochhar, Rakesh; Wig, Jai Dev; Khandelwal, Niranjan

2012-01-01

Objective: To compare neutral and positive enteral contrast media for MDCT enteroclysis (MDCTE) in various small bowel diseases. Materials and methods: 40 patients with suspicion of small bowel diseases were divided randomly into two equal groups. In one group, water was used as neutral enteral contrast and in other group, 2% water soluble iodinated contrast was used as positive enteral contrast. All MDCTE were done on a 16-slice multidetector row CT unit. The findings of MDCTE were compared with the standards of reference. Results: There were 12 cases of abdominal tuberculosis (30%), 5 cases of bowel masses (12%), 4 cases of Crohn's disease (10%), 3 cases of small bowel adhesions (7%), 2 cases of midgut volvulus (5%), 2 cases of segmental enteritis (5%) and 12 of all cases (30%) were normal. There was no statistically significant difference between neutral and positive enteral contrast with regards to bowel distention, contrast reflux and evaluation of duodenum. Abnormal bowel wall enhancement was appreciated only with use of neutral enteral contrast (n = 12). Evaluation of ileocaecal junction was possible in all 20 patients (100%) with positive enteral contrast but in only 17 patients (85%) with neutral enteral contrast. Overall sensitivity and specificity of MDCTE with use of neutral contrast medium (100 and 88% respectively) was greater for evaluation of small bowel diseases, when compared to MDCTE using positive enteral contrast medium (92.8 and 83.3% respectively). Conclusions: Water is a good enteral contrast medium for MDCT enteroclysis examination and allows better evaluation of abnormal bowel wall enhancement. Ileocaecal junction evaluation is better with positive enteral contrast medium.

[Enteral alimentation at home: why PEG now?].

Science.gov (United States)

Suzuki, Y; Hanyu, N; Kashiwagi, H; Kubo, T; Aoki, T

1996-12-01

The history of percutaneous endoscopic gastrostomy (PEG) is relatively short. In 1980, a report entitled "Gastrostomy without laparotomy: A percutaneous endoscopic technique" by Ponsky and Gaudere was first published in the Journal of Pediatric Surgery. Thereafter, PEG soon saw widespread use in Western countries because of its clinical efficacy and economy. It has been performed in about 170,000 cases annually in the US. In contrast, its spread in Japan has been extremely slow: only about 10,000 cases have undergone this procedure annually, and this number accounted for less than 5% of patients receiving enteral alimentation. The reason why PEG has not spread may be the medical insurance system in Japan and the local distaste for operation scarring. However, in consideration of the unprecedented ageing of society that is surely coming in the near future, the role of PEG in Japan must be reexamined. In this report, we presented the methodology of enteral alimentation at home by means of PEG, giving special consideration to: (1) "What points are improved by using enteral alimentation at home by means of PEG in various diseases; (2) dysphagia due to cerebral angiopathy; (3) terminal cancer; (4) otolaryngological diseases; and (5) Crohn disease. We also discussed "Why PEG is important now?" in performing enteral alimentation at home.

The spectrum of radiation enteritis: surgical considerations

International Nuclear Information System (INIS)

Haddad, G.K.; Grodsinsky, C.; Allen, H.

1983-01-01

Radiation therapy, often used to treat gynecologic and urologic pelvic malignancies, has varying, adverse effects on the bowel. Radiation enteritis may occur from one month to 20 years after irradiation, and disabling symptoms may require surgery in 10 to 20 per cent of patients. From our experience with 20 patients who required surgery for radiation enteritis and who were followed for up to 20 years, we were able to identify three clinical groups. Patients in the first group need only medical treatment for their symptoms, and observation, whereas patients in the second group may present with acute, debilitating, life-threatening symptoms that may require emergency surgery. Patients in the third group have a long-standing history of intermittent bowel obstruction and/or enteric fistulas that are best treated with adequate nutritional support followed by timely surgical intervention

Tratamento de compactação do cólon maior em eqüídeos com fluidoterapia enteral

OpenAIRE

Lopes,Marco Aurélio Ferreira; Moura,Gabriela Soares de; Junqueira,Luiz Arthur Camargo; Lima,Leonardo Rodrigues de; Pinto,José de Oliveira; Dantas Filho,José; Assis,Carlos Batista de

1998-01-01

A eficiência da fluidoterapia por via enteral foi avaliada em 14 eqüídeos (12 eqüinos e dois muares) que apresentavam compactação do cólon maior. Os animais tinham entre um ano e meio e 20 anos de idade e todos eram alimentados com capim elefante (Pennisetum purpureum Schumach) triturado. O início dos sinais de cólica foi observado no dia do internamento em seis casos, um dia antes em cinco casos, três dias antes em um caso, quatro dias antes em um caso e seis dias antes em um caso. Um cavalo...

Early enteral nutrition compared to outcome in critically ill trauma ...

African Journals Online (AJOL)

Objectives: The benefit of an early enteral nutrition start in critical ill patients is widely accepted. However, limited published data focus on trauma patients. This study aimed to investigate the effect of early enteral nutrition initiation on length of stay and mortality in an intensive care unit (ICU), as well as explore if enteral ...

Usefulness of enteral contrast media in MR evaluation of pelvic mass

International Nuclear Information System (INIS)

Kim, Hun; Kim, Jung Sik; Kim, Hong; Shon, Chul Ho; Lee, Hee Jung; Lee, Sung Moon; Woo, Sung Ku; Suh, Soo Jhi

1999-01-01

To assess the value of enteral contrast media for the evaluation of pelvic masses by MR imaging. Between April and July 1998, 16 women with pelvic masses were examined by MRI. The origin of the lesion was the ovary in twelve cases, the uterus in three, and the sigmoid in one. Using a 1.5T scanner(Magnetom Vision, Siemens), T1-weighted axial spin echo(SE), T2-weighted turbo spin echo(TSE), two dimensional fast low-angle shot(FLASH 2D), and half-Fourier TSE(HASTE) images were obtained in all patients after the administration of Magnevist Enteral (Shering, Berlin, Germany). In each MR imagine sequence, distinction between the lesion and adjacent bowel (1, not distinguished; 2, partly distinguished; 3, clearly distinguished), artifact (0, absent; 1, mild; 2, severe), image quality (1, poor; 2, fair; 3, good), were compared before and after the use of enteral contrast media. Changes in MRI impression after the use of enteral contrast media were also evaluated. Two radiologists reached a consensus after reviewing the images. Statistical significance was determined by Wilcoxon's signed ranked test. For distinguishing lesions, SE T1WI and FLASH 2D with enteral contrast media were significantly superior to SE T1WI without enteral contrast media (p < 0.05). With regard to image quality, FLASH 2D and HASTE, both with enteral contrast media, were significantly superior to SE T1WI and TSE T2WI, respectively, both without enteral contrast media (p < 0.05). Artefacts were more frequently found after the application of enteral contrast media in conventional sequences but were not present in breathhold sequences. In two patients, MRI impression changed after the application of enteral contrast media. In a limited number of cases, enteral contrast media improved lesion detection, image quality and diagnostic accuracy when breathhold fast MR imaging was applied

Role of FODMAP content in enteral nutrition-associated diarrhea.

Science.gov (United States)

Halmos, Emma P

2013-12-01

Gastrointestinal symptoms including diarrhea are common complications of enteral nutrition (EN); however, the cause is unclear. Mode of EN delivery that alters digestion and possibly absorption is suggested to contribute to the high incidence of diarrhea; however, enteral formula is frequently blamed. Most research has focused on fiber-supplemented EN, with a meta-analysis showing that fiber reduces the incidence of diarrhea in non-intensive care unit studies. Other hypotheses include formula osmolality and FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content. FODMAPs are poorly absorbed short-chain carbohydrates that exert an osmotic effect. Dietary FODMAPs have been shown to reduce gastrointestinal symptoms, including diarrhea, in those with irritable bowel syndrome and, given a high-enough dose, will induce a laxative effect in most people. As FODMAPs are commonly added to enteral formula and EN is frequently used as the main source of nutrition, it is reasonable to hypothesize that EN provides more FODMAPs than usual dietary intake and increases risk for developing diarrhea. This hypothesis was assessed through a retrospective study showing that the standard-use enteral formula Isosource 1.5 had a protective effect of developing diarrhea. The only characteristic unique to Isosource 1.5 was the lower FODMAP content as determined through methodologies previously validated for food analysis. Methodologies for application to enteral formulas are currently undergoing formal validation. Once confirmed for application in enteral formula, future directions include FODMAP analysis of specific ingredients to increase understanding of potential problems associated with enteral formula and a randomized, controlled trial investigating the role of formula FODMAP content. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Do parto institucionalizado ao parto domiciliar

Directory of Open Access Journals (Sweden)

Clara Fróes de Oliveira Sanfelice

2014-01-01

Full Text Available El objetivo fue describir la experiencia vivida por un grupo de enfermeras en Campinas, SP, Brasil, acerca del proceso de transición de la atención institucionalizada para el parto domiciliario, en el período de 2011 a 2013. Relato de experiencia, cuyas reflexiones, percepciones y problemas enfrentados en este proceso fueron recolectados mediante la técnica lluvia de ideas. Se utilizó el análisis de contenido propuesto por Bardin, que emergieron cuatro categorías temáticas: experiencia del hospital, convivir con la violencia obstétrica; de vuelta a casa y desafíos de la atención domiciliaria. En conclusión, atender el parto en el hogar tiene ofrecido mayor satisfacción a las enfermeras, a pesar de diversos obstáculos, ya que es posible prestar asistencia a las mujeres y los recién nacidos que abarca tanto el concepto de integralidad como recomendaciones científicas actuales.

Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis

OpenAIRE

Cheng, Ying; Zhang, Junfeng; Zhang, Liwei; Wu, Juan; Zhan, Zhen

2018-01-01

Background Nutrition support is a common means for patients with gastric cancer, especially for those undergoing elective surgery. Recently, enteral immunonutrition (EIN) was increasingly found to be more effective than enteral nutrition (EN) in enhancing the host immunity and eventually improving the prognosis of gastric cancer patients undergoing gastrectomy. However, the results reported were not consistent. This meta-analysis aimed to assess the impact of EIN for patients with GC on bioch...

Manifiesto Abarán: el farmacéutico comunitario en la atención domiciliaria y sociosanitaria

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SEFAC.

2015-03-01

Full Text Available En los últimos años la esperanza de vida en España ha aumentado considerablemente, de modo que actualmente el 18 por ciento de la población es mayor de 65 años (los mayores de 80 años son el 6 por ciento y con previsiones de que en solo quince años una de cada cuatro personas superará esa edad. Algunas estimaciones apuntan, incluso, a que España será el tercer país más envejecido del mundo en 2050. A esto hay que añadir que a medida que la vida de las personas avanza suelen ir apareciendo enfermedades crónicas que, poco a poco, van reduciendo su calidad de vida, de tal manera que al llegar a la vejez es frecuente que se den varias patologías y que ello produzca un estado de fragilidad y dependencia. Además, y aunque según los datos disponibles el 72 por ciento de los mayores de 65 años son pacientes con patologías crónicas, no se debe olvidar que la cronicidad no está exclusivamente ligada a la edad, sino que afecta también a población infantil y juvenil.

Estudo comparativo da adequação das prescrições e ofertas protéicas a pacientes em uso de terapia nutricional enteral = Comparative study on the adequacy of protein prescription and supply to patients undergoing enteral nutritional therapy

Directory of Open Access Journals (Sweden)

Vanessa Taís Nozaki

2008-07-01

Full Text Available O objetivo desse estudo foi de avaliar as prescrições e ofertas protéicas a pacientes em uso de terapia nutricional enteral em dois hospitais da região metropolitana de Maringá, Estado do Paraná. Como metodologia utilizou-se os valores prescritos e o consumo de proteínas pelos pacientes foram obtidos dos prontuários médicos e comparados com as recomendações de consumo diário de proteínas por quilo de peso corporal para cada patologia. Os principais resultados dessa pesquisa foram que apenas 11,43% das dietas prescritas no Hospital A e 22,22% das dietas prescritas no Hospital B estavam corretas com relação à quantidade recomendada de proteínas. Nos dois hospitais, apenas 11% dos pacientes ingeriram a quantidade diária recomendada de proteínas. Pode-se concluir que a terapia nutricional enteral inadequada foi encontrado nos dois hospitais. Este estudodemonstrou a necessidade de melhoras nos serviços de nutrição enteral. Isto pode ser conseguido adotando-se procedimentos de padronização e avaliação regulares dos pacientes.The aim of this study was to evaluate protein prescription and supply to patients undergoing enteral nutritional therapy at two general hospitals in Maringá, Paraná State, Brazil. How methodology used isthe prescribed protein values and protein intake of each patient were obtained from medical records, and compared with the recommended daily protein intake per kilogram of body weight for each pathology. The main results of this survey were that only 11.43% of theprescribed diets in Hospital A and 22.22% of the prescribed diets in Hospital B were correct with respect to recommended protein amounts. In both hospitals, only 11% of all patients ingested the daily recommended amount of protein. It was concluded inadequate enteralnutritional therapy was found in both hospitals. The study demonstrates a need for improvement in enteral nutrition practices. This can be accomplished through the adoption of

Defining travel-associated cases of enteric fever.

Science.gov (United States)

Freedman, Joanne; Lighton, Lorraine; Jones, Jane

2014-01-01

There is no internationally recognized case-definition for travel-associated enteric fever in non-endemic countries. This study describes the patterns of case reporting between 2007 and 2011 as travel-associated or not from the surveillance data in England, Wales and Northern Ireland (EWNI), before and after a change in the time component of the case-definition in January 2011. It examines in particular the role of a time frame based on the reported typical incubation period in defining a case of travel-associated enteric fever. The results showed no significant differences in the distribution of cases of enteric fever in regards to the interval between the onset and UK arrival in 2011 compared to 2007-2010 (p=0.98 for typhoid and paratyphoid A); the distribution for paratyphoid B was also similar in both time periods. During 2007-2010, 93% (1730/1853) of all of the cases were classified as travel-associated compared to 94% (448/477) in 2011. This difference was not statistically significant. Changing the time component of the definition of travel-associated enteric fever did not make a significant difference to the proportion of travel-associated cases reported by investigators. Our analysis suggests that time might be subordinate to other considerations when investigators classify a case as travel-associated. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Celulitis por citomegalovirus

Directory of Open Access Journals (Sweden)

A. Ruiz Lascano

2002-12-01

Full Text Available Las lesiones cutáneas por citomegalovirus (CMV son infrecuentes y a menudo una manifestación tardía de una enfermedad sistémica, que generalmente anuncia un curso fatal. Comunicamos un caso de celulitis por CMV: una mujer de 70 años con trasplante renal efectuado 1 mes antes de la consulta, terapia inmunosupresora con ciclosporina A y metilprednisona. La paciente ingresó por fiebre, dolor e impotencia funcional en pierna derecha. Comprobamos la existencia de una placa de 8 por 4 cm eritematoedematosa. La tratamos con antibióticos sin mejoría, por lo que realizamos un estudio histopatológico de piel que mostró cambios citopáticos compatibles con infección por CMV. Los cultivos bacteriológicos y micológicos fueron negativos. La inmunohistoquímica específica para CMV y el estudio de reacción en cadena de la polimerasa (PCR de la biopsia de piel fueron positivas, al igual que la antigenemia. El tratamiento con ganciclovir produjo la mejoría del cuadro clínico. En la literatura revisada no hemos encontrado la celulitis como manifestación de enfermedad cutánea por CMV.

Effectiveness of the herbal medicine daikenchuto for radiation-induced enteritis.

Science.gov (United States)

Takeda, Takashi; Kamiura, Shouji; Kimura, Tadashi

2008-07-01

Radiation-induced enteritis is a serious clinical problem for which there is currently no recommended standard management. Daikenchuto (DKT) is a Japanese herbal medicine that has been used to treat adhesive bowel obstruction in Japan. This report describes a patient with radiation-induced enteritis whose clinical symptoms were much improved by treatment with DKT. The patient was administered DKT, a traditional Japanese herbal formula, orally (2.5 g 3 times daily). Abdominal distention was evaluated objectively with computed tomography. Gastrointestinal symptoms associated with radiation-induced enteritis were controlled successfully with DKT treatment. DKT treatment may be useful for the management of radiation-induced enteritis.

Relevancia de la infección natural por Trypanosoma cruzi en triatominos selváticos provenientes de seis municipios de Santander, Colombia

Directory of Open Access Journals (Sweden)

Sergio Gómez

2016-06-01

genotipificación se realizó mediante PCR del espaciador intergénico del gen mini-exón (SL-IR, que amplifica fragmentos de 350 y 300 pb para T. cruzi I (TcI y T. cruzi II o V-VI (TcII-V-VI, respectivamente. Resultados: Se analizaron 50 especímenes adultos de Panstrongylus geniculatus (64% y Rhodnius pallescens (36% capturados principalmente en el domicilio y peridomicilio, respectivamente. La TI en los triatominos fue de 53,6% al examen directo y de 68,0% mediante PCR de satADN. La TI fue mayor para R. pallescens (77,8% en comparación con P. geniculatus (62,5%. Se observaron altas tasas de infección en triatominos provenientes de Floridablanca (90,9%, Bucaramanga (66,7% y Capitanejo (50,0%. En San Vicente de Chucurí y Lebrija también se detectaron altos índices de infección, no obstante, el número de vectores capturados en estos municipios fue muy bajo (entre 1 y 3. Se determinaron las DTUs de las poblaciones de T. cruzi presentes en el 41,2% de los triatominos selváticos positivos por PCR de satADN. En ambas especies vectoriales se evidenció el predominio de TcI (86% y una alta frecuencia (33% de infección mixta por TcI y TcII-V-VI en R. pallescens. Conclusiones: Se determinó la alta tasa de infección por T. cruzi en triatominos selváticos capturados en los municipios evaluados, lo cual resalta su importancia epidemiológica por la posibilidad de transmisión del parásito por vía oral, aún en zonas de baja endemia o donde no hay reporte de vectores domiciliados. Igualmente, es urgente la implementación de estrategias de control dirigidas a prevenir la intrusión domiciliaria de estos vectores.

Enteric alpha defensins in norm and pathology

Directory of Open Access Journals (Sweden)

Lisitsyn Nikolai A

2012-01-01

Full Text Available Abstract Microbes living in the mammalian gut exist in constant contact with immunity system that prevents infection and maintains homeostasis. Enteric alpha defensins play an important role in regulation of bacterial colonization of the gut, as well as in activation of pro- and anti-inflammatory responses of the adaptive immune system cells in lamina propria. This review summarizes currently available data on functions of mammalian enteric alpha defensins in the immune defense and changes in their secretion in intestinal inflammatory diseases and cancer.

Kokainudløst iskaemisk enteritis

DEFF Research Database (Denmark)

Hobolth, Lise; Bendtsen, Flemming

2009-01-01

and a pill cam capsule endoscopy were normal. In all cases the condition normalized spontaneously. A thorough interview revealed a recreational use of cocaine, and diary recordings confirmed the association between her abdominal pain and cocaine use. Ischaemic enteritis has previously been described...

Enteric Duplication Cysts in Children: A Clinicopathological Dilemma.

Science.gov (United States)

Sharma, Sonam; Yadav, Amit K; Mandal, Ashish K; Zaheer, Sufian; Yadav, Devendra K; Samie, Amat

2015-08-01

Enteric duplication cysts are rare and uncommon congenital malformations formed during the embryonic period of the development of human digestive system and are mainly encountered during infancy or early childhood, but seldom in adults. The clinical presentation is extremely variable depending upon its size, location and type. We present six cases of enteric duplication cysts with diverse clinico-pathological features. This study was carried out in the Department of Pathology and Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India for a period of 2 years (January 2013 - December 2014). We retrospectively analyzed six patients of enteric duplication cysts based on data obtained, which consisted of patient's age, sex, clinical presentation, radiological features, operative findings and histopathology report. The data collected was analyzed by descriptive statistics. Six children between age range of 3 days to 10 years had enteric duplication cysts. Two had ileal and one each were of pyloroduodenal, colonic and rectal duplication cyst. In one patient a presumptive diagnosis of enteric duplication cyst was made. Radiology played an important contributory role in diagnosis of these cysts in all the patients but histopathology proved to be gold standard for its confirmation. All these patients were managed by surgical excision. The postoperative and follow up period in all the cases was uneventful. It is important to be aware and make a definitive diagnosis of this rare congenital anomaly as they can present in various clinical forms and can cause significant morbidity and even mortality if left untreated by causing life threatening complications.

[Enteral distress syndrome in surgery: definition, pathogenesis, diagnosis].

Science.gov (United States)

Vlasov, A P; Trofimov, V A; Grigorieva, T I; Shibitov, V A; Vlasov, P A

2016-01-01

It was performed a comprehensive experimental and clinical study of functional and metabolic status of the intestine in acute peritonitis, pancreatic necrosis, acute intestinal obstruction. We obtained objective data of impaired barrier function based on levels of toxins in arterial and mesenteric venous blood. Association of organ and organismic homeostatic changes was revealed. It was proved an important role of membrane-destabilizing processes in intestinal epithelium as a cause of enteral insufficiency. Leading trigger mechanisms of lipid metabolic disorders were determined. Enteral distress syndrome was determined as pathological response to acute abdominal surgical diseases. Enteral distress syndrome is a complex of pathological processes due to membrane-destabilizing mechanisms, impaired intestinal barrier function followed by progression of endogenous intoxication. This syndrome significantly aggravates the course of acute surgical abdominal diseases.

Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

Science.gov (United States)

Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh

2017-10-01

BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume ( p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days ( p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.

Antimicrobial effect of Malaysian vegetables against enteric bacteria

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Hassanain Al-Talib

2016-03-01

Conclusions: Garlic had excellent antimicrobial effects against enteric bacteria and was recommended to be given to patients with gastroenteritis. The other vegetables (pennywort, mint, parsley and celery showed no inhibitory effects on enteric bacteria but still can be used for its richness in vitamins and fibers. The performance of the well diffusion method was better than that of the disc diffusion method in detecting the antibacterial effects of green vegetables.

CERN openlab enters fifth phase

CERN Multimedia

Andrew Purcell

2015-01-01

CERN openlab is a unique public-private partnership between CERN and leading ICT companies. At the start of this year, openlab officially entered its fifth phase, which will run until the end of 2017. For the first time in its history, it has extended beyond the CERN community to include other major European and international research laboratories.   Founded in 2001 to develop the innovative ICT systems needed to cope with the unprecedented computing challenges of the LHC, CERN openlab unites science and industry at the cutting edge of research and innovation. In a white paper published last year, CERN openlab set out the main ICT challenges it will tackle during its fifth phase, namely data acquisition, computing platforms, data storage architectures, computer management and provisioning, networks and connectivity, and data analytics. As it enters its fifth phase, CERN openlab is expanding to include other research laboratories. "Today, research centres in other disciplines are also st...

Portable exhauster POR-007/Skid E and POR-008/Skid F storage plan

International Nuclear Information System (INIS)

Nelson, O.D.

1998-01-01

This document provides storage requirements for 1,000 CFM portable exhausters POR-O07/Skid E and POR-008/Skid F. These requirements are presented in three parts: preparation for storage, storage maintenance and testing, and retrieval from storage. The exhauster component identification numbers listed in this document contain the prefix POR-007 or POR-008 depending on which exhauster is being used

Randomized clinical trial of arginine-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing gastric cancer surgery.

Science.gov (United States)

Zhao, Hongyan; Zhao, Hongying; Wang, Yu; Jing, Huang; Ding, Qian; Xue, Jun

2013-09-01

Significant malnutrition exists in a high percentage of patients with gastric cancer. It is, therefore, crucial to establish an effective means to provide nutrition for these patients. This prospective, randomized, double-blinded clinical trial aims to assess the long-term survival of arginine-supplementation enteral nutrition versus standard enteral nutrition in malnourished patients with gastric cancer. The control group (36 cases) received postoperative standard enteral nutrition. Meanwhile, the arginine-supplementation group (37 cases) adopted the same nutrition product but enriched with arginine (9.0 g/L). The primary study objective was overall survival (OS). Secondary endpoints were progression-free survival (PFS); serum parameters including total protein, albumin, proalbumin, and transferrin obtained on preoperative day 1, postoperative day 2, and day 12; CD4(+) and CD8(+) T cells, natural killer (NK) cells, immunoglobulin M (IgM), and immunoglobulin G (IgG) obtained on preoperative day 1 and postoperative day 7. No significant differences in baseline characteristics were observed between groups. The group receiving arginine-enriched nutrition had a significantly better OS (P = 0.03, 41 vs. 30.5 months) and better PFS (P = 0.02, 18 vs. 11.5 months). On postoperative day 7, CD4(+) T cells, NK cells, IgM and IgG levels of the arginine-supplemented group increased prominently and were significantly higher than those of the control group and those on preoperative day 1. There is no significant difference in the serum total protein, albumin, proalbumin, and transferrin levels between the two arms. Arginine-supplemented enteral nutrition significantly improves long-term survival and restores immunity in malnourished gastric cancer.

Complications relating to enteral and parenteral nutrition in trauma ...

African Journals Online (AJOL)

Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...

La nutrición enteral precoz en el enfermo grave Early enteral nutrition in the critically-ill patient

OpenAIRE

B. García Vila; T. Grau

2005-01-01

La nutrición enteral se ha demostrado como un método eficaz y seguro de nutrir a los enfermos graves ingresados en una Unidad de Cuidados Intensivos. Aunque se desconoce cuánto tiempo puede estar un enfermo grave sin nutrición, el catabolismo acelerado y el ayuno pueden ser deletéreos en el enfermo grave y la recomendación más frecuente es la de empezar la nutrición artificial cuando se prevea un período de ayuno superior a los siete días. Las ventajas de la nutrición enteral sobre la nutrici...

Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems

International Nuclear Information System (INIS)

Nijs, Els L. F.; Cahill, Anne Marie

2010-01-01

Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

Genomic diversification of giant enteric symbionts reflects host dietary lifestyles

KAUST Repository

Ngugi, David; Miyake, Sou; Cahill, Matthew; Vinu, Manikandan; Hackmann, Timothy J.; Blom, Jochen; Tietbohl, Matthew; Berumen, Michael L.; Stingl, Ulrich

2017-01-01

of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial

CUIDADO FAMILIAL DAS CRIANÇAS COM NECESSIDADES ESPECIAIS DE SAÚDE: UM PROCESSO (SOBRENATURAL E DE (SUPERPROTEÇÃO

Directory of Open Access Journals (Sweden)

Andressa da Silveira

2013-01-01

Full Text Available Estudio descriptivo, exploratorio, tuvo como objetivo describir el proceso de atención desarrollado por la familia y cuidadores de niños con necesidades especiales de salud. Los sujetos fueron 10 cuidadores de niños en una unidad pediátrica. La producción de datos se dio a través del método creativo y sensible mediada por la dinámica de la creatividad y la sensibilidad, sometida al análisis del discurso. Los resultados mostraron una atención (sobrenatural y (súperprotección de la actividades comunes de la vida diaria con el fin de protegerlo de posibles problemas de salud. El estudio encontró la abnegación personal del familiar a favor de la atención requerida por el niño, y la presencia del padre como cuidador principal. Se recomienda el desarrollo de actividades de divulgación específicas para estos familiares, la creación de programas dirigidas para la atención en el hogar del niño y actividades que beneficien a la mejora de la práctica domiciliaria.

Parenteral and Early Enteral Feeding in Patients with Colonic Tumor

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O. A. Malkov

2008-01-01

Full Text Available Objective: to provide evidence whether it is expedient to use an early enteral feeding protocol in patients with colonic malignancies in the postoperative period to prevent and to correct hemodynamic disorders, oxygen imbalance, and malnutrition. Subjects and methods. A hundred patients (61 males and 39 females aged 66.2±5.0 years, who had Stages 2—3 colonic malignancies, were examined. Two algorithms of postoperative management were analyzed using the traditional diet and early enteral feeding. Results. The early enteral feeding protocol improves central hemodynamics and oxygen and nutritional status, prevents moderate protein-energy deficiency in the early postoperative period and reduces the number of complications and fatal outcomes in patients with colonic malignancies. Key words: malignancies, malnutrition, hemo-dynamics, oxygen status, enteral feeding.

Radiation enteritis

International Nuclear Information System (INIS)

Sato, Makoto; Sano, Masanori; Minakuchi, Naoki; Narisawa, Tomio; Takahashi, Toshio

1981-01-01

Radiation enteritis with severe complications including intestinal bleeding, fistula, and stenosis were treated surgically in 9 cases. These 9 cases included 7 cases of cancer of the uterine cervix and 2 single cases of seminoma and melanoma. The patients received 60 Co or Linac x-ray external irradiation with or without intracavitary irradiation by a radium needle. Radiation injury began with melena, vaginorectal fistula, and intestinal obstruction 3 to 18 months after irradiation. One patient with melena underwent colostomy and survived 2 years. One of the three patients with vaginorectal fistula who had colostomy survived 1.5 years. In intestinal obstruction, one patients had bypass operation and three patients had resection of the intestine and the other had both. Leakage was noted in one patient, but the others had favorable prognosis. (Ueda, J.)

American Society for Parenteral & Enteral Nutrition

Science.gov (United States)

... Center Advertising and Sponsorship Learn More ASPEN Enteral Nutrition by the Numbers: EN Data Across the Healthcare Continuum Learn More The ASPEN Adult Nutrition Support Core Curriculum, 3rd Edition Has Arrived! The ...

Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever

Science.gov (United States)

Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M

2017-01-01

Background Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. Objectives To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. Selection criteria We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Data collection and analysis Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Main results Thirty-seven studies met the inclusion

[Biological evaluation of a protein mixture intended for enteral nutrition].

Science.gov (United States)

Meneses, J Olza; Foulquie, J Porres; Valero, G Urbano; de Victoria, E Martínez; Hernández, A Gil

2008-01-01

Enteral nutrition is the best way to feed or supplement the diet when gastrointestinal tract functions of patients are partially or totally preserved. Whenever total enteral nutrition is needed, it represents the only source of nutrients for patients. Thus, it is mandatory to ensure that high biological value proteins are included in enteral formulae. To assess the biological quality of a protein blend constituted by 50% potassium caseinate, 25% whey protein and 25% pea protein intended to be used in enteral nutrition products. Forty Wistar rats (20 male and 20 female), with initial body weight of 51 g, where divided into four groups and feed for 10 days with: casein (Control), experimental protein blend (Experimental), liophylized normo- and hyperproteic enteral nutrition formulae adapted to the animal nutritional requirements (Normoproteic and Hyperproteic). Protein efficiency ratio (PER), apparent digestibility coefficient (ADC), relationship between retained and absorbed nitrogen (R/A) and relationship between retained and consumed nitrogen (R/I) where calculated. Experimental and control groups had similar values for all analysed indices (PER, ADC, R/A and R/I). These indices where also similar between normo and hyperproteic groups, but lower than experimental and control groups, except in PER, where normoproteic group was either similar to control and hiperproteic group. The quality of the protein blend used in this study is high. It is a good protein source to be used in the development of new enteral nutritional products.

IODINE CONTENT OF ENTERAL AND PARENTERAL NUTRITION SOLUTIONS.

Science.gov (United States)

Willard, Devina L; Young, Lorraine S; He, Xuemei; Braverman, Lewis E; Pearce, Elizabeth N

2017-07-01

Iodine is essential for thyroid hormone synthesis, and iodine deficiency may result in thyroid disorders including goiter and hypothyroidism. Patients on long-term enteral nutrition (EN) or parenteral nutrition (PN) may be at risk for micronutrient deficiencies. The recommended daily allowance for iodine intake is 150 μg for nonpregnant adults. However, there is no current consensus among scientific societies regarding the quantity of iodine to be added in adult EN and PN formulations. The objective of this study was to determine the iodine content of U.S. adult enteral and parenteral nutrition solutions. This study also aimed to determine whether adult patients in the United States who are receiving long-term artificial nutrition may be at risk for iodine deficiency. Ten enteral nutrition solutions and 4 parenteral nutrition solutions were evaluated. The iodine contents of these solutions were measured spectrophotometrically and compared to the labeled contents. Measured and labeled EN iodine contents were similar (range 131-176 μg/L and 106-160 μg/L, respectively). In contrast, PN formulas were found to contain small, unlabeled amounts of iodine, averaging 27 μg/L. Typical fluid requirements are 30 to 40 mL/kg/day for adults receiving either total EN (TEN) or total PN (TPN). Adults on long-term TEN likely consume enough servings to meet their daily iodine requirements. However, patients on long-term TPN would require on average 5.6 L PN/day to meet the recommended daily allowance of iodine. This volume of PN is far in excess of typical consumption. Thus, U.S. patients requiring long-term TPN may be at risk for iodine deficiency. EN = enteral nutrition; PN = parenteral nutrition; TEN = total enteral nutrition; TPN = total parenteral nutrition; UIC = urinary iodine concentration.

Communication Skill Attributes Needed for Vocational Education enter The Workplace

Science.gov (United States)

Wahyuni, L. M.; Masih, I. K.; Rejeki, I. N. Mei

2018-01-01

Communication skills are generic skills which need to be developed for success in the vocational education entering the workforce. This study aimed to discover the attributes of communication skill considered important in entering the workforce as perceived by vocational education students. The research was conducted by survey method using questionnaire as data collecting tool. The research population is final year student of D3 Vocational education Program and D4 Managerial Vocational education in academic year 2016/2017 who have completed field work practice in industry. The sampling technique was proportional random sampling. Data were analyzed with descriptive statistics and independent sampel t-test. Have ten communication skills attributes with the highest important level required to enter the workplace as perceived by the vocational education diploma. These results indicate that there was the same need related communication skills to enter the workforce

Ammonia modifies enteric neuromuscular transmission through glial γ-aminobutyric acid signaling.

Science.gov (United States)

Fried, David E; Watson, Ralph E; Robson, Simon C; Gulbransen, Brian D

2017-12-01

Impaired gut motility may contribute, at least in part, to the development of systemic hyperammonemia and systemic neurological disorders in inherited metabolic disorders, or in severe liver and renal disease. It is not known whether enteric neurotransmission regulates intestinal luminal and hence systemic ammonia levels by induced changes in motility. Here, we propose and test the hypothesis that ammonia acts through specific enteric circuits to influence gut motility. We tested our hypothesis by recording the effects of ammonia on neuromuscular transmission in tissue samples from mice, pigs, and humans and investigated specific mechanisms using novel mutant mice, selective drugs, cellular imaging, and enzyme-linked immunosorbent assays. Exogenous ammonia increased neurogenic contractions and decreased neurogenic relaxations in segments of mouse, pig, and human intestine. Enteric glial cells responded to ammonia with intracellular Ca 2+ responses. Inhibition of glutamine synthetase and the deletion of glial connexin-43 channels in hGFAP :: Cre ER T2+/- /connexin43 f/f mice potentiated the effects of ammonia on neuromuscular transmission. The effects of ammonia on neuromuscular transmission were blocked by GABA A receptor antagonists, and ammonia drove substantive GABA release as did the selective pharmacological activation of enteric glia in GFAP::hM3Dq transgenic mice. We propose a novel mechanism whereby local ammonia is operational through GABAergic glial signaling to influence enteric neuromuscular circuits that regulate intestinal motility. Therapeutic manipulation of these mechanisms may benefit a number of neurological, hepatic, and renal disorders manifesting hyperammonemia. NEW & NOTEWORTHY We propose that local circuits in the enteric nervous system sense and regulate intestinal ammonia. We show that ammonia modifies enteric neuromuscular transmission to increase motility in human, pig, and mouse intestine model systems. The mechanisms underlying the

DESAJUSTE EDUCATIVO POR REGIONES EN COLOMBIA: ¿COMPETENCIA POR SALARIOS O POR PUESTOS DE TRABAJO?

Directory of Open Access Journals (Sweden)

Maribel Castillo Caicedo

2007-06-01

Full Text Available Este trabajo aporta una perspectiva del fenómeno de la sobreeducación, entendida como un desajuste por exceso, entre el nivel educativo alcanzado por el individuo y el exigido por el puesto de trabajo en el cual se desempeña; esto se debe a que existe una demanda laboral estrecha de puestos de trabajo para personas calificadas en Colombia. Se analizan las contribuciones empíricas existentes y el debate sobre las mismas; se examinan las teorías que permiten explicar la existencia de un desajuste educativo y se realiza una revisión de la literatura internacional y nacional sobre el tema. Adicionalmente, se plantean una serie de hipótesis para desarrollar un esquema que permita determinar el comportamiento del individuo en el fenómeno de la sobreeducación.

The radiological features of chronic radiation enteritis

International Nuclear Information System (INIS)

Mendelson, R.M.; Nolan, D.J.

1985-01-01

The radiological findings, using a single-contrast barium infusion technique, are described in a series of 13 patients with chronic radiation enteritis. The signs include evidence of submucosal thickening, single or multiple stenoses, adhesions and sinus or fistula formation. A combination of these signs characterises the condition. This technique is particularly suited to the investigation of radiation enteritis because of its ability to distend maximally the small intestine. A cause, stenosis and/or adhesions, was demonstrated in the eight of the 13 patients presenting with intermittent small-intestinal obstruction. Three patients had diarrhoea as their predominant complaint and a fistula was demonstrated in two. (author)

Tracing enteric viruses in the European berry fruit supply chain

NARCIS (Netherlands)

Maunula, L.; Kaupke, A.; Vasickova, P.; Soderberg, K.; Kozyra, I.; Lazic, S.; Poel, van der W.H.M.; Bouwknegt, M.; Rutjes, S.; Willems, K.A.; Moloney, R.; Agostino, D' M.; Husman, A.M.D.; Bonsdorff, C.H.; Rzezutka, A.; Pavlik, I.; Petrovic, T.; Cook, N.

2013-01-01

In recent years, numerous foodborne outbreaks due to consumption of berry fruit contaminated by human enteric viruses have been reported. This European multinational study investigated possible contamination routes by monitoring the entire food chain for a panel of human and animal enteric viruses.

Mining free-text medical records for companion animal enteric syndrome surveillance.

Science.gov (United States)

Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C

2014-03-01

Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. Copyright © 2014 Elsevier B.V. All rights reserved.

Enteric Diseases of Poultry with Special Attention to Clostridium perfringens

Directory of Open Access Journals (Sweden)

Hafez Mohamed Hafez

2011-06-01

Full Text Available The enteric heath of growing poultry is imperative to success of the production. The basic role of poultry production is turning feed stuffs into meat. Any changes in this turning process, due to mechanical, chemical or biological disturbance of digestive system (enteric disorders is mostly accompanied with high economic losses due to poor performance, increased mortality rates and increased medication costs. The severity of clinical signs and course of the disorders are influenced several factors such as management, nutrition and the involved agent(s. Several pathogens (viruses, bacteria and parasites are incriminated as possible cause of enteric disorders either alone (mono-causal, in synergy with other micro-organisms (multi-causal, or with non-infectious causes such as feed and /or management related factors. In addition, excessive levels of mycotoxins and biogenic amines in feed lead to enteric disorders. Also factors such as high stocking density, poor litter conditions, poor hygiene and high ammonia level and other stressful situation may reduce the resistance of the birds and increases their susceptibility to infections. Under field conditions, however, under filed conditions it is difficult to determine whether the true cause of enteric disorders, is of infectious or non-infectious origin. In recent years and since the ban of use of antimicrobial growth promoters in several countries the incidence of intestinal disorders especially those caused by clostridial infection was drastically increased. The present review described in general the several factors involved in enteric disorders and summarized the available literatures about Clostridium perfringens infection in poultry.

Enteric methane emissions from German pigs

DEFF Research Database (Denmark)

Dämmgen, Ulrich; Schulz, Joachim; Klausing, Heinrich Kleine

2012-01-01

Methane emissions from enteric fermentation of pigs are object of emission reporting. Hitherto they were treated as part of the energy balance of pigs, in accordance with IPCC guidance documents. They were calculated from the gross energy intake rate and a constant methane conversion ratio....... Meanwhile numerous experimental data on methane emissions from enteric fermentation is available in Germany and abroad; the results are compiled in this work. These results also allow for a description of transformation processes in the hind gut and a subsequent establishment of models that relate emissions...... to feed and performance data. The model by Kirchgeßner et al. (1995) is based on German experimental data and reflects typical national diet compositions. It is used to quantify typical emissions and methane conversion ratios. The results agree with other experimental findings at home and abroad...

Desajuste educativo por regiones en Colombia: ¿competencia por salarios o por puestos de trabajo?

Directory of Open Access Journals (Sweden)

Castillo Caicedo Maribel

2007-08-01

Full Text Available Este trabajo aporta una perspectiva del fenómeno de la sobreeducación,
entendida como un desajuste por exceso, entre el nivel educativo alcanzado
por el individuo y el exigido por el puesto de trabajo en el cual se
desempeña; esto se debe a que existe una demanda laboral estrecha de
puestos de trabajo para personas calificadas en Colombia. Se analizan las
contribuciones empíricas existentes y el debate sobre las mismas; se
examinan las teorías que permiten explicar la existencia de un desajuste
educativo y se realiza una revisión de la literatura internacional y
nacional sobre el tema. Adicionalmente, se plantean una serie de hipótesis
para desarrollar un esquema que permita determinar el comportamiento
del individuo en el fenómeno de la sobreeducación.

Intestinal endocrine cells in radiation enteritis

NARCIS (Netherlands)

Pietroletti, R.; Blaauwgeers, J. L.; Taat, C. W.; Simi, M.; Brummelkamp, W. H.; Becker, A. E.

1989-01-01

In this study, the intestinal endocrine cells were investigated in 13 surgical specimens affected by radiation enteritis. Endocrine cells were studied by means of Grimelius' silver staining and immunostaining for chromogranin, a general marker of endocrine cells. Positively stained cells were

Costo de un sistema de atención de adultos mayores dependientes en Chile, 2012 - 2020

Directory of Open Access Journals (Sweden)

Mauricio Matus-López

2014-07-01

Full Text Available OBJETIVO: Obtener una estimación de los costos relativo y absoluto de un sistema de atención domiciliaria para los adultos mayores dependientes en Chile y reflexionar sobre las consideraciones metodológicas a tener en cuenta en estimaciones para otros modelos en otros países. MÉTODOS: Se utilizaron tasas de prevalencia por sexo y edad con base en los microdatos de la Encuesta Nacional de Dependencia (ENDPM 2009 y se proyectaron tres escenarios para 2012 - 2020. Se estimó la población beneficiaria y la demanda de 12 programas de servicios de atención domiciliaria. Las características de los programas, en horas y tipo de atención se obtuvieron del juicio de expertos, ajustados por la revisión bibliográfica. Se utilizaron salarios/hora del sistema público y privado. RESULTADOS: Entre los mayores de 65 años, 20,3% sería beneficiario del sistema; 21,7% sobre el total de mujeres y 18,4% sobre el total de hombres. Su número asciende a 336 874 personas para 2012. El costo anual del sistema alcanza los 1 214 millones de dólares para 2012. Esto equivale a 0,45% del PIB (producto interior bruto, que se podría incrementar entre 32,1% y 33,1% hasta 2020. CONCLUSIONES: El costo de un sistema inicial para adultos mayores dependientes en Chile es relativamente bajo en comparación con los modelos de los países industrializados. En términos metodológicos, se destaca la importancia de la discusión previa sobre el tipo de modelo que se desee implementar y las posibilidades financieras de llevarlo a cabo. Además, se valida la opción de utilizar juicios de expertos para la evaluación, aunque se aconseja ampliarla.

Recomendaciones para la prevención, diagnóstico y tratamiento de LA EPOC en la Argentina

Directory of Open Access Journals (Sweden)

Juan Carlos Figueroa Casas

2012-08-01

Full Text Available La enfermedad pulmonar obstructiva crónica (EPOC está aumentando marcadamente su morbimortalidad, costos e indicadores epidemiológicos. Por ello la Asociación Argentina de Medicina Respiratoria (AAMR convocó a un grupo de especialistas para actualizar conocimientos básicos y efectuar recomendaciones para su diagnóstico, prevención y tratamiento. Se revisan definición, avances en fisiopatología, presentación clínica, diagnóstico por imágenes y evaluación funcional. Se enfatiza su diagnóstico temprano mediante exploración funcional -esencialmente espirometría- y la prevención a través de la cesación del tabaquismo. Se describen estrategias para dejar de fumar, tratamiento farmacológico y no farmacológico. La administración de broncodilatadores, preferentemente de acción prolongada, es la primera opción de tratamiento farmacológico. Los corticoides inhalados se indican en combinación con los broncodilatadores en pacientes con obstrucción al flujo aéreo persistente asociada con exacerbaciones frecuentes, si bien se requieren estudios que confirmen su relación costo/beneficio. La vacuna antigripal es recomendada en todos los pacientes. Con respecto a las intervenciones no farmacológicas, la cirugía del enfisema solo se recomienda en circunstancias especiales. La rehabilitación respiratoria es una herramienta útil en pacientes con limitación en la actividad física habitual. La oxígenoterapia crónica domiciliaria mejora la supervivencia en pacientes con hipoxemia crónica grave. La ventilación no invasiva domiciliaria fuera de las exacerbaciones, tiene indicaciones en pacientes seleccionados. Las exacerbaciones agudas deben tratarse con broncodilatadores, oxígeno, corticoides, antibióticos y, bajo ciertas circunstancias, asistencia respiratoria mecánica tanto no invasiva como invasiva. El papel de la educación pública, del paciente y su familia, es considerada esencial en la prevención y tratamiento.

Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

Directory of Open Access Journals (Sweden)

Dhana G Gorasia

2016-08-01

Full Text Available The type IX secretion system (T9SS has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component.

Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System.

Science.gov (United States)

Gorasia, Dhana G; Veith, Paul D; Hanssen, Eric G; Glew, Michelle D; Sato, Keiko; Yukitake, Hideharu; Nakayama, Koji; Reynolds, Eric C

2016-08-01

The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32-36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component.

[ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

Science.gov (United States)

Escortell Sánchez, Raquel; Reig García-Galbis, Manuel

2015-10-01

to identify what effect causes enteral nutrition on nutritional status of cancer. a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Perfuração do colo por colite amebiana invasiva durante terapia anti-TNF para espondiloartrite♧

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Juan Pablo Restrepo

2014-12-01

Full Text Available O bloqueio do TNF tem tido sucesso no tratamento de algumas doenças reumáticas, como a espondiloartrite. Relatam-se muitas complicações infecciosas com a terapia anti-TNF, principalmente infecções bacterianas, micobacterianas, virais e fúngicas. A Entamoeba histolytica é um protozoário extracelular que causa principalmente colite e abscesso hepático, sendo que a perfuração intestinal é uma complicação rara, com alta mortalidade. O TNF é considerado o principal mediador da imunidade celular contra a amebíase. Inicialmente, é quimiotático para a E. histolytica, potencializando sua adesão ao enterócito por meio da lectina galactose-inibível, e depois ativando os macrófagos para matarem a ameba pela liberação de NO; assim, o bloqueio do TNF poderia ser prejudicial, aumentando a virulência amebiana. Descreve-se o caso de uma mulher de 46 anos com espondiloartrite que apresentou uma perfuração do colo por colite amebiana invasiva durante uso de anti-TNF.

Isolated Enteric Cyst in the Neck

Directory of Open Access Journals (Sweden)

Amit Mahore

2014-01-01

Full Text Available We report an extremely rare case of isolated enteric cyst in the neck region which was diagnosed on the histopathological examination. It was suspected to be duplication cyst on radiology. We have also evaluated the differential diagnosis and management issues.

The PorX response regulator of the Porphyromonas gingivalis PorXY two-component system does not directly regulate the Type IX secretion genes but binds the PorL subunit.

Directory of Open Access Journals (Sweden)

Maxence S Vincent

2016-08-01

Full Text Available The Type IX secretion system (T9SS is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion of surface attachment of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY and PorX encode typical two-component system (TCS sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of the porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we showed that PorX does not bind and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS.

The PorX Response Regulator of the Porphyromonas gingivalis PorXY Two-Component System Does Not Directly Regulate the Type IX Secretion Genes but Binds the PorL Subunit

Science.gov (United States)

Vincent, Maxence S.; Durand, Eric; Cascales, Eric

2016-01-01

The Type IX secretion system (T9SS) is a versatile multi-protein complex restricted to bacteria of the Bacteriodetes phylum and responsible for the secretion or cell surface exposition of diverse proteins that participate to S-layer formation, gliding motility or pathogenesis. The T9SS is poorly characterized but a number of proteins involved in the assembly of the secretion apparatus in the oral pathogen Porphyromonas gingivalis have been identified based on genome substractive analyses. Among these proteins, PorY, and PorX encode typical two-component system (TCS) sensor and CheY-like response regulator respectively. Although the porX and porY genes do not localize at the same genetic locus, it has been proposed that PorXY form a bona fide TCS. Deletion of porX in P. gingivalis causes a slight decrease of the expression of a number of other T9SS genes, including sov, porT, porP, porK, porL, porM, porN, and porY. Here, we show that PorX and the soluble cytoplasmic domain of PorY interact. Using electrophoretic mobility shift, DNA-protein co-purification and heterologous host expression assays, we demonstrate that PorX does not bind T9SS gene promoters and does not directly regulate expression of the T9SS genes. Finally, we show that PorX interacts with the cytoplasmic domain of PorL, a component of the T9SS membrane core complex and propose that the CheY-like PorX protein might be involved in the dynamics of the T9SS. PMID:27630829

Vaccines against enteric infections for the developing world

Science.gov (United States)

Czerkinsky, Cecil; Holmgren, Jan

2015-01-01

Since the first licensure of the Sabin oral polio vaccine more than 50 years ago, only eight enteric vaccines have been licensed for four disease indications, and all are given orally. While mucosal vaccines offer programmatically attractive tools for facilitating vaccine deployment, their development remains hampered by several factors: —limited knowledge regarding the properties of the gut immune system during early life;—lack of mucosal adjuvants, limiting mucosal vaccine development to live-attenuated or killed whole virus and bacterial vaccines;—lack of correlates/surrogates of mucosal immune protection; and—limited knowledge of the factors contributing to oral vaccine underperformance in children from developing countries.There are now reasons to believe that the development of safe and effective mucosal adjuvants and of programmatically sound intervention strategies could enhance the efficacy of current and next-generation enteric vaccines, especially in lesser developed countries which are often co-endemic for enteric infections and malnutrition. These vaccines must be safe and affordable for the world's poorest, confer long-term protection and herd immunity, and must be able to contain epidemics. PMID:25964464

Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit.

Science.gov (United States)

Lewis, Sharon R; Schofield-Robinson, Oliver J; Alderson, Phil; Smith, Andrew F

2018-06-08

Critically ill people are at increased risk of malnutrition. Acute and chronic illness, trauma and inflammation induce stress-related catabolism, and drug-induced adverse effects may reduce appetite or increase nausea and vomiting. In addition, patient management in the intensive care unit (ICU) may also interrupt feeding routines. Methods to deliver nutritional requirements include provision of enteral nutrition (EN), or parenteral nutrition (PN), or a combination of both (EN and PN). However, each method is problematic. This review aimed to determine the route of delivery that optimizes uptake of nutrition. To compare the effects of enteral versus parenteral methods of nutrition, and the effects of enteral versus a combination of enteral and parenteral methods of nutrition, among critically ill adults, in terms of mortality, number of ICU-free days up to day 28, and adverse events. We searched CENTRAL, MEDLINE, and Embase on 3 October 2017. We searched clinical trials registries and grey literature, and handsearched reference lists of included studies and related reviews. We included randomized controlled studies (RCTs) and quasi-randomized studies comparing EN given to adults in the ICU versus PN or versus EN and PN. We included participants that were trauma, emergency, and postsurgical patients in the ICU. Two review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias. We assessed the certainty of evidence with GRADE. We included 25 studies with 8816 participants; 23 studies were RCTs and two were quasi-randomized studies. All included participants were critically ill in the ICU with a wide range of diagnoses; mechanical ventilation status between study participants varied. We identified 11 studies awaiting classification for which we were unable to assess eligibility, and two ongoing studies.Seventeen studies compared EN versus PN, six compared EN versus EN and PN, two were multi-arm studies comparing EN versus PN

Intestine, immunity, and parenteral nutrition in an era of preferred enteral feeding.

Science.gov (United States)

Barrett, Meredith; Demehri, Farokh R; Teitelbaum, Daniel H

2015-09-01

To review the benefits of enteral nutrition in contrast to the inflammatory consequences of administration of parenteral nutrition and enteral deprivation. To present the most recent evidence for the mechanisms of these immunologic changes and discuss potential areas for modification to decrease infectious complications of its administration. There is significant data supporting the early initiation of enteral nutrition in both medical and surgical patients unable to meet their caloric goals via oral intake alone. Despite the preference for enteral nutrition, some patients are unable to utilize their gut for nutritious gain and therefore require parenteral nutrition administration, along with its infectious complications. The mechanisms behind these complications are multifactorial and have yet to be fully elucidated. Recent study utilizing both animal and human models has provided further information regarding parenteral nutrition's deleterious effect on intestinal epithelial barrier function along with the complications associated with enterocyte deprivation. Changes associated with parenteral nutrition administration and enteral deprivation are complex with multiple potential areas for modification to allow for safer administration. Recent discovery of the mechanisms behind these changes present exciting areas for future study as to make parenteral nutrition administration in the enterally deprived patient safer.

The Sensitivity Of Diazo Test In The Diagnosis Of Enteric Fevers ...

African Journals Online (AJOL)

serological) test in the diagnosis of enteric fevers, blood specimens from101 patients suspected of having enteric fevers were collected. 54.5% (55) of the patients were significantly seropositive. Fifteen urine specimens from these 55 seropositive ...

Genomic diversification of giant enteric symbionts reflects host dietary lifestyles

KAUST Repository

Ngugi, David

2017-08-24

Herbivorous surgeonfishes are an ecologically successful group of reef fish that rely on marine algae as their principal food source. Here, we elucidated the significance of giant enteric symbionts colonizing these fishes regarding their roles in the digestive processes of hosts feeding predominantly on polysiphonous red algae and brown Turbinaria algae, which contain different polysaccharide constituents. Using metagenomics, single-cell genomics, and metatranscriptomic analyses, we provide evidence of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial herbivores. Over 90% of the enzymes for deconstructing algal polysaccharides emanate from members of a single bacterial lineage,

Radiogenic enteritis in children: study in a series of 63 patients

International Nuclear Information System (INIS)

Alert Silva, J.; Longchong Ramos, M.; Castillo Otero, E.; Valdes Zamora, M.

1981-01-01

In children, the abdominal irradiation being part of multidisciplinary therapeutical treatment for various malignant neoplasias, inferred radiogenic enteritis onset. In a group of 63 patients treated at the Institute of Oncology and Radiobiology, in Havana City, who presented intraabdominal located no Hodgkin's linfomas, Wilms' tumors, neuroblastomas, intraabdominal sarcomas and ovarium malignant neoplasias, incidence for this complication was 63,5%; in 34 children showed up during radiant treatment (early enteritis) and in eleven children after it was finished (late enteritis). Extended surgical exeresis accounted to clinical picture onset. Hygienicdietetic treatment improves patient's clinical evolution. (author)

Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

International Nuclear Information System (INIS)

Fietkau, R.

1998-01-01

Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de

Comportamiento de la Tecnología PLC en la Red Eléctrica

OpenAIRE

García Guibout, J.; García Garino, Carlos; Fusario, Rubén J.; Castro Lechtaler, Antonio; Sevilla, Guillermo

2007-01-01

La tecnología PLC1 - PowerLine Communications- está referida a la transmisión de datos utilizando la red eléctrica, tanto domiciliaria, como la red de distribución de baja tensión. Dependiendo del tipo de red que se utilice como soporte esta tecnología se divide en PLC indoor y outdoor. La primera se refiere a la utilización de la red domiciliaria y utiliza las frecuencias más altas de 5 MHz a 30 ó 40 MHz. La segunda, outdoor, usa la red de distribución y las frecuencias bajas de 1 MHz a 5 ó ...

Encefalopatía por priones

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Carlos Colegial

1999-01-01

Full Text Available Las encefalopatías espongiformes por priones son enfermedades neurodegenerativas que pueden ser esporádicas o transmisibles, ya sea por mecanismos infecciosos o hereditarios. Su investigación ha planteado enormes retos y en el recorrido histórico en busca de su causa dos médicos han recibido el premio Nobel de Medicina: Carleton Gajdusek, por sus trabajos en Nueva Guinea donde describió la transmisión infecciosa por ritos canibalísticos, que llevó a estudios de transmisión experimental en chimpancés y a su teoría de los "virus lentos" (por el largo período de incubación de la enfermedad.

Comparison of canine parvovirus with mink enteritis virus by restriction site mapping.

OpenAIRE

McMaster, G K; Tratschin, J D; Siegl, G

1981-01-01

The genomes of canine parvovirus and mink enteritis virus were compared by restriction enzyme analysis of their replicative-form DNAs. Of 79 mapped sites, 68, or 86%, were found to be common for both types of DNA, indicating that canine parvovirus and mink enteritis virus are closely related viruses. Whether they evolved from a common precursor or whether canine parvovirus is derived from mink enteritis virus, however, cannot be deduced from our present data.

Enteral Formula Containing Egg Yolk Lecithin Improves Diarrhea.

Science.gov (United States)

Akashi, Tetsuro; Muto, Ayano; Takahashi, Yayoi; Nishiyama, Hiroshi

2017-09-01

Diarrhea often occurs during enteral nutrition. Recently, several reports showed that diarrhea improves by adding egg yolk lecithin, an emulsifier, in an enteral formula. Therefore, we evaluated if this combination could improve diarrhea outcomes. We retrospectively investigated the inhibitory effects on watery stools by replacing a polymeric fomula with that containing egg yolk lecithin. Then, we investigated the emulsion stability in vitro. Next, we examined the lipid absorption using different emulsifiers among bile duct-ligated rats and assessed whether egg yolk lecithin, medium-chain triglyceride, and dietary fiber can improve diarrhea outcomes in a rat model of short bowel syndrome. Stool consistency or frequency improved on the day after using the aforementioned combination in 13/14 patients. Average particle size of the egg yolk lecithin emulsifier did not change by adding artificial gastric juice, whereas that of soy lecithin and synthetic emulsifiers increased. Serum triglyceride concentrations were significantly higher in the egg yolk lecithin group compared with the soybean lecithin and synthetic emulsifier groups in bile duct-ligated rats. In rats with short bowels, the fecal consistency was a significant looser the dietary fiber (+) group than the egg yolk lecithin (+) groups from day 6 of test meal feedings. The fecal consistency was also a significant looser the egg yolk lecithin (-) group than the egg yolk lecithin (+) groups from day 4 of test meal feeding. The fecal consistency was no significant difference between the medium-chain triglycerides (-) and egg yolk lecithin (+) groups. Enteral formula emulsified with egg yolk lecithin promotes lipid absorption by preventing the destruction of emulsified substances by gastric acid. This enteral formula improved diarrhea and should reduce the burden on patients and healthcare workers.

Vaccines against enteric infections for the developing world.

Science.gov (United States)

Czerkinsky, Cecil; Holmgren, Jan

2015-06-19

Since the first licensure of the Sabin oral polio vaccine more than 50 years ago, only eight enteric vaccines have been licensed for four disease indications, and all are given orally. While mucosal vaccines offer programmatically attractive tools for facilitating vaccine deployment, their development remains hampered by several factors: -limited knowledge regarding the properties of the gut immune system during early life; -lack of mucosal adjuvants, limiting mucosal vaccine development to live-attenuated or killed whole virus and bacterial vaccines; -lack of correlates/surrogates of mucosal immune protection; and -limited knowledge of the factors contributing to oral vaccine underperformance in children from developing countries. There are now reasons to believe that the development of safe and effective mucosal adjuvants and of programmatically sound intervention strategies could enhance the efficacy of current and next-generation enteric vaccines, especially in lesser developed countries which are often co-endemic for enteric infections and malnutrition. These vaccines must be safe and affordable for the world's poorest, confer long-term protection and herd immunity, and must be able to contain epidemics. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

The natural history of clinically established radiation enteritis

International Nuclear Information System (INIS)

Galland, R.B.; Spencer, J.

1985-01-01

70 patients presenting to a surgical unit with radiation enteritis were followed up. 11 of the 61 who underwent operations died of operation-related causes. The 51 patients who survived for more than 3 months were followed up for up to 12 years (median 12 months). 24 had no further symptoms related to their radiation enteritis. The other 27 patients had persistence of symptoms, post-operative complications, new radiation-related problems, or a combination of these. The twenty new radiation-related problems were stricture (8 patients), malabsorption (5), fistula(1), and miscellaneous(6). These developed in in 12 of 36 patients presenting initially with stricture, compared with 8 of 9 patients presenting with a perforation or fistula (p=0.007 Fisher's exact test) and none whose first symptom was bleeding (p=0.001 vs perforation and fistula combined). 10 of the 27 patients with further problems required operations and 5 of them died. Radiation enteritis is thus a progressive disease, with further complications becoming apparent in about half of those surviving the initial lesion. Perforation or fistula formation indicates a poorer prognosis than does stricture or haemorrhage. (author)

Biomaterial-Derived Calcium Carbonate Nanoparticles for Enteric Drug Delivery

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Diane Render

2016-01-01

Full Text Available Oral drug delivery systems provide the most convenient, noninvasive, readily acceptable alternatives to parenteral systems. In the current work, eggshell-derived calcium carbonate (CaCO3 nanoparticles were used to develop enteric drug delivery system in the form of tablets. CaCO3 nanoparticles were manufactured using top-down ball-milling method and characterized by X-ray diffractometry (XRD and transmission electron microscopy (TEM and loaded with 5-fluorouracil as a model drug. Tablets with varying CaCO3 core and binder compositions were fabricated and coated with Eudragit S100 or Eudragit L100. Suitability for enteric delivery of the tablets was tested by oral administration to rabbits and radiography. Radiograph images showed that the tablet remained in the stomach of the rabbit for up to 3 hours. Further modifications of these biomaterial-derived nanoparticles and the coatings will enable manufacturing of stable formulations for slow or controlled release of pharmaceuticals for enteric delivery.

Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

Science.gov (United States)

Umpierrez, Guillermo E.

2013-01-01

Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support. PMID:23065369

OCCURRENCE OF ENTERIC VIRUSES IN SURFACE WATERS

Science.gov (United States)

Human enteric viruses cause a number of diseases when individuals are exposed to contaminated drinking & recreational waters. Vaccination against poliovirus has virtually eliminated poliomyelitis from the planet. Other members of enterovirus group cause numerous diseases. Hepatit...

Influence of intestinal early enteral nutrition therapy on intestinal barrier function and immune response of patients with radiation enteritis

International Nuclear Information System (INIS)

Liu Guohui; Kang Xin; Chen Gong; Wang Guangyi

2012-01-01

Objective: To investigate the influence of early enteral nutrition therapy on the intestinal barrier function and immune response of the patients with radiation enteritis (ER) so as to find a relatively simple and effective method to treat RE. Methods: Fifty-six patients with radiation enteritis (RE) diagnosed by colonoscopy, X-rays, and pathology were randomly divided into 2 equal groups: experimental group undergoing enteral nutrition therapy, and control group undergoing conventional therapy only. Peripheral blood samples were collected 1, 11, and 21 days after admission. Plasma diamine oxidase (DAO), D-lactic acid, endotoxin, and lactulose/mannitol (L/M) ratio, and levels of IgG, IgM, and IgA, and CD4/CD8 ratio were examined. Five cases from the experimental group and 5 cases from the control group underwent second-time operation because of incomplete intestinal obstruction, intestinal stenosis, or recurrent tumor respectively. The biopsy specimens of the terminal ileum or distal descending colon taken during the first and second operations underwent pathological examination. Peripheral blood samples were collected 1, 11, and 21 days after admission. Plasma diamine oxidase (DAO), D-lactic acid, endotoxin, and lactulose/mannitol (L/M) ratio, and levels of IgG, IgM, and IgA, and CD4/CD8 ratio were examined. Results: There were no significant differences in the intestinal function and blood immunological indices between these 2 groups. The levels of DAO, D-lactic acid, and endotoxin,and the L/M ratio 11 days after admission of the experiment group were all significantly lower than those of the control group (t=2.568, 2.427, 2.143, 2.443, P<0.05), and all those indices 21 days after admission of the experiment group were all much more significantly lower in comparison with the control group (t=6.019, 12.834, 7.837, 7.997, P<0.01). The levels of IgG, IgM, and IgA, and CD4/CD8 ratio 11 days after admission of the experimental group were all significantly higher than

Hemogasometria em eqüinos com compactação experimental do cólon maior tratados com sene, fluidoterapia enteral e parenteral Blood gas analysis in equine with experimental large colon impaction treated with sene, enteral and parenteral fluid therapy

Directory of Open Access Journals (Sweden)

José Dantas Ribeiro Filho

2007-06-01

Full Text Available O equilíbrio ácido-base foi estudado em eqüinos com compactação experimental do cólon maior após o uso de solução isotônica poliônica enteral, sene mais hidratação intravenosa e hidratação intravenosa. As amostras sangüíneas foram colhidas de 20 animais, quatro grupos (E8, RL, SE e C de cinco animais cada. Os animais dos grupos tratados eram portadores de compactação no cólon maior induzida experimentalmente. Eqüinos no grupo E8 receberam solução isotônica poliônica enteral (8mL kg-1 h-1 48h-1; no grupo SE, sene foram administrados na dose de 20mg kg-1, duas doses de 24/24h, mais Ringer lactato intravenoso, 10mL kg-1h(-112h-1, durante dois dias; sendo que o grupo RL recebeu Ringer lactato intravenoso (16mL kg-1h(-112h-1 durante dois dias. O grupo C, controle, não foi tratado. Entre os tratamentos testados, a fluidoterapia intravenosa com solução de Ringer lactato (RL foi o tratamento mais eficiente para a correção das variáveis hemogasométricas em eqüinos com compactação do cólon maior. A solução isotônica poliônica enteral (E8 e sene associada com fluidoterapia intravenosa (SE foram eficientes, porém em menor grau.The blood acid-base status was studied in equines when induced large colon impaction was followed by applying an isotonic polionic enteral solution, or sene associated with intravenous fluid therapy, or fluid therapy alone. The blood samples were collected in twenty animals, four groups (E8, RL, SE, and C of five animals each. Animals of the treated groups had experimentally induced colon impactions. Equines in group E8 received isotonic polionic enteral solution (8 mL kg-1 h-1 48 h-1; in group SE, sene was applied at 20mg kg-1, two doses per animal, at 24-hour intervals, along with the Ringer lactate IV, 10mL kg-1 h-1, 12 h-1, both during two days; and in the RL animals received Ringer lactate IV only (16mL kg-1 h-1 12h-1, applied during two days. Group C was the non-treated control. Among the

Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever.

Science.gov (United States)

Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M

2017-05-26

Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Thirty-seven studies met the inclusion criteria and included a total of 5080 participants (range 50 to 1732). Enteric fever prevalence

Problems experienced by women re-entering into the education profession / Melanie Beyers

OpenAIRE

Beyers, Melanie

2001-01-01

This study investigated problems experienced by women re-entering into the education profession by focusing on: • The nature and scope of re-entry by women into the education profession; • the features and problems experienced by women on re-entering the education profession; • the problems women educators experience on re-entering the education profession in the North West Province. To achieve these goals, both an empirical survey and a survey of literature was conducted. The study...

Human milk consumption and full enteral feeding among infants who weigh

Science.gov (United States)

Sisk, Paula M; Lovelady, Cheryl A; Gruber, Kenneth J; Dillard, Robert G; O'Shea, T Michael

2008-06-01

Establishing enteral feeding is an important goal in the care of very low birth weight infants. In such infants, receipt of >/=50 mL/kg per day human milk during hospitalization has been associated with shorter time to full enteral feeding. The objective of this study was to determine whether high proportions (>/=50%) of human milk during feeding advancement are associated with shorter time to full enteral feeding and improved feeding tolerance. This was a prospective cohort study of very low birth weight infants (n = 127) who were grouped into low (/=50%; n = 93) human milk consumption groups according to their human milk proportion of enteral feeding during the time of feeding advancement. The primary outcomes of interest were ages at which 100 and 150 mL/kg per day enteral feedings were achieved. The high human milk group reached 100 mL/kg per day enteral feeding 4.5 days faster than the low human milk group. The high human milk group reached 150 mL/kg per day enteral feeding 5 days faster than the low human milk group. After adjustment for gestational age, gender, and respiratory distress syndrome, times to reach 100 and 150 mL/kg per day were significantly shorter for those in the high human milk group. Infants in the high human milk group had a greater number of stools per day; other indicators of feeding tolerance were not statistically different. In infants who weighed milk was associated with fewer days to full enteral feedings.

Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

Science.gov (United States)

Abunnaja, Salim; Cuviello, Andrea; Sanchez, Juan A.

2013-01-01

Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations. PMID:23429491

Casipoemas por Navidad : (1969-2010)

OpenAIRE

Sena Medina, Guillermo

2011-01-01

PRESENTACIÓN AL AIRE DE LA POESÍA RELIGIOSA Y NAVIDEÑA DE GUILLERMO SENA MEDINA Constituye un gran honor hacer la presentación de Guillermo Sena Medina por un doble motivo; por la larga y sincera amistad que nos une desde hace muchos años al socaire de nuestra común afición por la Historia, como cronistas oficiales de nuestros municipios; y, sobre todo y particularmente, por su rica y profunda personalidad como hombre de letras, nacida de su aún más rica y profunda personalidad humana. A...

Enteral Nutrition in Dementia: A Systematic Review

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Joanne Brooke

2015-04-01

Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

Design and development of a manual pump for bolus enteral nutrition.

Science.gov (United States)

Romano-García, Judit; Fernández-Morera, Juan Luis

2018-02-01

Enteral nutrition (EN) is based on administration of liquid solutions into the gastrointestinal tract using a tube. After identifying unsolved practical difficulties in administration of EN using volume syringes, a new device to overcome such technical difficulties was proposed. Specific technologies (CAD, 3D printing) were used in collaboration with the PRODINTEC Foundation (Gijón, Asturias). Clarke Modet, a law firm specialized in intellectual property, provided legal advice on formulas for legal protection of the invention. The resulting device is a manual pump for infusion of EN to patients that solves previously identified problems and is highly functional and compact. It would allow for comfortable and safe administration of solutions. Integration of a bottle into the device itself and pump dimensions facilitate transport and patient mobility. According to the described configuration, this invention has many advantages over the previously known procedures, such as a simpler administration within the field of intermittent EN, improving the standard nutritional support technique, which in this case is use of volume syringes. This would facilitate the work of caregivers while promoting patient self-care and autonomy. The pump was accredited novelty of design, inventive activity and industrial exploitation potential by the European Patent Office (EPO), to which a patent has been requested. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Sequential intrahepatic metabolic effects of enteric galactose alimentation in newborn rats.

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Kliegman, R M; Morton, S

1988-09-01

We determined metabolic responses after enteric galactose alimentation in 5- to 7-day-old newborn rats fasted for 24 h. The glycemic response was attenuated after enteric galactose feeding compared with the response after enteric glucose-fed rat pups. 14C radioactivity in blood from galactose-fed pups was reduced as counts in blood galactose were lower than counts in blood glucose in glucose-fed pups. Nonetheless within 15 min, [14C] from galactose appeared in blood glucose suggesting rapid conversion of galactose to glucose. The plasma insulin response was also attenuated after galactose feeding compared with the insulin response after enteric glucose. Hepatic glycogen content increased rapidly after enteric galactose feeding and was higher than after glucose feeding at 60, 120, and 180 min. Significant glycogen synthesis after oral glucose was delayed and occurred at 240 min. Carbon radioactivity in glycogen was higher in galactose fed pups between 15 and 360 min of the study. Serial determination of hepatic metabolites revealed an increase of galactose-1-phosphate levels after oral galactose at 240 and 300 min and a transient decline of ATP at 15 min. Other hepatic metabolites did not demonstrate significant differences between the two groups. These data suggest that hepatic glycogen synthesis is more rapid and occurs sooner after galactose than after glucose alimentation in previously fasted newborn rats. Galactose may enter a more direct pathway for neonatal hepatic glycogen synthesis. The relatively delayed entry of glucose label into hepatic glycogen and the delay of net glycogen synthesis after oral glucose suggest that glucose entry is not direct and may require further metabolism before incorporation into glycogen.(ABSTRACT TRUNCATED AT 250 WORDS)

effects of enteral glutamine supplementation on reduction

African Journals Online (AJOL)

Objective: To determine the effect of enteral glutamine in reducing the incidence of ... in use. These modalities include among others; topical antibacterial agents, early excision of eschar, and ... in the burns unit and plastic surgery ward 4D of.

Home parenteral nutrition in treatment of severe radiation enteritis

International Nuclear Information System (INIS)

Miller, D.G.; Ivey, M.; Young, J.

1979-01-01

Ten patients with radiation enteritis unresponsive to conventional medical and surgical therapy were put on long-term parenteral nutrition at home. Six of the patients are alive at home; four patients died, two from recurrent cancer. Some of the patients have been able to resume oral intake, but none have been able to discontinue parenteral nutrition. Fistulas healed or had a marked decrease in output. Two patients in our series were given prednisone and sulfasalazine without significant benefit, in contrast to previously reported clinical improvement of radiation enteritis with this therapy

Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study.

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Sun, Jia-Kui; Li, Wei-Qin; Ke, Lu; Tong, Zhi-Hui; Ni, Hai-Bin; Li, Gang; Zhang, Lu-Yao; Nie, Yao; Wang, Xin-Ying; Ye, Xiang-Hong; Li, Ning; Li, Jie-Shou

2013-09-01

To investigate the effects of early enteral nutrition (EEN) on intra-abdominal pressure (IAP) and disease severity in patients with severe acute pancreatitis (SAP). Enteral nutrition (EN) was started within 48 h after admission in the EEN group and from the 8th day in the delayed enteral nutrition (DEN) group. The IAP and intra-abdominal hypertension (IAH) incidence were recorded for 2 weeks. The caloric intake and feeding intolerance (FI) incidence were recorded daily after EN was started. The severity markers and clinical outcome variables were also recorded. Sixty patients were enrolled to this study. No difference about IAP was found. The IAH incidence of the EEN group was significantly lower than that of the DEN group from the 9th day (8/30 versus 18/30; P = 0.009) after admission. The FI incidence of the EEN group was higher than that of the DEN group during the initial 3 days of feeding (25/30 versus 12/30; P = 0.001; 22/30 versus 9/30; P = 0.001; 15/30 versus 4/30; P = 0.002). Patients with an IAP FI incidence than those with an IAP ≥15 mmHg on the 1st day (20/22 versus 17/38; P < 0.001), the 3rd day (11/13 versus 8/47; P < 0.001), and the 7th day (3/5 versus 3/55; P = 0.005) of feeding. The severity markers and clinical outcome variables of the EEN group were significantly improved. Early enteral nutrition did not increase IAP. In contrast, it might prevent the development of IAH. In addition, EEN might be not appropriate during the initial 3-4 days of SAP onset. Moreover, EN might be of benefit to patients with an IAP <15 mmHg. Early enteral nutrition could improve disease severity and clinical outcome, but did not decrease mortality of SAP.

In Vitro Evaluation of Eslicarbazepine Delivery via Enteral Feeding Tubes.

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Reindel, Kristin; Zhao, Fang; Hughes, Susan; Dave, Vivek S

2017-12-01

Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found to be best with standard mortar/pestle. The viscosity analysis and physical stability studies showed that ORA-Plus:water (50:50 v/v) was optimal for suspending ability and flowability of suspension through the tubes. The developed HPLC method was found to be stability indicating and suitable for the assay of eslicarbazepine acetate in the prepared suspension. The eslicarbazepine concentrations in separately prepared suspensions were within acceptable range (±3%), indicating accuracy and reproducibility of the procedure. The eslicarbazepine concentrations in suspensions before and after delivery through the enteric feeding tubes were within acceptable range (±4%), indicating absence of any physical/chemical interactions of eslicarbazepine with the tubes and a successful delivery of eslicarbazepine dosage via enteric feeding tubes. The stability study results showed that eslicarbazepine concentration in the suspension remained unchanged when stored at room temperature for 48 hours. Conclusion: The study presents a convenient procedure for the preparation of a stable suspension of eslicarbazepine acetate (40 mg/mL) using Aptiom tablets, for administration via enteral feeding tubes.

Enteral Nutrition Support to Treat Malnutrition in Inflammatory Bowel Disease

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Altomare, Roberta; Damiano, Giuseppe; Abruzzo, Alida; Palumbo, Vincenzo Davide; Tomasello, Giovanni; Buscemi, Salvatore; Lo Monte, Attilio Ignazio

2015-01-01

Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aetiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal-tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or the elderly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral nutrition—total parenteral, oral supplementation and enteral tube feeding—in terms of results, patients compliance, risks and and benefits. We also focus on the home entaral nutrition strategy as the future goal for treating IBD while focusing on patient wellness. PMID:25816159

Descriptive study of enteric zoonoses in Ontario, Canada, from 2010 – 2012

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Yvonne Whitfield

2017-02-01

Full Text Available Abstract Background Contact with animals and their environment has long been recognized as an important source of enteric zoonoses. However, there are limited data available on the burden of illness associated with specific types of animals in Canada. This study describes the overall burden of enteric zoonoses in Ontario, Canada from 2010 to 2012. Methods Confirmed cases of seven enteric zoonotic diseases (campylobacteriosis, cryptosporidiosis, giardiasis, listeriosis, salmonellosis, verotoxin-producing E. coli (VTEC infection, and yersiniosis with episode dates from 2010 to 2012 were extracted from the integrated Public Health Information System (iPHIS. Reported exposures were categorized as animal contact, foodborne, waterborne and ‘other’, with animal contact grouped into nine sub-categories based on the type of animal or transmission setting. Overall incidence rates and proportions by animal exposure categories, age and sex-specific incidence rates and hospitalization and death proportions were calculated and sex proportions compared. Results Our study found that approximately 26% of the enteric pathogens assessed during the 2010 to 2012 period reported contact with animals and their environments as the mode of transmission. Of enteric disease cases reporting animal contact, farm exposures were reported for 51.3%, dog or cat exposures for 26.3%, and reptile or amphibian exposures for 8.9%. Conclusions Contact with animals was reported more frequently during the period 2010 to 2012 in comparison to the period 1997 to 2003 when 6% or less of enteric cases were associated with animal contact. Public health professionals, stakeholders associated with animals and their related industries (e.g., pet treats, mobile zoos, abattoirs, and the public should recognize that animal contact is an important source of enteric illnesses in order to take measures to reduce the burden of illness from animal sources.

Evolution of NADPH-cytochrome P450 oxidoreductases (POR) in Apiales - POR 1 is missing

DEFF Research Database (Denmark)

Andersen, Trine Bundgaard; Hansen, Niels Bjørn; Laursen, Tomas

2016-01-01

The NADPH-dependent cytochrome P450 oxidoreductase (POR) is the obligate electron donor to eukaryotic microsomal cytochromes P450 enzymes. The number of PORs within plant species is limited to one to four isoforms, with the most common being two PORs per plant. These enzymes provide electrons to ...... (available from the SRA at NCBI). All three genes were shown to be functional upon reconstitution into nanodiscs, confirming that none of the isoforms are pseudogenes....

Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

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Juan A. Sanchez

2013-02-01

Full Text Available Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations.

Aspects of enteral nutrition in cancer chemotherapy

NARCIS (Netherlands)

Smit, Jitske Martha

1985-01-01

This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients

Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

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Mohammadtaghi Rajabi Mashhadi

2015-09-01

Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients.   Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein          (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group.   Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction.   Conclusion:  The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

Enteric coating of granules containing the probiotic Lactobacillus acidophilus

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Pyar Hassan

2014-06-01

Full Text Available In the present study, a capsule formulation composed of enteric coated granules of Lactobacillus acidophilus ATCC 4962 was developed using Eudragit L30D-55 as enteric polymer. Optimization of the capsule formulation was achieved with a maximum viable cell count after 2 h of incubation in acid medium and disintegration time of 1 h in buffer pH 6.8. The amount of Eudragit L30D-55 in the capsules correlated with gastric juice resistance. The best protective qualities against artificial gastric juice were observed when capsules were prepared from granules composed of L. acidophilus, corn starch, lactose monohydrate, polyvinylpyrrolidone and coated with 12.5 % (m/V of Eudragit L30D-55. Capsule formulation of L. acidophilus in edible broth medium suspension serves as a cheap alternative to the expensive freeze-drying procedure for preparing L. acidophilus. In addition, the enteric coating using Eudragit L30D-55 could protect probiotics from the acidic gastric environment and enhance the bioactivity of probiotics along with replacement of pathogenic microbes in human intestine

Epidemiology of Enteric Disease in C-EnterNet’s Pilot Site – Waterloo Region, Ontario, 1990 to 2004

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Victoria A Keegan

2009-01-01

Full Text Available OBJECTIVE: The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario’s Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available.

Quantification of gut lesions in a subclinical necrotic enteritis model

DEFF Research Database (Denmark)

Gholamiandehkordi, Ahmad R.; Timbermont, Leen; Lanckriet, Anouk

2007-01-01

Currently Clostridium perfringens-induced necrotic enteritis is a major problem in broiler flocks. In the present study, broilers were inoculated with a combination of Eimeria maxima or overdose coccidial vaccine (one inoculation) with C. perfringens (repeated inoculations). Single C. perfringens...... in combination with multiple oral C. perfringens inoculations is a suitable model for necrotic enteritis without inducing mortality of the animals. C. perfringens and Eimeria act synergistically in inducing grossly visible gut damage....

Determinantes do consumo de frutas e hortaliças em adolescentes por regressão quantílica Determinantes del consumo de frutas y hortalizas en adolescentes por regresión cuantílica Determinants of fruit and vegetable intake in adolescents using quantile regression

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Roberta Schein Bigio

2011-06-01

,4% consumieron la recomendación mínima de 400g/día de FLV y 22% no consumieron ningún tipo de FLV. En los modelos de regresión cuantílica, ajustados por el consumo energético, el intervalo etario y sexo, la renta domiciliar per capita y la escolaridad del jefe de familia se asociaron positivamente al consumo de FLV, mientras que el hábito de fumar se asoció negativamente. Renta se asoció significativamente a los menores percentiles de ingestión (p20 al p55; tabaquismo a los percentiles intermediarios (p45 al p75 y escolaridad del jefe de familia a los percentiles finales de consumo de FLV (p70 al p95. CONCLUSIONES: El consumo de FLV por adolescentes de Sao Paulo se mostró por debajo de las recomendaciones del Ministerio de la Salud Brasileño y es influenciado por la renta domiciliaria per capita, por la escolaridad del jefe de familia y por el hábito de fumar.OBJECTIVE: To analyze fruit and vegetable intake in adolescents and to identify associated factors. METHODS: A population-based cross-sectional study was conducted with a representative sample of 812 adolescents of both sexes in the city of São Paulo, Southeastern Brazil, in 2003. Food consumption was measured with the 24-hour dietary recall. Fruit and vegetable intake was described in percentiles. Quantile regression models were used to investigate the association between this intake and explanatory variables. RESULTS: Of all adolescents interviewed, 6.4% consumed the minimum recommendation of 400 g/day of fruits and vegetables and 22% did not consume any type of fruits and vegetables. According to quantile regression models, adjusted for energy intake, age group and sex, per capita household income and head of household's level of education were positively associated with fruit and vegetable intake, whereas smoking habit showed a negative association. Income was significantly associated with lower intake percentiles (p20 to p55; smoking, with intermediate percentiles (p45 to p75; and head of household

Living arrangements of the elderly and the sociodemographic and health determinants: a longitudinal study.

Science.gov (United States)

Bolina, Alisson Fernandes; Tavares, Darlene Mara Dos Santos

2016-08-08

to describe the sociodemographic characteristics and the number of morbidities in the elderly, according to the dynamics of living arrangements and evaluate the sociodemographic and health determinants of the living arrangements. this is a household longitudinal survey (2005-2012), carried out with 623 elderly people. Descriptive statistical analysis and multinomial logistic regression were performed (pde morbidades de idosos, segundo a dinâmica do arranjo domiciliar; e verificar os determinantes sociodemográficos e de saúde do arranjo domiciliar. trata-se de uma pesquisa domiciliar e longitudinal (2005-2012), conduzida com 623 idosos. Foi realizada análise estatística descritiva e regressão logística multinomial (pde estudo e com renda entre 1├┤ 3 salários mínimos. Durante o desenvolvimento dessa pesquisa, identificou-se uma elevação da distribuição de idosos com 1├┤3 salários mínimos. O número de morbidades aumentou nos três grupos ao longo do estudo, com maiores taxas entre os idosos que mudaram a dinâmica do arranjo domiciliar. Verificou-se que idosos do sexo masculino apresentaram menores chances de morar sozinhos (p=0,007) e mudar o arranjo domiciliar comparados às mulheres (p = 0,005). Ganhar menos de um salário mínimo diminuiu as chances de mudança do arranjo domiciliar em relação aos que ganham mais de três salários (p=0,034). os fatores determinantes do arranjo domiciliar foram o sexo e a renda, sendo que as variáveis capacidade funcional e número de morbidades não estiveram associadas ao desfecho analisado. describir las características sociodemográficas y el número de enfermedades concomitantes de ancianos, según la dinámica de la acomodación domiciliaria; y verificar los determinantes sociodemográficos y de salud del espacio domiciliario. se trata de una investigación domiciliaria y longitudinal (2005-2012), realiza con 623 ancianos. Fue realizado análisis estadístico descriptivo y regresión log

Predictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study.

Science.gov (United States)

Khan, Faraz A; Squires, Robert H; Litman, Heather J; Balint, Jane; Carter, Beth A; Fisher, Jeremy G; Horslen, Simon P; Jaksic, Tom; Kocoshis, Samuel; Martinez, J Andres; Mercer, David; Rhee, Susan; Rudolph, Jeffrey A; Soden, Jason; Sudan, Debra; Superina, Riccardo A; Teitelbaum, Daniel H; Venick, Robert; Wales, Paul W; Duggan, Christopher

2015-07-01

In a large cohort of children with intestinal failure (IF), we sought to determine the cumulative incidence of achieving enteral autonomy and identify patient and institutional characteristics associated with enteral autonomy. A multicenter, retrospective cohort analysis from the Pediatric Intestinal Failure Consortium was performed. IF was defined as severe congenital or acquired gastrointestinal diseases during infancy with dependence on parenteral nutrition (PN) >60 days. Enteral autonomy was defined as PN discontinuation >3 months. A total of 272 infants were followed for a median (IQR) of 33.5 (16.2-51.5) months. Enteral autonomy was achieved in 118 (43%); 36 (13%) remained PN dependent and 118 (43%) patients died or underwent transplantation. Multivariable analysis identified necrotizing enterocolitis (NEC; OR 2.42, 95% CI 1.33-4.47), care at an IF site without an associated intestinal transplantation program (OR 2.73, 95% CI 1.56-4.78), and an intact ileocecal valve (OR 2.80, 95% CI 1.63-4.83) as independent risk factors for enteral autonomy. A second model (n = 144) that included only patients with intraoperatively measured residual small bowel length found NEC (OR 3.44, 95% CI 1.36-8.71), care at a nonintestinal transplantation center (OR 6.56, 95% CI 2.53-16.98), and residual small bowel length (OR 1.04 cm, 95% CI 1.02-1.06 cm) to be independently associated with enteral autonomy. A substantial proportion of infants with IF can achieve enteral autonomy. Underlying NEC, preserved ileocecal valve, and longer bowel length are associated with achieving enteral autonomy. It is likely that variations in institutional practices and referral patterns also affect outcomes in children with IF. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the risk for pressure ulcers in bedridden elderly at home Evaluación del riesgo de úlceras por presión en cama ancianos en el hogar Avaliação de risco para úlcera por pressão em idosos acamados no domicílio

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Geridice Lorna de Andrade Moraes

2012-01-01

Full Text Available OBJECTIVE: To evaluate the risk for pressure ulcers in elderly in their homes, after a period of hospitalization. METHODS: A longitudinal prospective study conducted in the homes of 40 elderly identified with risk for pressure ulcer (PU at hospital discharge, using the Braden Scale. The monitoring was conducted over four home visits, in the period between June and August of 2010, in Fortaleza (CE and its metropolitan region. RESULTS: The majority of the elderly were female (65% with a medical diagnosis of cerebral vascular accident (55%. In the first and second visits, 55% and 40% of the elderly, respectively, presented high risk for PU, and the incidence of PU was 22.5%. The association of the risk scores presented significant association in the first three visits. CONCLUSION: The risk for PU development was higher in the first two weeks, after hospital discharge, but diminished for the remainder of the visits.OBJETIVO: Evaluar el riesgo a úlcera por presión en ancianos en el domicilio, después del período de internamiento hospitalario. MÉTODOS: Estudio longitudinal prospectivo realizado en domicilio de 40 ancianos identificados en el alta hospitalaria, con riesgo a úlcera por presión (UP, mediante aplicación de la escala de Braden. El acompañamiento fue realizado en cuatro visitas domiciliarias, en el período entre junio y agosto de 2010, en Fortaleza (CE y región metropolitana. RESULTADOS: La mayoría de los ancianos era del sexo femenino (65% y con diagnóstico médico de accidente cerebro vascular (55%. En la primera y segunda visitas, 55% y 40% de los ancianos, respectivamente, presentaron riesgo elevado para UP y la incidencia de lesión fue del 22,5%. La asociación de los scores de riesgo presentó asociación significativa en las tres primeras visitas. CONCLUSIÓN: El riesgo para el desarrollo de UP fue más elevado en las dos primeras semanas, después del alta hospitalaria, pero fue disminuyendo en el transcurrir de las

Ability of select probiotics to reduce enteric Campylobacter colonization in broiler chickens

Science.gov (United States)

Campylobacter is the leading cause of foodborne enteritis worldwide and is primarily caused by consumption/mishandling of contaminated poultry. Probiotic use in poultry has been an effective strategy in reducing many enteric pathogens, but has not demonstrated consistent reduction against Campylobac...

Astronaut John Glenn Enters Friendship 7

Science.gov (United States)

1962-01-01

Astronaut John Glenn enters the Mercury spacecraft, Friendship 7, prior to the launch of MA-6 on February 20, 1961 and became the first American who orbited the Earth. The MA-6 mission was the first manned orbital flight boosted by the Mercury-Atlas vehicle, a modified Atlas ICBM (Intercontinental Ballistic Missile), lasted for five hours, and orbited the Earth three times.

Abdominal and pelvic CT: is positive enteric contrast still necessary? Results of a retrospective observational study.

Science.gov (United States)

Kammerer, S; Höink, A J; Wessling, J; Heinzow, H; Koch, R; Schuelke, C; Heindel, W; Buerke, B

2015-03-01

Evaluation of diagnostic accuracy of abdominal CT depending on the type of enteric contrast agent. Multislice CTs of 2,008 patients with different types of oral preparation (positive with barium, n = 576; neutral with water, n = 716; and no enteric contrast, n = 716) were retrospectively evaluated by two radiologists including delineation of intestinal segments and influence on diagnosis and diagnostic reliability exerted by the enteric contrast, using a three-point scale. Furthermore, diagnostic reliability of the delineation of selected enteric pathologies was noted. CT data were assigned into groups: oncology, inflammation, vascular, pathology, trauma and gastrointestinal pathology. Delineation of the bowel was clearly practicable across all segments irrespective of the type of enteric contrast, though a slight impairment was observed without enteric contrast. Although delineation of intestinal pathologies was mostly classified "clearly delimitable" more difficulties occurred without oral contrast (neutral/positive/no contrast, 0.8 %/3.8 %/6.5 %). Compared to examinations without enteric contrast, there was a significant improvement in diagnosis that was even increased regarding the reader's diagnostic reliability. Positive opacification impaired detection of mucosal enhancement or intestinal bleeding. Water can replace positive enteric contrast agents in abdominal CTs. However, selected clinical questions require individual enteric contrast preparations. Pathology detection is noticeably impaired without any enteric contrast.

Recent advances in regenerative medicine to treat enteric neuropathies: use of human cells.

Science.gov (United States)

Stamp, L A; Young, H M

2017-01-01

As current options for treating most enteric neuropathies are either non-effective or associated with significant ongoing problems, cell therapy is a potential attractive possibility to treat congenital and acquired neuropathies. Studies using animal models have shown that following transplantation of enteric neural progenitors into the bowel of recipients, the transplanted cells migrate, proliferate, and generate neurons that are electrically active and receive synaptic inputs. Recent studies have transplanted human enteric neural progenitors into the mouse colon and shown engraftment. In this article, we summarize the significance of these recent advances and discuss priorities for future research that might lead to the use of regenerative medicine to treat enteric neuropathies in the clinic. © 2016 John Wiley & Sons Ltd.

characterisation of gastro- enteritis-associated adenoviruses in ...

African Journals Online (AJOL)

Objective. To analyse adenovirus (Ad) numbers and types associated with paediatric gastro-enteritis in South Africa. Setting. Gauteng, 1994-1996. Metfwds. A total of 234 paediatric diarrhoeal stool samples were screened for Ad using commercial enzyme-linked. iInmunosorbent assays (EUSAs). Adenoviral isolates were.

Application of a PCR method for the diagnosis of ulcerative enteritis: preliminary results

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Fabrizio Agnoletti

2010-01-01

Full Text Available Ulcerative enteritis or “quail disease” is an acute clostridial infection of young birds reported in many avian species, chicken and turkey included. Clostridium colinum is the causative agent of ulcerative enteritis and because of the difficulties bound to the isolation and identification of this bacterium by means of classic bacteriological techniques, its detection appears very hard and the prevalence of this disease could be underestimated. To investigate the diffusion of C. colinum in enteric disease of birds, a recently developed PCR protocol was applied to 42 cultural broths previously inoculated with organs and intestinal samples collected from diseased subjects. PCR-positive broths were cultivated to attempt the isolation of C. colinum. Samples collected from positive birds were subjected to histological examinations. 4 birds (3 broilers chickens and 1 pigeon resulted PCR-positive and, in one case, C. colinum was isolated. Gross and histological lesions of positive birds were compatible with those described in other ulcerative enteritis outbreaks. These preliminary results demonstrates that C. colinum is sporadically implicated in enteric diseases of broiler chickens (14.2%. In addition, the PCR assay proved to be an useful and reliable instrument to support the diagnosis of ulcerative enteritis and to facilitate the isolation of C. colinum.

Implementation of enteral feeding protocol in an intensive care unit

DEFF Research Database (Denmark)

Padar, Martin; Uusvel, Gerli; Starkopf, Liis

2017-01-01

AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013......, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population...... the groups. Patients in the After group had a lower 90-d (P = 0.026) and 120-d (P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently (P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher...

A case of ileo-cutaneou fistula due to radiation enteritis

Energy Technology Data Exchange (ETDEWEB)

Oyama, Tsukasa; Oguchi, Yoshiro; Nakaba, Hiroyuki [Kure National Hospital, Hiroshima (Japan); and others

1992-07-01

Radiation enteritis can cause late complications including stenosis, perforation, fistulization, and bleeding, which sometimes necessitate surgical treatment, but a complication of ileocutaneous fistula is rarely reported. In this paper, an excellent result of an operation for ileocutaneous fistula due to radiation enteritis is described. A 68-year-old woman had undergone extended total histerectomy and radiation therapy on uterine cervical cancer. After the operation and the radiation therapy, frequent abdominal pain bothered her and then the intestinal fistula ensued resulted in the fistulization. The fistula was located between two stenotic lesions of the intestine caused by radiation enteritis. Resection of ileum including the two stenotic lesion and the fistula and end-to-end anastomosis relieved the symptoms and the treatment course has been satisfactory. The two stenotic lesions were resected because it was suggested that the two stenotic lesions directly led the fistulization. She is now followed asymptomatically. (author).

High-protein enteral nutrition enriched with immune-modulating nutrients vs standard high-protein enteral nutrition and nosocomial infections in the ICU: a randomized clinical trial.

Science.gov (United States)

van Zanten, Arthur R H; Sztark, François; Kaisers, Udo X; Zielmann, Siegfried; Felbinger, Thomas W; Sablotzki, Armin R; De Waele, Jan J; Timsit, Jean-François; Honing, Marina L H; Keh, Didier; Vincent, Jean-Louis; Zazzo, Jean-Fabien; Fijn, Harvey B M; Petit, Laurent; Preiser, Jean-Charles; van Horssen, Peter J; Hofman, Zandrie

2014-08-06

Enteral administration of immune-modulating nutrients (eg, glutamine, omega-3 fatty acids, selenium, and antioxidants) has been suggested to reduce infections and improve recovery from critical illness. However, controversy exists on the use of immune-modulating enteral nutrition, reflected by lack of consensus in guidelines. To determine whether high-protein enteral nutrition enriched with immune-modulating nutrients (IMHP) reduces the incidence of infections compared with standard high-protein enteral nutrition (HP) in mechanically ventilated critically ill patients. The MetaPlus study, a randomized, double-blind, multicenter trial, was conducted from February 2010 through April 2012 including a 6-month follow-up period in 14 intensive care units (ICUs) in the Netherlands, Germany, France, and Belgium. A total of 301 adult patients who were expected to be ventilated for more than 72 hours and to require enteral nutrition for more than 72 hours were randomized to the IMHP (n = 152) or HP (n = 149) group and included in an intention-to-treat analysis, performed for the total population as well as predefined medical, surgical, and trauma subpopulations. High-protein enteral nutrition enriched with immune-modulating nutrients vs standard high-protein enteral nutrition, initiated within 48 hours of ICU admission and continued during the ICU stay for a maximum of 28 days. The primary outcome measure was incidence of new infections according to the Centers for Disease Control and Prevention (CDC) definitions. Secondary end points included mortality, Sequential Organ Failure Assessment (SOFA) scores, mechanical ventilation duration, ICU and hospital lengths of stay, and subtypes of infections according CDC definitions. There were no statistically significant differences in incidence of new infections between the groups: 53% (95% CI, 44%-61%) in the IMHP group vs 52% (95% CI, 44%-61%) in the HP group (P = .96). No statistically significant differences were

Impacto da adequação da oferta energética sobre a mortalidade em pacientes de UTI recebendo nutrição enteral Impact of the adequacy of energy intake on intensive care unit mortality in patients receiving enteral nutrition

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Natália Sanchez Oliveira

2011-06-01

Full Text Available OBJETIVO: Investigar a relação entre adequação da oferta energética e mortalidade na unidade de terapia intensiva em pacientes sob terapia nutricional enteral exclusiva. MÉTODOS: Estudo observacional prospectivo conduzido em uma unidade de terapia intensiva em 2008 e 2009. Foram incluídos pacientes >18 anos que receberam terapia nutricional enteral por >72h. A adequação da oferta de energia foi estimada pela razão administrado/prescrito. Para a investigação da relação entre variáveis preditoras (adequação da oferta energética, escore APACHE II, sexo, idade e tempo de permanência na unidade de terapia intensiva e o desfecho mortalidade na unidade de terapia intensiva, utilizou-se o modelo de regressão logística não condicional. RESULTADOS: Foram incluídos 63 pacientes (média 58 anos, mortalidade 27%, 47,6% dos quais receberam mais de 90% da energia prescrita (adequação média 88,2%. O balanço energético médio foi de -190 kcal/dia. Observou-se associação significativa entre ocorrência de óbito e as variáveis idade e tempo de permanência na unidade de terapia intensiva, após a retirada das variáveis adequação da oferta energética, APACHE II e sexo durante o processo de modelagem. CONCLUSÃO: A adequação da oferta energética não influenciou a taxa de mortalidade na unidade de terapia intensiva. Protocolos de infusão de nutrição enteral seguidos criteriosamente, com adequação administrado/prescrito acima de 70%, parecem ser suficientes para não interferirem na mortalidade. Dessa forma, pode-se questionar a obrigatoriedade de atingir índices próximos a 100%, considerando a elevada frequência com que ocorrem interrupções no fornecimento de dieta enteral devido a intolerância gastrointestinal e jejuns para exames e procedimentos. Pesquisas futuras poderão identificar a meta ideal de adequação da oferta energética que resulte em redução significativa de complicações, mortalidade e custos

Sistema aberto ou fechado de nutrição enteral para adultos críticos: há diferença? Open versus closed enteral nutrition systems for critically ill adults: is there a difference?

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Stella Marys Rigatti Silva

2012-04-01

Full Text Available OBJETIVO: Comparar o volume, calorias totais e proteínas recebidos pelos pacientes críticos quando utilizada nutrição enteral (NE por sistema aberto (SA e sistema fechado (SF; identificar os principais motivos para interrupção da NE. MÉTODOS: Estudo de coorte em que foram acompanhados adultos internados no Centro de Terapia Intensiva (CTI em dois períodos: em novembro de 2009, quando se adotava SA de NE para a totalidade dos pacientes (n = 85; e entre outubro de 2010 e abril de 2011, quando foi utilizado SF de NE (n = 170. Foram utilizados testes paramétricos e não paramétricos para comparação das variáveis respeitando-se sua distribuição. RESULTADOS: Os grupos assemelharam-se quanto às características clínicas e demográficas. Diferenças de mínima magnitude matemática e de nenhuma relevância clínica foram observadas entre os grupos: mais calorias/quilo foram prescritas ao grupo SA (p OBJECTIVE: To compare the volume, total calories, and protein received by critically ill patients between open and closed enteral nutrition (EN systems and identify the main reasons for EN discontinuation. METHODS: A cohort study in which adult patients admitted to the intensive care unit (ICU were followed-up in two periods: throughout November 2009 with all patients (n = 85 receiving EN using the open system (OS group; and from October 2010 to April 2011 with patients (n = 170 receiving EN using the closed system (CS group. Parametric and nonparametric tests were used to compare the variables, taking into account their distribution. RESULTS: Demographic and clinical characteristics were similar in both groups. There were minor differences with no statistical significance between groups: more calories/kg were prescribed to the OS group (p < 0.001, and a higher volume (mL/kg, p = 0.002 and protein (g/kg, p = 0.001 were prescribed to the CS group. Fasting, enteral feeding or gastrointestinal problems, and performance of procedures and ICU

Osteomalacia inducida por tumor: hemangiopericitoma rinosinusal

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Enriqueta M. Serafini

2013-02-01

Full Text Available La osteomalacia inducida por tumor es una rara enfermedad del metabolismo óseo caracterizada por el aumento en la excreción de fosfato a nivel renal seguido de hipofosfatemia. Es causada por agentes fosfatúricos producidos por determinados tumores. La resección total del tumor resulta en la completa reversión de las anormalidades bioquímicas, la desaparición de las manifestaciones clínicas y los hallazgos en los estudios por imágenes. Presentamos el caso de un varón de 61 años con cuadro clínico y laboratorio compatibles con osteomalacia oncogénica inducida por tumor mesenquimático de localización rinosinusal. En nuestro caso el diagnóstico histológico correspondió a una neoplasia de tipo vascular: hemangiopericitoma.

Development of a vaccine for the prevention of hemorrhagic enteritis in turkeys

NARCIS (Netherlands)

Hurk, van den J.V.J.M.

1988-01-01

Hemorrhagic enteritis (HE) in turkeys is an acute infectious disease characterized by depression, intestinal bleeding, and death. HE occurs worldwide affecting 6 to 12 week-old turkeys and lasting 4 to 6 days. This economically important disease is caused by hemorrhagic enteritis virus (HEV), a

Abdominal and pelvic CT: is positive enteric contrast still necessary? Results of a retrospective observational study

Energy Technology Data Exchange (ETDEWEB)

Kammerer, S.; Hoeink, A.J.; Wessling, J.; Schuelke, C.; Heindel, W.; Buerke, B. [University Hospital Muenster, Department of Clinical Radiology, Muenster (Germany); Heinzow, H. [University Hospital Muenster, Department of Gastroenterology and Metabolic Diseases, Muenster (Germany); Koch, R. [University Muenster, Institute of Biostatistics and Clinical Research, Muenster (Germany)

2014-10-15

Evaluation of diagnostic accuracy of abdominal CT depending on the type of enteric contrast agent. Multislice CTs of 2,008 patients with different types of oral preparation (positive with barium, n = 576; neutral with water, n = 716; and no enteric contrast, n = 716) were retrospectively evaluated by two radiologists including delineation of intestinal segments and influence on diagnosis and diagnostic reliability exerted by the enteric contrast, using a three-point scale. Furthermore, diagnostic reliability of the delineation of selected enteric pathologies was noted. CT data were assigned into groups: oncology, inflammation, vascular, pathology, trauma and gastrointestinal pathology. Delineation of the bowel was clearly practicable across all segments irrespective of the type of enteric contrast, though a slight impairment was observed without enteric contrast. Although delineation of intestinal pathologies was mostly classified ''clearly delimitable'' more difficulties occurred without oral contrast (neutral/positive/no contrast, 0.8 %/3.8 %/6.5 %). Compared to examinations without enteric contrast, there was a significant improvement in diagnosis that was even increased regarding the reader's diagnostic reliability. Positive opacification impaired detection of mucosal enhancement or intestinal bleeding. Water can replace positive enteric contrast agents in abdominal CTs. However, selected clinical questions require individual enteric contrast preparations. Pathology detection is noticeably impaired without any enteric contrast. circle Neutral oral contrast ensures an equivalent delineation of the bowel. (orig.)

Clinical and nutritional implications of radiation enteritis

Energy Technology Data Exchange (ETDEWEB)

Beer, W.H.; Fan, A.; Halsted, C.H.

1985-01-01

The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value.

Clinical and nutritional implications of radiation enteritis

International Nuclear Information System (INIS)

Beer, W.H.; Fan, A.; Halsted, C.H.

1985-01-01

The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value

Enteric Virome Sensing—Its Role in Intestinal Homeostasis and Immunity

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Rebecca N. Metzger

2018-03-01

Full Text Available Pattern recognition receptors (PRRs sensing commensal microorganisms in the intestine induce tightly controlled tonic signaling in the intestinal mucosa, which is required to maintain intestinal barrier integrity and immune homeostasis. At the same time, PRR signaling pathways rapidly trigger the innate immune defense against invasive pathogens in the intestine. Intestinal epithelial cells and mononuclear phagocytes in the intestine and the gut-associated lymphoid tissues are critically involved in sensing components of the microbiome and regulating immune responses in the intestine to sustain immune tolerance against harmless antigens and to prevent inflammation. These processes have been mostly investigated in the context of the bacterial components of the microbiome so far. The impact of viruses residing in the intestine and the virus sensors, which are activated by these enteric viruses, on intestinal homeostasis and inflammation is just beginning to be unraveled. In this review, we will summarize recent findings indicating an important role of the enteric virome for intestinal homeostasis as well as pathology when the immune system fails to control the enteric virome. We will provide an overview of the virus sensors and signaling pathways, operative in the intestine and the mononuclear phagocyte subsets, which can sense viruses and shape the intestinal immune response. We will discuss how these might interact with resident enteric viruses directly or in context with the bacterial microbiome to affect intestinal homeostasis.

Enteric Virome Sensing-Its Role in Intestinal Homeostasis and Immunity.

Science.gov (United States)

Metzger, Rebecca N; Krug, Anne B; Eisenächer, Katharina

2018-03-23

Pattern recognition receptors (PRRs) sensing commensal microorganisms in the intestine induce tightly controlled tonic signaling in the intestinal mucosa, which is required to maintain intestinal barrier integrity and immune homeostasis. At the same time, PRR signaling pathways rapidly trigger the innate immune defense against invasive pathogens in the intestine. Intestinal epithelial cells and mononuclear phagocytes in the intestine and the gut-associated lymphoid tissues are critically involved in sensing components of the microbiome and regulating immune responses in the intestine to sustain immune tolerance against harmless antigens and to prevent inflammation. These processes have been mostly investigated in the context of the bacterial components of the microbiome so far. The impact of viruses residing in the intestine and the virus sensors, which are activated by these enteric viruses, on intestinal homeostasis and inflammation is just beginning to be unraveled. In this review, we will summarize recent findings indicating an important role of the enteric virome for intestinal homeostasis as well as pathology when the immune system fails to control the enteric virome. We will provide an overview of the virus sensors and signaling pathways, operative in the intestine and the mononuclear phagocyte subsets, which can sense viruses and shape the intestinal immune response. We will discuss how these might interact with resident enteric viruses directly or in context with the bacterial microbiome to affect intestinal homeostasis.

The IAEA inventory databases related to radioactive material entering the marine environment

International Nuclear Information System (INIS)

Rastogi, R.C.; Sjoeblom, K.L.

1999-01-01

Contracting Parties to the Convention on the Prevention of Marine Pollution by Dumping of Wastes and other Matter (LC 1972) have requested the IAEA to develop an inventory of radioactive material entering the marine environment from all sources. The rationale for developing and maintaining the inventory is related to its use as an information base with which the impact of radionuclides entering the marine environment from different sources can be assessed and compared. Five anthropogenic sources of radionuclides entering the marine environment can be identified. These sources are: radioactive waste disposal at sea; accidents and losses at sea involving radioactive material; discharge of low level liquid effluents from land-based nuclear facilities; the fallout from nuclear weapons testing; and accidental releases from land-based nuclear facilities. The first two of these sources are most closely related to the objective of the LC 1972 and its request to the IAEA. This paper deals with the Agency's work on developing a database on radioactive material entering the marine environment from these two sources. The database has the acronym RAMEM (RAdioactive Material Entering the Marine Environment). It includes two modules: inventory of radioactive waste disposal at sea and inventory of accidents and losses at sea involving radioactive material

Galanin enhances systemic glucose metabolism through enteric Nitric Oxide Synthase-expressed neurons

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Anne Abot

2018-04-01

Full Text Available Objective: Decreasing duodenal contraction is now considered as a major focus for the treatment of type 2 diabetes. Therefore, identifying bioactive molecules able to target the enteric nervous system, which controls the motility of intestinal smooth muscle cells, represents a new therapeutic avenue. For this reason, we chose to study the impact of oral galanin on this system in diabetic mice. Methods: Enteric neurotransmission, duodenal contraction, glucose absorption, modification of gut–brain axis, and glucose metabolism (glucose tolerance, insulinemia, glucose entry in tissue, hepatic glucose metabolism were assessed. Results: We show that galanin, a neuropeptide expressed in the small intestine, decreases duodenal contraction by stimulating nitric oxide release from enteric neurons. This is associated with modification of hypothalamic nitric oxide release that favors glucose uptake in metabolic tissues such as skeletal muscle, liver, and adipose tissue. Oral chronic gavage with galanin in diabetic mice increases insulin sensitivity, which is associated with an improvement of several metabolic parameters such as glucose tolerance, fasting blood glucose, and insulin. Conclusion: Here, we demonstrate that oral galanin administration improves glucose homeostasis via the enteric nervous system and could be considered a therapeutic potential for the treatment of T2D. Keywords: Galanin, Enteric nervous system, Diabetes

Enteric virus removal inactivation by coal-based media

Energy Technology Data Exchange (ETDEWEB)

Gupta, A.; Chaudhuri, M. [Indian Institute of Technology, Kanpur (India). Dept. of Civil Engineering

1995-02-01

Four coal-based media, viz. alum-pretreated or ferric hydroxide-impregnated Giridih bituminous coal and lignite (alum-GBC, Fe-GBC; alum-lignite and Fe-Lignite) were laboratory tested to assess their potential in removing/inactivating enteric viruses in water. Batch-sorption screening tests, employing a poliovirus-spiked canal water, indicated high poliovirus sorption by Fe-GBC and alum-GBC in a short contact time of 5 min. Based on the results of further batch-sorption tests, using silver incorporated media (alum/Ag-GBC, alum-GBC-Ag and Fe-GBC-Ag), as well as aesthetic water quality consideration and previous findings on removal of coliforms and turbidity, alum/Ag-GBC, alum-GBC and alum-GBC-AG were included in downflow column studies employing poliovirus-spiked canal water. All three media showed potential in removing/inactivating enteric viruses. In a separate column study employing a joint challenge of poliovirus and rotavirus, alum/Ag-GBC removed 59.3-86.5% of the viruses along with more than 99% reduction in indigenous heterotrophic bacteria. Alum/silver-pretreated bituminous coal medium appears promising for use in household water filters in rural areas of the developing world. However, improved medium preparation to further enhance its efficiency is needed; also, its efficacy in removing/inactivating indigenous enteric bacteria, viruses and protozoa has to be ensured and practicalities or economics of application need to be considered.

Evaluation of Intensivist-Nurses’ Knowledge Concerning Medication Administration Through Nasogastric and Enteral Tubes Evaluación del conocimiento del enfermero de terapia intensiva sobre administración de medicamentos por sonda nasogástrica y nasoentérica Avaliação do conhecimento do enfermeiro de unidade de terapia intensiva sobre administração de medicamentos por sonda nasogástrica e nasoenteral

Directory of Open Access Journals (Sweden)

Maria Lurdemiler Sabóia Mota

2010-10-01

Full Text Available This study evaluates the knowledge of nurses working in intensive care units concerning recommendations for the proper administration of medication through nasogastric and enteral tubes. This exploratory-descriptive study with a quantitative approach was carried out with 49 nurses in an intensive care unit of a tertiary hospital in Fortaleza, CE, Brazil. A total of 36.7% of nurses reported they disregard the dosage forms provided by the pharmacy at the time of administering the medication through tubes. Metal, wood, or a plastic mortar is the method most frequently reported (42.86% for crushing prescribed solid forms; 32.65% leave the drugs in 20ml of water until dissolved; 65.3% place the responsibility for choosing the pharmaceutical formulation and its correlation with the tube site, either into the stomach or into the intestine, on the physician. The results indicate there is a gap between specific literature on medication administered through tubes and knowledge of nurses on the subject.El objetivo del estudio fue evaluar los conocimientos del enfermero de la unidad de cuidados intensivos sobre las recomendaciones para la correcta administración de medicamentos por sonda nasogástrica y nasoentérica. Se trata de un estudio exploratorio-descriptivo y cuantitativo con 49 enfermeros en una unidad de cuidados intensivos de un hospital terciario, en la ciudad de Fortaleza, estado de Ceará, Brasil. 36,7% no prestan atención a las formas disponibles en el sector de farmacia en el momento de su utilización por sonda. El pilón de metal, madera o plástico fue el método más citado (42,86% para triturar las formas sólidas prescritas. 32,65% dejan los fármacos en 20mL de agua hasta que se disuelvan. 65,3% atribuyen al médico la responsabilidad de decidir sobre la formulación y la correlación con la ubicación de la sonda en el tracto gastrointestinal. Los resultados indican que hay una diferencia entre la literatura para los medicamentos

Effect of pentoxifylline and tocopherol on radiation proctitis/enteritis

International Nuclear Information System (INIS)

Hille, A.; Christiansen, H.; Pradier, O.; Hermann, R.M.; Siekmeyer, B.; Weiss, E.; Hess, C.F.; Schmidberger, H.; Hilgers, R.

2005-01-01

Background and purpose: Chronic radiation proctitis/enteritis is a relevant complication of pelvic irradiation, which is still mainly treated by supportive measures only. There is some evidence that the combined treatment with pentoxifylline and tocopherol might alter the pathogenesis of radiation-induced fibrosis. In a retrospective analysis the clinical benefit of the treatment with pentoxifylline/tocopherol on radiation-induced proctitis/enteritis was evaluated, compared to supportive care only. Patients and methods: Of 30 patients with radiation-induced proctitis/enteritis grade I-II according to the RTOG/EORTC toxicity criteria, 21 were treated with pentoxifylline and tocopherol. Depending on physician's decision nine patients received symptomatic treatment only. Results: With pentoxifylline/tocopherol treatment 15/21 patients (71%) experienced a relief of their symptoms. A reduction from grade I/II to grade 0 toxicity was observed in seven and from grade II to grade I toxicity in eight patients. No improvement was seen in six patients. The median time to improvement with pentoxifylline and tocopherol treatment was 28 weeks. In three of nine patients who were treated supportively only, deterioration of symptoms occurred. Three patients experienced no amelioration, and three patients with grade I toxicity experienced a spontaneous relief of their symptoms (33%). Conclusion: The combination treatment with pentoxifylline and tocopherol seems to have a benefit in patients with grade I-II radiation-induced proctitis/enteritis. The optimal schedule of treatment duration is not yet clear. From the observations made in this study it is assumed the treatment should be given for 6-12 months at least. A prospective phase II study should be undertaken to evaluate optimal treatment duration. (orig.)

Effect of pentoxifylline and tocopherol on radiation proctitis/enteritis

Energy Technology Data Exchange (ETDEWEB)

Hille, A.; Christiansen, H.; Pradier, O.; Hermann, R.M.; Siekmeyer, B.; Weiss, E.; Hess, C.F.; Schmidberger, H. [Goettingen Univ. (Germany). Dept. of Radiotherapy and Radiation; Hilgers, R. [Goettingen Univ. (Germany). Dept. for Medical Statisics

2005-09-15

Background and purpose: Chronic radiation proctitis/enteritis is a relevant complication of pelvic irradiation, which is still mainly treated by supportive measures only. There is some evidence that the combined treatment with pentoxifylline and tocopherol might alter the pathogenesis of radiation-induced fibrosis. In a retrospective analysis the clinical benefit of the treatment with pentoxifylline/tocopherol on radiation-induced proctitis/enteritis was evaluated, compared to supportive care only. Patients and methods: Of 30 patients with radiation-induced proctitis/enteritis grade I-II according to the RTOG/EORTC toxicity criteria, 21 were treated with pentoxifylline and tocopherol. Depending on physician's decision nine patients received symptomatic treatment only. Results: With pentoxifylline/tocopherol treatment 15/21 patients (71%) experienced a relief of their symptoms. A reduction from grade I/II to grade 0 toxicity was observed in seven and from grade II to grade I toxicity in eight patients. No improvement was seen in six patients. The median time to improvement with pentoxifylline and tocopherol treatment was 28 weeks. In three of nine patients who were treated supportively only, deterioration of symptoms occurred. Three patients experienced no amelioration, and three patients with grade I toxicity experienced a spontaneous relief of their symptoms (33%). Conclusion: The combination treatment with pentoxifylline and tocopherol seems to have a benefit in patients with grade I-II radiation-induced proctitis/enteritis. The optimal schedule of treatment duration is not yet clear. From the observations made in this study it is assumed the treatment should be given for 6-12 months at least. A prospective phase II study should be undertaken to evaluate optimal treatment duration. (orig.)

Enteral Feeding Set Handling Techniques.

Science.gov (United States)

Lyman, Beth; Williams, Maria; Sollazzo, Janet; Hayden, Ashley; Hensley, Pam; Dai, Hongying; Roberts, Cristine

2017-04-01

Enteral nutrition therapy is common practice in pediatric clinical settings. Often patients will receive a pump-assisted bolus feeding over 30 minutes several times per day using the same enteral feeding set (EFS). This study aims to determine the safest and most efficacious way to handle the EFS between feedings. Three EFS handling techniques were compared through simulation for bacterial growth, nursing time, and supply costs: (1) rinsing the EFS with sterile water after each feeding, (2) refrigerating the EFS between feedings, and (3) using a ready-to-hang (RTH) product maintained at room temperature. Cultures were obtained at baseline, hour 12, and hour 21 of the 24-hour cycle. A time-in-motion analysis was conducted and reported in average number of seconds to complete each procedure. Supply costs were inventoried for 1 month comparing the actual usage to our estimated usage. Of 1080 cultures obtained, the overall bacterial growth rate was 8.7%. The rinse and refrigeration techniques displayed similar bacterial growth (11.4% vs 10.3%, P = .63). The RTH technique displayed the least bacterial growth of any method (4.4%, P = .002). The time analysis in minutes showed the rinse method was the most time-consuming (44.8 ± 2.7) vs refrigeration (35.8 ± 2.6) and RTH (31.08 ± 0.6) ( P refrigerating the EFS between uses is the next most efficacious method for handling the EFS between bolus feeds.

Infection and cross-infection in a Paediatric Gastro-enteritis unit

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Jean Bowen Jones

1989-09-01

Full Text Available A two month study to investigate the incidence o f nosocomial infection was conducted in a paediatric gastroenteritis ward o f a black academic hospital. Enteric pathogens were identified on admission in 61 (47,2% o f 129 patients; 56 bacterial and 25 viral. Six per cent o f patients had a combination o f bacterial and viral pathogens. Enteric pathogens most frequently identified on admission were Campylobacter jejuni in 22%, Rotavirus in 19,3%, EPEC in 10,8% and Shigella spp. in 6,9% patients. Twenty six (20% patients had more than 1 enteric pathogen. The nosocomial infection rate was recorded at 17,1%. EPEC occurred most commonly in 5,3% patients, Salmonella typhimurium in 4,6% and Shigella spp. in 2,3%. Nosocomial infections increased the mean length o f hospital stay from 7,2- 20,2 days. Contributory factors to the spread o f nosocomial infection were the unsatisfactory methods o f bathing patients and giving naso-gastric feeds.

Do low-calorie drinks 'cheat' the enteral-brain axis?

Science.gov (United States)

Ferreira, Adaliene V M; Generoso, Simone Vasconcelos; Teixeira, Antônio Lúcio

2014-09-01

The consumption of low-calorie beverages has increased worldwide, mainly because of their combination of sweet taste without adding significant calories to the diet. However, some epidemiological studies have linked the higher consumption of low-calorie beverages with increased body weight gain. Although a matter of debate, this paradoxical association between low-calorie beverages and weight gain has been attributed to their effect on the enteral-brain axis. More specifically, artificial sweeteners present in low-calorie beverages could induce appetite increase, probably due to an ambiguous psychobiological signal (uncoupling sweet taste from calorie intake) that confounds the appetite's regulatory mechanisms, promoting overeating and, ultimately, leading to weight gain. However, many studies do not support this assumption, and the mechanisms underlying the interaction between low-calorie beverages and the enteral-brain axis remain to be defined. The understanding of the effects of low-calorie drinks on the enteral-brain axis still remains in its infancy and needs to be unveiled. The consumption of low-calorie beverages reduces the calories from that drink, but compensatory phenomena may increase energy intake, and if so must be recognized and avoided.

Benefits of postpyloric enteral access placement by a nutrition support dietitian.

Science.gov (United States)

Jimenez, L Lee; Ramage, James E

2004-10-01

Although enteral nutrition is considered the preferred strategy for nutrition support, it is often precluded by nasogastric feeding intolerance or the inability to place feeding access into the postpyloric position. In an effort to improve enteral nutrition (EN) outcomes at our institution, the nutrition support dietitian (NSD) began placing postpyloric feeding tubes (PPFT) in intensive care unit patients. Intensive care unit patients who received blind, bedside PPFT placements by the NSD (n = 18) were compared with a concurrent age- and diagnosis-matched control group that received standard nutritional care without NSD intervention (n = 18). Interruption of EN infusion, appropriateness of parenteral nutrition (PN) prescription (based on American Society of Parenteral and Enteral Nutrition guidelines), and incidence of ventilator-associated pneumonia (VAP), as defined by the American College of Chest Physicians practice guidelines, were determined in each group. The NSD was successful in positioning the PPFT at or distal to the third portion of the duodenum in 83% of attempts. The PPFT group demonstrated no interruption of enteral feeding compared with 56% in the control group (p VAP in the PPFT group (6% vs 28%, p = .07). Of the PN initiations in the control group, 88% were deemed to be potentially avoidable; 6 of 8 PNs were initiated because of gastric residuals. Enteral nutrition facilitated by NSD placement of postpyloric feeding access is associated with improved tube feeding tolerance and reduced PN use. Further studies are needed to evaluate a possible effect of postpyloric feeding on the incidence of VAP.

Fibras solúveis e insolúveis de verduras, tubérculos e canela para uso em nutrição clínica Soluble and insoluble fibres of vegetables, tubers and cinnamon for use in enteral nutrition

Directory of Open Access Journals (Sweden)

Edma Maria de Araújo

2009-06-01

Full Text Available Dietas enterais com alimentos convencionais são usadas para obter individualização e menor custo. No entanto, para melhorar o teor de fibras alimentares, o valor nutritivo e a confiabilidade, mais estudos são necessários. A proposta desse estudo foi estudar fontes de fibra alimentar de abóbora, agrião, canela em pó, couve-flor, inhame e tomate, para uso em nutrição enteral ou suplemento nutricional oral. Esses alimentos foram escolhidos por conter fibras alimentares e outros elementos considerados funcionais (isotiocianatos, indóis, licopeno, carotenoides, clorofila. Foram formuladas preparações com os alimentos em solução de água e adicionadas a uma formulação enteral domiciliar. Foram determinadas fibras solúvel e insolúvel, a composição centesimal dos alimentos e a atividade de água das formulações. Os alimentos foram acrescentados à formulação enteral domiciliar em quantidades de 100 g/2000 kcal/2 L e à água 150 g/2000kcal/2 L. Essas quantidades equivalem a duas porções diárias de cada alimento. A maior quantidade de fibra alimentar (base úmida foi de canela (50,11%, sendo o teor dos outros alimentos: abóbora 1,76%; agrião 0,85%; couve-flor 1,51%; inhame 1,56%; e tomate 1,00%. Os valores de atividades de água ficaram entre 0,988 e 0,999, indicando que as dietas são suscetíveis à contaminação microbiana, sendo mais seguro consumir essas dietas imediatamente após o preparo.Enteral diets containing conventional foods are used to reduce costs and obtain individualization. However, more studies are required to improve their dietary fibre content, the nutritive value, and reliability. This study proposed to study the dietary fibres of different vegetables and spices such as pumpkin, watercress, powdered cinnamon, cauliflower, yam, and tomato for use in enteral nutrition or in oral nutritional supplements. These foods were chosen since they contain dietary fibres and other elements considered to be

Early postoperative enteral nutrition is useful for recovering gastrointestinal motility and maintaining the nutritional status.

Science.gov (United States)

Kawasaki, Naruo; Suzuki, Yutaka; Nakayoshi, Tomoko; Hanyu, Nobuyoshi; Nakao, Masatoshi; Takeda, Akihiro; Furukawa, Yoshiyuki; Kashiwagi, Hideyuki

2009-01-01

The efficacy of enteral nutrition in postoperative nutritional management is known, but the effects on gastrointestinal motility and nutrition have not yet been elucidated. The purpose of this study was to compare the effects of enteral and parenteral nutrition soon after open abdominal surgery on gastrointestinal motility and nutritional status. A partial resection of rectum models was prepared to compare two types of nutrient administration: enteral nutrition and total parenteral nutrition. The differences between the effects of nutrition types in terms of gastrointestinal motility and nutritional status were investigated. Enteral nutrition contributed to recovery of gastrointestinal motility and maintenance of nutritional status. Enteral nutrition should therefore be initiated soon after surgery if the gastrointestinal tract is available.

77 FR 69650 - Agency Information Collection Activities: Holders or Containers Which Enter the United States...

Science.gov (United States)

2012-11-20

... Activities: Holders or Containers Which Enter the United States Duty Free AGENCY: U.S. Customs and Border... information collection requirement concerning the Holders or Containers which Enter the United States Duty... concerning the following information collection: Title: Holders or Containers which Enter the United States...

Emerging antibiotic resistant enteric bacterial flora among food ...

African Journals Online (AJOL)

Emerging antibiotic resistant enteric bacterial flora among food animals in Abeokuta, Nigeria. ... Nigerian Journal of Animal Production ... Bacterial resistance to antibiotic in food animals is an emerging public health concern as a result of ...

Effect of Calcium Ions on the Disintegration of Enteric-Coated Solid Dosage Forms.

Science.gov (United States)

Al-Gousous, Jozef; Langguth, Peter

2016-02-01

To investigate the effect of calcium ions on the disintegration of enteric-coated dosage forms, disintegration testing was performed on enteric-coated aspirin tablets in the presence and absence of calcium in the test media. The results show that the presence of calcium ions retards the disintegration of enteric-coated dosage forms. This finding, which has not been reported in scientific literature, sheds light on the importance of conducting well-designed detailed investigations into the potential of calcium from dietary sources, calcium supplements, antacids, and/or phosphate binders affecting the absorption of drugs formulated into enteric-coated dosage forms. Moreover, it shows the necessity to investigate the potential of the occurrence of additional nutrient-excipient interactions. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Nutritional and microbiological quality of commercial and homemade blenderized whole food enteral diets for home-based enteral nutritional therapy in adults.

Science.gov (United States)

Vieira, Maricy Machado Cavalca; Santos, Valdirene Francisca Neves; Bottoni, Andrea; Morais, Tania Beninga

2018-02-01

Serious nutritional and contamination risks may be involved in the preparation of blenderized tube-feeding diets and in the handling of commercial diets. Their nutritional and microbiological quality in home settings is unknown. The objective of this study was to assess the nutritional and microbiological quality of commercial enteral and homemade blenderized whole foods diets intended to adult patients in home nutritional therapy. In a cross sectional study, 66 samples of commercial (CD) and noncommercial (NCD) enteral diets were collected at the homes of patients in home enteral nutritional therapy, 33 of each type. Commercial diets were either powder (PCD; n = 13) or liquid (LCD; n = 20). The samples were analyzed in laboratory to assess their nutritional and microbiological quality. Anthropometric data of mid upper arm circumference (MUAC) and triceps skinfold (TST) thickness were obtained from the patients' medical records. NCD presented significantly lower values for protein, fat, fiber, carbohydrate and energy while water content was significantly higher. PCD and LCD did not show any statistically significant differences between them. In the NCD, the values measured for macronutrients and energy corresponded to less than 50% of the prescribed values (except for fat). In CD, protein value was about 20% more than the prescribed value; fat and energy values corresponded to approximately 100% of the prescription, while carbohydrate corresponded to 92%. Regardless the type of the diet, prevalence of undernutrition was high in both groups though patients of the NCD presented a higher percentage. Samples of NCD complied significantly less with the microbiological standards; only 6.0% complied with the standard for coliform bacteria. Escherichia coli was detected in 10, 2, and 2 samples of NCD, PCD and LCD, respectively. Homemade blenderized enteral diets showed low values of energy and macronutrients, delivered less than 50% of the prescribed values and had

Nursing administration of medication via enteral tubes in adults: a systematic review.

Science.gov (United States)

Phillips, Nicole M; Nay, Rhonda

2007-09-01

Background  Enteral tubes are frequently inserted as part of medical treatment in a wide range of patient situations. Patients with an enteral tube are cared for by nurses in a variety of settings, including general and specialised acute care areas, aged care facilities and at home. Regardless of the setting, nurses have the primary responsibility for administering medication through enteral tubes. Medication administration via an enteral tube is a reasonably common nursing intervention that entails a number of skills, including preparing the medication, verifying the tube position, flushing the tube and assessing for potential complications. If medications are not given effectively through an enteral tube, harmful consequences may result leading to increased morbidity, for example, tube occlusion, diarrhoea and aspiration pneumonia. There are resultant costs for the health-care system related to possible increased length of stay and increased use of equipment. Presently what is considered to be best practice to give medications through enteral tubes is unknown. Objectives  The objective of this systematic review was to determine the best available evidence on which nursing interventions are effective in minimising the complications associated with the administration of medications via enteral tubes in adults. Nursing interventions and considerations related to medication administration included form of medication, verifying tube placement before administration, methods used to give medication, methods used to flush tubes, maintenance of tube patency and specific practices to prevent possible complications related to the administration of enteral medications. Search strategy  The following databases were searched for literature reported in English only: CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO. There was no date restriction applied. In addition, the reference lists of all included

Mortalidade materna na perspectiva do familiar Mortalidad materna en la perspectiva del familiar Maternal mortality on the family members' perspective

Directory of Open Access Journals (Sweden)

Flávia Azevedo Gomes

2006-03-01

Full Text Available A mortalidade materna é um dos indicadores do desenvolvimento de saúde e social de um país. É uma tragédia para a família, pois a morte da mãe priva a criança da amamentação e do contato materno, e pelo fato de caber à mulher manter a unidade da família. Este estudo teve como objetivo compreender o significado da morte atribuído por familiares das mulheres falecidas por causas maternas. A população foi constituída por dez familiares de sete mulheres que morreram durante o ciclo grávido-puerperal no município de Ribeirão Preto. Realizamos visitas domiciliares e a coleta de dados foi realizada por meio de entrevista dada pelo familiar da mulher. Para a análise dos dados, utilizamos a análise temática, em que depreendemos três categorias temáticas: significado da morte materna, vivenciando a mortalidade materna na família e vivenciando a mortalidade materna na instituição de saúde. As visitas domiciliares confirmaram que existem fatores coadjuvantes que influenciaram na ocorrência das mortes maternas.La mortalidad materna es uno de los indicadores del desarrollo en salud y social de un país. Es una tragedia para la familia, pues la muerte de la madre priva al niño del amamantamiento y del contacto materno, y por el hecho de que cabe a la mujer mantener la unidad de la familia. Este estudio tuvo como objetivo comprender el significado de la muerte atribuido por familiares de las mujeres fallecidas por causas maternas. La población estuvo constituida por diez familiares de siete mujeres que murieron durante el ciclo grávido-puerperal en el municipio de Ribeirão Preto. Se efectuaron visitas domiciliarias y la recolección de datos fue realizada por medio de entrevista al familiar de la mujer. Para el análisis de los datos, se utilizó el análisis temático, desprendiéndose tres categorías temáticas: significado de la muerte materna, vivenciando la mortalidad materna en la familia y vivenciando la mortalidad

9 CFR 590.26 - Egg products entering or prepared in official plants.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Egg products entering or prepared in..., DEPARTMENT OF AGRICULTURE EGG PRODUCTS INSPECTION INSPECTION OF EGGS AND EGG PRODUCTS (EGG PRODUCTS INSPECTION ACT) Scope of Inspection § 590.26 Egg products entering or prepared in official plants. Eggs and...

Continuous elemental enteral alimentation in children with Crohn's disease and growth failure.

Science.gov (United States)

Morin, C L; Roulet, M; Roy, C C; Weber, A

1980-12-01

Four children aged (11.7-13.5 yr) with protracted growth retardation related to Crohn's disease, received a 6-wk period of continuous elemental enteral alimentation with no other form of treatment. Despite drug therapy the yearly height and weight gain velocities of these children (1.7 +/- 0.3 cm and -0.8 +/- 1.4 kg, respectively) had been abnormal during the previous 2 yr. All patients experienced a complete remission of symptoms, improved nutritional status, and significant height (1.8 +/- 0.3 cm) and weight (3.8 +/- 0.5 kg) gains during the 67 wk of treatment. After cessation of elemental enteral alimentation, 3 of the 4 patients continued to grow, and over a period of 4.5 mo from the beginning of this form of nutritional therapy, they gained an average of 5.0 +/- 1.6 kg and 3.5 +/- 0.3 cm. The disease became active thereafter, and the 3 children resumed their previously abnormal growth patterns during the ensuing year. The 4th patient had surgery 2 mo after elemental enteral alimentation and experienced a subsequent second spurt of growth and pubertal changes. This study suggests that a relatively short course of elemental enteral alimentation leads to a temporary resumption of growth in children with severe growth failure and Crohn's disease. The possibility that repeated courses of elemental enteral alimentation might be beneficial needs to be explored.

Bacteriophages as indicators of faecal pollution and enteric virus removal.

Science.gov (United States)

McMinn, B R; Ashbolt, N J; Korajkic, A

2017-07-01

Bacteriophages are an attractive alternative to faecal indicator bacteria (FIB), particularly as surrogates of enteric virus fate and transport, due to their closer morphological and biological properties. Based on a review of published data, we summarize densities of coliphages (F+ and somatic), Bacteroides spp. and enterococci bacteriophages (phages) in individual human waste, raw wastewater, ambient fresh and marine waters and removal through wastewater treatment processes utilizing traditional treatments. We also provide comparisons with FIB and enteric viruses whenever possible. Lastly, we examine fate and transport characteristics in the aquatic environment and provide an overview of the environmental factors affecting their survival. In summary, concentrations of bacteriophages in various sources were consistently lower than FIB, but more reflective of infectious enteric virus levels. Overall, our investigation indicates that bacteriophages may be adequate viral surrogates, especially in built systems, such as wastewater treatment plants. Bacteriophage are alternative fecal indicators that may be better surrogates for viral pathogens than fecal indicator bacteria (FIB). This report offers a summary of the existing literature concerning the utility of bacteriophage as indicators of viral presence (fecal sources and surface waters) and persistence (in built infrastructure and aquatic environments). Our findings indicate that bacteriophage levels in all matrices examined are consistently lower than FIB, but similar to viral pathogens. Furthermore, in built infrastructure (e.g. wastewater treatment systems) bacteriophage closely mimic viral pathogen persistence suggesting they may be adequate sentinels of enteric virus removal. © 2017 The Society for Applied Microbiology.

Entering a Crack: An Encounter with Gossip

Science.gov (United States)

Henderson, Linda

2014-01-01

In this paper, I enter a crack to think otherwise about the concept "gossip". Drawing on previous scholarship engaging with Deleuzian concepts to inform research methodologies, this paper builds on this body of work. Following Deleuze and Guattari, the paper undertakes a mapping of gossip, subsequent to an encounter with a crack.…

Porøse materialer

DEFF Research Database (Denmark)

Hansen, Ernst Jan de Place

2000-01-01

Dette undervisningsnotat er en samling af noter, der refererer til den indledende del af kurset Materialmekanik og Porøse materailer på Insitut for Bærende Konstruktiner og Materialer (BKM).......Dette undervisningsnotat er en samling af noter, der refererer til den indledende del af kurset Materialmekanik og Porøse materailer på Insitut for Bærende Konstruktiner og Materialer (BKM)....

Entering behavior of Gasteruption brachychaetum Schrottky (Hymenoptera, Gasteruptiidae into a nest of Hylaeus Fabricius (Hymenoptera, Colletidae Comportamento de entrada de Gasteruption brachychaetum Schrottky (Hymenoptera, Gasteruptiidae em um ninho de Hylaeus Fabricius (Hymenoptera, Colletidae

Directory of Open Access Journals (Sweden)

Antonio Carlos Cruz Macedo

2012-09-01

Full Text Available Nests of Hylaeus aff. guaraniticus (Schrottky, 1906 were parasited by females of Gasteruption brachychaetum Schrottky, 1906 in trap nests in São Paulo (Brazil. This is thefirst host record of a Gasteruptiidae in the Neotropical Region. The behavior of a G.brachychaetum female entering a host's nest is described as follows: an inquiline female hovered near the host's nest, landed and detected that a female of H. aff. guaraniticus was inside the nest, waited for the host female to fly out, entered backwards into the nest, remained there for almost six minutes, and then went out the nest. The development time of immature stages of G.brachychaetum varied between 16 and 299 days.Ninhos de Hylaeus aff. guaraniticus (Schrottky, 1906foram parasitados por fêmeas de Gasteruption brachychaetum Schrottky, 1906 em ninhos-armadilha em São Paulo (Brasil. Este é o primeiro registro de hospedeiro de um Gasteruptiidae na região Neotropical. O comportamento de uma fêmea entrando no ninho do hospedeiro é descrito: a fêmea inquilina pairou sobre o ninho do hospedeiro, pousou e detectou que a fêmea de H. aff. guaraniticus estava dentro do ninho, esperou a fêmea hospedeira voar para fora do ninho, entrou de costas no ninho, permanecendo no local por quase seis minutos, em seguida, partiu voando. O tempo de desenvolvimento dos imaturos de G.brachychaetum variou entre 16 e 229 dias.

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

Science.gov (United States)

Akbulut, Gamze

2011-07-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

Critical analysis of the factors associated with enteral feeding in preventing VAP: a systematic review.

Science.gov (United States)

Chen, Yu-Chih

2009-04-01

Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre-post) studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent), feeding site on aspiration (gastric vs. small bowel), and the timing of enteral feeding (early vs. late). The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP still need further

Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

Directory of Open Access Journals (Sweden)

Yu-Chih Chen

2009-04-01

Full Text Available Ventilator-associated pneumonia (VAP is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre–post studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent, feeding site on aspiration (gastric vs. small bowel, and the timing of enteral feeding (early vs. late. The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP

Settling and survival profile of enteric pathogens in the swine effluent for water reuse purpose.

Science.gov (United States)

Fongaro, G; Kunz, A; Magri, M E; Schissi, C D; Viancelli, A; Philippi, L S; Barardi, C R M

2016-11-01

The present study evaluated the pathogens persistence and settling profile in swine effluent. We determined the enteric pathogens settling characteristics, their survival and inactivation profile in swine effluent (for water reuse purpose) and in sludge (generated after aerobic treatment - during secondary settling process). The study was performed in laboratorial-scale and in full-scale (manure treatment plant). Enteric viruses and enteric bacteria were used as biomarkers. Results showed that these enteric pathogens were significantly reduced from swine effluent during secondary settling process, and enteric viruses removal was correlated with the suspended solids decantation. The design of secondary settlers can be adapted to improve pathogens removal, by diminishing the solids loading rate per area and time, ending in higher hydraulic retention times. Copyright © 2016 Elsevier GmbH. All rights reserved.

Verdad por definición

OpenAIRE

Garrido Garrido, Julián

1997-01-01

Not available.La verdad por definición es un tipo peculiar de verdad científica, distinguible de las verdades lógicas, matemáticas y empíricas. La definición, por su parte, designa diversos procedimientos de asignación de significado, cuyas diferencias exigen una adjetivación cuidadosa: definiciones ostensivas y operacionales, definiciones de diccionario y definiciones teóricas. Pero sólo las del último tipo son verdaderas por definición. En el presente artículo se precisa el concepto formal ...

Navigating Risk When Entering and Participating in a Business Ecosystem

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Derek Smith

2013-05-01

Full Text Available Entrepreneurs typically have limited resources during the start-up phase of a business. Business ecosystems are a strategy for entrepreneurs to access and exchange many different aspects of value, resources, and benefits. However, there may be business risks for entering a particular type of ecosystem, and further risks may be encountered after entering and participating in a business ecosystem. These risks are significant and can inhibit a startup's growth. In this article, the literature on business ecosystems is reviewed as it relates to risk to discover insights of relevance to entrepreneurs, top management teams, and business-ecosystem operators. First, the published research is organized into two streams: i risks relating to categories of business ecosystems, and ii risks relating to participating in business ecosystems. Then, the problem is abstracted to develop a potential strategy for managing these risks, which features a pre-entry inspection followed by real-time resource management. Finally, five recommendations are offered for entrepreneurs seeking to enter and participate in business ecosystems.

Employee and work-related predictors for entering rehabilitation: a cohort study of civil servants.

Science.gov (United States)

Lamminpää, Anne; Kuoppala, Jaana; Väänänen-Tomppo, Irma; Hinkka, Katariina

2012-07-01

The aim of this study was to determine how employee well-being, psychosocial factors at work, leadership and perceived occupational health services predict entering rehabilitation as modelled in the Job Well-being Pyramid. A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. A total of 147 employees entered rehabilitation during the median follow-up time of 7 years. Permanent employment, large organizations, feedback from supervisors, client violence and physically monotonous work were associated with an increased rate of entering rehabilitation, whereas physical jobs, clear aims, high appreciation, job satisfaction and job enjoyment were associated with a decreased rate of entering rehabilitation. Employee well-being in general was also associated with entering rehabilitation, and this was decreased by good work ability, good health, mental well-being and physical fitness and increased by constant musculoskeletal symptoms. On the other hand, support from supervisors, job control, work pressure, team climate at work, communication, bullying and discrimination, physical work environment, and sense of coherence appeared to have no association. Various psychosocial factors at work and job well-being predict entering rehabilitation. The association between employee health and entering rehabilitation refers to the fact that the selection process for rehabilitation works reasonably well and those in need of rehabilitation are also granted it. In general, these findings coincide well with the Job Well-being Pyramid model. Improving job conditions and well-being at work is likely to decrease the need for rehabilitation.

Electrocardiografo por computadora

OpenAIRE

Tinoco Hernandez, Rosanna; Paredes Bejarano, Margarita; Romero Chaglia, Norman; Yapur Auad, Miguel Eduardo

2009-01-01

El presente trabajo trata sobrees el diseño y la implementación de un graficador de señales cardiacas por computadora, para lo cual diseñamos un circuito electrónico capaz de recibir la senal analógica proveniente de la actividad electrica del corazón , amplificarla, y luego convertirla en una señal digital para ser procesada por software y finalmente ser graficada, siendo posible así observar la señal cardiaca en el monitor de un computador como un tren de pulsos. Cabe destacar que par...

IDOSOS COM ALZHEIMER: UM ESTUDO DESCRITIVO

Directory of Open Access Journals (Sweden)

Ítala Thaise Aguiar Holanda

2012-01-01

Full Text Available Estudio exploratório y descriptivo cujo objetivo fue clasificar el grado de demencia en ancianos afectados por la enfermedad de Alzheimer mediante el Clinical Dementia Rating y describir el perfil de estos a partir de informaciones del cuidador familiar. El Clinical Dementia Rating fue aplicado a 30 pacientes durante visita domiciliaria y sus miembros cuidadores integrantes de la Asociación de Alzheimer de Fortaleza, Ceará, Brasil, en 2009. Los resultados señalaron que los pacientes eran en su mayoría mujeres, casadas, de bajo nivel de educación y com grado de demencia grave. Se entiende la importancia de implementar programas multiprofesionales para pacientes y famílias, así como establecer acciones específicas de educación en salud y aplicación del Clinical Dementia Rating en la evaluación de estos.

Age most significant predictor of requiring enteral feeding in head-and-neck cancer patients

International Nuclear Information System (INIS)

Sachdev, Sean; Refaat, Tamer; Bacchus, Ian D; Sathiaseelan, Vythialinga; Mittal, Bharat B

2015-01-01

A significant number of patients treated for head and neck squamous cell cancer (HNSCC) undergo enteral tube feeding. Data suggest that avoiding enteral feeding can prevent long-term tube dependence and disuse of the swallowing mechanism which has been linked to complications such as prolonged dysphagia and esophageal constriction. We examined detailed dosimetric and clinical parameters to better identify those at risk of requiring enteral feeding. One hundred patients with advanced stage HNSCC were retrospectively analyzed after intensity-modulated radiation therapy (IMRT) to a median dose of 70 Gy (range: 60-75 Gy) with concurrent chemotherapy in nearly all cases (97%). Patients with significant weight loss (>10%) in the setting of severely reduced oral intake were referred for placement of a percutaneous endoscopic gastrostomy (PEG) tube. Detailed DVH parameters were collected for several structures. Univariate and multivariate analyses using logistic regression were used to determine clinical and dosimetric factors associated with needing enteral feeding. Dichotomous outcomes were tested using Fisher’s exact test and continuous variables between groups using the Wilcoxon rank-sum test. Thirty-three percent of patients required placement of an enteral feeding tube. The median time to tube placement was 25 days from start of treatment, after a median dose of 38 Gy. On univariate analysis, age (p = 0.0008), the DFH (Docetaxel/5-FU/Hydroxyurea) chemotherapy regimen (p = .042) and b.i.d treatment (P = 0.040) (used in limited cases on protocol) predicted need for enteral feeding. On multivariate analysis, age remained the single statistically significant factor (p = 0.003) regardless of other clinical features (e.g. BMI) and all radiation planning parameters. For patients 60 or older compared to younger adults, the odds ratio for needing enteral feeding was 4.188 (p = 0.0019). Older age was found to be the most significant risk factor for needing enteral feeding in

Formation and malformation of the enteric nervous system

NARCIS (Netherlands)

J.H.C. Meijers (Johan)

1989-01-01

textabstractTo clarify pathogenetic mechanisms of congenital malformations of the ENS, the formation of the ENS was investigated in chicken and murine embryos. The experimental work was concentrated on several aspects of the interaction between neural crest cells and the enteric microenvironment.

Effect of bismuth citrate, lactose, and organic acid on necrotic enteritis in broilers

Science.gov (United States)

Clostridium perfringens – associated necrotic enteritis causes significant losses and increased morbidity in poultry. The objective of this study was to evaluate the effect of bismuth citrate and acidifiers on the development of necrotic enteritis in broilers. The first study was a dose response t...

Infection control in enteral feed and feeding systems in the community

OpenAIRE

Ojo, Omorogieva; Bowden, Julie

2013-01-01

This article examines the infection risk to adult patients receiving home enteral nutrition (HEN) and strategies for its prevention and management. Enteral nutrition was historically associated with acute care settings owing to its invasive nature. The changing landscape of community care means that it is now likely to be administered in the patient’s home or in other community settings such as nursing homes. HEN is associated with two main routes of infection risks: the risk of gastrointesti...

Phlegmonous enteritis in a patient with congestive heart failure and colon cancer

Energy Technology Data Exchange (ETDEWEB)

Namkung, Sook; Yoo, Yoon Sik; Hwang, Im Kyung; Kim, Bong Soo; Bae, Sang Hoon; Choi, Young Hee [Hallym University, Chuncheon (Korea, Republic of)

2001-12-01

Phlegmonous enteritis is a rare infective inflammatory disease of the intestine, predominantly involving the submucosal layer. It is difficult to diagnose and often fatal. Its association with alcoholism and various liver diseases, although rarely reported, is well documented. We report a case of phlegmonous enteritis in a male patient with congestive heart failure and colon cancer, and describe the ultrasonographic and CT findings.

Environmental change and enteric zoonoses in New Zealand: a systematic review of the evidence.

Science.gov (United States)

Lal, Aparna; Lill, Adrian W T; Mcintyre, Mary; Hales, Simon; Baker, Michael G; French, Nigel P

2015-02-01

To review the available evidence that examines the association between climatic and agricultural land use factors and the risks of enteric zoonoses in humans and consider information needs and possible pathways of intervention. The electronic databases PubMed, Web of Science and Embase and government websites were searched systematically for published literature that investigated the association of climatic and/or agricultural exposures with the incidence of the four most common enteric zoonotic diseases in New Zealand (campylobacteriosis, salmonellosis, cryptosporidiosis and giardiasis). Results The 16 studies in the review demonstrated significant associations between climate, agricultural land use and enteric disease occurrence. The evidence suggests that enteric disease risk from environmental reservoirs is pathogen specific. In some rural regions, environmental pathogen load is considerable, with multiple opportunities for zoonotic transmission. Enteric disease occurrence in NZ is associated with climate variability and agricultural land use. However, these relationships interact with demographic factors to influence disease patterns. Improved understanding of how environmental and social factors interact can inform effective public health interventions under scenarios of projected environmental change. © 2014 Public Health Association of Australia.

Lupus enteritis: from clinical findings to therapeutic management

Science.gov (United States)

2013-01-01

Lupus enteritis is a rare and poorly understood cause of abdominal pain in patients with systemic lupus erythematosus (SLE). In this study, we report a series of 7 new patients with this rare condition who were referred to French tertiary care centers and perform a systematic literature review of SLE cases fulfilling the revised ACR criteria, with evidence for small bowel involvement, excluding those with infectious enteritis. We describe the characteristics of 143 previously published and 7 new cases. Clinical symptoms mostly included abdominal pain (97%), vomiting (42%), diarrhea (32%) and fever (20%). Laboratory features mostly reflected lupus activity: low complement levels (88%), anemia (52%), leukocytopenia or lymphocytopenia (40%) and thrombocytopenia (21%). Median CRP level was 2.0 mg/dL (range 0–8.2 mg/dL). Proteinuria was present in 47% of cases. Imaging studies revealed bowel wall edema (95%), ascites (78%), the characteristic target sign (71%), mesenteric abnormalities (71%) and bowel dilatation (24%). Only 9 patients (6%) had histologically confirmed vasculitis. All patients received corticosteroids as a first-line therapy, with additional immunosuppressants administered either from the initial episode or only in case of relapse (recurrence rate: 25%). Seven percent developed intestinal necrosis or perforation, yielding a mortality rate of 2.7%. Altogether, lupus enteritis is a poorly known cause of abdominal pain in SLE patients, with distinct clinical and therapeutic features. The disease may evolve to intestinal necrosis and perforation if untreated. Adding with this an excellent steroid responsiveness, timely diagnosis becomes primordial for the adequate management of this rare entity. PMID:23642042

Comparación entre encuestas telefónicas y encuestas «cara a cara» domiciliarias en la estimación de hábitos de salud y prácticas preventivas Telephone versus face-to-face household interviews in the assessment of health behaviors and preventive practices

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Iñaki Galán

2004-12-01

Full Text Available Objetivo: En este estudio se examina la influencia del método de encuesta, telefónica y «cara a cara» domiciliaria, sobre la estimación de los factores de riesgo para la salud asociados al comportamiento y la realización de prácticas preventivas. Material y método: El mismo cuestionario fue administrado en 2 muestras independientes de población de 18-64 años residente en el municipio de Madrid. Una muestra (n = 1.391 realizó la entrevista telefónica y la otra (n = 739, la entrevista «cara a cara» domiciliaria. Se compararon los resultados de las 2 muestras para 28 variables relacionadas con la antropometría, la actividad física, el consumo de alimentos, el consumo de tabaco y alcohol, las prácticas preventivas y la accidentabilidad. Resultados: La muestra telefónica obtuvo una mayor tasa de no contactos (31,8 frente a 22,2% pero un mayor grado de cooperación que la muestra con entrevista «cara a cara» (83 frente a 74%. En total, 19 de las 28 variables mostraron una variación relativa entre ambas encuestas Objective: This study examines the influence of the interview method (telephone or face-to-face in households on the assessment of health behaviors and preventive practices. Material and method: The same questionnaire was completed by two independent samples of the population aged 18-64 years living in the municipality of Madrid. One sample (n = 1,391 subjects completed the questionnaire by telephone interview and the other (n = 739 by face-to-face interview in households. The results of the two samples for 28 variables related to anthropometry, physical activity, food consumption, tobacco and alcohol use, preventive practices and injuries were compared. Results: The telephone sample had a higher rate of failed contact (31.8% vs. 22.2% but a greater degree of cooperation than the sample for the face-to-face interview (83.0% vs. 74.0%. In total, 19 of the 28 variables showed a relative variation of less than 10% between the

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

Science.gov (United States)

AKBULUT, GAMZE

2011-01-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. PMID:22977559

Persistence of enteric viruses within oysters (Crassostrea virginica)

Science.gov (United States)

It is well known that water-borne enteric viruses are concentrated by bivalves. Why these viruses are selectively retained and remain infectious within shellfish tissues for extended periods is unknown. Our current hypothesis is that phagocytic hemocytes (blood cells) are a site of virus persiste...

9 CFR 355.21 - Products entering inspected plants.

Science.gov (United States)

2010-01-01

... INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER CARNIVORA; INSPECTION... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Products entering inspected plants. 355.21 Section 355.21 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF...

Enteric neurons show a primary cilium.

Science.gov (United States)

Luesma, Ma José; Cantarero, Irene; Castiella, Tomás; Soriano, Mario; Garcia-Verdugo, José Manuel; Junquera, Concepción

2013-01-01

The primary cilium is a non-motile cilium whose structure is 9+0. It is involved in co-ordinating cellular signal transduction pathways, developmental processes and tissue homeostasis. Defects in the structure or function of the primary cilium underlie numerous human diseases, collectively termed ciliopathies. The presence of single cilia in the central nervous system (CNS) is well documented, including some choroid plexus cells, neural stem cells, neurons and astrocytes, but the presence of primary cilia in differentiated neurons of the enteric nervous system (ENS) has not yet been described in mammals to the best of our knowledge. The enteric nervous system closely resembles the central nervous system. In fact, the ultrastructure of the ENS is more similar to the CNS ultrastructure than to the rest of the peripheral nervous system. This research work describes for the first time the ultrastructural characteristics of the single cilium in neurons of rat duodenum myenteric plexus, and reviews the cilium function in the CNS to propose the possible role of cilia in the ENS cells. © 2012 The Authors. Published by Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Enteral nutrition practices in the intensive care unit: Understanding of nursing practices and perspectives

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Babita Gupta

2012-01-01

Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding

A Comparative Study of Recent Trends and Characteristics of Students Entering American Junior Colleges, 1968-72.

Science.gov (United States)

Fenske, Robert H.; Scott, Craig S.

Recent changes in the background characteristics and attributes of students entering American junior colleges are compared with those of students entering colleges offering baccalaureate and graduate degrees. Comparisons are also made between students entering private and public junior colleges. The characteristics and attributes are: Level of…

Microbiological quality and safe handling of enteral diets in a hospital in Minas Gerais, Brazil.

Science.gov (United States)

Pinto, Raquel Oliveira Medrado; Correia, Eliznara Fernades; Pereira, Keyla Carvalho; Costa Sobrinho, Paulo de Souza; da Silva, Daniele Ferreira

2015-06-01

Contamination of enteral diets represents a high risk of compromising the patient's medical condition. To assess the microbiological quality and aseptic conditions in the preparation and administration of handmade and industrialized enteral diets offered in a hospital in the Valley of Jequitinhonha, MG, Brazil, we performed a microbiological analysis of 50 samples of diets and 27 samples of surfaces, utensils, and water used in the preparation of the diets. In addition, we assessed the good handling practices of enteral diets according to the requirements specified by the Brazilian legislation. Both kinds of enteral diets showed contamination by coliforms and Pseudomonas spp. No sample was positive for Staphylococcus aureus and Salmonella spp. On the other hand, Listeria spp. was detected in only one sample of handmade diets. Contamination was significantly higher in the handmade preparations (p Nonconformities were detected with respect to good handling practices, which may compromise the diet safety. The results indicate that the sanitary quality of the enteral diets is unsatisfactory, especially handmade diets. Contamination by Pseudomonas spp. is significant because it is often involved in infection episodes. With regard to aseptic practices, it was observed the need of implementing new procedures for handling enteral diets.

Enteric glial cells and their role in gastrointestinal motor abnormalities: Introducing the neuro-gliopathies

Institute of Scientific and Technical Information of China (English)

Gabrio Bassotti; Vincenzo Villanacci; Simona Fisogni; Elisa Rossi; Paola Baronio; Carlo Clerici; Christoph A Maurer; Gieri Cathomas; Elisabetta Antonelli

2007-01-01

The role of enteric glial cells has somewhat changed from that of mere mechanical support elements, gluing together the various components of the enteric nervous system, to that of active participants in the complex interrelationships of the gut motor and inflammatory events. Due to their multiple functions, spanning from supporting elements in the myenteric plexuses to neurotransmitters, to neuronal homeostasis, to antigen presenting cells, this cell population has probably more intriguing abilities than previously thought. Recently,some evidence has been accumulating that shows how these cells may be involved in the pathophysiological aspects of some diseases. This review will deal with the properties of the enteric glial cells more strictly related to gastrointestinal motor function and the human pathological conditions in which these cells may play a role, suggesting the possibility of enteric neurogliopathies.

Celulitis por citomegalovirus Cytomegalovirus cellulitis

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A. Ruiz Lascano

2002-12-01

Full Text Available Las lesiones cutáneas por citomegalovirus (CMV son infrecuentes y a menudo una manifestación tardía de una enfermedad sistémica, que generalmente anuncia un curso fatal. Comunicamos un caso de celulitis por CMV: una mujer de 70 años con trasplante renal efectuado 1 mes antes de la consulta, terapia inmunosupresora con ciclosporina A y metilprednisona. La paciente ingresó por fiebre, dolor e impotencia funcional en pierna derecha. Comprobamos la existencia de una placa de 8 por 4 cm eritematoedematosa. La tratamos con antibióticos sin mejoría, por lo que realizamos un estudio histopatológico de piel que mostró cambios citopáticos compatibles con infección por CMV. Los cultivos bacteriológicos y micológicos fueron negativos. La inmunohistoquímica específica para CMV y el estudio de reacción en cadena de la polimerasa (PCR de la biopsia de piel fueron positivas, al igual que la antigenemia. El tratamiento con ganciclovir produjo la mejoría del cuadro clínico. En la literatura revisada no hemos encontrado la celulitis como manifestación de enfermedad cutánea por CMV.Cutaneous lesions in CMV infection are rare, often a late manifestation of systemic infection, and usually herald a fatal course. A 70 year-old woman received a kidney transplantation one month before consulting and immunosuppressive therapy that included cyclosporine A and methylprednisone. She complained of fever, local pain in her right leg, and an erythematous and swelling plaque. She was treated with intravenous antibiotics without improvement. A skin biopsy was performed and the tissue obtained was sent for bacterial and fungal cultures as well as for histological examination. Cultures were negative. The biopsy showed CMV cytopathic changes. Immunoperoxidase staining was positive for CMV and polymerase chain reaction (PCR testing revealed CMV DNA. She was treated with ganciclovir with resolution of the lesion. CMV cellulitis is a rare cutaneous manifestation

Selective grazing by protists upon enteric bacteria in an aquatic system Predación selectiva de bacterias entéricas por protistas en un ambiente acuático

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María S Domínguez

2012-03-01

Full Text Available It is well known that protozoan grazing can be an important agent of mortality for suspended bacteria, both in marine and freshwater environments. Considering that the presence of fecal contamination is a frequent phenomenon in tríese environments, and that Escherichia coli and the genus Enterococcus are indicators of microbiological water quality, the effect of protozoan grazing on E. coli and Enterococcus faecalis in Los Padres Lagoon waters (Buenos Aires, Argentina, 37° 56'30" S, 57° 44'30" W was herein analyzed. Microcosm assays were carried out, simulating lacustrine conditions, confronting suspensions of autochthonous bacterivorous protozoans with suspensions of autochthonous and collection strains of E. coli and E. faecalis, combined and individually. Daily counts were made for evaluating bacterial survival and the number of ciliates. The results obtained indicate that there is a preferential sequence for bacterial removal in the water, where E. faecalis is more grazing-resistant than E. coli. Moreover, it was noted that the origin of bacterial strains influenced their sensitivity for grazing, at least in the short term (e.g. the collection strains were less affected. We conclude that protozoan grazing can modify the relative abundance of fecal indicator microorganisms, thus altering the results of water quality studies.Está bien establecido que la predación por protozoos puede ser un factor importante de mortalidad para las bacterias en suspensión, tanto en ambientes marinos como de agua dulce. Considerando que la contaminación fecal es un fenómeno frecuentemente observado en estos ambientes, y que Escherichia coli y miembros del género Enterococcus son indicadores de calidad microbiológica del agua, se analizó el efecto de la predación por protozoos sobre E. coli y Enterococcus faecalis en aguas de la Laguna de los Padres (Buenos Aires, Argentina, 37° 56'30" S, 57° 44'30" W. Se realizaron ensayos a microcosmos, simulando

[Croatian guidelines for perioperative enteral nutrition of surgical patients].

Science.gov (United States)

Zelić, Marko; Bender, Darija Vranesić; Kelecić, Dina Ljubas; Zupan, Zeljko; Cicvarić, Tedi; Maldini, Branka; Durut, Iva; Rahelić, Velimir; Skegro, Mate; Majerović, Mate; Perko, Zdravko; Sustić, Alan; Madzar, Tomislav; Kovacić, Borna; Kekez, Tihomir; Krznarić, Zeljko

2014-01-01

Nutritional status of patients significantly affects the outcome of surgical treatment, whether it's about being obese or malnutrition with loss of muscle mass. Inadequate nutritional support in the perioperative period compromises surgical procedures even in patients who are adequately nourished. In this paper, particular attention was paid to malnourished patients, and their incidence in population hospitalized in surgical wards can be high up to 30%. Special emphasis was paid to the appropriateness of preoperative fasting and to the acceptance of new knowledge in this area of treatment. The aim of this working group was to make guidelines for perioperative nutritional support with different modalities of enteral nutrition. The development of these guidelines was attended by representatives of Croatian Medical Association: Croatian Society for Digestive Surgery, Croatian Society for Clinical Nutrition, Croatian Society of Surgery, Croatian Society for Endoscopic Surgery, Croatian Trauma Society and the Croatian Society of Anesthesiology and Intensive Care. The guidelines are designed as a set of questions that arise daily in clinical practice when preparing patients for surgery and after the surgical treatment, which relate to the assessment of nutritional status, perioperative nutritional support, duration of preoperative fasting period and the selection of food intake route. Assessment of nutritional status and the use of different modes of enteral nutrition should enter into standard protocols of diagnosis and treatment in the Croatian hospitals.

Can wheat bran mitigate malnutrition and enteric pathogens?

Science.gov (United States)

Child malnutrition is a complex global problem, of which lack of food is only one component. Enteric pathogens and malnutrition work in a cyclic manner to depress a child’s intestinal immunity, while decreasing nutrient absorption. This cycle leads to stunting, wasting, and death. Often malnourished...

Entering adulthood in a recession tempers later narcissism.

Science.gov (United States)

Bianchi, Emily C

2014-07-01

Despite widespread interest in narcissism, relatively little is known about the conditions that encourage or dampen it. Drawing on research showing that macroenvironmental conditions in emerging adulthood can leave a lasting imprint on attitudes and behaviors, I argue that people who enter adulthood during recessions are less likely to be narcissistic later in life than those who come of age in more prosperous times. Using large samples of American adults, Studies 1 and 2 showed that people who entered adulthood during worse economic times endorsed fewer narcissistic items as older adults. Study 3 extended these findings to a behavioral manifestation of narcissism: the relative pay of CEOs. CEOs who came of age in worse economic times paid themselves less relative to other top executives in their firms. These findings suggest that macroenvironmental experiences at a critical life stage can have lasting implications for how unique, special, and deserving people believe themselves to be. © The Author(s) 2014.

Enteral feeding via jejunostomy as a cause of intestinal perforation and necrosis

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María Victoria Vieiro-Medina

Full Text Available Background: Jejunostomy for enteral feeding is excellent for patients who cannot manage oral intake, with a low complication rate. A Foley catheter, Ryle tube, Kerh tube or needle-catheter (Jejuno-Cath® are commonly used. It is a safe procedure but it can lead to severe complications. Case report: We present two cases: firstly, an 80 year old male who was admitted to the Emergency Room with a bowel perforation secondary to Jejuno-Cath® for enteral feeding after a subtotal gastrectomy with Roux-en-Y reconstruction; and secondly, a 53 year old male who was admitted to the Emergency Room due to gastric perforation developing multiple complications, including bowel necrosis and enteral feeding impaction. Discussion: We have reviewed the recent literature with regard to this rare complication.

Tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional, 2000-2010

Directory of Open Access Journals (Sweden)

Cristian A. Herrera Riquelme

2015-01-01

Full Text Available Objetivo. Caracterizar la tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional en el período 2000-2010 en la población mayor de 20 años. Métodos. Cálculo de las tasas de mortalidad específica por cáncer ajustadas por edad para diferentes niveles educacionales (NE, para el período 2000-2010. Las tasas obtenidas se analizaron con un modelo de regresión de Poisson, calculando el índice de desigualdad relativa (IDR y el índice de desigualdad de la pendiente (IDP para cada año. Resultados. Se registraron 232 541 muertes por cáncer en el período 2000-2010. Los tipos de cáncer más frecuentes fueron de mama, estómago y vesícula biliar en mujeres; y estómago, próstata y pulmón en hombres. Las tasas de mortalidad por cáncer estandarizadas por edad fueron mayores en los NE más bajos, excepto para el de mama en mujer y el de pulmón en hombres. Las mayores diferencias se encontraron en el de vesícula biliar en mujeres y el de estómago en hombres, con mayores tasas de mortalidad específica de hasta 49 y 63 veces respectivamente, para NE bajo respecto al NE alto. Entre 2000 y 2010, las diferencias en mortalidad por NE se redujeron para todos los cánceres combinados en ambos géneros, mama en mujeres, y pulmón y estómago en hombres. Conclusiones. Durante el período estudiado, la mortalidad por cáncer en Chile estuvo fuertemente asociada al NE de la población. Esta información debe ser considerada al definir estrategias nacionales para reducir la mortalidad específica por cáncer en los grupos más desprotegidos.

Glucose, epithelium, and enteric nervous system: dialogue in the dark.

Science.gov (United States)

Pfannkuche, H; Gäbel, G

2009-06-01

The gastrointestinal epithelium is in close contact with the various components of the chymus, including nutrients, bacteria and toxins. The epithelial barrier has to decide which components are effectively absorbed and which components are extruded. In the small intestine, a nutrient like glucose is mainly absorbed by the sodium linked glucose cotransporter 1 (SGLT1) and the glucose transporter 2 (GLUT2). The expression and activity of both transport proteins is directly linked to the amount of intraluminal glucose. Besides the direct interaction between glucose and the enterocytes, glucose also stimulates different sensory mechanisms within the intestinal wall. The most important types of cells involved in the sensing of intraluminal contents are enteroendocrine cells and neurones of the enteric nervous system. Regarding glucosensing, a distinct type of enteroendocrine cells, the enterochromaffine (EC) cells are involved. Excitation of EC cells by intraluminal glucose results in the release of serotonin (5-HT), which modulates epithelial functions and activates enteric secretomotorneurones. Enteric neurones are not only activated by 5-HT, but also directly by glucose. The activation of different cell types and the subsequent crosstalk between these cells may trigger appropriate absorptive and secretory processes within the intestine.

Nurses' Competency and Challenges in Enteral feeding in the ...

African Journals Online (AJOL)

Studies have emphasised the role of nurses in nutritional support. .... Ethical consideration. The study was ... Mann-Whitney U test was applied to make associations ..... based guidelines and critical care nurses knowledge of enteral feeding.

Patient needs and research priorities in the enteral nutrition market - a quantitative prioritization analysis.

Science.gov (United States)

Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P

2014-10-01

A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they

Glutamine-enriched enteral diet increases renal arginine production

NARCIS (Netherlands)

Houdijk, A. P.; van Leeuwen, P. A.; Teerlink, T.; FLINKERBUSCH, E. L.; Boermeester, M. A.; Sauerwein, H. P.; Wesdorp, R. I.

1994-01-01

Arginine (Arg) is generated in the kidney by the conversion of circulating citrulline. The most important source for circulating citrulline is the metabolism of glutamine (Gln) by the gut. In this study, we investigated the influence of an enteral diet enriched with Gln on renal Arg synthesis in the

Antibiotic-Resistant Enteric Bacteria in Environmental Waters

OpenAIRE

Lisa M. Casanova; Mark D. Sobsey

2016-01-01

Sources of antibiotic resistant organisms, including concentrated animal feeding operations (CAFOs), may lead to environmental surface and groundwater contamination with resistant enteric bacteria of public health concern. The objective of this research is to determine whether Salmonella, Escherichia coli, Yersinia enterocolitica, and enterococci resistant to clinically relevant antibiotics are present in surface and groundwater sources in two eastern North Carolina counties, Craven and Wayne...

Re-entering fast ion effects on NBI heating power in high-beta plasmas of the Large Helical Device

International Nuclear Information System (INIS)

Seki, Ryosuke; Watanabe, Kiyomasa; Funaba, Hisamichi; Suzuki, Yasuhiro; Sakakibara, Satoru; Ohdachi, Satoshi; Matsumoto, Yutaka; Hamamatsu, Kiyotaka

2011-10-01

We calculate the heating power of the neutral beam injection (NBI) in the = 4.8% high-beta discharge achieved in the Large Helical Device (LHD). We investigate the difference of the heating efficiency and the heating power profile between with and without the re-entering fast ion effects. When the re-entering fast ion effects are taken into account, the heating efficiency in the co injection of the NBI (co-NBI case) is improved and it is about 1.8 times larger than that without the re-entering effects. In contrast, the heating efficiency with the re-entering effects in the counter injection of the NBI (ctr-NBI case) rarely differs from that without the re-entering ones. We also study the re-entering fast ion effects on the transport properties in the LHD high beta discharges. It is found that the tendency of the thermal conductivities on the beta value is not so much sensitive with and without the re-entering effects. In addition, we investigate the difference in the re-entering fast ion effects caused by the field strength and the magnetic configuration. In the co-NBI case, the re-entering fast ion effects on the heating efficiency increases with the decrease of the field strength. In the contrast, the re-entering fast ion effects in the ctr-NBI case rarely differs by changing the field strength. (author)

Muerte materna por malaria grave por Plasmodium vivax

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Nancy Arróspide

Full Text Available Se presenta el caso de una mujer de 19 años con 29 semanas de gestación, procedente de Llumpe (Ancash con antecedentes de viajes a las localidades de Chanchamayo (Junín y Rinconada (Ancash. Ingresó al Hospital de Chacas (Ancash por presentar mal estado general, deshidratación, dificultad respiratoria, ictericia, sensación de alza térmica y dolor abdominal, tuvo reporte de: hemoparásitos 60% en frotis sanguíneo. Fue transferida al Hospital Ramos Guardia (Huaraz donde presentó mayor dificultad respiratoria, coluria, hematuria, disminución del débito urinario y reporte de Plasmodium (+, luego fue transferida al Hospital Cayetano Heredia (Lima donde ingresó a la Unidad de Cuidados Intensivos (UCI, con evolución a falla multiorgánica, óbito fetal y muerte materna. Se confirmó infección por Plasmodium vivax. Destacamos la importancia de mejorar nuestras capacidades de diagnóstico y manejo para brindar un tratamiento adecuado y oportuno.

Drug Resistance and Pseudoresistance: An Unintended Consequence of Enteric Coating Aspirin

Science.gov (United States)

Grosser, Tilo; Fries, Susanne; Lawson, John A.; Kapoor, Shiv C.; Grant, Gregory R.; FitzGerald, Garret A.

2013-01-01

Background Low dose aspirin reduces the secondary incidence of myocardial infarction and stroke. Drug resistance to aspirin might result in treatment failure. Despite this concern, no clear definition of “aspirin resistance” has emerged and estimates of its incidence have varied remarkably. We aimed to determine the commonality of a mechanistically consistent, stable and specific phenotype of true pharmacological resistance to aspirin – such as might be explained by genetic causes. Methods and Results Healthy volunteers (n=400) were screened for their response to a single oral dose of 325 mg immediate release or enteric coated aspirin. Response parameters reflected the activity of aspirin's molecular target, cyclooxygenase-1. Individuals who appeared “aspirin resistant” on one occasion underwent repeat testing and if still “resistant” were exposed to low dose enteric coated aspirin (81 mg) and clopidogrel (75 mg) for one week each. Variable absorption caused a high frequency of apparent resistance to a single dose of 325 mg enteric coated aspirin (up to 49%) but not to immediate release aspirin (0%). All individuals responded to aspirin upon repeated exposure, extension of the post dosing interval or addition of aspirin to their platelets ex vivo. Conclusions Pharmacological resistance to aspirin is rare; this study failed to identify a single case of true drug resistance. Pseudoresistance, reflecting delayed and reduced drug absorption, complicates enteric coated but not immediate release aspirin administration. Clinical Trial Registration Information clinicaltrials.gov. Identifier: NCT00948987. PMID:23212718

Transmesocolic double gastro-enteric fistulas due to ingestion of 28 magnets

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Adrian Surd

2018-05-01

Full Text Available Introduction: Accidental ingestion of magnetic foreign bodies has become more common due to increased availability of objects and toys with magnetic elements. The majority of them traverse the gastrointestinal system spontaneously without complication. However, ingestion of multiple magnets may require surgical resolution. Magnet ingestion usually does not cause serious complications, but in case of multiple magnet ingestion or ingestion of magnet and a metal object, it could cause intestinal obstruction, fistula formation or even perforation. Case report: We report case of a transmesocolic double gastro-enteric fistula formation following ingestion of 28 small magnets in a 17 months old boy. No history of foreign body ingestion could be obtained from parents therefore the patient was treated conservatively in a pediatric clinic for vomiting, dehydration, upper respiratory tract infection and suspicion of upper digestive tract bleeding. After 48 h he was sent in our clinic for surgical evaluation. Intraoperatively double transmesocolic gastro-enteric fistula was found. After separation of de gastric and enteral walls, resection of gastric wall and intestinal segment containing the two perforations was performed, followed by gastric suture in two layers and entero-enteric anastomosis. A total of 28 magnets were removed from the stomach and small intestine. Conclusion: Single magnet ingestion is treated as non-magnetic foreign body. Multiple magnet ingestion should be closely monitored and surgical approach could be the best option to prevent or to cure its complications. Keywords: Ingestion, Magnetic foreign body, Multiple magnets, Intestinal fistula, Children

Transgastrostomy jejunal intubation for enteric alimentation.

Science.gov (United States)

McLean, G K; Rombeau, J L; Caldwell, M D; Ring, E J; Freiman, D B

1982-12-01

Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.

Microbiological quality and safe handling of enteral diets in a hospital in Minas Gerais, Brazil

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Raquel Oliveira Medrado Pinto

2015-06-01

Full Text Available Contamination of enteral diets represents a high risk of compromising the patient's medical condition. To assess the microbiological quality and aseptic conditions in the preparation and administration of handmade and industrialized enteral diets offered in a hospital in the Valley of Jequitinhonha, MG, Brazil, we performed a microbiological analysis of 50 samples of diets and 27 samples of surfaces, utensils, and water used in the preparation of the diets. In addition, we assessed the good handling practices of enteral diets according to the requirements specified by the Brazilian legislation. Both kinds of enteral diets showed contamination by coliforms and Pseudomonas spp. No sample was positive for Staphylococcus aureus and Salmonella spp. On the other hand, Listeria spp. was detected in only one sample of handmade diets. Contamination was significantly higher in the handmade preparations (p < 0.05. Nonconformities were detected with respect to good handling practices, which may compromise the diet safety. The results indicate that the sanitary quality of the enteral diets is unsatisfactory, especially handmade diets. Contamination by Pseudomonas spp. is significant because it is often involved in infection episodes. With regard to aseptic practices, it was observed the need of implementing new procedures for handling enteral diets.

Desenvolvimento de um kit de irrigação por microtubos com moto-bomba propulsionada por energia solar

OpenAIRE

Luiz Ricardo Sobenko

2016-01-01

O bombeamento de água por meio da energia solar vem se mostrando uma alternativa para localidades onde outras fontes de energia não estão disponíveis ou são limitadas. Torna-se interessante aliar essa alternativa a um sistema de irrigação que opera com vazão e pressão relativamente baixas, como a irrigação localizada por microtubos, possibilitando assim a obtenção de alta eficiência. No presente trabalho teve-se por objetivo dimensionar e avaliar um kit de irrigação por microtubos, alimentado...

Tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional, 2000-2010

OpenAIRE

Cristian A. Herrera Riquelme; Lucy Kuhn-Barrientos; Roberto Rosso Astorga; Jorge Jiménez de la Jara

2015-01-01

Objetivo. Caracterizar la tendencia de la mortalidad por cáncer en Chile según diferencias por nivel educacional en el período 2000-2010 en la población mayor de 20 años. Métodos. Cálculo de las tasas de mortalidad específica por cáncer ajustadas por edad para diferentes niveles educacionales (NE), para el período 2000-2010. Las tasas obtenidas se analizaron con un modelo de regresión de Poisson, calculando el índice de desigualdad relativa (IDR) y el índice de desigualdad de la pendiente (ID...

Polución por material particulado fino (PM 2,5) incrementa las hospitalizaciones por insuficiencia cardiaca

OpenAIRE

Castro, Pablo; Vera, Jeanette; Cifuentes, Luis; Wellenius, Gregory; Verdejo, Hugo; Sepúlveda, Luis; Vukasovic, José Luis; Llevaneras, Silvana

2010-01-01

Antecedentes: Estudios recientes han reportado una asociación entre la contaminación ambiental por material particulado (PM) y el riesgo de hospitalizaciones de pacientes con insuficiencia cardiaca (IC). La región metropolitana de nuestro país constituye un área geográfica en la cual la contaminación es especialmente relevante, asociándose a incrementos periódicos en la morbimortalidad por causa respiratoria. Sin embargo el efecto de la polución por PM en la morbilidad de pacientes con IC no ...

Pharmaceutical assistance in the enteral administration of drugs: choosing the appropriate pharmaceutical formulation

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Gisele de Lima

2009-03-01

Full Text Available Objective: To study solid medications for oral delivery on the formulary of Hospital Israelita Albert Einstein (HIAE, investigating the  possibility of using these drugs through enteral feeding tubes, and recommending appropriate administration. Methods: Study carried out through survey of solid medications for oral delivery included on the formulary of HIAE, literature review, and analysis of medication monographs, manufacturer information and pharmacotechnical data of active ingredients and excipients. It was observed the factors that might hinder or complicate the administration of these drugs though enteral tubes, and was drawn an information chart with recommendations about drug administration in this context. Rresults: The study evaluated 234 medications; and the main problems of administering these drugs through enteral feeding tubes were as follows: changes in drug pharmacokinetics (38; gastrointestinal damage (9; risk of obstruction (40, drug-nutrient interactions (7; biological hazards (5 and no information (33. Cconclusions: Compiling this information helps the healthcare team to choose the appropriate pharmaceutical formulation for medications administered through enteral tubes, and may help identify adverse events related to this technique.

Preparation and evaluation of enteric coated tablets of hot-melt extruded lansoprazole.

Science.gov (United States)

Alsulays, Bader B; Kulkarni, Vijay; Alshehri, Sultan M; Almutairy, Bjad K; Ashour, Eman A; Morott, Joseph T; Alshetaili, Abdullah S; Park, Jun-Bom; Tiwari, Roshan V; Repka, Michael A

2017-05-01

The objective of this work was to use hot-melt extrusion (HME) technology to improve the physiochemical properties of lansoprazole (LNS) to prepare stable enteric coated LNS tablets. For the extrusion process, we chose Kollidon ® 12 PF (K12) polymeric matrix. Lutrol ® F 68 was selected as the plasticizer and magnesium oxide (MgO) as the alkalizer. With or without the alkalizer, LNS at 10% drug load was extruded with K12 and F68. LNS changed to the amorphous phase and showed better release compared to that of the pure crystalline drug. Inclusion of MgO improved LNS extrudability and release and resulted in over 80% drug release in the buffer stage. Hot-melt extruded LNS was physically and chemically stable after 12 months of storage. Both formulations were studied for compatibility with Eudragit ® L100-55. The optimized formulation was compressed into a tablet followed by coating process utilizing a pan coater using L100-55 as an enteric coating polymer. In a two-step dissolution study, the release profile of the enteric coated LNS tablets in the acidic stage was less than 10% of the LNS, while that in the buffer stage was more than 80%. Drug content analysis revealed the LNS content to be 97%, indicating the chemical stability of the enteric coated tablet after storage for six months. HME, which has not been previously used for LNS, is a valuable technique to reduce processing time in the manufacture of enteric coated formulations of an acid-sensitive active pharmaceutical ingredient as compared to the existing methods.

Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

OpenAIRE

Yu-Chih Chen

2009-01-01

Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving a...

Eosinophilic enteritis – A diagnostic dilemma | Clegg-Lamptey ...

African Journals Online (AJOL)

It may mimic peptic ulcer, subacute (or chronic) intestinal obstruction, gastroenteritis, irritable bowel syndrome, and inflammatory bowel disease. The diagnosis is often ... Finalement laparotomy a revele des segments enflames de petit intestin, une biopsie de qui a montré Eosinophilic enteritis. Le malade a été traite par la ...

Toxin-mediated effects on the innate mucosal defenses: implications for enteric vaccines

DEFF Research Database (Denmark)

Glenn, Gregory M; Francis, David H; Danielsen, E Michael

2009-01-01

mucosal barrier as a key step in enteric pathogen survival. We review key observations relevant to the roles of LT and cholera toxin in protective immunity and the effects of these toxins on innate mucosal defenses. We suggest either that toxin-mediated fluid secretion mechanically disrupts the mucus...... layer or that toxins interfere with innate mucosal defenses by other means. Such a breach gives pathogens access to the enterocyte, leading to binding and pathogenicity by enterotoxigenic E. coli (ETEC) and other organisms. Given the common exposure to LT(+) ETEC by humans visiting or residing...... unexpectedly broad protective effects against LT(+) ETEC and mixed infections when using a toxin-based enteric vaccine. If toxins truly exert barrier-disruptive effects as a key step in pathogenesis, then a return to classic toxin-based vaccine strategies for enteric disease is warranted and can be expected...

Fitness levels and physical activity among class A drug users entering prison.

Science.gov (United States)

Fischer, Jan; Butt, Christine; Dawes, Helen; Foster, Charlie; Neale, Joanne; Plugge, Emma; Wheeler, Carly; Wright, Nat

2012-12-01

Physical activity could benefit drug users' physiological and mental health. Previous research has suggested that physical activity levels change when drug users enter prison. Twenty-five class A drug users who were new to prison answered physical activity and drug use cross-sectional questionnaires, took a submaximal fitness test and wore a pedometer for 1 week. Participants' mean aerobic capacity was estimated as 49 mls O2/kg/min (±12 SD). Their mean self-reported walking distance outside of prison was 4.67 miles on an average day (±4.14 SD). Pedometer data suggest they walked a mean of 1.8 miles/day in prison. Many class A drug users entering prison had high levels of fitness and physical activity before admission, often gained from walking. Walking activity reduced when they entered prison, posing a challenge to maintaining healthy activity levels.

Enteral peptide formulas inhibit radiation induced enteritis and apoptosis in intestinal epithelial cells and suppress the expression and function of Alzheimer's and cell division control gene products

International Nuclear Information System (INIS)

Cope, F.O.; Issinger, O.G.; McArdle, A.H.; Shapiro, J.; Tomei, L.D.

1991-01-01

Studies have shown that patients receiving enteral peptide formulas prior to irradiation have a significantly reduced incidence of enteritis and express a profound increase in intestinal cellularity. Two conceptual approaches were taken to describe this response. First was the evaluation in changes in programmed intestinal cell death and secondly the evaluation of a gene product controlling cell division cycling. This study provided a relationship between the ratio of cell death to cell formulations. The results indicate that in the canine and murine models, irradiation induces expression of the Alzheimer's gene in intestinal crypt cells, while the incidence of apoptosis in apical cells is significantly increased. The use of peptide enteral formulations suppresses the expression of the Alzheimer's gene in crypt cells, while apoptosis is eliminated in the apical cells of the intestine. Concomitantly, enteral peptide formulations suppress the function of the CK-II gene product in the basal and baso-lateral cells of the intestine. These data indicate that although the mitotic index is significantly reduced in enterocytes, this phenomenon alone is not sufficient to account for the peptide-induced radio-resistance of the intestine. The data also indicate a significant reduction of normal apoptosis in the upper lateral and apical cells of the intestinal villi. Thus, the ratio of cell death to cell replacement is significantly decreased resulting in an increase in villus height and hypertrophy of the apical villus cells. Thus, peptide solutions should be considered as an adjunct treatment both in radio- and chemotherapy

Problems experienced by women re-entering the education profession

African Journals Online (AJOL)

Problems experienced by women re-entering the education profession: a South ... in maternity benefits, as well as the introduction of paternity and childcare leave, should be introduced to assist women educators to combine work and family ...

Comparing Entering Freshmen's Perceptions of Campus Marijuana and Alcohol Use to Reported Use

Science.gov (United States)

Gold, Gregg J.; Nguyen, Alyssa T.

2009-01-01

Use of marijuana and alcohol among current college students (N = 1101) was compared to the perceptions and use of entering freshmen (N = 481) surveyed before the start of classes. Entering freshmen significantly misperceived campus norms for marijuana use, over-estimating that almost every student used in the last 30 days, p less than 0.001.…

Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae

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Smith Craig

2009-09-01

Full Text Available Abstract Background The objective of this study was to determine whether neonatal nasogastric enteral feeding tubes are colonised by the opportunistic pathogen Cronobacter spp. (Enterobacter sakazakii and other Enterobacteriaceae, and whether their presence was influenced by the feeding regime. Methods One hundred and twenty-nine tubes were collected from two neonatal intensive care units (NICU. A questionnaire on feeding regime was completed with each sample. Enterobacteriaceae present in the tubes were identified using conventional and molecular methods, and their antibiograms determined. Results The neonates were fed breast milk (16%, fortified breast milk (28%, ready to feed formula (20%, reconstituted powdered infant formula (PIF, 6%, or a mixture of these (21%. Eight percent of tubes were received from neonates who were 'nil by mouth'. Organisms were isolated from 76% of enteral feeding tubes as a biofilm (up to 107 cfu/tube from neonates fed fortified breast milk and reconstituted PIF and in the residual lumen liquid (up to 107 Enterobacteriaceae cfu/ml, average volume 250 μl. The most common isolates were Enterobacter cancerogenus (41%, Serratia marcescens (36%, E. hormaechei (33%, Escherichia coli (29%, Klebsiella pneumoniae (25%, Raoultella terrigena (10%, and S. liquefaciens (12%. Other organisms isolated included C. sakazakii (2%,Yersinia enterocolitica (1%,Citrobacter freundii (1%, E. vulneris (1%, Pseudomonas fluorescens (1%, and P. luteola (1%. The enteral feeding tubes were in place between 48 h (13%. All the S. marcescens isolates from the enteral feeding tubes were resistant to amoxicillin and co-amoxiclav. Of additional importance was that a quarter of E. hormaechei isolates were resistant to the 3rd generation cephalosporins ceftazidime and cefotaxime. During the period of the study, K. pneumoniae and S. marcescens caused infections in the two NICUs. Conclusion This study shows that neonatal enteral feeding tubes

Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

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Maria Gabriella Gentile

2012-09-01

Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

Síndrome de Munchausen por mandato

OpenAIRE

Esteban, Miguel A.; Pérez, Miriam R.; Bracco, Anahí

2006-01-01

El Síndrome de Munchausen por mandato, "un trastorno ficticio, por el cual la enfermedad del niño es inducida, promovida o provocada por la persona más próxima a él, generalmente su madre", es todavía mal conocido y su génesis imperfectamente comprendida. Esta comunicación está destinada a esclarecer al pediatra esta patología, con elevada morbilidad y secuelas, como así también de altísima mo...

Interaction of Human Enterochromaffin Cells with Human Enteric Adenovirus 41 Leads to Serotonin Release and Subsequent Activation of Enteric Glia Cells.

Science.gov (United States)

Westerberg, Sonja; Hagbom, Marie; Rajan, Anandi; Loitto, Vesa; Persson, B David; Allard, Annika; Nordgren, Johan; Sharma, Sumit; Magnusson, Karl-Eric; Arnberg, Niklas; Svensson, Lennart

2018-04-01

Human adenovirus 41 (HAdV-41) causes acute gastroenteritis in young children. The main characteristics of HAdV-41 infection are diarrhea and vomiting. Nevertheless, the precise mechanism of HAdV-41-induced diarrhea is unknown, as a suitable small-animal model has not been described. In this study, we used the human midgut carcinoid cell line GOT1 to investigate the effect of HAdV-41 infection and the individual HAdV-41 capsid proteins on serotonin release by enterochromaffin cells and on enteric glia cell (EGC) activation. We first determined that HAdV-41 could infect the enterochromaffin cells. Immunofluorescence staining revealed that the cells expressed HAdV-41-specific coxsackievirus and adenovirus receptor (CAR); flow cytometry analysis supported these findings. HAdV-41 infection of the enterochromaffin cells induced serotonin secretion dose dependently. In contrast, control infection with HAdV-5 did not induce serotonin secretion in the cells. Confocal microscopy studies of enterochromaffin cells infected with HAdV-41 revealed decreased serotonin immunofluorescence compared to that in uninfected cells. Incubation of the enterochromaffin cells with purified HAdV-41 short fiber knob and hexon proteins increased the serotonin levels in the harvested cell supernatant significantly. HAdV-41 infection could also activate EGCs, as shown in the significantly altered expression of glia fibrillary acidic protein (GFAP) in EGCs incubated with HAdV-41. The EGCs were also activated by serotonin alone, as shown in the significantly increased GFAP staining intensity. Likewise, EGCs were activated by the cell supernatant of HAdV-41-infected enterochromaffin cells. IMPORTANCE The nonenveloped human adenovirus 41 causes diarrhea, vomiting, dehydration, and low-grade fever mainly in children under 2 years of age. Even though acute gastroenteritis is well described, how human adenovirus 41 causes diarrhea is unknown. In our study, we analyzed the effect of human adenovirus 41

Enteric Viruses in Raw Vegetables and Groundwater Used for Irrigation in South Korea▿

Science.gov (United States)

Cheong, Sooryun; Lee, Cheonghoon; Song, Sung Won; Choi, Weon Cheon; Lee, Chan Hee; Kim, Sang-Jong

2009-01-01

Raw vegetables irrigated with groundwater that may contain enteric viruses can be associated with food-borne viral disease outbreaks. In this study, we performed reverse transcription-PCR (RT-PCR) and cell culture-PCR to monitor the occurrence of enteric viruses in groundwater samples and in raw vegetables that were cultivated using that groundwater in South Korea. Samples were collected 10 times from three farms located in Gyeonggi Province, South Korea. RT-PCR and cell culture-PCR were performed to detect adenoviruses (AdVs), enteroviruses (EVs), noroviruses (NoVs), and rotaviruses, followed by sequence analyses of the detected strains. Of the 29 groundwater samples and the 30 vegetable samples, five (17%) and three (10%) were positive for enteric viruses, respectively. AdVs were the most frequently detected viruses in four groundwater and three vegetable samples. EVs and NoVs were detected in only one groundwater sample and one spinach sample, respectively. The occurrence of enteric viruses in groundwater and vegetable samples was not correlated with the water temperature and the levels of indicator bacteria, respectively. Phylogenetic analysis indicated that most of the detected AdVs were temporally distributed, irrespective of sample type. Our results indicate that raw vegetables may be contaminated with a broad range of enteric viruses, which may originate from virus-infected farmers and virus-contaminated irrigation water, and these vegetables may act as a potential vector of food-borne viral transmission. PMID:19854919

DESGASTE POR ABRASIÓN DEL ACERO API 5L X65 REVESTIDO CON NIOBIO POR ASPERSIÓN TÉRMICA A PLASMA Y CON INCONEL 625 POR SOLDADURA

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JOSE MATOS

2012-01-01

Full Text Available El objetivo de este trabajo fue evaluar y caracterizar el comportamiento mecánico en desgaste del acero API 5L X65, revestido con niobio en comparación al desempeño del revestimiento de la aleación de inconel 625 empleados en la industria de petróleo y gas. El revestimiento de niobio fue obtenido por el proceso de aspersión térmica a plasma de arco no transferido y el revestimiento inconel 625 por soldadura con electrodo revestido. La resistencia al desgaste por abrasión fue evaluada según la norma Petrobras N-2568, en un tribómetro CTER, la rugosidad y el volumen de material desgastado se determinó a través de perfilometría y la dureza de los revestimientos por microscopia Vickers. Los revestimientos obtenidos fueron caracterizados respecto a su morfología por microscopia electrónica de barrido (MEB y microscopía óptica (MO. La mayor dureza del revestimiento con niobio obtenido puede haber contribuido a reducir la tasa de desgaste en comparación con el revestimiento de inconel 625.

Scheme for Entering Binary Data Into a Quantum Computer

Science.gov (United States)

Williams, Colin

2005-01-01

A quantum algorithm provides for the encoding of an exponentially large number of classical data bits by use of a smaller (polynomially large) number of quantum bits (qubits). The development of this algorithm was prompted by the need, heretofore not satisfied, for a means of entering real-world binary data into a quantum computer. The data format provided by this algorithm is suitable for subsequent ultrafast quantum processing of the entered data. Potential applications lie in disciplines (e.g., genomics) in which one needs to search for matches between parts of very long sequences of data. For example, the algorithm could be used to encode the N-bit-long human genome in only log2N qubits. The resulting log2N-qubit state could then be used for subsequent quantum data processing - for example, to perform rapid comparisons of sequences.

Study on the relationship between infant rotavirus enteritis and breast feeding

International Nuclear Information System (INIS)

Chen Yanping; Liu Hui; Sun Xuerong; Wei Tao; Wang Bin

2005-01-01

Objective: To study the relationship between infant rotavirus enteritis and breast feeding, with emphasis on early immuno-protection provided by breast feeding as well as later possible hazards with rotavirus carrier mothers. Methods: Stool specimens from 520 infants with diarrhea were screened for rotavirus with colloid gold method. Positive specimens were confirmed with RT-PCR. Results: In local (Qingdao) infants with enteritis, the over-all incidence of rotavirus infection was 31.2%. Positive rate in breast-feeding infants was only 26.8%, being significantly lower than that in bottle-feeding ones (45.2%). The virus infectivity rate in both groups of breast- feeding infants (below 6 months and 7-12 months) was lower than the corresponding rate in the bottle feeding group. However, infant fed from rotavirus carriers had significantly higher fecal positive rate of rotavirus than that in infants fed from non-carriers. Conclusion: (1) At beginning, especially below 6 months, breast-feeding provided important protection again rotavirus enteritis in the infants. (2) certain infections could be transmitted through breast feedings, which deserved closer observation. (authors)

Clinical review: optimizing enteral nutrition for critically ill patients - a simple data-driven formula

Science.gov (United States)

2011-01-01

In modern critical care, the paradigm of 'therapeutic nutrition' is replacing traditional 'supportive nutrition'. Standard enteral formulas meet basic macro- and micronutrient needs; therapeutic enteral formulas meet these basic needs and also contain specific pharmaconutrients that may attenuate hyperinflammatory responses, enhance the immune responses to infection, or improve gastrointestinal tolerance. Choosing the right enteral feeding formula may positively affect a patient's outcome; targeted use of therapeutic formulas can reduce the incidence of infectious complications, shorten lengths of stay in the ICU and in the hospital, and lower risk for mortality. In this paper, we review principles of how to feed (enteral, parenteral, or both) and when to feed (early versus delayed start) patients who are critically ill. We discuss what to feed these patients in the context of specific pharmaconutrients in specialized feeding formulations, that is, arginine, glutamine, antioxidants, certain ω-3 and ω-6 fatty acids, hydrolyzed proteins, and medium-chain triglycerides. We summarize current expert guidelines for nutrition in patients with critical illness, and we present specific clinical evidence on the use of enteral formulas supplemented with anti-inflammatory or immune-modulating nutrients, and gastrointestinal tolerance-promoting nutritional formulas. Finally, we introduce an algorithm to help bedside clinicians make data-driven feeding decisions for patients with critical illness. PMID:22136305

CARACTERÍSTICAS DA VIOLÊNCIA SEXUAL SOFRIDA POR CRIANÇAS ASSISTIDAS POR UM PROGRAMA DE APOIO

OpenAIRE

KELLY LINHARES VASCONCELOS; ADRIANA GOMES NOGUEIRA FERREIRA; ELIANY NAZARÉ OLIVEIRA; DANIELLE D\\u2019ÁVILA SIQUEIRA; PATRÍCIA NEYVA DA COSTA PINHEIRO

2010-01-01

En Brasil, las estadísticas de la violencia sexual contra niños están lejos de reflejar la verdadera realidad actual debido a la baja notificación de los casos. La finalidad de este estudio fue caracterizar el abuso sexual sufrido por niños asistidos por el Programa Sentinela y el perfil del agresor, en Sobral-Ceará, en el periodo que va del 2002 al 2006. La muestra no probabilística intencional fue compuesta por 50 víctimas de abuso sexual y de las mismas, el 66% es del sexo femenino, con pr...

Enteric Protozoa in the Developed World: a Public Health Perspective

Science.gov (United States)

Fletcher, Stephanie M.; Stark, Damien; Harkness, John

2012-01-01

Summary: Several enteric protozoa cause severe morbidity and mortality in both humans and animals worldwide. In developed settings, enteric protozoa are often ignored as a cause of diarrheal illness due to better hygiene conditions, and as such, very little effort is used toward laboratory diagnosis. Although these protozoa contribute to the high burden of infectious diseases, estimates of their true prevalence are sometimes affected by the lack of sensitive diagnostic techniques to detect them in clinical and environmental specimens. Despite recent advances in the epidemiology, molecular biology, and treatment of protozoan illnesses, gaps in knowledge still exist, requiring further research. There is evidence that climate-related changes will contribute to their burden due to displacement of ecosystems and human and animal populations, increases in atmospheric temperature, flooding and other environmental conditions suitable for transmission, and the need for the reuse of alternative water sources to meet growing population needs. This review discusses the common enteric protozoa from a public health perspective, highlighting their epidemiology, modes of transmission, prevention, and control. It also discusses the potential impact of climate changes on their epidemiology and the issues surrounding waterborne transmission and suggests a multidisciplinary approach to their prevention and control. PMID:22763633

Abdome agudo por obstrução por ileobiliar

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Márcia Cristina de Alencastro

Full Text Available OBJETIVO: descrever a experiência na abordagem dos doentes com abdome agudo por obstrução por IB, desde o diagnóstico até o tratamento definitivo. MÉTODOS: estudo retrospectivo incluindo todos os casos de IB tratados em um período de 23 anos. De acordo com a abordagem cirúrgica realizada, os pacientes foram divididos em dois grupos (1 enterolitotomia com colecistectomia no segundo momento; e (2 enterolitotomia, colecistectomia e abordagem da fístula. RESULTADOS: Doze pacientes foram incluídos, sendo 11 mulheres (91,6%, com média de idade de 72,2 anos. Todos os pacientes apresentavam doenças associadas, principalmente hipertensão arterial sistêmica (75%. Dois pacientes não apresentavam sintomas significativos de obstrução intestinal. O diagnóstico de IB foi realizado em seis pacientes (50% antes da laparotomia. O grupo 1 foi constituído de oito pacientes e o grupo 2 de quatro, e a morbidade foi, respectivamente, 33,3% e 8,3%. A mortalidade foi 16,6% (um paciente de cada grupo. CONCLUSÃO: O manejo do IB deve ser individualizado. O tratamento da obstrução mediante remoção do cálculo biliar por enterotomia proximal é a escolha inicial para o tratamento do IB. A colecistectomia e a correção da fístula bilioentérica podem ser realizadas juntamente com a remoção do cálculo, no entanto, em pacientes com comorbidades significativas, esses procedimentos devem ser realizados posteriormente.

Entering the lesbian world in Japan: debut stories.

Science.gov (United States)

Kamano, Saori

2005-01-01

Conceiving of a "lesbian community" as the process and/or the end product of a lesbian's going outside herself or her intimate relationship to connect with other lesbians, this paper explores the experiences of lesbians in entering the community in Tokyo, Japan, which lesbians refer to as "community debut." Based on the personal accounts gathered through interviewing 24 women in 2002 in the Tokyo area, this paper examines the personal contexts in which the women entered a lesbian community, which included searching for and defining themselves, accepting themselves, and acting out the new identity to make changes in their lives. Some of the women interviewed were prompted by a need to understand themselves as lesbians. Others with a lesbian identity searched for further affirmation through connecting with "the world of lesbians" beyond their immediate contexts. For some other women interviewed, entering the community was a way to help them start their lives anew by getting out of their previous (married) lives. The paper also specifically touches on the significance of the Internet as a source of information for individual women and as a way of creating a lesbian community, identifying both positive and negative aspects. Although the research reported in this paper leaves for further exploration how boundaries of the communities are negotiated and drawn, the norms of the communities, and conflicts and negotiations among individuals and groups, it has provided one piece of the mosaic of lesbian communities in Japan. The communities, while still largely invisible in the mainstream society, are nonetheless an important part of life, albeit in different ways, of many lesbians. The research process leads the author to anticipate greater visibility of lesbians and lesbian communities in Japan in the not too distant future.

Enteric Micromotor Can Selectively Position and Spontaneously Propel in the Gastrointestinal Tract.

Science.gov (United States)

Li, Jinxing; Thamphiwatana, Soracha; Liu, Wenjuan; Esteban-Fernández de Ávila, Berta; Angsantikul, Pavimol; Sandraz, Elodie; Wang, Jianxing; Xu, Tailin; Soto, Fernando; Ramez, Valentin; Wang, Xiaolei; Gao, Weiwei; Zhang, Liangfang; Wang, Joseph

2016-09-22

The gastrointestinal (GI) tract, which hosts hundreds of bacteria species, becomes the most exciting organ for the emerging microbiome research. Some of these GI microbes are hostile and cause a variety of diseases. These bacteria colonize in different segments of the GI tract dependent on the local physicochemical and biological factors. Therefore, selectively locating therapeutic or imaging agents to specific GI segments is of significant importance for studying gut microbiome and treating various GI-related diseases. Herein, we demonstrate an enteric micromotor system capable of precise positioning and controllable retention in desired segments of the GI tract. These motors, consisting of magnesium-based tubular micromotors coated with an enteric polymer layer, act as a robust nanobiotechnology tool for site-specific GI delivery. The micromotors can deliver payload to a particular location via dissolution of their enteric coating to activate their propulsion at the target site toward localized tissue penetration and retention.

Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Fietkau, R. [Strahlentherapeutische Klinik und Poliklinik, Rostock Univ. (Germany)]|[Strahlentherapeutische Klinik und Poliklinik, Erlangen Univ. (Germany)

1998-11-01

Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [Deutsch] Hintergrund: Der Ernaehrungsstatus von Tumorpatienten ist haeufig bereits vor jeder antitumoroesen Therapie reduziert und kann sich durch die notwendige Radio(chemo)therapie weiter verschlechtern. Methode: Im Rahmen dieses Uebersichtsartikels werden die Moeglichkeiten und Risiken der enteralen und parenteralen Ernaehrung waehrend einer Radiotherapie besprochen. Die Indikationen der enteralen Ernaehrung werden anhand von eigenen Ergebnissen begruendet. Ergebnisse: Die Langzeiternaehrung wird am besten ueber einen enteralen Zugang durchgefuehrt. In einer prospektiven, nichtrandomisierten Studie konnten wir zeigen, dass eine enterale Ernaehrung mittels perkutaner endoskopisch kontrollierter Gastrostomie (PEG) nicht nur die anthropometrischen und biochemischen Parameter waehrend einer Radio(chemo)therapie verbessert, sondern auch die Lebensqualitaet. Eine weitere Moeglichkeit besteht in der

Incidence of gastric extubation of users in a home care program of a university hospital La incidencia de la extubación gástrica de los usuarios en el programa de atención domiciliaria en un hospital universitario Incidência de extubação gástrica dos usuários em um programa de assistência domiciliar de um hospital universitário

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Larissa Kozloff Naves

2012-06-01

pacientes con intubación gástrica para el aporte nutricional en la atención domiciliaria, forneciendo subsidios para el establecimiento de las metas asistenciales y de gestión para la mejora continua de la calidad.Trata-se de estudo quantitativo, prospectivo, que objetivou caracterizar o perfil de usuários e cuidadores e mensurar a incidência de extubação gástrica, identificando o tipo e os motivos das extubações desses usuários, em um Programa de Assistência Domiciliar de um hospital universitário. A população foi composta por 37 sujeitos e os dados foram coletados de abril a agosto de 2010. Para a análise, adotou-se estatística descritiva, teste de significância de 5% e cálculo de indicadores. Constatou-se que 51,4% dos usuários pertenciam ao sexo feminino, 67,5% na faixa etária >60 anos e 67,6% apresentavam doenças neurológicas. Quanto aos cuidadores, 89,2% eram do sexo feminino e média de idade de 50,6 anos. A incidência de extubação, considerando-se 100 dias de entubação, correspondeu a 1,08; sendo 0,26 planejadas e 0,82 não planejadas (p=0,009. Os achados permitiram calcular as taxas de extubações dos portadores de entubação gástrica, para aporte nutricional em assistência domiciliar, fornecendo subsídios no estabelecimento de metas assistenciais e gerenciais para a melhoria contínua da qualidade.

Effects of entering adulthood during a recession

OpenAIRE

Dettling, Lisa

2016-01-01

Current cohorts of young adults entered adulthood during an international labor and housing market crisis of a severity not experienced since the Great Depression. Concerns have arisen over the impacts on young adults’ employment, income, wealth, and living arrangements, and about whether these young adults constitute a “scarred generation” that will suffer permanent contractions in financial well-being. If true, knowing the mechanisms through which young adults’ finances have been affected h...

Ageing of enteric neurons: oxidative stress, neurotrophic factors and antioxidant enzymes

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Korsak Kris

2012-08-01

Full Text Available Abstract Background Ageing is associated with gastrointestinal dysfunction, which can have a major impact on quality of life of the elderly. A number of changes in the innervation of the gut during ageing have been reported, including neuronal loss and degenerative changes. Evidence indicates that reactive oxygen species (ROS are elevated in ageing enteric neurons, but that neurotrophic factors may reduce generation of neuronal ROS. Two such factors, glial cell line derived neurotrophic factor (GDNF and neurotrophin-3 (NT-3 have also been found to protect enteric neurons against oxidative stress induced cell death of enteric ganglion cells in vitro. We have investigated the possible roles of neurotrophic factors further, by examining their expression in the gut during ageing, and by analysing their effects on antioxidant enzyme production in cultures of enteric ganglion cells. Results Analysis of the expression of GDNF and its receptors c-Ret and GFR α − 1 in rat gut by RT-PCR showed that expression continues throughout life and into ageing, in both ad libitum(AL and calorically-restricted (CR animals. Levels of expression of GDNF and GFR α − 1 were elevated in 24 month AL animals compared to 24 month CR animals, and to 24 CR and 6 month control animals respectively. The related factor Neurturin and its receptor GFR α − 2 were also expressed throughout life, the levels of the GFR – α-2(b isoform were reduced in 24 m AL animals. Immunolabelling showed that c-Ret and GFR α − 1 proteins were expressed by myenteric neurons in ageing animals. GDNF, but not NT-3, was found to increase expression of Cu/Zn superoxide dismutase and catalase by cultured enteric ganglion cells. Conclusions The neurotrophic factors GDNF and neurturin and their receptors continue to be expressed in the ageing gut. Changes in the levels of expression of GDNF , GFR α-1 and GFR α-2(b isoform occurred in 24 m AL animals. GDNF, but not

Design and evaluation of enteric-coated tablets for rifampicin and isoniazid combinations.

Science.gov (United States)

Wang, Yongjun; Liu, Hongzhuo; Liu, Kai; Sun, Jin; He, Zhonggui

2013-01-01

In order to improve the bioavailability of rifampicin (RIF) from rifampicin and isoniazid (INH) combination formulations, the physicochemical characteristics of RIF, stability of RIF in different pH buffers in the presence of INH, as well as the effect of particle size of RIF materials on the dissolution rate were investigated. On the basis of the above examinations, enteric-coated tablets for RIF and INH combinations were designed and prepared. RIF showed low solubility and high apparent distribution coefficient in the intestinal pH (pH 4.0-7.4). With the decrease in pH, the degradation of RIF increase and the presence of INH deepen the degradation. Enteric-coated tablets were prepared after grinding the RIF materials by dry granulation technique. The pharmacokinetics of RIF and INH of self-made enteric-coated tablets in dogs were studied by comparing with the reference tablets. The AUC(0-48) of RIF in both reference and test tablets were 304.77 ± 42.27 and 353.79 ± 31.63 µg·h·mL(-1), respectively. The AUC(0-48) of INH in both reference and test tablets were 17.14 ± 8.59 and 19.62 ± 10.57 µg·h·mL(-1), respectively. Enteric-coated tablets may minimize the decomposition of RIF in gastrointestinal tract and improve the bioavailability.

Investigation of the effects of oleuropein rich diet on rat enteric bacterial flora.

Science.gov (United States)

Kiraz, A; Simsek, T; Tekin, S Z; Elmas, S; Tekin, M; Sahin, H; Altinisik, H B; Pala, C

2016-01-01

Oleuropein is a phenolic compound of olive leaves. Enteric bacterial flora is very important for human health and diet is a directly affecting factor of enteric bacterial flora composition. In this study, it was hypothesized that oleuropein could reduce total aerobic bacterial count in rat caecal flora. Twenty adult, male, Wistar albino rats were randomly divided into two groups. Group C (n=10) was fed with standard rat chow and water for 30 days. Group O (n=10) received olive leaf extract 20 mg/kg/day by intragastric gavage in addition to standard rat chow and water for 30 days. One gram of caecal content was collected from each rat and then consecutive 10-fold serial dilutions were prepared with a final concentration of 10-8. Then 0.1 ml of each dilution were spread onto the surfaces of Plate Count Agar and Violet Red Bile Glucose Agar to enumerate the aerobic enteric bacteria. Total aerobic bacterial counts of Group O were significantly lower than of Group C in all agar plates inoculated with ceacal samples for every dilution (pbacterial translocation by reducing enteric bacterial counts (Tab. 1, Ref. 32).

Natural history and surgical management of radiation enteritis

International Nuclear Information System (INIS)

Galland, R.B.; Spencer, J.

1987-01-01

The natural history and surgical management of radio enteritis is reviewed. Predisposing factors include the dose of radiation patients build, combination with chemotherapy, previous operations and vascular disease. Management is related to the stage of disease at presentation, and tailored to the clinical problem. Surgical management must take into account the poor healing associated with irradiated intestine. (author)

Uso das diretrizes para tratamento da úlcera por pressão por enfermeiros de um hospital geral

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Elaine Maria Leite Rangel

2009-03-01

Full Text Available Este estudo objetivou identificar a freqüência do uso das diretrizes para o tratamento da úlcera por pressão(UP por enfermeiros de um hospital geral no interior do estado de São Paulo. É transversal de caráterdescritivo com análise quantitativa de dados. Amostra de 25 enfermeiros. Para a coleta de dados utilizou-se uminstrumento, construído a partir das diretrizes para o tratamento da UP. As questões foram relacionadas aostipos de intervenções usadas pelos enfermeiros para o tratamento da UP em estágio I, II, com necrose e comtecido de granulação. Para UP em estágio I, 24 (96% enfermeiros sempre realizavam a mudança de decúbito.Nas úlceras em estágio II a utilização de óleos vegetais na ferida era realizada sempre por 10 (40%enfermeiros e o curativo de hidrocolóide nunca era utilizado por 12 (57,1% enfermeiros. Em UP com necrose alimpeza com povidine era realizada por 4 (17,4% enfermeiros às vezes. Para o desbridamento, 16 (64% àsvezes utilizavam papaína e 15 (71,4% às vezes utilizavam colagenase. Em úlceras com tecido de granulaçãosempre era utilizado o soro fisiológico por 25 (100% enfermeiros. Houve variação nas práticas para otratamento da UP e falta de adesão às diretrizes.

Mortalidad por causas externas en Medellín, 1999-2006

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Doris Cardona Arango

2008-01-01

Full Text Available Caracterizar el comportamiento de la mortalidad por causas externas en la ciudad de Medellín, Colombia, entre 1999-2006, según sexo, edad y causa básica de muerte fue el objetivo de este estudio descriptivo longitudinal, con fuente de información secundaria de 22 128 registros de defunción por causas externas. El análisis realizado es univariado y bivariado por sexo, grupos de edad y causa de muerte. Las causas externas registradas en el periodo fueron: 72.9 por ciento por homicidio; 15.3 por ciento, accidente de transporte; 7.3 por ciento, traumatismos; 4.2 por ciento, por suicidio, y por otras causas, 0.4 por ciento. La mayor tasa de mortalidad se presentó en el grupo de edad de 20 a 24 años (27.6 por cien mil habitantes, hecho que merece especial consideración por las implicaciones sociales, familiares y laborales que representa el fallecimiento de una persona en su etapa productiva.

Intestinal obstruction by eosinophilic jejunitis Aspectos quirúrgicos de la enteritis eosinofílica

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J. M. Álamo Martínez

2004-04-01

Full Text Available Eosinophilic enteritis is an uncommon disease that rarely devel-ops as a surgical emergency. Although it may be associated with infestation by Ancylostoma caninum, its etiology is unknown and often related to a personal or family history of atopy. A transmural involvement may cause intestinal obstruction -more frequently in the jejunum- or even acute abdomen, which may or may not be accompanied by intestinal perforation. The latter two conditions tend to be more commonly associated with ileum disease, causing pain in the lower right quadrant of the abdomen. Patient history, eosinophil count -which may be paradoxically reduced when the disease appears in this way-, ultrasonography, and/or CT lead to the suspicion of this condition before a surgical procedure is considered. A definitive diagnosis, however, must be reached by means of an anatomopathological study. Macroscopically, intestinal loops exhibit a thickened appearance with an elastic consistency. Laparoscopic intestinal biopsy may play a major role in the diagnosis of disease.La enteritis eosinofílica es una enfermedad poco frecuente que debuta de forma extraordinaria como urgencia quirúrgica. Su etiopatogenia, aunque pudiera estar asociada a la infestación por Ancylostoma caninum, se desconoce, y en muchas ocasiones se relaciona con antecedentes personales o familiares de atopia. La afectación transmural puede ocasionar síndrome obstructivo intestinal, más frecuente a nivel yeyunal, o incluso un abdomen agudo acompañado o no de perforación entérica. Estas dos últimas entidades suelen estar asociadas más usualmente con el asentamiento de la enfermedad en íleon, provocando dolor en la fosa iliaca derecha. Los antecedentes del enfermo, el recuento de eosinófilos en sangre, que paradójicamente puede estar disminuido cuando la enfermedad debuta de esta forma, la ecografía y/o la TAC, pueden hacernos sospechar de esta patología antes de plantearse la intervención quir

La modificacion del biotopo perihabitacional en la profilaxis de la enfermedad de Chagas

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Miguel Eduardo Jörg

1989-06-01

Full Text Available La modification del biotopo perihabitacional consiste en crear alrededor de la vivienda humana, rural, selvática o suburbuna, un espado perimetral limpio, totalmente libre de malezas y chaparral, despojado de nidos, madrigueras o refúgios de animales silvestres y de habitáculos de animales domésticos; de suficiente magnitud para evitar que tras desinsectación, queden focos peridomiciliarios de proliferation de triatomineos, vectores del Trypanosoma cruzi, focos inmediatos y habituales de reinfestación domiciliaria por estos redúvidos hematófagos. Los trabajos de rociado entomicida y aún el mejoramiento de la vivienda se reducen extremadamente si no son complementadas con la modificación del biotopo perihabitacional. Se expone una experiencia piloto sobre un barrio de la ciudad Villa Carlos Paz, provinda Córdoba, Argentina, que en 2 anos de aplicación permitió verificar la desaparición de vinchucas en un area de baja desindad de vectores y hospedadores.

Impacto da nutrição enteral na toxicidade aguda e na continuidade do tratamento dos pacientes com tumores de cabeça e pescoço submetidos a radioterapia com intensidade modulada

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Liêvin Matos Rebouças

2011-02-01

Full Text Available OBJETIVO: Analisar o impacto da terapia nutricional enteral na manutenção do peso corpóreo e na necessidade de replanejamento e/ou interrupção da radioterapia em pacientes com câncer de cabeça e pescoço submetidos a radioterapia de intensidade modulada (IMRT. MATERIAIS E MÉTODOS: Foram analisados, retrospectivamente, os pacientes submetidos a IMRT entre janeiro de 2005 e outubro de 2008, com a inclusão de 83 casos. RESULTADOS: A idade mediana foi de 58,6 anos. Em apenas em cinco pacientes (6% houve interrupção do tratamento, que variou de 4 a 18 dias, e em 19 casos (23% houve necessidade de replanejamento. A terapia nutricional enteral foi instituída antes do início da radioterapia em 16 pacientes (19%. Perda de peso > 5% ocorreu em 58 casos (70%, sendo mais prevalente no grupo de pacientes em que a terapia nutricional enteral não foi instituída pré-radioterapia. Na comparação entre os grupos não houve diferença significativa na realização de replanejamento (25% versus 21%; p = 0,741 ou na ocorrência e duração da interrupção da radioterapia. CONCLUSÃO: A terapia nutricional enteral tem um claro ganho na manutenção do peso corporal, porém, não houve um benefício na realização da gastrostomia percutânea endoscópica ou da sonda nasoenteral em relação à interrupção e ao replanejamento da radioterapia.

Radiation enteritis. A rare complication of the transverse colon in uterine cancer

International Nuclear Information System (INIS)

Yoshimura, Kenji; Hirata, Ichiro; Maemura, Kentaro; Sugi, Kazunori; Tahara, Tetsuo

2000-01-01

Radiation therapy is a powerful method for the control of cancer. The utilization of abdominal or pelvic radiation has been extended, and the incidence of radiation enteritis appears to be increasing. The majority of the induced lesions is in the distal ileum, sigmoid colon, or rectum. Reported here is an unusual case of radiation enteritis which caused a severe sequelae of stricture in the transverse colon as a long-term effect of therapeutic irradiation for uterine cancer, and required a surgical resection. (author)

Radiation enteritis. A rare complication of the transverse colon in uterine cancer

Energy Technology Data Exchange (ETDEWEB)

Yoshimura, Kenji [Kodama Hospital, Takarazuka, Hyogo (Japan); Hirata, Ichiro; Maemura, Kentaro; Sugi, Kazunori; Tahara, Tetsuo

2000-12-01

Radiation therapy is a powerful method for the control of cancer. The utilization of abdominal or pelvic radiation has been extended, and the incidence of radiation enteritis appears to be increasing. The majority of the induced lesions is in the distal ileum, sigmoid colon, or rectum. Reported here is an unusual case of radiation enteritis which caused a severe sequelae of stricture in the transverse colon as a long-term effect of therapeutic irradiation for uterine cancer, and required a surgical resection. (author)

Multidrug resistance in enteric and other gram-negative bacteria.

Science.gov (United States)

George, A M

1996-05-15

In Gram-negative bacteria, multidrug resistance is a term that is used to describe mechanisms of resistance by chromosomal genes that are activated by induction or mutation caused by the stress of exposure to antibiotics in natural and clinical environments. Unlike plasmid-borne resistance genes, there is no alteration or degradation of drugs or need for genetic transfer. Exposure to a single drug leads to cross-resistance to many other structurally and functionally unrelated drugs. The only mechanism identified for multidrug resistance in bacteria is drug efflux by membrane transporters, even though many of these transporters remain to be identified. The enteric bacteria exhibit mostly complex multidrug resistance systems which are often regulated by operons or regulons. The purpose of this review is to survey molecular mechanisms of multidrug resistance in enteric and other Gram-negative bacteria, and to speculate on the origins and natural physiological functions of the genes involved.

A systematic review of zoonotic enteric parasitic diseases among nomadic and pastoral people.

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Amber N Barnes

Full Text Available Zoonotic enteric parasites are ubiquitous and remain a public health threat to humans due to our close relationship with domestic animals and wildlife, inadequate water, sanitation, and hygiene practices and diet. While most communities are now sedentary, nomadic and pastoral populations still exist and experience unique exposure risks for acquiring zoonotic enteric parasites. Through this systematic review we sought to summarize published research regarding pathogens present in nomadic populations and to identify the risk factors for their infection.Using systematic review guidelines set forth by PRISMA, research articles were identified, screened and summarized based on exclusion criteria for the documented presence of zoonotic enteric parasites within nomadic or pastoral human populations. A total of 54 articles published between 1956 and 2016 were reviewed to determine the pathogens and exposure risks associated with the global transhumance lifestyle.The included articles reported more than twenty different zoonotic enteric parasite species and illustrated several risk factors for nomadic and pastoralist populations to acquire infection including; a animal contact, b food preparation and diet, and c household characteristics. The most common parasite studied was Echinococcosis spp. and contact with dogs was recognized as a leading risk factor for zoonotic enteric parasites followed by contact with livestock and/or wildlife, water, sanitation, and hygiene barriers, home slaughter of animals, environmental water exposures, household member age and sex, and consumption of unwashed produce or raw, unprocessed, or undercooked milk or meat.Nomadic and pastoral communities are at risk of infection with a variety of zoonotic enteric parasites due to their living environment, cultural and dietary traditions, and close relationship to animals. Global health efforts aimed at reducing the transmission of these animal-to-human pathogens must incorporate

Clinical Efficacy and Residue Depletion of 10% Enrofloxacin Enteric-Coated Granules in Pigs.

Science.gov (United States)

Lei, Zhixin; Liu, Qianying; Yang, Bing; Xiong, Jincheng; Li, Kun; Ahmed, Saeed; Hong, Liping; Chen, Pin; He, Qigai; Cao, Jiyue

2017-01-01

A new, more palatable formulation of 10% enrofloxacin enteric-coated granules was investigated to evaluate the pharmacokinetic effect in plasma, the residue elimination in tissues and the clinical efficacy against Actinobacillus pleuropneumonia (APP) and Mycoplasam suis (MS) in pigs. In this study, the enrofloxacin concentrations in plasma and tissues were detected using high-performance liquid chromatography with phosphate buffer (pH = 3) and acetonitrile. The pharmacokinetics and elimination of enrofloxacin enteric-coated granules were performed after oral administration at a single dose of 10 mg/kg body weight (bw) and 5 mg/kg twice per day for 5 consecutive days, respectively. The in vivo antibacterial efficacy and clinical effectiveness of enrofloxacin enteric-coated granules against APP and MS were assayed at 2.5, 5, 10 mg/kg, compared with tiamulin (8 mg/kg) based on establishment of APP and MS infection models. 56 APP strains were selected and tested for in vitro antibacterial activity of enrofloxacin enteric-coated granules. The main parameters of elimination half-life (t 1/2β ), T max , and area under the curve (AUC) were 14.99 ± 4.19, 3.99 ± 0.10, and 38.93 ± 1.52 μg h/ml, respectively, revealing that the enrofloxacin concentration remained high and with a sustainable distribution in plasma. Moreover, the analysis on the evaluation of enrofloxacin and ciprofloxacin in muscle, fat, liver and kidney showed that the recovery were more than 84% recovery in accordance with the veterinary drug residue guidelines of United States pharmacopeia, and the withdrawal periods were 4.28, 3.81, 4.84, and 3.51 days, respectively, suggesting that the withdrawal period was 5 d after oral administration of 5 mg/kg twice per day. The optimal dosage of enrofloxacin enteric-coated granules against APP and MS was 5 mg/kg, with over 90% efficacy, which was significantly different ( p enrofloxacin enteric-coated granules had significant potential for treating APP and MS

Necrotizing enterocolitis is associated with earlier achievement of enteral autonomy in children with short bowel syndrome.

Science.gov (United States)

Sparks, Eric A; Khan, Faraz A; Fisher, Jeremy G; Fullerton, Brenna S; Hall, Amber; Raphael, Bram P; Duggan, Christopher; Modi, Biren P; Jaksic, Tom

2016-01-01

Necrotizing enterocolitis (NEC) remains one of the most common underlying diagnoses of short bowel syndrome (SBS) in children. The relationship between the etiology of SBS and ultimate enteral autonomy has not been well studied. This investigation sought to evaluate the rate of achievement of enteral autonomy in SBS patients with and without NEC. Following IRB approval, 109 patients (2002-2014) at a multidisciplinary intestinal rehabilitation program were reviewed. The primary outcome evaluated was achievement of enteral autonomy (i.e. fully weaning from parenteral nutrition). Patient demographics, primary diagnosis, residual small bowel length, percent expected small bowel length, median serum citrulline level, number of abdominal operations, status of the ileocecal valve (ICV), presence of ileostomy, liver function tests, and treatment for bacterial overgrowth were recorded for each patient. Median age at PN onset was 0 weeks [IQR 0-0]. Median residual small bowel length was 33.5 cm [IQR 20-70]. NEC was present in 37 of 109 (33.9%) of patients. 45 patients (41%) achieved enteral autonomy after a median PN duration of 15.3 [IQR 7.2-38.4]months. Overall, 64.9% of patients with NEC achieved enteral autonomy compared to 29.2% of patients with a different primary diagnosis (p=0.001, Fig. 1). Patients with NEC remained more likely than those without NEC to achieve enteral autonomy after two (45.5% vs. 12.0%) and four (35.7% vs. 6.3%) years on PN (Fig. 1). Logistic regression analysis demonstrated the following parameters as independent predictors of enteral autonomy: diagnosis of NEC (pChildren with SBS because of NEC have a significantly higher likelihood of fully weaning from parenteral nutrition compared to children with other causes of SBS. Additionally, patients with NEC may attain enteral autonomy even after long durations of parenteral support. Copyright © 2016 Elsevier Inc. All rights reserved.

In vivo transplantation of enteric neural crest cells into mouse gut; Engraftment, functional integration and long-term safety

NARCIS (Netherlands)

J.E. Cooper (Julie E.); C. Mccann; D. Natarajan (Dipa); S. Choudhury; W. Boesmans (Werend); J.-M. Delalande (Jean-Marie); P.V. Berghe (Pieter Vanden); A.J. Burns (Alan); N. Thapar (Nikhil)

2016-01-01

textabstractObjectives: Enteric neuropathies are severe gastrointestinal disorders with unsatisfactory outcomes. We aimed to investigate the potential of enteric neural stem cell therapy approaches for such disorders by transplanting mouse enteric neural crest cells (ENCCs) into ganglionic and

Potential virulence of Klebsiella sp. isolates from enteral diets

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S.C.L. Pereira

2015-01-01

Full Text Available We aimed to evaluate the potential virulence of Klebsiella isolates from enteral diets in hospitals, to support nosocomial infection control measures, especially among critical-care patients. Phenotypic determination of virulence factors, such as capsular expression on the external membrane, production of aerobactin siderophore, synthesis of capsular polysaccharide, hemolytic and phospholipase activity, and resistance to antibiotics, which are used therapeutically, were investigated in strains of Klebsiella pneumoniae and K. oxytoca. Modular industrialized enteral diets (30 samples as used in two public hospitals were analyzed, and Klebsiella isolates were obtained from six (20% of them. The hypermucoviscous phenotype was observed in one of the K. pneumoniae isolates (6.7%. Capsular serotypes K1 to K6 were present, namely K5 and K4. Under the conditions of this study, no aerobactin production, hemolytic activity or lecithinase activity was observed in the isolates. All isolates were resistant to amoxicillin and ampicillin and sensitive to cefetamet, imipenem, chloramphenicol, gentamicin and sulfamethoxazole-trimethoprim. Most K. pneumoniae isolates (6/7, 85.7% from hospital B presented with a higher frequency of resistance to the antibiotics tested in this study, and multiple resistance to at least four antibiotics (3/8; 37.5% compared with isolates from Hospital A. The variations observed in the antibiotic resistance profiles allowed us to classify the Klebsiella isolates as eight antibiotypes. No production of broad-spectrum β-lactamases was observed among the isolates. Our data favor the hypothesis that Klebsiella isolates from enteral diets are potential pathogens for nosocomial infections.

Changes and clinical significance of liver function and myocardial zymogram in children with rotavirus enteritis

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Lan-Ping Yang

2016-12-01

Full Text Available Objective: To explore the changes and clinical significance of liver function and myocardial zymogram in children with rotavirus (RV enteritis. Methods: A total of 70 children with RV enteritis who were admitted in our hospital were included in the study and served as the observation group. The liver function and myocardial zymogram before and after treatment were detected. The proportion of RV enteritis children with liver and myocardial damage was calculated. The effect of dehydration on the liver function and myocardial zymogram in children with RV enteritis was analyzed. A total of 65 children with non-RV enteritis who were admitted in our hospital at the same stage were served as the control group. Results: The serum ALT, AST, CK, CK-MB, LDH, and α-HBDH levels, and liver myocardial damage children proportion in the observation group were significantly higher than those in the control group (P<0.05. The serum ALT, AST, CK, CK-MB, LDH, and α-HBDH levels in the observation group were significantly elevated with the acceleration of dehydration degree (P<0.05. In the observation group, 45 children had liver and myocardial damage, whose ALT, AST, CK, CKMB, LDH, and α-HBDH levels after treatment were significantly reduced when compared with before treatment (P<0.05. Conclusions: Early detection of liver function and myocardial zymogram can accurately reflect the condition in children with RV enteritis, which can provide an evidence for the formulation of clinical treatment protocol.

Enteric disease surveillance under the AFHSC-GEIS: Current efforts, landscape analysis and vision forward

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Kasper Matthew R

2011-03-01

Full Text Available Abstract The mission of the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS is to support global public health and to counter infectious disease threats to the United States Armed Forces, including newly identified agents or those increasing in incidence. Enteric diseases are a growing threat to U.S. forces, which must be ready to deploy to austere environments where the risk of exposure to enteropathogens may be significant and where routine prevention efforts may be impractical. In this report, the authors review the recent activities of AFHSC-GEIS partner laboratories in regards to enteric disease surveillance, prevention and response. Each partner identified recent accomplishments, including support for regional networks. AFHSC/GEIS partners also completed a Strengths, Weaknesses, Opportunities and Threats (SWOT survey as part of a landscape analysis of global enteric surveillance efforts. The current strengths of this network include excellent laboratory infrastructure, equipment and personnel that provide the opportunity for high-quality epidemiological studies and test platforms for point-of-care diagnostics. Weaknesses include inconsistent guidance and a splintered reporting system that hampers the comparison of data across regions or longitudinally. The newly chartered Enterics Surveillance Steering Committee (ESSC is intended to provide clear mission guidance, a structured project review process, and central data management and analysis in support of rationally directed enteric disease surveillance efforts.

Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

DEFF Research Database (Denmark)

Aunsholt, Lise; Qvist, Niels; Sangild, Per Torp

2018-01-01

BACKGROUND: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would...... be well tolerated in patients with short bowel syndrome. METHODS: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient......, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow's milk allergy. CONCLUSION: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly...

Apendicitis por Paracoccidioides brasiliensis

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Ana Beatriz MUÑOZ URRIBARRI

2006-01-01

Full Text Available La paracoccidioidomicosis es la micosis más prevalente en Sudamérica. La forma aguda afecta el sistema fagocítico mononuclear de niños y personas inmunocomprometidas. El compromiso gastrointestinal es frecuente y su patogenia implica diseminación hematógena y linfática. La linfadenomegalia abdominal causa obstrucción intestinal y abdomen agudo. En este artículo damos a conocer el caso de un niño con compromiso gastrointestinal por apendicitis. Este es el primer caso reportado de apendicitis por esta patología. (Rev Med Hered 2006;17:58-60.

High enteric bacterial contamination of drinking water in Jigjiga city ...

African Journals Online (AJOL)

unhcc

Key words: Contamination, drinking water, households, enteric bacteria, Jigjiga. Introduction. Water safety ... regular sanitary checks for un-chlorinated water (9). Because of this ... 238, considering 5% non-response rate. All kebeles have.

Entering Chinese market for Finnish fashion jewellery company : case: Ninja Finland Oy

OpenAIRE

Wang, Yujue

2014-01-01

As one of the fastest-growing economies in the world, China is expected to become the largest fashion market in the world in a few years. As a result, more and more foreign companies have entered the Chinese market and the market has been more competitive than ever. This requires any fashion company to adopt a strategic development plan when entering the Chinese market. Ninja Finland Oy is a fashion jewellery company which offers a wide range of fashion jewellery and accessories. The comp...

Effect of minimal enteral feeding on recovery in a methotrexate-induced gastrointestinal mucositis rat model

NARCIS (Netherlands)

Kuiken, Nicoline S. S.; Rings, Edmond H. H. M.; Havinga, Rick; Groen, Albert K.; Tissing, Wim J. E.

Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administration in a methotrexate

Enteric neurospheres are not specific to neural crest cultures : Implications for neural stem cell therapies

NARCIS (Netherlands)

Binder, E. (Ellen); D. Natarajan (Dipa); J.E. Cooper (Julie E.); Kronfli, R. (Rania); Cananzi, M. (Mara); J.-M. Delalande (Jean-Marie); C. Mccann; A.J. Burns (Alan); N. Thapar (Nikhil)

2015-01-01

textabstractObjectives Enteric neural stem cells provide hope of curative treatment for enteric neuropathies. Current protocols for their harvesting from humans focus on the generation of 'neurospheres' from cultures of dissociated gut tissue. The study aims to better understand the derivation,

The Challenges of Home Enteral Tube Feeding: A Global Perspective

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Omorogieva Ojo

2015-04-01

Full Text Available The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF and to outline some of the challenges of home enteral nutrition (HEN provisions. It is well established that the number of patients on HETF is on the increase worldwide due to advances in technology, development of percutaneous endoscopic gastrostomy techniques, and the shift in care provisions from acute to community settings. While the significance of home enteral nutrition in meeting the nutritional requirements of patients with poor swallowing reflexes and those with poor nutritional status is not in doubt, differences exist in terms of funding, standards, management approaches and the level of infrastructural development across the world. Strategies for alleviating some of the challenges militating against the effective delivery of HETF including the development of national and international standards, guidelines and policies for HETF, increased awareness and funding by government at all levels were discussed. Others, including development of HEN services, which should create the enabling environment for multidisciplinary team work, clinical audit and research, recruitment and retention of specialist staff, and improvement in patient outcomes have been outlined. However, more research is required to fully establish the cost effectiveness of the HEN service especially in developing countries and to compare the organization of HEN service between developing and developed countries.

Efficacy of zinc as an antibacterial agent against enteric bacterial pathogens

International Nuclear Information System (INIS)

Faiz, U.; Butt, T.; Hussain, W.; Hanif, F.

2011-01-01

Background: Diarrhoea is a serious threat all over the world with great economic implications especially evident in the developing world. This study was aimed at determining in vitro efficacy of Zinc (Zn) against common enteric bacterial pathogens. Method: A total of 100 bacterial enteric pathogens: Salmonellae (n=16), enteropathogenic Escherichia coli (EPEC) (n=26), Shigellae (n=28) and Vibrio cholerae (n=30) were isolated from diarrhoeal stool specimens at Department of Microbiology, Armed Forces Institute of Pathology Rawalpindi during April 2009 to Jan 2010. These isolates were tested against various concentrations of Zn supplemented in Mueller Hinton (MH) agar using a multipoint inoculator. A minimum inhibitory concentration of active Zn in ZnSO/sub 4/.7H/sub 2/O ranging from 0.03 mg/ml to 1 mg/ml was used. Results: Zn completely inhibited the growth of all the tested pathogens and most of them were inhibited at a concentration of 0.06 mg/ml to 0.5 mg/ml of Zn. Conclusions: Zinc has an excellent antibacterial activity against enteric bacterial pathogens common in our setup which may provide basis for treatment of diarrhoea. Clinical study based on these findings is recommended. (author)

Clinical and microbiological profile of a retrospective cohort of enteric fever in 2 Spanish tertiary hospitals.

Science.gov (United States)

Sánchez-Montalvá, Adrián; Martínez-Pérez, Ángela; Pérez-Molina, José Antonio; González-López, Juan José; Lopez-Vélez, Rogelio; Salvador, Fernando; Sánchez, Irene; Planes, Anna M; Molina, Israel

2015-05-01

Enteric fever in high-income countries is diagnosed mainly in patients returning from endemic countries. We assess the clinical, microbiological, and prognosis aspects of enteric fever in 2 Spanish tertiary hospitals. A retrospective observational study was conducted at Vall d'Hebron University Hospital and Ramón y Cajal University Hospital in Spain. We reviewed medical records of all patients who were diagnosed with enteric fever from January 2000 to January 2014 at these hospitals. We identified 47 patients with enteric fever episodes. According to their travel history, 35 (74.5%) patients had travelled to highly endemic countries. Imported enteric fever was acquired mainly in Asia (70.3%). Imported infections were implicated in travelers (48.6%), visiting friends and relatives (40%) and immigrants (11.4%). We found that 12 patients were diagnosed with enteric fever without a travel history (autochthonous infection). The resistance profile of the isolates showed decreased ciprofloxacin susceptibility in 66.7% of the imported group and 8.3% of the autochthonous group (P = 0.001). Salmonella strains from patients returning from Asia had an increased risk of having decreased ciprofloxacin susceptibility (odds ratio, 52.25; 95% confidence interval: 8.6-317.7). Patients with imported enteric fever are at higher risk for having a Salmonella strain with decreased ciprofloxacin susceptibility, especially in patients returning from Asia. Initial treatment with third-generation cephalosporin or azithromycin is strongly recommended until a drug-susceptibility test is available. Prevention strategies such as pretravel counseling and immunization before travel may be beneficial.

A MODEL OF MIRA'S COMETARY HEAD/TAIL ENTERING THE LOCAL BUBBLE

International Nuclear Information System (INIS)

Esquivel, A.; Raga, A. C.; RodrIguez-Gonzalez, A.; Lopez-Camara, D.; Velazquez, P. F.; Canto, J.; De Colle, F.

2010-01-01

We model the cometary structure around Mira as the interaction of an asymptotic giant branch stellar wind from Mira A with a streaming environment. Our simulations introduce the following new element: we assume that after 200 kyr of evolution in a dense environment, Mira entered the Local Bubble (low-density coronal gas). As Mira enters the bubble, the head of the comet expands quite rapidly, while the tail remains well collimated for a >100 kyr timescale. The result is a broad-head/narrow-tail structure that resembles the observed morphology of Mira's comet. The simulations were carried out with our new adaptive grid code WALICXE, which is described in detail.

ESTUDO DA MUCOSA ENTERAL DE RESERVATÓRIOS EM "J" EM CÃES

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SANDRA PEDROSO DE MORAES

1998-07-01

Full Text Available A proctocolectomia total com reservatório enteral é a principal técnica utilizada para o tratamento operatório de algumas doenças do intestino grosso. Com o objetivo de estudar as características da mucosa enteral de reservatórios em J, foram operados 36 cães. Após a ressecção de 5 cm do jejunum caudalis, para estudo-controle, os cães foram separados em dois grupos (GI e GII. No GI, foi realizada anastomose êntero-enteral término-terminal; no GII, foi feito um reservatório na forma de "J" no segmento cranialis, que foi anastomosado ao segmento caudalis da mesma forma que no GI. Aos 21, 42 e 63 dias de pós-operatório, foi realizada eutanásia de 6 cães de cada grupo para estudos macroscópico e microscópico, incluindo-se contagens celulares e medidas da lâmina própria da mucosa enteral. Os resultados revelaram, aos 21 dias, edema e enantema, à macroscopia, e necrose à microscopia, em freqüências semelhantes nos dois grupos. Aos 42 e 63 dias, essas alterações diminuiram ou desapareceram no GI e persistiram no GII. Somente neste último foram observadas úlceras à macroscopia aos 21 dias (2 cães e 42 dias (1 cão. Não houve diferença significante à presença de abscesso, à microscopia, nos dois grupos. Na contagem celular, já aos 21 dias houve aumento da densidade volumétrica de neutrófilos, macrófagos, eosinófilos, plasmócitos e linfócitos nos dois grupos. Todas as células, exceto eosinófilos, apresentavam-se com densidade volumétrica significantemente maior no GII, aos 63 dias. O diâmetro transversal da lâmina própria, excluindo a altura dos vilos, apresentou-se significantemente maior no GII aos 63 dias de pós-operatório. Concluiu-se que a mucosa enteral de reservatórios em J, em cães, apresenta modificações do padrão de normalidade macroscópica e microscópica, entre as quais o aumento da densidade volumétrica de células inflamatórias.Total proctocolectomy with enteral reservoir is, at

Single-layer closure of typhoid enteric perforation: Our experience ...

African Journals Online (AJOL)

Materials and Methods: We retrospectively studied the effects of single versus double layer intestinal closure after typhoid enteric perforation with peritonitis in 902 pediatric patients from September 2007 to April 2012. All the patients underwent laparotomy after resuscitation and antibiotic cover. The patients were divided ...

Regional enteritis and gluten-free diet. A clinical study

NARCIS (Netherlands)

Merwe, Christiaan Frederik van der

1974-01-01

The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the

Enteral feeding practices in preterm infants in South Africa

African Journals Online (AJOL)

Background. Optimal feeding regimens in babies weighing <1 000 g have not been established, and wide variations occur. In South Africa. (SA) this situation is complicated by varied resource constraints. Objective. To determine the preterm enteral feeding practices of paediatricians in SA. Methods. We invited 288 ...

Heritability for enteric methane emission from Danish Holstein cows using a non-invasive FTIR method

DEFF Research Database (Denmark)

Lassen, Jan; Løvendahl, Peter

2013-01-01

Enteric methane emission from ruminants contributes substantially to the greenhouse effect. Few studies have focused on the genetic variation in enteric methane emission from dairy cattle. One reason for that is the limited number of methods appropriate for large scale phenotyping to measure...

Tatuaje por amalgama. Reporte de un caso

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Luis Fang Mercado

2012-01-01

Full Text Available El tatuaje por amalgama se origina por el depósito en el tejido conectivo subepitelial de fragmentos de amalgama resultado de procedimientos iatrogénicos por parte del operador. La profundidad a la que se encuentren albergados los residuos de este material influye en la presentación clínica de las lesiones. Radiográficamente se pueden identificar los fragmentos mientras tengan diámetros razonables; histológicamente se pueden observar las partículas de amalgama como gránulos oscuros, sólidos e irregulares dispuesto entre los haces de colágeno y vasos sanguíneos. Este artículo refiere el caso clínico de un paciente que presentó pigmentación por amalgama en mucosa vestibular, originada por una porción de amalgama usada como material obturador en una apicectomía del 11 realizada con anterioridad. Teniendo en cuenta las consideraciones clínicas y radiográficas se optó por realizar una segunda apicectomía con obturación retrógrada con MTA del 11. Durante el procedimiento quirúrgico se cureteó y adelgazó la cara interna del colgajo mucoperióstico para tratar de disminuir el grado de pigmentación.

Trends in MD/PhD Graduates Entering Psychiatry: Assessing the Physician-Scientist Pipeline.

Science.gov (United States)

Arbuckle, Melissa R; Luo, Sean X; Pincus, Harold Alan; Gordon, Joshua A; Chung, Joyce Y; Chavez, Mark; Oquendo, Maria A

2018-06-01

The goal of this study was to identify trends in MD/PhD graduates entering psychiatry, to compare these trends with other specialties, and to review strategies for enhancing the physician-scientist pipeline. Data on 226,588 medical students graduating from Liaison Committee on Medical Education accredited programs between 1999 and 2012 (6626 MD/PhDs) were used to evaluate the number, percentage, and proportion of MD/PhDs entering psychiatry in comparison with other specialties (neurology, neurosurgery, internal medicine, family medicine, and radiation oncology). Linear regression and multiple linear regression determined whether these values increased over time and varied by sex. Over 14 years, an average of 18 MD/PhDs (range 13-29) enrolled in psychiatry each year. The number of MD/PhDs going into psychiatry significantly increased, although these gains were modest (less than one additional MD/PhD per year). The proportion of students entering psychiatry who were MD/PhDs varied between 2.9 and 5.9 per 100 residents, with no significant change over time. There was also no change in the percentage of MD/PhDs entering psychiatry from among all MD/PhD graduates. The rate of increase in the number of MD/PhDs going into psychiatry did not differ significantly from other specialties except for family medicine, which is decreasing. The rate of MD/PhDs going into psychiatry was higher for women, suggesting closure of the sex gap in 17 years. Despite the increase in the number of MD/PhDs entering psychiatry, these numbers remain low. Expanding the cohort of physician-scientists dedicated to translational research in psychiatry will require a multipronged approach.

Permissive or Trophic Enteral Nutrition and Full Enteral Nutrition Had Similar Effects on Clinical Outcomes in Intensive Care: A Systematic Review of Randomized Clinical Trials.

Science.gov (United States)

Silva, Camila F A; de Vasconcelos, Simone G; da Silva, Thales A; Silva, Flávia M

2018-01-26

The aim of this study was to systematically review the effect of permissive underfeeding/trophic feeding on the clinical outcomes of critically ill patients. A systematic review of randomized clinical trials to evaluate the mortality, length of stay, and mechanical ventilation duration in patients randomized to either hypocaloric or full-energy enteral nutrition was performed. Data sources included PubMed and Scopus and the reference lists of the articles retrieved. Two independent reviewers participated in all phases of this systematic review as proposed by the Cochrane Handbook, and the review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 7 randomized clinical trials that included a total of 1,717 patients were reviewed. Intensive care unit length of stay and mechanical ventilation duration were not statistically different between the intervention and control groups in all randomized clinical trials, and mortality rate was also not different between the groups. In conclusion, hypocaloric enteral nutrition had no significantly different effects on morbidity and mortality in critically ill patients when compared with full-energy nutrition. It is still necessary to determine the safety of this intervention in this group of patients, the optimal amount of energy provided, and the duration of this therapy. © 2018 American Society for Parenteral and Enteral Nutrition.

Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

Science.gov (United States)

Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

1988-01-01

The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

Systematic review of the global epidemiology, clinical and laboratory profile of enteric fever

Directory of Open Access Journals (Sweden)

Asma Azmatullah

2015-12-01

Full Text Available Children suffer the highest burden of enteric fever among populations in South Asian countries. The clinical features are non–specific, vary in populations, and are often difficult to distinguish clinically from other febrile illnesses, leading to delayed or inappropriate diagnosis and treatment. We undertook a systematic review to assess the clinical profile and laboratory features of enteric fever across age groups, economic regions, level of care and antibiotic susceptibility patterns.

Role of central nervous system glucagon-like Peptide-1 receptors in enteric glucose sensing.

Science.gov (United States)

Knauf, Claude; Cani, Patrice D; Kim, Dong-Hoon; Iglesias, Miguel A; Chabo, Chantal; Waget, Aurélie; Colom, André; Rastrelli, Sophie; Delzenne, Nathalie M; Drucker, Daniel J; Seeley, Randy J; Burcelin, Remy

2008-10-01

Ingested glucose is detected by specialized sensors in the enteric/hepatoportal vein, which send neural signals to the brain, which in turn regulates key peripheral tissues. Hence, impairment in the control of enteric-neural glucose sensing could contribute to disordered glucose homeostasis. The aim of this study was to determine the cells in the brain targeted by the activation of the enteric glucose-sensing system. We selectively activated the axis in mice using a low-rate intragastric glucose infusion in wild-type and glucagon-like peptide-1 (GLP-1) receptor knockout mice, neuropeptide Y-and proopiomelanocortin-green fluorescent protein-expressing mice, and high-fat diet diabetic mice. We quantified the whole-body glucose utilization rate and the pattern of c-Fos positive in the brain. Enteric glucose increased muscle glycogen synthesis by 30% and regulates c-Fos expression in the brainstem and the hypothalamus. Moreover, the synthesis of muscle glycogen was diminished after central infusion of the GLP-1 receptor (GLP-1Rc) antagonist Exendin 9-39 and abolished in GLP-1Rc knockout mice. Gut-glucose-sensitive c-Fos-positive cells of the arcuate nucleus colocalized with neuropeptide Y-positive neurons but not with proopiomelanocortin-positive neurons. Furthermore, high-fat feeding prevented the enteric activation of c-Fos expression. We conclude that the gut-glucose sensor modulates peripheral glucose metabolism through a nutrient-sensitive mechanism, which requires brain GLP-1Rc signaling and is impaired during diabetes.

Risk Factors Associated With Canine Parvovirus Enteritis In Vom ...

African Journals Online (AJOL)

Risk Factors Associated With Canine Parvovirus Enteritis In Vom And Environs. J G Mohammed, AO Ogbe, NJ Zwandor, JU Umoh. Abstract. No Abstract. Animal Research International Vol. 2 (3) 2005 pp. 366-368. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

Barriers and strategies for innovations entering BoP markets

NARCIS (Netherlands)

Kamp, L.M.; Ortt, J.R.; Harahap, B.

2015-01-01

Companies that bring a new product to the market or enter a new market with an existing product, come across a number of barriers that prevent large?scale diffusion. In order to circumvent or remove these barriers, they can adopt alternative strategies. This paper looks into these barriers and

Genetic aspects of enteric methane emission in ruminants livestock

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Martino Cassandro

2013-10-01

Full Text Available This review summarizes the importance of enteric methane (CH4 emission in ruminants and relevant to the current on knowledge relevant to genetic aspects of enteric CH4 production, highlighting future research needs and directions. Global average temperature has increased by about 0.7°C in the last century. The Intergovernmental Panel on Climate Change (IPCC reported that anthropogenic greenhouse gases (GHG, including carbon dioxide (CO2, CH4, nitrous oxide (N2O and halocarbons, have been responsible for most of the observed temperature increase since the middle of the twentieth century. Agriculture, particularly livestock, is increasingly being recognized as both a contributor to the process and a potential victim of it. Policy interventions and technical solutions are required to address both the impact of livestock production on climate change and the effects of climate change on livestock production. Food and Agriculture Organization (FAO, declared that in the next 50 years, the world’s farmers will be called upon to produce more food than has been produced in the past 10,000 years, and to do so in environmentally sustainable ways. Therefore, the GHG reduction should be treated as a public good. The United States congress is prospecting to define a price on GHG emissions. Limiting the concentration of CO2 and other GHG in Earth’s atmosphere requires a technological and economic revolution. A cost-effective way could be the genetic improvement of livestock, which produces permanent and cumulative changes in performance. Animal variation in enteric CH4 emission has been reported in the literature, providing potential for improvement through genetic selection. 

77 FR 63221 - Waiver of Requirement To Enter Into a Reciprocal Waiver of Claims Agreement With All Customers

Science.gov (United States)

2012-10-16

... To Enter Into a Reciprocal Waiver of Claims Agreement With All Customers AGENCY: Federal Aviation... a launch operator enter into a reciprocal waiver of claims with each customer. The FAA grants the... enter into a reciprocal waiver of claims (a ``cross-waiver'') with each of its customers. The FAA...

La pintura vista por un pintor joven

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Fuentes Pozo, Pedro

2000-01-01

Full Text Available Not available

El pintor se define a lo largo del tiempo como un artista en mutación influenciado por la sociedad de su momento y por su propio mundo interior Esto ha contribuido a la creación de distintos estilos pictóricos y a una evolución que conlleva la despreocupación por el aspecto formal en aras de una introspección al mundo interior En el cambio constante se refleja la búsqueda del artista que valida la intemporalidad del arte. Así, el verdadero artista sobrevive al aplauso o rechazo de la crítica, convirtiéndose en un verdadero hombre renancentista preocupado por el hallazgo del conocimiento universal.

Experiência inicial com terapia por pressão negativa por instilação em feridas complexas

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Dimas André Milcheski

Full Text Available RESUMO Objetivo: relatar a experiência inicial com a terapia por pressão negativa por instilação em feridas complexas infectadas ou contaminadas. Métodos: a terapia por pressão negativa por instilação utilizada foi o V.A.C. Ulta com instilação Veraflo (Kinetic Concepts, Inc. O modo de operação foi contínuo com pressão sub-atmosférica ajustada em 125 mmHg por duas horas e instilação entre as pausas. O tempo de instilação foi de 20 minutos (tempo de contato do agente tópico com a ferida e a substância instilada foi solução salina padrão a 0,9%. Após obtenção de preparo adequado da ferida, ela foi coberta com enxerto ou retalho. Resultados: foram operados dez pacientes com feridas complexas contaminadas ou infectadas. O número médio de trocas da TPNi foi 1,4, o número médio total de cirurgias foi de 2,4, o intervalo até a cobertura da ferida foi de 6,3 dias e o intervalo até a alta foi de 11,4 dias. Conclusão: a comparação da terapia por pressão negativa por instilação com dois estudos prévios (controle histórico evidenciou um tempo de internação menor, favorecendo a TPNi. Este estudo teve um caráter inicial, fazendo-se necessário conduzir um trabalho randomizado e controlado para confirmar a eficácia desta terapia e verificar a sua custo-efetividade.

Prevalencia de síntomas respiratorios indicativos de asma y asociación con contaminación atmosférica en preescolares de Bucaramanga, Colombia

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Laura Andrea Rodríguez

2010-03-01

Conclusiones. Es posible que en Bucaramanga los factores de contaminación domiciliaria puedan tener un mayor efecto sobre la presencia de síntomas respiratorios indicativos de asma en menores de siete años que los contaminantes externos.

Neuropatia experimental por DDT: análise de nervo por microdissecção de fibras

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Edison Matos Nóvak

1984-09-01

Full Text Available Estudou-se o nervo gênito-femural do rato albino submetido a intoxicação crônica por DDT, administrado por 180 dias na dose de 5 mg/kg de peso via oral. Os resultados mostraram proporção anormal de fibras tipo C, sendo sugerido ocorrer degeneração tipo axonal determinada pelo DDT.

Ptose palpebral causada por Paquidermoperiostose

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Patricia Regina de Pinho Tavares

2014-08-01

Full Text Available A paquidermoperiostose é uma síndrome caracterizada por acometimento cutâneo e ósseo, e em alguns casos ocorre comprometimento palpebral leve. É uma síndrome rara, idiopática ou hereditária, com provável herança autossômica dominante de penetrância variável. Descreve-se o caso de um paciente com ptose grave por paquidermoperiostose elucidando sua fisiopatologia e conduta cirúrgica aplicada.

Size distribution of air bubbles entering the brain during cardiac surgery.

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Emma M L Chung

Full Text Available Thousands of air bubbles enter the cerebral circulation during cardiac surgery, but whether high numbers of bubbles explain post-operative cognitive decline is currently controversial. This study estimates the size distribution of air bubbles and volume of air entering the cerebral arteries intra-operatively based on analysis of transcranial Doppler ultrasound data.Transcranial Doppler ultrasound recordings from ten patients undergoing heart surgery were analysed for the presence of embolic signals. The backscattered intensity of each embolic signal was modelled based on ultrasound scattering theory to provide an estimate of bubble diameter. The impact of showers of bubbles on cerebral blood-flow was then investigated using patient-specific Monte-Carlo simulations to model the accumulation and clearance of bubbles within a model vasculature.Analysis of Doppler ultrasound recordings revealed a minimum of 371 and maximum of 6476 bubbles entering the middle cerebral artery territories during surgery. This was estimated to correspond to a total volume of air ranging between 0.003 and 0.12 mL. Based on analysis of a total of 18667 embolic signals, the median diameter of bubbles entering the cerebral arteries was 33 μm (IQR: 18 to 69 μm. Although bubble diameters ranged from ~5 μm to 3.5 mm, the majority (85% were less than 100 μm. Numerous small bubbles detected during cardiopulmonary bypass were estimated by Monte-Carlo simulation to be benign. However, during weaning from bypass, showers containing large macro-bubbles were observed, which were estimated to transiently affect up to 2.2% of arterioles.Detailed analysis of Doppler ultrasound data can be used to provide an estimate of bubble diameter, total volume of air, and the likely impact of embolic showers on cerebral blood flow. Although bubbles are alarmingly numerous during surgery, our simulations suggest that the majority of bubbles are too small to be harmful.

Clinical Efficacy and Residue Depletion of 10% Enrofloxacin Enteric-Coated Granules in Pigs

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Zhixin Lei

2017-05-01

Full Text Available A new, more palatable formulation of 10% enrofloxacin enteric-coated granules was investigated to evaluate the pharmacokinetic effect in plasma, the residue elimination in tissues and the clinical efficacy against Actinobacillus pleuropneumonia (APP and Mycoplasam suis (MS in pigs. In this study, the enrofloxacin concentrations in plasma and tissues were detected using high-performance liquid chromatography with phosphate buffer (pH = 3 and acetonitrile. The pharmacokinetics and elimination of enrofloxacin enteric-coated granules were performed after oral administration at a single dose of 10 mg/kg body weight (bw and 5 mg/kg twice per day for 5 consecutive days, respectively. The in vivo antibacterial efficacy and clinical effectiveness of enrofloxacin enteric-coated granules against APP and MS were assayed at 2.5, 5, 10 mg/kg, compared with tiamulin (8 mg/kg based on establishment of APP and MS infection models. 56 APP strains were selected and tested for in vitro antibacterial activity of enrofloxacin enteric-coated granules. The main parameters of elimination half-life (t1/2β, Tmax, and area under the curve (AUC were 14.99 ± 4.19, 3.99 ± 0.10, and 38.93 ± 1.52 μg h/ml, respectively, revealing that the enrofloxacin concentration remained high and with a sustainable distribution in plasma. Moreover, the analysis on the evaluation of enrofloxacin and ciprofloxacin in muscle, fat, liver and kidney showed that the recovery were more than 84% recovery in accordance with the veterinary drug residue guidelines of United States pharmacopeia, and the withdrawal periods were 4.28, 3.81, 4.84, and 3.51 days, respectively, suggesting that the withdrawal period was 5 d after oral administration of 5 mg/kg twice per day. The optimal dosage of enrofloxacin enteric-coated granules against APP and MS was 5 mg/kg, with over 90% efficacy, which was significantly different (p < 0.05 to the 2.5 mg/kg group, but not to the 10 mg/kg group or the positive

Suppression of cytochrome P450 reductase (POR) expression in hepatoma cells replicates the hepatic lipidosis observed in hepatic POR-null mice.

Science.gov (United States)

Porter, Todd D; Banerjee, Subhashis; Stolarczyk, Elzbieta I; Zou, Ling

2011-06-01

Cytochrome P450 reductase (POR) is a microsomal electron transport protein essential to cytochrome P450-mediated drug metabolism and sterol and bile acid synthesis. The conditional deletion of hepatic POR gene expression in mice results in a marked decrease in plasma cholesterol levels counterbalanced by the accumulation of triglycerides in lipid droplets in hepatocytes. To evaluate the role of cholesterol and bile acid synthesis in this hepatic lipidosis, as well as the possible role of lipid transport from peripheral tissues, we developed a stable, small interfering RNA (siRNA)-mediated cell culture model for the suppression of POR. POR mRNA and protein expression were decreased by greater than 50% in McArdle-RH7777 rat hepatoma cells 10 days after transfection with a POR-siRNA expression plasmid, and POR expression was nearly completely extinguished by day 20. Immunofluorescent analysis revealed a marked accumulation of lipid droplets in cells by day 15, accompanied by a nearly 2-fold increase in cellular triglyceride content, replicating the lipidosis seen in hepatic POR-null mouse liver. In contrast, suppression of CYP51A1 (lanosterol demethylase) did not result in lipid accumulation, indicating that loss of cholesterol synthesis is not the basis for this lipidosis. Indeed, addition of cholesterol to the medium appeared to augment the lipidosis in POR-suppressed cells, whereas removal of lipids from the medium reversed the lipidosis. Oxysterols did not accumulate in POR-suppressed cells, discounting a role for liver X receptor in stimulating triglyceride synthesis, but addition of chenodeoxycholate significantly repressed lipid accumulation, suggesting that the absence of bile acids and loss of farnesoid X receptor stimulation lead to excessive triglyceride synthesis.

Consanguinidad por isonimia en Salta

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Albeza, María V.

2007-01-01

Full Text Available Se estimó el coeficiente de parentesco por isonimia para localidades de la Puna, Valle Calchaquí y Valle de Lerma, a fin de evaluar diferentes factores evolutivos que podrían estar afectando la composición genética de la población. A partir de los apellidos de las parejas consignadas en fuentes primarias de información, se estimó la isonimia conyugal o marital, el coeficiente total Ft y sus componentes Fr (inbreeding azaroso y Fn (inbreeding no azaroso. De las localidades estudiadas, en la Puna se ha detectado sólo una pareja isónima en una de ellas, en el Valle Calchaquí, tres y ninguna en el Valle de Lerma. Tanto en el Valle Calchaquí como en el de Lerma, se han estimado valores negativos de Ft, y en la Puna se registran los valores más elevados. En las localidades estudiadas no se cumple el supuesto de transmisión patrilineal de apellidos por lo que los valores de Fr y por ende de Ft podrían estar subestimados. Es por ello que sería necesario contar con información desde otras vertientes metodológicas para corroborar, complementar y manejar cuidadosamente el análisis de los datos y las conclusiones que se obtienen.

Nefrectomía simple por puerto único (LESS) asistida por robot (da Vinci)

OpenAIRE

CASTILLO C,OCTAVIO A; VIDAL M,IVAR; SEPÚLVEDA T,FRANCISCO

2011-01-01

Introducción: La cirugía mínimamente invasiva en urología avanza rápidamente y la cirugía laparo-endoscópica a través de puerto único (LESS) no es la excepción. Esta técnica por vía laparoscópica presenta mucha dificultad y requiere de un cirujano laparoscópico experimentado debido a la falta de triangulación y el cruce de los instrumentos. Los beneficios del sistema quirúrgico da Vinci® han sido introducidos recientemente en LESS. Presentamos dos casos de nefrectomía LESS asistida por robot....

Therapeutic effects of Glucagon-Like Peptide-2 on experimental radiation enteritis in rat

International Nuclear Information System (INIS)

Torres, S.

2007-01-01

Radiation enteritis in patients treated by abdominal and pelvic radiotherapy is characterized by acute mucosal disruption and chronic intestinal fibrosis. Using a model of localized intestinal irradiation in the rat, we showed remote intestinal dysfunction outside the irradiation field along the whole gut, probably associated with perturbations in the systems regulating intestinal functions. Based on the hypothesis of consequential late effects, acute administration of Glucagon-Like Peptide-2, a growth factor with specific trophic effect on the intestinal mucosa, limited the apparition of both acute and chronic radiation enteritis. This suggests that therapeutic strategies targeting the severity of acute tissue damage may also limit chronic sequelae. The study of GLP-2 effects on epithelial cells in co-culture with either subepithelial myo-fibroblasts or enteric nervous system emphasized the problem of the modelization of complex systems in vitro, and suggested a synergic action from these different actors in vivo. (author)

78 FR 9720 - Agency Information Collection Activities: Holders or Containers Which Enter the United States...

Science.gov (United States)

2013-02-11

... Activities: Holders or Containers Which Enter the United States Duty Free AGENCY: U.S. Customs and Border... or Containers which enter the United States Duty Free. This is a proposed extension of an information..., or other technological techniques or other forms of information. Title: Holders or Containers which...

Prediction of enteric methane production, yield, and intensity in dairy cattle using an intercontinental database

DEFF Research Database (Denmark)

Niu, Mutian; Kebreab, Ermias; Hristov, Alexander N

2018-01-01

data from animals under different management systems worldwide. The objectives of this study were to (1) collate a global database of enteric CH4production from individual lactating dairy cattle; (2) determine the availability of key variables for predicting enteric CH4production (g/day per cow), yield...

Pemberian makanan enteral berformulasi bahan pangan lokal terhadap kadar zat besi dan hemoglobin pada tikus putih (Rattus norvegicus

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Dini Ariani

2013-07-01

Full Text Available Background: Enteral nutrition is nutrition used to fulfill the needs of nutrition entirely and as the supplement for malnutrition patient. In a certain condition of a patient, this nutrition is usually given in the form of liquid. Local material foods such as tempeh, rice, mung bean, and ganyong have adequate nutrition, therefore they are suitable for being used as main raw materials in the making of enteral nutrition. Objective: To know the influence of feeding enteral nutrition formulated with local food material toward malnutrition white rats (Rattus norvegicus of which the parameters are iron (Fe, hemoglobin (Hb level and weight. Method: This research used Completely Random Design (CRD. Twenty-seven of malnutrition male white rats were divided into 3 groups of treatment with 9 repetitions for each group of the treatment. Group A was given enteral nutrition diet of formula A (tempeh, rice, and mung bean as the main raw material, group B was given enteral nutrition diet of formula B (tempeh, rice, mung bean, and ganyong as the main raw material, and group C (as the positive control was given commercial enteral nutrition. The daily giving of enteral nutrition is 20 g/day during 30 days. The analysis of Fe and Hb level and the measurement of weight firstly were done before the treatment is given. The next measurement was conducted in 15th day and 31st day. Statistical analysis used ANOVA test dan DMRT of significance 5%. Results: The result showed that the treatment of the enteral nutrition feeding of formula B was more optimal than formula A in terms of the way to increase the level of Hb and Fe. Those two components will give positive effect toward the increasing of the weight of malnutrition white rats (Rattus norvegicus. Conclusion: The enteral nutrition of formula B is more proper to be developed as the main material of making enteral food in order to treat the malnutrition.

Antral localization worsens the efficacy of enteral stents in malignant digestive tumors.

Science.gov (United States)

Dolz, Carlos; Vilella, Àngels; González Carro, Pedro; González Huix, Ferran; Espinós, Juan Carlos; Santolaria, Santos; Pérez Roldán, Francisco; Figa, Montserrat; Loras, Carmen; Andreu, Hernán

2011-02-01

Malignant gastric outlet obstruction can be treated by means of enteral stenting or surgical gastrojejunalanatomosis. We evaluated in a prospective and multicentre study the efficacy of the enteral stent on food intake, the quality of life impact, and the relationship between efficacy and determined clinical and technical parameters. Seventy one patients affected by symptoms arising from gastroduodenal obstruction due to malignant tumors, with criteria of irresecability, metastatic disease or very high surgical risk, were treated by means of self expanding metal stents. We used the GOOSS index to evaluate efficacy, and the Euro Qol-5D index to evaluate quality of life. Before stenting patients with GOOSS 0 and 1 were 68 (98.5%). After stenting patients with GOOSS 2 and 3 (semisolid and solid food) were 58 (84,1%) (P<.0001). The Euro Qol-5D index measured before and a month after stenting were 10.17 and 10.04 respectively (P=.6). The median survival was 91 days (9-552). The enteral stents for localised tumors in the duodenum and the gastrojejunalanastomosis were effective in 26 patients (70.2%) and 13 patients respectively (86.6%), while the enteral stents of tumors in the antrum were effective in only 5 patients (29.4%). The palliative treatment of malignant gastric outlet obstruction with a uncovered metal stent produces a significant improvement of oral food intake and maintains the overall quality of life index. The antral localization is associated with a lower efficacy of the procedure. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Factors related to nursing students' readiness to enter working life - A scoping literature review.

Science.gov (United States)

Järvinen, Tiina; Eklöf, Niina; Salminen, Leena

2018-03-01

The aim of this scoping literature review was to identify the factors related to nursing students' readiness to enter working life. The literature search was carried out in autumn 2017 in PubMed and CINAHL databases. The studies selected for this review (n = 17) were analyzed thematically with inductive content analysis. Four subthemes that were combined into two main factors related to nursing students' readiness to enter working life were found. The main factors found were 1) educational factors and 2) personal factors. Educational factors consisted of professional competence and clinical practice, while personal factors consisted of nursing students' background and feelings. Some nursing students tend to feel insecure about entering working life as a newly graduated nurse. This literature review also supports the importance of clinical practice periods in nursing education and for readiness for working life. Nurse education needs to ensure clinical practice periods which support nursing students' professional growth. Further research is needed on how the factors related to nursing students' readiness to enter working life correlate with each other. Particularly, the association between competence, readiness and positive feelings towards graduation needs further investigation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Análisis de costos por ausentismo laboral atribuibles a licencias médicas por enfermedad. Hospital Nacional Arzobispo Loayza 2015

OpenAIRE

Jave Escalante, Gladys Lizeth

2015-01-01

Determina el costo generado por el ausentismo laboral atribuible a licencias médicas por enfermedad en el Hospital Nacional Arzobispo Loayza 2015. METODOLOGÍA: Estudio no experimental. La muestra estuvo conformada por 118 médicos asistenciales y personal de enfermería. Para el análisis de los costos se utilizó el costo de tiempo perdido del paciente, ingresos dejados de percibir por el hospital y descuento económico al trabajador. Además se realizó un análisis económico y de sensibilidad. ...

Indice por Materias

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Montoya H Luz Marina

1982-09-01

Full Text Available Un índice es una lista de palabras o frases indicadores asociados que permite la ubicación de material al interior de un libro o una publicación, en este caso será por el nombre de la materia.

Perceived and real barriers for men entering nursing: implications for gender diversity.

Science.gov (United States)

Roth, Jay E; Coleman, Christopher Lance

2008-01-01

The objective of this literature review is to describe the perceived or real barriers to men seeking a career in nursing, and to suggest strategies for ameliorating barriers. A literature search exploring barriers existing for men pursuing nursing was conducted. Although the literature underscored the structure of nursing has changed substantially over the last fifty years, these changes have not always provoked a change in the public's perception of nursing. Barriers for men entering nursing still exist. Implications for gender diversity in nursing are discussed. Strategies for decreasing barriers experienced by males entering nursing are warranted.

The effect of commonly used anticoccidials and antibiotics in a subclinical necrotic enteritis model

OpenAIRE

Lanckriet , Anouk; Timbermont , Leen; De Gussem , Maarten; Marien , Maja; Vancraeynest , Dieter; Haesebrouck , Freddy; Ducatelle , Richard; Van Immerseel , Filip

2010-01-01

Abstract Necrotic enteritis poses an important health risk to broilers. The ionophore anticoccidials lasalocid, salinomycin, maduramicin, narasin and a combination of narasin and nicarbazin were tested in feed for their prophylactic effect on the incidence of necrotic enteritis in a subclinical experimental infection model that uses coccidia as predisposing factor. In addition, drinking water medication with the antibiotics amoxicillin, tylosin and lincomycin was evaluated as curat...

Haemorrhagic enteritis seroconversion in turkey breeders: field observations

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Raffaella Ceruti

2010-01-01

Full Text Available Seroconversion to viral haemorrhagic enteritis (HE was studied in seven flocks of turkey breeders (17.974 birds in total, after 20 weeks of the onset of egg production. They showed no clinical signs, and mortality rate was normal. However, the infection caused a drop in egg production lasting about five weeks (-2.32 eggs laid during this period, but had no effect on hatching parameters.

Environmental enteric dysfunction is associated with altered bile acid metabolism

Science.gov (United States)

Environmental enteric dysfunction (EED), a clinically asymptomatic condition characterized by inflammation of the small bowel mucosa, villous atrophy, and increased gut permeability, is common among children in developing countries. Because of abnormal gut mucosa and altered gut microbiome, EED coul...

Human enteric pathogen internalization by root uptake into food crops

Science.gov (United States)

With an increasing number of outbreaks and illnesses associated with pre-harvest contaminated produce, understanding the potential and mechanisms of produce contamination by enteric pathogens can aid in the development of preventative measures and post-harvest processing to reduce microbial populati...

Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

Science.gov (United States)

Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

2017-08-01

The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of

Mortalidad intrahospitalaria por accidente cerebrovascular

OpenAIRE

Federico Rodríguez Lucci; Virginia Pujol Lereis; Sebastián Ameriso; Guillermo Povedano; María F. Díaz; Alejandro Hlavnicka; Néstor A. Wainsztein; Sebastián F. Ameriso

2013-01-01

La mortalidad global por accidente cerebrovascular (ACV) ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Str...

Introducing enteral feeding induces intestinal subclinical inflammation and respective chromatin changes in preterm pigs

DEFF Research Database (Denmark)

Willems, Rhea; Krych, Lukasz; Rybicki, Verena

2015-01-01

AIM: To analyze how enteral food introduction affects intestinal gene regulation and chromatin structure in preterm pigs. MATERIALS & METHODS: Preterm pigs were fed parenteral nutrition plus/minus slowly increasing volumes of enteral nutrition. Intestinal gene-expression and chromatin structure......; no significant differences for colostrum) with corresponding decondensed chromatin configurations. On histology this correlated with mild mucosal lesions, particularly in formula-fed pigs. In CaCo-2 cells, histone hyperacetylation led to a marked increase in TLR4 mRNA and increased IL8 expression upon...... stimulation with lipopolysaccharide (median: 7.0; interquartile range: 5.63-8.85) compared with naive cells (median 4.2; interquartile range: 2.45-6.33; p = 0.03). CONCLUSION: Enteral feeding, particular with formula, induces subclinical inflammation in the premature intestine and more open chromatin...

Enteric and indicator virus removal by surface flow wetlands.

Science.gov (United States)

Rachmadi, Andri T; Kitajima, Masaaki; Pepper, Ian L; Gerba, Charles P

2016-01-15

We investigated the occurrence and attenuation of several human enteric viruses (i.e., norovirus, adenovirus, Aichi virus 1, polyomaviruses, and enterovirus) as well as a plant virus, pepper mild mottle virus (PMMoV), at two surface flow wetlands in Arizona. The retention time in one of the wetlands was seven days, whereas in the other wetland it could not be defined. Water samples were collected at the inlet and outlet from the wetlands over nine months, and concentration of viral genomes was determined by quantitative polymerase chain reaction (qPCR). Of the human enteric viruses tested, adenovirus and Aichi virus 1 were found in the greatest prevalence in treated wastewater (i.e., inlet of the wetlands). Reduction efficiencies of enteric viruses by the wetlands ranged from 1 to 3 log10. Polyomaviruses were generally removed to below detection limit, indicating at least 2 to 4 log10 removal. PMMoV was detected in a greater concentration in the inlet of both wetlands for all the viruses tested (10(4) to 10(7) genome copies/L), but exhibited little or no removal (1 log10 or less). To determine the factors associated with virus genome attenuation (as determined by qPCR), the persistence of PMMoV and poliovirus type 1 (an enterovirus) was studied in autoclaved and natural wetland water, and deionized water incubated under three different temperatures for 21 days. A combination of elevated water temperature and biological activities reduced poliovirus by 1 to 4 log10, while PMMoV was not significantly reduced during this time period. Overall, PMMoV showed much greater persistence than human viruses in the wetland treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Mycophenolic acid agents: is enteric coating the answer?

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Manitpisitkul W

2011-03-01

Full Text Available Wana Manitpisitkul1, Sabrina Lee2, Matthew Cooper31Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA; 2Solid Organ Transplant Program, University of Utah Health Care, Salt Lake City, UT, USA; 3Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Addition of mycophenolate mofetil (MMF to calcineurin-based immunosuppressive therapy has led to a significant improvement in graft survival and reduction of acute rejection in renal transplant recipients. However, in clinical practice, MMF dose reduction, interruption, or discontinuation due to hematological and gastrointestinal (GI side-effects occurred in up to 50% of the patients. Large retrospective analyses have demonstrated that patients requiring MMF dose manipulation due to adverse events experienced a higher rate of rejection and graft loss. Enteric-coated mycophenolate sodium (EC-MPS was developed with the goal of improving upper GI side-effects. Here, we review the efficacy and safety of EC-MPS in de novo kidney transplant recipient, and in stable renal transplant patients who were converted from MMF. The changes in GI-related adverse events using patient-reported outcome instruments are also reviewed.Keywords: enteric-coated mycophenolate sodium, mycophenolate mofetil, kidney transplant, efficacy, gastrointestinal tolerability

Serotyping of Campylobacter jejuni from an outbreak of enteritis implicating chicken.

Science.gov (United States)

Rosenfield, J A; Arnold, G J; Davey, G R; Archer, R S; Woods, W H

1985-09-01

An outbreak of campylobacter enteritis involving 7 of 17 people over a period of 5 days followed a dinner at a restaurant. A chicken casserole dish was implicated with a food-specific attack rate of 58%. Campylobacter jejuni Penner serotype 18/21/29, resistant to metronidazole, was isolated from 3 of 4 symptomatic patients and from three raw fresh chicken samples closely associated with the implicated chicken. Numbers of C. jejuni in the chicken ranged from 5.3 X 10(1) to 7.5 X 10(2) colony forming units per square centimeter of surface area. This is the first outbreak of campylobacter enteritis reported in Australia in which C. jejuni has been isolated from both human and food sources and the isolates serologically confirmed as identical.

Plasticity and Neural Stem Cells in the Enteric Nervous System

NARCIS (Netherlands)

Schaefer, Karl-Herbert; Van Ginneken, Chris; Copray, Sjef

2009-01-01

The enteric nervous system (ENS) is a highly organized part of the autonomic nervous system, which innervates the whole gastrointestinal tract by several interconnected neuronal networks. The ENS changes during development and keeps throughout its lifespan a significant capacity to adapt to

Early enteral nutrition compared to outcome in critically ill trauma ...

African Journals Online (AJOL)

2014-11-01

Nov 1, 2014 ... 16.4 days, p-value 0.00315) and mortality (9.5 % vs. 20.7 % ..... had a more complicated clinical picture, despite no significant differences in terms ... In other words, an early enteral nutrition start was associated with an almost.

Glutamine-enriched enteral nutrition in very low-birth-weight infants

NARCIS (Netherlands)

van den Berg, Anemone; van Zwol, Annelies; Moll, Henriëtte A.; Fetter, Willem P. F.; van Elburg, Ruurd M.

2007-01-01

Objective: To determine the effect of glutamine-enriched enteral nutrition in very low- birth- weight infants on the incidence of allergic and infectious diseases during the first year of life. Design: Follow- up study. Setting: Tertiary care hospital. Participants: All surviving infants who

Case Study: Enteral formula: Selecting the right formula for your ...

African Journals Online (AJOL)

placed on the type of fat (mono-unsaturated fatty acids), the addition ... patient with normal GIT function, but could worsen symptoms of poor enteral feed tolerance in a .... of omega-3 fatty acids, as well as gamma-linolenic acid (GLA) reflect an ...

CARACTERÍSTICAS DA VIOLÊNCIA SEXUAL SOFRIDA POR CRIANÇAS ASSISTIDAS POR UM PROGRAMA DE APOIO

Directory of Open Access Journals (Sweden)

KELLY LINHARES VASCONCELOS

2010-01-01

Full Text Available En Brasil, las estadísticas de la violencia sexual contra niños están lejos de reflejar la verdadera realidad actual debido a la baja notificación de los casos. La finalidad de este estudio fue caracterizar el abuso sexual sufrido por niños asistidos por el Programa Sentinela y el perfil del agresor, en Sobral-Ceará, en el periodo que va del 2002 al 2006. La muestra no probabilística intencional fue compuesta por 50 víctimas de abuso sexual y de las mismas, el 66% es del sexo femenino, con predominio de rango de edad entre 8-12 años incompletos, (58%; en el 36% de los casos los padres están separados, siendo la madre la principal responsable por la familia (62%. La mayoría de los agresores es del sexo masculino (78%. En el ambiente fuera de la familia los agresores son conocidos o amigos de la familia (14%; dentro del seno familiar el padrastro es identificado como siendo el agresor más frecuente (18%. Los datos destacan características similares a las de otros estudios, definiendo una cierta igualdad en este tipo de violencia.

In-vitro studies of enteric coated diclofenac sodium-carboxymethylcellulose microspheres.

Science.gov (United States)

Arica, B; Arica, M Y; Kaş, H S; Hincal, A A; Hasirci, V

1996-01-01

MIcrospheres containing diclofenac sodium (DS) were prepared using carboxymethylcellulose (CMC) as the main support material (1.0, 2.0, 3.0% (w/v)) and aluminum chloride as the crosslinker. Drug to polymer ratios of 1:1, 1:2 and 1:4 were used to obtain a range of microspheres. The microspheres were then coated with an enteric coating material, Eudragit S-100, efficiency, % yield value, particle sizes an in-vitro dissolution behaviour were investigated. The surface of the enteric coated microspheres seemed to be all covered with Eudragit S-100 from scanning electron microscopy observation. It was also observed that increasing the CMC concentration led to an increase in the encapsulation efficiency, % yield value and particle size and decreased the release rate. Eudragit S-100 coating did not significantly alter the size but the release rate was significantly lower even when the lower concentration solution was used.

Effectiveness of Enteral Nutritional Therapy in the Healing Process of Pressure Ulcers: A Systematic Review

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Gisely Blanc

2015-02-01

Full Text Available OBJECTIVE To evaluate the effectiveness of enteral nutritional therapy (ENT in the healing process of pressure ulcers (PU in adults and the elderly. METHOD A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. RESULTS We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. CONCLUSION Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found.

Experimental Justification of Enteral Lavage by Osmotically Active Solution in Acute Intestinal Obstruction Complicated by Intraabdominal Hypertension

OpenAIRE

Lukoyanychev E.E.; Ryabkov M.G.; Kudykin M.N.

2011-01-01

The aim of the study is to determine the influence of intra-enteric pressure level on the mechanism causing decompensation of microcirculation defects in the wall of a small intestine and to assess the effectiveness of enteral lavage by hydroxyethyl amylum in case of an increased intra-enteric pressure in acute intestinal obstruction. Materials and Methods. The experiment was carried out on 54 laboratory animals. In I series of the experiment (36 non-pedigree dogs) the processes of microc...

Home visit improves knowledge, self-care and adhesion in heart failure: randomized Clinical Trial HELEN-I Visita domiciliar mejora conocimiento, auto cuidado, adhesión en la insuficiencia cardíaca: Ensayo Clínico Aleatorizado HELEN - I Visita domiciliar melhora conhecimento, autocuidado e adesão na insuficiência cardíaca: ensaio clínico randomizado HELEN-I

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Cláudia Motta Mussi

2013-02-01

Full Text Available OBJECTIVE: To verify the effect of an educative nursing intervention composed of home visits and phone calls on patients' knowledge about the disease, self-care and adhesion to the treatment. METHODS: Randomized clinical trial with patients with recent hospitalization caused by decompensated heart failure. There were two groups: the intervention group, which has received four home visits and four phone calls to reinforce the guidelines during six months of follow up; and the control group, which has received conventional follow up with no visits or phone calls. RESULTS: Two hundred patients were randomized (101 in the intervention group and 99 in the control group. After six months, a significant improvement was observed in self-care and knowledge about the disease in the intervention group (P=0.001 and POBJETIVO: Verificar el efecto de una intervención educativa de enfermería combinada de visita domiciliaria y contacto telefónico en pacientes con internación reciente por insuficiencia cardiaca descompensada, en el conocimiento de la enfermedad, las habilidades para el autocuidado y la adhesión al tratamiento comparado con el acompañamiento convencional de pacientes en el período de seis meses. MÉTODOS: Ensayo Clínico Aleatorizado en pacientes que fueron ingresados recientemente por insuficiencia cardiaca descompensada. El grupo intervención recibió cuatro visitas domiciliarias y cuatro contactos telefónicos para reforzar las orientaciones en seis meses de acompañamiento; el grupo control recibió acompañamiento convencional sin visitas y sin contactos telefónicos. RESULTADOS: Fueron aleatorizados doscientos pacientes (101: intervención y 99: control. Tras seis meses, se observó una mejoría significativa en el conocimiento y el autocuidado para el grupo intervención (P=0,001 y POBJETIVO: verificar o efeito de uma intervenção educativa de enfermagem combinada, caracterizada por visita domiciliar e contato telefônico, em

Overconfidence of Vocational Education Students When Entering Higher Education

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Bowden, Mark P.; Abhayawansa, Subhash; Bahtsevanoglou, John

2015-01-01

Purpose: There is evidence that students who attend Technical and Further Education (TAFE) prior to entering higher education underperform in their first year of study. The purpose of this paper is to examine the role of self-efficacy in understanding the performance of students who completed TAFE in the previous year in a first year subject of…

How EPC firms can enter the nuclear renaissance

OpenAIRE

Locatelli, Giorgio; Mancini, Mauro

2012-01-01

the so called “nuclear renaissance” is creating a millionaire market for new nuclear reactors. Few firms have the capabilities to work in this complex and highly demanding market, whereas many other are investigating the option to enter. Quite surprising the international scientific literature provides information regarding the high-level governmental aspects of nuclear power programs in different countries while the analysis at firm level is almost inexistent. Moreover the usual business mod...

Regional Comparison of Enteral Nutrition-Related Admission Policies in Skilled Nursing Facilities.

Science.gov (United States)

Burgermaster, Marissa; Slattery, Eoin; Islam, Nafeesa; Ippolito, Paul R; Seres, David S

2016-06-01

Nursing home admission policies are one driver of increased and earlier gastrostomy placement, a procedure that is not always medically or ethically indicated among patients needing short-term nutrition support. This important clinical decision should be based upon patient prognosis, goals, and needs. We compared nursing home enteral nutrition-related admission policies in New York City and other regions of the United States. We also explored motivations for these policies. We conducted a telephone survey with skilled nursing facility administrators in New York City and a random sample of facilities throughout the United States about enteral nutrition-related admission policies. Survey data were matched with publically available data about facility characteristics from the Centers for Medicare and Medicaid Services. The relationship between facility location and admission policies was described with regression models. Reasons for these policies were thematically analyzed. New York City nursing homes were significantly less likely to admit patients with nasogastric feeding tubes than were nursing homes nationwide, after we controlled for facility characteristics (odds ratio = 0.111; 95% CI, 0.032-0.344). Reasons for refusing nasogastric tubes fell into 5 categories: safety, capacity, policy, perception of appropriate level of care, and patient quality of life. Our findings indicate that enteral nutrition-related admission policies vary greatly between nursing homes in New York City and nationwide. Many administrators cited safety and policy as factors guiding their institutional policies and practices, despite a lack of evidence. This gap in research, practice, and policy has implications for quality and cost of care, length of hospital stay, and patient morbidity and mortality. © 2016 American Society for Parenteral and Enteral Nutrition.

Nutritional analysis and microbiological evaluation of commercially available enteral diets for cats.

Science.gov (United States)

Prantil, Lori R; Markovich, Jessica E; Heinze, Cailin R; Linder, Deborah E; Tams, Todd R; Freeman, Lisa M

2016-01-01

To determine the prevalence of nutrients less than or greater than accepted standards in commercially available enteral diets for cats, and to identify contamination incidence in enteral diets for cats. Prospective cross-sectional study. University teaching hospital. Seven commercial enteral diets for cats. Labels were evaluated to determine if diets were intended to be nutritionally complete and balanced. One diet under storage techniques partially representative of clinical conditions was sampled on days 0, 1, 3, 5, and 7 of storage for aerobic bacterial culture. All 7 diets were analyzed for key nutrients and results were compared to Association of American Feed Control Officials (AAFCO) Nutrient Profiles for Adult Cats for maintenance and National Research Council recommended allowance (NRC-RA). From label information, 4 diets were classified as complete and balanced and 3 diets were classified as not complete and balanced. All 7 diets had at least 1 nutrient less than the AAFCO minimums and the NRC-RA. The total number of nutrients less than AAFCO minimums ranged from 3 to 9 (median = 4), with iron, potassium, and manganese being the most common. Concentrations of some nutrients were undetectable. None of the samples tested had a positive aerobic culture at baseline (day 0) or on subsequent samples from days 1, 3, 5, and 7 under any storage condition. None of the diets analyzed met all of the minimum nutrient concentrations. While short-term feeding may not be of concern for an individual patient, clinicians should be aware of potential nutritional limitations when feeding enteral diets to ill or injured cats. © Veterinary Emergency and Critical Care Society 2015.

Canine parvoviral enteritis: an update on the clinical diagnosis, treatment, and prevention

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Mylonakis ME

2016-07-01

Full Text Available Mathios E Mylonakis, Iris Kalli, Timoleon S Rallis Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece  Abstract: Canine parvovirus type 2 is the cause of a highly contagious acute enteritis associated with high morbidity and mortality, with very low survival rates in untreated dogs. Although severe clinical disease typically occurs in dogs younger than 6 months of age, adults with insufficient immunity may potentially be affected. In this article, the current state of knowledge is reviewed regarding the diagnostic aspects of parvoviral enteritis, with special emphasis placed on the clinical relevance of the detection of viral antigens in the feces, detection of viral antibodies in the serum, or the polymerase chain reaction-based amplification of the viral DNA in the feces. In addition, the components of the supportive and symptomatic treatment aiming to optimize the outcome of the disease in the clinical setting are thoroughly reviewed. Immunization guidelines for the prevention of the disease are also updated. Keywords: dog, parvovirus type 2, acute enteritis, treatment, vaccination

Recombinant granulocyte colony-stimulating factor administered enterally to neonates is not absorbed.

Science.gov (United States)

Calhoun, Darlene A; Maheshwari, Akhil; Christensen, Robert D

2003-08-01

Granulocyte colony-stimulating factor (G-CSF) is present in liquids swallowed by the fetus and neonate; specifically, amniotic fluid, colostrum, and human milk. The swallowed G-CSF has local effects on enteric cells, which express the G-CSF receptor. However, some portion of the G-CSF ingested by the fetus and neonate might be absorbed into the circulation and have systemic actions, such as stimulating neutrophil production. To assess this possibility we sought to determine if circulating G-CSF concentrations of neonates increase after enteral administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF). This was a single-center, prospective, blinded, randomized, 2 x 2 crossover study, with each infant receiving 1 dose of rhG-CSF (100 microg/kg) and 1 dose of placebo. Plasma G-CSF concentrations were measured at 2 and 4 hours after administration of the test solution. No significant change in plasma G-CSF concentration was observed after the enteral administration of rhG-CSF. On this basis, we conclude that orally administered rhG-CSF is not absorbed in significant quantities, and we speculate that the G-CSF swallowed by the fetus and neonate has local but not systemic effects.

Enteric disease episodes and the risk of acquiring a future sexually transmitted infection: a prediction model in Montreal residents.

Science.gov (United States)

Caron, Melissa; Allard, Robert; Bédard, Lucie; Latreille, Jérôme; Buckeridge, David L

2016-11-01

The sexual transmission of enteric diseases poses an important public health challenge. We aimed to build a prediction model capable of identifying individuals with a reported enteric disease who could be at risk of acquiring future sexually transmitted infections (STIs). Passive surveillance data on Montreal residents with at least 1 enteric disease report was used to construct the prediction model. Cases were defined as all subjects with at least 1 STI report following their initial enteric disease episode. A final logistic regression prediction model was chosen using forward stepwise selection. The prediction model with the greatest validity included age, sex, residential location, number of STI episodes experienced prior to the first enteric disease episode, type of enteric disease acquired, and an interaction term between age and male sex. This model had an area under the curve of 0.77 and had acceptable calibration. A coordinated public health response to the sexual transmission of enteric diseases requires that a distinction be made between cases of enteric diseases transmitted through sexual activity from those transmitted through contaminated food or water. A prediction model can aid public health officials in identifying individuals who may have a higher risk of sexually acquiring a reportable disease. Once identified, these individuals could receive specialized intervention to prevent future infection. The information produced from a prediction model capable of identifying higher risk individuals can be used to guide efforts in investigating and controlling reported cases of enteric diseases and STIs. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Dietas enterais não industrializadas: análise microbiológica e verificação de boas práticas de preparação Non industrialized enteral diets: microbiological analysis and verification of good preparation practices

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Angélica Aparecida Maurício

2008-02-01

Full Text Available OBJETIVO: Verificar a adequação das áreas de produção e o nível de contaminação microbiana de dietas enterais utilizadas em três hospitais privados da Região Noroeste do Paraná. MÉTODOS: A análise das Boas Práticas de Preparação da Nutrição Enteral seguiu a Resolução da Diretoria Colegiada nº 63/2000, da Agência Nacional de Vigilância Sanitária, e as análises microbiológicas das 15 amostras de dietas enterais seguiram as recomendações da Resolução da Diretoria Colegiada nº 12/2001, da Agência Nacional de Vigilância Sanitária, nas quais foram pesquisados bolores e leveduras, bactérias mesófilas, coliformes a 35 e 45ºC, Estafilococos coagulase positiva, Salmonella sp. e Bacillus cereus. RESULTADOS: A maior porcentagem para as Não Conformidades foi do hospital HS (61% e a menor do hospital HT (43,5%. Foi observada, em 100% das amostras dos hospitais HP e HT, contaminação por coliformes a 45ºC acima do padrão de referência da Resolução da Diretoria Colegiada nº 12/2001 e 60% das amostras do hospital HS apresentaram contaminação por coliformes a 35ºC acima do limite aceitável. As amostras encontravam-se dentro dos padrões para Estafilococos coagulase positiva, Salmonella sp., Bacillus cereus e bactérias mesófilas. Nos hospitais HT e HP a contaminação por bolores e leveduras estava acima do padrão permitido pela legislação. Os resultados das análises mostraram que a contaminação das dietas está relacionada ao tipo de ingrediente utilizado e ao excesso de manipulação. CONCLUSÃO: Conclui-se que as boas práticas de preparação da nutrição enteral não estavam de acordo com a Resolução da Diretoria Colegiada nº 63/2000 e que os hospitais estavam inadequados para preparar esse tipo de alimento.OBJECTIVE: To verify the degree of suitability of production areas and the level of microbial contamination in enteral diets used in three private hospitals in the Northwest region of Paran

30 CFR 77.508-1 - Lightning arresters; wires entering buildings.

Science.gov (United States)

2010-07-01

.... 77.508-1 Section 77.508-1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS... buildings. Lightning arresters protecting exposed telephone wires entering buildings shall be provided at...

Viral Agents Associated with Poult Enteritis in Croatian Commercial Turkey Flocks

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Ivana Lojkić

2010-01-01

Full Text Available From 2003 to 2006, samples of intestinal content and spleens from 10-day-old to 6-week-old fattening turkeys showing clinical signs of enteritis were analyzed by specific PCR and RT-PCRs for detection of haemorrhagic enteritis virus (HEV, avian reovirus (ARV, turkey astrovirus-2 (TastV-2, and turkey coronavirus (TCV. A total of 23 flocks from 6 farms were included in the study. Specific sequence for HEV hexon gene was present in 6 samples from turkeys younger than and in one turkey at 6 weeks of age. A product of TastV-2 capsid gene was detected in 17/23 intestinal content samples. A 626-bp band of sigma A (S2 encoding gene segment from avian reovirus was present in three samples, all from the same farm. Sequence analysis of 450 bp fragment of avian reovirus sigma A encoding gene sequence showed that our strain had the identity of 91.3% with the strains 138, 2408, 1733, 919, T6, and Os161. No TCV specific PCR band was found in any sample. Four flocks were positive simultaneously for HEV and TastV-2, and three flocks on TastV-2 and ARV. Severity of poult enteritis described in our study is caused by immunosuppressive TastV-2 in combination with HEV or ARV.

Modulation of intestinal inflammation by minimal enteral nutrition with amniotic fluid in preterm pigs

DEFF Research Database (Denmark)

Østergaard, Mette Viberg; Bering, Stine Brandt; Jensen, Michael Ladegaard

2014-01-01

Background: Necrotizing enterocolitis (NEC) is a severe inflammatory disorder, associated with the difficult transition from parenteral to enteral feeding after preterm birth. We hypothesized that minimal enteral nutrition (MEN) with amniotic fluid (AF), prior to enteral formula feeding, would...... improve resistance to NEC in preterm pigs. Methods: Experiment 1: IEC-6 cells were incubated with porcine (pAF) and human AF (hAF) to test AF-stimulated enterocyte proliferation and migration in vitro. Experiment 2: Cesarean-delivered, preterm pigs were fed parenteral nutrition and MEN with pAF, h...... fed AF as MEN, but NEC incidences were similar (NEC-pAF) or increased (NEC-hAF) compared with controls. Conclusions: Intake of pAF or hAF improved body growth and modulated intestinal inflammatory cytokines during a period of parenteral nutrition, but did not protect against later formula-induced NEC...

Influence of SPK with Enteric Drainage on the Pancreatic Exocrine Function in Diabetic Patients with Uremia

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Guanghui Pei

2017-01-01

Full Text Available Objective. This study aimed to determine the use of fecal elastase in evaluating the effect of simultaneous pancreas–kidney transplantation with enteric drainage on the pancreatic exocrine function of diabetic patients with uremia. Methods. A total of 19 patients with simultaneous pancreas–kidney transplantation (SPK with enteric drainage, 31 diabetic patients with uremia (chronic renal failure (CRF, 22 diabetic patients with uremia who underwent renal transplantation (RT, and 20 normal individuals (CON were included in the study. Pancreatic exocrine insufficiency was determined using fecal elastase. Results. The fecal pancreatic elastase level in SPK patients with enteric drainage was 479 μg/g, which was significantly higher than 229 μg/g in CRF patients and 197 μg/g in RT patients. Using 200 μg/g as the established threshold, a reduced fecal pancreatic elastase level was found in 14/31 of CRF patients, 12/22 of RT patients, 1/19 of SPK patients with enteric drainage, and 1/20 of CON patients. The correlation analysis revealed a significant association between fecal elastase and glycosylated hemoglobin. Conclusions. The present study indicated that SPK with enteric drainage improves pancreatic endocrine and exocrine functions. Fecal elastase may be a clinically relevant means to determine the therapeutic effects.

A Map Enters the Conversation

DEFF Research Database (Denmark)

Munk, Anders Kristian

Over the past decade STS scholars have been engaged in a continuous dialogue about the performativity of their methods and the interventions of their research practices. A frequently posed question is how STS can make a difference to its fields of study, what John Law has called its different...... 'modes of mattering'. In this paper I explore what difference digital cartography can make to STS practice. I draw on three examples from my own work where digitally mediated maps have entered the conversation and made critical, often surprising, differences to the research process. In my first example...... the map is brought along as an ethnographic device on a piece of fieldwork, in my second example it serves as the central collaborative object in a participatory design project, and in my third example the map becomes the object of contestation as it finds itself centre stage in the controversy...

The effects of necrotic enteritis, aflatoxin B1, and virginiamycin on growth performance, necrotic enteritis lesion scores, and mortality in young broilers.

Science.gov (United States)

Cravens, R L; Goss, G R; Chi, F; De Boer, E D; Davis, S W; Hendrix, S M; Richardson, J A; Johnston, S L

2013-08-01

The effects of increasing aflatoxin B1 concentration (0, 0.75, 1.5 mg/kg) on broilers with or without necrotic enteritis or virginiamycin were determined. In the 23-d study, 22 male Cobb 500 chicks per pen were allotted to 12 treatments (3 × 2 × 2 factorial arrangement) with 8 replications. Intestines of 5 birds per pen were examined for lesions on d 21. Birds were allowed to consume feed and water ad libitum. Aflatoxin was included in the diets from d 0. All birds received a 10× dose of coccidiosis vaccine on d 10. Pens of birds where necrotic enteritis was being induced were on Clostridium perfringens pathogen (CPP) contaminated litter from d 0. Aflatoxin decreased gain and feed intake and resulted in poorer feed:gain, increased mortality, and higher lesion scores. Inducing necrotic enteritis increased lesion scores and decreased feed intake and gain. Adding virginiamycin to the diets improved gain, feed intake, feed conversion, and decreased mortality. There was a 3-way interaction (aflatoxin × virginiamycin × CPP) on gain; increasing aflatoxin decreased gain and the effects of CPP and virginiamycin were dependent on aflatoxin concentration. In the absence of aflatoxin virginiamycin increased gain but was unable to prevent the growth suppression caused by CPP. At 0.75 mg/kg of aflatoxin virginiamycin no longer increased growth in non-CPP challenged birds but was able to increase growth in CPP-challenged birds. At the 1.5 mg/kg of aflatoxin concentration, virginiamycin increased gain in non-CPP-challenged birds but challenging birds with CPP had no effect on gain. Virginiamycin improved overall feed conversion with the greatest improvement at 1.5 mg/kg (aflatoxin × virginiamycin, P broiler performance and interact to decrease weight gain, virginiamycin helps improve gain in challenged birds at 0.75 mg/kg of aflatoxin, but not at 1.5 mg/kg of aflatoxin.

Vivencias psicosociales reveladas por niños que reciben tratamiento con quimioterapia por cáncer

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BLANCA CECILIA VANEGAS DE AHOGADO

2009-12-01

Full Text Available Se realizó un estudio cualitativo con el propósito de descubrir las vivencias psicosociales de niños y niñas de 9 a 12 años que recibían tratamiento con quimioterapia por cáncer. La recolección de la información se hizo mediante encuentros lúdicos con el apoyo de algunas preguntas básicas que facilitaron las revelaciones narrativas. Tres aspectos se destacan en los hallazgos del estudio: vivencias desfavorables, vivencias relacionadas con la autoestima y vivencias favorables; las dos primeras, de diversa manera, afectan en estos niños su vida personal, familiar, escolar y, en general, todo su entorno. Es de resaltar que, como consecuencia de la caída del cabello, con frecuencia han sido objeto de burla y de rechazo por sus compañeros de estudio, lo que produce el más notorio efecto sobre su autoimagen; por otra parte, el ausentismo escolar conlleva dificultades académicas y sentimientos de tristeza en estos niños, situación que empeora cuando, por motivos de tratamiento, su lugar de residencia está alejado de la ciudad, viéndose sometidos a largos periodos de separación, no solo de su familia sino de sus pares. Se concluye que la mayor parte de las revelaciones son impactantes por su gran contenido de sufrimiento y dolor para estos niños, lo que demuestra la urgencia de retomar los hallazgos del estudio para orientar el cuidado de enfermería de manera más integral y apoyar para que se haga lo propio en el hogar y en las instituciones educativas.

Tolerance and efficacy of nasogastric enteral nutrition for severe acute pancreatitis: a metaanalysis

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Shu-fen FENG

2013-02-01

Full Text Available Objective 　To evaluate the tolerance and efficacy of nasogastric enteral nutrition (NGEN in the treatment of severe acute pancreatitis (SAP. Methods 　PUBMED, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2011 (up to October and Chinese Journals Full-text Database (CNKI, Database for Chinese Technical Periodicals (VIP and Wanfang Digital Journal Full-text Database from 1978 to 2011 (up to October were retrieved to collect clinical randomized controlled trials of NGEN to compare with nasojejunal enteral nutrition (NJEN in the treatment of SAP. Two reviewers independently screened the literature for eligibility and evaluated the quality with confirmation of cross-check. Different opinions would be decided by the third party. Statistical analysis was performed by meta-analysis using Review Manager 4.2. Results 　Three randomized controlled trails including 159 patients with SAP met the inclusion criteria, involving 82 patients in NGEN group and 77 in NJEN group. There was no significant difference between NGEN and NJEN group in the risk of mortality of SAP (RR=0.69, 95%CI: 0.37-1.29, P=0.25, conversion to surgery (RR=2.09, 95% CI: 0.55-7.92, P=0.28, diarrhea subsequent to enteral nutrition (RR=1.43, 95% CI: 0.59-3.45, P=0.43, rate of tube displacement (RR=0.42, 95%CI: 0.08-2.17, P=0.30 and pain related with enteral nutrition (RR=0.94, 95%CI: 0.32-2.70, P=0.90. While compared with NJEN, the risk of infectious complications was lower than NGEN (RR=0.64, 95%CI: 0.42-0.99, P=0.04. Conclusion 　In enteral nutrition support of SAP, NGEN is comparable to NJEN in efficacy and tolerance, but the former has the lower rate of infectious complications and easier to operate, and there is a tendency of NEGN to replace the latter.

Compounded Apixaban Suspensions for Enteral Feeding Tubes.

Science.gov (United States)

Caraballo, Maria L; Donmez, Seda; Nathan, Kobi; Zhao, Fang

2017-07-01

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride, with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A 7-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40% to 60% Ora-Plus in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus:water, was compatible with both tubing types, retaining >98% drug in posttube samples. The stability study also confirmed that this formulation was stable physically and chemically over 7 days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus:water. The stability study results supported a beyond-use date of 7 days at room temperature.

Methane emissions from enteric fermentation in dairy cows, 1990-2008

NARCIS (Netherlands)

Bannink, A.

2011-01-01

The Dutch protocol for the national inventory estimates the methane emission of the average Dutch dairy cow based on a Tier 3 approach. A dynamic, mechanistic model is used to represent the enteric fermentation processes, using annual national statistics on feed intake and feed composition as model

The Use of Enteric Contrast Media for Diagnostic CT, MRI, and Ultrasound in Infants and Children: A Practical Approach.

Science.gov (United States)

Callahan, Michael J; Talmadge, Jennifer M; MacDougall, Robert; Buonomo, Carlo; Taylor, George A

2016-05-01

Enteric contrast media are commonly administered for diagnostic cross-sectional imaging studies in the pediatric population. The purpose of this manuscript is to review the use of enteric contrast media for CT, MRI, and ultrasound in infants, children, and adolescents and to share our experiences at a large tertiary care pediatric teaching hospital. The use of enteric contrast material for diagnostic imaging in infants and children continues to evolve with advances in imaging technology and available enteric contrast media. Many principles of enteric contrast use in pediatric imaging are similar to those in adult imaging, but important differences must be kept in mind when imaging the gastrointestinal tract in infants and children, and practical ways to optimize the imaging examination and the patient experience should be employed where possible.

Pedro Teixeira y su viaje por Mesopotamia

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Fuente del Pilar, José Javier

2005-04-01

Full Text Available Pedro Teixeira es un integrante notable de la ilustre nómina de los viajeros portugueses que, a finales del s, XVI y principios del XVII, ensancharon para Occidente las fronteras del mundo. Su conocimiento en España se debe a la publicación en 1994 de su obra «Relaciones del Origen, Descendencia y Sucesión de los Reyes de Persia, y de Harmuz, y de un viaje hecho por el autor dende la India hasta Italia por tierra», en edición realizada por el profesor Eduardo Barajas Sala, lamentablemente fallecido en 1997. En este artículo se ofrece una reseña biográfica de Pedro Teixeira, y un análisis del viaje narrado por el autor en la última parte de sus «Relaciones »: el que desde Ormuz le conducirá, a través de Mesopotamia, hasta la costa del Mediterráneo.…

Violência e mortes por causas externas

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Graciete Oliveira Vieira

2003-02-01

Full Text Available Através de um estudo ecológico caracterizou-se a violência e as mortes por causas externas em Salvador e Bahia utilizando-se dados da Fundação Nacional de Saúde-Ministério da Saúde, dos registros de mortalidade e das estimativas populacionais do IBGE. O risco de morrer por homicídio no Brasil é 3 vezes o do Estados Unidos, chegando a ser 40 vezes superior ao do Japão. Homicídio foi a primeira causa de anos potenciais de vidas perdidos (13,4% no Brasil (1997, seguido por acidentes de trânsito (10,6%. Causas externas foi a segunda causa de morte em Salvador e Bahia (1996. A violência tem raízes sócio-culturais e político-ideológicas e pode ser prevenida por ações intersetoriais e multidisciplinares.

Enteral nutrition in the chronic obstructive pulmonary disease (COPD) patient.

Science.gov (United States)

DeBellis, Heather F; Fetterman, James W

2012-12-01

Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient's nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient's dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

Associação entre violência por parceiro íntimo contra a mulher e infecção por HIV

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Claudia Barros

2011-04-01

Full Text Available OBJETIVO: Analisar a associação entre a violência por parceiro íntimo contra mulheres e a infecção ou suspeita de infecção pelo vírus da imunodeficiência humana (HIV. MÉTODOS: Estudo transversal com base em dados de questionários aplicados face-a-face e de prontuários médicos de 2.780 mulheres de 15 a 49 anos, atendidas em unidades do sistema único de saúde da Grande São Paulo, SP, em 2001-2002. As mulheres foram categorizadas em: usuárias em tratamento por serem "soropositivas para o HIV", com "suspeita de HIV" e aquelas que procuraram os serviços por outros motivos. A violência por parceiro íntimo contra mulheres na vida foi categorizada por gravidade e recorrência dos episódios de violência. A associação com o desfecho foi testada pelo modelo de Poisson com variância robusta e ajustada por variáveis sociodemográficas, sexuais e reprodutivas. RESULTADOS: A prevalência de violência foi de 59,8%. Sofrer violência reiterada e grave apresentou maior associação de infecção confirmada pelo HIV (RP = 1,91. A violência independente da gravidade e da recorrência dos episódios apresentou maior associação para a suspeita de infecção por HIV (RP = 1,29. CONCLUSÕES: A violência por parceiro íntimo contra mulheres tem papel relevante nas situações de suspeita e confirmação da infecção pelo HIV, sendo essencial incluir sua detecção, controle e prevenção como parte da atenção integral à saúde das mulheres.

Predominant porB1A and porB1B genotypes and correlation of gene mutations with drug resistance in Neisseria gonorrhoeae isolates in Eastern China

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Tang Renxian

2010-11-01

Full Text Available Abstract Background Variations of porB1A and porB1B genes and their serotypes exist in Neisseria gonorrhoeae isolates from different geographical areas, and some site mutations in the porB1B gene correlate with drug resistance. Methods The β-lactamase production of N. gonorrhoeae isolates was determined by paper acidometric test and nitrocefin discs. The porB1A and porB1B genes of 315 non-penicillinase-producting N. gonorrhoeae (non-PPNG strains were amplified by PCR for sequencing to determine serotypes and site mutations. A duplex PCR was designed to simultaneously detect both porB1A and porB1B genes. Penicillin and tetracycline resistance was assessed by an in vitro drug sensitivity test. Results Of the N. gonorrhoeae isolates, 31.1% tested positive for porB1A and 68.9% for porB1B genes. All the 98 porB1A+ isolates belonging to IA6 serotype with either no mutation at the 120 and 121 sites (88.8% or a D120G (11.2% mutation and were no resistance to both penicillin and tetracycline. Among the 217 porB1B+ isolates, 26.7%, 22.6% and 11.5% belonged to IB3, IB3/6 and IB4 serotypes, respectively. Particularly, two novel chimeric serotypes, IB3/6-IB2 and IB2-IB4-IB2, were found in 77 and 8 porB1B+ isolates. Two hundred and twelve (97.7% of the porB1B+ isolates were presented G120 and/or A121 mutations with 163 (76.9% at both sites. Interestingly, within the 77 porB1B+ isolates belonging to IB3/6-IB2 serotype, 15 were discovered to possess novel deletions at both A121 and N122 sites. All the replacement mutations at these sites in PorB1B were correlated with resistance and the deletion mutation showed the highest resistance. Conclusion N. gonorrhoeae isolates circulating in Eastern China include a sole PorB1A serotype (IA6 and five PorB1B serotypes. Multiple mutations in porB1B genes, including novel A121 and N122 deletions, are correlated with high levels of penicillin and tetracycline resistance.

Conservación por calor

OpenAIRE

Cobos García, Angel; Díaz Rubio, Olga

2011-01-01

Esta unidade didáctica denominada Conservación por calor forma parte da materia «Tecnoloxía do procesado de alimentos» que se impartirá no primeiro semestre do 2º curso do Grao en Nutrición Humana e Dietética. A materia estrutúrase en diferentes unidades didácticas, tratando cada unha delas as diferentes tecnoloxías de procesado dos alimentos, tanto de conservación coma de transformación. A presente unidade didáctica aborda a conservación dos alimentos por calor. Este método permite destruír ...

Las cosas por su nombre

OpenAIRE

Storani, Emilia

2017-01-01

El artículo propone indagar sobre los modos y diferentes formatos que se utilizan tanto en la escritura como en la lectura, para articular con las luchas por la identidad de género. La Ley de Identidad de Género ha sido un puntapié clave para pensarnos a nosotros mismos culturalmente y para pensar a los demás. Pero, ¿cómo mencionamos, escribimos y leemos las diferentes identidades? La escritura, también es un mundo transformador para quienes bregan por una sociedad más libre y sin prejuicios....

Diverticulitis yeyunal perforada por enterolito.

OpenAIRE

Marenco De la Cuadra, Beatriz; Gomez-Rosado, Juan-Carlos; Capitan-Morales, Luis-Cristobal; Valdés Hernández, Javier; Reyes-lopera, N.J. De los

2012-01-01

La diverticulosis yeyunal es una enfermedad adquirida rara. Casi el 60-70% keeps asymptomátic or Con síntomas crónicos inespecíficos, aunque puede presentarse como un abdomen agudo. La perforación debida a enterolitos es una causa extremadamente rara do complicación, y puede producirse por la impactación de ésta contra la pared intestinal. Presentamos caso de un varón de 82 años que acude a urgencias por un dolor súbito abdominal, difuso, con irritación peritoneal, leucocitosis con neutro...

Por y para en los manuales de ELE

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Sidoti, Rossana

2008-12-01

Full Text Available La oposición por / para es una de las cuestiones gramaticales que comportan mayor dificultad a la hora de acercarse al estudio del español como L2 sobre todo cuando remiten a conceptos lingüísticos difíciles de entender por no tener ésta referente alguno en el mundo extralingüístico. Si, por un lado, nos resulta fácil entender lo que tiene un referente en el mundo concreto; por otro, no podemos advertir el referente extralingüístico de preposiciones como por / para, si este no existe. Si las preposiciones son elementos abstractos, difíciles de aferrar de por sí, podemos sólo examinar los elementos que éstas ponen en relación y en qué contextos esta relación se determina. Para poder utilizar con precisión las dos preposiciones, es importante no reducirlas a una sola preposición como ocurre en otros idiomas, y sobre todo no relacionarlas sólo a los conceptos de causa y finalidad. Este trabajo se propone individualizar los manuales de español como lengua extranjera más utilizados en las universidades italianas para luego comparar las distintas fuentes de información sobre por / para y exponer comentarios, reflexiones y sugerencias sobre el tema con el fin de precisar en qué medida se puede mejorar lo que los manuales reducen o generalizan, puesto que para los estudiantes de ELE estos representan una herramienta valiosa a la que acudir.

Eudragit L/HPMCAS blend enteric-coated lansoprazole pellets: enhanced drug stability and oral bioavailability.

Science.gov (United States)

Fang, Yu; Wang, Guozheng; Zhang, Rong; Liu, Zhihua; Liu, Zhenghua; Wu, Xiaohui; Cao, Deying

2014-06-01

The objectives of the present work were to use blends of Eudragit L and hydroxypropyl methylcellulose acetate succinate (HPMCAS) as enteric film coatings for lansoprazole (LSP) pellets. The enteric-coated pellets were prepared with a fluid-bed coater. The influence of the blend ratio, type of plasticizer, plasticizer level, coating level, and curing conditions on gastric stability in vitro drug release and drug stability was evaluated. Furthermore, the bioavailability of the blend-coated pellets in beagle dogs was also performed. The blend-coated pellets exhibited significant improvement of gastric stability and drug stability compared to the pure polymer-coated pellets. Moreover, the AUC values of blend-coated pellets were greater than that of the pure polymer-coated pellets. It was concluded that the using blends of Eudragit L and HPMCAS as enteric film coatings for LSP pellets improved the drug stability and oral bioavailability.

STRATEGIC APPROACHES OF INTERNATIONAL HOTEL CHAINS TO ENTER ON THE ROMANIAN MARKET

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Cosma Smaranda

2012-07-01

Full Text Available On the Romanian market 23,9% of all accommodation structures are hotels. Among these 4% are belonging to international hotel chains which is a very small percentage. Almost all international hotel chains realized the potential of the market and that is why they intend to increase the number of hotels opened in Romania. Hotel chains attempt to control and dominate the market as result of an extremely dynamic and complex environment. The decision made by a hotel company to carry out its activity in a foreign country and the way to enter into the market can be motivated by many reasons. The paper analysis the presence of international hotel chains on the Romanian hospitality market and the strategies used to enter on the Romanian market compared with the global strategies. The paper used the comparison method to highlight different entry strategies used by international hotel chains when entering a foreign market. For data collection, the main method used was the observation of annual statistical reports with the support of international hotel chains. The first international hotel chain that came in Romania was InterContinental in 1971, but the majority entered on the Romanian market after 2000. In 2012 other chains announced the intension to penetrate this market. The study identifies strategies for penetrating the Romanian market by international hotel chains. The preferred penetration strategy on the Romanian market is management contract followed by franchise. Not least are highlighted comparative aspects of internationalization decisions taken by the chains in the world and in Romania, analyzing whether in Romania are predominantly used the same strategy as in most other countries or some specific strategies. International hotel companies want to entre on the Romanian market because they consider that in this area is need for hotels which belong to the luxury segment but also hotels that belong to the economy segment.

La vacunación antisarampionosa en México por el método de aerosol

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JORGE FERNÁNDEZ-DE CASTRO

1997-01-01

Full Text Available En este trabajo se describen las acciones de vacunación contra el sarampión por el método de aerosol inhalado llevadas a cabo en la República Mexicana entre 1988 y 1990. Se hace mención pormenorizada del equipo simplificado que se empleó, del personal, de su adiestramiento, de la promoción y de la estructura de las campañas correspondientes. También se precisa la vacuna usada: cepa Edmonston-Zagreb cultivada en células diploides, del Instituto Nacional de Virología de la Secretaría de Salud en México, con un título que varió, de 10(4.5 unidades formadoras de placa/ml (PFU/ml a 10(4.8 PFU/ml, administrada en 30 segundos de inhalación, con una descarga del nebulizador, durante este lapso, de 2 800 a 4 000 PFU por niño, estimándose la dosis retenida en 25%, por ejemplo, 700 a 1 000 PFU. En total se tiene documentada la vacunación de 3 760 684 niños prescolares y escolares en 13 de las 32 entidades federativas del país. No se observaron efectos indeseables de gravedad y los estudios limitados que se realizaron, tanto serológicos como de campo, avalan la efectividad y seguridad de este método que es, por otra parte, mucho más barato, rápido y aceptable por la población que el de inyección subcutánea..The present work describes the anti-measles vaccination program by the inhaled aerosol method undertaken in Mexico between 1988 and 1990. Detailed descriptions are given of the equipment, staff, training programs, promotion and campaigns. The vaccine is specified: Edmonston-Zagreb strain cultured in diploid cells at the Instituto Nacional de Virología of the Secretaría de Salud in Mexico with titres varying from 1045 plaque forming units (PFU/ml to 1 048 PFU/ml administered in a 30 sec inhalation with aerosol. During this exposure period, 2 800 to 4 000 PFU per child are estimated to enter the child, of which approximately 25% is the retained dosis, i.e. 700 to 1 000 PFU/child. A total of 3 760 684 children of school and pre

Role of External Audit in Attracting Foreign Investment and in the Domestic Companies' Entering the IPO Market

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Lubenchenko Olga Е.

2016-01-01

Full Text Available In this article, a way of attracting investors in the long-term perspective, namely: entering the IPO (Initial Public Offering markets by the domestic economic entities, has been considered. Also essence and objectives of IPO, advantages and disadvantages of holding the IPO have been determined. The main stages of the enterprises' entering the IPO market have been allocated: preparing for the IPO; entering the exchange; further statements by public company to investors. The key role of external auditors (auditing firms on the stages of preparing the enterprise to entering the IPO market has been defined, popular auditing services have been listed. Investment accounting methods have been examined. Reflection in accounting the profit and its distribution mechanism in terms of investor and issuer, depending on the method of investments accounting according to international accounting standards, have been considered.

Clostridial necrotic enteritis in chicken associated with growth rate depression

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Adin Priadi

2008-03-01

Full Text Available Clostridium perfringens (C. perfringens is a normal inhabitant of the intestinal tract of chickens as well as a potential pathogen causing necrotic enteritis. C. perfringens only causes necrotic enteritis when it transforms from non-toxin producing type to toxin producing type. The alpha toxin, (phospholipase C is believed to be a key to the occurrence of Clostridial necrotic enteritis (CNE. The best known predisposing factor is mucosal damage, caused by coccidiosis that damages the intestinal lining, making the gut susceptible to infections including C. perfringens. The purpose of this study was to observe the chicken performance in experimental CNE and field cases of CNE. Diagnosis of CNE were made by latex agglutination test, isolation and identification of the agent. Pathological and histopathological changes were also observed. Experimentally, NE could be reproduced when Eimeria sp and C. perfringens spores are inoculated in chicken. Signs of an NE are wet litter and diarrhea, and an increase in mortality is not often obvious. The depression of growth rate and feed efficiency of chicken become noticeable by week 5 because of damage to the intestine and the subsequent reduction in digestion and absorption of food. Subclinical form of CNE was also frequently found in the field, leading to significant decreases in performance. Chicken gut samples examinations revealed that subclinical form of CNE causes damage to the intestinal mucosa caused by C. perfringens leads to decreased digestion and absorption, increased feed conversion ratio and reduced weight gain. Dual infection with C. perfringens and Eimeria sp. was frequently found in field. The results of these studies provide evidence for C. perfringens as a causative bacteria for growth depression.

The effect of enteric galactose on neonatal canine carbohydrate metabolism

International Nuclear Information System (INIS)

Kliegman, R.M.; Miettinen, E.L.; Kalhan, S.C.; Adam, P.A.

1981-01-01

Newborn pups were assigned to a fasting group or to a group receiving intravenous glucose alimentation. Glucose turnover was determined during steady state equilibration of simultaneously infused [6- 3 H] glucose. Thereafter, pups from each group received 0.625 g/Kg of either oral [U- 14 C] galactose or [U- 14 C] glucose. In fasted or intravenously alimented pups enteric glucose resulted in a rapid and sustained elevation of blood glucose concentrations. Systemic appearance of 14 C label from enteric glucose increased rapidly as did the enrichment of blood [ 14 C] glucose specific activity. In those pups given enteric galactose, blood glucose values were equivalent to that in the glucose fed groups, however 14 C appearing in blood glucose and blood glucose specific activity was significantly lower. The peak values for rates of appearance and disappearance of systemic glucose were significantly lower in pups fed galactose than among pups fed glucose. Glucose clearance was also significantly lower in these pups despite equivalent plasma insulin responses. Among fasting pups hepatic glycogen content was significantly higher in those given either oral glucose or galactose when compared to a completely starved control group. In contrast, among alimented pups galactose administration significantly enhanced hepatic glycogen content compared to those fed glucose. In addition, hepatic glycogen synthase (glucose-6-phosphate independent) activity was increased only among alimented pups fed galactose when compared to completely fasted pups. In conclusion these data suggest that following gastrointestinal galactose administration, hepatic carbohydrate uptake is augmented while glycogen synthesis may be enhanced. Augmented glycogen synthesis following galactose administration may reflect alterations in hepatic glycogen synthase activity or enhanced hepatic carbohydrate uptake

Application of a radiotelemetric system to evaluate the performance of enteric coated and plain aspirin tablets.

Science.gov (United States)

Lui, C Y; Oberle, R; Fleisher, D; Amidon, G L

1986-05-01

The bioavailability of enteric coated and plain aspirin tablets was studied in four beagle dogs. Blood sampling for enteric coated tablets was planned with the aid of a radiotelemetric system. The release of aspirin from its dosage form was detected by monitoring the change in intestinal pH. Aspirin and salicylic acid levels in plasma obtained from the enteric coated dosage form exhibited familiar concentration versus time absorption profiles. Variation in the plasma concentrations of these two compounds within each dog studied (four runs each) was relatively small when time zero was adjusted to the commencement of tablet dissolution. The plasma levels obtained from plain aspirin (three runs each), however, show atypical absorption. The estimated absolute bioavailability was 0.432 +/- 0.0213 and 0.527 +/- 0.0260 for enteric coated and plain aspirin, respectively. Other pharmacokinetic parameters for these two dosage forms such as the highest observed plasma concentration (Cmax) (10.9 +/- 0.535 microgram/mL versus 13.6 +/- 1.88 micrograms/mL) and the time to reach Cmax (tmax) (26.6 +/- 1.94 min versus 31.0 +/- 7.04 min) agree well. The mean values for gastric emptying time, in vivo coating dissolution time, and in vivo disintegration/dissolution time of the tablet core for enteric coated aspirin are 48.7 +/- 7.23 min, 44.3 +/- 3.80 min, and 34.7 +/- 2.04 min, respectively.

Why did I become a nurse? Personality traits and reasons for entering nursing.

Science.gov (United States)

Eley, Diann; Eley, Rob; Bertello, Marisa; Rogers-Clark, Cath

2012-07-01

This article is a report of a mixed method study of the association between personality traits of nurses and their reasons for entering nursing. Background.  The worldwide nursing shortage prompts research into better understanding of why individuals enter nursing and may assist in exploring ways to increase their recruitment and long term retention. A mixed method sequential explanatory design employed semi-structured interviews and a validated personality inventory measuring temperament and character traits. Registered Nurses (n = 12) and nursing students (n = 11) working and studying in a regional area of Queensland Australia were purposively sampled for the interviews in 2010 from their participation in the survey in 2009 investigating their personality traits. Qualitative data collection stopped at saturation. A thematic content analysis of the qualitative data using the framework approach was interpreted alongside their personality trait profiles. Two dominant themes were identified from the participant interviews about reasons for entering nursing; 'opportunity for caring' and 'my vocation in life'. These themes were congruent with key temperament and character traits measured in the participants. All nurses and students were very high in traits that exude empathy and altruistic ideals regardless of other characteristics which included highly pragmatic and self-serving principles. Qualitative and quantitative findings suggest that a caring nature is a principal quality of the nursing personality. Recruitment and retention strategies whilst promoting multiple benefits for the profession should not forget that the prime impetus for entering nursing is the opportunity to care for others. © 2012 Blackwell Publishing Ltd.

Poultry management: a useful tool for the control of necrotic enteritis in poultry.

Science.gov (United States)

Tsiouris, Vasilios

2016-06-01

The intestinal ecosystem of poultry has been inevitably changed as a result of the ban of antimicrobial growth promoters. The re-emergence of necrotic enteritis has been the most significant threat for the poultry industry, which, in clinical form, causes high mortality and in subclinical forms, affects growth and feed conversion. It is one of the most common and economically devastating bacterial diseases in modern broiler flocks in terms of performance, welfare and mortality. Necrotic enteritis is a multi-factorial disease process, in which a number of co-factors are usually required to precipitate an outbreak of the disease. Although, Clostridium perfringens has been identified as the aetiological agent of the disease, the predisposing factors that lead to over-proliferation of C. perfringens and the subsequent progression to disease are poorly understood. Any factor that causes stress in broiler chicks could suppress the immune system and disturb the balance of the intestinal ecosystem, in such a way that the risk of a necrotic enteritis (NE) outbreak increases. Poultry management could significantly affect the pathogenesis of NE. In particular, feed restriction and coccidiosis vaccination can protect against NE, while extreme house temperature, feed mycotoxins and high stocking density predispose to NE. It becomes really important to understand the pathogenesis of the disease, as well as to clarify the interactions between husbandry, nutritional and infectious factors and the outbreak of necrotic enteritis. This is necessary and extremely important in order to develop managerial strategies at the farm level to control the incidence and severity of the disease in the post-antibiotic era.

Application of spiral nasointestinal tube in enteral nutrition support for patients with extensive burn

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Lai-Ping Wang

2016-09-01

Full Text Available Objective: To observe the effect of spiral nasointestinal tube on enteral nutrition support in patients with extensive burn. Methods: A total of 60 patients with extensive burn who were admitted in our hospital from January, 2014 to June, 2015 were included in the study and divided into the observation group and the control group with 30 cases in each group according to different catheter indwelling methods. The patients in the observation group were given spiral nasointestinal tube for enteral nutrition support, while the patients in the control group were given routine gastric tube for enteral nutrition support. The nutrition status and the occurrence rate of complications before catheter indwelling, 3, 6, and 10 d after catheter indwelling in the two groups were recorded. Results: The levels of ALB, HB, PA, and Scr 6, 10 d after catheter indwelling in the observation group were significantly higher than those in the control group (P<0.05. The occurrence rate of complications during the treatment period in the observation group was significantly lower than that in the control group (P<0.05. Conclusions: The spiral nasointestinal tube can provide the patients with extensive burn a better effective enteral nutrition support and improve the nutrition support, with a lower occurrence rate of complications, which is beneficial for the patients’ rehabilitation.

CERN openlab enters new phase

CERN Multimedia

Katarina Anthony

2012-01-01

The newest phase of CERN’s openlab framework was inaugurated this week during a meeting of the openlab partners. This phase will last three years and will bring together existing openlab partners and a new contributor: Huawei.   Group picture taken at the first CERN openlab IV annual Board of Sponsors meeting, in the presence of the CERN Director-General, the partners and the openlab team members. © Fons Rademakers (CERN Photo Club). Eleven years ago, the creation of the CERN openlab created a long-term link between industrial partners and the Organization. Its framework has allowed industry to carry out large-scale IT research and development in an open atmosphere – an “Open Lab”, if you will. For CERN, openlab has contributed to giving the computing centre and, more broadly, the LHC community, the opportunity to ensure that the next generation of services and products is suitable to their needs. Now entering its fourth phase, openlab will ...

Calcium Montmorillonite-based dietary supplement attenuates Necrotic Enteritis induced by Eimeria maxima and Clostridium perfringens in broilers

Science.gov (United States)

We provide the first description of Dietary Supplement of sorbent minerals attenuates Necrotic Enteritis Induced by Eimeria maxima and Clostridium perfringens in Broilers. Necrotic enteritis (NE) is a poultry disease caused by Clostridium perfringens and characterized by severe intestinal necrosis....

Enteric-coated epichlorohydrin crosslinked dextran microspheres for site-specific delivery to colon.

Science.gov (United States)

Rai, Gopal; Yadav, Awesh K; Jain, Narendra K; Agrawal, Govind P

2015-01-01

Enteric-coated epichlorohydrin crosslinked dextran microspheres containing 5-Fluorouracil (5-FU) for colon drug delivery was prepared by emulsification-crosslinking method. The formulation variables studied includes different molecular weights of dextran, volume of crosslinking agent, stirring speed, time and temperature. Dextran microspheres showed mean entrapment efficiencies ranging between 77 and 87% and mean particle size ranging between 10 and 25 µm. About 90% of drug was released from uncoated dextran microspheres within 8 h, suggesting the fast release and indicated the drug loaded in uncoated microspheres, released before they reached colon. Enteric coating (Eudragit-S-100 and Eudragit-L-100) of dextran microspheres was performed by oil-in-oil solvent evaporation method. The release study of 5-FU from coated dextran microspheres was complete retardation in simulated gastric fluid (pH 1.2) and once the coating layer of enteric polymer was dissolved at higher pH (7.4 and 6.8), a controlled release of the drug from the microspheres was observed. Further, the release of drug was found to be higher in the presence of dextranase and rat caecal contents, indicating the susceptibility of dextran microspheres to colonic enzymes. Organ distribution and pharmacokinetic study in albino rats was performed to establish the targeting potential of optimized formulation in the colon.

Preparing Our Undergraduates to Enter a Cyber World

OpenAIRE

Schweitzer , Dino; Gibson , David; Bibighaus , David; Boleng , Jeff

2011-01-01

Part 2: WISE 7; International audience; Today’s students have grown up with computer-based technology and need to be prepared to enter a career in a digital world. This includes an understanding of the broader implications of technology such as the growing threat of cyber-crime and cyber-terrorism, cyber-ethics, the legal and social implications of technology, and the local and global impacts. At our institution, we have taken a broad look at ways of integrating cyber awareness and education ...

Franchising as a method of entering the market

OpenAIRE

Kolář, Jan

2008-01-01

This bachelor thesis deals with franchising as a method of entering the market. My work is divided into theoretical and practical part. In the first part I describe the essential principals of functioning every franchising system. I explain the mutual relationship between franchisor and franchisee and also advantages and disadvantages for both of them. As a next part I mention the importance of using franchising in the world and also in the Czech Republic. Practical part deals with concrete u...

The incidence of infants with rotavirus enteritis combined with lactose intolerance.

Science.gov (United States)

Hu, Yulian; Gui, Linyan; Chang, Jing; Liu, Jingyan; Xu, Shuling; Deng, Caiyan; Yu, Fengqin; Ma, Zhanmin; Wang, Guangzhou; Zhang, Changjun

2016-01-01

This study was to research the incidence of infants with rotavirus enteritis combined with lactose intolerance and the clinical effect of low lactose milk powder for infantile rotavirus enteritis with lactose intolerance. The control groups were 126 cases of infants with diarrhea randomly collected from our hospital at the same period, which their rotavirus detection was negative. The observation group was 185 cases of infants with rotavirus, which was tested to be positive. Through the urine galactose determination, 62 cases of the control group were positive and 124 cases of the observation group were positive. Then 124 cases of infants with rotavirus combined with lactose intolerance were randomly divided into two groups. 60 cases in the control group were given rehydration, correction of acidosis, oral smecta, Intestinal probiotics and other conventional treatment, then continued to the original feeding method. While, 64 cases in the treatment group, on the basis of routine treatment, applied the low lactose milk feeding. To observe the total effective rate for the two groups. The incidence of lactose intolerance in children with rotavirus enteritis (67.03%) was significantly higher than that of children with diarrhea (49.2%), which was tested to be negative. And the difference was statistically significant (plactose intolerance. The low lactose milk powder could improve the therapeutic effectively and could reduce the duration of disease, and restored to normal diet for 2 weeks feeding time.

Concentration of enteric virus indicator from seawater using granular activated carbon.

Science.gov (United States)

Cormier, Jiemin; Gutierrez, Miguel; Goodridge, Lawrence; Janes, Marlene

2014-02-01

Fecal contamination of shellfish growing seawater with enteric viruses is often associated with human outbreaks of gastroenteritis. Male specific bacteriophage MS2 is correlated with those of enteric viruses in a wide range of water environments and has been used widely as a surrogate for pathogenic waterborne viruses. Since viruses in contaminated water are usually at low levels, the development of methods to concentrate viruses from water is crucial for detection purposes. In the present study, granular activated carbon was evaluated for concentration of MS2 from artificial seawater, and different parameters of the seawater were also compared. Recovery of MS2 from warm seawater (37°C) was found to be significantly greater than from cold seawater (4 and 20°C), and even greater than from fresh water (4, 20 and 37°C); the difference between seawater and fresh water became less profound when the temperatures of both were below 37°C. Although not of statistical significance, recovery of MS2 from low salinity seawater (10 and 20 parts per thousand, ppt) was greater than from high salinity seawater (30 and 40ppt). One gram of granular activated carbon was able to extract 6-log plaque forming units (PFU) of MS2 from 500ml seawater at 37°C. This study demonstrated that granular activated carbon can concentrate an enteric virus indicator from shellfish growing seawater effectively. Copyright © 2013 Elsevier B.V. All rights reserved.

Gastrointestinal function in chronic radiation enteritis -effects of loperamide-N-oxide

International Nuclear Information System (INIS)

Yeoh, E.K.; Horowitz, M.; Russo, A.; Muecke, T.; Chatterton, B.E.; Robb, T.

1993-01-01

The effects of loperamide-N-oxide, a new peripheral opiate agonist precursor, on gastrointestinal function were evaluated in 18 patients with diarrhoea caused by radiation enteritis. Each patient was given loperamide-N-oxide and placebo for 14 days, separated by a washout period of 14 days. Gastrointestinal symptoms; absorption of bile acid, vitamin B12, lactose, and fat; gastric emptying; small intestinal and whole gut transit; and intestinal permeability were measured during placebo and loperamide-N-oxide phases. Data were compared with those obtained in 18 normal subjects. In the patient, in addition to an increased frequency of bowel actions there was reduced bile acid absorption, higher prevalence of lactose malabsorption associated with a reduced dietary intake of dairy products and faster small intestinal and whole gut transit when compared with the normal subjects. There was no significant difference in gastric emptying between the two groups. Treatment with loperamide-N-oxide was associated with a reduced frequency of bowel actions, slower small intestinal and total gut transit, more rapid gastric emptying improved absorption of bile acid and increased permeability to 51 Cr EDTA. These observations indicate that: (1) diarrhoea caused by chronic radiation enteritis is associated with more rapid intestinal transit and a high prevalence of bile acid and lactose malabsorption, and (2) loperamide-N-oxide slows small intestinal transit, increases bile acid absorption, and is effective in the treatment of diarrhoea associated with chronic radiation enteritis. (Author)

Epidemiology and geographical distribution of enteric protozoan infections in Sydney, Australia

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Stephanie Fletcher

2014-07-01

Full Text Available Background. Enteric protozoa are associated with diarrhoeal illnesses in humans; however there are no recent studies on their epidemiology and geographical distribution in Australia. This study describes the epidemiology of enteric protozoa in the state of New South Wales and incorporates spatial analysis to describe their distribution. Design and methods. Laboratory and clinical records from four public hospitals in Sydney for 910 patients, who tested positive for enteric protozoa over the period January 2007-December 2010, were identified, examined and analysed. We selected 580 cases which had residence post code data available, enabling us to examine the geographic distribution of patients, and reviewed the clinical data of 252 patients to examine possible links between protozoa, demographic and clinical features. Results. Frequently detected protozoa were Blastocystis spp. (57%, Giardia intestinalis (27% and Dientamoeba fragilis (12%. The age distribution showed that the prevalence of protozoa decreased with age up to 24 years but increasing with age from 25 years onwards. The geographic provenance of the patients indicates that the majority of cases of Blastocystis (53.1% are clustered in and around the Sydney City Business District, while pockets of giardiasis were identified in regional/rural areas. The distribution of cases suggests higher risk of protozoan infection may exist for some communities. Conclusions. These findings provide useful information for policy makers to design and tailor interventions to target high risk communities. Follow-up investigation into the risk factors for giardiasis in regional/rural area is needed.

Pronóstico de la diarrea por rotavirus

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Mota-Hernández Felipe

2001-01-01

Full Text Available Objetivo. Comparar la gravedad de la diarrea por rotavirus (RV y por no rotavirus. Material y métodos. Estudio transversal en 520 lactantes con diarrea aguda, efectuado entre octubre de 1994 y marzo de 1995 en siete centros del primer nivel de atención en cinco estados de México. El diagnóstico de RV se realizó con ensayo inmunoenzimático o por electroforesis. El análisis se hizo a través de medidas de tendencia central. Los resultados se presentan como promedio y desviación estándar o mediana o variación. Resultados. Se aisló RV en 264 lactantes (50.7% con predominio en varones de 6 meses a un año. Las manifestaciones clínicas fueron significativamente diferentes entre el grupo rotavirus positivo y el grupo rotavirus negativo en mediana de evacuaciones por 24 horas, frecuencia de vómitos, temperatura > 38° C, deshidratación y calificación de gravedad, respectivamente. Conclusiones. Estos resultados mostraron peor pronóstico por mayor gravedad de la diarrea por RV en lactantes, con relación a otra etiología. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

Evaluation of Human Enteric Viruses in Surface Water and Drinking Water Resources in Southern Ghana

Science.gov (United States)

Gibson, Kristen E.; Opryszko, Melissa C.; Schissler, James T.; Guo, Yayi; Schwab, Kellogg J.

2011-01-01

An estimated 884 million people worldwide do not have access to an improved drinking water source, and the microbial quality of these sources is often unknown. In this study, a combined tangential flow, hollow fiber ultrafiltration (UF), and real-time PCR method was applied to large volume (100 L) groundwater (N = 4), surface water (N = 9), and finished (i.e., receiving treatment) drinking water (N = 6) samples for the evaluation of human enteric viruses and bacterial indicators. Human enteric viruses including norovirus GI and GII, adenovirus, and polyomavirus were detected in five different samples including one groundwater, three surface water, and one drinking water sample. Total coliforms and Escherichia coli assessed for each sample before and after UF revealed a lack of correlation between bacterial indicators and the presence of human enteric viruses. PMID:21212196

Fatores influenciadores dos cuidados de enfermagem domiciliários na prevenção de úlceras por pressão Factores que influyen en los cuidados de enfermería domiciliarios en la prevención de úlceras por presión Factors influencing domiciliary nursing care for the prevention of pressure ulcers

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Alexandre Marques Rodrigues

2011-12-01

efectuarse el análisis del contenido de las cuestiones en abierto, se llevó a cabo un análisis cuantitativo a través del programa estadístico SPSS 16.0. Se comprobó que tan solo una minoría de enfermeros conduce una evaluación del riesgo del desarrollo de una UPP; la mayoría de los enfermeros implica al cuidador informal; la formación de los enfermeros es actual. Se constata una reducida cantidad de dispositivos de alivio de presión así como la escasa existencia de protocolos de prevención. Los factores que influyen positiva y negativamente en los cuidados adecuados según su abundancia o escasez son, por un lado, los recursos materiales y los recursos humanos, la formación de los enfermeros y las políticas de prevención de las instituciones y por otro lado, la frecuencia de las visitas domiciliarias, la implicación de los cuidadores y la colaboración con otros profesionales de la salud como potenciadores de la prevención de las UPP.Epidemiological levels of pressure ulcers (PU in domiciliary care are higher than those in any other type of care in the Azores Region (AR. Our goal is to analyze the factors that influence nursing care for PU prevention in domiciliary care, so that they can be monitored or improved to provide quality care. A quantitative descriptive study, with an analytical intention, was carried out, and included all AR domiciliary care nurses. We analyzed the content of open questions, and this was followed by a quantitative analysis using the SPSS 16.0 statistical program. From this data analysis we showed that there is a small percentage of nurses who evaluate the risk of developing a PU; the majority of the nurses include the informal caregiver; the nurses’ training in this area is up-to-date. We found a reduced amount of pressure relief devices and a scarce availability of prevention protocols. The factors that positively or negatively influence satisfactory care, depending on its abundance or scarcity are: material resources and

Miasis cutanea por cordylobia anthropophaga

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Alkorta Gurrutxaga Miriam

2001-01-01

Full Text Available El incremento progresivo en el número de personas que viajan a países tropicales ha hecho que las enfermedades importadas adquieran una relevancia cada vez mayor. Las miasis (o infestaciones por larvas de moscas cutáneas se encuentran entre este tipo de enfermedades siendo especialmente frecuentes en países tropicales. A propósito de la observación de un caso de miasis cutánea masiva por Cordylobia antropophaga, que ocurrió en una mujer de 34 años de edad al volver de un viaje a Senegal, se ha efectuado una revisión de los casos de miasis cutáneas forunculoides importadas publicados en España, así como de la biología, patología, tratamiento y prevención de la miasis humana por Cordylobia anthropophaga. El caso referido, se caracterizó por la infestación con un número inusualmente elevado de larvas, no sospechándose su etiología hasta la fase final de la enfermedad. La emergencia continuada de larvas (se recogieron 91 generó en la paciente un estado de ansiedad importante. Finalmente, la eliminación de las larvas provocó una rápida mejoría de la paciente. Aunque los casos de miasis cutánea no tienen la gravedad de otras enfermedades importadas, su conocimiento es necesario desde el punto de vista preventivo, diagnóstico y terapeútico. Es importante proceder a la identificación morfológica de las larvas diferenciándolas de otro tipo de miasis con implicaciones terapéuticas diferentes.

Duck viral enteritis in domestic muscovy ducks in Pennsylvania

Science.gov (United States)

Davison, S.; Converse, K.A.; Hamir, A.N.; Eckroade, R.J.

1993-01-01

Duck viral enteritis (DVE) outbreaks occurred at two different locations in Pennsylvania in 1991 and 1992. In the first outbreak, four ducks died out of a group of 30 domestic ducks; in the second outbreak, 65 ducks died out of a group of 114 domestic ducks, and 15 domestic geese died as well. A variety of species of ducks were present on both premises, but only muscovy ducks (Cairina moschata) died from the disease. On necropsy, gross lesions included hepatomegaly with petechial hemorrhages, petechial hemorrhages in the abdominal fat, petechial hemorrhages on the epicardial surface of the heart, and multifocal to coalescing areas of fibrinonecrotic material over the mucosal surface of the trachea, esophagus, intestine, and cloaca. Histologically, the liver had random multifocal areas of necrosis and eosinophilic intranuclear inclusion bodies in hepatocytes. DVE virus was isolated and identified using muscovy duck embryo fibroblast inoculation and virus neutralization. /// En dos sitios diferentes se presentaron brotes de enteritis viral de los patos en el estados de Pensilvania en los a??os 1991 y 1992. En el primer brote, cuatro de un lote de 30 patos murieron mientras que en el segundo brote murieron 65 patos de un lote de 114 patos y 15 gansos. En ambas localidades exist?-a una variedad de especies de patos, sin embargo, s??lamente los patos almizcleros (Cairina moschata) murieron. A la necropsia, las lesiones macrosc??picas incluyeron hepatomegalia con hemorragias petequiales, hemorragias petequiales en la grasa abdominal y en la superficie del epicardio, y ?!reas multifocales o coalescentes de material fibrinonecr??tico sobre la superficie de la mucosa de la tr?!quea, es??fago, intestino y cloaca. Histol??gicamente, el h?-gado mostraba ?!reas multifocales de necrosis y cuerpos de inclusi??n intranucleares eosinof?-licos en los hepatocitos. El virus de la enteritis viral de los patos fue aislado e identificado usando fibroblasto de embriones de pato almizclero

Associação entre violência por parceiro íntimo contra a mulher e infecção por HIV Asociación entre violencia contra la mujer por pareja íntima e infección por VIH Association between intimate partner violence against women and HIV infection

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Claudia Barros

2011-04-01

Full Text Available OBJETIVO: Analisar a associação entre a violência por parceiro íntimo contra mulheres e a infecção ou suspeita de infecção pelo vírus da imunodeficiência humana (HIV. MÉTODOS: Estudo transversal com base em dados de questionários aplicados face-a-face e de prontuários médicos de 2.780 mulheres de 15 a 49 anos, atendidas em unidades do sistema único de saúde da Grande São Paulo, SP, em 2001-2002. As mulheres foram categorizadas em: usuárias em tratamento por serem "soropositivas para o HIV", com "suspeita de HIV" e aquelas que procuraram os serviços por outros motivos. A violência por parceiro íntimo contra mulheres na vida foi categorizada por gravidade e recorrência dos episódios de violência. A associação com o desfecho foi testada pelo modelo de Poisson com variância robusta e ajustada por variáveis sociodemográficas, sexuais e reprodutivas. RESULTADOS: A prevalência de violência foi de 59,8%. Sofrer violência reiterada e grave apresentou maior associação de infecção confirmada pelo HIV (RP = 1,91. A violência independente da gravidade e da recorrência dos episódios apresentou maior associação para a suspeita de infecção por HIV (RP = 1,29. CONCLUSÕES: A violência por parceiro íntimo contra mulheres tem papel relevante nas situações de suspeita e confirmação da infecção pelo HIV, sendo essencial incluir sua detecção, controle e prevenção como parte da atenção integral à saúde das mulheres.OBJETIVO: Analizar la asociación entre la violencia contra mujeres por pareja íntima y la infección o sospecha de infección por el virus de inmunodeficiencia humana (VIH. MÉTODOS: Estudio transversal con base en datos de cuestionarios aplicados cara-a cara y de prontuarios médicos de 2.780 mujeres de 15 a 49 años, atendidas en unidades del sistema único de salud de la Gran Sao Paulo, Sureste de Brasil, en 2001-2002. Las mujeres fueron categorizadas en: usuarias en tratamiento por ser

Efeitos laxativos do polietilenoglicol 3350 e de soluções eletrolíticas em equinos

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C.L.N. Gomes

2012-08-01

Full Text Available Compararam-se a motilidade intestinal, a frequência de defecação, a umidade e o aspecto das fezes, o tempo médio de retenção (TMR e a taxa de passagem (TxP da ingesta no intestino grosso (ig, em cinco éguas hígidas tratadas com: polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral (PEG; ou por polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral, associado ao Ringer lactato, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (PEG+RL; ou por solução isotônica poliônica enteral, 15mL kg-1 h-1 em fluxo contínuo de 12h (SIPE; ou por solução isotônica poliônica enteral, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via enteral, associada ao Ringer lactato, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (SIPE+RL; ou por cloreto de sódio 0,9%, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (NaCl 0,9%. O PEG apenas amoleceu discretamente as fezes. O PEG+RL, o SIPE+RL e o NaCl 0,9% foram mais eficazes em amolecer as fezes e aumentar a frequência de defecação do que o PEG. O SIPE foi o único tratamento que aumentou a motilidade intestinal, e foi o melhor em aumentar a frequência de defecações, amolecer as fezes e diminuir o TMRig, aumentando a TxPig. Conclui-se que os cinco tratamentos demonstraram efeito laxativo, sendo o SIPE o mais eficaz.

Lack of beta1 integrins in enteric neural crest cells leads to a Hirschsprung-like phenotype

DEFF Research Database (Denmark)

Breau, Marie A; Pietri, Thomas; Eder, Olivier

2006-01-01

The enteric nervous system arises mainly from vagal and sacral neural crest cells that colonise the gut between 9.5 and 14 days of development in mice. Using the Cre-LoxP system, we removed beta1 integrins in the neural crest cells when they emerge from the neural tube. beta1-null enteric neural...

GPR41/FFAR3 and GPR43/FFAR2 as Cosensors for Short-Chain Fatty Acids in Enteroendocrine Cells vs FFAR3 in Enteric Neurons and FFAR2 in Enteric Leukocytes

DEFF Research Database (Denmark)

Nøhr, Mark K; Pedersen, Maria H; Gille, Andreas

2013-01-01

The expression of short-chain fatty acid receptors GPR41/FFAR3 and GPR43/ free fatty acid receptor 2 (FFAR2) was studied in the gastrointestinal tract of transgenic monomeric red fluorescent protein (mRFP) reporter mice. In the stomach free fatty acid receptor 3 (FFAR3)-mRFP was expressed...... for the majority of enteroendocrine cells of the small and large intestine and that FFAR3 and FFAR2 both act as sensors for short-chain fatty acids in enteroendocrine cells, whereas FFAR3 apparently has this role alone in enteric neurons and FFAR2 in enteric leukocytes....

The mycotoxin deoxynivalenol predisposes for the development of Clostridium perfringens-induced necrotic enteritis in broiler chickens.

Science.gov (United States)

Antonissen, Gunther; Van Immerseel, Filip; Pasmans, Frank; Ducatelle, Richard; Haesebrouck, Freddy; Timbermont, Leen; Verlinden, Marc; Janssens, Geert Paul Jules; Eeckhaut, Venessa; Eeckhout, Mia; De Saeger, Sarah; Hessenberger, Sabine; Martel, An; Croubels, Siska

2014-01-01

Both mycotoxin contamination of feed and Clostridium perfringens-induced necrotic enteritis have an increasing global economic impact on poultry production. Especially the Fusarium mycotoxin deoxynivalenol (DON) is a common feed contaminant. This study aimed at examining the predisposing effect of DON on the development of necrotic enteritis in broiler chickens. An experimental Clostridium perfringens infection study revealed that DON, at a contamination level of 3,000 to 4,000 µg/kg feed, increased the percentage of birds with subclinical necrotic enteritis from 20±2.6% to 47±3.0% (Peffect on in vitro growth, alpha toxin production and netB toxin transcription of Clostridium perfringens. In conclusion, feed contamination with DON at concentrations below the European maximum guidance level of 5,000 µg/kg feed, is a predisposing factor for the development of necrotic enteritis in broilers. These results are associated with a negative effect of DON on the intestinal barrier function and increased intestinal protein availability, which may stimulate growth and toxin production of Clostridium perfringens.

Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients

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Portanova Michel

2010-08-01

Full Text Available Abstract Background Esophagojejunal fistula is a serious complication after total gastrectomy in gastric cancer patients. This study describes the successful conservative management in 3 gastric cancer patients with esophagojejunal fistula after total gastrectomy using total enteral nutrition. Methods Between January 2004 to December 2008, 588 consecutive patients with a proven diagnosis of gastric cancer were taken to the operation room to try a curative treatment. Of these, 173 underwent total gastrectomy, 9 of them had esophagojejunal fistula (5.2%. In three selected patients a trans-anastomotic naso-enteral feeding tube was placed under fluoroscopic vision when the fistula was clinically detected and a complete polymeric enteral formula was used. Results The complete closing of the esophagojejunal fistula was obtained in day 8, 14 and 25 respectively. Conclusion In some selected cases it is possible to make a successful enteral nutrition using a feeding tube distal to the leak area inserted with the help of fluoroscopic vision. The specialized management of a gastric surgery unit and nutritional therapy unit are highlighted.

Enteral Feeding in Abdominal Compartment Syndrome

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Ye. V Grigoryev

2009-01-01

Full Text Available Objective: to substantiate the choice of a gastrointestinal tract (GIT function support regimen as a mode for correction of the abdominal compartment syndrome (ACS. Subjects and methods. Forty-three patients with different causes of inadequate GIT function of various origin and ACS (disseminated peritonitis (45%, pancreatitis (24%, and severe concomitant injury (31% were examined. Group 1 (control received complete parenteral nutritional feeding (n=23; APACHE II scores, 21±4; calculated probability of fatal outcome, 33.5%. In Group II (study, complete parenteral feeding in the first 24 hours after stabilization was supplemented with GIT function support with Pepsisorb (Nutricia in doses of 500, 1000, and 1500 ml on days 1, 2, and 3, respectively (n=20; APACHE II scores, 20±6; calculated probability of fatal outcome, 37.1%. During early enteral nutritional support, the SOFA score was significantly less than that in Group 1 on days 2—3; the oxygenation index significantly increased on day 3; the value of intra-abdominal hypertension decreased to the control values. The positive effect of the GIT function support regimen on regression of the multiple organ dysfunction syndrome (MODS was confirmed by the lowered levels of biological markers (von Willebrand factor (WF and endothelin-1 as markers of endothelial damage of MODS. Correlation analysis showed a direct correlation between the markers of endothelial damage and the SOFA scores (r=0.34; p=0.05 for WF and r=0.49;p=0.03 for endothelin. Conclusion. The GIT function support regimen via early enteral alimentation with Peptisorb, which was initiated in the first 24 hours after admission, is able to level off the manifestations of the early stages of the abdominal compartment syndrome, with the acceptable values of oxygen balance and water-electrolyte and osmotic homeostasis being achieved. Key words: abdominal compartment syndrome, nutritional support, biological markers, oxygenation index

Itinerarios Didácticos por la isla de Lanzarote

OpenAIRE

Becerra-Ramírez, Rafael; González Cárdenas, Elena; Gosálvez, Rafael U.; Escobar Lahoz, Estela; Dóniz-Páez, Javier

2013-01-01

Con la confección de esta guía de itinerarios didácticos por la isla de Lanzarote pretendemos contribuir a un mayor conocimiento de las características geográficas de este espacio dominado por las formas volcánicas que caracterizan un paisaje modificado por la mano del hombre que convive con los volcanes y los usa, tradicionalmente como soporte de sus cultivos, y modernamente como base de la industria turística. Los itinerarios didácticos por la isla de Lanzarote son la adaptación de los t...

Het Guillain-Barré-syndroom na een Campylobacter jejuni-enteritis

NARCIS (Netherlands)

Beenen, L. F.; Scholten, H. G.

1990-01-01

A 7-year-old boy nine days before onset of a Guillain-Barré-syndrome had had enteritis caused by Campylobacter jejuni. The clinical signs were restricted to minor motor and sensory deficits in the limbs; 5 weeks after the onset of the syndrome, recovery was complete. So far, 16 cases of

Enteric disease in broiler chickens following experimental infection with chicken parvovirus

Science.gov (United States)

Day-old broiler chickens were inoculated orally with the chicken parvovirus strain, chicken parvovirus-P1. In four independent experiments, characteristic clinical signs of enteric disease including watery, mustard color diarrhea and growth retardation were observed following infection. The virus wa...

Detection of enteric Adenoviruses in South-African waters using gene probes

CSIR Research Space (South Africa)

Genthe, Bettina

1995-01-01

Full Text Available Gene probes developed locally for both enteric Adenoviruses 40 and 41 were used to determine whether these viruses were present in both raw and treated waters. Approximately sixty water samples were concentrated by ultra filtration and analysed...

Signos Vitales de los CDC-Muertes por intoxicación por alcohol (Alcohol Poisoning Deaths)

Centers for Disease Control (CDC) Podcasts

2015-01-06

Este podcast se basa en la edición de enero del 2015 del informe Signos Vitales de los CDC. En los Estados Unidos, mueren en promedio seis personas cada día debido a la intoxicación por alcohol. Infórmese sobre lo que puede hacer para prevenir los atracones de alcohol y las intoxicaciones por alcohol.  Created: 1/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/6/2015.

Topoplastia de Cvintal assistida por laser de femtossegundo

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Alexandre Takayoshi Ishizaki

2013-06-01

Full Text Available Apresentamos um relato de astigmatismo tardio progressivo pós-transplante de córnea para ceratocone, associado à afinamento periférico na junção doador-receptor, o que presumidamente pode ser considerado como recorrência da ectasia. O caso foi tratado por meio de Topoplastia de Cvintal assistida por laser de femtossegundo para a confecção da incisão com geometria "top hat", seguido de sutura com ajuste per-operatório guiado por ceratoscopia.

Randomised clinical trial: enteral nutrition does not improve the long-term outcome of alcoholic cirrhotic patients with jaundice.

Science.gov (United States)

Dupont, B; Dao, T; Joubert, C; Dupont-Lucas, C; Gloro, R; Nguyen-Khac, E; Beaujard, E; Mathurin, P; Vastel, E; Musikas, M; Ollivier, I; Piquet, M-A

2012-05-01

Malnutrition and jaundice are independent prognostic factors in cirrhosis. To assess the impact of enteral nutrition on the survival of alcoholic cirrhotic patients with jaundice but without acute alcoholic hepatitis. The study was a multicentre prospective randomised controlled trial comparing effects of enteral nutrition vs. a symptomatic support in patients with alcoholic cirrhosis and jaundice (bilirubin ≥51 µmol/L) but without severe acute alcoholic hepatitis. A total of 99 patients were randomised to receive either the conventional symptomatic treatment (55 patients) or the symptomatic support associated with 35 kcal/Kg/day of enteral nutrition during 4 weeks followed by an oral nutritional support during 2 months (44 patients). Randomisation was stratified on nutritional status. One-year survival curves were compared using the Kaplan-Meier method and Logrank test. Populations in both arms were similar. One-year survival was similar in the overall population (27/44 patients (61.4%) in the enteral nutrition arm vs. 36/55 (65.5%) in the control arm; Logrank P = 0.60) and in the subgroup suffering from malnutrition [18/29 patients (62.1%) in the enteral nutrition arm vs. 20/32 (62.5%) in the control arm; Logrank P = 0.99]. There was no statistical difference for bilirubin, prothrombin rate, Child-Pugh score, albumin or nutritional assessment. Complications during treatment (bleeding, encephalopathy, infection) occurred in 23% of patients in the enteral nutrition group (10/44) vs. 16% (9/55) of the control patients (P = 0.59). Enteral nutrition does not improve the survival and hepatic or nutritional parameters of cirrhotic patients with jaundice. © 2012 Blackwell Publishing Ltd.

Micetoma por Nocardia brasiliensis: reporte de caso

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Miriam Guevara R

2003-07-01

Full Text Available Se presenta el caso de un paciente peruano, agricultor, con una infección cutánea de origen traumático causada por Nocardia brasiliensis, que evolucionó hacia la amputación del miembro inferior afectado. El diagnóstico se realizó por examen directo y cultivo del espécimen.

Mortalidad por envenenamiento en niños

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Híjar Martha

1998-01-01

Full Text Available Objetivo. Conocer el panorama de las muertes por envenenamiento en niños de 0-14 años ocurridas en la República mexicana, entre 1979 y 1994. Material y métodos. Se utilizaron fuentes secundarias. Las variables analizadas fueron: edad, sexo, año, causa externa de traumatismos y envenenamientos, de la IX Clasificación Internacional de Enfermedades: E850-E858, E860-E869 y E905. Mediante un modelo de regresión Poisson se analizaron tendencias por causa específica y se obtuvieron riesgos relativos según edad, sexo y entidad federativa. Resultados. Hubo un total de 11 272 defunciones en menores de 15 años; las principales causas fueron el envenenamiento y las reacciones tóxicas causadas por plantas y animales venenosos (E905, el envenenamiento accidental por gas de uso doméstico y por monóxido de carbono (E868 y el envenenamiento accidental por otras drogas (E858. El grupo de edad que presentó los mayores riesgos, para las causas mencionadas, fue el de menores de un año con un riesgo relativo (RR de 29.6, IC95% 29.2-33.4; RR 3.47, IC95% 2.86-4.22, y RR 31.86, IC95% 24.8-40.9. El riesgo fue similar en ambos sexos, salvo para la causa E905. El estado de Aguascalientes se situó sistemáticamente entre los de mayor riesgo para todas las causas analizadas, mientras que Nuevo León siempre se ubicó entre los de riesgo más bajo. Conclusiones. El envenenamiento constituye una importante causa de muerte en los niños; el riesgo se incrementa al disminuir la edad. Considerando que esas muertes son potencialmente evitables y que la mayor parte de los envenenamientos ocurren en el hogar, para prevenirlos, se recomienda a los familiares vigilar y mantener fuera de peligro al niño. Por otra parte, la multicausalidad del fenómeno requiere que su prevención se realice desde una perspectiva multidisciplinaria que genere una cultura y un ambiente de seguridad en la sociedad.

Influence of postoperative enteral nutrition on cellular immunity. A random double-blinded placebo controlled clinical trial

DEFF Research Database (Denmark)

Beier-Holgersen, R; Brandstrup, B

2012-01-01

The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive "water".......The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive "water"....

Radiation enteritis. Evaluation of surgical cases

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Sato, M.; Sano, M.; Minakuchi, N.; Narisawa, T.; Takahashi, T. (Akita Univ. (Japan))

1981-09-01

Radiation enteritis with severe complications including intestinal bleeding, fistula, and stenosis were treated surgically in 9 cases. These 9 cases included 7 cases of cancer of the uterine cervix and 2 single cases of seminoma and melanoma. The patients received /sup 60/Co or Linac x-ray external irradiation with or without intracavitary irradiation by a radium needle. Radiation injury began with melena, vaginorectal fistula, and intestinal obstruction 3 to 18 months after irradiation. One patient with melena underwent colostomy and survived 2 years. One of the three patients with vaginorectal fistula who had colostomy survived 1.5 years. In intestinal obstruction, one patients had bypass operation and three patients had resection of the intestine and the other had both. Leakage was noted in one patient, but the others had favorable prognosis.

Enteric Glia Mediate Neuron Death in Colitis Through Purinergic Pathways That Require Connexin-43 and Nitric OxideSummary

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Isola A.M. Brown

2016-01-01

Full Text Available Background & Aims: The concept of enteric glia as regulators of intestinal homeostasis is slowly gaining acceptance as a central concept in neurogastroenterology. Yet how glia contribute to intestinal disease is still poorly understood. Purines generated during inflammation drive enteric neuron death by activating neuronal P2X7 purine receptors (P2X7R; triggering adenosine triphosphate (ATP release via neuronal pannexin-1 channels that subsequently recruits intracellular calcium ([Ca2+]i in surrounding enteric glia. We tested the hypothesis that the activation of enteric glia contributes to neuron death during inflammation. Methods: We studied neuroinflammation in vivo using the 2,4-dinitrobenzene sulfonic acid model of colitis and in situ using whole-mount preparations of human and mouse intestine. Transgenic mice with a targeted deletion of glial connexin-43 (Cx43 [GFAP::CreERT2+/−/Cx43f/f] were used to specifically disrupt glial signaling pathways. Mice deficient in inducible nitric oxide (NO synthase (iNOS−/− were used to study NO production. Protein expression and oxidative stress were measured using immunohistochemistry and in situ Ca2+ and NO imaging were used to monitor glial [Ca2+]i and [NO]i. Results: Purinergic activation of enteric glia drove [Ca2+]i responses and enteric neuron death through a Cx43-dependent mechanism. Neurotoxic Cx43 activity, driven by NO production from glial iNOS, was required for neuron death. Glial Cx43 opening liberated ATP and Cx43-dependent ATP release was potentiated by NO. Conclusions: Our results show that the activation of glial cells in the context of neuroinflammation kills enteric neurons. Mediators of inflammation that include ATP and NO activate neurotoxic pathways that converge on glial Cx43 hemichannels. The glial response to inflammatory mediators might contribute to the development of motility disorders. Keywords: Enteric Nervous System, Hemichannels

Reactive Arthritis Caused by Yersinia enterocolitica Enteritis.

Science.gov (United States)

Honda, Kazuya; Iwanaga, Nozomi; Izumi, Yasumori; Tsuji, Yoshika; Kawahara, Chieko; Michitsuji, Toru; Higashi, Shuntaro; Kawakami, Atsushi; Migita, Kiyoshi

2017-01-01

We report a case of reactive arthritis (ReA) triggered by Yersinia enterocolitica enteritis. A 24-year-old Japanese man developed polyarthritis in the lower limbs. Two weeks prior to these symptoms, he noted diarrhea, right lower abdominal pain and a fever. Y. enterocolitica was not isolated from a stool culture; however, he was diagnosed with ReA based on the colonoscopic findings of a high anti-Y. enterocolitica antibody titer and HLA-B27 antigen positivity. Following treatment with methotrexate and steroids, his arthritis improved. This is the first reported Japanese case of ReA in the English literature after a gastrointestinal infection caused by Y. enterocolitica.

The survival and inactivation of enteric viruses on soft surfaces: A systematic review of the literature.

Science.gov (United States)

Yeargin, Thomas; Buckley, David; Fraser, Angela; Jiang, Xiuping

2016-11-01

Worldwide, enteric viruses are the main cause of acute gastroenteritis. In humans, these viruses spread via person-to-person contact, food, water, and/or the environment. Their survival and inactivation on hard surfaces have been extensively studied; however, nonlaunderable soft surfaces, such as upholstery and carpet, have received little attention. The aim of this systematic review was to determine factors that influence the survival and inactivation of enteric viruses on nonlaunderable soft surfaces. EBSCO and Web of Science were searched for experimental studies published between 1965 and 2015 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methods. Titles and abstracts were screened using 3 eligibility criteria. The quality of all study methods was also assessed. Our search yielded 12 articles. Viruses survived between 0 hours and 140 days depending on surface and environment conditions. Virus survival was influenced by temperature, relative humidity, organic content, and deposition method. A variety of chemistries were tested across studies and were shown to have a varied effect on enteric viruses. Chlorine, glutaraldehyde, vaporous ozone, and hydrogen peroxide were the most efficacious against enteric viruses (> 3-log reduction). Environmental factors, such as temperature and relative humidity, can influence survival of enteric viruses on nonlaunderable soft surfaces. The efficacy of liquid and vaporous chemistries are associated with surface and virus type. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Distinction between porcine circovirus type 2 enteritis and porcine proliferative enteropathy caused by Lawsonia intracellularis